Talk:Quetiapine

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Contents 1 Incidence of Akathisia 2 Off-Label Uses of Quetiapine 3 Pediatric Bipolar disorder 4 Treating Quetiapine-induced Akathisia 5 Restless Leg Syndrome 6 Anecdotal Self Report (moved here from article) 7 Drugbox 8 Seroquel 9 Experimentation on Children 9.1 Why do you keep taking off those links? 10 Could someone explain this? 11 Exorbiant cost 12 Serequel & Lorazapam 13 Bad Drug?

[edit] Incidence of Akathisia

This article as currently written (Nov 12, 2006) looks like an advertisement right from Astra Zeneca - the maker of quetiapine. I've removed text from the Uses heading that is unrelated and uncitied as well as biased in the drugs favour. Please add citations to this information if you want to re-add it, preferably from studies that are not funded by Astra Zeneca. The assertion of "placebo-level occurrence of EPS (including akathisia)" is incorrect as well. The only study I found supporting this was funded by Astra Zeneca, and there are many studies showing cases of akathisia with quetiapine use, for example: http://psy.psychiatryonline.org/cgi/content/abstract/46/4/291

and a report of a case of severe akathisia from quetiapine use: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12784279&dopt=Abstract

-Jamie

In considering your above changes I would like to add the following point of view. The presence of case studies indicating that quetiapine can cause akasthisia does not invalidate the previous finding by the manufacturer that it occurs similar to the level of placebo. This is because the placebo level is not 0%. In other words people who are on placebo still get akasthisia. So when researchers report cases of the presence of akasthisia in a person taking quetiapine it is still consistent with the orginal research. If a researcher did a large placebo controlled study that found that the incidence of akasthisia was higher or much higher than previously reported then this would be grounds to alter a statment suggesting that the incidence was close to placebo and viewing such statements as biased. Also, keep in mind that your second citation Akathisia as a side effect of antipsychotic treatment with quetiapine in a patient with Parkinson's disease. is a single case report of a person who already suffers from Parkinson's disease. This complicates the issue since Parkinson's disease involves movement and the dopamine system (i.e. this is a special or exceptional case). I think the statement could be modified to:

placebo-level occurrence of EPS (including akathisia) Quetiapine in patients with schizophrenia. A high- and low-dose double-blind comparison with placebo. Seroquel Study Group. However, the incidence is not 0% and case reports have emerged describing the occurrence of akathisia in patients while taking quetiapine Acute Akathisia Associated With Quetiapine Use.

This I think would be more consistent with Wikipedia guidelines based on NPOV and verifiability.--Psychofarm 15:35, 23 November 2006 (UTC)

[edit] Off-Label Uses of Quetiapine

I am thinking of adding a note that using seroquel to treat non-schizophrenic symptoms is more of a short-term solution for extreme accute cases. When I was frequently showing mania, or having my panic attacks closer and closer together I was put on it. --user not clearly identified

The section on uses includes a statment about off-label uses. That statement essential encompasses the additional non-schizophrenic uses that you describe though it does use broad categories. As a basic information source "anxiety disorders" would include panic attacks. Treatment of the manic phase is explicitely covered in the use section.--Psychofarm 15:35, 23 November 2006 (UTC)

[edit] Pediatric Bipolar disorder

I am 14 years old diagnosed with bipolar disorder by my psychiatrist. First I was put on Risperdal. Horrible side effect, made me feel like I had breast (male, haven't even been on it for a week.) Very painful. So then I was put on quetiapine 25mg for two days with Lexapro (10mg), then went up to quetiapine 50mg. When I was on quetiapine 50mg I just didn't feel right. When I went back to my psychiatrist I told her it [quetiapine] made me feel better, but kinda weird. My dosage was then adjusted to quetiapine 75 mg, and I have been feeling better than I ever have in my life.

Anybody else here on this drug? How have you responded to seroquel therapy?--Moop stick 02:58, 21 January 2006 (UTC)

[edit] Treating Quetiapine-induced Akathisia

I have taken seroquel twice a day for about 4 years (since I was first diagnosed with schizophrenia). My initial dose was 300mg twice a day and I now take 250mg twice a day (500mg/day) and I have always experienced the extrapyramidal side effects of akathisia which when acute feels literally like dying. This side effect has always occured in the several hours after taking each dose and it then disappears until the next dose. I recently read a study that used high doses of vitamin B6 (600mg twice a day) to treat acute akathisia and I am now taking 500mg of vitamin B6 once a day and this has relieved my side effects almost fully for the first time in 4 years which has made a very positive difference in my daily life. I may increase the dose of vitamin B6 to that used in the study but it seems to be effective for me at 500mg per day. Here is a link to the study: [1]

I would like to put some of the above information on the main seroquel page and on the general neuroleptic page as this information would be very helpful to people taking these medications and suffering the extrapyramidal side effects, which is estimated conservatively at 30% of people taking neuroleptics in the above referenced study.

