Quiet 100 mg Tablet

Atypical antipsychotic for:

• Schizophrenia
• Bipolar disorder: manic episodes, depressive episodes, and prevention of relapse
• Add-on treatment for major depression (extended-release form, specialist use)

Schizophrenia (immediate release): day 1: 50 mg, day 2: 100 mg, day 3: 200 mg, day 4: 300 mg daily in 2 doses; usual 300–450 mg/day, range 150–750 mg/day.

Bipolar mania: increase to 400–800 mg/day in 2 doses.

Bipolar depression: 50 mg at bedtime on day 1, increasing to 300 mg at bedtime by day 4 (up to 600 mg).

Extended release (XR): once daily in the evening, without food or with a light meal.

Elderly / liver impairment: start at 25 mg daily and increase slowly.

• Not recommended for children under 18 (except specialist use).
• Do not stop suddenly; reduce over 1–2 weeks.
• Low doses for sleep alone are not recommended.

• Allergy to quetiapine
• Use with strong CYP3A4 inhibitors: ketoconazole, itraconazole, ritonavir, clarithromycin, nefazodone

Very common: drowsiness, dizziness, dry mouth, weight gain, raised cholesterol and triglycerides, withdrawal symptoms if stopped suddenly.

Common: low blood pressure on standing, fast heartbeat, constipation, indigestion, raised blood sugar, increased appetite, blurred vision, restlessness, tremor.

Rare but serious: neuroleptic malignant syndrome (high fever, stiffness, confusion), tardive dyskinesia, seizures, low white cells, QT prolongation, severe skin reactions, pancreatitis, increased risk of stroke and death in elderly people with dementia, suicidal thoughts in young adults with depression.

• Monitor weight, blood sugar and lipids regularly.
• Heart disease, low blood pressure, seizure history, diabetes, liver disease: caution.
• Avoid driving if drowsy; avoid alcohol.
• Not approved for dementia-related behavioural problems.
• Watch for mood changes and suicidal thoughts.

Use in pregnancy only if benefit outweighs risk; newborn may have withdrawal or movement symptoms after exposure in the last trimester. Small amounts pass into milk — specialist decision about breastfeeding.

• Strong CYP3A4 inhibitors (contraindicated); erythromycin, fluconazole, grapefruit (raise levels)
• Carbamazepine, phenytoin, rifampicin (greatly reduce levels)
• Alcohol, opioids, benzodiazepines, sedating antihistamines (more sedation)
• QT-prolonging drugs (amiodarone, macrolides, some antidepressants)
• Antihypertensives (more low blood pressure)

Drowsiness, low blood pressure, fast heartbeat, QT prolongation, seizures, coma. Emergency treatment.

Store below 30°C.