Seroquel (Quetiapine fumarate)

Seroquel or quetiapine fumarate is a medicine that can be prescribed by doctors to patients that have bipolar illness or schizophrenia. It can not cure these diseases; it just can help you to maintain the symptoms.

The studies that were previously made in clinics, had shown that patients that take Seroquel experience symptoms of schizophrenia less than before. These symptoms are incredulity and hallucinations.

The tablets of Seroquel are of different color, depending on the dose. For example, a 25mg pill is peach and round, a 50mg pill and a 200mg pill is white and round, a 100 mg tablet is yellow and round. The other tablets of 300 and 400 mg are capsule-shaped and are white or yellow respectively.
The following inactive ingredients contain in this medicine: sodium starch glycolate, titanium dioxide, hypromellose, povidone, lactose monohydrate, dibasic dicalcium phosphate dihydrate, polyethylene glycol and microcrystalline cellulose. Tablets of 400mg have yellow ferric oxide. Pills with dosage of 25mg have yellow and red ferric oxide.

Seroquel can act together with a list of different drugs. Such as Ativan or lorazepam, other antidepressant drugs, Mellaril or thioridazine, steroid medicine, Tagamet or cimetidine and antifungal medicine. It is not really recommended to use this medicine by pregnant women, only when there is a high need. You still need to have a discussion with your doctor about negative and positive sides. A baby can be effected by this medicine, because it can go to a breast milk.

A company AstraZeneca Pharmaceutical produces this medicine.




Uses


Schizophrenia treatment


Schizophrenia
Schizophrenia
 
Schizophrenia disease is among the most disabling and unclear mental diseases. The name of this disease explains the list of psychiatric illnesses that include thinking abnormal in people. Whilst no one can explain why schizophrenia happens to people, they think that the cause could be environment or genetics.

The following symptoms can happen to people considering their type of schizophrenia:
  • Condition when person is not capable to stay concentrated
  • Dissatisfaction with life
  • Rare speech even when the pressure is involved
  • Hard to move
  • Hard to remember information and keep it mind for some time
  • Deliration
  • A condition of being disorganized and unenterprising
  • Aphronia
  • Low activity, when the person is not able to understand and explain the information and decide according to what he knows
  • Hallucinatory effects
  • A condition when a person has monotonous voice and his face is flat

Sometimes doctors apply to schizophrenia treatment with medicine, some kinds of psychotherapy. Seroquel is a medicine that they use to make the symptoms of schizophrenia appear less. This drug prevents the repetition of schizophrenia and its worsening. But it can not be prescribed as a cure for this sickness.

Treatment of bipolar disorder


Bipolar disorder
Bipolar disorder
 
Bipolar disease is also called manic depression. It is a dangerous sickness of brain when a person experiences changes in activity, mood and performance. At the present time, doctors think that this disease is partly caused by genetic reasons.

The symptoms that are caused by bipolar disorder are more strong and dangerous and should not be confused with usual every one of us has ups and downs. The person has seldom effects of depression and obsession throughout his whole life time. When the patient doesn't experience these effects, there no symptoms of disease. The most effective treatment of this sickness is a combined process of taking bipolar drugs and psychotherapy.

Seroquel helps to reduce the symptoms of frenetic effects and bipolar disease. The medicine has an approval to be taken in combination with divalproex like Depakote ER and Depakote, or with lithium, like Lithobid or Eskalith to treat and maintain the bipolar disease and is considered as a continuous treatment.


Dosage

Seroquel dosages
Seroquel dosages
 
Seroquel is retailed as tablets. Regularly it is prescribed for taking 1-3 times per day by mouth. In event you're prescribed to take it once a day, it is advised to take pills at bedtime. Seroquel can be taken as food accompaniment. It is actually a preferred way to take it in case your stomach reacts abnormally.

A patient taking Quetiapine fumarate is advised to stick to the constant schedule of taking it in order to support the same level of the medicine in the blood. For Seroquel to be effective, it should be taken in strict accordance to prescription. Its effect will be cancelled if a patient abruptly stops taking it.

Should you encounter any uncertainties in regards to usage or dosage of Seroquel, please consult your nurse, pharmacist or doctor. Similarly, decision about end of medication course should be coordinated by your healthcare provider.

