Benzos how is seroquel for anxiety

[ErgicMergic]

I tried it once, even at dose of like 25 mgs....I ended up passed out on the floor and felt paralyzed! I had to pee it took me like an hour to get up to go to the bathroom!! lol Although frequent users may get used to the dosage and may not experience this all the time, this was just my own experience.

LOL, this is why I'm scared to ever take Seroquel, since doses under 100mg are so ridiculously anti-cholinergic that they sedate and cause RLS like mad. 12.5mg seems enough to knock most people off their asses, 25mg is way too much. Doses over 100mg start acting as an antipsychotic, and lose their sedative effects.

There are better anti-cholinergic drugs for sleep out there, in my opinion, from OTC ones Doxylamine is best due to least amount of side effects and perfect half life for sleep at a 12.5-25mg Doxylamine dosage. If you need something Rx strength, have you tried low-dose Mirtazapine? It kicks ASS for sleep and even for anxiety for some people, much better than the nasty ass Trazadone which produces the MCPP metabolite, causing morning anxiety (fuck that). Mirtazapine at doses of 3.75-7.5mg WILL knock you flat on your ass, man, but taking more than 15mg, especially >30mg, it becomes more stimulating.

For anxiety OTC options, try 400mg of L-Theanine per day, with 80 drops of HerbPharm Kava Kava Tincture in the glass bottles once or twice a day, with 0.3-0.5mg melatonin (not more) for its GABA activity, with 400-600mg chelated Mg and 30mg of chelated Zinc a day. For Rx anxiety options, 30mg hydroxyzine daily is great for certain types of anxiety. Take all those, try to exercise as much as your body allows, and then tell us you still have no improvement with your anxiety.

 

[pizzystrizzy]

LOL, this is why I'm scared to ever take Seroquel, since doses under 100mg are so ridiculously anti-cholinergic that they sedate and cause RLS like mad. 12.5mg seems enough to knock most people off their asses, 25mg is way too much. Doses over 100mg start acting as an antipsychotic, and lose their sedative effects.

No offense, but this is basically wrong. First, when you say 'anti-cholinergic,' you must really mean 'anti-histamine,' right? Anticholinergic drugs give you dry mouth, make it hard to pee, can make you confused or at least make it harder to concentrate and remember things, raise your heart rate, make you lose your balance, etc. They don't, however, make you sleepy, or at least if they do, it isn't because they are anti-cholinergic. More to the point, quetiapine has clinically negligible anticholinergic properties.

Second, the antihistamine-related sedation increases until the dose gets to approx. 200 mg, after which it no longer increases -- though it doesn't lose its sedative effects at higher doses, they just stop getting stronger as the dose increases. As for its antipsychotic effects, for an average size adult male, the dose on average has to get to above 300mg before it occupies more than 50% of D2 receptors, and it dissociates from them rather quickly. The dose for someone who was acutely psychotic can be as high as 800mg. The typical dose for acute mania is 600mg. Typical doses for depression are around 200-300mg, though they can be much lower particularly if the major indication is for insomnia.

As for restless leg syndrome -- certainly possible, but not terribly likely. I just checked the incidence rate and it is .48%, typically occurs at doses of 300mg or more, and there are some case reports indicating that it can be treated successfully with ropinrole.

 

[ErgicMergic]

No offense, but this is basically wrong. First, when you say 'anti-cholinergic,' you must really mean 'anti-histamine,' right? Anticholinergic drugs give you dry mouth, make it hard to pee, can make you confused or at least make it harder to concentrate and remember things, raise your heart rate, make you lose your balance, etc. They don't, however, make you sleepy, or at least if they do, it isn't because they are anti-cholinergic. More to the point, quetiapine has clinically negligible anticholinergic properties.

Second, the antihistamine-related sedation increases until the dose gets to approx. 200 mg, after which it no longer increases -- though it doesn't lose its sedative effects at higher doses, they just stop getting stronger as the dose increases. As for its antipsychotic effects, for an average size adult male, the dose on average has to get to above 300mg before it occupies more than 50% of D2 receptors, and it dissociates from them rather quickly. The dose for someone who was acutely psychotic can be as high as 800mg. The typical dose for acute mania is 600mg. Typical doses for depression are around 200-300mg, though they can be much lower particularly if the major indication is for insomnia.

