Seroquel (Quetiapine): Uses, Dosage, Side Effects, & More

What Is Seroquel?

Seroquel, containing the active ingredient quetiapine, falls into the category of prescription drugs known as atypical antipsychotics. It is FDA-approved for treating two main conditions: psychosis, such as schizophrenia, in individuals aged 13 and older, and bipolar I disorder in adults. For bipolar disorder, Seroquel is used as a mood stabilizer to help manage depressive episodes and manic episodes when used alone or alongside lithium or Divalproex.¹

FDA approval means that after rigorous testing and evaluation, the medication has been deemed safe and effective for these specific uses in the indicated age groups. However, its safety and effectiveness in children under ten years old have not been established.

Is Seroquel Available as a Generic Medication?

Yes, Seroquel is available as a generic medication. It contains the active drug quetiapine, which can be found in generic form. Generic drugs are identical to their brand-name counterparts, offering a more cost-effective alternative while maintaining the same active ingredient and efficacy.

How Does Seroquel Work?

Seroquel is thought to work by helping to balance certain chemicals in the brain. It can reduce symptoms of psychosis, like hallucinations or confusion, by reducing the action of certain neurotransmitters in certain areas of the brain. For bipolar I disorder, it can stabilize mood swings, making the highs (mania) and lows (depression) less severe. Essentially, Seroquel acts like a regulator in the brain, making it easier for people with these conditions to manage their symptoms and lead more stable lives.¹

What Is Seroquel Used to Treat?

Seroquel is FDA-approved for conditions of psychosis and bipolar 1 disorder. Being FDA-approved means that after rigorous testing, the medication has been found safe and effective for these specific uses.¹

Seroquel, in its generic version, quetiapine, can be used as an off-label for different mental health problems such as:²

• Insomnia
• Dementia
• Specific personality disorders

Prescribers may opt for off-label use when they believe it could be beneficial for a patient based on their professional judgment and the individual’s unique circumstances.

Common Side Effects of Seroquel

Common side effects of Seroquel in adults may include drowsiness, weight gain, dizziness, and upset stomach. Some individuals may experience a sudden drop in blood pressure when standing up or other effects like sluggishness, dry mouth, or weakness. If you encounter severe or persistent side effects, consult a healthcare professional for guidance.

Common side effects of Seroquel include:¹

• Drowsiness
• Weight gain
• Dizziness
• Upset stomach
• Dry mouth
• Weakness
• Abnormal liver tests (based on laboratory assessments)

*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 understand the potential side effects and benefits of any medication.

Serious Side Effects of Seroquel

Seroquel can have serious side effects that need immediate medical attention. These effects can affect different parts of your body and range from strokes to conditions like neuroleptic malignant syndrome (NMS), which can be life-threatening. NMS symptoms include high fever, sweating a lot, stiff muscles, confusion, and changes in vital signs. If you notice any of these, contact a doctor right away.

Serious side effects of Seroquel include:¹

• Stroke (particularly in elderly individuals with dementia)
• High fever
• Rigid muscles
• Hallucinations
• Falls leading to severe injuries
• Tardive dyskinesia (uncontrollable movements)
• Orthostatic hypotension
• Elevated blood pressure in children and teenagers
• Seizures
• Difficulty swallowing

*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.

Seroquel Warnings & Precautions

Seroquel carries several important warnings and precautions that require careful consideration. These warnings and precautions emphasise the importance of careful patient assessment, monitoring, and consideration of individual risk factors when using Seroquel. Always consult with a healthcare professional for personalized guidance.

