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Can Seroquel be used as an antidepressant?

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Posted on Sat, 17 Jan 2015
Question: When Seroquel is used off label to treat anxiety does it have to build up in your system over many weeks like an antidepressant does to be effective or is it more like a benzo where the relief from anxiety is more immediate ?
What is the effective dose of Seroquel for anxiety as I am currently on 25mg 3 times daily and I am still very anxious.My psychiatrist did say a week ago when I first started it that I may need to double the dose. Thank you Regards Rick
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Answered by Dr. Chintan Solanki (1 hour later)
Brief Answer:
It acts in both ways like antidepressant and benzo

Detailed Answer:
Hello XXXXXXX

Thanks for writing back again. Your question is very good from technical point of view.

Seroquel acts on many receptors. It is a dopamine, serotonin, and adrenergic antagonist, and a potent antihistamine drug.

Exact mechanism of its effects in anxiety problem is not proven. It has shown effectiveness in some drugs trial for anxiety disorder but yet not approved by FDA due to concern of side effects.

Adrenergic Alpha 1 and Histaminic H1 antagonism are responsible for sedation and sympatholytic activity. These effects are like benzo and help in anxiety problem immediately. But simultaneously they are responsible for side effects like sedation and postural hypo tension.

Serotonergic 5HT2A, Dopaminergic D2 antagonism 5HT1A partial agonism is responsible for its effect like antidepressant (SSRI) in anxiety disorder. This effect takes time for 3-4 weeks to show clinical improvement.

In clinical trials dose of seroquel for anxiety disorder was ranging from 150 to 300 mg in divided dosage. Most of the studies have used extended release (xr) preparation to reduce side effects.

According to above information you need to increase the dose as suggested by your doctor.

Hope I have answered your query, I will be happy to help further.

Regards,
Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
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Answered by
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Dr. Chintan Solanki

Psychiatrist

Practicing since :2007

Answered : 2406 Questions

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Can Seroquel be used as an antidepressant?

Brief Answer: It acts in both ways like antidepressant and benzo Detailed Answer: Hello XXXXXXX Thanks for writing back again. Your question is very good from technical point of view. Seroquel acts on many receptors. It is a dopamine, serotonin, and adrenergic antagonist, and a potent antihistamine drug. Exact mechanism of its effects in anxiety problem is not proven. It has shown effectiveness in some drugs trial for anxiety disorder but yet not approved by FDA due to concern of side effects. Adrenergic Alpha 1 and Histaminic H1 antagonism are responsible for sedation and sympatholytic activity. These effects are like benzo and help in anxiety problem immediately. But simultaneously they are responsible for side effects like sedation and postural hypo tension. Serotonergic 5HT2A, Dopaminergic D2 antagonism 5HT1A partial agonism is responsible for its effect like antidepressant (SSRI) in anxiety disorder. This effect takes time for 3-4 weeks to show clinical improvement. In clinical trials dose of seroquel for anxiety disorder was ranging from 150 to 300 mg in divided dosage. Most of the studies have used extended release (xr) preparation to reduce side effects. According to above information you need to increase the dose as suggested by your doctor. Hope I have answered your query, I will be happy to help further. Regards, Dr.Chintan Solanki.