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Understanding the Potential Risks of Long-Term Quetiapine Treatment

This entry was posted in Antipsychotic and tagged , on by .

Last Updated on July 14, 2022 by Chris Weatherall

Seroquel Long-Term Effects
Alternative to Meds Editorial Team
Medically Reviewed by Dr Samuel Lee MD

Quetiapine, sold under the brand name Seroquel, is a powerful antipsychotic medication that works upon the brain’s chemistry and is typically prescribed in the treatment of schizophrenia, major depressive disorder, some anxiety disorders, and other serious conditions.1 It affects the levels and behavior of various neurotransmitters in the human brain, including serotonin and dopamine, intended to stabilize a patient’s mood and break harmful thought patterns.


Seroquel has played a role in treating patients with serious psychological disorders. Early trials showed that it was well tolerated by human patients and worked consistently to reduce symptoms of schizophrenia. However, there are some experts in psychiatric and health communities who have come to criticize it as being over-prescribed and too heavily relied upon for long-term mental health stabilization.

Arguments commonly arise based on the lack of information about long-term use. As preliminary data emerges about those long-term effects, this criticism has only become more pronounced. Consumer health advocates have cautioned that the negative health effects of long-term Seroquel use in humans appear potentially serious. The full extent of those effects is not yet fully understood.

When Is Seroquel Prescribed?

The United States Food and Drug Administration (FDA) has approved Seroquel for a variety of uses beyond serious cases of schizophrenia. Some prescribers have also turned to it for treating related symptoms “off label,” prescribing the drug in a way not explicitly endorsed by the FDA.

Some of the symptoms or conditions that might prompt a medical practitioner to start treatment with Seroquel or generic quetiapine include the following:

  • Acute episodes (either manic or depressive) resulting from bipolar disorder
  • Long-term maintenance of bipolar disorder
  • Delusional thoughts, including paranoid thoughts
  • Hallucinations – auditory or visual
  • Inability to organize thoughts coherently
  • Severe cases of depression – prescribed in conjunction with an antidepressant
  • Post-traumatic stress disorder (PTSD) and other serious anxiety disorders
When Is Seroquel Prescribed

The long-term side effects of Seroquel therapy are not fully understood, and will be discussed further later in the post.

Some of the more common short-term side effects reported by Seroquel patients are also fairly unpleasant, and include:

  • Headache
  • Drowsiness or dizziness
  • Dry mouth
  • Constipation
  • Changes in mood (agitation)
  • Increased heart rate
  • Restless or stiff muscles
  • Unexpected changes in cholesterol levels

Is Seroquel Good for Long-Term Use?

One of the more concerning aspects of quetiapine treatment for those doing their initial research into the drug is that most prescribing professionals approach it as a long-term maintenance drug. While Seroquel has shown some efficacy in treating acute episodes related to schizophrenia and various other psychological disorders, Seroquel is typically seen as a daily maintenance drug.

However, Seroquel treatment is typically seen as a months- or even years-long project by healthcare professionals who are proponents of the drug. Similar to other neurotransmitter influencing drugs such as SSRI and SNRI antidepressants, Seroquel is intended to build up to therapeutic levels over time, typically as you increase your dose.

Is Seroquel Good for Long-Term Use

This means that your body and brain will have some major adjustments to make if you should ever need to quit taking Seroquel. Missing a dose of Seroquel can even increase your risk for relapsing and experiencing schizophrenic symptoms.

This creates something of a paradox because it means Seroquel treatment can potentially trigger schizophrenic episodes in the course of managing them. Avoiding these withdrawal-induced relapses requires the patient to manage their daily medication routine perfectly. Unfortunately, people with serious mental health issues can sometimes struggle with memory issues and maintaining consistent routines due to the very nature of their illnesses.

Seroquel use may also be directly implicated in memory issues for some patients. This likely has to do with the mechanism by which it works to affect dopamine regulation. The rewarding, accomplished feeling dopamine produces is believed to be central to learning and memorization. It has, therefore, been posited that Seroquel’s powerful disruption of the dopamine response system has the potential to affect memory through its disruption of natural dopamine balances.

The reality is that there is no known pharmacological cure for schizophrenia, and like most mental health issues, its symptoms are subjectively felt and largely unseen. Living with schizophrenia often involves a lifetime of work, ongoing treatment, and developing healthy coping skills. Whether that treatment involves powerful pharmaceuticals, psychiatric treatment, new emerging therapies, or some combination of those elements will represent a deeply personal healthcare choice, just as experiencing schizophrenia is a deeply personal journey.

Speak openly with your health professionals and other trusted resources about what you are experiencing and what your concerns are with your current treatment method. Do not settle for a treatment plan that you do not feel is working for you. Continue working and exploring your options until you can develop and implement a treatment plan that addresses your individual mental health needs and makes the symptoms of schizophrenia in your day-to-day life manageable. Not everyone who lives with schizophrenia will require daily treatment with Seroquel or other potent drugs.

