It is an incredibly high dose. 800 is the max FDA approved. Going that high was necessary because I am not able to take any other atypicals and am essentially out of medication options until something new comes out (or I have to go on an older med and I'm at higher risk for movement disorders because I've had them from meds less likely to cause them, several times).

The 1200 does work for me. What I meant was that at that does I'm not sure how much different XR is from regular release in terms of side effects. I still am sedated, I still have weight gain that doesn't come off no matter what I do. In fact 1200 has been extremely efffective and I made it a year without a major episode (if you don't count struggling greatly with something anyone would struggle greatly with) which is beyond amazing for me since I usually have had a major episode about 1-2 months after the end of the prior one for many years. I've never gone that long without a big episode.

1200 is about as high as I'm allowed to go. A very painful event is pending on an unknown timeline for me and when I was concerned that having my dose maxed out meant nothing to increase when that happens my psychiatrist said I could go up 100-200 mg for a month or two when that happens but only for a short time. So pretty much if I happen to be stable we can do that and if I'm still not stable from this episode then I'll be looking at another medication. And since I'm already on a bunch nobody wants that.

I know my psychiatrist has a few other people on really high doses. She feels like it is a safe, clean drug and that it is ok to use it this high with careful monitoring (I'm seen monthly and have email to contact her between if needed). It's funny, I get it from patient assistance and they have fought hard about sending it to me, I think because it is so much. Hopefully we have finally convinced them it's ok but they've ignored numerous requests from my psychiatrist to send it to me and we think it is because it is so much since none of her other patients have that happen with patient assistance.
So it works but it does get some requests for clarification from my family dr (who is used to me being on huge doses of stuff but when he was a newly practicing dr my doses used to stun him "I've never seen anyone AWAKE on this much Depakote and wait you're taking HOW MUCH Seroquel?" (not on Depakote and fighting to stay off it. Hate that drug).). I break one tablet so it is immediate release which we hoped would help me fall asleep. I don't remember if that worked initially, it must have or I wouldn't have kept doing it, but it doesn't now.

But yes, it's very safe to go up higher. When I was suicidal the amount I had access to was seriously restricted (actually it was restricted for nearly 3 years until they were SURE I was safe) and once when I accidentally took my PM meds at 9 AM and my own psychiatrist was not working that day I was questioned very heavily by the person covering for her to be sure I had't taken 2400 mg in 12 hours on purpose. And then I slept for about 2 days straight.