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Dr. Bob is Robert Hsiung, MD,
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Posted by chemist on July 11, 2004, at 0:21:41
In reply to Seroquel - don't think so » chemist, posted by barbaracat on July 10, 2004, at 22:59:42
> A question for chemist and a comment on Seroquel. I am bipolar II and have been on every AD on the book, most recently lithium and lamictal. I stopped everything this past January after coming down with SJS and tried to do it au natural. Didn't work and went back on lithium and pharmaceutical grade St. John's Wort and was and was doing great, really good. But sleep has always been a problem, even with Ambien, and I thought to try Seroquel for sleep and any extra therapeutic protection against bipolar depression.
>
> I started with 12.5 mg 4 days ago and am crashing into a vegetative, yet agitated depression since. A very small amount, I know, but I'm tired and jaggy all day PLUS, it has not helped me sleep. I'm afraid to take more considering how strongly I've been affected. I am constantly hungry, hungry, hungry and have gained 7 pounds in 4 days. I just feel yicky, somewhat like my short trial of zyprexa.
>
> Chemist, you mention the histamine blockade with Seroquel. I'm reading that some of us can have disordered histadine/histamine production which can result in depression and paradoxical med effects. Also the affinity to a particular serotonin receptor you mentioned. Now, doesn't Seroquel work in part by reducing dopamine (which could by itself cause a lack of pleasure seeking activity) and doesn't it also reduce serotonin through the affinity with this receptor? I don't get this since reducing serotonin does not seem logical in light of it's touted antidepressant behavior. Reduced serotonin could also explain my haunting the cupboards and fridge prowling for sweets. Normally I could care less for cupcakes and brownies, but I drool at the thought, probably an attempt to increase serotonin. Any comments appreciated. In the meantime, I will drop Seroquel, go back on Ambien and note if I start feeling better. It will be a good test and I will post back with my progress which I hope improves. - BarbaraCat
>
> p.s. BTW, the www.psycheducation.org site is consistently fab, in my book.
hello there, chemist here.....seroquel is an antagonist for several serotonin, histamine, dopamine, and adrenergic receptors. an antagonist inhibits reuptake of the compound that ought to righfully be in the receptor, thus preventing the receptor from doing it's work. hence, you are keeping levels of all of these neurotransmitters high by using seroquel, because seroquel binds to the receptors more tightly than do the ``rightful owners,'' if you will. so actually seroquel acts as a pretty wide-spectrum drug. the extrapyramidal side effects (such as those related to movement) are caused by the same mechanism that the are in patients with Parkinson's disease, in that the dopamine system gets shut down (diminished, perhaps, is a better word) and there is only so much dopamine out in the brain (and this dopamine needs to be replenished and is not geting replenished, thus, movement disorders, among other things). a parting shot: low doses of seroquel make one quite drowsy. higher doses (200 mg-800 mg) are less sedating and more for use in treating psychoses. you might have better luck on 25 or 50 mg, strange as it may seem. please do let me know if your questions have been addressed satisfactorily, i will do my best to provide info should you need it...all the best, chemist
Posted by chemist on July 11, 2004, at 0:31:46
In reply to Re: Seroquel users: a couple of questions (HELP) » chemist, posted by cpallen79 on July 11, 2004, at 0:09:23
> Thank god for you chemist! I really appreciate your responses, they've been comforting. I was reading up on the net and was wondering if Trazodone can be used with an SSRI? I currently take Lexapro, Buspar, and Adderall. The Seroquel will be no more. Trazodone sounds like a potential opportunity but I've heard that one of it's metabolites (m-chlorophenylpiperazine) can build up in the blood and cause anxiety/panic. Same with Serzone too. Can it be taken in conjunction with an SSRI or am I asking for a panic attack? I'd love to give trazodone a try but i hate panic attacks, that's for sure.
