Medication and Treatment Reviews

Seroquel

Generic Name: Quetiapine fumarate

Uses

Seroquel is an anti-psychotic primarily used to treat symptoms of schizophrenia in people over 13 years of age, bipolar disorder in adults, and manic episodes in children between 10 and 17. The safety and effectiveness of taking Seroquel for children under age 10 is unknown. Seroquel can be dangerous for elderly people with dementia. Physicians may recommend a reduced dose for adults over age 65 or people with liver problems.

Seroquel XR, the extended release formulation, is sometimes used to treat anxiety disorder and major depressive disorder in adults and children over the age of 10, in combination with antidepressants.

How to Use Seroquel

Before starting or refilling a Seroquel prescription, read the medication guide included with your pills, as it may be updated with new information.

This guide should not replace a conversation with your doctor, who has a holistic view of your medical history, other diagnoses, and other prescriptions. If you have questions, ask your doctor or pharmacist before you begin taking the medication.

Dosage

As with all medications, follow your Seroquel prescription instructions exactly. Seroquel is taken by mouth, with or without food. The optimal dosage varies by age and condition treated. Seroquel is available in two formulations:

  • Seroquel Immediate Release: Tablets are available in 25mg, 50mg, 100mg, 200mg, 300mg, and 400mg dosages. It is commonly taken two to three times daily. Tablets should be swallowed whole, never crushed or chewed.
  • Seroquel XR: Tablets are available in 50mg, 150mg, 200mg, 300mg, and 400mg dosages. The time-release formulation is designed to maintain a steady level of medication in your body throughout the day. It is commonly taken once daily at bedtime. Tablets should be swallowed whole, never crushed or chewed.

If you miss a dose, you should take it as soon as possible, unless it is already time for your next dose. You should not take two doses of Seroquel at the same time. Contact your doctor if you have questions about skipped pills.

Do not drink alcohol while taking Seroquel.

When discontinuing treatment, or decreasing dosage, patients should work with a doctor to gradually taper the level of medication. Stopping Seroquel suddenly can create serious symptoms including difficulty sleeping, nausea, and vomiting.

Side Effects

The most common side effects of Seroquel are as follows:

Children and Adolescents (ages 10 to 17): Nausea, dry mouth, weight gain, increase appetite, vomiting, and rapid heartbeat.

Adults: Dry mouth, dizziness, weakness, abdominal pain, constipation, sore throat, and difficulty moving.

The most common side effects of Seroquel XR are as follows: dry mouth, constipation, dizziness, increased appetite, upset stomach, fatigue, stuffy nose, and difficulty moving.

Medications like Seroquel can increase risk of suicide and suicidal thoughts, especially at the start of treatment. Report any sudden changes in mood to your healthcare provider, including depression, anxiety, restlessness, panic, irritability, impulsivity, or aggression.

Other serious side effects include: low white blood cell count, cataracts, seizures, abnormal thyroid tests, increase in prolactin levels, sleepiness, elevated body temperature, difficulty swallowing, insomnia, and vomiting.

Taking Seroquel may impair your ability to drive, operate machinery, or perform other potentially dangerous tasks. This side effect usually wears off with time. If side effects are bothersome, or do not go away, talk to your doctor.

Most people taking this medication do not experience any of these side effects.

Elderly people with dementia can develop neuroleptic malignant syndrome (NMS) from taking Seroquel. This is a rare, but serious condition that can cause a stroke resulting in death. If you experience high fever, sweating, rigid muscles, confusion, or changes in breathing or heartbeat, these could be warning signs of NMS and you should seek medical help at a hospital immediately.

Tell your doctor if you have diabetes or difficulty managing your blood sugar. Taking Seroquel can increase blood sugar which, when untreated, can cause ketoacidosis, coma, or death. Warning signs of hyperglycemia include: excessive thirst, frequent urination, feeling very hungry, weak, tired or nauseous, fruit-scented breath, and nausea. If you experience these, contact your healthcare provider.

Some people experience tardive dyskinesia, a condition which causes uncontrollable movements in the face, tongue, or other body parts. This may not go away, even if you stop taking Seroquel.

While taking Seroquel, your doctor should regularly monitor the fat levels in your blood (cholesterol and triglycerides), weight, and blood pressure. Seroquel can increase blood fat levels, cause weight gain, and create sudden changes in blood pressure, especially in children and teenagers.

