- published: 22 Nov 2011
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- author: Seena Haines
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- 2-Aminoindane
- 2-Aminotetralin
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- ICI-118,551
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- L-694,247
- L-745,870
- L-765,314
- L-772,405
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- LY-367,642
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Send this Playlist by SMS
Quetiapine REMS Educational Video
- Order: Reorder
- Duration: 5:36
- Updated: 28 Jan 2013
This video creatively educates patients regarding the FDA risk evaluation and mitigation strategies REMS list of medications. This video educates patients ab...
http://wn.com/Quetiapine_REMS_Educational_Video
This video creatively educates patients regarding the FDA risk evaluation and mitigation strategies REMS list of medications. This video educates patients ab...
Quetiapine - You can't live with it, You cant live without it
- Order: Reorder
- Duration: 9:12
- Updated: 29 May 2013
As the title says....PLEASE can I have your thoughts/opinions/experience of taking Quetiapine and anything else Quetiapine related....video responses accepte...
http://wn.com/Quetiapine_You_can't_live_with_it,_You_cant_live_without_it
As the title says....PLEASE can I have your thoughts/opinions/experience of taking Quetiapine and anything else Quetiapine related....video responses accepte...
- published: 21 Nov 2012
- views: 1880
- author: justlotte82
Quetiapine (Seroquel) Review, Side Effects - Anti Psychotic Medications
- Order: Reorder
- Duration: 12:06
- Updated: 08 May 2013
Quetiapine (Seroquel) Review - Side Effects and more - Anti Psychotic Medications.
http://wn.com/Quetiapine_Seroquel_Review,_Side_Effects_Anti_Psychotic_Medications
Quetiapine (Seroquel) Review - Side Effects and more - Anti Psychotic Medications.
- published: 20 Feb 2013
- views: 381
- author: ben rogers
quetiapine
- Order: Reorder
- Duration: 4:34
- Updated: 19 May 2013
quetiapine abuse...WTF...
http://wn.com/quetiapine
SEROQUEL XR® quetiapine fumarate Mechanism of Action
- Order: Reorder
- Duration: 6:09
- Updated: 26 May 2013
http://wn.com/SEROQUEL_XR®_quetiapine_fumarate_Mechanism_of_Action
Seroquel (quetiapine) first days review...
- Order: Reorder
- Duration: 14:51
- Updated: 14 May 2013
I was added a low dose of quetiapine to my regimen of meds... a review of the first days on it.
http://wn.com/Seroquel_quetiapine_first_days_review
I was added a low dose of quetiapine to my regimen of meds... a review of the first days on it.
- published: 28 Jun 2011
- views: 5525
- author: 91rivo
Quetiapine Side Effects - Know Them, Avoid Them
- Order: Reorder
- Duration: 1:11
- Updated: 01 May 2013
http://www.sideeffectsuk.co.uk/ Quetiapine Side Effects - Quetiapine is a very powerful drug. In order to shield yourself from the nasty side effects it has,...
http://wn.com/Quetiapine_Side_Effects_Know_Them,_Avoid_Them
http://www.sideeffectsuk.co.uk/ Quetiapine Side Effects - Quetiapine is a very powerful drug. In order to shield yourself from the nasty side effects it has,...
- published: 26 Jun 2012
- views: 1396
- author: Hard Drugs Side Effects
Over The Rainbow - Quetiapine.
- Order: Reorder
- Duration: 1:10
- Updated: 15 Jun 2011
My first installment of a series documenting my mental health stuff - meds, experiences with healthcare professionals, day to day issues etc. I'm kinda hopin...
http://wn.com/Over_The_Rainbow_Quetiapine
My first installment of a series documenting my mental health stuff - meds, experiences with healthcare professionals, day to day issues etc. I'm kinda hopin...
- published: 03 May 2011
- views: 1166
- author: IronicEncounter's channel
thursday 25.02.10 - no more quetiapine
- Order: Reorder
- Duration: 3:54
- Updated: 16 Jan 2012
After spending a few hours researching the side effects today I made up my mind not to take any more. I've never even had a real manic episode so it seems to...
http://wn.com/thursday_250210_no_more_quetiapine
After spending a few hours researching the side effects today I made up my mind not to take any more. I've never even had a real manic episode so it seems to...
- published: 26 Feb 2010
- views: 3490
- author: sygnitte
Quetiapine aftermath
- Order: Reorder
- Duration: 1:45
- Updated: 29 Nov 2012
Sam Sparro "Black and Gold"
http://wn.com/Quetiapine_aftermath
1 month Seroquel (quetiapine) 100 mg update
- Order: Reorder
- Duration: 8:01
- Updated: 07 May 2013
I've been taking quetiapine for 1 month now, I'm taking 100 mg/day!
http://wn.com/1_month_Seroquel_quetiapine_100_mg_update
I've been taking quetiapine for 1 month now, I'm taking 100 mg/day!
