quetiapine - wikipedia, the free encyclopedia

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6/16/2014 Quetiapine - Wikipedia, the free encyclopedia

http://en.wikipedia.org/wiki/Seroquel

Quetiapine

Systematic (IUPAC) name

2-(2-(4-dibenzo[b,f][1,4]thiazepine- 11-yl- 1-

piperazinyl)ethoxy)ethanol

Clinical data

Trade names Seroquel

AHFS/Drugs.com monograph

MedlinePlus a698019

Licence data US FDA:link

Pregnancy cat. B3 (AU)C (US)

Legal status Prescription Only (S4) (AU)

POM (UK)-only (US)

Routes Oral

Pharmacokinetic data

Bioavailability

QuetiapineFrom Wikipedia,the free encyclopedia (Redirected from Seroquel)

Quetiapine(/kwta.pin/ kwi-TY--peen) (branded asSeroquel,Xeroquel, Ketipinor) is a short-acting atypicalantipsychotic approved for the treatment of schizophrenia,

bipolar disorder, and along with an antidepressant to treatmajor depressive disorder.

Annual sales areapproximately $5.7 billion worldwide, with

$2.9 billion in the United States.[6]The U.S. patent,[7]whichwas set to expire in 2011, received a pediatric exclusivityextension whichpushed its expiration to March 26,

2012.[6][8]The patent has already expired in Canada.Quetiapine was developed by AstraZeneca from 1992-1996

as an improvement from first generation antipsychotics. Itwas first approved by the FDA in 1997. There are nowseveral generic versions of quetiapine, such as Quepin,

Syquel and Ketipinor.[9]

Contents

1 Medical uses

1.1 Schizophrenia1.2 Bipolar disorder

1.3 Major depressive disorder

1.4 Alzheimer's disease

1.5Other

2 Adverse effects

2.1 Discontinuation

2.2 Overdosage

2.3 Pregnancy and lactation

3 Pharmacology

4 Synthesis

5 Dosage

5.1 Sustained-release

6 Society and culture

6.1 Regulatory status
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http://en.wikipedia.org/wiki/Seroquel 2

100%[1]

Protein binding 83%[2]

Metabolism Hepatic via CYP3A4-catalysed

sulfoxidation to its active

metabolite norquetiapine (N-

desalkylquetiapine) [3]

Half-life 7 hours (parent compound); 9-

12 hours (active metabolite,

norquetiapine)[2][4]

Excretion Renal (73%), faeces

(20%)[1][2][4][5]

Identifiers

CAS number 111974-69-7

ATC code N05AH04

PubChem CID 5002

IUPHAR ligand 50

DrugBank DB01224

ChemSpider 4827

UNII BGL0JSY5SI

KEGG D08456

ChEBI CHEBI:8707

ChEMBL CHEMBL716

Chemical data

Formula C21H25N3O2S

Mol. mass 383.5099 g/mol

Physical data

Solubility in

water

3.29 mg/mL (20 C)

(what is this?) (verify)

6.2 Lawsuits

6.3 Controversy

6.4 Recreational use

6.5 Nurofen Plus tampering case

7 References

8 External links

Medical uses

Quetiapine fumarate is primarily used to treat schizophrenia

or bipolar disorder.[10]

Schizophrenia

There is tentative evidence of the benefit of quetiapine versusplacebo in schizophrenia; however, definitive conclusions arenot possible due to the high rate of attrition in trials (greaterthan 50%) and the lack of data on economic outcomes,

social functioning, or quality of life.[11]

It is debatable whether, as a class, typical or atypical

antipsychotics are more effective.[12]Both have equal drop-out and symptom relapse rates when typicals are used at low

to moderate dosages.[13]

While quetiapine has lower rates ofextrapyramidal side effects, there is greater sleepiness and

rates of dry mouth.[11]

Bipolar disorder

In those with bipolar disorder, quetiapine is used to treatdepressive episodes, acute manic episodes associated with

bipolar I disorder (as either monotherapy or adjunct therapyto lithium, valproate or lamotrigine), and maintenance

treatment of bipolar I disorder (as adjunct therapy to lithiumor divalproex).[14][15]

Major depressive disorder

Quetiapine is effective when used by itself[16]and when used

along with other medications in major depressive disorder (MDD).[16][17]However, sedation is often an

undesirable side effect.[16]

SMILES

InChI
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Quetiapine (Seroquel) 25 mg tablets,next to US one-cent coin forcomparison.

