DRUG OF THE DAY
quetiapine
Second-generation antipsychotic
Before opening the card, recall one use, one safety check and one counseling point.
Reveal the drug learning card
Names and formulations
- Seroquel: immediate-release tablet
- Seroquel XR: extended-release tablet with distinct administration and indication details
IR and XR products are not administered identically; XR tablets must be swallowed whole and are generally taken without food or with a light meal per label.
Common use
Schizophrenia and bipolar disorder; the exact acute, maintenance, age, and adjunctive-depression indications depend on the IR or XR product.
Mechanism of action
Antagonizes central dopamine D2 and serotonin 5-HT2A receptors; activity at histamine H1 and alpha1 receptors contributes to sedation and orthostasis.
Important adverse effects and monitoring
- Boxed warning: increased mortality in older adults with dementia-related psychosis; quetiapine is not approved for dementia-related psychosis.
- Boxed warning: antidepressants increased suicidal thoughts and behaviors in pediatric and young-adult patients in short-term studies; monitor for clinical worsening and emergent suicidality.
- Monitor weight, glucose, lipids, blood pressure, orthostasis, sedation, extrapyramidal symptoms, and tardive dyskinesia.
- Evaluate fever, rigidity, altered mental status, or autonomic instability urgently for neuroleptic malignant syndrome.
Patient counseling
- Rise slowly and avoid driving or hazardous tasks until sedation and orthostasis are understood.
- Report new or worsening depression, suicidal thoughts, unusual behavior changes, abnormal movements, severe restlessness, or marked metabolic changes promptly.
Interaction to recognize
With: strong CYP3A4 inhibitors or inducers
Why it matters: Inhibitors can markedly increase quetiapine exposure; inducers can markedly lower it.
Practical response: Follow the substantial product-label dose modification and transition instructions; do not adjust empirically.
Check the original sources
- DailyMed — Seroquel immediate-release prescribing information
Sections: Boxed Warning; 1 Indications and Usage; 5 Warnings and Precautions; 7 Drug Interactions; 12.1 Mechanism of Action; 17 Patient Counseling Information. Source checked 2026-09-13.
- DailyMed — Seroquel XR prescribing information
Sections: 1 Indications and Usage; 2 Dosage and Administration; 7 Drug Interactions. Source checked 2026-09-13.
Selected learning points; verify current labeling for the complete prescribing information.