Seroquel XR (Quetiapine) for Depression

Seroquel XR (quetiapine) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) as an add-on treatment to antidepressants for adults with major depressive disorder (MDD).

How Seroquel XR Works and How It’s Taken

Seroquel XR is an atypical antipsychotic that may affect dopamine and serotonin signals in the brain. Dopamine and serotonin are neurotransmitters that play a role in major depressive disorder. The exact way it works in depression is not fully known.

Doctors prescribe Seroquel XR as an add-on treatment to antidepressants for adults with MDD who did not have an adequate response to antidepressant therapy.

Seroquel XR is a tablet taken by mouth, typically once daily in the evening. It should be swallowed whole and taken without food or with a light meal.

Typical Dosing for Depression

The recommended starting dose of Seroquel XR for MDD is 50 milligrams once daily in the evening on day 1 and day 2, then 150 milligrams once daily in the evening on day 3.

For individuals who respond to treatment, the recommended maintenance dose is 150 milligrams to 300 milligrams once daily in the evening.

This information is based on the prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Seroquel XR Side Effects

In studies of Seroquel XR used as an add-on treatment with antidepressants for major depressive disorder in adults, the most common side effects occurred in about 11 percent to 43 percent of people. They include:

Sleepiness or drowsiness
Dry mouth
Fatigue (low energy)
Constipation
Weight gain

Serious Side Effects and Warnings

Seroquel XR can cause serious side effects that require immediate medical attention. These include:

Risk of death in elderly individuals with dementia — Seroquel XR is not approved for elderly individuals with dementia-related psychosis.
Risk of suicidal thoughts or actions — This risk may be higher in young adults taking antidepressants.
Stroke — A stroke that can lead to death can happen in elderly individuals with dementia who take medicines like Seroquel XR.
Neuroleptic malignant syndrome (NMS) — This is a rare, life-threatening reaction that can include high fever, severe muscle stiffness, confusion, and unstable blood pressure or heart rate.
Falls — Injuries can happen due to sleepiness, low blood pressure, or problems with balance.
Metabolic changes — These can include high blood sugar, high fat levels in your blood, and weight gain.
Tardive dyskinesia — Uncontrolled, repetitive movements may not go away.
Orthostatic hypotension and fainting — A drop in blood pressure when standing can cause dizziness, falls, or passing out.
Low white blood cell count, including severe neutropenia or agranulocytosis — This can raise the risk of serious infections.
Cataracts — Clouding of the eye’s lens can affect vision.
Seizures — Seizures may occur.
Abnormal thyroid tests — Changes may appear on thyroid tests.
Increases in prolactin levels — Prolactin levels may increase.
Increased body temperature — Body temperature may increase.
Difficulty swallowing — Trouble swallowing may occur.
Acute withdrawal symptoms — Symptoms such as insomnia, nausea, and vomiting can happen if you suddenly stop taking Seroquel XR.

Get medical help right away if you think you are having a serious reaction.

How To Save on Seroquel XR

The Seroquel XR website offers the Seroquel XR Savings Card. Eligible people with commercial insurance may pay as little as $3.

To learn more, visit SeroquelXR.com, call 888-864-2308, or download the savings card PDF.

What To Know Before Taking Seroquel XR

Before starting Seroquel XR, your doctor may check your weight, blood sugar, and cholesterol levels. An eye exam for cataracts is recommended at the beginning of treatment and every six months thereafter.

Tell your doctor if you have any allergies to quetiapine or any ingredients in Seroquel XR. Do not take Seroquel XR if you have had a serious allergic reaction to quetiapine or any of its ingredients.

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, and supplements. Seroquel XR and other medicines may affect each other, causing serious side effects.

Before you take Seroquel XR, tell your healthcare provider if you have or have had:

Diabetes or high blood sugar in you or in a family member
High levels of total cholesterol, triglycerides, or LDL cholesterol, or low levels of HDL cholesterol
Low or high blood pressure
Low white blood cell count
Cataracts
Seizures
Abnormal thyroid tests
High prolactin levels
Heart problems
Liver problems
Any other medical condition
Urinary retention (inability to completely empty your bladder), an enlarged prostate, constipation, or increased pressure inside your eyes

Since drowsiness has been reported with Seroquel XR, you should not drive or operate machinery until you know that you can do so safely. Avoid becoming overheated or dehydrated while taking Seroquel XR. Do not drink alcohol while taking Seroquel XR.

Due to these side effects, it is best to take Seroquel XR in the evening.

Do not stop taking Seroquel XR without talking to your doctor. Stopping Seroquel XR suddenly may cause side effects.

If you miss a dose of Seroquel XR, take it as soon as you remember. If you are close to your next dose, skip the missed dose and take the next dose at your regular time. Do not take two doses at the same time unless your doctor tells you to.

Seroquel XR is also FDA approved in adults for:

Acute depressive episodes in bipolar disorder
Acute manic or mixed episodes in bipolar disorder alone or with lithium or divalproex
Long-term treatment of bipolar disorder with lithium or divalproex
Schizophrenia

Seroquel XR is also approved for acute manic episodes in bipolar disorder in children and adolescents ages 10 to 17 years and for schizophrenia in adolescents ages 13 to 17 years.

If you are pregnant, planning to become pregnant, or breastfeeding while taking Seroquel XR, talk with your doctor about the risks and benefits. It is not known if Seroquel XR will harm your baby if you are pregnant. If you become pregnant while receiving Seroquel XR, talk to your healthcare provider about registering with the National Pregnancy Registry for Atypical Antipsychotics.

Seroquel XR can pass into your breast milk, so talk with your healthcare provider about the best way to feed your baby while taking Seroquel XR.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Seroquel XR for MDD?
In adults with major depressive disorder who were already taking an antidepressant, adding Seroquel XR helped improve depression symptoms in two studies that both lasted six weeks. Doses of 150 milligrams and 300 milligrams worked better than placebo (an inactive treatment) when added to an antidepressant.

Can Seroquel XR cause weight gain or increased appetite when used for MDD?
Yes, Seroquel XR can cause weight gain in some people. In adults with major depressive disorder using it with an antidepressant, weight increased in 3 percent of people taking 150 milligrams and 5 percent taking 300 milligrams, compared with 0 percent on placebo. Increased appetite was also reported with Seroquel XR, but the rate was equal or similar to placebo.

Can Seroquel XR cause sleepiness or trouble thinking when used for MDD?
Yes. Sleepiness was common in studies. It was reported in up to 43 percent of adults taking it with an antidepressant for major depressive disorder versus 9 percent with placebo.

Seroquel XR can also affect judgment, thinking, or motor skills, so people are cautioned not to drive or do other activities that require alertness until they know how it affects them.