The Negative Side Effects of Long-Term Seroquel Use

While we do not yet know the full extent of Seroquel’s long-term effects, some of the research so far has been concerning to psychiatrists and health advocates. While the initial trials that were used to approve Seroquel for the treatment of schizophrenia demonstrated fairly consistent tolerance and efficacy, the studies into long-term use so far have had mixed results, at best.

The data we currently have about the long-term use of Seroquel and similar antipsychotics shows some very disappointing and concerning trends for those who are looking to modern medicine to provide a cure—or at least a viable treatment—for schizophrenia and psychotic episodes.

In a study conducted over a 15-year span, it was found that patients not taking any antipsychotics at all were more likely to have recovered from schizophrenia than those being treated with Seroquel-like drugs. To date, there is simply no evidence suggesting Seroquel is successful as a long-term treatment for schizophrenia, psychotic episodes, or any other mental health issues.

Long-Term Seroquel Use and Muscle Problems

Long-Term Seroquel Use and Muscle Problems

Some of the most common side effects emerging among long-term quetiapine patients include muscle issues. The side effects reported range from simple annoyances like stiff muscles to debilitating conditions like constant involuntary movement in the mouth.

The muscle problems related to long-term Seroquel treatment can be divided into two categories, the first being extrapyramidal symptoms (EPS) and the other being tardive dyskinesia (TD). EPS manifests as muscles that are restless, prone to involuntary trembling, and frequently feel stiff. TD results in slow muscle response and awkward, difficult-to-control movements. The first symptoms of TD often manifest in small, involuntary movements in the muscles in the mouth, jaw, and tongue.

Elevated Prolactin

Quetiapine may be to blame for increased levels of the hormone prolactin in long-term users.

This hormonal imbalance can lead to all sorts of additional problems, including:

  • Osteoporosis and resulting bone fractures
  • Loss of sex drive
  • Disruption or absence of menstrual cycle
  • Production of breast milk outside of pregnancy/motherhood
  • Erectile dysfunction

Weight Gain

One commonly reported result of treatment with Seroquel and some other neurotransmitter manipulating drugs is significant weight gain.2 Related conditions like high blood sugar, diabetes, high triglycerides, and high cholesterol are also linked to long-term users of second-generation antipsychotics like Seroquel. These effects are so well known that doctors who prescribe Seroquel will often conduct regular blood sugar panels and other hemoglobin testing to monitor their patients’ health in these areas.

Temperature Regulation

Some long-term Seroquel users have experienced an impairment to their body’s ability to regulate temperature. This can lead to life-threatening overheating issues when the Seroquel user works out or spends time in the sun, for example.

Does Quetiapine Shorten Your Life?

Perhaps the most concerning side effect of all, is that second-generation antipsychotics have been linked to a higher risk of death. Even more troubling is the fact that these Seroquel-related deaths stem from more than one root cause.

Seroquel May Be Associated With Strokes

The research to date primarily associates an elevated risk of fatal strokes with elderly dementia patients who are taking Seroquel for behavioral issues.

Does Seroquel Cause Heart Problems?

Antipsychotics in general are also associated with an elevated risk of death due to cardiac issues. Antipsychotic medications, including Seroquel, seem to increase the likelihood that a patient will die suddenly due to arrhythmia, or irregular heartbeat.

Seroquel is Linked to Increased Falls

Antipsychotics can exacerbate that dizzy feeling that you experience when standing up after sitting down or bending over for long periods. The sensation is known to be rooted in something called orthostatic hypotension, a rapid drop in blood pressure. When antipsychotics elevate this phenomenon to dangerous levels, a patient can lose balance or even consciousness, resulting in serious and potentially fatal falls.

Seroquel is Associated With Neuroleptic Malignant Syndrome

Although this rare side effect occurs in less than 1% of antipsychotic users, neuroleptic malignant syndrome is another potentially fatal issue linked to long-term antipsychotic use. Signs of developing problems may include profuse sweating, disorientation, and muscle stiffness.

Is Seroquel Hard on the Kidneys?

Quetiapine and several other antipsychotic drugs have recently been named in class action lawsuits surrounding an elevated risk of acute kidney injury in patients. Research shows that quetiapine can be statistically linked to kidney injuries that result in urinary tract problems, hypotension, and the aforementioned neuroleptic malignant syndrome.3

Does Seroquel Cause Fatty Liver?

Antipsychotics like quetiapine have also been implicated in a condition called nonalcoholic fatty liver.4 Just as its name suggests, this disease results in liver issues similar to those of long-term alcohol addicts, except without the element of alcohol present. If left untreated, this can lead to more serious disease like cancer or cirrhosis.

Is Seroquel Habit Forming?

