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Active Ingredient: Quetiapine
Brand Name: Seroquel

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What is Seroquel?

Seroquel is an oral antipsychotic (neuroleptic) medication used for treating schizophrenia and acute manic episodes associated with bipolar disorder. It shows more affinity with serotonin receptors (5-HT2) than with dopamine receptors D1 and D2 in the brain. It is also active toward the alpha 1 adrenoreceptor and less active toward the alpha 2 adrenoreceptor.

  • Duration of binding with 5-HT2-serotonin and D2 dopamine receptors is less than 12 hours. Mechanism of Quetiapine action is unknown. Though it is supposed that the therapeutic effect is mediated through a combination of dopamine type 2 (D2) and serotonin type 2 (5HT2) receptor antagonism. This medication is used to treat acute and chronic psychosis also ones in patients with schizophrenia.

Why is Quetiapine so effective?

It works by altering the levels of certain chemical messengers called neurotransmitters in your brain, in particular serotonin and dopamine. Although it has a sedative effect, quetiapine isn’t recommended for insomnia.

How does Seroquel make you feel?

Quetiapine works by attaching to the brain’s dopamine receptors and altering serotonin levels. Short-term effects include feeling sleepy, having a dry mouth, dizziness, and low blood pressure when you stand up. These effects last about six hours.

What can you use Quetiapine for?

This medication is used to treat certain mental and mood conditions (such as schizophrenia, bipolar disorder, sudden episodes of mania or depression associated with bipolar disorder). Quetiapine is known as an anti-psychotic drug (atypical type).

Schizophrenia

If the psychotic episode is over, you will usually need to continue taking this medicine for a long time. Otherwise, the risk of a new psychosis (relapse) is too high. The doctor will sometimes reduce the dose during this period.

If you have had a psychotic episode for the first time, you will usually need to take this medicine for 1 or 2 years after your recovery before you can try to stop. Only in exceptional cases, if you have recovered very quickly, can you try to stop six months after recovery. This must be done under proper supervision, and the risk of relapse is still greater. If you have had a psychosis before, you usually have to continue taking an antipsychotic for the rest of your life.

Mania and depression

When the worst of the agitation symptoms have subsided, the doctor may recommend slowly tapering the use of quetiapine. Lithium, valproic acid, or the medication for depression should then usually continue to be used. Sometimes the doctor may recommend continuing quetiapine to prevent a new mania or depression.

Restlessness

Quetiapine is usually used for several years by people with severe agitation, aggression, or anxiety, such as people with dementia, mentally retarded people, and people with autism. The dosage is usually reduced, however, as symptoms subside.

Obsessive-compulsive disorder

If the drug works well, you usually need to keep taking it for several years.

Does Seroquel help with paranoia?

Quetiapine (Seroquel®) helps moderate paranoia, delusions, and hallucinations. It is less likely to cause side effects like involuntary movements or stiffness. Because of this, it may be a good option, but it may rarely cause more confusion for those suffering from Parkinson’s or Lewy Body dementia.

How do I use Quetiapine?

Seroquel should be taken twice or thrice daily with or without food, with a full glass of water. Swallow the tablet whole; do not crush or chew an extended-release tablet. A daily dose of the first four therapeutic days is 50 mg; 100 mg (second day); 200 mg (third day); and 300 mg (fourth day). Starting from the fourth day, the dosage should be adjusted to the level of the effective one (which can reach 750 mg daily). In patients with liver or kidney failure, the initial dose is 25 mg/day, increased gradually by 25–50 mg till the effective dose is reached. Take it exactly as prescribed by your physician and do not exceed the recommended dose.

Quetiapine tablets:

  • Swallow the tablet whole with water without chewing.
  • Extended-release tablets (identified by XR): swallow the tablet whole without chewing. These tablets should not be taken with food. Take these tablets at least 1 hour before eating.

Is 25 mg of Quetiapine enough?

The usual therapeutic dose range for the approved indications is 400–800 mg/day. The 25 mg dose has no uses that are evidence-based other than for dose titration in older patients.

