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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by tensor on November 28, 2011, at 9:27:39
I'm taking Seroquel for unipolar depression and anxiety. I'm also weaning myself off clonazepam. Currently on 300mg Seroquel. My pdoc says 150mg is enough, my second opinion pdoc says titrate to 500mg, so I'm not sure what to do. Do you think I should raise to 400mg? I do have anxiety and my depression has not lifted.
Thanks.
Posted by billy h3ll on November 28, 2011, at 10:08:02
In reply to Seroquel dosing question, posted by tensor on November 28, 2011, at 9:27:39
i take 600 at night and 300 in the morning and no complaints seroquel doesnt have many side effects cept for the munchies. have u considered seroquel XR around dinner time? i myself cant tolerate it cause it makes me feel narcoleptic during the day but some people react well to it from what i hear. i wouldnt be too worried about taking a lot of seroquel the max dose range is pretty high
Posted by tensor on November 28, 2011, at 10:13:28
In reply to Re: Seroquel dosing question, posted by billy h3ll on November 28, 2011, at 10:08:02
> i take 600 at night and 300 in the morning and no complaints seroquel doesnt have many side effects cept for the munchies. have u considered seroquel XR around dinner time? i myself cant tolerate it cause it makes me feel narcoleptic during the day but some people react well to it from what i hear. i wouldnt be too worried about taking a lot of seroquel the max dose range is pretty high
What do you take it for? I take the XR version 1-2hrs before bedtime and I fall asleep and sleep well on it, don't think taking it daytime would be a good idea for me.
Posted by billy h3ll on November 28, 2011, at 10:18:27
In reply to Re: Seroquel dosing question » billy h3ll, posted by tensor on November 28, 2011, at 10:13:28
bipolar disorder and sleep
Posted by Christ_empowered on November 28, 2011, at 10:34:08
In reply to Re: Seroquel dosing question, posted by billy h3ll on November 28, 2011, at 10:18:27
What symptoms are you targeting? Depression covers a lot of ground in terms of symptoms. Personally, I'd try the lower end recommended dose, give it a couple weeks, and then try moving it up. 500 sounds HIGH for depression that I'm assuming doesn't involve psychosis. Even with seroquel, you have to worry about TD and NMS and other dreadful neuroleptic-related side-effects, so I think the most prudent move would be to titrate to the lowest dose that's been recommended, wait, and then continue increasing if you have problems (assuming these problems are the sort that would respond to drug treatment and not other treatments or other medications).
If you can, try to get an AIMS test done every 3 months or so. Also, keep up with your blood work--triglycerides, cholesterol, blood sugar, etc.
Posted by tensor on November 28, 2011, at 10:54:50
In reply to Re: Seroquel dosing question, posted by Christ_empowered on November 28, 2011, at 10:34:08
> What symptoms are you targeting? Depression covers a lot of ground in terms of symptoms. Personally, I'd try the lower end recommended dose, give it a couple weeks, and then try moving it up. 500 sounds HIGH for depression that I'm assuming doesn't involve psychosis. Even with seroquel, you have to worry about TD and NMS and other dreadful neuroleptic-related side-effects, so I think the most prudent move would be to titrate to the lowest dose that's been recommended, wait, and then continue increasing if you have problems (assuming these problems are the sort that would respond to drug treatment and not other treatments or other medications).
>
> If you can, try to get an AIMS test done every 3 months or so. Also, keep up with your blood work--triglycerides, cholesterol, blood sugar, etc.No psychosis, but anxiety and no energy/interest. I will do blood works soon and I have a baseline. It's hard to say which anxiety-related symptoms come from clonazepam withdrawal and which are side effects from Seroquel, like dizziness and shakiness.
Posted by Phillipa on November 28, 2011, at 11:40:55
In reply to Re: Seroquel dosing question » Christ_empowered, posted by tensor on November 28, 2011, at 10:54:50
Tensor that is tough one as the benzo withdrawal would definitely cause some but seroquel is very potent to me and was so dizzy on a low dose couldn't speak and nearly fainted in hospital. Phillipa
Posted by tensor on November 28, 2011, at 11:55:15
In reply to Re: Seroquel dosing question » tensor, posted by Phillipa on November 28, 2011, at 11:40:55
> Tensor that is tough one as the benzo withdrawal would definitely cause some but seroquel is very potent to me and was so dizzy on a low dose couldn't speak and nearly fainted in hospital. Phillipa
I think I'm not so sensitive to antihistamines anymore.
Posted by sk85 on November 28, 2011, at 12:13:50
In reply to Seroquel dosing question, posted by tensor on November 28, 2011, at 9:27:39
Why are you taking this for depression as opposed to taking an SSRI, tricylcic etc?
For me Seroquel monotheraphy wasn't the answer as far as depression goes. I only went up to 150 mg though. It did work a little for anxiety and EPS.
Posted by tensor on November 28, 2011, at 12:46:13
In reply to Re: Seroquel dosing question, posted by sk85 on November 28, 2011, at 12:13:50
> Why are you taking this for depression as opposed to taking an SSRI, tricylcic etc?
>
> For me Seroquel monotheraphy wasn't the answer as far as depression goes. I only went up to 150 mg though. It did work a little for anxiety and EPS.I'm taking it with 30mg Remeron and 20mg escitalopram. I don't respond to antidepressants, have tried tricyclics.
Posted by Christ_empowered on November 28, 2011, at 21:12:57
In reply to Re: Seroquel dosing question » Christ_empowered, posted by tensor on November 28, 2011, at 10:54:50
Seroquel is a really sedating tranquilizer. In my experience taking neuroleptics, if you hit a "sweet spot," your interest in life increases because your agitation has decreased. Go over the "sweet spot," or use an excessively sedating agent, or get EPS or dysphoria, and you're miserable again. Kinda sucks.
I've heard that neuroleptics can make benzo withdrawal worse. I don't know why that would be the case or if its true. They can induce seizures, so maybe that's part of the problem?
Have you considered Abilify? I know, I take it and I recommend it to everybody. Its just...safer. More tolerable. Low doses aren't so tranquilizing.
I don't know anything else to recommend. Some people take Geodon, but that seems tricky, what with the 2x daily dosing, the heart thing and the need to take it with food for best absorption (check The Last Psychiatrist for info that). The newer antipsychotics are, well, new, so I don't think anybody knows how well they'll do in mood-disorder treatment.
Good luck to you.
Posted by Phillipa on November 29, 2011, at 18:22:27
In reply to Re: Seroquel dosing question, posted by Christ_empowered on November 28, 2011, at 21:12:57
CE I didn't know that about neuroleptics. Why would they make it harder to quit a benzo? Phillipa
Posted by Phidippus on November 30, 2011, at 20:57:00
In reply to Seroquel dosing question, posted by tensor on November 28, 2011, at 9:27:39
If it isn't helping at 300, it's not going to help at 500 mg.
Are you on an antidepressant?
Eric
This is the end of the thread.
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