Talk:Quetiapine/Archive 1

note
RE: Note: repetition of 50 mgs removed under "Forms" Heading —Preceding unsigned comment added by 24.72.56.3 (talk) 09:47, 27 September 2008 (UTC)

Note: 50mg is mentioned twice under the "Forms" heading - someone should remove one. I don't know which. —Preceding unsigned comment added by 82.11.242.149 (talk) 17:11, 2 September 2008 (UTC)

Suspicious Edits
This page has been the subject of a news story regarding Suspicious editing by a drug company. —Preceding unsigned comment added by Mabu2 (talk • contribs) 19:54, August 30, 2007 (UTC)


 * Removal of negative information about Seroquel, possibly by employees of Astra Zeneca, is denying patients important information about the risks and side effects of Seroquel. Clinical trials for Seroquel, along with Risperdal and Zyprexa, have shown an extremely high rate of suicidal ideation, suicide attempt and completed suicide.  While taking Seroquel this author had several periods of SI/HI that progressed much too far and lasted for months at a time.  Putting the profits of a $75 billion corporation ahead of the safety of patients and those around them is disgusting.


 * "Extremely high"? What is that?  50%?  90%?  Pills can't make you kill yourself.  The ideation was already there to begin with.  Enough already.  —Preceding unsigned comment added by 67.160.174.24 (talk) 00:56, 5 August 2008 (UTC)
 * I doubt you have any proof at all that the ideation was already there to begin with. To assume either way in this case is foolish. Besides, all it needs to do is increase ideation, not necessarily cause it in someone who never had it, to be a real risk. Pills can certainly make a person kill themselves -- I see no reason why they can't as all they have to do is change a person's threshold. A threshold that may never be reached without drugs. This, of course, varies with different people, but to say that the drug plays no role and that a person would already have been suicidal regardless of the drug shows a serious lack of understanding about the subject. 122.57.136.77 (talk) 13:23, 10 November 2008 (UTC)

Incidence of Akathisia
This article as currently written (Nov 12, 2006) looks like an advertisement right from Astra Zeneca - the maker of quetiapine. I've removed text from the Uses heading that is unrelated and uncitied as well as biased in the drugs favour. Please add citations to this information if you want to re-add it, preferably from studies that are not funded by Astra Zeneca. The assertion of "placebo-level occurrence of EPS (including akathisia)" is incorrect as well. The only study I found supporting this was funded by Astra Zeneca, and there are many studies showing cases of akathisia with quetiapine use, for example: http://psy.psychiatryonline.org/cgi/content/abstract/46/4/291

and a report of a case of severe akathisia from quetiapine use: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12784279&dopt=Abstract

-Jamie
 * In considering your above changes I would like to add the following point of view. The presence of case studies indicating that quetiapine can cause akasthisia does not invalidate the previous finding by the manufacturer that it occurs similar to the level of placebo.  This is because the placebo level is not 0%.  In other words people who are on placebo still get akasthisia.  So when researchers report cases of the presence of akasthisia in a person taking quetiapine it is still consistent with the orginal research.  If a researcher did a large placebo controlled study that found that the incidence of akasthisia was higher or much higher than previously reported then this would be grounds to alter a statment suggesting that the incidence was close to placebo and viewing such statements as biased.  Also, keep in mind that your second citation Akathisia as a side effect of antipsychotic treatment with quetiapine in a patient with Parkinson's disease. is a single case report of a person who already suffers from Parkinson's disease.  This complicates the issue since Parkinson's disease involves movement and the dopamine system (i.e. this is a special or exceptional case).  I think the statement could be modified to:


 * placebo-level occurrence of EPS (including akathisia) Quetiapine in patients with schizophrenia. A high- and low-dose double-blind comparison with placebo. Seroquel Study Group. However, the incidence is not 0% and case reports have emerged describing the occurrence of akathisia in patients while taking quetiapine Acute Akathisia Associated With Quetiapine Use.


