Rage, Anger, and Seroquel. Can severe anger be a side effect of quetiapine?

I have survived for more than twenty-five years while taking many antipsychotics. While some atypical antipsychotics are quite good at controlling anger, namely, Clozaril, Zyprexa, and Risperdal, others are not as good. Zyprexa and Risperdal basically block, or are antagonists, at the D2 dopamine receptors and serotonin receptors. They are not partial agonists. Clozaril is a partial agonist at the D2 receptor, but because of a compensatory mechanism with the NMDA receptor, it has both the greatest efficacy against psychosis and anger of any available antipsychotic. Truly, Clozaril is one of a kind. If not for the deadly possibility of Clozaril causing deadly  low white blood cell count, I am sure it would be the mainstay of schizophrenia pharmacotherapy around the world. European psychiatrists use Clozaril more than American psychiatrists, and their patients, accordingly, on average live longer and more productive lives. Seroquel, Geodon, and Abilify do not have the same compensatory effect on NMDA, and in my opinion, therein lies the danger of these three partial agonists to cause extreme medication-induced rage

Seroquel

It struck me that Mr. Levine seemed to talk a lot about Seroquel and rage in his first chapter. I survived Seroquel, as detailed  in my autobiography A Schizophrenic Will: A Story of Madness, A Story of Hope. I wrote an article titled Is Seroquel Safe? About the sometimes causal relationship between Seroquel and anger, indeed sometimes extreme homicidal anger and rage,  years ago, and I am now re-posting it because when my WordPress went down, so did the article.

Abilify

Many years later, after working really well for many years Abilify eventually made me homicidal and suicidal. I had so much rage on Abilify, eventually my body was shaking for two days straight and I had to use all my will not to explode and kill anyone in the process of letting out the rage. I put myself into the hospital.  I went into more depth in my little library science way, and in an article for Psychcentral.org titled Angry? It might be Abilify.  I wrote the following:  “The ehealthme.com database shows the following drug- percentage chance of causing anger: Abilify – 0.77% ; Geodon – 0.93%;  and Seroquel -1%. All of these drugs either modulate dopamine or serotonin. When 1 out of 100 people will notice anger or rage issues, that’s a common side effect, but is is nowhere in the prescribing information for these drugs in the Physician’s Desk Reference. Also, it turns out that the raw number of people who have anger from Abilify on ehealthme.com is higher than Accutane: the famous drug that made the kids go crazy violent in Bowling for Columbine.” This is all public knowledge but, not one of these three drugs has “Anger” or “Rage” as a possible side effect listed anywhere in the prescribing information. I feel this hampers otherwise good doctors from doing their jobs, as anger can also be a side-effect of PTSD or psychosis. So, when rage appears the doctors are not alerted that the side effect of anger, indeed, could be due to the atypical antipsychotic they are prescribing, unwittingly putting lives are risk.- even at the low 2 milligram dose I was taking, even after many years with no problems on the drug.

Author William Jiang, MLS quoted featured on CBS News and in the NEW YORK TIMES

 Partial Dopamine and Partial Serotonin Agonists  Can Cause Rage

Let me explain the neurobiology of extreme anger and its connection to serotonin and dopamine. When one increases serotonin in a teenager or possibly another person with an SSRI it is well recognized that anger or suicidality may result. Seroquel and Geodon are partial serotonin agonists- they can raise serotonin when it gets low. Also, dopamine is another neurotransmitter involved in anger formation or suppression. Quoting verbatim, the medical researcher Yao Xue Xue Bao. in an article from 1992 titled  [Amphetamine–induced rage reaction in mice and its mechanism]. “…Therefore, it may be deduced that the APT-induced rage reaction results from increased release of dopamine in the limbic system “ There are quite a few other articles indexed by MEDLINE that include much of the same information, but not so many are as unequivocally clear that dopamine can cause rage. How does this apply to Abilify? Abilify works with a “Goldilocks” mechanism. When dopamine goes too high, it is blocked, but if it goes too low, it is raised in a mechanism called partial dopamine agonism. So, Abilify can raise dopamine, therefore, increasing dopamine can cause rage: as well-evidenced by a few people who do cocaine as well.  Hence, partial dopamine agonism explains why Abilify can cause extreme rage. Partial serotonin agonism explains why Geodon, and Seroquel can cause extreme rage.

For most of the people, most of the time, these drugs work as intended without the side-effect of rage. However, sometimes not.