What does 300 mg of Seroquel do?

Quetiapine 300 mg tablets are white, capsule-shaped and engraved with SEROQUEL on one side and 300 on the other side. Treatment of schizophrenia.-For the prevention of recurrence of manic or depressive episodes in patients with bipolar disorder who have previously responded to quetiapine treatment.

How long before bed should I take Quetiapine?

Because it is an extended-release medicine, the dose should be taken once a day, 3–4 hours before bedtime. It is very important to follow your health care professional’s directions when you take this drug.

Missed dose

Take the missed dose as soon as you remember. If it is almost time for your next dose, just skip the missed dose and return to your schedule. Do not double-dose this medication to make up for the missed dose.

Overdose

If you take too much Seroquel, you may experience such symptoms as extreme drowsiness, fast heart rate, feeling light-headed, or fainting. If you suspect that you took too much of this medication, seek immediate medical help.

Possible side effects

Seroquel’s antagonism of adrenergic a1 receptors may explain the orthostatic hypotension observed with this drug. The most common and frequent adverse effects of Seroquel are headache, agitation, dizziness, drowsiness, weight gain, and stomach upset. Long-term use of this medication may cause irreversible tardive dyskinesia, a neurologic disease that consists of involuntary movements of the jaw, lips, and tongue.

  • Other side effects concern nervous system: headache, anxiety, fatigue, hostility, agitation, insomnia, tremors, convulsions, depression, neuroleptic malignant syndrome (hyperthermia, muscle rigidity, altered mental status, the lability of the autonomic nervous system increased activity of CPK).
  • Adverse effects of Quetiapine for cardiovascular system are tachycardia, prolongation of the interval QT.
  • Dryness of the oral mucosa, nausea, vomiting, abdominal pain, diarrhoea or constipation, increased activity of “liver” transaminases, pharyngitis, rhinitis may also appear. Allergic reactions such as skin rash, eosinophilia are also not excluded.

Precautions

This medication affects the ability to maintain a high concentration of attention, so it may affect your ability to drive a car or operate machinery. Before taking Seroquel, notify your doctor if you have liver or kidney disease, high blood pressure, heart rhythm problems, heart attack or stroke in history, a history of low white blood cell counts, a thyroid disorder, high cholesterol or triglycerides, a personal or family history of diabetes, or trouble swallowing, as you may need your dosage to be adjusted or pass special safety tests for this medication.

Is it hard to get off Seroquel?

If you stop taking Quetiapine abruptly, it may be important to know that there have been rare reports of mild or severe withdrawal symptoms. Some of these symptoms may include nausea, vomiting, or restlessness. In rare cases, a patient might experience abnormal movements known as withdrawal dyskinesia.

What happens if you suddenly stop taking Quetiapine?

If you suddenly stop taking quetiapine, you may experience withdrawal symptoms such as nausea, vomiting, and difficulty falling asleep or staying asleep. Your doctor will probably want to decrease your dose gradually.

How much weight do you gain on Seroquel?

In patients treated with  200 mg/day of quetiapine, mean weight gain was 1.54 kg, compared with 4.08 kg for 200 to 399 mg/day, 1.89 kg for 400 to 599 mg/day, and 3.57 kg for > or = 600 mg/day; median weight gain was 0.95 kg, 3.40 kg, 2.00 kg, and 3.34 kg, respectively.

Can Seroquel cause nightmares?

Quetiapine can also cause sleep-talking and sleep-walking, and some people have done other activities while they were asleep, like eating. You might also have strange dreams or nightmares. Talk to your doctor if any of this worries you.

Does quetiapine cause alopecia?

Alopecia has previously been reported with the atypical antipsychotic medicines olanzapine and risperidone, but has not been described with quetiapine. Case reports of alopecia associated with quetiapine reported to the New Zealand Intensive Medicines Monitoring Programme were reviewed.

