Seroquel (Quetiapine) is a popular atypical antipsychotic medication that has been approved by the FDA to treat schizophrenia, bipolar disorder, and as an antidepressant augmentation strategy in cases of refractory depression. Due to the variety of conditions for which this drug is prescribed, it is considered highly profitable and has made AstraZeneca (the developers) billions of dollars since it hit the market.

In addition to being used for serious psychiatric disorders, some medical professionals prescribe it for the treatment of insomnia and various forms of anxiety disorders. Although the drug is not approved for these conditions, it is more effective than traditional medications for some individuals. Despite the variety of conditions that Seroquel is capable of treating, many people have a difficult time staying on the drug as a result of side effects, in particular, weight gain.

Seroquel and Weight Gain

When taking Seroquel, most people are faced with unavoidable weight gain. No matter how well the drug is working, a drawback that the majority of users face is that they gain weight. For certain people, a lot of weight will be gained, while for others, they may not gain enough to notice. Scientific studies have reported that the average weight gain throughout treatment with Seroquel is considered “moderate.”

How Seroquel Causes Weight Gain

Below is a list of ways by which Seroquel is capable of causing weight gain. Keep in mind that everyone will have a different experience on the drug as a result of individualized factors. That said, many people notice appetite increases, cravings for specific foods (i.e. carbs), and a slower than average metabolism.

  • Appetite surge: If you started taking Seroquel, one thing that you’ll likely notice is that your appetite increases – sometimes to an extreme. Those who had trouble eating food prior to taking the drug should no longer have any problem eating enough. For some individuals their appetite increases so much that they wake up in the middle of the night “starving” and raid the fridge for all the snacks they can find.
  • Cravings: Many atypical antipsychotics are associated with cravings of foods. A majority of people notice that they start to crave carbohydrates and/or other unhealthy foods like sugars and sweets. If you notice that you are eating more sugar-laden candies and having “treats” more frequently, it’s likely a reaction to the Seroquel. Some people have reported craving “fast food” and thus end up eating out more often.
  • Fat storage: It is believed that the mechanism by which the body processes food and stores fat becomes altered for those taking an atypical antipsychotic. Seroquel makes it easy for people to pack on weight because it has changed the way the body stores fat. You may notice that you’re packing on fat in specific places throughout your body that were previously skinny; this is a result of the drug.
  • Hormonal changes: The drug is believed to alter the production of hormone levels throughout the body. Altering hormone levels can significantly impact the amount of weight that you pack on as a result of the drug. It notably interferes with production of thyroid-stimulating hormone and lowers the levels of (T4) thyroxine and (T3) triiodothyronine throughout the bloodstream. It is also capable of altering glucose levels and manipulating enzymes in the liver and heart.
  • Interaction effects: Those that take Seroquel with other drugs should note that the drugs could be interacting to increase weight gain. In some cases, psychiatric drugs work synergistically in that they amplify weight gain together more than they would if you were to take the drugs separately.
  • Motivational deficits: For some people, Seroquel can decrease motivation and lead to sleepiness or grogginess. The swamped motivation may lead you to get less physical activity to keep your metabolism high. Anytime you’re lacking motivation as a result of this medication, the chance that you’ll gain weight increases.  Some attribute the motivational decline as a result of this drug’s effect on dopamine.
  • Side effects: You may feel fatigued and experience a variety of synonymous side effects such as: lethargy, drowsiness, etc. while taking the drug. Anyone experiencing increased tiredness as a result of the drug is less likely to get proper physical activity and exercise. Unfortunately these side effects can be too debilitating to overcome, and lead to inevitable weight gain.
  • Slows metabolism: Even if you maintained the same diet and exercise patterns pre-drug that you did while taking Seroquel, you’d probably still gain some weight. This is due to the fact that the drug slows your metabolism. The degree to which it slows is subject to individual variation, but explains why most people end up gaining weight.
  • Social eating: If you are taking this drug and your symptoms improve, you may be more likely to hang out with friends. This typically leads to “social eating” or more frequent dining out with friends. Dining out is a quick way for anyone (even non-medicated) to gain weight. Someone taking Seroquel will have no problem packing on pounds if they frequently eat out.
  • Taste improvement: For certain people, their taste seems to dramatically improve after taking the drug. Some people believe that the taste improvement is closely linked to the “cravings” they experience. In any regard, if food is tasting better than before, you’re probably going to eat more of it.

Note: Although you may be attempting to pinpoint one specific cause of your weight gain, it is important to realize that it may be a combination of factors. You may have a slower metabolism along with side effects that make you tired, and hormonal changes that lead to greater fat storage.

Factors that influence weight gain on Seroquel

There are several other factors that will influence the amount of weight you gain on Seroquel. Understand that these are individualized factors and cannot be generalized. They may explain why you gain significantly more weight than someone else (or vice versa).

