Seroquel for Anxiety: Effectiveness, Side Effects, & Risks

What Is Seroquel?

Seroquel, with the active ingredient quetiapine, is an atypical antipsychotic medication. The U.S. Food and Drug Administration (FDA) has approved Seroquel for use with several conditions, including the treatment of schizophrenia and bipolar disorder. Seroquel also comes in an extended-release version called Seroquel XR that can be used for all of these conditions as well as major depressive disorder. Seroquel and Seroquel XR are also available as generic quetiapine.

Seroquel is thought to work by affecting the activity of certain chemicals in the brain. These play a crucial role in regulating mood, emotions, and cognitive functions. Seroquel is often prescribed to help manage symptoms such as hallucinations, delusions, mood swings, and other disturbances associated with mental health disorders.

It is essential for individuals taking Seroquel to follow their healthcare provider’s instructions carefully, as the medication may have specific dosage recommendations and potential side effects.¹

How Does Seroquel Work?

Seroquel is thought to work by influencing certain chemicals in the brain called neurotransmitters, particularly dopamine and serotonin. By blocking specific receptors for dopamine and serotonin, Seroquel helps restore the balance of these neurotransmitters. This rebalancing effect can alleviate symptoms associated with mental health disorders, making it an effective medication for managing conditions like schizophrenia and bipolar disorder. It’s important to note that the exact mechanism of action may vary depending on the specific mental health condition being treated.¹

Does Seroquel Reduce Anxiety Symptoms?

While Seroquel is FDA-approved for conditions like schizophrenia, and bipolar disorder, it is sometimes prescribed off-label for certain anxiety disorders. An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone.

Several studies have explored the off-label use of Seroquel for anxiety, particularly in generalized anxiety disorder (GAD).² While the evidence is not as robust as for its approved indications, some clinicians may consider prescribing Seroquel when other standard treatments for anxiety have not been effective.

Research has suggested that Seroquel’s ability to modulate neurotransmitters like serotonin and dopamine may contribute to its anxiolytic effects. Seroquel generally appears to be very effective in trauma-related conditions by improving mental stability and decreasing the stress and anxiety response that arises due to specific fears or triggers. Seroquel also appears to be particularly useful for normalizing obsessions and compulsions and improving low mood, irritability, and aggressiveness.³

Types of Anxiety Treated with Seroquel

Seroquel may be used off-label to treat certain types of anxiety disorders, particularly generalized anxiety disorder. Generalized anxiety disorder is characterized by excessive worry and anxiety about everyday situations.²

It’s important to note that while some healthcare providers may consider Seroquel as a treatment option for anxiety, it is not a first-line choice and individual responses to the medication can vary.

Can Seroquel Be Used Like Xanax for Anxiety?

Seroquel and Xanax (alprazolam) belong to different classes of medications and have distinct mechanisms of action. Xanax is FDA-approved to treat anxiety and Seroquel may be used off-label to treat anxiety. While both may be prescribed for anxiety, they work in different ways. Xanax is a benzodiazepine, which acts on the central nervous system to enhance the effects of a neurotransmitter called gamma-aminobutyric acid (GABA). This may result in a calming effect. Seroquel, on the other hand, is an atypical antipsychotic that modulates neurotransmitters like serotonin and dopamine.⁴

How Effective is Seroquel for Anxiety?

Clinical trials and reviews indicate that Seroquel may have a modest impact on reducing anxiety symptoms, noting a similar level of response comparable to SSRIs. But it’s important to note that other medications, such as selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines, are typically preferred as first-line treatments for anxiety.

The decision to use Seroquel for anxiety should be made on a case-by-case basis, taking into account the specific circumstances of the individual and after thorough consultation with a healthcare professional.⁵

How Quickly Does Seroquel Work for Anxiety?

The onset of action for Seroquel in the context of anxiety can vary among individuals. Unlike medications like benzodiazepines, which often have a more rapid onset, Seroquel typically takes longer to show therapeutic effects. It is an atypical antipsychotic that works by modulating neurotransmitters like serotonin and dopamine in the brain.

In clinical practice, individuals may not experience immediate relief from anxiety symptoms upon starting Seroquel. It often takes several weeks of consistent use for the medication to reach its full therapeutic potential.¹

How Long Do the Effects of Seroquel Last?

The duration of the effects of Seroquel can vary based on factors such as the individual’s metabolism, the specific formulation of the medication (immediate-release or extended-release), and the dosage. Generally, the immediate-release formulation may have effects that last around 6 to 12 hours, while the extended-release formulation is designed to provide a more sustained effect over a longer period, often up to 24 hours.¹

Who Might Benefit From Taking Seroquel for Anxiety?

