Managing Mental Health with Quetiapine

Quetiapine

Quetiapine, also known as Seroquel, is a prescription medication used to treat mental health conditions. It belongs to a category of drugs called atypical antipsychotics. Atypical antipsychotics are a newer class of medications that target various brain chemicals more selectively to reduce side effects compared to older antipsychotics.

Quetiapine works by adjusting the levels of neurotransmitters such as dopamine and serotonin in the brain. These neurotransmitters play a crucial role in regulating mood, thoughts, and behavior. By managing their balance, quetiapine helps alleviate symptoms of schizophrenia, bipolar disorder, and depression.

Uses

Quetiapine is often used for psychiatric conditions, including the following:

• Bipolar disorder: In adults and adolescents aged 10 years and older
• Schizophrenia: In adults and adolescents aged 13 years and older
• Depression (Adjunct treatment): The extended-release or long-acting formulation of Quetiapine can also be used as an adjunct treatment option for adults with. Quetiapine extended-release tablets are not approved for use in pediatric patients under 10 years old.

Research indicates that those taking Quetiapine for schizophrenia or bipolar disorder may begin to observe changes in their mood or thought patterns within the first week of treatment. However, experiencing the complete therapeutic effects of this medication may require more time for some.

Dosage and instructions

Immediate-release (IR) tablets—short-acting

Immediate-release (IR) quetiapine tablets are designed to release the medication into your bloodstream rapidly after taking it. These tablets are often administered multiple times per day, usually in divided doses, to maintain therapeutic levels of the medication in your body throughout the day.

Available strength: 25, 50, 100, 200, 300, 400 mg

The shorting acting formulations can be taken with or without food, however, if you experience any upset stomach, then it is recommended to take this medication with food.

Extended-release (XR) tablets—long-acting

This formulation helps minimize fluctuations in medication levels, reducing the risk of side effects and providing greater convenience for patients. Extended-release tablets are also often preferred for long-term treatment to improve medication adherence and enhance overall stability in those with psychiatric conditions.

Available strength: 50, 150, 200, 300, 400 mg

The long-acting formulations should be taken on an empty stomach or with a small meal.

Quetiapine tablets should be swallowed whole, and it is not recommended to split, chew, or crush them.

When beginning treatment with Quetiapine, your doctor will likely start your regimen with a low dose, then steadily increase it over the first week.

Missed dose and Discontinuation

If you forget to take a dose, take the missed dose immediately. If it is almost time for your next dose, then skip the forgotten dose, and take the next dose at your regular scheduled time. However, it is important not to take 2 doses at the same time.

It is also important to avoid changing your dose or discontinuing this medication abruptly without first consulting with your doctor. Abrupt changes can lead to withdrawal symptoms such as nausea, vomiting, and dizziness.

If you're considering discontinuing this medication, speak with your doctor for guidance. Your doctor will provide specific instructions on gradually reducing your dose over a specified period before complete cessation of this medication.

However, if you have not taken Quetiapine for a week or more, it is recommended to contact your doctor before continuing this medication again. Your doctor is likely to recommend starting the medication with a low dose and then slowly increasing it, following a similar approach to when you initially started taking this medication.

Side Effects

Common side effects

• Drowsiness or sedation
• Dizziness
• Fatigue
• Headache
• Dry mouth
• Agitation
• Constipation, indigestion, abdominal pain
• Nausea, vomiting
• Increased appetite, weight gain
• Rapid heartbeat
• Weakness
• Difficulty controlling muscle movements

If you are experiencing any of these side effects be sure to talk with your doctor to determine whether a dose adjustment or switching to a different medication would be beneficial for you.

