Seroquel (Quetiapine) for sleep: Dosage, uses, and other concerns

Seroquel (Quetiapine) for sleep
Medically reviewed by Dr. Mavra Farrukh


The use of Seroquel (Quetiapine) for sleep is not FDA-approved for primary insomnia, but it is being used more commonly for its sedative properties. It is prescribed off-label at lower doses, and it may assist in falling and staying asleep, particularly for individuals with mental health conditions. However, caution is advised due to potential side effects, and exploring safer alternatives is recommended. This blog explores Seroquel’s role in sleep, dosage for adults and children, its impact on birth control and breastfeeding, and important considerations and precautions.

Exploring the potential of Seroquel (Quetiapine) as a sleep aid involves understanding its effectiveness, benefits, and considerations. This blog delves into the impact of Seroquel on sleep and provides insights for individuals seeking information on its sleep-promoting properties.

Is Seroquel prescribed for sleep problems?

Due to its sedative properties, Seroquel (Quetiapine) is being prescribed off-label at lower doses for the treatment of primary insomnia (difficulty initiating or maintaining sleep), even though the FDA has not approved this use.

Using Seroquel (Quetiapine) for sleep should only be done under a doctor’s supervision or monitoring. While it may enhance sleep for some individuals, especially those with mental health conditions, it carries potential risks and side effects. 

Research advises against its use for insomnia, emphasizing the availability of safer and more effective alternatives. Discussing sleep concerns and treatment options with a healthcare provider is essential to identify the most suitable and secure approach for addressing sleep problems. 

Non-pharmacological methods like cognitive-behavioral therapy for insomnia (CBT-I) and adopting good sleep hygiene practices can prove highly effective in improving sleep without resorting to medication. Therefore, seeking medical advice before considering Seroquel for sleep is recommended.

FDA has not approved its use for sleep as it has been studied; it has side effects, including negative side effects like gaining weight, akathisia (restlessness), and high blood sugar. Safety concerns and the possibility of abuse call for serious thought even though it may be helpful, especially for people with mental health issues.

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What is the Seroquel dosage for insomnia?

As shared above, the FDA has not yet approved Seroquel (Quetiapine) for treating primary insomnia. There is insufficient evidence that it works or is safe for use as a treatment for primary insomnia, even though its sedative properties help some people fall asleep and sleep better overall.

The usual starting dose of Seroquel (Quetiapine) for insomnia is 25 mg once daily at bedtime. Depending on individual needs and tolerance, dosage can be increased by 25-50 mg daily every 3-7 days.

Seroquel can cause serious side effects such as weight gain, drowsiness during the day, and involuntary movements; it is critical to explore alternative, safer sleep aid options. 

Consulting a healthcare provider to identify appropriate and safe approaches to addressing sleep-related issues is critical. The best way to determine what works best for your sleep problems is to discuss your concerns and treatment options with your doctor.

Seroquel and children

There is no indication that Seroquel (Quetiapine) should be used in children under the age of 18 for any purpose. But it is legal to use for treating bipolar disorder in kids and teens (10–17 years old) for a limited time during manic episodes.

For children experiencing manic episodes, the usual dosage recommendation is 400 mg to 600 mg daily, with a maximum dose of 600 mg. 

To begin, take 25 mg twice a day on day 1, then 50 mg, 100 mg, 150 mg, and 200 mg twice daily on the following days. This is the initial dosage schedule for this purpose. Once the child reaches day 5, the doctor can keep adding or removing 100 mg daily until they find the right dose for their condition.

Children with schizophrenia who require long-term maintenance treatment typically take 400 mg to 800 mg daily, split into two or three doses, with 800 mg being the maximum daily dose. It should be noted that maintenance therapy should only involve the administration of the lowest effective dose.

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Seroquel and birth control

Seroquel (Quetiapine) does not appear to affect the efficacy of oral contraceptives, integrated oral contraceptives, or emergency contraception in any way. The possible risk of temporary symptoms in newborns shortly after birth, commonly known as withdrawal, makes it imperative to emphasize that Seroquel is not recommended during pregnancy.

It is important for women to consult their healthcare provider before taking Seroquel during pregnancy or while trying to conceive to weigh the risks and benefits of the medication. The use of Seroquel during pregnancy has the added risk of causing the baby to experience temporary withdrawal symptoms.

Seroquel and breastfeeding

The amount of Quetiapine (brand name Seroquel) in breast milk is extremely low, usually less than one percent of the parent’s dosage. A breastfed baby’s blood concentration of medicine is very low and, in rare instances, may not be detectable. 

