Original synthesis to sit alongside the encyclopedia article below. Not part of Wikipedia; verify facts on Wikipedia when precision matters.
Quetiapine (generic Chinese name 喹硫平, originally branded Seroquel by AstraZeneca) is a second-generation atypical antipsychotic of the dibenzodiazepine class, that acts as an antagonist for dopamine and serotonin receptors, with additional activity targeting histamine and alpha adrenergic receptors. It is a widely prescribed psychiatric medication for multiple severe mental health indications.
Key moments
1997First approved for clinical use in the United States, initially indicated for treatment of schizophrenia
Early 2000sPatent expiry allows launch of low-cost generic formulations, drastically expanding global access to the drug
2000s to 2010sRegulators expand official indications to cover acute mania, bipolar depression episodes, and adjunctive therapy for treatment-resistant major depressive disorder
2025Multiple regional public health agencies release formal clinical guidance explicitly recommending against off-label use of quetiapine for insomnia, citing weak supporting evidence of efficacy and preventable safety risks
Off-label use regulatory controversies
While quetiapine is well tolerated for its approved psychiatric indications with relatively low risk of extrapyramidal movement side effects common to older first-generation antipsychotics, its widespread unapproved prescription for insomnia, mild anxiety, and behavioral symptoms in dementia populations has been a longstanding public health concern. Recent clinical reviews have found that for non-indicated uses, the drug delivers minimal symptomatic benefit while exposing patients to unnecessary risks of metabolic weight gain, persistent drowsiness, and cognitive impairment.
Public health impact of generic access
With generic formulations available at very low cost globally, quetiapine has become one of the most frequently dispensed psychiatric medications, with over 10 million prescriptions filled annually in the US alone. This broad accessibility has filled a critical gap in care for low-income patient groups who previously lacked affordable treatment options for severe conditions like schizophrenia and recurrent bipolar mood episodes.
B3
routes of administration
By mouth
atc prefix
N05
atc suffix
AH04
class
Atypical antipsychotic
legal au
S4
legal au comment
‡R1R‡
legal br
C1
legal br comment
‡R2R‡
legal ca
Rx-only
legal nz
Prescription only
legal uk
POM
legal us
Rx-only
legal us comment
‡R3R‡
bioavailability
100%
metabolism
Liver via CYP3A4-catalysed sulfoxidation to its active metabolite norquetiapine (N-desalkylquetiapine)‡R4R‡
Quetiapine, sold under the brand name Seroquel among others, is an atypical antipsychotic medication used in the treatment of schizophrenia, bipolar disorder, and major depressive disorder.[9][10] Despite being widely prescribed as a sleep aid due to its tranquillizing effects, the benefits of such use may not outweigh the risk of undesirable side effects.[11] It is taken orally.[9]
Common side effects include sedation, fatigue, weight gain, constipation, and dry mouth.[9] Other side effects include low blood pressure with standing, seizures, high blood sugar, tardive dyskinesia, and neuroleptic malignant syndrome.[9] In older people with dementia, its use increases the risk of death.[9] Use in the third trimester of pregnancy may result in a movement disorder in the baby for some time after birth.[9] Quetiapine is believed to work by blocking a number of receptors, including those for serotonin and dopamine.[9]
Quetiapine was developed in 1985 and was approved for medical use in the United States in 1997.[9][12] It is available as a generic medication.[13] In 2023, it was the most prescribed antipsychotic and 60th most commonly prescribed medication in the United States, with more than 10million prescriptions.[14][15] It is on the World Health Organization's List of Essential Medicines.[16]
The drug is typically among two antipsychotics (the other being olanzapine) to have superior efficacy for the treatment of bipolar disorder.Quetiapine is one of only two antipsychotics (the other is cariprazine) that produce equal efficacy as standalone therapies for mixed manic-depressive mood swings as they do in combination with an SSRI antidepressant.However, it is less potent than clozapine, amisulpride, olanzapine, risperidone, and paliperidone in alleviating psychotic symptoms or treating schizophrenia.
