Medication Adjustment For This?

So I am currently on: (also listed below)

- Sertaline 200 mg
- Flupentixol 0,5 mg
- Quetiapine 100 mg
- Lithium 400 mg

I was hit by a sudden depression that honestly came out of nowhere. I am seeing my doctor tomorrow. (the appointment happened to be tomorrow) and I am not exactly sure what adjustments can be made? From what I understand. 200 mg is where the Zoloft range ends. Fluanxol can be raised to 1 mg for anxiety or depression. Any higher a Seroquel dosage makes me drowsy. Lithium, well you be the judge.

What does one do? What are the options?

What if you take the Seroquel at night? Does it have a hangover effect?

I'm pretty sure that lithium can go a lot higher. I know someone more informed than I am will reply....

@Laurie- yes, it gives the hangover effect in the morning at 150 mg and higher.

**Correction** 400 mg bd so 800 mg in total

personally....and this is just me...I'd pick -1- major tranquilizer/neuroleptic/"antipsychotic," bump the dose up a bit, and drop the other one.

@still_crazy:

Yeah, I would agree with that. I saw her today. Her first suggestion was bump up the Seroquel to 125, which I said was a dosage that caused a lot of drowsiness. Then she wanted to bump up the lithium, to which I expressed worry about the side effects (skin, constipation, tremors) getting worse.

Then we ended up lowering the lithium dosage because... surprise,
I had developed a habit of making it seem like I was bipolar (otherwise called factitious disorder) and I think stunned my doctor. I said I was sorry... she said yes she knows but she seemed perplexed.

She has decided to not add anything, not increase anything... but let the depressed feeling die down (we will observe for the rest of the week) and phase out the lithium. If you wanna ask more, I will happily answer private messages. It was a cry out for help by seeking attention despite the many downfalls.

What's your diagnosis? MDD?

Depends on what's being treated, but yes, it can go a lot higher. In general, it's based on your blood level, not dosage, so they try to shoot for 0.7-1.1. 600mg is usually a starter dose for bipolar and then they gradually bump it up, usually 300mg at a time, and do weekly blood draws to check your levels and kidney function