Quetiapine for Anxiety (An Update)
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It comes under the brand name of SEROquel or SEROquel XR.
It is known as an antipsychotic drug which works by restoring the natural chemical balance of the brain.
It decreases hallucination and enhances the concentration of individuals. It makes a person to have control on his never and be calm.
It also enables individuals to perform everyday life effectively and take more part in everyday life.
It enhances sleep, appetite or the general energy level of an individual.
It can help individuals deal with mood swings and can reduce mood swings.
In this article we will discuss Quetiapine for Anxiety
Uses of Quetiapine:
This is an antipsychotic drug which is helpful in treating adult people with schizophrenia or those children with the age of 13 or more.
There are numerous other benefits of using Quetiapine such as it is helpful in treating patients with bipolar disorder or manic depression in adults as well as in those children who are at the age of 10 or more.
Most adult patients who are suffering from any major depressive disorder are treated by using Quetiapine along with antidepressant drugs.
Mechanism of Quetiapine:
Quetiapine is labeled the category of drugs which is known as unconventional antipsychotics.
A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.
Quetiapine is antipsychotic drug functioning as antagonist for α1-adrenergic, 5-HT2A serotonergic, histaminergic receptors, muscarinic, minor affinity for dopamine D2 and 5-HT1A receptors, and a low affinity for 5-HT2C, α2-adrenergic and D1 receptors.
It blocks these receptors in the mesolimbic part of the brain.
It isn’t known exactly how this drug works.
However, it’s thought that it helps regulate the amount of certain chemicals (dopamine and serotonin) in your brain to control your condition.
Kapur in his study showed how Quetiapine changes the brain chemistry. Through PET, he showed that Quetiapine results in dissociation of D2 receptors.
Previous studies have shown that D2 receptor dissociation has an antipsychotic effect.
Usually 60 to 70% of D2 receptor dissociation shows antipsychotic effect but Quetiapine results in only 30% of D2 receptor dissociation.
This discrepancy has been explained by Kapur by his “Kiss and Run hypothesis” in which he suggests that Quetiapine has more rapid dissociation than others.
Administration:
Quetiapine is usually administered orally in the form of tablets.
It is available in two forms that is Quetiapine extended release or Quetiapine immediate release.
Both of them are available in different potencies such as 25mg, 50mg, 100mg, 200mg, 300mg, 400mg and 800mg.
Two other potencies of this medicine are 1200mg and 1600mg.
The latter two potencies are not FDA thus should be avoided.
The form and dosage of a drug depends on following:
- Age of the patient
- Condition of the patient being treated
- Severity of condition being treated
- Other medical conditions that patient suffers from
- Reaction of individual to first dose
Potential Risks:
Certain warnings are given by FDA for patients taking Quetiapine and they should be aware of these warning before they start the course medicine:
- It may result in suicidal ideations or actions.
- It can also result in narcoleptic malignant syndrome, symptoms may include, excessive sweating, excessive fever, rigidity in muscles, confusion, variations in heartbeats and blood pressure problems.
- It may also cause hyperglycemia which causes high blood sugar. Its symptoms can be, feelings and extreme thirst, severe hunger, frequent urination, tiredness weakness, stomachache and fruity-smelling breath.
- It can cause an increased level of cholesterol and triglycerides means it can produce high fat levels in blood resulting in gaining weight and tardive dyskinesia. Symptoms include uncontrollable movements of face, tongue and other body parts.
- It may also result in orthostatic hypotension or decreased blood pressure when rising too quickly after sitting or lying down. Symptoms can be, fainting, dizziness and light-headedness.
In older adults:
Quetiapine is used to treat psychosis in older adults.
However, it should not be used to treat schizophrenia or other psychological disorder in older adults with dementia as it can enhance their risk of death.
Precautions:
Individuals taking Quetiapine need to take certain precautions to negative effects of the medicine.
If the person has any of the following conditions they should consult with their doctor.
Doctors then undergo cost benefit analysis where they analyze the harm caused by medicine and its benefits.
If the benefits of medicine outweigh the harm, doctors usually prescribe the medicine but if it other way around it is not prescribed.
In any case doctor should be aware if patient suffers from any of the following:
Quetiapine and Alcohol:
Quetiapine causes drowsiness as its natural effect thus alcohol should not be used when taking this medicine as it can increase drowsiness resulting in inhibition of daily functioning.
Diabetic patients:
Quentiapine have tendency to increase blood sugar level thus diabetic patient should constantly keep track of their sugar level when taking this medicine for psychosis or anxiety as extremely high sugar level can result in death.
Patients of hypertension:
Quetiapine deregulates the normal body blood pressure in adults as well as in children.
Thus it is recommended that those patients who suffer from high or low blood pressure should monitor their blood pressure during the course of medication.
Lowered rate of white blood cells:
Quetiapine has a tendency to lower the white blood cell count which can result in fever or contraction of infection.
Thus patients suffering from leukemia should monitor their blood cell count when taking this medicine to avoid any negative consequences.
