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    amphetamine and quetiapine (Seroquel) 
    #1
    What are the suspected neurological interactions between amphetamine and quetiapine (Seroquel)?
    I have read that seroquel can actually potentiate amphetamine if, say, taken before sleeping and then taking the amphetamine the next day.
    I am guessing this is the result of the quetiapine action as a dopamine antagonist, and in effect it pre-loads the presynaptic vesicles with dopamine by allowing dopamine to accumulate overtime (since no sufficient amount of dopamine is being released due to the DA pathways practically being shutdown by the quetiapine).

    However, I have read that for someone who experiences akathisia (which can be caused by amphetamine), quetiapine can greatly exacerbate this.

    What would happen if quetiapine was taken while amphetamine was in effect? Would it hault the effects of amphetamine, or would it cause akathisia?
     

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    #2
    Bluelight Crew Desdenova's Avatar
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    I'd like to hear an answer to this myself, so I'm going to bump it

    Maybe it should be in OD?
     

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    #3
    Bluelighter DarksidePharmacist's Avatar
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    Im not certain, but i think quetiapine, like the other atypical anti psychotics would reduce, if not halt completely the effects of the amphetamine. As far as other effects... i dont know. Not very helpful i know
     

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    #4
    i've taken seroquel to negate the effects of amphetamine and be able to sleep. don't know if it potentiates it the next day but it definitely makes you feel like a zombie.
     

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    #5
    If you take an amphetamine with most atypical antipsychotics, you're highly liable to experience akathisia, if I'm not mistaken.

    Many atypicals - or at least ziprasidone and quetiapine - act as alpha 1 and alpha 2 antagonists. Since the alpha 2 adrenergic receptor is an autoreceptor it actually promotes the release of adrenaline and noradrenaline when antagonized. Because the alpha 1 receptor is being blocked by the neuroleptic, the only adrenergic receptors available for binding to these catecholamines are the beta 1, 2, and 3 receptors. So what you have is considerable alpha 1 antagonism and unopposed beta receptor activation. This, or so my hypothesis goes, is the cause of akathisia. This hypothesis finds support in the fact that propranolol, clonidine, and other substances which reduce the activation of the beta receptors can alleviate or bring akathisia entirely to an end.

    If you add amphetamine to the mix while you're already experiencing akathisia... well, god help you. That's going to be some terrifying shit.

    And no, neuroleptics are almost certainly not going to improve the high if taken just once the night before. They antagonize D2 autoreceptors as well as postsynaptic D2 receptors, meaning that they cause the dopamine storage vesicles to disgorge all their dopamine upon unavailable receptors (on account of the neuroletpic). That means less dopamine available the next day for the amphetamine to release into the synapse. If you were to take a neuroleptic on a long-term basis on the other hand, that would sensitize post-synaptic D2 receptors and increase (probably) the hedonic effect of amphetamine, but I think most atypical antipsychotics - and definitely quetiapine - don't cause D2 upregulation (because they disassociate from the receptor so quickly?).

    If you're wondering why none of the regulars has responded, it's because they hold you in contempt for the perception that you are very poorly informed with respect to pharmacology (one of the main reasons they don't like me; that and they think I'm an insufferable, self-centered whiner). As for me, what I am wondering is why the mods haven't moved this thread...
    Last edited by shibireru; 22-08-2009 at 05:38.
     

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    #6
    Bluelighter almost-'s Avatar
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    Detection of dopaminergic supersensitivity induced by neuroleptic drugs in mice.
    Yen-Koo HC, Balazs T.
    Drug Chem Toxicol. 1980;3(2):237-47.

    We investigated the sensitivity of dopaminergic receptors in mice fed neuroleptic drugs. Groups of mice were fed daily doses of approximately 10% of the LD50 of haloperidol, clozapine, chlorpromazine, trifluoperazine, or thioridazine for 2, 4, or 8 weeks. Four days after withdrawal of the neuroleptics, thozalinone, a dopaminergic stimulant, was given ip at 50 mg/kg to elicit gnawing behavior. Increased gnawing behavior was seen in mice after 4 weeks of administration of haloperidol (80%), chlorpromazine (80%), trifluoperazine (100%), and thioridazine (100%) compared with control values (50%). The gnawing behavior in mice treated with clozapine was the same as that for control mice. Levels of gnawing behavior after 2 or 8 weeks of administration of the same drugs were lower than those reported above. Alcohol increased the thozalinone-elicited gnawing behavior 2 weeks after dosing with haloperidol and trifluoperazine. After 4 and 8 weeks of administration of the drugs, the locomotor activity of mice was increased from 29-113% (4 weeks) to 37-110% (8 weeks) compared with controls. The study of neuroleptic drug-induced dopaminergic supersensitivity may serve as a method for detection of tardive dyskinesia-inducing effects.

    http://www.ncbi.nlm.nih.gov/pubmed/6112126
     

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    #7
    Don't mix quetiapine with amphetamine... From taking 50mg of quetiapine about 3 hours after taking 120mg of amphetamine, my entire body was pulsating with high blood pressure. I could feel my pulse without my hands, just by feeling it in my neck and face and really everywhere in my body.

