Seroquel

Generic name: Quetiapine fumarate

What is this medication?

Seroquel is an antipsychotic medication prescribed for the treatment of schizophrenia. It is also used for the treatment of mania associated with bipolar disorder as well as for the treatment of depressive episodes associated with bipolar disorder.

What is the most important information I should know about this medication?

The safety and effectiveness of Seroquel in children have not been established.

Antidepressants have increased the risk of suicidal thoughts and actions in children and teenagers. All patients starting treatment should be watched closely for worsening of depression, suicidal thoughts or actions, unusual changes in behavior, agitation, and irritability. Families and caregivers should watch patients daily and report these symptoms immediately to their physician.

Seroquel may increase the risk of death when used to treat mental problems caused by dementia in elderly patients and therefore should not be used in these patients. Most of the deaths were linked to heart problems or infection.

Seroquel may cause tardive dyskinesia, a potentially irreversible condition characterized by uncontrollable muscle spasms and twitches in the face and body. Older adults, especially women, appear to be at greater risk. Patients at risk of seizures should use Seroquel cautiously.

Seroquel may cause neuroleptic malignant syndrome (NMS), a serious, and potentially fatal, reaction to the drug. Call your doctor immediately if you develop muscle stiffness, confusion, irregular or rapid heartbeat, excessive sweating, and high fever. Be especially wary if you have a history of heart attack, heart disease, heart failure, circulation problems, or irregular heartbeat.

Certain antipsychotic drugs, including Seroquel, are associated with an increased risk of developing high blood sugar, which on rare occasions has led to coma or death. See your doctor right away if you develop signs of high blood sugar, including dry mouth, unusual thirst, increased urination, and tiredness. If you have diabetes or have a high risk of developing it, see your doctor regularly for blood sugar testing. In addition, Seroquel may affect cholesterol and triglyceride levels. Some patients have also experienced weight gain.

Seroquel may rarely cause a prolonged, painful erection. This could happen even when you are not having sex. If this is not treated right away, it could lead to permanent sexual problems, such as impotence. Contact your doctor right away if this happens.

Do not drink alcohol while you are using Seroquel.

Do not become overheated or dehydrated in hot weather or while you are being active; heatstroke, dizziness, or fainting may occur.

Seroquel may cause drowsiness, dizziness, or decreased vision. These effects may be worse if you take it with alcohol or certain medicines. Use Seroquel with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.

Use Seroquel with particular caution if you have cardiovascular disease, cerebrovascular disease, or conditions that could lead to low blood pressure (dehydration, low blood volume and treatment with blood pressure medications).

An eye exam for cataracts is recommended at the beginning of treatment and every six months.

Do not suddenly stop taking Seroquel without first talking with your doctor, as this may increase the risk of side effects. If you need to stop Seroquel or add a new medicine, your doctor will gradually lower the dose.

Rarely, Seroquel may lower the ability of your body to fight infection. Avoid contact with people who have colds or infections. Tell your doctor if you notice signs of infection like fever, sore throat, rash, or chills, especially if you have low white blood cell counts.

Who should not take this medication?

Do not take Seroquel if you are allergic to the medication or any of its ingredients.

What should I tell my doctor before I take the first dose of this medication?

Tell your doctor about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with Seroquel. Also, talk to your doctor about your complete medical history, especially if you have liver, kidney, or heart disease, high or low blood pressure, high cholesterol, heart rhythm problems, a history of heart attack or stroke, a thyroid disorder, seizures, epilepsy, Alzheimer's disease, obesity, breast cancer, thyroid problems, cataracts, narrow-angle glaucoma, high blood prolactin levels, neuroleptic malignant syndrome, a personal or family history of diabetes, or trouble swallowing.

What is the usual dosage?

The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

Bipolar Disorder

Adults: The usual dosage range is 300 to 800 milligrams (mg) a day. Doses above 800 mg a day have not been tested for safety. The dosage will be gradually increased over 4 to 6 days until the most effective dose is reached.

Schizophrenia

Adults: Adults: The usual dosage range is 300 to 400 mg a day, divided into two or three smaller doses. Doses as low as 150 mg a day sometimes prove effective; the dose rarely exceeds 750 mg per day. Doses above 800 mg per day have not been tested for safety. The dose is gradually increased over 4 days until the most effective dose is reached. If you have liver problems, you may be started at 25 mg a day. The doctor will increase the dose as needed.

Debilitated, elderly, or prone to low blood pressure: You may need your dose adjusted depending on your condition and response to the drug.

How should I take this medication?

Your doctor will increase your dose gradually until the drug takes effect. If you stop Seroquel for more than one week, you'll need to build up to your ideal dosage once again.

What should I avoid while taking this medication?

Seroquel tends to cause drowsiness, especially at the start of therapy, and can impair your judgment, thinking, and motor skills. Avoid driving or operating machinery until you know how the medication affects you.

Avoid exposure to extreme heat, strenuous exercise, and dehydration.

Avoid drinking alcohol while taking Seroquel. The drug increases the effects of alcohol.

When you first start treatment, avoid sitting up or standing up too quickly, especially in the morning. Seroquel may cause dizziness, lightheadedness, or fainting due to a decrease in blood pressure. Alcohol, hot weather, exercise, or fever may increase these effects. Sit or lie down at the first sign of any of these effects.

Rarely, Seroquel may lower the ability of your body to fight infection. Avoid contact with people who have colds or infections. Tell your doctor if you notice signs of infection like fever, sore throat, rash, or chills.

What are possible food and drug interactions associated with this medication?

If Seroquel is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Seroquel with the following: alcohol, barbiturates such as phenobarbital, carbamazepine, cimetidine, divalproex, erythromycin, fluconazole, itraconazole, ketoconazole, levodopa, lorazepam, phenytoin, rifampin, steroids such as hydrocortisone and prednisone, and thioridazine.

What are the possible side effects of this medication?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

Side effects may include: abdominal pain, constipation, diminished movement, dizziness, drowsiness, dry mouth, excessive muscle tone, fatigue, headache, indigestion, low blood pressure (especially upon standing), nasal inflammation, neck rigidity, rapid or irregular heartbeat, rash, sleepiness, tremor, uncontrollable movements, vomiting, weakness, weight gain

Can I receive this medication if I am pregnant or breastfeeding?

The effects of Seroquel during pregnancy and breastfeeding are unknown. Tell your doctor immediately if you are pregnant, plan to become pregnant, or are breastfeeding. Seroquel should only be used during pregnancy if the potential benefit justifies the potential risk to the fetus.

What should I do if I miss a dose of this medication?

Take it as soon as you remember. If it is almost time for the next dose, skip the one you missed and go back to your regular schedule. Do not take two doses at once.

How should I store this medication?

Store at room temperature away from heat, moisture, and light. Do not store in the bathroom.