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Quetiapine Augmentation Monitoring — MRCPsych Paper B MCQ

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ModerateMood DisordersQuetiapine Augmentation MonitoringMRCPsych Paper B

A 60-year-old woman with treatment-resistant depression starts adjunctive quetiapine prolonged release 150 mg daily in addition to her SSRI. Which adverse-effect cluster is particularly important to monitor proactively during treatment?

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Correct answer: C — Weight, glycaemic and lipid indices, and somnolence or sedation

Quetiapine can cause weight gain and deterioration in glucose and lipid parameters, so these require baseline assessment and scheduled monitoring during antipsychotic augmentation. Somnolence or sedation is also common, often beginning shortly after treatment starts, and should be assessed clinically because it may impair functioning and increase falls risk. EPS, akathisia and prolactin-related effects should still be considered at reviews, but monitoring only one of these domains is inadequate. Liver tests may be indicated according to the SmPC and clinical circumstances, but isolated hepatic monitoring would omit the characteristic metabolic and sedative burden. Therefore, B is the best answer.

Reference: Seroquel XL 150 mg prolonged-release tablets, Summary of Product Characteristics, sections 4.4 and 4.8, revised June 2024. https://www.medicines.org.uk/emc/product/7605/smpc