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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Wildman on November 3, 2004, at 19:42:32
As this falls wears on and the weather gets colder, I am finding that I am really wound up and unable to focus on my work (ants in the pants syndrome).
I take 15mg Lexapro each morning and 25-50mg Seroquel at night for sleep. I find that sometimes I benefit from 12.5mg of Seroquel in the afternoon if I am all wound up. I find that it really helps me to settle down and keeps me from wandering around during work.
Am I addressing this "restlessness" correctly with the Seroquel? It works, but is it the right answer? Pdoc will not give me benzos, which is just as well as they make me too sleepy and don't address the restlessness.
I'm also dealing with some cognitive issues (forgetfulness and feeling dense most days) and some anhedonia and lack of motivation and energy (even though I can't sit still).
Any thoughts?
Wildman
Posted by HappyGirl on November 3, 2004, at 23:38:24
In reply to Seroquel PRN?, posted by Wildman on November 3, 2004, at 19:42:32
Hi Wildman:
I recall your previous post as to 'depression' issue.
In my personal experience through the years as Bp II,... once started the problem whether a large or small, it does NOT go away without some intervention which is most likely 'to add' some med. In my 'hunch,' you seem to CERTAINLY need an A.D. for the 'energy,' 'restlessness,' 'focus,' and other related issues about which you mentioned here, above.I am surprised to see why your pdoc. did NOT prescbie a second A.D., such as Wellbutrin, Provigil and even Strattra(sp?) which, in my experience, would alleviate most(90%) of the problems you've been experiencing.
In my personal experience, also ....., bumping up any of A.P., such as Seroquel, Zyprexa and other A.P., has some 'good' effectiveness on depressive side of the Bp, however does not last long. I could say it for just temporary remedy. In my case, I had almost EXACT problem before a second A.D., Wellbutrin, then I did address my concern to my pdoc. who rxed WB right away as if he KNEW already my problem with only one A.D.
I can not tolerate any of SSRIs, then need to take some 'milder' form of A.D., although the depressive side of my Bp is regarded 'severe' form. Then, at the beginning I was SO devasted NOT able to find any effective A.D.s. However, the Serzone(maximum dosage, from 600 mg. to 450 mg.), did alleviate my problem, ... not completely but at 80% range. After having added WB(standard dosage, 300 mg.), my depression has been MUCH improved. BTW, since the Summer, I've been taking the 'Trazodone'(minimum dosage, 225 mg. before the bed) for the replacement of Serzone and it works MUCH BETTER than the Serzone. With this A.D. combo., the Trazodone and WB sr is a life-saver for me in the area of all of my depressive problems. And, of course I've been almost 90% stabilized since then, except morning-sluggishness due to sedation coming from both Zyprexa(5mg) and the Trazodone. However, I'm willing to take some 'morning-sluggishness' for my 'over-all' mental health, Bp.
In my suggestion, you need to talk about your problem with your pdoc. more seriously.
H.G.
Posted by Wildman on November 4, 2004, at 6:07:34
In reply to Re: Seroquel PRN?, posted by HappyGirl on November 3, 2004, at 23:38:24
HappyGirl,
Thank you very much for taking the time to read my post and write such a thoughtful answer. I am impressed by your knowledge.
My wife, who is a therapist, has suggested exactly what you mention, namely Wellbutrin.
I must admit some hesitance in trying a new medication, but it appears that I have to get over that.
I believe I am experiencing "mixed states", although I am still learning how to characterize what I feel.
Once again, thank you for your valuable feedback, I really appreciate it!!!
Wildman
Posted by Ritch on November 5, 2004, at 13:08:38
In reply to Seroquel PRN?, posted by Wildman on November 3, 2004, at 19:42:32
>I find that sometimes I benefit from 12.5mg of Seroquel in the afternoon if I am all wound up. I find that it really helps me to settle down and keeps me from wandering around during work.
Seroquel has a short half-life. It's dopamine receptor blocking ability is reduced by more than half after about 12 hrs (from what I read somewhere about a radiolabeled PET scan study). Whenever I was taking a tiny dose (25mg) at bedtime for sleep I had a zingy "bounce-back" syndrome of intense stimulation (felt like amphetamines) about 16-24hrs post-dosing. Taking a tiny dose midday is probably a good solution.
This is the end of the thread.
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