Dose choice for schizophrenia


Patients of age 13 and up, initial advised dose in case of schizophrenia comprises 25 mg of Seroquel two times a day. As a rule, the doctor will add up to your daily dose soon up to value of around 800 mg (split into 2 or 3 daily doses) to achieve treatment response.

Dose under condition of bipolar disorder


Adult patients with bipolar disorder can be prescribed to take various doses of Seroquel taking into consideration the actual type and stage of this disorder. It is advised to start with 50 mg of Quetiapine taken at bedtime every day. The doctor will typically add up to your dose within the next days to as much as 300 mg.

When bipolar mania is the case, the initial dose will be also 50 mg for adults, but taken two times a day. In case of need the dose will be increased to 400 mg two times a day.

For patients with bipolar mania aged from 10 to 17, the initial prescribed dose will normally be 25 mg two times a day. The child's doctor will be increasing the dose according to treatment plan as necessary. It is not advised to raise the total daily dose above 600 mg (split into two or three takings) when treating children.

Seroquel is authorized for purpose of bipolar disorder ongoing treatment in adults (aimed at preventing and reduction of further relapses/symptoms), when taken combined with divalproex (Depakote Depakote ER) or lithium (Lithobid, Eskalith). When used for this matter, the recommended dose comprises between 400 to 800 mg given in two smaller doses daily.


Warnings and Precautions

Considering you have one or more diseases from the list below, always consult your doctor before starting treatment with Quetiapine fumarate:

Among other things the doctor should be informed about are breastfeeding, pregnancy (or potential pregnancy), and alcohol drinking. Also you should mention that you should disclose full information about other medications you have prescription for, as well as non-prescription ones taken at will (such as herbal additives or vitamins).

Important notes regarding Seroquel


Seroquel is been supplied with a special warning (a "black box" on the cover) issued by U.S. FDA (Food and Drug Administration), which states the risk of using this medicine for elderly patients diagnosed with dementia or psychosis (particularly, conditions that are accompanied by disorientation, confusion, intellect and memory loss). Elderly patients suffering from such conditions (with Alzheimer's seen most often) are strongly cautioned against treatment with antipsychotics (Seroquel being one of them). In a test group of elderly patients, the ones that took Seroquel have shown worsening of their condition of various kinds, while the others who didn't take Seroquel were fine. Note that Quetiapine itself is not approved as a treatment for dementia-related psychosis.

Seroquel doesn't belong to the class of antidepressants, albeit FDA issued suicide and antidepressant warning for this medicine for the reason it is prescribed as treatment to bipolar depression. Suicidal behavior or thinking can be provoked by taking antidepressants. Should you notice the least sign of symptoms adding up or changing, consult your doctor without delay. Among dangerous symptoms are:
Dangerous symptoms
Dangerous symptoms
 
  • Aggression
  • Restlessness
  • Tension
  • Panic
  • Anxiety
  • Excess hyperactivity
  • Suicidal thoughts
  • Visions


Be aware that Seroquel is known to possibly cause neuroleptic malignant syndrome (NMS), which can be life-threatening. NMS symptoms are as follows:
  • Abnormal blood pressure or pulse
  • Inflexible muscles
  • Broken rhythms of heart contractions (arrhythmias)
  • Disorientation
  • Tachycardia (excessive heart contraction rate)
  • Sweating
  • Great fever

Seroquel is known to possibly cause tardive dyskinesia. Uncontrollable muscle contractions and face expressions are symptoms of this condition. There is a danger that this disease stays permanently (regardless of stopping or continuing Seroquel). A reliable way of preventing this danger is informing your doctor of any abnormal body movements noticed at times of taking Seroquel.

Sugar in blood
Sugar in blood
Seroquel can possibly provoke sugar content increase in the blood, therefore raising the risks of diabetes to start. Should you detect signs of developing diabetes, your doctor should be informed without delay. Among such signs are: frequent urination, constant hunger and thirst. In case you had diabetes before treatment with Quetiapine, allow your healthcare provider to monitor blood sugar level regularly in order to spot possible worsening of the condition in time.

Blood pressure decrease is also among Seroquel's effects, especially when switching body positions (from lying to sitting or standing). Medical term for such effect is orthostatic hypotension. It may cause dizziness, fainting or lightheadedness. It is important that you don't ignore these symptoms. You may be in real danger if hypotension occurs on the background of congestive heart failure or other heart sickness.

