What is Quetiapine
Quetiapine is an atypical antipsychotic structurally similar to clozapine, a dibenzodiazepine antipsychotic.
Atypical antipsychotics, also known as second generation antipsychotics (SGAs), are considered to be the standard of care for schizophrenia and related disorders, and may be considered as first-line treatment options for the management of psychosis (with the exception of clozapine).
Similar to other atypical antipsychotics, quetiapine carries a risk of metabolic changes including hyperglycemia, diabetes, dyslipidemia, and weight gain, and may increase the risk of cardiac events, such as QT prolongation.
Quetiapine causes anticholinergic effects, sedation, and orthostatic hypotension.
A meta-analysis found that efficacy favored the comparator SGAs (e.g., olanzapine, risperidone, paliperidone) as assessed by the Positive and Negative Syndrome Scale (PANSS), although the clinical impact of these data are not clear.
In the same meta-analysis, quetiapine induced less movement disorders, fewer parkinsonian symptoms, and less increases in prolactin than the comparator drugs.
Brand Name
- Seroquel
- Seroquel XR
Indications
- behavioral or psychological symptoms of dementia
- bipolar depression
- bipolar disorder
- borderline personality disorder
- dementia with Lewy bodies
- depression
- mania
- obsessive-compulsive disorder (OCD)
- schizophrenia
Side Effects
- abdominal pain
- acne vulgaris
- acute generalized exanthematous pustulosis (AGEP)
- agitation
- agranulocytosis
- akathisia
- amblyopia
- amenorrhea
- amnesia
- anaphylactoid reactions
- anemia
- angina
- anorexia
- anxiety
- aphasia
- apnea
- appetite stimulation
- arthralgia
- asthenia
- ataxia
- atopic dermatitis
- atrial fibrillation
- AV block
- back pain
- blepharitis
- blurred vision
- bone fractures
- bone pain
- bowel ischemia
- breast discharge
- bundle-branch block
- cardiomyopathy
- chills
- choreoathetosis
- confusion
- conjunctivitis
- constipation
- contact dermatitis
- cough
- cyanosis
- cystitis
- dehydration
- delirium
- dental caries
- depression
- diabetes mellitus
- dizziness
- drowsiness
- Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
- dysarthria
- dysgeusia
- dyskinesia
- dysmenorrhea
- dyspepsia
- dysphagia
- dysphemia
- dyspnea
- dystonic reaction
- dysuria
- ecchymosis
- ejaculation dysfunction
- elevated hepatic enzymes
- emotional lability
- eosinophilia
- epistaxis
- euphoria
- exfoliative dermatitis
- fatigue
- fecal incontinence
- fever
- flatulence
- galactorrhea
- gastritis
- gastroesophageal reflux
- GI bleeding
- GI obstruction
- gingivitis
- glossitis
- glycosuria
- gout
- gynecomastia
- hallucinations
- headache
- hearing loss
- heart failure
- hematemesis
- hemolysis
- hemorrhoids
- hepatic failure
- hepatic necrosis
- hepatitis
- hiccups
- hypercholesterolemia
- hyperglycemia
- hyperhidrosis
- hyperkinesis
- hyperprolactinemia
- hypertension
- hypertensive crisis
- hyperthyroidism
- hypertriglyceridemia
- hyperventilation
- hypoesthesia
- hypoglycemia
- hypokalemia
- hyponatremia
- hypotension
- hypothermia
- hypothyroidism
- ileus
- impotence (erectile dysfunction)
- increased urinary frequency
- infection
- infertility
- irritability
- lethargy
- leukocytosis
- leukopenia
- leukorrhea
- libido decrease
- libido increase
- maculopapular rash
- malaise
- mania
- melena
- migraine
- musculoskeletal pain
- myalgia
- myasthenia
- myocarditis
- myoclonia
- nasal congestion
- nausea
- neuroleptic malignant syndrome
