From the Guidelines
The standard dose of Seroquel (quetiapine) is an initial dosage of 12.5 mg twice daily, with a maximum of 200 mg twice daily. This dosing recommendation is based on guidelines for managing behavior and mood disorders, specifically for the treatment of problematic delusions, hallucinations, severe psychomotor agitation, and combativeness 1. It's essential to note that quetiapine is more sedating and can cause transient orthostasis, so caution is advised. The dosage may vary depending on the individual patient's response and tolerance to the medication.
When considering the use of Seroquel, it's crucial to weigh the potential benefits against the risks, particularly in elderly patients or those with hepatic impairment, who may require lower starting doses and slower titration. The medication's effectiveness develops gradually over days to weeks, and common side effects include sedation, dizziness, dry mouth, and weight gain.
Key points to consider when prescribing Seroquel include:
- Initial dosage: 12.5 mg twice daily
- Maximum dosage: 200 mg twice daily
- Potential side effects: sedation, dizziness, dry mouth, weight gain, and transient orthostasis
- Special considerations: lower starting doses and slower titration for elderly patients or those with hepatic impairment.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION Quetiapine tablets can be taken with or without food. Indication InitialDose RecommendedDose MaximumDose Schizophrenia-Adults 25 mg twice daily 150 to 750 mg/day 750 mg/day Schizophrenia-Adolescents (13 to 17 years) 25 mg twice daily 400 to 800 mg/day 800 mg/day Bipolar Mania- Adults Monotherapy or as an adjunct to lithium or divalproex 50 mg twice daily 400 to 800 mg/day 800 mg/day Bipolar Mania-Children and Adolescents (10 to 17 years), Monotherapy 25 mg twice daily 400 to 600 mg/day 600 mg/day Bipolar Depression-Adults 50 mg once daily at bedtime 300 mg/day 300 mg/day
The standard dose of Seroquel (Quetiapine) varies by indication:
- For Schizophrenia in adults, the recommended dose is 150 to 750 mg/day.
- For Bipolar Mania in adults, the recommended dose is 400 to 800 mg/day.
- For Bipolar Depression in adults, the recommended dose is 300 mg/day. 2
From the Research
Standard Dose of Seroquel
The standard dose of Seroquel (Quetiapine) can vary depending on the condition being treated and the individual patient's response.
- For schizophrenia, studies have shown that doses of 150-450 mg/day are effective and well-tolerated 3, 4.
- A study comparing different dosing regimens found that 225 mg twice daily and 150 mg three times daily were equally effective and well-tolerated 3.
- Another study found that high-dose quetiapine (>250 mg/day) was more effective than low-dose quetiapine (<250 mg/day) in reducing positive symptoms of schizophrenia 4.
- For bipolar affective disorder, a study found that low doses of quetiapine (25-75 mg/day) were effective in reducing impulsivity in patients with bipolar affective disorders in remission 5.
- A review of the dose-response relationship of quetiapine in schizophrenia found that fixed-dose efficacy studies suggest that dosages of 150-450 mg/day are more effective than placebo and no less effective than dosages of 600 or 750 mg/day 6.
- A pilot study found that rapid dose escalation with quetiapine to 400 mg/d in 2-5 days was safe and well-tolerated in acutely ill, hospitalized patients with schizophrenia 7.
Dosage Regimens
Different dosage regimens have been studied, including:
- Twice daily dosing: 225 mg twice daily has been shown to be effective and well-tolerated 3.
- Three times daily dosing: 150 mg three times daily has been shown to be effective and well-tolerated 3.
- Extended-release quetiapine: a fixed-dose study found that dosages of 600 and 800 mg/day were equally efficacious and numerically superior to 400 mg/day 6.