Seroquel can provoke development of cataracts (eye-related problem). Patients taking Quetiapine are advised to consult ophthalmologist at least two times a year to spot cataracts development early on.

Seroquel belongs to medications that may provoke seizures. The information about condition of epilepsy or previous seizures should be obligatory given to your doctor.

Seroquel can possibly affect the heart rhythm up to dangerous extent defined as QT prolongation. The danger would be even higher if Seroquel is taken in combination with QT-prolonging medicines. Patients having decreased levels of magnesium or potassium in their blood, or suffering from arrhythmias/congestive heart failure should take Quetiapine with extra caution and only under medical supervision.

Hypothyroidism
Hypothyroidism
Seroquel can be a possible cause of hypothyroidism (decrease in thyroid activity), cholesterol content increase, liver enzymes overproduction, or excessive triglycerides. Patients are advised to take a blood test once in several days to monitor these problematic effects while being treated with Seroquel.

Production of hormone prolactin can vastly increase when taking Seroquel. High content of prolactin in blood is usually revealed by breast discharge and breast enlargement. Tell your doctor about such symptoms without delay.

Although spotted only in rare cases, Seroquel can potentially cause priapism (erection that prolongs without psychical or physical stimulation, potentially painful). Such condition is classified as medical emergency, so never delay seeking of medical care, otherwise penis can undergo permanent damage.

Seroquel is known to potentially make swallowing harder, therefore raising a chance of food inhalation (which ultimately can lead to pneumonia). You should inform your doctor in case of even least noticeable swallowing difficulties.

Pregnancy category of Seroquel is C. This category is characterized by moderate risk of taking while pregnant. Should the necessity of taking medicine arise during pregnancy, consult with your doctor on the matters of pros and cons under these circumstances.

Breast milk is capable of transiting medicine to the baby. Before going for Seroquel treatment, consult with your doctor on measures of precaution.


Side Effects

The following list of possible side effects when taking Seroquel includes most, but not all known side effects. Your doctor may warn you about other side effects not mentioned in this lest.

Seroquel was a subject of comprehensive clinical tests. Such tests included two groups of people, of which the first group received this medication, and the second did take 'placebo' pills. Such test allows pointing out side effects and the frequency of their appearance.

Below is the average statistics of Seroquel side effects tests:
Seroquel side effects
Seroquel side effects
 
  • Dehydrated mouth - 44 percent of tested people
  • Drowsiness - 53 percent
  • Increased level of triglycerides - 23 percent
  • Headaches - 21 percent
  • Development of obesity - 23 percent
  • Faintness - 18 percent
  • Agitation - 20 percent
  • Increased cholesterol level - 17 percent
  • Tiredness - 11 percent
  • Constipation - 10 percent
  • Weakness - 10 percent

Some other common side effects (occurring in 2 to 10 percent of people taking the drug) included:
  • Heartburn or stomachache
  • Tachycardia (increased heart rate)
  • Fever
  • Increased appetite
  • Nausea
  • Vomiting
  • Nasal blocking
  • Back aching
  • Trembling
  • Aggression
  • Lethargy
  • Aching throat
  • Runny or irritated nose
  • Aching in joints
  • Worsening of vision

Potentially dangerous side effects


Should you notice one of the following side effects while being treated with Seroquel, seek medical care without delay, as those can prove to be life-threatening:
  • Increased level of blood sugar, constant thirst, urinating more often, hunger that doesn't go away and any other signs of diabetes
  • Suicidal thoughts
  • Allergies revealed in any form, for example rash, troubled breathing, itching, wheezing
  • Quick gain of weight
  • Inner restlessness
  • Changing body position from lying-down (sitting) to standing causes fainting
  • Revelations of neuroleptic malignant syndrome such as inflexible muscles, disorientation, high body temperature, abnormal blood pressure/pulse, sweating, heart problems (tachycardia, arrhythmias)
  • Unwanted and unexplained muscle movements (can stay permanently if Seroquel isn't stopped)

Uncommon side effects


The following list includes side effects of Quetiapine that happened to show for not more than 2 percent of people in test groups. In fact, such uncommon effects could be caused by something else than Seroquel.
Seroquel uncommon side effects
Seroquel uncommon side effects
 
  • Anemia
  • Hemorrhoids
  • Neck aching
  • Excessive salivation
  • Gas
  • Lightheadedness (a spinning feeling)
  • Yeast contagion
  • Canker sores
  • Coughing
  • Tinnitus (noise in the ears)
  • Migraines
  • Eczema
  • Alteration of sex drive
  • Teeth pain
  • Impotence
  • Excessive thyroid or abnormally low thyroid
  • Dry eyes


Mechanism of action

Quetiapine fumarate formula
Quetiapine fumarate formula
 
Quetiapine belongs to a class of atypical antipsychotic substances. Quetiapine as well as the native human plasma metabolite, norquetiapine, act on many various neurotransmitter receptors.

