Quetiapine: Treatment for substance abuse and drug of abuse

Hanley, Michael; Kenna, George A.

doi:10.2146/ajhp070112

Cited by 41 publications

(32 citation statements)

References 50 publications

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“…[47] Both quetiapine and olanzapine have acquired a street price in the US. [47,48] Of note, quetiapine has picked up a collection of street names including Susie-Q, Baby Heroin, Quell and Q-Ball. [46,49,50] …”

Section: Abuse Of Aapsmentioning

confidence: 99%

Off-Label Use of Atypical Antipsychotics

McKean

Monasterio²

2012

CNS Drugs

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Licensed indications for medicines were designed to regulate the claims that can be made about a medicine by a pharmaceutical company. Off-label prescribing (i.e. prescribing a drug for an indication outside of that for which it is licensed) is legal and an integral part of medical practice. In psychiatry, off-label prescribing is common and gives clinicians scope to treat patients who are refractory to standard therapy or where there is no licensed medication for an indication. However, efficacy or safety of such off-label use may not be established. There is a growing list of licensed indications for atypical antipsychotics (AAP) beyond schizophrenia and bipolar affective disorder, and also more evidence for other indications where pharmaceutical companies have not obtained a license. Pharmaceutical companies have promoted AAPs for off-label indications to increase sales and consequently have been fined by the US FDA for this. Since the 1990s, AAP use has expanded considerably, for example, the off-label use of quetiapine alone accounted for an estimated 17% of the AAP spend in New Zealand in 2010. There are a number of potential problems with the expanded use of AAPs outside of schizophrenia and related psychoses. A larger population will be exposed to their adverse effects, which include weight gain, type 2 diabetes mellitus, sudden cardiac death and increased mortality rates in the elderly with dementia. There are also concerns with the abuse of these agents, in particular quetiapine. Given that an increasing percentage of the population is being treated with these agents, off-label prescribing of AAPs is a cause for concern; they have a propensity to cause significant side effects and their efficacy and long-term safety for most off-label indications remains largely unknown, and therefore the risks and benefits of their use should be carefully weighed up prior to prescribing these agents off-label.

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Section: Abuse Of Aapsmentioning

confidence: 99%

Off-Label Use of Atypical Antipsychotics

McKean

Monasterio²

2012

CNS Drugs

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“…Interestingly, patients initiated on olanzapine and quetiapine, both multi-receptor targeted antipsychotics 35 , were more likely to have a history of drug abuse (6.8% for lurasidone versus 13.9% for olanzapine and 13.6% for quetiapine) than patients initiated on lurasidone. Previous research has also reported that quetiapine was more likely to be used by patients with comorbid substance use 36 and anecdotal evidence suggests that quetiapine may be used off-label to treat substance abuse 37 . Finally, patients treated with lurasidone in this study had a lower prior risk of hospitalization, an important potential marker of a more debilitating condition 30 .…”

Section: Discussionmentioning

confidence: 98%

Hospitalization risk in bipolar disorder patients treated with lurasidone versus other atypical antipsychotics

Ng-Mak

Halpern

Rajagopalan

et al. 2018

Current Medical Research and Opinion

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“…Quetiapine is used to treat the symptoms of patients suffering from schizophrenia, bipolar disorder and major depressive disorder, under the trade name Seroquel ® (AstraZeneca) [5,6]. There is also evidence that quetiapine may benefit patients diagnosed with a mental illness who are also dependent on alcohol [7][8][9], cocaine [5,7,9], amphetamines [9,10], and for the reduction of opioid withdrawal symptoms [11]. Although, more rigorous studies are needed [10].…”

Section: Introductionmentioning

confidence: 99%

“…It is surprising that quetiapine appears to be the primary if not the only one antipsychotic drug which is misused for this purpose [14,29]. Curiously, the drug accused of misuse/abuse is used as a treatment for those who misuse and abuse various substances, such as opioids, cocaine, and amphetamines or alcohol [1,5,[7][8][9][10][11]. It is discussed whether quetiapine works by improving comorbid psychiatric conditions of drug addicts or by directly reducing craving [27,30].…”

Section: Introductionmentioning

confidence: 99%

A validated GC/MS method for the investigation of quetiapine-related deaths in Greece

Papoutsis¹,

Katselou²,

Nikolaou³

et al. 2017

Eur J Forensic Sci

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Objective: Quetiapine is an atypical antipsychotic drug that is used to treat the symptoms of schizophrenia and other psychiatric disorders. During the last years, quetiapine has also been associated with cases of misuse and abuse, and there are strong indications that it possesses an addictive potential. A suitable method is necessary for the toxicological investigation of such cases. Materials and Methods: A simple gas chromatographymass spectrometric method was developed, validated, and applied for the determination of quetiapine in biological fluids during the investigation of quetiapine-related cases. The sample preparation procedure includes solid-phase extraction and silylation using N-methyl-N-tert-butyldimethylsilyl-trifluoroacetamide with 1% tert-butyldimethylsilylchloride. Results: The limits of detection and quantification were 1.50 and 5.00 ng/mL, respectively. The calibration curves were linear up to 2000 ng/mL (R 2 ≥ 0.991) and absolute recovery higher than 81%. Accuracy (intra-and inter-day) was found to be between −11.1 and 12.4%, whereas the precision was found to be <13.3%. The validated method was successfully applied to post-mortem blood samples during the toxicological investigation of 50 quetiapine-related sudden and violent deaths. Quetiapine was determined at toxic levels (>1800 ng/mL) in eight cases and at lower concentrations (5.21-1430 ng/mL) in the other 42 cases. It is remarkable to be mentioned that in all 50 cases one or more drugs were detected along with quetiapine. Conclusions: Quetiapine has been detected with increasing frequency in post-mortem cases in Greece during the last 3 years. This is in accordance with the growing concerns worldwide about the misuse or abuse of the drug and its contribution to the cause of death of quetiapine-related lethal cases. Physicians should be alert about the toxicity of quetiapine, its possible misuse or abuse, and its synergy with other drugs, medicinal or not, especially in patients under multiple drug therapy or drug addicts.

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Quetiapine: Treatment for substance abuse and drug of abuse

Abstract: Quetiapine is a promising treatment for substance use disorders alone or combined with other psychiatric diagnoses, such as bipolar disorder and schizophrenia. Quetiapine abuse has also been documented, particularly in the correctional setting.

Cited by 41 publications

References 50 publications

Off-Label Use of Atypical Antipsychotics

Off-Label Use of Atypical Antipsychotics

Hospitalization risk in bipolar disorder patients treated with lurasidone versus other atypical antipsychotics

A validated GC/MS method for the investigation of quetiapine-related deaths in Greece

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