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.
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
Quetiapine (Seroquel) is an atypical antipsychotic. It's not completely known how the medication works. But it's thought to help balance the dopamine and serotonin levels in your brain. These natural chemicals help regulate your mood, thoughts, and behaviors.
Source:Â DailyMed
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Chills
cold sweats
confusion
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
sleepiness or unusual drowsiness
Less common
Black, tarry stools
blurred vision
changes in patterns and rhythms of speech
inability to move the eyes
inability to sit still
increased blinking or spasms of the eyelid
lip smacking or puckering
loss of balance control
mask-like face
muscle aches
need to keep moving
painful or difficult urination
puffing of the cheeks
rapid or worm-like movements of the tongue
restlessness
shakiness in the legs, arms, hands, or feet
shuffling walk
slowed movements
slurred speech
sores, ulcers, or white spots on the lips or in the mouth
sticking out of the tongue
stiffness of the arms or legs
sweating
swelling of the face, arms, hands, feet, or lower legs
swollen glands
trembling and shaking of the hands and fingers
trouble with breathing, speaking, or swallowing
uncontrolled chewing movements
uncontrolled movements of the arms and legs
uncontrolled twisting movements of the neck, trunk, arms, or legs
unusual bleeding or bruising
unusual facial expressions
unusual tiredness or weakness
Rare
Dry, puffy skin
fast, pounding, or irregular heartbeat
loss of appetite
menstrual changes
unusual secretion of milk (in females)
Incidence not known
Aching or discomfort in the lower legs or sensation of crawling in the legs
agitation
bed-wetting
blistering, peeling, or loosening of the skin
bluish lips or skin
chest discomfort
dark urine
decreased awareness or responsiveness
decreased urine output
difficulty breathing
difficulty in passing urine (dribbling)
difficulty swallowing
dizziness
faintness
general feeling of tiredness or weakness
headache
hoarseness
increased thirst
indigestion
irritability
joint or muscle pain
light-colored stools
loss of consciousness
lower back or side pain
muscle cramps, spasms, stiffness, or twitching
painful or prolonged erection of the penis
pains in the stomach, side, or abdomen, possibly radiating to the back
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
red skin lesions, often with a purple center
red, irritated eyes
seizures
severe constipation
severe sleepiness
severe vomiting
stomach pain, continuing
tightness in the chest
tingling of the hands or feet
unusual bleeding or bruising unusual drowsiness, dullness, or feeling of sluggishness
unusual weight gain or loss
upper right abdominal pain
vomiting
yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Abnormal vision
belching
decreased appetite
decreased strength and energy
increased appetite
increased muscle tone
increased sweating
indigestion
stomach discomfort or upset
stuffy or runny nose
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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
Might cause weight gain
Can raise your blood sugar and cholesterol levels
Not recommended for older adults who have dementia-related psychosis
Swallow quetiapine (Seroquel) whole. Don't cut, crush, or chew the immediate-release or extended-release tablets. If you have trouble swallowing the tablet whole, talk to your prescriber about your options. You might need to switch to another medication that's easier for you to take.
For the immediate-release tablets (Seroquel): You can take the medication with or without food.
For the extended-release tablets (Seroquel XR): Take the medication on an empty stomach or with a light meal (about 300 calories). This makes sure a safe amount of medication gets absorbed into the body.
Avoid grapefruit and grapefruit juice while taking quetiapine (Seroquel). Grapefruit can raise the levels of the medication in your body. This might make side effects more likely.
It's not recommended to drink alcohol while taking quetiapine (Seroquel). Alcohol can worsen common side effects like feeling drowsy or dizzy. It can also make your schizophrenic or bipolar disorder symptoms worse. Talk to your prescriber about your drinking habits and how to take quetiapine (Seroquel) safely.
You might feel sleepy when you take quetiapine (Seroquel). You also might have trouble focusing or thinking. Don't drive or do anything that needs your full attention until you know how this medication affects you. Talk to your prescriber if these side effects start getting in the way of your daily life.
Quetiapine (Seroquel) can cause a drop in blood pressure when you stand up after sitting or lying down. This can make you feel dizzy and raise your risk of falls. Get up slowly and try to hold onto something to keep you stable. If you end up falling or hitting your head, get medical help right away.
Tell your care team if you have uncontrolled body movements, like fidgeting, lip-smacking, or arm swinging. These side effects are more likely to happen if your quetiapine (Seroquel) dose is too high. Your care team can lower your dose to help. If needed, they might recommend other treatment options.
Rarely, some people who took antipsychotics like quetiapine (Seroquel) have had trouble swallowing. This can raise the risk of choking. Take small bites of food and eat slowly to lower your risk of choking.
Quetiapine (Seroquel) can interact with many medications. For example, it can make your blood pressure drop too low if taken with blood pressure medications. Taking quetiapine (Seroquel) with anticholinergic medications can also raise the risk of serious constipation or trouble urinating. Tell your prescriber and pharmacist about all your medications. They might need to adjust your doses to keep you safe.
