![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by UgottaHaveHope on July 15, 2006, at 4:53:33
I hesitate to take such a definitive stance since I fully know that "every med affects everyone differently." However, with that said, I know a lot of people who take Seroquel and we all agree ... if it is the only thing it will do for you, it will knock you out for sleep (aka elephant dart).
Now before you respond, I am talking about taking Seroquel with NO other meds. Just Seroquel. I have read on here that Seroquel may have the opposite effect in combo with this or that.
Now Seroquel does have side effects, mainly dry mouth and grogginess but there is always a trade-off. To me, it's well worth it. My anxiety, my health is 100 times worse when I don't get my sleep.
Oh yeah, what dose? 25 mg is the smallest dose they make. You can even cut it in half. You will feel Seroquel the first day you take it and not have to wait 4-6 weeks.
Posted by SLS on July 15, 2006, at 6:05:12
In reply to Seroquel is a MIRACLE drug for Insomnia, posted by UgottaHaveHope on July 15, 2006, at 4:53:33
> Oh yeah, what dose? 25 mg is the smallest dose they make. You can even cut it in half. You will feel Seroquel the first day you take it and not have to wait 4-6 weeks.
Do you find it to be true that Seroquel begins to lose its hypnotic effect the higher one raises the dosage?
- Scott
Posted by Crazy Horse on July 15, 2006, at 9:57:51
In reply to Re: Seroquel is a MIRACLE drug for Insomnia, posted by SLS on July 15, 2006, at 6:05:12
> > Oh yeah, what dose? 25 mg is the smallest dose they make. You can even cut it in half. You will feel Seroquel the first day you take it and not have to wait 4-6 weeks.
>
> Do you find it to be true that Seroquel begins to lose its hypnotic effect the higher one raises the dosage?
>
>
> - Scott
>Hey Scott,
Isn't Seroquel an atypical antipsychotic? Antipsychotics scare me because of the possibility of developing Tardive Diskinesia. Is the probability high (just a rough estimate) of developing T.D. on seroguel? Thanks.
Monte
Posted by Phillipa on July 15, 2006, at 11:46:28
In reply to Re: Seroquel is a MIRACLE drug for Insomnia » SLS, posted by Crazy Horse on July 15, 2006, at 9:57:51
Monte yes it is and I wish I know as the pdocs keep throwing them at me. Last night I took l2.5mg of seroquel with the valium. I don't feel very well. Love Phillipa
Posted by SLS on July 15, 2006, at 12:03:13
In reply to Re: Seroquel is a MIRACLE drug for Insomnia » SLS, posted by Crazy Horse on July 15, 2006, at 9:57:51
> > > Oh yeah, what dose? 25 mg is the smallest dose they make. You can even cut it in half. You will feel Seroquel the first day you take it and not have to wait 4-6 weeks.
> >
> > Do you find it to be true that Seroquel begins to lose its hypnotic effect the higher one raises the dosage?> Isn't Seroquel an atypical antipsychotic? Antipsychotics scare me because of the possibility of developing Tardive Diskinesia. Is the probability high (just a rough estimate) of developing T.D. on seroguel? Thanks.
The risk of developing TD might be lowest for Seroquel, although some people will argue that Clozaril is lowest. Seroquel has the lowest binding affinity to the D2 receptor. It hops on and hops off very quickly and is thought not to provoke the induction of the supersensitivity that is thought to be responsible for the production of TD.
I am not as afraid of TD with the atypical neuroleptic drugs as I once was. Risperdal is the only one I would worry about at dosages exceeding 6mg. However, EPS has been reported with every neuroleptic drug, and I have to believe that even Seroquel is capable of producing TD and NMS.
I am ambivalent about the use of Seroquel for insomnia and other antipsychotics for indications other than schizoid conditions. I use them because I have few alternatives. They do have antidepressant and anti-suicide properties. Seroquel is sometimes the only drug that will treat insomnia effectively. It is not the ideal solution, but mental illness is not the ideal living condition.
- Scott
Posted by UgottaHaveHope on July 15, 2006, at 21:03:38
In reply to Re: Seroquel is a MIRACLE drug for Insomnia, posted by SLS on July 15, 2006, at 12:03:13
SLS, good question. On the short term, it seemed like the more Seroquel I took (up to 400mg/day), the less sleepy I became. However, after taking 300-400 for a few weeks, it was most certainly stronger than the 25mg I had been taking previously.
As far as TD, my pdoc said you only have to watch out for other things if you take 400mg+ ... but more than likely I would be safe.
It really is a great drug, miracle drug. And taken alone, it is hard for me to believe it won't terminate insomnia.
Posted by linkadge on July 15, 2006, at 21:24:54
In reply to Re: Do not fear Seroquel, posted by UgottaHaveHope on July 15, 2006, at 21:03:38
I think the antisuicide effects of antipsychotics is related to their effects on 5-ht2a. Clozapine is really the one antipsychotic that has been shown to produce a strong effect in this regard, and it has high antagonist affinity for 5-ht2a.