Seroquel may be considered off-label for individuals with anxiety, especially when other more commonly prescribed anxiolytic medications like selective serotonin reuptake inhibitors (SSRIs) or benzodiazepines have not provided sufficient relief or are not well-tolerated.

Seroquel is often considered when there are comorbidities with anxiety and other mental health conditions like bipolar disorder or schizophrenia, for which Seroquel is FDA-approved.¹ Other individuals who may benefit from Seroquel are those who do not respond well to or cannot tolerate the side effects of traditional anxiety medications.

Side Effects of Seroquel for Anxiety

Seroquel is associated with a range of potential side effects, which can vary in severity and occurrence among individuals. As with most antipsychotics, the side effects of Seroquel are a result of its impact on neurotransmitters in the brain. Common side effects may include drowsiness, dizziness, and weight gain. More serious side effects may include metabolic changes, such as increased blood sugar levels and cholesterol, and in rare cases, movement disorders.¹

Side effects often occur due to the intended actions of the medication. For instance, the sedative effect of Seroquel can lead to drowsiness and dizziness. Additionally, its influence on neurotransmitters may contribute to other bodily changes. It’s crucial for individuals prescribed Seroquel to be aware of potential side effects and promptly report any concerning symptoms to their healthcare provider. It’s also important to keep in mind that the side effects reported with Seroquel are from clinical trials studying Seroquel in schizophrenia and bipolar disorder.

Common side effects of Seroquel for anxiety include*:¹

• Drowsiness
• Dizziness
• Weight gain
• Increased blood sugar levels
• Increased cholesterol levels
• Constipation
• Dry mouth
• Headache
• Fatigue
• Increased appetite

*All medications, including Seroquel, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

Serious side effects of Seroquel for anxiety that require immediate medical attention include*:¹

• Uncontrollable movements (tardive dyskinesia)
• High fever
• Severe dizziness
• Trouble swallowing
• Fainting
• Irregular heartbeat
• Persistent nausea or vomiting
• Changes in vision
• Extremely high blood sugar (hyperglycemia)
• Neuroleptic malignant syndrome (NMS) (high fever, muscle stiffness, confusion, and changes in heart rate and blood pressure)

*All medications, including Seroquel, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

When using Seroquel off-label for anxiety disorders, certain side effects, such as drowsiness, dizziness, and fatigue, may be more noticeable, potentially impacting daily activities. Weight gain is another common side effect that individuals may experience. It is also important to be aware of severe side effects like neuroleptic malignant syndrome (NMS), which requires immediate medical attention. Although NMS is rare, individuals with anxiety disorders taking Seroquel should be vigilant for symptoms such as high fever, muscle stiffness, or changes in mental status.

Seroquel for Anxiety Dosage

As the use of Seroquel for anxiety is considered off-label, specific dosage recommendations cannot be provided. Healthcare providers may prescribe a broad range of doses based on individual factors, considering variables such as the patient’s overall health, tolerance to the medication, and potential interactions with other drugs. For example, one study used a range of extended-release Seroquel from 50 mg to 150 mg daily.⁵

It’s important to emphasize that symptom severity is not the sole determinant for dosage, and healthcare professionals will assess various factors to determine the most appropriate and effective dose for each individual. Regular communication with the healthcare provider is crucial to monitor the response to the medication and make any necessary adjustments to ensure optimal treatment outcomes.

Seroquel for Anxiety Warnings & Precautions

There are important warnings and precautions associated with the use of Seroquel for any condition. One significant concern is the potential for elevated blood sugar levels and increased cholesterol, which may increase the risk of diabetes and cardiovascular issues. Individuals with a history of diabetes or cardiovascular conditions should be closely monitored during treatment. Additionally, Seroquel may cause orthostatic hypotension, a sudden drop in blood pressure upon standing, leading to dizziness or fainting. Caution is advised, especially in elderly individuals.

It is crucial for individuals taking Seroquel to be aware of these warnings and precautions and promptly report any concerning symptoms to their healthcare provider. Regular monitoring, including blood tests to assess metabolic parameters, may be recommended.

