Seroquel (quetiapine)

Seroquel vs. Seroquel XR

There are two versions of Seroquel: Seroquel and Seroquel XR. Both contain the same active drug: quetiapine. However, Seroquel XR contains an extended-release form of this active drug. (Extended-release means the drug releases slowly in your body over a period of time.)

This article focuses only on Seroquel, but here are some of the key differences between that medication and Seroquel XR. Milligrams are abbreviated as “mg.”

* For more details about Seroquel’s uses, see the “Seroquel uses” section below. To learn more about Seroquel XR’s uses, see the drug’s prescribing information or talk with your doctor or pharmacist.

Seroquel generic

Seroquel is a brand-name drug that contains the active drug quetiapine. This active drug is also available as a generic medication. A generic drug is an exact copy of the active drug in a brand-name medication.

The generic is considered to be as safe and effective as the original drug. Generics tend to cost less than brand-name drugs.

If you’re interested in using the generic form of Seroquel, talk with your doctor. They can tell you if it comes in forms and strengths suitable for your condition.

Seroquel dosage

The Seroquel dosage your doctor prescribes will depend on several factors. These include:

• the type and severity of the condition you’re taking Seroquel to treat
• your age
• other medical conditions you may have, such as liver problems
• other medications you may take

Typically, your doctor will start you on a low dosage. Then they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug form

Seroquel comes as an oral tablet.

Drug strengths (25 mg, 50 mg, 100 mg, 200 mg, 300 mg, 400 mg)

Seroquel is available in six strengths: 25 milligrams (mg), 50 mg, 100 mg, 200 mg, 300 mg, and 400 mg.

Dosage for schizophrenia

For treating schizophrenia in adults, Seroquel is typically started at the lowest dose. Your doctor will likely titrate (gradually increase) your dosage over the first 4 days of treatment. The dose of some drugs, including Seroquel, is increased gradually to help prevent or lessen possible side effects.

Here’s a sample starting dosage schedule for this use:

• day 1: 25 mg twice per day
• day 2: 50 mg twice per day
• day 3: 100 mg twice per day
• day 4: 100 mg three times per day

After day 4, your doctor may continue increasing your dose by 50 mg to 100 mg every 2 or more days. The goal is to find the amount that’s right for you. This amount, typically 150 mg to 750 mg per day, depends on how well Seroquel is working to treat your symptoms. The amount will be divided into two or three doses throughout the day.

The usual maintenance (long-term) dosage for schizophrenia is 400 mg to 800 mg per day. Maintenance treatment helps manage the symptoms of schizophrenia, which is a long-term condition. Seroquel’s maximum dose in adults is 800 mg per day.

Dosage for manic episodes of bipolar I disorder

For the acute (short-term) treatment of manic episodes of bipolar I disorder in adults, Seroquel is typically started at a lower dose. Your doctor will likely increase your dosage gradually over the first 4 days of treatment. The dose of some drugs, including Seroquel, is increased gradually to help prevent or lessen possible side effects.

Here’s the typical starting dosage schedule for this use:

• day 1: 50 mg twice per day
• day 2: 100 mg twice per day
• day 3: 150 mg twice per day
• day 4: 200 mg twice per day

After day 4, your doctor may continue to increase your dosage until they find the amount that’s right for you. The amount, typically 400 mg to 800 mg per day, depends on how well the drug is working to treat your manic episodes.

Once your manic episode eases, your doctor will likely have you continue taking Seroquel as a maintenance (long-term) treatment. This helps manage the symptoms of bipolar I disorder and prevent further manic episodes. The usual maintenance dosage is 400 mg to 800 mg per day, divided into two doses throughout the day. Seroquel’s maximum dose in adults is 800 mg per day.

For the acute treatment of bipolar mania in adults, Seroquel may be prescribed by itself or in combination with lithium (Lithobid) or divalproex (Depakote, Depakote ER). For maintenance treatment, Seroquel is typically prescribed in combination with lithium or divalproex.

Dosage for depressive episodes of bipolar disorder

Seroquel is used for the acute (short-term) treatment of depressive episodes of bipolar I disorder or bipolar II disorder in adults. For this purpose, the drug is typically taken once per day. Your doctor will likely increase your dose gradually over the first 4 days of treatment. The dose of some drugs, including Seroquel, is increased gradually to help prevent or lessen possible side effects.

Here’s the typical starting dosage schedule for this use:

• day 1: 50 mg once per day
• day 2: 100 mg once per day
• day 3: 200 mg once per day
• day 4: 300 mg once per day

You’ll likely continue taking 300 mg until your depressive episode eases, according to your doctor’s instructions. In clinical trials for this use, depressive symptoms eased within 8 weeks of starting Seroquel treatment.

Children’s dosage

Seroquel is approved for certain uses in children. The dosages for these uses are described below.

Dosage for schizophrenia in children

To treat schizophrenia in children (ages 13 to 17 years), Seroquel is typically started at the lowest dose. The doctor will likely titrate (incrementally increase) the dose over the first 5 days of treatment. The dose of some drugs, including Seroquel, is increased gradually to help prevent or lessen possible side effects.

Here’s a typical starting dosage schedule for this use:

• day 1: 25 mg twice per day
• day 2: 50 mg twice per day
• day 3: 100 mg twice per day
• day 4: 150 mg twice per day
• day 5: 200 mg twice per day

After day 5, the doctor may continue increasing the dosage by 100 mg each day until they find the amount that’s right for your child. This depends on how well the drug is working to treat your child’s condition.

