Generic Name: quetiapine (kwe TYE a peen)
Brand Names: SEROquel, SEROquel XR
What is quetiapine?
Quetiapine is an antipsychotic medicine. It works by changing the actions of chemicals in the brain.
Quetiapine is used to treat schizophrenia in adults and children who are at least 13 years old.
Quetiapine is used to treat bipolar disorder (manic depression) in adults and children who are at least 10 years old.
Quetiapine is also used together with antidepressant medications to treat major depressive disorder in adults.
Extended-release quetiapine (Seroquel XR) is for use only in adults and should not be given to anyone younger than 18 years old.
Quetiapine may also be used for purposes not listed in this medication guide.
What is the most important information I should know about quetiapine?
Never take quetiapine in larger amounts, or for longer than recommended by your doctor. High doses or long-term use of quetiapine can cause a serious movement disorder that may not be reversible. Symptoms of this disorder include tremors or other uncontrollable muscle movements. Quetiapine is not for use in psychotic conditions related to dementia. Quetiapine may cause heart failure, sudden death, or pneumonia in older adults with dementia-related conditions. Stop using quetiapine and call your doctor at once if you have the following symptoms: very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, uncontrolled muscle movements, feeling light-headed, blurred vision, eye pain, increased thirst and urination, excessive hunger, fruity breath odor, weakness, nausea and vomiting.
Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.
Treatments for depression are getting better everyday and there are things you can start doing right away.
What should I discuss with my healthcare provider before taking quetiapine?
Quetiapine is not for use in psychotic conditions related to dementia. Quetiapine may cause heart failure, sudden death, or pneumonia in older adults with dementia-related conditions.
To make sure you can safely take quetiapine, tell your doctor if you have any of these other conditions:
liver or kidney disease;
heart disease, high blood pressure, heart rhythm problems, a history of heart attack or stroke;
a history of low white blood cell (WBC) counts;
a thyroid disorder;
seizures or epilepsy;
cataracts;
high cholesterol or triglycerides;
a personal or family history of diabetes; or
trouble swallowing.
You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.
Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.
FDA pregnancy category C. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Quetiapine can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using quetiapine. Taking antipsychotic medication during the last 3 months of pregnancy may cause problems in the newborn, such as withdrawal symptoms, breathing problems, feeding problems, fussiness, tremors, and limp or stiff muscles. However, you may have withdrawal symptoms or other problems if you stop taking your medicine during pregnancy. If you become pregnant while taking quetiapine, do not stop taking it without your doctor's advice. Do not give quetiapine to a child without a doctor's advice. Extended-release quetiapine (Seroquel XR) is for use only in adults and should not be given to anyone younger than 18 years old.
How should I take quetiapine?
Never take quetiapine in larger amounts, or for longer than recommended by your doctor. High doses or long-term use of quetiapine can cause a serious movement disorder that may not be reversible. Symptoms of this disorder include tremors or other uncontrollable muscle movements.
Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results.
Take this medicine with a full glass of water. You may take quetiapine with or without food. Do not crush, chew, or break an extended-release tablet. Swallow the pill whole. Breaking the pill may cause too much of the drug to be released at one time.
Quetiapine may cause you to have high blood sugar (hyperglycemia). Talk to your doctor if you have any signs of hyperglycemia such as increased thirst or urination, excessive hunger, or weakness. If you are diabetic, check your blood sugar levels on a regular basis while you are taking quetiapine.
This medication can cause you to have a false positive drug screening test. If you provide a urine sample for drug screening, tell the laboratory staff that you are taking quetiapine. Store at room temperature away from moisture and heat.
See also: Quetiapine dosage (in more detail)
What happens if I miss a dose?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of quetiapine can be fatal. Overdose symptoms may include extreme drowsiness, fast heart rate, feeling light-headed, or fainting.
What should I avoid while taking quetiapine?
Quetiapine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.
Avoid becoming overheated or dehydrated during exercise and in hot weather. You may be more prone to heat stroke.
Avoid drinking alcohol. It can increase certain side effects of quetiapine.
Quetiapine side effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.
