Seroquel for Anxiety

Even if your anxiety symptoms improve and you feel you no longer need the drug, don’t discontinue use without first consulting with your doctor.

Seroquel (Quetiapine) – Oral

Queen Buyalos is a pharmacist and freelance medical writer. She takes pride in advocating for cancer prevention, overall health, and mental health education. Queen enjoys counseling and educating patients about drug therapy and translating complex ideas into simple language.

Published on March 21, 2022

Erika Prouty, PharmD, is a professional community pharmacist who aids patients in medication management and pharmacy services in North Adams, Massachusetts.

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Table of Contents
Table of Contents

Seroquel can increase the risk of death in older adults (aged 65 years and older) with dementia-related psychosis treated with antipsychotic drugs. Seroquel should not be used in this population.

Children, adolescents, and young adults may experience an increased risk of suicidal thoughts or behavior. Monitor for the signs of worsening or emerging suicidal thoughts or behavior.

What Is Seroquel?

Seroquel ( quetiapine ) is a prescription atypical antipsychotic that treats bipolar disorder manic episodes, depression, and schizophrenia. It is approved for use in people aged 10 years and older.

This drug works by acting on dopamine, a molecule in your brain. Dopamine helps with movement, thoughts, emotions, arousal, and reward. It is also known as the “feel-good” chemical. Too much dopamine in the brain can cause many symptoms in people with schizophrenia, including manic episodes. Seroquel blocks certain parts of the brain where dopamine acts on. It reduces overactive dopamine and calms the brain.

Seroquel also blocks another chemical in the brain called serotonin. Serotonin is involved with mood, balance, and memory. Too much of this chemical can lead to schizophrenia symptoms, depression, and movement control issues. Seroquel balances these particular chemical messengers in the brain to reduce psychotic episodes and depression.

It is available as immediate-release (IR) and extended-release (ER) tablets.

Drug Facts

Generic Name: Quetiapine

Brand Name(s): Seroquel, Seroquel XR

Administration Route(s): Oral

Drug Availability: Prescription

Therapeutic Classification: Antipsychotic

Available Generically: Yes

Controlled Substance: N/A

Active Ingredient: Quetiapine

Dosage Form(s): Tablet, extended-release tablet

What Is Seroquel Used For?

The Food and Drug Administration (FDA) approved Seroquel to control symptoms in people with:

• Bipolar disorder
• Depression
• Schizophrenia

Seroquel balances how specific chemical messengers in the brain act to lower symptoms in people with these conditions.

How to Take Seroquel

You may take Seroquel in divided doses or as a single dose at bedtime. Take your prescription by mouth as directed by your healthcare provider.

Take Seroquel IR with or without food. You can crush it if your provider tells you to. However, take Seroquel XR with a light meal (300 calories or less) or an empty stomach, preferably in the evening. Swallow Seroquel XR tablets whole. Do not break, chew, or crush them.

Do not drink alcohol while taking Seroquel.

Storage

Store your medicine at room temperature (77 degrees Fahrenheit [F]) away from light. If traveling, Seroquel can be stored safely at temperatures as low as 59 degrees F and as high as 89 degrees F.

Do not store this drug in your bathroom. Keep Seroquel in a dry and safe place, away from children and pets.

If you have medication that is unused or expired, it is important to dispose of it properly and safely. It should not be flushed down a toilet or thrown down a drain. Drug take-back programs may be available in your area. Many police stations and city halls have medication drop boxes to dispose of these medications. If neither is available, mixing the medication with undesirable trash items, such as cat litter or coffee grounds, is an option

Off-Label Use

Seroquel can also be used to treat some other medical issues off-label. These conditions include:

• Aggression and psychosis
• Agitation and delirium
• Delusional infestation
• Generalized anxiety disorder
• Obsessive-compulsive disorder
• Insomnia

Additionally, certain people may not be able to take whole tablets by mouth due to health conditions. Some people may take Seroquel through other means like feeding tubes (nasogastric or enteral tube).

How Long Does Seroquel Take to Work?

Seroquel starts working within days from when you start taking it. Depending on your condition, you may see effects as early as four days up to 12 weeks.

What Are the Side Effects of Seroquel?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

Some of the common side effects of Seroquel include but are not limited to:

• Headache
• Feeling nervous and excitable
• Constipation
• Dry mouth
• Feeling more hungry
• Upset stomach or throwing up
• Back pain
• Sleepiness
• Weight gain
• Dizziness

Severe Side Effects

Seroquel can cause many serious side effects. Tell your healthcare provider or get medical help right away if you have any of the following signs or symptoms. Serious side effects and their symptoms can include the following:

• Signs of an allergic reaction, like a rash or trouble breathing
• Memory problems
• Chest pain or pressure
• Fast or abnormal heartbeat
• Mood changes
• Constipation
• Not able to handle cold temperatures
• Burning, numbness, or tingling feeling that is not usual
• Passing out
• Seizures
• Change in balance
• Drooling
• Nipple discharge
• Change in eyesight
• Trouble passing urine
• Sexual dysfunction
• Severe muscle problems and trouble controlling body movements, known as tardive dyskinesia

Seroquel can also increase the risk of death in older adults (aged 65 years and older) with dementia-related psychosis treated with antipsychotic drugs. Seroquel is not approved for use in this population.

