What is the starting dose of Quetiapine (Seroquel)?

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Last updated: April 12, 2025View editorial policy

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From the Guidelines

The starting dose of Seroquel (quetiapine) should be 25 mg taken once daily, with gradual increases as needed and tolerated, to minimize the risk of sedation, dizziness, and orthostatic hypotension. This recommendation is based on the most recent and highest quality study available, which suggests that a lower starting dose is recommended for elderly patients and those with hepatic impairment, with slower titration schedules 1. The study also notes that quetiapine can cause sedation, dizziness, and orthostatic hypotension, especially during initial treatment, so starting at a lower dose helps minimize these side effects. Some key points to consider when initiating Seroquel treatment include:

  • Starting with a low dose of 25 mg once daily to minimize side effects
  • Gradually increasing the dose as needed and tolerated
  • Monitoring patients for metabolic changes, including weight gain and blood glucose alterations, which can occur with continued use
  • Being cautious when using Seroquel in elderly patients and those with hepatic impairment, as they may require lower doses and slower titration schedules. It's also important to note that the medication should be taken consistently with or without food, and patients should be monitored for any adverse effects. In terms of specific dosing regimens, the study suggests that for treating schizophrenia in adults, physicians often start at 25 mg twice daily, increasing by 25-50 mg two to three times daily over several days until reaching an effective dose, usually 300-400 mg daily divided into two or three doses 1. However, the most important consideration is to prioritize the patient's safety and well-being, and to adjust the dosing regimen accordingly. Overall, the key is to start with a low dose and gradually increase as needed and tolerated, while closely monitoring the patient for any adverse effects.

From the Research

Seroquel Starting Dose

  • The provided studies do not directly mention the starting dose of Seroquel (quetiapine) 2, 3, 4, 5, 6.
  • However, the studies discuss the efficacy and safety of quetiapine in the treatment of bipolar disorder, comparing it to other medications such as lithium, valproate, olanzapine, and risperidone.
  • The studies suggest that quetiapine is effective in treating bipolar disorder, with a good tolerability profile 2, 5, 6.
  • One study compared the mental health resource use of patients with bipolar disorder treated with risperidone, olanzapine, or quetiapine, and found that quetiapine had lower charges for other mental health care services 3.
  • Another study found that quetiapine was associated with a lower risk of mortality compared to olanzapine and risperidone 4.

Dosage Information

  • Unfortunately, the provided studies do not provide information on the starting dose of Seroquel.
  • It is recommended to consult the prescribing information or a healthcare professional for guidance on the appropriate starting dose of Seroquel for a specific patient.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Pharmacotherapy of bipolar disorder with quetiapine: a recent literature review and an update.

Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology, 2015

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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