Posted by linkadge on December 9, 2007, at 13:18:36
In reply to Re: Why is Seroquel so popular as a sleep aid? » clipper40, posted by Emme on December 9, 2007, at 12:55:49
>So there's really been no reason to try a med >class with a high side effect profile
The side effects of the TCA's aren't necessarily more numerous than the side effects of other classes. The TCA's have different side effects. For many who do well on TCA's, the side effects are much more tollerable than those of other medications.
For instance, I never got akathesia, insomnia, anxiety, or apathy on a TCA.
Another thing to consider is that seroquel actually has a TCA structure itself. I believe it is a TCA derivitive. The TCA's and Seroqel have many common targets namely antihistamine, antiserotonin (5-ht2a/c). A metabolite of seroquel has affinity fo the norepinephrine reuptake pump, like the TCA antidepressants.
The sedating TCA's like doxapin, amitryptaline or trimipramine, were use for many of the same purposes that seroquel is now. It seems to me that the common mechanism between the two is likely antihistamine effects, antiserotonin effects, and possible norepinephrine reuptake inhibition.
For many people taking seroquel off lable, I don't think the dopamine blockade is necessary. It is probably a side effect that can produce apathy, reduced vitality, and or movement disorders.
As such, for primary sleep issues, I would personally recomend a sedating TCA over seroquel. I found doxapin did everything seroquel did for sleep but I woke up feeling not half bad as compared to uuugggg.
Linkadge
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URL: http://www.dr-bob.org/babble/20071204/msgs/799740.html