SEROQUEL (Quetiapine Fumarate) | Antipsychotic Agent

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Indications:

  • the management of the manifestations of schizophrenia
  • acute management of manic episodes associated with bipolar disorder.
  • acute management of depressive episodes associated with bipolar I and bipolar II disorder.


Notes:

  • Geriatrics (> 65 years of age): SEROQUEL is not indicated in elderly patients with dementia.
  • Pediatrics (< 18 years of age): Based on the data submitted and reviewed by Health Canada, the safety and efficacy of SEROQUEL in pediatric patients have not been established.


Serious Warnings and Precautions:

  • Increased Mortality in Elderly Patients with Dementia.


Monitoring and Tests:

  • Blood sugar
  • Red and white blood cell count amount of platelets
  • Liver enzymes
  • Lipid levels
  • Creatine phosphokinase levels
  • Prolactin levels


Others:

  • Body weight checks to monitor any weight gain.
  • Eye examinations to monitor any lens changes in the eyes.
  • In some cases, babies born to a mother taking SEROQUEL during pregnancy have symptoms of withdrawal that are severe and require the newborn to be hospitalized.


Precautions:

  • It is important not to become too hot or dehydrated while taking SEROQUEL
  • Not exercise too much.
  • In hot weather, stay inside in a cool place if possible.
  • Stay out of the sun.
  • Not wear too much clothing or heavy clothing.
  • Drink plenty of water.
  • May make the patient feel sleepy & drowsy.


SEROQUEL can cause serious side effects including:

  • Neuroleptic Malignant Syndrome.
  • Severe skin reactions that can be life-threatening such as Stevens-Johnson Syndrome (SJS), Toxic Epidermal Necrolysis (TEN), Acute Generalized Exanthematous Pustulosis (AGEP), Erythema Multiforme (EM) and Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS).
  • Tardive Dyskinesia (TD) and Extrapyramidal Symptoms (EPS).
  • Pancreatitis.
  • Feeling invincible or an all powerful inflated self-esteem
  • Having racing thoughts, easily losing train of thought.
  • Needing less sleep.
  • Severe irritability.

Note: SEROQUEL is not a cure, but it can help manage symptoms.


The following may interact with SEROQUEL:

  • Acohol.
  • Diltiazem & verapamil.
  • Carbamazepine, phenytoin & divalproex.
  • Thioridazine.
  • Nefazodone.
  • Eerythromycin & clarithromycin.
  • Anticholinergics.
  • Ketoconazole.
  • Levodopa.
  • Rifampin.
  • Diuretics (water pills).
  • Protease inhibitors.


Usual dose:

Schizophrenia
Starting dose is 25 mg, twice daily. The recommended dose range is 25 to 400 mg, taken twice daily.

Bipolar Mania
Starting dose is 50 mg, twice daily. The recommended dose range is 50 to 400 mg, taken twice daily.

Bipolar Depression
50 mg on day 1, 100 mg on day 2, 200 mg on day 3, and 300 mg on day 4 and onwards taken once daily. Dose may be increased to 400 mg on day 5 and up to 600 mg per day from day 8 onwards depending on the response and tolerability. The maximum dose is 600 mg per day.


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Resource Person: Lobna Adi

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