Seroquel XR 150 mg tablet box

In the US,[4]the UK[18]and Australia (in this indication it isn't covered by the Pharmaceutical Benefits Scheme),

quetiapine is licensed for use as an adjunct in the treatment of MDD. [19]

Alzheimer's disease

Quetiapine does not decrease agitation among people with Alzheimer's,whose usage of the drug once constituted 29% of sales. Quetiapine

worsens intellectual functioning in the elderly with dementia and thereforeis not recommended.[20]

Other

The use of low doses of quetiapine for insomnia, while common, is notrecommended; there is little evidence of benefit and concerns regarding

adverse effects.[21][22]

It is sometimes used off-label, often as an augmentation agent, to treatconditions such as Tourette syndrome,[23]musical hallucinations[24]and

anxiety disorders.[25]

Quetiapine and clozapine are the most widely used medications for thetreatment of Parkinson's disease psychosis due to their very lowextrapyramidal side effect liability. Owing to the risks associated withclozapine (e.g. agranulocytosis, diabetes mellitus, etc.), clinicians oftenattempt treatment with quetiapine first, although the evidence to supportquetiapine's use for this indication is significantly weaker than that of

clozapine.[26][27]

Adverse effects

Sources for incidence lists:[1][4][18][19][27][28]

Very common (>10% incidence) adverse effects

Dry mouth

DizzinessHeadache

Somnolence (drowsiness; of 15 antipsychotics quetiapine causes the 5th most sedation. Extended release

(XR) formulations tend to produce less sedation, dose-by-dose than the immediate release formulations) [29

Common (1-10% incidence) adverse effects

High blood pressure
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Extrapyramidal disease quetiapine and clozapine are noted for their relative lack of extrapyramidal side

effects[18][27][29]

Weight gain SMD 0.43 kg when compared to placebo. Produces roughly as much weight gain as

risperidone, less weight gain than clozapine, olanzapine and zotepine and more weight gain than

ziprasidone,lurasidone, aripiprazole and asenapine.[29]As with many other atypical antipsychotics this actio

is likely due to its actions at the H1histamine receptor and 5-HT2C receptor.[3]

Rare (


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Restless legs syndrome

Hyponatraemia, low blood sodium.

Jaundice, yellowing of the eyes, skin and mucous membranes due to an impaired ability of the body to clear

bilirubin, a by product of haem breakdown.

Pancreatitis, pancreas swelling.

Agranulocytosis, a potentially fatal drop in white blood cell count.

Leukopenia, a drop in white blood cell count, not as severe as agranulocytosis.

Neutropenia, a drop in neutrophils, the cell of the immune cells that defends the body against bacterial

infections.

Eosinophilia

Anaphylaxis, a potentially fatal allergic reaction.

Seizure

Hypothyroidism, underactive thyroid gland.

Myocarditis, swelling of the myocardium.Cardiomyopathy

Hepatitis, swelling of the liver.

Suicidal ideation

Priapism. A prolonged and painful erection.

Stevens-Johnson syndrome. A potentially fatal skin reaction.

Neuroleptic malignant syndrome a rare and potentially fatal complication of antipsychotic drug treatment. It

characterised by the following symptoms: tremor, rigidity, hyperthermia, tachycardia, mental status changes(e.g. confusion), etc.

Tardive Dyskinesia. A rare and often irreversible neurological condition characterised by involuntary

movements of the face, tongue, lips and rest of the body. Most commonly occurs after prolonged treatment

with antipsychotics. It is believed to be particularly uncommon with atypical antipsychotics, especially

quetiapine and clozapine[19][30]

There is an emerging controversy regarding quetiapine fatalities. The deaths of at least six U.S. military veterans

who were given drug cocktails including quetiapine[31]have been attributed to its inclusion by military doctors to

treat PTSD. Approximately 10,000[32]lawsuits[33][34][35][36][37]against AstraZeneca for problems ranging fromslurred speech and chronic insomnia to death have been filed by individuals from civilian populations.

