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Seroquel vs. Clozaril

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Quetiapine (Seroquel) and clozapine (Clozaril) are both atypical antipsychotics, but they have some key differences. Quetiapine is used to treat schizophrenia, bipolar disorder, and depression, while clozapine is mainly used for schizophrenia that hasn't responded to other treatments. It can also help with suicidal behavior in people who have schizophrenia or schizoaffective disorder. Quetiapine is available in both immediate-release and extended-release forms, whereas clozapine comes in regular and dissolvable tablets. Clozapine requires regular blood tests due to the risk of dangerously low white blood cell counts. This increases the risk of severe infections, which is why clozapine must be prescribed under a special program called Risk Evaluation and Mitigation Strategies (REMS). Both medications can cause weight gain, high blood sugar, and high cholesterol, but clozapine is more likely to cause these side effects. Clozapine also has a higher risk of causing severe constipation and liver problems. Its not a first-choice medication due to its many side effects and the need for close monitoring. Both medications are available as low-cost generics.

Quetiapine

(Seroquel)

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Clozapine

(Clozaril)

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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

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:

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 Clozaril

Prescription only

Clozapine (Clozaril) is used to treat schizophrenia. It's an atypical antipsychotic, but it's not a first-choice medication for schizophrenia because it can cause many bothersome side effects, such as drowsiness and dizziness. It can also cause your white blood cell (WBC) count to drop dangerously low and raise your risk for serious infections. As a result, clozapine (Clozaril) is prescribed under a special program called Risk Evaluation and Mitigation Strategies (REMS). In order to pick up your medication at the pharmacy, your provider will ask you to get blood work regularly (weekly to monthly) to make sure your WBC count is at a healthy level.

Indications for Clozaril

  • Schizophrenia that hasn't responded to other treatments
  • Suicidal behavior in people with schizophrenia or schizoaffective disorder

Pros and Cons for Clozaril

Pros

  • Works well to treat schizophrenia when other medications haven't worked well
  • Taken by mouth
  • Comes as both a regular tablet (that you swallow by mouth) and as a dissolvable tablet that you place on the tongue
  • Available as a lower-cost generic

Cons

  • Need to get blood work done every time you get a prescription filled (weekly to monthly)
  • Can cause dizziness and drowsiness
  • Can cause high blood sugar, high cholesterol, and weight gain
  • Not a good option for people with a history of seizures

Common Side Effects for Clozaril

  • Increased salivation (Up to 48%)
  • Drowsiness (up to 46%)
  • Dizziness (up to 27%)
  • Fast heart rate (up to 25%)
  • Constipation (up to 25%)
  • Trouble sleeping (up to 20%)
  • Nausea/vomiting (17%)
  • High or low blood pressure (up to 13%)
  • Fever (up to 13%)
  • Headache (10%)
  • Heartburn (up to 14%)

Warnings for Clozaril

  • Risk of serious infection (from low white blood cells)
  • Low blood pressure, slow heartbeat, and fainting
  • Seizures
  • Heart problems
  • Higher risk of death in older people with dementia-related psychosis
  • High blood sugar, high cholesterol, and weight gain
  • Severe constipation
  • Serious allergic reactions or inflammation problems
  • Life-threatening abnormal heart rhythm (QT prolongation)
  • Neuroleptic malignant syndrome
  • Driving impairment
  • Liver problems
  • Difficulty controlling body movements
  • Not for people with phenylketonuria (dissolvable tablets only)

Prices with our coupons for Seroquel vs. Clozaril

Price Card Drug Icon
Quetiapine30 tablets / 50mg
$9.87$69.41
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Clozapine90 tablets / 100mg
$64.59$177.45
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