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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by jay on April 26, 2005, at 13:56:16
Hi Chemist:
Sorry to bug...I know you are a busy person..but in a post above you said something to the effect that Seroquel 200-300mg+ has less sedation and type side effects than below that dose. If you don't mind me asking, do you have a reference to this? (i.e. a study or something similar.) It's just that I do sort of see this, as 25-100mg used to knock me out into 15 or so hours of restless, horrible, constant rem sleep. I am finding at the 200-300 mg level, those side effects seem less pronounced. I still fall asleep quite quickly, but am able to get up without feeling like I've been run over by a truck. For the original reasons, I wrote Seroquel off as having any use, but may be now changing my mind, as it seems to have consistent sedation when taken, without the problems of Zyprexa, and seems much stronger than Risperdal. Any comments please...thank you so kindly...
Jay :-)
Posted by PM80 on April 26, 2005, at 16:35:50
In reply to Chemist...Seroquel...hlp please.., posted by jay on April 26, 2005, at 13:56:16
Ok, Im no chemist, but I'm on Seroquel too. I used to take 200mg at bedtime and 50mg 2x during the day. I always seemed to get incredibly drowsy after I took my day-time dose. My night-time dose seemed to have a more relaxing, but could-still-keep-my-eyes-open-if-I-wanted-to kind of effect. Now I only take Seroquel during the day if I need to (i'm getting really hypomanic or panic-attacky), but still take it at night. I does help me sleep. Also interesting to note, if I take 300mg at night for a few consecutive nights, I start waking up feeling depressed. So, 200-250 at night is the magic dose for me. I'm also on Depakote (750mg/day), just fyi.
So, in short, I love that seroquel at 200mg at bedtime. For me it works really well in combo with Depakote.
Posted by jay on April 26, 2005, at 18:05:35
In reply to Not chemist, but have experience here, posted by PM80 on April 26, 2005, at 16:35:50
> Ok, Im no chemist, but I'm on Seroquel too. I used to take 200mg at bedtime and 50mg 2x during the day. I always seemed to get incredibly drowsy after I took my day-time dose. My night-time dose seemed to have a more relaxing, but could-still-keep-my-eyes-open-if-I-wanted-to kind of effect. Now I only take Seroquel during the day if I need to (i'm getting really hypomanic or panic-attacky), but still take it at night. I does help me sleep. Also interesting to note, if I take 300mg at night for a few consecutive nights, I start waking up feeling depressed. So, 200-250 at night is the magic dose for me. I'm also on Depakote (750mg/day), just fyi.
>
> So, in short, I love that seroquel at 200mg at bedtime. For me it works really well in combo with Depakote.
>
>Hey, that is great news....very positive, thanks. I found Seroquel hard to start on, but once on it for awhile at bigger doses, some of the more troublesome side effects seem to go away, while it still helps good with sleep and psychic anxiety as well as dysphoria. Best wishes, and thanks!!
Jay
Posted by cache-monkey on April 26, 2005, at 21:51:18
In reply to Chemist...Seroquel...hlp please.., posted by jay on April 26, 2005, at 13:56:16
I'm wondering what this means in terms of ramping up the dose to 200-300 mg. I.e. does the sedation just diminish at higher doses? Or is it that one develops tolerance over the period of titration?
I've actually heard the second argument, and that the tolerance to the sedation is accomplished more quickly the faster one titrates up.
However, if it is simply a dose-related thing, I would definitely like to hear more about the mechanism at work.
Best,
cache-monkey
> Hi Chemist:
>
> Sorry to bug...I know you are a busy person..but in a post above you said something to the effect that Seroquel 200-300mg+ has less sedation and type side effects than below that dose. If you don't mind me asking, do you have a reference to this? (i.e. a study or something similar.) It's just that I do sort of see this, as 25-100mg used to knock me out into 15 or so hours of restless, horrible, constant rem sleep. I am finding at the 200-300 mg level, those side effects seem less pronounced. I still fall asleep quite quickly, but am able to get up without feeling like I've been run over by a truck. For the original reasons, I wrote Seroquel off as having any use, but may be now changing my mind, as it seems to have consistent sedation when taken, without the problems of Zyprexa, and seems much stronger than Risperdal. Any comments please...thank you so kindly...
