Can quetiapine be used for anxiety?

This article will answer the question of whether quetiapine can be used for anxiety.

We will also discuss what quetiapine is, what it is used for, side effects, and precautions to be taken for the use of this drug. 

Can quetiapine be used for anxiety?

Yes, Quetiapine can be used for treating or alleviating anxiety symptoms however it is to be mentioned that the treatment of anxiety with this drug is not FDA approved. 

Most of the doctors who prescribe this medication for anxiety do so “off-label” however, there have been studies that have shown that this particular class of antipsychotics is effective in treating anxiety disorders. 

In a clinical trial that aimed to study the effect of quetiapine for general anxiety disorders, 2000+ participants were divided into two groups where one of the groups was administered the drug.

The results found that Quetiapine in the extended release was found to be effective for treating GAD symptoms in adults however it is to be mentioned that there were many adverse side effects that lead to individuals dropping out of the trial.

A systematic review on the use of this drug for anxiety disorders also echoed the same conclusions, that Quetiapine is in fact an effective treatment for anxiety symptoms. 

The review considered 29 studies regarding the use of quetiapine in mood disorders. The review concluded that Quetiapine was effective in reducing anxiety symptoms that are usually comorbid with Depression and Bipolar disorders- mood disorders. 

As of present day research and evidence, experts conclude that the drug quetiapine could be used “off-label” for the treatment of anxiety in spite of the side effects but because of these serious side effects, the treatment must be carefully discussed and it’s cost and benefits weighed out before starting treatment., .

What is quetiapine?

Quetiapine is an antipsychotic medicine which belongs to the class of drugs known as atypical antipsychotic. 

This drug, quetiapine, is primarily used to treat schizophrenia in adults and children at least aged 13. 

The drug is also used to treat bipolar disorder for both adults and children down to age 10 either on it’s own or with other drugs. It is also used together with antidepressant medications to treat major depressive disorder in adults.

Quetiapine is usually available under the brand names Seroquel (immediate-release tablet) and Seroquel XR (extended-release tablet) which  may be used as part of a combination therapy for the treatment of depression, bipolar disorder, and schizophrenia. 

It is not clearly known how quetiapine works or it’s mechanisms clearly understood but experts believe that the drug helps to regulate neurochemicals dopamine and serotonin in the brain. 

What is quetiapine used for?

Quetiapine tablets and extended-release (long-acting) tablets are primarily used to treat the symptoms of schizophrenia.

The drug Quetiapine in both forms-tablets and extended-release tablets- are also used alone or with other medications to treat episodes of Bipolar disorder- mania (frenzied, abnormally excited or irritated mood) or depression.

It is also used as a maintenance medication, with other medications to prevent episodes of mania or depression in individuals with bipolar disorder as well as Clinical depression. 

The drug is also used in the treatment of Schizophrenia and Bipolar disorder in children and teenagers however, this age group has more risk that involve the treatment of these conditions with this drug, 

In adults the symptoms of Bipolar disorders- both kinds of episodes, and clinical depression are treated with this drug alone or in addition to drugs lithium or divalproex. 

For major depression, in adults quetiapine is used as an add-on treatment for people already taking antidepressant drugs; however when these drugs are not enough, quetiapine is also added to the treatment.

What are the side effects of quetiapine?

For this particular drug, the side effects differ according to the form of the medication.

The more common side effects of the immediate-release tablets can include:

  • dry mouth
  • dizziness
  • pain in your stomach area
  • constipation
  • nausea
  • vomiting
  • weight gain
  • increased appetite
  • sore throat
  • trouble moving
  • rapid heartbeat
  • Weakness (Medlineplus)

The more common side effects of the extended-release tablets can include:

  • dry mouth
  • constipation
  • dizziness
  • increased appetite
  • upset stomach
  • tiredness
  • stuffy nose
  • trouble moving(Medlineplus)

These side effects can range from serious to mild. Mild side effects can disappear on their own; however , if any of these side effects impact your daily life, let your doctor know.

Serious side effects that require immediate medical care include:

  • Suicidal thoughts or actions
  • Neuroleptic malignant syndrome. Symptoms can include:
  • high fever
  • excessive sweating
  • rigid muscles
  • confusion
  • changes in your breathing, heartbeat, and blood pressure
  • Hyperglycemia (high blood sugar). Symptoms can include:
  • extreme thirst
  • frequent urination
  • severe hunger
  • weakness or tiredness
  • upset stomach
  • confusion
  • fruity-smelling breath
  • Increased cholesterol and triglycerides (high fat levels in your blood)
  • Weight gain
  • Tardive dyskinesia. Symptoms can include:
  • movements you can’t control in your face, tongue, or other body parts
  • Orthostatic hypotension 
  • Increases in blood pressure in children and teenagers
  • Low white blood cell count. 
  • fever
  • infection
  • Cataracts.:
  • clouding of the lens of your eye
  • blurry vision
  • loss of vision
  • Seizures
  • Abnormal thyroid levels 
  • Increases in blood prolactin levels. 
  • breast enlargement 
  • milky discharge from nipple of the breast (in women)
  • erectile dysfunction
  • absence of menstrual period
  • Increased body temperature
  • Trouble swallowing
  • Risk of death from stroke in seniors with dementia (Medlineplus)

How to use quetiapine?