- neuropathic pain
- neutropenia
- nightmares
- nocturia
- ocular hypertension
- ocular pain
- oral ulceration
- orthostatic hypotension
- otalgia
- palpitations
- pancreatitis
- paranoia
- paresthesias
- pelvic pain
- peripheral edema
- pharyngitis
- photosensitivity
- polydipsia
- polyuria
- priapism
- pruritus
- pseudoparkinsonism
- psoriasis
- psychosis
- QT prolongation
- rash
- renal failure (unspecified)
- restless legs syndrome (RLS)
- restlessness
- rhabdomyolysis
- rhinitis
- seborrhea
- seizures
- serotonin syndrome
- SIADH
- sinus tachycardia
- sinusitis
- skin discoloration
- skin ulcer
- somnambulism
- Stevens-Johnson syndrome
- stomatitis
- stroke
- suicidal ideation
- syncope
- tardive dyskinesia
- teeth grinding (bruxism)
- thrombocytopenia
- tinnitus
- torsade de pointes
- toxic epidermal necrolysis
- urinary incontinence
- urinary retention
- vaginal bleeding
- vaginitis
- vertigo
- vomiting
- water intoxication
- weight gain
- weight loss
- withdrawal
- xerophthalmia
- xerostomia
Monitoring Parameters
- AIMS assessment
- blood glucose
- CBC
- glycosylated hemoglobin A1c (HbA1c)
- LFTs
- neurologic function
- ophthalmologic exam
- pregnancy testing
- serum creatinine
- serum electrolytes
- serum lipid profile
- serum prolactin
- thyroid function tests (TFTs)
- weight
Contraindications
- abrupt discontinuation
- agranulocytosis
- alcoholism
- ambient temperature increase
- anticholinergic medications
- bradycardia
- brain tumor
- breast cancer
- breast-feeding
- cardiac arrhythmias
- cardiac disease
- cataracts
- cerebrovascular disease
- children
- coadministration with other CNS depressants
- constipation
- coronary artery disease
- dehydration
- dementia
- diabetes mellitus
- driving or operating machinery
- dysphagia
- ethanol ingestion
- females
- geriatric
- heart failure
- hematological disease
- hepatic disease
- hypercholesterolemia
- hypertension
- hyperthermia
- hypertriglyceridemia
- hypocalcemia
- hypokalemia
- hypomagnesemia
- hypotension
- hypothermia
- hypothyroidism
- hypovolemia
- increased intraocular pressure
- infertility
- leukopenia
- long QT syndrome
- malnutrition
- myocardial infarction
- neonates
- neurological disease
- neutropenia
- obesity
- orthostatic hypotension
- Parkinson’s disease
- pregnancy
- pregnancy testing
- prostatic hypertrophy
- QT prolongation
- reproductive risk
- seizure disorder
- strenuous exercise
- stroke
- suicidal ideation
- tardive dyskinesia
- thyroid disease
- urinary retention
Interactions
- Abarelix
- Acarbose
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
- Acetaminophen; Codeine
- Acetaminophen; Dextromethorphan; Doxylamine
- Acetaminophen; Dichloralphenazone; Isometheptene
- Acetaminophen; Diphenhydramine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetaminophen; Pentazocine
- Acetaminophen; Propoxyphene
- Acetaminophen; Tramadol
- Acetazolamide
- Aclidinium; Formoterol
- Albiglutide
- Albuterol
- Albuterol; Ipratropium
- Aldesleukin, IL-2
- Alfentanil
- Alfuzosin
- Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
- Aliskiren; Hydrochlorothiazide, HCTZ
- Alogliptin
- Alogliptin; Metformin
- Alogliptin; Pioglitazone
- Alpha-glucosidase Inhibitors
- Alprazolam
- Amifampridine
- Amiloride; Hydrochlorothiazide, HCTZ
- Amiodarone
- Amitriptyline; Chlordiazepoxide
- Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
- Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
- Amobarbital
- Amoxapine
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Amprenavir
