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Quetiapine: Managing Metabolic and Cardiovascular Side Effects of Atypical Antipsychotics

A middle-aged Hispanic man and woman are in a consultation with a Hispanic female doctor in her 40s. The man, wearing a light blue shirt, is seated on the examination table, while the woman, in a casual blouse, takes notes. The doctor, dressed in a white coat with a stethoscope, stands next to a chart on cardiac health and metabolism. This scene conveys trust and communication, essential for discussing the management of metabolic and cardiovascular side effects of quetiapine, an atypical antipsychotic associated with sedation, orthostatic hypotension, and weight gain.

Quetiapine, an atypical antipsychotic, is widely used in the treatment of psychiatric disorders such as schizophrenia and bipolar disorder. However, its use is associated with a range of metabolic and cardiovascular side effects that require careful attention from clinicians. These effects include sedation, orthostatic hypotension, and weight gain, which can significantly impact patients' quality of life and treatment adherence.

Diving into the Side Effects

Weight gain is one of the most common side effects associated with quetiapine and other second-generation antipsychotics. This effect can lead to metabolic complications such as insulin resistance and dyslipidemia, increasing the risk of developing metabolic syndrome and cardiovascular diseases. A systematic review and meta-analysis have demonstrated that all antipsychotics, including quetiapine, are associated with a significant increase in weight, underscoring the need for proactive monitoring and management of these side effects (ver estudio).

Additionally, quetiapine can cause orthostatic hypotension, a cardiovascular side effect that can be particularly problematic in elderly patients or those with cardiovascular comorbidities. Orthostatic hypotension can increase the risk of falls and fractures, necessitating careful dose adjustments and regular blood pressure monitoring (ver estudio).

Regarding metabolic effects, quetiapine has shown a decrease in fasting glucose, which could be a beneficial effect in some patients, but it may also mask underlying glucose regulation issues (ver estudio). However, the risk of dyslipidemia and other metabolic disorders remains a significant concern, especially in patients with a history of metabolic or cardiovascular diseases (ver estudio).

Conclusions

Managing the metabolic and cardiovascular side effects of quetiapine is crucial for optimizing treatment outcomes and improving patients' quality of life. Physicians should implement regular monitoring strategies for weight, blood pressure, and lipid profiles, as well as consider lifestyle interventions and adjunct therapies when necessary. Early identification of at-risk patients and personalized treatment can help mitigate these side effects and enhance long-term treatment adherence.

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Created 6/1/2025