I was just thinking about the use of APs as prn meds. Now I'd never heard of them used that way before coming back to pc. I was thinking though when I was first put on seroquel in the hospital in 2010, I was so woozy I would half fall asleep sitting straiight up in group time and I barely remember the first week I was in the hospital. This was taking it everyday. But it got better and 5 days later when I went back to the hospital I was able to fully engage in the groups and with the people there. My point being if I was taking it just every once in a while I would always have the woozy feeling and not benefit from it for its longer lasting effects.
Which is to break and prevent the mania and help stabilize the mood state. Not just help with sleep though thank goodness it helps with that. Does this make sense?

[venusss]

I understand some people take it only in case of bad episode because of the long term side effects (brain atrophy, destroyed metabolism...).

I don't know that taking them PRN (as in one today, none the next or so, then one here or there) is all that helpful as they do need to be taken consistently for effectiveness, but that doesn't mean you necessarily have to take them forever. My pdoc has me take them during an episode for perhaps a few months and then go off them when the racing thoughts, etc. have stabilized.

That's kind of what I thought. I associate prn with something like taking a tylenol for a headache. But yes, I don't think people should have to be on an AP forever. Unfortunately my three month hiatus last year was completely miserable, I asked for the saphris back.

[~Christina]

I have a PRN AP .. I refuse to take any of them fulltime.

Christina, how do you take yours? I'm being curious is all

[~Christina]

If I start to feel out of touch and question if hallucinations are real .. I use an AP for 3-4 days then stop it.. It's typically all I need.

This is a plan my Pdoc and I agreed on. Not all Pdoc's I understand are willing to do this.

[Skittles56]

My psychiatrist gave me a little different regimen. I'm on a regular dose of Seroquel, but he said to take another half of a pill if I hallucinate and then to drop back to my other dosage when they go away. Needless to say (see my other rant), I haven't done it.

[ultramar]

I take Seroquel both regularly and PRN. I take 150 mg at night and 100 mg in the morning and when I start to go into a hypo/manic episode, I up it until I start getting better. Then slowly lower it again, by 50 mg/week, until I (hopefully) get back down to my baseline dose.

For me, the regular dose has helped to prevent both hypomania and mania (though I've had two breakthrough manic episodes), the evening dose helps enormously for sleep, and the PRN is effective in bringing me down, though it tends to help me sleep again a while before it helps with the rest.

So, overall, for Bipolar, it's been effective for me.

BUT: I crave sweets all the time and have gained a lot of weight, if I don't get enough sleep I fall dead asleep at work, anywhere really... At first it slowed down my thinking, but these days I don't think it's as much of a problem. It's also ended up helping me a good deal with my anxiety, and this is one of the reasons that, despite the side effects, I have stayed with it. My pdoc has suggested Abilify on a couple of occasions (due to complaints re side effects), but he's said that it probably won't help me with anxiety so much...

Maybe you could do a trial run of taking it every day -maybe starting with a low dose (the first 50 mg I told initially practically put me in a coma, now, of course, I'm far more used to it). See how you do, if it helps, give it some time... These things are so different for everyone, you don't really know until you try.

[polesapart]

I have been prescribed Seroquel as prn. Currently I am stable, but if my mood starts to tip either way I will add in the Seroquel for a few days, if that doesn't help then back to the pdoc.

When I was manic I was taking 250mg regularly at night, but was also prescribed 25 or 50mg as prn. If I was too restless, going higher, getting ramped up by anything during the day I was supposed to take it to stop the escalation immediately.

[Victoria'smom]

I'm suppose to take the PRN when I'm not sleeping. I was taking it every other day but I became angry and numb (I don't feel it was the meds) along with other issues. I would really talk to your pdoc.

[Amelie10]

Originally Posted by 1914sierra

I don't know that taking them PRN (as in one today, none the next or so, then one here or there) is all that helpful as they do need to be taken consistently for effectiveness, but that doesn't mean you necessarily have to take them forever. My pdoc has me take them during an episode for perhaps a few months and then go off them when the racing thoughts, etc. have stabilized.

This is exactly how I take Seroquel. My pdoc is worried about side effects long term, although I am very grateful because so far I have not had any.

[BipolaRNurse]

Originally Posted by 1914sierra

I don't know that taking them PRN (as in one today, none the next or so, then one here or there) is all that helpful as they do need to be taken consistently for effectiveness, but that doesn't mean you necessarily have to take them forever. My pdoc has me take them during an episode for perhaps a few months and then go off them when the racing thoughts, etc. have stabilized.

How do you get off them? My pdoc and I both want me to wean down at some point, but I've never been stable long enough to try it (except for a short-lived attempt last month that did not go well), and going off entirely doesn't seem to even be on the table. Do many people just stay on APs for the rest of their lives? I'm doing very well on my current regimen BTW.

Bipolarnurse, I guess thats what confuses me, I started on seroquel in Oct 10 in the hospital and took it until Jan 12 when I switched to saphris which I continue to take. I havent had a major episode of any sort in these past few years until this past spring and that would not have gotten so bad if not for my anxiety going through the roof. I would credit the lack of episodes to continual use of the AP. I believe I started the anxiety problem this spring myself with the use of caffeinated diet pills in Feb, it just snowballed from there. Lesson learned there folks.

I've never had trouble coming off AP's, but I rarely have problems with meds. Very fortunate that way.

For me personally the PRN AP are used for sedation for me to get through tough times. Its to bring the level of distress down until I am able to cope again. I have used seroquel PRN for years and years, it is a very good medication for me to be used that way. When you use small doses not regularly the sedative affect tends to stick around. I rarely use the seroquel long enough for the sedation to wear off (and if I do I just up the dose, it stops being sedating at around 200-300mg and starts then working as an antipsychotic rather than a tranquiliser). I have a full time AP so using seroquel this way works for me. I doubt I could do the same with Zeldox, different meds would work in different ways.

I have also used xyprexa PRN too, love those wafers but glad I have not had an episode where I have needed them for a long time. They are quick and effective treatments for people who need something strong to work very quickly.

[BipolaRNurse]

Aw, so that's what I should've taken tonight instead of the 3 Ativan I just downed.......I could've taken one of my old Zyprexa tablets and probably been asleep by now. (The reason I'm getting stoned on Vitamin A tonight is better explained in my post about being trashed on the Internet by my only sister.) I know I shouldn't and I almost never do it because of my ETOH history, but I need to feel something besides hurt and anger and I need to sleep.