Quetiapine (Seroquel)

Description
An atypical antipsychotic drug.
Indications
Used in the treatment of schizophrenia.
Effects on oral and dental structures
Xerostomia, taste alteration, and uncontrollable oro-facial muscle activity (tardive dyskenesia) may be produced.
Effects on patient management
Xerostomia may increase caries incidence and thus a preventive regimen is important. If the xerostomia is severe, artificial saliva may be indicated. Uncontrollable muscle movement of jaws and tongue as well as the underlying psychotic condition may interfere with management, as satisfactory co-operation may not be achieved readily.
There may be problems with denture retention and certain stages of denture construction (e.g. jaw registration) can be difficult. Postural hypotension often occurs with this drug, therefore rapid changes in patient position should be avoided. Long term use may produce blood dyscrasias which can interfere with postoperative healing. If white cell counts are low prophylactic antibiotics should be considered prior to surgery.
Drug interactions
There is increased sedation when used in combination with CNS depressant drugs such as alcohol, opioid analgesics, and sedatives.
Combined therapy with tricyclic antidepressants increases the chances of cardiac arrhythmias and exacerbates antimuscarinic effects such as xerostomia.