Effect of quetiapine on inflammation and immunity: a systematic review

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.