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How Long Does Seroquel Stay In Your System After Stopping?

Seroquel (Quetiapine) is a medication that was developed by AstraZeneca from 1992 through 1996.  It received FDA approval in 1997 for the treatment of schizophrenia, and has since received approval to treat both acute mania and depressive phases of bipolar disorder.  The drug is classified as an atypical, second-generation antipsychotic and exerts pharmacological effects via an array of targets including: D2, 5-HT2A, H1, Alpha-1, and 5-HT1A receptors.

In short, the drug affects the neurotransmission of dopamine, serotonin, histamine, and norepinephrine.  It specifically combats psychotic symptoms via minimization of dopaminergic transmission in the mesolimbic pathway of the brain (ventral tegmental area to nucleus accumbens).  Additionally, it is sometimes utilized as an antidepressant adjunct and in rare cases as an off-label treatment for insomnia (usually at low doses).

Though an effective medication for many conditions, some individuals experience adverse reactions and/or deleterious long-term effects.  Examples of such problematic effects may include: dizziness, dry mouth, fatigue, headaches, high blood pressure, sleepiness, and weight gain from Seroquel.  As a result, many individuals have ceased taking Seroquel, but upon quitting, wonder how long it takes before the drug is fully out of their system.

How long does Seroquel stay in your system after stopping?

If you’ve completely stopped taking this drug, you’re likely to experience a multitude of Seroquel withdrawal symptoms; some of which may be debilitating.  As you navigate your way through these discontinuation symptoms, you may be wondering how long before the active ingredient “quetiapine” is cleared from your system.  Most sources suggest that the immediate-release and extended release (XR) version of quetiapine have an elimination half-life of approximately 7 hours.

This indicates that it takes an average of 7 hours post-ingestion for 50% of the quetiapine dosage to get eliminated from systemic circulation.  Based off of this information, it is possible to predict that Seroquel stays in your system for around 1.6 days after your last dose.  In other words, it will likely take over 24 hours, but less than 48 hours for your system to have fully cleared itself of the drug.

Unlike many other substances that form metabolites with half-lives exceeding that of the parent chemical, metabolites of quetiapine are thought exhibit half-lives approximately equal to or lesser than quetiapine itself.  As a result, most people should expect to have cleared Seroquel from their system within 2 days of discontinuation.  That said, the approximation of 1.6 days is an “average” – some people may clear the drug quicker or slower than this average.

  • Source: http://www.ncbi.nlm.nih.gov/pubmed/11510628/
  • Source: https://pubchem.ncbi.nlm.nih.gov/compound/quetiapine

Variables that influence how long Seroquel stays in your system

There are an array of variables to consider when contemplating the specifics of how long Seroquel is likely to remain in your system following discontinuation.  These variables include things like: individual factors, the dosage you were taking, term (and frequency) of administration, as well as whether you’re taking other drugs along with it.  Certain variables tend to promote faster systemic clearance, while others may prolong the process.

  1. Individual factors

Two people could start taking Seroquel XR at precisely the same time at matching doses, and discontinue simultaneously, yet one individual may clear the drug considerably faster from his/her system than the other.  This expedited clearance speed is often a result of individual factors such as the person’s age, body mass, genetics, liver/kidney health, etc.

Age: In many cases, elderly individuals are unable to excrete Seroquel as quickly as adults and adolescents.  Elderly (or those over the age of 65) often exhibit reduced hepatic blood flow and are more likely to be taking medications for other health conditions – both of which interfere with the metabolism of Seroquel.  Poorer metabolic breakdown of the drug can lead to increased accumulation and an extended half-life.

Adolescents and younger adults tend to exhibit normative hepatic blood flow and are less likely to have other health problems requiring additional medications.  As a result, they are able to clear Seroquel from systemic circulation approximately 40% more efficiently than elderly.  An elderly individual taking a low dose may clear it with the similar efficiency as a young adult on a significantly greater dose.

  • Source: http://www.accessdata.fda.gov/drugsatfda_docs/label/2004/20639se1-017,016_seroquel_lbl.pdf

Body mass: The size of your body relative to the dosage of Seroquel you take could slightly affect how long it stays in your system.  Particularly, the greater your size (height/weight) relative to the dosage of Seroquel you’re taking, the quicker you’re likely to clear it from your system.  On the other hand, the smaller you’re overall size relative to dosage, the longer it will likely take to excrete.

