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Seroquel is the name brand for an atypical (second generation) antipsychotic drug called quetiapine.1 As a prescription medication used to treat serious mental illnesses like bipolar disorder and schizophrenia, Seroquel is a valuable pharmaceutical tool used by practitioners to mitigate certain mental health symptoms and improve the wellbeing of their patients.2

Despite the many benefits of Seroquel, the drug carries a risk of side effects and some danger of lasting health consequences. Like many other psychoactive prescription medications, there is emerging evidence to suggest Seroquel is sometimes misused.1 Although the drug’s use is generally safe, it is valuable to know and understand the possible repercussions of use to keep yourself and your loved ones well.

Side Effects of Seroquel

Unfortunately, Seroquel has many unwanted side effects that can present even in people who take the substance as directed. Some may resolve over a few days while others have the potential to persist throughout the duration of treatment.

In general, short-term side effects from Seroquel may include:3

  • Trouble thinking.
  • Problems speaking.
  • Unusual dreams.
  • Irritability and mood swings.
  • Weight gain.
  • Indigestion.
  • Constipation.
  • Dry mouth.
  • Dizziness.
  • Headaches.
  • Muscle weakness.

Seroquel may also be associated with certain hormonal changes, resulting in side effects such as:3

  • Increased breast tissue in men (gynecomastia).
  • Irregular or dropped menstrual periods in women (dysmenorrhea or amenorrhea).
  • Lowered interest in sex or ability to perform sexually.

Serious Side Effects

In some cases, Seroquel use is associated with more serious side effects, including:3

  • Fainting.
  • Confusion.
  • Unexpected or uncontrollable movements in your arms, legs, face, tongue, or lips.
  • Heart rate changes.
  • Vision changes.
  • Trouble breathing.

As with other drugs, Seroquel may be more likely to have adverse outcomes in people who abuse the substance. Often in these scenarios, dosing is not able to be supervised or adjusted, nor is a medical professional able to monitor or respond to an individual’s ongoing health status adequately.

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Seroquel Abuse

OThough Seroquel has known pharmacotherapeutic uses, is not a controlled substance, and is not generally considered to have a high potential for abuse or addiction, there have been reports of the medication being misused or abused. It is sometimes abused in combination with cocaine.2 The combination of Seroquel and cocaine is sometimes called a “Q-ball.”2

Other potential slang or street terms used to refer to Seroquel as a drug of abuse include:1

  • Baby heroin
  • Quell.
  • Susie-Q.
    • While rates of Seroquel abuse are low on the whole, there have been reports of people abusing it various ways—via oral route, by crushing and snorting it, and by injecting it.1

      There is debate about why Seroquel, more than other antipsychotics, tends to be abused; however, some hypothesize that the sedating effects play a part.1

      A study found that Seroquel was the only atypical antipsychotic drug to be somewhat desirable on the street. One dose of Seroquel has a reported street value of between $3 and $8 for a 25 mg pill.1

      Seroquel abuse is likely to be more prevalent in prison and inpatient psychiatric populations. In these settings, people have been reported to feign psychotic symptoms like hallucinations or delusions to obtain Seroquel prescriptions from staff.2

      Chronic Effects of Abuse

      Over time, especially if abused, Seroquel can lead to the development of several adverse, and potentially long-lasting side effects. In some instances, these effects are reversible when use of the drug ends, but in other situations, the changes can be permanent.

      One of the most commonly reported side effects is weight gain.4 Over time, excess weight can harm the heart, lungs, stomach, liver, pancreas, and other organs. While many people gain weight while taking Seroquel as prescribed, the result isn’t inevitable. Some are able to remain within a healthy weight by following their doctors’ orders regarding a healthy balance of diet and exercise.

      Along with the added weight, Seroquel carries a risk of other metabolic problems like increased blood sugar.4 There is a link between using Seroquel and diabetes diagnoses. The high blood sugar associated with Seroquel can, in some cases, be extreme and lead to a precipitous drop in blood pH levels (ketoacidosis), coma, or death.

      Signs of persistent hyperglycemia (high blood sugar) may include:4

      • Feeling very thirsty.
      • Frequent urination.
      • Increased hunger.
      • Feeling weak or tired.
      • Intense nausea or feeling sick to your stomach.
      • A fruity smell to your breath.
      • Periods of confusion or disorientation.

      High cholesterol can also be harmful, increasing the risk of strokes or heart attacks. Having high cholesterol and blood pressure is often associated with being overweight or having an unhealthy life style. Abusing Seroquel puts one at risk of developing these conditions related to weight gain.

      Other long-term physical effects associated with Seroquel include:4

      • Tardive dyskinesia: This condition affects a person’s nervous system and is characterized by numerous involuntary movements. A person with tardive dyskinesia may lose the ability to control their facial expressions and experience impaired use of their tongue and mouth. Worse, the condition may be irreversible.
      • Blood pressure changes: Seroquel use is known to result in some alterations in the blood pressure of those who use it. Interestingly, children and adolescents using the drug will generally experience higher blood pressure (hypertension) while adults will likely experience lower blood pressure (hypotension). Both conditions are potentially problematic and require further observation to assess any risks to the patient (such as increased risk of falls related to hypotensive episodes; see below).