Stop using quetiapine and call your doctor at once if you have a serious side effect such as:
very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors;
feeling like you might pass out;
jerky muscle movements you cannot control, trouble swallowing, problems with speech;
tremors, or restless muscle movements in your eyes, tongue, jaw, neck, arms, or legs;
mask-like appearance of the face, trouble swallowing, problems with speech;
blurred vision, eye pain, or seeing halos around lights;
increased thirst and urination, excessive hunger, fruity breath odor, weakness, nausea and vomiting; or
fever, chills, body aches, flu symptoms, white patches or sores inside your mouth or on your lips.
Less serious side effects may include:
dizziness, drowsiness, tired feeling;
dry mouth, sore throat;
stomach pain, upset stomach, nausea, vomiting, constipation;
breast swelling or discharge;
missed menstrual periods; or
increased appetite, weight gain.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Quetiapine Dosing Information
Usual Adult Dose for Schizophrenia:
Immediate-release tablets:
Initial Dose: 25 mg orally twice a day.
The dosage may be increased in increments of 25 to 50 mg two times a day or three times a day on the second and third days (as tolerated). By the fourth day a dosage range of 300 mg to 400 mg daily (divided into 2 or 3 doses a day) may be achieved. Additional dosage adjustments (increases or decreases) of 25 to 50 mg twice a day may be made, as needed. However, at least 2 days should pass between the additional dosage adjustments.
Efficacy in schizophrenia has been reported with doses ranging from 150 to 750 mg/day. Maximum clinical effect has been reported at 300 mg/day. The safety of doses above 800 mg/day has not been evaluated in clinical trials.
Extended-release tablets:
Initial dose: 300 mg orally once daily without food or with a light meal.
Maintenance dose: 400 to 800 mg orally once daily depending on response and tolerance.
Maximum dose: Doses above 800 mg daily have not been studied.
The dosage of the extended-release tablets may be increased in increments of up to 300 mg daily at intervals as short as 1 day.
The efficacy of quetiapine in long-term use (over 6 weeks) has not been studied in clinical trials. Patients who respond favorably to quetiapine may be continued on the lowest dose which is effective in maintaining their remission. Patients should be periodically reassessed to determine their need for maintenance treatment.
Usual Adult Dose for Bipolar Disorder:
Immediate-release tablets:
Mania associated with bipolar I disorder as monotherapy or as adjunct therapy to lithium or divalproex:
Initial Dose: 50 mg orally twice a day
The dose may be increased to 200 mg orally twice daily on day 4 in increments of up to 50 mg twice daily. Further dosage adjustments up to 800 mg per day by day 6 should be in increments of no greater than 200 mg/day. Data has been reported to indicate that the majority of patients responded between 400 mg per day to 800 mg per day. The safety of doses above 800 mg per day has not been evaluated in clinical trials.
Immediate-release tablets:
Depressive episodes associated with bipolar disorder:
Initial dose: 50 mg orally once a day
The dose may be increased to reach 300 mg orally once a day by day 4. Some patients may require a further increase to 600 mg once a day by increasing the daily dose to 400 mg on day 5 and 600 mg on day 8 of treatment. Efficacy was demonstrated in this patient population at both 300 mg and 600 mg per day. However, no additional benefit was observed in patients receiving 600 mg per day as compared to those patients receiving 300 mg per day.
Extended-release tablets:
Bipolar Depression:
(Depressive Episodes Associated with Bipolar Disorder)
Usual dose for Acute Treatment: administer orally once daily in the evening starting with 50 mg per day and increasing doses to reach 300 mg per day by day 4.
Recommended Dosing Schedule: Day 1 - 50 mg, Day 2 - 100, mg, Day 3 - 200 mg, & Day 4 - 300 mg
Bipolar Mania:
Usual dose for Acute Monotherapy or Adjunct Therapy (with lithium or divalproex): administer orally once daily in the evening starting with 300 mg on day 1, 600 mg on day 2, and adjust between 400 mg and 800 mg per day thereafter depending on the clinical response and tolerance of the individual patient.
Bipolar Maintenance:
Continue treatment at the dosage required to maintain symptom remission.
While there is no body of evidence available to specifically address how long patients should remain on quetiapine extended-release tablets, maintenance of efficacy in Bipolar I Disorder has been demonstrated with quetiapine (administered orally twice daily totaling 400 to 800 mg per day) as adjunct therapy to lithium or divalproex. Generally, in the maintenance phase, patients continued on the same dose on which they were stabilized during the stabilization phase. Patients should be periodically reassessed to determine the need for maintenance treatment and the appropriate dose for such treatment.
