Quetiapine Initiation and Titration

Rationale for Immediate-Release Formulation

• The European Society for Medical Oncology (ESMO) guidelines recommend immediate-release quetiapine for acute settings, such as delirium management, starting with 25 mg orally stat, with scheduled dosing every 12 hours if needed 1
• Immediate-release quetiapine allows for twice-daily or three-times-daily dosing with flexible titration schedules, which is particularly important when starting therapy to assess tolerability and minimize adverse effects like orthostatic hypotension and sedation 1

Critical Safety Considerations

• Monitor for orthostatic hypotension during initial dose titration, particularly in elderly patients and those on concurrent CNS depressants 1, 2, 3
• Avoid abrupt discontinuation or rapid dose decreases, as withdrawal symptoms can occur 3