# How do Seroquel (Quetiapin) and Zoloft (Sertraline) work together?



## ronki23 (Apr 14, 2013)

I don't fully understand the difference between SSRIs and antipsychotics

I was originally on Zoloft 50mg for OCD and phobias 2007-2012 but I stopped my psychology treatment in 2008 and my GP wanted me off of them when I went to University for a year

Over that year (2013) I developed depression; it took me until April 2014 to see the psychiatrist and he put me on 100mg sertraline and then increased the dosage to 150mg (50mg morning and 100mg evening) after October. I was doing CBT too

For a week he's given me Seroquel 50mg but last month said he was hesitant to increase sertraline to 200mg

So now i'm on 150mg sertraline and 50mg quetiapin. Was just wondering how both are necessary in my case?


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## Saiga (Jul 18, 2012)

I've had similar situations like "why am I on this?", and my current psychiatrist does not understand why my previous psychiatrist put me on some of the things he did. I've been on both medications so I'll try to answer for you.

I was on 250mg Zoloft which is over the max recommended dose and had no noticeable side effects. Not sure why you were only on 50mg for awhile. That's a very low dose. I'm also confused as to why you take it twice a day. I've never heard of that. I took mine in one dose in the morning.

Seroquel, personally that stuff was too strong for me. Half of a 25mg pill would have me barely able to walk. I was prescribed it for sleep. If you take it at night maybe that is why? 

If you take it in the morning it may be to help control the OCD. You may have noticed it slows your brain down and reduces thoughts quite a bit. For me too much, but for someone with obsessions I can see how that could potentially be helpful especially if they are very irrational obsessions. I believe some psychiatrists also try to use Seroquel to boost the effect of antidepressants. I don't know about the effectiveness of that so I can't really speak on it but if your doctor puts you on I guess it's worth a try unless it is causing you intolerable side effects or something. 

I don't know why your psychiatrist would be hesitant to increase your Zoloft unless it is causing side effects or not working at all. If it's not working at all he may be considering tapering you off of it to try something else. 

My father has very bad OCD and did for his entire life until he started taking Luvox, in his own words he now has his OCD under control but still has depression. I have noticed most of his obsessions are gone on Luvox but some of his compulsive behavior like trading in his car and buying TVs he really doesn't have the money for (bad decisions) are still around but lessened. He was really bad and hospitalized so many times he and I both lost count and had ECT numerous times, and his OCD is now managed fairly well so I'm sure you will find the right medication if that combination isn't working. 

If the Seroquel makes you too tired ask your doc if you can take it at night. Personally makes me sleep 12-14 hours and wake up feeling like a truck hit me for most of the next day. Maybe I just had a bad reaction. 

As for the medications being a combination, that may not even be the case. They may be serving separate purposes. For example Zoloft to control depression and anxiety and Seroquel to help control the OCD. That's all I can think of.


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## ronki23 (Apr 14, 2013)

Saiga said:


> I've had similar situations like "why am I on this?", and my current psychiatrist does not understand why my previous psychiatrist put me on some of the things he did. I've been on both medications so I'll try to answer for you.
> 
> I was on 250mg Zoloft which is over the max recommended dose and had no noticeable side effects. Not sure why you were only on 50mg for awhile. That's a very low dose. I'm also confused as to why you take it twice a day. I've never heard of that. I took mine in one dose in the morning.
> 
> ...


In 2007 up to 2012 I was prescribed 50mg Zoloft for OCD and phobias, but it helped more with OCD

In 2014 I was prescribed Zoloft at 100mg for depression and six months later it was increased to 50mg in mornings and 100mg in evenings. But my Dr was reluctant to increase it to 200mg as I still go to bed and wake up late (when I was depressed I was avoiding people and sleeping awkward hours). Zoloft made me less obsessive and got rid of a lot of my inertia

But I don't understand the difference between antipsychotics and antidepressants and why I am on Seroquel.

I was prescribed Seroquel as i'm 'sticky' with memory and past events but that sounds like OCD. I've been on Seroquel for a week now

I see Zoloft inhibits the reuptake of serotonin as serotonin being reuptaken means it's lost in translation as opposed to going normally?

Seroquel reduces dopamine in the brain.

So sertraline helps with serotonin but quetiapin reduces dopamine. I thought you need both?


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## watertouch (Nov 4, 2013)

Normally OCD respond to Serotonin meds, for some about a 4th,(I need to check the serotonin hypotesis). dopamine works better... Seroguel/quetiapine works by blocking the 5HT2 receptor thus increasing Dopamine signaling.

http://stahlonline.cambridge.org/pr...erapeutics&name=Quetiapine&title=Therapeutics


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## ronki23 (Apr 14, 2013)

Saiga said:


> I've had similar situations like "why am I on this?", and my current psychiatrist does not understand why my previous psychiatrist put me on some of the things he did. I've been on both medications so I'll try to answer for you.
> 
> I was on 250mg Zoloft which is over the max recommended dose and had no noticeable side effects. Not sure why you were only on 50mg for awhile. That's a very low dose. I'm also confused as to why you take it twice a day. I've never heard of that. I took mine in one dose in the morning.
> 
> ...


I'm finding that the Seroquel is a knockout pill for me; I'm sleeping 10-11 hours with it and am exhausted with less than 9 hours sleep

I see you find 25mg too high when I'm on 50mg. The average dosage is 300-400mg, more than both of our dosages put together!

I'm considering cutting down to 25mg and perhaps increasing Sertraline to 200mg. Because I don't feel cured of clinging on to past traumas and worrying about the future-better yes, cured no


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