Quetiapine: Uses, Dosage, Side Effects, Warnings & more

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What is quetiapine?

Quetiapine is a second-generation or atypical antipsychotic that is used to treat schizophrenia, bipolar disorder, and depression. It is sold under the brand names Seroquel and Seroquel XR.

It is believed that quetiapine works by assisting in the re-balancing of particular neurotransmitters or chemical messengers in the brain, which leads to improvements in mood as well as thinking and behavior. Blocking the receptors of the neurotransmitters serotonin and dopamine is the primary mechanism by which it exerts its therapeutic effect.

Within your body, serotonin is engaged in a wide variety of processes and functions, and it also works as a natural mood stabilizer. It is believed that depression, anxiety, and manic episodes might be caused by insufficient levels of serotonin. Dopamine is involved in a variety of functions, including mood regulation, behavior, and sleep, amongst others. It’s possible that feeling miserable, lacking motivation, having mood swings, having trouble sleeping, and other symptoms could be caused by a lack of dopamine.

In 1997, the Food and Drug Administration (FDA) of the United States gave its initial blessing to the use of quetiapine. Tablets, both regular and extended-release varieties, are both branded and generic versions of the medication that can be purchased.

What conditions does quetiapine treat?

Tablets and extended-release tablets of quetiapine are employed in the treatment of the following conditions:

Schizophrenia in patients who are at least 13 years old and bipolar disorder in adults, including: depressive episodes associated with bipolar disorder manic episodes associated with bipolar I disorder alone or with lithium or Divalproex long-term treatment of bipolar I disorder with lithium or Divalproex schizophrenia in patients who are at least 13 years old

bouts of mania that are associated with bipolar I illness in children and adolescents aged 10 to 17

Tablets of extended-release quetiapine are also used to treat the following conditions:

major depressive disorder can be treated with additional antidepressant medication in the event that your healthcare provider thinks that treating you with only one antidepressant is not sufficient to alleviate the symptoms of your depression.

There is insufficient evidence to determine if quetiapine is both safe and effective for use in children younger than 10 years old.

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Information that is essential to know

There is a potential for major adverse effects to be caused by quetiapine, including:

1. the danger of death for older people who have dementia. It is possible for medicines such as this one to raise the risk of death in older patients who suffer from memory loss (dementia). This medicine is not appropriate for the treatment of psychosis in elderly patients who also have dementia.
2. the possibility of having suicidal thoughts or acting on them (antidepressant medicines, depression and other serious mental illnesses, and suicidal thoughts or actions).

Talk to your healthcare provider or the healthcare provider of a member of your family about all of the risks and benefits of treating depression with antidepressant medications.

all available options for the treatment of depression and other major mental illnesses

Within the first few months of treatment, certain children, teenagers, and young adults who use antidepressant drugs may experience an increase in the frequency of suicidal thoughts or actions.

The most significant contributors to suicide ideation and behavior are clinical depression and other severe forms of mental illness. It’s possible that certain persons have an especially high risk of having suicidal thoughts or acting on those thoughts. People who experience depression, bipolar disorder (also known as a manic-depressive disease), suicidal thoughts or behaviors, or a family history of these conditions are examples of those who fall into this category.

How can I keep an eye out for suicidal tendencies in myself or a member of my family, and what can I do to attempt to prevent them?

Pay great attention to any shifts in your disposition, behaviors, thoughts, or feelings, particularly any shifts that occur suddenly. When beginning treatment with an antidepressant medication or altering the dosage, this is a very significant consideration.

Changes in mood, behavior, thoughts, or feelings should be reported immediately to a healthcare physician, especially if they have come on suddenly.

Maintain all of your regularly scheduled follow-up appointments with the healthcare practitioner. If you feel the need to call the healthcare practitioner in between visits, especially if you are concerned about your symptoms, do so.

If you or a member of your family is experiencing any of the following symptoms, including if they are new, getting worse, or causing you concern, you should contact a healthcare physician as soon as possible:

Suicidal ideation or behavior, as well as attempted suicide, can signal the onset of a new or more severe depressive episode.

worry that is either new or worse

panic episodes are characterized by extreme agitation or restlessness.

problem sleeping (insomnia)

a fresh or exacerbated level of irritation

exhibiting aggressive behavior, hostile feelings, or violent behavior, and acting on potentially harmful impulses

a significant increase in both activity and conversation (mania)

additional peculiarities in either conduct or disposition

What more do I need to know about the medications used to treat depression?

