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Indications & Usage

Seroquel (Quetiapine) is a 2nd generation antipsychotic medicine that is indicated for:

  • Schizophrenia
  • Depression
  • Bipolar disorder

Dosage and Administration

Tablets

  • Adults who suffer from schizophrenia should begin with 25 milligrams two times every day. The recommended dosage is between 150 to 750 milligrams daily.
  • Teenagers (13 years and above) should begin with 24 milligrams two times every day for cases of schizophrenia. However, the daily dosage is capped at four hundred to eight hundred milligrams.
  • Adults suffering from bipolar disorder should begin with 50 milligrams twice every day. However, the daily dosage is capped at four hundred to eight hundred milligrams.
  • Young children (10 years & above) who are suffering from bipolar disorder should begin with 25 milligrams twice every day. However, they can consume between 400 to 600 milligrams daily.
  • Adults who are suffering from depression should begin with 50 milligrams to be taken only at night. The total daily recommended dosage is 300 milligrams.

Extended Release (XR) Tabs

  • Adults and teenagers (13 years & above) who suffer schizophrenia should consume 400 to 800 milligrams daily. However, adults should begin with 300 milligrams every day while teenagers should take 50 milligrams daily.
  • Adults experiencing bipolar disorder should consume four hundred to eight hundred milligrams every day, beginning with 300 milligrams.
  • Children and teenagers (10 years & above) experiencing bipolar disorder should consume 400 to 600 milligrams every day, beginning with 50 milligrams.
  • Adults suffering from depression should consume 300 milligrams every day, beginning with 50 milligrams. If consuming another antidepressant, the daily dosage would be between 150 to 300 milligrams, beginning with 50 milligrams.

Instructions for Administration

  • The physician will commence Quetiapine therapy with a smaller dosage and then adjust it gradually to avoid triggering side effects. 
  • You can consume Quetiapine with food or on an empty stomach.
  • Avoid increasing the dose or discontinuing therapy without the physician’s knowledge. Abrupt discontinuation of Quetiapine therapy will result in insomnia or nausea.
  • Ensure to consume the drug at a specific time every day.
  • Never chew Seroquel XR form as this might reduce its efficacy.

Overdosage

If you consume excess Quetiapine, contact the Poison helpline in your locality. The signs of overdose are:

  • Drowsiness
  • Unconsciousness
  • Difficulty in breathing

To avoid overdosing, take the prescribed dose as soon as you remember it. But if it’s close to when you should consume the next dose, skip the missed dose unless the physician advises otherwise. In case you cannot remember the prescribed dosage, contact the physician. 

Dosage Forms & Strengths

Seroquel (immediate release) tabs: 25 milligrams, 50 milligrams, 100 milligrams, 200 milligrams, 300 milligrams, and 400 milligrams

Seroquel XR tabs: 50 milligrams, 150 milligrams, 200 milligrams, 300 milligrams, and 400 milligrams.

Contraindications

Inform the physician if you have experienced the following:

  • A family or personal history of diabetes
  • High triglycerides or cholesterol
  • Hypertension
  • Hypotension
  • Low WBC
  • Seizures
  • Cardiac conditions
  • Eye disease
  • Liver problems
  • Thyroid issues
  • High prolactin
  • Enlarged prostate
  • Optical hypertension
  • Urinary retention
  • Difficulty in sleeping
  • Severe constipation
  • Other medical problems

Warnings and Precautions

  • Inform your physician about all the allergies you’ve experienced.
  • Seroquel has the tendency to make you dizzy.
  • Avoid consuming alcohol with Seroquel as it could trigger severe side effects.
  • Don’t drive/ operate machines that require alertness.
  • Avoid exercising for longer hours.
  • Avoid becoming dehydrated.
  • Don’t discontinue Seroquel if you’ve not discussed it with the physician.
  • This drug may not be suitable for your child. Ensure you discuss your options with the specialist.
  • Tell the physician every medication that you’re consuming as Seroquel can interact with various drugs.
  • It isn’t known whether Seroquel can harm a fetus or not. Hence, inform your physician if you’re pregnant or might become pregnant during therapy.
  • Seroquel may be present in breast milk. Therefore, lactating women should consult their physicians to choose other means of feeding their babies during the treatment period.

Adverse Reactions & Side Effects

Quetiapine presents the following side effects:

  • Increase in weight
  • Stomach upset
  • Drowsiness
  • Fainting spell
  • Slow movements
  • Dryness of the mouth
  • Sore throat
  • Constipation
  • Irregular liver function test results
  • Weakness
  • Pain in the abdomen
  • Nasal congestion
  • Incoherent speech
  • Irregular heartbeat

Severe side effects of Quetiapine are:

  • Stroke especially in geriatric patients
  • Profuse perspiration
  • High fever
  • Falls leading to bodily injury
  • Hyperglycemia
  • High cholesterol 
  • Tardive dyskinesia
  • Hypertension
  • Hypotension
  • Vomiting 
  • Sleep apnea
  • Prolonged erection in males

Drug Interactions

The following drugs may affect your heart rhythm besides Seroquel:

  • Quinidine
  • Thioridazine 
  • Moxifloxacin 

The following drugs could influence how the body absorbs and gets rid of Seroquel:

  • Ketoconazole
  • Rifampin
  • Phenytoin

Inform your physician if you’re consuming products that induce dizziness such as:

  • Codeine
  • Alcoholic drinks and beverages
  • Opioids
  • Marijuana
  • Sleeping pills e.g., lorazepam
  • Antihistamine e.g., diphenhydramine
  • Muscle relaxing medicines e.g., cyclobenzaprine

Note: Quetiapine may cause a false laboratory test result. Ensure to inform the physician as well as laboratory technicians about any drugs you’re consuming.

Patient Counseling Information

Patients should be informed of the following before commencing Seroquel therapy:

  • Geriatric patients who are suffering from dementia may die if they consume Seroquel. Also, the drug must never be administered for psychosis in geriatric patients suffering from dementia.
  • Antidepressants can make children & teenagers become violent or harbor thoughts of committing suicide when they begin Seroquel therapy. The risk increases in patients whose family members may have suffered from depression, feelings of suicide, or bipolar disorder.

Use these tips to prevent yourself or patients from becoming suicidal while consuming Seroquel:

  • Closely observe the patient or yourself for slight shifts in behavior, mood, or feeling, especially when you commence therapy or start consuming a higher dose.
  • Report these changes or any new findings to your physician immediately.
  • Don’t miss any doctor’s appointments and contact the physician between visits if the need arises.
  • Call the physician if you notice any of these symptoms, particularly if they are just starting, becoming worse, or give you concern:
    • Thoughts of death or suicide
    • Suicidal attempts
    • Depression or if it comes worse
    • Anxiety or if it worsens
    • Restlessness or agitation
    • Panic attack
    • Insomnia
    • Irritability
    • Violent behaviors
    • Mania behaviors
    • Mood swings