(Quetiapine 200mg + Xanax 2mg) - Experienced - Paradoxical rise in Pulse

[King-Anubis]

(Quetiapine 200mg + Xanax 2mg) - Experienced - Tachycardia and Peak Hypertention

Hey,

This probably won't interest the majority of you, but I frequently take multiple sedatives to sleep and was wondering what the effect are on my blood pressure and pulse - as I often I find myself lying in bed falling asleep with my breathing slowing to the point that it stops, jolting me awake in the process.

For this reason I decided to take both drugs, as I usually do, and monitored my blood pressure and pulse using a sphygmomanometer for the duration. As I had done it I thought I might as well share it with everyone, as it may interest some - especially as the results go against what I believed would happen.


The dosage: 200mg of Quetiapine + 2mg Alprazolam.
The user: 18 Years old, 5'11", 68kg.
Other drugs in system: 100mg Caffeine 12 hours previously. 100mg 5-HTP 13 Hours previously.
Tolerance: Very High to Quetiapine, none to Alprazolam.
Expected result: Drop in blood pressure and pulse rate.
Actual Result: Fluctuating blood pressure, including a huge systolic pressure spike. 30% rise in pulse rate.
Results Graph: http://postimage.org/image/cgzeoauh3/

Background: I Take 200mg of Quetiapine every night for psychosis. For insomnia I work on a drug rotation: one week i'll take an extra 100mg of Quetiapine for sleeping, the next I'll take a benzodiazepine each night. This stops me from building a tolerance to either drug, whilst also preventing addiction. Each month i'm given a different benzodiazepine, and this month I'm on alprazolam. This experiment is taking place on the first day on Alprazolam.


T: 0:00 (BP: 139/77 ~ BPM: 98) - Resting Heart rate is characteristically high as a side effect of the anti-psychotics - I very rarely have a resting heart rate below 90 BPM . Physically I feel relaxed, albeit sweating due the slightly high room temperature. I take 200mg of Quetiapine, followed by 2mg Alprazolam with water. Last slept 14 hours ago, so feel slightly fatigued - but not overly so. Last ate 5 hours ago.

T: 0:05 (BP: 139/74 ~ BPM: 90) - Pulse is starting to slow - I imagine because of the Alprazolam. No physical or mental changes.

T: 0:10 (BP: 149/83 ~ BPM: 85) - Very mild pain in the centre of my chest. Blood pressure has risen unexpectedly. Mentally I'm starting to feel hazy, although there's a pervasive sense of well being and relief. Palms are sweating, although it now feels cold in here. Thermometer records no change in temperature.

T: 0:15 (BP: 142/90 ~ BPM: 90) - Rise in BPM is unexpected. Diastolic blood pressure continues to rise to hypertension levels. Mentally i'm starting feel tired. Chest pain has started to dissipate. I've become very aware of my breathing, and I seem to be taking long shallow breathes - although this is not bothering me.

T: 0:20 (BP: 132/77 ~ BPM: 101) - Mind feels hazy - trying to type this is slightly difficult. I keep hitting the wrong keys and my movement feels slowed. Struggling to keep my eyes focused, and I have slight double vision. Head feels very heavy and I’m feeling very lightheaded.

After a few minutes I found it very difficult to type my observations up, so I made notes and constructed them into sentence the following day.

T: 0:25 (BP: 133/80 ~ BPM: 104) - Feeling extremely tired and dizzy. I have blurred vision and I’m getting confused easily. Whole body feels as if it’s floating, although my legs and arms feel heavy, making them require a lot of effort to move. Chest hurts slightly. I noticed I was swaying slowly from side to side. Buy this time I expected the quetiapine to being kicking in noticeable, as it usually does within half an hour. Normally at this point I would be in bed, ready to sleep - but I decided to continue observations until the hour mark.

T: 0:30 (BP: 127/73 ~ BPM: 111) - By this point I’m yawning excessively. I beginning to feel the usual effects of quetiapine: foggy mind, difficult concentrating, a sense of detachment and zoning out. These all seems to be amplified by the alprazolam. I feel very, very tired and bordering on falling asleep. Eyes feel heavy and I have very blurry vision.

