Seroquel / Quetiapine Medication Profile

by Marcia Purse

Classification and Use

Seroquel - generic quetiapine - is classed as an atypical antipsychotic medication. It is used to treat psychotic symptoms of such illnesses as schizophrenia and schizoaffective disorder, including hallucinations, delusions, catatonia and paranoia. It is also approved for use in treating acute manic episodes of bipolar disorder with or without psychotic features. Efficiency of Seroquel for acute mania was increased by adding Lithium or Depakote to the therapy.

Complications

Treatment with Seroquel is associated with the risk of some serious complications. These include:

• Neuroleptic Malignant Syndrome (NMS), a potentially fatal illness whose symptoms include high fever, muscle rigidity, profuse sweating and dark urine. Read more: Neuroleptic Malignant Syndrome.

• Tardive Dyskinesia, a movement disorder that may not go away unless treated promptly. Symptoms include uncontrolled movements of the lips and tongue. Read more: Tardive Dyskinesia.

• High blood sugar and diabetes. Patients who have diabetes mellitus or have risk factors such as obesity and family history of diabetes should have fasting blood glucose tests before beginning treatment with Seroquel and at regular intervals during treatment.

Rare but Significant Side Effects

In 1% or fewer of patients taking Seroquel in clinical trials, the following were reported:

• Dizziness or fainting upon standing
• Cataracts
• Seizures
• Underactive thyroid
• Elevated cholesterol and triglycerides

Also, patients may experience sleepiness and impaired motor control (difficulty walking, etc.) especially at the beginning of treatment with Seroquel. The usual warning about not driving or operating heavy machinery is important with this medication.

Black Box Warning for Elderly Patients

Seroquel carries the following black box warning:

Increased Mortality in Elderly Patients with Dementia-Related Psychosis

Elderly patients with dementia-related psychosis treated with atypical antipsychotic drugs are at an increased risk of death compared to placebo. Analyses of seventeen placebo-controlled trials (modal duration of 10 weeks) in these patients revealed a risk of death in the drug-treated patients of between 1.6 to 1.7 times that seen in placebo-treated patients. Over the course of a typical 10 week controlled trial, the rate of death in drug-treated patients was about 4.5%, compared to a rate of about 2.6% in the placebo group. Although the causes of death were varied, most of the deaths appeared to be either cardiovascular (eg, heart failure, sudden death) or infections (eg, pneumonia) in nature. SEROQUEL (quetiapine) is not approved for the treatment of patients with Dementia-Related Psychosis.

Pregnancy/Breast-Feeding

It is recommended that Seroquel treatment be discontinued during pregnancy. Women taking Seroquel should not breast-feed their infants.

Other Cautions and Warnings

• Do not drink alcoholic beverages while taking Seroquel.
• Avoid overheating and dehydration
• Seroquel is not approved for pediatric use
• Patients with liver disease should start at the lowest dose (25 mg) and increase the dosage slowly

Most Common Side Effects

• Weight Gain
• Sleepiness
• Headache
• Drop in blood pressure upon standing
• Dry mouth
• Constipation
• Dizziness
• Weakness
• Upset stomach

More on Seroquel's side effects.

Disclaimer: This is not intended to be all-inclusive or to replace information provided by your doctor or with the prescription from the manufacturer.