Medical uses
Quetiapine is primarily used to treat schizophrenia and bipolar disorder.[17] It targets both positive and negative symptoms of schizophrenia.[18]
Schizophrenia
A 2013 Cochrane review compared quetiapine to typical antipsychotics:
In a 2013 comparison of 15 antipsychotics in effectiveness in treating schizophrenia, quetiapine demonstrated standard effectiveness. It was 13–16% more effective than ziprasidone, chlorpromazine, and asenapine and approximately as effective as haloperidol and aripiprazole.
There is tentative evidence of the benefit of quetiapine versus placebo in schizophrenia; however, definitive conclusions are not possible due to the high rate of attrition in trials (greater than 50%) and the lack of data on economic outcomes, social functioning, or quality of life.[20]
Both typical and atypical antipsychotics can cause tardive dyskinesia.[51] According to one study, rates are lower with the atypicals at 3.9% as opposed to the typicals at 5.5%.[51]
Overdose
Most instances of acute overdosage result in only sedation, hypotension and tachycardia, but cardiac arrhythmia, coma and death have occurred in adults.Serum or plasma quetiapine concentrations are usually in the 1–10 mg/L range in overdose survivors, while postmortem blood levels of 10–25 mg/L are generally observed in fatal cases.[64] Non-toxic levels in postmortem blood extend to around 0.8 mg/kg, but toxic levels in postmortem blood can begin at 0.35 mg/kg.[65][66]
Quetiapine is a tetracyclic compound and is closely related structurally to clozapine, olanzapine, loxapine, and other tetracyclic antipsychotics.
Synthesis
The synthesis of quetiapine begins with a dibenzothiazepinone. The lactam is first treated with phosphoryl chloride to produce a dibenzothiazepine.A nucleophilic substitution is used to introduce the sidechain.[90]
History
Sustained-release
AstraZeneca submitted a new drug application for a sustained-release version of quetiapine in the United States, Canada, and the European Union in the second half of 2006 for treatment of schizophrenia.[91][92]
In May 2007, the United States FDA approved Seroquel XR for acute treatment of schizophrenia.[93] During its 2007 Q2 earnings conference, AstraZeneca announced plans to launch Seroquel XR in the United States in August 2007.[94] However, Seroquel XR has become available in American pharmacies only after the FDA approved Seroquel XR for use as maintenance treatment for schizophrenia, in addition to acute treatment of the illness, on 16 November 2007.[95]
Society and culture
Regulatory status
In the United States, the Food and Drug Administration (FDA) has approved quetiapine for the treatment of schizophrenia and of acute manic episodes associated with bipolar disorder (bipolar mania) and for treatment of bipolar depression.[99] In 2009, quetiapine XR was approved as adjunctive treatment of major depressive disorder.[100]
Quetiapine received its initial approval from the US FDA for the treatment of schizophrenia in 1997.[74][101] In 2004, it received its second indication for the treatment of mania-associated bipolar disorder.[102]
It is debatable whether, as a class, typical or atypical antipsychotics are more effective.[21] Both have equal drop-out and symptom relapse rates when typicals are used at low to moderate dosages.[22] While quetiapine has lower rates of extrapyramidal side effects, there is greater sleepiness and rates of dry mouth.[20]
A Cochrane review comparing quetiapine to other atypical antipsychotic agents tentatively concluded that it may be less efficacious than olanzapine and risperidone; produce fewer movement related side effects than paliperidone, aripiprazole, ziprasidone, risperidone and olanzapine; and produce weight gain similar to risperidone, clozapine and aripiprazole.It found that quetiapine produces suicide attempts; death; QTc prolongation, low blood pressure; tachycardia; sedation; gynaecomastia; galactorrhoea, menstrual irregularity, and decline in white blood cell count at a rate similar to first-generation antipsychotics.[23]
Bipolar disorder
In those with bipolar disorder, quetiapine is used to treat depressive episodes; acute manic episodes associated with bipolar I disorder (as either monotherapy or adjunct therapy to lithium; valproate or lamotrigine); acute mixed episodes; and maintenance treatment of bipolar I disorder (as adjunct therapy to lithium or divalproex).
