Seroquel (Quetiapine) is an atypical antipsychotic drug that is used primarily for the treatment of schizophrenia and in some cases, bipolar disorder. It is also a relatively popular antidepressant augmentation strategy for individuals who don’t respond to monotherapeutic options. Off-label some doctors prescribe it at low doses for Tourette syndrome, insomnia and anxiety disorders, despite having no medical (FDA) approval for such conditions.
This drug is considered short-acting and acts as an antagonist on the neurotransmitters dopamine, serotonin, and norepinephrine. It also carries significant antihistamine properties like many other antipsychotics, which tends to result in sedation. In comparison to other antipsychotics, it has rapid-action on the D2 dopamine receptor, which in theory should minimize the likelihood of dangerous side effects and significant increases in prolactin.
When used to treat a disease like schizophrenia, it can be a very effective drug. Unfortunately, most people that take antipsychotics have a difficult time dealing with the side effects that they cause. If you are taking Seroquel, it is important to understand that potential side effects that you may experience and various factors that contribute to their prevalence.
Factors that influence Seroquel side effects
There are always factors that influence the occurrence and intensity of side effects that you may experience while taking Seroquel. These factors include things like: individual variation, dose of your medication, how long you’ve been taking it, and whether you take any other medications.
1. Individual Variation
It should be understood that your reaction to taking this drug will be completely unique to you. The side effects that you experience at your dose, may be completely different for someone else who’s taking the same dose. Since everyone has differences in genetics, the way your nervous system reacts to this drug may be completely different than that of another individual.
Some people may report significant sexual dysfunction and restlessness, while others may report vomiting and fatigue. There’s really no telling what specific side effects will be most problematic for you until you give the medication a shot. Certain individuals will tolerate this antipsychotic well, while others will find the side effects debilitating.
2. Dosage (25 mg to 400 mg)
What dosage of Seroquel have you been taking? In general, the greater the dose you take, the more likely you will be to experience side effects. At lower doses, the drug isn’t having as much of an influence over your nervous system functioning as it does at higher doses. Therefore lower doses are much less likely to cause significant side effects.
As the dosage increases, a person not only will build up more of a tolerance, but the drug will be more influential over their nervous system. At higher doses your body will have to accommodate for a greater amount of the drug, which will impair many natural processes within your body. To minimize side effects, it is always recommended to stay on as low of a dose as possible while still getting benefit from the drug.
3. Time Span
The amount of time that you’ve been taking Seroquel can also influence side effects. If you just started taking the drug, experiencing some side effects is actually expected. Most people experience a significant number of unwanted effects during the first couple weeks that they take the drug. This is because the nervous system hasn’t yet adjusted to the effects of the drug and accommodated for it in everyday functioning.
After a month or so, most preliminary side effects should subside and your body should be adjusted to the drug. You may notice some side effects that never go away even after the initial adjustment period – these effects can be expected to stay throughout treatment. Finally, as you stay on this drug for a longer time period, you may notice that side effects continue to worsen.
For some individuals, they end up increasing the dose because they’ve become tolerant to the effects of the drug over time. Increasing the dose is much more likely to also increase side effects. Additionally even if you don’t increase the dose over time, for some individuals the drug takes a toll on their nerves and unwanted side effects can intensify or emerge after months or years.
4. Other Drugs
Do you currently take any other medications with Seroquel? It is important to realize that many psychotropic medications and illicit drugs can interact and lead to increased side effects. Seroquel is known to interact with antidepressants, steroids, anxiolytics, and even some antifungal drugs. Your doctor should be aware of any contraindications (interactions) with other medications that you are currently taking.
If you are unsure about how a drug will interact with Seroquel or suspect an interaction problem, be sure to talk to your doctor. Some people notice that when a new drug is introduced (as in poly-drug treatment) that the new medication causes many unwanted side effects. Understand that this may be a result of an interaction that it is having with Seroquel.
Seroquel Side Effects: List of Possibilities
Below is a list of common side effects that have been reported while taking Seroquel. Realize that you may not experience every side effect on this list and that most side effects are subject to individual variation.
- Anxiety: At low doses, this medication is actually used to treat anxiety. However, in some people, this medication can make anxiety even more intense. Anxiety is a common side effect to experience while taking an antipsychotic because you never know how you’ll react to the neurotransmitter changes its making.
- Appetite changes: You may notice an increase or decrease in appetite when initially starting this drug. As you continue taking this drug for awhile, you’ll likely notice an increase in appetite. Increased appetite is commonly reported and is associated with weight gain on antipsychotics.
- Balance problems: This isn’t considered a serious side effect, but many people experience difficulties with balance and coordination. If you feel as if your equilibrium is thrown out of whack and you have a tough time maintaining balance, it is likely due to the drug.
