Indications
Bipolar Mania – Quetiapine is indicated for the treatment of acute manic episodes associated with bipolar I disorder, as either monotherapy or adjunct therapy to lithium or divalproex.
Schizophrenia
Quetiapine is indicated for the treatment of schizophrenia. Physician who elects to use Quetiapine for extended periods should periodically re-evaluate the long-term usefulness of the drug for the individual patient
Dosage & Administration
Bipolar Mania
As monotherapy or as adjunct therapy with other anti-psychotic drugs
Days Dosage
1st 50 mg Twice daily
2nd 100 mg Twice daily
3rd 150 mg Twice daily
4th 200 mg Twice daily
5th 300 mg Twice daily
6th 400 mg Twice daily
Data indicates that the majority of patients responded between 400 to 800 mg/day. The safety of doses above 800 mg/day has not been evaluated in clinical trials.
Schizophrenia
Usual Dose: Quetiapine should generally be administered with an initial dose of 25 mg bid, with increments of 25-50 mg bid or tid on the second and third day, as tolerated, to a target dose range of 300 to 400 mg daily by the fourth day, given bid or tid. Further dosage adjustments, if indicated, should generally occur at intervals of not less than 2 days, as steady-state for Quetiapine would not be achieved for approximately 1-2 days in the typical patient. When dosage adjustments are necessary, dose increments/decrements of 25-50 mg bid are recommended. Most efficacy data with Quetiapine were obtained using tid regimens, but in one controlled trial 225 mg bid was also effective.
Pediatric Use: The safety and effectiveness of Quetiapine in pediatric patients less than 18 yrs have not been established
Side Effects
Somnolence, dizziness, dry mouth, constipation, dyspepsia, postural hypotension, elevated ALT (SGPT) levels, weight gain
Precautions
Neuroleptic malignant syndrome, tardive dyskinesia. Hypotension and syncope, especially during the initial dose titration period. Conduct eye examinations prior to or shortly after starting Quetiapine and at 6-month intervals thereafter; discontinue the drug if clinically significant lens changes are observed. History of seizures. Hypothyroidism. Hyperprolactinemia. Antiemetic effect. Suicide. Use with great caution in moderate or severe hepatic impairments. Renal impairment, cardiovascular disease. Disruption of body temperature regulation. Hyperglycemia. Lactation (avoid breast-feeding).
Contraindications
Quetiapine is contraindicated in individuals with a known hypersensitivity to this medication or any of its ingredients.
Use in Pregnancy & Lactation
Pregnancy Category C. There are no adequate and well-controlled studies in pregnant women and Quetiapine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
Nursing Mothers: It is recommended that women receiving Quetiapine should not breast feed.
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