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Qmax is indicated for:
- Acute and chronic psychoses, including schizophrenia.
- Bipolar disorder, including:
- Treatment of manic episodes meeting DSM-IV criteria.
- Treatment of depressive episodes.
- Maintenance therapy in bipolar I disorder, in combination with a mood stabilizer, for preventing recurrence of manic, depressive, or mixed episodes.
Elderly: Slower titration and lower doses may be required. Clearance is reduced by 30–50%.
Children/Adolescents (<18 years): Not recommended.
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বাহিরে
✅ Description:
Quetiapine Fumarate is an atypical antipsychotic belonging to the dibenzothiazepine class.
It acts as an antagonist at multiple brain neurotransmitter receptors:
- Serotonin (5HT1A, 5HT2)
- Dopamine (D1, D2)
- Histamine (H1)
- Adrenergic (α1, α2)
It has negligible affinity for muscarinic cholinergic and benzodiazepine receptors.
The therapeutic effect in schizophrenia is thought to result from a combination of dopamine D2 and serotonin 5HT2 antagonism.
Histamine H1 antagonism may explain sedation, while α-adrenergic blockade may contribute to orthostatic hypotension.
- Suicidal thoughts/behavior: Monitor patients with depression until remission.
- Orthostatic hypotension: Use caution in patients with cardiovascular or cerebrovascular disease.
- Seizures: Use cautiously in patients with seizure history.
- Tardive Dyskinesia / EPS: Consider dose reduction or discontinuation if symptoms appear.
- Neuroleptic Malignant Syndrome (NMS): Discontinue immediately if suspected.
- QT prolongation: Use with caution in at-risk patients.
- Neutropenia: Rare but possible; monitor CBC.
- Hyperglycemia/Diabetes: Monitor blood glucose in at-risk patients.
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✔️ Dosage & Administration
Schizophrenia & chronic psychoses:
- Day 1: 50 mg
- Day 2: 100 mg
- Day 3: 200 mg
- Day 4: 300 mg
Effective dose range: 300–450 mg/day, titrated as needed (150–750 mg/day possible).
Administered twice daily, with or without food.
Manic episodes (bipolar disorder):
Day 1: 100 mg → Day 4: 400 mg
Up to 800 mg/day by Day 6 (increments ≤200 mg).
Effective range: 400–800 mg/day.
Twice daily, with or without food.
Depressive episodes (bipolar disorder):
At bedtime: start 50 mg (Day 1) → 300 mg (Day 4).
May increase to 400 mg (Day 5) and 600 mg (Day 8).
Usual effective dose: 300 mg/day.
Maintenance (bipolar I disorder, with mood stabilizer):
Continue same effective dose from acute phase.
Typically 400–800 mg/day, administered twice daily.
✔️ Side Effects
Most commonly reported adverse effects include:
- Somnolence, dizziness, dry mouth.
- Discontinuation/withdrawal symptoms.
- Lipid changes: ↑ triglycerides, ↑ LDL cholesterol, ↓ HDL cholesterol.
- Weight gain, reduced hemoglobin.
- Extrapyramidal symptoms (EPS).
✔️ Drug Interactions
Use caution with drugs that prolong QT interval or cause electrolyte imbalance.
Thioridazine, carbamazepine, and phenytoin increase the clearance of Quetiapine.
Enzyme inducers may lower plasma levels of Qmax.
✔️ Contraindications
Known hypersensitivity to Quetiapine or any component of the formulation.
✔️ Pregnancy & Lactation
Safety not established. Use only if potential benefits outweigh risks.
Excretion into human milk unknown → breastfeeding is not recommended during treatment.
✔️ Overdose Effects
- Survival reported after ingestion up to 30 g.
- No specific antidote.
- Management: airway support, oxygenation, cardiovascular monitoring, IV fluids.
- Avoid adrenaline/dopamine (risk of worsening hypotension due to α-blockade).
- Continuous monitoring required until recovery.
✔️ Storage:
Store in a cool, dry place, away from light.
Keep out of reach of children.
⚠️Disclaimer:
At ePharma, we’re committed to providing accurate and accessible health information. However, all content is intended for informational purposes only and should not replace medical advice from a qualified physician. Please consult your healthcare provider for personalized guidance. We aim to support, not substitute, the doctor-patient relationship.
