Seroquel, the brand name for quetiapine, is an atypical antipsychotic medication widely prescribed to manage a range of mental health conditions such as bipolar disorder, major depressive disorder, generalized anxiety disorder, and schizophrenia. While it’s effective for many, questions often arise around how long Seroquel stays in your system, especially if you’re facing drug tests, considering withdrawal, or experiencing side effects.
Let’s dive into the specifics, including Seroquel’s half-life, how the body processes it, what to expect during Seroquel withdrawal, and more.
In this article, you will learn:
- What is Seroquel used for?
- How long does Seroquel stay in your system?
- Is Seroquel addictive?
- Who should be wary of Seroquel?
Understanding Seroquel: What Is It Used For?
Seroquel (quetiapine) belongs to the atypical antipsychotic drug class. It works by altering the levels of neurotransmitters—specifically dopamine and serotonin—in the brain, which are associated with mood, perception, and behavior.
It’s commonly prescribed to:[1]
- Treat schizophrenia or schizoaffective disorder
- Manage bipolar disorder (both manic and depressive episodes)
- Serve as an adjunctive treatment for major depressive disorder
- Address generalized anxiety disorder (off-label in some cases)
- Function as a sleep aid (off-label and often controversial)
Seroquel is available in immediate release and extended release formulations, with dosages ranging from low dose (25 mg) to higher levels (up to 800 mg/day) depending on the condition.
How Long Does Seroquel Stay in Your System?
The answer depends on multiple factors, including the formulation (immediate vs. extended release), your age, liver function, metabolism, and dosage.
Seroquel Half-Life
The half-life of a drug refers to the amount of time it takes for half of the medication to be eliminated from the body.
For Seroquel:[2]
- Immediate Release Version: The average elimination half-life is about 6 hours.
- Extended Release Tablet: This version stretches that to about 7 hours, although the drug stays active in the system longer due to the slow release.
Using the general rule of thumb that it takes about 5 half-lives for a drug to be fully eliminated:
- Immediate Release: Clears your system in 30 hours
- Extended Release: Clears your system in 35 hours
So, how long does Seroquel stay in your system?
Technically, it could remain detectable in some form for up to six days, though this varies. In certain cases, traces could linger even up to six weeks, especially in elderly patients, people with liver impairment, or those on high or long-term doses.
Factors That Influence How Long Seroquel Stays in Your Body
1. Dosage and Frequency
Higher or more frequent doses increase the time it takes to metabolize and eliminate the drug.
2. Formulation Type
Immediate release formulations act fast and leave fast, while extended release stays in your body longer.
3. Age and Metabolism
Younger patients generally clear the drug faster, while elderly patients may take longer due to slower metabolism and possible liver function decline.
4. Liver Function
Because Seroquel is primarily metabolized in the liver, medical conditions affecting the liver can slow its clearance.[3]
5. Other Medications and Substances
Combining Seroquel with other drugs can either delay or speed up metabolism, depending on interactions.
Will Seroquel Show Up on a Drug Test?
Seroquel is not a controlled substance and is not typically screened in standard drug testing.
However, false positives for tricyclic antidepressants (TCAs) or methadone have been reported.[4] If you’re taking Seroquel quetiapine and face a drug test for employment, it’s a good idea to inform the test administrator in advance.
Specialized or forensic drug tests can detect quetiapine, but these are rare and generally reserved for specific clinical or legal cases.
Is Seroquel Addictive?
Seroquel is not considered an addictive substance in the traditional sense (i.e., like opioids or benzodiazepines). However, physical dependence can occur with long-term use.
This is why stopping Seroquel suddenly is not advised. It should always be done under medical supervision to avoid rebound withdrawal and potential life-threatening reactions, especially if the medication is part of a long-term treatment plan.
Seroquel Withdrawal: What to Expect
Even though it’s not classically addictive, quitting Seroquel can lead to uncomfortable — and sometimes severe withdrawal symptoms. These are often called quetiapine withdrawal symptoms or simply Seroquel withdrawal.
The common withdrawal symptoms of Seroquel include:[5]
- Insomnia or sleep disturbances
- Nausea
- Dizziness
- Agitation or irritability
- Rebound anxiety or psychotic symptoms
- Suicidal ideation (in rare or severe cases)
- Flu-like symptoms
These can range from mild to extreme depending on how long you’ve been taking it, your dosage, and whether you stop suddenly.
The withdrawal timeline for Seroquel is usually as follows:
- Days 1–3: Symptoms usually begin within 24–72 hours after the last dose.
- Days 4–7: Most acute symptoms peak.
