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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by LouF on February 13, 2001, at 9:25:04
Ever since I started Seroquel about 4-5 months ago, I've not had a period. My OB-GYN said, "What's Seroquel?" and mypdoc said, "so what?" I'm to see the OB/GYN today...if the hormone levels are off, is this likely due to the Seroquel or to menopause (I'm in my late 40's)? How do I figure out which (or whether both) are going on? Thanks!--Louf
Posted by Cam W. on February 13, 2001, at 11:17:38
In reply to Cam--Seroquel effect on hormones?, posted by LouF on February 13, 2001, at 9:25:04
Lou - Prolactin increases seen in most of the older neuroleptics and occasionally in higher dose atypical antipsychotics seems to be due to the level of binding to dopamine-2 (D2) receptors. Seroquel binds to D2 receptors at a very low level (similar to Clozaril, which also does not increase prolactin levels). Therefore, the risk of menstrual problems via prolactin elevation by Seroquel is low (but not totally impossible).
Are you taking any other medication other than Seroquel? Other medications, which could have been causing borderline prolactin elevations could have further elevations when Seroquel is added. Still, I think that this is unlikely.
It could be a combination of the drug and your body (ie onset of menopause). This could be possible, especially if early menopause runs in your family.
So, to answer your question is one, the other, or both. The Seroquel, even though it binds very loosely to D2 receptors, may have been just enough to block those D2 receptors and elevating prolactin levels from a borderline state to an active state of hormonal change.
The only way to tell would be to go off your Seroquel (**which I would "definitely" advise against if it is working for your symptoms**) to see if your menstruation returns. This is something that you'd have to discuss with both docs.
This is one of those times that YOU have to make an informed choice. If the Seroquel is working, I'd be inclined to keep taking it (if it ain't broke, don't fix it), but that is my personal opinion. This is your body. Again, the chance of the menstrual changes being caused by Seroquel is very low (but not impossible). Talk to the docs and get their opinions.
Also, ask the docs to speak to each other on this. It is always nice when the whole treatment team is on the same page.
I hope this is of some help - Cam
Posted by LouF on February 14, 2001, at 0:23:41
In reply to Re: Cam--Seroquel effect on hormones? » LouF, posted by Cam W. on February 13, 2001, at 11:17:38
> Lou - Prolactin increases seen in most of the older neuroleptics and occasionally in higher dose atypical antipsychotics seems to be due to the level of binding to dopamine-2 (D2) receptors. Seroquel binds to D2 receptors at a very low level (similar to Clozaril, which also does not increase prolactin levels). Therefore, the risk of menstrual problems via prolactin elevation by Seroquel is low (but not totally impossible).
>
> Are you taking any other medication other than Seroquel? Other medications, which could have been causing borderline prolactin elevations could have further elevations when Seroquel is added. Still, I think that this is unlikely.
>
> It could be a combination of the drug and your body (ie onset of menopause). This could be possible, especially if early menopause runs in your family.
>
> So, to answer your question is one, the other, or both. The Seroquel, even though it binds very loosely to D2 receptors, may have been just enough to block those D2 receptors and elevating prolactin levels from a borderline state to an active state of hormonal change.
>
> The only way to tell would be to go off your Seroquel (**which I would "definitely" advise against if it is working for your symptoms**) to see if your menstruation returns. This is something that you'd have to discuss with both docs.
>
> This is one of those times that YOU have to make an informed choice. If the Seroquel is working, I'd be inclined to keep taking it (if it ain't broke, don't fix it), but that is my personal opinion. This is your body. Again, the chance of the menstrual changes being caused by Seroquel is very low (but not impossible). Talk to the docs and get their opinions.
>
> Also, ask the docs to speak to each other on this. It is always nice when the whole treatment team is on the same page.
