Anthropometric Measurements as Predictors of Low Birth Weight Among Tanzanian Neonates: A Hospital-Based Study
November 7, 2025
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Brand Name :
Seroquel, Seroquel XR
Synonyms :
quetiapine
Class :
Atypical antipsychotics
Brand Name :
Seroquel, Seroquel XR
Synonyms :
quetiapine
Class :
Atypical antipsychotics
Dosage Forms & Strengths
tablet, extended release
400mg
300mg
200mg
150mg
50mg
tablet, immediate release
400mg
300mg
200mg
100mg
50mg
25mg
Immediate release
On day 1: 50 mg daily orally divided 2 times a day
On days 2 and 3: Dosage increased every day in the increments of 25-50 mg 2-3 times a day to 300-400 mg on day 4; additional modifications may be made in the increments of 25-50 mg 2 times a day at more than 2-day intervals.
Dosage: 150-750 mg daily
Extended release
On day 1: 300 mg daily orally; subsequently, the dose can be increased by up to 300 mg/day at more than one-day intervals.
400-800 mg daily for maintenance (monotherapy).
Patients who have been discontinued treatment for more than one week should reduce their dose upon start of therapy; patients who have been discontinued treatment for less than one week may restart at their past maintenance dose.
(Depressive Episodes)
The dosage can be titrated upward over four days using either extended-release or immediate-release tablets.
Day 1: 50 mg orally before bed.
Day 2: 100 mg orally before bed.
Day 3: 200 mg orally before bed.
Maintenance (from day 4): 300 mg orally before bed
Dose Adjustments
Mania, Bipolar I Disorder
Given either monotherapy or in the combination with lithium or divalproex.
Immediately release
on day 1: 100 mg orally divided every 12 hours
on day 2: 200 mg orally divided every 12 hours.
on day 3: 300 mg daily orally divided every 12 hours
on day 4: 400 mg daily orally divided every 12 hours
Additional dosage modifications, up to 800 mg daily by day 6, should be given in 200 mg/day increments.
Dosage: 400-800 mg daily, should not exceed more than 800 mg daily
.
Extended release
On Day 1: 300 mg orally once a day
On Day 2: 600 mg orally once a day
Maintenance (after day 3): 400-800 mg daily orally
Maintenance, Bipolar I Disorder
Given in addition to divalproex or lithium
400-800 mg daily orally divided every 12 hours for immediate release
400-800 mg daily orally in a single dose, extended release
In general, patients in the maintenance phase continue to receive the same dose that was used to stabilise them.
Antidepressant extended-release formulation
On days 1 & 2: 50 mg orally in the evening
Day 3: The dose can be increased to 150 mg orally in the evening.
Dosage range: 150-300 mg/day
Insomnia (Off-label)
Initially, 25 mg orally daily at bedtime.
Alcohol Dependence (Off-label)
25-50 mg orally at bedtime; can be titrated; should not exceed more than 300 mg
Dosage Forms & Strengths
tablet, extended release
400mg
300mg
200mg
150mg
50mg
tablet, immediate release
400mg
300mg
200mg
100mg
50mg
25mg
Below 12 years
Safety and efficacy were not established
Above 12 years (immediate release, monotherapy,)
Day 1: 50 mg daily orally divided 2 times a day
Day 2: 100 mg daily orally divided 2 times a day
Day 3: 200 mg daily orally divided 2 times a day
Day 4: 300 mg daily orally divided 2 times a day
Day 5: 400 mg daily orally divided 2 times a day; further dose modifications should be less than 100 mg daily in increments
Dosage: 400-800 mg daily
Depending on tolerance and response, the daily dose can be divided 3 times a day
Above 12 yrs (extended release, monotherapy)
Day 1: 50 mg orally once a day
Day 2: 100 mg orally once a day
Day 3: 200 mg orally once a day
Day 4: 300 mg orally once a day
Day 5: 400 mg orally once a day; further dose modifications should be less than 100 mg daily in increments
Mania, Bipolar I Disorder
Below 10 yrs
Safety and efficacy were not established
Above 10 years (immediate release,monotherapy)
Day 1: 50 mg daily orally divided 2 times a day
Day 2: 100 mg daily orally divided 2 times a day
Day 3: 200 mg daily orally divided 2 times a day
Day 4: 300 mg daily orally divided 2 times a day
Day 5: 400 mg daily orally divided 2 times a day; further dose modifications should be less than 100 mg daily in increments
Dosage: 400-600 mg daily
Depending on tolerance and response, the daily dose can be divided 3 times a day
Above 10 years (extended release, monotherapy)
Day 1: 50 mg orally once a day
Day 2: 100 mg orally once a day
Day 3: 200 mg orally once a day
Day 4: 300 mg orally once a day
Day 5: 400 mg orally once a day; further dose modifications should be less than 100 mg daily in increments
Dosage: 400-600 mg daily once
Dosage Forms & Strengths
Because of the increased risk of infectious or the cardiovascular related deaths, this medication is not approved for the dementia-related psychosis.
