Seroquel (Quetiapine)

Seroquel Review

Seroquel is used for treating schizophrenia. It is also used to treat acute manic episodes associated with bipolar disorder (manic-depression). It may also be used for other conditions as determined by your doctor.

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Seroquel Drug Class and Mechanism

Quetiapine is an oral antipsychotic drug used for treating schizophrenia and bipolar disorder. Although the mechanism of action of quetiapine is unknown, like other anti-psychotics, it inhibits communication between nerves of the brain. It does this by blocking receptors on the nerves for several neurotransmitters, the chemicals that nerves use to communicate with each other. It is thought that its beneficial effect is due to blocking of the dopamine type 2 (D2) and serotonin type 2 (5-HT2) receptors.

Seroquel Uses

Quetiapine usually is taken two or three times daily. The dose usually is increased slowly over several days or weeks to achieve the desired effect. Quetiapine can be taken with or without food. The initial dose for bipolar disorder is 50 mg twice daily (100 mg/d). The dose can be increased by 100 mg/d to a daily dose of 400 mg/d. Most patients respond to 400-800 mg/d. Doses greater than 800 mg/d have not been studied. The initial dose for schizophrenia is 25 mg twice daily (50 mg/d). The dose can be increased by 25-50 mg two or three times daily. The target dose is 300-400 mg/d in two or three doses. Patients respond to 150-750 mg/d, and doses greater than 800 mg/d have not been evaluated.

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Seroquel Side Effects

Quetiapine has many side effects, some of them common, a few of them serious and life-threatening. The most common side effect of quetiapine is sedation. It is prescribed specifically (off-label) for this effect in patients with sleep disorders. Beginning users may feel extremely tired and 'out of it' for the first few days, sometimes longer. Quetiapine's newest indication, for bipolar depression, usually specifically calls for the entire dose to be taken before bedtime due to its sedative effects. Although quetiapine is approved by the FDA for the treatment of schizophrenia and bipolar disorder, it is frequently prescribed for off-label purposes, including insomnia and the treatment of anxiety disorders. The sedative effects may disappear after some time on the drug, or with a change of dosage, and with possibly different, non-sedative side effects emerging. Common side effects include constipation, headache, dry mouth, weight gain (or loss). Less common side effects (less than 1% of patients) include abnormal liver tests, dizziness, upset stomach, substantial weight gain or weight loss, a stuffy nose, akathisia and increased paranoia. There is a risk of development of tardive dyskinesia, an incurable neurological disorder, with any prolonged use of quetiapine and some other neuroleptic drugs. However, quetiapine is believed to cause tardive dyskinesia somewhat less often than typical antipsychotics based on the data sources which point to placebo-level incidence of extrapyramidal side effects.The rare, but life-threatening, neuroleptic malignant syndrome may also result from quetiapine use. Weight gain can be a problem for some patients using quetiapine, by causing the patient's appetite to persist even after meals. However, this effect may occur to a lesser degree compared to some other atypical antipsychotics such as olanzapine or clozapine. As with other atypical antipsychotics, there is evidence suggesting a link to the development of diabetes and blood sugar disorders, however this remains controversial due to disparities between the results of studies. In the United States, two separate lawsuits—over claims that quetiapine use has led to diabetes—have been filed in federal court. Studies conducted on beagles have resulted in the formation of cataracts—while there are reports of cataracts occurring in humans, controlled studies including thousands of patients have not demonstrated a clear causal association between quetiapine therapy and this side effect. (Reference needed to April 2006 results of CATIE study.) However, the Seroquel website still recommends users have eye examinations every six months.

Seroquel Pregnancy

Patients should be advised to notify their physician if they become pregnant or intend to become pregnant during therapy.

Seroquel Overdose

Canadian residents should call their local poison control center directly. Symptoms of overdose may include drowsiness, rapid pulse, weakness, fatigue, and dizziness.

Seroquel More Information

Seroquel is to be used only by the patient for whom it is prescribed. Do not share it with other people.