Irritability, reactivity, and anger can arise from a variety of underlying causes—ranging from mood disorders to neurodevelopmental conditions. At Alpine Psychiatry, we take a personalized, integrative approach to treatment, combining medication management, therapy, and, when appropriate, biomedical interventions to address these challenging symptoms.
While many treatment options exist, Seroquel (quetiapine) can sometimes be an effective off-label choice for reducing irritability and anger, especially when other medications have been ineffective or poorly tolerated. As with all medications, we carefully weigh potential benefits against possible side effects to find the safest and most effective plan for each patient.
Schizophrenia – Helps manage symptoms such as hallucinations, delusions, and thought disturbances.
Bipolar Disorder – Approved for both manic and depressive episodes.
Depression – Can be used as an add-on treatment when other antidepressants are insufficient.
In addition to its approved uses, quetiapine is sometimes prescribed for:
Irritability and Anger – May help regulate emotional reactivity in certain patients.
Anxiety – Can reduce excessive worry and tension.
Obsessive-Compulsive Disorder (OCD) – Often used alongside SSRIs or SNRIs.
Insomnia – Sedative effects can support improved sleep.
Nausea – Occasionally used in specific medical contexts.
Appetite Regulation – May influence appetite, which can be beneficial in select cases.
Clinical experience and research suggest that quetiapine may benefit 60–70% of patients experiencing irritability or anger, possibly by modulating neurotransmitters involved in mood and behavior regulation.
One case study described a seven-year-old with Pitt-Hopkins syndrome, autism spectrum disorder, and intellectual disability who had not responded well to other medications. After starting quetiapine, the child experienced:
Longer, more restful sleep
Reduced hyperactivity
Decreased episodes of abnormal breathing
Improved social communication and eye contact
This mirrors broader clinical observations in which quetiapine has helped manage agitation, disruptive mood dysregulation disorder (DMDD), intermittent explosive disorder (IED), and sleep disturbance—sometimes with better tolerability than other medications like aripiprazole or risperidone.
For off-label uses such as irritability and anger, effective doses are often lower than those used for schizophrenia or bipolar disorder. Typical starting ranges are 25–250 mg daily, usually taken at night to minimize daytime sedation.
Possible side effects include:
Drowsiness or dizziness
Dry mouth
Constipation
Weight gain (with potential risk for type 2 diabetes)
Blurred vision
Rare risk of tardive dyskinesia (involuntary movements)
Quetiapine should be used cautiously in individuals with:
History of cataracts
Significant cardiovascular disease
Diabetes or pre-diabetes
Seizure disorders
Seroquel (quetiapine) is a versatile medication that can help reduce irritability, reactivity, and anger in some individuals, especially when other treatments have failed. If you’re considering whether this might be the right option for you or your child, our team can guide you through the decision-making process, review potential side effects, and design a personalized plan that integrates holistic and evidence-based approaches.