Quetiapine abuse and dependence in psychiatric patients: a systematic review of 25 case reports in the literature

Background: Quetiapine is an atypical antipsychotic approved for the treatment of schizophrenia, bipolar disorder and major depressive disorder. There has been a growing amount of quetiapine abuse cases in psychiatric patients. The purpose of this article is to analyse these reports to recognize identifiable patterns of quetiapine misuse. Approach: We searched the PubMed, Scopus, Medline/Ovid and GoogleScholar databases for case reports of quetiapine abuse and/or dependence among patients with: bipolar disorder, anxiety disorders, panic disorder, social phobia, generalized anxiety disorder, obsessive-compulsive disorder and substance use/dependence. Findings: The search retrieved 25 cases of quetiapine abuse and/or dependence among psychiatric patients. Higher frequency of abuse/dependence was observed in men and people being in their mid-thirties. Only half of the cases reported a positive history of substance abuse. The most prominent phenomenon associated with quetiapine abuse/dependence was marked withdrawal symptoms. Conclusions: Our research indicates that quetiapine is likely to be abused by male psychiatric patients in their mid-thirties and less than 50% of them having positive history of substance abuse/dependence. Caution should be taken when considering the prescription of quetiapine to that special patient group and close monitoring for drug misuse is needed in the course of the entire treatment period.