Seroquel Side Effects: Complete Guide

Key Takeaways

• Common Seroquel side effects include drowsiness, dizziness, dry mouth, and increased appetite, especially during the first few weeks of treatment.
• While many side effects improve as your body adjusts, some long-term effects, including weight gain and metabolic changes, may require ongoing monitoring.
• Serious side effects are uncommon but can occur, making regular follow-up with your healthcare provider an important part of treatment.

Seroquel (quetiapine) can be an effective treatment for conditions such as schizophrenia, bipolar disorder, and depression, but like any medication, it may cause side effects. Some side effects are mild and temporary, while others may persist or require medical attention.

Knowing what side effects to expect can help you recognize changes early and have informed conversations with your healthcare provider. Whether you're considering Seroquel for the first time or already taking it, understanding the potential risks and benefits can help you use the medication safely and confidently.

What is Seroquel and How Does it Work?

Seroquel (quetiapine) is a prescription medicine in the class of drugs known as atypical antipsychotics. Research in the American Journal of Psychiatry shows its effectiveness as it is commonly used to treat several mental health and psychiatric conditions, like schizophrenia, depression, and bipolar disorder.

This medicine works by affecting certain chemical messengers in the brain, primarily dopamine and serotonin. These neurotransmitters help regulate mood, thinking, behavior, and perception. By helping balance their activity, Seroquel can reduce symptoms associated with conditions such as schizophrenia and bipolar disorder, and may also help improve mood in people with depression.

Because Seroquel changes how these brain chemicals function, it can take time for its full effects to develop. The medication may also affect people differently depending on their condition, dosage, and overall health. Like all medications, Seroquel has potential side effects and symptoms that users must understand to take it safely and effectively.

What Common Side Effects Might You Notice First?

It's common to experience at least some Seroquel side effects, especially during the first few weeks as your body adjusts to the new medication. Knowing what to expect will help you navigate this period and manage your antipsychotic treatment better. It can also help you decide whether to seek professional advice.

When side effects may occur:

• Shortly after starting treatment: Drowsiness, dizziness, dry mouth, and constipation are among the side effects people may notice early in treatment.
• During the first several weeks: Some side effects improve as the body adjusts to the medication.
• With longer-term use: Weight gain and metabolic changes, including increased blood sugar or cholesterol levels, may develop over time and often require ongoing monitoring.

According to the FDA, below are some of the more frequently reported Seroquel side effects experienced during clinical trials:

• Drowsiness or sedation (somnolence)
• Dry mouth
• Dizziness
• Constipation
• Feeling tired or weak (asthenia)
• Weight gain
• Sore throat (pharyngitis)
• Abdominal pain
• Indigestion (dyspepsia)
• Low blood pressure when standing (postural hypotension)
• Lethargy
• Abnormal liver function tests (ALT increased)

"With Seroquel, sedation is the most prominent side effect. Stimulation of appetite can lead to weight changes. There is a need to monitor the metabolic profile, including blood sugar and lipid profile. Having a healthy lifestyle, exercise, and eating habits is essential while taking Seroquel."

– Talkspace psychiatrist, Dr. Muhammad Munir

Regular consultation with your doctor is vital throughout your treatment with this medicine to address any emerging side effects listed above or health concerns related to this antipsychotic. If any of these common side effects persist or worsen, contact a healthcare provider to discuss them. Only your doctor can determine if you should change dosage or consider a different medication.

How Long Do Seroquel Side Effects Last?

Seroquel side effects typically last a few days to a few weeks, depending on the dose and your individual response. The short-term side effects, like drowsiness and dizziness, often improve within days or weeks as your body adjusts to the dose. However, other side effects, like weight gain or metabolic changes, might last as long as you are taking Seroquel.

Which Less Common Side Effects Should You Still Know?

It's possible to experience less common quetiapine side effects when taking Seroquel. While they generally occur less frequently, being aware of them is still important in understanding how this medicine might affect you. If you notice any of the following side effects after starting Seroquel, notify your healthcare provider to determine the best course of action.

