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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by mogger on April 30, 2005, at 14:56:52
Hello,
does anyone know whether 300mg of Seroquel is that high of a dose? I am just worried that she will become dull and sluggish as the Selegiline is working really well for but she is having trouble sleeping. She uses Seroquel just for sleeping. Any thoughts would be great.
Posted by linkadge on April 30, 2005, at 15:13:32
In reply to sister on Seroquel, posted by mogger on April 30, 2005, at 14:56:52
300mg is a antipsychotic dose. Ususally it is used in much lower quantities when used for insomnia etc.
Linkadge
Posted by alexandra_k on April 30, 2005, at 16:09:53
In reply to Re: sister on Seroquel, posted by linkadge on April 30, 2005, at 15:13:32
though I have been on 250mg 2x daily to help with sleep and anxiety.
Different people may respond to the same amount differently.
Some people have a high tolerance and other people feel fairly sedated on a lower dose.
I used to have a high tolerance, but now I just take 50mg at night to help me sleep.
If you think the Seroquel is sedating her - then there is only one way to find out. How about telling her p-doc your thoughts (or getting her to pass them on) and maybe they could try a slightly lower dose to see whether she is less sedated on that?
Posted by mogger on April 30, 2005, at 17:05:36
In reply to Re: sister on Seroquel, posted by alexandra_k on April 30, 2005, at 16:09:53
alexandra,
did you feel a dullness or blunt feeling at 500mg or were you just the same? thanks for your advise.
Posted by mogger on April 30, 2005, at 19:46:17
In reply to Re: sister on Seroquel, posted by linkadge on April 30, 2005, at 15:13:32
> 300mg is a antipsychotic dose. Ususally it is used in much lower quantities when used for insomnia etc.
>
> Linkadgethanks linkadge,
is it a low mid or high antipsychotic dose?
Posted by cache-monkey on April 30, 2005, at 20:00:24
In reply to sister on Seroquel, posted by mogger on April 30, 2005, at 14:56:52
I'm interested in this combo, since I think it might be my next trial... Out of curiousity what dose of selegiline is she on?
Smaller doses (e.g. 25-100 mg) are what I usually see just for sleep. But at a therapeutic dose (e.g. 300 mg) it can be additionally beneficial for anxiety/depression. I'm actually considering it in that range as a mood stabilizer due to a soft bipolar tendency.
If it's just for sleep, I could see a small dose at night helping. Some people do report sedation carrying into the next day, but from what I've read many (most?) wake up fine, especially after getting used to the drug for a little while. So it might be something try and see how it goes.
Other similar options for sleep could be low-dose trazodone, or benadryl at night. These, as well as Seroquel, work for sleep by targetting the histamine receptor. Other sleep options are available, too, e.g. Ambien, or the new Lunesta, which is supposed to have fewer issues with tolerance. These have a different mechanism of action.
If the goal is augmenting for some therapeutic benefit, I've heard that for many (but not all) sedation at, e.g. 300 mg, is intense for a couple of weeks and then dissapates. To the extent that some lose much of the sleep benefit. Something to do with adaptive down-regulation of the histamine receptors.
Just my sense based on various things I've read...
Hope this helps,
cache-monkey> Hello,
> does anyone know whether 300mg of Seroquel is that high of a dose? I am just worried that she will become dull and sluggish as the Selegiline is working really well for but she is having trouble sleeping. She uses Seroquel just for sleeping. Any thoughts would be great.
Posted by cache-monkey on April 30, 2005, at 20:04:31
In reply to Re: sister on Seroquel, posted by mogger on April 30, 2005, at 19:46:17
Hey,
That's on the low end of the antipsychotic dose range, which is (I think) 200-800 mg.
I'd also like to point out that Seroquel in those ranges is showing strong promise as a mood stabilizer for bipolar, working on both the (hypo)manic and depressive sides, as well as anxiety/mixed states.
The sweet spot as an antipsychotic seems to be around 300 mg for the average person, based on some numbers I was looking at. Also in a fixed-dose study for bipolar depression 300 mg was slightly better than (but not statistically distinguishable from) 600 mg.