The usual maintenance (long-term) dosage to treat children with schizophrenia is 400 mg to 800 mg per day. The doctor may divide it into two or three doses throughout the day. The maximum dose of Seroquel for this purpose is 800 mg per day.

Dosage for manic episodes in children

Seroquel is approved for the acute (short-term) treatment of manic episodes of bipolar I disorder in children ages 10 to 17 years. For this purpose, Seroquel is typically started at a lower dose. The doctor will likely increase the dosage gradually over the first 5 days of treatment. The dose of some drugs, including Seroquel, is increased gradually to help prevent or lessen possible side effects.

Here’s the typical starting dosage schedule for this use:

• day 1: 25 mg twice per day
• day 2: 50 mg twice per day
• day 3: 100 mg twice per day
• day 4: 150 mg twice per day
• day 5: 200 mg twice per day

After day 5, the doctor may continue increasing the dosage by 100 mg each day. The goal is to find the amount that’s right for your child. The amount depends on how well the drug is working to treat the manic episodes. The typical dosage to treat manic episodes in children is 400 mg to 600 mg per day. For this use, Seroquel’s maximum dose in children is 600 mg per day.

Your child will usually continue taking Seroquel until their manic episode eases, according to their doctor’s instructions. In clinical trials for this use, mania symptoms eased within 3 weeks of starting treatment.

What if I miss a dose?

If you miss a dose of Seroquel, take it as soon as possible. However, if it’s almost time for your next regular dose, skip the missed dose. You should not take two doses at the same time unless your doctor specifically says to do so.

If you miss taking Seroquel for more than a week, talk with your doctor. They’ll likely have you restart treatment at a lower dose. Then they’ll gradually increase your dose over several days.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.

Will I need to take this drug long term?

Seroquel is prescribed as either a short-term or long-term treatment. This depends on several factors, including your age and the condition the drug is being used to treat.

Seroquel is typically used short term, for a few weeks or months, to treat bipolar mania or bipolar depression. In some cases, your doctor may have you continue taking the drug long term to help prevent manic episodes from recurring.

Seroquel is typically used long term to treat schizophrenia if you and your doctor determine that the medication is safe and effective for you.

Seroquel side effects

Seroquel can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Seroquel. These lists do not include all possible side effects.

For more information about the possible side effects of Seroquel, talk with your doctor or pharmacist. They can give you tips on how to manage any side effects that may be concerning or bothersome. In addition to the information below, you can also refer to this article about Seroquel’s side effects.

Note: The Food and Drug Administration (FDA) tracks the side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Seroquel, you can do so through MedWatch.

Mild side effects

Below is a partial list of mild side effects of Seroquel. To learn about other mild side effects, talk with your doctor or pharmacist or view Seroquel’s prescribing information.

Mild side effects of Seroquel can include:

• sleepiness
• dry mouth
• dizziness
• constipation
• feeling weak
• abdominal pain
• sore throat
• weight gain
• lethargy (not having the energy or motivation to do anything)
• increased levels of liver enzymes, which could indicate liver damage
• indigestion (upset stomach)
• headache
• unusual dreams or nightmares
• mild allergic reaction*

Most of these side effects may go away within a few days to a couple of weeks. However, if they become more severe or don’t go away, talk with your doctor or pharmacist.

* For more information about allergic reaction and Seroquel, see “Allergic reaction” below.

Serious side effects

Serious side effects from Seroquel aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

• Orthostatic hypotension (a drop in blood pressure that occurs when standing up). Symptoms can include:
  • dizziness
  • fainting
  • falling, which may cause injuries
• Tardive dyskinesia (a movement disorder sometimes caused by antipsychotic drugs). Symptoms may include:
  • abnormal movements of the jaw, lips, and tongue that you can’t control
• Neuroleptic malignant syndrome, a rare, potentially life threatening reaction to an antipsychotic drug (also known as a neuroleptic drug). Symptoms may include:
  • high fever
  • rigid muscles
  • excessive sweating
  • changes in your heart rate or blood pressure
  • confusion
• Changes in metabolism, such as hyperglycemia (high blood sugar level),* changes in cholesterol levels,* or weight gain. These metabolism changes could lead to serious conditions or complications.
• Blood disorders, such as neutropenia (low level of white blood cells called neutrophils).*
• Cataracts (clouding of the lens of your eye). Symptoms may include:
  • blurred vision
  • lights appearing brighter than usual or seeing halos around them
  • colors looking faded
• Hypothyroidism (underactive thyroid gland). Symptoms may include:
  • lack of energy
  • weight gain
  • feeling cold
• Seizures. Symptoms can include:
  • jerking or shaking
  • muscle stiffening
  • feeling dazed or confused
• High blood level of prolactin, a type of hormone. Symptoms can include:
  • menstrual cycle changes
  • breast tissue enlargement
  • erectile dysfunction
• Problems with thinking and movement, which can affect the ability to safely drive or operate machinery. Symptoms can include:
  • drowsiness
  • trouble thinking clearly
  • decreased motor skills
• Increased risk of death in older adults with psychosis related to dementia.†
• Suicidal thoughts and behaviors.†
• Severe allergic reaction.‡

* This side effect typically doesn’t cause symptoms and would likely be identified in standard blood tests.
† Seroquel has a boxed warning for this side effect. This is a serious warning from the FDA. To learn more, see the “Seroquel precautions” section below.
‡ For details about allergic reaction and Seroquel, see “Allergic reaction” below.