T: 0:35 (BP: 127/76 ~ BPM: 114) - Can’t think straight. Attempted to read a sentence of text and found myself slurring and mispronouncing words. Moving my head gives me slightly motion sickness and my eyes can’t keep up. Feel very zombie like. Breathing is very slow, no more then half a dozen breathes per minute. Eyes are watering - veins on my arms have become prominent.

T: 0:40 (BP: 189/75 ~ BPM: 127) - Struggling to think at all. I’ve made few notes at this point beside “No see/memory” - by this I mean I struggled to read, and notice details in objects around me, and that I couldn’t remember what I was doing - like being very, very drunk. Begining to fall asleep for short periods of time. I’m also extremely thirsty - an expected effect from the quetiapine.

T: 0:45 (BP: 133/116 ~ BPM: 134) - Struggled to do anything - sat staring at my laptop, zoned out. Eyes we’re rolling back. Despite this I feel very relaxed and at ease with the world. Breathing is still shallow. One of my notes simply says “no scared” next to my pulse which is continuing to rise.

T: 0:50 (BP: 118/92 ~ BPM: 130) - Bordering passing out. Feel very cold. Decided to go to bed but struggled to find the energy so I just sat staring at the clock on my laptop.

T: 0:55 (BP: 95/80 ~ BPM: 135) - Managed to take one more blood reading using the machine and scrawl down the result. All other notes on the pc from here are ineligible - and so the last entry is recounted from memory.

T: 0:60 I forced myself up - legs fell very heavy and knees ached. Stumbled across my room with little coordination and fell into multiple objects. Eventually pulled myself into bed and promptly passed out.

Next day I awoke and took three more readings, with the average being a blood pressure of 117/67 and a pulse rate of 95

In retrospect I found the pulse rate rise the most surprising. As Alprazolam works faster, I attribute that to the initial slow in pulse and rise in blood pressure. Although I expected this trend to continue once the quetiapine began to work, but strangely (to me at least) the opposite of this occurred. I believe the Quetiapine peaked at the 40 minutes mark, due to the quick decline in blood pressure following.

As for effects the day after, my mind feels slightly hazy and theres some fogginess. Besides this I’m back to what I felt before the drugs.

Because of the results, I’m planning to repeat the experiment with each drug on their own to try and identify which drug was responsible for the rise in pulse rate - or if it was a mixture of the two. I’ll post it on here if anyone is interested!

Tagged by devilsgospel
substancecode_quetiapine
substancecode_antipsychotics
substancecode_pharms
substancecode_xanax
substancecode_alprazolam
substancecode_pharms
substancecode_benzos
substancecode_gabaergics
_combo_
explevel_veryexperienced
explevel_retrospective
exptype_neutral
exptype_healthissues
roacode_oral

 

[King-Anubis]

So I decided to repeat the experiment tonight with the quetiapine dose delayed to see if it was the alprazolam causing the blood pressure spike at to T+0:40 mark. Because the drugs didn't 'hit' at the same time, their power alone was not enough to get me to a point where I felt desperate to sleep, or on the brink of passing out, so I decided to continue the experiment until T+3:30. I shall only provide data, as three hours worth of 5 minute interval logs would be tedious, as best, to rest.

The Dosage:: 2mg Alprazolam + 200mg Quetiapine (T +0:60). Both taken orally.
Known Onset Time from Experience: 30 minutes for Quetiapine. Unknown for alprazolam
The User: 18 Years old, 5'11", 68kg. - Will be sat on a chair relaxing for the duration to prevent exertion raising the pulse rate.
Other Drugs in System: 100mg Caffeine 5 hours previously.
Tolerance: Very High to Quetiapine, none to Alprazolam.
Data Collected:Blood Pressure and Heart Rate every 5 minutes for 3h30h

As you can see, for the hour which the alprazolam was left to act alone it did very little. There was a slight drop in my heart rate near the beginnings, but it quickly returned to baseline. Blood pressure remained relatively stable throughout.

