The Role of Quetiapine in the Treatment of Alzheimer's Disease

Behavioral and psychological symptoms in dementia (BPSD) include an array of neuropsychiatric symptoms, such as delusions, hallucinations, aggression, and agitation. In recent years, the use of antipsychotics, both conventional and atypical, has been widely debated because of concerns about their safety in treating behavioral disturbances in elderly patients affected with dementia, and the possible risks for stroke and sudden death. In this review we described the pharmacokinetic of quetiapine, its correlation in patients with Alzheimer’s disease and its possible role in BPSD. Quetiapine has a bioavailability of 5-13%, about 83% is bound to plasma protein and is largely metabolized in the liver through CYP3A4, the mean plasma half-life is about 6 h and clearance is reduced by 40% in the elderly. Usually CYP3A4 inhibitors are able to increase the plasma levels of quetiapine, while CP3A4 inducers accelerating the drug clearance reduce the quetiapine plasma levels. Quetiapine does not affect metabolism of other compounds known to be metabolized by CYP system. Studies showing its effectiveness for treating BPSD and the authors’clinical experience are reported too. In conclusion, quetiapine appears to be effective for treating BPSD.