- published: 04 Aug 2011
- views: 7481
- author: 91rivo
Quetiapine
- Order: Reorder
- Duration: 1:33
- Updated: 27 Apr 2013
rate and comment.
http://wn.com/Quetiapine
quetiapine paradox
- Order: Reorder
- Duration: 3:19
- Updated: 12 May 2013
prof. Tarek Asaas explains the calming and sedating effect of quetiapine , small vs high doses?for more hints and video clips visit www.seragpsych.com/wordpress.
http://wn.com/quetiapine_paradox
prof. Tarek Asaas explains the calming and sedating effect of quetiapine , small vs high doses?for more hints and video clips visit www.seragpsych.com/wordpress.
- published: 22 Dec 2012
- views: 114
- author: Dr. Adel Serag
My medication, Diazepam (Valium), Zopiclone, Quetiapine (Seroquel), Amisulpride, Bisoprolol Fumarate
- Order: Reorder
- Duration: 7:00
- Updated: 24 May 2013
Medication I need to take day to day: Diazepam (Valium) Zopiclone, Quetiapine (Seroquel), Amisulpride, Bisoprolol Fumarate, Codeine Phosphate - now replaced ...
http://wn.com/My_medication,_Diazepam_Valium,_Zopiclone,_Quetiapine_Seroquel,_Amisulpride,_Bisoprolol_Fumarate
Medication I need to take day to day: Diazepam (Valium) Zopiclone, Quetiapine (Seroquel), Amisulpride, Bisoprolol Fumarate, Codeine Phosphate - now replaced ...
- published: 14 Oct 2012
- views: 1971
- author: ben rogers
Quetiapine and Weight Gain Rant
- Order: Reorder
- Duration: 10:47
- Updated: 28 May 2013
Quetiapine makes me fat, Quetiapine makes me sleep......I also ramble on about other eating disorder related things, self harm and just general Mentalness.
http://wn.com/Quetiapine_and_Weight_Gain_Rant
Quetiapine makes me fat, Quetiapine makes me sleep......I also ramble on about other eating disorder related things, self harm and just general Mentalness.
- published: 11 Jul 2011
- views: 1974
- author: justlotte82
Seroquel Side Effects and Seroquel Warnings
- Order: Reorder
- Duration: 1:33
- Updated: 12 May 2013
To help with prescription drug addiction visit: http://GetOffMeds.com. The antipsychotic Seroquel (quetiapine) makes a fortune for its manufacturer. But it a...
http://wn.com/Seroquel_Side_Effects_and_Seroquel_Warnings
To help with prescription drug addiction visit: http://GetOffMeds.com. The antipsychotic Seroquel (quetiapine) makes a fortune for its manufacturer. But it a...
- published: 16 Jan 2012
- views: 7275
- author: brumpbm's channel
Vlog #25 quetiapine trial
- Order: Reorder
- Duration: 3:41
- Updated: 30 Nov 2012
Zzzzzzz sleepy.
http://wn.com/Vlog_25_quetiapine_trial
How to Pronounce Quetiapine
- Order: Reorder
- Duration: 0:21
- Updated: 01 May 2013
Learn how to say Quetiapine correctly with EmmaSaying's "how do you pronounce" free tutorials. http://www.emmasaying.com Take a look at my comparison tutoria...
http://wn.com/How_to_Pronounce_Quetiapine
Learn how to say Quetiapine correctly with EmmaSaying's "how do you pronounce" free tutorials. http://www.emmasaying.com Take a look at my comparison tutoria...
- published: 02 Jan 2013
- views: 262
- author: Emma Saying
Quetiapine Overdose and Hallucinations: Depression is setting in...
- Order: Reorder
- Duration: 7:31
- Updated: 13 May 2013
Just a little chat about my 'overdose' the other day - it was pretty lame really... been hearing voices, feeling spirits in me, intrusive thoughts... an unsu...
http://wn.com/Quetiapine_Overdose_and_Hallucinations_Depression_is_setting_in
Just a little chat about my 'overdose' the other day - it was pretty lame really... been hearing voices, feeling spirits in me, intrusive thoughts... an unsu...
- published: 13 May 2013
- views: 6
- author: MentalNotes400
Seroquel (Quetiapine Fumarate Tablets) at the Discount Pharmacy
- Order: Reorder
- Duration: 1:32
- Updated: 19 Feb 2013
The official commercial for Seroquel XR. Visit http://www.abconlinepharmacy.com/ns/customer/product1604-c-p1 for more information.
http://wn.com/Seroquel_Quetiapine_Fumarate_Tablets_at_the_Discount_Pharmacy
The official commercial for Seroquel XR. Visit http://www.abconlinepharmacy.com/ns/customer/product1604-c-p1 for more information.
