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Seroquel (quetiapine) Side Effects

Last Updated on August 17, 2026 by Diane Ridaeus

Alternative to Meds Editorial Team

Seroquel (quetiapine) side effects are frequently not discussed at the time of prescribing in the middle of a mental health crisis. However, after the crisis has passed, there may be an opportunity for discussion and strategizing a pathway to reduction or elimination of such medication.

Side effects that are associated with Seroquel can limit their usefulness for some, especially if they become severe and debilitating, and if their continued use is adversely affecting one’s quality of life. Here you can earn more about Seroquel side effects, and other information you may wish to discuss with your prescriber if dose reduction, or elimination is an option you are considering.


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Side Effects of Seroquel vs Seroquel XR: Similarities and Differences

Seroquel, generic quetiapine, is an antipsychotic medication Seroquel XR is the same drug but formulated to release gradually over time. The side effect profile for each of these formations is virtually identical, as shown below. The 2 differences comprise added warnings indicating caution in drug-drug interactions with anticholinergic medications taken concurrently with the extended-release version, and for immediate-release Seroquel, cautions for other types of drug interactions because of their genetic targeting profiles, which are not specifically listed and would require a pharmacologist to exactly determine.1,2

Warnings Listed on the Labels that are identical for both Seroquel and Seroquel XR:
  • Seroquel use carries very serious risksIncreased risk of death in elderly dementia patients
  • Suicidal thoughts or behaviors
  • Cerebrovascular adverse events, i.e., stroke, mini-strokes in elderly dementia patients
  • NMS (neuroleptic malignant syndrome) requiring immediate drug discontinuation
  • Metabolic changes leading to weight gain, high cholesterol levels
  • Dysregulated blood sugar (hyperglycemia) leading to diabetes
  • Tardive dyskinesia (involuntary movement disorder)
  • Dysregulated blood pressure
  • Lowered white blood cell count
  • Formation of cataracts

Seroquel Side Effects Common to Both Versions

In addition to the warnings listed, Seroquel side effects and side effects associated with Seroquel XR are also identical. Some of these, like the warnings above, require regular medical monitoring over time to prevent worsening physical or mental health conditions.

Seroquel side effects include the following:
  • Seizures
  • Extrapyramidal disorders
  • Tremor
  • Restless legs syndrome
  • Balance disorder
  • Akathisia
  • Lowered thyroid hormones
  • Hyperprolactinemia
  • Cognitive and motor impairment
  • Abnormal thinking
  • Dysregulated body temperature
  • Pneumonia
  • Daytime sleepiness, drowsiness, lethargy
  • Abnormal dreams
  • Dry mouth
  • Difficulty swallowing (dysphagia), drooling
  • Constipation
  • Dizziness
  • Increased appetite
  • Indigestion
  • Weight gain
  • Fatigue
  • Nasal congestion
  • Nausea
  • Vomiting
  • Tachycardia (elevated heart rate when body at rest)
  • Heart palpitations
  • Sore throat, runny nose, sinusitis
  • Cough
  • Fainting/lightheadedness after standing up
  • Elevated liver enzymes
  • Elevated enzymes in heart, muscle or other tissues
  • Difficulty in speech, i.e., slurring of words (dysarthria) 
  • Headache
  • Anxiety
  • Depression
  • Irritability, aggression
  • Agitation
  • Pain, back pain, abdominal pain
  • Pain in the joints (arthralgia)
  • Muscle stiffness
  • Physical weakness (asthenia)
  • Rash
  • Fever
  • Lazy eye syndrome (amblyopia)
  • Blurred vision
  • Ear pain
  • Increased muscle tension (hypertonia)
  • Twitching
  • Sweating
  • Thirst
  • Urinary tract infection
  • Paraesthesia (pins and needles sensation)
  • Anorexia
  • Nosebleeds
  • Abscess in tooth
  • Acne
  • Pallor (unhealthy paleness)

Understanding How the Body Reacts to Seroquel

Another way the label explains side effects is by categorizing which body part or parts or system are affected.1,2

Nervous System:

These adverse effects include tardive dyskinesia, other dyskinesias, involuntary or uncontrolled body movements, abnormal gait, vertigo, amnesia, paranoia, confusion, delusions, delirium, hallucinations, abnormal thinking, mania, euphoria, apathy, depersonalization, psychosis, stupor, catatonic reaction, emotional lability, abnormal dreams, dysregulated libido, neuralgia, stuttering, urinary retention, grinding of the teeth, clenching of the jaw, disordered speech (aphasia), paralysis of one side of the body (hemiplegia), uncontrolled jerking motions, i.e., hiccups or “sleep starts” when falling asleep, subdural hematoma which means a pooling of blood around the brain which can be life-threatening.

Digestive System:

Digestive side effects of Seroquel listed on the label include anorexia (eating disorder), increased appetite, flatulence, thirst, difficulty swallowing, drooling, increased salivation, tooth decay, gingivitis, swelling of the tongue, bleeding gums, mouth ulcerations, hemorrhoids, intestinal obstruction, rectal hemorrhage, pancreatitis, reflux heartburn, inability to control bowel movements, dark sticky stool, gastritis (inflamed stomach lining leading to nausea, vomiting, pain), inflammation of the mucous lining in the mouth (stomatitis), elevated liver enzymes, vomiting blood (hematemesis).

Musculoskeletal System:

The label lists various presentations of “myasthenia,” which primarily affects voluntary muscles resulting in symptoms such as drooping eyelids, uncontrolled muscles in the mouth, jaw, throat, and limbs. Other presentations include leg cramps, twitching, bone pain, joint pain, muscle pain.

