Can Quetiapine (Seroquel) cause metabolic alkalosis?

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Last updated: March 16, 2025View editorial policy

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From the Guidelines

Quetiapine (Seroquel) is not typically associated with causing metabolic alkalosis. The medication's primary mechanism of action involves blocking dopamine and serotonin receptors in the brain, which affects neurotransmitter activity but not acid-base homeostasis 1. While Seroquel can cause various side effects including sedation, weight gain, dry mouth, and potentially metabolic changes, it does not significantly impact the mechanisms that regulate blood pH. Alkalosis is more commonly caused by medications like diuretics, excessive vomiting, or certain respiratory conditions. If a patient taking Seroquel develops symptoms that might suggest alkalosis (such as confusion, muscle twitching, or numbness), they should seek medical attention as this would likely be due to another cause rather than the Seroquel itself. Some studies discuss metabolic derangements in certain conditions, such as acute liver failure, where alkalosis and acidosis may both occur, but these are managed by identifying and treating the underlying cause 1. However, the most recent and relevant evidence regarding Quetiapine's side effects does not support a direct link to metabolic alkalosis 1. Key points to consider when evaluating the potential for Quetiapine to cause metabolic alkalosis include:

  • The medication's mechanism of action and its effects on the body
  • Common side effects of Quetiapine and their potential impact on acid-base balance
  • Other potential causes of alkalosis and how they might be distinguished from any possible effects of Quetiapine. Given the available evidence, Quetiapine is not considered a typical cause of metabolic alkalosis 1.

From the Research

Metabolic Alkalosis and Quetiapine

  • There is limited direct evidence linking Quetiapine (Seroquel) to metabolic alkalosis in the provided studies.
  • However, one study 2 reports a case of hyperventilation associated with Quetiapine, which led to acute respiratory alkalosis.
  • Another study 3 discusses diuretic-induced metabolic alkalosis, but does not mention Quetiapine specifically.
  • The other studies 4, 5, 6 focus on hypokalemia, hyperkalemia, and electrolyte abnormalities, but do not provide direct evidence of Quetiapine causing metabolic alkalosis.

Related Electrolyte Abnormalities

  • Hypokalemia is a common electrolyte disturbance that can be associated with metabolic alkalosis, as seen in study 3.
  • Quetiapine is not mentioned as a cause of hypokalemia or metabolic alkalosis in studies 4 and 5.
  • Study 6 discusses electrolyte abnormalities in patients with acute leukemia, but does not mention Quetiapine.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Hyperventilation associated with quetiapine.

The Annals of pharmacotherapy, 2000

Research

Acid-base and electrolyte abnormalities observed in patients receiving cardiovascular drugs.

Journal of cardiovascular pharmacology and therapeutics, 2003

Research

Electrolytes: Potassium Disorders.

FP essentials, 2017

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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