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During a suicidal depression last year, after numerous failed med trials and my pdoc bringing up the subject of ECT, I requested to try a few more atypicals. I’d already tried Zyprexa and Geodon without much difference, so he suggested Seroquel.

Wow. Every now and then a drug comes along that is nothing short of a miracle. Two weeks and I began to notice colours again. (Lest this sound too wonderful and like the end to all my problems, let me add that it doesn’t last – my brain chemistry changes or the drug ‘poops out’ or whatever, but it stops being as effective.)

Anyhoo, adding Seroquel 400mg to my existing cocktail worked a charm and brought me out of depression. A little mania followed, nothing extreme, just a hypo and then two months ago I slid into depression again (I cycle continuously.) Now my pdoc suspects that the Seroquel may be bringing me down and has (telephonically, via a message) tapered it down to 100mg. I didn’t get a chance to speak to him about it.

I’d like to discuss Seroquel. I want to understand how my Rx works and now I am confused, to say the least. Add it at 400mg when depressed and then later decrease it to 100mg when depressed (?)

I have faith he knows what he’s doing. I know that these drugs work in mysterious ways and half the time no-one knows how or why. Also, drugs can have a different action depending on the dosage. I’m halfway down the taper, at 200mg, and I guess there has been a small difference, not sure.

Does anyone here know about Seroquel and why it would work this way? Or what the rationale might be behind his decision?

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Hi Luna, I guess the best persons to answer this is David or Allen...

But I have been on all that you mentioned and typical of the meds, the drug induced mania is short lived and the meds can "poop out".

Have you tried lamictal?, MAOI?(Emsam Patch), Calcium channel blocker?, Clozaril?(only as a last resort)

__________

I had ECT 4 yrs ago after many failed meds it did not work for me and I dont want to elaborate on the reasons so you wont get discouraged.... I have seen it work miracles on others so that is why it is worth trying....

I would recommend try it but be careful of short term memory loss. Try writing down real simple stuff like the directions to your grocery store or Dr office, phone numbers etc... whatever you assume is easy may not be until you reintroduce it back into your mind after ECT. And of course the anesthesia, there are minimal side effects and for me I have been told I am "allergic" to it so I have to tell them before they knock me out so they can monitor me more closely.... Gee why am I not surprised!!! ;)

Good luck in your meds venture...

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Hi Luna

I am currently on seroquel, quite a small dose 50mg at night - but since it was introduced about 5 weeks ago my mood is the best and most stable it has been in years. I keep telling everyone that I love my medication ;).

Not sure what the long term plan is, have to see the pdoc again in April.

I am worried about the side effects, dry mouth - have to carry water with me, drowsyness - this has improved a bit, but would prefer to be more alert and weight gain - well I can't afford to gain weight.

It is good that you trust your pdoc, it truely is a balancing act, getting the meds right.

Goose

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My son (13) takes seroquil 400mg for mood stabalizing and sleeping at night before bed but the Dr said the lower dose acts as a sedative but then the higher dose stabalizes and then it doesnt have the sedating effect. So we give it to him right before bed so it makes him sleep then hopefully it is helping further with mood stabalizing....

It seems my pdoc is looking into some "micro" dosing of some meds for me for the cycles. Anyone hear of that?

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That is one med I have not been on. Right now I just started Abilify a couple of weeks ago after being taken off Geoden . I also started taken anther new med called Keppra for a mood stabilizer drug, that is 1500mg a day , along with Lexapro, 30mg . Their are more that i take too, but thats what my Pdoc wants me to be on.

I have heard Seroquel can make you gain weight, a side effect of the medication. I don't know if that is for everybody who takes that med. but it can be something to know .

Glad Seroquel is working for you .

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Thanks, everyone. :)

Weight gain - hoo boy, does it cause weight gain! Depressing.

I don't know about it being less sedating at higher doses - it certainly has sedated me a LOT! I think the only reason I'm not a zombie is the 450mg Wellbutrin that is activating. But I'm like you goose, I like Seroquel.

It is apparently being thought more and more, to act as a mood stabiliser, more than an anti-psychotic, so that would make sense for your son, Linda. (It is anti-psychotic at around 800mg.) It worked like an anti-depressant for my last depression! (so why isn't it doing so this time around? I'm just sliding further and further downhill. :o )

And of course there's the nasty serious side-effect (SE) profile. That scared me, but when I saw how well it worked and how the people with the bad SEs were in the minority, I decided it was well worth the risks. I'm that desperate. So I have the increased appetite (and why is it never a craving for lettuce???), weight gain, sedation and akathisia at any single dose over 150mg. I have to take it in divided doses during the day to avoid the akathisia. That has to be my all-time most horrible SE and it trumps the sedation.