Children, adolescents, and young adults may experience an increased risk of suicidal thoughts or behavior. Monitor for the signs of worsening or emerging suicidal thoughts or behavior.

This is not a comprehensive list of all side effects. Talk to your healthcare provider if you have questions. Call your healthcare provider as soon as possible if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you have a medical emergency.

Long-Term Side Effects

Side effects usually go away after ending drug treatments. Sadly, some side effects of Seroquel do not go away, even after stopping the drug. The risk of this occurring is higher in people aged 65 years and older (especially older females), and people with diabetes. Also, more extended use of this drug increases the chances of long-term side effects.

Seroquel is linked to long term issues like:

• Weight gain
• Increased blood sugar
• Cataracts
• Tardive dyskinesia
• Pancreatitis
• Increased cholesterol

Report any long-term side effects to your healthcare provider. Call 911 if your symptoms feel life-threatening or if you think you have a medical crisis.

Report Side Effects

Seroquel may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting Program or by phone (1-800-332-1088).

Dosage: How Much of Seroquel Should I Take?

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The dose of this medicine will be different for different patients. Follow your doctor’s orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (extended-release tablets):
  • For treatment of depression with bipolar disorder:
    • Adults—At first, 50 milligrams (mg) once a day in the evening. Your doctor may adjust your dose as needed. However, the dose is usually not more than 300 mg per day.
    • Children—Use and dose must be determined by the doctor.
    • Adults—At first, 300 milligrams (mg) once a day in the evening. Your doctor may adjust your dose as needed. However, the dose is usually not more than 800 mg per day.
    • Children 10 to 17 years of age—At first, 50 mg once a day in the evening. Your doctor may adjust your dose as needed. However, the dose is usually not more than 600 mg per day.
    • Children younger than 10 years of age—Use and dose must be determined by the doctor.
    • Adults—At first, 50 milligrams (mg) once a day in the evening. Your doctor may adjust your dose as needed. However, the dose is usually not more than 300 mg per day.
    • Children—Use and dose must be determined by the doctor.
    • Adults—At first, 300 milligrams (mg) once a day in the evening. Your doctor may adjust your dose as needed. However, the dose is usually not more than 800 mg per day.
    • Children 13 to 17 years of age—At first, 50 mg once a day in the evening. Your doctor may adjust your dose as needed. However, the dose is usually not more than 800 mg per day.
    • Children younger than 13 years of age—Use and dose must be determined by the doctor.
    • For treatment of depression with bipolar disorder:
      • Adults—At first, 50 milligrams (mg) once a day at bedtime. Your doctor may adjust your dose as needed. However, the dose is usually not more than 300 mg per day.
      • Children—Use and dose must be determined by the doctor.
      • Adults—At first, 50 milligrams (mg) 2 times a day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 800 mg per day.
      • Children 10 to 17 years of age—At first, 25 milligrams (mg) 2 times a day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 600 mg per day.
      • Children younger than 10 years of age—Use and dose must be determined by the doctor.
      • Adults—At first, 25 milligrams (mg) 2 times a day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 750 mg per day.
      • Children 13 to 17 years of age—At first, 25 milligrams (mg) 2 times a day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 800 mg per day.
      • Children younger than 13 years of age—Use and dose must be determined by the doctor.

      Modifications
      

      Use only the immediate-release version of this drug for children and people who cannot swallow. You can crush and mix Seroquel IR in soft food or liquid. Seroquel IR is compatible with feeding tubes. You can grind and give this drug through a feeding tube as directed by your healthcare provider.

      Your healthcare provider may change your dose of Seroquel if you are:

      • Aged 65 years or older
      • Have liver problems
      • Taking other medications that interact with Seroquel
      • Restarting Seroquel XR after being off of it for more than one week

      Missed Dose
      

      Take the missed dose of Seroquel as soon as you think of it. If the missed dose is too close to your next dose, skip the missed dose. Return to your regular dosing time. Do not take extra doses or double up doses. Always ask your doctor or your pharmacist if you have any questions.

      Take your drug as directed. Do not stop taking your medicine without telling your healthcare provider even if you feel well. If you suddenly stop taking your pill, you can have withdrawal symptoms like:

      • Alternating feelings of warmth and cold
      • Insomnia
      • Vertigo

      Overdose: What Happens If I Take Too Much Seroquel?

