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Re: Seroquel for anxiety? » kaleidoscope

Posted by yxibow on November 30, 2007, at 5:05:32

In reply to Re: Seroquel for anxiety? » banga, posted by kaleidoscope on November 25, 2007, at 13:10:24

> Hi Banga
>
> Nice to see you again :)
>
> Seroquel has a longer duration of action than you would expect from its short half life. Daytime drowsiness is common even when it's taken as a single (small) dose in the evening.
>
> High doses of Seroquel are generally needed for psychosis eg. at least 300mg per day. Very low doses eg. 25mg at night may have a similar effect to taking a sedating antihistamine such as Atarax/Vistaril.
>
> Seroquel is an expensive drug which frequently causes weight gain. I would not advocate taking an antipsychotic solely for anxiety unless other treatments had been tried first and failed. Side effects are very common and there is very little high quality evidence to support the effectiveness of APs in primary anxiety disorders. If insomnia is caused by anxiety, long term treatment of the anxiety (eg. with an SSRI) can be combined with short term and/or intermittent use of a hypnotic eg. temazepam or zolpidem.
>
>

Seroquel and Zyprexa are unique in how low their minimum effective dose is vs. possible long term side effects in the population. Zyprexa actually is lower in weight gain for me and caused weight loss but for its semi-permanent EPS can't use it.
200mg is possible for Seroquel in some patients.

I would always agree in limiting AP use but there are some cases that warrant as there are few antidepressants (Trazodone, Serzone, high dose Remeron, the antihistamine cyproheptadine), etc, that have a multi-subtransmitter blockade at 5HT2.

 

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