Side effects in children

In general, Seroquel’s side effects in children are similar to those seen in adults, with a few differences.

Blood pressure

One key difference is how Seroquel affects blood pressure in children versus adults.

Increased blood pressure may occur in children taking Seroquel. Rarely, blood pressure may become very high. Because of this risk, the doctor will monitor your child’s blood pressure before and during Seroquel treatment.

Increased blood pressure doesn’t usually cause symptoms. However, very high blood pressure may lead to headaches, chest pain, and dizziness.

Increased blood pressure was seen in Seroquel’s clinical trials in children but did not occur in adults in clinical trials.

Orthostatic hypotension

Another side effect called orthostatic hypotension occurs more commonly in adults than children. In fact, the side effect is rare in children. (Orthostatic hypotension is a drop in blood pressure that occurs when standing up.)

Common side effects of Seroquel in children

In clinical trials, the more common side effects of Seroquel in children were:

• sleepiness
• dizziness
• fatigue
• increased appetite
• nausea and vomiting
• dry mouth
• increased heart rate
• weight gain

If you have questions about Seroquel’s side effects in children, talk with your doctor.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Seroquel. Allergic reactions were reported in the drug’s clinical trials. However, it’s unknown how often they occurred.

Symptoms of a mild allergic reaction can include:

• skin rash
• itchiness
• flushing

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

• swelling under your skin, typically in your eyelids, lips, hands, or feet
• swelling of your tongue, mouth, or throat
• trouble breathing

Call your doctor right away if you have an allergic reaction to Seroquel, as the reaction could become severe. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Is Seroquel prescribed for sleep problems?

The Food and Drug Administration (FDA) has not approved Seroquel to treat sleep problems, such as insomnia. However, the drug may be prescribed off-label for this purpose. (With off-label use, a drug is prescribed for a condition other than its FDA-approved uses.)

Despite this, doctors don’t typically prescribe Seroquel for sleep. This is because other treatment options for insomnia generally cause milder side effects and have fewer safety risks than Seroquel. For example, doctors may recommend a melatonin supplement to help with sleep.

Sometimes a doctor may prescribe Seroquel for insomnia if you have multiple health conditions that could benefit from the drug’s effects.

For instance, if you have both schizophrenia and insomnia, your doctor may recommend Seroquel. This is because the drug is approved to treat schizophrenia. And Seroquel is thought to help with sleep because it can cause drowsiness. So, the drug may aid both conditions. However, there isn’t a specific dosage for sleep. Your doctor will recommend the dosage that’s right for you, including the maximum dosage of Seroquel for sleep problems.

If you’d like to learn more about taking Seroquel for sleep, including any dangers, talk with your doctor or pharmacist.

Common questions about Seroquel

Here are answers to some frequently asked questions about Seroquel.

Is Seroquel prescribed for anxiety?

Seroquel is not approved to treat anxiety, but the drug may be prescribed off-label for treating this condition. With off-label use, a drug is prescribed for a condition other than those the Food and Drug Administration (FDA) approved.

Some evidence suggests that quetiapine extended-release (the active drug in Seroquel XR*) may effectively treat generalized anxiety disorder (GAD) in adults. More research is needed to confirm this. Further studies are also required to determine whether the immediate-release form of Seroquel might be effective for this use.

Other research suggests that a low dosage of Seroquel may be effective for treating treatment-resistant GAD. (This means you tried other medications for GAD, but they didn’t help enough.)

However, there isn’t a specific dosage of Seroquel for anxiety. If your doctor recommends Seroquel for anxiety, they’ll likely prescribe the lowest possible dosage that works to manage your anxiety symptoms. You can talk with them to learn more.

* For more information about Seroquel XR, see the “Seroquel vs. Seroquel XR” section above.

What is Seroquel’s half-life?

Seroquel’s half-life is about 6 hours. (A drug’s half-life is the amount of time it takes for your body to get rid of half a dose.)

It takes about five half-lives for a drug to be cleared out of your system. Based on this, Seroquel may stay in your body for about 30 hours after your last dose.

If you have additional questions about Seroquel’s half-life, talk with your doctor or pharmacist.

Is Seroquel a controlled substance?

No, Seroquel is not a controlled substance.

Controlled substances are regulated by the government. This is because they carry risks of misuse, dependence, or addiction. With misuse, a person takes a drug in a way other than how it’s prescribed. With dependence, a person’s body needs the drug to function as usual. And with addiction, a person takes a drug even if it’s causing harm.

In clinical trials, Seroquel use was not associated with symptoms of misuse, dependence, or addiction.

However, some drugs that affect brain chemicals may lead to misuse in some people. This can occur even if a particular drug is not classified as a controlled substance.

It’s possible for quetiapine (the active drug in Seroquel) to be misused, although clinical trials did not show this side effect. If you have or had substance use disorder, talk with your doctor. They can advise you on whether it’s safe for you to take Seroquel for your condition.

Does Seroquel cause long-term side effects?

It’s possible. Certain side effects may start during Seroquel treatment and continue to affect you for a long time, even after you stop taking the drug.

For example, Seroquel may cause changes in your metabolism, which may lead to significant weight gain. This side effect may cause overweight, obesity, and type 2 diabetes in some people. It may take a lot of time and effort to lose the weight gained during Seroquel treatment. And type 2 diabetes typically requires long-term management.