    Not only that, but I had helpless feelings of panic and restlessness... I got the feeling that something very very wrong was happening in my body, but I felt too retarded to do anything about it.

    It was mental torture really.

    PS I wouldn't have done it if a doctor hadn't prescribed it to me for the exact reason of being able to get sleep while amphetamine was still lingering in effect... maybe doctors should take it upon themselves to research a little bit more what the side effects are going to be from an interaction?
     

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    #8
    120mg of amphetamine??? Seroquel only 3 hours after that? Sleeping 3 hours after 120mg of amphetamine?
     

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    #9
    Quote Originally Posted by SpunkySkunk347 View Post
    Don't mix quetiapine with amphetamine... From taking 50mg of quetiapine about 3 hours after taking 120mg of amphetamine, my entire body was pulsating with high blood pressure. I could feel my pulse without my hands, just by feeling it in my neck and face and really everywhere in my body.

    Not only that, but I had helpless feelings of panic and restlessness... I got the feeling that something very very wrong was happening in my body, but I felt too retarded to do anything about it.

    It was mental torture really.
    And that goes some way to validating my hypothesis, I do think.
     

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    #10
    Bluelighter Cyanoide's Avatar
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    Quote Originally Posted by shibireru View Post
    And that goes some way to validating my hypothesis, I do think.
    The last three times I've taken stimulants and taken quetiapine to get sleep I have got exactly the same symptoms as SpunkySkunk347. The first two times I couldn't believe it was quetiapine that was responsible for the reaction, as I've used it so many times to knock myself out on whatever drug is keeping me awake when I just want to sleep. I've never had akathisia with quetiapine before and I used it for some 3-4 years to get sleep at one point in my life. It just makes me extremely tired and lethargic and puts me to sleep, even if there is strong residual stimulation from a stimulant. But now, taken after stimulant use to get sleep I get a horrific anxiety, hypertension, panic, my blood pressure soars and I have a burning sensation inside me. Because I've taken stimulants, beta blockers are out of the question, I think they would relieve these symptoms almost completely. There is a big risk the blood pressure would rise to dangerously high levels because the residual stimulation of the stimulant is still there.

    What baffles me most is why I react like this now when it's never happened before and I've unfortunately used a lot of quetiapine in my life.

    Never ever again will I take these two together. I actually hate both. They're just effective for what they're designed for.
     

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    #11
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    The reactions described in this thread are puzzling, as antipsychotic use in conjunction with methylphenidate, amphetamine, and methamphetamine has been shown to be safe in children by a number of clinical trials.

    As far as I know, there haven't been any clinical trials with this combinations in adults, but I can't think of a reason why they would be any less safe for adults to use than children. Amphetamine doses in children-adolescents max out at 60 mg/day IIRC, so perhaps it had to do with a higher dose (120mg)?

    Antipsychotics are also used off-label to help both adults and children on pyschostimulants sleep, and I couldn't find any type of negative interactions published in the literature. I take 40-50 mg/day amphetamine XR with 25-50 mg quetiapine at night to sleep. I've never had any weird interactions, so I raise your n=2 with my n=1 !

    Joking aside, let's see what the scientific literature says about this topic:

    Atypical antipsychotics, are approved for use in combination with methylphenidate for children/adolescents with dual diagnoses of ADHD and oppositional defiant disorder (or another aggression-heavy psychiatric illness). In this trial , the side effects from combining respiradone and stimulants was additive (eg no different than a combination of side effects from both drugs). In a more recent trial, a lack of interactions between stimulants and anti-psychotics was further substantiated.

    Quetiapine has been explicitly shown to be safe in combination with methylphenidate in adolescents, although no trials have been done with amphetamine. Antipsychotics are however safe to administer to children in acute methamphetamine overdoses.

    The only published negative interactions for antipsychotics + amphetamines are from case reports from 2-3 patients where dystonia or other neurological symptoms were observed. Neurological, not hypertensive, cardiac, or psychiatric (eg anxiety).
     

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    #12
    Bluelighter Cyanoide's Avatar
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    raybeez, I have actually experienced this once with MXE too - as it's a stimulating dissociative,

    I would not say what I experienced was dangerous - well if the blood pressure would have rise further it may have been - but it was mentally terrifying. For this reason I have now swtiched to mirtazapine if I need to "knock myself out" when I just can't get sleep.
     

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    #13
    Bluelighter Cyanoide's Avatar
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    Quote Originally Posted by hugo24 View Post
    120mg of amphetamine??? Seroquel only 3 hours after that? Sleeping 3 hours after 120mg of amphetamine?
    It is perfectly possible to sleep with quetiapine 3 hours after a 120 mg amphetamine dose. It's possible to sleep even one hour after as long as the quetiapine dose is high enough. When the doses of quetiapine are high enough, it starts blocking the release of dopamine, hance cancelling out the effects of amphetamine and putting you to sleep (without tolerance you have no other option, you will fall asleep whether you want it or not). That is one of the main functions, if not the main function of anti-psychotics; to not let your dopamine levels rise too much (high levels of dopamine is strongly linked to psychosis).

