Table of ContentsView AllTable of ContentsBenefitsTreating InsomniaDosageSafetyRisk of MisuseRisk of Rebound InsomniaSide EffectsAlternatives
Table of ContentsView All
View All
Table of Contents
Benefits
Treating Insomnia
Dosage
Safety
Risk of Misuse
Risk of Rebound Insomnia
Side Effects
Alternatives
Seroquel (quetiapine) is a second-generation (or atypical)antipsychotic, a drug used to treat certain mood disorders, such asschizophreniaandbipolar disorder.
Some people prefer trying Seroquel for help with sleep orinsomniaas it doesn’t have the same risk of dependency as other medications that can be addictive, but Seroquel can cause other side effects that you should be aware of.
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Benefits of Seroquel
The FDA approved Seroquel (quetiapine) to treat:
What Is “Off-Label” Use?When a healthcare provider uses an FDA-approved drug for an unapproved use, that use is considered off-label. When the FDA approves a drug for any use, they deem it safe for its intended uses.However, providers can use their medical expertise to prescribe FDA-approved drugs for unapproved uses. This occurs if they determine that the drug is medically appropriate for you. They may do this because another drug is unavailable or you have tried other medications that have not worked.
What Is “Off-Label” Use?
When a healthcare provider uses an FDA-approved drug for an unapproved use, that use is considered off-label. When the FDA approves a drug for any use, they deem it safe for its intended uses.However, providers can use their medical expertise to prescribe FDA-approved drugs for unapproved uses. This occurs if they determine that the drug is medically appropriate for you. They may do this because another drug is unavailable or you have tried other medications that have not worked.
Seroquel for Primary Insomnia
The sleep benefits of Seroquel may be related to the fact that once under treatment, someone with mental health conditions finds it easier to sleep well. This means it would not have benefits for someone only suffering from a sleep disorder.
Only limited studies have been conducted to determine Seroquel’s effectiveness in treating insomnia orimproving sleepin otherwise healthy individuals. These include the following:
A Word From VerywellSeroquel should only be used if other non-medication options have been thoroughly tried and failed. It should be used as an aid and not a permanent solution. When used appropriately and with monitoring from your healthcare provider, it can be a good agent to try before benzodiazepines or Z-drugs, even preferred.—ERIKA PROUTY, PHARMD, MEDICAL EXPERT BOARD
A Word From Verywell
Seroquel should only be used if other non-medication options have been thoroughly tried and failed. It should be used as an aid and not a permanent solution. When used appropriately and with monitoring from your healthcare provider, it can be a good agent to try before benzodiazepines or Z-drugs, even preferred.—ERIKA PROUTY, PHARMD, MEDICAL EXPERT BOARD
Seroquel should only be used if other non-medication options have been thoroughly tried and failed. It should be used as an aid and not a permanent solution. When used appropriately and with monitoring from your healthcare provider, it can be a good agent to try before benzodiazepines or Z-drugs, even preferred.
—ERIKA PROUTY, PHARMD, MEDICAL EXPERT BOARD
Seroquel Dosage for Sleep
Seroquel comes in immediate-release (IR) and extended-release (ER or XR) tablets.Either form may be used off-label to help improve sleep within about an hour of taking the medication.
The most common doses of Seroquel used in clinical sleep trials ranged from 25 mg to 300 mg once daily before bed. Some clinical trials recommend a starting dosage range from 50 mg to 150 mg per day.
Higher doses of Seroquel are associated with a higher risk of side effects, but even lower doses have been associated with side effects such as weight gain and increasedtriglyceridelevels.
Older people may experience more side effects and should start with a lower dose of Seroquel.
How to Take Seroquel Safely
Due to its sleep-promoting effects, avoid driving or other activities requiring focus or alertness after taking Seroquel until you know exactly how it will affect you.
For your first dose, try taking it at night when you don’t have to be awake too early the next day. This is because it can cause grogginess in the morning.
Before taking Seroquel, your healthcare provider should assess the following:
It’s best to avoid drinking alcohol while taking Seroquel, as it has the potential to worsen some side effects.
If you need to stop Seroquel, talk with your healthcare provider first. If you stop taking it suddenly, you may have a greater chance of side effects like trouble sleeping, nausea, and vomiting.