As for restless leg syndrome -- certainly possible, but not terribly likely. I just checked the incidence rate and it is .48%, typically occurs at doses of 300mg or more, and there are some case reports indicating that it can be treated successfully with ropinrole.

^ No offense taken. I've never taken Seroquel and don't know much about antipsychotics, atypical or typical, and since I've never had a reason to take them, I haven't done much research on them.

Having said that, I definitely meant anti-cholinergic, as Seroquel makes you tired through its affinity for the mACH receptors. There are all sorts of anti-histamines, either generation one or Gen2 ones that antagonize the H1 receptor, but only ones that cross the BBB (generation 1 ones like DPH, Doxylamine, Promethazine, etc.) have clinically relevant anticholinergic activity, I mean, that's why Gen1's make you tired, make your eyes dry, cause difficulty urinating, etc. Gen2's, on the other hand, like Zyrtec, don't cross the BBB in clinically significant amounts, so they have no sedative action due to a lack of anti-cholinergic effects and a lack of ability to cross the BBB.

Therapeutic doses of clozapine, olanzapine, and, to a lesser extent, quetiapine are associated with clinically relevant AA [anticholinergic activity].

Source for above statement and dose-dependent graph

On the other hand, the I found another peer reviewed article that says the opposite:

Quetiapine may, in theory, be particularly advantageous in this regard because of its lack of anticholinergic activity and its relatively loose binding to dopamine receptors.

Source for above statement

So, there are conficting reports in the peer-reviewed literature. What say you, Bluelight? Chime in if you have any experience with Seroquel, including both positive therapeutic effects, or adverse side effects.

 

[pizzystrizzy]

But histamine and acetylcholine are two completely different neurotransmitters. Something can be an antihistamine without being anticholinergic, and likewise something can be anticholinergic without being an antihistamine. And there are lots of different anticholinergic side-effects, but not sedation.

The reason cetirizine (zyrtec) doesn't cause sedation has nothing to do with its not blocking mACH receptors -- it doesn't cause sedation like other antihistamines b/c almost none of it gets past the blood-brain barrier. So you are conflating two things and it is unclear to me why.

In the brain, the rate that histaminergic neurons fire is strongly connected to the sleep-wake cycle, so that while you are awake, they are firing at a steady rate, but they slow down during stage 3 and stage 4 sleep and completely stop during rem sleep. Drugs that are H1 receptor antagonists (actually inverse agonists, since no neutral H1 antagonist has been discovered afaik) and that cross the blood-brain barrier are sedating. This is the mechanism by which quetiapine causes sedation.

According to the Astra-Zeneca PI:

12.2 Pharmacodynamics
SEROQUEL is an antagonist at multiple neurotransmitter receptors in the brain: serotonin 5HT1a and 5HT2 (IC50=717 & 148nM, respectively), dopamine D1 and D2 (IC50=1268 & 329nM, respectively), histamine H1 (IC50=30nM), and adrenergic a1 and a2 receptors (IC50=94 & 271nM, respectively). SEROQUEL has no appreciable affinity at cholinergic muscarinic and benzodiazepine receptors (IC50 > 5000 nM).

I'm not sure what to make of the study you posted from Schizophrenia Research since it is at such stark odds with the above -- but it was only in vitro, and that might explain the difference.

I found this, which speaks directly to the matter -- Goldstein, J. M., & Brecher, M. (2000). Clarification of anticholinergic effects of quetiapine. The Journal of clinical psychiatry, 61(9), 680.

Clarification of Anticholinergic Effects of Quetiapine

Sir: In Table 1 of the article by Kumar and Brecher,1 the
muscarinic receptor binding affinity shown for quetiapine is
not supported by the pharmacologic and clinical properties of
quetiapine and may mislead the readers regarding the anticholinergic
effects of quetiapine. The reference used to support the
affinity for the muscarinic receptor (rated as “+++,” or “moderate,”
in Table 1) was taken from Pickar,2 but this value has
previously been refuted by Goldstein.3 It is again important to
set the record straight, in particular because their article deals
with elderly patients who are especially sensitive to the distressing
adverse effects resulting from blockade of the muscarinic
receptor.

With regard to anticholinergic properties, the following are
true about quetiapine:

• Quetiapine has no appreciable affinity for muscarinic
cholinergic receptors (IC50 > 5000 nM).4–8

• Quetiapine demonstrates no muscarinic acetylcholine
antagonist activity in a standard isolated tissue assay
(guinea pig ileum) for anticholinergic activity (data
on file, AstraZeneca Pharmaceuticals).