Never stop taking an antidepressant medication without first discussing it with your primary care physician or another healthcare provider. Suddenly discontinuing the antidepressant medication may result in the emergence of additional symptoms.

Antidepressants can be used to treat a variety of mental health conditions, including depression. It is essential to have a conversation about all of the potential adverse effects of treating depression, in addition to the potential adverse effects of not treating it. Not only should patients and their families or other caregivers discuss the usage of antidepressants with their healthcare professional, but they should explore all therapeutic options available to them.

Other adverse effects are possible when taking antidepressant medication. Have a conversation with the healthcare professional about the potential negative effects of the medication that has been given to you or a member of your family.

There is the potential for antidepressant medications to interact with other medications. Be well-informed about any and all medications that you or a member of your family take. Always have a list of medications on hand to show your doctor or another medical professional. Do not begin taking any new medications before consulting with your primary care physician or another healthcare provider.

Some antidepressant medications that are recommended for children are not considered safe or effective for use in children by the FDA. For more information, we recommend that you discuss it with your child’s healthcare professional.

What should I discuss with my medical professional before beginning treatment with quetiapine?

Inform your healthcare provider if you now have or have ever had any of the following conditions:

diabetes or hyperglycemia in either you or a member of your family. Before you begin taking this medication, your primary care physician should check your blood sugar. During treatment, your primary care physician should also monitor you for high levels of total cholesterol, triglycerides, or LDL cholesterol, as well as low levels of HDL cholesterol.

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blood pressure that is either low or high

reduced number of white blood cells in the blood

cataracts

seizures

abnormal results on the thyroid testing

elevated levels of prolactin

issues with the heart

liver troubles

If you now have or have previously suffered from urinary retention (a condition in which you are unable to completely empty your bladder), an enlarged prostate, constipation, increased pressure inside your eyes, or any other medical problem, you are not eligible for this offer.

Warnings for Quetiapine use during pregnancy and breastfeeding (more detail)

What dosage of quetiapine should I take?

Follow the instructions of your doctor or another healthcare professional regarding how to use this medication. You should not adjust the dosage on your own.

Take this medicine orally, either with or without a meal.

If you are using the quetiapine extended-release (XR) tablet form of the medication, the tablet should be taken as a whole and not split, crushed, or chewed in any way.

If you feel as though you need to stop taking this medicine, you should first discuss your options with your healthcare professional. If you stop taking quetiapine all of a sudden, you run the risk of experiencing withdrawal symptoms such as difficulty falling asleep or staying asleep (also known as sleeplessness), nausea, and vomiting.

What should I expect if I forget to take a dose?

If you forget to take your quetiapine dose, you should take it as soon as you realize you forgot. If you are almost due for the following dose, you should skip the dose that you missed. Just make sure you take the next dose at the same time each day. If your healthcare practitioner has not instructed you otherwise, you should avoid taking two doses at once. Call your healthcare practitioner if you are unsure about the dosage that you should be taking.

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What happens if I overdose?

In the event that you take an excessive amount of quetiapine, you should seek immediate medical assistance or call the Poison Help line at 1-800-222-1222.

What should I try to steer clear of while I’m on quetiapine?

Do not get behind the wheel of a vehicle, operate heavy machinery, or participate in any other potentially hazardous activity until you have determined how this drug affects you. It may make you drowsy.

Make sure you don’t overheat or become dehydrated.

Avoid doing too much activity.

In really hot weather, it is best to be indoors where it is cooler.

Keep your head out of the sun. Do not pile on excessive or cumbersome layers of clothing.

Make sure you get lots of water.

While using quetiapine, you should avoid drinking alcohol at all costs. It is possible that it will make the adverse effects of this medicine even more severe.

