What parameters should be monitored in patients taking Seroquel (quetiapine)?

From the FDA Drug Label

Patients who are diagnosed with diabetes, those with risk factors for diabetes, or those that develop these symptoms during treatment should have their blood glucose monitored at the beginning of and periodically during treatment Patients should have their lipid profile monitored at the beginning of and periodically during treatment Patients should have their weight monitored regularly Children and adolescent patients should have their blood pressure measured at the beginning of, and periodically during, treatment Patients with a pre-existing low WBC or a history of drug induced leukopenia/neutropenia should be advised that they should have their CBC monitored while taking quetiapine

The parameters that should be monitored in patients taking Seroquel (quetiapine) include:

• Blood glucose: in patients with diabetes or risk factors for diabetes
• Lipid profile: to monitor for changes in total cholesterol, LDL-cholesterol, and triglycerides
• Weight: to monitor for weight gain
• Blood pressure: in children and adolescent patients
• CBC (Complete Blood Count): in patients with a pre-existing low WBC or history of drug-induced leukopenia/neutropenia 1

From the Research

Patients taking Seroquel (quetiapine) should be monitored for blood glucose levels, lipid profiles, and weight, as it can cause metabolic changes including hyperglycemia, hyperlipidemia, and significant weight gain, as evidenced by a recent study 2 that found significant dose-dependent metabolic alterations.

Monitoring Parameters

The following parameters should be monitored in patients taking Seroquel:

• Blood glucose levels: to detect hyperglycemia, a common side effect of Seroquel, as reported in a study 3 that found significant increases in glucose and lipid metabolism parameters with quetiapine-extended release.
• Lipid profiles: to detect hyperlipidemia, another common side effect of Seroquel, as reported in a study 4 that found statistically significant increases in triglyceride levels with quetiapine.
• Weight: to detect significant weight gain, a common side effect of Seroquel, as reported in a study 2 that found a dose-dependent effect on weight gain.
• Blood pressure and heart rate: to detect potential cardiovascular effects, including orthostatic hypotension, especially during initial dose titration, as reported in a study 3 that found significant increases in blood pressure with quetiapine-extended release.
• Complete blood counts: to detect rare but serious blood dyscrasias, as reported in a study 5 that found quetiapine to be metabolized hepatically.
• Liver function tests: to detect potential liver damage, as quetiapine is metabolized hepatically, as reported in a study 5 that found quetiapine to be eliminated primarily through hepatic metabolism.
• Electrocardiograms: to detect QT interval prolongation, particularly in patients with cardiac risk factors, as reported in a study 6 that found no significant differences in QT interval prolongation with quetiapine compared to placebo.
• Neurological assessments: to evaluate for extrapyramidal symptoms and tardive dyskinesia, though these occur less frequently with Seroquel than with typical antipsychotics, as reported in a study 6 that found a low incidence of extrapyramidal symptoms with quetiapine.

Additional Considerations

• Medication adherence and therapeutic response should be regularly assessed, with particular attention to target symptoms such as psychosis, mood disturbances, or insomnia depending on the indication for treatment.
• Patients should also be monitored for sedation, dizziness, and signs of suicidal ideation, especially in younger patients.
• The dose of Seroquel should be adjusted based on the patient's response and tolerance, as evidenced by a study 2 that found a dose-dependent effect on metabolic parameters.