Quetiapine and norquetiapine demonstrate interaction with brain's receptors of serotonin (5HT2) and dopamine D1 and D2. Exactly this combination of higher choosiness for 5HT2 compared to Dopamine2 receptors and receptor antagonism is considered to make for the medical antipsychotic features and no significant extrapyramidal side effects (EPS) danger of quetiapine relative to common antipsychotics. Furthermore, norquetiapine is characterized by positive affinity towards norepinephrine transporter (NET). Adrenergic alpha1 and histaminergic receptors are also highly affected by quetiapine and norquetiapine, while they exert smaller effect on serotonin 5HT1A and adrenergic alpha2 receptors. Quetiapine doesn't reveal interaction with benzodiazepine or muscarinic receptors.


History

AstraZeneca Pharmaceuticals
AstraZeneca Pharmaceuticals
 
Treatment of schizophrenia received its new birth with development of antipsychotic agents in the 1950s. Psychotic symptoms proved to be less severe under medication of the dopamine D2 receptor antagonists. In later years, the discovery of advanced agents revealed a more complex brain interaction in condition of schizophrenia, and it added to pathophysiology knowledge. A principal feature of atypical agents is a better chance of serotonin (5HT2) receptor blocking than D2 receptor blocking. The first clinically tested atypical agent was Clozapine, superseded later by risperidone, and olanzapine. Its current modification is called quetiapine, which is still structurally similar to predecessors and is a derivative of dibenzothiazepine.


Generic Seroquel

Generic Seroquel
Generic Seroquel
 
AstraZeneca Pharmaceuticals is the manufacturer of Seroquel branded medication. Nevertheless, Seroquel's patent has expired, therefore making generic forms of the medicine available too.

The list of strengths of retailed generic Seroquel: 25 mg, 50 mg, 100 mg, 200 mg, 300 mg, and 400 mg.

At present time, only one vendor (Teva Pharmaceutical Industries, Ltd.) is known to supply generic Seroquel, albeit other companies can join Seroquel production anytime soon.

Is generic medication inferior compared to brand?


All generic forms of medications without exception are thoroughly tested and compared with corresponding brand original. U.S. FDA (Food and Drug Administration) analyzes test results and issues a rating of equivalency of the generic form to the brand medicine.

Rating that reads "AB" denotes a FDA's conclusion that generic medicine is equivalent to its brand original. At this point, all available generic Seroquel tablets are rated "AB", which states their equivalency to brand Seroquel.

Unlike brand ones, generic medicines have no restrictions related to inactive ingredients though. These inactive ingredients can include aromas, dyes, fillers etc., which may be unwanted for patients with certain sensitivities or allergies.


Drug Interactions

Like with any medical preparations, when you use Seroquel all possible negative drug interactions have to be considered. The full list of all Seroquel drug interactions that may cause negative adverse reactions is given in the leaflet. When taking this medicine keep in mind that the most negative consequences for health can be triggered by the simultaneous use of Seroquel with specific groups of medications like antifungal agents, antibiotics, Thioridazine and Lorazepam based drugs.

The significant decrease of efficacy (both of Seroquel and of the drug it interacts with) and overdose in a case if Seroquel is taken with a medication with a similar active component are the most possible consequences of bad drug interaction. In certain cases when a person needs to use both preparations involved into negative drug interaction a therapist may recommend decreasing the daily dose of Seroquel.