Don't suddenly lower your dose or stop taking quetiapine (Seroquel) without talking to your prescriber first. Otherwise, you might have withdrawal symptoms, like nausea, trouble sleeping, and anxiety. If you want to take a lower dose or stop treatment, your prescriber can help you do this in a safe way. They'll lower your dose slowly over time to lessen the risk of withdrawal.
Quetiapine (Seroquel) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
People 65 years and older with dementia sometimes have schizophrenia symptoms like delusions and hallucinations. This is called dementia-related psychosis. Studies show that older adults with this condition have a higher risk of death and stroke when taking antipsychotics like quetiapine (Seroquel). Most of the time, the cause of death was related to heart problems or infections.
Because of this risk, quetiapine (Seroquel) shouldn't be used to treat older adults with dementia-related psychosis. Tell your prescriber if you have dementia before starting this medication. Caregivers should also let the prescriber know if the person they care for has dementia.
Risk factors: Age younger than 24 years old | History of depression or other mental health conditions
Quetiapine (Seroquel) might make mental health get worse in people with depression. There's also a risk of thoughts of suicide or harming yourself. The risk is highest for people who are 24 years of age or younger.
Watch for worsening depression or unusual changes in your mood, behavior, or thoughts while taking quetiapine (Seroquel). This is very important during the first few weeks of starting the medication and when your dose changes.
If you or someone close to you notices that you seem more depressed or are acting differently, talk to your prescriber right away. Call 911 as soon as possible if you start thinking about hurting yourself.
Antipsychotic medications like quetiapine (Seroquel) have been linked to a rare but very serious condition called neuroleptic malignant syndrome (NMS). Get medical help right away if you have a high fever, sweating, stiff muscles, confusion, or a fast or irregular heartbeat. These can be symptoms of NMS. If this happens, your prescriber will probably switch you to a different medication.
Risk factors: Diabetes | High cholesterol | People who are considered obese
Quetiapine (Seroquel) can raise your blood sugar, sometimes to very high and dangerous levels. Your prescriber might check your blood sugar occasionally while you're taking this medication. Tell your care team if you have symptoms of high blood sugar. This can include feeling very thirsty, urinating more often, or having dry mouth or fruity-smelling breath.
Quetiapine (Seroquel) can also make your cholesterol levels go up. In addition, this medication can sometimes cause weight gain. Your prescriber will check your cholesterol levels with blood tests during treatment. They'll also check in with you about your weight for any notable changes.
It's important to check for changes in blood sugar, cholesterol levels, and weight during treatment. High blood sugar, high cholesterol, and large body size are risks for heart disease, stroke, and other serious health issues. Talk to your care team if you have concerns about taking quetiapine (Seroquel).
Risk factors: Older adults | Female and 65 years or older | Higher-than-recommended dose of quetiapine (Seroquel) | Taking quetiapine (Seroquel) for a long time
Quetiapine (Seroquel) can cause tardive dyskinesia (TD), or uncontrolled muscle movements. These movements can happen in the face, mouth, neck, arms, and legs. It can look like lip smacking, grimacing, eye twitching, and rocking the body from side to side. Sometimes, this side effect can become permanent even after stopping the medication. This is more likely to happen with long-term treatment.
To lower your risk of TD, you should take the lowest dose of quetiapine (Seroquel) possible to treat your symptoms. Your prescriber will check in with you to see if you still need the medication. Talk to your prescriber right away if you notice signs of TD and you can't stop making these movements.
Risk factors: Low blood pressure | History of heart disease, heart attack, heart failure, or heart rhythm problems | Dehydration | Medical conditions that can lower blood pressure | Taking medications that lower blood pressure
Quetiapine (Seroquel) can make your blood pressure drop too low when you stand up. It can make you dizzy, have a fast heart rate, or sometimes even faint. This can raise your risk of falls. Make sure to get up slowly and hold onto something sturdy when standing up. Talk to your prescriber if you feel dizzy or faint when you stand up. Your prescriber might lower your dose of quetiapine (Seroquel) to see if that helps.
Sometimes, quetiapine (Seroquel) can also raise blood pressure in children or teens. Because of this, the prescriber will check your child's blood pressure before starting this medication and regularly during treatment.
Quetiapine (Seroquel) can make you tired. It can also lower your blood pressure and make you lose your balance. These effects can lead to falls that can get you hurt.
Tell your prescriber about all your medical conditions and the medications you take. Some conditions and medications can raise your risk of falls even more. Your prescriber can check your risk and give tips to help prevent falls.
Risk factors: History of low blood cell count
Although rare, quetiapine (Seroquel) can lower your white blood cell count. This can put you at risk of infection.
This might be more likely to happen if you already have a low white blood count. If you're at risk, you'll need to get blood tests done more often during the first few months of taking quetiapine (Seroquel). These blood tests help your prescriber make sure your blood cell count is in a safe range. If your white blood cell count is too low, you'll need to stop taking quetiapine (Seroquel).
Tell your care team if you notice that you get sick more often while taking quetiapine (Seroquel). Look out for signs of infection, like unexplained fever, tiredness, chills, cough, and sore throat.
