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Side effects of Seroquel vs. Risperdal?


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#1 mertzo

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Posted 29 April 2011 - 01:44 PM

Hello all,

Today my pdoc switched me from 1.5mg Risperdal twice a day to 150mg Seroquel once a day because I continued to have eps (oculogyric crisis) even after my dose was lowered. What I'm wondering is, what is the side effect profile of Seroquel compared to that of Risperdal? With Risperdal, at 3mg twice a day I had verbal dulling, and at 1.5mg twice a day I had the eps as well as trouble maintaining an erection/non-intense ejaculation. Are any of these symptoms common with Seroquel? Also, are there any new side effects I ought to worry about? Thanks.
Dx: psychotic disorder NOS, OCD
Rx: Risperidone 1.5mg twice daily [soon to change to Seroquel 150mg once daily], Klonopin 0.5mg three times daily, Cogentin 1mg once daily


#2 tryp

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Posted 29 April 2011 - 02:04 PM

I've never had any sexual side effects on Seroquel, for what it's worth. Doesn't mean it won't happen, but it didn't happen to me.
With Seroquel, the biggest issues I've had is that it made me very sleepy and very hungry. If weight gain is a problem for you, keep an eye on what you're eating, because Seroquel will most likely make you hungry.
For me, most of the side effects wore off after the first few months though. it's been a great medication for me - hopefully it will be for you too.

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#3 enlightened_plutonian

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Posted 29 April 2011 - 02:12 PM

I've never been on Risperdal, but I am on Seroquel currently. I can't compare the 2 meds, but I will say how the Seroquel has affected me.

For me the first few days sucked the most. I was sedated loads, but this reduced in time. Now (3 weeks into my treatment) I am still sedated, but I can function. Plus the general consensus from what I have read on here (+ personal experience too) is that the sedation is more at lower doses.

In fact, I have noticed a massive improvement in my symptoms. My anxiety disappeared for the first couple of weeks and is now evening out at a more healthy level (some anxiety is needed for self protection). My thought control (main reason I went on Seroquel) has gone all together.

I've had very few other side effects. I do get a dry mouth since going on to 600mg, but that doesn't really bother me as I can just drink plenty of water. And a reduction in my hayfever symptoms too since the morning after the night I started my Seroquel. I don't believe in coincidence.

Hope that helped. :rolleyes:
Current diagnosis = psychosis NOS
History = depression (remission since April 2009), SI (remission since April 2009), alcohol abuse (remission since March 2007)
Past false dx = BPD (only symptom I had was SI), schizophrenia (I was very sleep deprived at the time)
Also have diabetes and pain issues (undiagnosed) and hayfever (April - June)

Current meds = Seroquel 800mg XR (as 400 in the morning and 400 in the night)
Also on insulin and Microgynon

I am not deluded, I just don't agree with your reality!

#4 Blart752

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Posted 29 April 2011 - 03:23 PM

i havent had sexual se's with seroquel, altho they aren't out of the question. i was only on 25mg anyways. like EP said, drink plenty of water, the sedation of seroquel is a bit prominent so look out for that. appetite does increase, so be wary of that.

with the oculo crisis, I suggested artane for that which is indicated, and cogentin doesn't even touch that. but since you're on seroquel, and it's heavy alpha adrenergic stimulation, (which is why it has warnings for orthostatic hypotension). then artane would not mix well with that, since artane also affects blood pressure to a certain degree. or at least with me it did, so it never mixed well with seroquel.
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#5 Velvet Elvis

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Posted 29 April 2011 - 06:13 PM

Your seroquel dose is nowhere close to equivalent to the risperdal dose you were on so you're much less likely to experience any kind of side effects like you did on risperdal at your current dose. If you're going to have side effects akin to those you had on risperdal, they likely won't happen until you are at an equivalent dose which would be starting around 400-600 megs.

It sounds like your doc is starting you slow and working the dose up gradually to help reduce any side effect risks, which is good.

At 150mgs the only side effect you're likely to have is some sedation, but oddly enough that tends to go away as the dose increases.

