Yeah well I don't know if I would exactly mention the beagle thing at all because it'll often times make the patient flip out needlessly. I had a patient just yesterday in her 8th month of pregnancy, and I just started working with her, and her previous doctor put her on Ambien & Seroquel & didn't document that these are class C meds, without much data for their safety on a fetus. Of course, I did discuss this issue with her, and she started flipping out. (Actually IMHO despite the lack of data that Ambien is bad for a fetus--since it works similar to a benzo, I would've avoided it completely, but hey, I'm not the idiot who gave it to her in the first place without documenting a discussion with her and the lack of data).
I did have one case where a patient did have serious eye problems & was on Seroquel. I stopped it for the following reasons...
1-Seroquel in the CATIE trial had the least efficacy by their gauge.
2-she was complaining of several side effects from Seroquel such as weight gain and sedation
3-there are plenty of meds that were more efficacious for her diagnosis, and without the side effects
4-with her eye problems I could see a potential legal pitfall like the one I mentioned above.
This entire beagle BS is one of the reasons I I believe the FDA needs to be more proactive & willing to drop warnings. The Geodon QT prolongation & Welbutrin seizure problem has been largely debunked, yet the warnings are still there.
And every once in awhile, you have a patient who has a seizure DO, and several of the SSRIs & SNRIs have been tried with no success--but there's that FDA Welbutrin warning blocking you from trying it.
The way I work, I pretty much don't even give Seroquel in general unless I notice that the person has extreme EPS sensitivity to antipsychotics. I've only had a small handful of patients that fit that description. The only one coming to mind was a guy who only on 1-2 mg of Risperdal had his muscles stiffen to the point where he was in extreme pain, got injections of benadryl & cogentin which caused little benefit, and he had to be brought to an ER. Seroquel per CATIE had the least amount of EPS, and he didn't have this problem with Seroquel.
yet that darned warning is still there--telling doctors to make the patient see an eye doctor. Anything happens to the person's eyes that indicate cataracts, and they're on Seroquel--well I don't like those 2 factors happening. Expect it to happen with you so long as you have a handful of patients over the age of 40 on Seroquel. As mentioned above--the odds of that happening aren't small.