Quetiapine is sold under the brand name "Seroquel".
Quetiapine is an atypical antipsychotic closely related to clozapine and olanzapine. It is FDA approved for the acute and maintenance treatment of Bipolar Disorder and Schizophrenia.
Each of the atypical antipsychotics has its own profile or personality. Quetiapine seems to have intermediate liability to weight gain of the atypical antipsychotics. It tends to be quite sedating, however, which often limits its usefulness in higher functioning outpatient populations.
Quetiapine has complex mechanisms of action that include blockade of dopamine and serotonin receptors for its therapeutic benefits. Blockade of histamine and acetylcholine receptions account for most of its adverse effects. The atypical antipsychotics as a group are distinguished by blockade of postsynaptic serotonin 2A receptors which confers relative protection against many of the serious adverse effects (e.g. tardive dyskinesia, akathisia and dystonic reactions) of the first generation, or typical, antipsychotics (e.g. haloperidal (Haldol), perphenizine (Trilafon), chlorpromazine (Thorazine), and others).
Quetiapine is processed for elimination from the body (“metabolized”) in the liver to inactive compounds that are in turn eliminated by the kidneys. The half life of quetiapine is significantly less than one day and consequently if stopped abruptly (not recommended) it is out of the body in about 3 days.
Possible adverse effects can include diabetes, weight gain, abnormal triglycerides and cholesterol, insulin resistance, sedation, dizziness, dry mouth, constipation, and others. These is data that suggest this category of medication can rarely cause strokes in the elderly.
Quetiapine, along with the other atypical antipsychotics, carries a warning from the FDA against the possibility of new onset diabetes mellitus. Guidelines for the appropriate medical monitoring of this category of medications for these possible medical adverse events were published in 2003. We follow these guidelines at Scott P. Hoopes, M.D., & Associates. It you are prescribed quetiapine you will be referred to our Metabolic Clinic for medical monitoring. Following these guidelines is essential for the responsible use of all the atypical antipsychotics in patients of all ages.
Quetiapine has no effects on liver enzyme systems and consequently does not significantly effect the elimination of other medications.
If you miss a dose of quetiapine do not take the missed dose with the next dose. It is important to take quetiapine regularly as prescribed.
