What is Seroquel (quetiapine)?
Seroquel (generic name Quetiapine) is an atypical antipsychotic drug to treat schizophrenia and bipolar disorder. You can also buy Seroquel XR (an extended-release version of the drug), which is used in combination with SSRIs to treat a major depressive disorder. Seroquel XR is used only for adults.
It is a very popular drug for mental disorders with annual sales of the drug are about $ 5.7 billion worldwide. US drug patent has expired in 2011 but has been extended until 2012 due to the expansion of its use in pediatrics. Now the patent has already expired in Canada. That is why you can also buy Seroquel generic, which is usually named for its active ingredient – Quetiapine.
What is Seroquel used for?
Quetiapine fumarate is used to treat schizophrenia or bipolar disorder.
Seroquel was approved by FDA for short-term treatment of schizophrenia and acute episodes of mania associated with bipolar disorder (bipolar mania) and for the treatment of bipolar depression. In 2009, Quetiapine ER was approved as an additional medication to treat major depressive disorder.
Seroquel is also used off-label to treat aggression, Alzheimer's disease, anxiety, attention deficit hyperactivity disorder, bipolar disorder, dementia, depression, mood disorders, post-traumatic stress disorder and insomnia, as well as a drug to control anger.
Seroquel for schizophrenia
It is not clear exactly, which drugs are more effective - typical or atypical antipsychotics. They all have an equal period of excretion and recurrence of symptoms when used at low to moderate dosages.
Seroquel for bipolar disorder
In patients with bipolar disorder, medication is used for depressive episodes, acute manic episodes associated with bipolar disorder I (as monotherapy or adjunctive treatment with lithium, valproate, and lamotrigine), and maintenance treatment of bipolar disorder I (as adjunctive therapy with lithium or Divalproex).
Seroquel for Alzheimer's disease
Seroquel is not effective to reduce the excitability for people with Alzheimer's disease. Quetiapine impairs cognitive function in elderly people with dementia, and therefore its use is not recommended among these categories of people.
Seroquel for other purposes
The drug is sometimes used off-label for the treatment of conditions such as obsessive-compulsive disorder, posttraumatic stress disorder, autism, alcoholism, borderline personality disorder, depression, Tourette's syndrome, musical hallucinations. The drug is also used as a sedative for people with sleep disorders or anxiety disorders. The use of off-label is not approved by the manufacturer. There are still no medical researches of Seroquel side effects in case of long-term use of the drug off-label, for example, to treat sleep disorders.
Seroquel side effects
The most common side effect of quetiapine is drowsiness. Other common side effects include weakness, fatigue, dry mouth, sore throat, dizziness, abdominal pain, constipation, indigestion, orthostatic hypotension, inflammation or swelling of the sinuses or throat, blurred vision, increased appetite and weight gain.
Less common side effects include bruising and disorders of speech and language. Sores in a mouth is a rare side effect. Very rare side effects include fast the swelling of the skin around eyes, that visually accelerates skin aging.
There have recently been several lethal outcomes, which some medical specialists connect with Quetiapine intake. At least six US military veterans, who received the drug cocktails, which military doctors have approved for the treatment of post-traumatic stress disorder, died. There were thousands of lawsuits filed against the drug manufacturer by civilian people, who faced health problems while using Seroquel, such as slurred speech, chronic insomnia and even death.
The product is positioned as one of the most sedative antipsychotics, although this fact is disputed. During the first few days of taking the drug, and sometimes longer, users may feel tired. The latest guidelines for Seroquel for bipolar depression recommends that you should take an entire dose at bedtime due to the sedative effect of the drug. Sedation may disappear whether after some time of the drug intake or because of a change in dosage.
Both typical and atypical antipsychotics can cause the development of tardive dyskinesia (involuntary movements of the tongue, lips, face, trunk, and body parts). Although Seroquel is an atypical antipsychotic, choosing this drug is a good way to minimize symptoms of tardive dyskinesia caused by other atypical drugs.
Some patients should monitor their weight gain. It was found that Seroquel has a greater potential to weight gain than fluphenazine, haloperidol, loxapine, molindone, olanzapine, pimozide, risperidone, thioridazine, thiothixene, trifluoperazine, and Ziprasidone, but less than chlorpromazine, clozapine, perphenazine, and Sertindole.
