Does Quetiapine (Seroquel) Cause Hot Flashes?
No, quetiapine does not cause hot flashes as a side effect. In fact, preliminary research suggests it may actually reduce hot flashes in some populations, though this is not an approved indication and requires further study.
Evidence from FDA Drug Label
The official FDA prescribing information for Seroquel lists extensive adverse reactions occurring at ≥2% incidence in clinical trials, and hot flashes are not among them 1. The most common adverse reactions include:
- Somnolence (18-57% depending on indication)
- Dry mouth (9-44%)
- Dizziness (11-18%)
- Constipation (8-10%)
- Weight gain (4-5%)
- Orthostatic hypotension (3-7%)
The FDA label documents adverse reactions across multiple indications (schizophrenia, bipolar mania, bipolar depression) in thousands of patients, and hot flashes were never reported as a treatment-emergent adverse event 1.
Exploratory Research Findings
Interestingly, one small pilot study (n=24) in perimenopausal/early postmenopausal women with depression found that quetiapine XR 150-300 mg/day was associated with reduction in menopause-related symptoms, including hot flashes, as measured by the Greene Climacteric Scale and Hot Flash-Related Daily Interference Scale 2. However, this was an 8-week open-label trial with a placebo lead-in, and these findings have not been confirmed in larger controlled trials.
Clinical Context
Important caveats:
- The evidence base for quetiapine consists primarily of studies for approved indications (schizophrenia, bipolar disorder) where hot flashes would not be expected as a medication side effect
- Systematic reviews have documented that quetiapine is widely used off-label based on small exploratory studies that often lack confirmatory evidence 3
- In older adults, quetiapine's most concerning adverse effects are somnolence (25-39%), dizziness (15-27%), postural hypotension (6-18%), falls, and metabolic effects—not vasomotor symptoms 4
Bottom Line
If a patient reports hot flashes while taking quetiapine, look for alternative explanations such as:
- Natural menopause/perimenopause
- Other medications
- Underlying medical conditions
- Withdrawal from other medications
Hot flashes are not a recognized adverse effect of quetiapine based on extensive clinical trial data and FDA labeling 1.