I understand about dose-dependent actions, but I find it very paradoxical that the pdoc is lowering the dose, when for the last depression, a higher dose worked. I am already on Lamictin (400mmg). Haven't tried MAOIs, but they clash with my other meds. Nor ca channel blockers or clozaril.

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I know Luna, I feel for you... it sucks... and I always wondered where that craving for lettuce is too :)

The coctail recipe for this is so frustrating. My pdoc found out I can only do monotherapy and I remeber those days of being on 3-4-5 meds at a time and I am still amazed that that is the answer..... Or is it??? :(

I wish you luck with the meds. It is a frustrating way to live....

:)

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Guest ASchwartz

Hi Everyone,

The problems of these medications and weight gain is really chronic. Have or do any of you try exercise to counteract the weight gain and, if so, what results have you gotten, if any??

Allan

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I wish that Seroquel would have had the weight gain side effect on me... maybe that would have helped with my eating disorder!! (Or, perhaps, it DID have that side effect & I noticed it, causing my ED to go out of control....? Who knows...)

I absolutely love Seroquel. It was one of the first meds that I was on and I've been able to keep it in my regimen. The only reason I can think that the pdoc would want to decrease it would be the possibility that, while the high dose worked before, maybe you got too much in your system, causing a suicidal/depressed reaction. (Unfortunately these types of meds can do that) I would trust your pdoc, decrease the dosage, and then call him ASAP. Just ask him why he thought that would be best. :( Take care.

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Hi amberlyn, thanks. I did decrease the dose as the pdoc said (don't I always? I'm sufficiently terrified of the suicidal depressions.) I'll ask him why next time I see him; for now I am just complying.

Allan, to leave your question unanswered is an answer in itself, isn't it?

I have tried it but haven't had much success. That said I may not have kept at it long enough. I don't enjoy it. As soon as I get my heart rate up, I get exercise headaches. I also have high blood pressure. The increased exercise gives me a correspondingly increased appetite and as I said, it isn't for lettuce.

How's that for rationalisation?

What works better for me is to cut out eating the junk and eat properly. When I feel reasonably good I can do this, but if depressed, I comfort eat. I try to remember to park the car further away and walk. I'm overweight and it began with specific drugs, I was a normal weight before.

But exercise is my greatest weakness in my management of BP. There, I've 'fessed up.

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Hi Luna,

I've done a quick look-up on Seroquel, and it seems to have pretty unique and diverse pharmacological actions. I wouldn't know how to predict its effect looking at its mechanisms. Though of course that could just be me being an amateur on this field of science. All I really know is that I would have to make a very unhealthy cocktail with the drugs I know to mimic Seroquel's mechanism. ;)

Exercise's a bitch, isn't it? I can't allow myself to really stop and think about it. Nothing makes me feel like I'm enslaved by mental illness than having to run circles. So useless! At least in the past the slaves could see a pyramid grow. :) But then the happy chemicals get released and I remember why I'm doing this to myself.

Much love,

Schillaci

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Guest ASchwartz

Hi Luna,

I hear you. Of course, you don't need to do heavy exercise. A daily walk in the park is good. Helps with mood too.

Are you in psychotherapy along with taking medication? Of course you are fearful of suicidal thinking but that is where cognitive behavioral therapy can be just as effective as medication or a good reinforcement with the meds.

Allan:)

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I started taking Seroquel for anxiety/panic in early 2006. I checked myself into a hospital because I could barely function anymore. They gave me Seroquel, and within an hour I could feel a change. It was maybe a 25% improvement in symptoms, but it was the first time anything worked on me.

I don't like taking it for a number of reasons. It does nothing for my depression. I'm already an addictive person, and a smoker, and Seroquel makes me want to eat, smoke, drink every minute, all day long. My body gets used to the dosage very quickly, so doctors are always upping the dose. (At one point I was at 800mg XR, plus 300 to sleep!) But it does calm me down when I feel out of control, and it is great for falling asleep. (Unfortunately, another side effect is that I wake up at 4 am each day very nervous. There seems to be rebound anxiety.)

I doubt that helps much, but I just wanted to share my experience. I have tried almost every med out there over the years, been inpatient a number of times for anxiety and depression, and also underwent 30 ECT sessions, which completely eliminated my anxiety temporarily, but once the sessions stopped the anxiety and depression were back stronger than ever.

