Quetiapine in psychiatric practice: A narrative review on clinical efficacy, cardiac safety, and emerging therapeutic innovations

Quetiapine is an atypical antipsychotic widely prescribed for schizophrenia, bipolar disorder, and major depressive disorder, with off-label use for insomnia. Its active metabolite, norquetiapine, contributes additional antidepressant and anxiolytic benefits. In addition, recent advances have explored the development of electrochemical sensors to monitor quetiapine levels, as well as novel applications in delirium management in intensive care units and as an adjunct in breast cancer therapy. However, despite its clinical utility, quetiapine carries significant cardiovascular and metabolic risks, highlighting the importance of electrocardiogram and metabolic monitoring, particularly in vulnerable populations or in the context of overdose. This literature review gives an updated synthesis of the most recent data while critically assessing quetiapine’s therapeutic potential and safety profile. Important conclusions highlight that while low-dose quetiapine can effectively address insomnia and mood symptoms, careful patient selection and monitoring are essential to minimize adverse effects. By integrating pharmacological characteristics, emerging applications, and cardiovascular risk data, this review offers a comprehensive perspective to inform safe and effective quetiapine use in diverse clinical settings.