High-dose quetiapine in treatment refractory schizophrenia

Serotonin2A receptor blockade and clinical effect in first-episode schizophrenia patients treated with quetiapine

“…To achieve a full therapeutic response, it has been suggested that some patients might require higher than licensed dosages (above 800 mg/day; Citrome et al 2005;Khazaal et al 2007;Pierre et al 2005). The use of highdose quetiapine is common in clinical practice, although support for this practice builds on case reports (Sparshatt et Fig.…”

The role of antihistaminic effects in the misuse of quetiapine: A case report and review of the literature

“…Although it was initially believed quetiapine had minimal anticholinergic activity (Goldstein and Brecher, 2000), trials of highdose quetiapine have demonstrated anticholinergic effects in humans (Boggs et al, 2008;Pierre et al, 2005) and there are multiple case reports of anticholinergic drug abuse/misuse in the literature (Buhrich et al, 2000;Hidalgo and Mowers, 1990;Land et al, 1991;Pullen et al, 1984). However, these reports have almost uniformly described anticholinergic intoxication as euphoric and stimulatory.…”

Focus on The clinical ramifications of antipsychotic choice for the risk for developing type 2 diabetes mellitus

“…The dose of quetiapine used may also impact on Emsley's observations -their average dose of quetiapine at end-point was 400 mg/d, substantially lower than the average dose of y600 mg/d used in New York State psychiatric hospitals, with y30 % receiving a dose greater than 750 mg/d . For some patients, higher doses may be associated with greater weight gain, as described in a case series (Pierre et al, 2005) where the net weight gain among seven patients was 8.7 lb, with some patients losing and others gaining large amounts of weight (range x40 to +64 lb). In a 6-wk registration study comparing five fixed doses of quetiapine (75, 150, 300, 600, and 750 mg/d) to placebo in patients with an acute exacerbation of schizophrenia (Arvanitis and Miller, 1997), a linear dose-response was found for weight gain.…”