Highlighting uses, dosage, how to take and discontinue


Seroquel’s Side Effects, Warnings, etc. >>

Brand & Generic Names; Drug Classes

US brand name: Seroquel
Generic name: quetiapine

Drug Class(es)

Primary drug class: Antipsychotics
Additional drug class(es): Antidepressants Anxiolytics/Anti-anxiety MoodStabilizers Sleep Disorder meds

Approved & Off-Label Uses (Indications)

Seroquel’s US FDA Approved Treatment(s)

Immediate-Release Seroquel

Immediate-release Seroquel was originally approved in September 1997 to treat schizophrenia in adults . Since then its approvals have been expanded to include:

  • Treatment of schizophrenia in adolescents aged 13 to 17 .
  • Acute depressive episodes in bipolar disorder .
  • Acute manic episodes in bipolar I disorder, as either monotherapy or adjunct therapy to lithium or divalproex, in adults as well as children and adolescents aged 10 to 17 .
  • Maintenance treatment of bipolar I disorder as an adjunct to lithium or divalproex .

Extended-Release Seroquel

Seroquel XR is rated XR, in that it is for adults only. Otherwise its approvals are almost identical to vanilla1, immediate-release Seroquel:

  • Schizophrenia
  • Acute depressive episodes in bipolar disorder
  • Acute manic or mixed episodes in bipolar I disorder, as either monotherapy or adjunct therapy to lithium or divalproex.
  • Maintenance treatment of bipolar I disorder as an adjunct to lithium or divalproex.
  • Bonus approval: adjunctive therapy to antidepressants in major depressive disorder .

Uses Approved Overseas but not in the US

Off-Label Uses of Seroquel

When & If Seroquel Will Work

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.

Taking and Discontinuing

How to Take Seroquel

Manufacturer’s Recommendations

AstraZeneca says this for the eXtended Release (XR) form :
  • For Adults with Bipolar Disorder 1, manic or mixed : start at 300 mg taken once a day. Increase that to 600 mg a day on day two, and on day three you and your doctor can figure out where in the range of 400 to 800 mg a day should work for you2.
  • For Adults with Bipolar Disorder, Depressive Episodes : start at 50 mg taken once a day. Increase to 100 mg a day on day two, 200 mg on day three, and 300 mg on day four.
  • For Adults with Bipolar Disorder 1 - maintenance therapy : 400 mg to 800 mg taken once a day.
  • For Adults with Schizophrenia - acute treatment : start at 300 mg taken once a day. Increase by however much you and your doctor think is required, by up to 300 mg! a day, until your symptoms are under control.
  • For Adults with Schizophrenia - maintenance therapy : 400 mg to 800 mg taken once a day.
  • For Adults with Major Depressive Disorder - Adjunctive Therapy with Antidepressants : start at 50 mg taken once a day. Increase to 150 mg a day on day three. After that there is no clear instruction on reaching the target dosage of 150–300 mg a day for maintenance therapy.

--Seroquel XR PI sheet:

Crazymeds’ Suggestions

  • Bipolar Disorder: We suggest starting with one 50 mg dose at night if you’re taking another mood stabilizer, or 100 mg a day if you aren’t. If you need to increase by 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 800 mg a day.
    • By “seriously flipping out” I mean you’re hospitalized, or close to being hospitalized.
  • Schizophrenia: We suggest starting with 50 mg a day and, as with bipolar disorder, increasing by 50 mg 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 300–400 mg by day four. If not sooner.
  • As an add-on for MDD: Sorry, I haven’t looked into this.

How to Stop Taking Seroquel (discontinuation / 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.

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1 Vanilla as the geek slang for plain. As far as I know, no one makes a vanilla-flavored quetiapine. Although that does seem like a good idea.

2 Which is a neat trick when you consider it often takes a week for Seroquel to fully work.

Last modified on Fri, 22 May, 2015 at 11:58:08 by JerodPoorePage Author Date created Tuesday, 25 January 2011 at 17:03:23
“Seroquel (quetiapine): Uses and Using” by Jerod Poore is copyright © 2011 Jerod Poore Published online 2011/01/25

Seroquel, and all other drug names on this page and used throughout the site, are the trademarks 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.

Page design and explanatory material by Jerod Poore, copyright © 2003 - 2015. All rights reserved. See the full copyright notice for full copyright details.
Don’t automatically believe everything you read on teh Intergoogles. 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. For more details see the Crazymeds big-ass disclaimer.

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