It is marketed as one of the most sedating of all anti-psychotics, although those claims are contested. [38]Beginningusers may feel extremely tired and 'out of it' for the first few days, and sometimes longer. Quetiapine's newestindication, for bipolar depression, usually specifically calls for the entire dose to be taken before bedtime due to itssedative effects. The sedative effects may disappear after some time on the drug, or with a change of dosage, andwith possibly different, non-sedative side-effects emerging.
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Both typical and atypical antipsychotics can cause tardive dyskinesia.[39]According to one study, rates are lower

with the atypicals at 3.9% as opposed to the typicals at 5.5%. [39]Although Quetiapine and Clozapine are atypicalantipsychotics, switching to these atypicals is an option to minimize symptoms of tardive dyskinesia caused by othe

atypicals.[40]

Weight gain can be a problem for some, with quetiapine causing more weight gain than fluphenazine, haloperidol,loxapine, molindone, olanzapine, pimozide, risperidone, thioridazine, thiothixene, trifluoperazine, and ziprasidone,

but less than chlorpromazine, clozapine, perphenazine, and sertindole.[41]

Studies conducted on beagles have resulted in the formation of cataracts. While there are reports of cataractsoccurring in humans, controlled studies including thousands of patients have not demonstrated a clear causal

association between quetiapine therapy and this side-effect. However, the Seroquel website[42]still recommendsusers have eye examinations every six months.

As with some other anti-psychotics, quetiapine may lower the seizure threshold,[43]and should be taken withcaution in combination with drugs such as bupropion.

A recent comparative study of anti-psychotics drugs has found that quetiapine mono treatment was associated witincreased risk of death relative to the other analyzed treatments (but still better than no anti-psychotics drug

treatment at all).[44]

Discontinuation

Quetiapine should be discontinued gradually, with careful consideration from the prescribing doctor, to avoidwithdrawal symptoms or relapse.

The British National Formulary recommends a gradual withdrawal when discontinuing anti-psychotic treatment to

avoid acute withdrawal syndrome or rapid relapse.[45]Due to compensatory changes at dopamine, serotonin,adrenergic and histamine receptor sites in the central nervous system, withdrawal symptoms can occur duringabrupt or over-rapid reduction in dosage. However, despite increasing demand for safe and effective antipsychoticwithdrawal protocols or dose-reduction schedules, no specific guidelines with proven safety and efficacy arecurrently available.

Withdrawal symptoms reported to occur after discontinuation of antipsychotics include nausea, emesis,lightheadedness, diaphoresis, dyskinesia, orthostatic hypotension, tachycardia, insomnia, nervousness, dizziness,

headache, excessive non-stop crying, and anxiety.[46][47]According to Eli Lilly internal documents, discontinuation

of atypical neuroleptics similar to seroquel can also cause psoriasis, gingivitis and other inflammatory conditions,dyspepsia, headache, high blood sugar and other health conditions unrelated to psychiatric condition.[1](http://nonpsychiatry.files.wordpress.com/2012/12/7-zy397116.pdf)[2](http://nonpsychiatry.files.wordpress.com/2012/12/8-zy621218.pdf) Some have argued that additional somatic an

psychiatric symptoms associated with dopaminergic super-sensitivity, including dyskinesia and acute psychosis, ar

common features of withdrawal in individuals treated with neuroleptics.[48][49][50][51]This has led some to suggestthat the withdrawal process might itself be psychosis-mimetic, producing psychotic-like symptoms even in

previously healthy patients, indicating a possible pharmacological origin of mental illness in a yet unknownpercentage of patients currently and previously treated with antipsychotics. This question is unresolved, and remain

a highly controversial issue among professionals in the medical and mental health communities, as well the public. [5
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Overdosage

Most instances of acute overdosage result only in sedation, hypotension and tachycardia, but cardiac arrythmia,coma and death have occurred in adults. Serum or plasma quetiapine concentrations are usually in the 110 mg/Lrange in overdose survivors, while postmortem blood levels of 1025 mg/L are generally observed in fatal

cases.[53]

Pregnancy and lactation

Placental exposure is least for quetiapine compared to other atypical antipsychotics.[27]The evidence is insufficiento rule out any risk to the foetus but available data suggests it is unlikely to result in any major foetal

malformations.[2][5][28]It is secreted in breast milk and hence quetiapine-treated mothers are advised not to

breastfeed.[2][5][28]

Pharmacology

Quetiapine has the following pharmacological actions:[58][59][60][61]

D1(IC50= 1268nM), D2(IC50= 329nM), D3, and D4receptor antagonist

5-HT1A(IC50= 717nM) partial agonist, 5-HT2A(IC50= 148nM), 5-HT2C, and 5-HT7receptor antagoni