50-200 mg/day orally for immediate release; can increase to 25-50 mg daily
50 mg/day orally for extended release; may can be increased to 50 mg daily.
Dose Adjustments
Alzheimer's Disease-Related Psychosis and Agitation (Off-label)
12.5-50 mg daily orally at start; increased gradually as tolerated; should not exceed more than 200-300 mg daily
may decrease the therapeutic effect when combined with anti-parkinson agents
may decrease the therapeutic effect when combined with anti-parkinson agents
may decrease the therapeutic effect when combined with anti-parkinson agents
may decrease the therapeutic effect when combined with anti-parkinson agents
may decrease the therapeutic effect when combined with anti-parkinson agents
may decrease the therapeutic effect when combined with anti-parkinson agents
may decrease the therapeutic effect when combined with anti-parkinson agents
may decrease the therapeutic effect when combined with anti-parkinson agents
may decrease the therapeutic effect when combined with anti-parkinson agents
may decrease the therapeutic effect when combined with anti-parkinson agents
anti-Parkinson Agents may diminish the therapeutic effect of anti-psychotic Agents
anti-Parkinson Agents may diminish the therapeutic effect of anti-psychotic Agents
anti-Parkinson Agents may diminish the therapeutic effect of anti-psychotic Agents
anti-Parkinson Agents may diminish the therapeutic effect of anti-psychotic Agents
anti-Parkinson Agents may diminish the therapeutic effect of anti-psychotic Agents
may decrease the therapeutic effect when combined with antipsychotic agents
may decrease the therapeutic effect when combined with antipsychotic agents
may decrease the therapeutic effect when combined with antipsychotic agents
may decrease the therapeutic effect when combined with antipsychotic agents
may decrease the therapeutic effect when combined with antipsychotic agents
may decrease the therapeutic effect when combined with antipsychotic agents
quetiapine: they may increase the QTc-prolonging effect of QTc-prolonging Agents
quetiapine: they may increase the QTc-prolonging effect of QTc-prolonging Agents
quetiapine: they may increase the QTc-prolonging effect of QTc-prolonging Agents
quetiapine: they may increase the QTc-prolonging effect of QTc-prolonging Agents
quetiapine: they may increase the QTc-prolonging effect of QTc-prolonging Agents
QTc interval is increased both by lenvatinib and quetiapin
CYP3A strong enhancers of the small intestine may reduce the bioavailability of quetiapine 
it decreases the effects of antipsychotic agents
may enhance the hypotensive effect of beta-blockers
may enhance the hypotensive effect of beta-blockers
may enhance the hypotensive effect of beta-blockers
may enhance the hypotensive effect of beta-blockers
may enhance the hypotensive effect of beta-blockers
may enhance the hypotensive effect of beta-blockers
may enhance the hypotensive effect of beta-blockers
may enhance the hypotensive effect of beta-blockers
may enhance the hypotensive effect of beta-blockers
may enhance the hypotensive effect of beta-blockers
may increase the adverse effect of amphetamines
may increase the adverse effect of amphetamines
may increase the adverse effect of amphetamines
may increase the adverse effect of amphetamines
may increase the adverse effect of amphetamines
It may enhance sedation when combined with a shepherd's purse
It may enhance the metabolism when combined with dexamethasone
quetiapine: they may diminish the serum concentration of CYP3A4 Inducers
quetiapine: they may diminish the serum concentration of CYP3A4 Inducers
quetiapine: they may diminish the serum concentration of CYP3A4 Inducers
quetiapine: they may diminish the serum concentration of CYP3A4 Inducers
quetiapine: they may diminish the serum concentration of CYP3A4 Inducers
may have an increased neurotoxic effect when combined with antipsychotic agents
may have an increased neurotoxic effect when combined with antipsychotic agents
quetiapine: they may enhance the serum concentration of CYP3A4 Inhibitors
quetiapine: they may enhance the serum concentration of CYP3A4 Inhibitors