1. Individual factors

The most important factor to consider is you as an individual. The way your genetics respond to the medication play a big role in determining how much weight you gain. Someone with drastically different genetics may experience more or less weight gain simply based on that factor. If you are interested in knowing how your genetics may be influencing your response to the drug, read about “GeneSight testing.”

Other individualized factors that need to be taken into account include: sleep quality, BMI, dietary intake, physical activity, and stress level. If you are getting poor sleep, are highly stressed, and make poor dietary choices, you’re probably going to gain more weight than someone who is getting quality sleep and making healthy dietary selections.

2. Time span

It would appear as though there is a relationship between duration taking Seroquel and weight gain. Although many people gain weight within the first 12-weeks of treatment, longer-duration administration can increase the amount of weight a person gains. In the case of most medications, including atypical antipsychotics, the weight gain tends to increase over time.

Despite the fact that Seroquel doesn’t produce a significant increase in weight after 12-weeks, most studies do show modest weight gain with additional time of treatment. Therefore the longer you’ve taken this medication, the more likely you are to gain additional weight. Fortunately for people taking it over a long-term, the amount of weight that is gained isn’t exponential and appears to increase at a slower rate once the body has adapted to treatment.

3. Other medications

If you are taking other medications, it is important to consider their role in potential weight gain. For example, some antidepressants are known to increase weight at similar rates to Seroquel. If you are taking both Seroquel and an antidepressant medication, you may need to understand that they both could be causing you to gain weight. They may also be having some interaction effect that leads to more weight gain than you’d experience if you were to take a different medication.

If you’re ever concerned about other medication(s) that you’re taking causing you to gain weight, be sure to get in touch with your doctor and ask. Most psychiatric drugs are known to increase weight to some degree. If the weight gain is a big deal, a doctor may be able to substitute other medications that may be less likely to increase your weight.

4. Dosage

According to studies, increasing the dosage of Seroquel is unlikely to facilitate additional weight gain. Some medications have a dose-weight relationship in that increasing the dose will also increase the amount of weight you’ll gain while taking it. Although medical professionals dismiss the likelihood that dosage plays a role, it is important to consider that it might for certain people.

When we increase the dosage of this drug, we are essentially giving it more control over the brain and nervous system. Thus in theory, it should amplify all of the changes that it has already made. If you are gaining weight at a lower dose, you should theoretically gain roughly double if you double the dose.

Just because there doesn’t appear to be further weight gain associated with increasing the dosage, doesn’t mean that this is true for all patients. However, many double-blind studies are consistent in their findings that increasing the dose will not contribute to additional weight gain. This fact may be highly encouraging for patients currently taking Seroquel.

How much weight will you gain from Seroquel?

There’s no exact estimate that can be given as each person’s weight gain is subject to individual variation. This is why it is important to avoid comparing your personal reaction to that of others. Over the short-term, most people gain an average of 4.5 lbs. (2.08 kgs) for the first 5-6 weeks of treatment. Over the long-term, it was reported that people gain an average of ~7 lbs. (3.19 kgs) after 52 weeks. Keep in mind that these are just averages, and relatively low averages when compared to other atypical antipsychotic medications.

Will everyone gain weight while taking Seroquel?

Although most people will gain some amount of weight while taking Seroquel, some people may deem the amount gained as being insignificant or not enough to worry about. It appears as though individuals with lower BMIs (body mass indexes) tend to gain the most weight, whereas people with average or high BMIs tend to experience less of a noticeable weight increase while taking Seroquel.

Seroquel: “Weighing” The Pros and Cons

If you are taking Seroquel, it is important to “weigh” the pros and cons of your treatment. Take the time to evaluate whether the drug has been effective in alleviating the symptoms of the condition that you needed to treat. Next consider the amount of weight gain and/or other side effects that you are experiencing as well as the degree to which they are bothersome.

If the efficacy of the drug outweighs the severity of unwanted side effects, then you should probably keep taking it. If on the other hand, the drug isn’t really helping treat your psychiatric condition and you have been packing on tons of weight, you may want to consider consulting your doctor about a medication change or Seroquel withdrawal.

Did you gain weight from taking Seroquel?

If you have experience taking Seroquel or are currently in the process of taking it, feel free to share your experience in the comments section below. Did you end up gaining weight throughout your first 6 weeks of treatment? Was the weight bothersome or too insignificant to notice? Feel free to also share whether you noticed weight increase as a result of increasing the dosage. Also discuss the time span over which you have been taking the drug and any other factors that may have contributed to your weight gain.

  • Source: http://www.ncbi.nlm.nih.gov/pubmed/17474816
  • Source: http://psychrights.org/research/Digest/NLPs/Seroquel/090520UnsealedSeroquelExhibits/Misc/Nashrallah18.pdf