精神分裂症 思樂康持續性藥效錠 50毫克 急性治療劑 …

1 50 . seroquel XR 300. seroquel XR 50mg mg . 400-800 mg [ ] . 025001 300 mg 800mg .. 200 .. seroquel XR 200mg . seroquel XR 300mg . 024887 .. 300 . seroquel XR 300mg seroquel XR 50mg 100mg 200mg 300mg 024886 . divalproex . 400 seroquel XR 300mg . 600mg . seroquel XR 400mg 400-800mg seroquel XR . 024885 .. seroquel XR 300mg 600mg 400mg 800mg (dementia-related psychosis) .. seroquel XR . (10 ).. 10 . seroquel XR 50mg .. 50mg . ( ) ( ) seroquel seroquel XR 50mg . XR . 50mg .. Phenytoin quetiapine phenytoin . (MDD) . carbamazepine phenobarbital quetiapine . (suicidality) . [ quetiapine ] . seroquel .. 24 . seroquel XR. 65 .. seroquel XR .. seroquel seroquel XR . seroquel XR [ seroquel . ] seroquel XR .. seroquel XR .. seroquel XR 300 . (depot 1(11). antipsychotics) seroquel XR . seroquel XR .. 50 mg . 200 mg . 300 mg ( ) . 400 mg . ( ).

2 / .. seroquel XR (quetiapine fumarate) ( ) . ( ) . (Randomized controlled trial, CRT) . (Retrospective cohort study ) , seroquel . (Conventional) (Atypical) .. ( ) . / . MDD . suicidality .. ( quietiapine) . SSRls . ( ) . MDD . ( ) . 18-24 .. suicidality 24 .. 65 .. MDD .. 11 295 2 77,000 .. ( ). MDD .. 1000 - 1 .. 1 .. 1000 .. - . ( .. 14 ) . <18. 18-24 5 ( ) .. 25-64 1 . 65 6 (Neuroleptic malignant syndrome NMS). ( .. quetiapine) (NMS) . quetiapine NMS NMS . ( . 2(11). ) (creatine quetiapine . phosphokinase) ( ) quetiapine .. ( ) quetiapine [ . (EPS) ) quetiapine . (CNS) quetiapine . NMS (1) 6 . (2) (3) NMS .. NMS .. NMS . seroquel XR (1/1239) seroquel XR .. (3/619) seroquel . (18/2792) seroquel (1/607) . Quetiapine . 1 ( ) . seroquel XR (4 1239) quetiapine fumarate 65 . (2/619) seroquel . 1% (28/3265) (2/954) .. ( . seroquel XR (4/806) seroquel XR.]

3 ( . 0% (0/262) (21/786). ) quetiapine . seroquel XR (3/256) TSH .. TSH .. seroquel T4 T4 . / . 20% quetiapine . ( quetiapine fumarate) . T4 T4 . ( ) . T4 T4 . / . TSH TBG . (WBC) / . quetiapine quetiapine T4 . / . T4 (12/2791) . (CBC) . seroquel TSH TSH .. seroquel XR . ( <1000/mm3) seroquel XR . 4% 15% . ( ) . 2% 6% . (Tardive dyskinesia).. seroquel XR 7% 8% .. 3% 8% .. seroquel XR .. 7% 15% 4% 6% .. seroquel XR (46/750) seroquel XR .. 4% (10/428) (prolactin) .. quetiapine .. [ ] .. ( ) .. quetiapine .. (1) . ( ALT) . (2) . 3 .. seroquel XR 1% 2% .. 3(11). 2% 3-6 (10-17 ). 3 seroquel 6% 1% seroquel . seroquel .. ( ). quetiapine 26 . 3 . seroquel XR 4% 7% . seroquel XR . ( . ) (ketoacidosis) . seroquel XR (Hyperglycemic Hyperosmolar Nonketotic Coma) . quetiapine . quetiapine . ( ) .. quetiapine .. quetiapine - .. quetiapine .. seroquel XR.