hello there, chemist here....i'd be careful but not overly so if the trazodone/ssri is going to be used for sleep purposes. i do know that trazodone is a no-no in conjunction with serzone, yet serzone will be packing it's bags from the drugstore shelves soon. trazodone on its own is quite sedating, and the metabolite is not a heavy-hitter, from what i recall. now, you are taking a stimulant (adderall) and a rather ineffective (in my opinion) anxiolytic, buspar, in addition to an antidepressant, lexapro. my first suggestion is to consider discussing with your doctor dropping buspar and replacing it with a small dose (perhaps 1-2 mg qd) a benzo such as klonopin. my second suggestion is to lower your adderall intake a bit, as you are being overstimulated and the buspar cannot handle it. please be well, and keep us all posted if any of these suggestions are of help and, should you make the switch, if it is effective for you. trazodone really leaves one in a fog, you know, and it does have andi-depressant qualities (it is an atypical TCA), so adding that on along with another AD (lexapro) and your adderall would, i presume, lead to a queasy state of ``masked'' anxiety/panic. all the best, chemist
Posted by cpallen79 on July 11, 2004, at 2:04:06
In reply to Re: Seroquel users: a couple of questions (HELP) » cpallen79, posted by chemist on July 11, 2004, at 0:31:46
Hey Chemist, thanks for the follow up. You want to know something wierd? The adderall actually calms me down! It's when it wears off that I'm not as well. I guess it tends to have a paradoxical effect on us ADD'ers. The lexapro lifted me out of the depths of severe anxiety/agitation. To make a long story short, I had a nervous breakdown in February due to severe stress (my guard was also most likely down due to a painful effexor w/d that I went through about a month prior to the breakdown) and i went into a nasty agitated depression with what can only be described as akathisia symptoms. That's why I'm so frustrated by the seroquel setback, I never want to go back to that place again, and that akathisia felt alot like the agitated depression I've been battling to overcome. I'm hoping Trazodone will do the trick for a good night's sleep. My PDOC wants me to avoid Benzos because we have some nasty addiction issues in our family and I think everyone's weary enough of me taking a stimulatnt for A.D.D. Guess I'm not sure what to do...
Posted by BarbaraCat on July 11, 2004, at 2:48:41
In reply to Re: Seroquel users: a couple of questions (HELP) » chemist, posted by cpallen79 on July 11, 2004, at 2:04:06
Have you considered you might be BP-II? Your recurring agitated depression might warrant further investigation. Agitated dysphoric depression has been the bane of my life but I always thought I had unipolar depression and never considered it might be part of the bipolar spectrum. I'd always considered bipolar 'mania' as the classic grandiose mapcap stuff, not the panicked agitated mixed states hell I experienced or the irritibility and pissed-offness. I'd been on SSRI's for many many years and they worked fairly well, but then the agitated depression broke through big time. Kept increasing the SSRI, got twitchy akathisia from too much, got no relief from the agitated depression, fell apart, and ended up hospitalized. Through this board and other research and self-reflection it became clear that my symptoms were pretty classic BP-II. I've learned the hard way time and time again that if I don't take lithium, no matter what else I take I'll eventually descend into a bleak agitated hell.
The thing with bipolar is that during the manic phase my thoughts can get very disorganized and my behavior looks very much like ADD. In fact, there are definite overlaps between the two disorders. My self medicating drug of choice during my younger years was speed. But throughout the years, stress took a heavy toll and pstims now send me over the edge. I may have been ADD and unipolar depressed at first, but I can't help thinking that high dose SSRI's exacerbated a latent bipolar disorder.
Lithium has worked wonders for me, although it's not the best choice for everyone. A mood stabilizer is critical for anyone bipolar if they take an antidepressant. Otherwise, SSRI's can easily kindle an agitated depression. This might be old news to you but just thought I'd share this in case not. When I hear severe agitated depression, I immediately think 'dysphoric hypomania' and bipolar mixed states. Very uncomfortable stuff - oh I know it well and am soooooo grateful that lithium works for me. BTW, trazodone was a great med for me while it worked. Put me to sleep, helped my depression, a great antianxiety med. Hell to wake up on but after a few jumping jacks and a shower I was ready to go. The problem was that after a while it too stopped working, probably because I needed lithium. And it does slow you down during the day, but if you've got agitated depression, that's not a bad thing. One thing you might try is taking L-taurine which acts as a natural mood stabilizer and might even take the place of a prescription med. - BarbaraCat
> Hey Chemist, thanks for the follow up. You want to know something wierd? The adderall actually calms me down! It's when it wears off that I'm not as well. I guess it tends to have a paradoxical effect on us ADD'ers. The lexapro lifted me out of the depths of severe anxiety/agitation. To make a long story short, I had a nervous breakdown in February due to severe stress (my guard was also most likely down due to a painful effexor w/d that I went through about a month prior to the breakdown) and i went into a nasty agitated depression with what can only be described as akathisia symptoms. That's why I'm so frustrated by the seroquel setback, I never want to go back to that place again, and that akathisia felt alot like the agitated depression I've been battling to overcome. I'm hoping Trazodone will do the trick for a good night's sleep. My PDOC wants me to avoid Benzos because we have some nasty addiction issues in our family and I think everyone's weary enough of me taking a stimulatnt for A.D.D. Guess I'm not sure what to do...
