Clinical Use of Quetiapine in Disease States Other Than Schizophrenia

Although quetiapine was introduced as an atypical antipsychotic drug with clinical efficacy inschizophrenia patients, it has been used in a variety of disease states over the last 5 years. The mostcommon conditions have included mood and anxiety disorders, obsessive-compulsive disorder, aggression,hostility, posttraumatic stress disorder, borderline personality disorder, delirium, and comorbidsubstance abuse. Considering its efficacy in a wide variety of neuropsychiatric conditions and itsexcellent tolerability profile, quetiapine could emerge as a broad-spectrum psychotropic medicationthat may be helpful in psychiatry across various diagnostic categories. Traditionally, studies on thepredictive validity of psychiatric disorders help with nosologic issues and controversies. Assessingquetiapine’s tolerability and its overall treatment response might help tease out the predictive validityof various psychiatric syndromes (based currently on an atheoretical descriptive approach) and mayshape psychiatric nosology in the future. Quetiapine’s low affinity and fast dissociation from postsynapticdopamine-2 receptors give the least risk of producing acute extrapyramidal side effects, tardivedyskinesia, and neuroleptic malignant syndrome. These factors suggest that the clinical utility of quetiapinein psychiatric conditions other than schizophrenia has not been fully exploited thus far.