Medication Guide
Quetiapine (Seroquel, Seroquel XR) Side Effects and Uses
A plain-language guide to Quetiapine, an atypical antipsychotic. Learn how it helps, what it treats, how to take it and which side effects to know about.
Quick answer. Quetiapine (Seroquel) is an atypical antipsychotic. Common quetiapine side effects include drowsiness, dry mouth, dizziness when standing and weight gain and bigger appetite. The rare but serious ones, and when to get help, are listed under quetiapine side effects below. Never stop or change your dose on your own.
How Quetiapine Can Help You
Quetiapine works on dopamine and serotonin in the brain. This can ease mania, low mood, voices and mixed-up thinking. It is one of the few drugs approved for both the high and low phases of bipolar disorder. The slow-release form is Seroquel XR. It can also be added on for major depression.
Its calming effect can help with agitation, racing thoughts or poor sleep. Sleep often gets better from the first few doses. Mood and thinking usually improve over one to four weeks. More gains can come after that. Your prescriber looks for a balance that helps while keeping daytime drowsiness in check.
Uses for Quetiapine
- Schizophrenia
- Bipolar I mania
- Bipolar depression
- Bipolar maintenance, with lithium or divalproex
- Add-on care for major depression (XR form)
- Generalized anxiety disorder (off-label)
How to Take Quetiapine
Quetiapine comes as a regular tablet and a slow-release (XR) tablet. Your prescriber decides the form and the dose. They usually start low and raise it slowly. The regular tablet can be taken with or without food. The XR tablet is often taken in the evening. Swallow it whole and do not crush, split or chew it.
Quetiapine can make you drowsy. It can also cause a drop in blood pressure when you stand. Get up slowly until you know how it affects you. Do not drive until you know how alert you feel. Your prescriber will check weight, blood sugar and cholesterol from time to time. If you miss a dose, skip it if the next one is close. Never double up.
Do not stop quetiapine all at once. Stopping fast can cause poor sleep and nausea. Symptoms can also come back. Any change should be a slow taper planned with your prescriber.
Quetiapine Side Effects
Common Side Effects
- Drowsiness
- Dry mouth
- Dizziness when standing
- Weight gain and bigger appetite
- Constipation
- Headache
- Blurred vision
- Feeling foggy at first
Serious: Get Medical Help Promptly
- Death risk in older adults with dementia and psychosis (boxed warning)
- Suicidal thoughts in young people (boxed warning)
- Tardive dyskinesia (movements you cannot control, which may last)
- Neuroleptic malignant syndrome (high fever, stiff muscles, confusion)
- High blood sugar or new diabetes
- Big changes in cholesterol
- Very low blood pressure or fainting
How Quetiapine Works
Quetiapine blocks dopamine D2 and serotonin 5-HT2A receptors. Calming dopamine in some brain pathways eases voices, false beliefs and mania. The serotonin effect is thought to lower the chance of movement side effects. Older drugs of this kind cause more of them.
Quetiapine also blocks histamine receptors. That is why it can make you sleepy. It blocks some adrenaline receptors too. That can cause dizziness when you stand up. A breakdown product of quetiapine is thought to help its effect on low mood. Together, these actions explain its benefits and side effects.
Before You Start Quetiapine
Tell your prescriber about diabetes or heart disease. Also share low blood pressure, seizures, thyroid problems and cataracts. Say if you ever had a low white blood cell count. Share every medicine and supplement you take. Some raise or lower quetiapine levels.
Quetiapine has two boxed warnings. One is a higher risk of death in older adults with dementia and psychosis. The other is a risk of suicidal thoughts in young people who take it for depression. If you are thinking about harming yourself, call or text 988, or call 911.
Alcohol adds to drowsiness, so it is best avoided. Quetiapine can make it harder to cool down. So drink enough fluids in hot weather. If you are pregnant or planning a pregnancy, talk it through with your prescriber. Our medication management visits happen by secure telehealth video from anywhere in California.
Is Quetiapine Right for You?
Only a full evaluation with a prescriber can tell you if Quetiapine fits your symptoms, history and goals. Harpal Singh, PMHNP-BC offers psychiatric evaluations and ongoing medication management by telehealth anywhere in California.
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Related Medication Guides
Other guides in the same group, written the same simple way. Being in one group does not mean you can swap one medicine for another.
- Aripiprazole (Abilify), atypical antipsychotic
- Brexpiprazole (Rexulti), atypical antipsychotic
- Cariprazine (Vraylar), atypical antipsychotic
- Clozapine (Clozaril), atypical antipsychotic
- Haloperidol (Haldol), typical (first-generation) antipsychotic
- Lurasidone (Latuda), atypical antipsychotic
FAQ
Questions About Quetiapine
Why do I feel so sleepy on quetiapine?
Sleepiness is the most common side effect of quetiapine, especially when you first start. Taking it in the evening helps, and daytime grogginess often improves within a couple of weeks. If sleepiness keeps getting in the way, your prescriber can change the dose or timing.
Is quetiapine addictive?
Quetiapine is not a controlled substance. Stopping it suddenly can still cause trouble sleeping, nausea and other withdrawal-like symptoms. Always taper slowly with your prescriber's guidance.
Will quetiapine cause weight gain?
Weight gain and a bigger appetite are common with quetiapine, more than with some other antipsychotics. Your prescriber will track your weight, blood sugar and cholesterol. Paying early attention to meals and activity makes a real difference.
What is the difference between Seroquel and Seroquel XR?
The regular form works quickly, which is part of why it can feel sedating. The XR form releases slowly through the day, is often taken in the evening and must be swallowed whole. Your prescriber will choose the form that fits your needs.
Can quetiapine be used just for sleep?
Quetiapine is not approved for insomnia. Most guidelines advise against it for everyday sleep problems. The reason is its effect on weight, blood sugar and cholesterol. When it treats a mood or psychotic condition, better sleep is often a welcome extra benefit.
How long does quetiapine take to work?
Sleep often improves in the first few days. Mood, racing thoughts and psychotic symptoms usually improve over one to four weeks, with more gains after that. Keep taking it as prescribed and tell your prescriber how you are doing.
Can I drink alcohol while taking quetiapine?
It is best to avoid alcohol. Alcohol adds to the drowsiness and dizziness quetiapine can cause and can make mood symptoms worse. Talk with your prescriber about what is safe for you.
Can I stop quetiapine once I feel better?
Feeling better usually means the medicine is working. Stopping on your own can bring back symptoms and cause rebound trouble sleeping. If stopping makes sense, your prescriber will plan a slow taper with you.