 * This I think would be more consistent with Wikipedia guidelines based on NPOV and verifiability.--Psychofarm 15:35, 23 November 2006 (UTC)

Off-Label Uses of Quetiapine
I am thinking of adding a note that using seroquel to treat non-schizophrenic symptoms is more of a short-term solution for extreme accute cases. When I was frequently showing mania, or having my panic attacks closer and closer together I was put on it. --user not clearly identified
 * The section on uses includes a statment about off-label uses. That statement essential encompasses the additional non-schizophrenic uses that you describe though it does use broad categories.  As a basic information source "anxiety disorders" would include panic attacks.  Treatment of the manic phase is explicitely covered in the use section.--Psychofarm 15:35, 23 November 2006 (UTC)

Been on Seroquel 25mg for use as an off label sleep aid for 6 years. It has succeeded in treating my insomnia after Ambien failed miserably. —Preceding unsigned comment added by 68.49.199.246 (talk) 22:00, 10 July 2008 (UTC)

The PI sheet of Seroquel (in Belgium) specifically mentions "restless leg syndrome" as one of the side effects ( 0.1 to 1% of users). Seems strange that it would be used to treat that disorder. DiedSmets (talk) 01:37, 21 February 2010 (UTC)

Anglo-Swedish pharmaceutical firm AstraZeneca has agreed to pay a $510 million fine to settle a case alleging that it illegally marketed an anti-psychotic drug, the US justice department has confirmed.

The firm's US division agreed to the fine for marketing the the anti-psychotic drug Seroquel for so-called "off-label" uses not included in the drug's approved product label, the Justice Department said.

US authorities contended that AstraZeneca illegally marketed Seroquel for uses never approved by the Food and Drug Administration (FDA) such as aggression, Alzheimer's disease, anger management, anxiety, attention deficit hyperactivity disorder, bipolar maintenance, dementia, depression, mood disorder, post-traumatic stress disorder, and sleeplessness.

By doing so, the pharmaceutical group received government insurance payments that officials said were fraudulent.

Under the settlement terms, the federal government will receive some $301 million and various state insurance programs will get $218 million.

In New York, AstraZeneca shares were down over two-and-a-half percent, to $43.77 before the close of trading.

The FDA originally approved Seroquel in September 1997 to treat manifestations of psychotic disorders. In September 2000, FDA proposed narrowing Seroquel's approval to the short term treatment of schizophrenia only. It later approved Seroquel for short term treatment of acute manic episodes associated with bipolar disorder and for bipolar depression.

"When pharmaceutical companies interfere with the FDA's mission to insure that drugs are safe and effective, they undermine the doctor-patient relationship and put the health and safety of patients at risk," said Michael Levy, the US attorney for the Eastern District of Pennsylvania.

"People have a legal right to know that pharmaceutical companies are marketing their drugs only for uses approved by the FDA and that their doctors' judgment has not been affected by misinformation from a pharmaceutical company trying to boost revenues."

The government also contended that AstraZeneca violated the federal Anti-Kickback Statute by offering and paying illegal remuneration to doctors it recruited to "advise" the firm about marketing for unapproved and unaccepted uses of Seroquel.

"Rooting out health care fraud is a top priority for the Obama administration," said US Health and Human Services Secretary Kathleen Sebelius.

"Today's settlement sends a clear warning to any individual or company seeking to defraud our health care system and returns hundreds of millions of dollars of taxpayer money to the Medicare trust fund where they belong."

The investigation was triggered by a "whistleblower lawsuit" filed under US law.

James Wetta, the whistleblower in the action, will receive more than $45 million from the federal share of the civil recovery.

AstraZeneca's US general counsel Glenn Engelmann said the company agreed to the fine without admitting wrongdoing.

"It is in the best interest of AstraZeneca to resolve these matters and to move forward with our business of discovering and developing important, life-changing medicines, while avoiding the delay, uncertainty, and expense of protracted litigation," he said.

"While we deny the allegations, AstraZeneca takes its obligations very seriously under its agreements with the government." AFP/The Local (news@thelocal.se) - http://www.thelocal.se/26326/20100428/

Treating Quetiapine-induced Akathisia
I have taken seroquel twice a day for about 4 years (since I was first diagnosed with schizophrenia). My initial dose was 300mg twice a day and I now take 250mg twice a day (500mg/day) and I have always experienced the extrapyramidal side effects of akathisia which when acute feels literally like dying. This side effect has always occured in the several hours after taking each dose and it then disappears until the next dose. I recently read a study that used high doses of vitamin B6 (600mg twice a day) to treat acute akathisia and I am now taking 500mg of vitamin B6 once a day and this has relieved my side effects almost fully for the first time in 4 years which has made a very positive difference in my daily life. I may increase the dose of vitamin B6 to that used in the study but it seems to be effective for me at 500mg per day. Here is a link to the study: 

I would like to put some of the above information on the main seroquel page and on the general neuroleptic page as this information would be very helpful to people taking these medications and suffering the extrapyramidal side effects, which is estimated conservatively at 30% of people taking neuroleptics in the above referenced study.

