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Seroquel, also known by its generic name quetiapine, is an atypical antipsychotic used for bipolar disorder and schizophrenia. It’s also used for depression when antidepressants aren’t providing enough relief.
Seroquel can be helpful for many people, but like all medications, it can come with side effects. Below, we’ll break down the most common side effects of Seroquel, when they typically occur, how long they last, and what you can do to manage them.
Common Side Effects of Seroquel
Common side effects of Seroquel include:
- Feeling very sleepy or drowsy
- Dry mouth
- Dizziness or lightheadedness
- Constipation
- Increased appetite and weight gain
- Low blood pressure when standing up (orthostatic hypotension)
- Upset stomach or indigestion
- Sore throat
- Fatigue or low energy
Keep in mind, not everyone will experience side effects from the medication. You may also experience side effects not on this list.
If you do experience side effects, it’s hard to say exactly when they may start. Most of what we know comes from short-term clinical trials. These trials don’t break down exactly which week each side effect starts, and everyone’s experience can be different.
Still, here’s what those studies found:
| Study length | Common side effects |
|---|---|
| Up to 3 weeks | Sleepiness/drowsiness, dry mouth, low energy, constipation, low blood pressure when standing, sore throat, weight gain |
| Up to 6 weeks | Sleepiness/drowsiness, dizziness, dry mouth, constipation, weight gain, and upset stomach/indigestion |
| Up to 8 weeks | Sleepiness/drowsiness, dry mouth, dizziness, constipation, fatigue, upset stomach/indigestion, increased appetite, low energy, low blood pressure when standing, restlessness, pounding or fast heartbeat, and weight gain |
Leslie Lugo, RPh, BCPP, a psychiatric pharmacist with Experts Ink, has seen these side effects firsthand. Based on her experience, “sleepiness and dizziness tend to occur first. It’s important to not drive while you are adjusting to the medication,” she says. “Metabolic side effects like weight gain take longer. Seroquel can also cause cataracts when taken over a long period of time.”
How Long Do Seroquel Side Effects Typically Last?
It depends on the side effect and the person. It may even depend on the dosage and how recently you’ve had an increase in dosage.
What may improve: From Lugo’s experience, anticholinergic side effects like dry mouth and constipation usually show up early and get better over time, though they can worsen when the dosage is increased. Drowsiness may also improve for some people, though this varies widely. “Some people notice it gets better as the dose is increased,” Lugo says.
What tends to persist: “The main side effects that tend to last with Seroquel are drowsiness, weight gain, and metabolic disorders,” Lugo explains. “Weight gain can show up in the first few months and tends to stick around. Over time, that can lead to metabolic disorders like high cholesterol.”
You may be able to manage some side effects at home. For example, you can help with constipation by drinking plenty of water, getting enough fiber in your diet, and using a laxative or stool softener if needed. Staying hydrated and avoiding certain foods and drinks can help relieve dry mouth.
If you’re experiencing side effects that get worse over time or become bothersome, speak with your provider. They can help determine the next best steps.
Serious Side Effects to Watch For
While rare, Seroquel can cause more serious side effects. Your provider will monitor for these, but it’s important to know what to watch for and report any concerning symptoms. They include:
- High blood sugar or diabetes: Seroquel can affect how your body uses glucose and increase the risk for high blood sugar and diabetes. Symptoms include increased thirst, frequent urination, and unusual hunger.
- High cholesterol or triglycerides: These changes often don’t cause symptoms, but your provider may want to check these with blood tests periodically.
- Tardive dyskinesia (TD): A rare movement disorder that causes involuntary facial or body movements, such as lip smacking, tongue movements, or unusual arm or leg motions. It’s more likely with long-term use, but the risk for TD with Seroquel is lower than with other antipsychotics.
- Low white blood cell counts: This can make it harder for your body to fight infection. Watch for fever, sore throat, or other signs you might be getting sick.
- Cataracts: Your provider may recommend periodic eye exams to check for changes.
- Trouble swallowing: Seroquel can sometimes affect the muscles involved in swallowing. If you’re coughing or choking often while eating or drinking, let your provider know.
Life-Threatening Side Effects Requiring Urgent Care
These rare side effects need immediate medical attention:
- Neuroleptic malignant syndrome: Symptoms include very high fever, stiff muscles, confusion, sweating, and changes in pulse or blood pressure.
- Severe allergic reaction: Symptoms include rash, swelling of the face/tongue/throat, severe dizziness, or trouble breathing.
- Seizures
- Serious heart rhythm changes (Long QT Syndrome): This often causes no symptoms. When symptoms do occur, they can include a fast, pounding, or irregular heartbeat.
Long-Term Side Effects of Seroquel
Taking Seroquel for a long-term period of time can increase the risk for other side effects. These may not necessarily show up right away once you start taking the medication. They include:
Metabolic Disease
As mentioned above, Seroquel can lead to weight gain over time. It can also raise blood sugar and change cholesterol or triglyceride levels. Together, these changes may increase your risk for diabetes, high blood pressure, or heart disease. Regular check-ins with your provider, nutrition support, and physical activity can help reduce these risks.