Final Thoughts

Popular partial agonists like Abilify, Seroquel, and Geodon are used for treating schizophrenia, PTSD, bipolar disorder, depression, and other psychiatric issues. If you are taking a newer atypical antipsychotic for one of these these issues there is a good chance it is a partial agonist of dopamine or serotonin, possibly to “augment” your antidepressant. Literally, millions of people in the United States alone take these three medications. 1% of just one million people is 10,000 people.  To put this in a statistical perspective, when we realize that according to CBS News 1 in 6 Americans take some kind of psychiatric drug and there are about 300 million people in the USA, that means 50 million people are taking psychiatric medicines and Seroquel, Geodon, and Abilify are some of the most popular psychiatric drugs.  If only half of one percent of 50 million people is affected by anger that is a staggering 250,000 people who may be put in danger of excessive and dangerous rage.

If it were in my power to magically wave my hand and force this knowledge into the textbooks of young resident doctors and psychiatrists as well as educating the general public in an instant, I would, but I need help spreading this message. I am just one person with a blog. You can help! Please share this essential post to help others! A personal note, I am currently stable with my paranoid schizophrenia on Navane chemical name thiothixene at a very low 10 milligram dose, with a beautiful girlfriend, a good writing career of many books behind me, I am the first in the world to use a Vagus Nerve Stimulator for severe Multiple Chemical Sensitivities, and I am currently looking for gigs as a Spanish to English and English to Spanish Translation and Statistician, my profile is on Upwork.

However, my main goal in life is to help others. So thanks for reading, and please let me know what you think in a comment, and please feel free to link to my blog or this article in particular, if you think it was helpful!

Don’t let them bury me, I need your help!

Look, as I said, I wrote an article a bit after 2000 titled “Is Seroquel Safe?” It got over 10,000 views on Geocities in six months because it was #1 for the keywords “Seroquel Safety” Then, somebody, somewhere made the decision to bury the story. It was buried under money. Six months after it was put up, it went from the #1 position, seemingly overnight, to the 10th page, and then even further down the list. Buried. Let’s be honest. I am a bestselling mental health author who backs everything he says up with hard medical science. But, who am I to the 2017 income of Geodon’s $53 Billion made for Pfizer, Abilify’s $19.4 billion made for Bristol-Myers Squibb, and Seroquel’s more than $25 billion made for Astrazeneca PLC? I am a mote of dust. PLEASE do not let them bury this article! You are seeing it at #1 on Google because Google thinks is an important article. You are seeing it because people are linking to this article, because maybe they know or knew somebody who got angry, enraged, suicidal, homicidal, incarcerated, or worse because of the drug they relied on had an undocumented serious side effect. I, myself, have very strong powers of insight. Most people do not. I have the training of a Columbia Psychiatry Library Chief. Most do not. I was so close to killing or being killed, more than 9 months ago. An update: I went to see my old psychiatrist about his nearly deadly error in insisting on my taking Abilify. He was a gentleman and a true doctor, when he said three times. “Will it seems you were totally right.” I have no problems with this man. I have a problem with the system that he relied on for information. I have a problem with the money. Please, share this page everywhere on your social media: Reddit, Facebook, Twitter, Instagram, Google+, Digg, Orkut, Pinterest. Everywhere. Copy the text of this article to your blog and link to the original, please. I do not want to be buried. I do not want them to cover up this “little problem” that is killing and incarcerating thousands and thousands per year, when it is not the fault of the patient. For more information, I invite you to follow me on Facebook and  sign up for email blasts. Very importantly!!! If you are somebody with money and power and you think I can help you help others with this, please contact me. I can do a lot with a little. Salud!

See Author William Jiang, MLS featured

in the NEW YORK TIMES and on CBS National News

William Jiang, MLS is currently the AuRage, Anger, and Geodon- Is Ziprasidone Causing your Anger?thor of 69 books, including the bestselling books The Medical Librarian’s Guide to Natural Mental Health: Anxiety, Bipolar, Depression, Schizophrenia, and Digital Addiction: Nutrition, and Complementary Therapies, 4th edition and his critically-acclaimed autobiographies A Schizophrenic Will: A Story of Madness, A Story of Hope and William Jiang and the Gamma Core. You can see a selection of his books about mental and physical health nicely laid out on his blog at http://www.mentalhealthbooks.net

I probably need Deep Brain Stimulation of the Globus pallidus interna for dangerous tardive myoclonus but ASAP

Me going to a recent speeddating event, to try to take my mind off of things- Guapo!

