Recommendations for dosing in special patients
Seroquel is to be administered with much caution to older patients and patients with serious diseases of kidneys and liver.
Geriatrics may be more sensitive to the effects of Seroquel so they should start with a lower dose. The same dosing recommendation is for those patients who feel weakness or are predisposed to hypotensive reactions. These patients should be monitored regularly by their doctors.
Patients with liver dysfunction should be initiated with 25 mg per day. The dose may be increased daily in increments of 25mg per day – 50 mg per day to an effective dose. The treatment in such patients strongly depends on their clinical response and tolerability.
For patients who have previously stopped or discontinued the treatment with Seroquel and had an interval of less than a week off this medication, the dose of Seroquel may be reinitiated. For those patients who have had a period without Seroquel for more than a week, the initial titration schedule should be taken.
Seroquel Indications and Usage (Bipolar Disorder)
Seroquel is indicated to treat Bipolar I Disorder in adult patients, especially the sharp cases of manic episodes.
Seroquel can be used as monotherapy or adjunct therapy (combined with lithium or divalproex). Seroquel starting dose on the 1st day is 100mg divided into 2 doses, increased to 400 mg per day on the 4th day divided into several doses.
On the 6th day the dose may be increased up to 800 mg per day in increments of no greater than 200 mg per day. The dose should not be increased above 800 mg per day. The results of clinical trials have demonstrated that the most patients tolerated and well responded to the therapy between 400 and 800 mg per day.
For children and adolescents (1—17 years of old) suffering from manic episodes in Bipolar I Disorder Seroquel is administered according to the following dosing schedule: the 1st day – 50 mg, the 2nd day – 100 mg, the 3rd day – 200 mg, the 4th day -300mg, the 5th day – 400mg. After that the drug can be enlarged in dose to 600 mg per day if well tolerated.
Depressive episodes in Bipolar Disorder in adult patients are treated with administration of Seroquel once daily at bedtime from 50 mg on the 1st day, 100mg on the 2nd day and 200mg on the 3rd day to reach 300 mg per day on the 4th day.
Seroquel may be indicated to treat psychotic states such schizophrenia and Bipolar I Disorder in patients who are recommended to switch from other antipsychotic medications to quetiapine.
Seroquel Indications and Usage (Schizophrenia)
The drug should be taken exactly as prescribed by your doctor, do not take it longer than recommended or in larger doses. Seroquel can be taken with or without food.
When Seroquel is used to treat schizophrenia in adults, an initial dose of 25mg is administered daily. The dose may be increased to 50mg divided in 2 or 3 doses on the second and third day, if well tolerated; the daily dose on the fourth day may be 300mg up to 400mg.
Further dosage adjustments are indicated at intervals of 2 or more days as steady state for the drug would not be succeeded for approximately 1-2 days in the typical patient.
It is noted that most efficacy data with this drug were got using it 3 times daily in dosing regiments. The results of trial 225mg given twice a day under control were also positive.
The efficacy of the drug was demonstrated in clinical trial when 150mg per day to 750 mg per day were administered to adult patients.
In some cases doses above 300 mg per day were not more effective than 300 mg per day. In other cases larger doses were required, doses in the range of 400mg -500 mg per day. It is not recommended to use the doses above 800 mg per day, because their efficacy and safety were not clinically tested and evaluated.
Young people (13-17 years) are usually administered the drug to take 2 times a day. Still the drug may be given three times a day if needed.
The therapy consists of 5 days; the first day dose is usually 50mg, the second day 100mg, the 3rd day 200mg, the 4th day 300mg and the 5th day 400mg. After the 5th day the dose is adjusted within the recommended range of 400 to 800mg per day it depends on the response to the therapy and tolerance of the patient.
Young patients should be controlled regularly and if necessary the dose adjustments should be altered.
How to take this drug
Before using this drug, consult your doctor. Seroquel is to be taken exactly as your doctor prescribed for you. The drug should not be taken in larger amounts to avoid overdosing. You should take it as long as your doctor recommends you.
Your doctor may change your dose of Seroquel to avoid side effects of the drug and get the best results.
The drug should be takenwith a full glass of water. Try to drink more liquid than because the drug may cause dehydration.
You may take the drug with or without food.
Swallow the tablet whole, never crush, chew, or break an extended-release tablet. Crushing or chewing the tablet may cause too much of the drug to be released at one time.
While being treated with Seroquel, follow all your doctor’s prescriptions and advice – check your blood cells, blood pressure, and test vision regularly.
