Guidelines for Switching from Quetiapine to Tiapride

Background Information

• Quetiapine is a second-generation antipsychotic commonly used at doses of 25-600mg daily with sedating properties and lower risk of extrapyramidal side effects compared to first-generation antipsychotics 1.

Special Considerations

• Elderly patients may be more sensitive to medication changes and require closer monitoring 2.
• For patients with delirium or acute agitation, more careful monitoring is required during the switch 1.
• Tiapride has shown efficacy in maintaining abstinence from alcohol and may be particularly beneficial in patients with comorbid alcohol use disorder 2, 3.

Monitoring and Management

• Assess for emergence of extrapyramidal symptoms with tiapride introduction 2.
• Evaluate sleep patterns, as the sedating properties of quetiapine may not be matched by tiapride 1.
• If EPSEs emerge, consider slowing the titration schedule or temporarily reducing the tiapride dose 2.