Seroquel withdrawal

[Inspired_Neurosis]

I tapered off of Seroquel on the advice of my sleep doc, and my body feels incredibly weak--almost weightless. I expected insomnia to follow, and it did, but the flu-like subjective weakness doesn't appear(from my research, at least) to be normal. Anyone well versed on the topic?

[jarn]

I tapered off of Seroquel on the advice of my sleep doc, and my body feels incredibly weak--almost weightless. I expected insomnia to follow, and it did, but the flu-like subjective weakness doesn't appear(from my research, at least) to be normal. Anyone well versed on the topic?

I threw up for 2.5 weeks, with a respite one weekend, though felt off that weekend, after being taken off Seroquel cold turkey.

I am tapering off Seroquel, or I was, but below 200mg I start to trigger up.

Anyways, I haven't experienced the weakness, but I would expect everyone to react differently, and flu-like symptoms would not surprise me at all.

[Inspired_Neurosis]

Thank you for your input; sounds about right to me. I've been pretty on-and-off nauseous.

[buddha443556]

I experienced some weakness however I was taking a ton of hydroxyzine which may have been the cause. The insomnia sucked, wide awake for a week straight.

[Inspired_Neurosis]

I experienced some weakness however I was taking a ton of hydroxyzine which may have been the cause. The insomnia sucked, wide awake for a week straight.

I'm wide awake and yet exhausted. How the hell does that work?

[jarn]

I experienced some weakness however I was taking a ton of hydroxyzine which may have been the cause. The insomnia sucked, wide awake for a week straight.

I'm wide awake and yet exhausted. How the hell does that work?

It's the magic of Seroquel!!

[MarkP]

Seroquel is a benzodiazepine derivative, so its going to have similar withdrawal symptoms to benzodiazepines in a portion of the population. Although people think of Seroquel as an anti-psychotic, really, its just a benzo in sheep's clothing, with relatively weak dopaminergic antagonistic properties (which makes it a poor choice of anti-psychotic).

I would suggest tapering it just like one would taper a med like Ativan or Valium (diazepam). And if high-dose benzos aren't effective for insomnia, its very unlikely that Seroquel will be effective either.

Its kind of scandalous that this med isn't called exactly what it is -- a benzo. Guess that's a victory of AZ marketing. Being on 200mg Seroquel isn't really all that different from being on 100mg or 150mg of diazepam -- of course tolerance builds, and of course, eventually what would be a 'normal' dose would be good enough, in a benzo-naive person, to knock out a horse.

[Aurochs]

stuff

1. If any of this were true, we would also expect cloazpine and olanzapine, which share the same basic structure, to have similar withdrawl syndromes. I have not heard of them.
2. Also if this were true, we would expect quetiapine to bind to the benzodiazepine site, and thus modulate GABA. In fact, it has no detectable affinity for GABA A receptors.
3. Benzos induce sleep by modulating GABA. Quetiapine induces sleep by blocking histamine receptors. Completely different mechanisms of action.
4. Structurally, benzodiazepines are similar to quetiapine. This is correct. However, pharmacologically, they are nothing like each other. This makes any comparisons on anything other than a structural basis meaningless.

[MarkP]

stuff

1. If any of this were true, we would also expect cloazpine and olanzapine, which share the same basic structure, to have similar withdrawl syndromes. I have not heard of them.
2. Also if this were true, we would expect quetiapine to bind to the benzodiazepine site, and thus modulate GABA. In fact, it has no detectable affinity for GABA A receptors.
3. Benzos induce sleep by modulating GABA. Quetiapine induces sleep by blocking histamine receptors. Completely different mechanisms of action.
4. Structurally, benzodiazepines are similar to quetiapine. This is correct. However, pharmacologically, they are nothing like each other. This makes any comparisons on anything other than a structural basis meaningless
   

1) Clozapine patients report going through absolutely terrible withdrawals as well. Cold-turkey off of olanzapine or clozapine pretty much has the same outcome as cold-turkey off of the benzos. What makes olanzapine, clozapine, and quietiapine unique in the benzodiazepine family of compounds is that they exhibit dopamine antagonism to an extent not found in the more traditional benzos, in addition to the usual action at the GABA(A) receptors. 2) http://www.pubmedcen...i?artid=1573270

"Several neuroleptics including clozapine inhibit the GABA response on GABA_A receptor-chloride (Cl⁻) channel complex in previous ³⁵S-t-butylbicyclophosphorothionate ([³⁵S]-TBPS) binding studies (Korpi et al., 1995; Squires & Saederup, 1997; 1998). Clozapine was also reported to inhibit the GABA-induced Cl⁻ current in a previous ³⁶Cl⁻ flux-measured study (Korpi et al., 1995). Several phenothiazines including chlorpromazine were reported to inhibit the GABA-induced Cl⁻ current in previous patch-clamp studies (Yang & Zorumski, 1989; Zorumski & Yang, 1988). However, haloperidol, which is a butylophenon, only slightly affected the GABA-induced Cl⁻ current (Zorumski & Yang, 1988)."

