Core pharmacology

Class Group

Second Generation Antipsychotics/Atypical (D2-Antagonism/5-HT2a)

Legacy Cicm Level

Level 3

Introduction

Atypical antipsychotic

Indications Uses

1. Psychosis
2. Bipolar disorder
3. Agitation

Presentation

IR and SR tablets
Start 50mg nocte and uptitrate to 300mg nocte
Dose reduce by 30-50% in elderly

Mechanism of action

D2<5-HT2a and H1-R antagonism

Physiological effects

sedating

Absorption

Good oral absorption

Protein binding

Protein bound

Metabolism

Active metabolite norquetiapine which has anticholinergic effects

Half-life

Elimination t1/2 is 7 hours, active metabolite elimination T1/2 is 12 hours