11 Quetiapine Side Effects You Should Know About

Treating schizophrenia and bipolar disorder often includes therapy and medications. Antipsychotic medications, such as quetiapine (Seroquel), are first-choice medication options for both of these mental health conditions. But quetiapine can cause a variety of side effects.

If you have a prescription for quetiapine, it’s good to know what side effects are possible. Some may improve on their own with continued use of the medication. But more serious quetiapine side effects may require medical attention.

Here, we’ll review 11 notable quetiapine side effects. But keep in mind, the list below doesn’t include every possible side effect. It’s also important to know that tips for managing some side effects vary, depending on if you’re taking the immediate-release (IR) or extended-release (ER) version.

1. Sleepiness

One common quetiapine side effect is feeling extra sleepy. Clinical trials have shown that between 20% to 57% of people taking it experienced sleepiness.

If you’re only taking quetiapine once a day, consider taking it in the evening. But if you’re taking quetiapine more than once a day, space out your doses evenly as directed by your healthcare provider.

When starting quetiapine, or when changing your dose, avoid activities that require alertness. This includes driving a car or performing other activities that require focus. Once you see how quetiapine affects you, you can determine if you’re alert enough to do those activities.

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If you have excessive sleepiness from quetiapine that doesn’t improve, let your healthcare provider know. They may lower your dose or switch you to another antipsychotic.

2. Headache

Headaches are one of the most common quetiapine side effects. About 20% of people taking the medication in clinical trials reported this side effect. Headaches may improve as your body gets used to the medication. But if they don’t go away, or get worse at any point, contact your healthcare provider for guidance.

They may offer a few tips like making sure you’re drinking enough water and getting enough sleep. They may also recommend an over-the-counter (OTC) pain reliever. But don’t start a new medication without talking to your provider first.

3. Stomach-related side effects

Quetiapine can cause constipation, an upset stomach, and stomach pain. Of these side effects, constipation is the most common.

If you have constipation from quetiapine, a high fiber diet may help. This includes foods like whole grains, fruits, and vegetables. Exercising regularly and staying hydrated are also important. If needed, talk to your healthcare provider about OTC medications to help treat your constipation.

If you have an upset stomach and you take quetiapine IR, try taking your dose with food to help lessen stomach upset. But quetiapine ER should be taken on an empty stomach or with a light meal of less than 300 calories. A heavier meal can interfere with how quetiapine ER is absorbed by the body.

4. Metabolic changes like weight gain, high cholesterol, and high blood sugar

Weight gain is possible while taking atypical antipsychotics, including quetiapine. In clinical studies, up to 23% of people taking quetiapine for schizophrenia gained 7% or more of their body weight. A similar number of people taking it for bipolar mania experienced the same amount of weight gain.

Among the atypical antipsychotics, quetiapine is considered to cause a moderate amount of weight gain. This means it tends to cause less weight gain than some atypical antipsychotics like olanzapine (Zyprexa) and clozapine (Clozaril). But it may cause more weight gain than others, like risperidone (Risperdal) and paliperidone (Invega). For some people, lifestyle changes, like following a healthy diet and exercising regularly, can help manage weight gain from quetiapine.

Higher blood glucose (sugar), cholesterol, and triglyceride levels may also occur. Your healthcare provider should monitor these items with blood tests while you take quetiapine. Blood glucose levels should be watched extra closely if you have diabetes.

5. Dry mouth

Quetiapine is one of many medications that can cause dry mouth.

To relieve the discomfort of dry mouth, stay hydrated. You can also try sucking on ice chips or rinsing your mouth with cold water throughout the day. Limiting salty, dry, or acidic foods may also help.

If these tips don’t work, talk to your healthcare provider. They may lower your quetiapine dose since dry mouth is more common with higher doses. Or they may recommend saliva substitutes, like Biotene. In some cases, a prescription medication for dry mouth may be recommended, but this isn’t common.

6. Lowered blood pressure and dizziness

Quetiapine may cause a drop in blood pressure when you change positions. This is called orthostatic hypotension. If you’re taking quetiapine, take your time standing up.

Dizziness may also occur with quetiapine. This most often occurs at the beginning of treatment or after a dose change. Dizziness and orthostatic hypotension can lead to falls. Let your healthcare provider know if you are finding it difficult to maintain balance or you frequently feel lightheaded.

7. High blood pressure in children

Elevated blood pressure has been seen in children and adolescents taking quetiapine. Your child’s healthcare provider will likely check their blood pressure before starting quetiapine and throughout treatment. If your child feels any symptoms of high blood pressure, like chest pain, headaches, or unexplained dizziness, seek medical help.

8. Withdrawal symptoms

Atypical antipsychotics like quetiapine shouldn’t be stopped abruptly. Withdrawal symptoms can occur if you stop the medication or lower your dose too quickly. These include difficulty sleeping, nausea, and vomiting.

If you’re interested in stopping quetiapine, talk to your healthcare provider. They can help you decide if this is a good idea and help you come up with a plan to slowly lower your dose.

9. Movement problems

Quetiapine can impact your movement. This could be an inability to sit still (akathisia). Or it could be other movement problems like tardive dyskinesia, especially if you’re taking quetiapine for a longer period of time. Tardive dyskinesia causes uncontrollable body movements, but it can be irreversible in some cases.

A serious medical condition called neuroleptic malignant syndrome (NMS) can also cause movement issues. NMS can cause rigid muscles along with fever and confusion. It can be life-threatening, so it’s important to seek treatment immediately if symptoms develop.

If you experience a change in your movements after starting quetiapine, contact your healthcare provider right away. It may require you to stop taking quetiapine. If your symptoms are severe, seek emergency help immediately.

10. Mood changes

It’s possible to experience changes in your mood while taking quetiapine. In rare cases, it may increase feelings of depression, or raise the risk of suicidal thoughts or behavior. It’s important to pay close attention to any changes in your mood while taking quetiapine, especially when you first start taking it or after a dose change.

Disclaimer:

If you or someone you know is having thoughts of suicide, you’re not alone, and help is available. Call the National Suicide Prevention Lifeline at 988, or text HOME to 741-741 to reach the Crisis Text Line.

11. Higher risk of death for older adults with dementia

Older adults who take quetiapine for dementia-related psychosis may have a higher risk of death compared to those who don't. Experts aren’t sure exactly why this risk exists. One reason could be that metabolism side effects, like higher cholesterol, may worsen existing health conditions, like heart disease, which are more common in older adults.

Quetiapine has a boxed warning (the FDA’s strictest warning for medications) regarding this risk. It’s recommended that healthcare providers avoid prescribing quetiapine for dementia-related psychosis in older adults.

When should I contact my healthcare provider about side effects from quetiapine?

If you have any bothersome side effects, contact your healthcare provider. They can help you decide if you should continue taking quetiapine as is, lower the dose, or try another medication. They may also be able to give you tips for how to manage these side effects, including the tips we discussed above.

If you notice serious side effects, including movement problems or mood changes, call your healthcare provider. And if you have symptoms that feel severe (like confusion, high fever, or rigid muscles), seek immediate medical attention.

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Written by:

Alexa Mader, PharmD

Alexa Mader has been a practicing pharmacist since 2018. She earned her Doctor of Pharmacy degree from the University of Georgia College of Pharmacy.

Edited by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

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