Quetiapine
Use during pregnancy and breastfeeding
During pregnancy and lactation, use is possible in cases where the expected benefit to the mother outweighs the potential risk to the fetus.
It is unknown whether quetiapine is excreted in breast milk. If use is necessary during lactation, breastfeeding should be discontinued. Experimental studies on animals did not reveal the mutagenic and clastogenic effects of quetiapine. There was no effect of quetiapine on fertility (decreased male fertility, pseudopregnancy, increased period between two estrus, increased precoital interval and decreased pregnancy rate), but the data obtained cannot be directly transferred to humans, because There are specific differences in the hormonal control of reproduction.
Use for liver dysfunction
Quetiapine undergoes active metabolism in the liver. In patients with impaired liver function, the clearance of quetiapine is reduced by approximately 25%. Therefore, quetiapine should be used with caution in patients with impaired liver function.
Use for renal impairment
In patients with impaired renal function, the clearance of quetiapine is reduced by approximately 25%. Therefore, quetiapine should be used with caution in patients with impaired renal function.
Use in elderly patients
Use with caution in the elderly, especially when taking drugs that prolong the QT interval.
special instructions
Use with caution in patients with cardiovascular diseases and other conditions associated with the risk of arterial hypotension, especially at the beginning of treatment and in the elderly; when there is a history of seizures.
Quetiapine undergoes active metabolism in the liver. In patients with impaired liver and kidney function, the clearance of quetiapine is reduced by approximately 25%. Therefore, quetiapine should be used with caution in patients with impaired liver and/or kidney function.
Use with caution simultaneously with drugs that prolong the QT interval (especially in the elderly); with drugs that have a depressant effect on the central nervous system, as well as with ethanol; with potential inhibitors of the CYP3A4 isoenzyme (including ketoconazole, erythromycin).
If NMS develops during treatment, quetiapine should be discontinued and appropriate treatment should be prescribed.
With long-term use, there is a risk of developing tardive dyskinesia. In such cases, it is necessary to reduce the dose of quetiapine or discontinue it.
Use with caution in combination with other drugs that affect the activity of the central nervous system, as well as with ethanol.
In experimental studies studying the carcinogenicity of quetiapine, an increase in the incidence of mammary adenocarcinomas in rats was noted (at doses of 20, 75 and 250 mg/kg/day), which is associated with prolonged hyperprolactinemia.
In male rats (250 mg/kg/day) and mice (250 and 750 mg/kg/day), there was an increase in the incidence of benign adenomas from thyroid follicular cells, which was associated with a known, rodent-specific mechanism of increased hepatic clearance of thyroxine.
Impact on the ability to drive vehicles and operate machinery
Quetiapine may cause drowsiness, so patients are not recommended to perform work that requires concentration and high speed of psychomotor reactions (including driving).
Pharmacological properties
Quetiapine Formula
Quetiapine has antipsychotic effects. This drug is an atypical antipsychotic, with properties similar to serotonin or hydroxytryptamine receptors.
In addition, there is a clear affinity for alpha1-adrenergic receptors and histamine-type receptors, but in relation to alpha2-adrenergic receptors the affinity is reduced. In standard test studies, Quetiapine exhibits strong antipsychotic activity.
During oral administration, rapid absorption is observed in the stomach and intestines, then active metabolism of the drug occurs in the liver. During metabolism, several metabolites appear that are inactive and are mainly found in the blood plasma.
Eating food does not affect the level of bioavailability of the main active ingredient. Almost 83% of the main substance binds to plasma proteins. Excretion mainly occurs in the urine, with feces excreted in the form of metabolites. In an unchanged state, it is excreted in small quantities.
Overdose symptoms
During therapeutic therapy with Quetiapine, overdose symptoms occur in rare cases. Typically, an overdose is accompanied by the following conditions:
- the appearance of drowsiness;
- increased sedation;
- sometimes tachycardia appears;
- Blood pressure may decrease.
If these symptoms suddenly occur, then it is necessary to perform a gastric lavage, and also take activated charcoal or medications with a laxative effect that can remove unabsorbed Quetiapine.
Before you take your first pill
The doctor's opinion and reviews of patients already taking the drug Quetiapine will be useful to study for everyone who is prescribed this drug.
Psychiatrist review
Quetiapine is an antipsychotic drug that helps treat serious disorders of the central nervous system.
The effect of taking it is quite slow, so you should not expect that there will be an improvement from the first days of taking it. This drug accumulates in the body and over time begins to affect the nervous system.
After this, the psyche is observed to normalize, various mental disorders disappear. This medicine is often taken for insomnia, mental and neurological disorders such as excitability, anxiety, and schizophrenia. Before using this remedy, it is better to consult a doctor, because the drug has side effects.
