quetiapine (cont.)
NURSING MOTHERS: Quetiapine is excreted in the milk of animals during
lactation. Although it is not known if it is excreted in
human milk, it is
recommended that women taking quetiapine not breast feed.
SIDE EFFECTS: Frequent adverse effects include headache, agitation,
dizziness, drowsiness, weight gain and stomach upset. Quetiapine can cause
orthostatic hypotension (a drop in blood pressure upon standing that can lead to
dizziness or fainting) especially during the first 3-5 day period of treatment,
when it is restarted after temporary discontinuation, and after an increase in
the dose. The risk of orthostatic hypotension is about 1 in 100 (one of every
hundred patients who takes quetiapine). Quetiapine frequently causes tiredness
(1 in 5 patients), especially during the first 3-5 days of treatment. Because of
this tiredness, care should be exercised in any activity requiring mental
alertness such as operating a motor vehicle or hazardous machinery. Less common
side effects include seizures (1 in 125 patients) and
hypothyroidism (1 in 250
patients).
As with other antipsychotics, long-term use of quetiapine may lead to
irreversible tardive dyskinesia, a neurologic disease which consists of
involuntary movements of the jaw, lips, and tongue.
A potentially fatal complex referred to as neuroleptic malignant syndrome (NMS) has been reported with antipsychotic drugs. Patients who develop NMS may have high fevers, muscle rigidity, altered mental status, irregular pulse or blood pressure, rapid heart rate, excessive sweating, and heart arrhythmias.
In animals, quetiapine has been associated with the development of
cataracts, and cataracts have been reported in patients using quetiapine for prolonged periods. Although it is not clear if quetiapine is responsible for the cataracts seen in humans, eye examinations by slit-lamp (to identify cataracts before they impair vision) are recommended at the beginning of treatment and every six months during treatment. If cataracts form, treatment should be discontinued.
Quetiapine may increase blood concentrations of
cholesterol and triglycerides by 11% and 17%, respectively.
There is an increased risk of hyperglycemia (high blood glucose) and related events in patients taking atypical antipsychotics, including quetiapine. Patients should be tested during treatment for elevated blood-sugars. Additionally, persons with risk factors for
diabetes, including
obesity or a family history of diabetes, should have their fasting levels of blood sugar tested before starting treatment and periodically throughout treatment to detect the onset of diabetes. Any patient developing symptoms that suggest diabetes during treatment should be tested for diabetes.
Reference: FDA Prescribing Information
Last Editorial Review: 11/1/2006
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