The above is not a complete list of potential side effects. If you notice any health changes not listed above, discuss them with your doctor or pharmacist.

Precautions and Safety

Store Seroquel in a secure place out of the reach of children, and at room temperature. Do not share your Seroquel prescription with anyone, even another person with schizophrenia or bipolar disorder. Sharing prescription medication is illegal, and can cause harm.

You should not take Seroquel if you have an allergy to quetiapine fumarate or any of the ingredients in Seroquel. Before taking Seroquel, tell your doctor if you have a personal or family history of diabetes, high cholesterol, abnormal blood pressure, low white blood cell count, cataracts, seizures, abnormal thyroid, high prolactin levels, heart problems, or liver problems.

Do not become overheated or dehydrated while taking Seroquel. This includes avoiding extremely strenuous exercise, spending time in the sun, or wearing too heavy clothing.

If you’re thinking of becoming pregnant, discuss the use of Seroquel with your doctor. Especially when taken in the last three months of pregnancy, it is known to cause fetal harm. It is recommended that mothers do not nurse while taking Seroquel, as it is unsafe for infants, and Seroquel passes into breastmilk.

Interactions

Before taking Seroquel, discuss all other active prescription medications with your doctor.

Medications that inhibit or induce CYP3A4, an enzyme that metabolizes certain drugs, can increase or decrease how the body absorbs Seroquel. Physicians may need to increase or decrease Seroquel dosage when taken with prescriptions like ketoconazole, ritonavir, carbamazepine, and rifampin.

Seroquel can interact with certain antihypertensive agents, dopamine agonists, and levodopa.

Share a list of all vitamin or herbal supplements, and prescription and non-prescription medications, you take with the pharmacist when you fill your prescription, especially any drugs that cause drowsiness. Let all doctors and physicians know you are taking Seroquel before having any surgery or laboratory tests. Seroquel can alter the results of urine drug screens.

The above is not a complete list of all possible drug interactions.

Sources:

http://www.fda.gov/downloads/drugs/drugsafety/ucm089126.pdf
http://www.accessdata.fda.gov/drugsatfda_docs/label/2009/020639s045s046lbl.pdf
https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=0584dda8-bc3c-48fe-1a90-79608f78e8a0#ID_6ac3db63-3706-49e7-abb1-db99b2427d00
https://www.seroquelxr.com/
http://www.azpicentral.com/seroquel-xr/seroquelxr.pdf#page=17
http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/PediatricAdvisoryCommittee/UCM191895.pdf
https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=473a3ac4-67f4-4782-baa9-7f9bdd8761f4#ID_62d610f6-be85-4854-8299-61751ee077ad

11 reviews

  1. I was having trouble staying asleep at night. I took Seroquel at night and quickly realized I couldn’t keep my eyes open more than 15 minutes if I wanted to, where before, I could “override” any medication. Also, I would sleep the entire night so hard that one minute my head hit the pillow and the next minute, I was waking up 8 full hours later. The side effect though was that if I took it too late, my brain would feel like cotton for about the first hour and a half of the day. Not cool for working a 9 to 5 job that took me an hour to get to. So I learned to take it at 9 pm, would be in bed no later than 9:30 pm and be fairly well rested by the morning. That was probably the best time of my life to finally have a regulated sleep schedule.

  2. I remember being put on Seroquel when I was very depressed years ago (before I quit drinking booze – so like when I was 20) and I hated it. I gained like 40lbs in 6 weeks and felt drowsy all the time.

  3. I also don’t get tired until 3 or 4 a.m. every night! I hate going to bed because I have to force myself to long hours of trying to “be still and relax”. And I hate going to bed because I never get enough sleep. I have to slam myself with a medicinal hammer every night (100 mg of Seroquel), which makes me tired after waiting for two hours!

  4. I am 53, ADHD and BP2. Just started Seroquel XR and take it at 7 PM and then Lamictal at bedtime, both these meds help the depression (I was taken off Prozac) the BP2 and the PLMD (Periodic Limb Movement Disorder). I take Vyvanse for the ADHD and Seroquel XR at night to help with depression that goes with the BP~2. I do go to a psychiatrist and she takes care of these meds over my PCP.