- published: 03 Dec 2010
- views: 2642
- author: abconlinepharmacy
Seroquil & BPD
- Order: Reorder
- Duration: 6:34
- Updated: 07 May 2013
I dont even know.
http://wn.com/Seroquil_BPD
Quetiapine Generic - Did You Suffer from Depression
- Order: Reorder
- Duration: 0:44
- Updated: 05 Mar 2013
Generic Quetiapine is also called Qutipin made by Sun Pharma available in a several strengths. Seroquel is the most prescribed antidepressant medication for ...
http://wn.com/Quetiapine_Generic_Did_You_Suffer_from_Depression
Generic Quetiapine is also called Qutipin made by Sun Pharma available in a several strengths. Seroquel is the most prescribed antidepressant medication for ...
- published: 10 Nov 2011
- views: 193
- author: canadadrugsonline
Quetiapine. feeling Spaced out !
- Order: Reorder
- Duration: 2:28
- Updated: 23 Sep 2012
http://wn.com/Quetiapine_feeling_Spaced_out_!
photo: AP / Nigerian Army
31 May 2013
Nigerian authorities have have arrested three Lebanese men in northern Nigeria on suspicion of being members of the Lebanese movement Hezbollah. Soldiers uncovered a hidden arms cache that authorities believe belonged to members of the Shia political party and armed group, the military and secret police said on Thursday ... All suspects reportedly admitted to being members of Hezbollah under questioning ... News....(size: 8.8Kb)
photo: Creative Commons / Xabier Eskisabel
30 May 2013
Syria has already received the first shipment of an advanced Russian air defence system, Syria's President Bashar al-Assad is reported to have said in a Lebanese TV interview. Russia vowed to go ahead with sending the weapons soon after an EU decision not to renew an arms embargo on Syria. Mr Assad is also reported to have told Hezbollah-linked Al Manar TV that also said the tide of the war was turning ... Hezbollah ... Type ... Source ... ....(size: 3.1Kb)
photo: AP / Ng Han Guan
28 May 2013
May 28, 2013 -- Updated 2150 GMT (0550 HKT). (CNN) -- A new SARS-like virus recently found in humans is "a threat to the entire world," according to the director-general of the United Nations' World Health Organization ... The world needs to pull together its resources to properly tackle the virus which, Chan said, is her "greatest concern" at present ... "We do not know where the virus hides in nature ... These are alarm bells ... 0 ... SHARE THIS ... U.S. ....(size: 5.6Kb)
photo: US Army
30 May 2013
So-called killer robots are due to be discussed at the UN Human Rights Council, meeting in Geneva. A report presented to the meeting will call for a moratorium on their use while the ethical questions they raise are debated ... They include ... ....(size: 1.5Kb)
photo: AP / Hussein Malla
31 May 2013
Although the death toll in this war has reached into the tens of thousands and uncollaborated reports indicate the government forces have started using chemical weapons against rebel controlled territories, almost nothing will justify the United States aiding either side in this war ... America must depend on the Israelis who are not ruling out an attack into Syria in order to destroy the missile batteries ... Suggested by the author. ... Tweet....(size: 6.3Kb)
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StreetInsider
19 May 2013
and Sanis Health Inc.) are voluntarily recalling all lots of their antipsychotic product (Quetiapine) due to potential contamination with an antibiotic product (Clindamycin) during the manufacturing process. The recall affects the 25 mg, 100 mg, 200 mg and 300 mg doses of Co Quetiapine, Riva Quetiapine, and Sanis Quetiapine. Quetiapine is used in the treatment of schizophrenia and bipolar disorder in adult patients....(size: 5.1Kb)
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CBC
19 May 2013
Health Canada says three companies are voluntarily recalling all lots of the antipsychotic drug quetiapine ... Health Canada says quetiapine is used in the treatment of schizophrenia and bipolar disorder in adult patients....(size: 1.1Kb)
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CBC
07 May 2013
A researcher in Victoria is suing Health Minister Margaret MacDiarmid and the province over their handling of a health data privacy breach last summer. Dr ... residents had their medical information compromised by a group of researchers. The B.C ... (iStock) ... Warburton claims he was going to work with data gathered on the use of drugs such as aripiprazole, quetiapine, olanzapine, risperidone, ziprasidone, paliperidone, and clorzapine ... ....(size: 2.3Kb)
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Buffalo News
27 Mar 2013
This promise remains largely unfulfilled. During the past few decades, pharmaceutical manufacturers have consolidated. Giant firms swallowed smaller corporations ... Americans spent more than $25 billion on such medications last year ... Clozaril, Risperdal and the medications that followed them, such as aripiprazole (Abilify), olanzapine (Zyprexa), quetiapine (Seroquel) and ziprasidone (Geodon), were supposed to be easier to tolerate....(size: 3.5Kb)
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PR Newswire
25 Mar 2013
NEW YORK, March 25, 2013 /PRNewswire/ -- Reportlinker.com announces that a new market research report is available in its catalogue.. Global CNS Therapeutics Industry. http.//www.reportlinker.com/p01139068/Global-CNS-Therapeutics-Industry.html#utm_source=prnewswire&utm_medium=pr&utm_campaign=Therapy ... I ... Study Reliability and Reporting Limitations I-1 ... II ... Teva Pharmaceutical Industries Introduces Quetiapine and. Quetiapine XL II-84....(size: 44.1Kb)