In addition, certain side effects of Seroquel may be more likely to affect someone who has taken the drug for a long time. One example is tardive dyskinesia (a movement disorder sometimes caused by antipsychotic drugs). Symptoms can include abnormal movements of the jaw, lips, and tongue that you can’t control. Tardive dyskinesia may not go away completely after Seroquel treatment ends.

To learn about your risk of developing side effects with Seroquel, including those with long-term consequences, talk with your doctor.

Seroquel uses

The Food and Drug Administration (FDA) approves prescription drugs such as Seroquel to treat certain conditions. Seroquel may also be used off-label for other conditions. Off-label drug use is when an FDA-approved drug is prescribed for a purpose other than what it’s approved for.

Seroquel is FDA-approved to treat the conditions described below.

Seroquel for schizophrenia

Seroquel is FDA-approved to treat schizophrenia in adults and children ages 13 and older.

Schizophrenia explained

Schizophrenia is a chronic (long-term) mental illness that often starts in the teen years or early adulthood. This condition affects how a person perceives reality, which can impact their thoughts, emotions, and behavior.

Symptoms of schizophrenia often include:

• paranoia (feeling like others are out to get you)
• hallucinations (seeing or hearing things that aren’t there)
• delusions (strongly believing in something that’s not real or has been proven false)
• little or no emotional expression
• unusual thoughts and speech patterns, making communication with others difficult
• trouble organizing thoughts, making it difficult to complete tasks

Currently, no treatments are available that cure schizophrenia. It’s a chronic condition that does not go away. However, Seroquel and other drugs are available to help ease the symptoms of the condition.

You can learn more about schizophrenia by visiting our mental health hub.

Effectiveness for schizophrenia

Clinical trials found Seroquel effective for treating schizophrenia in adults and children.

The American Psychiatric Association includes antipsychotics, such as Seroquel, in its current treatment guidelines for schizophrenia.

If you have questions about how effective Seroquel may be for you, talk with your doctor.

Seroquel for bipolar disorder

Seroquel is FDA-approved for:

• Acute treatment of manic episodes of bipolar I disorder. These manic episodes are also called bipolar mania. For this purpose, Seroquel is used as an acute (short-term) treatment in adults and children ages 10 years and older. The drug may be prescribed alone or in combination with lithium (Lithobid) or divalproex (Depakote, Depakote ER). These are types of mood stabilizer drugs.
• Maintenance treatment of bipolar I disorder. For this purpose, Seroquel is used as a maintenance (long-term) treatment in adults. Maintenance treatment usually follows acute treatment of a manic episode of bipolar I disorder. Seroquel is typically prescribed in combination with lithium or divalproex for this use.
• Acute treatment of depressive episodes of bipolar I disorder or bipolar II disorder. These depressive episodes are also called bipolar depression. For this purpose, Seroquel is used as a short-term treatment in adults. Seroquel is not prescribed with other medications for this use.

Bipolar disorder explained

Bipolar disorder is a mental health condition that causes shifts in a person’s mood, energy levels, and behavior. If you have this condition, you may have:

• Manic episodes. During a manic episode, you have extremely high energy levels that affect your thoughts and behavior. For example, you may feel unusually happy, have racing thoughts, and talk excessively. Manic episodes of bipolar I disorder are at least 7 days long or become so severe that you need care in a hospital.
• Depressive episodes. During a depressive episode, you may feel down, have low energy, and be less active than usual. These episodes typically last for 2 weeks or longer.

Bipolar I disorder and bipolar II disorder are similar conditions. The main difference is that manic episodes are more severe in people with bipolar I disorder than in those with bipolar II disorder.

You can learn more about bipolar disorder by visiting our bipolar disorder hub.

Effectiveness for bipolar disorder

In clinical trials, Seroquel was found to be effective for treating manic episodes, depressive episodes, or both in adults and some children with bipolar disorder. The trials also showed that Seroquel was an effective maintenance treatment for bipolar I disorder in adults when combined with other therapies.

The American Psychiatric Association recommends antipsychotics, including Seroquel, in its treatment guidelines for bipolar disorder.

If you have questions about how effective Seroquel may be for you, talk with your doctor.

Seroquel and children

Seroquel is FDA-approved for use in children ages 13 to 17 years with schizophrenia. The drug is also approved for use in children ages 10 years and older with bipolar disorder. For more details, see “Seroquel for schizophrenia” and “Seroquel for bipolar disorder” above.

Seroquel use with other drugs

For certain uses, Seroquel is prescribed in combination with lithium (Lithobid) or divalproex (Depakote, Depakote ER). These are mood stabilizer drugs, and they help manage mood shifts.

For acute (short-term) treatment of manic episodes of bipolar I disorder, Seroquel may be prescribed alone or in combination with lithium or divalproex.

For maintenance (long-term) treatment of bipolar I disorder, Seroquel is typically prescribed in combination with lithium or divalproex.

Keep in mind that your doctors may prescribe other drugs to help manage your condition. They may also recommend lifestyle changes and psychotherapy as part of a comprehensive treatment approach.

Seroquel withdrawal and dependence

If you and your doctor decide that you’ll stop taking Seroquel, they’ll first guide you on how to gradually reduce your dosage. This is because stopping Seroquel treatment suddenly may cause various side effects known as discontinuation syndrome (also called withdrawal).

