What is Quetiapine?
Quetiapine is the generic name of Seroquel, an antipsychotic drug approved by the U.S. Food and Drug Administration (FDA)  prescribed for schizophrenia treatment, major depression disorder treatment, and bipolar disorder treatment. In some cases, a doctor may prescribe this medication for insomnia or anxiety treatment. It works to rebalance serotonin and dopamine to improve a person’s mood, behavior, and thinking. This drug comes in a tablet form that is meant to be ingested orally. Seroquel has two formulations: IR (immediate release) and XR (extended-release) .
Seroquel is not a controlled substance, but there is still a risk of abuse or addiction. It is important to understand how this drug can affect people, especially if someone is taking it improperly. There are reports of misuse of the drug by crushing and snorting the tablets, injecting the medication, or combining it with cocaine and injecting the mixture. Quitting Quetiapine abruptly may lead to serious health issues by affecting the distribution of major neurotransmitters in the brain. Quetiapine withdrawal symptoms can be extreme and pose a risk to wellbeing.
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There is FDA indication through three 6-week trials and one 6-week trial for schizophrenia in adults and adolescents ages 13 to 17. The first trial showed that in adults, the maximal effect occurred at 300 mg per day. A mean of around 450 mg per day in the second trial showed superiority over the placebo, and a mean of 500 mg per day in the third trial showed superiority over the group that received 50 mg a day .
The researchers concluded that the effective range was from 150 mg to 750 mg for treating schizophrenia in adults. In the one six-week trial, the conclusion was that quetiapine, at an average dose of 400 mg/day to 800 mg/day, was superior to the placebo in adolescents. Two 12-week trials showed efficacy for mono-therapeutic effects .
Treatment for acute manic episodes associated with bipolar I disorder in adults with a majority at a dosing range of 400 mg/day to 800 mg/day. One three-week trial showed that quetiapine was effective as an adjunct treatment for acute manic episodes in bipolar I disorder to lithium or Divalproex in adults .
One three-week trial showed efficacy at 400 mg/day to 600 mg/day for mono-therapeutic treatment for bipolar I disorder for children and adolescents ages 10 to 17. Two trials showed effectiveness in the acute treatment of depressive episodes in bipolar I and II in adult patients. The drug showed efficacy at 300 mg/day, and no additional benefits were apparent at a high 600 mg/day dosage .
Quetiapine Side Effects
Despite the many benefits of Quetiapine, the drug carries a risk of Quetiapine side effects and some danger of lasting health consequences. Like many other psychoactive drugs, there is emerging evidence to suggest Quetiapine is sometimes misused. Although the drug’s use is generally safe, it is valuable to know and understand the possible repercussions of use in order to keep yourself and your loved ones safe.
The use of Quetiapine in people with depression has sometimes been linked with worsening of their clinical depression. As a result, individuals may experience suicidal behavior or suicidal thoughts. This has been of major concern in people taking this prescription drug and close monitoring is needed when taking Quetiapine in major depressive disorder.
Some individuals taking this medication may experience light-headedness and dizziness. This is usually postural meaning a sudden change in posture can worsen the symptoms. It is therefore recommended that all individuals taking the drug take extra care when standing up from a sitting position or sitting up from a lying position.
Some individuals also complain of feeling drowsy after taking Seroquel. The blurring of vision can also be a side-effect of quetiapine use. In elderly people who suffer from memory loss, such as dementia, Seroquel can sometimes cause psychosis. Moreover, there is an increased risk of stroke in elderly individuals taking this medication.
Another recognized Quetiapine side-effect is the development of abnormal involuntary movements. This condition is known as tardive dyskinesia and needs treatment by a specialist neurologist.
Some individuals taking Quetiapine have difficulty opening their bowels and can experience constipation. This usually requires the addition of laxative agents to help restore normal bowel movement.
In individuals taking Quetiapine, an increase in their blood sugar level has been noticed. In individuals with underlying diabetes mellitus, there could be a significant rise in the blood sugar levels leading to complications of diabetes such as diabetic ketoacidosis (a condition where the blood sugar levels are extremely high and there are breakdown products such as ketones present in the blood). Therefore, it is important for all patients with diabetes who take Seroquel to constantly monitor their blood sugar levels.
Individuals taking Quetiapine have also noticed an increase in their body weight, as demonstrated in clinical trials.
Quetiapine can cause postural hypotension, where the blood pressure decreases when the individual changes posture. In addition, an increase in blood pressure has also been noticed, especially in children and adolescents. These must be closely monitored as elderly patients tend to fall and injure themselves if they have postural hypotension.
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Warnings & Precautions
The FDA  requires all potential medication risks for Quetiapine (quetiapine fumarate tablet, film-coated) to be disclosed to consumers, no matter how rare. Here are the warnings and precautions for Seroquel.
Suicidal Thoughts and Behaviors
- Antidepressants increased the risk of suicidal thoughts and behavior in children, adolescents, and young adults in short-term studies. These studies did not show an increase in the risk of suicidal thoughts and behavior with antidepressant use in patients over age 24; there was a reduction in risk with antidepressant use in patients aged 65 and older.
- In patients of all ages who are started on antidepressant therapy, monitor closely for worsening, and for the emergence of suicidal thoughts and behaviors. Advise families and caregivers of the need for close observation and communication with the prescriber.
Increased Mortality in Elderly Patients with Dementia-Related Psychosis
- Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Quetiapine is not approved for the treatment of patients with dementia-related psychosis.