- Week 2+: Some symptoms may linger for weeks, especially sleep problems or mood instability.
In rare cases, especially after high-dose use, symptoms can persist up to six weeks or longer.
Severe Reactions to Seroquel: What to Watch For
While rare, Seroquel can cause life-threatening reactions in some patients.
1. Neuroleptic Malignant Syndrome (NMS)
This is a potentially fatal reaction to antipsychotic drugs characterized by:[6]
- High fever
- Muscle rigidity
- Confusion
- Irregular heartbeat
- Elevated blood pressure
NMS requires emergency medical attention.
2. Tardive Dyskinesia
This is a disorder involving involuntary, uncontrollable movements, often of the face, tongue, or limbs. It can become permanent, especially with long-term use of antipsychotic medications.
Who Should Be Cautious with Seroquel?
While Seroquel is generally safe to use, it can cause issues among certain populations, including:
- Elderly patients, especially those with dementia-related psychosis, face an increased risk of death from cardiovascular or infectious events.
- Individuals with cardiovascular conditions or low blood pressure should be monitored.
- Those taking other medications that interact with liver enzymes (especially CYP3A4) may need dosage adjustments.
- Seroquel may cause extreme drowsiness, affecting driving or operating machinery.
Your doctor will help you decide if taking Seroquel provides more benefits than risks, depending on your situation.
Safe Use and Discontinuation
Seroquel should only be started, adjusted, or discontinued under the guidance of a qualified healthcare provider or medical professional.
Gradual tapering of doses is the safest route to prevent Seroquel withdrawal symptoms and minimize risks.
Get Connected to Help for Seroquel Withdrawal
So, how long does Seroquel stay in your system? For most, it will be out in a few days — but its therapeutic effects, side effects, and potential for withdrawal may linger far longer.
Whether you’re taking Seroquel for mental illness, using it as a sleep aid, or part of a plan to treat bipolar disorders or major depressive disorder, always have a plan in place with your healthcare provider.
And if you’re concerned about drug use, drug test results, or seroquel withdrawal, there’s no substitute for professional medical advice tailored to your situation.
If you are dealing with Seroquel withdrawal and need help managing your symptoms, First Step is here for you. Contact us today for more information on our detox services.
Frequently Asked Questions (FAQ)
1. Can Seroquel be used short-term for sleep problems?
While some healthcare providers prescribe low doses of Seroquel off-label as a sleep aid, this is not its primary use. The practice is controversial due to potential side effects like daytime sedation, metabolic changes, and dependency concerns. Safer alternatives, such as CBT-I (Cognitive Behavioral Therapy for Insomnia), are often recommended for long-term sleep management.
2. What happens if you miss a dose of Seroquel?
If you miss a dose, take it as soon as you remember—unless it’s close to your next scheduled dose. In that case, skip the missed dose. Do not double up to make up for a missed dose, as this increases the risk of side effects like drowsiness, low blood pressure, or even overdose symptoms.
3. Can Seroquel interact with alcohol or other substances?
Yes. Combining Seroquel with alcohol, opioids, or other CNS depressants can lead to increased drowsiness, respiratory issues, and impaired judgment. These interactions may also mask overdose symptoms. Always consult your healthcare provider before using Seroquel alongside other medications or substances.
4. Is weight gain a side effect of taking Seroquel?
Weight gain is a common side effect, especially with long-term use. Seroquel can alter metabolism and increase appetite. Patients on extended treatment should monitor weight and metabolic indicators like blood sugar and cholesterol, ideally in collaboration with their healthcare provider.
5. Can children or teens take Seroquel?
Seroquel is approved for use in adolescents (ages 13–17) for certain conditions like bipolar disorder and schizophrenia, but it’s not typically prescribed for younger children. In pediatric cases, doctors weigh potential benefits against risks such as suicidal ideation or behavioral changes.
6. How do I know if Seroquel is working?
Signs that Seroquel is effective include a reduction in mood swings, hallucinations, anxiety, or disruptive behaviors, depending on the condition being treated. Effects may take several days to weeks to become noticeable. Regular follow-ups with your provider are essential to assess therapeutic response and adjust dosages if needed.
References:
- Medline Plus: Quetiapine
- The Food and Drug Administration (FDA): Seroquel
- Science Direct: Antipsychotic Safety in Liver Disease: A Narrative Review and Practical Guide for the Clinician
- The Journal of Clinical Psychiatry: False-Positive Methadone Drug Screens During Quetiapine Treatment
- Sage Journals: Quetiapine withdrawal: A systematic review
- The National Library of Medicine (NLM): Neuroleptic Malignant Syndrome
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