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> Seroquel


Seroquel Index | Brand and Generic Availability
Everything on Two Big-Ass Pages

Brand & Generic Names; Drug Class

US brand name: Seroquel
Generic name: quetiapine
Drug Class: Antipsychotics
More on Generic & Worldwide Availability

Seroquel’s Approved & Off-Label Uses (Indications)

US FDA Approved Treatment(s)

Schizophrenia, bipolar disorder, as an add-on to an antidepressant to treat depression

Popular Off-Label Uses

Insomnia, anxiety, Parkinson’s

Details about Approved & Off-label Uses

Seroquel’s Usual Onset of Action (when it starts working)

Unlike other antipsychotics, which can start getting your symptoms under control within 24 hours, Seroquel can take up to a week to work. Unless you’re taking it for sleep. That first 25mg knocks out most people.

Likelihood of Working

Approved uses: Pretty good for schizophrenia, so-so for bipolar mania, fairly good for bipolar depression.

Off-label uses: Excellent for insomnia, good for anxiety. Due to the way Seroquel works and the nature of anxiety spectrum disorders, Seroquel can potentially make your anxiety better or worse at first, then do the exact opposite at a higher dosage. Even if you’re not taking it specifically for anxiety. More on Chances of Working for You and Comparisons with Other Drugs

How to Take Seroquel

  • For bipolar: PI sheet: start at 100mg a day in two 50mg doses and increase by 100mg to 400mg day by day four. If needed, up it by 200mg a day until reaching 800mg a day by day six.
    • We suggest starting with one 25–50mg dose at night if you’re taking another mood stabilizers, or the 100mg a day in two 50mg doses if you aren’t. If you need to increase by 25–50mg a day every 3–4 days and stay at whatever dosage gets your symptoms under control. Unless you’re seriously flipping out, in which case follow the PI sheet’s guidelines until your symptoms are under control or you hit 800mg a day.
  • For schizophrenia: PI sheet: start at 50mg a day, divided into two 25mg doses, but they still want to ramp you up to 300–400mg a day by day four.
    • We suggest starting with 50mg a day and, as with bipolar disorder, increasing by 25–50mg every 3–4 days until your symptoms are under control. If you’re crazy enough to be getting coded messages in your cereal, especially if you’re NOT eating Alpha-Bits, then get to 300–400mg by day four.

How to Stop Taking Seroquel (discontinue / withdrawal)

Your doctor should be recommending that you reduce your dosage by 25–50mg a day every other day if you need to discontinue it. You can stop taking all it immediately if it’s an emergency (e.g. a life-threatening allergic reaction), but I wouldn’t recommend doing that without a doctor’s supervision. The major problem with stopping antipsychotics is a sudden return of your symptoms.

More about Taking and Discontinuation



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Pros and Cons

Pros

  • As one of the mildest - and most prescribed - of all antipsychotics it doesn’t really carry the antipsychotic stigma as heavily as the other meds in this class.
  • That also means it’s less likely to cause side effects involving prolactin (e.g. leaking nipples and/or man boobs) and movement disorders.

Cons

  • You’ll sleep until next Tuesday.
    • Of course, that could be a good thing, depending on how your life is at this moment.
  • Other than the sleep thing, it takes longer than any other atypical antipsychotic to work. * You’ll probably gain weight and you might come down with type 2 diabetes.

Interesting Stuff your Doctor Probably didn’t Tell You

Seroquel is marginally better absorbed with food. So if you feel you need just a little boost in the dosage, try taking it with dinner or a late-night snack. Since Seroquel can make you gain a lot of weight, be careful about that late-night snacking.

Like most drugs older people don’t clear it out of their systems as well, to the point that they may need a lower dosage. That’s not particularly interesting. What is interesting is that Seroquel seems to work better for people under 40 than over 40.

Best Known for

Seroquel is notorious for two things - making you sleep until next Tuesday, and leaving you with one hell of a hangover when you eventually wake up. It’s a lot like trazodone in this regard.