Neurologist
From patient experience
Due to problems at work, my nervous system was greatly shaken, I developed high excitability, nervous tics, frequent nervous breakdowns and insomnia. These problems began to cause me great discomfort, and my family almost broke up.
As a result, I went to the doctor for examination and consultation. There they recommended the drug Quetiapine to me. I took it for about two months, during which time I felt much better. I became calm, the insomnia completely disappeared.
Elena, 38 years old
For a long time I was tormented by psychosis, I thought that I would end up in a psychiatric hospital. All this was due to family problems. As a result, I had to undergo examination and treatment.
During treatment, the doctor prescribed me to take the drug Quetiapine. I took it for about 2 months. I liked this drug; at least it got rid of all the unpleasant symptoms. True, at first there were side effects in the form of nausea, dizziness, tachycardia.
Tatyana, 45 years old
Strategy and tactics of application
Features of the use and dosage of Quetiapine will differ depending on the purpose of its administration.
Therapy for psychosis and schizophrenia
During acute and chronic psychoses, as well as schizophrenia, the dosage of the drug during the first 4 days is calculated according to the following scheme:
- in the first 24 hours – 50 mg;
- second day – 100 mg;
- on the third day the dose is increased to 200 mg;
- then on the fourth day it increases to 300 mg.
The dose should then be titrated to a clinically effective dosage. The most effective dose in such cases usually varies from 300 to 450 mg per day. Depending on the effectiveness of treatment, the dosage can be from 150 mg to 750 mg per day.
Patients with manic and bipolar disorders
For manic episodes that are accompanied by bipolar disorders, the daily dosage during the first four days of treatment is calculated according to the following scheme:
- in the first 24 hours you should take 100 mg;
- on the second day of therapy, the dose is increased to 200 mg;
- on the third day the dosage is 300 mg;
- on the fourth day it is recommended to increase the dose to 400 mg.
Closer to the sixth day of treatment, the dose may increase to 800 mg. The increase in dosage per day should not be more than 200 mg.
In the treatment of schizophrenia, the highest dosage per day should be no more than 750 mg. For manic disorders, the highest dosage per day should be no more than 800 mg.
Elderly patients, as well as patients with kidney or liver failure, should begin treatment with 25 mg per day. Then gradually every day it is increased by 25-50 mg until complete recovery.
When is the drug particularly effective?
Quetiapine is recommended for the following disorders:
- psychoses of various types;
- schizophrenia;
- manic episodes associated with bipolar disorders;
- bipolar affective disorder;
- major depressive disorder;
- hebephrenic schizophrenia.
Side effects
When treating with Quetiapine, side effects usually appear that affect the nervous, digestive, respiratory, and cardiovascular systems. Sometimes allergic reactions may occur.
During therapy, in rare cases, the following unpleasant symptoms may appear:
- state of increased drowsiness;
- dizziness;
- bowel disorder, namely frequent constipation;
- the occurrence of tachycardia;
- the appearance of hypotension;
- increased dry mouth;
- increased cholesterol levels;
- increased levels of triglycerides in the blood plasma;
- moderate asthenia, dyspepsia, rhinitis may be observed;
- At the beginning of treatment, body weight may increase.
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With long-term therapeutic treatment, dyskinesia may appear. In these cases, it is necessary to reduce the dosage or completely abandon treatment.
But stopping the medicine should not be abrupt. Abrupt withdrawal usually results in nausea, vomiting, and sometimes insomnia.
Independent opinion
Doctor's opinion and reviews of patients who have undergone or are undergoing treatment with Quetiron.
The drug can reduce the clinical manifestations of various mental disorders and significantly alleviate the patient’s condition. The main advantages of the drug include a prolonged effect, as well as an affordable cost. The disadvantage is a large number of restrictions; treatment can only be carried out under the supervision of a specialist.
Neurologist, 21 years of experience
It's a good product, it helps me a lot. I didn’t notice any side effects, I feel good, nothing bothers me. I had to try a lot of medications, but Kvetiron turned out to be the best of all, I have been taking it for a long time and am happy with everything.
Nina, 47
Maybe the medicine is good, but we were just unlucky. Not only did this drug not help my wife, but health problems appeared in addition to those that existed before. I won’t draw categorical conclusions; the doctor warned us that Kvetiron is not suitable for everyone, and this was indicated in the instructions.
Andrey Pavlovich, 44
special instructions
Due to the fact that the drug affects the central nervous system, it should be taken with extreme caution together with other medications that have a suppressive effect on the central nervous system and together with alcoholic beverages.
If orthostatic hypotension occurs while taking Quetiapine, the dosage is reduced or treatment is stopped completely.
Sometimes when using this medication, neuroleptic malignant syndrome occurs, in such cases the drug is discontinued. Withdrawal should be done slowly.
Since the use of the medicine may cause drowsiness, it is best to refrain from driving a car or performing work that requires alertness during the period of treatment.
