![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 25. This is the beginning of the thread.
Posted by MTNDOG on January 15, 2007, at 11:43:36
I started seroquel back in October and went up to 50 mg at night in addition to 60 mg Celexa and 2 mg of klonopin. I sleep well on it but find myself tired, lethargic, irritable and unmotivated during the day so I cut back to 25 mg and got even more irritable.
I talked to my pdoc today and he said that seroquel is actually LESS sedating at higher doses so that aiming to go up to 75 mg may help with the sedation and the irritability. Have others found this to be true?
Also, is weight gain dependent on dosage. I've gained 10 pounds (gained 60 on risperdal!) so far but i will admit to eating quite a lot over the holidays.
Thanks!
Posted by Quintal on January 15, 2007, at 11:54:15
In reply to Are higher doses of seroquel LESS sedating?, posted by MTNDOG on January 15, 2007, at 11:43:36
My pdoc told me that the sedation from Seroquel reaches a plateau at around 100mg from there on sedation does not increase. I've never taken doses greater than 100mg myself.
Q
Posted by Phillipa on January 15, 2007, at 14:01:42
In reply to Re: Are higher doses of seroquel LESS sedating? » MTNDOG, posted by Quintal on January 15, 2007, at 11:54:15
25mg during bed pretty much was sedating but with valium . So I'm curious to know the same thing. Why would a higher dose be less sedating? Heck once in the hospital gave me 50 mg at bed and when I awoke gave me another 50mg and I couldn't talk could think but no words would come out. Love Phillipa
Posted by yxibow on January 15, 2007, at 14:02:31
In reply to Are higher doses of seroquel LESS sedating?, posted by MTNDOG on January 15, 2007, at 11:43:36
> I started seroquel back in October and went up to 50 mg at night in addition to 60 mg Celexa and 2 mg of klonopin. I sleep well on it but find myself tired, lethargic, irritable and unmotivated during the day so I cut back to 25 mg and got even more irritable.
>
> I talked to my pdoc today and he said that seroquel is actually LESS sedating at higher doses so that aiming to go up to 75 mg may help with the sedation and the irritability. Have others found this to be true?
>
> Also, is weight gain dependent on dosage. I've gained 10 pounds (gained 60 on risperdal!) so far but i will admit to eating quite a lot over the holidays.
I believe weight gain is dependent on dosage to a limited extent. Lipid profile (cholesterol and fat changes) is also an issue on Seroquel but not nearly as much as Zyprexa. It also is dependent as you said on intake, because no matter how much a medication changes metabolism, artificial adjustment (which I admit is hard) to that change can help. It may mean a more restrained diet.As for the holidays, well, everyone gains a bit there. Maybe its our way of hibernating over the winter :)
And no, its not less sedating at higher doses. I have been on a dose as high as 1200mg, and once accidentally took a dose that brought it to 1600mg. I'm currently on 750 and can safely say it is as sedating as lower doses. But I have gotten slightly used to it -- not terribly so though.
-- Jay
Posted by MTNDOG on January 15, 2007, at 14:06:35
In reply to Re: Are higher doses of seroquel LESS sedating? » MTNDOG, posted by yxibow on January 15, 2007, at 14:02:31
Thanks to both of you. He said it has a paradoxical effect and is less sedating at higher doses???? Hmmmm......I took my 50 mg (bedtime) once in the a.m. and it was horrible- I was wasted all day!
Posted by ronaldo on January 15, 2007, at 16:02:00
In reply to Are higher doses of seroquel LESS sedating?, posted by MTNDOG on January 15, 2007, at 11:43:36
According to cache-monkey:
“I think that Seroquel's sleep benefits might be better at *lower* doses at which it's mainly an anti-histamine. Higher doses leads to noradrenergic effects which could "burn" through the antihistamine drowsiness. I'm on it at 12.5 mg and am finding I sleep better and longer than when I was on 50 mg.