Heart Patients:
Heart patients should consult with their doctor if they have any heart condition as Quetiapine can lead to abnormal heart rate.
Pregnancy:
This medicine has been classified as class C drug which means that research on animals has indicated that Quetiapine adversely affects fetus and there has not been enough studies on human beings to establish its defined effects on fetus.
If a woman is pregnant or if she is planning to become pregnant, she should consult with her doctor.
Breastfeeding:
Studies have shown that Quetiapine passes to the baby through breast milk and causes many side effects thus a mother who breastfeeds a child should either stop breastfeeding or stop taking medicine.
Anxiety
Anxiety is generally known as fear of the future.
When the body naturally responds to stress it is denoted as anxiety that is feeling afraid or apprehensive about future happening.
A person may feel anxious about going for a job interview, first day at a new school or going to stage and delivering a speech to a gathering are the most common causes of instigating anxiety.
If this anxiety prolongs and remains for a longer period of time, i.e., six months and it starts disturbing the life patterns then it becomes anxiety disorder.
Quetiapine for Anxiety
Disorders which are related to anxiety can also be labeled as primary disorders.
These primary disorders may play their part in other major depressive disorders as their symptoms such as bipolar disorder, substance abuse disorder or schizophrenia.
There are more chances of major depressive disorder to occur with primary anxiety.
Major populations of adults who are suffering from any major depressive disorder also tend to face symptoms of anxiety.
Comorbid anxiety is considered to lead to psychosocial dysfunction, severe symptoms, prevalent thoughts of committing suicide and a more chronic course, compared to a major depressive disorder alone.
Additionally this is linked with weaker and sluggish treatment responses.
There are several options available to treat patients with comorbid anxiety and primary anxiety.
These options include, selective serotonin reuptake inhibitors (SSRI), serotonin-norepinephrine reuptake inhibitors (SNRI), tricyclic antidepressants and other antidepressants.
Despite all this, it is extremely important to note that not everyone suffering from anxiety can significantly benefit from the anxiolytic effects of antidepressants.
Treatment methods for those patients, suffering from anxiety disorders and comorbid anxiety symptoms, cannot get enough benefit from any antidepressants includes, augmentation with another therapy along with using another antidepressant or changing the antidepressant monotherapy.
Although, in a clinical practice, combination therapy or augmentation is used but there are not enough evidence which seem to support such treatment methods.
Side effects of Quetiapine
Taking Quetiapine can cause some serious and problematic consequences along with drowsiness.
Many other side effects it can cause include, dizziness, pain in stomach, dry mouth, nausea, constipation, increased appetite, vomiting, weight gain, troubles in movement, fast heartbeats, sore throat, weakness, tiredness and stuffy nose.
These side effects caused by taking Quetiapine may diminish if they are not severe after a few days.
If these side effects get more severe and do not diminish then it can cause many problems that might require professional attention.
If the symptoms caused by Quetiapine result in trouble and seem threatening then it is a medical emergency and the patient should immediately consult a doctor.
More severe side effects, which need immediate consultation of doctor are as follow:
- Contract including blurred vision or loss of vision
- Seizures
- Abnormal level of thyroid hormones
- Increased Prolactin level resulting in breast enlargement and erectile dysfunction
- Trouble in swallowing
- Increased blood pressure
- Loss of white blood cells count resulting in fever and infection
- Increased cholesterol level
Drug Dependency:
Quetiapine has been the most recommended drug for psychotic disorder and anxiety because it is not considered addictive as it has half life of 6 hours but its dependency has been reported in many studies.
If the person is taking more than the required amount of drug, he can become used to its effects as effects including alleviating depressive mood and anxiety and after a dose the patient feels new energy in himself making life easier for him.
This function is reinforced for him and a person is inclined to take the medicine again to go through those euphoric effects.
FAQs about Quetiapine
What If I miss the dose of Quetiapine?
If a patient misses the dose of Quetiapine he can take it whenever he becomes aware of the missed dose only if it is not near the time of the next dose.
In that case a patient can simply miss the dose and it will not have any significant effect on the benefit of the complete course of the medicine.
Is Quetiapine a sleeping pill?
Quetiapine has not been approved as a sleeping pill. It has been approved by FDA to treat schizophrenia, depressive disorder and Bipolar disorder.
It can also help individuals with anxiety.
It should be noted here that Quetiapine can induce drowsiness in aid in sleeping but it is not a sleeping pill itself.
How long does it take for Quetiapine to reduce anxiety?
Patients have reported that effects of Quetiapine can be experienced as early as the fourth day of treatment but usually it takes almost one and half weeks to show its effect.
Which antipsychotic is best for anxiety?
Researchers have proven atypical antipsychotic drugs such as Quetiapine and Olanzapine effective in treating a wide range of symptoms of depression and anxiet
References:
ncbi.nlm.nih.gov/books/NBK459145/
webmd.com/drugs/2/drug-4689-8274/quetiapine-oral/quetiapine-oral/details
healthline.com/health/quetiapine-oral-tablet#take-as-directed
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