Starting dose for seroquel Xr?

[vistaril]

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The official seroquel package insert says one thing....various usual somewhat reputable sources and books say another. It seems like there are a lot of different numbers I'm seeing.

Assume healthy non-elderly non kid patient who is not an acute presentation and has not been on antipsychotics before and has a dx of bipolar d/o.

Does 200 seem ok?

 

[xlithiumx]

Yes.

 

[Merovinge]

Given the relatively low affinity for D2 blockade, the main thing you are managing is the antihistamine and anticholinergic side-effects (as I'm sure you know). Ive seen inpatient docs using adjunct Seroquel really go low to help this accomadation (i.e. 50) and also seen many patients start on 300 and do fine.

 

[milesed]

Around 200 is okay, but may need to quickly titrate up for bipolar or psychosis. The sedation is what usually limits me here and I rec they take it about 3-4 hours before they want to sleep to lessen sedation the next day.

 

[TexasPhysician]

If healthy, non-acute, and neuroleptic naive, I'd start lower. It is not that 200mg would be a dangerous starting dose, but at this stage I'm more concerned about building rapport, minimizing side effects, and focusing on compliance. Lower doses often have fewer side effects and make the patient feel more comfortable about taking them.

 

[notdeadyet]

200 mg is a high starting dose for someone antipsychotic-naive, especially if they are not acutely manic.

Any particular reason you went with Seroquel as a medication choice for bipolar maintenance?

 

[myPsychAlt]

200 mg is a high starting dose for someone antipsychotic-naive, especially if they are not acutely manic.

Any particular reason you went with Seroquel as a medication choice for bipolar maintenance?

That's my question too... what else has he/she failed?

Seroquel is seldom my first choice for anything though...