Atypical Antipsychotics (Quetiapine/Seroquel) For Alcohol Withdrawal
Atypical antipsychotic drugs such as quetiapine, ziprasidone, olanzapine, and risperidone can be safe and effective in treating severe alcohol withdrawal symptoms like seizures, psychosis, and delirium tremens.
As of 2022, atypical antipsychotics are not first-line treatment options for alcohol use disorder. Benzodiazepines such as lorazepam and diazepam, as well as agonists such as naltrexone and acamprosate, are likely considered before atypical antipsychotics.
If patients have comorbid health problems that prevent them from taking approved medications, atypical antipsychotics may be considered as an adjunctive treatment option.
Effectiveness Of Atypical Antipsychotics For Alcohol Withdrawal
The evidence for atypical antipsychotics in the management of alcohol withdrawal come from studies performed on rats. In these studies, rats with acute alcohol withdrawal syndrome improved when given atypical antipsychotics.
These studies also suggest schizophrenia has similar effects on the central nervous system (CNS) as substance abuse, and that these conditions have a high comorbidity. Atypical antipsychotics that treat schizophrenia may also help patients struggling with alcohol addiction.
Evidence-based and placebo-controlled clinical trials on human participants may be needed before atypical antipsychotics can be approved to treat alcohol withdrawal.
Antipsychotic agents can cause side effects such as sedation, tachycardia, and neuroleptic malignant syndrome (NMS). If you are taking these drugs for alcohol withdrawal, your health may be closely monitored.
Quetiapine can reduce psychotic symptoms and withdrawal seizures caused by the discontinuation of alcohol.
Quetiapine is approved to treat schizophrenia and bipolar disorder under the brand name Seroquel. Patients suffering from co-occurring schizophrenia and alcohol withdrawal may be prescribed quetiapine.
Ziprasidone, Clozapine, & Olanzapine
Ziprasidone, clozapine, and olanzapine treat schizophrenia and bipolar disorder. These atypical antipsychotics can also help treat alcohol withdrawal syndrome.
Side effects of these antipsychotics may include weight gain, changes in behavior, and seizures. Side effects of alcohol withdrawal may also worsen, and close monitoring may be required.
Risperidone, also known as Risperdal, treats schizophrenia and irritability caused by autism. Studies performed on rats show that risperidone can be highly effective in improving alcohol withdrawal symptoms.
Atypical Vs. Typical Antipsychotic Medications
Atypical antipsychotic drugs affect the CNS differently than typical antipsychotic drugs. Atypical antipsychotics affect serotonin receptors, while typical antipsychotics such as haloperidol and chlorpromazine act as dopamine antagonists.
Studies suggest that typical antipsychotics may not be effective in treating substance use disorders due to their effects on dopamine receptors in the brain. Typical antipsychotics lower the seizure threshold, making seizures more likely in patients withdrawing from ethanol.
Standard alcohol dependence treatment options also include interventions, detoxification, the use of benzodiazepines, and behavioral therapy services. For information on our inpatient and outpatient alcohol addiction healthcare services, please contact us today.
Food and Drug Administration - SEROQUEL® (quetiapine fumarate) tablets, for oral use
JAMA Network - Management of Alcohol Withdrawal Delirium: An Evidence-Based Practice Guideline
Oxford Academic - Atypical Antipsychotic Drugs and Ethanol Withdrawal Syndrome: A Review
Substance Abuse and Mental Health Services Administration - What is Naltrexone?
UpToDate - Management of moderate and severe alcohol withdrawal syndromes
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