Seroquel (quetiapine) is an atypical antipsychotic medication commonly prescribed for the treatment of various mental health conditions, including schizophrenia, bipolar I disorder (manic episodes), bipolar disorder (depressive episodes), and depression. While Seroquel can be very helpful for some people, it's important to be aware of its potential side effects, one of the most common being weight gain. This article provides a comprehensive overview of Seroquel and weight gain, including potential causes, management strategies, and important considerations.
Understanding Seroquel
Quetiapine belongs to a group of medicines called antipsychotics. As an atypical antipsychotic, Seroquel works by affecting chemicals in the brain such as dopamine and serotonin. If you have too much dopamine it can make you see things that are not there (hallucinations) or think things that are not true (delusions). It does not cure your condition, but it can help the symptoms. Different people respond differently to antipsychotic medicine. You might have to try a few medicines before you find the medicine and dose that works for you.
It is very important that your doctor check your or your child's progress at regular visits to make sure this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects. You may also need to have your eyes tested on a regular basis.
The Link Between Seroquel and Weight Gain
Weight gain is a commonly reported side effect in both children and adults taking Seroquel. While not everyone experiences it, clinical trials have demonstrated a significant association between Seroquel use and increased body weight.
In short-term (3-6 weeks) clinical trials of children taking Seroquel, those with schizophrenia gained an average of 2 kg. This was compared to -0.4 kg in the placebo group. In a longer study, children who took Seroquel for up to 26 weeks gained an average of 4.4 kg. Researchers compared the weight gain in these patients to the weight that is normally expected to be gained as children grow. Another study looking at 352 patients taking Seroquel for schizophrenia over 52 weeks found that people taking the medication gained an average of 2.5 kg.
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Possible Reasons for Weight Gain
It isn’t fully clear why Seroquel causes weight gain. One possible reason is that the medication can increase your appetite, which can lead to consuming more calories. This can cause weight gain. Some studies have found a link between higher doses and more weight gain in the short term.
Metabolic Changes
Seroquel’s impact on metabolism can lead to significant weight gain and metabolic changes. The medication can increase your cholesterol and fats in the blood. If this condition occurs, your doctor may give you medicine to lower the cholesterol and fats in the blood. This medicine may increase your weight. Your doctor may need to check your weight on a regular basis while you are using this medicine.
Strategies for Managing Weight Gain While Taking Seroquel
The goal of treatment is always to maximize improvement and to avoid side effects whenever possible. If you’re concerned about weight gain, there are options and solutions. Your doctor will monitor your or your child’s weight during treatment with Seroquel. Too much weight gain can increase your risk for medical conditions like high blood pressure and diabetes. There are some things you can do to help prevent gaining weight while taking Seroquel. For best results, introduce changes to your diet and lifestyle gradually. If you have tried to avoid gaining weight and still need help, talk to your doctor.
1. Dietary Adjustments
Structured Meal Planning: Managing weight while taking Seroquel requires structured meal planning. This meal plan provides essential nutrients while maintaining caloric balance. Try to eat a healthy, balanced diet without increasing your portion sizes. Do not snack on foods that contain a lot of calories, such as crisps, cakes, biscuits and sweets.
Reduce Calorie Intake: A relatively small reduction of 150 calories per day can lead to about 16 pounds of weight loss over a year.
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Consider Low-Carbohydrate Diets: Very low carbohydrate diets like the ketogenic diet are popular these days. These diets are designed to reduce insulin levels, which can make it easier to lose weight (because insulin is a fat-storage signal). Many people who undertake these diets can maintain calorie deficits without feeling hungry.
Avoid Grapefruit: Do not eat grapefruit or drink grapefruit juice because it can increase the side effects of quetiapine. Apart from this, you can eat and drink normally while taking quetiapine. However, quetiapine can make you feel hungrier and put on weight. If you have an increased appetite, try to eat a healthy, balanced diet without increasing your portion sizes. Do not snack on foods that contain a lot of calories, such as crisps, cakes, biscuits and sweets.
2. Exercise and Physical Activity
Exercise and physical activity can enhance weight loss. Physical activity is a powerful tool in managing mental health while taking Seroquel.
3. Medication Management
- Medication Review: Table 1 in this open-access medical journal article lists medications with higher or lower risk of weight gain. Different antipsychotic medicines may have different side effects. You might have to try a few medicines before you find the medicine and dose that works for you.
Switching Medications:* On the other hand, some people (like the person who sent in today’s question) might mostly like their current medication, or may not want to take the risks involved in medication switching (e.g., the switched-to medication might not work as well, or might have other side effects).
Metformin: Metformin is a widely-used treatment for type-2 diabetes. It improves the body’s insulin signals and reduces spikes in blood sugar. Metformin can also help people without diabetes to lose weight.
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GLP-1 Agonists: GLP-1 is an abbreviation for glucagon-like peptide 1. The GLP-1 agonist drugs mimic the action of natural GLP-1. They optimize the body’s insulin responses and reduce appetite.
4. Lifestyle Adjustments
Stress Management: Stress management techniques work hand in hand with your medication and nutrition plan.
Structured Daily Routine: Creating a structured daily routine helps stabilize mood and energy levels.
5. The Importance of Nutrition
Research consistently shows that your diet plays a crucial role in mental health management. Your brain requires specific nutrients to produce neurotransmitters - the chemical messengers that regulate mood, sleep, and appetite. A deficiency in these essential nutrients can trigger or worsen symptoms of depression and anxiety. The gut-brain connection adds another layer to this relationship. Your digestive system produces about 95% of your body’s serotonin, highlighting the direct link between your diet and mental well-being.
