An atypical antipsychotic drug approved by the U.S. Food and Drug Administration (FDA) to treat schizophrenia, major depressive disorder, and bipolar I disorder, Seroquel is the brand name of quetiapine.

This drug comes in a tablet form that is meant to be ingested orally. Seroquel usually comes in either an IR (immediate release) or XR (extended release) format. The extended-release form is commonly used to treat schizophrenic and psychotic symptoms as a first-line medication, while the immediate-release format may be used more frequently in conjunction with other medications or treatment models, according to the journal Therapeutic Advances in Psychopharmacology.

Seroquel acts as an antagonist on both dopamine and serotonin receptors in an attempt to balance acute manic or depressive symptoms. It may be used as an adjunctive, or supplemental, part of depression or bipolar I treatment models and may be used for bipolar I long-term maintenance in combination with lithium and therapeutic treatments.

While prescription drugs are most often used as directed, about 20 percent of Americans aged 12 and older, or an estimated 54 million people, have used a prescription drug for nonmedical reasons, or for recreational purposes, the National Institute on Drug Abuse (NIDA) reports. Seroquel may be abused for its mind-altering, anxiety-reducing, pleasant, or sedative effects. While it is not believed that Seroquel is physically addictive, abuse of it can lead to psychological addiction.

Abuse of Seroquel

Seroquel may be most frequently abused within the prison and inpatient population of psychiatric institutions. It is also abused by those with a history of abusing substances like benzodiazepines (benzos), as well as young adult males, the journal Psychiatry publishes. The mechanisms of Seroquel are not fully understood; however, it seems that it is more preferable as a drug of abuse than other atypical antipsychotic drugs. A study of a Los Angeles County jail found that around 30 percent of the population who were seen in mental health services had manufactured psychotic symptoms in order to try and obtain prescriptions of quetiapine that they would take orally or crush and snort to get high, the journal Clinical Psychiatry News reports.

Seroquel tablets may also be crushed and dissolved in liquid in order inject the drug or even mixed with cocaine or heroin to amplify the effects of these illicit drugs. When quetiapine is mixed with cocaine, it may be called Q-ball. Other street names for quetiapine include:

  • Quell
  • Snoozeberries
  • Suzie-Q
  • Baby heroin

Seroquel may disassociate itself from the dopamine receptors in the brain more rapidly than other drugs of the same class, possibly making it more attractive for abuse as it may have fewer side effects than other drugs, Savvy Pharmaceuticals publishes. Also interesting is that quetiapine may actually be used in some cases for the treatment of substance abuse or dependency even though it has the potential for abuse or even addiction itself. It should therefore be used with caution when treating individuals with a history of substance abuse.

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Potential Seroquel Side Effects

Seroquel, like any drug or medication, has potential common side effects to regular use, which may include:

  • Headaches
  • Dry mouth
  • Dizziness (especially upon standing)
  • Constipation
  • Increased appetite and possible weight gain
  • Fatigue or drowsiness
  • Agitation
  • Low blood pressure
  • Increased heart rate
  • Abdominal pain
  • Somnolence (near-sleep state)

Side effects may amplify with long-term use or abuse of Seroquel and may lead to:

  • Increased levels of the hormone prolactin leading to loss of sex drive and potential erectile dysfunction for men; lack of menstruation and breast milk production for women, as well as possible osteoporosis and bone fractures as a result
  • High blood sugar levels, potentially leading to onset of diabetes
  • Extrapyramidal effects (EPS) indicated by tremors, stiffness, and restlessness
  • Tardive dyskinesia (TD) characterized by uncontrollable jerky or slow movements, chewing, or tongue rolling
  • High cholesterol and triglycerides
  • Weight gain
  • Arrhythmia or irregular heart rate, potentially causing sudden cardiac death

Seroquel may be particularly dangerous for certain populations, like the elderly or adolescents. The FDA warns that elderly individuals suffering from dementia may be at an increased risk for a fatal reaction to Seroquel; their risk may be as much as 1.6 or 1.7 times that of those not taking the drug. Therefore, the FDA does not approve the use of Seroquel for treating elderly individuals with dementia-related psychosis. Most of the reported deaths were due to cardiovascular complications, stroke, or from an infection such as pneumonia, the FDA reports.

