Sheldon asked
How to get off Seroquel XR 50? I am not bipolar but was prescribed this in July. I do not want to continue a drug I don't think I need. It was prescribed for sleep but did not work.
At a glance
- There is no known interaction between lithium and Zyrtec (cetirizine).
- Due to the narrow therapeutic index of lithium, it is important to look into all potential drug interactions.
Answer
If you are looking to discontinue taking Seroquel (quetiapine), it is commonly recommended to slowly reduce your dose over time (i.e. taper) instead of stopping 'cold turkey'. This is to reduce potential withdrawal reactions, side effects or disease state worsening.
Seroquel Withdrawal Reactions
Withdrawal symptoms of Seroquel can include:
- Sweating
- Salivation
- Runny nose
- Flu-like symptoms
- Paresthesia (e.g. burning or prickling sensation)
- Increased urination
- Gastrointestinal symptom
- Dizziness
- Insomnia
- Agitation
- Anxiety
Withdrawal symptoms from Seroquel can occur at any point after a decrease in dose, especially if you have been taking the drug more than a few weeks. They are generally mild and transient but can last from days to weeks.
Seroquel Tapering Recommendations
It is important to note that there is no 'single' recommended tapering method for Seroquel. More than one tapering method has been proposed, and the best approach is unknown. The tapering method your doctor recommends will generally be based on a variety of factors, including:
- The dose you are taking.
- How long you have been taking the medication.
- Disease state you are treating.
While there isn't one recommended method, below are some strategies studies have suggested:
- Consider tapering Seroquel if you have been taking the medication for 1-3 months or longer.
In general, start to decrease the dose by at most 25% each week.
- Decrease the dose by no more than 50% every 2 weeks.
- Continue to decrease the dose weekly until the medication can be completely stopped.
- If withdrawal symptoms appear while tapering your dose, it may be beneficial to return to a previously well-tolerated dose and taper more slowly.
Be sure to speak with your doctor regarding the best method for tapering off Seroquel in your particular medical situation.
About Seroquel
Seroquel (quetiapine) is classified as an atypical anti-psychotic, initially receiving FDA approval in 1997.
Atypical antipsychotics, also known as second-generation antipsychotics, are considered to be the standard of care for schizophrenia and related psychiatric disorders.
Seroquel is also used off-label for certain behavior problems, OCD and for insomnia.
Like other atypical antipsychotics, Seroquel carries a risk of metabolic side effects, including:
- Hyperglycemia (high blood sugar)
- Diabetes
- Dyslipidemia
- Weight gain
- Increase the risk of cardiac events
Seroquel can be administered without regard to meals.
Seroquel extended-release tablets (Seroquel XR) is recommended to be administered without food or with a light meal (approximately 300 calories). It is important to swallow the XR tablets whole and not split, chew, or crush them. Evening dosing is recommended.
References
- Quetiapine versus other atypical antipsychotics for schizophrenia. PubMed
- Seroquel Prescribing Information. FDA
- A Review of Pharmacologic Strategies for Switching to Atypical Antipsychotics. PubMed
- Guidelines for Antipsychotic Medication Switches. NHS
- Safety and tolerability of switching to asenapine from other antipsychotic agents: pooled results from two randomized multicenter trials in stable patients with persistent negative symptoms in schizophrenia. PubMed
- Real-life switching strategies with second-generation antipsychotics. PubMed
- Withdrawal symptoms and rebound syndromes associated with switching and discontinuing atypical antipsychotics: theoretical background and practical recommendations. PubMed
