Just occurred to me I am on a subtherapeutic dose of seroquel (quetiapine)

Medications
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Am kinda annoyed.

I was on 240mg depot of flupenthixol every 2 weeks. Plus 400mg of quetiapine daily taking orally.

I asked to change from the depot to pills which they agreed to.

However my pdoc (who I have never met) consulted the hospital pharmacist.

They were uncomfortable with the depixol and quetiapine so halved my quetiapine to 200mg

This is a sub therapeutic dose. What the ■■■■ is the point?!

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Well, won’t 200 mg help even a little? I take 100 mg of Seroquel as a PRN and it calms me down.

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This is what ChatGPT had to say about it:

schizophrenia

ChatGPT said:

For schizophrenia, most guidelines list the therapeutic range for quetiapine as about 300–800 mg/day.

At 200 mg/day, it’s usually considered below the standard maintenance range — more of a titration stage or a dose for someone extremely sensitive to side effects. Some people may get partial benefit at 200 mg, but for most adults, it would likely be sub-therapeutic for full symptom control.

In clinical practice, psychiatrists often:

  • Start low (e.g., 50–100 mg/day)
  • Increase by 50–100 mg/day every few days
  • Aim for ≥300 mg/day unless side effects or patient-specific factors prevent it

If you’re at 200 mg, it may mean the dose is still being adjusted, or your clinician is balancing symptom control against sedation and metabolic risks.

Do you want me to walk you through how quetiapine’s dose–response curve works for schizophrenia so you can see why200 mg might not be enough?

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Yeah it acts as a sedative I suppose. But not sure if sedation alone is worth the side effects - if that makes sense.

I think I would prefer Benadryl to achieve the same thing

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Thanks for the info @77nick77 - I will try and get in touch with my pdoc

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The highest dose of Seroquel XR I reached was 400mg
Like you said @el_Jimbobbio, 200mg is really like taking Benadryl
The “antipsychotic” effects usually start at 300 to 400mg.

It’s a good idea
Talk with your doctor

Edit: No the highest dose I reached was 350mg (pretty sure)

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I think that when you are on therapeutic doses of other AP’s, a subtherapeutic dose of Seroquel can act as an AP booster. That’s how it acts for me anyway.
@el_Jimbobbio @Wave @77nick77

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@SkinnyMe raises a good point. Perhaps the sub therapeutic dose of Seroquel is okay, as long as it’s taken in conjunction with another AP. Either way, it’s certainly something to ask your pdoc about.

I just realized myself that I’m on a sub therapeutic dose of lurasidone (Latuda). I will ask my pdoc about that!

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I take 200mg of Seroquel a day as my only schizophrenia medication. No relapse for 20 years.

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Thanks for all the replies folks. Is an interesting topic

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I don’t know. Seroquel is pretty strong though. I can’t take more than 200. Maybe you do better on just Seroquel?

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That is an interesting idea. I would prefer to be on only one AP so your idea might work. Thanks!

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If I take more than 200 I feel like I got smashed in the head with a sledgehammer.

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I was even on 100mg daily for 2 years and had no relapse. But I must admit that 100 and 200mg doses are weak for positive symptoms, and I have to take additional supplements like vitamins to reduce them. At least I’m not a zombie suffering much negative symptoms caused by APs.

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