If something worked better, I would gladly switch. I'm with a new doctor now, starting Wednesday. I've been on the med merry go round my whole life, but over the past year have quit everything but Seroquel (I even quit that for a few months). I had given up. But I'm going to give meds another try, because with my level of depression and anxiety hell, some help is better than none. I'm hoping that with this new doctor and a new therapist that things might be different this time. But as a long-time alcohol and marijuana abuser, my mind wants substances that will make everything go away, so it's hard to tell when something is actually helping, because I just want to feel numb.

Well, that last rambling probably didn't help you either, but I needed it for my own sake. :rolleyes:

Take care.

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Thanks for your input, archyb (and it does help, actually.) :D

And to answer you, Allan, yes, I'm in therapy. It's awesome stuff! :o. I've accepted that my brand of illness needs meds and I won't be able to get away from that if I want to stay well, but for me, it's always been a case of meds + therapy is like 1+1 = 3. Therapy has been life-altering for me. You guys done good!

So I'm now down to 100mg of Seroquel. I think I'm a bit better (I've been able to do stuff I couldn't before) but I still fall down at least once a day. I've wanted to phone my pdoc many times, but I know his answer: "It Needs More Time". Damn, I hate that sentence!

I still don't get the paradox of the Seroquel dose change but I'm doing it anyway. We'll see.

Edited by Luna-
I need a reason??
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Allan: if you can't exercise to counteract Seroquel weight gain, should your doctor allow tablets for weight loss (even if you haven't yet hit technically overweight, which by today's standards is rather high anyway)? Or is there anything else one can do? I actually eat very little and had a bad metabolism to start with and realise that won't help but don't know how to increase it.

To those Seroquel helped: excellent to hear and I hope it continues to.

archyb: That's quite a dose. May I ask did you find that you could've pretty much classified yourself narcoleptic on that dose? Like you I think I've tried everything and Anti-Depressants rarely work (though one helped of late thanks to a board member here sharing; brought the massively out of control fear back to its normal out of control level :D ) and I react to all Anti-Psychotics, but only in a minor way to Seroquel except of late (but that’s physical and related to me not the med really). I find, like you also, it doesn’t help with depression – but I am only given it for sleep anyway and that it does indeed help with. Though interesting coincidence, I often wake around 4am (on the dot) too. Except I feel my best (usually) at that time. For you do you wake at that time regardless of what time you went to sleep?

Luna-: I’m sorry to hear about your concerns that you seem to be getting a counter-productive response, but I think the key word there is “seem”. Until you find out exactly the reasons why, there’s nothing you can achieve worrying about the change and applaud you coming here and putting forward your concern so concisely and then accepting it so readily. I thought I’d ask, do you take XR or just straight Seroquel?

I understand your confusion too. Not long back my doctor responded to when my Seroquel started causing spinal cord spasms thus not being effective by reducing it, which confused the crap out of me. We went from 300mg a night to 100XRmg. I find that doesn’t consistently take the same amount of time to work and really didn’t help sleep so we’ve had to add back at least 100mg of Seroquel and an extra 50mgXR. All trial and error sometimes.

I also wanted to ask, since I notice you’re in South Africa and I’m not sure if this medication is available there but have come to find it’s not available in America. I have this medication on hand if I’m genuinely afraid I will follow through with my suicidal thoughts or impulses and I personally found that it’s a miracle for me. The first time I took Zyprexa it was the very similar but only about 30% as effective, but only once. Where this medication has always been this way and maybe because I react so badly to it the next day I can’t take it regularly and only take it if I’m daring to do anything or can’t handle the feeling anymore. Our brand name is Solian, it’s amisulpride. Just suggesting something that’s helped me, like I tried to, to an American only to find it’s not available there.

Also ever since I’ve owned it, knowing I have something that takes away that feeling, I don’t end up needing to take it very often at all. I end up going through the steps and measures to forge through, because it IS there. I paid a large amount for one box and am sure it’ll last a lifetime (I realise the medication will go out of date). In fact a sample pack from a psychiatrist I reckon would’ve lasted me (I only used a quarter of a tablet and you got like 15 I think). It maybe not be in RSA either, but thought it worth sharing my experience given I take Seroquel and that’s my back up.

Edited by seaj
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Hi seaj, thanks for responding :)

Allan: if you can't exercise to counteract Seroquel weight gain, should your doctor allow tablets for weight loss (even if you haven't yet hit technically overweight, which by today's standards is rather high anyway)?

