Quetiapine

If you have any thoughts of suicide, or of other ways of hurting yourself, go straight to a hospital with your tablets.

This may be a side-effect, and you need urgent help.

Quetiapine can make some people think about hurting themselves or committing suicide. This can happen to anyone, including people who are under 18.

You must go straight to hospital with your tablets if you have any of these thoughts. You must tell the doctor that you are taking quetiapine. There are other things you can take instead.

If you start to get movements of your tongue, mouth or face that you cannot control, you should go and see your doctor as soon as possible

Antipsychotic medicines can cause repeating movements of the tongue, mouth and face, however this problem is uncommon with quetiapine.

• This is called tardive dyskinesia.
• The first sign might be some movements of your tongue that you cannot control, and they may be quite regular and rhythmic.
• If you notice it early and take action with your doctor, the problem should go away, however in some cases tardive dyskinesia might not stop even if you stop taking your medicine. It is therefore very important to see your doctor as soon as possible.
• The problem with tardive dyskinesia is that it might not stop, even if you stop taking your medicine.

Tell your doctor or pharmacist before you take quetiapine if you have any of these conditions

You need to talk to your doctor or pharmacist if you have, or have ever had, any of the following:

• any heart problems such as a very fast heart beat or prolonged QT on an ECG (heart tracing), or if you are taking any medicines that affect the way your heart beats.
• low blood pressure
• a stroke
• problems with your liver
• a fit (seizure)
• low levels of white blood cells
• diabetes, or a risk of getting diabetes
• blood clots, or a family history of blood clots.
• a condition where you stop breathing for short periods during your normal nightly sleep (called “sleep apnoea).

Quetiapine has possible side effects, and some of these are rare but serious

Go to a doctor or hospital straight away if you get any of the following symptoms:

• Any combination of fever, severe muscle stiffness, sweating or a lowered level of consciousness (a disorder called “neuroleptic malignant syndrome”)
• Dizziness or feeling very sleepy
• Fits (seizures).
• In men, a long-lasting and painful erection (Priapism).

Some side-effects that do appear should get better after a few days. If they do not, you should go back to your doctor

Not everyone will experience side effects with quetiapine. Some of the more common side effects are listed at the bottom of this page. If you are experiencing a problem that might be a side effect, but that is not listed here, please take a look at the patient information leaflet that was in the medicine packet or speak to your pharmacist or doctor. If you think you have a side effect that has not got better within a few days go back to your doctor.

Some side-effects of quetiapine may – strangely - seem like other mental health symptoms. Some side-effects here are also the opposites of each other. The balance of chemicals in the brain is very fragile, and hard to control! If they do not get better after a few days on the tablets, go back to the doctor.

Young people were more likely than adults to get some side-effects in tests

Young people were more likely than adults to get the following side-effects:

• Having thoughts about hurting or killing themselves
• Increased appetite
• Higher blood pressure
• Movement disorders, like smacking of the lips
• Higher levels of prolactin in the blood
• Feeling irritable

Quetiapine does not mix well with some other medicines and drugs

Do not take quetiapine if you are taking any of these medicines:

• protease inhibitors, such as nelfinavir (for HIV infection)
• azole medicines (for fungal infections)
• medicines for an infection (like erythromycin or clarithromycin)
• nefazodone (for depression)

 Tell your doctor before you take quetiapine if you take:

• Epilepsy medicines (like phenytoin or carbamazepine)
• High blood pressure medicines
• Rifampicin (for tuberculosis)
• Medicines to help you sleep
• Medicines that affect the heart, like diuretics (water pills) or certain antibiotics

Do not drink grapefruit juice while you are taking quetiapine, as it can affect the way that the medicine works.

If you have any further questions about this you should speak to your doctor or pharmacist.

Always talk to the doctor if you are taking other medicines. Tell the pharmacist you are taking quetiapine if you buy medicines (including things you put on your skin) for common illnesses.

Get your weight and blood checked regularly when you are taking quetiapine

• You will have your weight checked, and have some blood tests, when you start taking quetiapine.
• You should then have your weight, blood sugar, blood fats, blood pressure and pulse measured regularly during early treatment, then at least 6 monthly or annually thereafter depending on your age.
• The doctor might also check your heart with an electrocardiogram ECG.
• They might also check your height and development, and whether a young woman’s periods are regular.
• It is very important to go for these checks when you are asked to do so.

Quetiapine use has been linked to high blood sugar and diabetes in some young people

• Some studies have shown a risk of developing diabetes among young people who have a family history of diabetes.
• This could be linked to putting on weight.
• Watch out for any early signs of diabetes:
  • wanting to drink a lot
  • going for a wee a lot
  • feeling more hungry
  • feeling weak
• If you are a young person who already has diabetes, taking quetiapine may affect your blood sugar levels.
• Talk to your doctor, and check your blood glucose levels regularly.
• You may have to increase the medication you use for your diabetes.

Quetiapine does not mix well with street drugs 

• Some street drugs can increase levels of dopamine in the brain (e.g. cocaine, cannabis, ecstasy). As antipsychotics block the effects of dopamine, the “high” from street drugs may not be as “high” as before. You may therefore be tempted to increase the dose of your street drug to make up for it, but this could be dangerous.
• Some street drugs can make you feel sleepy and this could be made worse with quetiapine.

• There are many other street drugs but we don’t know what effect taking them with quetiapine will have.

Stopping the medication causes the balance of chemicals in the brain to alter

• Once you start taking an antipsychotic, the brain adjusts to having a new level of dopamine around.
• If you stop taking the antipsychotic all at once, the balance starts to change again. You could get your old symptoms back.
• People usually take quetiapine for a long time, to keep those symptoms away.

Stopping this medicine quickly, or reducing the dose too much at once, may cause your old symptoms to come back, or some side-effects

You can stop taking it safely with your doctor’s help:

• You will probably get your old symptoms back if you stop quetiapine suddenly.
• You can also get side-effects including difficulty sleeping, feeling or being sick, headache, loose poo (diarrhoea), feeling dizzy or irritable.
• It is better to agree stopping with a doctor who will reduce your dose gradually.
• This will usually take 1-2 weeks.
• You will probably go for checks after you finish to see that your old symptoms have not come back.

Some people have thoughts about harming or killing themselves soon after they stop this medicine – you must go straight to a hospital if this happens to you, to get some help.

Tell them you have been taking quetiapine.