When Is Seroquel Prescribed?
The United States Food and Drug Administration (FDA) has approved Seroquel for a variety of uses beyond serious cases of schizophrenia. Some prescribers have also turned to it for treating related symptoms “off label,” prescribing the drug in a way not explicitly endorsed by the FDA.
1,8
Some of the symptoms or conditions that might prompt a medical practitioner to start treatment with Seroquel or generic quetiapine include the following:
- Acute episodes (either manic or depressive) resulting from bipolar disorder
- Long-term maintenance of bipolar disorder
- Delusional thoughts, including paranoid thoughts
- Hallucinations — auditory or visual
- Inability to organize thoughts coherently
- Severe cases of depression — prescribed in conjunction with an antidepressant
- Post-traumatic stress disorder (PTSD) and other serious anxiety disorders
Some of the more common short-term side effects reported by Seroquel patients can be fairly unpleasant, and include:
- Suicidality, especially near the beginning of the treatment
- Headache
- Drowsiness, lethargy, physical weakness, lack of energy
- Somnolence (daytime sleepiness)
- Dizziness
- Dry mouth
- Constipation
- Diarrhea
- Abdominal pain
- Impaired judgment, thinking, and motor skills
- Blurred vision
- Hypotension (low blood pressure)
- Restless or stiff muscles
- Unexpected changes in cholesterol levels
- Weight gain
Long-term Seroquel Risks — Known Side Effects of Long-term Use
Long-term Seroquel risks (and those of the generic version of quetiapine) are an important body of data because Seroquel is often used as a long-term maintenance drug. While Seroquel has shown some efficacy in treating acute episodes related to schizophrenia and various other psychological disorders, Seroquel is typically seen as a daily maintenance drug.
Many patients get stuck on Seroquel for months or years without hope of ever getting off it. Such prescribing practices are often without merit and can induce more harm than good for some, according to available research on the subject.
The reality is that there is no known pharmacological cure for schizophrenia, and like most mental health issues, its symptoms are subjectively felt and largely unseen. Living with schizophrenia often involves a lifetime of work, ongoing treatment, and developing healthy coping skills. Whether that treatment involves powerful pharmaceuticals, psychiatric treatment, new emerging therapies, or some combination of those elements will represent a deeply personal healthcare choice, just as experiencing schizophrenia is a deeply personal journey.
Speak openly with your health professionals and other trusted resources about what you are experiencing and what your concerns are with your current treatment method. Do not settle for a treatment plan that you do not feel is working for you. Continue researching and exploring your options until you and your prescriber can develop and implement a treatment plan that addresses your individual mental health needs. Not everyone who lives with schizophrenia will require daily treatment with Seroquel or other potent drugs.
The Negative Side Effects of Long-Term Seroquel Use
While we do not yet know the full extent of long-term Seroquel risks, some of the research has helped us to understand these better. While the initial trials that were used to approve Seroquel for the treatment of schizophrenia demonstrated fairly consistent tolerance and efficacy, the studies into long-term use so far have had mixed results, at best.
The data we currently have about the long-term use of Seroquel and similar antipsychotics show some very disappointing and concerning trends for those who are looking to modern medicine to provide a cure—or at least a viable treatment—for schizophrenia and psychotic episodes.
A recent Canadian investigative project found that an alarming number of patients in long-term care were given antipsychotic medications inappropriately without an actual diagnosis of psychosis, but simply to keep them sedated. Measures were put in place to monitor and hopefully reduce this practice.20
Long-term Seroquel risks can include:
- Extrapyramidal effects such as tardive dystonia, tardive dyskinesia, etc.
- Elevated prolactin in both males and females
- Weight gain
- Temperature dysregulation
- Increased mortality rate
- Memory or cognitive impairments
- Risk of stroke
- Cardiac disorders
- Increased falls and injuries
- Incidence of NMA (neuroleptic malignant syndrome)
- Kidney damage
- Impaired liver function
Long-Term Seroquel Use and Muscle Problems
Some of the most common side effects emerging among long-term quetiapine patients include muscle issues. The side effects reported range from simple annoyances like stiff muscles to debilitating conditions like constant involuntary movement in the mouth.
The muscle problems related to long-term Seroquel treatment can be divided into two categories, the first being extrapyramidal symptoms (EPS) and the other being tardive dyskinesia (TD). EPS manifests as muscles that are restless, prone to involuntary trembling, and frequently feel stiff. TD results in slow muscle response and awkward, difficult-to-control movements. The first symptoms of TD often manifest in small, involuntary movements in the muscles in the mouth, jaw, and tongue.