Jamie

I was told to take b12 w/ it - Andy —Preceding unsigned comment added by 70.178.54.154 (talk) 01:51, 30 July 2008 (UTC)

Anecdotal Self Report (moved here from article)
Someone wrote "A report suggests that a dose of 800mg everyday of quetiapine causes minor brain damage ."

Thanks for this link. I think that report is very worth reading, although the above statement neither follows from the report, nor is that "fact" in the report proved by anything at all. The report does not even say what caused the author to believe that she is suffering "minor brain damage", such as a CT or MRI scan. But even if it were true, the author has been given so many medications that it were not possible to tell which one caused what. --David Andel 10:11, 21 April 2006 (UTC)


 * I haven't written that it was a fact, only suggests. Criticism of the article which has not been published elsewhere is original research. Whereas we don't have to include every link in the article, I think that all reports of adverse effects have to be given consideration. --Mihai cartoaje 13:33, 21 April 2006 (UTC)


 * I agree. I just think that the appropriate place is here on the talk page. --David Andel 19:00, 21 April 2006 (UTC)
 * I agree as well, especially when considering No original research

Drugbox
moved here from User_talk:Moop_stick

Hey man, why did you replace my version using the marvellous drugbox template again with that old version with the ugly syntax?! Just for the Seroquel logo being on top? I don't think it belong there anyway. The Seroquel logo would be best on a Seroquel page, since it is the commercial product, not the substance Quetiapine. I don't think it makes much sense to just replace each other's version, that's why I am writing you here. What have been your exact reasons for replacement? I think they could be met using the drugbos template as well, and that would make the drug pages somehow consistent. Otherwise it's just a mess... --David Andel 19:02, 23 April 2006 (UTC)

Actually, its much more easier to read the information. Nearly every drug page with the logo on it has the logo above the chemical structure. (Before you edited them). Your edits to the drug box were also unessasary. You dont need a template to display information. The "mess" is more editable. Displaying The drug logo in a seperate box can also cause messes like these, such as the one on the Sertaline page. Old Zoloft Page Newer Zoloft page. --Moop stick 20:21, 23 April 2006 (UTC)

I don't agree. Even if you think the information is easier to read - obviously a matter of taste - using the table syntax means lots of redundancy and less uniformity, since then it's easy to add or remove arbitrary elements to or from the table. And I don't know where you took your Zoloft examples. The recent Zoloft page doesn't look like the "newer" one of your examples. --David Andel 21:47, 23 April 2006 (UTC)

Depends on the browser you use. I use IE 7, and thats how it renders at 1280x1024 res. --Moop stick 22:25, 23 April 2006 (UTC)

Since I couldn't reach an agreement with Moop stick I am asking here now for support from someone else. I really think that the Drugbox templete is great: IMHO it makes the drug pages standardized and the syntax more clear! And since there is no majority between two people I am asking for others to tell their opinion. --David Andel 08:47, 28 April 2006 (UTC)

Ok, so nobody voiced his or her opinion on this issue for a month now. But in the meantime the drugbox get updated by someone to be even prettier than before. So I've moved it back to drugbox now - I mean, all the other drugs are in this format for quite a while now and nobody but Moop stick changed any of them (and Moop stick himself changed Quetiapine only). So I assume that he is in the minority. David Andel 21:41, 1 June 2006 (UTC)

Experimentation on Children
There is currently a study underway to test the effect of this drug on 4-6 year old children. I know this violates "neutral point of view", but how can somone not be outraged by this?

http://www.clinicaltrials.gov/ct/show/NCT00181883?order=1

http://blogs.abcnews.com/theblotter/2006/05/tots_used_as_hu.html

--Moop stick 19:01, 15 May 2006 (UTC)
 * Well.. amphetamines are being perscribed to children for ADHD. Amphetamines are serious drugs, and can cause sudden death, and my grandma went on them for weight loss in the 50s and got really bad psychosis.