Posted by Quintal on January 15, 2007, at 16:31:56
In reply to Re: Are higher doses of seroquel LESS sedating? » MTNDOG, posted by ronaldo on January 15, 2007, at 16:02:00
I can't help wondering if cache-monkey isn't confusing Seroquel with Remeron? Remeron is allegedly less sedating at higher doses due to noradrenergic effects. I've never heard of Seroquel having any significant noradrenergic effect though. I'll have a look and see what I can find.
Q
Posted by UGottaHaveHope on January 15, 2007, at 17:10:12
In reply to Are higher doses of seroquel LESS sedating?, posted by MTNDOG on January 15, 2007, at 11:43:36
This is a difficult question to give you an exact answer because every med affects everyone differently. However, I must say in my situation, yes, 25mg of Seroquel has been just as sedating as 400 mg. You need to experiment and see what is best for you. Thats the only way to know.
Posted by alanjacobs on January 15, 2007, at 19:24:55
In reply to Are higher doses of seroquel LESS sedating?, posted by MTNDOG on January 15, 2007, at 11:43:36
When I started taking Seroquel I was already on Lamictal and Celexa. *I took 25mg to help me sleep. It was terrible I woke up feeling very hungover each morning. I talked to my Pdoc and he told me that in High Doses it has much less of a sleep or sedating effect.
Posted by Llurpsie_Noodle on January 16, 2007, at 18:37:38
In reply to Re: Are higher doses of seroquel LESS sedating?, posted by alanjacobs on January 15, 2007, at 19:24:55
I took 25 to 50 mg,which helped me fall asleep, but over time (several months) it was harder to STAY asleep.
for various reasons I increased over 10 days to 300 mg. After I was taking doses of 100 then 150 then 200 then 225, then 250, then 275 then 300
a week later I was starting to be able to get out of bed before 10 am.
a week later I was starting to be able to get out of bed before 9 am
after 3 weeks I felt "okay". I also take provigil to help me stay awake.
For whatever reason, (I've had this problem since I started taking >60mg cymbalta) I can wake up just fine, but I need about 4 naps a day. provigil keeps me awake until 9pm. then I'm just on babble-chat until I fall asleep.
The sedation caused by 300 mg seroquel (even after several months) is enough to make walking a very dangerous behavior. Sometimes I barely can move from the couch to my bed, much less find and put on my pjs. I never had that kind of effect with small (25-50 mg) doses of seroquel.
hope this helps,
-Ll
Posted by MTNDOG on January 16, 2007, at 19:31:46
In reply to Re: Are higher doses of seroquel LESS sedating?, posted by Llurpsie_Noodle on January 16, 2007, at 18:37:38
Thank you all from your input. I have a hard time walking around at night if I wake up- I'm dizzy and uncoordinated on 50 mg. I tripped over the dog about a month ago, crashed into an antique bureau and really hurt myself. If I have a cocktail, I might as well stay in bed until 4 pm the next day!
Posted by yxibow on January 17, 2007, at 1:42:59
In reply to Re: Are higher doses of seroquel LESS sedating?, posted by MTNDOG on January 16, 2007, at 19:31:46
> Thank you all from your input. I have a hard time walking around at night if I wake up- I'm dizzy and uncoordinated on 50 mg. I tripped over the dog about a month ago, crashed into an antique bureau and really hurt myself. If I have a cocktail, I might as well stay in bed until 4 pm the next day!
I do as well until the next morning. It is a good idea to take it about 30-60 minutes before you intend to sleep, thus limiting its half life extent into the next day. It only has a 6 hour half life.
What you are experiencing is the effects of low blood pressure and the general fogginess of the antihistamine effect of Seroquel.
-- tidings
Posted by MTNDOG on January 17, 2007, at 18:33:52
In reply to Re: Are higher doses of seroquel LESS sedating? » MTNDOG, posted by yxibow on January 17, 2007, at 1:42:59
Thanks- that makes sense! So, technically, at a dose like 50 mg, it's more of an anti-histamine (like Bendadryl) for sleep than a mood stabilizer?