Seroquel withdrawal symptoms may include trouble sleeping, nausea, and headache. These symptoms should go away within a week after your last dose.

Seroquel shouldn’t cause drug dependence. (With drug dependence, a person requires a specific substance to function as usual.)

If you have questions about Seroquel and withdrawal, talk with your doctor.

Seroquel interactions

Seroquel can interact with several other medications. It can also interact with certain supplements.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe. Drug-condition interactions can also cause certain effects. For information about these interactions, see the “Seroquel precautions” section below.

Seroquel and other medications

Below is a list of medications that can interact with Seroquel. The list below does not contain all drugs that may interact with Seroquel.

Before taking Seroquel, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also, tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

Drugs not to take with Seroquel

Doctors likely won’t prescribe certain drugs in combination with Seroquel. This includes drugs known to cause QT prolongation (a heart rhythm change seen on a heart monitor). Taking these drugs with Seroquel may be harmful because of the increased risk of long QT syndrome (a serious heart rhythm problem):

• certain antipsychotics, such as:
  • chlorpromazine
  • thioridazine
  • ziprasidone (Geodon)
• class 1A antiarrhythmic drugs, such as:
  • quinidine
  • procainamide
• class III antiarrhythmic drugs, such as:
  • amiodarone (Pacerone)
  • sotalol (Betapace AF)
• certain antimicrobial drugs, such as:
  • azithromycin (Zithromax, Z-Pak)
  • moxifloxacin
  • pentamide (Pentam)
• methadone (Methadose), a pain medication

Other drugs that could cause an interaction with Seroquel

Other drugs may affect the way Seroquel works. If your doctor prescribes certain types of drugs while you’re taking Seroquel, they may adjust your dosage of Seroquel or the other medication. They may also monitor you closely during treatment. Other drugs that could cause an interaction with Seroquel include the following:

• Medications that could reduce Seroquel’s effectiveness. Examples include:
  • certain antifungal drugs, such as itraconazole and ketoconazole
  • certain HIV drugs, such as indinavir and ritonavir
  • cimetidine (Tagamet), a heartburn drug
• Drugs that could prevent Seroquel from working effectively to treat your condition. Examples include:
  • certain seizure medications, such as carbamazepine and phenytoin
  • rifampin (Rifadin), an antibiotic
• Parkinson’s disease medications, whose effects Seroquel might block or decrease. Examples include:
  • levodopa/carbidopa (Sinemet, Rytary, Duopa)
  • bromocriptine (Parlodel)
  • ropinirole
• Anticholinergic drugs, which could lead to anticholinergic effects if taken in combination with Seroquel. These effects include dry mouth, constipation, and trouble emptying your bladder. Some anticholinergic drugs include:
  • tricyclic antidepressants, such as amitriptyline
  • first-generation antihistamines, such as diphenhydramine (Benadryl) and chlorpheniramine (found in some over-the-counter allergy or cold medicines, including Advil Multi-Symptom Cold & Flu)
  • certain drugs for an overactive bladder, such as oxybutynin (Ditropan XL)
• Drugs or substances that affect the central nervous system (CNS). Taking Seroquel with other medications or substances that affect the CNS can increase the risk of side effects of Seroquel and the other drugs and substances. These effects include sleepiness and problems with thinking and movement. Examples of drugs or substances that affect the CNS include:
  • benzodiazepines, such as alprazolam (Xanax) and lorazepam (Ativan)
  • other antipsychotics that may cause sleepiness, such as olanzapine (Zyprexa) and risperidone (Risperdal)
  • antidepressants, such as escitalopram (Lexapro) and trazodone
  • alcohol
• Medications to lower blood pressure. Seroquel may lower blood pressure, and taking medications that lower blood pressure with Seroquel could further lower the pressure. Examples of blood pressure medications include:
  • ACE inhibitors, such as lisinopril (Zestril)
  • angiotensin receptor blockers (ARBs), such as valsartan (Diovan)
  • beta-blockers, such as metoprolol (Toprol XL)
  • diuretics, such as furosemide (Lasix)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Seroquel and herbs and supplements

The herb St. John’s wort may interact with Seroquel. The combination could prevent Seroquel from working effectively to treat your condition.

Other herbs or supplements could possibly interact with Seroquel. Be sure to check with your doctor or pharmacist before using these products during Seroquel treatment.

Seroquel and foods

Grapefruit and grapefruit juice may interact with Seroquel. This could increase the risk or severity of the drug’s side effects. (For more about side effects, see the “Seroquel side effects” section above.) Your doctor will likely recommend avoiding grapefruit and grapefruit juice while taking Seroquel.

If you have any questions about eating certain foods with Seroquel, talk with your doctor.

Seroquel and lab tests

Taking Seroquel could affect the results of a urine test used to screen for the presence of drugs. However, you should not suddenly stop taking Seroquel if you’ll be having a urine test. Instead, be sure to tell the healthcare professional administering the test that you take Seroquel.

Your doctor can help answer any questions you have about Seroquel and lab tests.

Seroquel and alcohol

Doctors typically recommend not drinking alcohol while taking Seroquel. This is because alcohol may increase the risk of certain side effects of the drug or make them more severe. These side effects include sleepiness and problems with thinking and movement. (For more about the side effects of Seroquel, see the “Seroquel side effects” section above.)

Also, consuming alcohol may trigger episodes of psychosis (altered sense of reality) in people with schizophrenia. Even moderate alcohol use may increase the symptoms and severity of bipolar disorder. (Seroquel is used to treat these conditions.)

