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Seroquit

Seroquit (Quetiapine 25–300 mg) — IR atypical antipsychotic for schizophrenia, bipolar mania, bipolar depression, MDD adjunct. dose-dependent receptor profile across 25–800 mg range.

Medicinsk gennemgået af Morgan Ellis — Apoteksforsker · 8 års erfaring  · Sidst gennemgået: maj 2026

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Seroquit (Quetiapine 25 / 50 / 100 / 200 / 300 mg, immediate-release) is an atypical antipsychotic for schizophrenia, bipolar mania, bipolar depression, MDD adjunct, and GAD adjunct. Strongly sedating and metabolically heavy — but uniquely effective for bipolar depression. Often misused as a “sleeping pill” — discouraged because of metabolic burden.

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Hvorfor bestille fra MedsBase

Seroquit at MedsBase is supplied directly from a WHO-GMP certified manufacturer in plain, discreet packaging. Every order is covered by our Reshipment Assurance Policy — 20-hverdages leveringsvindue eller vi gensender uden ekstra omkostninger — og kvalificerer sig til vores kundeloyalitetsprogram. Verdensomspændende forsendelse er tilgængelig til de fleste destinationer.

What Seroquit is and how it works

Seroquit is a quetiapine immediate-release tablet supplied by Cipla. Available strengths: 25 / 50 / 100 / 200 / 300 mg. Quetiapine has loose D2 binding (rapid dissociation explains low EPS), strong 5-HT2A antagonism, very strong H1 antihistamine action (sedation, weight gain), α1-adrenergic antagonism (orthostasis), and α2 antagonism. Its active metabolite, norquetiapine, has noradrenaline transporter inhibition — the basis for the antidepressant effect in bipolar depression.

IR is dosed BID or TID. The strong sedation peaks 1–2 hours after each dose.

Indikationer og dosering

IndikationStartdosisMåldosisMaksimal dosis
Schizophrenia (IR)50 mg HS400–800 mg/day800 mg
Bipolar mania50 mg BID (IR) or 300 mg HS (SR)400–800 mg/day800 mg
Bipolar depression50 mg HS300 mg HS600 mg
MDD adjunct (SR)50 mg HS150–300 mg HS300 mg
GAD adjunct (off-label)50 mg HS50–150 mg HS
Older adults25 mg HS50–200 mg/dayby tolerability

Vigtige sikkerhedsovervejelser

FDA black-box — dementia-related psychosis

All atypical antipsychotics carry an FDA black-box warning for increased mortality (mostly cardiovascular and infectious) when used to treat behavioural disturbance in older adults with dementia. Atypicals are not approved for dementia-related psychosis or agitation. Use in this population is off-label, last-resort, time-limited, and requires explicit risk-benefit conversation.

Heavy metabolic burden

Weight gain, insulin resistance, dyslipidaemia — second only to olanzapine and clozapine among atypicals. Mandatory monitoring at baseline, 12 weeks, then 6-monthly: weight, fasting glucose / HbA1c, fasting lipids, BP. Counsel about diet/exercise from initiation.

Orthostatic hypotension

α1 antagonism produces orthostatic hypotension, particularly in older adults and at initiation. Titrate slowly. Check sitting and standing BP at follow-up.

“Off-label sleep aid” — discouraged

Low-dose quetiapine (25–50 mg HS) is widely used off-label as a hypnotic. The metabolic burden is the same regardless of indication — patients on quetiapine for sleep gain weight and develop insulin resistance just as much as patients on quetiapine for psychosis. Dedicated hypnotics (Z-drugs, low-dose doxepin, melatonin agonists, behavioural sleep therapy) are usually safer choices for primary insomnia.

Suicidality (under-25, MDD adjunct use)

When used as an antidepressant adjunct, the under-25 suicidality warning applies.

Almindelige bivirkninger

  • Sedation — universal; harness as bedtime benefit.
  • Weight gain and metabolic syndrome — heavy.
  • Orthostatisk hypotension og svimmelhed — common at initiation.
  • Dry mouth, constipation — moderate anticholinergic effect.
  • Takykardi — often noticed.
  • EPS / akathisia — less common than risperidone or olanzapine.
  • Prolactin — usually normal or low.
  • QT — modest dose-dependent prolongation.