-- no surprise there. Same effect as the traditional benzodiazepines, which is why withdrawal seizures are an issue with withdrawal from the antipsychotic-licensed 'pines', just like they are with the benzodiazepines. Not unexpected given that they both share the same fundamental benzodiazepine structure. And surprise, surprise, Haldol is one of the most un-sedating medicines in the entire pharmacopiea for psychosis because, as the research above shows, it does squat on the GABA system.

3) Why does quietiapine (olanzapine, clozapine, etc.) work in people who have failed other H antagonists then, for primary insomnia? Again, you're back to stuff going on at the GABA(A) receptors. If a physician is going to give a medication for sleep, they shouldn't delude themselves that Seroquel is magically "not" a benzo, while temazepam/triazolam/etc. is. Seroquel is like a wolf in sheep's clothing when used in this sort of application, complete with all the same 'problems' that come with benzo prescribing and use.

4) There's lots of evidence that they work in ways similar to benzodiazepines pharmacologically, which is to be expected since Seroquel is a benzodiazepine-derivative. Certain members of the benzodiazepine family have anti-depressant (ie: serotonin re-uptake capability, ie: alprazolam, adinazolam, triazolam). Some work on the alpha-1 receptor of the GABA(a) system more than others (ie: temazepam and flunitrazepam). Nearly all of the benzos, at high enough levels, are anti-psychotic (ie: provide dopamine blockade).

Of course, nobody calls Seroquel a benzodiazepine because apparently benzo is a dirty word out there, and AZ has done an excellent job of pushing its new-fangled benzo for insomnia (and in very high doses, for psychosis), over the traditional benzos that have a better safety profile, but obviously, are not very profitable as they've all gone generic.

Also, if you don't believe that the traditional benzos have some degree of dopamine (ie: D2) antagonism -- what's one of the rebound effects from sudden discontinuation of high-dose benzos? Psychosis! In other words, dopamine rebound. Same thing you find with people who try and cold-turkey off of clozapine -- the psychosis returns with a vengeance!

[Aurochs]

1) Clozapine patients report going through absolutely terrible withdrawals as well.

Perhaps I haven't come across enough clozapine-taking patients to know about this. Perhaps you have a link for me?

2) http://www.pubmedcen...i?artid=1573270

"Several neuroleptics including clozapine inhibit the GABA response on GABA_A receptor-chloride (Cl⁻) channel complex in previous ³⁵S-t-butylbicyclophosphorothionate ([³⁵S]-TBPS) binding studies (Korpi et al., 1995; Squires & Saederup, 1997; 1998). Clozapine was also reported to inhibit the GABA-induced Cl⁻ current in a previous ³⁶Cl⁻ flux-measured study (Korpi et al., 1995). Several phenothiazines including chlorpromazine were reported to inhibit the GABA-induced Cl⁻ current in previous patch-clamp studies (Yang & Zorumski, 1989; Zorumski & Yang, 1988). However, haloperidol, which is a butylophenon, only slightly affected the GABA-induced Cl⁻ current (Zorumski & Yang, 1988)."

-- no surprise there. Same effect as the traditional benzodiazepines, which is why withdrawal seizures are an issue with withdrawal from the antipsychotic-licensed 'pines', just like they are with the benzodiazepines. Not unexpected given that they both share the same fundamental benzodiazepine structure. And surprise, surprise, Haldol is one of the most un-sedating medicines in the entire pharmacopiea for psychosis because, as the research above shows, it does squat on the GABA system.

Hmm. That article talks about how antipsychotics reduce the seizure threshold, and links that to a decrease in Cl^- current. But that doesn't make sense - benzos increase the seizure threshold, don't they? In fact, they're occasionally used as anticonvulsants. So I looked up how benzos affect Cl^- current, and suprise suprise, they enhance it. If benzo-like antipsychotics decrease Cl^- current and benzodiazepines enhance Cl^- current, how in the world could they have the same effect? Besides, you didn't even address the question of affinity, which has been tested at over 10,000 nM (far too high a number for there to be an appreciable effect).