Seroquel and Risk for Misuse
Seroquel is not known to cause euphoric effects, but it may still be abused. It is sometimes added to other illegal substances or street drugs in an attempt to enhance them or to counter some of their side effects.
The risk of abuse or misuse of Seroquel is not as high as other drugs that are often used to treat insomnia, such asbenzodiazepinesor Z-drugs, but the risk of abuse should be weighed based on individual factors like past abuse or misuse of other drugs oraddictive personalities.
What Are “Z-Drugs?“Z-drugs refer to a group of nonbenzodiazepine hypnotic medications approved to treat insomnia, including:Lunesta (eszopiclone)Sonata (zaleplon)Ambien (zolpidem)
What Are “Z-Drugs?”
Z-drugs refer to a group of nonbenzodiazepine hypnotic medications approved to treat insomnia, including:Lunesta (eszopiclone)Sonata (zaleplon)Ambien (zolpidem)
Z-drugs refer to a group of nonbenzodiazepine hypnotic medications approved to treat insomnia, including:
Seroquel and the Risk for Rebound Insomnia
Seroquel, along with other antipsychotic drugs, may causewithdrawalsymptoms, includingrebound insomniawhen you stop taking them. Rebound insomnia can sometimes be even worse than the insomnia you had before you started taking the medication.
This is why it’s important to talk with your healthcare provider before stopping Seroquel. It should be tapered slowly, meaning the dose you’re taking slowly gets decreased.
Side Effects of Seroquel
Seroquel tends to cause a wide range of side effects involving multiple systems in the body. This is a large part of why it is not the ideal drug for people who have insomnia without the presence of additional conditions that Seroquel is approved or used more often to treat.
Potential side effects include:
Alternatives to Seroquel for Sleep
Before taking medication, you should try to practice the best possiblesleep hygieneor sleep habits, which can help improve your insomnia. Some examples include:
There are someherbal remedies and dietary supplementsthat may also help you sleep.However, they should be used with caution. Some herbal agents interact with other herbals and prescription medications, so please make sure your healthcare provider knows all the herbal or dietary supplements and medications you take.
Some options to look into that could potentially help include:
Melatonin supplements, which contain a synthetic form of the naturally occurring sleep hormone your body produces in response to darkness, are commonly used as a sleep aid. However, data does not support their use for treating insomnia.
Finally, some medications that are either approved for sleep or are sometimes used off-label to help with sleep include:
Summary
While Seroquel often causes sleepiness, it is not a sleeping pill. There isn’t enough evidence to recommend its use for treating primary insomnia. Still, it is sometimes prescribed off-label for sleeping problems, although it’s not the best choice for everyone.
Additionally, Seroquel doesn’t come without risks, as it has a broad side effect profile. These include metabolic, heart, and hematologic (blood) effects.
Seroquel may be helpful if it treats the underlying condition affecting your sleep. Otherwise, other options are available to help with sleep problems if you have insomnia and are otherwise healthy.
If you struggle with insomnia but can’t figure out the cause of your sleep issues, talk with your healthcare provider about other available interventions for improvement.
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Food and Drug Administration.Seroquel prescribing information.Modesto-Lowe V, Harabasz AK, Walker SA.Quetiapine for primary insomnia: consider the risks.Cleve Clin J Med. 2021;88(5):286-294. doi:10.3949/ccjm.88a.20031Anderson SL, Vande Griend JP.Quetiapine for insomnia: a review of the literature.Am J Health Syst Pharm. 2014;71(5):394-402. doi:10.2146/ajhp130221.Cohrs S, Rodenbeck A, Guan Z, et al.Sleep-promoting properties of quetiapine in healthy subjects.Psychopharmacology (Berl). 2004;174(3):421-429.Tassniyom K, Paholpak S, Tassniyom S, Kiewyoo J.Quetiapine for primary insomnia: a double blind, randomized controlled trial.J Med Assoc Thai. 2010;93(6):729-734.Medscape.Quetiapine.Lin CY, Chiang CH, Tseng MM, et al.Effects of quetiapine on sleep: a systematic review and meta-analysis of clinical trials.Eur Neuropsychopharmacol. 2023;67:22-36. doi:10.1016/j.euroneuro.2022.11.008Højlund M, Andersen K, Ernst MT, et al.Use of low-dose quetiapine increases the risk of major adverse cardiovascular events: results from a nationwide active comparator-controlled cohort study.World Psychiatry. 2022;21(3):444-451. doi:10.1002/wps.21010Brandt J, Leong C.Benzodiazepines and z-drugs: an updated review of major adverse outcomes reported on in epidemiologic research.Drugs R D. 2017;17(4):493-507. doi:10.1007/s40268-017-0207-7Cosci F, Chouinard G.Acute and persistent withdrawal syndromes following discontinuation of psychotropic medications.Psychother Psychosom. 2020;89(5):283-306. doi:10.1159/000506868Chan V, Lo K.Efficacy of dietary supplements on improving sleep quality: a systematic review and meta-analysis.Postgrad Med J. 2022;98(1158):285-293. doi:10.1136/postgradmedj-2020-139319Liu L, Liu C, Wang Y, et al.Herbal medicine for anxiety, depression and insomnia.Curr Neuropharmacol. 2015;13(4):481-493. doi:10.2174/1570159X1304150831122734National Institutes of Health National Center for Complementary and Integrative Health.Melatonin: what you need to know.Bollu PC, Kaur H.Sleep medicine: insomnia and sleep.Mo Med. 2019;116(1):68-75.
