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J Psychopharmacol. 2010 Nov;24(11):1725-6. doi: 10.1177/0269881109348159. Epub 2009 Nov 25.

Combined treatment with quetiapine and sertindole in therapy refractory insomnia after clozapine discontinuation.

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1
Klinik und Poliklinik für Neurologie, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Germany. Frank.hanisch@medizin.uni-halle.de

Abstract

Insomnia associated with chronic schizophrenia and after clozapine discontinuation represents a common, but mostly not predominant, complaint and often does not respond sufficiently to classical hypnotics. We report the case of a 46-year-old patient with schizophrenia who developed a rebound insomnia confirmed by polysomnography after discontinuation of long-term treatment with clozapine and changing to sertindole therapy. Zolpidem, zolpiclone and chloral hydrate only led to short-term improvement of subjective sleep quality. An add-on therapy with 300 mg quetiapine resulted in improved subjective quality of sleep regarding sleep latency and the number of nocturnal awakenings. The combination of the two neuroleptics did not lead to increased QTc intervals (normal QTc < 450 ms) or metabolic side effects. In conclusion, the combination of sertindole and quetiapine might be a safe and effective combination in therapy-refractory insomnia after clozapine discontinuation in schizophrenia.

PMID:
19939868
DOI:
10.1177/0269881109348159
[Indexed for MEDLINE]
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