Seroquel (Quetiapine) Essential Information

Seroquel (quetiapine fumarate) is classed as an atypical antipsychotic medication. It is used to treat psychotic symptoms of such illnesses like schizophrenia and schizoaffective disorder, including hallucinations, delusions, catatonia, and paranoia. Seroquel XR is the only medication in its class approved by the FDA to treat both major depressive disorder as adjunctive therapy and acute depressive episodes associated with bipolar disorder as monotherapy. Seroquel may be used adjunctively with Lithium or Depakote in the therapy of acute mania.

Drug Warnings and Complications

Treatment with Seroquel is associated with the risk of some serious complications. These include:

• Neuroleptic Malignant Syndrome (NMS), a potentially fatal illness whose symptoms include high fever, muscle rigidity, profuse sweating, and dark urine. Read more: Neuroleptic Malignant Syndrome.
• Tardive dyskinesia, a movement disorder that may not go away unless treated promptly. Symptoms include uncontrolled movements of the lips and tongue. 
• High blood sugar and diabetes: Patients who have diabetes mellitus or have risk factors such as obesity and family history of diabetes should have fasting blood glucose tests before beginning treatment with Seroquel and at regular intervals during treatment.

Rare but Significant Side Effects

In 1% or fewer of patients taking Seroquel in clinical trials, the following were reported:

• Cataracts
• Seizures
• Underactive thyroid
• Elevated cholesterol and triglycerides

Also, patients may experience sleepiness and impaired motor control (difficulty walking, etc.) especially at the beginning of treatment with Seroquel. The usual warning about not driving or operating heavy machinery is important with this medication.

Black Box Warning Regarding Elderly Patients

Seroquel carries the standard black box warning required for all antipsychotics regarding the increased risk of death in elderly patients with dementia-related psychosis.

Pregnancy and Breast-Feeding

It is recommended that Seroquel treatment is discontinued during pregnancy. Women taking Seroquel should not breastfeed their infants.

Other Cautions and Warnings

• Do not drink alcoholic beverages while taking Seroquel.
• Avoid overheating and dehydration
• Seroquel is not approved for pediatric use
• Patients with liver disease should start at the lowest dose (25 mg) and increase the dosage slowly

Most Common Side Effects

• Weight Gain
• Sleepiness
• Headache
• Dizziness
• Drop in blood pressure upon standing
• Dry mouth
• Constipation
• Dizziness
• Weakness
• Upset stomach