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.
✓ Orvosi ellenőrzés Morgan Ellis — Gyógyszerkutató · 8 év tapasztalat · Utolsó felülvizsgálat: 2026 május
⚡ Gyors válasz
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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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.
What Agoprex is and how it works
| Agoprex is a 25 mg agomelatine tablet supplied by Sun Pharma. Agomelatine is mechanistically unique among antidepressants: it acts as an agonist at melatonin MT1 and MT2 receptors and an antagonist at 5-HT2C serotonin receptors. The dual mechanism resynchronises disrupted circadian rhythms (a feature of major depression) while indirectly increasing dopamine and noradrenaline release in the frontal cortex. | Agomelatine has no SERT activity, no anticholinergic effects, and no histaminergic effects — explaining its very different side-effect profile from SSRIs and TCAs. | Indications and dosing | Indication |
|---|---|---|---|
| Schizophrenia (IR) | Max | 400–800 mg/nap | 800 mg |
| Bipolar mania | 50 mg BID (IR) or 300 mg HS (SR) | 400–800 mg/nap | 800 mg |
| Bipolar depression | Max | 300 mg HS | 600 mg |
| MDD adjunct (SR) | Max | 150–300 mg HS | 300 mg |
| GAD adjunct (off-label) | Max | 50–150 mg HS | — |
| Idősek | Target | 50–200 mg/nap | tolerancia alapján |
Fontos biztonsági megfontolások
Az összes atípusos antipszichotikum hordoz egy FDA fekete doboz figyelmeztetést a megnövekedett halálozási kockázat miatt (főleg cardiovascularis és fertőzéses okokból), amikor idős, demenciában szenvedő betegek viselkedészavarainak kezelésére használják. Az atípusos antipszichotikumok nincsenek jóváhagyva demenciával összefüggő pszichózis vagy agitáció kezelésére. Használatuk ebben a populációban off-label, utolsó lehetőség, időkorlátozott, és kifejezett kockázat-haszon beszélgetést igényel.
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.
α1 antagonism produces orthostatic hypotension, particularly in older adults and at initiation. Titrate slowly. Check sitting and standing BP at follow-up.
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.
Antidepresszívumként történő alkalmazáskor a 25 év alattiaknál figyelemmel kísérni kell az öngyilkossági kockázatot.
Gyakori mellékhatások
- Sedation — universal; harness as bedtime benefit.
- Testsúlygyarapodás és anyagcserezavar — súlyos.
- Ortosztatikus hypotónia és szédülés — gyakori kezdetben.
- Dry mouth, constipation — moderate anticholinergic effect.
- Tachycardia — often noticed.
- EPS / akathisia — less common than risperidone or olanzapine.
- Prolaktin — usually normal or low.
- QT — modest dose-dependent prolongation.
Gyógyszerkölcsönhatások
- Erős CYP3A4 gátlók (azoles, clarithromycin, ritonavir, grapefruit juice) — raise quetiapine levels several-fold; reduce dose or avoid.
- Erős CYP3A4 indukálók (rifampicin, carbamazepine, phenytoin, St John’s wort) — reduce levels; may need higher doses or switch.
- Egyéb QT-idejét meghosszabbító gyógyszerek — additive risk.
- KNS depresszánsok — strong additive sedation.
- Antihipertenzív szerek — additive orthostasis.
Terhesség, szoptatás, gyermekkori kor
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).
Tárolás
15–30 °C között tároljuk eredeti csomagolásban.
Gyakran Ismételt Kérdések
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.
Egyéb Pszichés Egészségügyi Gyógyszerek
- Aripicon (Aripiprazole — D2 részleges agonista)
- Olanzap (Olanzapin — erős antipszichotikum)
- Risdone (Risperidon)
- Seroquit (Kvetiapin — bipoláris depresszió)
- Atlura (Lurasidon — metabolikusan kedvező)
További lehetőségek a Pszichés Egészségügyi és Pszichiátriai Gyógyszerek között
Rangsorolva a MedsBase legutóbbi rendelési adatai alapján — hogy ebben a kategóriában más vásárlók mit választanak.
| Erősség | 25 mg, 50 mg, 100 mg |
|---|---|
| Mennyiség | 30 tabletta, 60 tabletta, 90 tabletta, 180 tabletta |
Seroquit
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Seroquit
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