Erdoğan Serap
Gaziosmanpasa University Faculty of Medicine, Psychiatry Department, Tokat.
Turk Psikiyatri Derg. 2010 Summer;21(2):167-75.
Quetiapine is an atypical antipsychotic approved by the FDA (Food and Drug Administration) for use in the treatment of schizophrenia, acute mania, and bipolar depression. Pharmacologically, it has antagonistic effects on serotonin 5-HT1A and 5-HT2A, dopamine D1 and D2, histamine H1, and adrenergic alpha1 and alpha2 receptors. In addition to reports of its use in schizophrenia and bipolar disorder, many studies have examined the use of quetiapine in the treatment of anxiety disorders and substance use disorders. In the treatment of patients with psychotic or bipolar disorder with a comorbid substance abuse disorder even though quetiapine was prescribed primarily for the treatment of the underlying psychotic symptoms, patients taking this medication reported a significant reduction in substance use. Yet, there are also case reports of quetiapine abuse and dependence; in particular among prisoners and patients diagnosed with substance abuse. Though quetiapine should be used peroral, it is also used intranasally and intravenously in these patient groups. Moreover, in some cases quetiapine is combined with other substances, such as cocaine or marijuana, to increase sedation. This abuse of quetiapine is thought to occur due to the anxiolytic and sedative effects of the drug. There are no controlled studies on quetiapine dependence in the literature and it remains unknown whether or not quetiapine causes dependence. This review aimed to present all published case reports on quetiapine abuse and to discuss the possible mechanisms that underlie its abuse and dependence.
喹硫平是一种非典型抗精神病药物，已获美国食品药品监督管理局（FDA）批准用于治疗精神分裂症、急性躁狂症和双相抑郁症。从药理学角度来看，它对5-羟色胺5-HT1A和5-HT2A、多巴胺D1和D2、组胺H1以及肾上腺素能α1和α2受体具有拮抗作用。除了有关其在精神分裂症和双相情感障碍中应用的报道外，许多研究还探讨了喹硫平在治疗焦虑症和物质使用障碍方面的应用。在治疗患有精神病性或双相情感障碍且合并物质滥用障碍的患者时，尽管喹硫平主要是为了治疗潜在的精神病性症状而开具的，但服用这种药物的患者报告称物质使用显著减少。然而，也有关于喹硫平滥用和依赖的病例报告；特别是在囚犯和被诊断患有物质滥用的患者中。尽管喹硫平应口服使用，但在这些患者群体中也有鼻内和静脉内使用的情况。此外，在某些情况下，喹硫平会与其他物质，如可卡因或大麻混合使用，以增强镇静作用。人们认为喹硫平的这种滥用是由于该药物的抗焦虑和镇静作用所致。文献中没有关于喹硫平依赖性的对照研究，喹硫平是否会导致依赖性仍然未知。本综述旨在呈现所有已发表的关于喹硫平滥用的病例报告，并讨论其滥用和依赖背后可能的机制。
