Quetiapine (Seroquel) is an atypical antipsychotic medication that is FDA approved for the treatment of schizophrenia, bipolar disorder, and as an add-on treatment for depression. Side effects like drowsiness, dizziness, and gastrointestinal problems are common. More serious side effects, including heart problems, liver problems, seizures, or dangerous spikes in blood sugar, can occur, but are less common. Withdrawals are also possible with long-term quetiapine use, so it’s essential to work closely with a prescriber to safely stop this medication. [1][2]
- Quetiapine is an atypical antipsychotic medication that is FDA-approved for the treatment of schizophrenia and bipolar disorder, and as an adjunctive treatment for depression.
- Most people who take quetiapine experience some side effects, such as drowsiness, dizziness, and slower thinking and processing. Serious side effects are less common and include things like heart problems, liver problems, and muscular or metabolic changes.
- Many people who stop quetiapine experience withdrawal symptoms, so it’s important to gradually taper off this medication under the supervision and advice of your prescriber.
Common side effects of quetiapine
Quetiapine is generally considered a safe medication for people diagnosed with severe mental illnesses like schizophrenia, bipolar disorder, and depression. However, all medications carry some risk for side effects. Antipsychotic medications like quetiapine cause side effects in as many as 65-70% of people who take them. [3]
Many people who take quetiapine describe feeling drowsy, especially while they are still adjusting to the medication and its effects. Trouble thinking, slowed processing, and emotional numbness are also common side effects of quetiapine. [1][3]
Some of the other common side effects of quetiapine include: [1][2][3]
- Weight gain
- Dizziness
- Confusion
- Nausea and vomiting
- Irritability
- Anxiety
- Constipation and bloating
- Trouble concentrating
- Loss of motivation and interest
- Sexual dysfunction
Serious or long-term side effects
Quetiapine can cause serious side effects for some people, including some that require immediate medical attention. Serious side effects are more common when the medication is being misused or taken in high doses. Certain people with pre-existing heart, metabolic, or cognitive problems may be at higher risk for serious side effects. Quetiapine can also increase the risk of suicidal thoughts in people with an existing diagnosis of depression. [1][3]
Some of the serious and long-term side effects of quetiapine include: [1][2]
- Fainting or falling
- Fast or irregular heartbeat
- Muscle stiffness, pain, or tension
- Uncontrollable muscle movements or tics
- Seizures
- Abnormal liver functioning
- Excessive sweating or overheating
- Blurred vision
- Trouble swallowing
- Low blood cell count
- Trouble breathing
- Extreme confusion or psychosis
- Increased thoughts of suicide
- Increased risk for stroke and heart attack
- Risk of sudden spikes in blood sugar
- Risk of neuroleptic malignant syndrome
- Risk of tardive dyskinesia
Interactions and warnings
Quetiapine may interact with other substances, including alcohol, illicit drugs, and other prescribed and over-the-counter medications. It’s important to be transparent and honest with your prescriber about any substances, medications, or supplements you take when considering starting this medication. Quetiapine is sometimes abused in combination with alcohol, other sedatives, or stimulants like cocaine to enhance or counteract the effects. [4] This is dangerous and could lead to life-threatening complications.
Quetiapine is not recommended for certain populations because of an increased risk for serious adverse effects. For example, quetiapine has been shown to increase the risk of death in older patients with dementia. [5] People with depression may experience an increase in suicidality when taking this medication. People with existing liver, heart, or metabolic problems may also be more at-risk for serious side effects and complications. Women who are pregnant, breastfeeding, or trying to become pregnant are also not advised to take this medication. [1][2]
Quetiapine overdose and poisoning
It is possible to overdose on quetiapine when misusing the medication or taking larger doses than prescribed. The maximum prescribed dose of quetiapine is 800 mg per day, and doses of 25 mg to 200 mg per kilogram of body weight can be lethal. [1][6] Quetiapine overdose can be life-threatening and requires immediate medical attention. If you or a loved one has overdosed on quetiapine, the best thing to do is call poison control at 1-800-222-1222 and report to your nearest emergency room.
Some of the risks associated with quetiapine overdose include: [1][6]
- Central nervous system depression
- Slowed breathing
- Sinus tachycardia (unusually fast heart rate)
- Hypotension (drop in blood pressure)
- Extreme drowsiness
- Hypokalemia (low potassium levels)
- Coma, loss of consciousness, and death
The risk of quetiapine misuse and vulnerable populations
Quetiapine misuse is becoming more common, especially in incarcerated or institutionalized settings where access to other illicit drugs is limited. There are increased reports of quetiapine being sold illegally to people without prescriptions and abused in combination with other substances. [4]
Some people mix quetiapine with alcohol, benzodiazepines, opioids, or other sedatives to enhance the effects. Others may use quetiapine to counteract the effects of stimulants like cocaine or to reduce withdrawal symptoms related to the abuse of other substances. Almost all reports of quetiapine misuse are among individuals with pre-existing substance abuse disorders. [4]
Side effects related to misuse and addiction
Quetiapine is a medication that works on the central nervous system (CNS) and is dangerous when combined with other CNS depressants or stimulants. Interactions with other drugs can be unpredictable and can increase the risk for serious complications. Taking the medication in higher doses than prescribed also increases the risk for serious side effects, overdose, or accidental poisoning. [1][2][6]
While quetiapine is not believed to be addictive because it does not produce euphoric effects on its own, many people have reported withdrawal symptoms when stopping this medication. [3][7] In many instances, withdrawal symptoms can be severe, especially when the medication is stopped suddenly after long-term use.
Some of the common withdrawal symptoms reported when stopping quetiapine include: [1][3][7]
- Nausea and vomiting
- Tremors, tics, and uncontrolled movements
- Anxiety, irritability, and agitation
- Confusion or psychosis
- Sleep problems
- Impaired concentration
- Feeling depressed
- Fast or irregular heartbeat
- Changes in blood pressure
When to seek immediate medical attention
Immediate medical attention is necessary in confirmed or suspected cases of quetiapine poisoning or overdose. Loss of consciousness, slowed breathing, or extreme changes in heart rate or blood pressure are warning signs that indicate the need for medical attention. Other serious side effects requiring medical treatment may be mental or emotional in nature, including extreme confusion, agitation, suicidality, or psychosis. [1][3][6][7]
Managing side effects safely: Tips for patients and caregivers
Quetiapine can be an effective medication for people with severe mental illnesses like schizophrenia and bipolar disorder, but reports of side effects are common. In some cases, side effects are mild and transient in nature and will resolve over time or with an adjustment in dosage. In other instances, side effects may be serious or severe in nature, requiring immediate medical attention.
When the risks associated with a medication outweigh the benefits, prescribers will often suggest a change in medication. Because of the risk for withdrawal symptoms, most people need to work closely with a prescriber to gradually reduce their dose over time, rather than stopping suddenly. Talk with your prescriber if you are concerned about the risks and side effects of quetiapine, and do not suddenly stop this medication on your own.
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