Usual Adult Dose for Depression:
As adjunctive therapy to antidepressants for use in the treatment of major depressive disorder:
Extended-release tablets:
Initial dose: 50 mg orally once daily in the evening
On day 3, the dose can be increased to 150 mg once daily in the evening.
Range: 150 mg to 300 mg orally daily. Doses above 300 mg have not been studied.
Usual Geriatric Dose for Schizophrenia:
Immediate-release tablets:
Initial Dose: 25 mg orally once a day.
The dose may be increased daily in increments of 25 mg/day to 50 mg/day to an effective dose, depending on the clinical response and tolerability of the patient.
Efficacy in schizophrenia has been reported with doses ranging from 150 to 750 mg/day. Maximum clinical effect has been reported at 300 mg/day. The safety of doses above 800 mg/day has not been evaluated in clinical trials.
Extended-release tablets:
When an effective immediate-release dose has been reached (above 200 mg), the patient may be switched to the extended-release formulation at an equivalent dose.
The efficacy of quetiapine in long-term use (over 6 weeks) has not been studied in clinical trials. Patients who respond favorably to quetiapine may be continued on the lowest dose which is effective in maintaining their remission. Patients should be periodically reassessed to determine their need for maintenance treatment.
Usual Geriatric Dose for Bipolar Disorder:
Extended-release tablets:
Initial dose: 50 mg/day
The dose can be increased in increments of 50 mg/day depending on the response and tolerance of the individual patient.
What other drugs will affect quetiapine?
Before using quetiapine, tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by quetiapine.
Tell your doctor about all other medicines you use, especially:
a medication to treat high blood pressure or a heart condition;
medications to treat Parkinson's disease;
steroids (prednisone and others);
an antibiotic or antifungal medication such as clarithromycin (Biaxin), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin, Pediazole), levofloxacin (Levaquin), ketoconazole (Nizoral), rifampin (Rifadin, Rimactane, Rifater), and others;
anti-malaria medications such as chloroquine (Aralen) or mefloquine (Lariam);
heart rhythm medicine such as amiodarone (Cordarone, Pacerone), dofetilide (Tikosyn), disopyramide (Norpace), procainamide (Procan, Pronestyl), propafenone (Rythmol), quinidine (Quin-G), and others;
medications to treat HIV or AIDS;
migraine headache medicine such as sumatriptan (Imitrex, Treximet) or zolmitriptan (Zomig);
narcotic medication such as methadone (Methadose, Diskets, Dolophine);
seizure medication such as carbamazepine (Carbatrol, Tegretol), divalproex (Depakote), phenobarbital (Luminal, Solfoton), phenytoin (Dilantin), or valproic acid (Depakene, Stavzor); or
other antidepressant or medicines to treat psychiatric disorders, such as amitriptylline (Elavil, Vanatrip, Limbitrol), clozapine (FazaClo, Clozaril), fluoxetine (Prozac, Sarafem, Symbyax), haloperidol (Haldol), risperidone (Risperdal), thioridazine (Mellaril), and others.
This list is not complete and other drugs may interact with quetiapine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.
More quetiapine resources
- Quetiapine Side Effects (in more detail)
- Quetiapine Dosage
- Quetiapine Use in Pregnancy & Breastfeeding
- Quetiapine Drug Interactions
- Quetiapine Support Group
- 277 Reviews for Quetiapine - Add your own review/rating
- quetiapine Advanced Consumer (Micromedex) - Includes Dosage Information
- Quetiapine MedFacts Consumer Leaflet (Wolters Kluwer)
- Quetiapine Fumarate Monograph (AHFS DI)
- Seroquel Prescribing Information (FDA)
- Seroquel Consumer Overview
- Seroquel XR Prescribing Information (FDA)
- Seroquel XR Sustained-Release Tablets MedFacts Consumer Leaflet (Wolters Kluwer)
Compare quetiapine with other medications
- Bipolar Disorder
- Borderline Personality Disorder
- Depression
- Generalized Anxiety Disorder
- Insomnia
- Obsessive Compulsive Disorder
- Paranoid Disorder
- Post Traumatic Stress Disorder
- Schizoaffective Disorder
- Schizophrenia
- Tourette's Syndrome
Where can I get more information?
- Your pharmacist can provide more information about quetiapine.
See also: quetiapine side effects (in more detail)
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