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PhysOrg
12 Mar 2013
Drugs added to antidepressants (like Prozac, Paxil and Celexa) include the antipsychotic medications aripiprazole (Abilify), quetiapine (Seroquel), risperidone (Risperdal) and olanzapine/fluoxetine (Symbyax). Antipsychotic drugs are traditionally used to treat conditions such as schizophrenia, bipolar disorder and obsessive-compulsive disorder—not depression ... Paul, Minn ... Some of these drugs are pricey ... ....(size: 3.6Kb)
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Yahoo Daily News
26 Feb 2013
A few weeks ago an article in the Scientific American Twitter stream caught my eye ... 1) ... 2) ... The U.S ... The math is simple ... the former wants quick or easy fixes, and the latter wastes no time in peddling the pharmaceutical flavor of the month, whether it's sertraline, paroxetine, fluoxetine, venlafaxine, risperidone, clonidine, diazepam, lorazepam, alpralozam, duloxetine, propranolol, prazosin, yohimbine, cortisol, quetiapine or gabapentin ... ....(size: 20.1Kb)
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noodls
15 Feb 2013
(Source. AstraZeneca plc). AstraZeneca today announced that, on 14 February 2013, the United States Court of Appeals for the Federal Circuit summarily upheld a lower court ruling that had found the formulation patent protecting SEROQUEL XR (quetiapine fumarate) extended release tablets in the US to be valid and infringed ... NOTES TO EDITORS. About the Seroquel XR formulation patent trial ... and Mylan Inc ... About AstraZeneca ... Media Enquiries UK....(size: 2.2Kb)
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London Evening Standard
08 Feb 2013
Nicola Edgington was also found guilty of attempting to kill a third victim by a jury at the Old Bailey ... In a series of 999 calls she warned the operator ... She told the court that she last met with Edgington, who was prescribed a high dose of the anti-psychotic drug quetiapine on her release, on 22 September 2011 where she had shown “no recurrence of psychotic symptoms including paranoia, hallucinations or intrusive thoughts” ... ....(size: 5.1Kb)
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The Daily Telegraph
07 Feb 2013
A convicted killer who was released into the community and two years later murdered an innocent passerby in a random attack with a butcher's knife faces a life sentence today ... CENTRAL. By Telegraph reporters. 5.08PM GMT 07 Feb 2013 ... She had been prescribed anti-psychotic drug Quetiapine and mood stabiliser drug Sodium Valproate ... She had admitted manslaughter on the grounds of diminished responsibility ... Related Articles ... . Crime ... ....(size: 13.3Kb)
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Seeking Alpha
13 Jan 2013
Deals and Financings. Joinn Laboratories, a pre-clinical CRO with facilities in Beijing and Taicang, was discovered to be the mystery buyer of the ex-Bayer (Xetra. BAY) biopharma campus in the San Francisco Bay area. Joinn, which was founded in 1995, is implementing a "go-big" strategy ... Shanghai Fosun Pharma (SHA ... Donging's major product is quetiapine fumarate, marketed in global markets as Seroquel, an AstraZeneca (NYSE ... (SHE ... ....(size: 3.5Kb)
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The Washington Post
07 Jan 2013
Several drugs are approved to treat it, including donepezil (Aricept and its generic cousins) and memantine (Namenda) ... Loading... Recommend ... But it’s generally best to avoid antipsychotic drugs, such as olanzapine (Zyprexa and generics), quetiapine (Seroquel and generics) and risperidone (Risperdal and generics), unless they’re absolutely necessary — for example, to quell severe agitation or hallucinations ... ....(size: 4.9Kb)
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Austin American Statesman
30 Dec 2012
Last year, the Pentagon spent more on pills, injections and vaccines than it did on Black Hawk helicopters, Abrams tanks, Hercules C-130 cargo planes and Patriot missiles — combined ... Seroquel, also known as quetiapine fumarate, a powerful anti-psychotic approved for schizophrenia and bipolar disorder, was prescribed throughout the past decade to troops suffering from insomnia and post-traumatic stress disorder....(size: 13.7Kb)
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 |
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| Systematic (IUPAC) name | |
| 2-(2-(4-dibenzo[b,f][1,4]thiazepine- 11-yl- 1-piperazinyl)ethoxy)ethanol | |
| Clinical data | |
| Trade names | Seroquel |
| AHFS/Drugs.com | monograph |
| MedlinePlus | a698019 |
| Pregnancy cat. | C (US) |
| Legal status | ℞-only (US) |
| Routes | Oral |
| Pharmacokinetic data | |
| Bioavailability | 9% |
| Metabolism | Hepatic |
| Half-life | 6 hours (parent compound); 12 hours (active metabolite) |
| Excretion | Renal |
| Identifiers | |
| CAS number | 111974-69-7  Y |
| ATC code | N05AH04 |
| PubChem | CID 5002 |
| IUPHAR ligand | 50 |
| DrugBank | DB01224 |
| ChemSpider | 4827 Y |
| UNII | BGL0JSY5SI Y |
| KEGG | D08456 Y |
| ChEBI | CHEBI:8707 Y |
| ChEMBL | CHEMBL716 Y |
| Chemical data | |
| Formula | C21H25N3O2S |
| Mol. mass | 383.5099 g/mol |
| SMILES | eMolecules & PubChem |
|
|
 Y (what is this?) (verify) |
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Quetiapine (
/kwɨˈtaɪ.əpiːn/ kwi-TY-ə-peen) (branded as Seroquel, Ketipinor), is an atypical antipsychotic approved for the treatment of schizophrenia, bipolar disorder and as an add-on to treat depression.
