The Traveler said:
corpus callosum said:
Quetiapines an interesting drug and is regarded as one of the atypical antipsychotics ie has significant effects on receptors other than dopamine, the principal target of the older 'typical' antipsychotics.A patient with Parkinsons disease who needs antipsychotics will do better on this med than most of the other available antipsychotics as its lowish affinity for the D1 and D2 receptors is less likely to worsen Parkinsons symptoms.Psychotic features can be seen in Parkinsons disease, often as a consequence of the dopaminergic therapy used to treat it.
It has a greater affinity for the 5HT receptors than it has for the Dopamine receptors; more importantly it has even more potent antihistamine receptor antagonist effects which makes the use of concomitant RIMAs potentially hazardous.Not recommended, IMO.
Kind regards,
The Traveler
Thanks traveler.
As always, the combination of Maoi with other substances provides much controversy.
The potential interaction which corpus is highlighting is due to the antihistamine effect of quetiapine. Some antihistamines increase tissue levels of noradrenaline, which when combined with a maoi, theoretically could lead to hypertensive crisis.
It appears that quetiapine does have some noradrenaline reuptake inhibiting properties, which would increase concerns.
None the less, I am unable to find case reports of poor outcomes for quetiapine and maoi.
I found some case reports of quetiapine and maoi being used in combination to effectively treat depression.
See the following reference, which is a good read on the subject,
Cns spectrum, 2017, 22,5, 391-396 by Meyer
Another insightful brief reference, albeit old, is,
Am j psychiatry, 1983, 140 (8), 1107 by jenike
So whilst there is a theoretical risk of combining maoi with quetiapine, doctors are using this combination, as referenced above.
Hope this helps the op.