4 seroquel XR 1239 . ( . seroquel XR . ) .. (ECG) . seroquel . XR .. MedDRA . seroquel XR .. (N=951) . seroquel XR . ( ) ( ) seroquel XR . ( seroquel XR ( seroquel N=137 N=140) XR ) . seroquel XR 13% seroquel XR 4% . (N=311 seroquel XR 151 160 ) seroquel XR . seroquel XR .. 5% seroquel XR .. seroquel XR [ . 2 ( 6 ) 5% seroquel XR. ] . ( 300 800mg/ ) ( . seroquel XR . ) seroquel XR .. seroquel XR [ . ] 2 6 .. / seroquel XR . ( quetiapine fumarate) . (n=951). (n=319). 4(11).. 12% 1% 4 3 .. 6% 5% .. 5% 2% seroquel XR . / (n=151). (n=160).. 2 25% 10%. 10% 4% 34% 7%. 10% 3%.. 7% 5% 7% 4%.. 1. seroquel XR 7% 4%.. 2. 7% 1%.. seroquel XR ( 5% ) .. 2 (25%) (12%) (10%) . 2 50% 12%. 5% . 10% 4%. 3 ( 8 ) 5% . seroquel XR 300 mg/ ( 5% 0%. ) seroquel XR .. 5% 1%. 3 6 . XR . seroquel . / . XR 2.. (n=140). (n=137). seroquel XR ( 5% ) . 2 (50%) (34%) (10%).

5 37% 7% (10%) (7%) (5%) (5%) .. 8% 6% 5% seroquel XR .. 7% 1% .. 6 .. seroquel XR . 6% 2%. (n=103) seroquel XR(N=94) 12 .. 7% 1%. ( ) ( ) 5% . <5% ( . 12% 6% ) .. 2 52% 13%.. 13% 11%. seroquel . (anaphylactic reaction) . 1. seroquel XR . -GT (Restless legs syndrome) . (dysarthia) (face edema) . 2.. seroquel XR ( 5% ) (EPS) . 2 (52%) (37%) . (12%) (7%) (7%) (6%) . 4 ( 3 ) 5% . seroquel XR 300 mg/ ( / . ) seroquel XR .. 5(11). EPS (1)Simpson-Angus ( / . ) (2) Barnes (BARS) (CBC) . (3) EPS( seroquel XR [ . ) ] . (4) EPS . quetiapine 800 mg seroquel XR . seroquel XR EPS quetiapine (>120 bpm) seroquel XR . 8% 11% 4% 11% 7 bpm 1 bpm seroquel . seroquel XR seroquel XR 3% 1% . 300 mg 800 mg EPS seroquel 7 bpm . seroquel XR 8% seroquel 8% 5% 1 bpm quetiapine . EPS ( [ . ) (10-17 ). 3% seroquel . SAS BARS .. seroquel ( ). seroquel XR. (10-17 ).]

6 300 mg EPS seroquel ADRs ADRs . XR EPS ( . (10-17 ) ADRs . ) . ADRs .. seroquel XR 5 . 400-800 mg EPS . seroquel XR .. EPS ( . ( 10%) . ) . 1.. 2. 3. Quetiapine [ ] . 1. (<18 ) > 20 g/L > 26 g/L .. >100 g/L 1% . seroquel XR 7% . seroquel XR 10% 5% 3 6 2 . 7% ( ) . seroquel (23%) > 20 mmHg > 10 mmHg . (6%) seroquel XR 3 . 7% seroquel XR . seroquel XR (13-17 ) . 7% seroquel XR seroquel 0% 21% seroquel 7% . 7% . seroquel ALT (10-17 ) . [ ] seroquel . ( LDL ) 12% seroquel 0% . seroquel XR 7% . X 10 /L < X 10 /L. 9 9. 63% (241/380). seroquel XR 26 seroquel 26 45%. 7% 26 . 3368 quetiapine BMI . fumarate 1515 seroquel 26 .. < X 109/L quetiapine (13-17 ) . (10/2967) (2/1349) seroquel . 6(11). ( Quetiapine . ) Lorazepam quetiapine 250 mg lorazepam (2 mg ). (10-17 ) 20% . seroquel Divalproex Divalproex (500 mg ) quetiapine (150 mg ) .. valproic acid.

7 seroquel . 10-12% Quetiapine (150 mg ) valproic acid ( .. divalproex 500 mg ) 11% .. seroquel .. seroquel Quetiapine (250 mg ) .. Antipyrine (SIADH) Stevens-Johnson 750 mg/ ( ) . (SJS) . quetiapine antipyrine antipyrine . quetiapine antipyrine . seroquel XR P450 . seroquel XR . Quetiapine .. quetiapine . C . seroquel XR . seroquel XR . quetiapine . seroquel XR levodopa dopamine . - . quetiapine . seroquel XR . Phenytoin quetiapine . Quetiapine (250 mg ) phenytoin (100 mg ) . quetiapine 5 seroquel XR phenytoin 21 quetiapine ( carbamazepine barbiturates 42 . quetiapine ( . rifampicin ) seroquel XR . phenytoin 36 6 ) .. ( valproate) [ ] . Divalproex quetiapine . Quetiapine (150 mg ) divalproex (500 mg ) (MRHD mg/m2 800. quetiapine 17% mg) / .. Thioridazine . Thioridazine (200 mg ) quetiapine(300 mg ) / ( ) . 65% ( / ). Cimetidine . cimetidine (400 mg 4 ) quetiapine ( ).

