# Does seroquel block the effects of concerta?



## Redefine (Jan 11, 2005)

My doctor prescribed 18mg of concerta because he believes a lot of my anxiety problems and lack of focus is caused by adult adhd. I know this is a rather small dose, but I really don't feel much different at all on it. He also prescribed me 50mg seroquel xr to take at around 6pm. I think he did this to ease the comedown off the methylphedidate and help sleep. Since seroquel is a dopamine antagonist, wouldn't the seroquel be blocking the effects of the concerta? Perhaps my dose is just too small, but I really don't feel much different at all, not even a loss of appetite. 

Keep in mind I weigh about 155lbs so I'm not a huge guy.


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## Vini Vidi Vici (Jul 4, 2009)

Redefine said:


> My doctor prescribed 18mg of concerta because he believes a lot of my anxiety problems and lack of focus is caused by adult adhd. I know this is a rather small dose, but I really don't feel much different at all on it. He also prescribed me 50mg seroquel xr to take at around 6pm. I think he did this to ease the comedown off the methylphedidate and help sleep. Since seroquel is a dopamine antagonist, wouldn't the seroquel be blocking the effects of the concerta? Perhaps my dose is just too small, but I really don't feel much different at all, not even a loss of appetite.
> 
> Keep in mind I weigh about 155lbs so I'm not a huge guy.


yes it could block the effects. but it doesnt block them via dopamine antagonism...Seroquel is actually only a rather weak dopamine antagonist. It blocks the effects of Concerta because it is a 5-HT2A receptor antagonist. 5ht2a antagonists can prevent/block the effects of many drugs, including cocaine, meth, opiates, ect. And since Concerta functions identically to cocaine (except being much weaker) it makes sense that its effectiveness would be inhibited.

Also, Seroquel can last a very long time in the brain, one dose can sometimes still be present in the brain after 24 hours in some people....it appears that even if the drug clears from the body, it still stays in the brain. this means that even if you take it at night, its still having effects throughout the whole next day. Seroquel has multiple other actions by which it can reduce the effects of Concerta, but 5ht2a antagonism is probably the most important. Try taking less Seroquel at night, or just ask your doc for some other sleep med. 50mg Seroquel is a huge dose for me...i would only take 12.5 mg, and id still be dead the next day. And also, chewing the pill will make it absorb faster, and stay in your system for less time. there is no reason to take eXtended release, unless you wish to have the drug in your system for the whole day (which is bad)


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## Redefine (Jan 11, 2005)

Vini Vidi Vici said:


> yes it could block the effects. but it doesnt block them via dopamine antagonism...Seroquel is actually only a rather weak dopamine antagonist. It blocks the effects of Concerta because it is a 5-HT2A receptor antagonist. 5ht2a antagonists can prevent/block the effects of many drugs, including cocaine, meth, opiates, ect. And since Concerta functions identically to cocaine (except being much weaker) it makes sense that its effectiveness would be inhibited.
> 
> Also, Seroquel can last a very long time in the brain, one dose can sometimes still be present in the brain after 24 hours in some people. this means that even if you take it at night, its still having effects throughout the whole next day. Seroquel has multiple other actions by which it can reduce the effects of Concerta, but 5ht2a antagonism is probably the most important. Try taking less Seroquel at night, or just ask your doc for some other sleep med. 50mg Seroquel is a huge dose for me...i would only take 12.5 mg, and id still be dead the next day. And also, chewing the pill will make it absorb faster, and stay in your system for less time. there is no reason to take eXtended release, unless you wish to have the drug in your system for the whole day (which is bad)


Very interesting, thanks maybe I will cut the pill in half. I've actually chewed the pill before like you said and I even asked for the non XR version, but he insisted on taking the XR earlier in the evening. It kinda stinks, being 20 I do most of my socializing at night and the seroquel makes me too sleepy to go out and pretty much does the opposite of any ADHD med, make my brain more foggy. Again, I think he's doing this to ease the comedown, but the dose is so low I doubt I would feel any comedown. I've never heard of a doctor doing this before, it sounds pretty uncommon.

I hate that I have to wait 3 weeks for the next appointment if I want to increase my dose or change medication.


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## crayzyMed (Nov 2, 2006)

Wait a minute, he prescribed seroques for "the comedown" wich you never complained off?

That doesnt make any sense. Try not taking it and see how your doing, and then tell hem you dont need it.
Especially since you socialize in the evening.


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## mark555666 (May 1, 2008)

I heard concerta is a terrible version of methylphenidate. Try normal ritalin not the extended release. Then you can take it in the evening and you dont need seroquel for the comedown.