Annual sales are approximately $5.7 billion worldwide, and $2.9 billion in the United States.[1] The U.S. patent,[2] which was set to expire in 2011, received a pediatric exclusivity extension which pushed its expiration to March 26, 2012.[3][4] The patent has already expired in Canada. There are now several generic versions of quetiapine, such as Quepin.[5]
Contents |
Medical uses[link]
Quetiapine fumarate is used to treat either schizophrenia or bipolar disorder.[6]
Schizophrenia[link]
It is debatable whether, as a class, typical or atypical antipsychotics are better.[7] Both have equal drop-out and symptom relapse rates when typicals are used at low to moderate dosages.[8]
Bipolar disorder[link]
In those with bipolar disorder, it is used for depressive episodes, acute manic episodes associated with bipolar I disorder (as either monotherapy or adjunct therapy to lithium, valproate or lamotrigine), and maintenance treatment of bipolar I disorder (as adjunct therapy to lithium or divalproex).[9]
Alzheimer's[link]
Quetiapine is ineffective in reducing agitation among people with Alzheimer's, whose usage of the drug once constituted 29% of sales. Quetiapine worsens cognitive functioning in the elderly with dementia[10] and therefore is not recommended.
Other[link]
It is sometimes used off-label, often as an augmentation agent, to treat conditions such as obsessive-compulsive disorder, post-traumatic stress disorder, autism, alcoholism, borderline personality disorder, depression,[11] Tourette syndrome,[12] and has been used by physicians as a sedative for those with sleep disorders or anxiety disorders.[13]
Adverse effects[link]
The most common side-effect of quetiapine is somnolence. Other common side-effects include: sluggishness, fatigue, dry mouth, sore throat, dizziness, abdominal pain, constipation, upset stomach, orthostatic hypotension, inflammation or swelling of the sinuses or pharynx, increased appetite, and weight gain.[14]
There is an emerging controversy regarding quetiapine fatalities. The deaths of at least six U.S. military veterans who were given drug cocktails including quetiapine [15] have been attributed to its inclusion by military doctors to treat PTSD. Approximately 10,000 [16] lawsuits [17],[18],[19],[20],[21] against AstraZeneca for problems ranging from slurred speech and chronic insomnia to death have been experienced by individuals from civilian populations.
It is marketed as one of the most sedating of all anti-psychotics, although those claims are contested.[22] Beginning users may feel extremely tired and 'out of it' for the first few days, and sometimes longer. Quetiapine's newest indication, for bipolar depression, usually specifically calls for the entire dose to be taken before bedtime due to its sedative effects. The sedative effects may disappear after some time on the drug, or with a change of dosage, and with possibly different, non-sedative side-effects emerging.
Both typical and atypical antipsychotics can cause tardive dyskinesia.[23] According to one study, rates are lower with the atypicals at 3.9% as opposed to the typicals at 5.5%.[23] Although Quetiapine and Clozapine are atypical antipsychotics, switching to these atypicals is an option to minimize symptoms of tardive dyskinesia caused by other atypicals.[24]
Weight gain can be a problem for some patients. Quetiapine has been found to cause more weight gain than fluphenazine, haloperidol, loxapine, molindone, olanzapine, pimozide, risperidone, thioridazine, thiothixene, trifluoperazine, and ziprasidone, but less than chlorpromazine, clozapine, perphenazine, and sertindole when calculated according to a fixed effects model.[25]
Studies conducted on beagles have resulted in the formation of cataracts. While there are reports of cataracts occurring in humans, controlled studies including thousands of patients have not demonstrated a clear causal association between quetiapine therapy and this side-effect.[citation needed] However, the Seroquel website[26] still recommends users have eye examinations every six months.
As with some other anti-psychotics, quetiapine may lower the seizure threshold,[27] and should be taken with caution in combination with drugs such as bupropion.
A recent comparative study of anti-psychotics drugs has found that quetiapine mono treatment was associated with increased risk of death relative to the other analyzed treatments (but still better than no anti-psychotics drug treatment at all).[28]
Discontinuation[link]
Quetiapine should be discontinued gradually, with careful consideration from the prescribing doctor, to avoid withdrawal symptoms or relapse.
