Quetiapine
Adverse effects
Sources for incidence lists: Very common (>10% incidence) adverse effects Dry mouth Dizziness Headache 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) Common (1–10% incidence) adverse effects High blood pressure Orthostatic hypotension High pulse rate High blood cholesterol Elevated serum triglycerides Abdominal pain Constipation Increased appetite Vomiting Increased liver enzymes Backache Asthenia Insomnia Lethargy Tremor Agitation Nasal congestion Pharyngitis Fatigue Pain Dyspepsia (Indigestion) Peripheral oedema Dysphagia Extrapyramidal disease: quetiapine and clozapine are noted for their relative lack of extrapyramidal side effects 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. As with many other atypical antipsychotics, this action is likely due to its actions at the H1 histamine receptor and 5-HT2C receptor. Rare (<1% incidence) adverse effects Prolonged QT interval (had an odds ratio for prolonging the QT interval over placebo of 0.17) Sudden cardiac death Syncope Diabetic ketoacidosis 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 is 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 Both typical and atypical antipsychotics can cause tardive dyskinesia. According to one study, rates are lower with the atypicals at 3.9% as opposed to the typicals at 5.5%. Although quetiapine and clozapine are atypical antipsychotics, switching to these atypicals is an option to minimize symptoms of tardive dyskinesia caused by other atypicals.
Quetiapine-17