Jeffrey Panko NP Psychiatry · Patient education
Quetiapine
Seroquel / Seroquel XR / Generic formulations
A guide for adults taking quetiapine.
Follow the directions on your prescription and your provider's recommendations.
Formulations: Immediate-release and extended-release tablets have different schedules and food instructions. Doses used for sleep do not establish treatment of an underlying mood or psychotic disorder.
What it is used for
Quetiapine treats schizophrenia and bipolar disorder, including bipolar depression and mania. The extended-release formulation is also approved as an add-on for major depression. Use solely for insomnia is off-label and carries the same important risks.
How it works
It affects dopamine and serotonin receptors; an active metabolite also affects norepinephrine signaling. Histamine and alpha-1 receptor effects contribute to sedation and dizziness.
What to expect over time
Some symptoms improve earlier than others. Changes in hallucinations, mood, or organized thinking often develop over several weeks. Track practical goals, such as regular sleep and daily activities, and report side effects or limited benefit.
Taking your medication
- Take immediate-release tablets according to the prescribed schedule, with or without food.
- Take XR in the evening without food or with a light meal of about 300 calories. Swallow XR whole.
- If you miss a dose, take it when you remember unless it is almost time for the next dose. Then skip it. Do not double a dose.
- After more than one week off, contact your provider before restarting; the initial titration is generally needed again.
When to get help
Emergency symptoms. Get emergency care for fever with severe muscle stiffness and confusion, a seizure, fainting with an irregular heartbeat, or trouble breathing. Fever and stiffness can signal neuroleptic malignant syndrome, a rare but serious reaction.
Prompt medical advice. Contact your provider promptly for new involuntary movements, trouble swallowing, severe restlessness, or symptoms of high blood sugar such as unusual thirst and frequent urination.
If you feel unsafe or have thoughts of self-harm, call 911 or go to an emergency department.
Possible side effects
- Sleepiness or dizziness
- Dry mouth or constipation
- Increased appetite or weight
- Restlessness or other movement effects
Keeping track of treatment
Some side effects resolve with time; others may require a change of medication. Discuss persistent or bothersome side effects with your provider.
Expect periodic checks of weight, blood pressure, blood sugar, cholesterol, and movement symptoms. Some changes, such as higher blood sugar, may occur before you feel different.
Report new mouth, tongue, face, or limb movements. Tardive dyskinesia is a movement disorder that can persist after medication is stopped.
Report severe constipation, persistent daytime sedation, or falls. Eye examinations may be recommended during ongoing treatment.
If you take too much
For a suspected overdose, call Poison Control at 1-800-222-1222 immediately, even if you feel well. Call 911 for a seizure, collapse, trouble breathing, or inability to wake.
Before you start
Discuss diabetes, heart-rhythm problems, fainting, seizures, low blood counts, swallowing difficulties, and kidney or liver disease. Antipsychotics increase the risk of death in older adults with dementia-related psychosis.
Discuss pregnancy, pregnancy plans, and breastfeeding with your provider. Treatment decisions should consider both the medication and the condition being treated.
Medicines and interactions
Review all your medications with your provider, including over-the-counter medicines and supplements. Have new medications checked before taking them.
Strong CYP3A inhibitors or inducers can require major dose changes. Do not adjust the dose yourself when another medication changes.
Alcohol, sedatives, anticholinergic drugs, and blood-pressure medicines can add impairment, constipation, or fainting.
Everyday tips
Stand up slowly. Avoid driving until you know how the medication affects alertness and coordination.
Stay hydrated and take breaks in hot weather. Some antipsychotics interfere with temperature regulation.
Discuss appetite or weight changes early, and keep scheduled monitoring visits.
Your questions answered
Can I stop when I feel better?
Consult with your provider. Continuing treatment may prevent symptoms from returning. Abrupt stopping can cause withdrawal symptoms or a relapse.
What if I cannot sit still?
An inner urge to keep moving can be akathisia, a medication side effect. Tell your provider promptly; it can be mistaken for worsening anxiety.
Storage and safety
Keep medication in its labeled container, away from excess heat and moisture and out of reach of children and pets. Do not share it. Ask a pharmacy about disposal of unused medication.
Sources
About this information
Educational handout; does not replace your prescription or provider's recommendations.
Educational inclusion does not mean this medication or its indications are treated at this practice. Review the guide for your exact product with your prescriber or pharmacist.