Major depressive disorder
Quetiapine is effective when used by itself[10] and when used along with other medications in major depressive disorder (MDD),[10][24] but sedation is often an undesirable side effect.[10]
In the United States,[6] the United Kingdom and Australia (while not subsidised by the Australian Pharmaceutical Benefits Scheme for treatment of MDD), quetiapine is licensed for use as an add-on treatment in MDD.[25]
Alzheimer's disease
Quetiapine does not decrease agitation among people with Alzheimer's disease.Quetiapine worsens intellectual functioning in the elderly with dementia and therefore is not recommended.[26]
Insomnia
The use of low doses of quetiapine for insomnia, while common, is not recommended; there is little evidence of benefit and concerns regarding adverse effects.[27][28][29][30][31][32] A 2022 network meta-analysis of 154 double-blind, randomized controlled trials of drug therapies vs. placebo for insomnia in adults found that quetiapine did not demonstrate any short-term benefits in sleep quality.Quetiapine, specifically, had an effect size (standardized mean difference) against placebo for treatment of insomnia of 0.05 (95% CI –1.21 to 1.11) at 4weeks of treatment, with the certainty of evidence rated as very low.[33] Doses of quetiapine used for insomnia have ranged from 12.5 to 800mg, with low doses of 25 to 200mg being the most typical.[34][27][28] Regardless of the dose used, some of the more serious adverse effects may still possibly occur at the lower dosing ranges, such as dyslipidemia and neutropenia.[35][36] Increases in serum triglycerides, LDL-C, and fasting blood glucose have been observed following quetiapine treatment at doses typically used off-label in the treatment of insomnia.[37][38] These safety concerns at low doses are corroborated by Danish observational studies that showed use of specifically low-dose quetiapine (prescriptions filled for tablet strengths >50 mg were excluded) was associated with an increased risk of major cardiovascular events as compared to use of Z-drugs, with most of the risk being driven by cardiovascular death.[39] Laboratory data from an unpublished analysis of the same cohort also support the lack of dose-dependency of metabolic side effects, as new use of low-dose quetiapine was associated with a risk of increased fasting triglycerides at 1-year follow-up.[40]
Others
It is sometimes used off-label, often as an augmentation agent, to treat conditions such as Tourette syndrome,[41]musical hallucinations[42] and anxiety disorders.[43]
Quetiapine and clozapine are the most widely used medications for the treatment of Parkinson's disease psychosis due to their relatively low extrapyramidal side-effect liability.[44] Owing to the risks associated with clozapine (e.g. agranulocytosis, diabetes mellitus, etc.), clinicians often attempt treatment with quetiapine first, although the evidence to support quetiapine's use for this indication is significantly weaker than that of clozapine.[45]
Although quetiapine and clozapine are atypical antipsychotics, switching to these atypicals is an option to minimize symptoms of tardive dyskinesia caused by other atypicals.
Weight gain can be a problem for some, with quetiapine causing more weight gain than fluphenazine, haloperidol, loxapine, molindone, olanzapine, pimozide, risperidone, thioridazine, thiothixene, trifluoperazine, and ziprasidone, but less than chlorpromazine, clozapine, perphenazine, and sertindole.[53]
As with some other anti-psychotics, quetiapine may lower the seizure threshold,[54] and should be taken with caution in combination with drugs such as bupropion.
Very common (>10% incidence) adverse effects
Dry mouth
Dizziness
Headache
Somnolence (drowsiness; of 15 antipsychotics quetiapine causes the 5th most sedation. Extended release (XR) formulations tend to produce less sedation, dose-by-dose, than the immediate release formulations.)[49]
Common (1–10% incidence) adverse effects
High blood pressure
Orthostatic hypotension
High pulse rate
High blood cholesterol
Elevated serum triglycerides
Abdominal pain
Constipation
Increased appetite
Vomiting
Increased liver enzymes
Backache
Asthenia
Insomnia
Lethargy
Tremor
Agitation
Nasal congestion
Pharyngitis
Fatigue
Pain
Dyspepsia (Indigestion)
Peripheral oedema
Dysphagia
Extrapyramidal disease: Quetiapine and clozapine are noted for their relative lack of extrapyramidal side effects.[49][46][47]
Weight gain: SMD 0.43 kg when compared to placebo. Produces roughly as much weight gain as risperidone, less weight gain than clozapine, olanzapine and zotepine and more weight gain than ziprasidone, lurasidone, aripiprazole and asenapine.[49] As with many other atypical antipsychotics, this action is likely due to its actions at the H1 histamine receptor and 5-HT2C receptor.[4]
Rare (<1% incidence) adverse effects
Prolonged QT interval (had an odds ratio for prolonging the QT interval over placebo of 0.17)[49]
Sudden cardiac death
Syncope
Diabetic ketoacidosis
Restless legs syndrome
Hyponatraemia, low blood sodium.
