Massimo Pasquini1, Azzurra Speca, Massimo Biondi. 1. Dept. of Psychiatric Science and Psychological Medicine, Psycho-oncology Unit, SAPIENZA, University of Rome, Viale dell'Università 30, 00185, Rome, Italy. massimo.pasquini@uniroma1.it
Abstract
BACKGROUND: Insomnia is a frequent adverse effect reported by women taking tamoxifen, an estradiol receptor-antagonist, for breast cancer. OBJECTIVE: The authors report on six patients treated with quetiapine, an atypical antipsychotic, for tamoxifen-related insomnia without depression. METHOD: Quetiapine was started at 25 mg/day 1 hour before bedtime; dose adjustments upward were made in 25-mg increments, titrated to a maximum dose of 100 mg according to therapeutic response and tolerance. RESULTS: Five of the six women showed a prompt improvement of their insomnia; this effect was maintained after 6 weeks of treatment. DISCUSSION: Quetiapine might improve sleep alterations because of its high affinity for serotonergic receptors, enhancing central serotonergic neurotransmission, thus possibly decreasing excitatory glutamatergic transmission.
BACKGROUND:Insomnia is a frequent adverse effect reported by women taking tamoxifen, an estradiol receptor-antagonist, for breast cancer. OBJECTIVE: The authors report on six patients treated with quetiapine, an atypical antipsychotic, for tamoxifen-related insomnia without depression. METHOD:Quetiapine was started at 25 mg/day 1 hour before bedtime; dose adjustments upward were made in 25-mg increments, titrated to a maximum dose of 100 mg according to therapeutic response and tolerance. RESULTS: Five of the six women showed a prompt improvement of their insomnia; this effect was maintained after 6 weeks of treatment. DISCUSSION: Quetiapine might improve sleep alterations because of its high affinity for serotonergic receptors, enhancing central serotonergic neurotransmission, thus possibly decreasing excitatory glutamatergic transmission.
Authors: Julie L Otte; Janet S Carpenter; Shalini Manchanda; Kevin L Rand; Todd C Skaar; Michael Weaver; Yelena Chernyak; Xin Zhong; Christele Igega; Carol Landis Journal: Cancer Med Date: 2014-11-30 Impact factor: 4.452