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Misuse and Associated Harms of Quetiapine and Other Atypical Antipsychotics

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Non-medical and illicit use of psychoactive drugs

Part of the book series: Current Topics in Behavioral Neurosciences ((CTBN,volume 34))

Abstract

Recent years have seen a significant increase in the reports of atypical antipsychotic diversion, misuse and even dependency syndrome. These reports have arisen amidst a marked increase in prescribing of these agents. Much of this increase in prescribing is because of a preferential use of these medications over typical antipsychotic agents to treat schizophrenia and bipolar disorder due to perceptions of fewer extrapyramidal side effects. However, there has also been a significant increase in the off-label prescribing of these medicines to treat less well evidence-based conditions. Misuse and abuse are perhaps surprising given the putative central role of dopamine in addiction and that these agents are dopamine antagonists. However, there may be other factors such as other pharmacological effects and increasing availability driving this misuse. It is also apparent that certain patient groups appear to be more at risk. Here, we explore the evidence behind the misuse of atypical antipsychotics with a focus of quetiapine. We consider the factors that may be driving this misuse, and then, we also detail some of the adverse effects that may ensue. We end by suggesting interventions at a prescriber and systems level that may be implemented to reduce the risk of atypical antipsychotic misuse.

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Author information

Authors and Affiliations

  1. Drug and Alcohol Service, South Eastern Sydney Local Health District, Surry Hills, Australia

    Mark E. Montebello

  2. National Drug and Alcohol Research Centre, University of New South Wales, Randwick, Australia

    Mark E. Montebello

  3. Drug Health Services, Sydney Local Health District, Camperdown, Australia

    Jonathan Brett

Authors
  1. Mark E. Montebello
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Correspondence to Mark E. Montebello .

Editor information

Editors and Affiliations

  1. National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia

    Suzanne Nielsen

  2. University of Tasmania School of Psychology, Launceston, Tasmania, Australia

    Raimondo Bruno

  3. Victoria University of Wellington School of Psychology, Wellington, New Zealand

    Susan Schenk

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Montebello, M.E., Brett, J. (2015). Misuse and Associated Harms of Quetiapine and Other Atypical Antipsychotics. In: Nielsen, S., Bruno, R., Schenk, S. (eds) Non-medical and illicit use of psychoactive drugs. Current Topics in Behavioral Neurosciences, vol 34. Springer, Cham. https://doi.org/10.1007/7854_2015_424

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