In addition to your size, it is necessary to consider your percentage of body fat.  Seroquel is considered highly lipophilic in that it binds to fat stores throughout the body.  If you have a high body fat percentage, more of the drug will stay stored in your fat prior to elimination.  Individuals with a lower percentage of body fat are unlikely to store as much Seroquel in their bodies, resulting in faster total excretion.

  • Source: http://www.ncbi.nlm.nih.gov/pubmed/23768031

Genetics: Certain genetic variants can facilitate differences in hepatic enzyme expression.  Since Seroquel is subject to hepatic metabolism, principally by CYP3A4 isoenzymes, genes that influence CYP3A4 expression may affect how long it stays in your system.  Those with optimal CYP3A4 activation (as a result of genes) are thought to metabolize Seroquel rapidly, leading to faster excretion.

Individuals with poorer CYP3A4 activation due to genetic variants may metabolize Seroquel poorly.  Poor metabolism of Seroquel could extend its half-life and substantially slow its clearance speed.  That said, reduced CYP3A4 activity isn’t as often related to genetics as it is to whether someone took a drug that inhibited CYP3A4.

Food intake / Hydration: It is known that absorption of Seroquel is affected significantly by food intake.  Specifically, if you eat a high-fat meal along with Seroquel, the maximum serum concentrations increase by an average of 8%.  On the other hand, taking Seroquel on an empty stomach or with a non-“high fat” meal may result in faster absorption and quicker systemic clearance.

Additionally, whether you stay hydrated after taking Seroquel could affect its elimination speed.  Hydration is known to improve urinary flow rate, which in turn is known to affect how quickly the drug is excreted.  Someone who stays hydrated should theoretically excrete more of the drug at a faster pace than someone who’s dehydrated.

Hepatic impairment: There is evidence to suggest that hepatic impairment slows clearance of Seroquel by approximately 30% compared to those with normative hepatic function.  In other words, individuals with liver problems tend to retain greater levels of the drug for a longer period of time compared to healthy people.  If you’ve had any problems with your liver function, realize that you may not metabolize the drug as quickly (especially at high doses), leading to greater accumulation and half-life.

It is thought that half-life could be extended by several hours among those with impaired hepatic function.  Furthermore, there is subtle evidence to suggest that renal insufficiency may have a slight effect on systemic clearance of Seroquel.  One report documented that renal insufficiency can lead to a 25% reduction in Seroquel clearance compared to those with normative renal function.

  • Source: http://www.ncbi.nlm.nih.gov/pubmed/12562141/
  • Source: http://www.ncbi.nlm.nih.gov/pubmed/20361059
  • Source: http://www.accessdata.fda.gov/drugsatfda_docs/label/2004/20639se1-017,016_seroquel_lbl.pdf

Metabolic rate: Your basal metabolic rate (BMR) indicates how much energy your body is burning at rest.  Individuals with high BMRs not only tend to burn more energy at rest, but also metabolize and excrete drugs quicker than those with low BMRs.  If you have a high BMR, your body may clear Seroquel from systemic circulation sooner than an individual with a low BMR.

The precise degree to which BMR affects clearance of quetiapine isn’t fully elucidated.  That said, BMR usually has an influence on a person’s body fat percentage.  Individuals with high BMRs are likely to have less overall body fat and possibly less Seroquel accumulation in fat stores.

Urinary pH: A person’s urinary pH can have an impact on how quickly drugs are excreted from their body.  If you have a high urinary pH, it indicates that your urine is “alkaline,” whereas a low urinary pH is indicative of acidity. Alkaline urine is thought to prolong excretion of various drugs like Seroquel because it promotes reabsorption in the kidneys, whereas acidic urine inhibits reabsorption and enhances clearance.

  1. Dosage (150 mg to 800 mg)

Medical documentation suggests that daily dosages of Seroquel can range from 150 mg to 800 mg, depending on the patient as well as the condition being treated.  In general, the higher the dose a person is taking (especially relative to body size), the longer it will stay in their system.  When a person ingests a high dose, there’s a greater level of the Seroquel circulating throughout his/her system – along with its metabolites.

As a result, greater dosages tend to facilitate increased accumulation of the drug within fat stores throughout the body.  Furthermore, those taking high dosages often have been on Seroquel for a longer duration than low dose users.  Longer-term among high dose users means the drug is likely to have accumulated to a greater extent within the body than those taking lower doses (over shorter-terms).

Individuals taking a low dose (or the minimal effective dose) are thought to excrete the drug more quickly than high dose users.  This is due to the fact that the liver and kidneys don’t need to work as hard because there’s less of the drug (quetiapine) to metabolize and excrete.  As a result, the body is able to more efficiently clear lower doses of quetiapine (and its metabolites) compared to higher doses.

