Comparison of Quetiapine Abuse and Misuse Reports to the FDA Adverse Event Reporting System With Other Second-Generation Antipsychotics.

BACKGROUND: Second-generation antipsychotics (SGAs) are assumed to have little abuse potential. However, reports of quetiapine abuse have emerged as prescribing has increased in recent years. The US Food and Drug Administration's (FDA) Adverse Event Reporting System (FAERS) provides postmarketing information regarding adverse drug events (ADEs). This is the first study to analyze quetiapine abuse-related ADEs reported to FAERS to determine whether a disproportionate rate of such events have been reported when compared with other commonly used SGAs. METHODS: A cross-sectional analysis of FAERS data from January 1, 2015, to December 31, 2017, was performed. The total number of all-cause and abuse-related ADEs reported to FAERS regarding quetiapine, olanzapine, aripiprazole, and risperidone were identified, along with demographic and mortality data. The proportional reporting ratio (PRR) was calculated to assess disproportionate reporting of abuse-related adverse drug reactions between quetiapine and each of three alternative SGA medications. RESULTS: Abuse-related ADEs represented 11% (3144/27 962) of total ADEs reported for quetiapine, 8% for olanzapine (1548/19 228), 5% (1380/29 699) for aripiprazole, and 3% (1168/45 518) for risperidone. The PRRs (95% confidence interval) for quetiapine versus olanzapine, aripiprazole, and risperidone were 1.40 (1.32-1.48), 2.42 (2.28-2.57), and 4.38 (4.10-4.68), respectively, indicating that abuse-related events were significantly more likely to be reported with quetiapine than each comparator drug. In addition, more deaths were reported among the abuse-related events regarding quetiapine (673) than olanzapine (200), aripiprazole (88), and risperidone (143). CONCLUSION: This study corroborates recent evidence indicating that quetiapine might possess a significantly higher abuse potential than other commonly used SGAs. Although prospective studies are needed to better understand the abuse potential of quetiapine, increased vigilance in monitoring for signs of substance abuse might be warranted when prescribing quetiapine.

Screening for erectile dysfunction in the primary care practice: results of a survey.

To evaluate the screening patterns of primary care physicians (PCP) with regards to erectile dysfunction, a study was performed using an Institution Review Board Approved SHIM (Sexual Health Inventory for Men) questionnaire of 131 male patients presenting to the Family Practice Clinic at West Virginia University School of Medicine in Morgantown. A total of 109 surveys were completed and the data were compiled and analyzed with descriptive statistics using SPSS version 10.0 software. Of these patients, over 92% were Caucasian. The average age bracket for the study population was 40-50, and the average number of risk factors for ED, not including age, was 1.65. Forty-one percent of patients had a SHIM score less than or equal to 21, indicative of an element of ED. A total of 84% had primary care physicians, 22% of patients with a PCP were screened for ED. Of those who were screened by their PCP over half were initiated by the patient. As a result of this study, we believe the SHIM instrument should be performed on patients with any identifiable risk factor since effective treatment of ED is available, and ED can be associated with occult cardiac disease.

Conflicting functional assessment of stenoses in patients with previous myocardial infarction.

The utility of fractional flow reserve, absolute and relative flow reserve, and intravascular ultrasound may have an impact on decision-making for percutaneous coronary intervention in patients with previous myocardial infarction and microvascular dysfunction. The role for fractional flow reserve, absolute and relative flow reserve, and intravascular ultrasound is discussed.