>
> I hope this is of some help - CamCam, am also taking Effexor-XR 375 mg/day, Serzone 75 mg/day, and Entex (decongestant). Another fact I forgot to mention is that I had hormone levels checked in August, and they were all NORMAL. I stopped having periods as soon as I started the Seroquel (l50 mg/night). After no menstrual irregularities (I've never even had cramps!), I had five months with no periods, with pretty much no other symptoms of menopause (except for feeling hot sometimes, which wasn't a big deal). Have already cut it in half and will try discontinuing it (will talk to my pdoc but can't get in to see him for another 4 weeks; I'd rather not be able to sleep than mess up my body and throw myself into early menopause!). Thank you for the feedback!!! My ob/gyn today said I have "total ovarian failure" which makes me feel bad since I don't even have any kids yet and hate to see my option cut off forever. The ob/gyn wanted me to start taking estrogen and progesterone replacement, but I'm holding off until I try decreasing and/or discontinuing the Seroquel. I started the Seroquel to help with sleep. (I'll try melatonin again instead I guess.) It's possible my body was going to go through menopause anyway, so that timing was accidental, but I'm just not convinced. Anyway, thanks!!! I'll keep you posted.--Lou (feeling very much like an "old" person!)
Posted by Cam W. on February 14, 2001, at 7:07:40
In reply to Re: Cam--Seroquel effect on hormones?, posted by LouF on February 14, 2001, at 0:23:41
Lou - •Do tell your pdoc• that you are stopping the Seroquel and starting melatonin. Everyone needs to be on the same page. Did the Ob/Gyn have an opinion on this? After all it might not be the Seroquel; even though it looks like a skunk, talks like a skunk and even smells like a skunk; it could be an old boyfriend. The Seroquel dose you are taking is fairly low (but is an adequate augmenting dose), which further leaves me to believe that it is not the Seroquel causing these problems.
I am not sure if melatonin interacts with your other med, either, but there is a remote possibility. Do the stopping of the Seroquel to ease your mind, BUT do it while being watched over by a doc. At least give the pdoc a call before stopping.
As for hormone replacement therapy (HRT), it couldn't hurt in a cases like this. Like you, I'd like to factor out all other possibilities, but do have an objective eye (ie your docs) watch over any decision you make. That way they can watch for any potential problems that may arise. Most times we cannot notice changes in ourselves, that are obvious to others, especially a trained eye.
Hang in there with the Seroquel, because really, it is only 4 more weeks out of 40 years. Hell, you're not old, just 'experienced'.
Good luck with your decision - but phone your damn pdoc ;^)
- Cam
Posted by LouF on February 14, 2001, at 23:46:09
In reply to Re: Cam--Seroquel effect on hormones? » LouF, posted by Cam W. on February 14, 2001, at 7:07:40
> Lou - •Do tell your pdoc• that you are stopping the Seroquel and starting melatonin. Everyone needs to be on the same page. Did the Ob/Gyn have an opinion on this? After all it might not be the Seroquel; even though it looks like a skunk, talks like a skunk and even smells like a skunk; it could be an old boyfriend. The Seroquel dose you are taking is fairly low (but is an adequate augmenting dose), which further leaves me to believe that it is not the Seroquel causing these problems.
>
> I am not sure if melatonin interacts with your other med, either, but there is a remote possibility. Do the stopping of the Seroquel to ease your mind, BUT do it while being watched over by a doc. At least give the pdoc a call before stopping.
>
> As for hormone replacement therapy (HRT), it couldn't hurt in a cases like this. Like you, I'd like to factor out all other possibilities, but do have an objective eye (ie your docs) watch over any decision you make. That way they can watch for any potential problems that may arise. Most times we cannot notice changes in ourselves, that are obvious to others, especially a trained eye.
>
> Hang in there with the Seroquel, because really, it is only 4 more weeks out of 40 years. Hell, you're not old, just 'experienced'.
>
> Good luck with your decision - but phone your damn pdoc ;^)
> - CamCam, I'll phone my pdoc, but have (as of tonight) stopped the Seroquel completely. Funny, I've stopped peeing myself (I would come home from shopping, start to open the door or take the groceries out of the car, and would stand there and pee myself totally and couldn't stop it! Also, I've already stopped peeing myself in my sleep. I know those are side effects from the Seroquel. I wish I could keep taking it, and will resume it if stopping it doesn't seem to bring back my periods or hormone levels, because on Seroquel, I've slept better than I've ever slept in my whole life. Plus, I know I am less anxious and think much more clearly on Seroquel. Will keep you posted, and yes, I'll call my pdoc! Thank you very very much for your help. (I don't think the OB/GYN knows anything about psych meds, and the pdoc doesn't know anything about hormones plus he's a guy and doesn't care).--Lou
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