Experiences with
Quetiapine

Quetiapine is a medicine that helps with mental health conditions such as:

schizophrenia, where you may see, hear or feel things that are not there or you believe things that are not true, or you feel unusually suspicious or have muddled thoughts
the mania symptoms of bipolar disorder, where your mood changes between feeling highly excited (mania) and very low (depression)
depression in bipolar disorder
depression (quetiapine is only used together with other medicines for depression)

It can help to prevent mania and depression if you have bipolar disorder.

It's an antipsychotic medicine that works by affecting chemicals in your brain such as dopamine and serotonin. It does not cure your condition, but it can help with the symptoms.

Quetiapine is only available on prescription.

It comes as tablets, including slow release tablets (these may have XL in the brand name), and as a liquid that you swallow.

Who can take quetiapine

Most adults aged 18 years and over can take quetiapine.

Who may not be able to take quetiapine

Quetiapine is not suitable for some people. To make sure it's safe for you, tell your doctor before starting to take it if you:

have ever had an allergic reaction to quetiapine or any other medicine
have a heart problem such as an irregular heartbeat (arrhythmia)
have low blood pressure (hypotension)
have had a stroke or are at high risk of having a stroke
have ever had problems controlling the movements of your tongue, mouth and face
have ever had a rare condition called neuroleptic malignant syndrome (symptoms include a high temperature, muscle stiffness, sweating, anxiety and excess saliva)
have Parkinson's disease or dementia
have ever had low levels of white blood cells
have diabetes
have epilepsy or have ever had a seizure or fit
have liver problems
have had a blood clot or someone else in your family has a history of blood clots
have ever had sleep apnoea, where you stop breathing for short periods during sleep
have ever had a condition where you cannot completely empty your bladder (urinary retention)
have an enlarged prostate (benign prostate enlargement)
have eye problems such as glaucoma

Dosage and strength

Standard quetiapine tablets come in strengths of 25mg, 100mg, 150mg, 200mg and 300mg.

The slow release tablets come in strengths of 50mg, 150mg, 200mg, 300mg, 400mg and 600mg.

The liquid contains 20mg of quetiapine in 1ml.

How much quetiapine you take depends on why you're taking it.

Your doctor may ask you to change your dose, depending on how well quetiapine works for you. It can take a few weeks to get to the dose that works best for you.

Doses may be lower for older people and people with liver problems.

Dose for schizophrenia

You'll usually start on a low dose of 50mg a day when taking standard tablets. This will be increased over a few days to start with.

Your doctor may advise you to slowly increase your dose even more, depending on how well quetiapine works for you. Most people feel better with a daily dose of 300mg to 600mg.

If you're taking standard tablets, take half your dose in the morning and half in the evening, unless your doctor gives you different instructions. If you're taking slow release tablets, take the whole daily amount in one dose.

Dose for mania symptoms of bipolar disorder

You'll usually start on a low dose of 100mg a day when taking standard tablets. This will be increased over a few days to start with.

Your doctor may ask you to slowly increase your dose even more, depending on how well quetiapine works for you. Most people feel better with a daily dose of 400mg to 800mg.

Dose for depression in bipolar disorder

You'll usually start on a low dose of 50mg a day. This will be increased over a few days. Most people feel better with a daily dose of 300mg.

Take it once a day at bedtime.

Dose for preventing mania or depression in bipolar disorder

If you've taken quetiapine to treat bipolar disorder and it has worked for you, you'll usually continue to take the same dose.

You doctor may ask you to increase or decrease your dose to find the best dose for you. Most people continue to feel better with a daily dose of 300mg to 800mg.

Dose for depression when used with other medicines

You'll usually start on a low dose of 50mg. This will be increased over a few days. Most people feel better with a daily dose of 150mg to 300mg.

Take it once a day at bedtime.

How to take tablets

If you're taking standard tablets, swallow them whole with a drink of water. You can take them with or without food.