quetiapine: they may enhance the serum concentration of CYP3A4 Inhibitors
quetiapine: they may enhance the serum concentration of CYP3A4 Inhibitors
quetiapine: they may enhance the serum concentration of CYP3A4 Inhibitors
may have an increasingly adverse effect when combined with amphetamines
may have an increasingly adverse effect when combined with amphetamines
may have an increasingly adverse effect when combined with amphetamines
may have an increasingly adverse effect when combined with amphetamines
may have an increasingly adverse effect when combined with amphetamines
may diminish the therapeutic effect of the drug
may diminish the therapeutic effect of the drug
quetiapine: they may enhance the serum concentration of CYP2D6 Inhibitors
quetiapine: they may enhance the serum concentration of CYP2D6 Inhibitors
quetiapine: they may enhance the serum concentration of CYP2D6 Inhibitors
quetiapine: they may enhance the serum concentration of CYP2D6 Inhibitors
quetiapine: they may enhance the serum concentration of CYP2D6 Inhibitors
may increase the hypotensive effect of antipsychotic agents
may increase the hypotensive effect of antipsychotic agents
may increase the hypotensive effect of antipsychotic agents
may increase the hypotensive effect of antipsychotic agents
may increase the hypotensive effect of antipsychotic agents
the effect of quetiapine is decreased by lorlatinib, by altering intestinal or hepatic CYP3A4 enzyme metabolism
May enhance the hypotensive effect of beta-Blockers
May enhance the hypotensive effect of beta-Blockers
May enhance the hypotensive effect of beta-Blockers
May enhance the hypotensive effect of beta-Blockers
May enhance the hypotensive effect of beta-Blockers
serotonergic Agents may enhance the adverse/toxic effect of antipsychotic Agents
may enhance the effect of antipsychotic agents
may enhance the effect of antipsychotic agents
may enhance the effect of antipsychotic agents
may enhance the effect of antipsychotic agents
may enhance the effect of antipsychotic agents
may increase the hypotensive effect of anti-hypertensives
may enhance the adverse effect of antipsychotic agents
may enhance the adverse effect of antipsychotic agents
may enhance the adverse effect of antipsychotic agents
may enhance the adverse effect of antipsychotic agents
may enhance the adverse effect of antipsychotic agents
may enhance the neurotoxic effect of antipsychotic agents
may enhance the neurotoxic effect of antipsychotic agents
may enhance the neurotoxic effect of antipsychotic agents
may enhance the neurotoxic effect of antipsychotic agents
may enhance the neurotoxic effect of antipsychotic agents
may diminish the therapeutic effect of antipsychotic agents
may diminish the therapeutic effect of antipsychotic agents
may diminish the therapeutic effect of antipsychotic agents
may diminish the therapeutic effect of antipsychotic agents
may diminish the therapeutic effect of antipsychotic agents
may enhance the adverse effect of antipsychotic agents
may enhance the adverse effect of antipsychotic agents
moexipril/hydrochlorothiazideÂ
may increase the hypotensive effect of blood pressure-lowering agents
may enhance the bradycardic effect of beta blockers
may increase the hypotensive effect of blood pressure-lowering agents
may increase the neurotoxic effect
may increase the neurotoxic effect
may increase the neurotoxic effect
may increase the neurotoxic effect
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may increase the neurotoxic effect
may increase the neurotoxic effect
may increase the neurotoxic effect
may increase the neurotoxic effect
may increase the neurotoxic effect
may increase the neurotoxic effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may have an increasingly adverse effect when combined with antipsychotic agent
may increase the QTc-prolonging effect
may increase the QTc-prolonging effect
may increase the QTc-prolonging effect
may increase the QTc-prolonging effect
may increase the QTc-prolonging effect
It could potentially amplify the QTc-prolonging effect of antipsychotic medications known for their QT-prolongation effects