    This is one of the reasons especially stimulants are among the main culprits in inducing psychosis among the various types of drugs. The amount of dopamine circulating in your brain (especially after a binge, no sleep, dehydration etc) is very high on stimulants (I'm now mainly referring to the highly dopaminergic stimulants). Psychosis is obviously a more complex phenomena and can be explained by many factors. But if we're speaking of drug induced psychosis, it is definitely a quite strong explaining factor.
    Last edited by Cyanoide; 27-03-2012 at 18:46.
     

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    #14
    I use amphetamines (mostly 2-fluoromethamp right now, but sometimes d-amp, adderalll, vyvanse, mostly 2-fma though - works the best out of all of em) and been taking seroquel to sleep with it for a long time. I remember at first i would get the RLS feeling in my legs.. and also i would hear voices when the seroquel kicks in (not that odd to report, a strange side effect for an anti-psychotic, only audio). None of that happens now, even when i skip many days and just smoke this super strong indica strain i have (knock me the fuck out so hard i love it). My dose is usually 100mg.. sometimes more sometimes less. But I can be ON a binge of stimulants for hours, and when i feel like ok this is boring - pop 200mg, smoke a bowl, and i'm out.

    I noticed when taking d-meth daily (not in a long time) the meth just seemed to almost last 24/7... Seroquel "shut it off" for about 8 hours of *awesome sleep*. I'd wake right up as if i'm feeling a little leftover methamp start to do something again. But yeah i'd say 200mg or more will definitely "shut off" any amount of amphetamine you can do even if you just did some. you can tell when it kicked in cause you'll have a maaad appetite (better run to the fridge and eat all you can before seroquel puts you on the kitchen floor... stuff can hit like a train ). Its kind of a curse (lack of a better word) to have a big stash of it around cause it lets you abuse stims more, use higher doses, never worrying about a missed night of sleep etc. Tweakin at midnight just did another line, but gotta be at work by 9am? pop 200mg, let that kick in and you should be out. If not 200, 300.. etc.. or Risperidol... 1mg SHUTS MY BRAIN DOWN and i sleep so hard i could barely make it up for work, had to IV a heavy dose of 3-fa mixed with 2-fma to have a chance in fighting that risperidone..i could barely do it but knew i had to (i didnt think 1mg would do THAT to me, lol. If i ever need to sleep for 24 hours or get like 10 hours sleep before something important, i'll take 1mg or less risperidone, then prepare a large IM or IV injection ready for the morning fog. (its only cause i'm not used to that drug).
     

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    #15
    seriously they should give it out to meth tweakers that stay up for days - i certainly would take it, no shadows no psychotic nothing with a full night of seroquel induced sleep. It would be harm reduction - if it was accepted and used, less psychosis = less crazies cops have to chase and less anti-meth bullshit ad's etc.

    But if there's anything similar or better/safer than seroquel that "shuts down stimulants" how it does, with less side effects would be nice. Other than *rare* deep indica certain strains that somehow knock me out (even soon after doing a big IM shot of 3-fa or something).

    But amphetamines and no sleep = psychosis. Even if you sleep every night for a few hours, it builds up.. i slowly changed and went totally manic save the world in 2012 lets contact the aliens kinda stuff because i was anti-seroquel and just wasn't sleeping properly. 8 hours good sleep a night stopped all that.
     

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    #16
    Quietiapine doesn't have strong D2 antagonism until around 300mg.; regardless, avoid concomitant dosing with dopamine agonists. More a 5HT2a thing.

    Such a shit antidepressant and there are better neuroleptics...
     

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    #17
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    Shit antidepressant in my opinion ...... anti psychotic actually. Do not like it. But for the purpose of this thread, I will say bad idea (but I am just biased against serequoel) Bad experience,,,, not just me but other people I know.
     

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    #18
    Bluelighter Cyanoide's Avatar
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    I have found that very high doses of mirtazapine is equally effective as quetiapine for cancelling out the effects of stimulants. Depending on the dose 60-120 mg will reduce the stimulant effect to almost zero, it removes anxiety and panic (unlike quetiapine) and puts you to sleep (well, it does knock you out with very high doses) more "gently", you get a warm and fuzzy, slightly euphoric feeling and then just close your eyes and fall asleep.

    The downside is the insanely long half-life which will have you "zombified" much longer than quetiapine.

    Quetiapine is not an antidepressant really anyway. And your receptors become sensitized to it. I used 100 mg for sleep for some 3-4 years, it was effective for sleep but you stop feeling like a zombie daytime after a few weeks. It did block my nose completely though, being an antihistamine, and I often had to take nasal spray because of it.
     

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