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## UltraShy (Nov 8, 2003)

I don't see any valid reason for use of Seroquel XR in this case. You should ask your doctor exactly what the reason for this drug is. Everybody should know why they are taking any med that's given to them.

As for Concerta, I tried it simply because they have a coupon for 42 free 18 mg pills (go to their web site if interested in that offer). It gave me a free way to try Ritalin. Concerta seems to wear off after about 10 hours, so I really don't see it as likely to cause sleep problems.

Given how long Seroquel lasts I can't imagine needing an XR version -- is that for those who'd like to sleep a full 24 hours?:stu You don't mention having any insomnia issues. I also don't see the need for something to help one come down from Concerta. It's a relatively subtle drug IMO and it's not like there is some euphoric high followed by a crash. The most I've tried is 3x18, so 56 mg in a day (which would be equal the largest size Concerta comes in). I notice that it definitely kills my appetite for the duration it's in effect, which seems to be around 10 hours.


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## Redefine (Jan 11, 2005)

I did fail to mention that I do have insomnia issues. I've taken mirtazapine, trazadone and seroquel in the past for it. I told him that regular seroquel was the best for me because it doesn't make me super drowsy the next day like the XR or mirtazapine. Trazadone just seemed to give me headaches. 

Yeah, it confuses me too. I don't understand the use of the XR at all. He actually told me to just take Seroquel XR at 6pm every day for a week before starting the Concerta. Why? I don't know. It's weird trying to figure out the logic of some doctors.

Anyway, what were your experiences with concerta compared to other adhd drugs?


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## Akane (Jan 2, 2008)

Why the heck is there an xr version of seroquel? That stuff lasts forever anyway. Even after I built tolerance from years of taking it I could sleep 12hours on a dose that works where I can't make 2 on ambien cr and raising my dose at all would make it stack on itself day after day until I gained more tolerance. 50mg is not a high dose although the suggested dose of 200mg for everyone is a bit unrealistic but 50mg in an xr version for no good reason.... It also interacts on some level with nearly everything that impacts brain chemistry. Despite the fact it's the only thing that's worked for me I wouldn't suggest seroquel as anything but a last ditch attempt. Unless you've got a good reason to take it I'd refuse for something else. I'd probably actually find another doctor if I didn't have to insist on it in order to get it. Particularly a doctor that prescribes things which may make each other ineffective unless he can really explain the logic to that.

Have you tried any of the sleeping meds? The stuff you mentioned are not sleeping meds but antipressants that were used for sleep before other meds were available. Antidepressants usually make crappy sleep aids because they interfere with deeper sleep and the side effects generally aren't worth it. Seroquel is an exception to the first one but not the latter unless your insomnia is severe and does not respond to anything else. GABA impacting medications are a better choice if they work for you and what most of the newer sleep aids as well as benzos mostly have an effect on. There should be a thread not too far down the page where we discussed sleeping meds.

Oh don't chew, crush, or cut xr and cr tablets. Potentially very bad idea.


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## UltraShy (Nov 8, 2003)

Akane said:


> Why the heck is there an xr version of seroquel?


I went to business school and hold a degree in finance, so I can answer this question expertly: *PROFIT*.

You may have noticed that a while before a drug's patent is about to expire the company magically comes out with an extended release version -- designated with XR, CR, SR, XL.

It's one of the standard games played to extend patents and keep milking the same old cash cow for a few more years. Other common methods include cutting a molecule in half and selling one of the isomers (Celexa cut in half becomes Lexapro), or selling the metabolite of a drug.

Anyone who wonders why health care costs so much can thank big pharma for all these nifty tricks and the docs who go along with such nonsense as they are part of the reason.


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## Redefine (Jan 11, 2005)

Akane said:


> Why the heck is there an xr version of seroquel? That stuff lasts forever anyway. Even after I built tolerance from years of taking it I could sleep 12hours on a dose that works where I can't make 2 on ambien cr and raising my dose at all would make it stack on itself day after day until I gained more tolerance. 50mg is not a high dose although the suggested dose of 200mg for everyone is a bit unrealistic but 50mg in an xr version for no good reason.... It also interacts on some level with nearly everything that impacts brain chemistry. Despite the fact it's the only thing that's worked for me I wouldn't suggest seroquel as anything but a last ditch attempt. Unless you've got a good reason to take it I'd refuse for something else. I'd probably actually find another doctor if I didn't have to insist on it in order to get it. Particularly a doctor that prescribes things which may make each other ineffective unless he can really explain the logic to that.
> 
> Have you tried any of the sleeping meds? The stuff you mentioned are not sleeping meds but antipressants that were used for sleep before other meds were available. Antidepressants usually make crappy sleep aids because they interfere with deeper sleep and the side effects generally aren't worth it. Seroquel is an exception to the first one but not the latter unless your insomnia is severe and does not respond to anything else. GABA impacting medications are a better choice if they work for you and what most of the newer sleep aids as well as benzos mostly have an effect on. There should be a thread not too far down the page where we discussed sleeping meds.
> 
> Oh don't chew, crush, or cut xr and cr tablets. Potentially very bad idea.