When it comes to the use of this drug, quetiapine the best thing you can do is to follow your doctor’s advice and orders carefully with respect to the dosage, the timings, and the routine of the drug intake.

The drug comes in the form of a tablet and an extended release tablet taken orally. It is recommended that the tablets are taken one to three times a day with or without meals while only one dose for extended release form. 

When it comes to taking the drug it is advised that you do not chew or crush the drug and instead swallow whole for the extended release form of quetiapine. This form is taken only once a day. 

Take the drug at the same time everyday and make sure that you follow the doctor’s instructions as well as the prescription label instructions.

Make sure that you take the medication at the same time everyday and for this you can use an alarm, a reminder etc to remind you to take the medication at the right time. You can also ask for assistance from a friend or caregiver to help you remember your dosages. 

Your doctor will probably tell you to start taking a low dose of the medication and gradually increase your dose.Even if you feel like the drug is making you feel better, usually happens after a few weeks, do not stop the drug intake as well as in the case of experiencing mild side effects as these mild effects will soon go away on their own over time.

What are the precautions one should know when using quetiapine?

Here are a few precautionary steps you should take if you are taking or being prescribed with quetiapine:

Inform your doctor if you are allergic to quetiapine or any other medications that have this ingredient and make sure to check the ingredient list of the medication for any allergens. 

Inform your doctor if you are taking any other prescription or non-prescription medication, supplements, and vitamins. This is very important because quetiapine can react with other medications. 

Let your doctor also know if you are taking any hormonal medications including contraceptives in every form- tablets, rings, patches etc or if you have been part of any hormone replacement therapies. 

Let your doctor know you entire medical history while highlighting if you have had any of the following conditions:

  • Diabetes 
  • Prolonged QT interval 
  • Low level of potassium or magnesium in your blood
  • Low number of white blood cells
  • Unable to completely empty your bladder
  • Vertigo
  • Seizures
  • Cataracts
  • High Cholesterol
  • High Prolactin levels
  • Prostate related problems
  • Blood Pressure problems
  • Heart disease
  • Stroke
  • Breast cancer
  • Thyroid disease
  • Liver disease

Tell your doctor of any plans to get pregnant or if you are already pregnant as well as if you are breastfeeding or planning to breastfeed your child since the medication can transfer from mother to child through milk.

Quetiapine may cause problems in newborns following delivery if it is taken during the last months of pregnancy and might decrease fertility in women.

Make sure you let your doctors know that you are taking quetiapine if you are having surgery, including dental surgery.

Make sure that if you are taking medication that you do not drive or use heavy machinery or do anything that is prone to accidents because the drug can make you drowsy and alcohol can add to the drowsiness caused by this medication. Do not drink alcohol while taking quetiapine.

It is also important to know that Ketoacidosis might develop when you’re taking this medication due to an increase in sugar levels caused by this medication. If you notice any of these symptoms, let your doctor know: extreme thirst, frequent urination, extreme hunger, blurred vision, or weakness. 

The drug also makes it harder for individuals to cool down, so avoid excessive exercise, stay in cool places, avoid the hot weather and drink plenty of fluids.

The drug can also increase blood pressure in children and teenagers, make sure that you keep tabs on your child’s blood pressure when you are under this prescription. 

One of the side effects of this drug is the fact that it does affect you mental health and you might develop suicidal ideation, so make sure that you and your doctor understand this risk and keep track of your mental health and report the same to your doctors or your caregiver in case you see any changes. 

Conclusion

This article answered the question of whether quetiapine can be used for anxiety.

We also discussed what quetiapine is, what it is used for, side effects, and precautions to be taken for the use of this drug. 

How long does it take for quetiapine to work?

It usually takes around 6 weeks for quetiapine to work properly and for individuals to see positive results. 

How much quetiapine should I take for anxiety?

When it comes to the use of this drug, quetiapine the best thing you can do is to follow your doctor’s advice and orders carefully with respect to the dosage, the timings, and the routine of the drug intake.

Does quetiapine calm you down?

Quetiapine can calm you down as it is a mood stabiliser that calms mood swings as well as sedates you.

References

Quetiapine Drugs.com. Retrieved on 5th February 2022. https://www.drugs.com/mtm/quetiapine.html#:~:text=Quetiapine%20is%20an%20antipsychotic%20 medicine,at%20least%2010%20years%20old.

Quetiapine. Medlineplus. Retrieved on 5th February 2022. https://medlineplus.gov/druginfo/meds/a698019.html

Quetiapine, oral tablet. Medicalnewstoday. Retrieved on 5th February 2022. https://www.medicalnewstoday.com/articles/quetiapine-oral-tablet

Maneeton N, Maneeton B, Woottiluk P, et al. Quetiapine monotherapy in acute treatment of generalised anxiety disorder: a systematic review and meta-analysis of randomised controlled trials. Drug Des Devel Ther. 2016;10:259-276. Published 2016 Jan 12. doi:10.2147/DDDT.S89485

Crapanzano, Calogero MD∗; Damiani, Stefano MD, PhD†; Guiot, Cecilia MD† Quetiapine in the Anxiety Dimension of Mood Disorders, Journal of Clinical Psychopharmacology: 7/8 2021 – Volume 41 – Issue 4 – p 436-449

doi: 10.1097/JCP.0000000000001420 

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