![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by banga on November 22, 2007, at 22:56:41
Hi,
Wondering if any of you are currently using Seroquel for anxiety/insomnia. What dose do you take, does it usually cause weight gain even at the smaller doses? DOes it ever give you a hazy feeling in the morning or other bad side effects?
Posted by your#1fan on November 22, 2007, at 23:39:43
In reply to Seroquel for anxiety?, posted by banga on November 22, 2007, at 22:56:41
Seroquel.........yes it very very popular where my doctors office is.... doctors here in the south prescribe it alot.
Seroquel just numbs out some thoughts...a new age Thorazine. But not quite as potent. It does help with anxiety, but i just dont like the fact that you feel so lousy on it. It makes life just a bit dull. Its an antipsychotic.
But just ask your doctor maybe for some samples....
Posted by Phillipa on November 23, 2007, at 10:14:45
In reply to Seroquel for anxiety?, posted by banga on November 22, 2007, at 22:56:41
Tried it once during the day at l2.5mg and fell asleep right away. Then once at night at 50mg x 2 and benzos. In the hospital and couldn't talk the next day even though the words were in my head. Doc took me off it. A ton of people here do love it though. Weigh gain sorry no experience with that. Phillipa
Posted by yxibow on November 23, 2007, at 12:43:23
In reply to Seroquel for anxiety?, posted by banga on November 22, 2007, at 22:56:41
> Hi,
> Wondering if any of you are currently using Seroquel for anxiety/insomnia. What dose do you take, does it usually cause weight gain even at the smaller doses? DOes it ever give you a hazy feeling in the morning or other bad side effects?Its dosal related weight gain. Up to around 25-50mg it basically has no antipsychotic effects. You're just using it for heavy Hx transmitter occupation -- Dx and 5HTx are minimal at that range.
Having taken Compazine before and even the laundry list of atypicals for off label antipsychotic use I can tell you its no Largactil. It is the mildest antipsychotic in terms of Dx occupancy at its minimum effective dose range and has no akathisia.
Yes, for severe anxiety disorders, OCD with psycosis features, psychotic depresssion, etc, the benefits way out the perceived risks at least in the short run. Excercise and therapy help add to this sort of condition. Some people (hopefully) can respond to as little as around 200mg which is usually considered the therapeutic range though I suppose lower amounts may work.
Its a drug to take at night, if you haven't already done so. It has a 6 hour half life but really lasts in the plasma for far longer than that.
For very minor anxiety that is causing insomnia for someone who has never gone through a list of insomnia agents, 25 mg as a starter is plenty enough. You will feel groggy the next day and be careful standing up and sitting or lying down fast. One slowly develops a bit of tolerance to it but it is still soporific.
To gain anti-anxiety effects as I mentioned, 50mg+ would probably do something for you. It is not a drug to drop like a stone either unless you're at some piddly 12.5mg prescription. Withdrawals can occur and anxiety can rear its ugly legs for some weeks afterwards if it isn't done in say 200, 150, 100, etc.
Posted by banga on November 23, 2007, at 14:42:16
In reply to Re: Seroquel for anxiety?, posted by yxibow on November 23, 2007, at 12:43:23
Thank you for responses!
So for someone with anxiety and anxiety-related insomnia, perhaps a dose of 50mg in the pm would be a logical starting point?
I actually am doing ok with Abilify 5mg for anxiety for now, but a friend of mine really needs something, asked me about Abilify but to me it sounds as if she is looking for anxiety control in the evening so she can sleep better. My guess is Abilify would be way too activating for her.
And the info is great for me if Abilify ever stops working or I need a more calming version. The 6 hour half life is darn short, I suppose that has both advantages and disadvantages, depending on your reason for taking it.
Posted by linkadge on November 23, 2007, at 16:20:44
In reply to Re: Seroquel for anxiety?, posted by banga on November 23, 2007, at 14:42:16
I know (for myself) that seroquel is a bad choice for long term anxiety treatment. If I take it, sure I sleep ok, but because of the cognative messedupnes it induces, I fall further behind in school work, which just makes the anxiety build up more over the long term.