The maker of Seroquel XR, AstraZeneca, publishes that the drug may increase depressive symptoms and raise the risk for suicidal thoughts and/or behaviors in children and young adults. It should therefore be used with caution in this population. Around 1 percent of people taking Seroquel may experience a life-threatening neuroleptic malignant syndrome, which is indicated by fever, sweating, confusion, and significant muscle stiffness, the National Alliance on Mental Illness (NAMI) reports.

Abuse of Seroquel may also cause an overdose, when the toxic effects of the drug overwhelm body systems. Most common symptoms are drowsiness, dizziness, fainting, increased heartbeat, and decreased blood pressure.

An overdose is considered a medical emergency, and immediate professional help should be sought if overdose is suspected.

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Treatment for Seroquel Abuse or Dependency

Seroquel may also cause withdrawal symptoms when the drug is stopped suddenly, which can be a sign of addiction. Withdrawal symptoms may occur in more than 12 percent of individuals taking Seroquel as the brain and body have become dependent on the drug. When it is removed, the brain rushes to attempt to regain balance and nausea, vomiting, irritability, insomnia, dizziness, and headaches may be common withdrawal side effects, according to the FDA.

Addiction is a disease wherein an individual can no longer control drug-seeking behaviors or drug usage. Addiction is both physical and psychological in nature, as the brain may be chemically dependent on the drug and behavioral changes may be evident.

Signs of abuse and addiction to Seroquel may include:

  • Manufacturing symptoms to obtain a prescription that may not be necessary
  • Tampering with, or altering, the drug, such as crushing it to snort or inject the substance
  • Pill bottles close at hand and potentially in someone else’s name as well as numerous empty pill bottles in the trash
  • Lack of interest in activities or social gatherings
  • Increased secrecy, social isolation, and withdrawal from friends and family
  • Drop in grades at school or production at work
  • Fluctuations in weight and changes in sleeping and eating habits
  • Mood swings or shifts in personality
  • Increased risky behaviors and use of the drug regardless of potential consequences

Due to the withdrawal symptoms, which may also include worsening depression, suicidal thoughts, or anxiety, Seroquel should not be stopped suddenly if someone has been using or abusing it for a period of time. Instead, a tapering schedule may be set up by a trained professional to slowly lower the dosage amount over a set amount of time until the drug is completely out of the person’s system.

Detox may be the first stage of addiction treatment, and this process will help remove all toxins from the body, including both prescription drugs the person is dependent on and illicit drugs or alcohol. Medications may be used during medical detox to help manage withdrawal symptoms, and individuals should be closely monitored and receive any necessary medical and mental healthcare.

Polydrug abuse, or the abuse of more than one drug at a time, may be prevalent with individuals abusing Seroquel. Often, a drug screen may be done during the initial assessment in order initial assessment in order to identify any other undisclosed substances the person may have used from which they may now experience withdrawal symptoms, as well as to ensure that no medications or supplements used during detox, treatment, or recovery will have inadvertent and negative interactions with substances used by the person prior to intake. Behavioral therapies are important during addiction treatment to help uncover the potential triggers or reasons for using a prescription drug like Seroquel for nonmedical purposes. Stressors can be identified and new coping mechanisms learned during group and individual therapy sessions.

Seroquel may be prescribed to treat mental health symptoms initially. According to SAMHSA data from 2014, 39.1% of adults who have had a substance use disorder in the past year have also had some type of mental illness in the past year. SAMHSA also states that 18.2% of adults with any mental illness in 2014 also had a substance use disorder in the same year, and this number increases to 23.3% among adults with a serious mental illness in 2014. Co-occurring disorders, such as mental illness and substance dependence, are therefore relatively common and may be treated with integrated treatment models that take into account both the medical and mental health components of both disorders.

Addiction treatment may be done through an outpatient or inpatient program, and both formats may use similar treatment methods. Residential treatment usually means that individuals stay on site in a specialized facility in order to receive around-the-clock and comprehensive care. With outpatient models, clients return home to sleep at night, and they schedule therapy and counseling sessions, as well as support group meetings, around their schedules, so they are able to maintain work and familial commitments if needed. Families and loved ones should decide on a treatment model that best fits their individual circumstances and work together with trained professionals to foster a long and healthy recovery.