Best,
cache-monkey> > 300mg is a antipsychotic dose. Ususally it is used in much lower quantities when used for insomnia etc.
> >
> > Linkadge
>
> thanks linkadge,
> is it a low mid or high antipsychotic dose?
>
>
Posted by Phillipa on April 30, 2005, at 21:27:40
In reply to Re: sister on Seroquel » mogger, posted by cache-monkey on April 30, 2005, at 20:04:31
l00mg for sleep didn't keep me asleep and I woke up drunk. Needless to say it was dc'd that day. I was in the hospital. Fondly, Phillipa
Posted by alexandra_k on April 30, 2005, at 22:13:00
In reply to Re: sister on Seroquel, posted by mogger on April 30, 2005, at 17:05:36
> alexandra,
> did you feel a dullness or blunt feeling at 500mg or were you just the same? thanks for your advise.Hmm. I think I felt ok. But it was a fair while ago now... Also I wasn't at uni then whereas I am now. I am much more sensitive to the effects of sedation when I have to get up to get to work and the effects on concentration etc when I have to work. At the time I think I felt ok. But... I was also smoking a lot of pot and taking 2 imovane for sleep and so... I was probably barely functioning to tell you the truth. Sometimes you just seem to aclimatise from a first person perspective - and it is from a third person perspective that you can really see how a medication is affecting someone.
I don't know.
Can you talk to your sister about your concerns?
Posted by mogger on May 1, 2005, at 3:19:24
In reply to Re: sister on Seroquel » mogger, posted by cache-monkey on April 30, 2005, at 20:00:24
cache-monkey,
thanks for the reply, it is very helpful.She is a completely treatment resistant patient.
Her doctor decided to try her on selegiline (15mg 2x daily=30mg) and 1000mg of phenylalinine. Keep in mind she had to gradually get up to the dose of selegiline slowly and then added the phenylalinine. So far she has got her energy back and is functioning much better, her concentration has improved i.e. she can now read a book which was previously tough for her to do because of the depression.
She definitely still struggles but there is an improvement. I just hope it doesn't poop out on her like all her previous meds.
She has unipolar depression so I am not sure how you (slightly bi-polar which means highs and lows right?) would react to it because it does give her energy and she has difficulty falling asleep, something she didn't have before. Be careful and talk to your doctor about it! Please let me know how you are doing and what the outcome is!
> mogger
>
Posted by mogger on May 1, 2005, at 3:22:52
In reply to Re: sister on Seroquel » mogger, posted by alexandra_k on April 30, 2005, at 22:13:00
thanks alexandra,
i take it you are from the UK as only brits call college uni! I am a brit myself! Your right, I shall have a chat with her as we are close and discuss what is happening. This site is so helpful and positive, hope you are well and thanks again!
mogger
Posted by alexandra_k on May 1, 2005, at 4:15:26
In reply to Re: sister on Seroquel, posted by mogger on May 1, 2005, at 3:22:52
> thanks alexandra,
> i take it you are from the UK as only brits call college uni!Ah. Brits and Aussies and Kiwis.
I am from New Zealand :-)
Posted by Cairo on May 1, 2005, at 8:03:52
In reply to Re: sister on Seroquel » mogger, posted by cache-monkey on April 30, 2005, at 20:00:24
> Smaller doses (e.g. 25-100 mg) are what I usually see just for sleep. But at a therapeutic dose (e.g. 300 mg) it can be additionally beneficial for anxiety/depression. I'm actually considering it in that range as a mood stabilizer due to a soft bipolar tendency.
>
> If it's just for sleep, I could see a small dose at night helping. Some people do report sedation carrying into the next day, but from what I've read many (most?) wake up fine, especially after getting used to the drug for a little while. So it might be something try and see how it goes.
Have you heard of LOW dose Seroquel as an adjunct for anxiety? In another thread on this board, I've stated that we are in a "discussion" with our daughter's pdoc over an out-of-state specialist's recommendation to add Seroquel to her SSRI for Social Anxiety. He categorically refuses to because of the sedation issues and says he hasn't seen it used for anxiety. She does have fatigue, but she's on Lexapro and she has a sleep phase shift with mild sleep apnea which no one seems to want to address.Anyways, we are diligently looking for any and all literature for atypicals or anything else being used as add-ons in social phobia. Thanks.