1-adrenergic (IC50= 94nM) and 2-adrenergic receptor (IC50= 271nM) antagonist

H1receptor (IC50= 30nM) antagonist

mACh receptor (IC50= >5000nM) antagonist

This means Quetiapine is a dopamine, serotonin, and adrenergic antagonist, and a potent antihistamine with clinicalnegligible anticholinergic properties. Quetiapine binds strongly to serotonin receptors; the drug acts as partial

agonist at 5-HT1Areceptors.[62]Serial PET scans evaluating the D2receptor occupancy of quetiapine have

demonstrated that quetiapine very rapidly disassociates from the D2receptor.[63]Theoretically, this allows for

normal physiological surges of dopamine to elicit normal effects in areas such as the nigrostriatal andtuberoinfundibular pathways, thus minimizing the risk of side-effects such as pseudo-parkinsonism as well as

elevations in prolactin.[64]Some of the antagonized receptors (serotonin, norepinephrine) are actually autoreceptorwhose blockade tends to increase the release of neurotransmitters.
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Comparison of affinities (Ki, nM)[54][55][56][57]

Receptor Quetiapine (Cloned human receptors) Norquetiapine (Cloned human receptors

D1 994.5 99.8 (Rat receptor)

D2 379 196

D3 340 -

D4 2019 -

5-HT1A 394.2 45

5-HT2A 118 48

5-HT2C 1843 107

5-HT6 948.75 -

5-HT7 307 76

1A 22 144

1B 14.6 46.4 (Rat receptor)

2A 3630 237

2C 28.85 -

H1 6.9 3.5

H2 41.24 -

M1 489 38.3 (Rat receptor)M3 1631.5 -

NET >10000 12

Norquetiapine's 3D molecularstructure in ball and stick format
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Norquetiapine's 2D molecularstructure

Synthesis

The synthesis of quetiapine begins with a dibenzothiazepinone. Thelactam is first treated with phosphoryl chloride to produce adibenzothiazepine. A nucleophilic substitution is used to introduce the

sidechain.[65]

osage

At very low doses, quetiapine acts primarily as a histamine receptor blocker (antihistamine) and 1-adrenergic

blocker. When the dose is increased, quetiapine activates the adrenergic system and binds strongly to serotoninreceptors and autoreceptors. At high doses, quetiapine starts blocking significant amounts of dopamine

receptors.[66][67]Use of low-dose quetiapine is not recommended except temporarily during drug titration period

(less than 30 days).[68]

Due to compensatory changes at dopamine, serotonin, adrenergic and histamine receptor sites in the centralnervous system, a gradual reduction in dosage is recommended to minimise or avoid withdrawal symptoms.Withdrawal symptoms reported to occur after discontinuation of quetiapine include insomnia, nausea, emesis,lightheadedness, diaphoresis, orthostatic hypotension, tachycardia, as well as nervousness, dizziness, headache, ananxiety. The present evidence suggests that these symptoms affect a small number of susceptible individuals treated

with quetiapine.[46]

The British National Formulary recommends a gradual withdrawal when discontinuing antipsychotic treatment to

avoid acute withdrawal syndrome or rapid relapse.[45]

Sustained-release
http://en.wikipedia.org/wiki/British_National_Formularyhttp://en.wikipedia.org/wiki/Anxietyhttp://en.wikipedia.org/wiki/Headachehttp://en.wikipedia.org/wiki/Dizzinesshttp://en.wikipedia.org/wiki/Anxietyhttp://en.wikipedia.org/wiki/Tachycardiahttp://en.wikipedia.org/wiki/Orthostatic_hypotensionhttp://en.wikipedia.org/wiki/Diaphoresishttp://en.wikipedia.org/wiki/Lightheadednesshttp://en.wikipedia.org/wiki/Emesishttp://en.wikipedia.org/wiki/Nauseahttp://en.wikipedia.org/wiki/Insomniahttp://en.wikipedia.org/wiki/Autoreceptorhttp://en.wikipedia.org/wiki/Alpha-1_adrenergic_receptorhttp://en.wikipedia.org/wiki/File:Quetiapine_syn.pnghttp://en.wikipedia.org/wiki/Nucleophilic_substitutionhttp://en.wikipedia.org/wiki/Dibenzothiazepinehttp://en.wikipedia.org/wiki/Phosphoryl_chloridehttp://en.wikipedia.org/wiki/Lactamhttp://en.wikipedia.org/wiki/File:Norquetiapine2DACS.svg


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AstraZeneca submitted a new drug application for a sustained-release version of quetiapine in the United States,