Jamie

[edit] Restless Leg Syndrome

I seem to have the symptomes of RLS, where my legs just cant stop twitching. And ever since taking any kind of Antipsychotic I notice it even more. I'll need to see my doctor about that.. Do antipsychotics make you twitch or make you perform some small movements too? --Moop stick 19:39, 25 January 2006 (UTC)

Your restless leg syndrome could be an extrapyramidal side effect of the neuroleptic you are taking, but it sounds like you had it before and now it has increased in intensity. Vitamin B6 has been shown to relieve extrapyramidal side effects (see the above link) so you may want to try taking a B complex supplement, and specifically 250mg to 500mg of vitamin B6 supplement per day. I was very surprised when I noticed my very severe extrapyramidal side effects of akathisia disappear within a few days of taking 500mg of vitamin B6 once a day. If taking a large B6 supplement it is also a good idea to take a 50mg B complex and a magnesium supplement at the same time.

Some sites you may want to check out:

[2]

[3]

Jamie

High doses of vitamin b6 can be toxic [4]. --Mihai cartoaje 13:12, 16 April 2006 (UTC)

Last time I had too much B6 my urine was neon green. :O --Moop stick 13:16, 17 April 2006 (UTC)

I'll need to see my psych about this. I'm going to see her monday. She's supposed to have some kind of degree in neurology. And I'll probally have my dosage adjusted again. I think I heard a demon. Or it couldve been a car. I'm not sure. but it was just strange. My mom sometimes takes my seroquel. which I hate her for doing that. I'll keep my meds in my own room, hide them somewhere.

I also take some kind of multivitamin for old people. The bottle says it has 3mg of B6. It also has 100mg of manganese. --Moop stick 20:05, 26 January 2006 (UTC)

Why does your Mom take your Seroquel? Does it even do anything for her taking them sporatically? --Noam Chomsky

She takes them to fall asleep.. in return I get to buy stuff with her money. Good trade. --Moop stick 01:35, 25 March 2006 (UTC)

Haha, Dances With Wolves! --Noam Chomsky

In all fairness to your mother, Seroquel is the most effective sleeping pill I've ever taken. But it's sort of like killing ants with a shotgun. Tell your mom to see a doctor for one of the non-addictive sleep aids, the commercials are all over TV and they're very effective. It sounds like seroquel really helps your symptoms, and it doesn't help you to have to share the medication with your mother. As I recall, it isn't an inexpensive treatment. 69.19.14.16 12:40, 19 December 2006 (UTC)

I've been under impression this medicine CAUSES RLS, instead of being a treatment for it? --84.230.176.116 04:24, 13 March 2007 (UTC)

[edit] Anecdotal Self Report (moved here from article)

Someone wrote "A report suggests that a dose of 800mg everyday of quetiapine causes minor brain damage [5]."

Thanks for this link. I think that report is very worth reading, although the above statement neither follows from the report, nor is that "fact" in the report proved by anything at all. The report does not even say what caused the author to believe that she is suffering "minor brain damage", such as a CT or MRI scan. But even if it were true, the author has been given so many medications that it were not possible to tell which one caused what. --David Andel 10:11, 21 April 2006 (UTC)

I haven't written that it was a fact, only suggests. Criticism of the article which has not been published elsewhere is original research. Whereas we don't have to include every link in the article, I think that all reports of adverse effects have to be given consideration. --Mihai cartoaje 13:33, 21 April 2006 (UTC)

I agree. I just think that the appropriate place is here on the talk page. --David Andel 19:00, 21 April 2006 (UTC)

I agree as well, especially when considering Wikipedia:No original research

[edit] Drugbox

moved here from User_talk:Moop_stick

Hey man, why did you replace my version using the marvellous drugbox template again with that old version with the ugly syntax?! Just for the Seroquel logo being on top? I don't think it belong there anyway. The Seroquel logo would be best on a Seroquel page, since it is the commercial product, not the substance Quetiapine. I don't think it makes much sense to just replace each other's version, that's why I am writing you here. What have been your exact reasons for replacement? I think they could be met using the drugbos template as well, and that would make the drug pages somehow consistent. Otherwise it's just a mess... --David Andel 19:02, 23 April 2006 (UTC)

Actually, its much more easier to read the information. Nearly every drug page with the logo on it has the logo above the chemical structure. (Before you edited them). Your edits to the drug box were also unessasary. You dont need a template to display information. The "mess" is more editable. Displaying The drug logo in a seperate box can also cause messes like these, such as the one on the Sertaline page. Old Zoloft Page Newer Zoloft page . --Moop stick 20:21, 23 April 2006 (UTC)

I don't agree. Even if you think the information is easier to read - obviously a matter of taste - using the table syntax means lots of redundancy and less uniformity, since then it's easy to add or remove arbitrary elements to or from the table. And I don't know where you took your Zoloft examples. The recent Zoloft page doesn't look like the "newer" one of your examples. --David Andel 21:47, 23 April 2006 (UTC)

Depends on the browser you use. I use IE 7, and thats how it renders at 1280x1024 res. --Moop stick 22:25, 23 April 2006 (UTC)

Since I couldn't reach an agreement with Moop stick I am asking here now for support from someone else. I really think that the Drugbox templete is great: IMHO it makes the drug pages standardized and the syntax more clear! And since there is no majority between two people I am asking for others to tell their opinion. --David Andel 08:47, 28 April 2006 (UTC)

