Effect of quetiapine on inflammation and immunity: a systematic review

Abstract

Introduction

Knowledge about the neurobiology of psychiatric disorders is increasing in the last decades and evidence from literature suggests a central role for immuno-inflammatory mechanisms in these illnesses. The antipsychotic quetiapine acts on dopamine and serotonin signalling and well-established evidence demonstrates that these neurotransmitters can modulate immune functions in healthy and diseased conditions. Starting from this perspective, in the last few decades, a number of studies attempted to identify quetiapine effects on immune functions in order to highlight a possible additional effect of this drug in psychotic diseases, although no conclusive results were obtained.

Methods

We critically reviewed preclinical and clinical studies evaluating quetiapine effects on immune systems, suggesting strategies for future work in this field.

Results

Computerised search, in PubMed and Embase databases, was performed in March 2020: 120 studies were identified but only 29 relevant papers were selected for detailed review.

Conclusion

Despite some interesting preliminary findings about anti-inflammatory effects of quetiapine, mainly supported by preclinical studies, it is possible to conclude further studies are needed to investigate the immunomodulatory effects of this drug and achieve a better understanding of its relevance on clinical outcomes to finally identify new therapeutic approaches in psychiatric treatment.

Keypoints

• Mounting evidence points to a role for immuno-inflammatory mechanisms in psychiatric disorders.

• Quetiapine (QUE) acts on catecholamine (dopamine and norepinephrine) and serotonin signalling.

• The immunomodulatory effects of catecholamines are well established.

• Treatment with QUE in psychiatric disorders could leverage immunomodulatory effects.

• QUE unclear role in immune function modulation suggests future work.

Keywords:

• Psychiatric disorders
• quetiapine
• inflammation
• immunity

Author contributions

Author contributions: F. M., C. C. and M. C. defined the topic and developed the literature search strategy together with M. F. and M. G.

M. F. and M. G. performed the literature search screening for relevant titles and abstracts, finally selecting the titles included in the review, which were cross-validated by F. M. and C. C.

M. F. and S. M. wrote the first draft of the manuscript and drafted tables. All authors were involved in drafting the article or revising it critically for important intellectual content, and all authors approved the final version to be published.

All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved and declare to have confidence in the integrity of the contributions of their co-authors. The final version of this article has been read and approved by all named authors, who agreed with all of its contents.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was performed during the PhD program of M. G. and during School of Specialisation in Clinical Pharmacology and Toxicology, University of Insubria, program of S. M. The study was supported with funds available for PhD students from the University of Insubria (fondi di dottorato a.a. 2016–2019) to M. G. The study was non-profit.