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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by sleepygirl on December 21, 2005, at 21:02:19
OK now I'm on a low dose of this stuff (just 25mgs in the evening) and it has been helpful with my anxiety, but I feel sort of dull, apathetic, like I couldn't care less. I can't think of anything to say......
Doesn't Kurt Cobain say something like "who cares, oh well, whatever, nevermind..."?Does anyone relate to this experience?
I'm on a "pitch all the meds" sort of wagon.
Posted by Phillipa on December 21, 2005, at 23:01:07
In reply to need to stop seroquel I think, any opinions, posted by sleepygirl on December 21, 2005, at 21:02:19
I'm not the best one to be replying to your thread but I kindda feel the same way you do sort of antimeds. But I did try seroquel once for a few days and I personally would try and get rid of it and substitute klonopin, valium, xanax, etc. Too little known and wt gain slim chance of TD not worth it to me. Fondly, Phillipa
Posted by yxibow on December 21, 2005, at 23:13:44
In reply to Re: need to stop seroquel I think, any opinions » sleepygirl, posted by Phillipa on December 21, 2005, at 23:01:07
> I'm not the best one to be replying to your thread but I kindda feel the same way you do sort of antimeds. But I did try seroquel once for a few days and I personally would try and get rid of it and substitute klonopin, valium, xanax, etc. Too little known and wt gain slim chance of TD not worth it to me. Fondly, Phillipa
The chance of TD (or weight gain) at 25mg, which is extremely subclinical (I take 900 and it isnt really considered clinical until around 400) is so remote that it is just as likely for a placebo to do so. I'm not negating your feelings with it -- none the less, there is always a concern of TD. If it actually has a psychiatric effect, then what you're experiencing is what I experience day in and day out, namely "blunting". Antipsychotics, by their action blunt affect -- emotions and one's ability to express them.
So yes, by all means, if such a low dose is already affecting you in that nature, then try a low dose of some benzodiazepine instead as suggested.
Cheers
Posted by sleepygirl on December 21, 2005, at 23:17:42
In reply to Re: need to stop seroquel I think, any opinions » Phillipa, posted by yxibow on December 21, 2005, at 23:13:44
How's the side effects for you at that dose?
Posted by Emme on December 22, 2005, at 6:04:15
In reply to need to stop seroquel I think, any opinions, posted by sleepygirl on December 21, 2005, at 21:02:19
Have you split the tablet and tried 12.5 mg?
> OK now I'm on a low dose of this stuff (just 25mgs in the evening) and it has been helpful with my anxiety, but I feel sort of dull, apathetic, like I couldn't care less. I can't think of anything to say......
> Doesn't Kurt Cobain say something like "who cares, oh well, whatever, nevermind..."?
>
> Does anyone relate to this experience?
>
> I'm on a "pitch all the meds" sort of wagon.
Posted by spriggy on December 22, 2005, at 14:40:07
In reply to Re: need to stop seroquel I think, any opinions » sleepygirl, posted by Emme on December 22, 2005, at 6:04:15
I think Klonopin is causing a " who gives a flyin' flip" attitude in me as well.
I feel very empty; dull. I don't like it.
It's weird; I guess I have to chose between that and horrific anxiety with mixed depression.
Life is great, huh? lol
Posted by Mimi on December 22, 2005, at 20:49:14
In reply to need to stop seroquel I think, any opinions, posted by sleepygirl on December 21, 2005, at 21:02:19
Hey sleepygirl,
Stay on it. It's a lifesaver for me. I mix it with 30mg. of Lexapro in the a.m. That gives me the get up and go to overcome the sedation of Seroquel. What's your diagnosis?
Mimi
Posted by sleepygirl on December 22, 2005, at 22:14:42
In reply to Re: Stay on it, posted by Mimi on December 22, 2005, at 20:49:14
Some mixture of depression with lots of anxiety. I take effexor XR, not sure I need that either lately.
Glad it's going well for you. I do appreciate the seroquel, but it's terribly sedating and lately I'm feeling a bit too apathetic.
all the best,
sleepygirl
Posted by sleepygirl on December 22, 2005, at 22:17:03
In reply to Re: need to stop seroquel I think, any opinions, posted by spriggy on December 22, 2005, at 14:40:07
yeah, nice choice right? I took klonopin for a while, but it didn't make me quite so dull, but I was still anxious. I don't think I ever went over 1mg a day.