- Anagrelide
- Anticholinergics
- Apalutamide
- Apomorphine
- Aprepitant, Fosaprepitant
- Arformoterol
- Aripiprazole
- Arsenic Trioxide
- Artemether; Lumefantrine
- Asenapine
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Oxycodone
- Atazanavir
- Atazanavir; Cobicistat
- Atenolol; Chlorthalidone
- Atomoxetine
- Atropine
- Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Atropine; Difenoxin
- Atropine; Diphenoxylate
- Atropine; Edrophonium
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Azelastine; Fluticasone
- Azilsartan; Chlorthalidone
- Azithromycin
- Barbiturates
- Beclomethasone
- Bedaquiline
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Belladonna; Opium
- Benazepril; Hydrochlorothiazide, HCTZ
- Bendroflumethiazide; Nadolol
- Benzhydrocodone; Acetaminophen
- Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Benztropine
- Betamethasone
- Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
- Bismuth Subsalicylate; Metronidazole; Tetracycline
- Bisoprolol; Hydrochlorothiazide, HCTZ
- Boceprevir
- Bosentan
- Brexpiprazole
- Brigatinib
- Bromocriptine
- Brompheniramine
- Brompheniramine; Carbetapentane; Phenylephrine
- Brompheniramine; Dextromethorphan; Guaifenesin
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Brompheniramine; Pseudoephedrine
- Budesonide
- Budesonide; Formoterol
- Buprenorphine
- Buprenorphine; Naloxone
- Buspirone
- Butabarbital
- Butorphanol
- Cabergoline
- Canagliflozin
- Canagliflozin; Metformin
- Candesartan; Hydrochlorothiazide, HCTZ
- Cannabidiol
- Captopril; Hydrochlorothiazide, HCTZ
- Carbamazepine
- Carbetapentane; Chlorpheniramine
- Carbetapentane; Chlorpheniramine; Phenylephrine
- Carbetapentane; Diphenhydramine; Phenylephrine
- Carbetapentane; Guaifenesin
- Carbetapentane; Guaifenesin; Phenylephrine
- Carbetapentane; Phenylephrine
- Carbetapentane; Phenylephrine; Pyrilamine
- Carbetapentane; Pseudoephedrine
- Carbetapentane; Pyrilamine
- Carbidopa; Levodopa
- Carbidopa; Levodopa; Entacapone
- Carbinoxamine
- Carbinoxamine; Dextromethorphan; Pseudoephedrine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Carbinoxamine; Phenylephrine
- Carbinoxamine; Pseudoephedrine
- Cariprazine
- Cenobamate
- Ceritinib
- Cetirizine
- Cetirizine; Pseudoephedrine
- Cetrorelix
- Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
- Chloramphenicol
- Chlorcyclizine
- Chlordiazepoxide
- Chlordiazepoxide; Clidinium
- Chloroquine
- Chlorothiazide
- Chlorpheniramine
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dextromethorphan
- Chlorpheniramine; Dextromethorphan; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Phenylephrine
- Chlorpheniramine; Pseudoephedrine
- Chlorpromazine
- Chlorthalidone
- Chlorthalidone; Clonidine
- Chlorzoxazone
- Ciclesonide
- Cimetidine
- Ciprofloxacin
- Cisapride
- Citalopram
- Clarithromycin
- Clemastine
- Clobazam
- Clofazimine
- Clonazepam
- Clonidine
- Clozapine
- Cobicistat
- Codeine
- Codeine; Guaifenesin
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- COMT inhibitors
- Conivaptan
- Corticosteroids
- Corticotropin, ACTH
- Cortisone
- Crizotinib
- Cyproheptadine
- Dabrafenib
- Dantrolene
- Dapagliflozin
- Dapagliflozin; Metformin
- Dapagliflozin; Saxagliptin
- Darifenacin
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Dasatinib
- Deflazacort
- Degarelix
- Delavirdine
- Desflurane
- Deutetrabenazine
- Dexamethasone
- Dexchlorpheniramine
- Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
- Dexmethylphenidate
- Dextromethorphan; Diphenhydramine; Phenylephrine