• Blurred vision
• Increased sweating
• Upset stomach
• Changes in appetite
• Nasal congestion
• Tremor
• Restlessness
• Increased heart rate
• Difficulty concentrating

Which Serious Side Effects Need Urgent Care?

For most users, Seroquel is well-tolerated. However, it can occasionally cause severe side effects in some people. These effects are significant considerations when taking this antipsychotic drug. Seroquel carries important FDA warnings regarding suicidal thoughts and behaviors in children, adolescents, and young adults taking antidepressant medications, as well as an increased risk of death in older adults with dementia-related psychosis.

If you experience any of the following serious Seroquel side effects, seek immediate medical attention:

• Severe allergic reaction: Symptoms of a serious allergic reaction to Seroquel may include wheezing, a racing heart, fever, and swelling of the lips, mouth, face, throat, or tongue. Seek immediate medical attention if these occur.
• Tardive dyskinesia: A serious condition characterized by involuntary, repetitive movements, particularly of the face and limbs. These movements may become permanent with prolonged use of Seroquel.
• Metabolic changes: Seroquel may cause significant weight gain, increased blood sugar levels, or diabetes. Symptoms of diabetes can include increased thirst, frequent urination, and fatigue. Severe cases may lead to coma or death.
• Low blood pressure: Seroquel can cause a sudden drop in blood pressure, particularly when standing up too quickly, leading to dizziness, fainting, or falls.
• Neuroleptic malignant syndrome (NMS): A rare but life-threatening condition that may occur with Seroquel use. Symptoms include severe muscle rigidity, high fever, confusion, and altered mental status. Seek emergency medical care if these symptoms appear.
• Body temperature regulation: Seroquel can interfere with the body's ability to regulate temperature, increasing the risk of overheating, especially during hot weather or physical activity. Stay hydrated and avoid overheating to reduce the risk of dehydration.
• Blood cell abnormalities: Seroquel can rarely lower white blood cell counts, including conditions called leukopenia, neutropenia, and agranulocytosis. Contact your healthcare provider if you develop symptoms of infection, such as fever, chills, or a persistent sore throat.
• Seizures: Although uncommon, seizures have been reported in people taking Seroquel. Seek immediate medical attention if you experience a seizure while taking this medication.
• Difficulty swallowing (dysphagia): Seroquel may affect swallowing in some people, increasing the risk of choking or aspiration. Contact your healthcare provider if you have trouble swallowing food or liquids.
• Falls: Drowsiness, dizziness, and low blood pressure can increase the risk of falls, particularly in older adults. Use caution when standing up quickly or engaging in activities that require balance.
• Sedation: Seroquel may cause excessive drowsiness that can interfere with daily activities or basic functioning. If affected, avoid operating heavy machinery or driving.

How Can Women Experience Seroquel Differently?

Women may experience some quetiapine side effects differently because of hormonal factors, body composition, and medication metabolism. However, many of the most common side effects, including drowsiness, dizziness, dry mouth, and weight gain, occur in both men and women.

If you're pregnant, planning to become pregnant, or breastfeeding, talk with your healthcare provider before starting or continuing Seroquel. The medication can pass into breast milk, and treatment decisions should carefully balance potential benefits and risks. Seroquel can also increase prolactin levels in some people. Elevated prolactin may contribute to menstrual changes, breast tenderness, or unexpected milk production in women.

Women may also be monitored closely for metabolic changes, including weight gain and blood sugar increases, since these effects can become more significant during long-term treatment. Regular follow-up appointments can help identify changes early and support ongoing treatment decisions. If you notice new or unexpected symptoms while taking Seroquel, discuss them with your healthcare provider. They can help determine whether symptoms are related to the medication and whether any treatment adjustments are needed.

Does Seroquel Cause Weight Gain and Other Long-Term Changes?

Prolonged use can lead to long-term Seroquel side effects, some of which may require ongoing management or intervention.