In-Depth Pros & Cons

Seroquel’s Side Effects

Typical Side Effects

The usual short-term side effects for second-generation / atypical antipsychotics (SGA/AAP): headache, nausea, dry mouth, sleepiness or insomnia, diarrhea or constipation, not giving a damn about anything (a.k.a. the zombification effect). Most, if not all of these will go away in a couple of weeks. Except for the excessive sleepiness, which could hang around for as long as you take this med, but is usually not much of a problem once you’re taking more than 100–200mg a day.
However, the excessively sleepiness tends to return if you start taking over 400–600mg a day. That’s also interesting, but many doctors and/or pharmacists will tell you that. The feeling like you were out drinking with the Wolfpack last night goes away after 2 or three days. A week at the most. If it hangs around for longer than that it might eventually go away, and it might not.
And, of course, weight gain. Although it’s not as bad as Zyprexa.

Uncommon Side Effects

Diabetes. Manic reaction. Muscle aches and pains. Getting all sweaty for no good reason. Tremor. Irregular heart beat and prolonged QT interval. While the sexual dysfunctions aren’t as bad as Risperdal (risperidone) or Zyprexa (olanzapine), they can still happen.

Freaky Rare Side Effects

Infanticide - although the lack of Seroquel was the real cause of that tragedy.

Priapism (the never-ending hard-on) from an overdose. Kids, don’t try this at home. The PI sheet also lists “bone pain” and “abnormal ejaculation” so I’d be especially careful about taking too much Seroquel as a Cialis substitute in order to stay hard. Unless you’re into that sort of thing.
Side Effect Details.
TMI at times


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What You Really Need to be Careful About

Black box and other warnings, pregnancy category, etc.

Half-Life & Clearance

Half-life: 12 hours. Clearance: 3 days.
Pharmacokinetics Information Overload

Half-life is the average time it takes for you to process half of the drug’s active ingredient. If a drug has a half-life of around 24 hours and you take a dose of 100mg, you’ll have roughly the equivalent a 50mg dose after one day, a 25mg dose after two days, and so on. The rule of thumb is: multiply the half-life by five and you get how long it is for the dose you took to be cleared from your bloodstream, so there’s nothing swimming around to attach itself to your brain and start doing stuff1. That’s called “plasma clearance.” Complete clearance is a complex equation based on a lot of factors which may or may not: be published in the PI sheet, include personal data like your weight, or even completely figured out by corporate and independent researchers. It usually winds up being 2–5 days after plasma clearance no matter what2, but can take weeks. Sometimes a drug will clear from your brain and other organs before it clears from your blood. If we’ve found the complete clearance, or how to calculate it if it requires things like your weight and what your piss looks like, you’ll find that on the pharmacokinetics page.

How quetiapine Works

the current best guess at any rate
Seroquel is a broad-spectrum atypical/second-generation antipsychotic, and is tied with Zyprexa for third place in how many, and which type, of neurotransmitter receptors it affects. Most of its activity involves reducing the activity 5HT-serotonin and alpha-1a & alpha-2c norepinephrine receptors. Like practically every AP on the planet, Seroquel is a D2 antagonist. Being a potent antagonist at 5-HT2A, 5-HT2C, and 5-HT7, a partial agonist at serotonin 5-HT1A, and a little norepinephrine reuptake inhibition accounts for its antidepressant effect. Because of that last one, and the nature of anxiety spectrum disorders, Seroquel can make you more or less anxious when you start taking it, then do the exact opposite at a higher dosage.

More than You Probably Ever Wanted to Know about How a Drug Works
AKA mechanism/method of action, pharmacodynamics

Ratings, Reviews, Comments, PI Sheet, and More

Seroquel Comments


Extended Comments
As if I didn’t go on long enough already.

Seroquel Ratings & Reviews, and Consumer Comments & Experiences

Rate Seroquel

Give your overall impression of Seroquel on a scale of 0 to 5. Detailed ratings and reviews are available on the Seroquel Ratings & Reviews Page.

Get all critical about Seroquel

3.5 stars Rating 3.1 out of 5 from 148 criticisms.
Vote Distribution: 26 – 5 – 19 – 17 – 46 – 35


Rate this article

If you’re still feeling judgmental as well as just mental3, please boost or destroy my self-confidence by honestly (and anonymously) rating this article on a scale of 0 to 5. The more value-judgments the better, even if you can criticize my work only once.

