Abilify vs Seroquel: What’s the Difference?

When addressing mental health conditions, Abilify and Seroquel are both commonly prescribed medications. They’re in the same class of drugs — atypical antipsychotics — and are widely used for various mental health treatments and psychiatric conditions, including schizophrenia, bipolar disorder, and major depressive disorder. 

Although they share some similarities, Abilify and Seroquel have important differences. Understanding the clear distinctions between these effective antipsychotic drugs is crucial in choosing the right one, a decision that should always include your doctor or mental health provider. 

	Abilify	Seroquel
Conditions Treated	Schizophrenia, bipolar disorder, depression (adjunctive)	Schizophrenia, bipolar disorder, depression (adjunctive)
Sedation Effects	Minimal sedation	Often causes sedation
Common Side Effects	Restlessness, insomnia, nausea	Drowsiness, weight gain, dry mouth
Key Considerations	Often preferred for minimal sedation, but may cause restlessness	Commonly used when sedation is desired

Differences Between Abilify and Seroquel

Antipsychotic drugs help manage a range of psychiatric disorders, including schizophrenia and bipolar disorder, by targeting neurotransmitter systems, particularly dopamine and serotonin. While both Abilify and Seroquel are effective atypical antipsychotics, they differ in several key aspects. Those differences are important, as they can significantly impact how suitable a medication might be for your specific needs. 

By understanding the distinctions, you can make more informed decisions about which medication will be most effective in enhancing your mental health.

Differences between Abilify and Seroquel include:

• How they work
• Sedation effects
• Onset of action
• Side effect profiles
• Use in treating depression

How they work

Both Abilify and Seroquel are classified as atypical antipsychotics, and they affect the neurotransmitters dopamine and serotonin levels in the brain — but their mechanisms differ. 

• Abilify (aripiprazole) is a partial agonist at dopamine D2 receptors, which modulates dopamine activity without entirely blocking it. This can make it effective for stabilizing mood and reducing symptoms of psychosis. 
• Seroquel (quetiapine), on the other hand, primarily blocks dopamine D2 receptors and serotonin 5-HT2A receptors, so it can offer a more pronounced antipsychotic effect in some people.

Sedation effects

A key difference between these medications is their impact on sedation. Seroquel is well-known for its sedative properties, often making it a preferred choice for people struggling with insomnia or agitation. In contrast, Abilify is less sedating and may even cause restlessness or agitation in some patients.

“When a patient struggles with consecutive sleepless nights and worsening moods, the sedative properties of these medications can be beneficial. This can help minimize the necessary use for additional sleep-inducing medications.”

– Talkspace psychiatrist Dr. Muhammad Munir

Onset of action

Both antipsychotic drugs begin to take effect within a few days to weeks, but their full therapeutic benefits might take up to several weeks or even months. A common consideration when choosing between Abilify vs. Seroquel is the urgency of symptom relief compared to possible side effects.

If you’re curious about the expected timeline, discover how long Seroquel takes to work​​ compared to Abilify.

Side effect profiles

The differences in side effects between Abilify and Seroquel are significant and can strongly influence the choice of medication.

• Abilify side effects: Abilify can cause side effects like restlessness, insomnia, and nausea. However, it’s less likely to cause significant weight gain or sedation like Seroquel. 
• Seroquel side effects: Seroquel, on the other hand, is associated with drowsiness, weight gain, and metabolic changes like increased cholesterol and blood sugar levels. 

Consult a doctor, psychiatrist, or medical professional for more information regarding the side effects of each. They both also have withdrawal side effects if an improper transition occurs.

“Clinically managing mood episodes, such as depression or hypomania/mania, often requires regulating sleep. These medications have a dual effect: their sedative properties aid sleep while also helping to regulate mood symptoms. In most cases, starting these medications at a lower dose is advisable to minimize potential side effects, including sedation, hypotension, and dizziness.”

– Talkspace psychiatrist Dr. Muhammad Munir

Use in treating depression

Both medications are FDA-approved as adjunctive treatments — meaning they’re used with another drug, typically an antidepressant — for major depressive disorder. However, Abilify tends to be a favored option due to its activating properties, which help counteract the lack of energy and lethargy that’s so commonly associated with depression. Seroquel’s sedative effects can be more suitable for people whose depression also includes anxiety or sleep disturbances.

Similarities Between Abilify and Seroquel

Although they have many differences, Abilify and Seroquel share many similarities that make them both valuable options for treating psychiatric conditions. Understanding their features can help you decide which medication might be a more suitable choice.