I'd rather not take any GABAergic meds everyday. I had to go through a tough withdrawal with klonopin and wouldn't like something like that to happen again. I would only take such medications on occasion.

Why is crushing, chewing or cutting xr meds so bad?

Also, why do you only consider seroquel good for a last ditch effort? Is it dangerous in some way?


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## UltraShy (Nov 8, 2003)

Redefine said:


> Why is crushing, chewing or cutting xr meds so bad?


If you crush, chew or cut XR meds they're not XR any longer. You've just turned them into immediate release. The pill/capsule in XR meds will have some delivery system that is designed to break down slowly in your digestive system such that the medication is delivered over a period of time, rather than all at once and that can only happen if the pill/capsule is swallowed intact.


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## jim_morrison (Aug 17, 2008)

Sometimes the pill or capsule will be designed to slow the absorption rate, however sometimes the contents inside are time released, for example the tiny spheres contained within effexor XR capsules are designed to slowly release the chemical into the body over an extended period of time. At any rate ultrashy is correct, crushing or chewing can interfere with this process.


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## Redefine (Jan 11, 2005)

UltraShy said:


> If you crush, chew or cut XR meds they're not XR any longer. You've just turned them into immediate release. The pill/capsule in XR meds will have some delivery system that is designed to break down slowly in your digestive system such that the medication is delivered over a period of time, rather than all at once and that can only happen if the pill/capsule is swallowed intact.


Well, that's the idea, I chew it so I don't get the extended release. I'm just wondering how that's potentially a very bad idea like Akane said. He makes it sound like it's dangerous or something.


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## Akane (Jan 2, 2008)

Suddenly releasing everything in an xr tablet can be dangerous. The dose is basically changed because the absorption rate is changed and sometimes it's mixed with something in order to slow it down. You can't know what will happen and the dose you are reporting isn't entirely accurate. 50mg released over half a day is not the same as 50mg absorbed all at once. The latter may cause reactions equivalent to a dose 2 to 4 times higher than the former. Some medications or doses that are safe in xr form may kill you if absorbed all at once. Kind of like taking several days worth of klonopin all at once instead of individually. You are on a lower dose so the risk is not as great but it's not a good habit to get in to. Much safer to just find a doctor that will give you the regular version of the medication and don't crush xr pills unless you really know what you are doing and don't mind taking the risk.

Almost all medications can have as bad of withdrawals as klonopin and just because you have trouble with one benzo doesn't mean you will with others. It took me 2months to get off 50mg of seroquel because of the withdrawal. Always fun when the warnings say stopping this medication quickly may cause seizures or death. It was easier to stop lunesta than seroquel. That took 3 days and I'd taken both the same amount of time with the highest dose of lunesta. Ambien and xanax I can take off and on all I want and stop it quickly. I took 10mg of ambien for 2 weeks and then just stopped it. I frequently trade it out for something else. Klonopin was a nightmare for me and I was having withdrawal symptoms before my next dose every day. Not touching that again but that doesn't mean I don't ask for ambien, lunesta, xanax, and I'm debating temazepam.

Seroquel has a ton of side effects. The index page of the company website starts with several warnings and side effects then links to ways to manage them. Basically name a body part and it's listed. Probably under multiple problems. Some of them don't go away after you stop taking it. Most notably it messes with metabolism frequently causing weight gain and sometimes extreme weight gain which is darn hard to get rid of even after you stop the medication. I'm still trying to find some way to jump start my metabolism again. Seroquel raises blood sugar levels and some law suits were won over it causing diabetes. Raises bad cholesterol and lowers good cholesterol. It's a strong antihistamine that could impact your immune system and has been reported to change white cell counts.

Most medications I read the side effect list half assed, laugh at the "may cause death" one, and then ignore it because the side effects are fairly uncommon. A lot of seroquel side effects though have a 25% chance and there are a few more minor ones that can approach 50%. Nothing has been proven but astrazeneca that makes seroquel is now recommending regular eye exams because of a possible link with cataracts. It's on their website. Eye exams every 6months if you are on seroquel xr.

