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Grand Member
Member Since Nov 2019
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#1
I'm currently taking Seroquel for acute treatment of a mixed episode. I find that for me there's a very narrow therapeutic range where the Seroquel alleviates my symptoms. If I'm below that dosage, the mixed symptoms come back with a vengeance. But if I go too high with the dosage, I start to become anhedonic, unmotivated, empty, desperate, suicidal, and I basically feel more dead than alive.
In my case the difference between being balanced with Seroquel and going out of control again is only about 50mg up or down from my "goldilocks zone." I think it's related to how seroquel works on different neuroreceptors based on dosage. I guess in my case it requires only minor dosage variations for the Seroquel to start affecting different receptors. This would be okay if I could just find a single dosage that I'm stable on. However, what has happened repeatedly now is that I go up to my "right" dosage, then I'm stable for about a week, and then things deteriorate again. I suspect it's because the Seroquel (XR) is not being fully metabolized in 24 hours, so it sort of builds up after a while. I'm trying to tackle this issue by reducing my dosage temporarily (1-2 days) when I start to get worse, but every time this happens it takes a few days before I start to feel right again. It's starting to get pretty annoying having to constantly tweak these meds. It doesn't feel like a stable situation at all, more like a rollercoaster. Has anyone else had the same experience? I'm starting to think I might be better off with a different med, but then again I don't want to write Seroquel off too soon because when the dosage is right, it does work pretty well for me. |
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Anonymous46341, bpcyclist, Living in LaLa Land
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#2
Not the exact same story, but, I did find regular Seroquel to work fairly well at one dosage for awhile, then, over time, to become less useful and then, not useful at all. Is it worth maybe looking at another atypical, possibly?
__________________ When I was a kid, my parents moved a lot, but I always found them--Rodney Dangerfield |
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Grand Member
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#3
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If this persists, then yes, I would consider another atypical (probably olanzapine I guess) or something else entirely, like Lamictal. That's what I'm starting to lean towards, actually, with all the good experiences I've heard here. But I want something that really helps me become stable, not something that makes me feel good for five days and then I'm back in the woods trying to find a balance again. |
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#4
With Seroquel there are a couple of things that come to mind. Firstly, the lower the dose, the more sedating it is. This is why a lot of people will have it prescribed for sleep. Higher doses are usually given to control episodes like you've had and other forms of psychosis. Seroquel also relies heavily on metabolism especially with the liver. If you do not metabolize like the average person then xr may not work. What about regular seroquel?
__________________ "I carried a watermelon?" President of the no F's given society. |
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bpcyclist
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#5
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As far as I know I don't have any metabolic problems, so I hope there's nothing to worry about in that department. That said, aside from the Seroquel issue I have also noticed my lithium levels going up (significantly) over time. So maybe taking the non-XR Seroquel variant will be a good option. I'll bring it up with my Pdoc to see which is the best alternative. Thank you for mentioning it! |
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bpcyclist
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#6
Might also want to check out Abilify.
__________________ When I was a kid, my parents moved a lot, but I always found them--Rodney Dangerfield |
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Grand Member
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#7
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bpcyclist
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#8
I have this same nature with Zyprexa. Probably not quite as bad because when I stay at 12.5mg I'm okay, and I don't have to keep adjusting. I think that "goldilocks zone" is a purely individual thing. As others are saying, maybe there's another med that would work while avoiding the need to monkey around so frequently. Zyprexa or Abilify?
__________________ Bipolar 1, GAD Lithium 900mg, Gabapentin 700mg, Zyprexa 10mg |
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#9
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__________________ When I was a kid, my parents moved a lot, but I always found them--Rodney Dangerfield |
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Grand Member
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#10
@bpcyclist @sarahsweets @unicornlady: Thanks everyone, for the suggestions. I've tried adjusting the dosage various ways and now I've decided I want to quit the Seroquel. First of all I'm tired of the messing around, and second I don't like the side effects.
I'll talk to my Pdoc about alternatives this week. Possibly another antipsychotic like Zyprexa or Ability, but actually I want to try Lamictal because I've heard good stories about it. I don't think I'll want to try an antidepressant for now because they can worsen mixed episodes and rapid cycling. |
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catches the flowers
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#11
I encourage you to give Lamictal a try. I can't recall any time I've heard of anyone complain about Lamictal having side effects or being difficult to stabilize.
I find that AP's, no matter which class (typical or atypical) always effect me in the way you've described. Finding that fine line between "flat and dull" and stable and okay takes work, especially if you're prone to mixed episodes (I am, too). As for Seroquel, I know it really helps some people. I have absolutely nothing good to say about it for myself, except that an occasional prn of 12.5mg can help sleep. Seroquel has given me metabolic syndrome, which has had adverse effects on my overall health. It never helped me in any way that it was supposed to. I know the search for the right medication(s) is wearying. And sometimes when a good med is found, it works for a while, then craps out. That's when support (like us, here) can really help. You're not alone, we understand All in all, it sounds to me like Seroquel is not working well for you. Lamictal's function is to provide emotional stability for people with bipolar disorder. I will mention that of all the AP's I've been on, which is many, I have found Trilafon (perphenazine) to be outstanding. __________________ |
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bpcyclist, xRavenx
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#12
I have my Seroquel XR adjusted up and down by 50 mg, frequently. Occasionally up 100 mg or even 150/200 mg, if my mood really skyrockets, which is rare. I don't mind the adjustments. It's not a biggie, for me.
I have had some periods when an evening dose of Seroquel XR alone (even 650 mg) seems to wear off too soon the next day. For that reason, my psychiatrist has added 50 mg Seroquel XR to my morning medication pile. That works well for me, but if/when I find myself tiring/dragging butt too early, my psychiatrist simply let's me remove the morning dose. I don't know what dose you take per 24 hours, but sometimes smaller doses are more sedating than larger ones, as I believe sarahsweets sort of referenced. My dose of Seroquel XR may be a bit larger than many people's. There's a possible drug interaction with my Tegretol that may require a bigger dose. I don't think you take Tegretol, so that likely doesn't apply to you. |
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bpcyclist, xRavenx
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bpcyclist, xRavenx
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Grand Member
Member Since Nov 2019
Location: In my head, mostly
Posts: 754
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#13
@BethRags @BirdDancer: Thank you both for the advice! After trying and failing to get myself stable on Seroquel for a few months, I've decided to try Lamictal instead (already discussed it with my Pdoc). I'm staying on Seroquel until the Lamictal is up and running, and then I hope to be able to drop it. I've heard Lamictal can even be a monotherapy, that would be great if it works out. I'm kind of scared to start Lamictal (as I am with any new med) but I'm hopeful after the good stories I've heard here.
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*Beth*, Anonymous46341, bpcyclist, xRavenx
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catches the flowers
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#14
I believe that Lamictal will be helpful for you. I'm basing that on how many success stories I've heard about it. Also, as I recall, I've known 2 people who used Lamictal as monotherapy and did really well with that. Honestly, the only complaint I remember hearing about Lamictal is the time it takes to reach a full dosage.
Definitely let me know how it's going for you! I'm sure hoping for the best __________________ |
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bpcyclist, xRavenx
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#15
Lamictal has been helpful for me and out of all the meds I've been on, it has never given me side effects. I take 400 mg daily. I hope it works out well for you
__________________ Bipolar 1 Disorder, Unspecified Anxiety Disorder |
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Grand Member
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Posts: 754
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#16
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