seroquel

[starbunny]

This drug has been a complete godsend for mania, insomnia, agitation and hallucinations, but I'm left with depression, no sex drive, intrusive thoughts and the paranoia has now returned. I also struggle with a racing heartbeat after taking it. I have become a recluse, and wonder if the outcome actually outweighs the problem in the first place. I am torn between insisting on changing medication, trying an antidepressant (which last time sent me into mania), or ditching it altogether. I have mentioned this to the doctor but he is insistent that my 'depressed' is in fact other people's normal and I should try and get used to it. I am finding this a struggle.
Apparently I need an antipsychotic, but have had no experience of any except for this one. Has anybody any advice, before I see my pdoc in Jan?

[starbunny]

Hi adeI, I think you may be right about me mistaking lethargy for depression, or at least it is playing a big part in it. When your'e too tired to join in social activities or housework etc you have all that extra time to mull over your problems. Your life becomes disorganised, and you end up isolated, like I have.
I am bearing in mind that perhaps this 'depression' may be even worse without the seroquel as I may naturally have been heading down anyway, so I am now trying not to be too hard on the drug.
I will enquire as to why they did not change to lamictal before, and the possibility of doing so in the future. It might make all the difference. Take care

[adel_ezz]

Hi

Your doctor is right and seroquel is a Godsend as you said. Had there been an efficient drug for this BP business, none will ever post here. Taking an AD will drive you manic while an AP suppresses your activities. Don't stop seroquel, it saved me from the mixed states I had and still does.

I think one has to try hard to struggle or at least doesn't give up easily. The depression side although it's said that seroquel helps in both ends of BP this is what pdocs say, but for me i find it not helpful in depression which is my main concern. BUT at least it doesn't worsen depression and this I am sure about it along with the other atypicals.. Although I feel that one is confused between depression and being lithergic, so you feel that you are depressed and in fact you are only tired. So sure seroquel doesn't worsen depression like IL said however you feel tired all the time and this happens to me although i am on 25mg only. I believe that AD's are the worst drugs they can transform your life like they did for me, e.g rapid cycling, mixed episodes, etc...

I've always thought and wrote here that the best combo for BP is lamictal + seroquel though i never tried this combination myself as lamictal brought me seizure yet my pdoc said it can't because it works against that and that I was only hysterical at the time. Yet somehow I feel they can equalise each other, thus you feel stable. The 1st moves upwards i.e. lifts depression while the 2nd downward. In fact the side effect of lamictal (except rash, rare) is little and no weight gain.

So speak with your pdoc, don't relinquish seroquel but consider adding lamictal, like this you shoot all the birds with one bullet

good luck

[ILADVOCATE]

Every person reacts differently but I had a bad reaction to Tegretol (the name of the first medication you posted) in that it caused psychosis but this can occur from any anti-convulsant in a certain class (lithium of course not being an anti-convulsant can't cause this, also this side effect is infrequent but should be noted, I did not have this from Lamictal but each person reacts differently to each medication). From what I know 300 mg. is on the low end of a working dose of Seroquel. An antipsychotic that is activating can sometimes cause insomnia or agitation but would not worsen mania the same way anti-depressents can. Best to talk all this over with a psychiatrist. For full information in the meantime you could go to the medication websites as well.

[starbunny]

I believe my diagnosis is bipolar wth psychotic features. I do take a mood stabiliser - carbamazepine 1400mg. I came close to changing to lamictal but at the last minute the doc changed his mind. Perhaps because he thought it more pressing to treat the mania side than the depression? I will enquire again about this in Jan.
I am on a low dose of seroquel, I started on 100mg then went to 300mg maintenence, so perhaps this is not enough or I need to change in order to beat the depression. As for paranoia, it's not as bad as it was but bad enough for me not to not to go out most days, and I am in danger of ruining my relationship through my suspicions. When people talk of 'activating' antipsychotics - does this mean that they can stop you from sleeping? or make you agitated? I would need to know they won't have the same effect as antidepressants.

[ILADVOCATE]

I believe all atypical antipsychotics are FDA approved as mood stabilizers. However, Seroquel I believe is more effective than some others but only a psychiatrist could explain for sure. The three newest antipsychotics, Abilify, Fanapt and Saphris are the least likely to cause weight gain and sedation though they can be activating. Seroquel can cause tachycardia which is a speeded up heart beat. I had that from it. That's generally not of concern. Loss of sex drive is from prolactin elevation which can happen from all antipsychotics. Some are less likely to cause it then others. Seroquel working as a mood stabilizer should treat depression. I believe that I experienced some minor depression when I was on Seroquel but that's not that common. It definitely should treat paranoia as that's part of psychosis in general. I don't know whether you need a change in antipsychotics, an increase in dose or to take a mood stabilizer (such as Lamictal which has a good anti-depressent effect but also works as a full mood stabilizer and as I remember although it couldn't replace an antipsychotic of course it had some antipsychotic effects). I do know as a person with schizoaffective which is still true to this day I require an antipsychotic and a mood stabilizer both and the same would generally be true of bipolar with psychotic features (if that's your diagnosis) though only a psychiatrist would know for sure.