From the Research
Quetiapine (Seroquel) is not known to trigger malignant hyperthermia (MH) and is generally considered safe for patients with MH susceptibility. Malignant hyperthermia is a rare, life-threatening genetic disorder triggered primarily by certain anesthetic gases (such as halothane, sevoflurane, desflurane) and the depolarizing muscle relaxant succinylcholine 1. Antipsychotic medications like quetiapine work through different mechanisms, primarily affecting neurotransmitters in the brain rather than skeletal muscle calcium regulation, which is the problem in MH. However, it's essential to note that quetiapine can cause a different condition called neuroleptic malignant syndrome (NMS), which has some similar symptoms to MH but involves different pathophysiology 2.
Key Considerations
- Malignant hyperthermia is triggered by specific anesthetic agents, not by antipsychotic medications like quetiapine 1, 3.
- Quetiapine is considered a reasonable option for patients with MH susceptibility who require antipsychotic medication, but they should be monitored for unusual reactions 4.
- Patients with known MH susceptibility should inform all healthcare providers about their condition, carry medical alert identification, and have their medication choices reviewed by specialists familiar with MH management 5.
Treatment and Management
The first-line treatment for MH is dantrolene, which significantly reduces mortality rates 4, 2. In cases where dantrolene is not readily available, early warning, diagnosis, and prompt effective therapies are crucial for MH patients to survive 3.
Monitoring and Precautions
Patients with MH susceptibility should be closely monitored for any signs of MH or NMS when taking quetiapine or other antipsychotic medications. This includes monitoring for hyperthermia, muscle rigidity, and other symptoms associated with these conditions 1, 2.