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Medicines > classes : Sedative-Hypnotic or [[:Category:Dibenzothiazepines|Dibenzothiazepine]] & routes: Oral

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generic:
Bromazolam (1) · Quetiapine (1)
brand:
(none, never marketed) (1) · Seroquel (1)
classes: (Click arrow to add another value)
mechanism:
Dopamine D2 and serotonin 5-HT2A receptor antagonist'"`UNIQ--ref-0000008D-QINU`"' '"`UNIQ--vote-0000008E-QINU`"' (1) · Positive allosteric modulator of the GABA<sub>A</sub> receptor at the benzodiazepine binding site; increases frequency of Cl<sup>−</sup> channel opening, producing anxiolytic, sedative, hypnotic, anticonvulsant, and skeletal-muscle relaxant effects. (1)
uses:
No approved medical problem. Encountered as a designer/research benzodiazepine and, increasingly, as an adulterant in illicit opioid supplies. (1) · '"`UNIQ--vote-0000008F-QINU`"', '"`UNIQ--vote-00000090-QINU`"', '"`UNIQ--vote-00000091-QINU`"', '"`UNIQ--vote-00000092-QINU`"' (1)
starting dose:
25 mg (schizophrenia, immediate-release); 50 mg (bipolar mania, immediate-release); 50 mg (Seroquel XR, schizophrenia or bipolar) (1) · No medical dose. Active recreational doses reported in the 0.5–1.5 mg range (similar potency to alprazolam). (1)
preparations:
25 mg, 50 mg, 100 mg, 200 mg, 300 mg, 400 mg immediate-release tablets; 50 mg, 150 mg, 200 mg, 300 mg, 400 mg extended-release tablets (Seroquel XR) (1) · Illicit tablets ("bars"), powders, blotter, occasionally solutions. No pharmaceutical product exists. (1)
fda max:
800 mg/day (1) · N/A (never approved) (1)
routes: (Click arrow to add another value)
onset:
30-60 min (sedation); days to weeks (neuroleptic effect) (1) · ~20–40 min PO; faster sublingual/intranasal. (1)
duration:
6-8 h (immediate-release); 24 h (extended-release) (1) · 6–10 h subjective; full pharmacologic effect considerably longer. (1)
halflife:
Estimated ~12–17 h (some sources cite up to ~21 h); active metabolites prolong effect. (1) · ~6 h (parent compound, immediate-release); ~9-12 h (active metabolite N-desalkylquetiapine, also called norquetiapine) (1)
bioavailability:
Not formally characterized in humans. (1) · Tablet ~100% relative to oral solution; extensive first-pass metabolism (1)
pregnancy:
Avoid. Benzodiazepines are associated with neonatal sedation, floppy-infant syndrome, and withdrawal; teratogenic signal weak but non-zero. Designer benzo with no safety data, assume worst-case. (1) · Pregnancy categories were retired by FDA in 2015. Quetiapine has reassuring active-comparator cohort data without consistent teratogenic signal; among the preferred neuroleptics when treatment is clinically necessary in pregnancy. See pregnancy_details for the full citation set. (1)
legal:
None (1) · [[USLegal:Prescription only|Prescription only]]; not a controlled substance (1)

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