Cardiovascular System:

These Seroquel side effects can be both painful and life threatening and include migraine, angina, stroke, and heart failure.

Please search the drug’s label carefully to find other categories of Seroquel side effects relating to other systems in the body, such as respiratory, metabolism, skin, urinary, genital, lymph, endocrine, and other systems in the body.

Seroquel in Pregnancy

The use of Seroquel (quetiapine) is cautioned in pregnancy, though no human testing has occurred. The label also mentions harm to the fetus may occur, based on results of animal testing.1,2

A warning is given that Seroquel may cause extrapyramidal (involuntary body movement disorders) and withdrawal symptoms in the infant when the mother takes Seroquel in the 3rd trimester of pregnancy. Be sure to discuss your own thoughts about Seroquel relating to pregnancy and breastfeeding with your care team, for your and your newborn’s best health outcome.

1 (800) 301-3753 for Help with Seroquel (quetiapine) Side Effects

Seroquel Side Effects FAQs

If you don’t see your question here, please reach out to us directly and we will help you get the answers you are looking for.

Can Seroquel Cause Drooling?

Yes. This is due to the drug’s weakening effects on voluntary muscles.

Is Difficulty in Speech a Risk with Seroquel?

Yes. Trouble controlling the mouth muscles, and disordered thinking can affect speech while taking Seroquel.

Why is Seroquel called an atypical antipsychotic?

Atypical is a term meant to distinguish newer antipsychotic drugs from older ones. These may have different molecular targets than older drugs in this class, and certainly are prescribed for many additional treatment targets including bipolar conditions, or as an added medication in polypharmacy in “treatment-resistive” depression and other conditions.3

It is also important to bear in mind that some persons classed as schizophrenic, or other labels, may not be the best candidates for antipsychotic drug treatment.5

Does Seroquel have any Black Box Warnings?

Yes. There are black box warnings for increased mortality in elderly dementia patients as well as suicidality in younger patients.

Since Seroquel/quetiapine is increasingly prescribed off-label for such things as insomnia, one should speak to one’s doctor about the potential side effects of Seroquel that should not be overlooked.4,7,8

Is it Possible to Safely Get Off Antipsychotic Medications?

There are methods that can allow for reduction of antipsychotic medication and even elimination in some cases. Never abruptly discontinue antipsychotic medication unless there is a medical reason to do so. 6

To find out more about safe tapering from antipsychotics please see the following:

Antipsychotic Tapering Help | Holistic Weaning & Titration Support

Gradual, professionally monitored Seroquel withdrawal is safest

Sources:

1. FDA Label Seroquel (quetiapine) tablets for oral use, approval 1997 [cited 2026 Aug 14]

2. FDA Label Seroquel XR (quetiapine) extended-release tablets for oral use approval 1997 [cited 2026 Aug 14]

3. Aringhieri S, Carli M, Kolachalam S, Verdesca V, Cini E, Rossi M, McCormick PJ, Corsini GU, Maggio R, Scarselli M. Molecular targets of atypical antipsychotics: From mechanism of action to clinical differences. Pharmacol Ther. 2018 Dec;192:20-41. doi: 10.1016/j.pharmthera.2018.06.012. Epub 2018 Jun 25. PMID: 29953902. [cited 2026 Aug 14]

4. Carney AC. Efficacy of quetiapine off-label uses: data synthesis. J Psychosoc Nurs Ment Health Serv. 2013 Aug;51(8):11-8. doi: 10.3928/02793695-20130709-01. [cited 2026 Aug 14]

5. Rappaport M, Hopkins HK, Hall K, Belleza T, Silverman J. Are there schizophrenics for whom drugs may be unnecessary or contraindicated? Int Pharmacopsychiatry. 1978;13(2):100-11. doi: 10.1159/000468327. PMID: 352976. [cited 2026 Aug 14]

6. Hansen HG, Speyer H, Stürup AE, Hjorthøj C, Öngür D, Nordentoft M, Albert N. Use and discontinuation of antipsychotic medication in 20 years following a first episode of schizophrenia: results from the OPUS trial. Psychol Med. 2024 Nov;54(15):4374-4384. doi: 10.1017/S0033291724002678. Epub 2024 Nov 18. PMID: 39552396; PMCID: PMC11650151. [cited 2026 Aug 14]

7. Højlund M, Andersen K, Ernst MT, Correll CU, Hallas J. Use of low-dose quetiapine increases the risk of major adverse cardiovascular events: results from a nationwide active comparator-controlled cohort study. World Psychiatry. 2022 Oct;21(3):444-451. doi: 10.1002/wps.21010. PMID: 36073694; PMCID: PMC9453914. [cited 2026 Aug 14]

8. Modesto-Lowe V, Harabasz AK, Walker SA. Quetiapine for primary insomnia: Consider the risks. Cleve Clin J Med. 2021 May 3;88(5):286-294. doi: 10.3949/ccjm.88a.20031. PMID: 33941603. [cited 2026 Aug 14]

Originally Published August __, 2026 by Diane Ridaeus

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ATMC Clinical Review Team

The ATMC Clinical Review Team includes licensed physicians and experienced healthcare professionals dedicated to ensuring the accuracy, quality, and integrity of our medical content. The team reviews articles for clinical accuracy, evidence-based guidance, and relevance while supporting Alternative to Meds Center’s whole-person approach to mental health, recovery, and long-term wellness.

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