Switch medication from Quetiapine to Clozapine.[5]
[6]
Stop Quetiapine
- Day 1-4: approx. 75% of initial dose
- Day 5-8: approx. 50% of initial dose
- Day 9-12: approx. 25% of initial dose
- Day 13: stop
Start Clozapine
- Day 1: start with 12,5 mg at night
- Day 2: 25 mg in divided doses
- Day 3-15: increase daily dose every 1-2 day(s) with 25 mg
- Day 16-28: if necessary, increase dose with 50-100 mg/week
- Low dose in the morning, high dose at night (twice daily dosage)
- Increments are dependent on the status of patient
More information
- During this switch you could monitor ECG, especially in patients prone to QT-conduction problems.
- There is a possibility of QT interval prolongation.[7]
- ↑ 1.0 1.1 1.2 KNMP; Informatorium Medicamentorum 2023; Monografie "quetiapine" (Dutch)
- ↑ NVZA; Toxicology.org; Monografie 73 (dutch)
- ↑ Woods SW Chlorpromazine equivalent doses for the newer atypical antipsychotics J Clin Psychiatry 2003;64:663-667
- ↑ Drugs.com quetiapine-fumarate
- ↑ Switches are based on literature references on this page and expert opinions of the authors. The authors have used pharmacokinetic and receptor affinity properties to determine the switch schedules
- ↑ Stahl, S. M. (2013). Stahl's essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). Cambridge University Press.
- ↑ Stöllberger C, Huber JO, Finsterer J, Antipsychotic drugs and QT prolongation. Int Clin Psychopharmacol. 2005 Sep;20(5):243-51.
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Stop Quetiapine 
Start Clozapine
More information