>
> Jay :-)
Posted by alienatari on April 26, 2005, at 21:57:39
In reply to Tolerance (and titration speed) vs. Dose-related?, posted by cache-monkey on April 26, 2005, at 21:51:18
When I was on 800mg of seroquel i found it extremely sedating. A lot more so than 25-50mg. For me, personally, I found the higher I went the more sedating it made me. I literally couldnt get out of bed for a good 10+ hours after taking it. Maybe my response was abnormal though, I havent really heard many people having this response too. Take care.
> I'm wondering what this means in terms of ramping up the dose to 200-300 mg. I.e. does the sedation just diminish at higher doses? Or is it that one develops tolerance over the period of titration?
>
> I've actually heard the second argument, and that the tolerance to the sedation is accomplished more quickly the faster one titrates up.
>
> However, if it is simply a dose-related thing, I would definitely like to hear more about the mechanism at work.
>
> Best,
> cache-monkey
>
>
> > Hi Chemist:
> >
> > Sorry to bug...I know you are a busy person..but in a post above you said something to the effect that Seroquel 200-300mg+ has less sedation and type side effects than below that dose. If you don't mind me asking, do you have a reference to this? (i.e. a study or something similar.) It's just that I do sort of see this, as 25-100mg used to knock me out into 15 or so hours of restless, horrible, constant rem sleep. I am finding at the 200-300 mg level, those side effects seem less pronounced. I still fall asleep quite quickly, but am able to get up without feeling like I've been run over by a truck. For the original reasons, I wrote Seroquel off as having any use, but may be now changing my mind, as it seems to have consistent sedation when taken, without the problems of Zyprexa, and seems much stronger than Risperdal. Any comments please...thank you so kindly...
> >
> > Jay :-)
>
>
Posted by chemist on April 26, 2005, at 22:45:17
In reply to Chemist...Seroquel...hlp please.., posted by jay on April 26, 2005, at 13:56:16
> Hi Chemist:
>
> Sorry to bug...I know you are a busy person..but in a post above you said something to the effect that Seroquel 200-300mg+ has less sedation and type side effects than below that dose. If you don't mind me asking, do you have a reference to this? (i.e. a study or something similar.) It's just that I do sort of see this, as 25-100mg used to knock me out into 15 or so hours of restless, horrible, constant rem sleep. I am finding at the 200-300 mg level, those side effects seem less pronounced. I still fall asleep quite quickly, but am able to get up without feeling like I've been run over by a truck. For the original reasons, I wrote Seroquel off as having any use, but may be now changing my mind, as it seems to have consistent sedation when taken, without the problems of Zyprexa, and seems much stronger than Risperdal. Any comments please...thank you so kindly...
>
> Jay :-)hello there, chemist here...i am the one usually doing the bothering: it's my calling!...the other posters who replied are, i believe, supportive of the seroquel phenomena. as for references, i am in short supply in re: quetiapine. i have aprox. 25 manuscripts in my general mood disorders files, and they are largely comparisons of the newer off-label drugs for BP vs. lithium and valproate. however: see keck and mcelroy (2002), j. clin. psychiatry 63 (suppl 4), pp. 3-11. be wary of this journal: almost every article emanates from ``unrestricted educational grants from'' insert pharma here. there are facts lurking, however, and this is a review-style paper. you can barely tell that lilly funded the research. anyhow, the drug hits a slew of receptors, including D_{1}, D_{2}, M_{1}, 5-HT_{1A} (weak affinity); and higher affinity for H_{1}, 5-HT_{2A/2C}, and alpha_{1} and alpha_{2}. the sedation is logically attributed to H_{1} and alpha_{1}, and the antimanic effects will be mostly with D_{2}, and some antidepressant with the remainder. mechanism? i don't know, and i suspect that given the high affinity for the histamine and alpha_{1} receptors that they get saturated first, and with higher doses, the other holes get plugged and the sedation is counteracted in a way....linear kinetics, and not much else i can tell you except that i will look into it further and that it was quite an effective drug for helping with sleep at the time....all the best, chemist
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