If you have questions about alcohol and Seroquel, talk with your doctor.

Alternatives to Seroquel

Other drugs are available that can treat your condition. Some may be a better fit for you than others. If you’re interested in finding an alternative to Seroquel, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label drug use is when a drug that’s approved by the Food and Drug Administration (FDA) is prescribed for a purpose other than what it’s approved for.

Alternatives for schizophrenia

Examples of other drugs that may be used to treat schizophrenia include:

• other second-generation antipsychotic drugs, such as:
  • aripiprazole (Abilify)
  • asenapine (Saphris)
  • brexpiprazole (Rexulti)
  • cariprazine (Vraylar)
  • clozapine (Clozaril)
  • iloperidone (Fanapt)
  • lurasidone (Latuda)
  • olanzapine (Zyprexa)
  • paliperidone (Invega)
  • quetiapine extended-release (Seroquel XR*)
  • risperidone (Risperdal)
• long-acting injectable antipsychotics, such as:
  • aripiprazole (Abilify Maintena)
  • aripiprazole lauroxil (Aristada)
  • haloperidol decanoate
  • paliperidone palmitate (Invega Sustenna, Invega Trinza, Invega Hafyera)
  • risperidone (Risperdal Consta)
• first-generation antipsychotics, such as:
  • chlorpromazine
  • haloperidol (Haldol)
  • perphenazine

* For more information about Seroquel XR, see the “Seroquel vs. Seroquel XR” section above.

Alternatives for bipolar disorder

Examples of other drugs that may be used to treat bipolar disorder include:

• other antipsychotic drugs, such as:
  • aripiprazole (Abilify)
  • asenapine (Saphris)
  • brexpiprazole (Rexulti)
  • cariprazine (Vraylar)
  • iloperidone (Fanapt)
  • lurasidone (Latuda)
  • olanzapine (Zyprexa
  • paliperidone (Invega)
  • quetiapine extended-release (Seroquel XR*)
  • risperidone (Risperdal)
  • ziprasidone (Geodon)
• mood stabilizer drugs (many of which are also considered antiseizure drugs), such as:
  • divalproex
  • carbamazepine (Equetro, Tegretol)
  • lamotrigine (Lamictal)
  • lithium
  • valproic acid
• combination of an antipsychotic with an antidepressant, such as olanzapine/fluoxetine (Symbyax)

In some cases, doctors may prescribe other drugs to help manage the symptoms of bipolar disorder. For example, they may prescribe a benzodiazepine, such as alprazolam (Xanax), to ease anxiety, and an antidepressant, such as trazodone, to help with sleep. (These may be prescribed as alternatives or in addition to Seroquel.)

* For more information about Seroquel XR, see the “Seroquel vs. Seroquel XR” section above.

How Seroquel works

Seroquel’s exact mechanism of action (how it works) isn’t known. The drug is thought to work by making certain neurotransmitters (chemical messengers) in the brain more available. These neurotransmitters include dopamine and serotonin.

With certain mental illnesses, including schizophrenia and bipolar disorder, your brain may have an imbalance of these neurotransmitters. This prevents brain cells from sending and receiving messages properly. These imbalances and other factors may play a role in the development of schizophrenia and bipolar disorder and their related symptoms. The other factors can include genetics and alcohol and drug use.

Antipsychotic drugs, such as Seroquel, are thought to help correct this imbalance and ease the symptoms of the conditions. (Seroquel is approved to treat schizophrenia and bipolar disorder. Seroquel is also known as a second-generation antipsychotic.)

How long does Seroquel take to work?

After you take a dose of Seroquel, the drug starts having an effect on your body within 1.5 hours. You may notice feeling sleepy. However, it could take several days or weeks before the drug helps improve the symptoms of your condition.

Looking at Seroquel’s clinical trials can give you an idea of how long the drug may take to work. In clinical trials for depressive episodes of bipolar disorder, depressive symptoms eased within 8 weeks of starting Seroquel treatment. And in clinical trials for manic episodes, mania symptoms eased within 3 weeks of starting treatment.

Seroquel overdose

Taking more than the recommended dosage of Seroquel can lead to serious side effects. (For information on the recommended dosages of Seroquel, see the “Seroquel dosage” section above.)

Overdose symptoms

Signs and symptoms of a Seroquel overdose can include:

• drowsiness
• increased heart rate
• low blood pressure
• trouble emptying your bladder
• constipation
• heart rhythm changes, such as long QT syndrome
• hypokalemia (low level of potassium in the blood)
• delirium (a state of confusion and reduced awareness of your surroundings)
• coma

In rare cases, death has been reported following an overdose of Seroquel. Do not take more of the medication than your doctor recommends. If you take too much Seroquel, you may require treatment in a hospital for an overdose.

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call America’s Poison Centers at 800-222-1222 or use its online tool. However, if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.

Seroquel and pregnancy

Your doctor will likely recommend that you do not take Seroquel while you’re pregnant. There’s not enough information known about the risks of taking Seroquel during pregnancy.

Some research shows that certain side effects can occur in babies exposed to antipsychotic drugs, such as Seroquel, as fetuses during the third trimester of pregnancy.* The side effects, referred to as extrapyramidal symptoms, are movement-related problems caused by certain drugs.