• Quetiapine demonstrates no muscarinic acetylcholine
antagonist activity in a standard behavioral model
(physostigmine-induced lethality in mice) for anticholinergic
activity (data on file, AstraZeneca Pharmaceuticals).

It is clear from preclinical pharmacology findings that quetiapine
would be predicted to have minimal anticholinergic effects
in humans.

In clinical use, the incidence of anticholinergic effects
is low. Any observed anticholinergic effects are most likely
due to quetiapine’s high affinity for the histamine H1 receptor,
since it is known that histamine blockade can cause some
“anticholinergic-like” actions that can be manifest in clinical
use.9 However, quetiapine is very well tolerated in special populations
that are especially sensitive to anticholinergic effects,
such as elderly patients with psychoses due to Parkinson’s disease
and Alzheimer’s disease. Quetiapine’s use as a first-line
agent for these populations and for patients with schizophrenia
is a testament to this characteristic.

The author is affiliated with AstraZeneca so he's certainly biased, but his arguments seem sound.

One last study -- here I didn't read the article, just the abstract, which I reproduce here:

The interactions of the atypical antipsychotic drugs (APD) clozapine, olanzapine, risperidone, quetiapine and ziprasidone with muscarinic receptors were reviewed. Only clozapine and olanzapine have marked affinity for muscarinic receptors in radioligand binding studies; however, the affinity of these compounds is considerably lower than classical muscarinic antagonists. Although functional assays in cell lines transfected with muscarinic receptors suggest that olanzapine and clozapine have weak partial agonist activity at muscarinic receptors, particularly M4 receptors, studies in vitro and in vivo indicate that the compounds function as antagonists. In animal studies and in humans, clozapine has pronounced antimuscarinic effects whereas olanzapine has weak antimuscarinic effects. However, olanzapine significantly occupies central muscarinic receptors in humans. Overall, the role of muscarinic receptors in the antipsychotic effects of clozapine and olanzapine is controversial and complex.

 

[MusicFiend420]

Serequel is only useful in sleeping. I have several 200mg pills that I tried maybe 5 times (last time with 2 huge Starbucks to try to stay awake haha) and each time I went to sleep or spent the whole time fighting sleep. I suppose if you call that slightly delirium onset of fighting sleep a distraction from withdrawls, then yeah just have some Starbucks on hand haha. I only attempt these things for recreational purposes so I honestly cannot you give you a detalied report on the pharmacology of the drug itself other than I know it's used to sleep instead of dealing with benzo and opiate withdrawls (again, ppl who are not prescribed the drug, so this is not medical use I'm talking).

 

[Rybee]

Why've you bumped an 8 month old thread?

 

[MusicFiend420]

Oh well

Why've you bumped an 8 month old thread?

Can't see any harm done.

 

[MrsMorphine]

Not to contradict my above post, or the nature of my posts in general, but Thorazine can actually work really well for migraine headaches. That is one condition I feel neuroleptics have a warranted use.

Whoa. Learn something new every day here, that's for sure. In thirty-odd (some very odd) years of dealing with chronic migraine, Thorazine is practically the only thing I have NOT seen recommended.

There's always decapitation, but so messy!

 

[R(x)AGE]

it good, dont drive.

 

[ErgicMergic]

it good, dont drive.

LOL



Seriously, though, like I said a year and a half ago in this thread, Seroquel is complete overkill for anxiety disorders, and the nastiness of the anticholinergic effects will probably make you feel even more physical anxiety.

Try 75-100mg hydroxyzine or 7.5-15mg mirtazapine before choosing Seroquel. Leave the 'quell for the schizophrenics and stimulant abusers, imo.

 

[Survival0200]

Seroquel is good for anxiety, because it makes you so tired, that you don't care about anxiety anymore! 8)

 

[qwe]

warning: seroquel helped me sleep good the first few times i used it. the first three times i was still tired in the morning. the first week or two it always got me to sleep on time. then after that, my sleep was like normal, but i stayed on it for a month or two. when i got off it, i couldn't sleep at all. it took a long time to fall asleep, and i kept waking up through out the night. it took two months or so for my sleep to get almost back to normal, though it still isn't.