What is the recommended starting dose for extended-release Seroquel (quetiapine)?

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Last updated: July 15, 2025View editorial policy

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Starting Dose for Extended-Release Seroquel (Quetiapine)

The recommended initial dose for extended-release quetiapine (Seroquel XR) is 50 mg once daily at bedtime, with gradual titration based on response and tolerability.

Dosing Guidelines by Indication

Schizophrenia

  • Initial dose: 50 mg once daily at bedtime
  • Day 2: 100 mg once daily
  • Day 3: 200 mg once daily
  • Day 4: 300 mg once daily
  • Target dose range: 400-800 mg once daily 1

Bipolar Depression

  • Initial dose: 50 mg once daily at bedtime
  • Day 2: 100 mg once daily
  • Day 3: 200 mg once daily
  • Day 4: 300 mg once daily
  • Target dose: 300 mg once daily 1

Bipolar Mania

  • Initial dose: 50 mg once daily at bedtime
  • Day 2: 100 mg once daily
  • Day 3: 200 mg once daily
  • Day 4: 300 mg once daily
  • Day 5: 400 mg once daily
  • Target dose range: 400-800 mg once daily 1

Administration Considerations

  • Take with or without food - A light meal has no significant effect on absorption, though high-fat meals can increase drug exposure 2
  • Evening dosing is preferred - This helps mitigate daytime sedation 2
  • Once-daily administration - XR formulation allows for once-daily dosing versus twice-daily with immediate-release 1, 2

Special Populations

Elderly Patients

  • Start at a lower dose of 50 mg/day
  • Increase in increments of 50 mg/day based on response and tolerability 1
  • Use caution due to increased risk of orthostatic hypotension

Hepatically Impaired Patients

  • Start at 25 mg/day
  • Increase daily in increments of 25-50 mg/day based on clinical response and tolerability 1

Pharmacokinetic Considerations

The extended-release formulation provides:

  • Similar overall drug exposure (AUC) compared to immediate-release
  • Lower peak concentration (Cmax) than immediate-release
  • Less pronounced D2 receptor occupancy peak
  • More sustained receptor occupancy over 24 hours 3, 2

Advantages of Extended-Release vs. Immediate-Release

  • Reduced sedation intensity during initial hours after administration 4
  • Less variable drug exposure (39.2% vs 51.2% coefficient of variation) 2
  • Simplified dosing schedule (once daily vs twice daily)
  • Potentially better adherence due to once-daily dosing

Important Monitoring Considerations

  • Monitor for orthostatic hypotension, especially during initial dose titration
  • Watch for excessive sedation, particularly in elderly patients
  • Be aware of potential metabolic effects with long-term use
  • Consider regular monitoring of weight, blood glucose, and lipid profiles

Common Pitfalls to Avoid

  1. Starting at too high a dose - This increases risk of sedation and orthostatic hypotension
  2. Titrating too quickly - Follow the recommended gradual titration schedule
  3. Morning dosing - Evening dosing helps minimize daytime sedation
  4. Failure to adjust dose in elderly or hepatically impaired patients - These populations require lower starting doses and more cautious titration
  5. Abrupt discontinuation - When stopping treatment, gradual tapering is recommended

Remember that the extended-release formulation was specifically designed to provide more consistent plasma levels throughout the day, which may improve tolerability while maintaining efficacy.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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