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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Scott L. Schofield on January 6, 2000, at 10:39:45
My doctor put me on Seroquel(quetiapine) yesterday to be used as an antidepressant. I didn't know that it was used for depression.This drug is considered to be an atypical neuroleptic, and as such carries a risk of inducing tardive-diskinisia.
I tried Zyprexa (olanzapine) in September and seemed to get a robust antidepressant effect within a few days, but it only lasted a week. I met a woman who described that she had a similar experience with Zyprexa. A friend of mine who worked in a day-program told me that this scenario was rather common with Zyprexa. He also said that those using Seroquel seemed less likely to relapse.
1. Is anyone else using Seroquel as an antidepressant?
2. How long has it been effective?
3. What has your doctor told you about tardive-dyskinisia?
Any information regarding Seroquel would be valueable.
Thanks.- Scott
Posted by Cass on January 6, 2000, at 14:20:39
In reply to Seroquel for Depression ?, posted by Scott L. Schofield on January 6, 2000, at 10:39:45
My doctor put me on Seroquel briefly for depression. At one point, I was shocked to find out that it was commonly used for Schizophrenia. I wrote a thread asking about it some months ago. I believe it was JD who responded, telling me it was commonly used for depression as well. My doctor never mentioned tardive-diskinisia (Did I spell that right?) I had to discontinue Seroquel after about a week becuase it had such an extreme sedating effect on me. It would have been extrememly dangerous for me to drive after taking it, and I always woke up in the morning feeling hung over. I was on a very low dose. That was perhaps an unusual reaction. Maybe it will work better for you. That's my experience. Good luck.
Cass
Posted by Elizabeth on January 7, 2000, at 10:42:51
In reply to Re: Seroquel for Depression ?, posted by Cass on January 6, 2000, at 14:20:39
I tried using Seroquel for insomnia, but I kept having to increase the dose every couple days. In general people develop tolerance to the sedative effect, though it may take longer than it did for me!
FWIW, the risk of tardive dyskinesia is comparable to that of Zyprexa -- i.e., low. I think Seroquel is a good choice, Scott, given your previous response to Zyprexa. Good luck with it! (How much are you starting out on?)
Posted by Janet on January 7, 2000, at 23:22:51
In reply to Re: Seroquel for Depression ?, posted by Elizabeth on January 7, 2000, at 10:42:51
> I tried using Seroquel for insomnia, but I kept having to increase the dose every couple days. In general people develop tolerance to the sedative effect, though it may take longer than it did for me!
>
> FWIW, the risk of tardive dyskinesia is comparable to that of Zyprexa -- i.e., low. I think Seroquel is a good choice, Scott, given your previous response to Zyprexa. Good luck with it! (How much are you starting out on?)
What is tardive dyskinesia? I take 100 mg a day for obssesive compulsive disorder. But I could easily sleep 15 hours a day, some correlation? I also have major tremors but I wonder if the Depakote is to blame.
Posted by Scott L. Schofield on January 8, 2000, at 16:56:12
In reply to Re: Seroquel for Depression ?, posted by Elizabeth on January 7, 2000, at 10:42:51
> I tried using Seroquel for insomnia, but I kept having to increase the dose every couple days. In general people develop tolerance to the sedative effect, though it may take longer than it did for me!
>
> FWIW, the risk of tardive dyskinesia is comparable to that of Zyprexa -- i.e., low. I think Seroquel is a good choice, Scott, given your previous response to Zyprexa. Good luck with it! (How much are you starting out on?)50 mg/day hs.
I do get quite sleepy after taking it, but I don’t experience somnolence the next morning. However, these past few days I have felt the need to take a nap (more so than usual). Hopefully, it will disappear as you have described.
From where I’m coming from, I have to plan on continuing to take whichever drugs I end up responding to for the rest of my life. Hopefully, that will be a good, long time. It also seems like an awfully long time to be on a neuroleptic that carries with it any risk of inducing an irreversible movement disorder, regardless of how small that risk may be.
As I’m writing this, I sort of hope that it won’t work. That’s pretty screwed-up seeing as how I have spent the last @1$9& years trying to find a treatment that will.
Thanks.