Posted by cpallen79 on July 11, 2004, at 3:49:08
In reply to Re: Seroquel users: a couple of questions (HELP) » cpallen79, posted by BarbaraCat on July 11, 2004, at 2:48:41
Darn Barbara, I just submitted a long reply to this, but now it got lost, darn!
In answer to your question, we don't think it's BP because A.D.D. runs heavily in my family (no reported or apparent cases of BP tho), and my depression/anxiety have been responses to issues with pretty bad OCD and GAD- both of which also run in the family. Both depressions I've endured have been because of a major stress response to a crisis situation because of my obsessing. I definetely will not rule out Bipolar though. Luckily Lexapro has lifted some of my problems. Adderall also helps me be more collected and relaxed and I can concentrate better. I think I want to dump the buspar and go for trazodone instead though.
Posted by Sad Panda on July 11, 2004, at 11:48:25
In reply to Re: Seroquel users: a couple of questions (HELP) » chemist, posted by cpallen79 on July 11, 2004, at 2:04:06
I've believe that the antipsychotics have no place as sleep meds. Seroquel at low doses is a bit like Remeron at low doses in that it only binds to H1 receptors. If all you want is some H1 blockade, then dirt cheap Doxepin or OTC Benadryl are all you really need to pay for.
If Trazodone does the job, then I would recommend you try Nortriptyline. Traz gives sleep via 5-HT2A & Alpha-1 blockade, Nort does this and is a good norepinephrine reuptake inhibitor. It would replace Buspar with ease, possibly reduce your Aderall consumption, fit in very nicely with Lexapro & add some extra antidepressant effect of it's own.
Cheers,
Panda.
Posted by chemist on July 11, 2004, at 12:50:28
In reply to Re: Seroquel users: a couple of questions (HELP) » chemist, posted by cpallen79 on July 11, 2004, at 2:04:06
> Hey Chemist, thanks for the follow up. You want to know something wierd? The adderall actually calms me down! It's when it wears off that I'm not as well. I guess it tends to have a paradoxical effect on us ADD'ers. The lexapro lifted me out of the depths of severe anxiety/agitation. To make a long story short, I had a nervous breakdown in February due to severe stress (my guard was also most likely down due to a painful effexor w/d that I went through about a month prior to the breakdown) and i went into a nasty agitated depression with what can only be described as akathisia symptoms. That's why I'm so frustrated by the seroquel setback, I never want to go back to that place again, and that akathisia felt alot like the agitated depression I've been battling to overcome. I'm hoping Trazodone will do the trick for a good night's sleep. My PDOC wants me to avoid Benzos because we have some nasty addiction issues in our family and I think everyone's weary enough of me taking a stimulatnt for A.D.D. Guess I'm not sure what to do...
hello there, chemist here. i had suspected that the benzo was on the forbidden list, so to speak, and hence the trazodone. if the adderall and lexapro are working, great. i think you will find that the trazodone will do the trick for sleep, and you can back off a little bit on the adderall if you're still restless, as the adderall is pretty user-friendly, in my opinion. in any event, give it a shot, i am certain you will be just fine with trazodone - it's very sedating. all the best, chemist
Posted by chemist on July 11, 2004, at 12:53:46
In reply to Re: Seroquel users: a couple of questions (HELP) » cpallen79, posted by Sad Panda on July 11, 2004, at 11:48:25
> I've believe that the antipsychotics have no place as sleep meds. Seroquel at low doses is a bit like Remeron at low doses in that it only binds to H1 receptors. If all you want is some H1 blockade, then dirt cheap Doxepin or OTC Benadryl are all you really need to pay for.
>
> If Trazodone does the job, then I would recommend you try Nortriptyline. Traz gives sleep via 5-HT2A & Alpha-1 blockade, Nort does this and is a good norepinephrine reuptake inhibitor. It would replace Buspar with ease, possibly reduce your Aderall consumption, fit in very nicely with Lexapro & add some extra antidepressant effect of it's own.