Avoid taking Seroquel if you:¹

• Increased mortality in elderly patients and dementia: Elderly patients with dementia-related psychosis taking Seroquel face an elevated risk of death, particularly due to cardiovascular and infectious causes.
• Suicidal thoughts and behaviors in adolescents and young adults: Patients with major depressive disorder, especially adolescents and young adults, may experience worsened depression or suicidal thoughts when taking Seroquel.
• Cerebrovascular adverse reactions such as stroke: Seroquel is not approved for treating dementia-related psychosis and may pose an increased risk of cerebrovascular events in this population.
• Neuroleptic malignant syndrome (NMS): NMS, a potentially fatal condition, has been reported with antipsychotic drugs, including Seroquel. It presents with symptoms like high fever, rigid muscles, and confusion.
• Metabolic changes: Seroquel can lead to metabolic changes, such as hyperglycemia, dyslipidemia, and weight gain, which should be closely managed, especially in patients with diabetes or other risk factors.
• Tardive dyskinesia: Seroquel may cause uncontrollable movements, and tardive dyskinesia may not always resolve upon discontinuation.
• Hypotension: Orthostatic hypotension may occur, leading to dizziness and falls, especially during initial dose titration.
• Fainting: Seroquel can make you feel very sleepy, dizzy when changing positions, and unsteady, which raises the chances of falling and getting hurt.
• Increases in blood pressure (children and adolescents): Blood pressure increases may occur in pediatric patients and should be monitored regularly.
• Leukopenia, neutropenia, and agranulocytosis: Blood cell abnormalities, including agranulocytosis, have been reported with Seroquel.
• Cataracts: While the causal relationship is unclear, cataracts have been observed in patients taking Seroquel.
• QT prolongation: Be careful when using Seroquel with drugs that can make your heart’s electrical activity longer, or if you have things that might increase this risk.
• Seizures: Seizures may occur, particularly in patients with a history of seizures or conditions lowering the seizure threshold.
• Hypothyroidism: Seroquel may affect thyroid hormone levels and should be monitored.
• Hyperprolactinemia: Elevated prolactin levels can occur, leading to various symptoms, including gynecomastia and menstrual irregularities.
• Potential for cognitive and motor impairment: Patients should be cautioned about activities requiring mental alertness, as Seroquel may impair judgment and motor skills.
• Body temperature regulation: Patients exposed to conditions that increase core body temperature should use caution when taking Seroquel.
• Dysphagia: Seroquel could lead to problems with swallowing and breathing in some people, especially those at risk for pneumonia caused by inhaling things into the lungs.
• Discontinuation syndrome: Abruptly stopping Seroquel may lead to withdrawal symptoms, such as insomnia and nausea. Gradual withdrawal is advised.
• Anticholinergic (antimuscarinic) effects: Seroquel, especially when taken with other anticholinergic drugs, can cause constipation and, in some cases, blockages in the intestines.

Seroquel Dosages for FDA-Approved Treatment

Seroquel dosages vary depending on factors like age and the condition being treated. Approved by the FDA for conditions like schizophrenia, bipolar disorder, and major depressive disorder (as adjunct treatment), dosages range widely from 25 mg – 400 mg.¹

Age plays a crucial role, with older adults usually needing lower doses due to increased sensitivity. Individual factors are critical in determining the right dosage. Off-label uses may have varying dosages, decided by healthcare professionals based on specific circumstances and patient characteristics.

Seroquel Forms & Strengths

Seroquel is available in different forms and strengths to accommodate individual needs. It comes in immediate-release tablets ranging from 25 mg to 400 mg. Additionally, there’s an extended-release version known as Seroquel XR, with strengths ranging from 50 mg to 400 mg. The choice of form and strength depends on factors like the patient’s condition, age, and response to the medication. Dosages may vary based on these considerations and the individual’s specific requirements.³

Seroquel is available in the following forms and strengths:¹

• 25 mg tablets (Peach, round, film-coated)
• 50 mg tablets (White, round, film-coated)
• 100 mg tablets (Yellow, round, film-coated)
• 200 mg tablets (White, round, film-coated)
• 300 mg tablets (White, capsule-shaped, film-coated)
• 400 mg tablets (Yellow, capsule-shaped, film-coated)

What’s the Most Effective Dose of Seroquel?

The most effective dose of Seroquel varies from person to person and depends on their specific condition, age, and individual response to the medication. Prescribers typically start with a low dose and adjust it gradually to find the optimal balance between symptom control and minimizing side effects. Therefore, there is no one-size-fits-all answer to the most effective dose of Seroquel, as it is tailored to each individual’s unique needs.

How Should I Take Seroquel?

To take Seroquel properly, follow your healthcare provider’s instructions carefully. You can take it with or without food. If you need to stop, discuss it with your provider first to avoid side effects. If you miss a dose, take it when you remember, but don’t double up if your next dose is soon. Contact your healthcare provider if you have any questions about your dosage or how to take Seroquel to ensure its effectiveness and safety.

What Happens If I Miss a Dose of Seroquel?

If you miss a dose of Seroquel, take it as soon as you remember. However, if your next dose is approaching, skip the missed one and continue with your regular dosing schedule. Avoid taking two doses at once. If you’re uncertain about what to do, consult your healthcare provider for guidance to ensure you maintain your medication regimen. Missing a dose occasionally is common, but it’s important to strive for consistency to achieve the best results with your treatment.

Can You Overdose on Seroquel?

Yes, an overdose of Seroquel is possible and can have serious consequences. Clinical trials have reported survival in cases of overdoses up to 30 grams of quetiapine, but there have been instances of death following an overdose of 13.6 grams.¹

Overdose symptoms may include extreme drowsiness, rapid heartbeat, low blood pressure, and anticholinergic toxicity. In cases of overdose, it is crucial to establish an open airway, ensure proper oxygenation and ventilation, and monitor the cardiovascular system closely for potential arrhythmias. Immediate medical attention is essential to prevent severe complications or fatalities.

