seroquel side effect question

hi all. i've recently gone back on seroquel for the 3rd (or 4th maybe!) time. the first time i was on it, i took it for ages (18 months or so) and had no major side effects. the 2nd time i got the effect of feeling very drunk. last time, last summer, it accelerated a stomach virus that was dormant and i landed in casualty after getting fever and passing out and being sick a lot at work (oops...).

i was a bit wary of going back on antipsychotics because (1) i hate the idea of being dependent on chemicals (although given my mood instability it's a necessary evil i suppose) and (2) they all seem to give me nasty side effects. i've been through zillions of anti-psychs and they have all done weird things. anyway, seroquel is the one that on the whole seems to affect me best in terms of mood and least in terms of side effects. so this was the one the doc decided to get me on.

so, i've been back on it a while, but the pdoc was very careful to titrate me really slowly to try to avoid collapse and sickness! at first the only side effect was the feeling of drunkenness and sleepiness. which i expected and can cope with.

i now have a new pdoc and he is quite keen for me to get onto a normal dose (ie 300-400mg), like i was on before, as i've had to re-titrate lithium and i'm only on 800mg not 1000mg like before.

i have exams on at the moment, so the capacity to take much seroquel in the mornings is virtually nil as it's still making me really sleepy and "drunken" (even 25mg) - but as it makes me sleep he has encouraged me to keep increasing the nightly dose, and then after exams to even out the morning and night doses.

i was on 75mg at night and 25 in the morning for quite a while but then he said i should increase the night dose by around 12.5mg every other night. i've been doing this over a space of around 2 weeks - i'm now up to 162.5mg (an increase of 12.5mg every 2-3 nights or so). but it's been problematic - or i think it has, but i want to find out whether what i'm experiencing is a likely side effect or just something else....

firstly i had to stop taking the morning dose of 25mg, because even after a few weeks of that dose i was still getting the drunkenness and sleepiness feelings most of the day. with exams i *cannot* afford to be sleepy in the day. apart from the fact that falling asleep in an exam would just be unthinkable, i have to revise for these too, and even on 25mg in the morning my brain goes to mush, i can't focus, i find myself drifting into lalaland. then i fall asleep for hours - not good. the pdoc wants me to increase the morning dose to at least 50mg, but i will be a wreck if i do!

the night time dosage is making me sleep very well at night, which is great. but since going above about 100mg at night, i've found that it hangs over to the day. these are problems i'm having which i've not had before - i'm not sure if they are the meds or just something else - can anyone advise?

if i take more than 100mg at night, the following day i feel lethargic, sluggish and tired. this is without the 25mg in the morning. everything feels like a major effort - sitting upright, standing up, walking etc. even breathing feels like a huge effort. walking the 8 mins or so to the station feels like running a marathon. plus i get major sleep urges, where i'll be sitting around and suddenly i *have to sleep*, and will be out for the count within seconds - which is somewhat worrying at exam time!

concurrently my chest has felt really tight, i've been wheezing a lot, i've found i've had to stop and take lots of deep breaths because i feel like i'm suffocating - and this is when i'm just sitting around, or lying in bed, when i walk around it gets worse.

the thing is i've had zillions of chest infections over time, and they think i have ME, as i felt flu-like symptoms for all of last year, and had 9 (no joke) chest infections between jan and april of this year alone. but i've not had one for a while - i've given up smoking (a big deal for me) and this seems to have stopped the infections. i've been feeling like i'm coming down with a cold, but that's only for a couple of days and i think it can be put down to stress of exams etc.

but the tight chest feeling coincides almost exactly with the first time i went over 100mg on seroquel - last night, because i was acutely aware of having an exam this morning, i only took 100mg as i really didn't want to feel sluggish today. on the whole i've felt better today - much less lethargic, and less sleepy but everything has still felt like an effort, breathing has been tight.

so after all that random waffle (oops) my question is: is next-day-lethargy a potential side effect of seroquel? and more worryingly, is tightness of the chest and difficulty breathing a possible side effect? i kind of hope it is, i really don't want another chest infection! and at least this can be fixed, if it is....

I could be wrong, but if taking more than 100mg makes you feel too sluggish, then I'd stick with 100mg tops. Does 100mg help you? If it does, then that's another reason to keep it down to 100mg. Why take more than necessary?

BTW - I take seroquel to help me sleep.

yeah, that's my view too - but the doc is adamant it's too low a dose. i think i'll have to have a word with him, find out whether he thinks this is a side effect or something unrelated.

Hope your doc will listen. Good luck.

last year i was on seroquel and the medication was increased slowly ending on 1000mg after afew months. The only side effect i had was the sedation. I found after i took the meds at night they would knock me out n id fall asleep within minutes and after waking up in mornings i felt like i had almost no energy. It was very hard to get out of bed and when i did i found it very tiring to walk around n stand up. I spent most of my days sitting down as i really didnt have the energy to do anything else.

Roy.

Guess I must be one of the lucky ones for a change...I usually get all the rotten side effects but not with this. I had some left over when my pdoc was giving me klonopin for my anxiecy that came with the trauma & my mothers death that happened the end of last year & beginning of this year...along with my excessive weight loss. While in the hospital, I was stuck with the klonopin but after those couple of months, I found the seroquel & tried it instead. I was having problems going to sleep...my mind refused to allow me to sleep in order to not experience the nightmares. I finally upped the dose to 200mg just before I go to sleep & have been able to sleep a little more....keeping most of the nightmares away (not all). I was so lucky because my Pdoc is very willing to let me find what works for me & then provides me samples so I don't have to pay for the med. He will initially suggest a dose, but I am the one that is ultimately responsible for finding the actual dose that works for me.

After going through a very suicidal state about 8 years ago with him too, I feel very lucky that he is willing to trust me well enough to give me this responsibility. During my extreme weight loss, he also put me in charge of finding the treatment that would work for me. Unfortunately that responsibility was just too much for me to handle but am trying to do better on my own with a little help from a psychologist I had 9 yrs ago.

However the seroquel is really great for allowing me to get some needed sleep after going months with only a few cat naps here & there. Even after taking it late at night, I am able to get up in the morning & perform well for my horse riding lessons where I am training for my dressage shows. I don't know why it is working...but really appreciate something working to give me a little relief.

Debbie

Debbie
I also take seroquel. I am on a much higher dosage than you. I take 100 mg in the morning and 700 at night. I also have found great relif from night terrors. I feel like I get a rested sleep and everything. I am happy that you have found a good dosage amount.

Glad it's all starting to work out for you.

thanks for the input everyone i've spoken to the doc and he still thinks i'm on too low a dose. i'm now on 200mg at night, and none in the morning, sometimes 25mg. the problem is 200mg at night makes me feel half asleep for ages, even after i get up in the morning. although it does guarantee a good sleep!

i find it a bit weird though, i was on seroquel for about 12 years up to a couple of years ago, on a much higher dose - about 800mg a day, if i remember right, then last year i went back on it and 300mg put me in casualty! it seems to me like my tolerance of it is decreasing. is that normal?