Low-dose quetiapine is prescribed for sleep. Its metabolic effects were tested in 106,711 people
The headline result is smaller and stranger than "it raises your cholesterol."
Well-supported by good-quality research. how we score evidence
Caveat on this rating: Study funding is public, but the author group carries extensive pharmaceutical relationships, all declared as unrelated to this work: honoraria from Lundbeck and Otsuka, consulting fees from Bristol-Myers Squibb, Novartis, Roche, Merck and Pfizer, stock options in several device and pharmaceutical companies, and participation in regulator-mandated phase IV studies funded by Alcon, Almirall, Astellas, AstraZeneca, Boehringer-Ingelheim, Novo Nordisk, Servier and LEO Pharma with funds paid to the institution. None of those are the makers of quetiapine, and the finding runs against the drug rather than for it, which is the direction sponsorship bias does not usually run. Recorded here so a reader can weigh it rather than discover it.
Quetiapine is very often prescribed off-label at low doses for sleep and anxiety, on the reasoning that the metabolic problems seen at antipsychotic doses do not apply down there. Danish researchers tested that using national registers: 106,711 people who newly started quetiapine at 50 mg or less between 2008 and 2018, with blood results from the year before and the year after they started.
What they found is worth reading carefully, because it does not flatten into a headline. Across everyone, triglycerides rose by about 5% and HDL — the cholesterol you want high — fell by about 2%. HbA1c did not change significantly, and total and LDL cholesterol actually went down.
The part that matters is underneath that. Among people whose levels were normal before they started, HbA1c, total cholesterol and LDL all rose significantly. The overall averages were being pulled down by people who started with high numbers and were presumably being treated for them. So a real effect in healthy-baseline patients was partly hidden by the population average. The effect was also dose-dependent, which is evidence against the idea that low doses are metabolically free.
These are small changes over one year, not a warning that the medication is dangerous. They are a reason for the blood test to happen.
Worth asking
What is this dose actually for, when did I last have lipids and HbA1c checked, and is there a plan to review whether I still need it.
What it is FDA approved for
Read off the label. Trial duration and approval year are shown only where they were recorded — never inferred.
- Schizophrenia (adults; adolescents 13-17)
- Bipolar I disorder, acute manic episodes (monotherapy or adjunct to lithium/divalproex; ages 10-17 monotherapy)
- Bipolar disorder, acute depressive episodes (monotherapy) · trials ran 8-week randomized trials
- Bipolar I disorder, maintenance treatment (adjunct to lithium or divalproex)
- Major depressive disorder, adjunctive treatment with antidepressants (Seroquel XR only)
Source
Impact of low-dose quetiapine-use on glycosylated hemoglobin, triglyceride and cholesterol levels — Højlund M, Støvring H, Andersen K, Correll CU, Hallas J (2023)
Reputable peer-reviewed journal
Read the source: https://doi.org/10.1111/acps.13515
DOI: 10.1111/acps.13515
How this was scored
- Study design
- Cohort study
- Funding
- Independently funded
- Published in
- Reputable peer-reviewed journal
- Sample size
- 106,711
- Preregistered
- No
- Conflicts disclosed
- Yes
- Independent of proponent
- Yes
- Retracted
- No
Read the full scoring rubric, including what it can't tell you.
Published August 5, 2026. Last verified August 19, 2026.
Questions
How strong is the evidence behind this?
Resolv rates this source "strong evidence". Well-supported by good-quality research. It scores 76 out of 100 on our published rubric. One caveat travels with that badge: Study funding is public, but the author group carries extensive pharmaceutical relationships, all declared as unrelated to this work: honoraria from Lundbeck and Otsuka, consulting fees from Bristol-Myers Squibb, Novartis, Roche, Merck and Pfizer, stock options in several device and pharmaceutical companies, and participation in regulator-mandated phase IV studies funded by Alcon, Almirall, Astellas, AstraZeneca, Boehringer-Ingelheim, Novo Nordisk, Servier and LEO Pharma with funds paid to the institution. None of those are the makers of quetiapine, and the finding runs against the drug rather than for it, which is the direction sponsorship bias does not usually run. Recorded here so a reader can weigh it rather than discover it. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
Impact of low-dose quetiapine-use on glycosylated hemoglobin, triglyceride and cholesterol levels — Højlund M, Støvring H, Andersen K, Correll CU, Hallas J (2023). Published in: Reputable peer-reviewed journal. DOI: 10.1111/acps.13515. The full source is linked on this page so you can read it yourself.
Who paid for this research, and does that matter?
Study design: Cohort study. Funding: Independently funded. The researchers were independent of whoever benefits from the result. Industry sponsorship is one of the most reliably measured biases in medicine, which is why funding carries real weight in the score rather than sitting in a footnote.
Is quetiapine (Seroquel) FDA approved?
Yes — FDA approved for Schizophrenia (adults; adolescents 13-17), Bipolar I disorder, acute manic episodes (monotherapy or adjunct to lithium/divalproex; ages 10-17 monotherapy), Bipolar disorder, acute depressive episodes (monotherapy), Bipolar I disorder, maintenance treatment (adjunct to lithium or divalproex), Major depressive disorder, adjunctive treatment with antidepressants (Seroquel XR only). Approval is for a specific indication, not for everything the drug is prescribed for.
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.