Lægemiddelinteraktioner

  • Stærke CYP3A4-hæmmere (azoles, clarithromycin, ritonavir, grapefruit juice) — raise quetiapine levels several-fold; reduce dose or avoid.
  • Stærke CYP3A4-inducerende midler (rifampicin, carbamazepine, phenytoin, St John’s wort) — reduce levels; may need higher doses or switch.
  • Andre QT-forlængende lægemidler — additive risk.
  • CNS depressants — strong additive sedation.
  • Antihypertensiva — additive orthostasis.

Graviditet, amning, pædiatrisk

Pregnancy: limited data; late-pregnancy exposure can produce neonatal EPS. Breastfeeding: passes into milk in small amounts; usually compatible with monitoring. Paediatric: licensed from 13 (schizophrenia), 10 (bipolar mania).

Opbevaring

Opbevares ved 15–30 °C i original emballage.

Ofte stillede spørgsmål

Why is Seroquit so sedating?

Strong H1 antihistamine action plus α1-adrenergic blockade — this is the dominant pharmacology at low doses. The antipsychotic dopamine-D2 effect dominates only at higher doses. The clinical translation: 25–100 mg is mostly a sleeping pill; 200–400 mg starts to have antipsychotic effect; 600–800 mg is the antipsychotic dose range.

Is using Seroquit for sleep a good idea?

Probably not. The metabolic burden of quetiapine is identical at 25 mg and at 800 mg — patients on low-dose quetiapine for insomnia gain weight, develop insulin resistance, and accumulate cardiometabolic risk just as much as patients on full antipsychotic doses. Z-drugs, low-dose doxepin, melatonin agonists, and CBT-I are usually safer for primary insomnia.

Why is Seroquit effective in bipolar depression?

The norquetiapine metabolite inhibits the noradrenaline transporter — adding an antidepressant component to the sedating-stabilising profile of the parent drug. Quetiapine and lurasidone are the two main atypicals with FDA approval for bipolar depression; quetiapine is more sedating, lurasidone is metabolically cleaner.

Will Seroquit make me gain weight?

Yes — typically 3–7 kg over 6 months, sometimes more. Dose-related but real at all doses. Plot weight at every visit and counsel about diet/exercise from week 1.

How long until Seroquit works?

Sleep effect: same night. Mood/anxiety effect: 1–2 weeks. Antipsychotic effect: 2–6 weeks at adequate dose. Bipolar depression effect: 2–6 weeks.

What is the difference between IR and SR quetiapine?

Both have the same molecule and the same active metabolite. SR/XR delivers it more slowly, producing a flatter sedation peak — better for daytime function and easier once-daily dosing. IR has stronger immediate sedation, useful when bedtime sedation is desired.

Can Seroquit be stopped abruptly?

Taper over 2–4 weeks. Abrupt cessation can produce cholinergic rebound (nausea, sweating, insomnia) and antipsychotic relapse. Never stop without prescriber agreement.

What about driving on Seroquit?

Avoid driving for at least the first 1–2 weeks of any new dose. Many patients on stable bedtime doses drive normally during the day; some patients on higher daytime doses or split BID dosing remain too sedated to drive safely.

Can Seroquit be combined with an SSRI?

Yes — quetiapine SR is FDA-approved as an adjunct to SSRI/SNRI in MDD at low doses (50–300 mg HS). Sometimes used in treatment-resistant anxiety as well.

Why avoid grapefruit juice?

Grapefruit juice strongly inhibits intestinal CYP3A4. Quetiapine is a CYP3A4 substrate; grapefruit raises levels markedly, increasing sedation, orthostasis, and metabolic burden. Avoid grapefruit and grapefruit juice during Seroquit therapy.

Andre Mental Sundhedsmedicin

Medicinsk ansvarsfraskrivelse. Denne side er udelukkende til informationsformål og er ikke erstatning for individuel lægevejledning. Behandling med psykofarmaka bør iværksættes, overvåges og tilpasses af en kvalificeret kliniker. Hvis du eller nogen du kender er i akut selvmordskrise, skal du kontakte lokale akutteams eller ringe til din lands selvmordsforebyggende kriselinje (US/Canada: 988; UK: Samaritans 116 123; international liste: findahelpline.com).

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25 mg, 50 mg, 100 mg

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30 Tablet/s, 60 Tablet/s, 90 Tablet/s, 180 Tablet/s

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