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The best medication for anxiety or depression is the one that works. But the truth is, not every medication works for everyone, and finding the right one can take time. That’s why it’s important to weigh the risks and benefits when considering medications like Seroquel® for anxiety or depression.
It’s not that Seroquel isn’t an effective treatment — we’ll get to the results in a moment — but just because a medication works doesn’t mean it’s right for you.
Prescription drugs often have side effects, they can cause negative reactions, and they can worsen some things while making others better.
Whether you’ve been struggling to find the right medication or are exploring all options before starting your first mental health medication, you’ll be interested to hear about this atypical antipsychotic medication and why it might not be your first choice — but may also be your best option.
Let’s start with the basics.
Seroquel is a medication approved by the FDA (U.S. Food and Drug Administration) for the treatment of a variety of mental illnesses under the generic name quetiapine. Quetiapine is part of a group of medications called antipsychotic drugs.
Quetiapine and quetiapine XR (extended-release quetiapine fumarate) are known as antagonists for certain neurological receptors. No, it’s not playing battleship with your brain cells — although that’s not terribly far from what’s actually going on.
These receptors are how your brain interacts with dopamine and serotonin, two neurotransmitters that affect your mood. Quetiapine basically targets these channels and blocks your brain from over-interacting with the neurotransmitters.
By altering the way these channels behave, the medication can help reduce symptoms of certain mental health conditions. In some cases, it may even out your mood, which can help in the treatment of insomnia, schizophrenia, bipolar disorder, panic disorder, major depression and other mental health conditions.
But that’s just the list of psychiatric disorders and mental disorders the FDA has approved it for. In clinical trials, these antipsychotic drugs have also seen success in off-label use to treat generalized anxiety disorder.
Seroquel and its generic versions have been used in off-label contexts to treat both generalized anxiety disorder (GAD) and depressive disorder symptoms to substantial effects.
Off-label use is essentially a way of saying that while the FDA has not formally approved a medication for use in the treatment of a particular disease or disorder, there’s recognition in the medical community that it could be effective in certain circumstances.
Let’s look at some clinical studies and observational studies on the treatment of anxiety disorders and depression with quetiapine.
A 2016 study found that in the treatment of generalized anxiety disorder, an extended-release version of quetiapine (quetiapine XR) is effective in treating GAD-suffering adults. A year earlier, an extensive review of literature on quetiapine concluded that it was a strong potential treatment option for adults who failed to respond to other medical products and therapies for anxiety.
And as recently as 2022, random controlled trials found that quetiapine was effective in the treatment of depression. In fact, one study considered it particularly effective for treating major depressive disorder (MDD) and comorbid anxiety symptoms in adults. Researchers suggested that this medication may be useful when you’ve got both.
Here’s the big caveat, though. In all the human studies we mentioned, researchers cautioned in some way that this medication was an alternative or secondary acute treatment (aka adjunctive treatment) for these conditions.
Using Seroquel for generalized anxiety disorder and depression treatment is by no means a first solution to the problems of anxiety disorders or depressive disorders.
But for people who may have had adverse reactions to first-line treatments like selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TCAs) or beta blockers, this medication might succeed where they have failed.
In certain patients, Seroquel can reduce symptoms, including:
When another treatment fails, quetiapine is worth considering. For instance, Seroquel for insomnia and anxiety could be beneficial if other medications weren’t effective at treating these comorbid conditions.
And the reason Seroquel is relatively poorly tolerated compared to other medications is that it has more side effects to be concerned about.
According to the Food and Drug Administration, so-called “steady state” concentrations of quetiapine XR and Seroquel XR are typically achieved within two days of dosing, which has more to do with blood concentrations than actual effects.
Like other mental health medications, Seroquel may take several months to show its full benefits as your brain adjusts to the medication’s effects and normalizes.
Keep in mind Seroquel is prescribed for a variety of conditions, including:
Psychosis in Parkinson’s disease
Borderline personality disorder
Each condition has differing symptoms, and the dosages prescribed to treat them vary.
Since anxiety and depression are technically considered off-label uses (when depression is not billed as bipolar and doesn’t require treatment of mania), there aren’t guidelines on dosage for the treatment of anxiety symptoms or antidepressant therapy.
With anxiety specifically, there’s no formal indication of how long it’ll take to see the full effects or whether long-term use is warranted. But you can assume the effects will be fairly standard regardless of what’s being treated.
You could also connect with a healthcare professional to discuss Seroquel dosage for anxiety. Why? It can cause serious side effects you’ll want to do your best to avoid.
The drawbacks of Seroquel treatment are that it’s not necessarily good for everyone. It mostly comes down to side effect risks and potential allergic reactions.
Elderly patients with dementia and related psychosis have an increased risk of death when taking this medication.
Those at a high risk of suicide or with a history of suicidal thoughts or attempts should be wary of using this medication, as it can increase those thoughts in people with major depressive disorder.
Beyond those serious concerns, adverse health effects commonly reported include hypotension, dizziness and fatigue.
Other common side effects of Seroquel include:
Blood pressure changes
Changes in breathing
High blood sugar
Increased risk of stroke
Increased risk of cataracts and seizures
Low white blood cell count
The list isn’t short — and many of the health risks can be quite serious.
So if you’re taking Seroquel and notice any of these side effects, talk to a healthcare professional sooner than later. And if you’re not yet taking it, be aware of the potential risks.
If your anxiety or depression (or both) have become unmanageable even with medication and therapy, a switch to Seroquel might be the right choice. It certainly has promising study data to suggest you’ll see some relief.
However, if you have anxiety or treatment-resistant depression (or both), discuss your symptoms and frustrations with your healthcare provider first.
Medications must be taken in certain ways at certain times to be effective, and your current dosage of another medication might need to be adjusted rather than replaced.
A healthcare professional may also suggest alternative treatments like diet, exercise and other lifestyle changes or forms of therapy like cognitive behavioral therapy (CBT).
The best treatment is the one that works, but you’ll need to connect with a healthcare provider to find the right one for you.
If you're ready today, get started with our mental health resources and online therapy platforms.
Kate Hagerty is a board-certified Family Nurse Practitioner with over a decade of healthcare experience. She has worked in critical care, community health, and as a retail health provider.