Weight gain

Seroquel can increase appetite, leading to significant weight gain over long-term treatment with this antipsychotic drug. This may elevate the risk of obesity-related conditions such as diabetes and heart disease.

Blood sugar changes

Long-term Seroquel use can elevate blood sugar levels, which can lead to type 2 diabetes in some people. Does Seroquel cause weight gain and blood sugar problems? Yes, both are common metabolic effects. Regular glucose monitoring is standard when using this antipsychotic medicine for long periods to ensure safety.

Cholesterol and heart health

Research in JCI Insight shows a link between Seroquel and high cholesterol levels, although the cause isn't fully understood. High cholesterol can increase the risk of heart disease and other cardiovascular issues. Your doctor might suggest routine blood tests if you're taking Seroquel. If there is a concern, they might discuss dietary changes or new medications to manage your levels.

Ongoing drowsiness

Some people who use Seroquel experience ongoing sedation that can impact their daily functioning and quality of life. Your doctor might have you adjust the timing of doses or suggest you explore alternative medications to help.

Tardive dyskinesia

Tardive dyskinesia is a rare movement disorder that can become permanent if untreated. It's characterized by involuntary, abnormal muscle movements that you should report to your healthcare provider as soon as you notice them.

In some cases, discontinuing Seroquel may help alleviate symptoms, but stopping the medication should only be done under a doctor's supervision. Treatment options for tardive dyskinesia may include switching to a different medication or prescribing medications specifically designed to manage the condition, such as valbenazine or deutetrabenazine. It's crucial to work closely with your healthcare provider to determine the best course of action.

Neuroleptic malignant syndrome (NMS)

Though very uncommon, NMS is a serious condition that warrants close monitoring and immediate intervention if symptoms appear. Routine check-ups and open communication with your healthcare provider are key to mitigating risk.

Symptoms of NMS can include:

• High fever (102–104°F)
• Muscle rigidity
• Irregular heartbeat or excessive sweating
• Altered mental state
• Laboratory abnormalities

Other long-term monitoring considerations

Long-term Seroquel treatment may require monitoring for additional health changes beyond weight gain and metabolic effects. Depending on your medical history and risk factors, your healthcare provider may recommend periodic blood tests, eye exams, or other evaluations.

Potential long-term concerns include:

• Cataracts
• Changes in white blood cell counts
• Elevated prolactin levels (hyperprolactinemia)
• Thyroid hormone changes
• Heart rhythm changes, including QT prolongation

Regular follow-up appointments can help identify these effects early and support safe, long-term treatment.

How Can You Safely Manage Side Effects with Your Clinician?

It's usually possible to effectively manage Seroquel side effects by working closely with your healthcare provider. Regular follow-up appointments can help identify side effects early, monitor your response to treatment, and determine whether any adjustments are needed. To reduce the risk of experiencing unwanted side effects, always take Seroquel exactly as directed. Never alter or skip doses without talking to your doctor first, as doing so could lead to Seroquel withdrawal.

Tips for managing unwanted quetiapine side effects include:

• Adjusting the dose: A lower dose may alleviate some side effects.
• Incorporating lifestyle changes: Making small lifestyle adjustments can help manage side effects. For example, maintaining a balanced diet can help combat weight gain, engaging in regular physical activity can boost energy levels and support cardiovascular health, and establishing a consistent sleep routine can reduce drowsiness.
• Using supportive treatments: For some side effects, over-the-counter remedies like stool softeners for constipation can offer relief.
• Scheduling regular check-ups: Routine blood tests and physical exams can help monitor weight, blood sugar, cholesterol levels, blood pressure, and other long-term Seroquel side effects. Depending on your health history, your provider may also recommend monitoring thyroid function, white blood cell counts, or other health markers during treatment.
• Reporting new symptoms promptly: Let your healthcare provider know if you experience unusual muscle movements, signs of infection such as fever or persistent sore throat, vision changes, trouble swallowing, severe dizziness, or any other unexpected symptoms. Early evaluation can help prevent complications and determine whether changes to your treatment plan are needed.
• Switching medications: In some cases, an alternative medication might be a better fit. Comparing medications like Abilify vs. Seroquel can help you find the best treatment option for your specific mental health condition.