>
> Cheers,
> Panda.
>
>
hello there, from chemist.....this is far more panda's territory than mine, i politely defer and suggest that you load up panda's in-box in re: this topic [sorry, panda, but that's what you get for being an expert:) ]....all the best, chemist
Posted by BarbaraCat on July 11, 2004, at 14:58:30
In reply to Re: Seroquel users: a couple of questions (HELP) » cpallen79, posted by Sad Panda on July 11, 2004, at 11:48:25
Got a burning question for you Panda. After my recent bad experience with Seroquel, I have to agree with you. AP's are a bit overkill if all one wants is to get some sleep, and who knows what else is brewing in the chemical soup. I'm very curious as to my extreme and immediate reaction. Very difficult waking up, much like when I was taking trazodone. I felt quite depressed and out of it the 4 days I was on 6.25 or 12.5 pm. Very lethargic but jittery at the same time.
My first thought was 'oh, I'm having a bad reaction to a reduction of dopamine - I need that dopamine'. Now, I realize that AP's reduce dopamine as part of their antipsychotic action, but I was under the impression Seroquel was not a heavy dopamine hitter. Also, none of these meds change neurotransmitter/receptor functionality that quickly, so dopamine doesn't seem a likely candidate. So perhaps the path is a similar 5Ht2-a blockade as w/trazodone and remeron, but we're still talking serotonin receptors and there's a lag time. It doesn't happen that quickly. My question is, is there also a histamine release which could account for the groggyness? Might this tie in with a possible dysfunction in my histamine levels? I haven't been tested for any of this but have been following the histadine/methylation theories. I'm also taking lithium and St. John's Wort (which is working surprisingly well). What could be at the root of the severe depression and restlessness I experienced immediately from Seroquel? After not taking it last night, I woke this morning fresh as a daisy and feeling sooooo much better. - Barbara
Posted by BarbaraCat on July 11, 2004, at 15:08:54
In reply to Re: Seroquel users: a couple of questions (HELP) » cpallen79, posted by Sad Panda on July 11, 2004, at 11:48:25
I loved nortriptyline. It was wonderful for severe anxiety, depression, and energy. Left me with appropriate emotional reponse, unlike the Stepford Wives Effect of SSRI's. Best AD I've ever had. Unfortunately, it caused extreme dryness and the constipation was becoming a real problem. I felt like I was becoming a prune - and I drink alot of water with the requisite electrolytes. I would have to say that it is not a sleep med, however. It gives a nice of jolt of NE which is quite smooth, but definitely energizing. Traz defintely has my vote for sleep, tryp for waking.
> If Trazodone does the job, then I would recommend you try Nortriptyline. Traz gives sleep via 5-HT2A & Alpha-1 blockade, Nort does this and is a good norepinephrine reuptake inhibitor. It would replace Buspar with ease, possibly reduce your Aderall consumption, fit in very nicely with Lexapro & add some extra antidepressant effect of it's own.
>
> Cheers,
> Panda.
>
>
Posted by BarbaraCat on July 11, 2004, at 15:25:38
In reply to Re: Seroquel users: a couple of questions (HELP) » BarbaraCat, posted by cpallen79 on July 11, 2004, at 3:49:08
Hi,
I also responded to Sad Panda's response to you and I second his suggestion. Nortryptaline is a very good antidepressant. I was surprised, thinking it was an 'old' one and not as effective as the 'new' ones. It helped me in every way, considering I was going through a terrible time. A year ago Christmas season my Mom was hit by a car while out for a walk and died 4 days later. It was an awful time and I was losing it to panic, disintegration, despair... well, you can imagine. Nortryp lifted me out of this frightening place where I could grieve appropriately, and I will bless it forever. The side effects were too much for me, unfortuntely, but I'm alot more sensitive to se's that don't normally bother other people. It's worth a try if you feel like considering another med. Certainly better than Buspar which made me feel icky. - BCat> Darn Barbara, I just submitted a long reply to this, but now it got lost, darn!
> In answer to your question, we don't think it's BP because A.D.D. runs heavily in my family (no reported or apparent cases of BP tho), and my depression/anxiety have been responses to issues with pretty bad OCD and GAD- both of which also run in the family. Both depressions I've endured have been because of a major stress response to a crisis situation because of my obsessing. I definetely will not rule out Bipolar though. Luckily Lexapro has lifted some of my problems. Adderall also helps me be more collected and relaxed and I can concentrate better. I think I want to dump the buspar and go for trazodone instead though.