Upon taking the 200mg of quetiapine at T+0:60 my blood pressure unexpectedly spiked, although this seems to have been an erroneous result as the next reading was back at baseline. The spike was probably the result of the physical exertion used to acquire and consume the medication (Walking over to my cabinet, etc).

During the next 30-40 minutes, when quetiapine begins to usually hit, the readings were becoming slightly more erratic, but they were otherwise within the normal range. 120 minutes after taking the drugs my diastolic blood pressure seemed to have pretty much stabilised at the 60-70mmHg level, but despite this my systolic pressure was rapidly rising and falling. It is perhaps useful to note that, in the majority of readings, whenever the systolic reading rose, the pulse rate dropped. This fluctuation continued until the end of the experiment.

I personally have no idea why the results fluctuate so much (I'm no doctor), so if anyone has any ideas I'd love to know, especially as it goes completely against what I thought would happens with these drugs.

Besides this I plan tomorrow to take 400mg (I'm only tolerant to 200mg) of quetiapine without the alprazolam to see what that does to the body alone, and to see if it creates these crazy fluctuations on its own. I Will also post results here.

 

[jackie jones]

Very nice report.

 

[King-Anubis]

Well, I repeated the experiment with 400mg of quetiapine - to disastrous results.

Having much experience with 300mg of quetiapine I was prepared for the extreme drowsiness and physical impediment that higher then usual doses bring. For me, 100mg extra then that I had gotten semi-used to seemed far from dangerous - especially as I'm aware that people take 400mg once or twice daily without problems.

So I recorded my blood pressure and pulse every five minutes for 30 minutes before taking the medication, with the results hovering around a pressure of 125/70 and a pulse of 90 BPM. Five minutes after I had taken the my pulse began to rise. First to 100, then to 105 at the ten minute mark. This steady increase was expected, given the results of my first experiment. However things soon took a turn for the worse, the next four pulse readings, taken five minutes apart, were: 117, 129, 137, 148. My blood pressure also spiked 190/100 and then dropped below 90/50.

During this whole process I began to experience symptoms which I had never experienced with new, higher doses of quetiapine. I began to hallucinate, experience depersonalisation, extreme panic and time dilation. I could feel my heart beating hard, and I started to feel pain in the back of my neck. I knew this wasn't right, yet I knew I hadn't overdosed - I'd taken 500mg before by accident and survived, and I know people who regularly take 400mg in one dose. Despite all this, I knew I needed help.

Unable to talk without severely slurring my speech, I couldn't call an ambulance myself. So I managed to find the energy to get off my chair and get out of my room. I live in shared residence, and there's around 2 dozen people on my floor, and although most have gone home for christmas there are a few left. As I attempted to make up way down the 10 metre corridor, very slowly, I stumbled frequently and stopped to rest periodically. Eventually a friend passed and noticed something wrong. I tried to tell him what had happened to no avail - I couldn't speak properly - and eventually managed to say I needed a medic.

After this he followed me as I attempted to get down the stairs. I stumbled and fell, but managed to grab the rail. I decided then to just sit on the stairs. I asked slowly for him to get somebody. He asked "Who?", and I replied "anyone".

A minute later the hall's senior team shows up. They asked a bunch of questions which I did my best to answer. By this time I began to pass out, but I used all my willpower to stay conscious. I felt very cold, and my heart still felt heavy. Zoning out I took no notice of what everyone was saying to me. I stayed like this - in a sort of zombie-like state - for the next ten minutes before two paramedics showed up.

They took some readings - by this time my pulse had hit 165 and my blood pressure had dropped below 80/50. They injected me with something and within 10 minutes my pulse had dropped back to 110. After ten minutes I started to 'return' to the world, and could answer their questions more easier. They were a little confused at first as 400mg of quetiapine is not a huge dosage, and they were in agreement that it seems to have had effected me far to severely. We later worked out that it was likely caffeine that was casing the problems. I'd had around 150mg four hours earlier, and it seems to have interacted with the antipsychotics. Regardless, a few minutes later they gave me an anti-anxiety drug and allowed me to head to bed. Because of the doseage I was at no risk of organ damage, so they said I should be fine in the morning and wouldn't need to stay the night in a hospital - although they did offer it to me, but I rejected the idea.

