Is seroquel developing an illicit reputation for misuse/abuse?

Area of Science:

• Pharmacology
• Psychiatry
• Substance Abuse Research

Background:

• Case reports suggest quetiapine, an atypical antipsychotic, may have potential for misuse and abuse.
• Observed patterns include male predominance, various administration routes (oral, intranasal, intravenous), and settings like jails or psychiatric facilities.
• Subjects often have extensive histories of polysubstance abuse.

Purpose of the Study:

• To review existing case reports on quetiapine misuse/abuse.
• To explore potential explanations and identify knowledge gaps regarding quetiapine's abuse potential compared to other atypical antipsychotics.

Main Methods:

• Review of available case reports detailing quetiapine misuse/abuse.
• Analysis of demographic, administration route, setting, and co-occurring substance use patterns.
• Comparison with the known abuse potential of other atypical antipsychotics.

Main Results:

• A pattern of misuse/abuse has been identified through case reports, predominantly in males with polysubstance abuse.
• No clear pharmacological explanation distinguishes quetiapine's abuse risk from other atypical antipsychotics.
• Limited empirical data (animal or human studies) exists to evaluate this risk.

Conclusions:

• Clinicians should remain vigilant for potential quetiapine misuse/abuse, especially in at-risk patient populations.
• Further empirical research is necessary to objectively assess the abuse potential of quetiapine.
• The current understanding relies heavily on anecdotal evidence from case reports.