8 (150 mg ) 20% cimetidine / quetiapine . P450 3A / . P450 3A ketoconazole(200 mg 4 . ) quetiapine 84% quetiapine . 335% seroquel XR ketoconazole CYP3A4 . seroquel XR . ( itraconazole fluconazole erythromycin ) .. ( seroquel XR ) . seroquel XR seroquel XR . Fluoxetine Imipramine Haloperidol Risperidone quetiapine 170. fluoxetine (60 mg ) imipramine (75 mg ) . g/L . haloperidol ( mg ) risperidone (3 mg ) . / (N=8) mg/kg( . quetiapine (300 mg ) quetiapine . 400 mg) mg/kg( 400 mg) .. 7(11).. seroquel XR .. seroquel XR 68 65 . seroquel XR (quetiapine fumarate) . seroquel XR . dibenzothiazepine 2-[2-(4-dibenzo [b,f]. seroquel XR . [1,4]thiazepin-11-yl-1-piperazinyl)ethox y]-ethanol fumarate (2:1) ( ) .. quetiapine fumarate . quetiapine fumarate C42H50N6O4S2 C4H4O4 . 30-50% [ . (fumarate ) . ] .. seroquel XR [ . ] .. quetiapine . [ . ] .. Quetiapine fumarate.

9 seroquel XR seroquel XR 50mg( ) 200 mg ( ) 300 mg ( ). 400 mg ( ) . seroquel XR seroquel XR . (Hypromellose) seroquel XR . 400 . / (50mg 200 mg 300 mg ) . seroquel XR 50 mg quetiapine fumarate 58 mg quetiapine 50. ( ) mg 200 mg quetiapine fumarate 230 mg . quetiapine 200 mg 300 mg quetiapine fumarate . 345 mg quetiapine 300 mg 400 mg .. quetiapine fumarate 461 mg quetiapine 400 mg . quetiapine 30 g .. quetiapine g . Quetiapine . (dopamine) (D2) (serotonin) (5HT2). [ ] N-desalkyl quetiapine (norquetiapine) . 9600 mg D2 5HT2A Quetiapine . quetiapine QTc norquetiapine norepinephrine .. dopamine serotonin .. quetiapine nor quetiapine (histamine). (oxygenation) ( ) . 1 .. (muscarinic) M1 .. disopyramide procainamide quinidine seroquel XR . QT bretylium - Quetiapine norquetiapine . quetiapine D1 D2 5HT1A 5HT2 H1 . Quetiapine (adrenergic) 1b 2 Quetiapine.

10 Norquetiapine (muscarinic) M1 . / ( epinephrine dopamine norquetiapine Quetiapine norquetiapine . quetiapine ) benzodiazepine . 8(11). Quetiapine Norquetiapine (Ki nM) . quetiapine . Quetiapine Norquetiapine . D1 428 quetiapine . D1 626 489 . 1040 191 (CLcr=10-30 mL/ n=8) quetiapine . 5HT1A. (CLcr>80 mL/ n=8) 25% . 5HT2A 38 quetiapine . >10000 .. H1. (n=8) quetiapine 30% 2. 1b AUC Cmax 3 quetiapine . 2 617 1290 . 1086 [ ] .. Benzodiazepine >10000 >10000. quetiapine 9 P450. 1A2 2C9 2C19 2D6 3A4 . ( ) 800 mg quetiapine quetiapine P450 3A4 phenytoin quetiapine . norquetiapine P450 3A4 ketoconazole quetiapine Norquetiapine Cmax phenytoin ketoconazole quetiapine . AUC quetiapine 21-27% 46-56% Quetiapine [ quetiapine . quatiapine 7 ] . norquetiapine 9-12 cimetidine quetiapine . seroquel XR P450 Quetiapine 750 mg antipyrine lorazepam . [ Quetiapine ].