Jaundice, yellowing of the eyes, skin and mucous membranes due to an impaired ability of the body to clear bilirubin, a by product of haem breakdown.
Pancreatitis, pancreas swelling.
Agranulocytosis, a potentially fatal drop in white blood cell count.
Leukopenia, a drop in white blood cell count, not as severe as agranulocytosis.
Neutropenia, a drop in neutrophils, the cell of the immune cells that defends the body against bacterial infections.
Eosinophilia
Anaphylaxis, a potentially fatal allergic reaction.
Seizure
Hypothyroidism, underactive thyroid gland. Common among bipolar patients; quetiapine increases incidence.[50]
Myocarditis, swelling of the myocardium.
Cardiomyopathy
Hepatitis, swelling of the liver.
Suicidal ideation
Priapism. A prolonged and painful erection.
Stevens–Johnson syndrome. A potentially fatal skin reaction.
Neuroleptic malignant syndrome a rare and potentially fatal complication of antipsychotic drug treatment. It is characterised by the following symptoms: tremor, rigidity, hyperthermia, tachycardia, mental status changes (e.g. confusion), etc.
Tardive dyskinesia. A rare and often irreversible neurological condition characterised by involuntary movements of the face, tongue, lips and rest of the body. Most commonly occurs after prolonged treatment with antipsychotics. It is believed to be particularly uncommon with atypical antipsychotics, especially quetiapine and clozapine[25]
Discontinuation
The British National Formulary recommends a gradual withdrawal when discontinuing antipsychotics to avoid acute withdrawal syndrome or rapid relapse.[55] Symptoms of withdrawal commonly include nausea, vomiting, and loss of appetite.[56] Other symptoms may include restlessness, increased sweating, and trouble sleeping.[56] Less commonly there may be a feeling of the world spinning, numbness, or muscle pains.[56] Symptoms generally resolve after a short period of time.[56]
There is tentative evidence that discontinuation of antipsychotics can result in psychosis.[57] It may also result in reoccurrence of the condition that is being treated.[58] Rarely tardive dyskinesia can occur when the medication is stopped.[56]
Pregnancy and lactation
Placental exposure is least for quetiapine compared to other atypical antipsychotics.[47] The evidence is insufficient to rule out any risk to the foetus but available data suggests it is unlikely to result in any major foetal malformations.[5][8][48] It is secreted in breast milk and hence quetiapine-treated mothers are advised not to breastfeed.[5][8][48]
Abuse potential
In contrast to most other antipsychotic drugs, which tend to be somewhat aversive and often show problems with patient compliance with prescribed medication regimes, quetiapine is sometimes associated with drug misuse and abuse potential, for its hypnotic and sedative effects.It has a limited potential for misuse, usually only in individuals with a history of polysubstance abuse and/or mental illness, and especially in those incarcerated in prisons or secure psychiatric facilities where access to alternative intoxicants is more limited.To a significantly greater extent than other atypical antipsychotic drugs, quetiapine was found to be associated with drug-seeking behaviors, and to have standardised street prices and slang terms associated with it, either by itself or in combination with other drugs (such as "Q-ball" for the intravenous injection of quetiapine mixed with cocaine).The pharmacological basis for this distinction from other second generation antipsychotic drugs is unclear, though it has been suggested that quetiapine's comparatively lower dopamine receptor affinity and strong antihistamine activity might mean it could be regarded as more similar to sedating antihistamines in this context.While these issues have not been regarded as sufficient cause for placing quetiapine under increased legal controls, prescribers have been urged to show caution when prescribing quetiapine to individuals with characteristics that might place them at increased risk for drug misuse.[59][60][61]
This means quetiapine is a dopamine, serotonin, and adrenergic antagonist, and a potent antihistamine with some anticholinergic properties.[78] Quetiapine binds strongly to serotonin receptors; the drug acts as a partial agonist at 5-HT1A receptors and as an antagonist to all other serotonin receptors it has affinity for.[79] Serial PET scans evaluating the D2 receptor occupancy of quetiapine have demonstrated that quetiapine very rapidly disassociates from the D2 receptor.[80] Theoretically, this allows for normal physiological surges of dopamine to elicit normal effects in areas such as the nigrostriatal and tuberoinfundibular pathways, thus minimizing the risk of side-effects such as pseudo-parkinsonism as well as elevations in prolactin.[81] Some of the antagonized receptors (serotonin, norepinephrine) are actually autoreceptors whose blockade tends to increase the release of neurotransmitters.