- Blurred vision: If you start taking Seroquel and notice your vision has become blurred, you are not alone. Many people note visual changes as long as they continue taking the medication. It isn’t known what causes blurred vision, but some speculate that neurotransmitter changes as well as the drug affecting electrical activity in the retina.
- Chills: Some people report feeling chilled when they take this drug. The chills may be a sign of a bad reaction or that the drug is making you sick. This drug can cause temperature changes throughout the body. If you feel chills, keep in mind that it’s likely from the drug and should eventually subside.
- Confusion: Another side effect that certain people experience is that of confusion. You may experience disorientation, foggy thinking, memory issues, and feel unable to focus. This state of confusion is usually significant enough to impair cognition. If you feel as though the confusion is overwhelming, talk to your doctor about a solution.
- Constipation: Inability to pass a bowel movement is another effect people report. If you feel constipated after you’ve been taking this drug awhile, realize that it’s a common side effect and nothing you can really control.
- Depression: Despite the fact that this drug is used to help some people with depression, others find that it makes them even more depressed. Most psychotropic drugs have different effects depending on the person. For some individuals, this drug may make them increasingly depressed.
- Dizziness: Do you feel really dizzy now that you’ve been taking Seroquel? Feeling dizzy is usually a result of the brain adapting to changes being made by the drug. You may notice sensations of dizziness and vertigo while on this drug. Usually dizziness is more severe during Seroquel withdrawal than it is while taking it.
- Drowsiness: It is important to note that the potent antihistamine properties of this drug can lead to significant drowsiness. Therefore it is recommended to avoid operating any motor vehicles or heavy machinery while on this drug. If you are unable to function as a result of the drowsiness, consult your doctor.
- Dry mouth: This is a very common side effect that most people are able to tolerate. It can be uncomfortable to feel as though your mouth is unable to produce saliva, but most people notice that it improves over time. Unfortunately compared to many other antipsychotics, dry mouth is very common on Seroquel.
- Extrapyramidal effects: This particular drug is associated with lower rates of extrapyramidal side effects, but that doesn’t mean they don’t occur. If you experience akathisia (inability to sit still) from restlessness or akinesia (inability to move) you could be having extrapyramidal effects. These are usually caused by the drugs’ influence over the D2 dopamine receptors.
- Fatigue: While taking this drug you may notice that you feel more sluggish than usual. Feelings of fatigue and lethargy are commonly reported while on Seroquel. Talk to your doctor if you need to come up with a way to combat this side effect.
- Headaches: This is a common side effect that can be experienced when taking nearly any medication. If you notice an increase in headaches after you start taking the drug, chances are that it’s a side effect. Be sure you are staying hydrated and doing your best to avoid stress as this can help reduce headaches.
- High blood pressure: Antipsychotics are known to increase a person’s blood pressure over time. Be sure to closely monitor your blood pressure to make sure that it falls within a healthy range. If you notice that it increases to a significant extent, your doctor should make medical adjustments.
- Insomnia: Despite usually causing drowsiness and sleepiness, some people may have the opposite reaction. Depending on the dose and how long a person has been taking it, some people may experience insomnia as a side effect.
- Memory loss: You may notice that your memory becomes significantly impaired while taking this drug. You may have a tough time remembering recent events and/or retrieving long-term memories. Long term usage of this drug at high doses is associated with permanent unwanted cognitive deficits.
- Mood swings: Some people have noticed that their moods become erratic and prone to “swings” while on this drug. You may notice you feel good at times, then depressed other times, and experience an array of mixed emotions. This drug is supposed to help with mood swings, but can make things worse for others.
- Nausea: A common side effect to experience in the first few weeks of taking the drug is that of nausea. You may feel nauseated to the point that you are about to vomit. Realize that this nausea may be overwhelming, but should subside as you adapt to the drug.
- Poor concentration: Having poor concentration from this drug is a common side effect, yet one that isn’t considered a big deal to doctors. If you are unable to focus on schoolwork and/or job-related tasks, you may need to come up with a solution to combat this effect. Drugs that reduce dopamine activity make concentration very difficult.
- Restlessness: For certain people, this drug can make them feel restless and unable to sit still. If you exhibit restlessness as a side effect, it may be associated with akathisia. Those who become restless as a result of this antipsychotic may need to take another medication to offset this effect.
- Sexual dysfunction: Your sex drive may completely diminish while taking Seroquel. Side effects such as erectile dysfunction and inability to orgasm have been reported. If you experience reductions in libido, just know that this effect is likely a result of the drug.
- Sleepiness: This drug is commonly used as a sleep aid due to the fact that it tends to make people sleepy. If you notice an increase in sleepiness, it is likely a result of the drug acting as an antihistamine. If the sleepiness becomes excessive, you may need to evaluate whether it is tolerable.