Posted by med_empowered on December 22, 2005, at 23:24:54
In reply to Re: Stay on it, posted by Mimi on December 22, 2005, at 20:49:14
It seems like lots of psychiatric meds induce apathy. SSRIs, antipsychotics, benzos--you name it, one of the main effects is a sort of sedated apathy.
Seroquel's apathetic effects are, I imagine, caused both by its antipsychotic action (which I would think would be minimal at 25mgs/day) and by its pronounced sedation.
The first choice for severe anxiety would probably be a benzo, for me at least. Ativan might be cleaner than Klonopin; it tends to just cause sedation and/or kill of anxiety, while Klonopin also has effects on mood. If you keep the dose low, and use it strictly as needed, then you could probably minimize apathy.
Effexor could also be causing some apathy for you..I know that SSRIs tend to make me much more apathetic, and I've noticed it in my friends as well.
I'm kind of concerned that so many people are on antipsychotics for anxiety. Antipsychotics can help with anxiety--this was one of their primary uses from the 50s-70s, before concerns about TD,NMS, and other issues became a big deal-- but given the cost and side effects, it would seem most prudent to use them **only** in psychosis or cases of unresponsive mood disorders.
I think you might want to try a benzo, such as ativan. BuSpar is an option. Its kind of antipsychotic-ish, and higher doses make me feel strangely "unnerved" (low-grade akathisia?) and somewhat dysphoric but...lower doses I imagine could be helpful without causing too many problems.
Some people swear by Lyrica, the super-Neurontin that just got released. However, given Neurontin's shady history in the psychiatric realm, I think it might be a good idea to put off using it until it has a good track record (assuming this happens).
Posted by yxibow on December 23, 2005, at 0:49:57
In reply to Re: need to stop seroquel I think, any opinions » yxibow, posted by sleepygirl on December 21, 2005, at 23:17:42
> How's the side effects for you at that dose?
Orthostatic hypotension (low blood pressure) after about an hour to an hour and a half before I go to bed -- e.g. a fainting feeling, if I dont hit the bed before it takes effect.
Fighting drowsiness in the morning.
Possible mild pseudoparkinsonism/tremor, although that can also be from past trials of other antipsychotics but I doubt it.
Mouth fasciculations (tremor of the mouth), identified by experts familiar with TD as not TD.
They don't occur very often, usually with cold drinks, and surprisingly with allowing my mouth to relax, for a short period of time. Generally TD by experts is something not aware by the patient, at least not at first, unless pointed out by someone else. This has been the opposite in my case for all EPS.Been checked for the "beagle eye" syndrome (there has only been one reported case that I know of cataracts from Seroquel, but my doctor was extra cautious)
Positive benefits -- reduction of unexplainable D2 activity and my rare light sensitivity somatiform disorder. There really isn't anything more "mild" than Seroquel other than Clozaril and that has hardly any D2 blockage and a host of hideous drooling and other side effects although nearly no TD.
EPS varies wildly from person to person and affects people with affective disorders such as myself (depression, anxiety, schizoaffective disorder) in a generally greater degree than those with schizophrenia although that varies too.I think that about sums it up.
cheers.
Posted by sleepygirl on December 23, 2005, at 11:14:23
In reply to need to stop seroquel I think, any opinions, posted by sleepygirl on December 21, 2005, at 21:02:19
it could be...perhaps, that the apathy is primarily from the sedation? since it's really a very low dose (25mgs). I'm thinking that really that's probably the only effect of this med at this level - I really cannot tell
Posted by greenhornet on December 27, 2005, at 7:30:06
In reply to medication-induced apathy, posted by med_empowered on December 22, 2005, at 23:24:54
I agree whole-heartedly with med-empowered.
..I was put on Seroquel due to a "psychotic reaction" to another med/med combo. (Actually I started on Zyprexa, but after gaining 50lbs in two months, I begged for the change) After a year I began to taper off the Seroquel and my experience is that, even with what are supposed to be "sub-clinical" doses, metabolism is effected. I took 25mgm for about six months then went to 12.5 for another six ("for sleep").Within days of stopping to Seroquel completely I began to lose weight, and my appetite was more managable (ie no carb cravings).
