Kvetiapinmisbruk – myte eller realitet?

Waal, Helge; Vold, Jørn Henrik

doi:10.4045/tidsskr.20.0059

Cited by 3 publications

(3 citation statements)

References 15 publications

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“…Although few, four of the five cases were registered in the last five years of the study period, in correlation with increased awareness of this issue in national and international literature. 12,17,28,29 Only three cases regarded potential misuse or dependency in individual patients (Table 1). All of these were subjective patient reports, implying that the physician did not objectively suspect any misuse or dependency, and it was information from the patient that prompted the physician to ask RELIS.…”

Section: Discussionmentioning

confidence: 99%

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Quetiapine, Misuse and Dependency: A Case-Series of Questions to a Norwegian Network of Drug Information Centers

Jahnsen¹,

Widnes²,

Schjøtt³

2021

DHPS

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The second-generation antipsychotic quetiapine has been associated with misuse and dependency. We aimed to review questions to the Norwegian network of drug information centers concerning this potential drug safety problem. Methods: We conducted a Boolean search in the database of the Regional Medicines Information and Pharmacovigilance Centres in Norway (RELIS) combining the indexed categories "quetiapine" and "adverse drug reaction" with the text words "misuse" or "dependency". Question-answer pairs (Q/As) in the full-text, searchable RELIS database were defined as cases. Cases were analyzed for drug safety issues linked to use of quetiapine, including off-label use, polypharmacy and other patient risk factors. Results: The search resulted in 54 cases. Forty-six cases (85%) were patient-related, and a majority came from physicians working in hospitals. Twenty-nine cases (54%) concerned patients with a history of addiction, 14 cases (26%) had polypharmacy, and off-label use of quetiapine for insomnia was identified in 14 of the cases (26%). Only three of the cases included a specific question about patient dependency of quetiapine, and these cases were all associated with insomnia. Conclusion:We conclude that our case series from the Norwegian network of drug information centres reflects that quetiapine frequently involves clinical narratives of a history of addiction, polypharmacy or insomnia (off-label use). However, the case series did not reveal new information about the drug's addictive potential.

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Section: Discussionmentioning

confidence: 99%

“…Drug safety problems, in particular off-label prescribing of quetiapine for insomnia is currently discussed in Norway. 16,17,28,29 In our experience, such publicity usually motivates frequent questions to RELIS about a drug. Therefore, we were surprised that so few queries concerned misuse or dependency of quetiapine.…”

Section: Discussionmentioning

confidence: 99%

Quetiapine, Misuse and Dependency: A Case-Series of Questions to a Norwegian Network of Drug Information Centers

Jahnsen¹,

Widnes²,

Schjøtt³

2021

DHPS

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“…Occasionally, quetiapine is associated with drug misuse, but it has limited potential for misuse [ 34 ]. Misuse is most often seen in patients with a history of polysubstance abuse and/or mental illness (especially those who are detained in prisons or secure psychiatric institutions) because the limited access to alternative intoxicants brings quetiapine to the fore.…”

Section: Use and Misusementioning

confidence: 99%

Quetiapine-Related Deaths: In Search of a Surrogate Endpoint

Šoša

2024

Toxics

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Quetiapine is a second-generation antipsychotic drug available for two and half decades. Due to increased misuse, prescription outside the approved indications, and availability on the black market, it is being encountered in medicolegal autopsies more frequently. For instance, it has been linked to increased mortality rates, most likely due to its adverse effects on the cardiovascular system. Its pharmacokinetic features and significant postmortem redistribution challenge traditional sampling in forensic toxicology. Therefore, a systematic literature review was performed, inclusive of PubMed, the Web of Science—core collection, and the Scopus databases; articles were screened for the terms “quetiapine”, “death”, and “autopsy” to reevaluate each matrix used as a surrogate endpoint in the forensic toxicology of quetiapine-related deaths. Ultimately, this review considers the results of five studies that were well presented (more than two matrices, data available for all analyses, for instance). The highest quetiapine concentrations were usually measured in the liver tissue. As interpreted by their authors, the results of the considered studies showed a strong correlation between some matrices, but, unfortunately, the studies presented models with poor goodness of fit. The distribution of quetiapine in distinct body compartments/tissues showed no statistically significant relationship with the length of the postmortem interval. Furthermore, this study did not confirm the anecdotal correlation of peripheral blood concentrations with skeletal muscle concentrations. Otherwise, there was no consistency regarding selecting an endpoint for analysis.

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