- Sweating: You may notice an increase in sweating throughout the day or night sweats while sleeping. The sweating may be minor or profuse and usually doesn’t improve over time. If you notice an increase in sweating, it will likely be a side effect you’ll need to put up with.
- Suicidal thoughts: Even though this medication is supposed to help with depression and suicidal thinking, some people experience a worsening of suicidal thinking. If you become agitated, anxious, and more depressed, then suicidal thoughts may occur. Be sure to talk to your doctor if you notice an increase in suicidal thoughts.
- Vomiting: Some people can feel sick as a result of taking Seroquel. The medication may prompt nausea, which can become extreme enough to lead a person to vomit. If you start vomiting, it could be a temporary side effect that lasts a few days. Always report this to your doctor, but realize that it may eventually stop as your body adapts to the drug.
- Weakness: Many people report feeling weakness and/or pain throughout their bodies. These drugs are very sedating and can reduce bone density, thus decreasing our physical strength. This may lead us to feel pain throughout the body and noticeably weak.
- Weight gain: Most people pack on serious weight when taking antipsychotics. Gaining weight can be depressing and is a reason why many people discontinue their antipsychotic treatment. The weight gain is a result of lethargy, slowed metabolism, and increased appetite while taking the drug.
Seroquel Severe Side Effects / Adverse Reactions
It is important to realize that many people also have adverse reactions or more “severe” side effects while taking this drug. If you notice any of the following side effects, be sure to report them to your doctor immediately.
- Breast enlargement: Even though Seroquel isn’t associated with as much prolactin release as other antipsychotics, it can still elevate prolactin levels. When elevated enough, the increase in prolactin will enlarge breasts in both males and females. In males, this side effect is known as “gynecomastia” and should be reported immediately.
- Cataracts: Taking an antipsychotic medication has been thought to increase risk of developing cataracts. If you notice changes in your vision, be sure to talk to your doctor. Makers of this drug recommend getting an eye examination every 6 months.
- Death risk: Taking this drug is associated with an overall increased risk of death. The increase risk is not a result of one particular cause, rather a culmination of possible adverse reactions and overdose while taking an antipsychotic. The increase in death risk is significant among elderly patients with dementia.
- Diabetes: An unfortunate side effect of taking antipsychotic medications is that they alter functioning in the body, and can lead to permanent development of Type 2 diabetes. Although this isn’t a common side effect, it has been reported by a considerable number of people.
- Heart rate changes: You may notice heart palpitations or sensations that your heart is beating abnormally or loudly in your chest. However, you may also notice that your heart rate becomes irregular or subject to change. This is a known side effect of antipsychotics that should be closely monitored by your doctor.
- High cholesterol: Your cholesterol and triglycerides may increase to a significant extent while on Seroquel. A medical professional should be able to tell you whether your cholesterol and triglyceride levels are safe. If you notice sudden increases, it’s pretty safe to assume that it’s from the medication.
- Low white blood cell count: It is important to monitor your blood cell counts while taking Seroquel. This drug has been found to lower white blood cells in some people. Most doctors will recommend routine blood samples be taken to make sure the drug isn’t causing this effect.
- Neuroleptic Malignant Syndrome: This is a rare reaction that usually results from taking this drug at high doses for extended periods of time. Signs typically include: rigid posture, fever, severe confusion, and an abnormally fast heart rate. If you notice signs of this potential side effect, seek immediate medical attention.
- Seizures: An adverse reaction that some people report is that of seizures. Having a seizure on this drug isn’t very common, but if you experience one, be sure to report it to your doctor.
- Tardive Dyskinesia: This is an irreversible condition that occurs when a person takes an antipsychotic medication for an extended period (usually at a high dose). The reduction in dopamine tends to cause a person to experience uncontrollable movements, particularly in the face (e.g. lips and tongue). Fortunately this is less common in newer, atypical antipsychotics compared to older “typical” ones.
Seroquel: Weighing the Side Effects (Cons) vs. Benefits (Pros)
It can be difficult to decide whether the side effects of Seroquel are worth any perceived benefits that you are getting from the drug. If this is the first antipsychotic medication you’ve tried and you are experiencing a lot of unwanted side effects, it may not be a good fit. On the other hand, if you’ve tried many antipsychotics and this is the only drug that is providing you with symptom relief, you may be more willing to put up with a few unwanted side effects.
Most professionals consider Seroquel to be among the most sedating atypical antipsychotics on the market. It can work well if you are experiencing a lot of agitation and inability to sleep as the antihistamine effects promote drowsiness. It may work great to manage positive symptoms of schizophrenia such as hallucinations and delusions, but may make you so tired that you can’t focus or function on any cognitively demanding tasks.
It is always recommended to work closely with your doctor to come up with possible solutions to mitigate any side effects caused by the medication. Most people will experience some side effects while taking this medication. It will be up to you to determine whether the drug is providing you with enough benefit to justify the unwanted side effects.