A comprehensive approach to the management of anxiety disorders continues to be a
clinical challenge as current therapies have shown only limited efficacy. Quetiapine (available as an
immediate-release and an extended-release [XR] formulation) is an atypical antipsychotic agent with
primary dopaminergic and serotonergic blocking activity, which has well-established records of
clinical efficacy and tolerability in the treatment of schizophrenia and bipolar disorder. Recent
controlled trials provide increasing evidence in support of the role of quetiapine XR as both
monotherapy and as an augmentation therapy in the treatment of several anxiety disorders, including
generalized anxiety disorder, social anxiety disorder, obsessive compulsive disorder, and posttraumatic
stress disorder. To date, there is only limited evidence for its use in panic disorder.
Quetiapine XR is an important alternative especially for patients who had a partial remission of
symptoms or who have not responded to first-line treatments for mood and anxiety disorders. It may also provide an
important option in patients whose anxiety disorder is comorbid with an underlying bipolar mood disorder. Quetiapine’s
safety and tolerability profile in the management of anxiety disorders is comparable to what is observed when quetiapine
is used for other psychiatric conditions, however, it has yet to receive FDA approval for use in generalized anxiety
disorder due to potential long-term metabolic adverse effects. Thus, given its efficacy and tolerability, it is important to
consider the potential benefit of its ability to manage mood and anxiety disorder symptomatology, while closely
monitoring for the more worrisome adverse events.
Keywords: Generalized anxiety disorder, obsessive compulsive disorder, panic disorder, post traumatic stress disorder,
quetiapine, social anxiety disorder.
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