Posted by cpallen79 on July 11, 2004, at 21:09:03
In reply to Re: Seroquel users: a couple of questions (HELP) » cpallen79, posted by BarbaraCat on July 11, 2004, at 15:25:38
Hey Barbara Cat- I agree about Buspar, It's dreadful and I'm going to taper off of the garbage, which I think my PDoc will want to kill me for... all it does is make me dizzy and agitated.
Posted by cpallen79 on July 11, 2004, at 21:12:53
In reply to Re: Seroquel users: a couple of questions (HELP) » cpallen79, posted by Sad Panda on July 11, 2004, at 11:48:25
Panda, thank you very much for your reply. I called my PDOC today, an absolute mess from the Seroquel still sitting in my system from Saturday... the restlessness alone was causing me panic. We're going to up my lexapro, add in trazodone, and she even offred me Ativan, which I accepted but will use very sparingly. I also plan on getting off that darn Buspar as it can interfere with Trazodone and all it does is make me dizzy, blah.
Cheers,
Chris
Posted by Sad Panda on July 12, 2004, at 11:02:43
In reply to read this one, y'all... » Sad Panda, posted by chemist on July 11, 2004, at 12:53:46
> > I've believe that the antipsychotics have no place as sleep meds. Seroquel at low doses is a bit like Remeron at low doses in that it only binds to H1 receptors. If all you want is some H1 blockade, then dirt cheap Doxepin or OTC Benadryl are all you really need to pay for.
> >
> > If Trazodone does the job, then I would recommend you try Nortriptyline. Traz gives sleep via 5-HT2A & Alpha-1 blockade, Nort does this and is a good norepinephrine reuptake inhibitor. It would replace Buspar with ease, possibly reduce your Aderall consumption, fit in very nicely with Lexapro & add some extra antidepressant effect of it's own.
> >
> > Cheers,
> > Panda.
> >
> >
> hello there, from chemist.....this is far more panda's territory than mine, i politely defer and suggest that you load up panda's in-box in re: this topic [sorry, panda, but that's what you get for being an expert:) ]....all the best, chemist
>
>Thanks Chemist, but I'm not an expert, I'm just a nosey parker with an opinion. :) If Seroquel blows your hair back, then that's fine with me & it does have less chance of causing weight gain than Zyprexa, Remeron & probably the sedating TCA's.
Cheers,
Panda.
Posted by Sad Panda on July 12, 2004, at 11:09:35
In reply to Nortryp and traz, posted by BarbaraCat on July 11, 2004, at 15:08:54
> I loved nortriptyline. It was wonderful for severe anxiety, depression, and energy. Left me with appropriate emotional reponse, unlike the Stepford Wives Effect of SSRI's. Best AD I've ever had. Unfortunately, it caused extreme dryness and the constipation was becoming a real problem. I felt like I was becoming a prune - and I drink alot of water with the requisite electrolytes. I would have to say that it is not a sleep med, however. It gives a nice of jolt of NE which is quite smooth, but definitely energizing. Traz defintely has my vote for sleep, tryp for waking.
>You are probably right about Nort not being a sleep med, but it maybe just enough for a lot of people & can kill alot of birds with one stone.
Cheers,
Panda.
Posted by Sad Panda on July 12, 2004, at 11:23:40
In reply to Re: Seroquel users: a couple of questions (HELP) » Sad Panda, posted by BarbaraCat on July 11, 2004, at 14:58:30
> Got a burning question for you Panda. After my recent bad experience with Seroquel, I have to agree with you. AP's are a bit overkill if all one wants is to get some sleep, and who knows what else is brewing in the chemical soup. I'm very curious as to my extreme and immediate reaction. Very difficult waking up, much like when I was taking trazodone. I felt quite depressed and out of it the 4 days I was on 6.25 or 12.5 pm. Very lethargic but jittery at the same time.
