From the Guidelines
The maximum daily dose of Seroquel (quetiapine) is 400 mg twice daily, which translates to 800 mg per day. This information is based on the study published in the American Family Physician in 2002 1. According to this study, the initial dosage of quetiapine is 12.5 mg twice daily, and the maximum dosage is 200 mg twice daily.
Key Considerations
- The medication should be started at a lower dose and gradually increased to minimize side effects like sedation and orthostatic hypotension.
- For treatment-resistant schizophrenia, doses up to 1200 mg daily may be used under close medical supervision, but this is not the typical maximum daily dose.
- The study published in the BMJ in 2020 1 provides information on various interventions for maintaining abstinence from alcohol, but it does not provide the most relevant or up-to-date information on the maximum daily dose of Seroquel.
- It is essential to prioritize the most recent and highest-quality study when determining the maximum daily dose of a medication, which in this case is the 2002 study published in the American Family Physician 1.
- Patients should take Seroquel exactly as prescribed, not suddenly stop taking it, and be monitored for potential side effects such as metabolic changes, including weight gain and increased blood glucose.
Administration and Monitoring
- The medication is typically taken once daily at bedtime for extended-release formulations or divided into two doses for immediate-release forms.
- Patients should be closely monitored for potential side effects, and the dosage should be adjusted accordingly to minimize adverse effects and optimize therapeutic benefits.
From the FDA Drug Label
The maximum human dose (MRHD) of 800 mg/day The maximum daily dose of Seroquel is 800 mg/day 2.
From the Research
Maximum Daily Dose of Seroquel
The maximum daily dose of Seroquel (quetiapine) varies depending on the condition being treated and the formulation used.
- For the treatment of schizophrenia, the recommended dose range is 300-500 mg/day 3.
- For the treatment of bipolar depression, the recommended dose is 300 or 600 mg/day 4.
- In some cases, doses greater than 750 mg/day have been used, with some patients receiving up to 2400 mg/day 3.
- However, it is essential to note that dosing of quetiapine in clinical practice is often higher than what has been established in registration studies for schizophrenia 3.
- The tolerability and sensitivity of quetiapine-XR (extended-release) have been compared across various psychiatric conditions, including schizophrenia, bipolar mania, bipolar depression, major depressive disorder, and generalized anxiety disorder 5.
Key Findings
- Quetiapine is generally well-tolerated, with most treatment-emergent adverse events being of mild to moderate severity 4, 6.
- Common adverse events include dry mouth, sedation, somnolence, dizziness, constipation, and increased appetite 4, 6.
- Extrapyramidal symptoms (EPS) occur across quetiapine and placebo groups, but there are no significant differences between quetiapine and placebo recipients on objective measures of EPS and akathisia 4.
- Some patients may experience weight gain, increases in blood glucose or lipid parameters, although the clinical significance of these changes is uncertain 4.