Posted by ed_uk on April 27, 2005, at 7:40:38
In reply to Re: seroquel, posted by alienatari on April 27, 2005, at 1:48:30
Hi Alien!
>When I would take it my throat would close up and make it hard to breathe and swallow.
It *might* have been an allergy (angioedema) but..........
It could have been a laryngeal-pharyngeal dystonia ie. a drug-induced spasm of the muscles in the throat or laynx.
If necessary, antipsychotic-induced dystonic reactions can be treated symptomatically with an anticholinergic drug such as procyclidine. Dystonic reactions tend to be dose-related, a smaller dose of Seroquel might have provided equivalent efficacy without causing such side effects.
On the other hand, allergic reactions are rarely dose-related ie. they can occur even at minute doses. If this particular side effect appeared soon after starting treatment with Seroquel, and was accompanied by other symptoms such as rash/itching, it was probably an allergy. If it only appeared after the dose was increased to a high level and was not accompanied by other symptoms (rash, itching, wheezing, swelling of the lips and face, fainting), it was probably a dystonia. Also, if the symptoms were ONLY present shortly after taking a dose (ie. when the blood concentration of Seroquel was particularly high), it was probably a dystonia. If you were having an allergic reaction, the symptoms would almost certainly have been present throughout the day. A physician could have examined the inside of your mouth to detect angioedema (an allergy).
If a laryngeal-pharyngeal dystonia is severe, it can compromise the airway- it can be life threatening. I can see why your doctor was concerned. On the other hand, acute dystonias are often very responsive to anticholinergics.
Rarely, after long term treatment with an antipsychotic, laryngeal-pharyngeal dystonias can occur/emerge as a variant of tardive dyskinesia. In this case, the difficulties associated with breathing and swallowing would have persisted after withdrawal of the antipsychotic.
The fact that you *may* have experienced a dystonia due to Seroquel suggests that you are very sensitive to the extrapyramidal (motor) side effects of antipsychotics. Seroquel is considerably less likly to cause dystonias than most antipsychotics. If I were you, I would avoid taking any antipsychotics in future unless it was clearly necessary (due to the absense of an alternative). I think you said that you have symptoms of tardive dyskinesia atm, I expect that these symptoms will improve if you avoid taking antipsychotics in future. You are young (AFAIK), and so your TD is likely to improve in time.
If you do need to take Seroquel in future, it would be particularly important to find the minimum effective dose. It's such a shame that you had side effects when it was working so well for you :-(
Kind regards,
Ed.
poster:ed_uk
thread:489880
URL: http://www.dr-bob.org/babble/20050423/msgs/490251.html