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Food and Drug Administration.Seroquel prescribing information.Modesto-Lowe V, Harabasz AK, Walker SA.Quetiapine for primary insomnia: consider the risks.Cleve Clin J Med. 2021;88(5):286-294. doi:10.3949/ccjm.88a.20031Anderson SL, Vande Griend JP.Quetiapine for insomnia: a review of the literature.Am J Health Syst Pharm. 2014;71(5):394-402. doi:10.2146/ajhp130221.Cohrs S, Rodenbeck A, Guan Z, et al.Sleep-promoting properties of quetiapine in healthy subjects.Psychopharmacology (Berl). 2004;174(3):421-429.Tassniyom K, Paholpak S, Tassniyom S, Kiewyoo J.Quetiapine for primary insomnia: a double blind, randomized controlled trial.J Med Assoc Thai. 2010;93(6):729-734.Medscape.Quetiapine.Lin CY, Chiang CH, Tseng MM, et al.Effects of quetiapine on sleep: a systematic review and meta-analysis of clinical trials.Eur Neuropsychopharmacol. 2023;67:22-36. doi:10.1016/j.euroneuro.2022.11.008Højlund M, Andersen K, Ernst MT, et al.Use of low-dose quetiapine increases the risk of major adverse cardiovascular events: results from a nationwide active comparator-controlled cohort study.World Psychiatry. 2022;21(3):444-451. doi:10.1002/wps.21010Brandt J, Leong C.Benzodiazepines and z-drugs: an updated review of major adverse outcomes reported on in epidemiologic research.Drugs R D. 2017;17(4):493-507. doi:10.1007/s40268-017-0207-7Cosci F, Chouinard G.Acute and persistent withdrawal syndromes following discontinuation of psychotropic medications.Psychother Psychosom. 2020;89(5):283-306. doi:10.1159/000506868Chan V, Lo K.Efficacy of dietary supplements on improving sleep quality: a systematic review and meta-analysis.Postgrad Med J. 2022;98(1158):285-293. doi:10.1136/postgradmedj-2020-139319Liu L, Liu C, Wang Y, et al.Herbal medicine for anxiety, depression and insomnia.Curr Neuropharmacol. 2015;13(4):481-493. doi:10.2174/1570159X1304150831122734National Institutes of Health National Center for Complementary and Integrative Health.Melatonin: what you need to know.Bollu PC, Kaur H.Sleep medicine: insomnia and sleep.Mo Med. 2019;116(1):68-75.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Food and Drug Administration.Seroquel prescribing information.Modesto-Lowe V, Harabasz AK, Walker SA.Quetiapine for primary insomnia: consider the risks.Cleve Clin J Med. 2021;88(5):286-294. doi:10.3949/ccjm.88a.20031Anderson SL, Vande Griend JP.Quetiapine for insomnia: a review of the literature.Am J Health Syst Pharm. 2014;71(5):394-402. doi:10.2146/ajhp130221.Cohrs S, Rodenbeck A, Guan Z, et al.Sleep-promoting properties of quetiapine in healthy subjects.Psychopharmacology (Berl). 2004;174(3):421-429.Tassniyom K, Paholpak S, Tassniyom S, Kiewyoo J.Quetiapine for primary insomnia: a double blind, randomized controlled trial.J Med Assoc Thai. 2010;93(6):729-734.Medscape.Quetiapine.Lin CY, Chiang CH, Tseng MM, et al.Effects of quetiapine on sleep: a systematic review and meta-analysis of clinical trials.Eur Neuropsychopharmacol. 2023;67:22-36. doi:10.1016/j.euroneuro.2022.11.008Højlund M, Andersen K, Ernst MT, et al.Use of low-dose quetiapine increases the risk of major adverse cardiovascular events: results from a nationwide active comparator-controlled cohort study.World Psychiatry. 