Anyway, what happened slightly disturbed me. Caffeine is not exactly a powerful stimulant, and if it alone can cause a dangerous reaction with quetiapine, any stronger stimulants would do the same - if not worse. Of course everyone knows not to mix downers and uppers, but I doubt many would include caffeine in the list of drugs not to mix with tranquillisers. What disturbs me most now however is that many people keep major tranquillisers to use in case of stimulant overdose. It makes sense after all - if you've taken too much and your heart is racing, a sedative would slow it down. But the opposite seems to have happened.

So, to point out the obvious: Do not mix quetiapine with any stimulants. - Especially if you have no tolerance to the quetiapine! I can take high doses of caffeine with my normal dose without problems, just not the increased doses it seems.

 

[Hiltoniano]

wow. things turned serious very fast in this report....

 

[MR.Z]

Dude what the hell did you do - Doesn't a high pulse and low blood pressure indicate that you were going into shock? Glad you're alive man - goes to show you shouldn't fuck with these drugs, even if they are prescription and you know the dangers. Good report.

 

[blight12]

Im confused, I use Seroquel to kill meth all the time with consistently excellent results and so do many emergency rooms use it to kill stimulant OD's.

Your point seems to contradict my experience as well as common recommended emergency treatments.

But we all experience substances differently...

 

[King-Anubis]

Im confused, I use Seroquel to kill meth all the time with consistently excellent results and so do many emergency rooms use it to kill stimulant OD's.

Your point seems to contradict my experience as well as common recommended emergency treatments.

But we all experience substances differently...

I was just as confused, as were the paramedics (In all honesty, I think they just claimed that stimulants were responsible for lack of a better explanation - but I can't know for sure). How much do you normally take to kill meth? I too have personally used quetiapine to kill stimulants stronger then caffeine and never experienced such a paradoxical occurrence, but then again I've never taken such a high dose.

From my knowledge few people take more then 100mg to counteract stimulants, as 25mg is more then enough to knock most unexperienced users out. I'm aware that therapeutic doses can go up to 400mg twice daily, but the pharmaceutical company that manufactures the drug here in the UK only offers tablets up to 300mg - which indicates to me that that's the highest 'official' dosage. Users are often slowly tapered onto higher doses as well, so the problems could have just come about as result of the sudden, large increase in dosage.

Then again, I might simply have a low overdose threshold, and 400mg was enough to cause extreme problems. There probably isn't much between someones safe and unsafe dosage - as quetiapine is one of the most sedating antipsychotics - so I could have easily crossed that line, possibly with the help of caffeine, and induced whatever that was that happened. I know for a fact that tachycardia is a symptom of quetiapine overdose, so it was certainly my first thought. The very fact that 200mg - my normal dose - increases my heart rate (mild tachycardia?) perhaps indicates that I'm already close to my overdose limit.

Either way, I would still advise caution - especially with the higher doses. But you're correct in saying that my experience contradicts many people's experience with the drug.

 

[Hiltoniano]

Plz tell me you changed to a antipsychotic that has less side effects after this. I would think you have a somewhat odd adverse type reaction to this drug in particular.

 

[King-Anubis]

Plz tell me you changed to a antipsychotic that has less side effects after this. I would think you have a somewhat odd adverse type reaction to this drug in particular.

I haven't. The side effects are generally manageable, and I don't want to go through all those initial side effects again. Either way, I'm trying to take myself off quetiapine at the moment - as per my thread in 'Other Drugs'.

 

[blight12]

I was just as confused, as were the paramedics (In all honesty, I think they just claimed that stimulants were responsible for lack of a better explanation - but I can't know for sure). How much do you normally take to kill meth? I too have personally used quetiapine to kill stimulants stronger then caffeine and never experienced such a paradoxical occurrence, but then again I've never taken such a high dose.