The British National Formulary recommends a gradual withdrawal when discontinuing anti-psychotic treatment to avoid acute withdrawal syndrome or rapid relapse.[29] Due to compensatory changes at dopamine, serotonin, adrenergic and histamine receptor sites in the central nervous system, withdrawal symptoms can occur during abrupt or over-rapid reduction in dosage. However, despite increasing demand for safe and effective antipsychotic withdrawal protocols or dose-reduction schedules, no specific guidelines with proven safety and efficacy are currently available. Some have suggested using the Ashton Manual http://www.benzo.org.uk/manual/, originally developed for benzodiazapine withdrawal. Support groups such as The Icarus Project http://theicarusproject.net/HarmReductionGuideComingOffPsychDrugs, and other online forums provide resources and social support for those attempting to discontinue antipsychotics and other psychiatric medications.
Withdrawal symptoms reported to occur after discontinuation of antipsychotics include nausea, emesis, lightheadedness, diaphoresis, dyskinesia, orthostasis, tachycardia, nervousness, dizziness, headache, excessive non-stop crying, and anxiety.[30][31] These withdrawal symptoms may be caused by irregularities in oxytocin levels. Some have argued that additional somatic and psychiatric symptoms associated with dopaminergic super-sensitivity, including dyskinesia and acute psychosis, are common features of withdrawal in individuals treated with neuroleptics.[32][33][34][35] This has led some to suggest that the withdrawal process might itself be schizo-mimetic, producing schizophrenia-like symptoms even in previously healthy patients, indicating a possible pharmacological origin of mental illness in a yet unknown percentage of patients currently and previously treated with antipsychotics. This question is unresolved, and remains a highly controversial issue among professionals in the medical and mental health communities, as well the public.[36]
Overdosage[link]
Most instances of acute overdosage result only in sedation, hypotension and tachycardia, but cardiac arrythmia, coma and death have occurred in adults. Serum or plasma quetiapine concentrations are usually in the 1–10 mg/L range in overdose survivors, while postmortem blood levels of 10–25 mg/L are generally observed in fatal cases.[37]
Pharmacology[link]
| Receptor | Quetiapine | Norquetiapine |
|---|---|---|
| D1 | 428 | 99.8 |
| D2 | 626 | 489 |
| 5-HT1A | 1040 | 191 |
| 5-HT2A | 38 | 2.9 |
| α1B | 14.6 | 46.4 |
| α2 | 617 | 1290 |
| H1 | 4.41 | 1.15 |
| M1 | 1086 | 38.3 |
| NET | >10000 | 34.8 |
Quetiapine has the following pharmacological actions:[39][40][41][42]
- D1 (IC50 = 1268nM), D2 (IC50 = 329nM), D3, and D4 receptor antagonist
- 5-HT1A (IC50 = 717nM), 5-HT2A (IC50 = 148nM), 5-HT2C, and 5-HT7 receptor antagonist
- α1-adrenergic (IC50 = 94nM) and α2-adrenergic receptor (IC50 = 271nM) antagonist
- H1 receptor (IC50 = 30nM) antagonist
- mACh receptor (IC50 = >5000nM) antagonist
This means Quetiapine is a dopamine, serotonin, and adrenergic antagonist, and a potent antihistamine with clinically negligible anticholinergic properties. Quetiapine binds strongly to serotonin receptors. Serial PET scans evaluating the D2 receptor occupancy of quetiapine have demonstrated that quetiapine very rapidly disassociates from the D2 receptor.[43] Theoretically, this allows for normal physiological surges of dopamine to elicit normal effects in areas such as the nigrostriatal and tuberoinfundibular pathways, thus minimizing the risk of side-effects such as pseudo-parkinsonism as well as elevations in prolactin.[44] Some of the antagonized receptors (serotonin, norepinephrine) are actually autoreceptors whose blockade tends to increase the release of neurotransmitters.
Norquetiapine is the active metabolite of quetiapine. It has most of the effects of quetiapine with similar potencies, and is also a potent norepinephrine reuptake inhibitor and muscarinic antagonist. Note that the data below is from another source (the official prescribing info for Seroquel), and the measure is different from the above (Ki vs. IC50). There are still order-of-magnitude discrepancies for D1, α1, H1 and M1.
Synthesis[link]
Warawa, E. J.; Migler, B. M.; 1988, U.S. Patent 4,879,288.
