Posted by Cam W. on October 3, 2001, at 0:39:45
In reply to Re: Report: Had to stop Risperdal, posted by SLS on October 2, 2001, at 14:22:01
Shar (& Scott) - Regarding the Seroquel™ (quetiapine), I am actually finding it very useful when added as an augmenting agent to both the typical and atypical antipsychotics. By itself, it doesn't seem to have the "holding power" of other atypicals. Seroquel seems to work well in situations where there is lower overall environmental stress (eg hospital), but when you add day-to-day stress (eg. paying bills, making it to appointments, interacting with strangers, etc.) to someone using as it as monotherapy, it's "anti-ruminating" effects seem to break down.
As an augmenting agent in situations, especially where one has trouble falling asleep due to too many ruminating thoughts, in many people it seems to work great. Another situation where I have found it useful is when dose-realted side effects of a primary antipsychotic are bothersome (eg. akathisia with Risperdal or hypersalivation with Clozaril), sometimes when you add Seroquel you can decrease the dose of the primary AP, and still have adequate protection, with the advantage of fewer side effects.
Shar, as Scott said, Geodon™ (ziprasidone) may be a good alternative, as would low-dose Zyprexa™ (olanzapine). The Neurontin™ (gabapentin) your doc has mentioned is not effective for everyone, but when is effective, it works great. I think it would definitely be worth a trial.
As for a wholesale med regimen change; I don't think that they are done as often as they should be. The trick is to keep people functioning while stopping the old regimen and getting up to speed on a new one. This is one situation where the expression "no pain, no gain" can really apply. The catch-22 of a change like this is that you can never be sure that you will be better off with a completely new regimen, but you will never know unless you try. Much heavy thinking and a lot of dialogue and understanding between you and your doc is necessary if you consider doing this.
Good luck in whatever you (and your doc) decide. I am in your corner waving some pom-poms. - Cam
poster:Cam W.
thread:80036
URL: http://www.dr-bob.org/babble/20010927/msgs/80131.html