Seroquel for the next year?

[Panamajack]

What is this going to do to me physically and emotionally? I just completed a 7 day Tramadol taper heroin detox. using Seroquel at 50 mg and Valium for sleep. I’m clean and feel as good as can be expected, and I'm committed to leave this drug in my past forever.

Now my psychiatrist wants me to up the dose of Seroquel to 200 mg for the next 9 months to a year, and then taper off of it. I posted this question on TDS and Nexius was kind enough to explain which receptors Seroquel is an antagonist for and how those sites are related to the emotional states in a basic way, but that didn’t answer the question “What’s it going to do to me?”

I posted the same question on BDD in another way, and nobody touched it. My brother is a schitzophrenic, and has been on anti psych drugs for 45 years. It hasn’t been pretty to say the least. I’m really concerned about this one year course of treatment. Can anyone answer my question?

 

[graugeist]

If you are concerned about what your psychiatrist is prescribing you then you should take it up with your psychiatrist; he has the training and the experience to provide you with the answers that you are seeking.

I have been taking Seroquel for bipolar disorder for over two years. I take 600mg every evening. I am in very good health. Seroquel is a relatively benign major tranquilizer (AKA atypical antipsychotic) compared to the older medications that your brother has likely been prescribed in the past. The closer you work with your psychiatrist by asking questions, asking him to provide you information about your medications, notifying him of concerns or side effects that bother you, the better the quality of care and treatment you will receive.

If I were you, I would trust the input of my psychiatrist over people on a forum like this. Not to say that there are no knowledgeable people here who could attempt to answer your question, but you'll get the best answer from your psychiatrist.

If schizophrenia runs in your family you should speak to your psychiatrist about the risk of developing the disorder yourself. There is a very strong genetic component to schizophrenia and siblings of persons who have schizophrenia are at risk of developing the disorder themselves.

 

[MeDieViL]

Id stay away from antipsychotic considering the risk of getting tardive dyskinesia.

Tardive dyskinesia and new antipsychotics.
Correll CU, Schenk EM.

The Zucker Hillside Hospital, North Shore Long Island Jewish Health System, Glen Oaks, NY 11004, USA. [email protected]
Abstract
PURPOSE OF REVIEW: To provide an update on tardive dyskinesia rates in patients treated with first-generation or second-generation antipsychotics in studies published since the last systematic review in 2004. RECENT FINDINGS: Across 12 trials (n = 28 051, age 39.7 years, 59.7% male, 70.9% white, followed for 463 925 person-years), the annualized tardive dyskinesia incidence was 3.9% for second-generation antipsychotics and 5.5% for first-generation antipsychotics. Stratified by age, annual tardive dyskinesia incidence rates were 0.35% with second-generation antipsychotics in children, 2.98% with second-generation antipsychotics versus 7.7% with first-generation antipsychotics (P < 0.0001) in adults, and 5.2% with second-generation antipsychotics versus 5.2% with first-generation antipsychotics (P = 0.865) in the elderly (based almost exclusively on one retrospective cohort study). In four adult studies (n = 2088, age 41.2 years, 71.2% male, 62.0% white), tardive dyskinesia prevalence rates were 13.1% for second-generation antipsychotics, 15.6% for antipsychotic-free patients, and 32.4% for first-generation antipsychotics (P < 0.0001). SUMMARY: Current evidence supports a lower tardive dyskinesia risk for second-generation antipsychotics than for first-generation antipsychotics. Tardive dyskinesia incidence was higher with second-generation antipsychotics than previously reported, possibly due to recent studies with relatively short mean durations and use of nonstandard tardive dyskinesia definitions.

Diabetis isnt fun either:

Adverse effects of antipsychotic medications.
Muench J, Hamer AM.

Oregon Health and Sciences University, 3181 SW Sam Jackson Park Blvd., Portland, OR 97213, USA. [email protected]
Comment in:

Am Fam Physician. 2010 Mar 1;81(5):585.
Abstract
The use of antipsychotic medications entails a difficult trade-off between the benefit of alleviating psychotic symptoms and the risk of troubling, sometimes life-shortening adverse effects. There is more variability among specific antipsychotic medications than there is between the first- and second-generation antipsychotic classes. The newer second-generation antipsychotics, especially clozapine and olanzapine, generally tend to cause more problems relating to metabolic syndrome, such as obesity and type 2 diabetes mellitus. Also, as a class, the older first-generation antipsychotics are more likely to be associated with movement disorders, but this is primarily true of medications that bind tightly to dopaminergic neuroreceptors, such as haloperidol, and less true of medications that bind weakly, such as chlorpromazine. Anticholinergic effects are especially prominent with weaker-binding first-generation antipsychotics, as well as with the second-generation antipsychotic clozapine. All antipsychotic medications are associated with an increased likelihood of sedation, sexual dysfunction, postural hypotension, cardiac arrhythmia, and sudden cardiac death. Primary care physicians should understand the individual adverse effect profiles of these medications. They should be vigilant for the occurrence of adverse effects, be willing to adjust or change medications as needed (or work with psychiatric colleagues to do so), and be prepared to treat any resulting medical sequelae.