Warnings and precautions for taking Seroquel include:^{1, 2}

• Metabolic changes: Seroquel may cause metabolic changes, leading to elevated blood sugar levels and increased cholesterol, increasing the risk of diabetes and cardiovascular issues. Regular monitoring is advised, especially in individuals with a history of diabetes or cardiovascular conditions.
• Orthostatic hypertension: Seroquel can cause orthostatic hypotension, a sudden drop in blood pressure upon standing, which may result in dizziness or fainting. Caution is recommended, particularly in elderly individuals.
• Neuroleptic malignant syndrome (NMS): A rare but serious condition, NMS may occur with Seroquel use, characterized by symptoms such as high fever, muscle stiffness, and changes in mental status. Immediate medical attention is necessary if these symptoms arise.
• Increased suicidal thoughts or behaviors: Seroquel may be associated with an increased risk of suicidal thoughts and behaviors, particularly in young adults. Close monitoring is essential, especially during the initial stages of treatment or dosage adjustments.
• CNS depression: Seroquel may cause central nervous system (CNS) depression, resulting in drowsiness. Caution should be exercised when engaging in activities requiring mental alertness.
• Seizures: Individuals with a history of seizures should be monitored closely, as Seroquel may increase the risk of seizures.
• White blood cell counts: Seroquel may lead to decreases in white blood cell counts, potentially increasing the risk of infections. Regular blood tests may be necessary to monitor these counts.
• Pregnancy and lactation: Pregnant or breastfeeding individuals should consult with their healthcare provider before using Seroquel, as the safety of the medication during these periods is not well-established.
• Cholesterol elevations: Seroquel may cause increases in cholesterol and triglyceride levels, requiring regular monitoring, especially in individuals with pre-existing lipid abnormalities.
• Neuroleptic-associated diabetes mellitus: Seroquel use may be associated with the development of diabetes mellitus. Monitoring for symptoms of hyperglycemia is recommended, and individuals with risk factors for diabetes should be closely monitored.

How To Take Seroquel for Anxiety

The timing of taking Seroquel for anxiety can vary among individuals, and it is typically prescribed once or twice daily. However, the specific dosing schedule should be determined by the healthcare provider, considering the individual’s condition and response to the medication. It is crucial for individuals to follow their prescriber’s instructions carefully regarding the timing and frequency of Seroquel doses.

Seroquel can be taken with or without food, but consistent administration with regard to meals is recommended to maintain a steady level of the medication in the bloodstream. It is essential to take Seroquel at the same time each day to establish a routine and maximize its effectiveness.¹ Seroquel comes in both an immediate-release form and an extended-release form with a variety of strengths.

What Happens If I Miss a Dose of Seroquel?

If you miss a dose of Seroquel, it is advisable to take the missed dose as soon as you remember unless it is almost time for the next scheduled dose. However, it’s crucial not to double up on doses or try to catch up by taking extra medication. Abruptly stopping Seroquel can lead to withdrawal symptoms or a return of anxiety symptoms.

If you have concerns about missed doses or need guidance on the best course of action, contact your healthcare provider.¹

What Is the Best Time to Take Seroquel?

The best time to take Seroquel for anxiety can vary based on individual factors. In general, Seroquel is often taken once or twice daily and should be taken at a similar time each day. For immediate-release formulations, the timing of administration can be flexible, as it can be taken with or without food, but extended-release formulations are recommended to be taken without food. Consistency in the timing of doses is important to maintain a steady level of the medication in the bloodstream.¹

What Does Seroquel Feel Like for Anxiety?

The experience of taking Seroquel for anxiety can vary among individuals. Generally, the medication is not intended to produce a noticeable immediate effect like some anxiolytics. Instead, individuals may gradually notice a reduction in anxiety symptoms over time with consistent use.

Seroquel is thought to work by affecting chemicals in the brain. Its impact on anxiety may be more subtle, compared to medications with rapid onset, such as benzodiazepines. It’s important to note that individuals may not “feel” Seroquel working in the same way they might feel a sedative; rather, the effectiveness is often observed in the alleviation of anxiety symptoms with continued use.

How to Get a Prescription for Seroquel for Anxiety

To obtain a prescription for Seroquel to treat anxiety, the first step is to consult with a healthcare professional. Typically, this involves scheduling an appointment with a primary care physician or a psychiatrist who can assess your mental health and discuss potential treatment options. The healthcare provider will conduct a thorough evaluation, considering factors such as the severity of anxiety symptoms, medical history, and any potential contraindications.

If Seroquel is deemed a suitable option, the healthcare provider can prescribe the medication and provide guidance on its use. In some cases, individuals may explore online psychiatry services, where licensed healthcare professionals offer virtual consultations. These services can be convenient for those seeking mental health assessments and prescriptions from the comfort of their homes.

How to Know if Seroquel for Anxiety Is Working

Determining whether Seroquel is effectively managing anxiety involves monitoring changes in symptoms over time. It’s essential to be aware of improvements in anxiety-related issues, such as a reduction in excessive worry, decreased frequency of panic attacks, and better overall mood stability. Tracking changes in sleep patterns and any enhancements in daily functioning can also indicate the medication’s effectiveness.