Serious side effects

• Seizures
• Suicidal thoughts or behaviors: It is important to inform your doctor right away if you have any sudden changes in mood, behavior, or thoughts about suicide.
• Neuroleptic malignant syndrome: Signs and symptoms of this may include experiencing a fever, sweating, stiff muscles, confusion, not being aware of your surroundings, and fast or irregular heartbeat.
• Signes of a serious infection: Fever, chills, sore throat, body aches, unusual tiredness, loss of appetite, or bruising or bleeding.
• Hyperglycemia: Signs and symptoms of this condition may include extreme thirst, needing to urinate often, severe hunger, tiredness, nausea, vomiting, difficulty breathing, having fruity breath, or having a dry mouth.
• Hypothyroidism: Fatigue, dry skin, thinning hair, weight gain, puffiness in your face, or feeling more sensitive to cold temperatures.
• Tardive dyskinesia: Signs and symptoms of this may include experiencing movements you can’t control in your face, tongue, or other body parts.
• Low blood pressure when getting up too quickly after sitting or lying down (hypotension). Signs and symptoms of this may include feeling lightheaded, dizzy, or having a fainting feeling like you may pass out.
• Allergic reactions: Difficulty breathing, or swelling of your face, lips, tongue, or throat.

If you are experiencing any of these serious side effects, immediately call your doctor and stop taking this medication.

Warnings

Avoid drinking alcohol while on Quetiapine, as it has the potential to exacerbate side effects, worsen symptoms of schizophrenia or bipolar disorder, and lower the effectiveness of this medication.

Avoid grapefruit and grapefruit juice while taking this medication, as they can elevate the levels of Quetiapine in your system, potentially leading to unwanted side effects.

Those with hyperlipidemia (high cholesterol) should be aware that Quetiapine use may exacerbate this condition by further increasing levels of cholesterol and triglycerides. Elevated fat levels in the bloodstream increase the risk of cardiovascular events such as heart attacks and strokes. Your healthcare provider should monitor your blood cholesterol and triglyceride levels throughout treatment.

Additionally, those with cataracts should be aware that Quetiapine has the potential to exacerbate this condition. Your doctor may closely monitor any changes in your cataracts. Initial eye exams will be conducted at the onset of treatment, followed by regular assessments every 6 months throughout your treatment.

Interactions

It is recommended to avoid using Quetiapine with medications that could increase your risk of certain side effects, including the following:

• Antifungals: Itraconazole, Ketoconazole
• Antibiotics: Gatifloxacin, Moxifloxacin.
• Anticonvulsants: Phenytoin, Carbamazepine
• Anti-arrhythmic drugs: Amiodarone, Procainamide.
• Antipsychotic drugs: Chlorpromazine, Thioridazine
• Antihistamines: Diphenhydramine

Pregnant or breastfeeding

Pregnant

Research indicates that Quetiapine does not appear to increase the likelihood of miscarriage or birth defects. However, pregnant women who use this medication may face potential pregnancy complications, including gestational diabetes.

Generally, antipsychotic medications may elevate the chances of infants experiencing abnormal muscle movements and withdrawal symptoms at birth if taken by mothers during the final trimester of pregnancy.

If you are currently pregnant or considering becoming pregnant, it is important to speak with your healthcare provider regarding the potential risks and advantages associated with taking this medication during pregnancy.

Breastfeeding

Some studies indicate that Quetiapine is present in minimal quantities in breast milk, however, it does not appear to cause adverse effects in breastfed infants. If you prefer to breastfeed while taking Quetiapine, it is important to closely monitor your infant for any potential side effects, such as drowsiness.

Should you notice excessive drowsiness in your infant or suspect any delays in developmental milestones, inform your healthcare provider for further evaluation and guidance.

Additionally, it is recommended to speak with your doctor about using Quetiapine while pregnant or breastfeeding to determine whether it is safe and appropriate for you.

Speak with your doctor

You should speak with your doctor about Quetiapine to fully understand the risks and benefits associated with this medication.

Quetiapine can be effective in managing conditions such as schizophrenia and bipolar disorder, but it also carries potential side effects such as weight gain, drowsiness, and increased blood sugar levels.

By discussing with your doctor, you can weigh these potential risks against the benefits of treatment, making informed and appropriate decisions tailored for you.