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Methods: A Retrospective Analysis was conducted from June 2022 to October 2025, enrolling 576 hospitalized patients: 198 with schizophrenia, 186 with manic episode, and 192 with a depressive episode. From the depressive episode group, 35 patients with severe comorbid insomnia as the primary treatment target were analyzed separately. Consequently, the core depressive episode group for efficacy analysis comprised 157 patients, while the depressive episode with comorbid insomnia subgroup (n\u2009=\u200935) was analyzed separately. Detailed administration regimens (dosage frequency) were recorded for all patients. Steady-state concentrations of QTP and NDQ were measured using ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS\/MS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Significant differences in optimal QTP concentration ranges were identified across diseases: 150\u2013550\u00a0ng\/mL for schizophrenia, 180\u2013580\u00a0ng\/mL for manic episode, 120\u2013480\u00a0ng\/mL for depressive episode (consistent with both\u2009\u2265\u200930% and\u2009\u2265\u200950% HAMD-17 reduction standards), and 40\u2013120\u00a0ng\/mL for depressive episode with comorbid insomnia (12\u00a0h concentrations). The mean QTP concentration was lower in the depressive episode group (302\u2009\u00b1\u2009276\u00a0ng\/mL), which showed a high response rate (82.3% for\u2009\u2265\u200930% HAMD-17 reduction). The highest response rate (85.7%) was observed in the depressive episode with comorbid insomnia subgroup. In contrast, schizophrenia patients required higher concentrations (389\u2009\u00b1\u2009286\u00a0ng\/mL) but had a lower response rate (73.7%). Polypharmacy with CYP3A4 inhibitors\/inducers was recorded; co-administration of venlafaxine (mild CYP3A4 inhibitor) significantly increased QTP concentrations in depressive episode patients, while co-administration of valproate or lithium had no significant impact on QTP concentrations in schizophrenia or manic episode patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This exploratory study proposes disease-specific QTP concentration ranges that show clinical relevance in this Chinese cohort, providing preliminary evidence to guide future research on personalized TDM. The findings should be interpreted cautiously and require validation in subsequent studies before being used to inform clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s44192-026-00526-0","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T08:34:39Z","timestamp":1783326879000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Disease-specific therapeutic plasma concentration ranges for quetiapine in schizophrenia, manic episode, depressive episode, and depressive comorbid insomnia"],"prefix":"10.1007","volume":"6","author":[{"given":"Jiezheng","family":"Dong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingshan","family":"Qiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhonglin","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunyan","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Lv","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Song","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiwen","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan","family":"Ju","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaowen","family":"Yin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"issue":"11","key":"526_CR1","doi-asserted-by":"publisher","DOI":"10.1093\/ijnp\/pyv060","volume":"18","author":"X Zhou","year":"2015","unstructured":"Zhou X, Keitner GI, Qin B, Ravindran AV, Bauer M, Del Giovane C, et al. 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This study was approved by the Ethics Committee of Hangzhou Seventh People\u2019s Hospital (approval number: R (2023) EA(001)). All participants or their legal guardians provided written informed consent prior to enrollment.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable. (This manuscript does not contain any individual person\u2019s data in any form.)","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All authors declare no conflicts of interest. The authors declare that they have no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results. The authors declare that there are no conflicts of interest regarding the publication of this paper.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"180"}}