3) Why does quietiapine (olanzapine, clozapine, etc.) work in people who have failed other H antagonists then, for primary insomnia? Again, you're back to stuff going on at the GABA(A) receptors. If a physician is going to give a medication for sleep, they shouldn't delude themselves that Seroquel is magically "not" a benzo, while temazepam/triazolam/etc. is. Seroquel is like a wolf in sheep's clothing when used in this sort of application, complete with all the same 'problems' that come with benzo prescribing and use.

What? Where do you get that it works when other H₁ antagonists don't? And how do you know that's not because of a higher affinity for the binding site rather than an affinity for a different binding site?

4) There's lots of evidence that they work in ways similar to benzodiazepines pharmacologically, which is to be expected since Seroquel is a benzodiazepine-derivative.

And yet you present none.

Certain members of the benzodiazepine family have anti-depressant (ie: serotonin re-uptake capability, ie: alprazolam, adinazolam, triazolam).

What does that have to do with anything?

Nearly all of the benzos, at high enough levels, are anti-psychotic (ie: provide dopamine blockade).

If I had to guess I'd say that it's because of a downstream effect (GABA has an inhibitory effect on the entire brain).

[snip]

Also, if you don't believe that the traditional benzos have some degree of dopamine (ie: D2) antagonism -- what's one of the rebound effects from sudden discontinuation of high-dose benzos? Psychosis! In other words, dopamine rebound. Same thing you find with people who try and cold-turkey off of clozapine -- the psychosis returns with a vengeance!

See above re: downstream effects.

[MarkP]

3) Why does quietiapine (olanzapine, clozapine, etc.) work in people who have failed other H antagonists then, for primary insomnia? Again, you're back to stuff going on at the GABA(A) receptors. If a physician is going to give a medication for sleep, they shouldn't delude themselves that Seroquel is magically "not" a benzo, while temazepam/triazolam/etc. is. Seroquel is like a wolf in sheep's clothing when used in this sort of application, complete with all the same 'problems' that come with benzo prescribing and use.

What? Where do you get that it works when other H₁ antagonists don't? And how do you know that's not because of a higher affinity for the binding site rather than an affinity for a different binding site?

Well why would anyone take Seroquel, when they could just take achieve H1 blockade with something like diphenhydramine, if, indeed, an antihistamine would actually do the job? The people who are using Seroquel for insomnia are people who have tried everything else under the sun before looking towards prescription sleep aids. Seroquel works so well for insomnia *because* it is a benzo, because it acts like a benzo, has the same side effects as a benzo, has the same addiction and abuse potential as a benzo, has the same withdrawal symptoms as a benzo, etc. Really, I have no idea how AZ managed to pull a fast-one with the DEA and not have this medication scheduled as a C-IV, given its characteristics as a sedative-hypnotic, and the C-IV categorization of the [all off-patent] benzodiazepines.

Its kind of unfortunate that AZ gets away with marketing this stuff as a non-addicting medication "for psychosis", while Roche's diazepam is villified for being...a 'highly addicting' benzo, not to be given to drug addicts or psychotics! And doctors are really doing their patients a disservice if they don't sit down with their patients and explain the risks of quietapine in the same way, and in the same words that they explain the risks of using a traditional benzo medication. Both benzos, and Seroquel/Clozaril/Zyprexa, need proper taper plans after prolonged use, or the patient is going to be exposed to very similar outcomes.

[maybetinymaybesad]

i'm too lazy to research the pharmacology, but seroquel does not feel like a benzo to me at all. i took 25 mg recently for an overnight flight, and i was rendered nearly completely thoughtless and sedated. i didn't care about anything. when i took benzos, they made me a little sleepy, a little less inhibited, but it was nothing compared to 25 mg of seroquel even the first time i took benzos (1 mg clonazepam).

seroquel is addictive (to some) and does have withdrawal, though.

[Aurochs]

Well why would anyone take Seroquel, when they could just take achieve H1 blockade with something like diphenhydramine, if, indeed, an antihistamine would actually do the job? The people who are using Seroquel for insomnia are people who have tried everything else under the sun before looking towards prescription sleep aids.