- Dextromethorphan; Promethazine
- Dextromethorphan; Quinidine
- Diazepam
- Dicyclomine
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Diltiazem
- Dimenhydrinate
- Dipeptidyl Peptidase-4 Inhibitors
- Diphenhydramine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Diphenhydramine; Phenylephrine
- Disopyramide
- Dofetilide
- Dolasetron
- Dolutegravir; Rilpivirine
- Donepezil
- Donepezil; Memantine
- Dopamine
- Doxylamine
- Doxylamine; Pyridoxine
- Dronabinol
- Dronedarone
- Droperidol
- Dulaglutide
- Duloxetine
- Duvelisib
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elbasvir; Grazoprevir
- Elexacaftor; tezacaftor; ivacaftor
- Eliglustat
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Empagliflozin
- Empagliflozin; Linagliptin
- Empagliflozin; Linagliptin; Metformin
- Empagliflozin; Metformin
- Emtricitabine; Rilpivirine; Tenofovir alafenamide
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Enalapril; Hydrochlorothiazide, HCTZ
- Encorafenib
- Enflurane
- Entacapone
- Entrectinib
- Enzalutamide
- Eprosartan; Hydrochlorothiazide, HCTZ
- Eribulin
- Ertugliflozin
- Ertugliflozin; Metformin
- Ertugliflozin; Sitagliptin
- Erythromycin
- Erythromycin; Sulfisoxazole
- Escitalopram
- Esketamine
- Eslicarbazepine
- Estazolam
- Eszopiclone
- Ethanol
- Exenatide
- Ezogabine
- Fentanyl
- Fesoterodine
- Fingolimod
- Flavoxate
- Flecainide
- Fluconazole
- Fludrocortisone
- Flunisolide
- Fluoxetine
- Fluoxetine; Olanzapine
- Fluphenazine
- Flurazepam
- Fluticasone
- Fluticasone; Salmeterol
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Fluvoxamine
- food
- Formoterol
- Formoterol; Mometasone
- Fosamprenavir
- Foscarnet
- Fosinopril; Hydrochlorothiazide, HCTZ
- Fosphenytoin
- Gabapentin
- Ganirelix
- Gemifloxacin
- Gemtuzumab Ozogamicin
- Gilteritinib
- Glasdegib
- Glimepiride; Pioglitazone
- Glimepiride; Rosiglitazone
- Glipizide; Metformin
- Glyburide; Metformin
- Glycopyrrolate
- Glycopyrrolate; Formoterol
- Goserelin
- Granisetron
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Halofantrine
- Halogenated Anesthetics
- Haloperidol
- Halothane
- Histrelin
- Homatropine; Hydrocodone
- Hydralazine; Hydrochlorothiazide, HCTZ
- Hydrochlorothiazide, HCTZ
- Hydrochlorothiazide, HCTZ; Irbesartan
- Hydrochlorothiazide, HCTZ; Lisinopril
- Hydrochlorothiazide, HCTZ; Losartan
- Hydrochlorothiazide, HCTZ; Methyldopa
- Hydrochlorothiazide, HCTZ; Metoprolol
- Hydrochlorothiazide, HCTZ; Moexipril
- Hydrochlorothiazide, HCTZ; Olmesartan
- Hydrochlorothiazide, HCTZ; Propranolol
- Hydrochlorothiazide, HCTZ; Quinapril
- Hydrochlorothiazide, HCTZ; Spironolactone
- Hydrochlorothiazide, HCTZ; Telmisartan
- Hydrochlorothiazide, HCTZ; Triamterene
- Hydrochlorothiazide, HCTZ; Valsartan
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydrocortisone
- Hydromorphone
- Hydroxychloroquine
- Hydroxyzine
- Hyoscyamine
- Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
- Ibuprofen; Oxycodone
- Ibutilide
- Idelalisib
- Iloperidone
- Imatinib
- Incretin Mimetics
- Indacaterol
- Indacaterol; Glycopyrrolate
- Indinavir
- Inotuzumab Ozogamicin
- Insulin Degludec; Liraglutide
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- Isavuconazonium
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- Isosulfan Blue
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- Ketoconazole
- Lapatinib
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- Lenvatinib
- Lesinurad
- Lesinurad; Allopurinol
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- Leuprolide
