The Misuse of Quetiapine
A lot of medication gets misused, as is the right expression, meaning not used for the intention or indication it was developed for in the first place. This reminded me of one of my first publications on the abuse of anticholinergics.
From case reports it appears that quetiapine is sought after for recreational use and inappropriate use such as intranasal and intravenous administration. Quetiapine is also for sale on the street, symptom malingering to obtain the drug and higher dosage requests. It’s always important to recognize such misuse of medication because in the case of quetiapine it can induce weight gain, glucose intolerance, in rare cases movement disorders. Moreover, these drugs are very expensive and will cost society more money when misused.
In a recent publication a case report and a review of previous case reports is discussed. The patients mostly seek the “dreamy”, calming, or soporific state with quetiapine. Most patients had a prior drug or alcohol problem and the misuse was often connected to a forensic setting.
Moreover, the authors present possible mechanism as explanation for it’s misuse. First it has an anticholinergic activity which has been described previously with other drugs as cause for misuse. Anticholinergic agents usually cause an euphoric and stimulatory state in patients which doesn’t match with the accounts of patients misusing quetiapine. The authors suggest that the antihistaminic property of questiapine is responsible for it’s misuse.
The misuse potential of quetiapine is likely related to its histaminic blockade coupled with its comparatively mild action at dopamine receptors. Accordingly, quetiapine substitutes for sedating agents and individuals with a history of alcohol, benzodiazepine, or opiate abuse are particularly at risk.
Fischer, B., & Boggs, D. (2010). The role of antihistaminic effects in the misuse of quetiapine: A case report and review of the literature Neuroscience & Biobehavioral Reviews, 34 (4), 555-558 DOI: 10.1016/j.neubiorev.2009.11.003
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Science Report » Blog Archive » The Misuse of Quetiapine
February 17, 2010 @ 5:48 pm
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Wednesday Round Up #103 « Neuroanthropology
February 17, 2010 @ 6:25 pm
[…] Shock, The Misuse of Quetiapine Sucking on antihistamines and singing the […]
February 17, 2010 @ 10:54 pm
A very interesting comment in the light of the constat that Quetiapine is rather massively promoted in treatment of bipolar disorder by the compagny Astra Zeneca. Also behaviour disturbances in dementia patients are a “silently” acknowledged target (although no official fiat is cleared for that indication and it has been said that neuroleptics are not always the best choice for that indication especially in frail elderly). I am bot daying this is a bad product, only the pharmacovigilance is and stays a necessity of life.
Dr. G. Otte
February 18, 2010 @ 8:42 am
I actually use quetiapine (800mg) and it does put you in a very calm/soporific state. What I don’t get, is why someone would misuse it?
Here’s my experience: I take it, then 2 hrs later I’m in a calm/soporific state…admittedly, that’s not such a bad state. I go to bed and sleep, sleep…sleep some more. I wake up 10 hrs later with a drug hangover that lasts for 2-3 hrs. I go about my day. I repeat the process.
I also take Vyvanse. I don’t feel anything when I take it. The only way I know I’ve taken is that my behavior changes (i.e. concentration, not drifting off, not yapping 24/7, etc). In other words, I actually get work done;)
Haha. Vyvanse is a controlled substance and Seroquel isn’t. But what’s funny is that Seroquel feels like it should be a controlled substance and Vyvanse doesn’t.
I’m feeling calm and soporific, so I’m going to bed.