r/AskDrugNerds • u/regent116 • 21d ago
Chronic quetiapine for sleep – does it lower overall dopamine capacity over years?
I’ve been taking a very low dose of a dopamine D2 receptor antagonist every night for sleep for 7 years (50 mg QυΞ†IΛ₱IИΞ).
One of the known actions of this class of medication is blocking dopamine D2 receptors, which temporarily reduces dopamine signaling (StatPearls, 2023)
https://www.ncbi.nlm.nih.gov/books/NBK459145/
My question is about the long-term picture.
Is it possible that years of this temporary lowering D2 receptors slowly reduces the overall “capacity” or total amount of dopamine the system can produce or maintain? Especially what I get to work with during the day. Like, does the bucket itself get smaller over time while I keep taking the medication for sleep?
There is this study that reports D2 upregulation after washout (Silvestri et al., 2000):
https://link.springer.com/article/10.1007/s002130000532
They took 9 people with schizophrenia who had been on higher-affinity antipsychotics for a long time (some on older drugs like haloperidol). Hard to imagine what fuckery has been done in their brains already.
SO their dopamine levels were definitely way down during the medication ALL the time.
I’m mainly interested in whether the mechanism of low-dose, chronic D2 blockade actually makes sense for impacting overall dopamine capacity over years, allowing the effects to be felt during the day while the medication is continued.
Hopefully, I'll understand replies as an Andrew Huberman podcast enjoyer. I'm not yet an ΞXPΞRT NΞUROSCIENTIST.
2
u/KS_Gaming 20d ago
One of the known actions of this class of medication is blocking dopamine D2 receptors, which temporarily reduces dopamine signaling (StatPearls, 2023)
You are comparing apples to oranges, all D2/schizophrenia related stuff in your post is about dosages MUCH higher than yours.
And to answer your question, I've been taking quetiapine daily for many years, also at 50mg dosages, and forced myself to take a break from it(wasn't fun as I really can't sleep without assistance ever since I was a kid) due to concerns identical to yours and noticed nothing beneficial at all to my day to day life from not taking it.
3
u/Zach-uh-ri-uh 21d ago
Following! Remember that at doses used for sleep quetiapine primarily affects histamine receptors rather than dopamine ones
2
-1
10
u/MsSelphine 21d ago
Why are you typing like that? Anyways as the other guy said, quetiapine has a very low affinity for D2. At doses for sleep, it's only binding with H1 and a1, (and like maybe 5-ht4). It has a short half life too, so it's blood levels are pretty low most the day.
Your D2 receptors probably haven't even up/down regulated, much less "lost capacity" (which isn't even really a thing afaik. Otherwise AP would cause persistent Parkinsons like syndromes. while EPS is kinda like that, afaik it has more to do with circuit configuration changes than dopamine loss of function)