Kevin asked
I am currently tapering off of Etizolam which is not FDA approved. Not safe, I know. I am slowly reducing the dose and waiting to see a Dr. to assist me. I am currently on about 1.5mg at 9 am and 3 pm and then 2mg at 9 pm and wake up at 3 am to take .5mg and go back asleep until 7 am. I also take 25mg of Seroquel once at 9 am and once at 9 pm. I was prescribed Naltrexone 50mg pills last year for Opioids, Alchohol, and general drug cravings. I am no longer using Opioids or Alchohol. I am wondering if it is safe to combine Etizolam while reducing my current dosage, as well as taking 25mg of Seroquel twice a day and 25mg of Naltrexone once a day in the morning. I know that because Etizolam is a Thienotriazolodiazepine and not FDA approved, it is unsafe anyway, but it is very similar to normal Benzodiazepines. I went to Drugs.com's Interactions checker and entered Seroquel, Naltrexone, and Xanax and no contraindications were there other than an increase in drowsiness.
Answer
The interaction checker you used (@ Drugs.com), is correct based on the data we have available. The precaution with that combination of medication is the excess drowsiness/sedation that can occur when using Seroquel (quetiapine) and any benzodiazepine, such as Etizolam.
Seroquel is well known for its sedation effects. In fact, many people use it off-label for insomnia. The daily dosage you are taking however, is relatively low at 50 mg. Dosages can go all the way up to 600 to 800 mg per day. If sedation does occur while taking it, it typically gets better over time, especially with such a low dose.
Benzodiazepines cause CNS (central nervous system) depression and are used for a variety of indications including anxiety, insomnia and agitation. Similar to Seroquel, they cause sedation and drowsiness. However, over time, this effect is reduced. Taking into account that you have been taking this drug for some time, and that you are tapering your dose, the sedation it causes should be minimal.
There are no reported side effects with Naltrexone and your other medications. Be aware of the sedation that may be caused by this combination of drugs but they are relatively free of any serious drug interactions. The one caveat is, as you are aware, etizolam is not an FDA approved medication and therefore drug interaction data regarding it may be lacking.