Canada, and the European Union in the second half of 2006 for treatment of schizophrenia. [69][70]AstraZeneca wretain the exclusive right to market sustained-release quetiapine until 2017. The sustained-release quetiapine ismarketed mainly as Seroquel XR. Other marketing names are Seroquel Prolong, Seroquel Depot and Seroquel X

On May 18, 2007, AstraZeneca announced that the U.S. FDA approved Seroquel XR for acute treatment of

schizophrenia.[71]During its 2007 Q2 earnings conference, AstraZeneca announced plans to launch Seroquel XR

the U.S. during August 2007.[72]However, Seroquel XR has become available in U.S. pharmacies only after theFDA approved Seroquel XR for use as maintenance treatment for schizophrenia, in addition to acute treatment of

the illness, on November 16, 2007.[73]The company has not provided a reason for the delay of Seroquel XR'slaunch.

Health Canada approved sale of Seroquel XR on September 27, 2007.[74]

The FDA approved Seroquel XR for the treatment of bipolar depression and bipolar mania in early October 200According to AstraZeneca, Seroquel XR is "the first medication approved by the FDA for the once-daily acutetreatment of both depressive and manic episodes associated with bipolar."

On July 31, 2008, Handa Pharmaceuticals, based in Fremont, California, announced that its abbreviated new drugapplication (ANDA) for quetiapine fumarate extended-release tablets, the generic version of AstraZenecasSEROQUEL XR, has been accepted by the FDA.

On December 1, 2008, Biovail announced that the FDA had accepted the company's ANDA to market its own

version of sustained-release quetiapine.[75]Biovail's sustained-release tablets will compete with AstraZeneca'sSeroquel XR.

On December 24, 2008, AstraZeneca notified shareholders that the FDA had asked for additional information on

the company's application to expand the use of sustained-release quetiapine for treatment of depression.[76]

Society and culture

Regulatory status

In the United States, the Food and Drug Administration (FDA) has approved quetiapine for the treatment ofschizophrenia and of acute manic episodes associated with bipolar disorder (bipolar mania) and for treatment of

bipolar depression.[77]In 2009, quetiapine XR was approved as adjunctive treatment of major depressive

disorder.[78]

Quetiapine received its initial indication from U.S. FDA for treatment of schizophrenia in 1997.[79]In 2004, it

received its second indication for the treatment of mania-associated bipolar disorder.[80]In 2007 and 2008, studiewere conducted on quetiapines efficacy in treating generalized anxiety disorder and major depression. In April2009, the Psychopharmacologic Drugs Advisory Committee of the FDA held a public meeting to discuss whetherstudy results supported the FDA's approval for anxiety and depression, with risks of metabolic side-effects and of

tardive dyskinesia and sudden cardiac death.[81]
http://en.wikipedia.org/wiki/Bipolar_disorder#Depressive_episodeshttp://en.wikipedia.org/wiki/Bipolar_disorder#Manic_episodeshttp://en.wikipedia.org/wiki/Bipolar_disorderhttp://en.wikipedia.org/wiki/Maniahttp://en.wikipedia.org/wiki/Schizophreniahttp://en.wikipedia.org/wiki/Food_and_Drug_Administrationhttp://en.wikipedia.org/wiki/United_Stateshttp://en.wikipedia.org/wiki/Biovailhttp://en.wikipedia.org/wiki/Health_Canadahttp://en.wikipedia.org/wiki/European_Unionhttp://en.wikipedia.org/wiki/Canadahttp://en.wikipedia.org/wiki/United_States_of_Americahttp://en.wikipedia.org/wiki/Sustained-releasehttp://en.wikipedia.org/wiki/New_drug_application


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Lawsuits

In April 2010, AstraZeneca settled a longstanding U. S. Department of Justice investigation into its aggressive

marketing of Seroquel for such off-label uses with a $520-million fine.[77]According to the Department of Justice,"the company recruited doctors to serve as authors of articles that were ghostwritten by medical literaturecompanies and about studies the doctors in question did not conduct. AstraZeneca then used those studies and

articles as the basis for promotional messages about unapproved uses of Seroquel."[77]

Multiple lawsuits have been filed in relation to quetiapine's side-effects, in particular, diabetes.[82][83][84][85]In2009, documents unsealed in litigation against AstraZeneca indicated that Dr. Charles Schulz, Chair of theDepartment of Psychiatry at the University of Minnesota and a consultant for AstraZeneca, had misrepresented the

benefits of Seroquel in research presentations and press releases.[86]

Controversy

AstraZeneca has been sued by the U.S. government (resulting from a qui tamlawsuit filed by Stefan P.