Babies exposed to antipsychotics as fetuses may also experience withdrawal symptoms after birth. Withdrawal symptoms are side effects that can occur when you stop taking a drug that your body has become dependent on. Examples of these symptoms include excessive sleepiness, tremor, and trouble breathing or feeding.

If you become pregnant while taking Seroquel, tell your doctor. They can provide more information about the risks of Seroquel use during pregnancy.

If you’re pregnant or planning a pregnancy, talk with your doctor. They can recommend the right treatment for you.

* The third trimester refers to weeks 29 to 40 of pregnancy.

Pregnancy registry

If you become pregnant during Seroquel treatment, your doctor may suggest that you enroll in the National Pregnancy Registry for Psychiatric Medications. This registry collects information to help people learn more about how these drugs affect pregnancy. You can call 866-961-2388 or visit the website to find out more details.

Seroquel and fertility

Taking Seroquel may reduce fertility in females.* (Fertility is the biological ability to reproduce.) This is because the drug can increase the levels of a hormone called prolactin. And high prolactin levels may affect or prevent ovulation (the release of an egg from the ovary).

The manufacturer of Seroquel hasn’t reported any specific fertility problems that have occurred in males.* However, high prolactin levels due to the drug may lead to erectile dysfunction in males.

Keep in mind that these effects in females and males should not be permanent. If you and your doctor decide that you will stop taking Seroquel, your fertility should return to where it was before you started treatment.

If you have questions about how Seroquel may affect your fertility, talk with your doctor.

* Sex and gender exist on spectrums. Use of the terms “female” and “male” in this article refers to sex assigned at birth.

Seroquel and birth control

It’s not known whether Seroquel is safe to take during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re taking Seroquel.

For more information about taking Seroquel during pregnancy, see the “Seroquel and pregnancy” section above.

Seroquel and breastfeeding

It’s unknown whether Seroquel is safe to take while breastfeeding. The drug passes into breast milk in small amounts. However, it’s unknown whether this might affect a child who’s breastfed.

Your doctor can tell you more about the safety of taking Seroquel if you’re breastfeeding. They may also suggest other ways to feed your child while you’re taking this medication.

Seroquel cost

As with all medications, the cost of Seroquel can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Keep in mind that you may be able to get a 90-day supply of Seroquel. If approved by your insurance company, getting a 90-day supply of the drug could reduce your number of trips to the pharmacy and help lower the cost. If you’re interested in this option, check with your doctor, pharmacist, or insurance company.

Before approving coverage for Seroquel, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure if you’ll need to get prior authorization for Seroquel, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Seroquel, or if you need help understanding your insurance coverage, help is available. You can search NeedyMeds to find programs that may help decrease Seroquel’s cost.

To learn more about saving money on prescriptions, check out this article.

Mail-order pharmacies

Seroquel may be available through a mail-order pharmacy. Using this service may help lower the drug’s cost and allow you to get your medication without leaving home.

If recommended by your doctor, you may be able to receive a 90-day supply of Seroquel, so there’s less concern about running out of the medication. If you’re interested in this option, check with your doctor, pharmacist, or insurance company. Some Medicare plans may help cover the cost of mail-order medications.

If you don’t have insurance, you can ask your doctor or pharmacist about online pharmacy options.

Generic version

Seroquel is available in a generic form called quetiapine. A generic drug is an exact copy of the active drug in a brand-name medication. The generic is considered to be as safe and effective as the original drug. And generics tend to cost less than brand-name drugs. To find out how the cost of quetiapine compares to the cost of Seroquel, talk with your doctor or pharmacist.

If your doctor has prescribed Seroquel and you’re interested in using quetiapine instead, talk with your doctor. They may have a preference for one version or the other. You’ll also need to check your insurance plan, as it may only cover one or the other.

Seroquel vs. Nuplazid

You may wonder how Seroquel compares with other medications that are prescribed for similar uses. To find out how Seroquel compares with Nuplazid, see this article.

How to take Seroquel

You should take Seroquel according to the instructions your doctor gives you.

Seroquel comes as an oral tablet that you swallow.

When to take

When you take Seroquel depends on your doctor’s instructions and the condition you’re taking the drug to treat. If they advise you to take Seroquel:

• once per day, you’ll take your dose at bedtime
• twice per day, you’ll take one dose in the morning and one dose in the evening
• three times per day, you’ll take one dose in the morning, one dose in the afternoon, and one dose at bedtime

Your doctor might tell you specific times of day to take Seroquel. Taking the medication on a consistent schedule helps keep a steady level of Seroquel in your body. This helps the drug work effectively.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.

Accessible labels and containers

If your prescription label is hard to read, talk with your doctor or pharmacist. Some pharmacies offer labels that have large print, braille, or a code you scan with a smartphone to convert text to speech. If your local pharmacy doesn’t have these options, your doctor or pharmacist may be able to direct you to one that does.

If you have trouble opening medication bottles, ask your pharmacist if they can put Seroquel in an easy-open container. They also may be able to recommend tools that can make it simpler to open lids.

Taking Seroquel with food

You can take Seroquel with or without food.

It’s important to note that grapefruit and grapefruit juice may interact with Seroquel. For details, see “Seroquel and foods” in the “Seroquel interactions” section above.

Can Seroquel be crushed, split, or chewed?

Seroquel tablets are meant to be swallowed whole. If you have trouble swallowing pills, see this article. You can also talk with your doctor or pharmacist. In some cases, your doctor may recommend a different treatment option.

