Seroquel, sedation and stabilization?

[hoodsurgeon]

I was recently put on Seroquel (Instant release) to take a bed time, and I know its infamous for its sedative properties; so my questions are:

-will the daytime sedation go away? If so, how long will it take to go away?
-Also if you're on it for mood stabilization at what dose was it effective?

Thanks

[GreyClouds]

My buddy was on it for around a month, he told me the only thing it did for him was make he drowsy all the time.
I met with him person a few times while he was on it, he had no personality and no energy. He was just in a constant haze.

Seroquel is a strange drug, it works for some but most people no.

[Monroe]

I'm on Seroquel, at 200 mg. I seem to be in a minority in the fact that I never got drowsy during the day, nor do I have any problems with getting up in the morning. It definitely works to put me to sleep when I take it at night, but I had no drowsiness problems during the day or morning.

I am on it for mood stabilization, and it works really well for me. I started taking it last December after having a horrid depressive episode - in only 1-2 weeks I felt a huge improvement and I've been on it ever since with a stable mood. I've only ever been on 200 mg. Giving my personal response probably isn't that helpful though, since everyone responds differently. My cure is another's poison. I've heard of many people that couldn't stand Seroquel, mostly due to the sedative effect.

[Equinox]

For me personally the daytime grogginess factor has unfortunately never went away even after 1 year+ of use. As Monroe pointed out however, your mileage may vary greatly.
I can't comment on it's mood stabilizing properties as I don't have a Bipolar diagnosis, there may be elements there but for me it's more like a complicated case of depression.

If sedation becomes too much of an issue in the long term there are certainly other options for bipolar disorder, here is a link to blog by a psychiatrist who ranks the mood stabilizers based on the amount of clinical success he's had with each one; http://www.askdrjones.com/2005/02/14...d-stabilizers/

[hoodsurgeon]

I'm on Seroquel, at 200 mg. I seem to be in a minority in the fact that I never got drowsy during the day, nor do I have any problems with getting up in the morning. It definitely works to put me to sleep when I take it at night, but I had no drowsiness problems during the day or morning.

I am on it for mood stabilization, and it works really well for me. I started taking it last December after having a horrid depressive episode - in only 1-2 weeks I felt a huge improvement and I've been on it ever since with a stable mood. I've only ever been on 200 mg. Giving my personal response probably isn't that helpful though, since everyone responds differently. My cure is another's poison. I've heard of many people that couldn't stand Seroquel, mostly due to the sedative effect.

Thanks, so far im only at 100mg (soon to be 200mg) and experiencing no day time drowsiness nor any mood stabilization though. If it does occur would Ritalin (for ADHD) counteract this?

For me personally the daytime grogginess factor has unfortunately never went away even after 1 year+ of use. As Monroe pointed out however, your mileage may vary greatly.
I can't comment on it's mood stabilizing properties as I don't have a Bipolar diagnosis, there may be elements there but for me it's more like a complicated case of depression.

If sedation becomes too much of an issue in the long term there are certainly other options for bipolar disorder, here is a link to blog by a psychiatrist who ranks the mood stabilizers based on the amount of clinical success he's had with each one; http://www.askdrjones.com/2005/02/14...d-stabilizers/

Thanks for the link but What dose are you on? (regardless of diagnosis)

[Monroe]

I'm not sure if taking Ritalin would help with Seroquel drowsiness. Do you have ADHD? Or Bipolar? I haven't heard of many with BP taking stimulants as it might trigger mania. That would be something to talk about with your doctor. It is a good sign that you've yet to have the drowsiness though!

[hoodsurgeon]

I'm not sure if taking Ritalin would help with Seroquel drowsiness. Do you have ADHD? Or Bipolar? I haven't heard of many with BP taking stimulants as it might trigger mania. That would be something to talk about with your doctor. It is a good sign that you've yet to have the drowsiness though!

I have both Bipolar and ADHD; My pdoc specalises in both ADHD and bipolar.

I know first hand that stimulants are very destabilizing and I stress the word VERY! But once you are stabilized Ritalin is okay apparently (According to the BNF (British National Formulary) it is a book that lists all medications for all their uses, their dosages for said usages, cautions and contraindications (Also side effects). But generally if you have bipolar and are taking stimulants be prepared for a very bumpy ride.

I need to talk to my pdoc ASAP as my mood has been all over the place (mixed state) due to stupid ritalin and/or rebound mania from risperdal withdrawal (and low seroquel dose).

[Equinox]

Thanks for the link but What dose are you on? (regardless of diagnosis)

I was on 150mg for the better part of the year but have currently tapered down to 100mg (hoping to go lower or stop completely, but I'm finding it hard to sleep without it).

[Equinox]

I have both Bipolar and ADHD; My pdoc specalises in both ADHD and bipolar.

I know first hand that stimulants are very destabilizing and I stress the word VERY! But once you are stabilized Ritalin is okay apparently (According to the BNF (British National Formulary) it is a book that lists all medications for all their uses, their dosages for said usages, cautions and contraindications (Also side effects). But generally if you have bipolar and are taking stimulants be prepared for a very bumpy ride.

I need to talk to my pdoc ASAP as my mood has been all over the place (mixed state) due to stupid ritalin and/or rebound mania from risperdal withdrawal (and low seroquel dose).