From my knowledge few people take more then 100mg to counteract stimulants, as 25mg is more then enough to knock most unexperienced users out. I'm aware that therapeutic doses can go up to 400mg twice daily, but the pharmaceutical company that manufactures the drug here in the UK only offers tablets up to 300mg - which indicates to me that that's the highest 'official' dosage. Users are often slowly tapered onto higher doses as well, so the problems could have just come about as result of the sudden, large increase in dosage.

Then again, I might simply have a low overdose threshold, and 400mg was enough to cause extreme problems. There probably isn't much between someones safe and unsafe dosage - as quetiapine is one of the most sedating antipsychotics - so I could have easily crossed that line, possibly with the help of caffeine, and induced whatever that was that happened. I know for a fact that tachycardia is a symptom of quetiapine overdose, so it was certainly my first thought. The very fact that 200mg - my normal dose - increases my heart rate (mild tachycardia?) perhaps indicates that I'm already close to my overdose limit.

Either way, I would still advise caution - especially with the higher doses. But you're correct in saying that my experience contradicts many people's experience with the drug.

Sure. Well usually I take 300mg to sleep without stims.

But with stims i take half that to end them. 150mg is more then enough to kill the strongest meth high for me, any more and i feel uncomfortable and far to sedated, as if im slipping away into coma. Perhaps to much Seroquel and stims is your issue?

I have heard that anything less has only anti hystamine effects and might not work ion regards to the anti psychotic properties meaning less effective for killing stims.
And i have also heard that anti hystamines plus stims can cause psychosis etc, not sure if its the same with Seroquel.

 

[King-Anubis]

Well usually I take 300mg to sleep without stims.

But with stims i take half that to end them. 150mg is more then enough to kill the strongest meth high for me, any more and i feel uncomfortable and far to sedated, as if im slipping away into coma. Perhaps to much Seroquel and stims is your issue?

300mg is a huge dose, I'm honestly quite surprised they'd put you on that just for sleep - although I can see why they'd be preferred over some of the stronger benzos. Either way, I had tried a few readings without stimulants and my pulse still rises - the same happens with my new lower dose, which is frankly very, very odd. It may just be my body's reaction to them, I'll ask my doctor next time I see him.

And i have also heard that anti hystamines plus stims can cause psychosis etc, not sure if its the same with Seroquel.

I doubt antipsychotics could cause psychosis - even if it did it'd be hidden by the antipsychotics effects. Despite this I'm pretty certain that stimulants plus quetiapine withdrawal could cause psychosis - if there's a sudden decrease after a period of continued use. I say that because I know that quetiapine withdrawal can produce schizophrenia like symptoms, and if someone has a case of stimulant psychosis - even if it's mild - it'll could increase the severity if it hadn't yet been 'cured' by the antipsychotics. Generally it passes but it can in some cases remain, leaving people to become 'dependent' for life upon quetiapine to provide them sanity.

 

[blight12]

Yeah your logic is 100% right. I'm on 300mg as my tolerance requires it unfortunately. I like to claim Seroquel doesn't cause tolerance but it did to a point, ensuring i needed 300mg instead of 100mg which worked from the beginning. 50mg and 25mg never did shit for me from the start. 300mg now works "ok" but still sometimes doesnt do the job.

Like right now its 5am in the morning and I have not slept yet even though im on 300mg Seroquel, 3g Phenibut, 5 beers and 1/3 bottle of brandy. And im not even tired (however gaba drugs usually make me awake and energetic, not sedated). Im about to hit some zolpidem to see if that will finally send me to sleep lol.

Other times 300mg and 2 beers destroys me and I cant even walk (this being a good thing since i get to sleep)

Oh and yes it does increase my heart rate a lot all the time as well but this is due to the drop in blood pressure, not an increase. I find walking around with that low BP causes serious uncomfortable increase in heart rate and I have often started to black out and faint but as long as im sitting or lying down (which you should be doing) it works great.

 

[Azron]

could be sleep apneoa?