What Should You Do If You Take Too Much Seroquel?

If you’ve taken too much Seroquel, it’s crucial to seek immediate medical help. Establish and maintain an open airway, ensure proper oxygen supply, and closely monitor your cardiovascular system for any irregularities using continuous electrocardiographic monitoring. Seeking prompt medical assistance is essential in such emergencies to ensure your well-being and safety.

What to Avoid When Taking Seroquel

Seroquel levels can be affected by other medications. Some drugs can increase their levels (inhibitors like ketoconazole), requiring a lower Seroquel dose. Others may reduce its levels (inducers like phenytoin), necessitating higher doses. To stay safe, discuss all your medications and supplements with your healthcare provider to prevent harmful interactions.

6 substances you should avoid while taking Seroquel include:¹

• Alcohol: Drinking alcohol can increase Seroquel’s sedative effects, leading to excessive drowsiness and impaired coordination.
• Central nervous system depressants: Medications like benzodiazepines or opioids that depress the central nervous system may intensify Seroquel’s drowsiness and sedation.
• CYP3A4 inhibitors (e.g., ketoconazole): These drugs can elevate Seroquel levels in the body, potentially requiring a lower Seroquel dose to prevent side effects.
• CYP3A4 inducers (e.g., phenytoin): Seroquel levels may decrease when taken with these drugs, possibly necessitating higher Seroquel doses for effectiveness.
• Levodopa and dopamine agonists: Seroquel may counteract the effects of these medications, commonly used to treat Parkinson’s disease which is a neurological disorder.
• Antihypertensive agents: Seroquel could enhance the effects of specific blood pressure medications, potentially causing low blood pressure.

How to Get a Prescription for Seroquel

Getting a prescription for Seroquel requires seeing a healthcare provider, typically a doctor or psychiatrist. They will evaluate your medical history and current condition to determine if Seroquel is a suitable treatment. This evaluation may involve discussing your symptoms, conducting physical exams, and considering your overall health. If your healthcare provider believes Seroquel is appropriate, they will write a prescription for you to obtain the medication from a pharmacy. It’s essential to follow their guidance and take the medication as prescribed to ensure its effectiveness and safety.

How Much Does Seroquel Cost?

The cost of Seroquel can vary depending on whether you choose the brand or generic version. The brand-name Seroquel can be more expensive, with prices ranging around $126.28 for a prescription. However, you can save significantly by opting for the generic version of Seroquel, quetiapine, which is available for as low as $5.00 using a GoodRx coupon.⁴

It’s important to explore your options and discuss them with your healthcare provider to find the most cost-effective solution for your prescription needs. Coupons and discounts like GoodRx can help you access medications at a more affordable price.

Questions to Ask Your Healthcare Provider About Seroquel

If you’re considering Seroquel as a treatment option, it’s essential to engage in an open dialogue with your healthcare provider, psychiatrist, and therapist. Ask them questions about the medication’s potential benefits, side effects, and how it may interact with your current medications or conditions. Additionally, inquire about alternative treatment options and whether Seroquel is the right choice for you. If you need to change prescribers or seek specialized advice, online psychiatry services can be a convenient and accessible option for consultations and evaluations.

Questions to ask your care team about Seroquel include:

• How safe is Seroquel for my specific condition?
• What is the typical adjustment period for starting Seroquel?
• Are there any potential interactions between Seroquel and my current medications?
• What is the recommended dosage to minimize side effects while effectively treating my symptoms?
• What are the most common side effects of Seroquel, and how can I manage them?
• Is there a risk of weight gain associated with Seroquel, and how can I address it?
• How will Seroquel affect my daily activities, such as driving or operating machinery?
• Are there any lifestyle changes or dietary considerations I should be aware of while taking Seroquel?
• Can I drink alcohol while on Seroquel, and if so, in moderation?
• What signs should I watch for that may indicate a serious adverse reaction to Seroquel?
• How often should I schedule follow-up appointments to monitor my progress and adjust my treatment plan if needed?
• Are there any alternative treatments or therapies I should explore alongside Seroquel?
• Can Seroquel be used to treat anxiety?
• Could Seroquel be considered as an Abilify alternative?

In My Experience

In my experience, discussing Seroquel with your doctor and following their guidance is vital for achieving the best outcomes. Some clients have found Seroquel to be effective, helping manage symptoms of conditions like schizophrenia and bipolar disorder and improving their quality of life. However, it can come with challenges like drowsiness or weight gain, necessitating close monitoring and treatment adjustments.

Regarding this topic, it’s essential to view Seroquel as part of a comprehensive treatment plan for mental health conditions. Seeking support from professionals, discussing potential benefits and risks, and adhering to their guidance are crucial. Treatment is highly individualized, and the right approach can significantly impact one’s well-being.