- Scott
Posted by Judy on January 8, 2000, at 17:16:31
In reply to Seroquel for Depression ?, posted by Scott L. Schofield on January 6, 2000, at 10:39:45
Coincidentally, I just read this article on Seroquel at Medscape today before I saw your post. Sounds good. I'll copy it all for those who don't have Medscape passwords.
************************
Seroquel Manages Depressive Symptoms and Minimizes Adverse Effects
December 15, 1999
MedscapeWire
--------------------------------------------------------------------------------Further evidence of the efficacy of the atypical antipsychotic Seroquel (quetiapine fumarate) was presented this week at a major US psychiatric conference. Studies show that Seroquel effectively controls the devastating depressive symptoms of psychosis with few of the adverse effects common with other antipsychotics that often interfere with treatment.
"The data presented support the use of Seroquel as a first-line treatment for psychotic disorders," said Jamie Mullen, MD, medical director of CNS Therapeutic Area at AstraZeneca, the manufacturer of Seroquel. "Patients treated with Seroquel experienced little weight gain and less incidence of tardive dyskinesia (TD), and overall had better control over depressive symptoms. By minimizing side effects and offering effective control over symptoms of psychosis, Seroquel offers doctors and patients an important choice in the battle against mental illness."
A recent study showed that the Seroquel was effective against the depressive symptoms in patients, particularly those who entered the trial with high scores on one of the most widely used instruments for clinical assessment of depressive symptoms, the Hamilton Rating Scale for Depression (HAM-D). Seven hundred fifty-one adult outpatients with psychotic disorders participated in the 4-month, multicenter, open-label safety and tolerability trial which additionally compared the efficacy of Seroquel and risperidone against depressive symptoms. Patients taking Seroquel had improvement in HAM-D scores by 44.6%.
"Although they might not be as obvious to the outside world as hallucinations and delusions, depressive symptoms can be just as devastating for patients suffering from psychosis," said Martha Sajatovic, an author of the study and assistant professor of psychiatry, Case Western Reserve University School of Medicine. "This study demonstrates that quetiapine fumarate offers patients improvement in the symptoms of psychosis and may provide an opportunity to live a more normal life."
Some adverse effects associated with antipsychotics can range from moderately troubling to potentially serious, and all can impact patients' quality of life. Approximately half of the patients recovering from a relapse stop taking medications within 1 year, and doctors say patients sometimes stop taking medication because of troublesome adverse effects such as weight gain, restlessness, and tremors.
One serious side effect of antipsychotic treatment is TD, a disorder that causes potentially irreversible involuntary muscle movements. Almost 1500 patients participating in 3 phase III clinical trials were assessed for TD after receiving Seroquel. Researchers found that the incidence of the disorder was lower than the incidence of TD associated with conventional antipsychotic medications in other studies.
Researchers also investigated the incidence of weight gain in 2216 patients taking Seroquel in controlled, uncontrolled, and open-label extension trials. Data were reported on weight changes observed in this large group with specified time intervals. After 9 months to a year of taking the medication, patients treated with Seroquel gained a mean of only 6 pounds.
"In general, the atypical antipsychotics do a better job of controlling the negative symptoms of psychosis and have much less chance of causing extrapyramidal symptoms (EPS) such as tremors and inability to sit still," said Dr. Mullen. "However, some of these atypical agents are associated with significant weight gain. The data presented here indicate that this problem is not significant for patients taking Seroquel."
Clinical trials with Seroquel have demonstrated efficacy in treating the positive and negative symptoms of schizophrenia. There were no differences from placebo across the clinical dose range in the incidence of EPS, including rigidity and difficulty starting and stopping movement, or elevation of plasma prolactin levels. In addition, studies have shown that Seroquel exhibits a low incidence of hormonal, reproductive (sexual dysfunction), and anticholinergic adverse effects (dry mouth, constipation).
In clinical trials, efficacy was demonstrated in a dose range of 150 mg/day to 750 mg/day. An initial target dose range of 300-400 mg can be given in 2 divided doses daily.
Posted by JohnL on January 8, 2000, at 17:20:12
In reply to Re: Seroquel for Depression ?, posted by Scott L. Schofield on January 8, 2000, at 16:56:12
Medscape today had an article about Seroquel's effectiveness in treating depression. It's working out there in the field, so don't lose hope in it yet.
This is the end of the thread.
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