Seroquel vs Abilify: antipsychotics compared
Seroquel (quetiapine) and Abilify (aripiprazole) are antipsychotics used for schizophrenia, bipolar disorder and, as add-on treatments, depression. Quetiapine is more sedating and more likely to cause weight gain; aripiprazole is less sedating but can cause restlessness.
Updated October 4, 2026
At a glance
- Sedation
- Seroquel
- Common and often marked
- Abilify
- Less common
- Weight and blood sugar
- Seroquel
- Higher risk of gain and metabolic changes
- Abilify
- Lower risk
- Restlessness (akathisia)
- Seroquel
- Less common
- Abilify
- More common
- Approved for
- Seroquel
- Schizophrenia, bipolar disorder (including depression), add-on for depression (XR)
- Abilify
- Schizophrenia, bipolar mania, add-on for depression, irritability with autism, Tourette’s
- Generic
- Seroquel
- Yes
- Abilify
- Yes
Seroquel quetiapine | Abilify aripiprazole | |
|---|---|---|
| Sedation | Common and often marked | Less common |
| Weight and blood sugar | Higher risk of gain and metabolic changes | Lower risk |
| Restlessness (akathisia) | Less common | More common |
| Approved for | Schizophrenia, bipolar disorder (including depression), add-on for depression (XR) | Schizophrenia, bipolar mania, add-on for depression, irritability with autism, Tourette’s |
| Generic | Yes | Yes |
Side effect profiles
Quetiapine’s sedation can help when sleep is badly disturbed but gets in the way during the day, and it carries a higher risk of weight gain, high blood sugar and cholesterol changes, which are monitored. Aripiprazole is less likely to cause these but more often causes an inner restlessness, and rarely strong urges such as gambling or binge eating, which should be reported.
Sleep
Quetiapine is sometimes prescribed at low doses for sleep, but because of its metabolic risks, guidelines generally advise against using it for insomnia alone. Other approaches, including cognitive behavioral therapy for insomnia, are usually tried first.
Shared warnings
Both carry boxed warnings about increased risk of death in older adults with dementia-related psychosis and about suicidal thoughts in young people. Both can cause movement disorders such as tardive dyskinesia, and both can make you dizzy when standing.
Interactions
Strong CYP3A4 blockers raise quetiapine levels, while aripiprazole is affected by both CYP2D6 and CYP3A4 blockers such as fluoxetine, paroxetine and ketoconazole, so doses are adjusted. Alcohol and sedatives add to drowsiness with either.
Cost
Both are generics. Extended-release quetiapine and some aripiprazole forms cost more, so ask for a quote on the exact form prescribed.
Stopping
Neither should be stopped suddenly without advice. Stopping abruptly can bring symptoms back or cause withdrawal effects such as nausea, sweating and trouble sleeping, so any change is made gradually with your prescriber, who can also help if side effects become a problem.
Questions for your prescriber
- Which side effects matter most for me: weight, sleepiness or restlessness?
- How will weight, blood sugar and cholesterol be monitored?
- What movement changes should I report?
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Sources
Written by the Script Unlock editorial team from the sources above. It is general information, not advice for you or your pet; your prescriber decides which medicine is right.
Script Unlock is a marketplace that lets licensed pharmacies quote a cash price on your prescription. It does not prescribe, dispense or sell medication, does not process patient payments, and does not give medical advice. Always follow the instructions of your prescriber and pharmacist and read the medication guide supplied with your medicine.