I doubt they would - appetite suppressants are very psycho-active and probably wouldn't mix well with APs.

I take straight Seroquel. The XR version isn't released here in SA yet.

I couldn't find out if amisulpride/Solian is available in SA. But I have been on a relative of it, sulpiride/Eglonyl. It was terrible for me. It didn't help my mood and I lactated dreadfully. I could have breastfed a baby! But thanks for the tip. I have a small supply of benzos for when I get really desperate and I also find that having it there to knock me out and sleep, helps me not to need it very often.

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Hi seaj, thanks for responding :)

I doubt they would - appetite suppressants are very psycho-active and probably wouldn't mix well with APs.

I take straight Seroquel. The XR version isn't released here in SA yet.

I couldn't find out if amisulpride/Solian is available in SA. But I have been on a relative of it, sulpiride/Eglonyl. It was terrible for me. It didn't help my mood and I lactated dreadfully. I could have breastfed a baby! But thanks for the tip. I have a small supply of benzos for when I get really desperate and I also find that having it there to knock me out and sleep, helps me not to need it very often.

I understand your response about certain weight loss medications - this has once caused seretonin syndrome for me. Just wondering if combatting it would allow for a less depressed mindset than gaining large amounts of weight for no reason in your lifestyle.

Sorry what you did try luna didn't work for you and I would never want to suggest something terrible for anyone, but do want to share my positive experiences in case even one person can benefit.

I am however really happy to read that you, like myself, have something on hand if you're really desperate which in turns does help you need it less. That's a good sign. I was interested to read also that when your heart rate goes up you get headaches. Me too and my blood pressure goes up also. Though since my blood pressure is naturally very low, doctors often think all is normal when they check when by any other standard it'd be high. If I exercise my pulse very quickly goes over 200 and my always solid 90 over 60 blood pressure goes to 120 over 60/80 as my headache-come-migraine gets worse.

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archyb: That's quite a dose. May I ask did you find that you could've pretty much classified yourself narcoleptic on that dose? Like you I think I've tried everything and Anti-Depressants rarely work (though one helped of late thanks to a board member here sharing; brought the massively out of control fear back to its normal out of control level ;) ) and I react to all Anti-Psychotics, but only in a minor way to Seroquel except of late (but that’s physical and related to me not the med really). I find, like you also, it doesn’t help with depression – but I am only given it for sleep anyway and that it does indeed help with. Though interesting coincidence, I often wake around 4am (on the dot) too. Except I feel my best (usually) at that time. For you do you wake at that time regardless of what time you went to sleep?

At first I was probably comatose, but my body gets used to Seroquel very quickly. The regular version causes me a lot of rebound anxiety and actually some withdrawal. But I'm back on XR now, just started yesterday, and I feel a lot better. I slept until 7 am for the first time in weeks. :)

For better or worse, Seroquel is really the only med I've ever taken where I can positively say that it makes things better, so I'm resigned to continue taking it.

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Holy crap! Having big time withdrawal as my body gets used to taking 300 XR at bedtime vs. taking 400 mg regular Seroquel during the day.

I know this isn't an addictive drug, but I definitely feel it when I don't take it. Anybody else has a similar experience?

I find I get that feeling from taking it - could it be a left over feeling of taking it at all? Something finally coming out? It makes me feel like I drank draino or something in the morning and ill in all kinds of ways, but like you, for better or worse, it's the only thing that always helps me sleep and fortunately without having to increase too high. Unlike actual sleepers.

But I go through major periods of narcolepsy.

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I know this isn't an addictive drug, but I definitely feel it when I don't take it.

Makes sense, though. Seroquel (all these drugs, really) is psychoactive and changes brain chemistry and the brain has to adjust to those changes to try to get back to it's 'equilibrium' (I put that in inverted commas, given that some brains are faulty and need their equilibrium reset from the outside.) If you don't feel anything then your brain is probably very good at adapting to change. Some of our brains are a bit sluggish. :)

I imagine the conversation goes something like this:

- Sir, incoming field report. The troops in the forebrain are restless, there has been an attack on one of their neuronal units.

- Not again! Well go tell the captain then.

- Captain, there's been an attack on the troops in charge of the GI tract. Permission to send reinforcements, Sir?

- *grumble* These attacks are getting tiresome! Do they have some sort of magic pill? Very well then, send them out.

(Oh, and by the way I didn't actually HEAR those voices speaking. :) )

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