All dopamine-blocking drugs have been clinically associated with the above tardive symptoms. The word “tardive” means delayed, or appearing over time.7,10
Elevated Prolactin
Quetiapine was shown in clinical trials to cause increased levels of the hormone prolactin of over three times higher than placebo in males, and 8 times greater in females, in short, and long-term use.8,11
This hormonal imbalance can lead to all sorts of problems, including:
- Osteoporosis, loss of bone density, and resulting bone fractures
- Loss of sex drive
- Disruption or absence of menstrual cycle
- Production of breast milk outside of pregnancy/motherhood
- Erectile dysfunction
Weight Gain
One commonly reported result of treatment with Seroquel and some other neurotransmitter-manipulating drugs is significant weight gain. Related conditions like high blood sugar, diabetes, high triglycerides, and high cholesterol are also linked to long-term users of second-generation antipsychotics like Seroquel. These effects are generally known, and doctors who prescribe Seroquel will often conduct regular blood sugar panels along with hemoglobin testing to monitor patient health in these areas.2,8
Temperature Dysregulation
Seroquel is associated with increasing body temperature. Some long-term Seroquel users have experienced an impairment in their body’s ability to regulate temperature. This can lead to spontaneous occurrences of life-threatening overheating, as well as life-threatening overheating issues when the Seroquel user works out or spends time in the sun, or becomes dehydrated, for example.8,12,13
Does Quetiapine Shorten Your Life?
Perhaps the most concerning side effect of all is the increased potential for death. The drug label warns of a higher risk of death for elderly dementia patients. In manufacturer drug trials, the rate of deaths was twice that of placebo. In an independent antipsychotic drug study, the death rate was 3-fold higher for those taking antipsychotics vs not taking antipsychotics. These deaths were listed as sudden deaths, heart failures, infections like pneumonia, and others not listed. Additionally, another warning appears on the drug label about the increased risk of suicidal thoughts and behavior.8,9
Cognitive and Memory Impairments
Seroquel is an anticholinergic drug, meaning it suppresses the excitatory neurotransmitter acetylcholine. Acetylcholine’s function, in part, is to facilitate sending messages throughout the CNS. Anticholinergic drugs are associated with causing or exacerbating memory impairments. Therefore, long-term Seroquel risks also include memory and cognitive impairments, according to research published as far back as 1996 in the Canadian Journal of Psychiatry.6
Seroquel May Be Associated With Strokes
The research to date has shown a 2.7-fold increase in the risk of brain stroke in patients taking quetiapine, although the biological mechanisms behind this risk are still incompletely understood.8,13
Does Seroquel Cause Heart Problems?
Antipsychotics in general are also associated with an elevated risk of death due to cardiac issues. Antipsychotic medications, including Seroquel, seem to increase the likelihood that a patient will become disabled or die suddenly due to arrhythmias, tachycardia, cardiac arrest, cardiomyopathy, or other heart-related injury.8,14
Seroquel is Linked to Increased Falls
Antipsychotics such as quetiapine can exacerbate that dizzy feeling that you experience when standing up after sitting down or bending over for long periods. The sensation is known to be rooted in something called orthostatic hypotension, a rapid drop in blood pressure. Cognitive impairment due to sedation and slowed psychomotor responses are also implicated in the heightened risk of falls in patients taking quetiapine. When antipsychotics elevate these phenomena to dangerous levels, a patient can lose balance or even consciousness, resulting in serious injuries, and a potentially fatal fall.8,15
Seroquel is Associated With Neuroleptic Malignant Syndrome
NMS, or neuroleptic malignant syndrome, is another potentially fatal issue linked to both short-term (rare) and long-term (more common) antipsychotic use. Signs of developing problems may include profuse sweating, disorientation, and muscle stiffness. Unlike the lingering symptoms of tardive dyskinesias, NMS symptoms have reversed when the medication was stopped.16
Is Seroquel Hard on the Kidneys?
Quetiapine and several other antipsychotic drugs have recently been named in class action lawsuits surrounding an elevated risk of acute kidney injury in patients. Research shows that quetiapine can be statistically linked to kidney injuries that result in urinary tract problems, hypotension, and the aforementioned neuroleptic malignant syndrome.3
Does Seroquel Cause Fatty Liver?
Antipsychotics like quetiapine have also been implicated in a condition called nonalcoholic fatty liver. Just as its name suggests, this disease results in liver issues similar to those of long-term alcohol addicts, except without the element of alcohol present. If left untreated, this can lead to more serious diseases like cancer or cirrhosis.4
As with most drugs that cause a sedative effect, the potential exists for Seroquel to become habit-forming. While the exact mechanism of quetiapine on the brain is not completely understood, we do know that the mechanism manipulates serotonin and dopamine levels. This is an effect seen across many addictive substances. Many Seroquel regimens as prescribed are essentially habit-forming by design, as they require the patient to take small maintenance doses of Seroquel every day.5
