Parkinsonism and Akathisia With Quetiapine: Three Case Reports

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Sir: Quetiapine, a dibenzothiazepine derivative produced by altering the structure of the clozapine molecule, has been shown to have low to moderate affinity for the D1, D2, 5-HT1A, and 5-HT2A receptors and moderate to high affinity for the a1- and a2-adrenergic receptors. Due to this receptor profile, quetiapine has been claimed to have a low incidence of extrapyramidal side effects. Large controlled trials have also shown that quetiapine is associated with placebo-level extrapyramidal side effects and akathisia in schizophrenia and bipolar disorder.​​

J Clin Psychiatry 2008;69(7):1189-1191 [letter]