Important Considerations and Precautions
Alcohol and CNS Depressants: This medicine may add to the effects of alcohol and other CNS depressants (medicines that make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds, sedatives, tranquilizers, or sleeping medicine, prescription pain medicine or narcotics, medicine for seizures or barbiturates, muscle relaxants, or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are using quetiapine. If you drink alcohol while taking quetiapine it may make you feel sleepy and unsteady on your feet. Drinking alcohol every day or in large amounts can make your symptoms worse. It also makes it harder for quetiapine to work properly. It might be best to stop drinking alcohol for the first few days of treatment until you see how the medicine affects you. Try to stick to the national guidelines of no more than 14 units a week. A standard glass of wine (175ml) is 2 units.
Suicidal Thoughts: For some patients, this medicine can increase thoughts of suicide. Tell your doctor right away if you start to feel more depressed and have thoughts about hurting yourself. Report any unusual thoughts or behaviors that trouble you, especially if they are new or are getting worse quickly. Make sure the doctor knows if you have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. Also tell the doctor if you have sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared. Let the doctor know if you or anyone in your family has bipolar disorder (manic-depressive illness) or has tried to commit suicide.
Drowsiness and Motor Skills: Quetiapine may cause drowsiness, trouble with thinking, trouble with controlling body movements, or trouble with your vision (especially during the first week of use), which may lead to falls, fractures, or other injuries. Do not drive or do anything else that could be dangerous until you know how this medicine affects you. Quetiapine can make you feel drowsy or sleepy. Some people cannot concentrate properly while they're taking it. When you first start taking quetiapine, it's a good idea to stop driving and cycling for the first few days until you know how this medicine makes you feel. It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive. Talk to your doctor or pharmacist if you're unsure whether it's safe for you to drive while taking quetiapine.
High Blood Sugar: This medicine may increase the amount of sugar in your blood. Check with your doctor right away if you have increased thirst or urination. If you have diabetes, the results of your urine or blood sugar tests may change. Check your blood sugar closely and talk with your doctor if you have any questions. Quetiapine can increase the amount of sugar in your blood, and this can sometimes lead to diabetes. It's an uncommon side effect of quetiapine and affects less than 1 in 100 people. You will usually have a blood test before you start taking quetiapine to see how much sugar you have in your blood. You'll usually have another test a few weeks after starting quetiapine to see if the results have changed.
Neuroleptic Malignant Syndrome (NMS): Check with your doctor right away if you have convulsions (seizures), difficulty breathing, a fast heartbeat, high fever, high or low blood pressure, increased sweating, loss of bladder control, severe muscle stiffness, unusually pale skin, or tiredness. These could be symptoms of a serious condition called neuroleptic malignant syndrome (NMS).
Dizziness and Lightheadedness: Dizziness, lightheadedness, or fainting may occur, especially when you get up suddenly from a lying or sitting position. Getting up slowly may help. If the problem continues or gets worse, check with your doctor.
Low White Blood Cell Count: Quetiapine can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding: If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination. Check with your doctor immediately if you notice any unusual bleeding or bruising, black, tarry stools, blood in the urine or stools, or pinpoint red spots on your skin. Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done. Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime. Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters. Avoid contact sports or other situations where bruising or injury could occur.
Tardive Dyskinesia: This medicine may cause tardive dyskinesia (a movement disorder). Check with your doctor right away if you have lip smacking or puckering, puffing of the cheeks, rapid or worm-like movements of the tongue, uncontrolled chewing movements, or uncontrolled movements of the arms and legs.
Heart Rhythm Changes: This medicine can cause changes in your heart rhythm, such as a condition called QT prolongation. It may change the way your heart beats and cause fainting or serious side effects. Contact your doctor right away if you have symptoms of heart rhythm problems, such as a fast, pounding, or uneven heartbeat.
Body Temperature Regulation: Quetiapine may make it more difficult for your body to cool down. It might reduce how much you sweat. Your body could get too hot if you do not sweat enough. If your body gets too hot, you might feel dizzy, weak, tired, or confused. You might vomit or have an upset stomach. Do not get too hot while you are exercising. Avoid places that are very hot. Call your doctor if you are too hot and can not cool down.
Withdrawal Symptoms: Do not suddenly stop taking this medicine without checking first with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping it completely. This will decrease the chance of having withdrawal symptoms such as nausea, vomiting, insomnia, dizziness, irritability, or headache.
Medical Tests: Before you have any medical tests, tell the medical doctor in charge that you are taking this medicine. The results of some tests (eg, urine drug screens) may be affected by this medicine.
Other Medications: Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St. John's wort) or vitamin supplements.
Seroquel and Nutrition: Supporting Mental Health with a Balanced Diet
Your diet plays a crucial role in managing Seroquel’s side effects. Regular monitoring of your nutritional intake and its effects on your body helps create a personalized approach that works with your medication regimen. If you’re struggling with mental health challenges despite maintaining a healthy diet, it may be beneficial to seek professional help. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums.
Seroquel as Part of a Comprehensive Treatment Plan
While Seroquel can be effective for many, it’s important to remember that it is only one part of a comprehensive treatment plan for mental health conditions. In some cases, individuals may also struggle with behavioral addictions alongside their mental health issues. Moreover, therapy plays a crucial role in recovery from both mental health issues and addiction.