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Quetiapine - D1 and D2 dopamine antagonist

Author: wikipedia, Posted on Tuesday, November 01 @ 05:59:35 IST by RxPG  

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Psychiatry

Quetiapine (kwe-TYE-a-peen) is one of the atypical antipsychotics. Quetiapine has FDA and international approvals for the treatment of schizophrenia and acute mania in bipolar disorder. It is used "off-label" to treat other disorders, such as post-traumatic stress disorder, obsessive compulsive disorder, anxiety disorders, and as a sedative for those with sleep disorders. The typical effective dose is between 300 and 600 mg daily given at bedtime or in divided doses during the day.

Chemistry

Quetiapine is 11-[4-[2-(2-hydroxyethoxy)ethyl]-1-piperazinyl]dibenzo[b,f][1,4]thiazepine, C21H25N3O2S. Dosages are based on millgrams of this base. The Seroquel formulation is as a fumarate salt with the chemical formula C42H50N6O4S2C4H4O4 and systematic name 2-[2-(4-dibenzo [b,f] [1,4]thiazepin-11-yl-1-piperazinyl)ethoxy]-ethanol fumarate (2:1) (salt).

How it works

Quetiapine is a dopamine, specifically D1 and D2 dopamine, inhibitor or antagonist. It also somewhat inhibits functioning of serotonin receptors, but in clinical tests it has been found that the human body is very adaptive to the serotonin blocking reaction, thus it can be used together with SSRI medication.

Side effects

The most common side effect is sedation. Seroquel will put the patient into a drowsy state, and will help the patient fall asleep. Even though official guidelines call for the quetiapine dosage to be divided throughout the day, many prescriptions call for the entire dose to be taken before bedtime because of its sedative effects. Other common side effects include: agitation, memory problems, and upset stomach.

Quetiapine is believed to be less likely to cause extrapyramidal side effects and tardive dyskinesia than typical antipsychotics. However, as with other antipsychotics, extrapyramidal side effects are a problem for some, and there is evidence implying that quetiapine may cause tardive dyskinesia. [1] [2] Weight gain, often as a result of increased hunger, is a problem for some patients using quetiapine, however this effect is reportedly minor in comparison to some of the other atypical antipsychotics such as risperidone. Like other atypical antipsychotics, there is some evidence suggesting a link to the development of diabetes, however this remains unclear and controversial.

Studies conducted on beagles have resulted in the formation of cataracts, however, there has been no report describing this effect within humans. However, amblyopia (commonly known as lazy eye) was found to occur in 2% of patients to whom it was prescribed.


Note: This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article Quetiapine.



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