As with most drugs that cause a sedative effect, the potential exists for Seroquel to become habit-forming.5 While the exact mechanism of quetiapine on the brain is not completely understood, we do know that the mechanism manipulates serotonin and dopamine levels. This is an effect seen across many addictive substances. Many Seroquel regimens as prescribed are essentially habit-forming by design, as they require the patient to take small maintenance doses of Seroquel every day.

Seroquel’s long-term effects on the dopamine response system also have the potential to create a dependence on the drug, even if Seroquel is not traditionally sought for euphoric effects. Any drug that works by deliberately manipulating or triggering your dopamine response has an unsettling potential to increase activity in the brain in a way that makes you need the drug’s effects to function normally. While it is true that very few people set out to “get high” when they take Seroquel, needing a drug to function normally is a hallmark of drug dependence.

What Happens When You Stop Taking Seroquel?

When Seroquel is taken as a daily maintenance medication over a long period of time, your body and brain adjust to it and even come to rely on its presence as a way to keep mood and behavior stabilized. For this reason, anyone wishing to stop using Seroquel must do so slowly, by reducing their dose in small increments over time.

The potential withdrawal symptoms of trying to quit Seroquel cold turkey can include:

  • Dizziness, nausea, vomiting
  • Profuse sweating
  • Elevated heart rate
  • Disrupted sleep patterns or inability to sleep
  • Disrupted eating patterns or loss of appetite

These effects can be quite severe in some patients, and for that reason it is crucial to work with a trusted, qualified healthcare professional when developing a plan to wean yourself off Seroquel.

In many patients, withdrawal from Seroquel appears indistinguishable from a return of the mental health symptoms that led to Seroquel therapy in the first place. A person might take their Seroquel dutifully for 10 years, and then find themselves right back where they started once they begin weaning off the medicine. This can be a scary and depressing realization for patients and loved ones, feeding negativity into a cycle that makes such symptoms worse still. 

When withdrawing from Seroquel, it is critical to avoid any stimulants, as they could exacerbate this effect and trigger a psychotic event. In severe cases, even a cup of coffee could potentially put someone struggling with Seroquel withdrawal over the edge. In extreme cases, common stimulants could trigger worse mental health symptoms than before.

What Is a Good Replacement for Seroquel?

There are no foolproof answers for patients who wish to treat schizophrenia without pharmaceutical intervention. However, a holistic approach with the right combination of nutrients, lifestyle changes, and psychiatric treatments tailored to your individual needs and strengths may offer a better, and healthier path to long-term success. A few of the strategies that may be used in a Seroquel-free treatment plan include:

  • Vitamin C. Vitamins support healthy brain processing in all sorts of ways.
  • Oxygen. Along with vitamin C, oxygen plays a critical role in managing the healthy breakdown of dopamine.
  • Niacin. This is another essential vitamin that is crucial for the development of healthy neurotransmitters.
  • Lithium orotate. For some, this treatment can help calm the brain and help promote a more positive mood.

What Does Quetiapine Do to the Brain?

In short, we don’t know exactly how Seroquel works on the brain. We know that using Seroquel produces a sedative effect that can help resolve serious schizophrenic episodes where someone is at risk of harming themselves and others, but we don’t know if relying too heavily on Seroquel over time might be doing more harm than good to the patient’s brain and body.

*Editor’s Note: This article was originally published May 30, 2022 and has been updated July 14, 2022.


References:

1. Maan JS, Ershadi M, Khan I, et al. (2022) Quetiapine. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Retrieved May 25, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK459145/

2. M Brecher, I.W. Rak, K Melvin & A.M. Jones (2000) The long-term effect of quetiapine (Seroquel TM ) monotherapy on weight in patients with schizophrenia, International Journal of Psychiatry in Clinical Practice, 4:4, 287-291, DOI: 10.1080/13651500050517849

3. Hwang, Y. J., Dixon, S. N., Reiss, J. P., Wald, R., Parikh, C. R., Gandhi, S., Shariff, S. Z., Pannu, N., Nash, D. M., Rehman, F., & Garg, A. X. (2014). Atypical antipsychotic drugs and the risk for acute kidney injury and other adverse outcomes in older adults: a population-based cohort study. Annals of internal medicine, 161(4), 242–248. https://doi.org/10.7326/M13-2796

4. National Institute of Diabetes and Digestive and Kidney Diseases (2018). Nonalcoholic Fatty Liver. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. Bethesda (MD). Retrieved May 25, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK547860/

5. Cha, H. J., Lee, H. A., Ahn, J. I., Jeon, S. H., Kim, E. J., & Jeong, H. S. (2013). Dependence potential of quetiapine: behavioral pharmacology in rodents. Biomolecules & therapeutics, 21(4), 307–312. https://doi.org/10.4062/biomolther.2013.035



This content has been reviewed and approved by a licensed physician.

Dr. Samuel Lee

Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente.  He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.

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Understanding the Potential Risks of Long-Term Quetiapine Treatment
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