title: The role of antihistaminic effects in the misuse of quetiapine: a case report and review of the literature.
abstract: Recent case reports and case series suggest that the atypical antipsychotic quetiapine has the potential for misuse. This includes drug-seeking behaviors motivated by quetiapine as well as inappropriate (intranasal or intravenous) administration. We present an additional case of quetiapine misuse and review other published cases. In general, quetiapine misuse is associated with prior CNS depressant use and is more common in forensic settings. The mechanism of reinforcement for this misuse is unknown, but we hypothesize that it is related to quetiapine's pharmacological profile as an antihistamine with a relative low affinity for dopamine receptors. The risks to individuals and society of exaggerating/simulating symptoms to obtain high-dose quetiapine in the absence of a clinical indication are discussed. This includes the unwelcome possibility of restricting access to this effective medication.
authors.affiliation: Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD 21228, USA. bfischer@mprc.umaryland.edu
authors.forename: Bernard A
authors.initials: BA
authors.lastname: Fischer
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Boggs
mesh_terms: D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use; D003987:Dibenzothiazepines / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use; D006633:Histamine Antagonists / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000188:drug therapy; D000069348:Quetiapine Fumarate; D019966:Substance-Related Disorders / Q000503:physiopathology*; D044465:White People
chemical_list: D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D006633:Histamine Antagonists; D000069348:Quetiapine Fumarate