Seroquel is a prescription drug that’s used to treat mental health issues that cause psychosis, like schizophrenia. Schizophrenia can be a disturbing and debilitating disorder that causes delusions and hallucinations. But drugs like Seroquel that are in a category of drugs called antipsychotics can help to ease or stop psychotic symptoms. Antipsychotics can help ease disturbing symptoms, but they can also come with some uncomfortable side effects, including withdrawal. Learn more about Seroquel withdrawal and how to stop taking quetiapine safely.

What Is Seroquel?

Seroquel was the first brand-name medication with quetiapine as its active ingredient. The medicine, produced by AstraZeneca, was approved by the U.S. Food and Drug Administration (FDA) in 1997. Seroquel was approved to treat psychotic conditions, including schizophrenia and bipolar disorder.

Since the prescription drug was approved, AstraZeneca has faced several lawsuits for marketing the medication to doctors for specific off-label uses, leading to wider availability of this substance. While it is legal for a doctor to prescribe a medication for off-label use in certain circumstances, it is illegal at the federal level for a pharmaceutical company to market drugs for these uses. AstraZeneca paid $520 million to settle these federal investigations.

Despite the federal investigations, Seroquel is rarely, but sometimes, still prescribed to treat Alzheimer’s disease, which can have some psychotic symptoms; aggression; anxiety; depression; attention deficit hyperactivity disorder (ADHD); post-traumatic stress disorder (PTSD); insomnia; and anorexia.

Since several off-label uses have been found to put people in danger, the FDA has issued two major black box warnings on the prescription.

Older Adults With Dementia Should Not Take Seroquel

This can increase confusion, decrease memory, and change mood and personality rapidly. Additionally, people with dementia have a higher risk of dying while taking Seroquel.

Seroquel Can Increase the Risk Of Suicide

This risk is highest at the beginning of treatment with Seroquel, and it is higher for people who are younger than 24 years old.

Several other risks are associated with Seroquel, including side effects that can become uncomfortable or risky, or limit one’s quality of life. The discomfort and adverse impact on your life may make you want to quit Seroquel suddenly; however, it is important to work with your prescribing doctor before stopping this medication.

Seroquel is an important psychiatric medication for many people in the United States. You may take this medication as prescribed and want to switch to a different medication, or you may want to try to stop using it and see if your symptoms are better. Sometimes, people abuse Seroquel to get high, and they may think about quitting this habit. Quitting can be very uncomfortable, so it is important to work with your doctor to taper your dosage until you are no longer physically dependent on the drug. It is important for people who abuse Seroquel to get high to find a detox program that can help them safely manage withdrawal symptoms.

How Does Seroquel Medication Work?

The nature of psychosis isn’t fully understood, so it’s not clear how antipsychotic medications like Seroquel work in the brain. However, one theory has to do with dopamine functions and hypotheses in the brain. Dopamine affects the brain in several ways, and it’s active in several pathways that affect things like mood, perception, and motor function. There are two dopamine receptors that are thought to be involved in psychosis, and antipsychotic medications can bind to one of them. The first antipsychotic medications were known as typical antipsychotics. These blocked certain dopamine receptors all over the brain, which had both positive and negative effects. 

Schizophrenia causes an increase in activity in certain parts of the brain and a decrease in activity in other parts. The increase causes symptoms like delusions and hallucinations, and the decrease causes things like depression, social isolation, flat affect, and little to no response to things that would normally excite you. However, since typical antidepressants cause an overall decrease in activities where dopamine binds in the brain, it can improve symptoms like delusions and hallucinations, but it can make other symptoms worse. They can also cause tremors and muscle rigidity. 

Seroquel is a relatively modern drug, and it’s considered an atypical antipsychotic or a second-generation antipsychotic. These drugs are able to block dopamine receptors and a particular serotonin receptor. The addition of this extra function is thought to decrease dopamine activity in some areas of the brain while increasing it where it’s needed. Ideally, atypical antipsychotics will be able to treat symptoms of schizophrenia without making other symptoms worse. However, second-generation antipsychotics have their own common side effects.

Physical Risks of Suddenly Quitting Seroquel

If you have any of the following underlying physical conditions, quitting Seroquel — whether you were prescribed the drug or you struggle with the abuse of it — is riskier and requires medical supervision:

  • Irregular heartbeat
  • History of heart attacks or other heart problems
  • Frequent nausea or diarrhea
  • High cholesterol
  • High or low blood pressure
  • Strokes
  • Cancer, currently or in the past
  • Liver disease
  • Leukemia or neutropenia (low white blood cell count)
  • Cataracts

It is also important to follow your doctor’s instructions for taking this medication consistently. If you miss a dose, take it when you remember unless it is close to the next dose because doubling the medication can be harmful. Speak with your doctor about details if you have questions about this process. They can guide you individually through safely taking this prescription drug.

For people who abuse Seroquel, physical tolerance and dependence may lead to quickly ramping up the dose to achieve the initial high or feel normal. Some people may mix the drug with other intoxicating substances like alcohol, which is dangerous because it increases the sedative effects of the drug. Again, it is important to find a medical professional to help you safely stop abusing Seroquel, which means finding a detox program that has addiction specialists who understand Seroquel withdrawal. A rehabilitation program should then follow detox.

Is Quetiapine Withdrawal Dangerous?

Coming off quetiapine can be unpleasant, especially if you do it abruptly. Quitting cold turkey can cause a variety of unpleasant symptoms like insomnia, dizziness, and vomiting. According to the Food and Drug Administration (FDA), a clinical trial of Seroquel XR found that a little more than 12% of participants experienced withdrawal symptoms after abrupt cessation. Seroquel isn’t known to cause life-threatening symptoms as some central nervous system depressants can, but nausea and vomiting may be uncomfortable. In some cases, vomiting can lead to dehydration, which can cause some serious complications if you’re not able to get plenty of fluids. Though it’s not known to cause deadly withdrawal, the FDA recommends to stop taking quetiapine safely by tapering slowly.

