Seroquel Patient Tips

How it works

Seroquel is a brand name for the drug quetiapine. Quetiapine acts on numerous receptors in the brain to calm and help diminish psychotic thoughts.

Upsides

Seroquel is used primarily to treat psychotic disorders such as bipolar disorder and schizophrenia. Its ability to also calm and make people sleepy means it may be used in addition to antidepressants or to treat other conditions (off-label uses include anxiety disorder).

Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

• Confusion, headache, drowsiness, agitation, constipation, weight gain, dry mouth and blurred vision.
• Sedation - which may affect your ability to drive or operate machinery. Avoid alcohol.
• May cause a lowering of blood pressure - this may be particularly noticeable when going from a sitting to standing position.
• Interaction or overdosage may cause serotonin syndrome (symptoms include mental status changes [such as agitation, hallucinations, coma, delirium], fast heart rate, dizziness, flushing, muscle tremor or rigidity and stomach symptoms [including nausea, vomiting, diarrhea]). Another serious syndrome called Neuroleptic Malignant Syndrome (NMS) has also been reported; symptoms include high body temperature, muscle rigidity, and mental disturbances; discontinue quetiapine immediately and seek urgent medical advice if symptoms of NMS develop.
• May increase risk of bleeding, especially if used with other drugs that also increase bleeding risk.
• May also cause anxiety, nervousness or insomnia.
• Significant weight loss has been reported, although may cause weight gain in some people.
• May precipitate a manic episode in people with undiagnosed bipolar disorder.
• May cause lowering of total body sodium (hyponatremia); elderly people or people taking diuretics or already dehydrated may be more at risk.
• May cause a discontinuation syndrome if abruptly stopped; symptoms include irritability, low mood, dizziness, electric shock sensations, headache and confusion.
• Withdrawal symptoms, such as irritability, nausea, vomiting, and insomnia may occur if quetiapine is stopped abruptly; taper off gradually under medical advice.
• High blood sugar levels or elevations in cholesterol or triglyceride levels reported.
• As with similar medications, quetiapine may increase the risk of suicidal thoughts or behavior in young adults; risk is higher in those aged less than 25.

Notes: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. For a complete list of all side effects, click here.

Bottom Line

Seroquel is an antipsychotic that helps to calm and also relieves psychotic thoughts. Often used because of its sedating potential; however, care is needed because it also lowers blood pressure.

Tips

• Immediate-release tablet can be administered either with or without food. Administer extended release tablets in the evening either without food or following a light meal. Swallow extended-release tablets whole, do not crush or chew.
• Initially, lower dosages are administered. These are gradually increased as needed so that tolerance develops to side effects such as drowsiness or low blood pressure.
• Get up slowly when going from a lying or sitting position to standing.
• Dosage may be given once daily or split depending on your doctors instructions and tablet form (ie, immediate vs extended release).
• Because of the risk of sedation, be cautious when driving or operating machinery until you know the effects of quetiapine on your mental functioning.
• Be alert for changes in behavior including agitation, depressed mood, and suicide-related events and seek medical advice if changes are apparent.
• Avoid alcohol while taking Seroquel and keep hydrated. Avoid over-exercising.
• Tell your doctor if you experience any abnormal facial movements.

Response and Effectiveness

Peak levels reached after 1.5 hours for immediate-release tablets or after 6 hours for extended-release tablets.