  1. Term of Administration

Typically the longer someone has stayed on Seroquel, the more likely they are to have reached peak concentrations of the drug throughout their bloodstream and bodily tissues.  Since it only takes 2 days for an individual to reach “steady state” concentrations, individuals taking the drug for 2+ days will likely retain the drug for a greater duration than those taking the drug for less than 2 days.  Some speculate that long-term daily administration may result in greater accumulation of quetiapine (and metabolites) in bodily tissues than those taking it for a short-term.

In part, the drug may take longer to clear among long-term users because they’ve likely increased their dosage.  Over time, individuals taking Seroquel (and other psychiatric medications) may build tolerance to the effects of the drug.  This leads to an increase (potentially doubling) of the dosage to maintain efficacy.

Following each dosage increase among long-term users, a greater amount of the drug circulates throughout the body with each dose.  For this reason, it may take the body of a long-term user substantially longer to rid itself of accumulated quetiapine (and metabolites) following cessation – compared to a short-term user.  A short-term user, or someone taking the drug “as needed” at low doses for a condition like insomnia, is subject to less total accumulation and should excrete quetiapine at a faster pace.

  1. Co-Ingestion of Drugs

Taking another drug (or supplement) along with Seroquel has the potential to influence its clearance speed.  Certain drugs are thought to expedite the metabolism and clearance of Seroquel, whereas others are known to inhibit the process.  Since Seroquel is metabolized chiefly by CYP3A4 isoenzymes, taking drugs that affect the function of CYP3A4 will affect how long Seroquel stays in your system.

Drugs known as CYP3A4 inducers are thought to enhance or ramp-up expression of CYP3A4 isoenzymes.  Should you have ingested a CYP3A4 inducer, you’ll likely metabolize Seroquel quicker than usual, leading to faster systemic clearance and possibly minimized peak plasma concentrations.  Examples of some common CYP3A4 inducers include: Butalbital, Carbamazepine, Efavirenz, Modafinil, Oxcarbazepine, Phenobarbital, Phenytoin, Rifampicin, and St. John’s wort.

Substances documented as CYP3A4 inhibitors are known to interfere with the functionality of CYP3A4 isoenzymes.  This means that it takes longer for the liver to metabolize Seroquel, resulting in an increased elimination half-life.  Some potent CYP3A4 inhibitors include: Clarithromycin, Cobicistat, Indinavir, Ketoconazole, Nelfinavir, Ritonavir, and Saquinavir.

  • Source: http://www.ncbi.nlm.nih.gov/pubmed/22688609

Seroquel (Quetiapine): Absorption, Metabolism, Excretion (Details)

Following oral administration of Seroquel, its pharmacologically active ingredient “quetiapine” is efficiently absorbed by the gastrointestinal (GI) tract.  Approximately 83% of the dosage binds to plasma proteins, and peak plasma concentrations are attained approximately 1.5 hours post-ingestion if administered in its “immediate-release” format.  If administered in an “extended-release” (XR) format, peak blood levels are attained approximately 6 hours post-ingestion.

Thereafter, the drug is distributed throughout the body at an estimated 10 L/kg (liters per kilogram).  Quetiapine undergoes significant hepatic metabolism and is converted to metabolites via sulfoxidation and oxidation.  Specifically, the human cytochrome P450 enzyme “CYP3A4” facilitates sulfoxidation to form the major (but inactive) metabolite “quetiapine sulfoxide.”

It also is subject to hydroxylation, of the dibenzothiazepine ring, O-deakylation, N-dealkylation, and conjugation. Upon ingestion of a quetiapine dose within the range of 200-950 mg, concentrations of quetiapine sulfoxide are ~3,379 mcg/L within the plasma.  By comparison, plasma levels of quetiapine are 83 mcg/L.

Other metabolite levels include: 127 mcg/L of N-desalkylquetiapine, 12 mcg/L of O-desalkylquetiapine, and 3 mcg/L of 7-hydroxyquetiapine.  As a result of its 6 to 7 hour half-life, the drug and its metabolites are eliminated from systemic circulation between 33 and 38.5 hours post-ingestion.  Nearly 73% of a quetiapine dose is excreted via urine, whereas 20% is eliminated through feces.