>
> My first thought was 'oh, I'm having a bad reaction to a reduction of dopamine - I need that dopamine'. Now, I realize that AP's reduce dopamine as part of their antipsychotic action, but I was under the impression Seroquel was not a heavy dopamine hitter. Also, none of these meds change neurotransmitter/receptor functionality that quickly, so dopamine doesn't seem a likely candidate. So perhaps the path is a similar 5Ht2-a blockade as w/trazodone and remeron, but we're still talking serotonin receptors and there's a lag time. It doesn't happen that quickly. My question is, is there also a histamine release which could account for the groggyness? Might this tie in with a possible dysfunction in my histamine levels? I haven't been tested for any of this but have been following the histadine/methylation theories. I'm also taking lithium and St. John's Wort (which is working surprisingly well). What could be at the root of the severe depression and restlessness I experienced immediately from Seroquel? After not taking it last night, I woke this morning fresh as a daisy and feeling sooooo much better. - Barbara
>
>Seroquel block Alpha-1 NE receptors the most, so I would possibly blame that. Coming in a close second is it's H1 blockade. At low doses I would say that's all it does as the next receptor is blocks is actually M1, so you'd probably notice a little dry mouth & constipation before 5-HT2A & D2 blockade ever comes to the party.
On this page is a pretty good table showing the differences: http://www.vh.org/adult/provider/psychiatry/CPS/04.html#table2
Cheers,
Panda.
Posted by Sad Panda on July 12, 2004, at 11:28:56
In reply to Re: Seroquel users: a couple of questions (HELP) » Sad Panda, posted by cpallen79 on July 11, 2004, at 21:12:53
> Panda, thank you very much for your reply. I called my PDOC today, an absolute mess from the Seroquel still sitting in my system from Saturday... the restlessness alone was causing me panic. We're going to up my lexapro, add in trazodone, and she even offred me Ativan, which I accepted but will use very sparingly. I also plan on getting off that darn Buspar as it can interfere with Trazodone and all it does is make me dizzy, blah.
> Cheers,
> Chris
>
>Hi Chris,
Sounds like a good plan. Traz will probably give you a little dizziness too. It has a 12 hour half life, so you should be OK in the morning, but a lot of people say it gives them morning groginess, so I would start on a small dose & take it early just in case.
Cheers,
Panda.
Posted by BarbaraCat on July 12, 2004, at 12:00:08
In reply to Re: Seroquel users: a couple of questions (HELP) » Sad Panda, posted by cpallen79 on July 11, 2004, at 21:12:53
Chris,
A little word to the wise from a former traz user. It will definitely make you groggy, extremely woozy. So yes, start very low, 10mg is not too low to start. For sleep, I never went above 50mg. For depression I was up to 200mg at one time.The groggyness is severe for the first few days and you'll just have to live with it for a short while. The morning groggyness never completely goes away and it was always a challenge for me, who is never a 'wake up and jump out of bed' kind of person. You'll have to make yourself get up but then you'll feel like you need to lie down again just to get over the woozyness. The way to beat it is to FORCE yourself out of bed and then immediately do some situps and pushups, whatever you can manage, to get some adrenaline and deep breathing going and some muscle engagement. Then take a shower and it will be gone. It's also a great incentive for getting those 6-pack abs.
But it's worth it. Traz saved my life at a time when I was very depressed and anxious. I used it for years as an AD and then at a lower dose as a sleeper. I don't understand why it's not used more. Good luck.
Posted by BarbaraCat on July 12, 2004, at 12:01:46
In reply to Re: Seroquel users: a couple of questions (HELP) » BarbaraCat, posted by Sad Panda on July 12, 2004, at 11:23:40
Thank you, thank you! That link is exactly what I've been looking for! - Barbara
> > Got a burning question for you Panda. After my recent bad experience with Seroquel, I have to agree with you. AP's are a bit overkill if all one wants is to get some sleep, and who knows what else is brewing in the chemical soup. I'm very curious as to my extreme and immediate reaction. Very difficult waking up, much like when I was taking trazodone. I felt quite depressed and out of it the 4 days I was on 6.25 or 12.5 pm. Very lethargic but jittery at the same time.