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#6 Blart752

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Posted 29 April 2011 - 11:05 PM

i never heard that the sedation goes away as you increase it? i'm pressed to ask for evidence or sources for this, but you probably won't find any, but it is rather by word of mouth. the only thing i heard was dopamine blockade increases as you go up.
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#7 jarn

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Posted 29 April 2011 - 11:16 PM

I know everyone says that the sedation lessens with higher doses - not my personal experience, but sedation was my big Seroquel side effect, so maybe it's just how it hit me.

I think EPS-type symptoms are more unusual on Seroquel - I had some issues with swallowing, like my throat would freeze, kind of, but it wasn't a huge deal. I haven't been on Risperidone, but I was on Invega - which I loved short of the lactation - and it's hard to say the difference, given that everyone reacts differently. I had breakthrough episodes on both meds - my breakthrough episodes I had on Invega I dealt with by adding back Seroquel. It's a good med, IMO.

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#8 SashaSue

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Posted 30 April 2011 - 11:30 AM

i never heard that the sedation goes away as you increase it? i'm pressed to ask for evidence or sources for this, but you probably won't find any, but it is rather by word of mouth. the only thing i heard was dopamine blockade increases as you go up.


There are plenty of sources for this. Here's one. http://thelastpsychi...article_on.html
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Rx: Seroquel, 800mg, Lamictal, 150mg, Effexor, 325mg, Wellbutrin, 450, Dexedrine ER, 60mg

#9 enlightened_plutonian

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Posted 30 April 2011 - 12:02 PM


i never heard that the sedation goes away as you increase it? i'm pressed to ask for evidence or sources for this, but you probably won't find any, but it is rather by word of mouth. the only thing i heard was dopamine blockade increases as you go up.


There are plenty of sources for this. Here's one. http://thelastpsychi...article_on.html


Interesting article. Explains too why my hayfever suddenly disappeared (or at least reduced) when I started taking Seroquel. Gotta love that side effect. :rolleyes:
Current diagnosis = psychosis NOS
History = depression (remission since April 2009), SI (remission since April 2009), alcohol abuse (remission since March 2007)
Past false dx = BPD (only symptom I had was SI), schizophrenia (I was very sleep deprived at the time)
Also have diabetes and pain issues (undiagnosed) and hayfever (April - June)

Current meds = Seroquel 800mg XR (as 400 in the morning and 400 in the night)
Also on insulin and Microgynon

I am not deluded, I just don't agree with your reality!

#10 Blart752

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Posted 30 April 2011 - 02:55 PM

yah that is a good article, although ive read some that had higher histamine levels for zyprexa
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#11 SashaSue

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Posted 30 April 2011 - 03:43 PM

yah that is a good article, although ive read some that had higher histamine levels for zyprexa


I really uave almost no idea what it is you mean here.
Dx: Bipolar I, ADHD<br />
Rx: Seroquel, 800mg, Lamictal, 150mg, Effexor, 325mg, Wellbutrin, 450, Dexedrine ER, 60mg

#12 Blart752

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Posted 30 April 2011 - 07:00 PM

h1 levels-zyprexa has higher levels oh h1 than seroquel, so you could be like oh that's why seroquel is so sedating, but as i talked with my pdoc about it's the alpha adrenergic antagonism that makes seroquel the super sleep med that it is.

Edited by Blart752, 30 April 2011 - 07:02 PM.

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#13 SashaSue

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Posted 30 April 2011 - 07:01 PM

h1 levels


I still really don't know what you mean. There's no histamine, no histamine agonism, in seroquel, or any other AAP I can think of.
Dx: Bipolar I, ADHD<br />
Rx: Seroquel, 800mg, Lamictal, 150mg, Effexor, 325mg, Wellbutrin, 450, Dexedrine ER, 60mg

#14 gonenative

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Posted 30 April 2011 - 08:28 PM

I took Risperal a long time ago, I don't remember the SE but with Seroquel (other that the ones discussed above) I have raw areas on my tongue from trying to create saliva by automatically sucking


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I function on a cocktail of Seroquel 300mg, Lithium 900mg, Xanax


#15 Blart752

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Posted 30 April 2011 - 09:45 PM

histamine antagonism is waht i meant, of course that was what i meant. this link makes it clear, zyprexa's affinity is 2 while seroquel is 11. h1 antagonism

Edited by Blart752, 30 April 2011 - 09:45 PM.