      Overdose symptoms may include symptoms of torsades de pointes like rapid pulse, cold sweats, and chest pain.

      What Happens If I Overdose on Seroquel?

      If you think you or someone else may have overdosed on Seroquel, call a healthcare provider or the Poison Control Center (1-800-222-1222).

      If someone collapses or isn’t breathing after taking Seroquel, call 911 immediately.

      Precautions

      Drug Content Provided and Reviewed by IBM Micromedex ®

      It is very important that your doctor check your or your child’s progress at regular visits to make sure this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects. You may also need to have your eyes tested on a regular basis.

      This medicine may add to the effects of alcohol and other CNS depressants (medicines that make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds, sedatives, tranquilizers, or sleeping medicine, prescription pain medicine or narcotics, medicine for seizures or barbiturates, muscle relaxants, or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are using quetiapine.

      For some patients, this medicine can increase thoughts of suicide. Tell your doctor right away if you start to feel more depressed and have thoughts about hurting yourself. Report any unusual thoughts or behaviors that trouble you, especially if they are new or are getting worse quickly. Make sure the doctor knows if you have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. Also tell the doctor if you have sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared. Let the doctor know if you or anyone in your family has bipolar disorder (manic-depressive illness) or has tried to commit suicide.

      Quetiapine may cause drowsiness, trouble with thinking, trouble with controlling body movements, or trouble with your vision (especially during the first week of use), which may lead to falls, fractures, or other injuries. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

      This medicine may increase the amount of sugar in your blood. Check with your doctor right away if you have increased thirst or urination. If you have diabetes, the results of your urine or blood sugar tests may change. Check your blood sugar closely and talk with your doctor if you have any questions.

      Check with your doctor right away if you have convulsions (seizures), difficulty breathing, a fast heartbeat, high fever, high or low blood pressure, increased sweating, loss of bladder control, severe muscle stiffness, unusually pale skin, or tiredness. These could be symptoms of a serious condition called neuroleptic malignant syndrome (NMS).

      Dizziness, lightheadedness, or fainting may occur, especially when you get up suddenly from a lying or sitting position. Getting up slowly may help. If the problem continues or gets worse, check with your doctor.

      Quetiapine can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

      • If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
      • Check with your doctor immediately if you notice any unusual bleeding or bruising, black, tarry stools, blood in the urine or stools, or pinpoint red spots on your skin.
      • Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
      • Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
      • Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
      • Avoid contact sports or other situations where bruising or injury could occur.

      This medicine may cause tardive dyskinesia (a movement disorder). Check with your doctor right away if you have lip smacking or puckering, puffing of the cheeks, rapid or worm-like movements of the tongue, uncontrolled chewing movements, or uncontrolled movements of the arms and legs.

      Quetiapine may increase your cholesterol and fats in the blood. If this condition occurs, your doctor may give you medicine to lower the cholesterol and fats in the blood.

      This medicine may increase your weight. Your doctor may need to check your weight on a regular basis while you are using this medicine.

      You will need to have your blood pressure measured before starting this medicine and while you are using it. If you notice any changes to your recommended blood pressure, call your doctor right away. If you have questions about this, talk to your doctor.

      This medicine can cause changes in your heart rhythm, such as a condition called QT prolongation. It may change the way your heart beats and cause fainting or serious side effects. Contact your doctor right away if you have symptoms of heart rhythm problems, such as a fast, pounding, or uneven heartbeat.

      Quetiapine may make it more difficult for your body to cool down. It might reduce how much you sweat. Your body could get too hot if you do not sweat enough. If your body gets too hot, you might feel dizzy, weak, tired, or confused. You might vomit or have an upset stomach. Do not get too hot while you are exercising. Avoid places that are very hot. Call your doctor if you are too hot and can not cool down.

      Do not suddenly stop taking this medicine without checking first with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping it completely. This will decrease the chance of having withdrawal symptoms such as nausea, vomiting, insomnia, dizziness, irritability, or headache.

      Before you have any medical tests, tell the medical doctor in charge that you are taking this medicine. The results of some tests (eg, urine drug screens) may be affected by this medicine.

      Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St. John’s wort) or vitamin supplements.

      What Are Reasons I Shouldn’t Take Seroquel?

      Do not take Seroquel if you have an allergy to it or any part of its formulation. Also, do not give it to a child less than 10 years old.

      What Other Medications Interact With Seroquel?

      Some drugs interact with Seroquel. They may worsen the side effects of Seroquel, or Seroquel may worsen their side effects.

      When taken together, Seroquel may enhance the effects of antihypertensive medications. It can also antagonize the effects of levodopa and dopamine agonists. Your healthcare provider may adjust your dosage if you are taking potent CYP3A4 inducers or inhibitors.