I find that when I take it TOO soon before bed, I want to eat everything in the house. It's the same effect that Phenergan (which I take for severe nausea when I accidentally get gluten in my system- have celiac) has on me and Phenergan is an anti-nausea, antihistamine as well.
Ugg! I'm still trying to decide whether or not to increase the dose. I'm afarid I won't wake up!
Thank you so much, this info is really helpful!
Posted by MTNDOG on January 17, 2007, at 18:43:27
In reply to Re: Are higher doses of seroquel LESS sedating?, posted by MTNDOG on January 17, 2007, at 18:33:52
Do you happen to know roughly at wat dose it loses it's anti-histamine effect? My pdoc wants me to go to 75.
Posted by Quintal on January 17, 2007, at 18:48:34
In reply to Re: Are higher doses of seroquel LESS sedating?, posted by MTNDOG on January 17, 2007, at 18:43:27
Seroquel doesn't lose it's antihistamine effect at any dose, but people do build tolerance to the sedative effects of histamine blockade over time. You'll still find it sedating at all doses but you may find it no longer helps you fall asleep and stay asleep after a while.
Q
Posted by Phillipa on January 17, 2007, at 19:36:55
In reply to Re: Are higher doses of seroquel LESS sedating? » MTNDOG, posted by Quintal on January 17, 2007, at 18:48:34
Q can you believe I took it at 25mg for three days with valium, xanax and it stopped working. The tolerance built up but not so with the benzos . Why? Love Phillipa
Posted by Quintal on January 17, 2007, at 19:46:33
In reply to Re: Are higher doses of seroquel LESS sedating? » Quintal, posted by Phillipa on January 17, 2007, at 19:36:55
I don't know why tolerance developed so quickly Phillipa. You must be very anxious and/or energetic to shake off all that sedation though.
Q
Posted by Phillipa on January 17, 2007, at 19:51:56
In reply to Re: Are higher doses of seroquel LESS sedating? » Phillipa, posted by Quintal on January 17, 2007, at 19:46:33
Q oh anxious. That's a fact. Give me an hour in the late am (sleep late and go to bed late) and I gotta go somewhere anywhere and then boom I'm so tired in a couple of hours. Any idea why? Love Phillipa
Posted by Llurpsie_Noodle on January 17, 2007, at 19:55:37
In reply to Re: Are higher doses of seroquel LESS sedating? » Phillipa, posted by Quintal on January 17, 2007, at 19:46:33
Hey,
I find that the anti-histamine effect is stronger at 300mg than at 50 mg. At 50 mg I still needed the occasional claritin or benedryl for my fluffily cat. At 300 I was able to ride horses for a week (second to rats, horses are my worst allergy) with only 1 allergy attack and only occasional sneezes.As I took seroquel for sleeping, I noticed that sometimes I could take half a 25mg pill and it would work fine. Other times with more stress (or a pre-bed cappucino) I would need 50. I didn't find any real habituation effect, in terms of helping me fall asleep (that's over 4 months).
Since taking a more "therapeutic" dosage of seroquel, I find that I am better able to gauge when I'm going to pass out. I am able to resist it longer, but I have never gone longer than 60 minutes between dose and unconsciousness. One time I woke up at my normal time (7 or 8 am) lying in bed, with my toothbrush (dry) in my jeans pocket (still on) and my shirt off, under the covers. I dunno how that happened.
I try to avoid posting under the influence, but sometimes I get sloppy and forget how compromised my (mental) coordination is. And yeah, there have been some interesting dreams, once I started remembering them again...
