Switching from Olanzapine to Quetiapine: Monitoring and Special Considerations

Monitoring During Transition

• The American Society of Clinical Oncology recommends monitoring closely for potential side effects of quetiapine, including sedation, orthostatic hypotension, and dizziness, with a strength of evidence based on clinical trials 1, 2
• Quetiapine is less likely to cause extrapyramidal side effects than other atypical antipsychotics, according to the American Society of Clinical Oncology, with a moderate level of evidence 1, 2

Special Considerations

• The American Society of Clinical Oncology advises avoiding combining either medication with benzodiazepines when possible, as fatalities have been reported with concurrent use of benzodiazepines with high-dose olanzapine, based on case reports and clinical experience 1, 2

Common Pitfalls to Avoid

• The American Society of Clinical Oncology recommends not starting quetiapine at too high a dose, as this increases risk of sedation and orthostatic hypotension, with a high level of evidence based on clinical trials 1, 2
• Ensuring adequate hydration during the transition is crucial to minimize risk of orthostatic hypotension, according to the American Society of Clinical Oncology, with a moderate level of evidence 1, 2