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Quetiapine
From WikEM
Contents
Administration
- Type: Atypical antipsychotics
- Dosage Forms: ER, IR
- Routes of Administration: oral
- Common Trade Names: Seroquel
Adult Dosing
- 25-400 mg PO 1-2 times daily
Pediatric Dosing
Safety/efficacy not established in children <10 years old
- 25-400 mg PO 1-2 times daily
Special Populations
- Pregnancy Rating: C
- Lactation risk: Infant risk cannot be ruled out
- Renal: No adjustment
- Hepatic dosing: initial dose 25 mg/day, titrate up slowly
- Concomitant use with strong CYP3A4 inducer: may need increased dose
- Concomitant use with strong CYP3A4 inhibitor: reduce quetiapine dose
Contraindications
- Allergy to class/drug
Adverse Reactions
Serious
- Prolonged QT interval, sudden cardiac death, syncope
- Neuroleptic malignant syndrome, tardive dyskinesia
- DKA
- Agranulocytosis, neutropenia
- Seizure
- Pancreatitis
- Suicidal ideation
Common
- Hypertension, weight gain, hyperlipidemia
- Abdominal pain, constipation, nausea/vomiting, xerostomia
- Somnolence, dizziness, asthenia, tremor, insomnia
- Extrapyramidal disease
- Headache
- URI-like symptoms
Pharmacology
- Half-life: 6-7 hours
- Metabolism: hepatic, extensive via CYP3A4
- Excretion: mostly renal
Mechanism of Action
- Mechanism not well understood
- Antagonizes D2, 5HT, histamine H1, and alpha1 receptors, as well as muscarinic and norepinepherine receptors.