Get all judgmental about the Seroquel (quetiapine) Synopsis

4 stars Rating 3.8 out of 5 from 55 value judgments.
Vote Distribution: 5 – 3 – 0 – 3 – 24 – 20


Full US Prescribing Information / PI Sheet

Allegedly Useful Links. Mostly official sites, PI sheet-equivalents4 from countries other than the US, and reviews from other consumer review sites.

Drugs.com’s drug-drug and drug-food interaction checker

It’s always a good idea to check for drug-drug interactions yourself. Just because most people in the crazy meds business know about really important interactions (e.g. MAOIs and a lot of stuff, warfarin and everything on the planet) doesn’t mean the person who prescribed your meds told you about them, or the pharmacist has all the meds you take at their fingertips like they’re supposed to. Or they have the time to do their jobs properly when not dealing with complete idiots or playing Angry Farmers on the Faecesbooks.


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Seroquel Index | Brand and Generic Availability
Everything on Two Big-Ass Pages

1 Based on Julien's calculations from A Primer of Drug Action, the half-life multiplied by five is the generally accepted estimate of how long it takes a single dose of any given drug to be eliminated from the blood stream/plasma of someone with a normal metabolism. That's also the rough estimate for steady stage if they can't get, or won't provide a number for that.

2 For crazy meds. I have no idea what the average complete clearance is for other types of medications. For all I know there are drugs that utterly vanish from your system in under five passes, and others that won't let go of your squishy bits for years after you stop taking them.

3 Thank you! I'll be here all weak. Be sure to tip your content provider. And don't try the veal, it's cruelicious!

4 These include: Canada's Product Monographs (PM), New Zealand's Medicine Data Sheets (MDS), the EU's European Public Assessment Reports (EPAR), and the Summary of Product Characteristics (SPC) used in Britain, Ireland, and many other places.


If you have any questions not answered here, please see the Crazymeds Seroquel discussion board. I welcome criticisms of the articles, notifications of bad links, site problems, consumer experiences with medications, etc. I’m not always able to write back. Hence I never answer questions about meds via e-mail that are answered by this or other articles. Especially if they have been repeatedly asked on the forum. That’s why I write these damn things. I’m frustrated enough as it is. Questions about which meds are best for your condition should also be asked on the forum; because this is a free site, so the price of admission is making things easier for somebody else searching for the same answer. We don’t deal with children on the forum or in private because after doing this for ten years I don’t have the emotional stamina to deal with kids who have brain cooties. How to contact Crazymeds.


Last modified on Thursday, 27 March, 2014 at 15:03:22 by SomeMedCriticPage Author: JerodPooreDate created Tuesday, 25 January 2011 at 17:03:23

Seroquel by JerodPoore is copyright © 2011 JerodPoore


Seroquel, and all other drug names on this page and use throughout the site, are a trademark of someone else. Look on the the PI sheet or ask Google who the owner is. The way pharmaceutical companies buy each other and swap products like Monopoly™ real estate, the ownership of the trademark may have changed without my noticing.




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Almost all of the material on this site is by Jerod Poore and is copyright © 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, and 2014 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and something along the lines of following disclaimer, I’m usually cool with it.



