Quetiapine

Abstract

Quetiapine, a dibenzothiazepine derivative, is a atypical antipsychotic which has greater in vitro binding affinity for serotonin 5-HT2 receptors than for dopamine D2 receptors. Quetiapine effectively treats both the positive and the negative symptoms of schizophrenia and is also associated with an incidence of extrapyramidal symptoms no greater than placebo across the entire dose range. In addition, it does not cause persistent hyperprolactinaemia. Quetiapine is associated with high levels of patient acceptability and satisfaction, which may result from its combination of efficacy and relatively benign adverse effect profile. The drug is well tolerated and has a low propensity to cause adverse events both during acute and long term treatment in the adult populations. The adverse effect profile of quetiapine makes the drug advantageous for patient populations who are susceptible to the adverse effects of drugs. Indeed, preliminary data show quetiapine to be very well tolerated in the elderly. Overdoses of quetiapine of up to 20g have been reported; however, with appropriate management in an intensive care setting there have been no reported fatalities. Quetiapine is metabolised by the cytochrome P450 3A4 isoenzyme, and the dose may need to be adjusted if quetiapine is co-administered with drugs which affect the activity of this isoenzyme. Overall, quetiapine has a favourable risk-benefit profile that should make it a valuable first-line agent in the treatment of schizophrenia.

Current approaches to treatments for schizophrenia spectrum disorders, part II: psychosocial interventions and patient-focused perspectives in psychiatric care

“…In two controlled trials with 227 and 307 patients with schizophrenia,104,114 second-generation antipsychotics could not demonstrate any better quality of life or cost-effectiveness than different types of first-generation antipsychotics during more than a 1-year follow-up. Nonetheless, more recent research and reviews on long-term use of second-generation antipsychotic therapy such as quetiapine115,116 and risperidone104 have shown that it was a more tolerated, acceptable, and satisfactory treatment than the other previously prescribed first-generation antipsychotics. It is recommended that the perceived benefits and other patient-focused outcomes of quetiapine, risperidone, and other newly introduced antipsychotics, compared with other second-generation antipsychotics, be the subject of further research.…”

Convulsive syncope related to a small dose of quetiapine in an adolescent with bipolar disorder

“…It also has antihistamine and anticholinergic properties. Hypotension is known as a common adverse effect, which is considered to be elicited by inhibition of adrenergic α 1 -receptors 9. However, the mechanism behind quetiapine-induced seizure remains unclear.…”

Raloxifen

“…In einem Bericht wird eine Frau erwähnt, bei der unter Raloxifen eine Überempfindlichkeitsreaktion mit Hautausschlag, Ikterus und Leberenzymerhöhung auftrat. 10 In der MORE-Studie beobachtete man in der Raloxifen-Gruppe mehr Fälle von Diabetes mellitus als in der Placebo-Gruppe. 5,6 Mit histologischen Untersuchungen und transvaginalen Sonografien wurde in mehreren Studien abgeklärt, welche Wirkungen Raloxifen auf das Endometrium ausübt.…”