My suspicions were correct. Suffering for  more than 3 years with my tardive symptoms getting worse and worse without any doctors telling me what my diagnosis was is very frustrating, indeed more than one doctor said it was “psychosomatic”, and now I am in crisis mode because the CAM and the medicines I have been using to protect myself are barely controlling this life-threatening myoclonus. My neurologist confirmed that I have a tardive myoclonus of the tongue . See his notes here. I am happy I will be seeing him again tomorrow. He prescribed me Artane which worked great, for 4 days at a very low dose. But, because of chest pain I had to stop the Artane and go back to using 75 mg of Benadryl to not choke on my own tongue at night. I can not raise the Benadryl much more and even at the high dose I am now on, I can feel myself losing this fight to not choke on my own tongue at night. If you know a good neurologist in nyc who can do Deep Brain Stimulation for a life-threatening case, ASAP, I would really be happy for a referral dear friend, unless my own doctors come through for me, which would be ideal.

Also, last month every afternoon I succumb to a strange narcolepsy about noon when I must be in bed, and no stimulant I have tried can overcome this.  This problem was in remission for a year because I started using calcium supplements. So, I my theory is that an ENT who told me to take 800mg of magnesium per day, double what I really should, probably damaged part of my circadian rhythm or something.  Because of this narcolepsy I have had to cancel on the most powerful man in Psychiatry my Columbia Psychiatry colleague and  mentor Doctor Jeffrey Lieberman. This pained me. I really want to get my 4th edition out of my Guide to Natural Mental Health in case something happens to me.

But, the Rumplestiltskin narcolepsy is not life threatening. The Myoclonus is. There are three things I want to try to do ASAP. I am working with my doctors as fast as they will go. I may have the luck to try an experimental drug, to avoid further tardive damage. Or, I want to try a mix of the aforementioned drug with a little Navane to boost the antipsychotic action of the experimental drug. Or, I may start Ingrezza, although 20% of the time this can exacerbate tardive symptoms so there is a 20% chance I would die , or probably, to me this seems like the preferable treatment-  Deep Brain Stimulation of the Globus pallidus interna. MEDLINE says it can help here.  In my ideal world I would get deep brain stimulation for my paranoia and vagal nerve stimulation for my multiple chemical sensitivities too. But most doctors would think that is crazy talk. 

Below is a snippet I have recently added to my 4th Edition of my Guide to Natural Mental Health which I want to release ASAP in case I die from these tardive symptoms.  Here is the snippet from the 4th edition with regards to tardive symptoms and complementary and alternative medicine. For almost one year, my myoclonus went into complete remission just with vitamin E. These strategies work to avoid tardive symptoms. I tested the theories on myself. So I am sure, and they are pretty safe.

CAM and Tardive Dyskinesia

Taking antipsychotics can cause more than ten tardive problems. The first generation such as Haldol is called ‘typical antipsychotics’. The second generation such as Abilify is called ‘atypical antipsychotics. All antipsychotics can tardive problems. The most well-known tardive syndrome is the disfiguring tardive dyskinesia of the tongue and mouth. The tongue can protrude and writhe as a snake and/or the jaw can make repetitive chewing motions. The chance of atypical antipsychotics causing tardive problems is about 20% for long term use; whereas the older, typical antipsychotics chance is roughly double that or 40%. Vitamin E, ginkgo biloba, branch chain amino acids (BCAAs), theanine, lecithin, and taurine have shown to have some protective effects against developing tardive symptomatology. Nobody wants tardive symptoms. Taking a vitamin E supplement everyday is an inexpensive, easy way to try to avoid, prevent, or delay this problem.

Source: Cochrane Database Syst Rev. 2018 Jan 17;1

Title: Vitamin E for antipsychotic-induced tardive dyskinesia.

Authors: Soares-Weiser K1, Maayan N, Bergman H.

Abstract: BACKGROUND: Antipsychotic (neuroleptic) medication is used extensively to treat people with chronic mental illnesses. Its use, however, is associated with adverse effects, including movement disorders such as tardive dyskinesia (TD) – a problem often seen as repetitive involuntary movements around the mouth and face. Vitamin E has been proposed as a treatment to prevent or decrease TD.

OBJECTIVES: The primary objective was to determine the clinical effects of vitamin E in people with schizophrenia or other chronic mental illness who had developed antipsychotic-induced TD.The secondary objectives were:1. to examine whether the effect of vitamin E was maintained as duration of follow-up increased;2. to test the hypothesis that the use of vitamin E is most effective for those with early onset TD (less than five years) SEARCH METHODS: We searched the Cochrane Schizophrenia Group Trials Register (July 2015 and April 2017), inspected references of all identified studies for further trials and contacted authors of trials for additional information.