Kruszewski) over the marketing of quetiapine. A $520-million settlement was reached on October 29, 2009.[87]

In 2004, a young man named Dan Markingson committed suicide in a controversial Seroquel clinical trial at the

University of Minnesota while under an involuntary commitment order.[88]A group of University of Minnesotabioethicists charged that the trial involved an alarming number of ethical violations, but the university declined to

investigate.[89]Quetiapine may have been a factor in the deaths of several US veterans who were taking large

doses as part of a cocktail of drugs for PTSD.[90]

In Australia, Professor Patrick McGorry, a key mental-health advisor, proposed a trial in Melbourne in 2011. Itspurpose was to investigate whether Seroquel would decrease or delay the risk that people aged between 15 and

40 with early signs of mental illness, might develop a later psychotic disorder. However in July 2011, psychiatrists,psychologists and researchers from Australia, New Zealand, Canada, Britain and the US lodged a complaint with

the ethics committee of Melbourne Health. They opposed the trial[91]as "unethical" and "dangerous".

Recreational use

Quetiapine is not classified as a controlled substance; "abusive self-administration seems to be driven byquetiapines sedative and anxiolytic effects (to help with sleep or to 'calm down') rather than by its antipsychotic

properties."[92]Reports of quetiapine abuse have emerged in medical literature. In addition to oral administration,

the drug is also taken intranasally by snorting pulverized tablets (insufflation). There have been reports ofintravenous abuse and intravenous co-administration with cocaine as well.[93]This is commonly referred to as a "Q

Ball".[93]A 2004 letter to the editor of the American Journal of Psychiatry provided an anecdotal estimate that upto 30% of inmates who were seen for psychiatric services in the Los Angeles County Jail were faking psychotic

symptoms in an attempt to obtain quetiapine.[94]Also known as "quell", "Snoozeberries", or "Susie-Q", the drugmay be more commonly abused in prisons due to its capacity to be regularly prescribed as a sedative and theunavailability in prison of more commonly abused substances. A letter to the editor that appeared in the January2007American Journal of Psychiatryhas proposed a need for additional studies to explore the addiction-

potential of quetiapine. The letter reports that its authors are physicians who work in the Ohio correctional system
http://en.wikipedia.org/wiki/Cocainehttp://en.wikipedia.org/wiki/Insufflation_(medicine)http://en.wikipedia.org/wiki/Anxiolytichttp://en.wikipedia.org/wiki/Patrick_McGorryhttp://en.wikipedia.org/wiki/PTSDhttp://en.wikipedia.org/wiki/Stefan_P._Kruszewskihttp://en.wikipedia.org/wiki/Qui_tamhttp://en.wikipedia.org/wiki/Diabeteshttp://en.wikipedia.org/wiki/Off-label_use


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They report that prisoners ... have threatened legal action and even suicide when presented with discontinuation oquetiapine and that they have not seen similar drug-seeking behavior with other second-generation antipsychoticof comparable efficacy. It has also been reported that when Seroquel is used with methadone, it causes the user t

experience abuzz, or opioid euphoria.[95]

Nurofen Plus tampering case

In August 2011, the UK's Medicines and Healthcare products Regulatory Agency (MHRA) issued a class-4 drugalert following reports that some batches of Nurofen plus contained Seroquel XL instead.[96]

Followingthe issue of the Class-4 Drug Alert, Reckitt Benckiser (UK) Ltd received further reports of rogue blistestrips in cartons of two additional batches of Nurofen Plus tablets. One of the new batches contained Seroquel XL50 mg tablets and one contained the Pfizer product Neurontin 100 mg capsules.

Followingdiscussions with the MHRA's Defective Medicines Report Centre (DMRC), Reckitt Benckiser (UK)Ltd decidedto recall all remaining unexpired stock of Nurofen Plus tablets in any pack size, leading to a Class-1

Drug Alert.[97]The contamination was later traced to in-store tampering by a customer. [98]

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Seroquel Adverse Events Reported to the FDA (http://www.drugcite.com?q=SEROQUEL)

Australian Public Assessment Report for Quetiapine (as fumarate)

(http://www.tga.gov.au/pdf/auspar/auspar-seroquel.pdf)

Retrieved from "http://en.wikipedia.org/w/index.php?title=Quetiapine&oldid=604978307"

Categories: Atypical antipsychotics Hypnotics Piperazines Sedatives Dibenzothiazepines Ethers

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