Why do you keep taking off those links?
What's wrong with those links in the "external links" section? I think there is some real controversy surrounding this drug.

So Dr. Zak is just taking off those links without giving a reason why? They are totally related to that drug. Who appointed Dr. Zak and PHenry as censors anyway?


 * Take the controversy on clinical trials on young children to clinical trials, please! Actually, the fact that clinical trials most often involve young men is a problem, it shifts the sample to, well, young men. In women, aged people and young children the drug may be metabolized at a different rate. Dr Zak 06:00, 4 June 2006 (UTC)

Could someone explain this?
"...a series of neuroleptics known as "atypical antipsychotics", which have, over the last four decades, become increasingly popular alternatives to "typical antipsychotics""

as far as I know, the very first atypical beeing marketed was clozapine (Clozaril, Leponex) in 1972; the second was Risperdal in 1994. What four decades of atypicals? Clozapine gained never a broad-band use due to its myelotoxic side effects, the era of atypicals began in early 90's.--84.163.108.243 22:13, 27 July 2006 (UTC)

From what I understand from the Canadian CPS(Compendium of Pharamecuticals and Specialities) Seroquil was actually formulated under another name going back into the late 60's. It was modified since then to provide the separation between D1, and D2 receptors, and S1, and S2 receptors to prevent the onset of parkinsons. Resperdal on the other hand has a very high risk of causing parkinsons behavior. —Preceding unsigned comment added by 24.72.56.3 (talk) 09:54, 27 September 2008 (UTC)

Bad Drug?
I have seen several commercials where a lawyer is asking for people who have taken Seroquel and have complications to join a lawsuit. Why is nothing on that here? —The preceding unsigned comment was added by 67.110.221.182 (talk) 08:51, 11 February 2007 (UTC).

Probably because Seroquel is not the only medicine the law firms are trying to sue. And their case is not a good one. They're saying it might cause diabetes but this is very well known by its users already and it's a risk you have to take. You can take pre-caution of course. --84.230.176.116 04:21, 13 March 2007 (UTC)
 * I think it's not causing diabetes, but causing "extreme harm" to those with diabetes. Either way, I personally think it's just the work of scumbag lawyers. Jmlk17 11:22, 21 April 2007 (UTC)
 * Some antipsychotics are elevating the risk of gainig diabetes; that's why the FDA issued the compulsory "blackbox" warning for all antipsychotics indiscriminately; while e.g. olanzapine (Zyprexa) is linked to significant increase in exacerbations of diabetes among patients taking it, quetiapine does not, or minimaly.--84.163.121.160 04:08, 24 April 2007 (UTC)
 * Law firms are always trying to sue for some drug or another though. Jmlk17 07:51, 6 May 2007 (UTC)


 * An example is here. (GARDINER HARRIS, BENEDICT CAREY and JANET ROBERTS, "Psychiatrists, Children and Drug Industry’s Role", New York Times  May 10, 2007)  This NY Times article also explains possible methodological flaws in a study that led to popularization of Seroquel.--C S (Talk) 18:35, 10 May 2007 (UTC)

__

Might I remind everyone that a talk page is for discussing the article itself, not the article content? I guarantee that for every Seroquel sob story there's another person who owes their life to this drug, (like myself, for that matter) that's just the way it is with these medicines. You should only be taking this drug if you are pretty sick already, and if the side effects aren't worth it, don't take it in the first place! It's just that simple. Now, can we return to the matter at hand (article quality) please?   L' Aquatique    talk  to  me   07:29, 21 October 2007 (UTC)

Origin of the SEROQUEL brand name?
Does anyone know, what should "SEROQUEL" mean? Why did AstraZeneca pick this name, or better asked, what is this brand name's meaning? It is clearly not straight derived from the INN Quetiapine, maybe stands "SERO-" for "Serenity"...? Anyone have an idea? Thanks.--84.163.108.96 03:32, 30 April 2007 (UTC)
 * Not sure on this end. It's simply a brand name that they chose, perhaps somewhat along the lines of what you were thinking.  I googled it, and tried searching online for a bit, but found little information.  Sorry.  I'm pretty interested myself though. Jmlk17 03:53, 30 April 2007 (UTC)


