From the Guidelines
Seroquel (quetiapine) has a lower risk of causing tardive dyskinesia compared to typical antipsychotics, but it is still a potential side effect, particularly with higher doses and longer duration of treatment. Tardive dyskinesia is a movement disorder characterized by involuntary, repetitive movements, typically affecting the face, mouth, and tongue. The risk of developing tardive dyskinesia with Seroquel increases with higher doses and longer duration of treatment, particularly in elderly patients, as noted in the guidelines for managing Alzheimer's disease 1. The mechanism involves dopamine receptor hypersensitivity after prolonged blockade.
Some key points to consider when prescribing Seroquel include:
- Regular monitoring for movement disorders is important while on this medication
- The risk-benefit profile should be regularly reassessed, especially for long-term use
- If tardive dyskinesia develops, the medication should be continued at the current dose only if the patient is in full remission and there is reason to believe that any change in dosage or agent will precipitate a relapse, as suggested by the practice parameter for the assessment and treatment of children and adolescents with schizophrenia 1
- Attempts should be made to either lower the dose or switch to another medication, most likely an atypical antipsychotic, if tardive dyskinesia occurs.
It is essential to note that the risk of tardive dyskinesia with Seroquel is lower compared to typical antipsychotics, but it is still a potential side effect that requires careful monitoring and management. If you're taking Seroquel and notice any unusual movements, such as lip smacking, tongue protrusion, or facial grimacing, contact your healthcare provider immediately.
From the FDA Drug Label
A syndrome of potentially irreversible, involuntary, dyskinetic movements may develop in patients treated with antipsychotic drugs, including quetiapine The risk of developing tardive dyskinesia and the likelihood that it will become irreversible are believed to increase as the duration of treatment and the total cumulative dose of antipsychotic drugs administered to the patient increase However, the syndrome can develop, although much less commonly, after relatively brief treatment periods at low doses or may even arise after discontinuation of treatment
Tardive Dyskinesia Risk: Yes, seroquel (quetiapine) may cause tardive dyskinesia.
- The risk of developing tardive dyskinesia increases with the duration of treatment and the total cumulative dose of antipsychotic drugs.
- It is recommended to prescribe quetiapine in a manner that minimizes the occurrence of tardive dyskinesia, such as using the smallest dose and shortest duration of treatment necessary to produce a satisfactory clinical response 2.
From the Research
Seroquel and Tardive Dyskinesia
- Seroquel, also known as quetiapine, is an atypical antipsychotic medication that has been studied in relation to tardive dyskinesia, a movement disorder characterized by involuntary, repetitive body movements 3, 4, 5.
- Research suggests that atypical antipsychotics like quetiapine may have a lower risk of causing tardive dyskinesia compared to conventional antipsychotics 3, 6.
- However, the risk of developing tardive dyskinesia still exists with atypical antipsychotics, including quetiapine 3, 6.
- Some studies have reported cases of improvement in tardive dyskinesia symptoms with the use of quetiapine, suggesting its potential as a treatment option for this condition 4, 5.
Risk Factors and Management
- The risk of developing tardive dyskinesia is higher with long-term use of antipsychotic medications, including quetiapine 3, 7.
- Management of tardive dyskinesia typically involves discontinuation or change of the causative medication, as well as treatment with other medications such as vesicular monoamine transporter 2 selective inhibitors 7.
- Other treatment options for tardive dyskinesia may include clonazepam, amantadine, yokukansan, and Ginkgo biloba extract, as well as botulinum toxin treatment and deep brain stimulation in refractory cases 7.