Expert: Ivan Goldberg, M.D. - 6/1/2008

Question
Hi there,

I have BPD and GAD and due to the extreme anxiety associated with these illnesses I don't sleep without medication.  The trouble is that for more than 3 years, the only drug that will knock me out is Seroquel, which has horrific side-effects.   For many years prior to that, Trazadone worked well, but my doctor and I are both stuck because nothing else seems to work.  I want to get off of Seroquel though, so if you have any suggestions at all that I can pass along to my doctor I'd appreciate it!  Thanks!

Answer
Hi . . .

As you know Seroquel is an antipsychotic (neuroleptic) medication that is used for many purposes other then the treatment of people who are psychotic. Seroquel is quite sedating and also has many side-effects including weight gain, diabetes, tardive dyskinesia and neuroleptic malignant syndrome.

When my patients have a hard time getting to sleep in addition to behavioral techniques, I usually prescribe a combination of benzodiazepines and antihistamines. My favorite combination is 10 mg of diazepam (Valium) and 100-200 mg of hydroxyzine (Atarax) taken 60 to 90 minutes prior to lights out.

Best regards . . .

Ivan
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