 * Naming of drugs is generally commercially driven (just think of Exubera, an inhaled insulin preparation - an obvious reference to "exuberant", or Januvia with its allusion to rejuvenating one's diabetic control). No sensible drug company will release this information into the public domain; it would undermine their capability of naming their products in a fashion that will make them commercially appealing. Speculation on the subject here on Wikipedia is generally original research unless very explicit references are available. JFW | T@lk  18:58, 1 May 2007 (UTC)

The idea behind the majority of drug names is to include a "Q", "X", or "Z" because it sounds scientific and impressive.
 * What's your basis on that? Jmlk  1  7  21:55, 20 August 2007 (UTC)

Seems like it's probably a portmanteau of Serenity and Tranquility?   L' Aquatique    talk  to  me   07:30, 21 October 2007 (UTC)

I would argue that due to the significant impact on SEROtonin (which differs from many AAP's in that they are mostly dopamine antagonists) and the ability of the drug the "QUELl" psychotic behavior, the name becomes obvious.

Just my $0.02, though! —Preceding unsigned comment added by 24.252.247.93 (talk) 22:41, 17 July 2008 (UTC)

Benzodiazepines do lower seizure threshold?
As with some other antipsychotics, quetiapine may lower the seizure threshold, and should be taken with care in combination with drugs such as bupropion and the benzodiazepines (e.g., lorazepam), as they also lower the seizure threshold.

While an abrupt benzodiazepine withdrawal does lower the seizure threshold and may lead to an epileptoid, and while some benzodiazepines (e.g. nitrazepam) do carry a risk of inducing some forms of seizures (notably, partial/focal paroxysms), the statement, that "the benzodiazepines [also] lower the seizure threshold" is wrong; in fact, benzodiazepines are mostly diminishing the risk of an epileptoid if administred concomitantly to an seizure threshold-lowering medication. If no one has objections, I would change this statement in next few days.--84.163.78.126 16:34, 16 August 2007 (UTC)

Quetiapine implicated in priapism (case report)
I'm not going to go to the effort of incorporating this into the main article text, but if someone else wants to, have at it. There is an interesting case report (available at http://www.medworksmedia.com/psychopharmbulletin/pdf/18/117-119_PB_V39N1_Harrison.pdf) describing the case of a 45 year old patient who developed an 18+ hour priapism apparently due to a combination of a higher-than-prescribed dose of quetiapine and methamphetamine. Authors explore correlations among quetiapine, methamphetamine abuse and HIV infection. 199.4.74.16 (talk) 23:55, 6 February 2008 (UTC)

Priapism is funny. Ha. Ha.

If one man's decision to blame his crankdick on SQ isn't notable enough for YOU to add in. . . why do you think it's notable enough for ANYONE? EXACTLY! It's not notable at all, except maybe in the land of 12 year old med students. —Preceding unsigned comment added by 67.160.174.24 (talk) 01:07, 5 August 2008 (UTC)

Critical research of neuroleptics
I would like to add a section citing from the large pool of research that has been critical of neuroleptics. I believe that the current page presents as though no such negative research exists. Specifically, I would like to cite the WHO studies, Hegarty (1994) and Mosher's research from Soteria House that show neuroleptic use being correlated with poorer outcome measures in the long term. Postcrypto (talk) 00:32, 23 March 2008 (UTC)


 * See my opinion at User_talk:MeekMark; I feel that the information is potentially useful, but the information perhaps belongs at a higher category, perhaps atypical antipsychotic. MeekMark (talk) 13:55, 24 March 2008 (UTC)


 * I would encourage the creation of a section on the long term use of antipsychotics.--Mark v1.0 (talk) 19:58, 14 May 2008 (UTC)

As ingredient of purple drank
Someone just objected to the inclusion of the following paragraph in the article. I'm removing it as it does not cite any sources—it doesn't even seem to have reached the, erm, literature :) Due to its sedating effects, it [quetiapine] is also crushed up and mixed with OTC cough syrup, as a substitute for prescription-strength cough syrup (which contains codeine and promethazine), in making "Purple Drank" (a.k.a. "Lean" or "Sizurp"), a slang term used for a recreational drug popular in the hip-hop community of the southern United States, containing cough syrup typically mixed with ingredients such as Sprite soft drink and pieces of Jolly Rancher candy. —Fvasconcellos (t·c) 19:11, 11 January 2009 (UTC)