Seroquel (Quetiapine)

Used For: Schizophrenia and acute mania in patients with bipolar disorder. Also often used as a sedative for very anxious patients with other psychiatric illnesses, like generalized anxiety disorder or depression.

Even though my diagnosis is schizoaffective disorder, which I think Seroquel works phenomenally for by the way, I also tend to have a lot of anxiety (mostly the social kind) and though this isn't part of my diagnosis, I've found that Seroquel helps me more with social anxiety by allowing me to comfortably go out in public and interact with strangers and stuff with ease more so than any other med, including so-called social phobia-treating meds. I've never tried one of the MAO Inhibitors though (which are the "big-dogs" when it comes to dealing with social anxiety disorder. I guess my social anxiety was never severe enough to call for one of those heavy-duty drugs, or Seroquel worked well enough because my anxiety was also paranoia-related (feeling people can read and control my thoughts, vice-versa, etc.)

Do Not Use If: There are no absolute contraindications for Quetiapine. However, patients who are obese or have a personal or family history of diabetes need to be very careful.

The reason I had to quit taking Seroquel was actually because it screwed up my thyroid gland er something, which is rare for this drug (and this effect it has goes away once you stop taking Seroquel, at least it did for me I should point out) so that is another reason to not use this med. I remember I found Seroquel a little sedating, probably not as sedating as most people find it for some reason, but then all of a sudden after taking Seroquel for a year and a half I couldn't stay awake for more than 10 hours a day and I had no appetite yet was strangely gaining two pounds a day despite hardly eating. After this started happening I read online (from my own damn website believe it or not...haha) that Seroquel can in fact tinker with a person's thyroid gland and cause the exact symptoms of thyroid problems that I was having. After reading that, I called my family doctor and had a thyroid test done sure enough to find out my thyroid was very slow and Seroquel was likely the culprite, so I was put on some levothyroxine drug which did help a little at helping me sleep less and regain an appetite, however, in the long run it was no match for the thyroid problems that Seroquel causes me (after a year and a half of taking it!) and I was forced to quit Seroquel all together. Oh yea, Seroquel also made me eat four large meals a day (or basically it made me eat all the time) so I would recommend getting diabetes related stuff tested, and if you're on the track towards developing it, then that would likely be another reason to not use Seroquel.

Tests to Take First: Weight and height should be recorded.

My weight and height were never recorded before starting Seroquel, but it doesn't sound like it would have been a bad idea considering how hungry Seroquel made me and how much weight it made me gain. I probably gained about 25 lbs. or so after being on doses ranging from 300mg-800mg of Seroquel for about a year and a half. (That's a lot of weight gain for any drug in my experiences). I did however, have regular diabetes-related tests done while I was taking Seroquel, and every time I was told "everything is in normal range."

Tests to Take While You Are on It: A physical examination called the AIMS test should be performed by the psychiatrist or nurse practitioner at least every six months to detect early signs of tardive dyskinesia. Weight should be monitored monthly. In order to guard against diabetes, it is important to try to keep the patient's weight under control as much as possible. The risk for diabetes is greatest in people who gain a lot of weight and/or have family history of diabetes. Checking the blood sugar level regularly is important.

I never had an AIMS test performed while I was taking Seroquel (still don't know what one is so if you email me asking I couldn't tell ya), likely because I never had early signs of tardive dyskinesia. I think I read on www.crazymeds.us once that Seroquel actually presents the lowest change of developing TD of any of the atypical antipsychotics, which I am not surprised to read because I remember while being on Seroquel (both low doses and high doses) I never had the occasional "twitches" that I've gotten from sometimes from other antipsychotics like Abilify, Geodon, and Risperdal. It was nice to be able to play the guitar without accidentally twitching my hand and thus screwing up the song when I went to guitar lessons briefly. Thanks Seroquel : )

Usual Dose: Seroquel lasts a relatively short time in the body (technically, it has a short half-life) and needs to be taken twice a day. Usually, it is started at 25 or 50 mg twice daily, but patients who are extremely agitated may be started at even higher doses. For schizophrenia, it usually takes at least 300 mg twice daily to work, and it can take a week or more to get the patient to that level. The highest dose is 800 mg a day, which requires that the patient can take a 100-mg and 300-mg pill in the morning and the same thing in the evening. When it is used for its calming and sedative properties in patients with anxiety disorder or depression, much lower doses are usually used and it is often given only at night, with 100 or 200 mg generally being tops.