- Leuprolide; Norethindrone
- Levalbuterol
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- Linagliptin
- Linagliptin; Metformin
- Liraglutide
- Lithium
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- Lofexidine
- Long-acting beta-agonists
- Loop diuretics
- Loperamide
- Loperamide; Simethicone
- Lopinavir; Ritonavir
- Lorazepam
- Lovastatin
- Lovastatin; Niacin
- Loxapine
- Lumacaftor; Ivacaftor
- Lumacaftor; Ivacaftor
- Lumateperone
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- Meglitinides
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- Meperidine; Promethazine
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- Metformin
- Metformin; Pioglitazone
- Metformin; Repaglinide
- Metformin; Rosiglitazone
- Metformin; Saxagliptin
- Metformin; Sitagliptin
- Methadone
- Methazolamide
- Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
- Methohexital
- Methscopolamine
- Methyclothiazide
- Methylphenidate
- Methylprednisolone
- Metoclopramide
- Metolazone
- Metronidazole
- Midazolam
- Midostaurin
- Mifepristone
- Miglitol
- Mirtazapine
- Mitotane
- Molindone
- Mometasone
- Monoamine oxidase inhibitors
- Morphine
- Morphine; Naltrexone
- Moxifloxacin
- Nabilone
- Nafarelin
- Nalbuphine
- Nateglinide
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- Nelfinavir
- Nilotinib
- Non-Ionic Contrast Media
- Norfloxacin
- Octreotide
- Ofloxacin
- Olanzapine
- Olodaterol
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- Omeprazole; Amoxicillin; Rifabutin
- Ondansetron
- Oritavancin
- Osilodrostat
- Osimertinib
- Oxaliplatin
- Oxazepam
- Oxybutynin
- Oxycodone
- Oxymorphone
- Ozanimod
- Paliperidone
- Panobinostat
- Paroxetine
- Pasireotide
- Pazopanib
- Pentamidine
- Pentazocine
- Pentazocine; Naloxone
- Pentobarbital
- Perampanel
- Pergolide
- Perphenazine
- Perphenazine; Amitriptyline
- Phenelzine
- Phenobarbital
- Phenylephrine; Promethazine
- Phenytoin
- Pimavanserin
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- Pioglitazone
- Pirbuterol
- Pitolisant
- Posaconazole
- Pramipexole
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- Propoxyphene
- Quazepam
- Quinidine
- Quinine
- Ranolazine
- Rasagiline
- Remifentanil
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- Ribociclib
- Ribociclib; Letrozole
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- Rifampin
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- Salmeterol
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- Saxagliptin
- Scopolamine
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- Semaglutide
- Sertraline
- Sevoflurane
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- Sibutramine
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- Sitagliptin
- Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
- Solifenacin
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- Thiazide diuretics
- Thiethylperazine
- Thiopental
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- Tiotropium; Olodaterol
- Tipranavir
- Tolcapone
- Tolterodine
- Toremifene
- Tramadol
- Trandolapril; Verapamil
- Tranylcypromine
- Trazodone
- Triamcinolone
- Triazolam
- Tricyclic antidepressants
- Trifluoperazine
- Trihexyphenidyl
- Triprolidine
- Triptorelin
- Trospium
- Tucatinib
- Umeclidinium; Vilanterol
- Valproic Acid, Divalproex Sodium
- Vandetanib
- Vardenafil
- Vemurafenib
- Venlafaxine
- Verapamil
- Voriconazole
- Vorinostat
- Zafirlukast
- Zaleplon
- Ziconotide
- Ziprasidone
- Zolpidem
- Zonisamide