There seems to be altered expression of the 5-ht2a receptors in suicide, whereas disturbances in d2 etc have not been noted in suicide.
Linkadge
Posted by Phillipa on July 15, 2006, at 21:25:05
In reply to Re: Do not fear Seroquel, posted by UgottaHaveHope on July 15, 2006, at 21:03:38
Michael what's your diagnosis? Love Phillipa
Posted by janeB on July 16, 2006, at 9:34:37
In reply to Re: Do not fear Seroquel, posted by linkadge on July 15, 2006, at 21:24:54
> I think the antisuicide effects of antipsychotics is related to their effects on 5-ht2a. Clozapine is really the one antipsychotic that has been shown to produce a strong effect in this regard, and it has high antagonist affinity for 5-ht2a.
Doesn't Periactin (cyproheptadine) also have a high affinity for 5-ht2a? I have observed many recommendations that periactin be used for sexual problems but no recommendations for its use in insomnia. Why is this? Years ago (about 30) a neurologist prescribed periactin for trigeminal neuralgia and I had the best sleep in years while on it. Makes me wonder what klonopin targets because that is what has worked for me to sleep for the last 10 years. What do you think? Jane
Posted by cindy lou on July 16, 2006, at 12:49:35
In reply to Seroquel is a MIRACLE drug for Insomnia, posted by UgottaHaveHope on July 15, 2006, at 4:53:33
Hi all,
I am jumping in on this thread -- hope that's okay. My pdoc just gave me Seroquel to try after SO MANY other meds I've tried have backfired on me (most recently Abilify.) I will mention here that I am extremely sensitive to meds, and will start at a very low dose. (I took 12.5 last night).I have some questions about Seroquel ...
1. what is the "timing" of it?
...e.g., how long after taking it will I start to feel tired? I seem to have "anxiety attacks" around late afternoon ... I wasn't sure if I should take the Seroquel around that time to ward off those attacks, or if it would make me too tired to function.2. How long does it last in my system?
...if I take it before I go to bed, will it still help to ward off those bouts of anxiety in the late afternoon the next day? Will I feel overly groggy all day? (I do feel "out of it" today)3. How would other meds affect it? (e.g. Klonapin and Dexedrine)
I noticed some vague talk about Seroquel + other meds. I have been taking Klonapin for sleep and anxiety for 6 years now. I am wondering if I should just stop the Klonapin cold turkey at this point? (I take 0.5 mg. at night, and sometimes during the day during PMS. I had to take a lot more after starting the Abilify due to the increased anxiety I had.)I have also been taking Dexedrine for about 6 years. I take 5-10 mg. as needed during the day for energy and focus (mainly to offset the fatigue from the meds I have taken for depression). I usually end up taking about 30 mg. in a day. I tried stopping the Dex about 6 months ago when my pdoc prescribed Concerta, and I went through quite a depression. I think I am addicted to the Dex at this point.
Thanks in advance for any help! I am so glad this board is here. You are all great.
cindy.
Posted by linkadge on July 16, 2006, at 17:46:59
In reply to Re: 5-ht2a » linkadge, posted by janeB on July 16, 2006, at 9:34:37
Periactin is a great sleeping medication. Some doctors have used it for anti-aging because of its melatonergic properties. Probably due to 5-ht2a blockade. It is very calming. Although it doesn't block dopamine receptors it does have some antipsychotic qualities.
Linkadge
Posted by crazy777girl on July 16, 2006, at 20:37:10
In reply to Re: Do not fear Seroquel, posted by linkadge on July 15, 2006, at 21:24:54
Fear Seroquel. Read the info provided about developing diabetes. I read it, casually. I developed it, in spite of my pdoc's advice that most of that would not apply to most people. Be informed - it is a very REAL RISK.
A.
> I think the antisuicide effects of antipsychotics is related to their effects on 5-ht2a. Clozapine is really the one antipsychotic that has been shown to produce a strong effect in this regard, and it has high antagonist affinity for 5-ht2a.
>
> There seems to be altered expression of the 5-ht2a receptors in suicide, whereas disturbances in d2 etc have not been noted in suicide.
>
> Linkadge
Posted by cindy lou on July 16, 2006, at 21:55:07
In reply to Re: Do not fear Seroquel » linkadge, posted by crazy777girl on July 16, 2006, at 20:37:10
All I know is that I tried it for the first time last night -- 12.5 mg. -- and felt so sick, groggy, dizzy, horrible today that I cannot take it again. But that's just me and my crazy metabolism. I just can't tolerate this stuff, and I am losing hope. This has been going on WAY TOO LONG.
cindy
> Fear Seroquel. Read the info provided about developing diabetes. I read it, casually. I developed it, in spite of my pdoc's advice that most of that would not apply to most people. Be informed - it is a very REAL RISK.
> A.