> >
> > My first thought was 'oh, I'm having a bad reaction to a reduction of dopamine - I need that dopamine'. Now, I realize that AP's reduce dopamine as part of their antipsychotic action, but I was under the impression Seroquel was not a heavy dopamine hitter. Also, none of these meds change neurotransmitter/receptor functionality that quickly, so dopamine doesn't seem a likely candidate. So perhaps the path is a similar 5Ht2-a blockade as w/trazodone and remeron, but we're still talking serotonin receptors and there's a lag time. It doesn't happen that quickly. My question is, is there also a histamine release which could account for the groggyness? Might this tie in with a possible dysfunction in my histamine levels? I haven't been tested for any of this but have been following the histadine/methylation theories. I'm also taking lithium and St. John's Wort (which is working surprisingly well). What could be at the root of the severe depression and restlessness I experienced immediately from Seroquel? After not taking it last night, I woke this morning fresh as a daisy and feeling sooooo much better. - Barbara
> >
> >
>
> Seroquel block Alpha-1 NE receptors the most, so I would possibly blame that. Coming in a close second is it's H1 blockade. At low doses I would say that's all it does as the next receptor is blocks is actually M1, so you'd probably notice a little dry mouth & constipation before 5-HT2A & D2 blockade ever comes to the party.
>
> On this page is a pretty good table showing the differences: http://www.vh.org/adult/provider/psychiatry/CPS/04.html#table2
>
> Cheers,
> Panda.
>
Posted by cpallen79 on July 12, 2004, at 12:11:59
In reply to Re: Seroquel users: a couple of questions (HELP) » BarbaraCat, posted by Sad Panda on July 12, 2004, at 11:23:40
Hi Panda, I was taking a tiny dose of Seroquel for sleep and a dab during the dayfor anxiety. I did well at first, but then after about a week I became very very restless and my anxiety levels really increased. Was this akathisia? I stopped takign the Seroquel Saturday but still have not felt well, what in the world happened?
Posted by Sad Panda on July 12, 2004, at 13:33:49
In reply to Re: Seroquel users: a couple of questions (HELP) » BarbaraCat, posted by Sad Panda on July 12, 2004, at 11:23:40
> > Got a burning question for you Panda. After my recent bad experience with Seroquel, I have to agree with you. AP's are a bit overkill if all one wants is to get some sleep, and who knows what else is brewing in the chemical soup. I'm very curious as to my extreme and immediate reaction. Very difficult waking up, much like when I was taking trazodone. I felt quite depressed and out of it the 4 days I was on 6.25 or 12.5 pm. Very lethargic but jittery at the same time.
> >
> > My first thought was 'oh, I'm having a bad reaction to a reduction of dopamine - I need that dopamine'. Now, I realize that AP's reduce dopamine as part of their antipsychotic action, but I was under the impression Seroquel was not a heavy dopamine hitter. Also, none of these meds change neurotransmitter/receptor functionality that quickly, so dopamine doesn't seem a likely candidate. So perhaps the path is a similar 5Ht2-a blockade as w/trazodone and remeron, but we're still talking serotonin receptors and there's a lag time. It doesn't happen that quickly. My question is, is there also a histamine release which could account for the groggyness? Might this tie in with a possible dysfunction in my histamine levels? I haven't been tested for any of this but have been following the histadine/methylation theories. I'm also taking lithium and St. John's Wort (which is working surprisingly well). What could be at the root of the severe depression and restlessness I experienced immediately from Seroquel? After not taking it last night, I woke this morning fresh as a daisy and feeling sooooo much better. - Barbara
> >
> >
>
> Seroquel block Alpha-1 NE receptors the most, so I would possibly blame that. Coming in a close second is it's H1 blockade. At low doses I would say that's all it does as the next receptor is blocks is actually M1, so you'd probably notice a little dry mouth & constipation before 5-HT2A & D2 blockade ever comes to the party.
>
> On this page is a pretty good table showing the differences: http://www.vh.org/adult/provider/psychiatry/CPS/04.html#table2
>
> Cheers,
> Panda.
>Ooops, Ignore what I said about Seroquel probably causing antimuscarinic dry mouth & constipation. Most other websites say it doesn't block M1.
Cheers,
Panda.
Posted by Sad Panda on July 12, 2004, at 13:51:08
In reply to Re: Seroquel users: a couple of questions (HELP) » Sad Panda, posted by cpallen79 on July 12, 2004, at 12:11:59
> Hi Panda, I was taking a tiny dose of Seroquel for sleep and a dab during the dayfor anxiety. I did well at first, but then after about a week I became very very restless and my anxiety levels really increased. Was this akathisia? I stopped takign the Seroquel Saturday but still have not felt well, what in the world happened?
>
>Possibly, Akathesia is said to be a feeling of inner agitation which makes you fidgety & unable to sit still. Perhaps there was a drug interaction involved? Some drugs can raise the levels of other drugs & vice versa if they share the same liver enzyme. It's an ideal question for Chemist. :)
Cheers,
Panda.