-Ll
Posted by yxibow on January 17, 2007, at 22:50:59
In reply to Re: Are higher doses of seroquel LESS sedating? » Quintal, posted by Phillipa on January 17, 2007, at 19:51:56
> Q oh anxious. That's a fact. Give me an hour in the late am (sleep late and go to bed late) and I gotta go somewhere anywhere and then boom I'm so tired in a couple of hours. Any idea why? Love Phillipa
Altering your sleep cycle so that you stay up late and go to bed late, and possibly nap during the day can contribute to a complete disruption of circadian rhythm. I can attest that when I stay up late for no particular reason other than I want to play with the computer, even if I get my usual paltry 7 hours of sleep, my daily rhythm has already changed.And I don't recall offhand, but for every hour you change your sleep cycle, it takes so many hours and so many days to change. As humans we have approximately a 24 hour cycle, actually it exceeds 24 hours by approximately half an hour depending on genetics.
This is one of the reasons people sometimes take melatonin to reset their clock (or Rozerem which is much more powerful than melatonin itself).
I guess in a way, ending the day earlier than I feel is normal is like saying goodbye to another day of life. But another way of looking at it, is that if you go to sleep earlier, you actually have the daytime (especially in winter) to utilize, and you're up when most of the rest of the population is.I know its connected to my fear of death which is just another part of the life cycle if you look at it that way but being agnostic and also having depression doesnt quite settle the concept for me. It is one if not the core issue that centers my anxiety.
But as for the original -- yes, small doses, any dose really of Seroquel, one can become use to the sedation somewhat, but I don't think nearly as fast as habituation to Trazodone.
The comment on Phenergan is probably on the nose -- I would say that if I "stayed up" for the Seroquel and I was hungry, I would attempt to eat possibly, but due to the way Seroquel affects my swallowing mechanism when it first comes on, is mildly dangerous, because you're downing a sandwich from the fridge and you're tired and crashing into things, and you can't swallow properly.I guess its all in the timing.
Seroquel also doesn't really change a plugged nose for me in the morning -- Claritin might -- but maybe I've become used to part of the antihistamine effect or maybe it really doesn't touch the "seasonal allergy" part, although you'd think a massive pie chart with H1 taking up like half of it would do so. Genetics? Who knows.
-- tidings
Posted by Phillipa on January 17, 2007, at 22:56:11
In reply to Re: Are higher doses of seroquel LESS sedating? » Phillipa, posted by yxibow on January 17, 2007, at 22:50:59
Jay I refuse to nap won't do that. But change of subject found out I'm one of 40% who has stinky pee from asparagus. A gene apparantely. So see how wierd I am? Love Jan I googled asparagus when someone wouldn't believe about the smell.
Posted by Quintal on January 17, 2007, at 23:10:16
In reply to Re: Are higher doses of seroquel LESS sedating? » yxibow, posted by Phillipa on January 17, 2007, at 22:56:11
>But change of subject found out I'm one of 40% who has stinky pee from asparagus. A gene apparently.
Me too. What does it mean? I just assumed it was due to some chemical being concentrated in the urine that happened to everyone. Another of my peculiarities.
Someone appears to have vandalized the Wikipedia article on asparagus. Was it you?
Q
Posted by Phillipa on January 17, 2007, at 23:34:17
In reply to Re: Are higher doses of seroquel LESS sedating? » Phillipa, posted by Quintal on January 17, 2007, at 23:10:16
Q just do a google search that's what I did I didn't go to wilipekia. So you stink too? Love Jan ps maybe we should start a thread on it. Maybe it's the key to depression stinky asparagus pee.
Posted by MTNDOG on January 18, 2007, at 2:08:12
In reply to Re: Are higher doses of seroquel LESS sedating? » Quintal, posted by Phillipa on January 17, 2007, at 23:34:17
My hubby has asparagus pee too! But I don't. That I know of anyway ;)
Posted by yxibow on January 18, 2007, at 3:28:18
In reply to Re: Are higher doses of seroquel LESS sedating?, posted by MTNDOG on January 18, 2007, at 2:08:12
> My hubby has asparagus pee too! But I don't. That I know of anyway ;)
Count me in on the loo....
I'd say its a pretty common asparagitis :)
Medication can apparently do all sorts of technicolor things too. Not to mention the odor of polypharmacy.
Hmm... good I wrote this before breakfast.
-- night. :)
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.