Common similarities between Abilify and Seroquel:

• Both drugs are in the class of medications known as atypical antipsychotics. 
• They’re both approved to treat schizophrenia, bipolar disorder, and depression (as adjunctive therapy). 
• Their overlapping uses demonstrate their efficacy in addressing many symptoms (although their mechanisms and side effect profiles vary). 
• They both usually come in oral tablets, which makes them easy to administer.

Conditions treated

Abilify and Seroquel are both FDA-approved antipsychotic treatments for schizophrenia and bipolar disorder. They’re also both used in combination with other drugs to treat major depressive disorder.  

Adjunctive use

Abilify and Seroquel are two medications commonly used with other drugs and can be a valuable combined treatment strategy. For example, they’re often paired with antidepressants to enhance outcomes, particularly in cases of treatment-resistant depression, where an antidepressant alone hasn’t offered sufficient relief.

Tolerability

Tolerability can widely vary in any treatment since medications don’t always work the same way on different people. These medications have unique side effect profiles, so they may affect users differently. That said, they’re both generally well-tolerated when used appropriately as prescribed. It’s essential to find the correct dose and monitor side effects.

FAQs About Abilify and Seroquel

When deciding between the antipsychotic drugs Abilify and Seroquel, it’s normal to have questions about their effectiveness, side effects, and suitability for specific conditions. Knowing how these drugs work and what to be aware of will help you better understand what to expect from each medication. 

Here, we’re addressing some of the most frequently asked questions about these antipsychotics to help guide your decision-making process.

Does Abilify work better than Seroquel?

How effective Abilify vs Seroquel is depends on the condition being treated, other mental health concerns, and your needs. Abilify might be better if you need an activating medication, while Seroquel’s sedative effects can be beneficial if your condition makes sleep difficult. 

Is Abilify or Seroquel better for bipolar?

When comparing Abilify and Seroquel for bipolar, both are effective. Ultimately, the choice depends on your symptoms and how well you tolerate each drug. Seroquel can be a good choice for acute manic episodes since it has sedative effects, and Abilify may be better for maintenance therapy or if you don’t want sedation side effects.

Does Seroquel cause more weight gain than Abilify?

Yes, Seroquel is more likely to cause weight gain than Abilify. This might be due to its more substantial impact on metabolic pathways. Many people who are concerned about weight changes prefer Abilify.

Can I switch from Abilify to Seroquel?

Yes, Abilify is one of the most common Seroquel alternatives, so you can switch from Abilify to Seroquel. However, switching medications should always be done under the guidance of your doctor or a mental healthcare provider. After you talk to your doctor and you both agree switching is the best option, they’ll create a taper schedule for you to wean off one drug and start taking the other. To avoid the risk of Abilify withdrawal effects, the transition should be gradual. 

Is Seroquel a mood stabilizer or antipsychotic?

Seroquel is an atypical antipsychotic medication used to treat conditions like schizophrenia and bipolar disorder. While its primary function is to target certain receptors in the brain to manage symptoms of these disorders, it can also help stabilize mood in some individuals. If you’re considering Seroquel as part of your treatment, discussing its potential benefits and side effects with your doctor is important to ensure the best approach for your mental health.

Who should not use Seroquel? 

Seroquel, like other antipsychotic medications, may not be suitable for individuals with certain health conditions, such as a history of heart issues or metabolic disorders. When discussing medications like Seroquel and alternatives with your doctor, it’s important to consider potential side effects, such as weight gain or other adverse effects. If you’re prescribed Seroquel, your healthcare provider will monitor your response to the drug to ensure it aligns with your treatment goals.

Which Medication is Right for You?

Choosing between Abilify and Seroquel involves looking at several factors. Decisions about any medication should always be made in consultation with a qualified doctor who can consider the full clinical picture. 

Examples of factors your healthcare provider will consider include:

• Specific diagnosis: Certain conditions may respond more effectively to one medication over another, influencing the treatment choice.
• Side effect profile: Your ability to tolerate potential side effects, such as sedation or weight gain, will be a key factor in the decision-making process.
• Sedation needs: The need for a sedative effect, particularly for symptoms like insomnia, will be considered when choosing the medication.
• Personal medical history: Your doctor will carefully review any pre-existing conditions, such as metabolic syndrome or cardiovascular issues, before prescribing a medication.

Get Professional Guidance with a Prescription

Working with a healthcare provider is important in finding the right treatment plan for your condition and desired outcome. Whether you’re exploring Abilify vs. Seroquel for bipolar disorder, depression, or another condition, a psychiatrist or your primary care doctor can help you weigh the pros and cons of each drug.

Talkspace offers access to licensed online psychiatric providers who can guide you through this process and help you get an online prescription for Seroquel or Abilify. Connect with an online psychiatrist today to discuss whether Abilify or Seroquel is right for you.