      • Risk of falls: People using Seroquel are in greater danger of falling and sustaining injuries from the fall. This danger is due to a combination of sleepiness, poor coordination, sensory instability, and low blood pressure.
      • Low white blood cell count: Seroquel may reduce the number of white blood cells (WBC) in the body, especially among those with a history of low WBCs. Having a pathologically low white blood cell count (leukopenia) can be dangerous because these cells normally fight infection; having a low WBC count could expose the user to an increased risk of infection.
      • Cataracts: Using Seroquel increases the chances of developing cataracts, which can blur and minimize vision.
      • Thyroid problems: Taking Seroquel may decrease the thyroid hormone levels. This may worsen as the dose increases.
      • Swallowing issues: Seroquel makes it more difficult to swallow, which may lead to aspiration pneumonia from food being inhaled into the lungs rather than being swallowed into the stomach.
      • Increased body temperature: Using Seroquel disrupts the body’s natural ability to manage and regulate heat and core temperature. Without care, people who exercise rigorously or are exposed to hot climates can become dehydrated more easily.
      • Seizures: Though the risk is slight, it is still worthwhile to mention the increase in seizures seen with Seroquel use among the general population. People with a history of seizures or other conditions that trigger seizures may be at an increased risk.
      • Cardiac issues: Seroquel, especially when combined with other medications, can result in heart rate abnormalities, which may result in cardiac emergencies.

      Certain populations may be at even greater risk of Seroquel-associated adverse events. For instance, when used in elderly people with dementia-related psychosis, Seroquel increases the risk of stroke and death from heart failure or infections like pneumonia.4 Due to these serious hazards, this population should only use Seroquel when no other options exist.

      More On Long-Term Effects:

      Seroquel Overdose

      While it is possible to overdose on quetiapine, the likelihood is quite low. People have consumed 30 grams of the drug and survived.4 This amount is very large considering the maximum dose of Seroquel is 800 mg daily for most people with bipolar disorder and schizophrenia and only 300 mg daily for people as an adjunctive treatment for depression.4 Despite this relatively large index of safety, taking larger than recommended doses of the medication is never advisable.

      A Seroquel overdose may result in unwanted effects like:4

      • Marked sedation/drowsiness.
      • Cardiac abnormalities (e.g., QT elevation).
      • Rapid heart rate (tachycardia).
      • Low blood pressure.

      Although very rare, overdose could result in coma and death in some individuals.4

      There is no Seroquel overdose antidote, so anyone who may have overdosed should contact emergency services or present to the nearest emergency room immediately. Once there, the staff will focus on airway support, ventilation assistance (if needed), and clearing the GI tract of any remaining Seroquel through gastric lavage, administration of activated charcoal, and laxatives.4

      Psychological Effects

      Depression, bipolar disorder, and schizophrenia are serious mental health conditions which can severely decrease a person’s quality of life. Overall, Seroquel has the ability to greatly improve the mental health of children, adolescents, and adults with various psychiatric issues.

      Sadly, Seroquel can also negatively influence someone’s mental health and well-being just as it can impair their physical health. The drug has the ability to impair judgment, reduce decision-making skills, and alertness.4 For these reasons, someone using Seroquel should avoid situations where they could endanger themselves or others like when driving a car or operating machinery.

      Suicidal thoughts and behaviors are another significant psychological effect of Seroquel to be aware of. People with a major depressive disorder who begin using Seroquel may report an increase in depression, which may result in suicide.4 This pattern has occurred in adults who use Seroquel, but the trend seems more prevalent in people 24 years of age or younger than in older adults.4

      Suicidal ideation has occurred in some children, teens, and young adults who use Seroquel. Young people who suffer from depression or another mental illness and who abuse Seroquel recreationally may be hesitant to disclose their symptoms to a doctor for fear of getting in trouble and may not get the proper treatment.

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      Does It Cause Withdrawal Symptoms?

      Many prescription and illicit drugs are associated with certain withdrawal symptoms when use is stopped or drastically reduced after the body has become accustomed to the substance’s presence in the body.

      Seroquel withdrawal may include symptoms such as:4

      • Trouble falling asleep or staying asleep.
      • Dizziness.
      • Headache.
      • Nausea and vomiting.
      • Diarrhea
      • Irritability

      These Seroquel withdrawal effects are uncomfortable, but they are a normal and expected part of the process. The symptoms will usually alleviate within a week of last use.4 Slowly lowering the dose under the care of a doctor can minimize any withdrawal discomfort.4

      Using Seroquel as directed can drastically improve mental health and wellbeing, but it can also trigger some significantly negative side effects and long-term consequences. Though abusing Seroquel may be rare, it can also increase the harm in a number of ways. Long-term abuse may increase the risk of serious, chronic health issues.

      If you or a loved one are abusing Seroquel or experiencing unwanted effects from the substance, it is important to let a professional know. Getting help to switch to another medication or to overcome abuse of this psychiatric medication can dramatically improve your quality of life.

Sources:

  1. Sansone, R. A., & Sansone, L. A. (2010). Is Seroquel Developing an Illicit Reputation for Misuse/Abuse?. Psychiatry (Edgmont (Pa. : Township)), 7(1), 13-6.
  2. Office of Alcoholism and Substance Abuse Services. (2011). Addiction Medicine – FYI Seroquel (Quetiapine) Abuse.
  3. U.S. National Library of Medicine: MedlinePlus. (2018). Quetiapine.

    U.S. National Library of Medicine: DailyMed. (2017). Seroquel.