Seroquel

Seroquel is the brand name of an atypical antipsychotic medication called quetiapine fumarate. It is a fairly popular choice for use with a number of different psychiatric illnesses, and is often added to existing medications to assist with sleep. Due to its sedating qualities and its relative availability, it has become a drug of abuse among teens. Sales of Seroquel on high school and even middle school campuses are on the rise but recreational use can be dangerous. In addition, Seroquel carries the same “black box warning” that serotonin-specific reuptake inhibitors (SSRIs) carry regarding the potential for suicide.

Approved Uses of Seroquel

Seroquel is FDA approved for several uses: as an antipsychotic medication for patients diagnosed with schizophrenia or mood disorders with psychotic features, and as an adjunct medication for treating depression and depressive or manic states in bipolar disorder. As you may have seen in advertisements, some of the atypical antipsychotic medications such as Seroquel or Abilify are being marketed as providing a little extra “lift” when depression is profound and antidepressants are not providing relief.

More specifically, FDA approval has been gained for the use of Seroquel in adults who meet the following criteria:

• A diagnosis of major depressive disorder, and a poor or insufficient response to antidepressants alone

• Depression caused by the depressive phase in a patient diagnosed with bipolar disorder

• As an addition to lithium or depakote for use in treating a manic phase or for overall treatment of bipolar disorder

In children, the criteria are slightly different:

• For patients ages 10 to 17, Seroquel is approved for the treatment of acute mania

• For adolescents aged 13 to 17, Seroquel is approved for the treatment of schizophrenia

How Does Seroquel Work?

Seroquel works in a number of ways. While an accurate chemical description of the precise mechanisms is beyond the scope of this article, five different known pharmacological actions are described for this medication, including dopamine, serotonin, and adrenergic actions. In part, this means that when seeking to discontinue this medication for any reason, physiological withdrawal symptoms may occur. Be sure to discuss any changes in dosage with your prescriber and follow medical advice very carefully.

What are the most common side effects?

Side effects differ slightly depending upon whether the extended release or the regular Seroquel is used. Adults are more likely to experience:

• Sleepiness or daytime sedation

• Issues with dryness: dry skin, dry mouth, constipation

• Weight gain and increases in appetite

• Nasal congestion

• Weakness or dizziness

• Blood pressure changes

• Changes in liver function

Children are more likely to experience:

• Increased heart rate

• Sedation

• Dizziness

• Gastrointestinal distress including nausea and/or vomiting

Special Concerns?

This medication is not recommended for older adults patients with dementia-related psychosis. Studies have linked treatment with Seroquel to death in some cases. Other antipsychotic medications for patients in these situations should be used.

As mentioned above, Seroquel also carries the “black box warning” regarding suicide in adolescents and children. This concern has been raised regarding treatment with SSRIs, but due to Seroquel’s multiple actions in the brain, and its impact upon serotonin receptors, it also meets criteria for this warning. Multiple lawsuits have been filed due to the link between suicide and treatment with SSRIs and Zoloft in particular. It is highly recommended that anyone started a new medication have both treatment professionals and friends and family closely monitor and create a safety plan around any changes in mental status or serious mood changes.

Seroquel may impact blood sugar and it may cause weight gain in some patients. Your doctor will need to know about your family health history and especially about any history of diabetes. If you have diabetes, have family members (living or deceased) with diabetes, or have several risk factors for developing diabetes, make sure you discuss