Linkadge
Posted by UGottaHaveHOPE on November 23, 2007, at 20:02:31
In reply to Seroquel for anxiety?, posted by banga on November 22, 2007, at 22:56:41
Every med affects everyone differently, but taken alone at night, Seroquel will make you sleep better than ever. You wake up with Benadryl-like hangover, which will work on your anxiety throughout the day. If it makes you too tired or lethargic, then simply drink some caffeine to give you some pep. Or half a Coke. You will learn your body's response.
Seroquel seems to work better in lower doses. Ive taken 25-100mg for years.
Posted by kaleidoscope on November 25, 2007, at 13:10:24
In reply to Re: Seroquel for anxiety?, posted by banga on November 23, 2007, at 14:42:16
Hi Banga
Nice to see you again :)
Seroquel has a longer duration of action than you would expect from its short half life. Daytime drowsiness is common even when it's taken as a single (small) dose in the evening.
High doses of Seroquel are generally needed for psychosis eg. at least 300mg per day. Very low doses eg. 25mg at night may have a similar effect to taking a sedating antihistamine such as Atarax/Vistaril.
Seroquel is an expensive drug which frequently causes weight gain. I would not advocate taking an antipsychotic solely for anxiety unless other treatments had been tried first and failed. Side effects are very common and there is very little high quality evidence to support the effectiveness of APs in primary anxiety disorders. If insomnia is caused by anxiety, long term treatment of the anxiety (eg. with an SSRI) can be combined with short term and/or intermittent use of a hypnotic eg. temazepam or zolpidem.
Posted by banga on November 28, 2007, at 7:30:05
In reply to Re: Seroquel for anxiety? » banga, posted by kaleidoscope on November 25, 2007, at 13:10:24
I think she tried ssris with little luck, but perhaps a more sedating/neutral tricyclic (my desipramine would be too activating) could be a viable option?
Posted by yxibow on November 30, 2007, at 5:05:32
In reply to Re: Seroquel for anxiety? » banga, posted by kaleidoscope on November 25, 2007, at 13:10:24
> Hi Banga
>
> Nice to see you again :)
>
> Seroquel has a longer duration of action than you would expect from its short half life. Daytime drowsiness is common even when it's taken as a single (small) dose in the evening.
>
> High doses of Seroquel are generally needed for psychosis eg. at least 300mg per day. Very low doses eg. 25mg at night may have a similar effect to taking a sedating antihistamine such as Atarax/Vistaril.
>
> Seroquel is an expensive drug which frequently causes weight gain. I would not advocate taking an antipsychotic solely for anxiety unless other treatments had been tried first and failed. Side effects are very common and there is very little high quality evidence to support the effectiveness of APs in primary anxiety disorders. If insomnia is caused by anxiety, long term treatment of the anxiety (eg. with an SSRI) can be combined with short term and/or intermittent use of a hypnotic eg. temazepam or zolpidem.
>
>Seroquel and Zyprexa are unique in how low their minimum effective dose is vs. possible long term side effects in the population. Zyprexa actually is lower in weight gain for me and caused weight loss but for its semi-permanent EPS can't use it.
200mg is possible for Seroquel in some patients.I would always agree in limiting AP use but there are some cases that warrant as there are few antidepressants (Trazodone, Serzone, high dose Remeron, the antihistamine cyproheptadine), etc, that have a multi-subtransmitter blockade at 5HT2.
Posted by Phillipa on November 30, 2007, at 20:34:28
In reply to Re: Seroquel for anxiety? » kaleidoscope, posted by yxibow on November 30, 2007, at 5:05:32
Jay you weren't here don't think when I tried the serzone no bad effects. Knowing me think it's a good one for me? Thanks would write but got home late. Phillipa
Posted by yxibow on December 1, 2007, at 2:02:33
In reply to Re: Seroquel for anxiety? » yxibow, posted by Phillipa on November 30, 2007, at 20:34:28
> Jay you weren't here don't think when I tried the serzone no bad effects. Knowing me think it's a good one for me? Thanks would write but got home late. Phillipa
As long as you get liver tests at reasonable intervals for nefazadone, and you didn't have any other bad effects, why not? It was made generic because the manufacturer fled after liver issues but this is not the first time that has ever happened...
Its not nearly as soporific as Trazodone.
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.