Seroquel (Quetiapine) – Uses, Side Effects & Treatment Programs

Seroquel, or Quetiapine, is an atypical antipsychotic prescription medication that is primarily used for treatment of schizophrenia, but also for some other mental health issues such as manic and depressive episodes. It is also known as a second generation antipsychotic (SGA) or atypical antipsychotic. Seroquel affects the chemical balance in the brain by rebalancing dopamine and serotonin levels in order to improve an individual’s ability to think clearly, as well as regulate general mood and behavior.1

Seroquel is a non-controlled substance that hasn’t been tested in animals or humans for its misuse potential, but there are reports of cases that may indicate it has certain potential for recreational use or abuse. Most cases of misuse were noted in males inside an inpatient rehabilitation setting, as well as among prison populations. Routes of administration were usually intranasal, oral, and intravenous by persons who had well established history of experimenting with polysubstance abuse.2

Even though Quetiapine’s efficacy in treatment of schizophrenia and manic episodes associated with bipolar disorder has been established in numerous medical trials and tests, there are certain side effects that may occur with Seroquel use, such as:3

  • Dry mouth
  • Headache
  • Dizziness 
  • Constipation
  • Drowsiness
  • Agitation
  • Fatigue
  • Increased heart rate
  • Increased glucose
  • Increased blood pressure
  • Weight gain and increased appetite
  • Cholesterol abnormalities

What Is Seroquel (Quetiapine)?

There are two versions of the Seroquel, also known as Quetiapine. They are distinguished by their formulation; extended release version called Seroquel XR and immediate release version called Seroquel IR. Seroquel XR is administered once daily and is characterized by sustained drug exposure and lower intensity of sedation than Seroquel IR.1

In contrast with this, the mean daily dosage administered during hospitalization was usually much higher than that of Seroquel IR. Unlike Seroquel XR which is used in significantly higher doses as a primary antipsychotic medication, Seroquel IR is used in lower doses as an add-on medication for anxiety and sleep because of its anxiolytic or sedative effects.4

Seroquel XR is more commonly used for treatment of schizophrenia, while the IR version is more commonly used in treatment of psychosis. Patients that suffered from somatic diseases as well as those with comorbid substance abuse were significantly more likely to be treated with Seroquel XR than Seroquel IR. XR and IR versions of Seroquel are not substitutes, but should be viewed as complementary in inpatient treatment of schizophrenia patients.4

Quetiapine Brand Name

Seroquel is a brand name for the substance Quetiapine which received approval from the FDA in 1997 for treatment of schizophrenia. It has been developed by AstraZeneca group of companies. Patent protection for the Seroquel expired in 2012, but protections for the XR version remained in place as late as 2017 in number of different jurisdictions.5

As there were certain indications that it may be beneficial for treatment of some other mental health issues, drug testing continued and Seroquel received its second approval from the FDA in 2004, this time for treatment of issues concerning bipolar disorder. In 2008, the FDA issued an approval for use of Seroquel XR in treatment of bipolar depression and bipolar mania before approving XR version as an adjunctive treatment of major depressive disorder in 2009.5

What is Seroquel (Quetiapine) Used for?

As was noted before, Seroquel tablets and extended-release (long-acting) tablets are primarily used for treatment of schizophrenia and related symptoms. Schizophrenia is a mental illness which is characterized by the presence of unusual or disturbed thinking patterns that can have a negative impact on people’s ability to function normally. It can also include hallucinations and delusions which lead to strong and inappropriate emotions and general loss of interest.3

Most common symptoms that may point to schizophrenia and are treated with Quetiapine include:1

  • Lack of initiative and any form of motivation in life.
  • Muddled thinking and inability to make sense of one’s thoughts.
  • Extreme emotional states with flattened or extremely heightened affect.
  • Loss of desire to be around people and engage in social activities.
  • Impaired speech and communication capabilities.
  • Delusions — ideas and beliefs that aren’t substantiated or quite simply aren’t true.
  • Hallucinations — seeing and hearing things that seem real but that in reality aren’t there.