I'm not saying it should not be used or that there aren't worse things. I'd take it before MAOIs. If it treated things equally I'd probably take it before SSRIs given my reaction to them. It's risky enough though that I sure wouldn't take it if I had anything else to try. Unfortunately after several days of not sleeping on ambien cr plus an extra 5mg of ambien beyond what I was prescribed, 900mg of neurontin, 20mg of melatonin, and a few other over the counter meds I resorted to 25mg of seroquel again. I also have some 50mg pills stashed in case I should get cut off from my prescriptions for sleep aids or my doctor won't give me anything that works. My tachycardia that put me in the ER might be back though and I took seroquel for 5 years without that side effect until 6months ago. I can't deny it works even when nothing else does but you are better off risking withdrawal from benzos and z drugs if they can work for you than seroquel.


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## Vini Vidi Vici (Jul 4, 2009)

Akane said:


> Unfortunately after several days of not sleeping on ambien cr plus an extra 5mg of ambien beyond what I was prescribed, 900mg of neurontin, 20mg of melatonin, and a few other over the counter meds I resorted to 25mg of seroquel again. I also have some 50mg pills stashed in case I should get cut off from my prescriptions for sleep aids or my doctor won't give me anything that works. My tachycardia that put me in the ER might be back though and I took seroquel for 5 years without that side effect until 6months ago. I can't deny it works even when nothing else does but you are better off risking withdrawal from benzos and z drugs if they can work for you than seroquel.


this happened 2 me....my doctor told me i had 2 take seroquel for 1 week if i wanted to get the other medication i wanted (Parnate) seroqeul helped me sleep very well. i took it for about 3 weeks, then when i stopped, it was completely impossible to sleep even with multiple doses of Ambien and other stuff, i actually had withdrawal from Seroquel, i felt a craving to take it. but after 3 days i was ok and started sleeping better. but it was really hard to get through the first couple days of not sleeping, and feeling restless.

yay for AstraZeneca. im not being sarcastic....Big pharma is supposed to make money, its a business. they are not supposed/required/obligated in Any way to act in the best interests of their ...clients/patients/those using their products lol. It is only logical that they milk the most profit out of any and all medications which they can get the FDA to approve:boogie of course, ive had times when i posses considerable hate/disgust for Big Pharma....but ive found that hate doesnt fix anything


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## crayzyMed (Nov 2, 2006)

It took me a week to be able to sleep again after taking seroquel for 2 months every night.


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## Redefine (Jan 11, 2005)

Thanks for your input Akane, I really didn't know that much about seroquel. However, I don't think the 50 mg Seroquel XR has any more than 50mg of quetiapine. I think this is why most XR formulas usually have a greater dosage than the IR versions. (There's no 25mg XR, so the 50mg XR is probably comparable to the 25mg IR) In other words, a 50mg XR isn't going to constantly release 50mg over a period of time, it's probably going to be closer to 25mg. For example I'm taking concerta right now which is 18mg of methylphenidate. This can be comparable to 10mg of Ritalin (probably less than 10mg) because it's a CR. However they can't say that concerta is 10mg of methylphenidate because, well, it's not even though it may release about 10mg over a period of time. They have to say it's 18mg. Actually it's probably impossible for the pill to constantly release 10mg over a period of time. If you were to graph the release over time, most likely it won't be linear, there'd be a curve.



crayzyMed said:


> It took me a week to be able to sleep again after taking seroquel for 2 months every night.


This is interesting. I feel like I just can't sleep at all without some type of sleep aide, but perhaps it's just because I'm dependent on these sleep meds. I try to go days without taking something but I just lay there all night. I think my brain just won't shut off. Maybe I'm going to have to go some more time without sleep to get back to normal.


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## walnutstreet (Feb 19, 2010)

*Crushing Seroquel or other XR, CR, etc.*

Crushing an XR pill only converts it to the same mg's of IR (immediate release, normal), it does not increase the dosage. IR is just the drug, XR is the drug with inactive ingredients added to stop your gut from absorbing it all at once. But to get any XR or ER or CR type of drug to it's equivalent IR potency, it may need to be pulverized to break through the time release coating, depending upon the type. This is most needed with the beaded type. Some XR are layered, which would require several breaks to allow stomach acid to reduce it to IR.

The foundation for understanding this is to know that any IR drug has no releasing or barrier mechanism in it. This is not required to slow the "instant absorption" of the medicine. What slows the absorption rate, which is different for every medicine, are the various chemical and cellular mechanisms by which the body absorbs the medicine. Or taking it IV generally gives much quicker effective drug levels than oral. But that's not what we're talking about.

When you think of it logically, a manufacturer is not going to trust their assets and liability to customers who will not "chew, break, or crush" the pill or capsule. The chew, break, or crush does not make it dangerous, it only gives you the whole amount at one time, as though you were taking that much immediate release (normal) form. So, don't crush 300 mg of XR if you only take 150 of IR, or you'll be doubling your dose, etc.


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