Seroquel Withdrawal Symptoms and Why they Occur

You may experience several discontinuation symptoms, or symptoms of withdrawal, when you quit taking Seroquel or miss enough doses that your body completely metabolizes the substance out.

More Common Withdrawal Symptoms Include:

  • Headaches
  • Nausea
  • Diarrhea
  • Vomiting
  • Stomach upset
  • Insomnia
  • Dizziness
  • Irritability and mood swings

More Uncomfortable Symptoms Commonly Include:

  • Shortness of breath
  • “Brain zaps,” or feeling electric shocks in the head
  • Dehydration from vomiting or diarrhea
  • Vision problems
  • Psychosis, including hallucinations or delusions
  • Rapid weight changes, either loss or gain

It is generally recommended to gradually withdraw from this medication with a doctor’s oversight, stepping down the dose slowly, over one to two weeks.

Seroquel is classified as an atypical, second-generation antipsychotic, which exerts pharmacological effects on several parts of the brain but especially D2, 5-HT2A, H1, alpha-1, and 5-HT1A receptors. This means the drug affects levels of dopamine, serotonin, norepinephrine, and histamine neurotransmitters available to the brain. By minimizing the dopamine transmission through certain parts of the brain, the drug manages psychotic symptoms like hallucinations, delusions, and intense fear.

Because the drug manages a wide range of neurotransmitters, which are also associated with mood, it is used off-label for other psychiatric treatments, and it may be abused by people who are seeking a high. Changing how the brain manages neurotransmitters like serotonin and dopamine can lead to the brain becoming dependent on the presence of the substance to reach a standard brain chemistry level.

In people who struggle with psychological conditions like schizophrenia, balancing brain chemistry is vital, but for people who abuse the drug or use it outside of how it was prescribed to them, Seroquel can lead to dependence.

Why Does Seroquel Cause Withdrawal Symptoms?

Withdrawal happens after you develop a chemical dependence on a drug, like Seroquel. Dependence occurs after a period of consistent use of a drug. It’s common with drug misuse, but it can also happen as a result of regular prescription drug use. As you use the drug over the course of a few weeks or months, your body will adapt to it. Your brain will adapt your brain chemistry around the drug, and when you stop using it, you’ll experience a chemical imbalance. Since Seroquel is still relatively new, the FDA reports that the drug’s dependence-causing potential has not been systematically studied in animals or humans. However, the fact that some people experience withdrawal symptoms could mean it does cause some dependence.

How Long Does Seroquel Withdrawal Take?

The length of time before withdrawal symptoms begin generally depends on how long you took Seroquel and at what doses. The medication is supposed to build up to a steady level in your body if you take it as prescribed so that your brain chemistry remains balanced. Substance abuse patterns do not lead to this kind of buildup. Instead, they lead to rapid dependence and increasingly more abuse.

Extended-release Seroquel is designed to remain in the body for about half a day. Its half-life is about seven hours, so after 14 hours to 15 hours, the drug begins to leave your body. Generally, it takes about 24 hours to 1.6 days for Seroquel to be completely metabolized out of your system. After this time, you will begin to experience withdrawal symptoms.

The tapering process will be individual, and your doctor will work with you on the exact speed at which you will stop taking Seroquel. However, there are some general approaches to the tapering timeline.

  • For those who took the medication fewer than 12 weeks at a low dose, quitting immediately can be done, with a two-week evaluation afterward to manage symptoms.
  • People who took the drug less than 12 weeks but at a high dose should taper over one month, reducing to half the dose in the first two weeks, with a review at that point. If things are progressing satisfactorily, it can continue in this same manner.
  • If the person took Seroquel more than 12 weeks, they need a minimum of three weeks’ tapering, and this can be extended as necessary.

Quitting Seroquel cold turkey, or totally discontinuing use without a doctor’s oversight, can be very uncomfortable. It may take less time, but tapering off this medication, especially if you struggled with abusing it, is the best way to avoid problems such as cravings, relapse, or psychiatric symptoms.

Safe At-Home Ways to Ease and Speed Withdrawal

Currently, there are no replacement medications to ease withdrawal symptoms associated with Seroquel. If you take the medication with a prescription, your doctor will taper the dosage and help you switch to something that will ease your symptoms better. If you struggle with Seroquel abuse, your overseeing detox physician will treat individual symptoms as they become uncomfortable, like nausea, physical pain, insomnia, and more.

If you are working with a detox program to stop Seroquel abuse, and you experience abnormal thoughts, visualizations, or something that seems like it may be a delusion or hallucination, let the doctor know immediately. You may need further treatment with different providers.

If you are working with your doctor to taper off Seroquel or working with an outpatient detox program to end your physical dependence on the drug, there are some lifestyle changes you can make that may improve how well your body metabolizes the drug. Check with your overseeing physician before attempting any of these, but they may be useful.

  • Stay hydrated during the detox process.
  • Eat healthy foods that do not upset your stomach.
  • Get enough exercise, starting with low-impact choices, and see if you can tolerate moderate exercise.
  • Acidify your urine pH by eating more acidic foods, such as oranges, to increase how fast the drug is excreted, as long as your stomach can handle it.

These tips can improve your overall sense of well-being as you detox from Seroquel. It is important to find a detox program that understands how to manage this particular drug and can work with you on evidence-based options that ease withdrawal symptoms. They should also be able to help you transfer to a rehabilitation program after detox is complete.

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