Seroquel (quetiapine fumarate)
SEROQUEL (quetiapine fumarate) – an atypical antipsychotic agent commonly used to treat schizophrenia and certain types of bipolar disorder. Though the exact mechanism of action of quetiapine is unknown, it is thought that Seroquel exerts its effects in schizophrenia and bipolar depression and mania through a combination of dopamine type 2 (D2) and serotonin type 2 (5HT2) antagonism.
FDA approved uses: Seroquel is indicated for – Treatment of schizophrenia in adults and adolescents aged 13 – 17 years; Acute treatment of manic episodes associated with bipolar I disorder, both as monotherapy and as an adjunct to lithium or divalproex in adults and children and adolescents aged 10 – 17 years; Acute treatment of depressive episodes associated with bipolar disorder in adults; Maintenance treatment of bipolar disorder as an adjunct to lithium or divalproex in adults.
Available dosage forms: Tablets – 25, 50, 100, 200, 300 and 400 mg.
Usual dosage: Titration is complex and individualized for each patient and condition. Some conditions and general dosage ranges (but not titration schedules) are listed: Adult schizophrenia – start 25 mg twice daily, range 150 – 750 mg/day. Adolescent schizophrenia – start 25 mg twice daily, range 400 – 800 mg/day. Adult bipolar mania – start twice daily dosing totaling 100 mg, range 400 – 800 mg/day. Child and adolescent bipolar mania – start twice daily dosing totaling 100 mg, range 400 – 600 mg/day. Adult depression – start 50 mg once daily at bedtime, range up to 300 mg/day. Adult maintenance of biploar I disorder – administer twice daily totaling 400 – 800 mg/day as an adjunct to lithium or divalproex.
Contraindications: The manufacturer states that there are no contraindications to quetiapine.
Special warnings: INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS – Antipsychotic drugs are associated with an increased risk of death. Quetiapine is not approved for elderly patients with Dementia-Related Psychosis. SUICIDALITY AND ANTIDEPRESSANT DRUGS – Increased risk of suicidal thinking and behavior in children, adolescents and young adults taking antidepressants for major depressive disorder and other psychiatric disorders.
Adverse reactions (side effects) of these medications: The most common side effects of quetiapine seen in clinical trials varied by the population studied. Adults – somnolence, dry mouth, dizziness, constipation, asthenia, abdominal pain, postural hypotension, pharyngitis, weight gain, lethargy, ALT increased, dyspepsia. Children and Adolescents – somnolence, dizziness, fatigue, increased appetite, nausea, vomiting, dry mouth, tachycardia, weight increased.
Common drug interactions: Seroquel has not been extensively studied for its drug interactions. Because of its effects on the central nervous system (CNS) caution should be used when it is given in combination with other centrally acting drugs. Alcoholic beverages should be avoided while taking Seroquel. Because of its potential for inducing hypotension, Seroquel may enhance the effects of certain antihypertensive agents. Seroquel may antagonize the effects of levodopa and dopamine agonists. The use of quetiapine should be avoided in combination with drugs known to increase QT interval, and caution should be exercised when quetiapine is used in combination with drugs known to cause electrolyte imbalance.
Special instructions for patients: Take this medication exactly as directed by physician. Read the official Medication Guide before starting Seroquel and when you receive new refills. Call your doctor right away if you have any of the following:
Full prescribing information may be found at the manufacturer‘s official website Seroquel.com or at the U.S. Food and Drug Administration’s website at Seroquel Indo at Drugs@FDA
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