It may enhance the serum concentration when combined with CYP3A4 Substrates
It may enhance the serum concentration when combined with CYP3A4 Substrates
It may enhance the serum concentration when combined with CYP3A4 Substrates
It may enhance the serum concentration when combined with CYP3A4 Substrates
It may enhance the serum concentration when combined with CYP3A4 Substrates
may have an increased neurotoxic effect when combined with antipsychotic agents
may have an increased neurotoxic effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased neurotoxic effect when combined with antipsychotic agents
may have an increased neurotoxic effect when combined with antipsychotic agents
itopride: they may decrease the therapeutic effect of antipsychotics
nicorandil: they may decrease the therapeutic effect of antipsychotics
quinagolide: they may decrease the therapeutic effect of antipsychotics
ramosetron: they may decrease the therapeutic effect of antipsychotics
may have an increasingly adverse effect when combined with antipsychotic agents
When quetiapine is used together in combination with profenamine, this leads to reduction in therapeutic effectiveness of profenamine
may increase the hypotensive effect of antipsychotic agents
may increase the hypotensive effect of antipsychotic agents
may increase the hypotensive effect of antipsychotic agents
may increase the hypotensive effect of antipsychotic agents
may increase the hypotensive effect of antipsychotic agents
antipsychotic agents increase the arrhythmogenic effect of mequitazine in the serum
Actions and spectrum:
quetiapine is a medication that belongs to the class of atypical antipsychotic drugs. The mechanism of action is known to be the antagonism of dopamine and serotonin receptors in the brain. quetiapine is primarily used to treat schizophrenia, bipolar disorder, and major depressive disorder.
In schizophrenia, quetiapine works by blocking the activity of dopamine receptors in the brain, which can help to reduce symptoms such as hallucinations, delusions, and disordered thinking.
In bipolar disorder, quetiapine can help to stabilize mood by reducing the occurrence and severity of hypomanicor manic episodes and depressive episodes.
In major depressive disorder, quetiapine is sometimes used as an add-on treatment to antidepressant medications to enhance their effectiveness.
quetiapine has also been used off-label for a range of other conditions, such as anxiety, insomnia, and post-traumatic stress disorder. However, its efficacy for these indications is less well-established.
Frequency defined
>10%
Fatigue (3-14%)
Increased blood pressure (41%)
Increased cholesterol (7-18%)
Constipation (6-11%)
Headache (7-21)
Dizziness (1-18%)
Extrapyramidal symptoms (1-13%)
Increased triglycerides (8-22%)
Increased appetite (2-12%)
Dry mouth (9-44%)
Somnolence (18-57%)
Dyspepsia (2-7%)
Back pain (3-5%)
Tachycardia (1-6%)
Rhinitis (3-4%)
Blurred vision (1-4%)
Myalgia (2%)
Dyskinesia (4%)
Hemorrhage (1%)
Abdominal pain (4-7%)
Tremor (2-8%)
Postural hypotension (2-7%)
Pharyngitis (4-6%)
Rash (4%)
Arthralgia (1-4%)
Neck pain (2%)
Neutropenia (2%)
< 1%
myocarditis
Cardiomyopathy
Nightmares
Rhabdomyolysis
Leukocytosis
Exfoliative dermatitis
Priapism
QTc prolongation
Pancreatitis
Palpitation
Epistaxis
Post marketing Reports
nocturnal enuresis, SIADH, toxic epidermal necrolysis, serious liver reactions like liver necrosis, hepatitis, ahepatic failure, intestinal obstruction, colon ischemia, sleep apnea, confusion state, DRESS, retrograde amnesia, Stevens-Johnson syndrome, decreased platelet count, agranulocytosis, ileus, urinary retention, AGEP, and vasculitis.
Black Box Warning:
quetiapine has a black box warning regarding an increased risk of mortality in the elderly patients with dementia-related psychosis. This warning is based on studies that have shown that older adults with dementia who are treated with antipsychotic medications such as quetiapine are at an increased risk of death when compared to those who receive a placebo. quetiapine is not approved in the treatment of dementia-related psychosis.