  • Source: https://pubchem.ncbi.nlm.nih.gov/compound/quetiapine
  • Source: http://www.ncbi.nlm.nih.gov/pubmed/12562141/

Tips to clear Seroquel from your system

If you stopped taking Seroquel and want to ensure that the quetiapine and its metabolites are eliminated from your body as quickly as possible, there may be some tricks that could enhance excretion speed.  Prior to implementing or considering any of the tips below, always verify safety and efficacy with a medical professional.  Realize that certain tips may prove more efficacious for some people than others.

  1. Completely discontinue: The most obvious tip here is to fully stop taking Seroquel if you want it cleared from your system. Usually it is best to conduct a “taper” (or gradual dosage reduction) with the aid of a medical professional. The longer it’s been since you took your final dose of the drug, the more likely you are to be completely detoxified.
  2. CYP3A4 induction: Various drugs and supplements are known to induce activity of CYP3A4 enzymes in the liver. Though quetiapine is extensively metabolized, its metabolism may be enhanced with administration of a substance that induces CYP3A4 activity. Taking a CYP3A4 inhibitor will likely ensure that the drug is extensively metabolized and efficiently excreted.
  3. Exercise daily: It is understood that Seroquel is lipophilic, meaning it is “fat soluble.” Long-term users may have accumulated the drug to a greater extent within bodily tissues and fat stores. Getting daily exercise, particularly cardio, can help you burn fat, increase blood flow, and maximize the efficiency of quetiapine clearance.
  4. Acidify urinary pH: If you have a highly alkaline urinary pH, there’s a chance that you’ll be retaining quetiapine (and its metabolites) for much longer than necessary. Individuals with alkaline urine may substantially decrease systemic excretion time via acidification of urine. Eating more acidic foods (to acidify urine) may enhance renal excretion, whereas alkaline foods may compromise it.
  5. Stay hydrated: If you’re attempting to detoxify your system from quetiapine, it may be helpful to stay hydrated. This means drink plenty of water to maximize your urinary flow rate. Increasing urinary flow rate by ramping up water intake has been shown to facilitate quicker clearance of drugs.  However, don’t go overboard with the water consumption as this could be toxic.

How long has Seroquel stayed in your system after stopping?

If you’ve recently stopped taking Seroquel, share a comment regarding how long you think it stayed in your system after stopping?  Do you believe that you cleared the drug more quickly than usual from your system or retained the drug for a longer period after your final dose?  To help others get a better understanding of your situation, share information such as: your age, dosage you were taking, and whether you were taking any CYP3A4 inhibitors (or inducers).

Realize that for most users, the drug will be completely cleared from systemic circulation within 48 hours.  In other words, quetiapine won’t be lingering in your bloodstream or eliciting pharmacological effects 2+ days after you stop taking it.

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{ 1 comment… add one }
  • Charles ( UK ) July 30, 2016, 11:20 am

    I’m 63 and started taking quetiapine some three years ago, I was also taking 30/500 co-codamol after two big operations on my left knee. They were a bad combination leading to heart problems. The dose was initially 25mg and rose over the year to 200mg which I rarely if ever took. In May 2016 I did a detox, on my own and at home for four weeks and came of the painkillers, I then decided it was time to get rid of the psychiatric medicine too, for me life had moved on and the time of crisis was over.

    I consulted with my doctor and the psychiatrist I’d seen on occasion and they supported me fully in my efforts, it meant a good deal to me. At this time… June 2016 I was taking 100mg of quetiapine in an evening, it was helping me to sleep when I first went up to that dose but had done little for me in the last year.

    -24 June 2016 I dropped to 75mg per night
    -4th July 2016 I dropped to 50mg per night
    -12th July 2016 I dropped to 25mg per night
    -24th July 2016 I dropped to ZERO

    For a few nights I was warm, slightly aching and had the occasional leg cramp at night, nothing more and sleep well, I go to bed at 11.00pm and sleep until 5.00am. Today is 30th July 2016 and I feel pretty good, eating like a horse, mostly brown rice and veggies, I exercise daily, I sleep well, I juice carrots, apples and celery every morning, I read every day and meditate too, I also play way more guitar than I have for three years.

    If this is the worst then for me it’s nothing, compared to codeine withdrawal this is a doddle. I do expect the brain to take a while to re-balance things… I think the body’s ability to heal itself is undervalued by reductionist medicine. What might help me is that I have nothing that might conflict with the withdrawal process, I have never smoked, never been a drinker and stopped over five years ago.

    I’ve never done recreational drugs. Not everybody might be so fortunate? I wish everybody well that is thinking of dong the same. May all sentient beings be happy and free from suffering :-)

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