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Reversing tolerance to Anti-Psychotics

quetiapine tolerance seroquel antipsychotic serotonin

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#1 BioInfinite

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Posted 27 August 2016 - 09:21 AM


I've been on Seroquel (Quetiapine) for over 2 years now. In the beginning it was very sedating and cured my anxiety and stabilised my mood well. After a year or so and over time, it became progressively less effective, leading me to keep increasing the dosage.

 

I reached my own personal ceiling about a year ago at 600mg/day. Basically I had serotonin toxicity several times before, and quetiapine is a 5-HT1A partial agonist. In the last 6 months I've been getting recurring akathisia around every two months. The only thing that worked was Propranolol the beta blocker (5-HT1A antagonist), because akathisia is usually treated by lowering serotonin. Risperidone made it worse, even though it's supposed to affect serotonin more than dopamine.

 

So I'm wondering if there is any way to reverse my tolerance? At the moment I'm needing to boost with Risperidone to quell my agitation and uncomfortable feelings, which is a double edged sword. 

 

I've been looking in to NMDA antagonists/agonists and it seems like antagonists can lower the tolerance of most drugs, but perhaps because antipsychotics have the opposite action, I need NMDA agonism?

 

Antagonists also increase the density of 5-HT1A receptors - would this be a good or bad thing for me? I'm assuming my current receptors are super sensitive, dense or damaged - not sure which.

 

Any insights are most appreciated!!

 

Thanks


Edited by BioInfinite, 27 August 2016 - 09:23 AM.


#2 Heisok

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Posted 09 September 2016 - 07:58 PM

I do not have an scientific answer to your question, but will give you my condolences for what you are going through. I wonder if a different method your doctor might recommend is adding a "Mood Stabilizer" such as Lamictal which seems to act differently than others such as Depakote or Lithium.  Perhaps this might help your original symptoms which you described in your post. That might allow you to bring the dose of Seroquel down. Granted you might have been given Seroquel for more reasons than simple mood and anxiety which the Lamictal might or might not help. My impression is that lowering of Seroquel even a fairly small amount can help to minimize  side effects even though one might still be on a relatively high dose. Only under your doctors care and close scrutiny of any deterioration in control of symptoms. The good news is that increasing the Seroquel seems to quickly reverse any symptoms which break through. Good luck.


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#3 BioInfinite

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Posted 27 September 2016 - 04:38 AM

Thanks for the reply Heisok. Unfortunately I already tried Lamictal and Lithium with catastrophic results due to my past serotonin toxicity/sensitivity. I also can't withstand anything too GABAergic due to my past over-use of GABAergics, I passed a threshold and my inhibitory ability was severely diminished due to some kind of damage. More drugs just produced paradoxical symptoms. I've visited that place a few times and I do get better with time, I just have to be really careful. I wish there was something that could repair the damage quicker.

 

I wonder if there is any sodium channel-blocker that is not also a GABAergic? What about the other channel-blockers like potassium, calcium etc, might they help calm neuronal excitation? 

 

I think that's the problem - my neurons are over excited which I'm using the seroquel to treat, and since I've been on it nearly 3 years my brain has gotten too used to it.

 

I really appreciate any replies! Thank you



#4 jack black

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Posted 27 September 2016 - 02:44 PM

Lamictal increased serotonin? This is news to me. I know Li can do that.
Have you tried inositol (supposedly 5ht2a inhibition)?

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#5 Grateful

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Posted 27 September 2016 - 10:48 PM

Not to hijack a post but have you tried L-stepholidine or L-tetrahydropalmatine supposedly both are dopamine antagonists but can't find much anecdotal data on it other than it is used in TCM to help sleep and psychosis. I am interested in the sleep aspect as well as possibly helping some ptsd triggered panic attacks.





Also tagged with one or more of these keywords: quetiapine, tolerance, seroquel, antipsychotic, serotonin

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