To the drug interaction list of Seroquel can be included the following preparations and substances:
  • Alcohol
  • Seroquel drug Interactions
    Seroquel drug Interactions
     
  • Some antifungals or antibiotics:
    • Clarithromycin (Biaxin)
    • Erythromycin (Ery-Tab)
    • Isoniazid (Nydrazid)
    • Itraconazole (Sporanox)
    • Ketoconazole (Nizoral)
    • Miconazole
    • Telithromycin (Ketek)
  • Cimetidine (Tagamet)
  • Divalproex (Depakote)
  • Lorazepam (Ativan)
  • Medications that alter heart rhythm
  • Phenytoin (Phenytek, Dilantin)
  • Thioridazine (Mellaril)


Various antifungal agents or antibiotics
If you want to avoid the significant increase of Seroquel's active component in blood and prevent the development of certain side effects, you are to consult a therapist prior to using Seroquel simultaneously with any kind of medications referred to antifungal agents or antibiotics. Perhaps you may require a dosage adjustment or cessation of taking certain drugs while treating with Seroquel.

Cimetidine
Beware the risk of side effects if you started to use Cimetidine along with Seroquel. This drug may increase the amount of Seroquel's active component in blood. Your therapist may advise to cease using Cimetidine or to decrease the average daily dose of this drug.

Divalproex
To avert any potential adverse reactions it is better to avoid the use of Seroquel and Divalproex. If you take these drugs together, you will get a risk of decreased Divalproex efficacy due to the reduced amount of its active component in blood. In a case you need to use these medications simultaneously ask your therapist to decrease your daily dose of Seroquel.

Lorazepam
While consulting a healthcare provider do not forget to tell if you use or have recently used Lorazepam before starting to take Seroquel pills. The combination of these drugs may cause Seroquel overdose and lead to serious adverse reactions. You may require Lorazepam dosage adjustment if you need to use this drug along with Seroquel.

Thioridazine or Phenytoin
Decreased efficacy of Seroquel is the first symptom of bad interaction with Thioridazine or Phenytoin since such combinations reduce the amount of Seroquel's active component in blood. Ask your healthcare provider to increase the daily dose of Seroquel if you also need to use simultaneously Phenytoin or Thioridazine.

Medications that alter heart rhythm
Among the negative consequences Seroquel may cause is the bad impact on the heart rhythm known as QT prolongation that may lead to fatal results for a patient. When you start combining Seroquel with any heart rhythm medications the risk of QT prolongation is increased significantly.

Alcohol
Like with the majority of medical preparations it is strongly recommended to avoid drinking any alcoholic beverages while taking Seroquel pills in order to avert serious adverse reactions.

Conclusion
There are possible other negative drug interactions of Seroquel that were not listed above. Please, before starting to use Seroquel on a daily basis, consult your therapist on possible negative interactions of this medication with any other preparations you are already taking or have stopped taken recently.

General keywords

User discussion about Seroquel

Adrian
14 February 2013
Extreme dormancy and overweight were consequences of my hard work (it happened very fast). So my decision was to take this medicine. I did it about a year then I changed my work.
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Dominic
19 March 2013
About three years I was using Seroquel for sleeplessness (50 mg) and it helped. Then I had to increase the dosage (100 mg) but it provoked leg syndrome. So, I concluded that this drug is effective remedy for short term. But if you need medicine for long term, find another one.
reply quote
Rosemary
30 January 2017
Damion, Rosemary Di Prima marybarbara@bigpond.com.au
I have suffered bipolar since i was 27 and am about to try 25mg of seroquel hoping it will stop my mind racing thinking of thinks go over and over and will give me a good nights sleep I also have Lithium 675mg Have been on Lithium since i was 27 years old. I had a breakdown and was taken to ward 10b in townsville i had been hospitialized 4 times since 1991 1992 1998 2002 i have seen ward 10b knocked down and the pyschic unit built have not been back since than had 2 GP's give me medication that was not recommend by a Professor who first met me in ward 10b he has lessened my Lithium and put me on seroquel have no true evidence that my breakdown was caused through to much intensive training through the RAAF and ARMY RESERVE they knew something was wrong with me and both armed forces asked me to discharge which i did on the 11th day of the 11 month at about 11 am I was admitted to ward 10b I had a disagreement with my father and drove my car and for so many nights did not sleep and all came to a head before i knew it i was seeing things hearings first i was diagnosed for scherferenia cant spell the word the second year was given a blood test and was told i had manic drepression which is know as bipolar
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Rosemary
30 January 2017
I was diagnosed as Schizophrenia when i first went into ward 10B in Townsville had to look the word up
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Rogerpar
14 October 2017
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