 

[paranoid android]

^^^ The risk of getting tardive dyskinesia from seroquel alone is pretty slim and i wouldnt worry about it at low doses. There are alot of complications you can get from atypical anti-psychotics but many people including myself don't get many of them.

In the past year ive been on seroquel and risperdal at different times as well as zyprexa zydis for emergencies (i have bipolar disorder) and besides a increase in appetite which could just as well be the up and down usage of cannabis and opiates i havent really gotten any side effects. Though i think risperidone may lower my IQ a few points in the morning before i have my coffee

 

[MeDieViL]

^^^ The risk of getting tardive dyskinesia from seroquel alone is pretty slim and i wouldnt worry about it at low doses. There are alot of complications you can get from atypical anti-psychotics but many people including myself don't get many of them.

In the past year ive been on seroquel and risperdal at different times as well as zyprexa zydis for emergencies (i have bipolar disorder) and besides a increase in appetite which could just as well be the up and down usage of cannabis and opiates i havent really gotten any side effects. Though i think risperidone may lower my IQ a few points in the morning before i have my coffee

Source?
The evidence says there's a 3,9% risk, why would this risk be lower for seroquel?

 

[indelibleface]

Source?
The evidence says there's a 3,9% risk, why would this risk be lower for seroquel?

But at what dosage? Any dosage?

Quetiapine (Seroquel) is wildly prescribed, at least in America. I'm his doctor is well aware of the potential side-effects associated with drugs in its class. Even so, the risk seems really negligible with quetiapine.

Specifically, quetiapine has been reported to produce low rates of extrapyramidal symptoms and of dopamine D2 receptor blockade, even at high doses (1). We are aware of only one previously reported case of tardive dyskinesia associated with quetiapine, which occurred in a 44-year-old woman with schizophrenia who had received treatment with typical neuroleptics for many years

Source: http://ajp.psychiatryonline.org/cgi/content/full/158/10/1737

 

[Panamajack]

If you are concerned about what your psychiatrist is prescribing you then you should take it up with your psychiatrist; he has the training and the experience to provide you with the answers that you are seeking.

Of course your advice to discuss all the aspects of my treatment with Seropuel with my psychiatrist is good advice and logical. Unfortunately, my situation is a little difficult. I live about as far away from civilization as you can get in a South American podunk country. My doc speaks only Spanish and is of the aristocratic class. Class consciousness is very much alive and well here. When I asked her how many patients she had treated successfully with this regimen, her answer was “ All cases are different”. It was obvious I insulted her pride by asking such a question. I’ve been living here a long time so I know how to handle that kind of thing, and we have a good understanding, nonetheless. But my question was never answered anyway. I’ve asked my basic question on TDS and BDD too, and so far all the responses have been from persons who are using Seroquel for bipolar or some problem other than PAWS. I’m still wondering if I’m some kind of an experiment she is conducting. I’ve only found one study in an abstract where persons in detox were given Seroquel. Nothing about using it for PAWS.
Can you see why I’m a little hesitant to just forge ahead with this one year Seroquel treatment under these conditions?

 

[Panamajack]

But at what dosage? Any dosage?

Quetiapine (Seroquel) is wildly prescribed, at least in America. I'm his doctor is well aware of the potential side-effects associated with drugs in its class. Even so, the risk seems really negligible with quetiapine.



Source: http://ajp.psychiatryonline.org/cgi/content/full/158/10/1737

I’m 4 years into a habit, and I’d just about rather die than continue to be an addict, so given the slim chance of tardive dyskinesia, I’m willing to take that risk. My doc never mentioned it as a side effect, but now that youall have enlightened me to the possibility, I’ll be vigilant to any symptoms. My brother suffered from it for years, so I’m not a rookie to the symptoms. Also, I have a pacemaker, and take Concor, so sudden cardiac death from an arrhythmia is probably not going to happen. I’m on day 8, and so far no tachycardia or anything else except extreme lethargy in the am, anxiety, and dry mouth. Light years better than the cold turkey I did the first and only other time I tried to quit.

I just wish there was someone out there who has been treated with Seroquel for PAWS for a year who would share their experience. I’d feel better about it.

 

[8ft-Sativa]

Does it cause withdrawl symptoms if you stop abruptly?

 

[Sweet P]

^ No. I've been on and off Seroquel for all of my adult life, and never experienced withdrawal symptoms.

