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Seroquel And Headaches

In regards to Seroquel and headaches, both Seroquel (quetiapine) and Zyprexa (olanzapine) are part of a class of drugs known as atypical anti-psychotics. At normal dosing levels, they are used in psychiatric conditions, usually schizophrenia, but recently they have gained attention in treatment of headaches. They are also used in treatment of major depression and bipolar disorder.

Now, bear in mind, once again when these are used for headache, they are used in small doses and no..it doesn't mean you are psychotic!

Generally speaking this is not the first class of drugs I reach for when a patient has chronic headaches. These are used when a patient has failed on anti-seizure drugs like Topamax or Depakote. Another use for these drugs in the presence of headache is post-tramatic headaches. I have patients who have responded to Seroquel when combined with Topamax. These patients had failed on previous medications and had suffered post-traumatic (or post-concussive) headaches for years. Daily. For years.

Each of these drugs is a little different.

Side Effects:

Seroquel's main side effect is sedation (18% incidence). Once again this is a benefit as most people take it before bed. The majority of headache patients can't sleep well anyway so this is a boon to them. Deep restful sleep is important in treatment of headaches. Other side effects include:

  • Dizziness 11%
  • Dry mouth 8%
  • Constipation 8%
  • Weight gain 5%
  • Upset stomach 5%

Over time both Seroquel and Zyprexa run the risk of raising blood sugar, so they are not an option for diabetics. Fortunately patients are not on the drugs for years (for headache), so at this point I have not seen this as a problem.

Zyprexa can also be effective in the same type of headaches, again at lower doses. Unfortunately, it can cause weight gain, so many patients are hesitant to stay on the drug for longer than a few months. Side effects of Zyprexa are similar to Seroquel and include:

  • Sedation 35%
  • Postural hypotension 5%
  • Weight gain 6%
  • Dizziness 11-18%
  • Constipation 11%
  • Increased appetite (especially carbs) 6%
  • Tremor 6%
  • Dry mouth 22%

Drug Interactions:

Unfortunatly when it comes to Seroquel and headaches, the drug may interact with several other medications. This includes many anti-depressants, Tagament (cimetidine..which interacts with just about everything!),anti-fungals, steroids and Ativan (lorazepam).

These medications are excreted in breast milk so probably should not be taken when breast feeding. They may have adversely affect the baby. Any use during pregnancy should be discussed with both your OB/GYN and your psychiatrist or neurologist as these are not recommmended when pregnant.

Both of these drugs work by dampening the pain pathways in the brain. The brain begins to perceive less pain and the patient feels better. Usually they need to be on the medication for several months, then it can be discontinued once the headaches are under better control.

In addition to Seroquel and headaches, there are other medications to take to stop a headache. You can also read more about different types of headaches.



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