SELECTION CRITERIA: We included reports if they were controlled trials dealing with people with antipsychotic-induced TD and schizophrenia who remained on their antipsychotic medication and had been randomly allocated to either vitamin E or to a placebo, no intervention, or any other intervention.

DATA COLLECTION AND ANALYSIS: We independently extracted data from these trials and we estimated risk ratios (RR) or mean differences (MD), with 95% confidence intervals (CI). We assumed that people who left early had no improvement. We assessed risk of bias and created a ‘Summary of findings’ table using GRADE.

MAIN RESULTS: The review now includes 13 poorly reported randomised trials (total 478 people), all participants were adults with chronic psychiatric disorders, mostly schizophrenia, and antipsychotic-induced TD. There was no clear difference between vitamin E and placebo for the outcome of TD: not improved to a clinically important extent (6 RCTs, N = 264, RR 0.95, 95% CI 0.89 to 1.01, low-quality evidence). However, people allocated to placebo may show more deterioration of their symptoms compared with those given vitamin E (5 RCTs, N = 85, RR 0.23, 95% CI 0.07 to 0.76, low-quality evidence). There was no evidence of a difference in the incidence of any adverse effects (9 RCTs, N = 205, RR 1.21, 95% CI 0.35 to 4.15, very low-quality evidence), extrapyramidal adverse effects (1 RCT, N = 104, MD 1.10, 95% CI -1.02 to 3.22, very low-quality evidence), or acceptability of treatment (measured by participants leaving the study early) (medium term, 8 RCTs, N = 232, RR 1.07, 95% CI 0.64 to 1.80, very low-quality evidence). No trials reported on social confidence, social inclusion, social networks, or personalised quality of life, outcomes designated important to patients. There is no trial-based information regarding the effect of vitamin E for those with early onset of TD.

AUTHORS’ CONCLUSIONS: Small trials of limited quality suggest that vitamin E may protect against deterioration of TD. There is no evidence that vitamin E improves symptoms of this problematic and disfiguring condition once established. New and better trials are indicated in this under-researched area, and, of the many adjunctive treatments that have been given for TD, vitamin E would be a good choice for further evaluation.

 

Be careful what you take with your psychiatric medicines with

I have a lot of great things going on in my life right now, but one always must be careful what one mixes with one’s psychiatric medicines.  I have a loving romantic woman in my life, she’s my favorite ladyfriend of all time. A great position with a prestigious institution’s library may be mine in the next few months. I am fighting for some justice for my family for my deceased stepfather’s tragic early demise due to COPD due to 9/11 and its aftermath. The fourth edition of The Medical Librarian’s Guide to Natural Mental Health, a follow up to my #1 best seller in the field of holistic mental health is shaping up well. I’m playing with a new potentially dangerous but powerful therapeutic modality, tDCS otherwise known as Transcranial Direct Current Stimulation to enhance my meditation, language learning abilities, and mood.  An advanced certification in the Spanish language the DELE level C1 is coming up. Also, I saved mom’s life from a basal skin cancer recently by forcing her to get it checked out. Mom should be around for many more happy years. My brothers are getting on with their lives in a positive manner, and all my nephews and nieces are in good health and growing up beautifully. The house is a lot quieter without Dad around, but he’d be happy and proud of what our family is up to. I hope he is looking down on us and smiling. So, I have a lot of great things happening in my life right now, a lot for which I am  thankful and grateful.

