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Quetiapine
Aka: Quetiapine, Seroquel
- Class
- Atypical Antipsychotic (Second Generation agent)
- Neuroleptic
- Dibenzothiazepine Antipsychotic
- Indications
- Schizophrenia
- Psychosis in Dementia
- Mania (not FDA approved)
- Bipolar Disorder (not FDA approved)
- Autism (not FDA approved)
- Insomnia (not FDA approved)
- Dosing
- Adults
- Initial: 25 mg PO bid-tid
- Increase in 25-50 mg/day increments
- Target: 300-400 mg/day divided bid-tid
- Maximum dose: 750 mg/day
- Elderly
- Initial dose: 12.5 mg PO qhs
- Titrate up every few days (caution due to Sedation)
- Adverse Effects
- Sedation
- Headache
- Orthostatic Hypotension
- Cataract formation
- Drug Interactions
- Increase Antipsychotic levels (toxicity risk): Monitor for toxicity
- Clarithromycin
- Erythromycin
- Grapefruit juice
- Fluconazole
- Itraconazole
- Ketoconazole
- Quinidine
- Decrease Antipsychotic levels (lower efficacy)
- Barbiturates
- Carbamazepine
- Phenytoin
- Rifampin
- Theophylline
- Other effects
- Avoid concurrent use of other medications prolonging QT Interval
- See Prolonged QT Interval due to Medication
- Monitoring
- See Antipsychotic
- Screen for Cataract formation every 6 months
- Consider EKG, electrolyte and Magnesium monitoring due to QT Interval prolongation risk
- Pharmacokinetics
- Metabolized by Cytochrome P450 3A4