If you're taking slow release tablets, swallow your tablet whole with a drink of water without food. It's best to take the tablets at least 1 hour before a meal and at least 2 hours after a meal. Do not break, chew or crush the tablets.

How to take liquid

If you're taking liquid quetiapine, it will come with a plastic syringe or dosing cup to help you measure out your dose. If you do not have one, ask your pharmacist for one. Do not use a kitchen spoon as it will not measure the right amount.

If your quetiapine liquid comes in a bottle with a syringe:

Shake the bottle.
Remove the cap and push the syringe adaptor into the bottle neck.
Put the syringe into the opening in the adaptor and turn the bottle upside down.
Fill the syringe to the right dose, turn the bottle the right way up and remove the syringe.
Put the end of the syringe into your mouth, and push the plunger to squirt the medicine into your mouth. Swallow your dose straight away. Have a drink of water afterwards if you need to.
Wash the syringe and let it dry before you use it again.

To use the dosing cup, shake the bottle, then pour the liquid into the cup until it reaches the mark shown for your dose.

Wash the cup and let it dry before you use it again.

You can take the liquid with or without food.

How long to take it for

If you take quetiapine for schizophrenia or depression, you may need to take it for a long time, maybe several years.

If you take it for mania or depression in bipolar disorder, you may need to take it for a few weeks or months. Your doctor may suggest that you keep taking it for a long time, maybe several years, to stop your symptoms coming back.

Keep taking quetiapine even if you feel better. Do not stop taking it without talking to your doctor.

If you forget to take a dose of quetiapine and you usually take it once a day, take the missed dose as soon as you remember, unless it's less than 12 hours until your next dose. In this case, skip the missed dose and take your next dose at the usual time.

If you forget a dose and you usually take it twice a day, take the missed dose as soon as you remember, unless it's less than 8 hours until your next dose. In this case, skip the missed dose and take your next dose at the usual time.

Do not take 2 doses at the same time to make up for a forgotten dose.

If you miss 2 or more doses, contact your doctor.

If you often forget doses it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

If you take too much

Taking too much quetiapine can cause serious side effects.

you take more than your prescribed dose of quetiapine and you:

feel sleepy or tired
feel dizzy
have changes to your heartbeat

you take more than your prescribed dose of quetiapine and you have a seizure or fit

If you need to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance.

Bring the quetiapine packet or leaflet inside it, any remaining medicine, and any other medicines you take.

Do not stop taking quetiapine unless your doctor tells you to, as your symptoms may come back.

If your doctor asks you to stop taking this medicine, your dose may be decreased slowly over a few days.

If you reduce your dose too quickly you may get withdrawal symptoms such as feeling or being sick (nausea or vomiting), sweating and problems sleeping.

Talk to your doctor if you have any problems when you reduce your dose or stop taking quetiapine.

Common side effects

These common side effects of quetiapine may happen in more than 1 in 10 people. There are things you can do to help cope with them:

Do not drive, cycle or use tools or machinery. Try to avoid drinking alcohol as this will make you feel more tired.

As your body gets used to quetiapine this side effect should wear off. If it still makes you feel sleepy after a few weeks, speak to your doctor.

Speak to your doctor if you have any problems with your movement. This can include difficulty moving or stiff muscles that make your movements jerky. Sometimes you may feel like you "freeze up" and then restart moving. You may have other symptoms like a slow shuffling walk, tremors and drooling.

Make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller.

Talk to your doctor if headaches last longer than a week or are severe.

Stop what you're doing and sit or lie down until you feel better. Do not drive, cycle or use tools or machinery. Try to avoid drinking alcohol as this will make you feel worse.

If you feel dizzy when you stand up, try standing up slowly and hold onto something to steady your balance until the dizziness has passed. It should only last a few moments.

As your body gets used to quetiapine, this side effect should wear off. If you still feel dizzy after a few weeks, speak to your doctor.

