From the Research
The recommended tapering schedule for quetiapine (Seroquel) should involve a gradual reduction over months or years, with dose reductions made in a hyperbolic manner to minimize the risk of relapse and withdrawal symptoms, as suggested by the most recent and highest quality study 1.
Tapering Schedule
When tapering quetiapine, it is essential to consider the patient's current dose, duration of treatment, and response to dose reductions.
- A patient on a higher dose or who has been taking quetiapine long-term may require a more gradual taper.
- The tapering process should be individualized, with smaller dose reductions made at lower doses to minimize the risk of psychotic symptoms.
- The dose should be reduced by a certain percentage (e.g., 10-25%) every 3-6 months, with the goal of reaching a final dose that is as small as 1/40th of the therapeutic dose before complete cessation.
Monitoring and Adjustments
During the tapering process, patients should be closely monitored for withdrawal symptoms, including:
- Insomnia
- Nausea
- Headache
- Dizziness
- Irritability
- Return of underlying symptoms If withdrawal symptoms occur, the patient's dose should be temporarily increased to the previous level, and then reduced more gradually.
Importance of Gradual Tapering
Gradual tapering of antipsychotics like quetiapine is crucial to minimize the risk of relapse and withdrawal symptoms, as it allows the brain to adapt to the decreasing dose and reduces the disruption of homeostatic equilibrium 2, 1.
Patient Communication
Patients should maintain regular communication with their healthcare provider throughout the tapering process to ensure that any concerns or symptoms are addressed promptly.