All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. If you still have questions about a medication or condition that were not answered on any of the pages you read, please ask them on Crazy Talk: the Crazymeds Forum.
The information on Crazymeds pertains to and is intended for adults. While some information about children and adolescents is occasionally presented (e.g. US FDA approvals), pediatric-specific data such as dosages, side effects, off-label applications, etc. are rarely included in the articles on drugs or discussed on the forum. If you are looking for information regarding meds for children you’ll have to go somewhere else.
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Nobody on this site is a doctor, a therapist, or a pharmacist. We don’t portray them either here or on TV. Only doctors can diagnose and treat an illness. While it’s not as bad as it used to be, some doctors still get pissed off by patients who know too much about medications, so tread lightly when and where appropriate. Diagnosing yourself from a website is like defending yourself in court, you suddenly have a fool for a doctor. Don’t be a cyberchondriac, thinking you have every disease you see a website about, or that you’ll get every side effect from every medication1. Self-prescribing is as dangerous as buying meds from fraudulent online pharmacies that promise you medications without prescriptions.
All information on this site has been obtained through our personal experience and the experiences family, friends, what people have reported on various reputable sites all over teh intergoogles, the medications’ product information / summary of product characteristic (PI/SPC) sheets, and from sources that are referenced throughout the site. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or patient information leaflet (PIL) that comes with your medications and never ever throw them away.
Crazymeds is not responsible for the content of sites we provide links to. We like them, or they’re paid advertisements, or they’re something else we think you should read to help you make an informed decision about a particular med. Sometimes they’re more than one of those things. But what’s on those sites is their business, not ours.
Very little information about visitors to this site is collected or saved. From time to time I look at search terms used and which pages they bring up in an effort to make the information I present more relevant. And the country of origin, just because I’m geeky like that. That’s about it. Depending on how you feel about Schrodinger, our privacy policy should either assuage or exacerbate your paranoia.
All brand names of the drugs listed in this site are the trademarks of the companies named on the PI/SPC sheet associated with the medication, sometimes on the pages about the drugs, even though those companies may have been acquired by other companies who may or may not be listed in this site by the time you read this. Or the rights to the drug were sold to another company. And any or all of the companies involved may have changed their names.
Crazymeds is optimized for the browser you’re not using on the platform you wish you had. Between you and me, it all looks a lot cleaner using Safari or Chrome, although more than half of the visitors to this site use either Safari or Internet Explorer, so I’m doing my best to make things look nice for IE as well. I’m using Firefox and running Windows 72. On a computer that sits on top of my desk. With a 23 inch monitor. Hey, at least you can make the text larger or smaller by clicking on the + or - buttons in the upper right hand corner. If you have Java enabled. Like 99% of the websites on the planet, Crazymeds is hosted on domain running an open source operating system with a variety of open source applications, including the software used to display what you’ve been reading. As such Crazymeds is not responsible for whatever weird shit your browser does or does not do when you read this site3.
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‘Everything is true, nothing is permitted.’ - Jerod Poore


1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.

2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.

3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?
[begin rant] I rent a dedicated server for Crazymeds. It’s sitting on a rack somewhere in Southern California along with a bunch of other servers that other people have rented. The hardware is identical, but no two machines have exactly the same operating systems. I don’t even need to see what is on any of the others to know this. If somebody got their server at the exact same time, with the exact same features as I did, I’m confident that there would be noticeable differences in some aspects of the operating systems. So what does this mean? For one thing it means that no two computers in the same office of a single company have the same operating system, and the techs can spend hours figuring out what the fuck the problem could be based on that alone. It also means that application software like IP board that runs the forum here has to have so many fucking user-configurable bells and whistles that even when I read the manual I can’t find every setting, or every location that every flag needs to be set in order for a feature to run the way I want it to run. And in the real world it means you can get an MBA not only with an emphasis on resource planning, but with an emphasis on using SAP - a piece of software so complex there are now college programs on how to use it. You might think, “But don’t people learn how to use Photoshop or Adobe Illustrator in college?” Sure, in order to create stuff. And in a way you’re creating stuff with SAP. But do you get a Bachelor of Fine Arts degree with an emphasis on Photoshop?
Back in the Big Iron Age the operating systems were proprietary, and every computer that took up an entire room with a raised floor and HVAC system, and had less storage and processing power than an iPhone, had the same operating system as every other one, give or take a release level. But when a company bought application software like SAP, they also got the source code, which was usually documented and written in a way to make it easy to modify the hell out of it. Why? Because accounting principles may be the same the world over, and tax laws the same across each country and state, but no two companies have the same format for their reports, invoices, purchase orders and so forth. Standards existed and were universally ignored. If something went wrong it went wrong the same way for everyone, and was easy to track down. People didn’t need to take a college course to learn how to use a piece of software.
I’m not against the open source concept entirely. Back then all the programmers read the same magazines, so we all had the same homebrew utilities. We even had a forerunner of QR Code to scan the longer source code. Software vendors and computer manufacturers sponsored conventions so we could, among other things, swap recipes for such add-ons and utilities. While those things would make our lives easier, they had nothing to do with critical functions of the operating system. Unless badly implemented they would rarely cause key application software to crash and burn. Whereas today, with open source everything, who the hell knows what could be responsible some part of a system failing. [/end rant]

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