Like I said, I was on a dose of Seroquel ranging from 300mg to as much as 800mg, always taking it all at night 'cause it's probably too sedating to take in the morning then expect to go function throughout an eventful day. Personally, I found 300mg to be more helpful that 800mg simply because 800mg made me so hungry that it lead to much weight gain and it just became bothersome, whereas 300mg (though this also increased my appetite) didn't cause as much hunger/weight gain and seemed to be just as effective at treating symptoms. Also, I've read on messageboards of people who take doses like 1000mg or even 1400mg of Seroquel, so I guess it shows some people may need more than the "maximum dose."

How Long Until It Works: Seroquel tends to have a fairly rapid calming effect, making it an attractive choice for very agitated patients. However, it can take a week or more to get to a therapeutic dose for patients with schizophrenia.

I remember being able to feel the sedating effects of Seroquel within an hour or so. This can actually be pretty convenient if you have trouble falling asleep at night, staying asleep at night, or have other sleep problems either because you're anxious er whatever or cause you're on some other med that makes you perk up at night such as certain antidepressants.

Common Side Effects: Seroquel is a very sedating drug, which is a benefit for very agitated patients or those with insomnia but difficult for others who find it makes them sleepy during the day. It can also cause dizziness, but this is usually transient. The biggest problem with Seroquel is the weight gain. Some patients gain twenty or more pounds over the first few months, putting them at risk for all the complications of obesity.

Side effects I had from Seroquel were weight gain, increased appetite, sedation, very rare and mild-nausea and diarrhea, and of course the thyroid problem that occurred after being on a high dose for over a year. I read an article once about a guy who gained 80 pounds and developed diabetes after being on Seroquel for just 6 months! I don't remember the dose of Seroquel he took, his diagnosis, family history of obesity, etc., but I would assume that if you gain 80 pounds in 6 months of Seroquel treatment, you might definitely want pay more attention to your scale when you stand on it, assuming you can still fit on it without breaking it.

Less Common Side Effects: As mentioned above, it is possible that quetiapine will cause tardive dyskinesia, but the risk if this is much less than with older antipsychotic drugs like Haldol and Prolixin. The biggest worries are the complications of obesity, such as diabetes and heart disease. Also, in elderly patients with dementia there is an increased risk of death, usually due to heart problems or infections. Seroquel caused cataracts in animal studies during initial testing and therefore it is recommended that patients see an ophthalmologist every six months for an eye exam. However, cataract information has not actually been seen in human patients.

Oh yea, sometimes when you read about Seroquel you will stumble upon something that says something like, "Be sure to get your eyes checked every 6 months while taking this drug." Personally, I never did these "6 month eye exams" and my eyes and vision were never altered from taking Seroquel. Though I do have a good family history of quality vision, and I've never had to wear prescribed eyeglasses before (any pictures on this website of me wearing eyeglasses have custom clear non-prescription lenses...Yes, I am quite the loser). I guess you can say that in my family, mental illness may be quite common but our vision is pretty damn superb!! Put that in your beer bong and beer bong it...

What to Do About Side Effects: The main side effect of concern is weight gain, about which there is not a lot that can be done. Diet and exercise will help. Sedation can be a problem and some patients try to take more of the medication at bedtime than during the daytime, although this means that a smaller dose at at work during the day.

For weight gain, I recommend really watching what you eat as well as how much you eat. Exercise will likely help a lot too.

Seriously, watch out for the weight gain if it starts getting out of hand. Remember in the book Animal Farm when the sheep kept saying, "Four legs good, two legs bad." er something like that? Well, imagine being a fat crazy person in a psychiatric with one leg amputated reading Animal Farm every day repeatedly saying, "Two legs good, one leg bad." cause you lost it from taking Seroquel and developed diabetes!