Emphasis mine. The only centrally acting antihistamine available over the counter in the US is diphenhydramine, which doesn't have nearly as high an affinity for the H₁ receptor as quetiapine does. Have these people tried hydroxyzine? doxepin? Both are stronger at the H₁ receptor than quetiapine is. I'll bet it doesn't take nearly as high a dose to sedate someone with either of those (and I have anecdata to show this).

At any rate, you can't point to this one effect and say "look, it's a benzo!" Heroin will put you to sleep; does that mean that it's a benzo?

Seroquel works so well for insomnia *because* it is a benzo

Saying it won't make it so.

because it acts like a benzo

I thought I just showed that it doesn't? Whatever happened to my last post?

has the same side effects as a benzo

Which ones are those?

has the same addiction and abuse potential as a benzo

Umm, I've heard of people abusing quetiapine in prisons, but I'm pretty sure that even then it doesn't have the same abuse potential as Xanax. The DEA probably would have noticed people selling it on the streets if it did.

has the same withdrawal symptoms as a benzo, etc.

Umm, doesn't benzo withdrawl involve seizures? Has anybody ever heard of someone getting a seizure when withdrawing from quetiapine?

[Guest darwinsmunky]

It was my intention to actually respond to many of the statements above, but having reread them i dont even want to make the effort. There is so much bullshit in this thread i wouldnt even know where to begin. I really wish people wouldnt just copy and paste a case study in attempts to define their arguments because the truth in nearly all psychopharmacological medications, while scientist and doctors might tell you some of the receptors, neurotransmitters, and general mechanisms, they know an an incredible amount of information LESS than they try to represent. Im still shaking my head thinking about some of the statements above. So if your new to this thread and have made it to my post, do yourself a favor and go somewere else. And dont depend on one site to find the information your looking for. It isnt until you have researched many sources, and actually understand the medical language that your reading, that you will receive an accurate amount of information. Good luck to you. Adios.

[Guest marni paulo]

I tapered off of Seroquel on the advice of my sleep doc, and my body feels incredibly weak--almost weightless. I expected insomnia to follow, and it did, but the flu-like subjective weakness doesn't appear(from my research, at least) to be normal. Anyone well versed on the topic?

[Alpam]

Just wanted to share my experiences as I have been on both benzo's and Seroquel.

In my experience benzos have never make me tired in the slightest, I have been on Temazepam (my first benzo, which I got frustrated with and took half the pack trying to get to sleep) Diazepam, Alprazolam and Clonazepam. I have also taken small vacations from these drugs and still had the same tolerance when I came back on them.

Seroquel however has been a wonder drug for my Insomnia! When I first started on 12.5mg it knocked me out like a light. I did built up a tolerance to it over a couple of years in which I had to take 600mg to get to sleep, but I stopped, switched to a sedating antidepressant and didn't notice any kind of withdrawl from the Seroquel. when I started taking it again a month later I was able to take the 25mg tablets successfully.

Also as a side note, Benzos have killed my panic attacks and have really helped my anxiety, while Seroquel does not even help in the slightest.

Not trying to stir anything up, I just wanted to share my own personal experience.

[NaturaLeigh]

My withdrawal from seroquel was the absolute worst medication related experience I've ever had. Every part of my body screamed in pain, I thought my head might actually explode, extreme dizziness reduced me to crawling if I was brave enough to exit the bed. I actually ended up having the doctor call in an emergency prescription and sending a nurse to deliver it as there was no other way to ease the withdrawal symptoms. It took me 6 months to stop seroquel completely, against dr recommendations. I was horrified at my weight gain and didn't fully grasp all that seroquel ws doing for me. Now I'm considering taking it again. The only thing causing me to hesitate is the memory of stopping it the first time....

[isis]

I stopped seroquel cold turkey but I didn't think it was going to be an issue because I hadn't been taking it consistently anyway. I was wrong. According to my doctor, it can work quite well as an anti-emetic, so coming off it, i had severe, actually i'd call it extreme nausea, but no vomiting. I had headaches, dizziness, felt absolutely disgusting. The only way to get through that was to take it again, and then slowly reduce the dose. Was definitely a shock to me at the time.

Not even entering into the benzo vs ap debate.

[Maddy]

I never had a problem with quitting Seroquel.

Quit it cold turkey multiple times. I was on 300 mgs. the last time and it was Seroquel Xr.

But I never got withdrawals from quitting Adderall, Ativan, Paxil, Prozac, etc.

Don't know why.