title: A Single-Dose Crossover Pharmacokinetic Comparison Study of Oral, Rectal and Topical Quetiapine in Healthy Adults.
abstract: Quetiapine is an oral atypical antipsychotic drug commonly used to treat a large number of neuropsychiatric disorders and conditions. However, a substantial number of patients who may benefit from treatment with quetiapine are unable to ingest quetiapine or other medications by mouth and thus require alternative routes of administration. There are currently no studies evaluating non-oral compounded dosage forms of quetiapine.
  
  
  
  We conducted a single-dose open-label crossover pharmacokinetic study in 10 healthy adults to determine whether quetiapine compounded as a rectal suppository or a topical cream achieved absorption similar to that achieved by a commercially available oral formulation.
  
  
  
  Rectal quetiapine produced an area under the plasma concentration-time curve from time zero to infinity (AUC∞) approximately 90 % greater than that produced by an equal (milligram per milligram) dose of oral quetiapine (15,333 ng/mL versus 8118.8 ng/mL, p = 0.005). However, only two of ten subjects who received topical quetiapine had detectable serum levels. When detected, serum levels achieved with topical quetiapine were delayed and low in comparison with those produced by the oral and rectal dosage forms.
  
  
  
  Our results suggest that rectal, but not topical, quetiapine may be useful in clinical settings. Clinical outcome studies of rectal quetiapine are needed.
authors.affiliation: Department of Pharmacy, Mayo Clinic Hospital-Rochester, 1216 2nd Street SW, Rochester, MN, 55902, USA. leung.jonathan@mayo.edu.
authors.forename: Jonathan G
authors.initials: JG
authors.lastname: Leung
authors.affiliation: Department of Pharmacy, Mayo Clinic Hospital-Rochester, 1216 2nd Street SW, Rochester, MN, 55902, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Nelson
authors.affiliation: Department of Pharmacy, Mayo Clinic Hospital-Rochester, 1216 2nd Street SW, Rochester, MN, 55902, USA.
authors.forename: Julie L
authors.initials: JL
authors.lastname: Cunningham
authors.affiliation: Department of Pharmacy, Mayo Clinic Hospital-Rochester, 1216 2nd Street SW, Rochester, MN, 55902, USA.
authors.forename: Virginia H
authors.initials: VH
authors.lastname: Thompson
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic Hospital-Rochester, 1216 2nd Street SW, Rochester, MN, 55902, USA.
authors.forename: William V
authors.initials: WV
authors.lastname: Bobo
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic Hospital-Rochester, 1216 2nd Street SW, Rochester, MN, 55902, USA.
authors.forename: Simon
authors.initials: S
authors.lastname: Kung
authors.affiliation: Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, 55902, USA.
authors.forename: Ross A
authors.initials: RA
authors.lastname: Dierkhising
authors.affiliation: Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, 55902, USA.
authors.forename: Matthew F
authors.initials: MF
authors.lastname: Plevak
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic Hospital-Rochester, 1216 2nd Street SW, Rochester, MN, 55902, USA.
authors.forename: Maria I
authors.initials: MI
authors.lastname: Lapid
mesh_terms: D000284:Administration, Oral; D000285:Administration, Rectal; D000287:Administration, Topical; D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics*; D001682:Biological Availability; D002626:Chemistry, Pharmaceutical; D018592:Cross-Over Studies; D004333:Drug Administration Routes; D004339:Drug Compounding; D005260:Female; D040361:Healthy People Programs; D006801:Humans; D008297:Male; D008875:Middle Aged; D000069348:Quetiapine Fumarate / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics*
chemical_list: D014150:Antipsychotic Agents; D000069348:Quetiapine Fumarate