quetiapine-fumarate and Fever

This case highlights recurrent low-grade fevers caused by extended-release Quetiapine (Quetiapine XR), a previously unreported side effect, in a patient with Schizophreniform Disorder. While there have been case reports of Quetiapine causing neuroleptic malignant syndrome, there is paucity of data specifically describing recurrent low-grade fevers, with no other accompanying symptoms, caused by Quetiapine XR.

Topics: Adult; Antipsychotic Agents; Delayed-Action Preparations; Female; Fever; Humans; Neuroleptic Malignant Syndrome; Psychotic Disorders; Quetiapine Fumarate; Treatment Outcome

A retrospective analysis was followed on 20 case reports covering the possible correlation between the atypical antipsychotic, quetiapine, and neuroleptic malignant syndrome (NMS), determined by the study of 7 different NMS criteria guidelines. A great majority (19) of the case studies did not meet the requirements of all 7 guidelines, frequently due to unreported information. Nor was quetiapine proven to be the sole cause of the possible NMS in the two age groups investigated. Only one case was found to have no other medication or medical conditions confounding the relationship of quetiapine and NMS symptoms, and that case was in the context of a significant quetiapine overdose. The other 19 cases demonstrated the difficulty of identifying the cause of NMS when polypharmacy and other medical conditions are involved. The authors note the need for caution in deciding both the presence of NMS and the causal factors of the symptoms.

Topics: Adult; Age Factors; Antiparkinson Agents; Antipsychotic Agents; Diagnosis, Differential; Diagnostic and Statistical Manual of Mental Disorders; Dibenzothiazepines; Dose-Response Relationship, Drug; Fever; Guideline Adherence; Humans; Mental Disorders; Middle Aged; Muscle Rigidity; Neuroleptic Malignant Syndrome; Practice Guidelines as Topic; Quetiapine Fumarate; Retrospective Studies; Selective Serotonin Reuptake Inhibitors; Serotonin Syndrome; Young Adult

Topics: Antipsychotic Agents; Dibenzothiazepines; Fever; Humans; Male; Middle Aged; Neuroleptic Malignant Syndrome; Quetiapine Fumarate

Topics: Abdominal Pain; Adult; Antipsychotic Agents; Clozapine; Combined Modality Therapy; Diagnostic Errors; Dibenzothiazepines; Drug Therapy, Combination; Female; Fever; Fluid Therapy; Headache; Hemodiafiltration; Humans; Lithium; Multiple Organ Failure; Norepinephrine; Quetiapine Fumarate; Schizophrenia; Systemic Inflammatory Response Syndrome; Urinary Tract Infections; Valproic Acid; Vasoconstrictor Agents

Since no experiment regarding a possible relation between quetiapine and orexin A has been reported in international literature, this experiment tested the effect of quetiapine on the sympathetic and thermogenic effects induced by orexin A. The firing rates of the sympathetic nerves to interscapular brown adipose tissue (IBAT), along with IBAT, colonic temperatures and heart rate were monitored in urethane-anesthetized male Sprague-Dawley rats before an injection of orexin A (1.5 nmol) into the lateral cerebral ventricle and over a period of 150 min after the injection. The same variables were monitored in rats with an intraperitoneal administration of quetiapine (5 or 10 mg/kg bw), injected 30 min before the orexin administration. The results show that orexin A increases the sympathetic firing rate, IBAT, colonic temperatures and heart rate. This increase is delayed or reduced by the injection of quetiapine. These findings indicate that quetiapine affects the complex reactions related to activation of orexinergic system. Possible influences on the control of body weight and temperature are discussed.

Topics: Adipose Tissue, Brown; Animals; Antipsychotic Agents; Body Weight; Dibenzothiazepines; Electrodes, Implanted; Fever; Heart Rate; Injections, Intraventricular; Intracellular Signaling Peptides and Proteins; Male; Neuropeptides; Orexins; Quetiapine Fumarate; Rats; Rats, Sprague-Dawley; Sympathetic Nervous System

The study objectives were to examine the effects of the atypical antipsychotic drugs olanzapine, risperidone, and quetiapine on core temperature in the rat in relation to such effects produced by clozapine and to compare possible in vivo intrinsic efficacy of olanzapine, risperidone, and quetiapine at dopamine (DA) D(1) receptors with such effects previously shown for clozapine. Core temperature measurements were made in adult male Wistar rats maintained under standard laboratory conditions using a reversed 12-h daylight cycle. Clozapine (0-32 micromol/kg s.c.), olanzapine (0-32 micromol/kg s.c.), and risperidone (0-4 micromol/kg s.c.) all produced a dose-dependent hypothermia. Except for slight nondose-dependent hyperthermia, there were no effects of quetiapine (0-16 micromol/kg s.c. or i.p.) on the core temperature. The hypothermia produced by clozapine, but not that produced by equipotent doses of olanzapine or risperidone, was fully antagonized by pretreatment with the DA D(1) receptor antagonist SCH-23,390 (0.1 micromol/kg s.c.). On the other hand, quinpirole-induced hypothermia (4 micromol/kg s.c.) was partially antagonized by olanzapine (2 micromol/kg s.c.), risperidone (4 micromol/kg s.c.), and quetiapine (16 micromol/kg s.c.) but not by clozapine (1 micromol/kg s.c.). Clozapine preferentially stimulates DA D(1) receptors in comparison with olanzapine and risperidone, whereas olanzapine, risperidone, and quetiapine preferentially block DA D(2) receptors compared with clozapine. It is suggested that stimulation of DA D(1) receptors, presumably in the prefrontal cortex, is a distinguishing feature of clozapine responsible for its favorable profile on cognitive functioning in schizophrenia.

Topics: Animals; Antipsychotic Agents; Benzazepines; Benzodiazepines; Clozapine; Dibenzothiazepines; Dopamine Agonists; Dose-Response Relationship, Drug; Drug Interactions; Fever; Hypothermia; Male; Olanzapine; Pirenzepine; Quetiapine Fumarate; Quinpirole; Rats; Rats, Wistar; Receptors, Dopamine; Risperidone; Time Factors