Hormonal Changes
For some people, Seroquel can raise prolactin levels, a hormone that may affect menstrual cycles, sex drive, or breast tissue. Let your provider know if you notice changes in your cycle, breast discharge, or other hormonal symptoms.
Thyroid Changes
Long-term use can sometimes lower thyroid hormone levels. Your provider will check your thyroid function during treatment.
Chronic Drowsiness
While many people feel sleepy when starting Seroquel, some continue to feel tired even after longer-term use.
Cognitive “Fog”
Some people report trouble concentrating or feeling mentally slower over time. This can be related to the dosage and may improve with adjustments.
How to Manage or Reduce Seroquel Side Effects
There are a number of things you can do at home to help manage Seroquel side effects. Keep in mind, you don’t necessarily need to do everything on this list. What you do at home will depend on what side effects you are experiencing.
Start with regular monitoring:
- Keep all your medical appointments: Regular blood tests monitor blood sugar, cholesterol, triglycerides, and thyroid function. This helps catch changes early, before they become bigger problems.
- Track your symptoms: A simple journal or phone note can help you and your provider see what’s improving, what’s not, and whether any adjustments are needed.
Lifestyle approaches can help with several side effects:
- Stay active: Even light activity, like walking or yoga, supports your overall health and boosts both mood and energy levels.
- Plan meals and snacks: Choosing balanced meals and keeping healthy snacks on hand helps manage appetite changes and sudden cravings.
- Stay hydrated and add fiber: Drinking enough water and eating fiber-rich foods like vegetables, beans, or whole grains can ease constipation and help with dry mouth.
- Limit alcohol: Alcohol can worsen drowsiness, dizziness, and coordination problems. It’s best to avoid alcohol while taking Seroquel. If you do decide to drink, keep it to a moderate amount.
For specific symptoms:
- If you get an upset stomach: Try taking Seroquel with a small snack and avoiding rich or spicy foods. Seroquel XR should be taken without food or with only a light snack under about 300 calories.
- For sore throat or congestion: Tea, saline spray, or lozenges may all help soothe your throat.
- If you feel dizzy when standing: Especially in the morning, take your time when getting out of bed or standing up.
Talk to your provider about:
- Extended-release (XR) versions: “For some people, taking the XR version at night may help reduce daytime drowsiness,” notes Lugo. Your provider can help you decide if it’s a good fit.
- Managing weight gain and metabolic changes: “A healthy lifestyle is very important to prevent high cholesterol, weight gain, and diabetes,” Lugo says, adding that “there are medications available to help if needed, like GLP-1’s, metformin, and statins.”
What About Seroquel Withdrawal or Stopping Seroquel?
Never stop taking Seroquel suddenly without speaking to your provider first. If you and your provider decide to stop Seroquel, they will gradually reduce your dosage. This gives your body time to adjust and helps make the process safe and tolerable.
Your body adjusts to the medication over time, so stopping too quickly can cause uncomfortable withdrawal symptoms. Withdrawal symptoms can start within four weeks of stopping and usually last one to four weeks. They may include:
- Nausea or stomach upset
- Diarrhea
- Dizziness
- Headache
- Sweating or feeling clammy
- Fast heartbeat
- Restlessness or feeling on edge; irritability or anxiety
- Muscle aches
- Trouble sleeping or vivid dreams (nightmares)
These symptoms can feel unsettling, but knowing they’re temporary and expected can help you get through them.
When to Talk to a Mental Health Professional
If Seroquel’s side effects are starting to get in the way of your daily life, it’s worth checking in with your provider. Sometimes a small adjustment can ease the problem. Other times a different medication or treatment may be a better fit. And if you notice any sudden or severe symptoms, call your provider right away.
Thriveworks offers both psychiatry and therapy services, which means you can work with a psychiatric provider for medication management and a therapist for additional support—all within the same practice. This integrated approach can help you manage side effects, adjust your treatment plan as needed, and address mood changes, anxiety, or other challenges you may be facing.
Frequently Asked Questions
Do Seroquel side effects go away over time?
Some side effects improve over time, but it depends on the person and dosage. Drowsiness may or may not go away. Weight gain and metabolic disorders tend to persist. Some Seroquel side effects are serious and require immediate attention. Contact your provider if you experience any bothersome side effects.
Are there ways to reduce Seroquel side effects?
Yes, there are several strategies to manage side effects. Regular check-ups allow your provider to monitor changes in blood sugar, cholesterol, and thyroid function. Choosing balanced, nutrient-rich meals, avoiding alcohol, and staying hydrated can help control weight gain and manage constipation and dry mouth.
Does Seroquel cause long-term health problems?
Seroquel can cause changes in weight, blood sugar, and cholesterol over time. This can increase the risk of developing diabetes, high blood pressure, and heart disease. Seroquel can also affect hormone levels, including thyroid function. Your provider will track your health over time and make adjustments as needed.
