Quetiapine

Quetiapine is the name of a drug that is used to treat mental illness. It belongs to the group of atypical neuroleptics.

What is quetiapine?

Quetiapine is an atypical neuroleptic. This group of active ingredients is primarily used for the therapy of bipolar disorders and schizophrenia. Quetiapine also has the advantage that it is a second-generation antipsychotic, which means that it has fewer undesirable side effects.

Quetiapine was developed in the 1990s by the international pharmaceutical company AstraZeneca. The first generation of typical neuroleptics was further developed. Quetiapine was approved in the USA in 1997. A short time later, the European countries followed. After the quetiapine patent expired in 2012, numerous generics were launched.

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In Germany, the atypical neuroleptic is on the market under the trade name Seroquel®. Since quetiapine is subject to a prescription, a prescription must be presented at the pharmacy.

Pharmacological effect

Dopamine is one of the most important messenger substances between the human brain and nerve cells. The release of the neurotransmitter causes downstream nerve cells to receive signals via receptors that serve as docking points.

This is the ability to remember things, to be happy, to be motivated, or to make purposeful movements. With an excess of dopamine, however, there is a risk of problems ranging from manic pleasure to schizophrenia to a loss of reality.

For the treatment of these dopamine-related psychological complaints, u. a. Quetiapine for use. The atypical neuroleptic binds dopamine receptors in the brain without activating them. In this way, a blockage takes place, which ensures a decrease in dopamine to normal levels.

A disadvantage of quetiapine, however, is that the active ingredient also occupies the receptors of adrenaline and noradrenaline. This in turn puts you at risk of side effects such as low blood pressure and drowsiness.

After its ingestion, the quetiapine is completely metabolized within the liver. The breakdown products of the drug also have antipsychotic effects. Around 50 percent of the neuroleptic has left the organism after about seven hours.75 percent of quetiapine is eliminated with the urine and 25 percent with the stool.

Medical application & use

Quetiapine is used to treat psychoses. These include in particular schizophrenia, bipolar disorders and manic diseases. The drug also has a soothing effect on states of agitation, anxiety disorders and depression. Quetiapine cannot completely counteract depressive or manic phases. However, the drug is considered useful to prevent relapses.

While higher doses of the neuroleptic are administered in the context of acute treatment, the dose is reduced in longer therapy. Quetiapine is usually taken in tablet form. The patients mostly take sustained-release tablets, which release the active ingredient in a delayed manner. This enables a stable blood level to be achieved.

The dosage of quetiapine depends on the respective area of ​​application. In all cases the treatment is started gradually. This means that the patient initially only receives smaller doses, which are then gradually increased as the therapy progresses until the desired effect is achieved. As part of maintenance therapy, the doctor reduces the amount of the active ingredient to the lowest sensible dose.

Quetiapine is taken once or twice a day, regardless of meals. It is important to adjust the dose individually to the patient.

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Risks & side effects

The use of quetiapine can be associated with undesirable side effects, but these do not occur in every patient. In most cases, side effects such as headache, drowsiness, drowsiness, weight gain, increased cholesterol levels, decreased HDL cholesterol, increased triglycerides, tachycardia (accelerated heartbeat), dry mouth, runny nose, constipation, nausea, vomiting, leukopenia (lack of white blood cells) and high blood sugar levels.

Occasionally, tics or convulsions, type 2 diabetes mellitus, seizures, rashes on the skin, itching, angioedema, or fainting occur. If the use of quetiapine leads to a malignant neuroleptic syndrome, the therapy must be discontinued immediately.

Quetiapine must not be used if the patient is hypersensitive to the active substance. Because the substance undergoes intensive restructuring in the liver, no other drugs may be taken that have the same metabolism. These drugs are u. a. to HIV-1 protease inhibitors, the antidepressant nefazodone, the antifungal agent ketoconazole and the antibiotics clarithromycin and erythromycin.

A careful risk-benefit assessment by the doctor is necessary in the case of impaired liver function, diabetes, seizures, low blood pressure, severe cardiovascular diseases and after a stroke. The dosage must be as low as possible. In addition, the functions of the organs and the blood count should be checked regularly.

Administration of quetiapine to older people who suffer from dementia-related psychosis does not make sense. They have an increased mortality rate during therapy.

Quetiapine should also be avoided during pregnancy and breastfeeding. Safe use in mother and child could not be proven. In addition, there is an increased risk for the unborn child due to side effects such as movement disorders in the last trimester of pregnancy.