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Compare Seroquel vs. Lithium

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

Key takeaways

Quetiapine (Seroquel) and lithium (Lithobid) are both used to treat bipolar disorder, but they have some key differences. Quetiapine is an atypical antipsychotic that can also treat schizophrenia and be used as an add-on for depression. It works by balancing dopamine and serotonin levels in the brain. Lithium, on the other hand, is a mood stabilizer specifically for bipolar disorder and manic episodes. Quetiapine is available in both immediate-release and extended-release forms, while lithium comes in instant-release pills, oral liquid, and extended-release tablets. Quetiapine can cause side effects like weight gain, high blood sugar, and high cholesterol levels, whereas lithium can lead to side effects such as shakiness, thirst, and excessive urination. Both medications require careful monitoring, but lithium needs regular blood tests to check its levels in your body to avoid toxicity. Quetiapine is generally not recommended for older adults with dementia-related psychosis, while lithium is not recommended for those with kidney problems.

Quetiapine (Seroquel)
Lithium
Quetiapine (Seroquel)
Lithium
Summary of Seroquel vs. Lithium
Summary for Atypical antipsychotic
Prescription only
Quetiapine (Seroquel) is an atypical antipsychotic that's used to improve mood, thoughts, and behaviors for people with schizophrenia and bipolar disorder. The extended-release form of quetiapine (Seroquel) can also be used to treat depression when combined with another antidepressant. While quetiapine (Seroquel) works well, it has many risks and side effects, so it's not the best choice for everyone. Make sure your provider knows about all of your medical conditions and medications you're taking before starting quetiapine (Seroquel) to make sure it's as safe for you as possible.
Summary for Antimanic
Prescription only
Lithium carbonate (or lithium) is a medication used to treat bipolar disorder and manic episodes. It's taken by mouth, typically 2 to 3 times a day. Lithium is available as instant-release pills and oral liquid as well as an extended-release tablet (brand name Lithobid). All lithium products are available as lower-cost generics. Lithium works well for treating bipolar disorder, but it can also cause side effects, such as shakiness, thirst, and nausea. To prevent lithium toxicity, your provider will check your blood lithium levels to make sure you're on a safe dose of the medication.
Indications of Seroquel vs. Lithium
Indications for

•Schizophrenia in adults and children age 13 years and older

•Bipolar disorder in adults and children age 10 years and older

•Add-on to antidepressants for depression (extended-release only)

Indications for

•Treatment of manic episodes of bipolar disorder

•Long-term maintenance treatment of bipolar disorder
Pros and Cons of Seroquel vs. Lithium
Pros and Const for Atypical antipsychotic
Pros

•Might notice an improvement in your symptoms in as early as a week of starting quetiapine (Seroquel)

•Taken by mouth

•Extended-release quetiapine (Seroquel) can help treat depression (adults only)

•Available as a lower-cost generic

•Available in both short-acting and long-acting forms

Cons

•Can cause weight gain and can raise your blood sugar and blood cholesterol levels

•Must be avoided in older adults who have dementia-related psychosis

•Can raise the risk of suicidal thoughts and behaviors, especially in people who are age 24 or younger

•Need to take immediate-release tablets 2 to 3 times a day

Pros and Const for Antimanic
Pros

•Works well for bipolar disorder

•Starts to work in about 1 to 3 weeks

•Available as a lower-cost generic

•Available as oral pills and oral liquid for those having trouble swallowing pills

Cons

•Can have a lot of side effects, including lithium toxicity if lithium levels are too high

•Requires routine blood tests to check the medication levels and how the medication is affecting your body

•Not the best option for people with severe kidney problems

•Interacts with a lot of medications such as non-steroidal anti-inflammatory drugs (NSAIDs), diuretics, and ACE-inhibitors
Common Side Effects of Seroquel vs. Lithium
Common Side Effects for
Immediate-release tablets

•Headache (21%)

•Agitation (20%)

•Sleepiness (18%)

•Dizziness (11%)

•Dry mouth (9%)

•Constipation (8%)

•Pain (7%)

Extended-release tablets

•Sleepiness (25-52%)

•Dry mouth (12-37%)

•Dizziness (10-13%)

•Constipation (6-10%)

•Difficulty controlling muscle movements (7-8%)

•Weight gain (7%)

Common Side Effects for
Adults:

•Hand trembling

•Excessive urination

•More thirst

•Nausea

•General discomfort when you start treatment

Children (7 to 17 years of age):

•Nausea or vomiting (57%)

•Urinating more often (38%)

•Tremor (32%)

•Feeling more thirsty (28%)

•Tiredness (26%)

•Higher thyroid hormone levels (25%)

•Dizziness (23%)
Warnings of Seroquel vs. Lithium
Common Side Effects for

•Higher risk of death in older people with dementia-related psychosis

•Worsening depression, suicidal thoughts and behavior

•Neuroleptic malignant syndrome

•Weight gain and high levels of blood sugar and cholesterol

•Difficulty controlling body movements

•Changes in blood pressure and higher risk of falls

•Risk of infection (from low white blood cell count)

•Life-threatening abnormal heart rhythm (QT prolongation)

•Seizures

•Hypothyroidism (low thyroid hormone)

•High prolactin levels

•Difficulty concentrating and extreme sleepiness

Common Side Effects for

•Lithium toxicity

•Kidney problems

•Serotonin syndrome

•Thyroid problems

•Heart problems (Brugada syndrome)

•Low blood sodium levels

•High blood calcium levels and high parathyroid hormone levels

•Brain-related side effects
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Key takeaways

Summary of Seroquel vs. Lithium

Indications of Seroquel vs. Lithium

Pros and Cons of Seroquel vs. Lithium

Common Side Effects of Seroquel vs. Lithium

Warnings of Seroquel vs. Lithium

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