There are many psychiatric drugs prescribed to treat numerous mental and behavioral health conditions.
These drugs may be therapeutic for people when used as directed. However, many psychiatric medications have a strong potential for abuse or addiction.
Stimulants and sedatives are common drugs of abuse. Less commonly misused are antipsychotic drugs prescribed to treat schizophrenia and bipolar disorder, like Seroquel.
Seroquel as a Drug of Abuse
- Seroquel, the brand name for generic drug quetiapine, acts on various brain receptors to alter activity within several neurotransmitter systems, including dopamine and serotonin. This medication is considered a second-generation antipsychotic (SGA).
- The Food and Drug Administration (FDA) approved Seroquel for prescription use in 1997 and by 2010 it was the fifth largest selling pharmaceutical in the United States reaching $6.8 billion in annual sales.2
- Seroquel is FDA approved as a treatment for schizophrenia, manic-depressive episodes, and maintenance therapy for bipolar disorder.1 However, numerous case reports have shown an increase in prescriptions for off-label use.
- In 2010, the drug’s manufacturer paid $520 million for government allegations of promoting off-label prescribing for a variety of indications including dementia, insomnia, and anger management.2
- Seroquel is currently a non-controlled substance, but recent studies have shown a strong potential for misuse and abuse when used beyond FDA-approved indications.3 In association with illicit use, it is reportedly referred to as Suzie-Q, Q-ball, or baby heroin.1
- Seroquel and other atypical antipsychotics have not historically been thought of as drugs of abuse as they are not strongly associated with euphoria or other reinforcing or desirable drug effects such as alertness. However, these drugs have reportedly been abused for sedative effects or a form of self-medication for anxiety or insomnia.
- Others may use these medications to enhance desirable effects or counter adverse effects of illicit drugs such as cocaine, heroin, or marijuana.3
- Seroquel is the most commonly abused atypical antipsychotic medication. A 10-year retrospective study of second-generation antipsychotic abuse using 2003-2010 data from the National Poison Data System (NPDS) reported 2,118 cases of quetiapine abuse, compromising 60.6% of all cases.4
- It is not clear why Seroquel is abused more frequently than other antipsychotics. It could be that because it is more frequently prescribed, it is more readily available for abuse.
- Schizophrenia and bipolar disorder are relatively uncommon mental illnesses. Antipsychotics like Seroquel may therefore not be as commonly encountered in medicine cabinets as other abuse-prone prescription drugs, although it can be purchased illicitly online or through drug dealers.
- One of the most common methods of abusing prescription drugs is by stealing them, asking for them, or buying them from friends or family with legitimate prescriptions. Seroquel abuse is also particularly common in institutional settings like prisons and impatient mental health care facilities where preferred illicit drugs may not be available 1,3
What Are the Signs of Seroquel Abuse?
While Seroquel can trigger side effects in people who take the drug as prescribed, a person who abuses this substance may be more likely to experience side effects.5
Physical side effects associated with Seroquel 4,5
- Weight gain.
- Increased appetite.
- Nausea and vomiting.
- Rapid heartbeat.
- Dry mouth.
- Body aches.
- Stuffy nose.
- Breast enlargement in men.
- Missed menstrual cycles in women.
- Nipple discharge.
Someone who abuses Seroquel may crush and snort the drug, or they may mix it with water and inject it intravenously. These are extremely dangerous practices that can quickly lead to overdose.
Signs that someone is abusing drugs in this manner include redness or dryness around the nose, constant sniffing or nasal congestion, sore throat, hoarse voice, and coughing.
Signs that someone abuses Seroquel through intravenous injection include skin infections at the site, track marks, and paraphernalia like rubber hoses, needles, and dirty spoons.1,4,5
Another sign that a person may be abusing Seroquel is tardive dyskinesia (TD) or extrapyramidal effects (EPS). The signs of TD are jerky, uncontrollable movements, often starting in the jaw, lips, and tongue. Someone with TD may appear to be chewing or grinding their teeth. EPS signs include restlessness, physical tremor, and stiffness.5
Mental side effects associated with Seroquel:4,5
- Irritability and mood swings.
- Foggy or unclear thinking.
- Poor judgment.
- Trouble speaking clearly.
- Unusual dreams or nightmares.
- Other sleep disturbances.
Other signs of prescription drug abuse, including abuse of Seroquel, may include needing frequent refills, stealing the drug, stealing money for the drug, or experiencing financial, legal, or social ramifications due to being intoxicated.
Substance abuse may not only harm a person’s mental and physical health, but can damage personal relationships with friends and family, make work or school more difficult, and can ultimately lower quality or enjoyment of life.
Overdose or toxicity may be more likely if the drug is taken in larger doses than prescribed.
- Sansone, R. & Sansone, L. (2010). Is Seroquel Developing an Illicit Reputation for Misuse/Abuse? Psychiatry, 7(1): 13-16.
- Brett, J. (2015). Concerns about Quetiapine. Australian Prescriber, 38(3):95-97.
- Kim, S., Lee, G., Kim, E., Jung, H., & Chang, J. (2017). Quetiapine Misuse and Abuse: Is It an Atypical Paradigm of Drug Seeking Behavior? Journal of Research and Pharmacy Practice, 6(1):12-15.
- Klein, L., Bangh, S., & Cole, J. (2016). Intentional Recreational Abuse of Quetiapine Compared to Other Second-generation Antipsychotics. Western Journal of Emergency Medicine, 18(2).
- Seroquel Medication Guide. (2013). Food and Drug Administration.