[Mackie51]

I have a daughter who's currently taking Seroquel. She used to be taking Lithium. Can anyone tell me, from your experience, what are the differences between the various bipolar medication? I've tried googling but I can't figure out what's the differences between them and why you might prefer one over the other.

[bioChE]

Lithium is the gold standard mood stabilizer, and can control both mania and depression. Seroquel is an atypical antipsychotic, and does a good job of controlling mania. I've heard it can be used to control depression as well, though I'm not sure whether or not it has an official indication for that.

They each have different side effect profiles, both of which can be found with a quick google search.

[still_crazy]

hi. lithium is a mineral. your body has trace amounts of it, naturally. very high doses are used in bipolar disorder and sometimes in some forms of depression. lithium has been used in bipolar for decades. ongoing treatment requires regular blood work. lithium levels can easily "go toxic," which can sometimes result in death. long term use can damage the kidneys.

seroquel is one of the newer antipsychotics. these drugs are standard treatment in Schizophrenia. they are also known as tranquilizers. all tranquilizers block dopmaine receptors in the brain. this can calm people down. this can also cause tremors, impair concentration, and over the long haul there can be permanent adverse effects, such as "tardive dyskinesia," which is a problem in which people who have taken antipsychotics have uncontrollable movements, most often (but not always...) in the face. tardive dyskinesia is a risk with any tranquilizer. once tardive dyskinesia develops, it is permanent in a large group of people, even if the tranquilizer is discontinued.

the risk of tardive dyskinesia and the tremor, tics, etc. is lower with seroquel and some of the newer tranquilizers than with many of the older ones. the risk is definitely not 0.

seroquel is very sedating. it is usually given at night. there is an older version, which is usually taken 2x daily, and a newer xr version, which is taken at night and lasts all day.

the older tranquilizers often made depression a lot worse. the newer ones help some people with depression. they are also effective at quickly calming people who are agitated, psychotic, or having mania.

seroquel and many other newer tranquilizers can cause weight gain. some people develop type II diabetes.

all tranquilizers can cause NMS--"neuroleptic malignancy syndrome". "Neuroleptic" is another, older term for antipsychotics. NMS is a sometimes fatal reaction to tranquilizers. prompt treatment is essential.

[Mackie51]

Many thanks for the quick replies. Are there any reasons why someone might want to try Seroquel instead of staying on Lithium? What's the best maintenance drug and dosage - i.e. if the patient is stable, what's the best drug to use long term? I'm just thinking that if they're all very similar, why not stay with the gold standard, as it were? There must be some perceived advantages.

[unlived]

Seroquel may work better than lithium for some people. Depends on the individual and in my experience they both work very differently and FEEL very different. Personally lithium worked well but I preferred seroquel (even though I took both together). I liked how seroquel calmed me down and helped me sleep and helped with depression. But lithium was good because it didn't have the weight gain or the cognitive effects. Just personal preference and how effective each med is to the individual.

[karritous]

Originally Posted by Mackie51

I have a daughter who's currently taking Seroquel. She used to be taking Lithium. Can anyone tell me, from your experience, what are the differences between the various bipolar medication? I've tried googling but I can't figure out what's the differences between them and why you might prefer one over the other.

seroquel makes you sleepy even at 25 mg and has the documented weight gain factor, while Lithium isn't likely to make you overweight or sleepy. I take both and they are a complement to each other since I have PTSD, Bipolar type II, and ADD

[rwwff]

Originally Posted by Mackie51

Many thanks for the quick replies. Are there any reasons why someone might want to try Seroquel instead of staying on Lithium? What's the best maintenance drug and dosage - i.e. if the patient is stable, what's the best drug to use long term? I'm just thinking that if they're all very similar, why not stay with the gold standard, as it were? There must be some perceived advantages.

Lithium is very sensitive, if you take an NSAID or diuretic it can make it very challenging to end up with an effective dose that also doesn't damage your body. Its why I'm on depakote instead of lithium as I take a sledgehammer version of both of those, it'd be impossible to hit the safe & effective window.

[unlived]

Also lithium makes you extremely thirsty and is hard on your kidneys. It also took away my creativity and does that for some other people too. Seroquel has worse side effects though IMO

[Mackie51]

Thank you all so much. This is amazing. My daughter is currently functioning very well, except when she has an episode (duhh). How are you guys functioning with your medication? Can you hold down a job? If so, what kind of job? Are there certain jobs that better suits your condition?

[bioChE]

Originally Posted by Mackie51

Thank you all so much. This is amazing. My daughter is currently functioning very well, except when she has an episode (duhh). How are you guys functioning with your medication? Can you hold down a job? If so, what kind of job? Are there certain jobs that better suits your condition?

I'm on several medications. I am an engineer for a pharmaceutical company.