If quetiapine makes you feel more hungry than usual, try to eat a healthy, balanced diet without increasing your portion sizes. Do not snack on foods that contain a lot of calories, such as crisps, cakes, biscuits and sweets. If you feel hungry between meals, eat fruit and vegetables and low-calorie foods. Regular exercise will also help to keep your weight stable.

Get more fibre into your diet, such as fresh fruit, vegetables and cereals, and drink plenty of water. Try to exercise more regularly, for example, by going for a daily walk or run. If this does not help, talk to your pharmacist or doctor.

Speak to your doctor if you get this side effect.

Speak to your doctor if you get changes to your periods.

Speak to your doctor if you get this side effect.

Speak to a doctor or pharmacist if the advice on how to cope does not help and a side effect is still bothering you or does not go away.

Serious side effects

Serious side effects are uncommon and may happen in up to 1 in 100 people.

Speak to your doctor or call 111 now if you get:

twitching or jerking movements that you cannot control in your face, tongue, or other parts of your body
infections, such as cold or flu symptoms, high temperature, or ear, eye, bladder or chest infections
swelling, pain and redness in your leg – this may be a sign of blood clots

you have weakness on one side of your face or body, trouble speaking or thinking, loss of balance or blurred eyesight – these can be signs of a stroke

you have a painful erection that lasts more than 2 hours (priapism) – this may happen even when you are not having sex
you have chest pain or difficulty breathing – these may be signs of a blood clot in your lungs
you have a high temperature, muscle stiffness, sweating, anxiety or excess saliva – these may be signs of a disorder called neuroleptic malignant syndrome

Find your nearest A&E

A&E safety messaging (for 999 only)

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to quetiapine.

Meds New IA (H4) - serious allergic reaction

These are not all the side effects of quetiapine. For a full list see the leaflet inside your medicines packet.

Quetiapine and pregnancy

There's no good evidence that taking quetiapine in early pregnancy will affect your baby.

Taking it in the weeks before delivery may sometimes cause withdrawal symptoms in your newborn baby. However, these symptoms do not last long. Your baby will be checked after they're born and given extra care if needed.

You may be more likely to develop gestational diabetes if you take quetiapine during pregnancy. For this reason, you may need to have your blood sugar levels checked.

It is important that mental health conditions are well treated since these can affect both your and your baby's wellbeing. Good treatment is important because sometimes symptoms of a mental health condition can get worse during pregnancy and after your baby's born.

Speak to your doctor if you become pregnant. They will help you decide on the best treatment for you and your baby.

Quetiapine and breastfeeding

If your doctor or health visitor says your baby is healthy, you can take quetiapine while breastfeeding.

Quetiapine passes into breast milk in tiny amounts and is unlikely to cause any side effects in your baby.

It's important to keep taking quetiapine to keep you well. Breastfeeding will also benefit both you and your baby.

If you notice that your baby is not feeding as well as usual, seems unusually sleepy, or seems irritable, or if you have any other concerns about your baby, talk to your health visitor, midwife, pharmacist or doctor as soon as possible.

Quetiapine and fertility

Quetiapine can affect hormones in up to 1 in 10 women. This sometimes causes problems with periods.

It can also cause sexual problems in men and women, although this is uncommon and affects less than 1 in 100 people.

If you're trying for a baby, then talk to your doctor if you have any of these problems or if you're worried.

Meds New IA (H2) - Pregnancy non-urgent care card

Cautions with other medicines

Some medicines may affect how quetiapine works.

Tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including:

medicines for fungal infections such as ketoconazole or fluconazole
carbamazepine or phenytoin, medicines for epilepsy

These are not all the medicines that may affect quetiapine. For a full list see the leaflet inside your medicines packet.

Mixing quetiapine with herbal remedies and supplements

There might be a problem taking some herbal remedies and supplements alongside quetiapine, especially ones that make you feel sleepy or dizzy.

There's not enough information to say that complementary medicines, herbal remedies and supplements are safe to take with quetiapine. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.

Meds New IA (H2) - Cautions with other medicines alert