It is pretty common knowledge that there are drug-drug interactions. If one takes ANY medication, and one is going to add a medicine, one must always check for medicines that do not mix, contraindicated medicines. For example, some cough syrups mix badly with some antidepressants. A few years back, I learned the hard way because of a lazy doctors work that the mood stabilizer Tegretol has a major contraindication with the antipsychotic thiothixene. That’s a funny story. I was in the hospital for two weeks. The second day as inpatient my doctor started me on Tegretol. I felt strange. I decided to trust the doctor for once and not check up on her work. Mistake. Days after being discharged I started becoming symptomatic with psychosis. After about a week of becoming sicker and sicker, I went to the Emergency Room. I told them about the medications I was taking, and how I was feeling. Their response? “Your doctor should raise your level of Tegretol if you are not feeling better soon.” I was dumbfounded. This was not how I should be. I know myself and my baseline. So, I Googled “tegretol navane contraindications”. Sure enough, the first hit said that Tegretol and Navane had a MAJOR contraindication. That means as a general rule, you should NEVER mix the two drugs. Anyways, I stopped the Tegretol by myself, and soon after was feeling much better. The way I understand it, Tegretol makes an enzyme that degrades the navane, thiothixene, making it less and less effective the longer the two are taken together and the higher the dose of the Tegretol. So, that’s one medication-medication interaction I had that I fixed myself and lived to tell the tale. Do not get me started on my Metformin Topamax interaction. That was REALLY frightening too. The point here is that one’s doctor should always check for drug-drug interactions. It’s really easy for them. There are databases for this. However, as I experienced, doctors sometimes will not check for even major drug drug interactions. So, ask your pharmacist. Then, do a check on Google yourself. Your life is too precious to trust to take any drug without checking for drug and vitamin/mineral/nutraceutical interactions.

Sometimes an usually harmless food or nutrient can interact badly with a drug.  Grapefruit juice can kill you. Yes. There is something called the “Grapefruit Juice Effect” or something like that. Grapefuit juice, for example, if mixed with some heart medications could kill you.

Don’t drink grapefruit juice if you’re taking any of these medications:

If one drinks a lot of green tea, it’s good for the health, right? Yes, usually, however, if one takes the mood stabilizer lithium, it can change your levels of lithium without you being aware. My primary diagnosis is paranoid schizophrenia, as detailed in my best-selling autobiography A Schizophrenic WIll: A Story of Madness, A Story of Hope. Paranoid in excess is never good. However, it is good to be cautious about what one is putting into one’s body, for sure.

Two weeks ago, mom made a suggestion me to start taking curumin, the stuff that makes curry yellow. I briefly looked it up. Cucurmin helps  inflammation, diabetes, and arthritis. I did not look into it any more. Curry never killed anybody right? Plus, it tastes so good! No worries, right? Wrong. It was crazy how fast my mind started to devolve into paranoia and insanity.

I felt a bit off the first day I took the curcumin. “No worries,” I told myself, “It is just a bit of a bad day.” The night of the second day on the curcumin, I was teaching my lady about some really cool and useful resources for learning languages. But, I did not sleep well the night before; and about 7pm that night, with her, I could not believe how divorced from reality I became. I took her home 30 minutes later because I was not good company, not even for myself. The third day was horrible. The fourth day  on the curcumin, about 5pm at a Clubhouse I go to sometimes to socialize called Fountain House, I got fully-blown paranoid. Psychotic paranoia can be totally overwhelming. I was almost totally sucked into a vortex of madness totally. I had not been that paranoid for over 20 years! I struggled to get home without unhappy incident. I was successful. At home, I was so sick that I took my medicine 2 hours early, and I started looking for a new anti-psychotic that would not allow me to get this sick, maybe something in clinical trials. There are a few good medicines in the pipeline, but nothing I could easily use. Then, something clicked in my mind. The only new thing in my diet was the curcumin. I thought, grasping at straws, that maybe that this was my issue.

Fortunately, I had in mind something about the liver and the metabolism of the Navane. It turns out that Navane aka thiothixene is metabolized in the liver at CYP1A2. I’m a medical researcher. This took me about 5 minutes to find on Google. Then, I went to the medical database MEDLINE and searched for “curcumin AND CYP1A2”. This is what I came up with: Plant polyphenol curcumin significantly affects CYP1A2. The curcumin was speeding up the metabolism of my thiothixene, my main antipsychotic. I was going loco for curry! Needless to say, I stopped the curcumin; and I am no longer psychotic.

The short take away from this long story is that if you take ANY medication, please check all your drugs against each other yourself as well as all the nutrients and foods in your diet, especially if you start feeling bad after adding a new food, medicine, or nutrient to your mix. It may not be coincidence. That being said, talk to your doctor or go to an Emergency Room to get to a safe place and proper medical care, if you think you have an emergency, and DO NOT STOP ANY MEDICINE without your doctor’s OK. Sometimes, one has to make the best of a temporarily bad situation, or one lands in a worse situation. “Out of the frying pan, into the fire,” as they say.

William Jiang, MLS is the Author of 63 books, including the bestselling books Guide to Natural Mental Health , 3rd ed and his critically-acclaimed autobiography A Schizophrenic Will: A Story of Madness, A Story of Hope. You can see a selection of his books about mental and physical health nicely laid out on his blog at http://www.mentalhealthbooks.net