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Comment by limeblack | Hacker News Reader

"Lamictal, a mood stabilizer; Lexapro, an antidepressant; and Seroquel, an antipsychotic that she was told to use as a sleep aid."

Lamictal and Seroquel can cause an often permanent condition called tardive dyskinesia[1]. Basically the dopamine receptors tend to permanent up scale leading to sleep disorders. This is fairly unique compared to most Psychiatric drugs out there.

[1]: http://www.onlinelawyersource.com/tardive-dyskinesia/seroque...

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Dopamine blockade isn't significantly induced by doses of Seroquel used for sleep. Although it and its metabolites do have action at certain dopamine receptors, lower doses will first occupy other receptors that they have a higher binding affinity for. Its metabolites are partial agonists at 5HT1A autoreceptors that induce downstream release of dopamine, which theoretically reduces the risk of tardive dyskinesia from direct dopamine blockade.

If you're curious about this, Stahl's Essential Psychopharmacology textbook goes into detail about this and is written in a way that some idiot (me) on HN can grok it.

> Dopamine blockade isn't significantly induced by doses of Seroquel used for sleep.

True at typical low dosages.

I have been on Seroquel at very high dosages for sleep and the doctor gave me the explanation above. I have after multiple attempts failed to taper off of it. I have even tried liquid. I will definitely check out the book. The key issue being that the receptor up scale permanently.

I don't see Lamictal on that list: https://medlineplus.gov/ency/article/000685.htm

I believe the risk is fairly small compared to the drugs on that list which is why its left out. Not that I trust this site more then a government site, but this list has it[1].

[1] https://www.ehealthme.com/ds/lamictal/tardive-dyskinesia/

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