Quetiapine (Seroquel): what it’s for and how to use it safely

Quetiapine, often known by the brand name Seroquel, is a commonly prescribed antipsychotic. Doctors use it for schizophrenia, bipolar disorder (mania and depression), and sometimes as an add-on for major depressive disorder. It comes in immediate-release and extended-release forms and affects brain chemicals to help stabilize mood and reduce psychosis.

Typical doses and how they work

Dosing varies by condition. For schizophrenia adults, treatment usually starts low (for example 25–50 mg once or twice daily) and is raised over days to a typical target of 300–400 mg per day, sometimes up to 800 mg if needed. For bipolar mania, target ranges commonly sit between 400 and 800 mg daily. When used as an add-on for depression, smaller doses are often used—many people take between 50 and 300 mg daily. Extended-release formulas allow once-daily dosing and may reduce morning drowsiness for some people.

Always follow your prescriber's instructions. Quetiapine is usually started at a low dose and increased slowly to lower the chance of side effects like dizziness and low blood pressure.

Common side effects and what to watch for

Some side effects are immediate and predictable: sleepiness, dry mouth, dizziness (especially when standing up quickly), and constipation. Over weeks to months many people notice weight gain, higher blood sugar, and raised cholesterol. These metabolic changes raise the long-term risk of diabetes and heart disease, so regular checks of weight, fasting glucose, and lipids are wise.

Serious but less common problems include severe low blood pressure, movement disorders (restlessness or tremor), and uncommon allergic reactions. Older adults with dementia-related psychosis have a higher risk of death when given antipsychotics; quetiapine is not approved for treating dementia-related behavior problems.

If you feel very sleepy, faint, develop fast heartbeat, severe muscle stiffness, fever, or sudden mood changes (including suicidal thinking), contact your provider right away.

Quetiapine interacts with other drugs. Strong CYP3A4 inhibitors (like ketoconazole) can raise quetiapine levels and cause more side effects. CYP3A4 inducers (like carbamazepine) can lower its effect. Alcohol and sedatives increase sleepiness and coordination problems. Tell your clinician about all meds, supplements, and herbal products you use.

Before starting, expect a baseline check: weight, blood pressure, fasting blood sugar and lipids. If you have heart issues, your doctor may check an ECG. When stopping quetiapine, most people should taper slowly to avoid withdrawal symptoms such as insomnia, nausea, or return of anxiety or mood symptoms.

Thinking of buying quetiapine online? Only use licensed pharmacies and always have a valid prescription. Rogue sites may sell counterfeit pills that are unsafe. If cost is an issue, ask your prescriber or pharmacist about patient-assistance programs or generic quetiapine options.

Questions for your doctor: What dose is right for me? How often will we check weight and blood tests? How long will I need to stay on quetiapine? Keep notes on side effects and share them—small changes early can prevent bigger problems later.