Quetiapine (Seroquel)

Quetiapine (or quetiapine fumerate as it is often called) is one of the newer generation of antipsychotic medications. It is more commonly known by its brand name, Seroquel.®; It was first approved for the treatment of adult schizophrenia back in 1997.

What it’s used to treat

Quetiapine has been used for many years to treat both schizophrenia and mania (due to bipolar disorder) in adults. In recent years it has also received FDA approval to treat adolescent (ages 13 to 17) schizophrenia, as well as acute mania caused by bipolar I disorder in teens and children who are at least 10 years old 1.

Unlike other similar medications, quetiapine has the distinction of being approved to treat episodes of depression in patients with bipolar disorder 2. Quetiapine is also sometimes given to patients as a sedative.

How it works

The way quetiapine works in the brain is not yet fully understood. However, it appears to affect certain brain chemicals known as neurotransmitters. Quetiapine primarily affects dopamine and serotonin. These brain chemicals are believed to be out of balance in individuals with schizophrenia or bipolar disorder, and quetiapine helps get them back into balance. As a result, symptoms are reduced or alleviated altogether.

How it’s administered

Quetiapine is available in regular tablet form at various dosage levels, as well as in an extended release tablet (Seroquel XR).

Potential Side Effects

As with all antipsychotic medications, there are many potential side effects associated with quetiapine. Some of the more common ones include:

  • Drowsiness
  • Dry mouth
  • Chills
  • Elevated triglycerides
  • Headaches
  • Light-headedness
  • Cold sweats
  • Confusion

Less common side effects may include (but are not limited to):

  • Fever
  • Cough
  • Blurry vision
  • Increase saliva production
  • Restlessness
  • Chest pain
  • Difficulties breathing
  • Weight gain
  • Anxiety

Also, quetiapine may cause a condition known as tardive dyskinesia (TD) which can become permanent for some individuals. TD symptoms involve involuntary, random and uncontrollable movements, such as lip smacking, odd tongue or jaw movements, blinking, grimacing, and movements involving the limbs, fingers, toes, upper body or hips.

It may also cause a potentially deadly side effect known as neuroleptic malignant syndrome (NMS). Some of the symptoms include muscle stiffness, changes in one’s mental state, fluctuations in blood pressure or heartbeat, sudden renal failure, tremors, difficulty breathing, dehydration, rapid heartbeat, and extremely high temperature.

Precautions

As with other antipsychotics, quetiapine can be fatal if used to treat dementia patients. In order to safely use quetiapine, let your doctor know if you or a family member has ever had diseases of the heart, liver, or kidney; stroke or heart attacks; thyroid problems; white blood cell counts which are low; problems with swallowing or a history of elevated triglycerides or cholesterol; seizures; or diabetes or high blood sugar. Also, be sure to let your doctor know if you are pregnant or nursing, or thinking about becoming pregnant.

written by Dr. Cheryl Lane, PsyD

References

  1. "US FDA Approves Seroquel For The Paediatric Treatment Of Schizophrenia And Bipolar Mania," Dec 2009
  2. "FDA Approves AstraZeneca's Seroquel For Bipolar Depression Treatment," Oct 2006