Ok, so nobody voiced his or her opinion on this issue for a month now. But in the meantime the drugbox get updated by someone to be even prettier than before. So I've moved it back to drugbox now - I mean, all the other drugs are in this format for quite a while now and nobody but Moop stick changed any of them (and Moop stick himself changed Quetiapine only). So I assume that he is in the minority. David Andel 21:41, 1 June 2006 (UTC)

[edit] Seroquel

Iv'e recently been diagnosed as having bipolar.... The Doctor has given me Seroquel 100mg to be taken three times a day, this is a hectic drug, it makes me feel really sedated, which is what it's supposed to do, but I am concerned over the side effects, ie: Causes High Blood sugar levels amongst many other side effects, there is even a web site entitled Seroquel Lawyers, Check it out on google. Should I be afraid?? Anyone care to comment?

You shouldnt be afraid. Seroquel's weight gain side effect is most responsible for the risk of diabetes. Although, Seroquel does not make you gain as much weight as other antipsychotics such as Risperdal and Zyprexa (especially Zyprexa). Following a good diet and excersize is the best way to avoid diabetes. --Moop stick 19:07, 28 April 2006 (UTC)

[edit] Experimentation on Children

There is currently a study underway to test the effect of this drug on 4-6 year old children. I know this violates "neutral point of view", but how can somone not be outraged by this?

http://www.clinicaltrials.gov/ct/show/NCT00181883?order=1

http://blogs.abcnews.com/theblotter/2006/05/tots_used_as_hu.html

• Well.. amphetamines are being perscribed to children for ADHD. Amphetamines are serious drugs, and can cause sudden death, and my grandma went on them for weight loss in the 50s and got really bad psychosis.

--Moop stick 19:01, 15 May 2006 (UTC)

[edit] Why do you keep taking off those links?

What's wrong with those links in the "external links" section? I think there is some real controversy surrounding this drug.

So Dr. Zak is just taking off those links without giving a reason why? They are totally related to that drug. Who appointed Dr. Zak and PHenry as censors anyway?

Take the controversy on clinical trials on young children to clinical trials, please! Actually, the fact that clinical trials most often involve young men is a problem, it shifts the sample to, well, young men. In women, aged people and young children the drug may be metabolized at a different rate. Dr Zak 06:00, 4 June 2006 (UTC)

[edit] Could someone explain this?

"...a series of neuroleptics known as "atypical antipsychotics", which have, over the last four decades, become increasingly popular alternatives to "typical antipsychotics""

as far as I know, the very first atypical beeing marketed was clozapine (Clozaril, Leponex) in 1972; the second was Risperdal in 1994. What four decades of atypicals? Clozapine gained never a broad-band use due to its myelotoxic side effects, the era of atypicals began in early 90's.--84.163.108.243 22:13, 27 July 2006 (UTC)

[edit] Exorbiant cost

My doctor prescribed this to me today, and we found out that my insurance covers but a fraction of it: which at the 800mg strength would be <$600 a month for me. I called her up, and I am starting out on Valproate semisodium instead. This is by far the most expensive medication me or my friends has ever heard of. $10 for generic Depakote vs. $580 for Seroquel.... even with monthly bloodwork, the old way's cheaper. :p Cwolfsheep 02:25, 10 August 2006 (UTC)

Umm, seroquel comes in samples. Ask your doctor about samples. At least as long as it's not in generic.

..Umm, samples are not going to be useful except for medications that are taken for a short time perhaps.

[edit] Serequel & Lorazapam

can someone tell me if it is safe to use Serequel and Lorazapam at the same time as a sedative anti-psychotic? thank you.

It is, well, safe if your doctor prescribes them both to you. I would suggest (but not trying to replace your doctor's advices, follow them firmly), that low doses of lorazepam (0.5-1mg) would cause a far more pronounced sedative effects than if taken without Seroquel medication. Higher doses can be needed, f.e. in patients with serious agitation by mania or psychosis, but should be taken/administered only in clinic setting, due to unpredictable extent of sedation, and possibly, some undesired effects (muscle weakness, blurred vision and the like), in my opinion. If your reaction to the prescribed doses of the medication is known, it can be possible to take these medications in higher doses also for an out-patient, but it always depends on your doctor's decision. Try to clarify these points with your doctor instead of on the internet. Remember, that lorazepam, as every benzodiazepine, is addictive.--Spiperon 00:25, 17 October 2006 (UTC)

[edit] Bad Drug?

I have seen several commercials where a lawyer is asking for people who have taken Seroquel and have complications to join a lawsuit. Why is nothing on that here? —The preceding unsigned comment was added by 67.110.221.182 (talk) 08:51, 11 February 2007 (UTC).

---

Probably because Seroquel is not the only medicine the law firms are trying to sue. And their case is not a good one. They're saying it might cause diabetes but this is very well known by its users already and it's a risk you have to take. You can take pre-caution of course. --84.230.176.116 04:21, 13 March 2007 (UTC)