Adding lithium to quetiapine.
- Quetiapine is principally metabolized by CYP3A4 to active and inactive metabolites.
- Lithium is eliminated by the kidney for about 95%. Changes in the rate of excretion can cause unwanted effects.
- This combination of drugs may have possible synergistic effects. However, this combination will also have additive side effects. Dose adaptation will be recommended for this combination. 
- Start lithium according to the general dosing advice.
- During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. 
- 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
- Farmacotherapeutisch Kompas - lithium (dutch)
- Vieta E at al, Efficacy and safety of quetiapine in combination with lithium or divalproex for maintenance of patients with bipolar I disorder (international trial 126). J Affect Disord. 2008 Aug;109(3):251-63. Epub 2008 Jun 24
- Interactions between quetiapine and lithium on drugs.com
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