Dosing information

Quetiapine – tablets

Condition	Initial dose (Tablets)	Recommended dose (Tablets)
Schizophrenia in adults	25 mg twice daily	150-750 mg/day
Schizophrenia in adolescents (13-17 years)	25 mg twice daily	400-800 mg/day
Bipolar Mania in adults – monotherapy or as an adjunct to lithium or divalproex	50 mg twice daily	400-800 mg/day
Bipolar Mania in children and adolescents (10-17 years) – monotherapy	25 mg twice daily	400-600 mg/day
Bipolar depression in adults	50 mg once daily at bedtime	300 mg/day

Quetiapine – extended-release tablets

Condition	Initial dose (Extended-release tablets)	Recommended dose (Extended-release tablets)
Schizophrenia in adults	300 mg/day	400-800 mg/day
Schizophrenia in adolescents (13-17 years)	50 mg/day	400-800 mg/day
Bipolar I Disorder manic or mixed in adults – acute monotherapy or adjunct to lithium or divalproex	300 mg/day	400-800 mg/day
Bipolar I Disorder, manic in children and adolescents (10 to 17 years) – acute monotherapy	50 mg/day	400-600 mg/day
Bipolar Disorder, depressive episodes in adults	50 mg/day	300 mg/day
Major Depressive Disorder in adults – adjunctive therapy with antidepressants	50 mg/day	150-300 mg/day

What are the side effects of quetiapine?

The following are examples of significant adverse effects caused by quetiapine:

Please refer to “Important information” further up.

People over the age of 65 who have dementia and take medications like neuroleptic malignant syndrome run the risk of having a stroke, which can ultimately result in death (NMS). People who use antipsychotic medications, such as quetiapine, run the risk of developing a condition known as a neuroleptic malignant syndrome (NMS), which is an extremely rare but very deadly disorder. NMS is a condition that can result in death and can only be treated in a hospital setting. If you get very ill and experience some or all of the following symptoms, you should contact your healthcare professional as soon as possible:

a high temperature, a significant amount of perspiration, and stiff muscle

alterations in your respiration, rate, and blood pressure brought on by confusion.

People who take this drug have a slightly increased risk of falling. These trips and falls could result in serious injury.

high blood sugar (hyperglycemia). Whether or not a person has ever been diagnosed with diabetes, they are nonetheless at risk for developing high blood sugar. If you have high blood sugar, this could cause: an increase in the amount of acid in your blood owing to ketones (ketoacidosis)

coma

death

Some individuals who use quetiapine may see an increase in their blood sugar levels. Coma or even death might result from having extremely high blood sugar levels. If you already have diabetes or have risk factors for developing diabetes (such as being overweight or having a family history of diabetes), your healthcare provider should check your blood sugar before you begin treatment with this medication and periodically throughout the course of your treatment.

If you develop any of the following symptoms of high blood sugar (hyperglycemia), you should contact your healthcare professional immediately:

feel the urge to urinate more frequently than usual feel extremely hungry feel weak or fatigued feel sick to your stomach feel confused or like you have a fruity odor coming from your breath

elevated quantities of fat in your blood (increased cholesterol and triglycerides). People who are given this drug may see increased levels of fat in their bodies. Even though you might not be experiencing any symptoms, your healthcare practitioner might still want to monitor your cholesterol and triglycerides while they are treating you.

Increase in terms of weight (weight gain). Because of the increased risk of weight gain associated with quetiapine use, you and your healthcare practitioner should monitor your weight on a consistent basis. Have a discussion with your healthcare practitioner about strategies to keep your weight gain under control, such as adopting a diet that is healthy, well-balanced, and active.

movements in your face, tongue, or other body parts that you are unable to control (tardive dyskinesia). These symptoms might point to a more serious health problem. Even if you stop using quetiapine, it is possible that your tardive dyskinesia will continue to persist. It is also possible that tardive dyskinesia will appear after you have stopped taking this medicine.

a drop in blood pressure, also known as orthostatic hypotension, can lead to symptoms such as dizziness and even fainting when someone stands up too rapidly from a seated or laying position. This can cause the heart rate and blood pressure to shift suddenly.

increases in the average blood pressure of children and adolescents. Before beginning treatment with this medicine and periodically during treatment, the child’s or adolescent’s healthcare provider should monitor the patient’s blood pressure.

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a low count of white blood cells. If you develop a fever, flu-like symptoms, or any other infection, you should discuss this with your healthcare practitioner as soon as possible because it is conceivable that this is the result of a very low white blood cell count. In order to assess if you require additional therapy or some other kind of intervention, your healthcare professional may check the number of white blood cells in your blood.

cataracts

seizures

abnormal results from the thyroid testing. Your doctor may examine your blood to determine the amount of thyroid hormone you have in your system.

rises in the amount of prolactin in the body

symptoms including drowsiness, difficulties thinking and performing routine activities, sleepiness, and sleepiness.

increasing warmth throughout the body

If you suddenly stop using quetiapine, you may experience symptoms such as difficulty swallowing, problems sleeping or difficulties remaining asleep (insomnia), nausea, or vomiting. After one week of experiencing these symptoms, you should typically begin to feel better.