Alternative Treatments for Anxiety

For individuals seeking alternatives to medication like Seroquel for anxiety, several effective treatments are available. Cognitive behavioral therapy (CBT) is a widely used therapeutic approach that focuses on identifying and changing negative thought patterns and behaviors associated with anxiety. CBT helps individuals develop coping strategies and skills to manage anxiety more effectively.

Exposure therapy is another evidence-based treatment, especially beneficial for specific phobias. This therapeutic technique involves gradually facing and overcoming feared situations or memories, reducing anxiety over time.

Online group therapy or support groups can provide valuable resources for individuals dealing with anxiety. Participating in these groups allows individuals to share experiences, gain support, and learn coping strategies from others facing similar challenges. Group settings, whether online or in-person, foster a sense of community and understanding.

Additionally, lifestyle changes play a crucial role in anxiety management. Regular exercise, a balanced diet, sufficient sleep, and stress-reduction techniques like mindfulness or meditation contribute to overall well-being and can significantly impact anxiety levels. Incorporating a combination of these alternative approaches tailored to individual needs often yields positive outcomes in anxiety treatment.

Alternative treatments for anxiety include:

• Selective serotonin reuptake inhibitors (SSRIs): SSRIs are a class of antidepressant medications that increase serotonin levels in the brain, effectively regulating mood and reducing anxiety symptoms.
• Serotonin-norepinephrine reuptake inhibitors (SNRIs): Similar to SSRIs, SNRIs influence serotonin and norepinephrine levels in the brain, providing relief from anxiety by enhancing neurotransmitter activity.
• Benzodiazepines: These medications, such as lorazepam or diazepam, work on the central nervous system to produce a calming effect, making them useful for acute anxiety episodes, but their long-term use is often limited due to the risk of dependence.
• Beta-blockers: Typically used for cardiovascular conditions, beta-blockers like propranolol can also be prescribed for anxiety by blocking the effects of adrenaline, which may reduce physical symptoms such as rapid heartbeat and tremors.
• Cognitive behavioral therapy (CBT): CBT is a therapeutic approach that focuses on identifying and challenging negative thought patterns and behaviors associated with anxiety, helping individuals develop effective coping strategies.
• Exposure Therapy: Exposure therapy is a behavioral therapy technique where individuals gradually face and overcome feared situations or stimuli, helping desensitize anxiety associated with specific phobias or traumatic experiences.
• Mindfulness-based therapies: Approaches like Mindfulness-Based Stress Reduction (MBSR) incorporate mindfulness meditation and awareness techniques to reduce stress and anxiety by fostering a present-focused mindset.
• Acceptance and commitment therapy (ACT): ACT combines mindfulness and behavioral strategies to help individuals accept and commit to values-based actions, promoting psychological flexibility and reducing anxiety.
• Dialectical behavior therapy (DBT): Initially developed for borderline personality disorder, DBT incorporates skills training, mindfulness, and acceptance techniques to manage emotional dysregulation, which can include anxiety.
• Relaxation techniques: Relaxation exercises for anxiety promote physical and mental relaxation, effectively reducing anxiety symptoms. These techniques may include deep breathing, progressive muscle relaxation, and guided imagery can promote physical and mental relaxation, effectively reducing anxiety symptoms.

Questions to Ask Your Healthcare Provider About Seroquel for Anxiety

When considering Seroquel for anxiety, individuals may want to gather comprehensive information to make informed decisions. Questions to ask their healthcare provider, psychiatrist, or therapist could include inquiries about how Seroquel works, its potential benefits for anxiety, and the expected timeline for symptom improvement.

Questions to ask your care team when considering the side effects of Seroquel may include:

• Can Seroquel be used with other anxiety medications?
• How long is the typical adjustment period for individuals starting Seroquel?
• Considering my current medications for anxiety or depression, am I at an increased risk of experiencing more severe symptoms or side effects with the addition of Seroquel?
• What dosage range is recommended to minimize potential side effects while effectively managing anxiety?
• Should I be cautious about any potential drug interactions?
• In case I experience side effects, when should I reach out to you for guidance, and what signs should I be particularly attentive to?
• How often will my care team monitor and assess the effectiveness of Seroquel, and what adjustments can be made if needed?
• Are there lifestyle factors, such as diet or alcohol consumption, that I should modify while taking Seroquel?
• What are the potential long-term effects of Seroquel, and how will its usage be reassessed over time?
• Are there specific considerations for individuals with pre-existing medical conditions, such as diabetes or cardiovascular issues, when using Seroquel for anxiety?
• Should I be concerned about any withdrawal symptoms or complications if I decide to stop taking Seroquel in the future?