Posted by uncouth on September 21, 2011, at 11:07:49
Here is my report. If anyone else has some experience comparing, please add to this thread.
I have been on all three of these meds the past few weeks to help treat my bipolar 2, predominantly depression, and sleeplessness.
I went off of Saphris, which was working great for sleep. I was on it for a few months, 10mg at night, 5mg at night. I went off because i had this sneaking suspicion it was "tamping me down", less creative thoughts, some anti-dopamine activity. But it definitely helped with stability, and when things got really bad, increasing to 20mg a day was pretty antidepressive but I was very zonked.
So I went off. I tried nothign for a few weeks, to see what life "without an AAP" woudl be like, which I had not experienced in a long time. I held up OK mood wise, but sleep was a disaster---I just could not sleep. Normal sleep inducing meds weren't working, my dr. was convinced the only thing that would help would be another AAP.
So we tried Seroquel. First low dose, just for sleep. That worked. 50-100mg and i'd mostly sleep through the night. Half of the time even with that i'd wake up in the middle of the night and have to redose a bit. I'd feel a little groggy (well sometimes more than a little groggy) upon wakeup but it worked well and I got used to it.
I even think that low dose had some positive effect on mood. But I got a little unstable, could feel hypomania come on, low grade, with some obsessive symptoms, maybe definitely feeling some NE activation. So we increased dose to 200 and 300mg of the XR (before I was on the IR). Whoa. Totally zonked. But mood def. improved, at least the times when I wasn't laying on the couch during the day because I was so tired. So had to ditch that. Doc said seroquel probably not right med for me, either IR or XR.
So lastly we tried Latuda. I spent just three nights on it, so please bear that in mind. First night at 20mg, didn't help much with sleep initiation, woke up in the middle of the night. No good. But upon wakeup i felt pretty clear headed although tired. Not zonked, mood ok. Next night, 20mg, still didn't sleep through the night, had to dose a seroquel to help out. Last night, 40mg, still didnt sleep through, had to redose a seroquel (25-50mg) but felt pretty good next morning mood wise.
So since Latuda alone wasn't doing it for sleep, doc said go back on Saphris 10mg at night. Ugh, back to Saphris, whole point was to get off of AAP but I just have to sleep. Took 10mg last night, slept, had deep dreams (always have very deep dreams on saphris), woke up, but woke up feeling dysphoric! Total mood change. Realized that all those months on saphris, this is sorta how i felt, pretty blah upon wakefulness, definitely too much antagonism going on it feels like.
SO I'm back at Square One having felt a bunch of AAP effects the last few weeks. I hope my experience helps and it will help me to read it someday when I have to go through this again, I'll search and find my own experience! I think i'm going to experiment again with the Latuda, it did feel like a pretty clean drug and now that I'm experiencing Saphris, I think Latuda was good for mood although I only had 3 days on it. Maybe I will eventually start sleeping with Latuda only. Other than that, I might go back to Seroquel IR just for sleep to eliminate the heavy AAP feeling of Saphris, or dose 5mg saphris at night. But my differential on Saphris is that it is probably really good for stability but definitely took "something away" and caused some dysphoria compared to the others.
Seroquel 300xr when it kicked in really was great, toally get why its indicated for BP 2 depression, but totally intolerable in terms of sleepyness and fatigue. I didnt work out for a month on that drug!
Ok over and out.