Quetiapine Fumarate(kwe tie’ ah peen)
Seroquel, Seroquel XRDNC
PREGNANCY CATEGORY C
Drug Classes
Antipsychotic
Dibenzothiazepine
Therapeutic Actions
Mechanism of action not fully understood: Blocks dopamine and serotonin receptors in the brain; also acts as a receptor antagonist at histamine and adrenergic receptor sites (which may contribute to the adverse effects of orthostatic hypotension and somnolence).
Indications
Treatment of schizophrenia in patients older than 13 yr
Adjunctive treatment of major depressive disorder in children (ER forms only)
Short-term treatment of acute manic or mixed episodes associated with bipolar I disorder, as monotherapy or in combination with lithium or divalproex
Acute treatment of depressive episodes associated with bipolar I disorder
Maintenance treatment of bipolar disorder as an adjunct to lithium or divalproex
Unlabeled uses: Alcohol dependence, OCD, Tourette syndrome
Contraindications and Cautions
Contraindicated with coma or severe CNS depression, allergy to quetiapine, lactation.
Use cautiously with CV disease, hypotension, hepatic impairment, seizures, exposure to extreme heat, autonomic instability, tardive dyskinesia, dehydration, thyroid disease, pregnancy, elderly patients with dementia-related psychosis.
Available Forms
Tablets—25, 50, 100, 200, 300, 400 mg; ER tabletsDNC—50, 150, 200, 300, 400 mg
Dosages
Adults
Schizophrenia: 25 mg PO bid. Increase in increments of 25–50 mg bid–tid on days 2 and 3; dosage range by day 4: 300–400 mg/day in two to three divided doses. Further increases can be made at no less than 2-day intervals. Maximum dose, 800 mg/day. When patient is stabilized on divided doses, may be switched to ER form at the total equivalent dose taken once per day. For ER tablets, 300 mg PO once daily in the evening; range, 400–800 mg/day.
Manic episodes: 100 mg/day PO divided bid on day 1; increase to 400 mg/day PO in bid divided doses by day 4 using 100-mg/day increments. Range, 400–800 mg/day given in divided doses. ER forms: 300 mg/day PO on day 1,600 mg on day 2; may be adjusted to 800 mg on day 3 if needed.
Depressive episodes (ER form): 50 mg PO on day 1, then 100 mg PO on day 2 given daily at bedtime; increase to desired dose of 300 mg/day by day 4.
Major depressive disorder (ER form): Initially, 50 mg PO at bedtime; on day 3, increase to 150 mg PO in the evening. Range is 150–300 mg/day. Give with other antidepressants.
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