At very low doses, quetiapine acts primarily as a histamine receptor blocker (antihistamine) and α1-adrenergic blocker.When the dose is increased, quetiapine activates the adrenergic system and binds strongly to serotonin receptors and autoreceptors.At high doses, quetiapine starts blocking significant amounts of dopamine receptors.[71][82] Due to the drug's sedating H1 activity, it is often prescribed at low doses for insomnia.While some feel that low doses of drugs with antihistamine effects like quetiapine and mirtazapine are safer than drugs associated with physical dependency or other risk factors, concern has been raised by some professionals that off-label prescribing has become too widespread due to underappreciated hazards.[83]
When treating schizophrenia, antagonism of D2 receptor by quetiapine in the mesolimbic pathway relieves positive symptoms and antagonism of the 5-HT2A receptor in the frontal cortex of the brain may relieve negative symptoms and reduce severity of psychotic episodes.[18][84][85] Quetiapine has fewer extrapyramidal side effects and is less likely to cause hyperprolactinemia when compared to other drugs used to treat schizophrenia, so is used as a first line treatment.[86][87]
Since the noradrenaline transporter is responsible for most of the dopamine clearance in the prefrontal cortex, norquetiapine blocks reuptake of dopamine too, accumulating the dopamine in the synapse.[88]
DopamineD1, D2, D3, D4, and D5 receptorantagonist
Serotonin5-HT1A receptorpartial agonist, 5-HT2A, 5-HT2B, 5-HT2C, 5-HT3, 5-HT6, and 5-HT7 receptorantagonist, and 5-HT1B, 5-HT1D, 5-HT1E, and 5-HT1F receptorligand
α1- and α2-adrenergic receptorantagonist
HistamineH1 receptorantagonist
Muscarinic acetylcholine receptorantagonist
Pharmacokinetics
Peak levels of quetiapine occur 1.5 hours after a dose. The plasma protein binding of quetiapine is 83%.The major active metabolite of quetiapine is norquetiapine (N-desalkylquetiapine).[68] Quetiapine has an elimination half-life of 6 or 7 hours.[5][6] Its metabolite, norquetiapine, has a half-life of 9 to 12 hours.[5][6] Quetiapine is excreted primarily via the kidneys (73%) and in feces (20%) after hepatic metabolism, the remainder (1%) is excreted as the drug in its unmetabolized form.[84][89]
The company has not provided a reason for the delay of Seroquel XR's launch.
Health Canada approved sale of Seroquel XR on 27 September 2007.[96]
In October 2008, the FDA approved Seroquel XR for the treatment of bipolar disorder, including its associated depression and manic episodes.
In December 2008, Biovail announced that the FDA had accepted the company's ANDA to market its own version of sustained-release quetiapine.[97] Biovail's sustained-release tablets will compete with AstraZeneca's Seroquel XR.
In December 2008, AstraZeneca notified shareholders that the FDA had asked for additional information on the company's application to expand the use of sustained-release quetiapine for treatment of depression.[98]
In 2007 and 2008, studies were conducted on quetiapine's efficacy in treating generalized anxiety disorder and major depression.