If the sedation effects of Seroquel are so bad that you can't stay up for more than 10 hours a day and when you are awake all you want to do is go to sleep, then switching to another antipsychotic may be a decent option. And if Seroquel tinkers with your thyroid (which again I point out is rare and this is really more of a Lithium thing) then you will probably have to take thyroid medication or just switch to a different antipsychotic all together.

If It Doesn't Work: You will probably need to try a different antipsychotic drug. Risperidone and Zyprexa are possibilities. Clozapine is another choice.

When I stopped taking Seroquel, I swtiched to Abilify which ended up being a smooth transition for the better somehow.

If It Does Work: The question of how long people with schizophrenia should stay on an antipsychotic medication has never been answered completely. Most say that after a first episode, it may be possible to try to stop the medication after six months to a year, but the risk of developing another psychotic episode is great. Because quetiapine is generally well tolerated and seems to have a very low risk of tardive dyskinesia, most doctors recommend that their patients with schizophrenia who respond to the medication stay on it for an indefinite period of time. However, severe weight gain may force a switch to a different drug.

Though I'm just a fat crazy-guy with personal experience taking antipsychotic medications, and not a fat medical-guy who actually knows Seroquel's mechanisms of action and whatknot, for me Seroquel helped bring me out of a manic-depressive-psychotic-funk, and it was a nice temporary medication that I would have stayed on, but Abilify turned out to be more effective and have even less side effects.

Cost: Generic Seroquel is not available and hence it is an expensive medication.

I think Seroquel came out in 1998, so perhaps generic Seroquel may be available sometime in the near future hopefully : )

Special Comments: Seroquel is a very frequently prescribed drug, but although its first official indication was for schizophrenia, it is not often prescribed for it. This is because the need to titrate up to a high dose, the sedation, and the twice-a-day schedule make it difficult to get food effects for patients with schizophrenia. On the other hand, Seroquel's calming and sedating properties have led it to be an add-on drug, that is, a drug that is added on to other medications, often instead of sleeping pills like Ambien or Lunesta or antianxiety medications like Xanax or Klonopin. Physicians believe that Seroquel is less habit-forming than those drugs, although there is as yet no proof that this is true. Because of this belief, Seroquel is often prescribed to patients recovering from alcohol or drug addiction who get anxious or can't sleep. It is a very useful medication, although not so much for its originally intended purpose.

Okay, there is a special comment I need to make about this drug, Seroquel. There appears to be some sort of urban legend going around that you can "get high" on Seroquel er something like that. I first heard this when I read a news article about a few high school kids who abused a friend's Seroquel before school one day in hopes to "catch a buzz," but both of them wound up in the emergency room because they couldn't stay awake in class and they felt sick. Haha....too funny. Then, after read that article, I made a post on this website about how it's not possible to get high on Seroquel, being under the impression that I would be informing my readers of some common sense, but sure enough, I realized that a decent amount of ZacharyOdette.com visitors were then finding my website by searching things on Google like "How do I get high on Seroquel?" Then, as if this all wasn't bad enough, my sister was telling me that at an AA meeting (she's a recovered alcoholic -- good for her) an old couple told her that "You can get high on the psychiatric drug Seroquel." Alright...this has to stop. Do you realize that by saying Seroquel gets people high (I'm going to assume "getting high" means like it makes you feel crazy and hallucinate and stuff like that) is honestly almost as bad as saying that people can drive a vehicle more safely shortly after consuming several alcoholic beverages. Seroquel is meant to prevent hallucinations, not cause them you morons!! I will let you all in on a little secret though...Seriously, spread the word if you want...Here it goes...If you take a multi-vitamin every day, you'll get the best buzz of your life. I know that sounds weird, but I'm not kidding. Try it yourself and tell me it doesn't work...

This Seroquel page was typed on February 16, 2008.
Back to the "my meds" page.