Seroquel study carried on beagle dogs suggests that there is a risk of cataracts. Although there are well-controlled studies of thousands of patients, informing about the risk of developing cataracts in humans, it has not yet found a clear causal link between the use of quetiapine and this side effect. However, people taking Seroquel are advised to conduct regular half-yearly examinations with an ophthalmologist.
As with some other antipsychotics, Quetiapine may reduce the seizure threshold, and should be used with caution in combination with drugs such as Bupropion.
Recent comparative studies of antipsychotics showed that treatment with Seroquel alone is associated with an increased risk of mortality compared to other analyzed treatments (which is still better than no antipsychotic treatment).
Acute and chronic psychosis, including schizophrenia
The daily dosage for the first 4 days of treatment is as follows: first day - 50 mg, second day - 100 mg, third day - 200 mg, fourth day - 300 mg. From the 4th day, the dose should be titrated to the clinically effective dose, which typically ranges from 300 to 450 mg a day. Depending on the clinical effect and individual tolerance, a dose can vary from 150 to 750 mg a day.
Treatment of manic episodes of bipolar disorder
Quetiapine is used as monotherapy or as adjunctive therapy for mood stabilization.
The daily dosage for the first 4 days of therapy: 1 st day - 100 mg, 2 day - 200 mg, 3 day - 300 mg, Day 4 - 400 mg. Subsequently, by the 6th day of treatment, the daily dose can be increased up to 800 mg. Increasing the daily dose should not exceed 200 mg a day.
Depending on the clinical effect and individual tolerability, the dose can vary from 200 to 800 mg a day. Typically, the effective dose is from 400 to 800 mg a day.
The maximum recommended daily dose to treat schizophrenia is 750 mg of Seroquel a day. The maximum recommended dosage for treatment of manic episodes of bipolar disorder is 800 mg a day.
An initial dose of Seroquel for elderly people is 25 mg a day. The dose should be increased by 25-50 mg daily to achieve an effective dose, which is likely to be smaller than in younger patients.
It is recommended to start treatment with Seroquel 25 mg a day in people with renal or hepatic impairment. It is recommended to increase the dose by 25-50 mg daily to achieve an effective dose.
Avoid taking Seroquel in case of:
- hypersensitivity to any component of the drug;
- simultaneous intake with CYP3A4 inhibitors such as HIV protease inhibitors, azole antifungal drugs, erythromycin, clarithromycin, nefazodone;
- children until 18 years old.
Take Seroquel with caution in case of:
- cardiovascular and cerebrovascular disease, or other conditions predisposing to hypotension;
- advanced age;
- liver disorder;
- seizures in history;
You should cancel Seroquel intake gradually under medical supervision and according to your doctor's instructions to avoid withdrawal symptoms or relapse.
British National Formulary recommends a gradual cessation of antipsychotic treatment to avoid acute withdrawal syndrome or rapid relapse of the disease. Withdrawal syndrome can occur due to compensatory changes in dopamine, serotonin, histamine and adrenergic receptors in the central nervous system if you sharply stop taking the drug. Despite the growing demand for safe and effective use of graphics reducing antipsychotics, there are currently no specific recommendations for their proven safety and efficiency.
Most common withdrawal symptoms, observed after canceling antipsychotic drugs, include nausea, vomiting, dizziness, sweating, dyskinesia, tachycardia, insomnia, nervousness, orthostatic hypotension, headaches, and anxiety. According to clinical trials, canceling atypical antipsychotics, similar to Seroquel, may also be a cause of psoriasis, gum disease and other inflammatory diseases, dyspepsia, increased the sugar in the blood, headache etc.
Acute overdose with Seroquel may cause sedation, hypotension and tachycardia, cardiac arrhythmia in most cases. There were also reports of coma and death in adults. Quetiapine concentration in serum or plasma in the range of 1-10 mg / l is considered relatively safe, while the concentration of 10-25 mg / l is associated with a risk of death.
Taking Seroquel during pregnancy and breastfeeding
The drug has a risk factor C for using during pregnancy. Quetiapine is toxic to embryo and fetus. However, the drug did not demonstrate any negative effect during a study on animals. There is no information about long-term exposure to the drugs in terms of a child development. However, the use of Seroquel during the third trimester of pregnancy has a risk of abnormal muscle movements and withdrawal symptoms manifestation at newborns. The following symptoms may be observed in newborns: anxiety, eating disorders, hypertension, hypotension, respiratory distress, drowsiness, and tremor. The drug is not recommended during breastfeeding since it has an ability to penetrate into breast milk.