Cairo
Posted by cache-monkey on May 1, 2005, at 14:57:32
In reply to Re: sister on Seroquel, posted by mogger on May 1, 2005, at 3:19:24
Hi mogger,
Thanks for the info about the selegiline. It must be hard for you to watch your sister try various meds and have them poop out. I hope that the selegiline continues to work for her. I think the combo strategy is a good one for treatment resistant cases.
Has she tried augementation with a mood stabilizer before? I've heard that Lithium can be added in the event of poop-out with sometimes good results. Some psychiatrists believe that multiple poop-outs can be a sign of some sort of latent bipolar.
Anyway, my pdoc and I think I'm bipolar II with rapid cycling. Ups and downs that are a little, but not excessively, past the bounds of 'normal,' dysphoric depressions. Frequent fluctuations, but way more time spent down. My pdoc wants to find a good mood stabilizer before trying an antidepressant again. (I went hypomanic on a combo of Celexa+Wellbutrin.) This process is hard because I'm really down most of the time these days.
I'm on Depakote right now, and that isn't doing much for me. Plus my sleep is worse. That's kind of why I want to try Seroquel as a mood-stabilizer next. It's supposed to be good for sleep and work on depression and anxiety, in addition to mania. (Depakote's really just an antimanic as far as I know.)
Anyway, I'll definitely keep you and the board posted on my progress.
Good luck to your sister!
~cache-monkey
Posted by mogger on May 1, 2005, at 23:26:42
In reply to Re: sister on Seroquel » mogger, posted by cache-monkey on May 1, 2005, at 14:57:32
cache-monkey,
thanks for the response. Have you ever tried Lamictal as a mood stabilizer? It has been a life saver for me as I too suffer from depression/ocd. I was exactly like my sister, a non-responder and then my doctor added Lamictal and it calmed my brain down.She has tried lithium in the past but not with any success atleast in the combo she was on at the time. Thanks for the good wishes for my sister and you have them right back from me,
mogger
Posted by mogger on May 1, 2005, at 23:34:19
In reply to Re: sister on Seroquel, posted by Cairo on May 1, 2005, at 8:03:52
cairo,
haven't heard of low dose Seroquel with SSRI for social anxiety relief but I remember I saw something about it on psycho-babble. try doing a search with those two key words and hopefully you will find som info.
mogger
Posted by wendy0006 on May 4, 2005, at 15:27:25
In reply to Re: sister on Seroquel, posted by mogger on May 1, 2005, at 23:34:19
I take a total of 600 mg of Seroquel a day - 300 at night and the 300 in the day is supposed to calm me down. I also take 300 mg of Zoloft and 200 mg of Lamictal for my psych stuff.
I take 1mg Klonopin, 8 mg Zanaflex and 30 mg Oxycontin a day for pain and restless legs.
I do start going a bit crazy if I forget my Seroquel, but I am still not sedated and retain my anxiety even with all this.
I know quite a few people in my Borderline group who take 600 mg of Seroquel with no side effects.
wendy
Posted by mogger on May 5, 2005, at 1:42:40
In reply to Re: sister on Seroquel, posted by wendy0006 on May 4, 2005, at 15:27:25
thanks for the reply wendy, I am on most of the same as you! I am on 200mg of Zoloft and 300mg of Lamictal. I see you are on 300mg of zoloft, do you have any sweating side effects with the zoloft. I am interested in going higher but my sweating is pretty bad but was wondering if it hits a peak at some point? many thanks,
mogger
Posted by wendy0006 on May 5, 2005, at 7:49:12
In reply to Re: sister on Seroquel, posted by mogger on May 5, 2005, at 1:42:40
Hi, I do get intense night sweats sometimes, but I think it is more related to anxiety than my medication - but, they have switched the meds around so much it is hard to tell. But now, on the 300mg, I don't sweat as much as I used to. But also, I still feel depressed and don't think the extra 100 has really helped.
wendy
This is the end of the thread.
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