side effects, dosage, reviews, how to take & discontinue, uses, pros & cons, and more

> Seroquel (quetiapine) Overview


Seroquel Article Index | Brand and Generic Availability

Brand & Generic Names; Drug Class

US brand name: Seroquel
Generic name: quetiapine
Drug Class: Antipsychotics
Learn More about Seroquel’s Generic & Worldwide Availability
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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

Learn More about Seroquel’s Approved & Off-label Uses

How Long Until Seroquel Starts Working (Onset of Action)

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. Learn how Seroquel Compares 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.

Learn More about Taking and Discontinuing Seroquel

Seroquel’s 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.
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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 about Seroquel

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 (Adverse Reactions)

Typical Side Effects

The usual short-term side effects for second-generation / atypical antipsychotics (SGA/AAP):

Headache, weight gain, nausea, dry mouth, constipation, sleepiness, general lethargy, and not giving a damn about anything (emotional blunting). Combine the lethargy and blunting and you get what’s known as zombification.

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 the weight gain with Seroquel is not considered to be as bad as that with Zyprexa, for some people it can be as bad, if not worse.

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.

Learn More about Seroquel’s Side Effects.
TMI at times

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What You Really Need to be Careful About

Seroquel’s Black Box and Other Warnings, Pregnancy Category, etc.

Pharmacology

quetiapine’s Half-Life & How Long Until It Clears Your System

Plasma half-life: Half-life: 12 hours. Clearance: 3 days.

quetiapine’s 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 quetiapine’s 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.

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

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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 stars Rating 3.0 out of 5 from 200 criticisms.
Vote Distribution: 34 – 11 – 24 – 25 – 59 – 47


Rate this article

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Get all judgmental about the Seroquel (quetiapine) Overview

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


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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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References

  1. Seroquel’s Full US Prescribing Information
  2. Faught, Edward. “Topiramate in the treatment of partial and generalized epilepsy.” Neuropsychiatric disease and treatment 3.6 (2007): 811-821.

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Seroquel Article Index | Brand and Generic Availability

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. We 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 we write these damn things. 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. — Jerod Poore, CME, Publisher crazymeds.us


Last modified on Saturday, 26 April, 2014 at 15:39:07 by JerodPoorePage Author Date created Tuesday, 25 January 2011 at 17:03:23
“Seroquel” by Jerod Poore is copyright © 2011 Jerod Poore Published online 2011/01/25
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Seroquel, and all other drug names on this page and used throughout the site, are a trademark of someone else.

will probably have the name of the manufacturer and trademark owner (they’re not always the same company) at or near the very bottom. 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. It may of changed hands by the time you finished reading this article.




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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.
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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. OK, you can throw away duplicate copies, but keep at least one, as that’s your proof of purchase of having taken a med in case a doctor doubts your medical history. Plus they take up less space than a bottle, although keeping one inside of a pill bottle is even better.
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.
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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.

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3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas? I don’t even need my big-ass rant any more. Heartbleed has made my case for me. And that’s just the one that got all the media attention. The very nature of an open source operating system makes security as much of an illusion of anonymity. Before you flip out too much: the domain Crazymeds is hosted on uses a version of SSL that is not affected by the Heartbleed bug. That’s one of the many reasons why I pay a lot of money and keep this site on Lunarpages.

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