In addition to being prescribed to patients with schizophrenia, Seroquel was approved by the FDA for treatment of bipolar disorder issues, including:6

  • Depressive episodes in adults who suffer from bipolar disorder.
  • Manic episodes in bipolar I disorder for children ages 10 to 17, and for adults in combination with lithium or divalproex.
  • Long-term treatment of bipolar I disorder in adults in combination with lithium or divalproex.

Extended-release version of tablets is also used as an adjunctive therapy with antidepressants for treatment of various forms of depression. Seroquel can also be prescribed by your mental health provider as an “off-label” option to deal with issues such as:1

  • Post-traumatic stress disorder (PTSD).
  • Obsessive compulsive disorder (OCD).
  • Delusional parasitosis.
  • Generalized anxiety disorder.
  • Episodes of delirium in ICU.
  • Dual diagnosis, also known as co-occurring disorder.

How Should I Take Seroquel?

Seroquel IR tablets are taken 1 to 3 times a day, while the extended release version is taken once per day, preferably in the evening. They should be taken without food or with a light meal (not more than 300 calories). Seroquel are tablets that are taken by mouth and shouldn’t be crushed, split or chewed but taken whole. It’s best if you stick to some type of schedule and take Seroquel tablets at roughly the same time every day.7

Make sure that you take Seroquel exactly as prescribed by your doctor. You should be careful never to take more or less than your doctor directed you to. For elderly patients it’s best if the starting dose is lowered to 50mg per day, preferably with slower titration and careful monitoring during the initial dosing period. For patients with hepatic impairment starting Seroquel XR dosage should be 50 mg per day, while Seroquel IR should be lowered to 25 mg per day and then gradually increased during the first week of treatment.8

If for some reason you stop taking Quetiapine for a week or longer, it’s best to consult your doctor before starting with medication again. The doctor will advise you to start with lower dosage like you did during the initial phase and then gradually increase the dosage. It’s important not to stop taking the medication without consulting your doctor first, even if you are satisfied with how you feel. If you discontinue taking Seroquel there is a risk of experiencing withdrawal symptoms like nausea, vomiting, sickness and sleeping issues.3

What are the Signs and Symptoms of Seroquel Abuse?

At the moment Seroquel is an FDA approved prescription drug that falls under the category of non-controlled substance. But a series of reports surfaced in recent years of people misusing Seroquel as a recreational substance. Majority of them have been males with previous record of incarceration and known history of substance abuse, but also those who submitted to drug treatment clinics. In addition to the oral route, Seroquel tablets have been misused intranasally and intravenously by previously crushing them.2

Since Seroquel doesn’t produce the feeling of euphoria, abuse is usually related to its sedative and anxiolytic characteristics. It’s mostly taken in order to enhance the effects of illicit substances and street drugs like cocaine and marijuana, or in some cases to counter their adverse effects. It’s also misused by individuals who wish to ameliorate the unpleasant feelings associated with withdrawal.2

Like other second-generation antipsychotics, Seroquel can cause metabolic disturbances such as:9

  • Weight gain
  • High blood sugar
  • High cholesterol
  • High blood pressure.

Recreational use of Seroquel is particularly dangerous due to morbidity and mortality that are associated with its misuse. Most common symptoms include:9

  • Confusion
  • Agitation
  • Tachycardia
  • Insomnia
  • Drowsiness

There are multiple studies that indicate that people who overdose on Seroquel face a great risk of:10

  • Coma
  • Hypotension
  • Respiratory depression
  • Seizures
  • Deadly outcomes

If you suspect that somebody close to you has been abusing or misusing Quetiapine, be on the lookout for some of these signs:11

  • Person looks visibly high or sedated.
  • Dramatic mood swings and uncharacteristic behavior patterns.
  • Abrupt changes in sleeping patterns, or evidence of insomnia.
  • Seclusion, withdrawal, sudden secrecy, or social isolation.
  • Having drugs that are prescribed to someone else.
  • Doctor-shopping (practice during which individuals visit several doctors in order to amass a large amount of medications).
  • Simulating symptoms (people attempting to feign symptoms in order to acquire the desired drugs).
  • Evidence of crushed medication is a clear sign the person has been trying to snort or inject them.
  • Presence of injections which indicate possible intravenous injection of drugs.

