Warnings

Seroquel

( Quetiapine Fumarate )

Medically Reviewed by HaVy Ngo, Pharm.D.

Last Reviewed: Jun 13, 2022

Warnings

What are the risks of taking Seroquel (quetiapine)?

Suicidal thoughts and behaviors:

Risk factors: Adolescents younger than 24 years of age.
In short-term studies, Seroquel increased the risk of suicidal thoughts and behavior in children, adolescents, and young adults. Patients should be monitored closely for worsening or the emergence of suicidal thoughts and behaviors. Advise family members and caregivers of the need for close observation and communication with the prescriber.

Increased risk of death and stroke::

Risk factors: Older adults with dementia-related psychosis.
Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Seroquel (quetiapine) is not approved for the treatment of patients with dementia-related psychosis.

Neuroleptic malignant syndrome (NMS):

High fever, sweating, extreme muscle stiffness, confusion, irregular pulse, increased heart rate, increased blood pressure, acute renal failure. NMS is rare; however, it can be life-threatening.

Uncontrollable body movement:

Risk factors: Long-term use, high doses, older adults
Quetiapine can cause uncontrollable body movement. Tardive dyskinesia (TD) can cause blinking or abnormal eye movement, lip smacking, chewing, frowning, tongue protrusion and movement. Extrapyramidal symptoms (EPS) include tremor, body stiffness, and restlessness.

Metabolic changes:

Risk factors: Existing diabetes, high cholesterol, obesity, or a family history of these conditions.
Quetiapine can cause an increase in appetite, blood sugar, and cholesterol that may result in weight gain. Labs should be completed regularly to monitor blood cholesterol and blood sugar levels.

Increased prolactin level:

High prolactin levels can cause fertility issues, sexual dysfunction, enlarged male breasts, menstrual changes, and unusual breastmilk production in females.

Low thyroid level:

Quetiapine can cause abnormal thyroid results. Low thyroid levels can cause weight gain, feeling tired, getting cold easily, and brittle nails.

Low white blood cell count:

Quetiapine can cause a drop in white blood cells. White blood cells are parts of your immune system that helps your body fight off infections. If you start getting sick easily, or having cold and flu symptoms often - these can be signs of low white blood cell count. Labs should be completed regularly to monitor the level of white blood cells to make sure that it is within the acceptable range.

Difficulty swallowing:

Increased risk: older adults with Alzheimer’s dementia.
Quetiapine can cause swallowing problems. This can be dangerous, especially with elderly patients, since the food or liquid can get into the lungs and cause breathing problems.

Priapism:

Quetiapine can cause painful, long-lasting erections that can cause permanent damage to the penile tissue. Seek medical attention right away if you have an erection that does not go away.

Eye problems:

Increased risk: long-term use
You can develop symptoms of eye problems such as cataracts. Eye exam should be completed at initiation at therapy, then every six months during chronic treatment.

Change in blood pressure:

Increased risk: Stroke; history of heart disease or high blood pressure; taking other blood pressure medications
Quetiapine can cause a sudden drop in blood pressure that can cause dizziness and lightheadedness, which can lead to falls and injuries--change position slowly until your body is used to the medication. Quetiapine can cause a rise in blood pressure in children between the age of 10 and 17. Blood pressure should be monitored frequently at home, especially in children, to ensure the blood pressure are within normal range.

Poor mental alertness:

Quetiapine can impair your judgment, thinking, and motor skills. You should refrain from driving, operating hazardous machinery, or any activities that require mental alertness until you know that your body is used to this medication.

Irregular heartbeat:

Increased risks: existing heart problem; taking medications for irregular heartbeat
Quetiapine (Seroquel) can cause or exacerbate irregular heartbeat (arrhythmia). Let your doctor know at the beginning of treatment if you have any type of heart condition or irregular heartbeat.

Withdrawal:

Increased risk: Abrupt discontinuation of quetiapine
You should not discontinue quetiapine (Seroquel) abruptly. Your doctor will need to slowly taper down the dose to avoid withdrawal symptoms such as nausea, vomiting, and trouble sleeping.

Risk to infant during and after delivery:

Taking quetiapine during the third trimester may increase the risk of withdrawal symptoms, breathing problems, feeding problems, tremors, and fussiness of newborns after delivery. If you are pregnant or planning to conceive, you should discuss with your healthcare provider the risks and the benefits of taking quetiapine (Seroquel) during the pregnancy.

What should I tell my doctor before starting Seroquel (quetiapine)?

You should not take Seroquel (quetiapine) if you are allergic to quetiapine. Seroquel (quetiapine) is not approved for use in older patients with dementia-related psychosis as this medication can increase the risk of death in this patient population.

Before taking Seroquel, to make sure that it is safe for you, tell your doctor if you have:

Heart disease, heart rhythm problems, or history of stroke and heart attack
Kidney or liver problems
Trouble swallowing
Personal history or family history of diabetes, high cholesterol, or high triglycerides
High or low blood pressure
Cataracts or other eye problems
A history of low white blood cell counts
Abnormal thyroid or prolactin level
Seizures

What proper medical care should I take while on Seroquel (quetiapine)?

Take this medication every day, around the same time. Do not discontinue Seroquel (quetiapine) unless your doctor instructs you to do so.
Check your blood pressure regularly at home. If your blood pressure is in the lower range, change position slowly to reduce dizziness and lightheadedness to avoid falls.
Follow your doctor’s medical advice and go to all of your doctor and lab appointments to ensure the safety and efficacy of this therapy.

What drugs can interact with Seroquel (quetiapine)?

Seroquel (quetiapine) can cause serious heart problems if used simultaneously with other medications, including HIV/AIDS medications, certain antidepressant therapy, antibiotics, heart rhythm medicines, antipsychotic medicines, and medications to treat cancer and malaria.

Inform your doctor if you are taking narcotic pain medicine, muscle relaxants, medicines for sleep, anxiety, or depression - these medications can make you sleepy and slow your breathing, which can be dangerous or potentially fatal.

This is not a complete list. Other drugs, including prescriptions, over-the-counter products, herbal supplements, and vitamins, may interact with Seroquel (quetiapine). Not all potential drug interactions are listed in this guide. It is highly recommended to keep a list of all the drug products you are using (prescriptions, over-the-counter products, herbal supplements, natural products, and vitamins) and share it with your doctor and pharmacist.

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