I have been off the Seroquel for nearly a year, and in that time returned to my weight of four years ago prior to being put on the atypical antipsychotics.
Lest you doubt all of this, last month I tried taking the 12.5 mgm because I was haveing some sleep difficulties; and after ONE WEEK I had gained seven pounds! I know it isn't "supposed to happen " at that low a dose, but arent there unknowns with all meds?!
------------------------------------------> It seems like lots of psychiatric meds induce apathy. SSRIs, antipsychotics, benzos--you name it, one of the main effects is a sort of sedated apathy.
>
> Seroquel's apathetic effects are, I imagine, caused both by its antipsychotic action (which I would think would be minimal at 25mgs/day) and by its pronounced sedation.
>
> The first choice for severe anxiety would probably be a benzo, for me at least. Ativan might be cleaner than Klonopin; it tends to just cause sedation and/or kill of anxiety, while Klonopin also has effects on mood. If you keep the dose low, and use it strictly as needed, then you could probably minimize apathy.
>
> Effexor could also be causing some apathy for you..I know that SSRIs tend to make me much more apathetic, and I've noticed it in my friends as well.
>
> I'm kind of concerned that so many people are on antipsychotics for anxiety. Antipsychotics can help with anxiety--this was one of their primary uses from the 50s-70s, before concerns about TD,NMS, and other issues became a big deal-- but given the cost and side effects, it would seem most prudent to use them **only** in psychosis or cases of unresponsive mood disorders.
>
> I think you might want to try a benzo, such as ativan. BuSpar is an option. Its kind of antipsychotic-ish, and higher doses make me feel strangely "unnerved" (low-grade akathisia?) and somewhat dysphoric but...lower doses I imagine could be helpful without causing too many problems.
>
> Some people swear by Lyrica, the super-Neurontin that just got released. However, given Neurontin's shady history in the psychiatric realm, I think it might be a good idea to put off using it until it has a good track record (assuming this happens).
>
>
>
Posted by sleepygirl on December 27, 2005, at 19:16:25
In reply to Re: medication-induced apathy, posted by greenhornet on December 27, 2005, at 7:30:06
I kinda thought my complaints didn't have merit on account of the small dose, but I just went down to 12.5 and I'm feeling a bit more motivated (perhaps it will help me with my lovely weight gain problem)
maybe it's an 'as needed' possibility for sleep for me, or when I'm really hyped up, but that's it I think.
thanks for the validation,
sleepygirl
Posted by bigscreen on December 27, 2005, at 20:12:47
In reply to medication-induced apathy, posted by med_empowered on December 22, 2005, at 23:24:54
hey i also started having psychotic episodes to a medication interaction. my psych is diagnosing it as psychotic depression. i also gained weight on seroquel and abilify made me have restless leg akathesia. the risperdal makes me have headaches at night so i think i will give risperdal a try again. i also take klonopin, celexa and trileptal. i go to my psyc tomorrow i think i want to try ativan because klonopin does effect my mood. any feedbacks or advice
Posted by Sarah T. on December 28, 2005, at 1:07:38
In reply to medication-induced apathy, posted by med_empowered on December 22, 2005, at 23:24:54
Hi med-empowered,
Are you saying that Ativan would be less likely to cause or exacerbate depression than Klonopin?
Posted by linkadge on December 29, 2005, at 17:00:18
In reply to Re: medication-induced apathy, posted by greenhornet on December 27, 2005, at 7:30:06
That is something you have to watch for.
Don't let doctors try and patch up their mistakes with more wrong decisions. I was a patch up job for years, untill I started to take some charge.
Don't let the doctors convince you that you had some latent psychosis or something. If a drug makes you psychotic, then discontinue the drug, and wait and see for yourself. Believe that it was the drug and not you.There is a tendancy for some meds to help anxiety *via* creating apathy.
For many years thats all I could achieve. Oh sure, we'll take away your anxiety, but we'll also sap your zest for all other good things.
Preventing apathy requires you to have the best base med possable, and then take as little else as possable.
Stay away from the atypicals if you're not psychotic.
Linkadge
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