How to Discontinue Quetiapine 12.5 mg Every Other Day
At this extremely low dose taken every other day, you can stop quetiapine immediately without tapering, as withdrawal symptoms are primarily associated with higher doses and daily use.
Understanding Your Current Regimen
Your current dose of 12.5 mg every other day is far below the therapeutic range used in clinical trials (150–750 mg/day) and represents approximately 1.7–8% of the minimum effective dose for psychiatric conditions 1. At this sub-therapeutic level, the risk of discontinuation symptoms is minimal.
Evidence for Direct Discontinuation
Withdrawal symptoms from quetiapine are uncommon and primarily occur after abrupt cessation of therapeutic doses (typically ≥150 mg/day), manifesting as nausea, vomiting, agitation, restlessness, diaphoresis, irritability, anxiety, insomnia, tachycardia, and dizziness 2.
Case reports documenting severe quetiapine withdrawal involved patients on therapeutic doses for extended periods (e.g., one year at standard dosing), not sub-therapeutic intermittent use 3.
The general principle of gradual tapering applies to medications used at therapeutic doses—your every-other-day 12.5 mg regimen does not meet this threshold 4.
Recommended Discontinuation Approach
Simply stop taking the medication. No taper is necessary at this dose and frequency.
Monitoring Plan (First 2 Weeks)
Watch for these unlikely but possible symptoms 2:
- Somatic symptoms: Nausea, dizziness, headache, sweating, sleep disturbance
- Psychological symptoms: Anxiety, irritability, restlessness
- Cardiovascular: Rapid heartbeat, blood pressure changes
If Symptoms Emerge
Mild symptoms (slight nausea, mild sleep disruption): These typically resolve within 3–7 days without intervention and can be managed with reassurance 5.
Moderate symptoms (persistent nausea interfering with daily function, significant anxiety): Contact your prescriber—you may need to reinstate a small dose briefly and taper more gradually 5.
Severe symptoms (vomiting, confusion, abnormal movements, severe agitation): Seek immediate medical attention, though this is extremely unlikely at your dose 2.
Critical Distinction: Withdrawal vs. Return of Original Symptoms
Withdrawal symptoms appear within 1–3 days of stopping and resolve within 1–2 weeks 5.
Return of the original condition (insomnia, anxiety, psychosis) may emerge weeks to months after discontinuation—this represents relapse, not withdrawal, and requires different management 4, 6.
Monitor for at least 3 months after stopping to distinguish between these two scenarios 6.
Why This Differs from Benzodiazepine Discontinuation
Unlike benzodiazepines, which require meticulous tapering even at low doses due to seizure risk 7, quetiapine does not carry the same life-threatening withdrawal risks. The evidence for quetiapine withdrawal is limited to case reports at therapeutic doses, not sub-therapeutic intermittent use 2.
Common Pitfalls to Avoid
Do not assume any symptoms emerging after stopping are automatically withdrawal—they may represent the underlying condition returning and require weeks to manifest 4, 6.
Do not restart quetiapine for mild transient symptoms that resolve within a week, as this may unnecessarily prolong medication exposure 5.
Do not stop in isolation if you are taking multiple psychiatric medications—coordinate with your prescriber to determine the appropriate sequence 4.
When to Contact Your Prescriber
Before stopping, confirm the original indication for quetiapine and whether that condition has been adequately treated or resolved 4, 6.
If you experience any concerning symptoms within the first two weeks after stopping 2.
If symptoms of your original condition (whatever quetiapine was prescribed for) return in the weeks to months following discontinuation 6.