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#16 Aurochs

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Posted 30 April 2011 - 11:44 PM

Okay, but that has absolutely nothing to do with the question posed or the content of this thread in general. 2 whats? Versus 11 whats? What do those numbers mean? (Yes, I am perfectly aware that those numbers are in units of nM, but you need to actually say that if you want to make sense in conversation. Don't assume that the person reading your posts knows what units you're using, or generally WTF you're talking about.)

Second, if you're going to talk about data, it would behoove you to specify what data you're talking about the first time you talk about it, instead of waiting three posts before you finally get around to it.

Finally, I'll get back to the point that VE and Sasha were trying to make in the first place: The mechanism by which quetiapine causes sedation at low doses becomes much less relevant at higher doses. Whether this mechanism is H1 antagonism or adrenergic antagonism does not matter. And Zyprexa has absolutely nothing to do with it.

Edited by Aurochs, 01 May 2011 - 12:21 AM.

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#17 jt07

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Posted 01 May 2011 - 12:59 AM

All I know is that I've heard that Seroquel is very sedating. Even though I think I could benefit from Seroquel, I won't take it for this reason. Risperidone, on the other hand, has 0 side effects for me.

So I think the answer to the original question is that each person responds differently to the meds and gets different side effects, or at least the side effects vary in intensity from person to person.

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#18 Blart752

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Posted 01 May 2011 - 02:53 AM

Okay, but that has absolutely nothing to do with the question posed or the content of this thread in general. 2 whats? Versus 11 whats? What do those numbers mean? (Yes, I am perfectly aware that those numbers are in units of nM, but you need to actually say that if you want to make sense in conversation. Don't assume that the person reading your posts knows what units you're using, or generally WTF you're talking about.)

Second, if you're going to talk about data, it would behoove you to specify what data you're talking about the first time you talk about it, instead of waiting three posts before you finally get around to it.

Finally, I'll get back to the point that VE and Sasha were trying to make in the first place: The mechanism by which quetiapine causes sedation at low doses becomes much less relevant at higher doses. Whether this mechanism is H1 antagonism or adrenergic antagonism does not matter. And Zyprexa has absolutely nothing to do with it.


well it does have relevance, sorry i just was too lazy to retrieve said page. which is why it took me like 3 posts to get around to it. the only reason i brought up zyprexa was because most people believe that h1 antagonism is the main function by which seroquel has it's sleep properties. but zyprexa has a higher affnity for histamine antagonism, meaning that in general works on those receptors more than seroquel does. that is a fact.
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#19 Aurochs

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Posted 01 May 2011 - 12:45 PM

Uhh, no, that's not quite true, and Zyprexa still has nothing to do with this. Why? Because Seroquel is extremely selective for H1 receptors, but Zyprexa is not.

The data to back this up is in the article Sasha linked to. (It's also in the article YOU linked to.) In fact, TLP directly compares Seroquel and Zyprexa using pie charts, so you can visually see for yourself what's happening. As he explains in the same article, 25 mg of Seroquel is primarily (almost exclusively) blocking H1 receptors. 25 mg of Zyprexa is blocking a lot of other receptors too, because Zyprexa is not as selective for H1. This selectivity, not the raw binding affinity, is what's responsible for Seroquel's legendary sedative powers. TLP spent most of that article explaining this phenomenon.

I won't discount that the alpha blockade could contribute to Seroquel's sedative properties, but I don't believe that it's primarily responsible. Much more selective alpha-1 blockers are available, primarily to treat hypertension and enlarged prostate. They don't typically put people to sleep the way Seroquel does.

Edited by Aurochs, 01 May 2011 - 07:08 PM.

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