2022;21(3):444-451. doi:10.1002/wps.21010Brandt J, Leong C.Benzodiazepines and z-drugs: an updated review of major adverse outcomes reported on in epidemiologic research.Drugs R D. 2017;17(4):493-507. doi:10.1007/s40268-017-0207-7Cosci F, Chouinard G.Acute and persistent withdrawal syndromes following discontinuation of psychotropic medications.Psychother Psychosom. 2020;89(5):283-306. doi:10.1159/000506868Chan V, Lo K.Efficacy of dietary supplements on improving sleep quality: a systematic review and meta-analysis.Postgrad Med J. 2022;98(1158):285-293. doi:10.1136/postgradmedj-2020-139319Liu L, Liu C, Wang Y, et al.Herbal medicine for anxiety, depression and insomnia.Curr Neuropharmacol. 2015;13(4):481-493. doi:10.2174/1570159X1304150831122734National Institutes of Health National Center for Complementary and Integrative Health.Melatonin: what you need to know.Bollu PC, Kaur H.Sleep medicine: insomnia and sleep.Mo Med. 2019;116(1):68-75.
Food and Drug Administration.Seroquel prescribing information.
Modesto-Lowe V, Harabasz AK, Walker SA.Quetiapine for primary insomnia: consider the risks.Cleve Clin J Med. 2021;88(5):286-294. doi:10.3949/ccjm.88a.20031
Anderson SL, Vande Griend JP.Quetiapine for insomnia: a review of the literature.Am J Health Syst Pharm. 2014;71(5):394-402. doi:10.2146/ajhp130221.
Cohrs S, Rodenbeck A, Guan Z, et al.Sleep-promoting properties of quetiapine in healthy subjects.Psychopharmacology (Berl). 2004;174(3):421-429.
Tassniyom K, Paholpak S, Tassniyom S, Kiewyoo J.Quetiapine for primary insomnia: a double blind, randomized controlled trial.J Med Assoc Thai. 2010;93(6):729-734.
Medscape.Quetiapine.
Lin CY, Chiang CH, Tseng MM, et al.Effects of quetiapine on sleep: a systematic review and meta-analysis of clinical trials.Eur Neuropsychopharmacol. 2023;67:22-36. doi:10.1016/j.euroneuro.2022.11.008
Højlund M, Andersen K, Ernst MT, et al.Use of low-dose quetiapine increases the risk of major adverse cardiovascular events: results from a nationwide active comparator-controlled cohort study.World Psychiatry. 2022;21(3):444-451. doi:10.1002/wps.21010
Brandt J, Leong C.Benzodiazepines and z-drugs: an updated review of major adverse outcomes reported on in epidemiologic research.Drugs R D. 2017;17(4):493-507. doi:10.1007/s40268-017-0207-7
Cosci F, Chouinard G.Acute and persistent withdrawal syndromes following discontinuation of psychotropic medications.Psychother Psychosom. 2020;89(5):283-306. doi:10.1159/000506868
Chan V, Lo K.Efficacy of dietary supplements on improving sleep quality: a systematic review and meta-analysis.Postgrad Med J. 2022;98(1158):285-293. doi:10.1136/postgradmedj-2020-139319
Liu L, Liu C, Wang Y, et al.Herbal medicine for anxiety, depression and insomnia.Curr Neuropharmacol. 2015;13(4):481-493. doi:10.2174/1570159X1304150831122734
National Institutes of Health National Center for Complementary and Integrative Health.Melatonin: what you need to know.
Bollu PC, Kaur H.Sleep medicine: insomnia and sleep.Mo Med. 2019;116(1):68-75.
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