Posted by cpallen79 on July 12, 2004, at 14:22:05
In reply to Sounds like a question for CHEMIST!, posted by Sad Panda on July 12, 2004, at 13:51:08
Hi Chemist, what do you think?
I currently take 12.5 MGs of Lexapro, 15mgs of Buspar, and was also starting to take 7.5 mgs of immediate release adderall (was adderall taking XR before). The reason I went on meds was for anxious depression, OCD, and ADD. things had gotten a bit better (but still had problems with hypervigilance, etc... from anxiety), but then i added in Seroquel. After starting that Seroquel,I did well for about a week, but then I slowly began to notice nighttime agitation and restlessnes... it got worse and worse until I felt like I was back in a high anxiety state. I feel like the cast put on me for my "broken brain" was stripped off and rebroken! I still do not feel well, I stopped taking the Seroquel on Saturday. I'm so upset as I feel like any progress I made went right down the tubes. Maybe it's just me, I think I put alot of hope in the Seroquel for a good night's sleep, and my hopes were dashed, thus sending me into panic mode. Another time this occurred was when I tried to increase my Buspar, I felt so agitated, restless, and panicky that had to drop back down to the lower dose. I've been at this for months and I feel so discouraged, I jsut want a day to come where I peacefully wake up, look around, and say "what a great day!"
> > Hi Panda, I was taking a tiny dose of Seroquel for sleep and a dab during the dayfor anxiety. I did well at first, but then after about a week I became very very restless and my anxiety levels really increased. Was this akathisia? I stopped takign the Seroquel Saturday but still have not felt well, what in the world happened?
> >
> >
>
> Possibly, Akathesia is said to be a feeling of inner agitation which makes you fidgety & unable to sit still. Perhaps there was a drug interaction involved? Some drugs can raise the levels of other drugs & vice versa if they share the same liver enzyme. It's an ideal question for Chemist. :)
>
> Cheers,
> Panda.
>
Posted by BarbaraCat on July 12, 2004, at 14:47:30
In reply to Re: Sounds like a question for CHEMIST!, posted by cpallen79 on July 12, 2004, at 14:22:05
HI Chris,
Let's pursue this one. I'm right there with ya and will post a separate question to Chemist. In the meantime, have you tried Ambien for sleep? It's what I'm currently on and find it very helpful. I have fibromyalgia along with bipolar depression and I NEED my sleep and can't take anything that interferes with Stage IV delta sleep. Ambien is great for this and there is absolutely no hangover. It does occasionally poop and I have to take more, but it hasn't been a problem.As with your experience, my recent foray into Seroquel was a nightmare, but a real good clue into what my personal chemistry is doing. It might have something to do with histamines. Keep you posted on anything interesting I dig up. - Barbara
Posted by chemist on July 12, 2004, at 14:48:13
In reply to Re: read this one, y'all... » chemist, posted by Sad Panda on July 12, 2004, at 11:02:43
> > > I've believe that the antipsychotics have no place as sleep meds. Seroquel at low doses is a bit like Remeron at low doses in that it only binds to H1 receptors. If all you want is some H1 blockade, then dirt cheap Doxepin or OTC Benadryl are all you really need to pay for.
> > >
> > > If Trazodone does the job, then I would recommend you try Nortriptyline. Traz gives sleep via 5-HT2A & Alpha-1 blockade, Nort does this and is a good norepinephrine reuptake inhibitor. It would replace Buspar with ease, possibly reduce your Aderall consumption, fit in very nicely with Lexapro & add some extra antidepressant effect of it's own.
> > >
> > > Cheers,
> > > Panda.
> > >
> > >
> > hello there, from chemist.....this is far more panda's territory than mine, i politely defer and suggest that you load up panda's in-box in re: this topic [sorry, panda, but that's what you get for being an expert:) ]....all the best, chemist
> >
> >
>
> Thanks Chemist, but I'm not an expert, I'm just a nosey parker with an opinion. :) If Seroquel blows your hair back, then that's fine with me & it does have less chance of causing weight gain than Zyprexa, Remeron & probably the sedating TCA's.
>
> Cheers,
> Panda.
>
>
>
well, your nose is deeper in the flora than mine, and i have a lousy track record with providing useful and/or factual info on certain meds....thus, you and SLS and King Vultan and Larry are getting the buck passed your way :).....cheers to you too, chemist
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