Seroquel precautions

This drug comes with several precautions.

FDA warnings

This drug has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.

Increased risk of death in older adults with psychosis related to dementia. Antipsychotic drugs, such as Seroquel, may increase the risk of death when used to treat psychosis related to dementia in older adults. (Older adults are ages 65 years and older.) Psychosis is a condition that causes you to lose touch with reality. And dementia refers to a decline in brain function. Because of the risk, doctors likely won’t prescribe Seroquel to older adults with psychosis related to dementia.

If you have questions about this boxed warning, talk with your doctor.

Suicidal thoughts and behaviors. Medications used to treat depression, such as Seroquel, can increase the risk of suicidal thoughts or behaviors in children and young adults. (Young adults are ages 24 years and younger.) Seroquel is not approved for use in children younger than 10 years.

If you notice changes in your behaviors or thoughts while taking Seroquel, tell your doctor right away. You may not notice changes in your own behavior, so be sure to ask friends and family to let you know if they notice any differences.

Examples of behavior changes include:

• new or worsened anxiety
• new or worsened depression
• panic attacks
• insomnia
• agitation (feeling annoyed, aggravated, or nervous)
• aggressive behavior
• being impulsive (acting on a desire without thinking of the consequences)
• restlessness

These changes may be more likely to occur shortly after starting Seroquel treatment or shortly after dose adjustments. Your doctor will monitor you closely while you take Seroquel. If you develop suicidal thoughts or behaviors, your doctor will likely recommend a different treatment option instead of Seroquel. They can also help answer any questions you have about this boxed warning.

Other precautions

Before taking Seroquel, talk with your doctor about your health history. Seroquel may not be right for you if you have certain medical conditions or other factors affecting your health. Some of these factors are considered drug-condition interactions. They include:

• Risk of stroke in older adults with dementia-related psychosis. Antipsychotic drugs, such as Seroquel, may increase the risk of stroke or ministroke when used to treat psychosis related to dementia in older adults. Because of this risk, doctors likely won’t prescribe Seroquel to older adults with psychosis related to dementia. Seroquel also has a boxed warning about the increased risk of death in this group of adults. For details, see “FDA warnings” above.
• Heart or blood pressure problems. Antipsychotic drugs, such as Seroquel, may affect your heart rhythm. Seroquel may also cause increases or decreases in blood pressure. If you already have a heart condition, high blood pressure, or low blood pressure, talk with your doctor. They can help determine whether it’s safe for you to take Seroquel.
• Diabetes. Seroquel can increase your blood sugar levels. Taking this drug may worsen diabetes and increase the risk of diabetes complications, such as nerve damage. Your doctor may have you monitor your blood sugar levels closely while you take Seroquel. They may also adjust your diabetes treatment plan.
• Cholesterol problems. Seroquel can affect blood cholesterol levels. Taking this drug may worsen your cholesterol problem and increase your risk of related complications, such as heart attack or stroke. Your doctor will likely monitor your cholesterol levels regularly while you take Seroquel. They may also adjust your cholesterol treatment plan.
• Cataracts or glaucoma. Taking Seroquel may cause you to have vision-related side effects, such as cataracts or glaucoma. If you already have one or both of these vision problems, talk with your doctor. They may recommend more frequent monitoring of your vision problem while you take Seroquel. You may also need treatment for your vision problem.
• Hypothyroidism. Seroquel can affect your thyroid gland function and cause it to be underactive. If you already have hypothyroidism, taking this drug may worsen your condition. Your doctor will likely monitor your thyroid hormone levels regularly while you take Seroquel. They may also adjust your thyroid treatment plan.
• Liver problems. If you have decreased liver function, such as with hepatitis or fatty liver disease, talk with your doctor before taking Seroquel. Depending on the health of your liver, your doctor may prescribe a lower dose of the drug. This should help lessen your risk of side effects, such as increased levels of liver enzymes. These increased levels could indicate liver damage.
• Trouble with urination or constipation. Seroquel can cause urinary retention or constipation in some people. If you already have certain health conditions, such as an enlarged prostate, or take medications that cause these problems, talk with your doctor. They can help determine if it’s safe for you to take Seroquel.
• Low levels of white blood cells. Seroquel can cause low levels of white blood cells. If your levels are already low, your doctor will likely not prescribe Seroquel. During treatment with this drug, your doctor will monitor your white blood cell levels regularly.
• Dehydration. Antipsychotic drugs, such as Seroquel, may affect how your body regulates its temperature. This can increase the risk of dehydration, especially if you work outside in hot weather or are an older adult. If you already have problems with dehydration, talk with your doctor. They can help figure out whether Seroquel is right for you.
• Seizures. Seroquel may cause seizures. If you have or have had seizures, talk with your doctor before starting Seroquel treatment. They can help determine whether it’s safe for you to take this drug.
• Allergic reaction. If you’ve had an allergic reaction to Seroquel or any of its ingredients, your doctor will likely not prescribe Seroquel. Taking the drug could cause another allergic reaction. Ask your doctor what other medications may be better options for you.
• Pregnancy. Your doctor will likely recommend that you do not take Seroquel while you’re pregnant. For more information, see the “Seroquel and pregnancy” section above.
• Breastfeeding. It’s not known if Seroquel is safe to take while breastfeeding. For more information, see the “Seroquel and breastfeeding” section above.

Note: For more information about the potential negative effects of Seroquel, see the “Seroquel side effects” section above.