Breastfeeding with Quetiapine is not likely to affect the baby’s development, according to the limited research that has been carried out on the topic. While nursing a baby while taking quetiapine, it is critical to monitor the infant closely to ensure it does not show signs of excessive drowsiness.

It is essential to consult your healthcare provider if you have any concerns regarding Quetiapine and its impact on breastfeeding. The potential effects of Quetiapine on fertility (the capacity to impregnate a partner) and the risk of birth defects in males are unclear. It is also unclear whether Quetiapine-exposed sperm poses any dangers to an unborn child.

What precautions should I take before starting Seroquel for sleep?

Before initiating Seroquel (Quetiapine) for sleep, taking certain precautions is crucial. First and foremost, consult with your doctor and refrain from using Seroquel for sleep unless specifically prescribed for this purpose. 

Be aware of potential side effects, including weight gain, restlessness, increased blood sugar, daytime drowsiness, dizziness, dry mouth, heartburn, increased appetite, and elevated cholesterol and triglycerides. 

Serious side effects may occur, and many doctors do not recommend Seroquel as a sleep aid for the general population, reserving it for individuals with specific mental health conditions. 

Additionally, monitor the long-term use of Seroquel, particularly considering potential negative effects on cardiovascular health. Lastly, discuss suitable and safe approaches to address your sleep problems with your healthcare provider.

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When should I see a doctor?

Talk to your doctor immediately if you or someone you know is experiencing suicidal thoughts, plans to hurt themselves or others, or severe distress due to Seroquel side effects. If your thoughts, feelings, or behavior change suddenly, if you have trouble concentrating, notice unusual sleep patterns, or if your weight changes significantly, you should seek medical attention.

Talk to your doctor if you are experiencing any symptoms interfering with your daily life, such as a persistent sense of emptiness, problems controlling your emotions, or anything else. To find the best and safest way to deal with your mental health issues, you must address these concerns.

Always consult your doctor or nurse for questions or concerns regarding Quetiapine while breastfeeding. Whether Quetiapine increases the risk of birth abnormalities or affects fertility (the capacity to impregnate a partner) in males is unclear. Also unknown are the possible hazards to a pregnancy posed by quetiapine-exposed sperm.

Can Seroquel be habit-forming?

No, Seroquel (quetiapine) is not habit-forming like physical dependence or addiction. It rarely causes withdrawal or cravings like habit-forming drugs. Unsupervised medication discontinuation or dosage changes can cause withdrawal-like symptoms or recurrence of prescribed symptoms. Follow the treatment plan and talk to your doctor if you have questions or need to change your medication.

Can Seroquel be used for the long-term treatment of sleep disorders?

No, Seroquel (Quetiapine) is not FDA-approved for long-term sleep disorder treatment. It may work in the short term, but its long-term effects on cardiovascular health are concerning. Studies show effectiveness in treating insomnia with comorbid conditions, but long-term effects and side effects, including sleep disruptions, need to be known.

How quickly can I expect to see improvements in my sleep with Seroquel?

Significant sleep improvements may occur after 2–4 days, but long-term efficacy and safety are unknown. Seroquel (Quetiapine) sleep effects vary. Antihistamine and antiadrenergic effects cause drowsiness at 25mg to 100mg. Discussing risks, benefits, and alternatives with a doctor is essential.

How long does Seroquel stay in your system?

It usually takes about a day or two for the drug to reach a steady state and stabilize in the body. Quetiapine has a half-life of about 6 hours and takes around a week or two to be eliminated from the body entirely. Dosage, frequency, and metabolism are some of the variables that affect how long Seroquel (Quetiapine) stays in the system.

Your Doctors Online uses high-quality and trustworthy sources to ensure content accuracy and reliability. We rely on peer-reviewed studies, academic research institutions and medical associations to provide up-to-date and evidence-based information to the users.

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  • Coe HV, Hong IS. Safety of low doses of quetiapine when used for insomnia. Ann Pharmacother. 2012 May;46(5):718-22. doi: 10.1345/aph.1Q697. Epub 2012 Apr 17. PMID: 22510671.
  • Lin, C. Y., Chiang, C. H., Tseng, M. C. M., Tam, K. W., & Loh, E. W. (2023). Effects of quetiapine on sleep: A systematic review and meta-analysis of clinical trials. European Neuropsychopharmacology67, 22-36.
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