      Avoid the following drugs while taking Seroquel:

      • Astepro (azelastine)
      • Dostinex (cabergoline)
      • Atrovent (Ipratropium)
      • Reglan (metoclopramide)
      • Symlin Pen (pramlintide)
      • Spiriva (tiotropium)
      • Incruse Ellipta (umeclidinium)
      • QT-prolonging agents (highest risk)

      What Medications Are Similar?

      Other drugs similar to Seroquel are:

      • Risperdal (risperidone)
      • Clozaril (clozapine)
      • Geodon (ziprasidone)
      • Latuda (lurasidone)

      Risperdal, Clozaril, Geodon, and Latuda treat schizophrenia, bipolar disorders, and depression symptoms. Risperdal and Seroquel have similar results and side effects.

      All antipsychotic drugs cause sleepiness. Clozaril and Seroquel are some of the most sedating ones. Clozaril works better but has more side effects than Seroquel.

      Geodon causes less weight gain, glucose abnormalities, and hyperlipidemia than Seroquel. Latuda also causes less weight gain but more Parkinson’s symptoms than Seroquel.

      This is NOT a list of drugs recommended to take with Seroquel. You should not take these drugs together. Ask your pharmacist or healthcare provider if you have any questions.

      Frequently Asked Questions

      What is Seroquel used for?
      Seroquel is used to treat bipolar conditions, schizophrenia, and depression.
      What should I do if I miss a dose of Seroquel?

      If you miss a dose of your drug, take it once you think of it. Skip that missed dose if it is too close to the next dose. Go back to your usual schedule.

      What are some side effects of Seroquel?

      • Weight gain
      • Dizziness
      • Constipation
      • Dry mouth
      • Back pain
      • Increased appetite
      • Upset stomach or vomiting
      • Sleepiness
      • Headache
      • Feeling nervous and excitable

      How long does it take for Seroquel to work?
      Seroquel starts working as early as four days up to 12 weeks.

      How Can I Stay Healthy While Taking Seroquel?

      There are a few things to remember while taking Seroquel:

      1. Always have your eyes and blood sugar checked as directed by your healthcare provider. Let your healthcare provider know if you have any signs of high blood sugar, such as excessive thirst or fruity breath.
      2. Stay hydrated with many non-caffeinated liquids, except if your healthcare provider tells you to drink less liquid.
      3. This drug can affect some lab results. Let your healthcare provider know that you are on Seroquel.
      4. Seroquel may affect your chances of getting pregnant. However, once stopped, your body can go back to normal. Let your healthcare provider know if you want to get pregnant while taking this medication.

      Your medicine can start working as early as four days up to 12 weeks. If you feel better, do not stop taking it. Suddenly stopping Seroquel can be very harmful. Talk to your healthcare team if you need to stop taking your medicine.

      Medical Disclaimer

      Verywell Health’s drug information is meant for education purposes only and not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare professional. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

      Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

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      2. Food and Drug Administration. Seroquel XR label.
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      4. Bobo W. Bipolar major depression in adults: efficacy and adverse effects of second-generation antipsychotics. UpToDate.
      5. Vázquez-Bourgon J, Pérez-Iglesias R, Ortiz-García de la Foz V, et al. Long-term metabolic effects of aripiprazole, ziprasidone and quetiapine: a pragmatic clinical trial in drug-naïve patients with a first-episode of non-affective psychosis. Psychopharmacology. 2018;235(1):245-255. doi:10.1007/s00213-017-4763-x
      6. Sato D, Uda K, Kumazawa R, Matsui H, Yasunaga H. Mortality and morbidity following postoperative use of short-term, low-dose quetiapine vs risperidone in patients with diabetes: analysis using a national inpatient database.Pharmacoepidemiol Drug Saf. 2020;29(12):1703-1709. doi:10.1002/pds.5164
      7. Kumar M, Chavan BS, Sidana A, Das S. Efficacy and tolerability of clozapine versus quetiapine in treatment-resistant schizophrenia.Indian Journal of Psychological Medicine. 2017;39(6):770-776. doi:10.4103/IJPSYM.IJPSYM_111_17
      8. Tiihonen J, Lönnqvist J, Wahlbeck K, et al. 11-year follow-up of mortality in patients with schizophrenia: a population-based cohort study (FIN11 study). Lancet. 2009;374(9690):620-627. doi:10.1016/S0140-6736(09)60742-X

      By Queen Buyalos, PharmD
      Queen Buyalos is a pharmacist and freelance medical writer. She takes pride in advocating for cancer prevention, overall health, and mental health education. Queen enjoys counseling and educating patients about drug therapy and translating complex ideas into simple language.

      See Also:  3 Best Types of Medication for Chronic Pain