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Dr. Bob is Robert Hsiung, MD,
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Posted by Cindy W on October 14, 2000, at 22:32:49
Does anybody know what action Seroquel has, in combination with AD's such as Effexor-XR and Serzone? Am taking Serzone l00-l50 mg/night now, and it really helps with sleep, but I don't notice anything else really happening, except for maybe feeling a ilttle calmer and thinking a little more clearly. Have been reading a couple of paperbacks I got about psychopharmacology, but they don't address Seroquel, and I haven't seen anything about its use with OCD or depression, just as an antipsychotic. I don't THINK I'm crazy, but I suspect some people would disagree < g >. Also, does anybody know if Clozaril has ever been tried with people with OCD? I read that it affects serotonin (HT2) primarily and wonder about its utility as an AD or anti-obsessive med. ?? Thanks!--Cindy W
Posted by Cam W. on October 18, 2000, at 19:48:06
In reply to Seroquel--Cam and others, posted by Cindy W on October 14, 2000, at 22:32:49
Cindy - The reason you don't find much on the use of Seroquel™ (quetiapine) in depression or OCD is that these are not "approved" uses of the drug. Seroquel is only approved for use in schizophrenia. This is the disorder that was treated when the drug company did the clinical trials for Seroquel. Seroquel was "proved" to work in decreasing the symptoms of schizophrenia.
Using Seroquel in unapproved disorders ("off-label" use) is discouraged by the FDA (and Health Canada), but is frequently done by the experts (ie psychiatrists), more so than by GPs. Another example of the "off-label" use of a drug is Topamax™ (topiramate) as a mood stabilizer, when it is only approved to be used in epilepsy.
I have not seen Seroquel used as an adjunct in depression or OCD, but since Zyprexa™ (olanzapine) and Risperdal™ (risperidone) are used in certain subsets of depressions (atypical, psychotic, treatment-resistant depressions, etc.) and both of these drugs have decreased the number of obsessions and compulsions in a number of people with OCD. Therefore, your doc probably thinks that Seroquel, having a similar mechanism of action as Zyprexa and Risperdal, should work in some people with treatment-resistant depression or OCD.
The atypical antipsychotics and the newer antidepressants should really be called "mood modifiers". Zyprexa was recently approved for use as an antimanic agent in bipolar disorder. Zyprexa was initially shown to work by doctors using the Zyprexa for treating the "off-label" indication of mania. Clinical trials to prove it's efficacy as an antimanic agent were then done by the drug company. The drug company proved to the FDA that it worked as an antimanic drug and the FDA approved Zyprexa for this use (indication).
I have seen both Zyprexa and Risperdal used to augment Effexor, but not Serzone (that doesn't mean that it is not done, just that I haven't personally seen it). There should be no reason that Seroquel couldn't be used to augment these antidepressants. Seroquel has relatively few side effects and really doesn't interact with other meds to any significant extent. It's worth a try. Give the Seroquel at least 8 weeks for full effect (sometimes longer for resistant OCD symptoms).
Hope this helps - Cam
Posted by Cindy W on October 21, 2000, at 12:24:48
In reply to Re: Seroquel--Cam and others » Cindy W, posted by Cam W. on October 18, 2000, at 19:48:06
> Cindy - The reason you don't find much on the use of Seroquel™ (quetiapine) in depression or OCD is that these are not "approved" uses of the drug. Seroquel is only approved for use in schizophrenia. This is the disorder that was treated when the drug company did the clinical trials for Seroquel. Seroquel was "proved" to work in decreasing the symptoms of schizophrenia.
>
> Using Seroquel in unapproved disorders ("off-label" use) is discouraged by the FDA (and Health Canada), but is frequently done by the experts (ie psychiatrists), more so than by GPs. Another example of the "off-label" use of a drug is Topamax™ (topiramate) as a mood stabilizer, when it is only approved to be used in epilepsy.
>
> I have not seen Seroquel used as an adjunct in depression or OCD, but since Zyprexa™ (olanzapine) and Risperdal™ (risperidone) are used in certain subsets of depressions (atypical, psychotic, treatment-resistant depressions, etc.) and both of these drugs have decreased the number of obsessions and compulsions in a number of people with OCD. Therefore, your doc probably thinks that Seroquel, having a similar mechanism of action as Zyprexa and Risperdal, should work in some people with treatment-resistant depression or OCD.
>
> The atypical antipsychotics and the newer antidepressants should really be called "mood modifiers". Zyprexa was recently approved for use as an antimanic agent in bipolar disorder. Zyprexa was initially shown to work by doctors using the Zyprexa for treating the "off-label" indication of mania. Clinical trials to prove it's efficacy as an antimanic agent were then done by the drug company. The drug company proved to the FDA that it worked as an antimanic drug and the FDA approved Zyprexa for this use (indication).
>
> I have seen both Zyprexa and Risperdal used to augment Effexor, but not Serzone (that doesn't mean that it is not done, just that I haven't personally seen it). There should be no reason that Seroquel couldn't be used to augment these antidepressants. Seroquel has relatively few side effects and really doesn't interact with other meds to any significant extent. It's worth a try. Give the Seroquel at least 8 weeks for full effect (sometimes longer for resistant OCD symptoms).
>
> Hope this helps - CamCam, thank you!!!-Cindy W
This is the end of the thread.
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