Patent protection for the product ended in 2012; however, in a number of regions, the long-acting version remained under patent until 2017.[103]
Lawsuits
In April 2010, the United States Department of Justice fined AstraZeneca $520 million for the company's aggressive marketing of Seroquel for off-label uses.[99] According to the Department of Justice, "the company recruited doctors to serve as authors of articles that were ghostwritten by medical literature companies and about studies the doctors in question did not conduct. AstraZeneca then used those studies and articles as the basis for promotional messages about unapproved uses of Seroquel."[99]
Multiple lawsuits have been filed in relation to quetiapine's side-effects, in particular, diabetes.[104][105][106][107]
Approximately 10,000[108] lawsuits[109] have been filed against AstraZeneca, alleging that quetiapine caused problems ranging from slurred speech and chronic insomnia to deaths.
Controversy
In 2004, a young man named Dan Markingson committed suicide in a controversial Seroquel clinical trial at the University of Minnesota while under an involuntary commitment order.[110] A group of University of Minnesota bioethicists charged that the trial involved an alarming number of ethical violations.[111]
Nurofen Plus tampering case
In August 2011, the United Kingdom's Medicines and Healthcare products Regulatory Agency (MHRA) issued a class-4 drug alert following reports that some batches of Nurofen Plus contained Seroquel XL tablets instead.[112]
Following the issue of the Class-4 Drug Alert, Reckitt Benckiser (UK) Ltd received further reports of rogue blister strips in cartons of two additional batches of Nurofen Plus tablets.One of the new batches contained Seroquel XL 50 mg tablets and one contained the Pfizer product Neurontin 100 mg capsules.
Following discussions with the MHRA's Defective Medicines Report Centre (DMRC), Reckitt Benckiser (UK) Ltd decided to recall all remaining unexpired stock of Nurofen Plus tablets in any pack size, leading to a Class-1 Drug Alert.[113] The contamination was later traced to in-store tampering by a customer.[114]
DailyMed, 27 January 2022, retrieved 22 September 2024
16.The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023) World Health Organization, 2023^
17.quetiapine-fumarate The American Society of Health-System Pharmacists, retrieved 3 April 2011^
18.Quetiapine: a review of its safety in the management of schizophrenia Drug Safety, October 2000^
20.Quetiapine for schizophrenia The Cochrane Database of Systematic Reviews, 2004^
21.Pharmacologic treatment of schizophrenia Dialogues in Clinical Neuroscience, 2010^
22.Schizophrenia: a review American Family Physician, June 2007^
23.Quetiapine versus other atypical antipsychotics for schizophrenia The Cochrane Database of Systematic Reviews, November 2013^
24.Adjunctive atypical antipsychotic treatment for major depressive disorder: a meta-analysis of depression, quality of life, and safety outcomes PLOS Medicine, 2013^
26.Quetiapine and rivastigmine and cognitive decline in Alzheimer's disease: randomised double blind placebo controlled trial BMJ, April 2005^
27.Safety of low doses of quetiapine when used for insomnia The Annals of Pharmacotherapy, May 2012^
28.Quetiapine for insomnia: A review of the literature American Journal of Health-System Pharmacy, March 2014^
29.Quetiapine for primary insomnia: Consider the risks Cleveland Clinic Journal of Medicine, May 2021^
30.Off-Label Use of Atypical Antipsychotics: An Update September 2011^
31.Off-Label Use of Atypical Antipsychotics: An Update Agency for Healthcare Research and Quality, 2011^
32.Safety of low doses of quetiapine when used for insomnia The Annals of Pharmacotherapy, May 2012^
33.Comparative effects of pharmacological interventions for the acute and long-term management of insomnia disorder in adults: a systematic review and network meta-analysis Lancet, July 2022^
34.Effects of quetiapine on sleep in nonpsychiatric and psychiatric conditions The Annals of Pharmacotherapy, April 2009^
35.Comparative effects of 18 antipsychotics on metabolic function in patients with schizophrenia, predictors of metabolic dysregulation, and association with psychopathology: a systematic review and network meta-analysis The Lancet. Psychiatry, January 2020^
