Posted by King Vultan on November 12, 2004, at 16:19:52
In reply to Seeing PDOC on Monday, med adjustment suggestions?, posted by Wildman on November 12, 2004, at 14:40:02
> I'm scheduled to see my pdoc on Monday - haven't seen him since August or so.
>
> I've been doing well, especially after I increased my Lexapro to 15mg/day. That has really made a big difference as I can now say that it is really helping me, I genuinely can say that I am not depressed for the first time in 20 years. I am having trouble with motivation and attention span, restless legs, forgetfulness. I am _easily_ distracted.
>
> I do take Seroquel at night (25-50mg) which has been working great at keeping me asleep. Lately I find that I wake up at 5AM for no reason, and then toss and turn for the next 2 hours and drift in and out of sleep. I do eventually wake up feeling pretty good. I have really been enjoying my music lately, which is a sign that the darkness is lifting.
>
> On days when I get too revved up (afternoon) I take 12.5-25mg of Seroquel, which takes the edge off quite nicely.
>
> To sum up, I am doing much better, but there's still a distance to go before I am satisfied.
> What to do about the motivation and the distractibility? I almost feel like I am hyper-active. I can't stay in my chair at work, am always wandering around, jump from topic to topic... I used to have motivation to projects around the house but when I get home I just want to veg out in from of the TV and escape.
>
> Any suggestions on adjustments to my meds? I'm hoping for ideas to bounce of my pdoc, who is great.
>
> Thanks in advance
>
> Wildman
It sounds like your dopamine system is being affected negatively, as you almost have ADHD symptoms, plus your restless legs syndrome is a typical EPSE (extrapyramidal side effect) from blockading dopamine D2 receptors by antipsychotic drugs. I would suggest lowering the Seroquel dosage or perhaps replacing it with another atypical antipsychotic that does not blockade dopamine D2 receptors to the same degree. I believe that what might work better is a drug that more selectively blockades serotonin-2A receptors. Supposedly, this is what Risperdal does at very low dosages, but I have no direct experience with it myself. There may be other atypical antipsychotics that might also be worth considering.Todd
poster:King Vultan
thread:415094
URL: http://www.dr-bob.org/babble/20041108/msgs/415120.html