Among adults, the following are the adverse reactions to quetiapine pills that are most frequently experienced:

 

drowsiness

sudden reduction in blood pressure upon standing weight gain

sluggishness

abnormal results on the liver tests

Unease in the stomach and a dry mouth

dizziness \sweakness

abdominal pain

constipation

throat irritation

The following are the adverse reactions to quetiapine pills that are seen most frequently in children and teenagers:

 

drowsiness \sdizziness \sfatigue

headaches dry mouth nausea increased appetite and weight gain

diarrhoea Nausea and vomiting Rapid heartbeat

The following are some of the most frequently reported adverse reactions to quetiapine extended-release (XR) tablets:

 

a lack of saliva dry mouth constipation

dizziness increased appetite

upset stomach fatigue

stuffed up nose trouble moving difficulty speaking or communicating disturbance in language

The following are some of the most often observed adverse reactions in children and adolescents taking quetiapine extended-release (XR) tablets:

drowsiness

dizziness fatigue stuffy nose increased appetite

bloating, cramping, nausea, vomiting, and dry mouth

tachycardia

The weight acquired more.

These are not all of the potential adverse effects of the medication. Please consult with your preferred healthcare provider or pharmacist for further information. Make an appointment with your primary care physician to discuss any adverse effects. You can call the FDA at 1-800-FDA-1088 to report any adverse effects.

Interactions

Tell the healthcare provider about any and all medications you are now taking or have recently taken, including those obtained by prescription, those obtained without a prescription, those obtained over the counter, herbal supplements, and vitamin products.

It is possible for quetiapine and other medications to interact, which could result in serious adverse effects.

Notifying your healthcare practitioner that you will be undergoing a urine drug screen is important if you are taking this medicine since it may impact the findings of the test. Make sure that the people administering the exam are aware that you are taking quetiapine.

Pregnancy and breastfeeding

Inform your physician if you are pregnant or if you want to become pregnant in the near future. It is not known whether quetiapine will harm your unborn child if you take it while you are pregnant.

If you become pregnant while taking this medicine, you should discuss the possibility of registering with the National Pregnancy Registry for Atypical Antipsychotics with your healthcare provider as soon as possible. You can sign up by giving us a call at 1-866-961-2388 or going to our website at http://womensmentalhealth.org/clinical-and-research-programs/pregnancyregistry/.

Inform your physician if you are currently nursing or if you have intentions to start breastfeeding. It is possible for quetiapine to make its way into breast milk. If you are taking this medicine, it is important that you discuss the best approach to feeding your infant with your healthcare professional.

Storage

• Keep at room temperature, which is between 20 and 77 degrees Fahrenheit (68 and 25 degrees Celsius).
• Make sure that children can’t get their hands on it.

What are the ingredients in quetiapine?

Active ingredients: quetiapine fumarate

Components that don’t do anything:

Povidone, dibasic dicalcium phosphate dihydrate, microcrystalline cellulose, sodium starch glycolate, lactose monohydrate, magnesium stearate, hypromellose, polyethylene glycol, and titanium dioxide are the active ingredients in the tablets sold under the brand name Seroquel. Ferric oxide, in both red and yellow forms, can be found in the 25 mg tablets. The single ingredient in both the 100 mg and 400 mg tablets is yellow ferric oxide.

Lactose monohydrate, microcrystalline cellulose, sodium citrate, hypromellose, and magnesium stearate are the active ingredients in the extended-release tablets sold under the brand name Seroquel XR. Titanium dioxide, hypromellose, and polyethylene glycol 400 are the three components that make up the film coating for all XR pills. In addition, the film coating of specified strengths contains yellow iron oxide in dosages of 50, 200, and 300 mg tablets as well as red iron oxide in dosages of 50 mg tablets.

Numerous generic formulations of this drug have already been given the green light. It is possible that generic versions will have inactive chemicals that differ from those listed above. Check the product label to get a comprehensive list of the components that went into making your unique formulation.

AstraZeneca Pharmaceuticals LP in Wilmington, Delaware 19850 is the company responsible for the distribution of the quetiapine brands Seroquel and Seroquel XR.