Weight gain quetiapine

Quetiapine (Seroquel). Another atypical antipsychotic, quetiapine has also been approved by the FDA for the treatment of acute mania. It is usually administered twice daily at doses of 150-750mg/day. Like its counterparts, quetiapine is a well-tolerated medication. Its common side effects are drowsiness, dizziness, and headache. It causes less weight gain than olanzapine or clozapine but more than ziprasidone or aripiprazole. Quetiapine also does not cause agranulocytosis nor does it increase the risk of seizures. It can occasionally cause mild changes in liver function tests, but these usually return to normal even if the patient continues taking quetiapine. 

Atypical antipsychotics cause fewer EPS than do conventional antipsychotics. Clozapine and quetiapine are the least likely to cause EPS and are therefore recommended for treatment of psychosis in patients with Parkinson s disease. With the notable exception of risperidone, atypical antipsychotics cause substantially less hyperprolactinemia than do conventional antipsychotics. Weight gain is a side effect of all atypical antipsychotics except ziprasidone and aripiprazole. Concerns about cardiac conduction delay with ziprasidone therapy exist and warrant consideration in patients who have... 

Quetiapine Sedation, mild weight gain, orthostatic hypotension 100 50-100 mg/day increments 600... 

Dibenzothiazepine Quetiapine Similar to olanzapine perhaps less weight gain May require high doses if there is associated hypotension short ti/2 and twice-daily dosing... 

Risperidone (1) has high affinity for D2, 5-HT2c and tti receptors and a very high affinity for the 5-HT2a receptor. Risperidone is the most likely of the atypical antipsychotics to cause prolactin increases, but has a lower weight gain liability than olanzapine or quetiapine. Risperidone has a relatively narrow therapeutic window since doses above 6 mg/day cause EPS in a dose-dependent manner. 

Quetiapine (3) has the lowest affinity for the D2 and 5-HT2a receptors among the atypicals therefore, relatively high doses are required for maximal efficacy. Quetiapine causes significant weight gain, but less than that of olanzapine. Other side-effects include sedation, dizziness and hypotension. 

Bobes J, Rejas J, Garcfa-Garcla M, Rico-Villademoros F, Garcfa-Portilla MP, Fernandez I, Hernandez G, for the EIRE Study Group. Weight gain in patients with schizophrenia treated with risperidone, olanzapine, quetiapine or haloperidol results of the EIRE study. Schizophr Res 2003 62 77-88. 

Clozaril (Clozapine), for example, can cause agranulocytosis (a potentially lethal suppression of white blood cells by the bone marrow). Parkinsonian symptoms and weight gain occur with risperidone (Risperdal) and olanzapine (Zyprexa). In addition, quetiapine (Seroquel) has been associated with an increased incidence of cataracts. 

Clozapine, olanzapine, and quetiapine display significant affinity to histamine Hj receptors, and it is widely accepted that some side effects of these agents (e.g., weight gain liability, sedation) are attributed to their histamine antagonism... 

Data from short-term clinical trials (6 weeks) suggest that quetiapine may be useful for the management of psychotic disorders in patients who do not tolerate the adverse effects of the typical antipsychotic drugs or clozapine (3). The most common adverse effects of quetiapine were dizziness, hypotension, somnolence, and weight gain. Raised hepatic enzymes have also been reported. In addition, two patients with idiopathic Parkinson s disease and psychosis were treated with quetiapine for 52 weeks (4). Psychotic symptoms were successfully controlled without worsening of motor disability. 

Holzer L, Paiva G, Halfon O. Quetiapine-induced weight gain and escitalopram. Am J Psychiatry 2005 162 192-193. 

Clozapine and olanzapine are the most likely of the atypical agents to cause anticholinergic (anti-muscarinic) effects. They are more likely than other atypicals to cause weight gain (glucose tolerance may be impaired and should be monitored in susceptible individuals) and are second only to quetiapine in their sedative effects. Sexual dysfunction and skin problems are rare with atypical antipsychotics. Risperidone and amisulpride are as likely as classical antipsychotics to raise prolactin concentrations and cause galactorrhoea. 

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