Risk factors: History of heart disease or heart failure | History of slow heart rate or other abnormal heart rhythms (arrhythmias) | Personal or family history of long QT syndrome | Older age | Low potassium or magnesium levels | Taking other medications that cause QT prolongation
It isn't clear if quetiapine (Seroquel) can cause QT prolongation at recommended doses. But it's happened in people who took too much medication and people at risk of this heart problem. QT prolongation happens when it takes longer for the heart to pump and then relax. This can potentially lead to dangerous changes in heart rhythm.
Before starting quetiapine (Seroquel), tell your prescriber about your health problems and medications. They can check for your risk of QT prolongation. Some medical issues that raise your risk include heart rhythm problems and abnormal electrolyte levels. And, some medications, like amiodarone (Pacerone) and other antipsychotics, can also put you at risk. It's best to avoid quetiapine (Seroquel) if you're at high risk of this problem.
Call 911 right away if you feel your heart pounding, have chest pain, have trouble breathing, or feel lightheaded. These could be signs of heart rhythm problems.
Risk factors: History of seizures | Health conditions that raise the risk of seizures
It's very rare, but some people who took quetiapine (Seroquel) had a seizure. Before starting this medication, tell your prescriber if you've had seizures before or if you have any medical conditions that put you at risk of seizures.
Although rare, quetiapine (Seroquel) can lower your thyroid hormone levels and cause hypothyroidism. Your prescriber might order lab work while you take this medication. This helps them check your thyroid hormone levels.
If you have any signs of hypothyroidism, like feeling very tired or cold, talk to your prescriber. They can help manage this problem.
Quetiapine (Seroquel) can raise the level of a hormone called prolactin in your body. Sometimes, it can stay high during treatment. High prolactin can cause breast growth in males, irregular periods in females, and fertility and sexual problems. Tell your care team if you notice these symptoms or are worried about high prolactin levels.
Quetiapine (Seroquel) can make you very sleepy. It can also make you have trouble thinking, reacting, and focusing.
Your risk of these side effects is higher if you also take other medications that can make you drowsy. This includes benzodiazepines, muscle relaxants, and sleep medications.
Make sure you know how quetiapine (Seroquel) affects you before driving a car or doing anything that needs concentration. Talk to your care team right away if you feel too sleepy from the medication.
Schizophrenia
Adults: The typical starting dose is 25 mg by mouth two times daily. Your prescriber will raise your dose slowly over time. The typical maintenance dose ranges from 150 mg to 750 mg daily. The maintenance dose is split into smaller doses and taken two or three times throughout the day.
Children ages 13 years and and older: The typical starting dose is 25 mg by mouth two times daily. Your prescriber will raise your dose slowly over time. The typical maintenance dose ranges from 400 mg to 800 mg daily. The maintenance dose is split into smaller doses and taken two or three times during the day.
Bipolar disorder 1
Adults: The typical starting dose is 50 mg by mouth twice daily. Your prescriber will raise your dose slowly over a few days. The typical maintenance dose ranges from 400 mg to 800 mg daily. This maintenance dose is split into smaller doses and taken twice throughout the day.
Children ages 10 years and older: The typical starting dose is 25 mg by mouth two times daily. The prescriber will raise the dose slowly over time. The typical maintenance dose ranges from 400 mg to 600 mg daily. This maintenance dose is split into smaller doses and taken two or three times during the day.
Bipolar depression
Adults: The typical starting dose is 50 mg by mouth once daily at bedtime. Your prescriber will raise the dose over a few days. The typical maintenance dose is 300 mg once daily at bedtime.
Schizophrenia
Adults: The typical starting dose is 300 mg by mouth once daily, preferably in the evening. Your prescriber will raise your dose slowly over time. The typical maintenance dose ranges from 400 mg to 800 mg once daily, preferably at night.
Children ages 13 years and older: The typical starting dose is 50 mg by mouth once daily, preferably in the evening. The prescriber will raise the dose slowly over a few days. The typical maintenance dose ranges from 400 mg to 800 mg once daily, preferably at night.
Bipolar disorder 1
Adults: The typical starting dose is 300 mg by mouth once daily, preferably in the evening. Your prescriber will raise your dose over a few days. The typical maintenance dose ranges from 400 mg to 800 mg once daily, preferably at night.
Children ages 10 years and older: The typical starting dose is 50 mg by mouth once daily, preferably in the evening. The prescriber will raise the dose over a few days. The typical maintenance dose ranges from 400 mg to 600 mg once daily, preferably at night.
Bipolar depression
Adults: The typical starting dose is 50 mg by mouth once daily, preferably in the evening. Your prescriber will raise your dose over a few days. The typical maintenance dose is 300 mg once daily at night.
Depression (in addition to other antidepressants)
Adults: The typical starting dose is 50 mg by mouth once daily, preferably in the evening. Your prescriber will raise your dose slowly over a few days. The typical maintenance dose ranges from 150 mg to 300 mg once daily, preferably at night.
Your dose might be lower if you're an older adult or if you have liver problems.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
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
Schizophrenia - people ages 13 years and older
Manic or mixed episodes associated with bipolar I disorder - people ages 10 years and older
Irritability associated with autism - children ages 5 to 17 years old
Tourette syndrome in children
Depression (add-on treatment)
Irritability associated with autistic disorder in children
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