Cerebrovascular Adverse Reactions
- Increased incidence of cerebrovascular adverse reactions (e.g., stroke, transient ischemic attack) has been seen in elderly patients with dementia-related psychoses treated with atypical antipsychotic drugs.
- Atypical antipsychotics have been associated with metabolic changes. These metabolic changes include hyperglycemia, dyslipidemia, and weight gain.
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Quetiapine oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.
To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.
Do not take these drugs with quetiapine. Doing so can cause heart rhythm problems that could cause sudden death. Examples of these drugs include:
- Anti-arrhythmic drugs such as quinidine, procainamide, amiodarone or sotalol
- Antipsychotic drugs such as ziprasidone, chlorpromazine, or thioridazine
- Antibiotics such as gatifloxacin or moxifloxacin
Quetiapine and Alcohol
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) estimates that the interaction between alcohol and medication may contribute to at least 25 percent of emergency room visits. Taking Seroquel and alcohol together may have serious consequences.
The FDA clearly directs people to “not drink alcohol while taking Quetiapine” because it may make some of the side effects worse. Furthermore, the NIAAA  advises that drinking even a little alcohol is too much when a person is taking medications that interact with alcohol.
A Quetiapine overdose can be a potentially life-threatening issue. It is important that all people who are around this drug know how to recognize an overdose. Quick treatment for the overdose is necessary to reduce the risk of further issues for the person experiencing the overdose.
If someone takes too much Quetiapine at one time, they are at risk for an overdose. Possible symptoms of an overdose include:
- Rapid heartbeat
There are some factors that can increase your risk for a fatal overdose, including mixing the drug with other substances that can also cause nervous system depressant effects. Opioids, alcohol, barbiturates, and benzodiazepines can cause the sedating side effects of Seroquel to intensify, leading to an overdose with relatively small doses of each individual drug.
It is possible for someone to experience a coma due to an overdose. When this happens, it is impossible to predict whether the person will wake from a coma. If they do wake up, there is the potential for additional complications, especially if the coma lasts a long time.
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There is a strong link between mental health and substance abuse. Individuals who struggle with mood disorders like depression and anxiety are more susceptible to developing an addiction to drugs or alcohol, often to self-medicate symptoms of their underlying mental health condition. These co-occurring disorders can make each other worse without proper treatment.
To determine the most effective ways for Quetiapine side effects and addiction treatment, it’s crucial to first get an accurate assessment of all the symptoms. When the symptoms have been evaluated by a mental health professional, it may be determined that another form of mental condition is present and needs a particular type of treatment. Very often, some combination of psychotherapy, medication, and/or lifestyle changes are effective for coping with functional.
Detox is often considered the first stage of treatment. It will help you navigate the complicated process of withdrawal, but it doesn’t address patterns of thought and behavior that contribute to drug abuse. Various treatment approaches and settings can help provide the ongoing support necessary to maintain long-term sobriety after you complete detox.
Cravings are very common during detox and can be challenging to overcome. This often leads to relapse. Constant medical care provided during inpatient treatment helps prevent relapse. Clinicians can provide necessary medication and medical expertise to lessen cravings and the effects of withdrawals.
Psychotherapy for Depression and Anxiety
Several different modalities of psychotherapy have been used in the treatment of depression including:
- Cognitive Behavioral Therapy (CBT) – is an effective treatment that involves making changes in both the patterns of negative thoughts and the behavioral routines which are affecting the daily life of the depressed person for various forms of depression.
- Person-Centered Therapy – is a strategy that allows and encourages clients to understand and resolve their concerns in a safe, supportive environment.
- Solution Focused Therapy – is an approach interested in solutions that can be quickly implemented with a simple first step leading to further positive consequences.
Dual Diagnosis Treatment
Substance abuse and mental health disorders often co-occur. In many cases, traumatic experiences can result in a mental health disorder and substance abuse. Dual diagnosis rehabilitation treats both of these issues together. The best approach for the treatment of dual diagnosis is an integrated system. In this strategy, both the substance abuse problem and the mental disorder are treated simultaneously. Regardless of which diagnosis (mental health or substance abuse problem) came first, long-term recovery will depend largely on the treatment for both disorders done by the same team or provider.
Medication-Assisted Treatments (MAT) for substance use disorders and mental health disorders are commonly used in conjunction with one another. This includes the use of medications and other medical procedures. During your rehab, the staff from your treatment facility will help you identify what caused your addiction and teach you skills that will help you change your behavior patterns and challenge the negative thoughts that led to your addiction. Sometimes, the pressures and problems in your life lead you to rely on substances to help you forget about them momentarily.
If you or a loved one are struggling with long-term substance abuse and a co-occurring mental health condition such as anxiety and depression, contact one of our helpful treatment specialists today. We Level Up NJ can provide information on dual diagnosis and detox programs that may fit your specific needs.
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 FDA – https://www.accessdata.fda.gov/drugsatfda_docs/label/2006/020639s026lbl.pdf
 NIH– https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=0584dda8-bc3c-48fe-1a90-79608f78e8a0
 NCBI – https://www.ncbi.nlm.nih.gov/books/NBK459145/
 NIAAA – https://www.nih.gov/news-events/news-releases/nih-study-reveals-many-americans-risk-alcohol-medication-interactions#:~:text=%E2%80%9CCombining%20alcohol%20with%20medications%20often%20carries%20the%20potential,they%20should%20be%20aware%20of%20the%20possible%20harms.%E2%80%9D