Skip to content
ClinCalc Pro
Menu
Calculators Drugs Pathways AI Dx Donate Get the App
Atypical Antipsychotic

Quetiapine (Elderly — Dementia Caution)

Brand names: Seroquel, Atrolak

Quetiapine is a second-generation (atypical) antipsychotic used in schizophrenia and bipolar disorder, and used with particular caution in older people.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

2 DOSAGE & ADMINISTRATION · Quetiapine tablets, USP can be taken with or without food ( 2.1 ) Indication Initial Dose Recommended Dose Maximum Dose Schizophrenia-Adults (2.2) 25 mg twice daily 150 to 750 mg/day 750 mg/day Schizophrenia-Adolescents (13 to 17 years) (2.2) 25 mg twice daily 400 to 800 mg/day 800 mg/day Bipolar Mania- Adults Monotherapy or as an adjunct to lithium or divalproex (2.2) 50 mg twice daily 400 to 800 mg/day 800 mg/day Bipolar Mania- Children and Adolescents (10 to 17 years), Monotherapy (2.2) 25 mg twice daily 400 to 600 mg/day 600 mg/day Bipolar Depression-Adults (2.2) 50 mg once daily at bedtime 300 mg/day 300 mg/day Geriatric Use: Consider a lower starting dose …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2025-06-27. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It antagonises multiple receptors, including dopamine D2 and serotonin 5-HT2; antihistamine activity contributes to sedation.

Prescribing in practice

  • In older people with dementia, antipsychotics increase the risk of stroke and death — use only when necessary, at the lowest dose for the shortest time.
  • Metabolic effects (weight gain, raised glucose and lipids), sedation and postural hypotension occur; it can prolong the QT interval.
  • Do not stop abruptly.

Monitoring

Monitor weight, glucose and lipids, blood pressure and (where relevant) ECG; review the need to continue, especially in dementia.

Counselling the patient

  • Sedation and weight gain can occur.
  • Rise slowly to avoid dizziness.
  • Do not stop it suddenly.

Evidence & guidelines

Used in schizophrenia and bipolar disorder; antipsychotics in dementia carry a stroke and mortality warning and are restricted (MHRA; NICE NG97).

Reference: MHRA guidance 2004; NICE NG97; CATIE trial; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

Calculators
Drugs
Pathways