Dosing Adjustments for Quetiapine in Elderly Patients with Behavioral Disorders

Precautions and Considerations

• The American Geriatrics Society recommends that antipsicotics, including quetiapine, increase the risk of mortality, cerebrovascular events, falls, and fractures in elderly patients with dementia, with a strength of evidence level of high 1
• The use of quetiapine is recognized as a preferred exception in patients with Parkinson's disease compared to other antipsicotics, due to its lower risk of extrapyramidal symptoms 1
• Elderly patients are at increased risk of falls due to sedation and hypotension, with a recommended monitoring strategy for adverse effects 1
• The European Heart Journal recommends avoiding combinations of quetiapine with other sedatives, such as benzodiazepines, due to the synergistic risk of falls, cognitive decline, and respiratory depression 2

Dosing Recommendations

• The American Geriatrics Society suggests that quetiapine can be used at a dose of 50-150 mg/day in elderly patients with dementia, with a strength of evidence level of moderate 1