"The dose of Seroquel needs to be adjusted to address the clinical symptoms in keeping with the side effect profile. A healthy diet, exercise, and regular monitoring of the lipid profile and blood sugar changes are an essential part of treatment. Once moods stabilize, reducing the dose is also a consideration."

– Talkspace psychiatrist, Dr. Muhammad Munir

See if Seroquel is Right for You with Talkspace

While it can be an effective treatment for managing several mental health conditions, it's important to understand and address potential Seroquel side effects for safe and successful use. You can minimize the risks associated with this medication by staying informed, working closely with licensed psychiatric providers, and making occasional lifestyle adjustments.

If you're considering this medication, Seroquel alternatives, or any prescription medication to help your mental health, and you want support in managing side effects, Talkspace offers online psychiatry and medication management from vetted, trained professionals to guide you. Get Seroquel prescribed online and take the first step toward better mental health.

Frequently Asked Questions (FAQs)

Is Seroquel safe long-term?

Seroquel is generally safe for long-term use when monitored by a healthcare provider. However, long-term use may increase the risk of metabolic changes, elevated cholesterol, or tardive dyskinesia, so regular check-ups are important.

When should I worry about Seroquel side effects?

You should worry about Seroquel (quetiapine) side effects if you develop severe or sudden symptoms like chest pain, fainting, irregular heartbeat, high fever with muscle stiffness, severe confusion, uncontrolled movements, or signs of an allergic reaction such as swelling or trouble breathing. You should also seek medical advice urgently if you notice mood worsening, suicidal thoughts, signs of infection (fever, sore throat), or extreme drowsiness that interferes with waking or daily functioning.

What are the rarest side effects of Seroquel?

The rarest Seroquel side effects include neuroleptic malignant syndrome, severe allergic reactions, and blood disorders. While extremely uncommon, these reactions can be life-threatening and require emergency medical attention. Other rare effects include liver problems, seizures, cataracts, and QT prolongation.

How soon do Seroquel side effects start after taking it?

Some quetiapine side effects, particularly drowsiness, dizziness, and dry mouth, can occur within hours or days of starting treatment. Other effects, including increased appetite and weight gain, may develop gradually over several weeks or months.

Should older adults be more concerned about Seroquel side effects?

Older adults may be more sensitive to side effects such as drowsiness, dizziness, falls, and low blood pressure. Seroquel also carries a boxed warning about an increased risk of death in older adults with dementia-related psychosis.

What lifestyle changes can help reduce Seroquel side effects?

With Seroquel, regular exercise, a balanced diet, good sleep habits, and avoiding alcohol can help reduce minor side effects like weight gain and drowsiness. Also, stand up slowly and monitor weight and blood sugar to manage dizziness and metabolic effects.

Can Seroquel side effects improve over time?

Many Seroquel side effects, like drowsiness, dizziness, and dry mouth, often diminish within weeks as your body adjusts. However, metabolic effects such as weight gain and elevated blood sugar typically persist or worsen with continued use, requiring ongoing management.

Sources

1. Curry DE, Richards BL. A brief review of Quetiapine. American Journal of Psychiatry Residents Journal. 2022;18(2):20-22. doi:10.1176/appi.ajp-rj.2022.180207. https://psychiatryonline.org/doi/full/10.1176/appi.ajp-rj.2022.180207. December 18, 2024.
2. Highlights of Prescribing Information. Seroquel.; 2022. https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/020639s072lbl.pdf‍
3. Meng Z, Gwag T, Sui Y, Park SH, Zhou X, Zhou C. The atypical antipsychotic quetiapine induces hyperlipidemia by activating intestinal PXR signaling. JCI Insight. 2019;4(3). doi:10.1172/jci.insight.125657. https://pmc.ncbi.nlm.nih.gov/articles/PMC6413802/. December 18, 2024.

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