  5. My son has had add for the last couple of years. It started with inappropriate hitting. After the diagnoses and started the Concerta it went away. Then he was diagnosed with depression an started Seroquel. Now the nightmare started he has been raiding the refrigerator in the middle of the night.

  6. I was diagnosed a couple of months ago with ADHD. But at same time was also give RX of a mood disorder. I was put on Seroquel first (at 150 mg) taken at 7 p.m. It’s not as sedating as first few weeks, but I’m definitely now in bed by 10 p.m. Wow, that sure helps with the “surfing the internet until 2 a.m. and getting over stimulated” part. Then she added the Focalin to treat ADHD. Take that 3x daily (5mg each).

    I just saw my doctor today and told her that I didn’t feel optimal. I’ve still had bouts of depression, anger, and anxiety. She was going to up my dosage of Seroquel. But I told her that was part of the problem. I’m feeling “sedated” for most of the morning. So we are switching to Abilify. I’m also going back up from my Paxil dose of 10 mg to 20 mg. I take 20 mg of Focalin in the am for my ADHD.

    I got a little “lecture” from my dr. because I took that 2.5 mg of Abilify just that first night then just stuck with the lower dose of the Seroquel (100 mg). I’m glad I decided not to take it. Just lowering the Seroquel by 50 mg made a huge difference. I’m not so sedated feeling and upping my Paxil to 20 mg from 10 also seems to be helping the equation.

  7. My son (age 7) also took Seroquel. He was previously taking Risperdone. His aggressive behaviors. The consideration was given that he may have bipolar disorder. He was prescribed Seroquel.
    He had a very bad reaction to the Seroquel—incoherent speech, terror. He would wake up in the middle of the night screaming at the top of his lungs banging on doors, for no apparent reason. My son’s behavior was typically upsetting to other people, but on the Seroquel he frightened ME. I immediately stopped giving him the drug, and the extreme behaviors disappeared.

  8. My 10 year old has been taking Seroquel for over a year now. It has helped him tremendously. He has ADHD, which is controlled with Vyvanse. He started the Seroquel to help with aggression and severe anxiety. We have had great benefits from it. At one point, he was taking 200mg 3 times a day; we were able to decrease to 200mg twice daily. I was originally worried about the dose (I work in healthcare, and see adults on 25mg, 50mg doses), but the doc explained that children are “fast metabolizers” so they need higher doses than adults.
    It has not been thoroughly studied in children, but honestly, most meds have not. I just know that my son is better able to function and be happy.

  9. My son is turning 10 and has been on Seroquel for several months. He is doing fairly well. We have had many ups and downs in trying to deal medically with his aggression issues. This is his third bi-polar med and he has been on several different ADHD meds as well. Currently he is on Vyvanse and Seroquel. The only side effect has been weight gain – which we believe he is especially vulnerable too as he had to be taken off Abilify due to weight gain. But he has responded well in terms of his ability to control his emotions as a result of the drug. The drug does seem to make my child very hungry at night (since he takes the does at night).

  10. My 7-year-old grandson has been on meds for ADHD since he was 3. We started with clonidine at that age because he wasn’t sleeping at all. He is currently in 1st grade and is on Strattera. This helps somewhat with focus, but he is still behind in academics. His behavior at home is the real problem, he has continually been on clonidine, but it is not enough to keep his meltdowns and aggression in check. We have tried many different meds. After much discussion with his psychiatrist, we just started him on Seroquel yesterday along with his Strattera, and weaning him off the clonidine. He is on 25mg daily, half in the morning and half in the afternoon. He was very agitated and aggressive all day. Hitting and kicking. This evening he had a major meltdown over a minor incident that lasted 40 minutes, I had to restrain him to keep him from biting, and hurting myself and the other children in the house.

  11. Seroquel did not help my 8-year-old. I do believe a lot of the issues were due to the wrong ADHD meds. We went from Vyvanse to Concerta and now Focalin. The first two caused the symptoms you listed. We stopped Seroquel before changing to Focalin. We also started a low dose of Abilify. We hope to stop the Abilify this summer with no school to see if necessary.
    I do believe there is a lot more than meds to help your child adjust. Parenting, as we knew it, is out the window. We make sure he gets plenty of protein in the morning, gets a good night rest (melatonin helps), wakes up quietly, sugar is way limited, plenty of exercise, no quick changes to routine/schedule, etc.

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