quetiapine, Seroquel, Seroquel XR (cont.)
Omudhome Ogbru, PharmD
Omudhome Ogbru, PharmD
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Medical and Pharmacy Editor:
WARNING: 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 take 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.
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 was 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 diabetes-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.
Medically Reviewed by a Doctor on 12/12/2014
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