Contraindication/Caution:
Contraindication:
Caution:
Comorbidities:
quetiapine should be used under caution in patients with risk of cerebrovascular disease that increase the risk of QT prolongation, such as electrolyte imbalances, cardiac arrhythmias, and concomitant use of drugs known to prolong the QT interval. It should also be used under caution in patients with a history of seizures, hepatic impairment, renal impairment, and in elderly patients with dementia-related psychosis. Additionally, quetiapine may cause orthostatic hypotension and should be used under caution in patients at risk for this condition.
Pregnancy consideration: US FDA pregnancy category: C
Lactation: quetiapine is excreted in human breast milk, and its use is not recommended while breastfeeding.Â
Pregnancy category:
Pharmacology:
quetiapine is an atypical antipsychotic medication that acts as an antagonist at multiple neurotransmitter receptors in the brain. It has high affinity for serotonin 5-HT1A and 5-HT2A receptors, dopamine D1 and D2 receptors, histamine H1 receptors, and adrenergic alpha 1 and alpha 2 receptors. quetiapine also has moderate affinity for muscarinic M1 receptors.
quetiapine’s antagonism of dopamine and serotonin receptors in the mesolimbic pathway is thought to be responsible for its antipsychotic effects. Its antagonism of histamine and alpha-adrenergic receptors is thought to be responsible for its sedative effects, while its antagonism of muscarinic receptors is thought to be responsible for some of its anticholinergic side effects.
Pharmacodynamics:
quetiapine is an atypical antipsychotic medication with a complex pharmacodynamic profile. It exerts its effects through its actions on several neurotransmitter receptors, including dopamine, serotonin, histamine, and adrenergic receptors. quetiapine is primarily an antagonist of dopamine D2 and serotonin 5-HT2A receptors, but it also has some affinity for alpha-adrenergic and histamine H1 receptors.
quetiapine’s blockade of dopamine D2 receptors in the mesolimbic pathway reduces the positive symptoms of schizophrenia such as hallucinations and delusions. Its antagonism of serotonin 5-HT2A receptors may contribute to its efficacy in treating negative symptoms of schizophrenia, such as social withdrawal and apathy.
Pharmacokinetics:
Absorption
quetiapine is well absorbed after oral administration, with a bioavailability of about 100%. Administration with food can delay the time to peak concentration (Tmax) by about 2 hours.
Distribution
quetiapine is extensively distributed in the body, with a volume of distribution (Vd) of about 10 L/kg. It is highly protein-bound, with approximately 83% bound to plasma proteins.
Metabolism
quetiapine is extensively metabolized in the liver by the cytochrome P450 (CYP) enzyme system, mainly CYP3A4 and CYP2D6. The primary metabolite is norquetiapine, which has approximately one-third to one-fifth the pharmacological activity of quetiapine.The elimination half-life of quetiapine is about 6 hours, while the elimination half-life of norquetiapine is about 12 hours.
Elimination and excretion
quetiapine and its metabolites are excreted mainly in the urine (73%) and feces (20%). Approximately 1% of the dose is excreted unchanged in the urine.
Administration:
quetiapine is available in several forms, including immediate-release tablets, extended-release tablets, and extended-release capsules. It can be administered with or without food, but it is recommended to take it with a meal to increase its absorption.
The immediate-release tablets are usually taken two or three times per day, while the extended-release tablets and capsules are taken once per day. The extended-release forms of quetiapine should be swallowed whole and not crushed or chewed.
The dosage of quetiapine may vary depending on the condition being treated and other individual factors such as age, weight, and kidney/liver function.
Patient information leaflet
Generic Name: quetiapine
Pronounced: (kweh-TEE-uh-peen)
Why do we use quetiapine?
quetiapine is an antipsychotic medication used to treat mental conditions such as schizophrenia, bipolar disorder, and major depressive disorder (as an add-on to antidepressant medication). It acts by helping to restore the balance of natural substances (neurotransmitters) in the brain. quetiapine can also be used to treat symptoms of anxiety and agitation in people with dementia.
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