> > I think the antisuicide effects of antipsychotics is related to their effects on 5-ht2a. Clozapine is really the one antipsychotic that has been shown to produce a strong effect in this regard, and it has high antagonist affinity for 5-ht2a.
> >
> > There seems to be altered expression of the 5-ht2a receptors in suicide, whereas disturbances in d2 etc have not been noted in suicide.
> >
> > Linkadge
>
>
Posted by UgottaHaveHOPE on July 16, 2006, at 23:37:01
In reply to Re: Do not fear Seroquel, posted by cindy lou on July 16, 2006, at 21:55:07
Yes, Seroquel, like most other meds, are to be watched closely taken in high doses for an extended period of time. My pdoc told me 400 and below per day is safe, and everything over that should be monitored. You should check with your MD for his or her opinion. Michael
Posted by Declan on July 17, 2006, at 15:32:51
In reply to Re: 5-ht2a, posted by linkadge on July 16, 2006, at 17:46:59
What dose did you take for sleep, Link?
I think I took half a 2mg tablet.
It seemed like mirtazepine in the way it promoted deep sleep, and was unpleasant on awaking too. It took ages to wear off.
Declan
Posted by yxibow on July 17, 2006, at 16:48:18
In reply to Re: 5-ht2a, posted by linkadge on July 16, 2006, at 17:46:59
> Periactin is a great sleeping medication. Some doctors have used it for anti-aging because of its melatonergic properties. Probably due to 5-ht2a blockade. It is very calming. Although it doesn't block dopamine receptors it does have some antipsychotic qualities.
>
>
> LinkadgeHmm.. curious... usually these days cyproheptadine is the drug of choice mostly for serotonin syndrome, besides propranolol.
Posted by linkadge on July 17, 2006, at 18:43:13
In reply to Periactin » linkadge, posted by Declan on July 17, 2006, at 15:32:51
Yeah, I think 1mg is fairly strong. I've taken as much as 2 mg at one time. It is pretty much remeron minus the alpha antagonism.
Hey, you could pick up some yohimbine, and combine it with periactin then you'd pretty much have mirtazapine.
It can make you feel pretty lousy the next day.
When I was taking a steady dose of it though I noticed most of that effect wore off.
Linkadge
Posted by linkadge on July 17, 2006, at 18:44:32
In reply to Re: 5-ht2a and Cyproheptadine » linkadge, posted by yxibow on July 17, 2006, at 16:48:18
Yes. Unfortunately periactin *may* have some antagonism at 5-ht1a, though I've heard mixed reports about that, in which case it could tend to be more depressogenic than other 5-ht2 antagonists.
Linkadge
Posted by Declan on July 17, 2006, at 19:09:27
In reply to Re: Periactin, posted by linkadge on July 17, 2006, at 18:43:13
Maximus took 8mg(!), I think, to get rid of SSRI sexual dysfunction. I couldn't begin to imagine how that would work, and it didn't.
What's alpha antagonism? I took yohimbine once, naturally I took double the dose, naturally it was worse than useless.
Posted by linkadge on July 17, 2006, at 20:02:36
In reply to Re: Periactin » linkadge, posted by Declan on July 17, 2006, at 19:09:27
Periactin is though to relieve sexual dysfunction by antagonizing the 5-ht2c receptors.
Sometimes however, it takes more than one dose to adress the problem since it may be more an issue of receptor density.
Mirtazapine is an norepinephrine alpha-2 adrenorecptor antagonist.
Instead of blocking the reuptake of serotonin, it blocks the inhibitory alpha-2 receptors, which results in the release of serotonin and norepinephrine.
Yohimbine has a similar effect. The NE release is proably why it can help some cases of sexual dysfunction.
Linkadge
Posted by yxibow on July 18, 2006, at 0:59:04
In reply to Re: DO NOT FEAR Seroquel at 400mg or less per day, posted by UgottaHaveHOPE on July 16, 2006, at 23:37:01
> Yes, Seroquel, like most other meds, are to be watched closely taken in high doses for an extended period of time. My pdoc told me 400 and below per day is safe, and everything over that should be monitored. You should check with your MD for his or her opinion. Michael
It's definately something one should monitor -- it isn't as nearly potent in the diabetic direction as Zyprexa (which is also more potent in D2 blockade and may be more effective for some individuals who need such a situation but cannot tolerate stronger atypicals) but nonetheless should be followed through diabetes testing and weight managment.
Believe me, its not easy to deal with the side effects of Seroquel, but it still remains to date among the safest neuroleptics in terms of side effect profiles outside of its lipid profile which is partially probably due to its extreme antihistamine profile and mostly due to mechanisms within the medicine not completely understood.
I'm not going to say oh, just go run around the block and it will be allright -- its hard work and an uphill battle, and to an extent lies within a genetic disposition towards diabetes (no fault to the individual who needs to take the medication).
I have taken it up to 1200mg. I do not suggest this as a treatment strategy for the average individual. The least amount the better.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.