 

[negrogesic]

When compared to other dopamine antagonists/anti-psychotics, seroquel has a rather low incidence of extrapyramidal symptoms, even when dosed high for prolonged periods of time. I think its a good drug for treating opioid and benzo withdrawal, and does not have the "meat-head" property of all the other dopamine antagonists. I would not be concerned about taking it as your doctor has suggested.

 

[seep]

Rapid D2 dissociation lessens the risk of EPS or TD.

Astrazeneca wants to test quetiapine on drug relapse prevention, but the anecdotal reports of quetiapine abuse give the FDA umbrage. The proposed mechanism obviously involves one of the dopaminergic "reward" pathways.

I'd be concerned with weight gain. Also, orthostatic hypotension due to the coadministration of the beta blocker.

 

[Panamajack]

Rapid D2 dissociation lessens the risk of EPS or TD.

Astrazeneca wants to test quetiapine on drug relapse prevention, but the anecdotal reports of quetiapine abuse give the FDA umbrage. The proposed mechanism obviously involves one of the dopaminergic "reward" pathways.

I'd be concerned with weight gain. Also, orthostatic hypotension due to the coadministration of the beta blocker.

This post and several others have led me to believe that I am, in fact, part of an experimental treatment of PAWS by administration of quetiapine, being undertaken by my psychiatrist. That doesn’t bother me really; I just wanted to know what was up.

I wanted to know why there were no references to any studies in the general search engines, or anecdotal histories by this forum’s community about its use for PAWS. From what I’m reading in these posts, the drug is relatively side effect free and might just be a good treatment for PAWS, and an effective agent to prevent drug relapse. On day 8 of H detox, I’m looking ahead, not back, so this is good news. Now that I know I’m being used as a guinea pig, I’ll judge for myself if and when to exit the treatment and pursue a more typical PAWS treatment.

BTW, unless your object for abuse of quetiapine is immediate unconsciousness for many hours, followed by a lousy hangover, then don’t look to it for a good time.


Thanks for the warning about orthostatic hypotension. I have a pacemaker because of a 30 year history of premature sinus syndrome which led to 100% atrial fib, so I suffered from daily bouts of fainting, not just after standing, but even during normal walking. I’d just kneel down to supposedly adjust my sock until I regained blood pressure in the brain.

I have a minor medical miracle to report!!

I’ve gone from 100% atrial fib before pacemaker implant one year ago, to 10% atrial fib, 40% paced beat, and 50% normal heart rhythm. The pacemaker is a new generation which has an anti atrial fib component to its program. It was touted to be effective in only small percentage of cases, and then with only a small percentage of improvement.

I hit a home run in the ninth with the bases loaded to win the game!! My stroke risk went from significant to nil, and I can feel the difference in my endurance and general well being. And, significantly, I’m completely free of any fainting. Welcome to the world of bionic men and women. Ha Ha

 

[seep]

^You can't be part of a pharmaceutical experiment unless you've gone through informed consent.

[URL="http://clinicaltrials.gov/ct2/show/NCT00668265]There is a similar study in progress[/URL]:

This is a 16 week study of the efficacy of quetiapine in treating symptoms of generalized anxiety disorder (GAD) in subjects with comorbid opiate dependence. The study will be conducted in a prospective, randomized, double-blind, and placebo-controlled fashion. Study subjects will be inpatients at a residential drug-treatment facility, enrolled in a 1 year methadone-to-abstinence treatment plan. Subjects will be randomized to receive either quetiapine or placebo in addition to ongoing drug addiction treatment. Subjects will be followed for 16 weeks and a variety of psychometric assessments will be made.

Hypothesis One: Compared to placebo, Quetiapine will demonstrate a greater reduction in symptoms of anxiety in subjects with GAD and remitted comorbid opiate abuse.

Exploratory Hypotheses: Compared to placebo, Quetiapine will demonstrate a greater improvement in psychosocial functioning and compliance with community norms in subjects enrolled in a residential drug addiction treatment facility.

Email the PI and he may send you a bibliography (it's a little annoying that they don't post one on the page; patients should be allowed to be as educated as they want to be).

Which model pacemaker?

 

[Panamajack]

^You can't be part of a pharmaceutical experiment unless you've gone through informed consent.

[URL="http://clinicaltrials.gov/ct2/show/NCT00668265]There is a similar study in progress[/URL]:



Email the PI and he may send you a bibliography (it's a little annoying that they don't post one on the page; patients should be allowed to be as educated as they want to be).

Which model pacemaker?

I'll be sure and press my doc for more background on the extended quetiapine treatment, and whether or not she has studies to back it up. To hell with her Aristocratic pride. Thanks for the tip on the trial in progress. I'll research its bibliography, as you suggested.

The pacemaker is a ST Jude Medical, model no. 58326, serial no. 1243690. I feel really lucky to have it ticking away in my heart.