Seroquel vs. Ambien for Bipolar Disorder and Insomnia: Important Differences and Potential Risks.

Key takeaways

Quetiapine (Seroquel) and zolpidem (Ambien) are both prescription medications, but they are used for different purposes and belong to different drug classes. Quetiapine is an atypical antipsychotic used to treat schizophrenia, bipolar disorder, and as an add-on for depression. It works by balancing chemicals in the brain like dopamine and serotonin. Zolpidem, on the other hand, is a GABA A receptor positive modulator used to treat insomnia by slowing down brain activity to help you fall asleep. Quetiapine is not a controlled substance, while zolpidem is a Schedule IV controlled substance due to its potential for misuse and dependency. Quetiapine can cause side effects like weight gain, high blood sugar, and suicidal thoughts, especially in younger people. Zolpidem can cause sleepwalking, sleep driving, and daytime sleepiness, and should only be used short-term. Both medications have generic forms available.

Quetiapine

(Seroquel)

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Zolpidem

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Summary for Seroquel

Prescription only

Quetiapine (Seroquel) is an atypical antipsychotic. It's used to treat mental health problems like schizophrenia and bipolar disorder. This medication comes as an immediate-release tablet (Seroquel) that's taken by mouth usually twice a day. There's also an extended-release tablet (Seroquel XR) that's taken once a day. The specific dosage depends on how well it's helping your mood, thoughts, and behaviors. Side effects can include sleepiness, headache, and possible weight gain. There are brand-name and generic versions of this medication.

Indications for Seroquel

Schizophrenia in adults and children ages 13 years and older
Bipolar disorder in adults and certain children ages 10 years and older
Depression in adults, as an add-on to other antidepressants - extended-release only

Pros and Cons for Seroquel

Pros

Taken by mouth
Might notice an improvement in your symptoms in as early as a week of starting the medication
Available in both short-acting and long-acting tablets

Cons

Might cause weight gain
Can raise your blood sugar and cholesterol levels
Not recommended for older adults who have dementia-related psychosis

Common Side Effects for Seroquel

Immediate-release tablets:

Headache (21%)
Agitation (20%)
Sleepiness (18%)
Dizziness (11%)
Dry mouth (9%)
Constipation (8%)
Pain (7%)
Fast heart rate (6%)
Vomiting (6%)

Extended-release tablets:

Sleepiness (25%)
Dry mouth (12%)
Dizziness (10%)
Trouble controlling muscle movements (8%)
Low blood pressure when standing up (7%)
Constipation (6%)

Warnings for Seroquel

Higher risk of death and stroke in older people with dementia-related psychosis
Risk of suicidal thoughts and behavior
Neuroleptic malignant syndrome
High blood sugar, high cholesterol, and weight gain
Trouble controlling muscle movements (tardive dyskinesia)
Changes in blood pressure
Risk of falls
Risk of infection (due to low white blood cell counts)
Possible changes in heart rhythm
Seizures
Hypothyroidism (low thyroid hormone)
High prolactin levels
Feeling very sleepy and having trouble concentrating

Summary for Ambien

Prescription only

Zolpidem is a sleeping pill used to treat insomnia, a condition where you have trouble falling or staying asleep. The dose is typically taken at bedtime to help you sleep. Since it's a controlled substance, it has a risk of misuse and dependency. Zolpidem should only be taken for a short period of time, especially since the medication can cause side effects like dizziness, daytime sleepiness, sleepwalking, or sleep driving. It comes as an oral tablet or capsule that you swallow and a sublingual tablet that you place under your tongue.

Indications for Ambien

Insomnia (trouble sleeping)
Waking up in the middle of the night - certain sublingual tablets only

Pros and Cons for Ambien

Pros

Works quickly within 15 to 30 minutes to help you feel sleepy
Available as a lower-cost generic medication
Comes in multiple strengths which can be helpful to determine the right dose for you
Available as a tablet that dissolves under your tongue if you have trouble swallowing pills

Cons

Can only be used for short-term treatment of insomnia
Has a serious risk of nighttime sleep behaviors, such as sleepwalking, sleep driving, or sleep eating
Can cause unpleasant withdrawal symptoms, such as stomach cramps, sweating, or vomiting, when stopped suddenly
Is a controlled substance with a risk of misuse and dependence