-1%
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.
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.