I am also diagnosed with ADHD and treated with a stimulant; Dextroamphetamine. In my experience I would say that Seroquel does interact with it somewhat in the sense that it blunts the cognitive enhancement and alerting effects to some degree (though not completely).

AFAIK your pdocs assertion is correct; Once a person is stabilized with a mood stabilizer, meds which would otherwise generally be considered 'destabilizing' can then be added more safely.

Furthermore I have to ask did you take Ritalin and Risperdal together? I ask because adding an atypical antipsychotic to a stimulant is actually sometimes done to treat very resistant ADHD by exploiting a synergistic mechanism, as crazy as it sounds. It generally works best with 'cleaner' atypicals such as Risperdal or Abilify rather than Zyprexa or Seroquel which are more 'dirty' and more likely to block this synergism.

[hoodsurgeon]

Furthermore I have to ask did you take Ritalin and Risperdal together? I ask because adding an atypical antipsychotic to a stimulant is actually sometimes done to treat very resistant ADHD by exploiting a synergistic mechanism, as crazy as it sounds. It generally works best with 'cleaner' atypicals such as Risperdal or Abilify rather than Zyprexa or Seroquel which are more 'dirty' and more likely to block this synergism.

I did indeed take my risperdal and ritalin together, the risperdal (And ritalin) were both prescribed at the same time as the diagnosis of ADHD (No prior treatment); However my pdoc stated that the risperdal was to stabilize my mood.

When you say "cleaner" do you mean It targets less receptors? for example risperdal doesn't antagonize H1, M1, 5-HT2c (Etc..) as much as zyprexa, but risperdal has a higher affinity for D2 receptors (And tighter binding) than zyprexa, thus making risperdal "cleaner" than zyprexa (And making zyprexa "dirtier").

Or have I got the concept completely wrong?

[Equinox]

I did indeed take my risperdal and ritalin together, the risperdal (And ritalin) were both prescribed at the same time as the diagnosis of ADHD (No prior treatment); However my pdoc stated that the risperdal was to stabilize my mood.

When you say "cleaner" do you mean It targets less receptors? for example risperdal doesn't antagonize H1, M1, 5-HT2c (Etc..) as much as zyprexa, but risperdal has a higher affinity for D2 receptors (And tighter binding) than zyprexa, thus making risperdal "cleaner" than zyprexa (And making zyprexa "dirtier").

Or have I got the concept completely wrong?

Yes by 'cleaner' I am in the broader sense saying that it does not target receptors such as H1, a1, M1, etc, which can interfere with cognition, however more importantly I am referring to the fact that the 'clean' drugs don't block D1 and D4 type dopamine receptors very strongly as these are thought to be the prime dopamine receptor targets in ADHD, so by blocking only D2 & D3 they redirect the stimulants preferential binding to these receptors.

[hoodsurgeon]

Yes by 'cleaner' I am in the broader sense saying that it does not target receptors such as H1, a1, M1, etc, which can interfere with cognition, however more importantly I am referring to the fact that the 'clean' drugs don't block D1 and D4 type dopamine receptors very strongly as these are thought to be the prime dopamine receptor targets in ADHD, so by blocking only D2 & D3 they redirect the stimulants preferential binding to these receptors.

Thanks for the info. By any chance do you have a study (/research paper....etc) regarding this? As I would like to read more into this topic

[Equinox]

Thanks for the info. By any chance do you have a study (/research paper....etc) regarding this? As I would like to read more into this topic

The main source where I attained this knowledge was from this paperback book; http://www.amazon.com/Stahls-Essenti.../dp/0521673763
But I will keep an eye out for any online papers discussing the subject for you.

[PurpleRose]

I have a love/hate relationship with seroquel because when I am literally falling apart at the seems or to anxious to even breath its a god send, it honestly is. However the side effects are horrible, I cannot stop eating and sleeping on them. I was on a 200mg dose too, it did help my mood but made me sleep far too much throughout the day and the evening with on going sedation and hunger, it was awful. I hated the weight gain on it and am still trying to lose it too Strong mood stabilizers like lamictal sound better to me but anyway there are also certain benzos which help stabilize moods although they are more addictive than seroquel but seroquel is not a non addictive drug either, it had bad withdrawals

[UltraShy]

I'm on Seroquel, at 200 mg. I seem to be in a minority in the fact that I never got drowsy during the day, nor do I have any problems with getting up in the morning. It definitely works to put me to sleep when I take it at night, but I had no drowsiness problems during the day or morning.

I talked with Monroe about this and she speculated that perhaps Seroquel is less sedating at higher doses. Seemed a reasonable hypothesis given that this tiny girl has no trouble with 200 mg while a big guy like me gets his [BEEP] kicked by 100 mg: a 15-hour nap followed by waking up all ready for another nap.

I asked my brother about this and found that for him it's a case of higher dose = more drowsiness, so a standard linear response. He tells me he loves 400 mg for when he has to sleep under the most adverse conditions. He finds those conditions in Hostels, as Motel 6 is simply far too expensive & luxurious for his travels. Seems 400 mg will give him a great 8-hour sleep even when stuffed into a room with a dozen other folks.

Just demonstrates how widely variable response can be. To make this even more odd, Seroquel has this extreme over-response in me even though hardly anything makes me drowsy. Things that don't make me drowsy include: benzos, Ambien, Lunesta, antihistamines, amitriptyline, doxepin, Remeron, Rozerem, melatonin.