In the US, around 19 percent of the adult population grapple with mental health conditions. Importantly, almost 5% suffered from serious mental conditions, requiring treatment and management of the conditions. Quetiapine is one among the various medications in use for treating some of the conditions. Commonly known by the brand name Seroquel, the antipsychotic is used for treating bipolar disorder, schizophrenia and depression. Despite the low risk levels and lesser possibility of adverse side effects of the drug, apprehension about side effects of Seroquel persist. Let’s take an informed look at the medication, its mechanism of action and the side effects.

Overview of Seroquel

Before we look at the side effects of Seroquel let us first take a quick look at the drug to understand how it works and its effectiveness. Belonging to the category of atypical antipsychotic drugs, Seroquel is a second generation formulation approved for use in the US more than two decades ago. By virtue of its good tolerance, it is also used in combination with other drugs. It is used for managing manic episodes of bipolar disorder, and is also used for managing major depression as a part of combination medication. Additionally the medication is also used for off-label purposes, including PTSD – post traumatic stress disorder, and psychosis that is attributed to Parkinson’s.

Different side effects of Seroquel

The side effects of Seroquel can be broadly classified into two different types – common with lesser intensity and rare side effects that could be severe in nature.
Commonly reported side effects include – dryness in the mouth, difficulty in digestion, sudden increase in weight, constipation, abnormal feelings of low energy, general weakness, inability to sleep properly, headache, irritation in the throat and one type of low blood pressure. These effects are likely to occur frequently and are of lesser intensity. These side effects are most likely to resolve faster, in some cases without the need for medical intervention.

Side effects of Seroquel that are rare and relatively serious in nature include – low thyroid levels, anaphylaxis, diabetic ketoacidosis, stroke, epidermic necrolysis, rhabdomyolysis, complications in menstruation, cataract, difficulty in emptying the bladder fully, diabetes, cardiomyopathy, movement disorder, low white blood cells, pancreatitis, blocked intestine and bowels, abnormal production of breastmilk when woman is not nursing a child, complications in the liver, reduction in body temperature, reduction in sodium levels, priapism, inflamed heart muscle tissue, seizures, reduction in heartbeat, retention of fluid in the limb extremities, depression, hepatitis, blood disorder and involuntary movements of certain parts of the body.

Mechanism of action of Seroquel

To understand the side effects of Seroquel better, it is essential to know more about the mechanism of action of the drug. While the actual mechanism of action is still not fully known, the treatment outcomes are attributed to certain characteristics of the drug. For instance, in schizophrenia, the effects of the drug are attributed to the blocking properties of the medication. The antagonism of various receptors – including dopamine type 2 and serotonin is known to cause the outcomes of the medication. Similarly, Seroquel’s mechanism of action in treating bipolar depression is attributed to its binding action with norepinephrine transporter. As a result of this binding action, the drug helps to manage the episodes of depression. The primary effects of Seroquel include orthostatic effects, anticholingergic effects and somnolence apart from hypotension. These effects are attributed the antagonistic effects exerted on various receptors including H1, muscarinic M1 and adrenergic alpha 1 receptors.

Recommended methods for using Seroquel

Considering the side effects of Seroquel, it is essential to understand the best/recommended methods for taking the medication. Available in oral form as tablets, Seroquel is also sold as extended release tablets for use in specific cases. The medication can be taken either with food or without food and is typically prescribed for consumption once a day or upto thrice a day depending on the condition. When the extended release medication is prescribed, it is typically taken once a day, preferably without food. Extended release tablets of Seroquel can also be taken once a day in the evening with food that is not too heavy. The purpose of taking it without food or with light food is to manage the rate of absorption. It is essential to take the medication at the same time every day, so as to manage the levels in the body. The extended release tablets are not to be crushed, chewed or cut.

In most cases, the doctor advises patients to start off on a small dose which is then gradually increased. Patients who have had a break in the medication for a weak are expected to seek medical advice about dosage before restarting the medication. Typically, doctors advise the patients to repeat the cycle of starting off on smaller dosages and then gradually increasing the dosage.

It is important to understand that the drug is intended for the purpose of managing the symptoms associated with the underlying conditions. It is not intended to be used as a cure for the condition. This puts the medication in the category of long term drugs. In other words, most patients are prescribed Seroquel and expected to take the drug even when the symptoms are not experienced. As a result of this, patients are more likely to experience withdrawal symptoms when the dosage is abruptly stopped. This includes nausea, sleep related problems and vomiting sensations.

Precautions to be taken to mitigate/prevent the side effects of Seroquel

To mitigate or prevent the side effects of Seroquel, a few precautions will help. This includes :

· Checking for allergies/contraindications
· Intimating the treating doctor about other medications including supplements and            herbal formulations.
· Report family medical history of diabetes or irregular heart beats
· Report past substance abuse
· Report pregnancy plans
· Report usage of the medication before any surgical procedure including dental surgeries
· Avoid activities that require focus and undivided attention as the drug is known to            cause drowsiness
· Stay away from alcohol when on Seroquel
· Avoid intensive workouts
· Rise from seated or reclining position slowly to avoid drowsiness and falls

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