Dosage[link]
At very low doses quetiapine acts primarily as a histamine receptor blocker (antihistamine) and α1-adrenergic blocker. When the dose is increased quetiapine activates the adrenergic system and binds strongly to serotonin receptors and autoreceptors. At high doses quetiapine starts blocking significant amounts of dopamine receptors.[45][46] Use of low-dose quetiapine is not recommended except temporarily during drug titration period (less than 30 days).[47]
Due to compensatory changes at dopamine, serotonin, adrenergic and histamine receptor sites in the central nervous system, a gradual reduction in dosage is recommended to minimise or avoid withdrawal symptoms. Withdrawal symptoms reported to occur after discontinuation of quetiapine include: insomnia, nausea, emesis, lightheadedness, diaphoresis, orthostasis, tachycardia, as well as nervousness, dizziness, headache, and anxiety. The present evidence suggests that these symptoms affect a small number of susceptible individuals treated with quetiapine.[30]
The British National Formulary recommends a gradual withdrawal when discontinuing antipsychotic treatment to avoid acute withdrawal syndrome or rapid relapse.[29]
Sustained-release[link]
AstraZeneca submitted a new drug application for a sustained-release version of quetiapine in the United States, Canada, and the European Union in the second half of 2006 for treatment of schizophrenia.[48][49] AstraZeneca will retain the exclusive right to market sustained release quetiapine until 2017. The sustained-release quetiapine is marketed mainly as Seroquel XR. Other marketing names are Seroquel Prolong and Seroquel Depot.
On May 18, 2007, AstraZeneca announced that the FDA approved Seroquel XR for acute treatment of schizophrenia.[50] During its 2007 Q2 earnings conference, AstraZeneca announced plans to launch Seroquel XR in the U.S. during August 2007.[51] However, Seroquel XR has only become available in U.S. pharmacies after the FDA approved Seroquel XR for use as maintenance treatment for schizophrenia, in addition to acute treatment of the illness, on November 16, 2007.[52] The company has not provided a reason for the delay of Seroquel XR's launch.
Health Canada approved sale of Seroquel XR on September 27, 2007.[53]
The FDA approved Seroquel XR for the treatment of bipolar depression and bipolar mania in early October, 2008. According to AstraZeneca, Seroquel XR is "the first medication approved by the FDA for the once-daily acute treatment of both depressive and manic episodes associated with bipolar."
On July 31, 2008, Handa Pharmaceuticals, based in Fremont, California, announced that its abbreviated new drug application (“ANDA”) for quetiapine fumarate extended-release tablets, the generic version of AstraZeneca’s SEROQUEL XR, has been accepted by the FDA.
On December 1, 2008, Biovail announced that the FDA had accepted the company's ANDA to market its own version of sustained-release quetiapine.[54] Biovail's sustained-release tablets will compete with AstraZeneca's Seroquel XR.
On December 24, 2008, AstraZeneca notified shareholders that the FDA had asked for additional information on the company's application to expand the use of sustained-release quetiapine for treatment of depression.[55]
Society and culture[link]
Legal status[link]
Quetiapine received its initial indication from the U.S. Food and Drug Administration for treatment of schizophrenia in 1997.[56] In 2004, it received its second indication for the treatment of mania-associated bipolar disorder.[57] In 2007 and 2008, studies were conducted on quetiapine’s efficacy in treating generalized anxiety disorder and major depression. In April 2009, the Psychopharmacologic Drugs Advisory Committee of the US Food and Drug Administration (FDA) held a public meeting to discuss whether study results supported the FDA's approval for anxiety and depression, with risks of metabolic side-effects and of tardive dyskinesia and sudden cardiac death.[58]
Controversy[link]
AstraZeneca has been sued by the U.S. (resulting from a Qui Tam lawsuit filed by Stefan P. Kruszewski) government over the marketing of quetiapine. A $520 million settlement was reached on October 29, 2009.[59]
Several American soldiers and veterans have died while taking Seroquel for PTSD.[relevant? – discuss][60][dead link]
Multiple lawsuits have been filed in relation to quetiapine's side-effects, in particular, diabetes.[61][62][63][64]
In Australia, Professor Patrick McGorry, a key mental health adviser proposed a trial in Melbourne in 2011. It was to investigate whether Seroquel would decrease or delay the risk of people aged between 15 and 40 with early signs of mental illness, developing a later psychotic disorder. However in July 2011 psychiatrists, psychologists and researchers from Australia, New Zealand, Canada, Britain and the US lodged a complaint with the ethics committee of Melbourne Health. They opposed the trial[65] as "unethical" and "dangerous".