What are the Common Quetiapine Warnings?

Seroquel is not approved for elderly patients who suffer from dementia-related psychosis since it’s especially dangerous for those individuals as it carries an increased risk of death. It also carries an increased risk of suicidal behavior in children, adolescents, and young adults who are taking antidepressants. For this reason they should be closely monitored for the possible emergence of suicidal ideation or signs that their behavior is changing.8

To learn more about Quetiapine related warnings and side effects, be sure to check out this dedicated web page which will provide you with more detailed information.

Warnings for People with Certain Health Conditions

Individuals who suffer from following issues should use Seroquel with precaution and be monitored for worsening of their conditions:8

  • Cerebrovascular illnesses
  • Neuroleptic malignant syndrome (NMS)
  • Hyperglycemia
  • Diabetes Mellitus
  • Dyslipidemia
  • Tardive dyskinesia
  • Hypotension
  • Children and adolescents with increased blood
  • Leukopenia
  • Neutropenia
  • Agranulocytosis
  • Cataracts

Some of the important things to know before you start taking Seroquel are:3

  • Tell your doctor that you are pregnant, and especially if you are in the last months of pregnancy
  • If you have future plans to have a child keep in mind that Seroquel may decrease your fertility
  • Tell your dentist that you are taking Seroquel before any surgery or procedure
  • Seroquel makes it harder for your body to cool down so you should drink plenty of fluid and avoid strenuous exercise and direct sun exposure on hot days
  • Since Seroquel can make you drowsy it’s best not to drive a car and avoid drinking alcoholic beverages.

What Does Seroquel Do to a Normal Person?

It is important never to take Seroquel on your own. You should always use it according to the doctor’s instructions. Seroquel is an antipsychotic that is prescribed for serious mental health issues. The risks associated with the drug may be acceptable in treatment of patients who have serious issues and little alternative for treatment, but everybody else will place themselves in a position of unnecessary risk of serious harm.12

There are a number of potential problems related to use of Seroquel outside of appropriate use for treatment of schizophrenia, bipolar spectrum issues and other psychoses. Taking Seroquel on your own will put you in a position of risk of serious side effects including overdose. The efficacy of Seroquel for off-label indications is still not researched enough. There are many potential side effects associated with Seroquel use, but most common issues associated with self-medication and prolonged use include constipation, weight gain, type 2 diabetes mellitus, tardive dyskinesia (TD), and even sudden cardiac death.12

How Long Does Quetiapine Stay in Your System?

Quetiapine is rapidly absorbed by the system after intake. It reaches peak plasma concentration about 1 hour and a half. The system eliminates Quetiapine mainly through hepatic metabolism which means it’s extensively metabolized by the liver. Mean terminal half-life is some 6 hours for the proposed clinical dose range. Steady-state concentration is usually achieved within two days of dosing Seroquel medication.8

Research has shown that only 1% of the administered Seroquel was present in the excrement, which points to the fact that it’s highly metabolized by the system. Almost three quarters of Seroquel dose can be found in the urine, and roughly one fifth will be present in the feces. Individuals with hepatic or renal insufficiency had 30% and 25% lower mean oral clearance, respectively. People with these problems will have to have their Seroquel dosage adjusted.8

What Happens During Seroquel Interactions with Other Medications?