Seroquel may induce orthostatic hypotension, especially during the initial dose-titration period (more likely for elderly patients than for younger people). There was no relationship between quetiapine and increase of QT-interval. However, take Seroquel with caution together with drugs that prolong QT interval, especially in advanced age.
Reduce Seroquel dosage or slower titration of dosages in case of orthostatic hypotension development during treatment. The drug is not indicated for a treatment of psychosis associated with dementia. In the case of symptoms of tardive dyskinesia, reduce your dosage or cancel taking the drug. The symptoms of tardive dyskinesia may be increased or even appear after you stop taking the drug.
Stop taking Seroquel immediately in case of neuroleptic malignant syndrome development.
Considering that Seroquel primarily affects the central nervous system, the drug should be used with caution in combination with other drugs, CNS depressants or alcohol. Antidepressants increase the risk of suicidal thoughts or suicidal behavior in children, teenagers and young adults (under 24 years) with depressions and other mental disorders. Therefore, children, teenagers and young adults (under 24 years) should weight the risk of suicide and the benefits from using the drugs before taking antidepressants. Any depressive disorder itself increases the risk of suicide. Therefore, all patients should be monitored for early detection of infringements or behavior changes and suicidal tendencies during treatment with this antidepressant.
Quetiapine can cause drowsiness, that is why it is recommended to refrain from driving a car, working with potentially dangerous equipment and sports activities that require high concentration and speed of psychomotor reactions.
It is recommended to start taking 25 mg of Seroquel a day for people with kidney failure. Increase your dose by 25-50 mg daily to achieve an effective dose.
It is recommended to start taking 25 mg of Seroquel a day for people with hepatic impairment. Increase your dose by 25-50 mg daily to achieve an effective dose.
An initial dose of Seroquel for people of advanced age is 25 mg a day. The dose should be increased by 25-50 mg daily to achieve an effective dose, which is likely to be smaller than for younger patients.
Avoid using Seroquel for children till 18 years old.
According to Seroquel reviews on medical forums, people mostly discuss the effect of the drug on nervous system such as panic attacks. Many users have reported that the treatment helped them to get rid of fear, panic, and anxiety. However, some people experienced sleepiness, which was manifested in mild as well as in more complicated forms. The reviews are the same of Seroquel generic and Seroquel brand.
As for professionals, they recommend treating mental disorders in a hospital. Hospital medical staff can correctly adjust your dosage and monitor your overall health condition to prevent the development of side effects.
Take Seroquel strictly according to your doctor instructions. Not all people are willing to go to a psychiatrist and start Seroquel treatment by themselves at their own risk.
Seroquel and alcohol
Can I drink alcohol while taking Seroquel? It is recommended to avoid taking alcohol during treatment with Seroquel or other antipsychotic drugs and antidepressants. Alcohol depresses the central nervous system, which in combination with antipsychotic medications may lead to serious side effects.
Can Seroquel get you high?
Seroquel is an atypical antipsychotic medication, it is not a narcotic substance. That is why it is unlikely to get your high like opiate drugs can do.
You can feel drowsy, but it will not be opiate-like induced drowsiness or euphoria. Even if you take too much of Seroquel, you can only get an overdose, which is very dangerous.
Does Seroquel cause weight gain?
Weight gain is a common side effect of antipsychotic and antidepressant drugs. Some people may experience substantial gain in weight, whereas others even weight loss or their weight remains the same. It all depends on your individual reaction to a definite medication. Unfortunately, it is impossible to find out whether you are going to gain weight during Seroquel treatment or not.
If you are concerned about not gaining weight while taking Seroquel, you have to monitor your daily eating habits, try to eat healthy food, calculate your calories intake and try to be more physically active throughout a day.
How much does Seroquel cost?
Seroquel price depends on several factors. You can buy Seroquel generic or Seroquel brand. Generic drugs are usually cheaper than brand ones. Moreover, you can order Seroquel from an online pharmacy without a prescription. Seroquel street value is different from a price in your local drugstore or in online pharmacy. However, we strongly advise you buying Seroquel only from trusted and reputable pharmacies.