Recreational use[link]
Quetiapine is not classified as a controlled substance, "abusive self-administration seems to be driven by quetiapine’s sedative and anxiolytic effects (to help with sleep or to 'calm down') rather than by its antipsychotic properties."[66] Reports of quetiapine abuse have emerged in the medical literature, however, while the drug is usually abused through the crushing and snorting of tablets (insufflation), there have also been reports of intravenous abuse and intravenous co-administration with cocaine.[67] This is commonly referred to as a "Q-Ball".[67] A 2004 letter to the editor of the American Journal of Psychiatry provided an anecdotal estimate that up to 30% of inmates who were seen for psychiatric services in the Los Angeles County Jail were faking psychotic symptoms in an attempt to obtain quetiapine.[68] Also known as "quell", "Snoozeberries", or "Susie-Q", the drug may be more commonly abused in prisons due to its capacity to be regularly prescribed as a sedative and the unavailability in prison of more commonly abused substances. A letter to the editor that appeared in the January 2007 American Journal of Psychiatry has proposed a “need for additional studies to explore the addiction-potential of quetiapine”. The letter reports that its authors are physicians who work in the Ohio correctional system. They report that “prisoners ... have threatened legal action and even suicide when presented with discontinuation of quetiapine” and that they have “not seen similar drug-seeking behavior with other second-generation antipsychotics of comparable efficacy”. It has also been reported that when Seroquel is used with methadone it causes the user to experience a buzz, or opioid euphoria.[69]
Date rape[link]
Quetiapine has sometimes been used as a date rape drug, causing person to lose consciousness before a sexual attack, especially when coadministered with alcohol.[70][71]
Nurofen plus error[link]
In August 2011 The UKs Medicines and Healthcare Regulatory Agency (MHRA) issued a class 4 drug alert following reports that some batches of Nurofen plus contained Seroquel XL instead.[72]
Following the issue of the Class 4 Drug Alert, Reckitt Benckiser (UK) Ltd received further reports of rogue blister strips in cartons of two additional batches of Nurofen Plus tablets. One of the new batches contained Seroquel XL 50 mg tablets and one contained the Pfizer product Neurontin 100 mg capsules.
Following discussions with the MHRA's Defective Medicines Report Centre (DMRC), Reckitt Benckiser (UK) Ltd decided to recall all remaining unexpired stock of Nurofen Plus tablets in any pack size leading to a Class 1 Drug Alert.[73] The contamination was later traced to in store tampering by a customer.[74]
References[link]
- ^ Details for Seroquel
- ^ Patent Document, U.S. Patent and Trademark Office
- ^ http://money.usnews.com/money/blogs/the-best-life/2011/04/29/blockbuster-drugs-that-will-go-generic-soon
- ^ Seroquel patent expiration
- ^ "Quepin Full Prescribing Information in Drug Reference Encyclopedia". http://www.theodora.com/drugs/quepin_tablets_specifar.html. Retrieved 2010-04-03.
- ^ "quetiapine-fumarate". The American Society of Health-System Pharmacists. http://www.drugs.com/monograph/quetiapine-fumarate.html. Retrieved 3 April 2011.
- ^ Kane JM, Correll CU. Pharmacologic treatment of schizophrenia. Dialogues Clin Neurosci. 2010;12(3):345–57. PMID 20954430.
- ^ Schultz SH, North SW, Shields CG. Schizophrenia: a review. Am Fam Physician. 2007;75(12):1821–9. PMID 17619525.
- ^ Thase, M. E.; MacFadden, W.; Weisler, R. H.; Chang, W.; Paulsson, B. ?R.; Khan, A.; Calabrese, J. R.; Bolder Ii Study, G. (2006). "Efficacy of Quetiapine Monotherapy in Bipolar I and II Depression". Journal of Clinical Psychopharmacology 26 (6): 600. DOI:10.1097/01.jcp.0000248603.76231.b7. PMID 17110817. edit
- ^ Ballard, C.; Margallo-Lana, M.; Juszczak, E.; Douglas, S.; Swann, A.; Thomas, A.; O'Brien, J.; Everratt, A. et al. (2005). "Quetiapine and rivastigmine and cognitive decline in Alzheimer's disease: randomised double blind placebo controlled trial". BMJ 330 (7496): 874. DOI:10.1136/bmj.38369.459988.8F. PMC 556156. PMID 15722369. //www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=556156. edit
- ^ Croissant, B.; Klein, O.; Gehrlein, L.; Kniest, A.; Hermann, D.; Diehl, A.; Mann, K. (2006). "Quetiapine in relapse prevention in alcoholics suffering from craving and affective symptoms: a case series". European Psychiatry 21 (8): 570. DOI:10.1016/j.eurpsy.2006.04.007. PMID 17161284. edit
- ^ Mukaddes, N. M.; Abali, O. (2003). "Quetiapine Treatment of Children and Adolescents with Tourette's Disorder". Journal of Child and Adolescent Psychopharmacology 13 (3): 295. DOI:10.1089/104454603322572624. PMID 14642017. edit
- ^ Becker, P. M. (2006). "Treatment of sleep dysfunction and psychiatric disorders". Current Treatment Options in Neurology 8 (5): 367–375. DOI:10.1007/s11940-006-0026-6. PMID 16901376. edit
- ^ http://www1.astrazeneca-us.com/pi/Seroquel.pdf
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External links[link]
- "Quetiapine". MedlinePlus. The American Society of Health-System Pharmacists, Inc.. 2008-09-01. http://nlm.nih.gov/medlineplus/druginfo/meds/a698019.html.
- NAMI summary
- Internet Drug List summary
- Compound #1802: Quetiapine ChemBank
- Intranasal Quetiapine Abuse
- U.S. National Library of Medicine: Drug Information Portal - Quetiapine
- Seroquel Adverse Events Reported to the FDA
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This article is licensed under the Creative Commons Attribution-ShareAlike 3.0 Unported License, which means that you can copy and modify it as long as the entire work (including additions) remains under this license.