Seroquel is primarily known to block the effects of medications used to treat Parkinson’s disease, including:1

  • Ropinirole (brand name Requip)
  • Levodopa or Carbidopa (Sinemet)
  • Pramipexole (Mirapex)
  • Bromocriptine

There is the potential that following drugs might increase the risk of heart problems if they are combined with Seroquel:1

  • Antipsychotics like Chlorpromazine (brand name Thorazine), Asenapine (Saphris), Ziprasidone (Geodon), Thioridazine (Mellaril), Paliperidone (Invega), and Iloperidone (Fanapt).
  • Antiarrhythmics (drugs that treat heart rhythm issues) like Sotalol (Betapace), Amiodarone (Cordarone), Quinidine, Procainamide, and Dronedarone (Multaq), 

The following medications might increase the effects or concentration levels of Seroquel:1

  • Erythromycin (Ery-Tab)
  • Nefazodone
  • Fluvoxamine (Luvox)
  • Fluconazole (Diflucan)

There are also medications which may decrease the concentration levels or effects of Seroquel:1

  • Phenobarbital
  • Carbamazepine (Tegretol)
  • Rifampin (Rifadin)
  • Phenytoin (Dilantin)

What are the Drugs Not to Take with Seroquel?

While the FDA currently lists no known contraindications for Seroquel, there are some drugs which warrant caution when used in combination with Seroquel. Special consideration is advised when combining Seroquel with medications that increase QT interval and when itorsades de pointespatients who have prolonged QT intervals. Combination of these drugs with Seroquel puts patients at risk of torsades de pointes:13

  • Quinine
  • Methadone
  • Antipsychotics
  • Pentamidine
  • Halofantrine
  • Macrolides
  • Antiarrhythmics
  • Levomethadyl acetate
  • Albendazole
  • Fluoroquinolone
  • Tricyclic antidepressants

What are The Treatment Programs for Seroquel Addiction?

There is no one-size-fits-all approach to treatment of substance addiction, and Seroquel addiction is no exception. First step would be to schedule an appointment with a medical professional who is qualified to look into your situation and advise what would be the appropriate steps to take.14

Patients who struggle with severe Seroquel addiction may need to submit to medically managed detox to cleanse their system from unwanted substances. Detox programs usually last for a couple of days or up to a week. Detox is not an addiction treatment in itself; it is rather a first step that is needed before patients can become ready to enter into specialized substance addiction recovery programs.14

After completing detox, patients can choose between several proven treatment approaches. One of the most popular rehab treatments is the outpatient treatment. Outpatient rehab can be modified in terms of program duration, number of visits per week, and the length of daily sessions. Patients who choose outpatient rehab can sleep in their homes, which will significantly reduce the cost of rehab.15

If an individual is suffering from severe addiction or has already relapsed in the past, it may be best for them to enter into inpatient treatment. Inpatient treatment provides patients with the highest quality of care since it takes place inside a rehab center that is designed to tackle addiction issues. Doctors and medical staff will be able to monitor patient’s progress at all times. Structured environment of inpatient rehab will encourage accountability, helping patients develop healthy habits that will enable them to remain sober after completion of their rehab program.16

How to Get Help for Seroquel Addiction?

You can easily find treatment centers through an online locator, or you can just call American Addiction Centers, which operates the largest network of rehab centers in the nation. AAC’s facilities are located around the country and offer an option of in-network treatment through their partnership with America’s biggest insurance providers.

To learn more about Seroquel addiction or substance abuse in general, call AAC’s hotlines which are available 24/7 for issues like alcohol, and prescription drugs addiction. There is no need to hesitate when contacting AAC’s hotlines since all calls are confidential and guarantee anonymity.

Professional and knowledgeable admissions navigators can provide you with a variety of information on all possible treatment options and approaches. They can also check the details of your healthcare insurance coverage over the phone, look into your benefits, and give you their honest advice concerning rehab centers that might be best suited to cater to your needs.

With just one call you can find out all you need to know concerning costs of various forms of treatment, payment options at your disposal, and all the information you generally need about financing that you need to make an informed decision about your addiction treatment.

Frequently Asked Questions