Quetiapine 300mg

Second Generation (atypical) Antipsychotic

“ALERT: US Boxed Warning

Increased mortality in elderly patients with dementia-related psychosis:

Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Quetiapine is not approved for the treatment of patients with dementia-related psychosis.

Suicidal thoughts and behavior:

Antidepressants increased the risk of suicidal thoughts and behavior in children, adolescents, and young adults in short-term studies. These studies did not show an increase in the risk of suicidal thoughts and behavior with antidepressant use in patients older than 24 years; there was a reduction in risk with antidepressant use in patients 65 years and older. In patients of all ages who are started on antidepressant therapy, monitor closely for clinical worsening and for emergence of suicidal thoughts and behaviors. Advise families and caregivers of the need for close observation and communication with the prescriber. Quetiapine is not approved for use in pediatric patients younger than 10 years.”

CSA NA – FDA Approved – REMS (N) – Can Ship

Quetiapine/Seroquel is an antagonist at various neurotransmitter receptors in the brain such as serotonin (5-HT1A, 5-HT2), dopamine (D1, D2), histamine (H1), and adrenergic (Alpha1, Alpha2).  Norquetiapine which is an active metabolite has high affinity for muscarinic M1 receptors. 

Quetiapine/Seroquel officially indicated for schizophrenia.  It may also be prescribed off-label for agitation/aggression in dementia, ICU delirium/agitation, bipolar disorder, generalized anxiety disorder, major depressive disorder, obsessive compulsive disorder, post-traumatic stress disorder, psychosis secondary to Parkinson’s disease. (may be used for other conditions not listed)

Before starting Quetiapine/Seroquel make sure your physician is aware of any allergies or medications you currently take, if you have kidney disease, liver disease, a history of seizures or are pregnant or breastfeeding.  This medication can cause suicidal ideation in young patients with major depressive disorder so must be used with caution and any major changes in personality or mood should be reported to physician immediately.

This medication also required regular bloodwork and follow up with your physician to monitor for adverse reactions

12.5- 800mg divided into 1-3 doses (instant release and slow release versions available) depending on what condition it is used for and patient response  

How to Take: Follow instructions provided by physician/pharmacy label, swallow whole (extended release), take consistently at same times each day unless otherwise directed, store at room temperature

You Need to Avoid: Operating heavy machinery or driving at least until you know how the medication affects you.  Do not stop this medication suddenly, make sure your physician is aware and can create a tapering schedule so you can come off slowly and prevent any withdrawal symptoms. 

Increased blood pressure, tachycardia (increased heart rate), decreased HDL (good cholesterol), hyperglycemia, increased LDL (bad cholesterol), weight gain, constipation, hunger, dry mouth, decreased hemoglobin, agitation, dizziness, drowsiness, fatigue, headache, withdrawal syndrome, and extrapyramidal reaction (involuntary movement)

Note- this is not a complete list of side effects, only common ones and are generally dosage dependent.  When higher doses are required the physician has weighed the risks and found the benefits to be greater, however regular monitoring (blood sugar, cholesterol, blood pressure, etc.) is important to make sure this does not change

1. What can I do if Quetiapine/Seroquel sedates me too much?
   It is a common side effect but in most cases the tablet can be split for smaller dosages to alleviate fatigue.  Discuss with your pharmacist or physician a plan to manage this or potential alternative medications.
2. Why would my doctor give me an antipsychotic? Does this mean I am psychotic?
   This medication can be used for many conditions outside of its original classification.  It commonly is used for nonpsychotic mood disorders and even insomnia in some cases.
3. Quetiapine/Seroquel has a lot of scary side effects, is it safe?
   All medications have side effects however quetiapine works on a lot of different neurotransmitter receptors in the brain which can lead to a variety of intentional and unintentional effects.  These are mostly dosage dependent and in lower doses the risk is low.  In all cases regular lab work will allow your physician to see if your blood sugar, cholesterol etc. start to move in the wrong direction so action can be taken before they become a problem.