Quetiapine is an atypical antipsychotic medication that is commonly prescribed in the treatment of schizophrenia and bipolar disorder. [1][2] Quetiapine is generally considered a safe medicine, but it can have side effects like drowsiness, dizziness, and gastrointestinal problems. [1][3] While uncommon, quetiapine is also sometimes abused by people for its sedating and calming effects, especially in combination with alcohol or other illicit substances. [4][5] Misuse and abuse of quetiapine can be life-threatening and may require immediate medical attention because of the risk for fatal overdose.
- Quetiapine is an atypical antipsychotic medication that is prescribed for people with schizophrenia, bipolar disorder, and as an adjunct treatment for depression. [1]
- Quetiapine is sometimes prescribed off-label for the treatment of PTSD, OCD, anxiety, Parkinson’s disease, and aggressive behavior. [2]
- Quetiapine is not considered an addictive medication, but there are reports of the medication being abused, often in combination with alcohol or other illicit drugs. [4][5]
What is Quetiapine?
Quetiapine is a prescription antipsychotic medication that is FDA-approved for schizophrenia and bipolar disorder, as well as an adjunctive treatment for major depressive disorder. [1][3] Quetiapine is a newer type of drug called an atypical antipsychotic that works to reduce mood and cognitive disturbances in people with serious mental illnesses.
Quetiapine is also known by the brand name Seroquel, which comes in an oral tablet. Both extended-release and instant-release versions of the drug are available. [1]
How does quetiapine work, and what doses are used?
Quetiapine is an atypical antipsychotic medication that works by balancing certain chemicals in the brain linked to mood, anxiety, and disturbed thinking patterns. Quetiapine is offered as an oral tablet that comes in both an instant-release form and an extended-release form. [1]Â
The drug is often prescribed under the brand name Seroquel, and typical doses range between 25 mg and 400 mg tablets. The maximum daily dose of quetiapine is 800 mg per day. People on the extended release version of the drug often take one dose per day in the evening, and people on the immediate release version may take 2-3 doses per day. [2][3]
While the exact mechanisms of action in quetiapine are not understood, the drug is known to decrease levels of dopamine and norepinephrine in the brain. This produces calming and sedating effects that can counteract symptoms of schizophrenia and mania in people with bipolar disorder. Quetiapine also works on certain hormones and histamines in the body, which help to regulate intrusive thoughts and mood swings associated with certain mental illnesses. [2]
Approved and off-label uses
Quetiapine is FDA-approved for the treatment of schizophrenia and bipolar disorder in children, teens, and adults. [1] It is also FDA approved as an adjunctive treatment for major depressive disorder, often prescribed in combination with an SSRI antidepressant. In addition to these approved uses, quetiapine is sometimes prescribed off-label for generalized anxiety disorder, obsessive-compulsive disorder, borderline personality disorder, Parkinson’s disease, PTSD, and agitation or aggression. [2]
Side effects and major safety warnings
While quetiapine is a newer type of antipsychotic drug and is considered safer than traditional antipsychotics, many people report experiencing side effects. The most commonly reported side effects are drowsiness, dizziness, gastrointestinal problems, and weight gain. Other side effects sometimes reported include: [1][2][3]
- Feeling dizzy or having blood pressure drop when standing up
- Nausea or vomiting
- Indigestion and heartburn
- Constipation, gas, or bloating
- Missed periods
- Drop in libido
- Decreased fertility in women
- Trouble thinking or concentrating
Serious side effects
In some instances, side effects can be severe or even life-threatening. Serious side effects some people report after taking quetiapine include: [1][3]
- Slurred speech
- Changes in vision
- Falling or fainting
- Seizures, uncontrolled muscle tics or movements
- Stiffness in the neck or trouble swallowing
- Hives, rashes, or blisters
- Fever or other signs of infection
- Changes in cognitive functioning or confusion
- Changes in liver functioning
- Drop in blood cell count
- Sudden rise in blood sugar
- Fast or irregular heartbeat
- Unexplained bleeding or bruising
- Painful erections lasting several hours
- Overheating or excessive sweating
- Neuroleptic malignant syndrome (NMS)
- Increased suicidal ideation in children and teens with depression
Quetiapine may be more likely to cause serious side effects in certain populations. For these reasons, quetiapine is often not recommended for older individuals struggling with dementia. Prescribers may also avoid prescribing the medication to individuals with a history of cardiac disease, diabetes, or poor liver functioning because of the risk of complications. Quetiapine is also not recommended for women who are pregnant, breastfeeding, or trying to become pregnant. [1]
Misuse, diversion, and dependence
Quetiapine is not a controlled medication and is not believed to be addictive or cause euphoric effects on its own. Still, there are increased reports of people abusing quetiapine, especially in incarcerated or institutionalized settings where access to other illicit drugs is limited. Also, some people mix quetiapine with alcohol, cocaine, marijuana, or other drugs to enhance or counteract the effects or withdrawal symptoms. [4]
Quetiapine misuse is dangerous and can lead to an accidental overdose or poisoning, which requires immediate medical attention. If you or a loved one has taken a large dose of quetiapine and is worried about the potential for overdose, contact poison control at 1-800-222-1222 and call 911 or report to your nearest emergency room.
Quetiapine overdose can be fatal and may require close monitoring and medical intervention, so getting help right away is recommended. Emergency medical interventions may include the administration of activated charcoal and laxatives to limit the amount of the medication that is absorbed by the body. Monitoring of the heart, blood pressure, and organ functioning may also be indicated after a suspected overdose. [1][2]
Withdrawal and stopping quetiapine safely
Quetiapine is not considered an addictive substance, but a certain physiological and psychological dependence can form when taking the drug for an extended period of time. Taking higher or more frequent doses may increase the risk for withdrawal symptoms, so it is important to work closely with your prescriber when considering stopping quetiapine. In many cases, prescribers will recommend gradually tapering off the medication to prevent serious withdrawal. [1][3]
Quetiapine in substance abuse disorders
Quetiapine has been explored for off-label usage in the treatment of substance use disorders. Specifically, quetiapine may be prescribed for individuals who are withdrawing from alcohol, cocaine, or opioid drugs. The calming and mood-stabilizing effects of the medication may be helpful in alleviating some of the withdrawal symptoms associated with these drugs, but there is insufficient research to support this as a frontline treatment for addiction. [4]
There have been reports of people misusing or abusing quetiapine, usually in combination with alcohol or other illicit drugs. While this is uncommon, almost all reports of quetiapine misuse are amongst individuals with pre-existing substance dependencies. Combining quetiapine with alcohol or other drugs can increase the risk for serious side effects, including the risk for accidental overdose. [4][5]
What to do if you're worried about quetiapine use or withdrawal
Concerns about quetiapine abuse, addiction, or withdrawal should be openly discussed with a prescribing physician who is familiar with this medication and can recommend steps to safely stop the medication. Prescribers can also address concerns of potential short and long-term side effects associated with the use of this medication.