36.Dose-dependent effects of antipsychotics on efficacy and adverse effects in schizophrenia Behavioural Brain Research, March 2021^
37.Evaluation of the use of low-dose quetiapine and the risk of metabolic consequences: A retrospective review The Mental Health Clinician, November 2016^
38.Impact of low-dose quetiapine-use on glycosylated hemoglobin, triglyceride and cholesterol levels Acta Psychiatrica Scandinavica, January 2023^
39.Use of low-dose quetiapine increases the risk of major adverse cardiovascular events: results from a nationwide active comparator-controlled cohort study World Psychiatry, October 2022^
57.Does antipsychotic withdrawal provoke psychosis? Review of the literature on rapid onset psychosis (supersensitivity psychosis) and withdrawal-related relapse Acta Psychiatrica Scandinavica, July 2006^
59.Intentional Recreational Abuse of Quetiapine Compared to Other Second-generation Antipsychotics The Western Journal of Emergency Medicine, February 2017^
60.Quetiapine Misuse and Abuse: Is it an Atypical Paradigm of Drug Seeking Behavior? Journal of Research in Pharmacy Practice, 2017^
61.Is There a Potential of Misuse for Quetiapine?: Literature Review and Analysis of the European Medicines Agency/European Medicines Agency Adverse Drug Reactions' Database Journal of Clinical Psychopharmacology, February 2018^
62.Comparison of Quetiapine Abuse and Misuse Reports to the FDA Adverse Event Reporting System With Other Second-Generation Antipsychotics Substance Abuse, 2019^
63.Quetiapine Abuse Fourteen Years Later: Where Are We Now? A Systematic Review Substance Use & Misuse, 2020^
64.Disposition of Toxic Drugs and Chemicals in Man Biomedical Publications, 2008^
65.Postmortem femoral blood reference concentrations of aripiprazole, chlorprothixene, and quetiapine Journal of Analytical Toxicology, Jan 2015^
66.Postmortem Quetiapine Reference Concentrations in Brain and Blood Journal of Analytical Toxicology, September 2015^
67.PDSP Ki Database Psychoactive Drug Screening Program (PDSP), University of North Carolina at Chapel Hill and the United States National Institute of Mental Health, retrieved 14 August 2017^
68.N-desalkylquetiapine, a potent norepinephrine reuptake inhibitor and partial 5-HT1A agonist, as a putative mediator of quetiapine's antidepressant activity Neuropsychopharmacology, September 2008^
69.Risperidone compared with new and reference antipsychotic drugs: in vitro and in vivo receptor binding Psychopharmacology, March 1996^
75.National Institute of Mental Health. PDSD Ki Database (Internet) [cited 2013 Sep 18]. Chapel Hill (NC): University of North Carolina. 1998-2013. Available from: ...list shows the top 100 Receptors/Targets in Ki retrieved 5 July 2013^
76.N-desalkylquetiapine, a potent norepinephrine reuptake inhibitor and partial 5-HT1A agonist, as a putative mediator of quetiapine's antidepressant activity Neuropsychopharmacology, September 2008^
77.Active metabolites as antidepressant drugs: the role of norquetiapine in the mechanism of action of quetiapine in the treatment of mood disorders Frontiers in Psychiatry, September 2013^
78.Anticholinergic activity of 107 medications commonly used by older adults Journal of the American Geriatrics Society, July 2008^
80.Does fast dissociation from the dopamine d(2) receptor explain the action of atypical antipsychotics?: A new hypothesis The American Journal of Psychiatry, March 2001^
81.Atypical antipsychotics: mechanism of action Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie, February 2002^
82.D(2) and 5HT(2A) receptor occupancy of different doses of quetiapine in schizophrenia: a PET study European Neuropsychopharmacology, April 2001^
86.Quetiapine: preclinical studies, pharmacokinetics, drug interactions, and dosing The Journal of Clinical Psychiatry, 2002^
87.Review of quetiapine and its clinical applications in schizophrenia Expert Opinion on Pharmacotherapy, May 2000^
88.Dopamine Uptake through the Norepinephrine Transporter in Brain Regions with Low Levels of the Dopamine Transporter: Evidence from Knock-Out Mouse Lines The Journal of Neuroscience, 2002^