Contraindications

hypersensitivity, pregnancy, breastfeeding. Seroquel should be used with caution in patients with hypotension, epilepsy, and epileptic seizures in history. Seroquel may contribute to the development of heart failure, pneumonia, and sudden death in older adults with conditions caused by dementia.

What can you not do when you take Seroquel?

Do not drive or operate machinery or perform hazardous tasks if Seroquel makes you sleepy. Talk to your doctor if you feel that your mood is worsening, you feel agitated, or you are having suicidal thoughts. Avoid alcohol while taking Seroquel and keep hydrated. Avoid over-exercising.

Drug interactions

Phenytoin (Dilantin) and thioridazine (Mellaril) decrease absorption of Seroquel in the intestines and decrease its effects. Seroquel interacts with narcotic pain relievers; medications for hypertension interact with and their activities add oxycodone and acetaminophen (Percocet, Roxicet, Tylox, Endocet), barbiturates, alprazolam (Xanax), clonazepam (Klonopin), ethanol, prazosin (Minipress), and terazosin (Hytrin).

Toxicity of Quetiapine may increase if it is co-administered with drugs able to influence the work of cytochrome P450, which is responsible for the metabolism of Seroquel. These drugs are ketoconazole (Nizoral), itraconazole (Sporanox), fluconazole (Diflucan), erythromycin, clarithromycin (Biaxin), nefazodone (Serzone), verapamil (Calan, Isoptin, Verelan), and diltiazem (Cardizem, Tiazac, Dilacor).

Storage

Store Seroquel at room temperature, 15–30 C (59–86 F) away from sunlight, moisture, children, and pets.

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Frequently asked questions

  1. What is Seroquel?

    Atypical antipsychotics are the kind to which quetiapine belongs. It does this by diminishing the effect that naturally occurring substances, primarily dopamine, have on the brain. This brings about a decrease in both psychosis and agitation. Psychosis, schizophrenia, depression, and agitation are some of the conditions that can be treated with this medication. Also, when you are too happy and have too much energy, which prevents you from getting enough sleep because of it, for instance (mania). In cases of obsessive-compulsive disorder, medical professionals may also recommend it.

  2. What should i do if i miss a dose?

    It is essential to take this medication on a regular basis. In the event that you forget a dose:

    – If you forget to take a dose of this medication and you normally take it once a day, you should determine whether it will be more than eight hours before you take the next dose as normal. If it will be less than eight hours, you should skip the forgotten dose.
    – If you forget to take a dose of this medication and you normally take it twice daily, wait until it has been more than four hours before taking the next dose as directed. If it will be less than four hours, continue with your regular schedule and do not take the forgotten dose.

  3. Can i just stop taking this medicine?

    No, many people do develop psychosis again after stopping the use of an antipsychotic, which is why it is important to consult with your doctor before making this decision. The risk of a new psychosis is not as great in some types of psychosis, but it is in others.

    If you are going to stop taking Seroquel, you should do so gradually over a period of at least four weeks. If you stop taking the medication gradually, you will have a lower risk of immediately experiencing a new psychosis. It will also prevent withdrawal symptoms such as sweating, nausea, loss of appetite, diarrhoea, anxiety, sleeplessness, restlessness, runny nose, muscle pain, and strange sensations like jitters.

  4. What are the side effects of Quetiapine?

    After taking Seroquel, the most common adverse reactions include drowsiness, dizziness, dry eyes, blurred vision, gastrointestinal symptoms, change in thoughts and behaviour, and unusual muscle movements. These reactions can also occur in combination with other adverse reactions.

    It is possible that you will have trouble moving your muscles as a result of the relaxing effect that quetiapine has. Other potential adverse effects of quetiapine include restlessness and stiffness in the muscles.
    If this is something that really bothers you, talk to your doctor or a dietitian about it because one of the side effects is weight gain. This is caused by a change in metabolism as well as an increase in appetite.
    – Another potential adverse effect is a diminished desire to engage in sexual activity, which can affect both men and women. For men, this can mean trouble getting an erection, and for women, it can make it harder to have an orgasm.

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