The drug may cause hyperglycemia. Check your blood sugar level and tell your doctor if there are any changes. The signs of hyperglycemia may include: increased thirst or urination, excessive hunger, or weakness. If you have diabetes, control your blood sugar regularly.
Before using this drug
Before adopting Seroquel, visit your doctor for consultation. Your doctor will decide if you can safely take Seroquel after careful examination. You should tell your doctor if you have the following conditions:
- liver or kidney disease;
- heart disease, high blood pressure, heart rhythm problems;
- a thyroid disorder;
- seizures;
- epilepsy;
- cataracts;
- high cholesterol;
- triglycerides;
- diabetes;
- trouble swallowing.
While being treated with this drug your doctor may recommend you be watchful for some conditions. Do not neglect any doctor’s advice.
Your family or caregivers (for children) should be watchful to changes in your mood or symptoms.
In the first 3-4 months of treatment your doctor will check you regularly. It is necessary to make sure the drug does not make you harm.
If you are pregnant or plan to become pregnant while using this medication, inform your doctor about it. Antipsychotic medications such as Seroquel during the last 3 months of pregnancy sometimes cause problems in the newborn (withdrawal symptoms, breathing problems, feeding problems, tremors, or stiff muscles). Withdrawal symptoms may occur if you stop taking your medicine suddenly during pregnancy. Do not stop taking the drug without consulting with your doctor.
Important details about Seroquel
Seroquel is a serious prescription medication that should be used as directed by your doctor. Do not take more amount of the drug than it was prescribed for you. An overdose of the drug can lead to death.
The drug must not be used to treat psychotic conditions related to dementia because it may cause heart failure, sudden death, or pneumonia in patients with dementia-related conditions.
When you use the drug for the first time, you should watch for certain health conditions. Stop using this medication and call your doctor at once if you experience the following symptoms:
- rigid muscles;
- high fever;
- sweating;
- confusion;
- fast or uneven heartbeats;
- tremors;
- uncontrolled muscle movements;
- blurred vision or eye pain;
- increased thirst and urination or excessive hunger;
- weakness, nausea and vomiting.
The drug may provoke thoughts about suicide when you first start taking it. This happens mostly to young people (younger than 24 years old). If case such thoughts appear, visit or call your doctor immediately. Remember that it is necessary for your doctor to check your condition regularly for at least the first 12 weeks of treatment.
Do not neglect any new or worsening symptoms, tell about them to your doctor. Report about:
- mood or behavior changes;
- panic attacks;
- if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically);
- if you are more depressed;
- if you have thoughts about suicide or hurting yourself.
Treating Schizophrenia and Bipolar I Disorder
Pediatric schizophrenia and bipolar I disorder are serious mental diseases which can be diagnosed with much difficulty.
The symptoms of pediatric schizophrenia are likely to vary during time, and patients suffering from bipolar I disorder may have changeable patterns of periodicity of manic or mixed symptoms. The treatment with medications should be started only after a thorough diagnostic evaluation. There can be health risks associated with medication treatment that is why it should be carefully considered what positive or negative results this treatment may bring.
Patients with pediatric schizophrenia and bipolar I disorder should be thoroughly diagnosed by professionals to initiate the medication therapy. The medical treatment should be included into a complex program which usually consists of social adaptation part and psychological part.
Families or caregivers are recommended closely observe a patient, communicate and support him/her during the treatment.
What is Seroquel?
Generic Name: quetiapine
Brand Names: Seroquel, Seroquel XR
Seroquel (the active component – quetiapine) is an antipsychotic drug used to treat depressive disorders. The drug acts by changing the chemical actions in the brain.
Quetiapine is indicated for schizophrenia treatment. It is used in adults and with great caution in children older 13 years.
The other indication of the drug is to treat bipolar disorder (or manic depression) in adults and children over 10 years of old.
Seroquel can be used together with antidepressant medications as a therapy for serious depressive disorders in adults.
Seroquel XR is produced in a form of extended-release of the main component and should be prescribed only for adults over18 years old.
The efficacy of the drug in schizophrenia treatment was estimated after 3 trials (lasting 6 weeks) in adults and 1 trial (lasting 6 weeks) in young people aged from 13 to 17 years of old.
The efficacy of Seroquel in manic episodes of bipolar disorder was estimated in 2 trials of monotherapy (lasting 12 weeks) and in as an adjunct to lithium and divalproex in 2 trials.
The trials have shown significant improvements in health conditions of the patients and efficacy of the drug used in monotherapy as well as together with other drugs.
Still such disorders as schizophrenia and bipolar I disorder should be treated not only with medications, but the treating program should include psychological, educational and social interventions.
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