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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by sheilac on May 3, 2011, at 13:40:06
I currently take 25mg of Seroquel at night and 5mg Adderall XR in the morning. This is a low dose of meds and has worked for the past couple of weeks.
But now, I feel like my mood during the day has been just under the boiling point (not good - thank God for Klonopin).
I am thinking I need to up my Seroquel back to 50mg in order to keep my mood stable and not rage at someone.
The problem is that I feel hungover and irritable in the morning on 50mg. Is this something I will get used to? I know the small dose of Adderall will help with my energy.
Is the Seroquel depleting my serotonin and making me irritable or is it just that I am hungover?
Posted by desolationrower on May 3, 2011, at 20:35:07
In reply to Upping Seroquel questions..., posted by sheilac on May 3, 2011, at 13:40:06
that dosage of seroquel probably isn't doing much, other than helping put you to sleep. So i don't think it is directly causing a problem, but the underlying problem isn't really being dealt with on that regimine.
Also, seroquel and its metabolite function as alpha2 antagonists, like mirtazapine. This is probably not the best for ADD or irritability. So i would suggest a different drug to target that. Have you tried an NRI. guanfacine might be good for irritability, but not energy or depression. an anticonfulsant might be good for irritability & mood.
-d/r
Posted by Christ_empowered on May 3, 2011, at 21:37:37
In reply to Upping Seroquel questions..., posted by sheilac on May 3, 2011, at 13:40:06
Seroquel always made me unhappy. I don't know what the deal was at the biochemical level--I just couldn't stand the stuff.
Maybe something else for sleep?
It seems to me you might also want to try supplements and/or some sort of self-help or therapy to deal with psychosocial issues.
Posted by SLS on May 3, 2011, at 22:54:21
In reply to Re: Upping Seroquel questions..., posted by desolationrower on May 3, 2011, at 20:35:07
> that dosage of seroquel probably isn't doing much, other than helping put you to sleep. So i don't think it is directly causing a problem, but the underlying problem isn't really being dealt with on that regimine.
>
> Also, seroquel and its metabolite function as alpha2 antagonists, like mirtazapine.I wasn't aware of that.
The active metabolite of Seroquel (quetiapine) is a potent NE reuptake inhibitor. (N-desalkylquetiapine / norquetiapine) It also is a partial agonist of 5-HT1a receptors.
http://www.ncbi.nlm.nih.gov/pubmed/18059438
- Scott
Posted by desolationrower on May 4, 2011, at 0:09:30
In reply to Re: Upping Seroquel questions..., posted by SLS on May 3, 2011, at 22:54:21
> > that dosage of seroquel probably isn't doing much, other than helping put you to sleep. So i don't think it is directly causing a problem, but the underlying problem isn't really being dealt with on that regimine.
> >
> > Also, seroquel and its metabolite function as alpha2 antagonists, like mirtazapine.
>
> I wasn't aware of that.
>
> The active metabolite of Seroquel (quetiapine) is a potent NE reuptake inhibitor. (N-desalkylquetiapine / norquetiapine) It also is a partial agonist of 5-HT1a receptors.
>
> http://www.ncbi.nlm.nih.gov/pubmed/18059438
>
>
> - Scotthm, i looked it up again and i think i was wrong in this conclusion. The affinity for a2 is similar to DA receptors, but probably not relevant at low doses. Both NET and a2 could be relevant at high doses. There are other reasons its not a great idea for adhd, but alpha2 is proabably not the biggest issue.
-d/r
here is the binding affinity
http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=41375#section-15.2here is a study on the levels of quietiapine vs metabolite
Quetiapine and Norquetiapine in Plasma and Cerebrospinal Fluid of Schizophrenic Patients Treated With Quetiapine: Correlations to Clinical Outcome and HVA, 5-HIAA, and MHPG in CSF
AbstractThis study investigated concentrations of quetiapine and norquetiapine in plasma and cerebrospinal fluid (CSF) in 22 schizophrenic patients after 4-week treatment with quetiapine (600 mg/d), which was preceded by a 3-week washout period. Blood and CSF samples were obtained on days 1 and 28, and CSF levels of homovanillic acid (HVA), 5-hydroxyindoleacetic acid (5-HIAA), and 3-methoxy-4-hydroxyphenylglycol (MHPG) concentrations were measured at baseline and after 4 weeks of quetiapine, allowing calculations of differences in HVA (ΔHVA), 5-HIAA (Δ5-HIAA), and MHPG (ΔMHPG) concentrations. Patients were assessed clinically, using the Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression Scale at baseline and then at weekly intervals. Plasma levels of quetiapine and norquetiapine were 1110 ± 608 and 444 ± 226 ng/mL, and the corresponding CSF levels were 29 ± 18 and 5 ± 2 ng/mL, respectively. After the treatment, the levels of HVA, 5-HIAA, and MHPG were increased by 33%, 35%, and 33%, respectively (P < 0.001). A negative correlation was found between the decrease in PANSS positive subscale scores and CSF ΔHVA (rrho = −0.690, P < 0.01), and the decrease in PANSS negative subscale scores both with CSF Δ5-HIAA (rrho = −0.619, P = 0.02) and ΔMHPG (rrho = −0.484, P = 0.038). Because, unfortunately, schizophrenic patients experience relapses even with the best available treatments, monitoring of CSF drug and metabolite levels might prove to be useful in tailoring individually adjusted treatments.
Posted by Sheilac on May 4, 2011, at 7:42:42
In reply to Re: Upping Seroquel questions... » SLS, posted by desolationrower on May 4, 2011, at 0:09:30
I do also take Klonopin and it helps alot for hypomania.
I had to stop Geodon because the combo of that and Adderall was giving me heart palps.
If Seroquel at 50mg is not a good thing for ADD (even if I take Adderall), what med is?
I still don't understand the crankiness in the morning from the Seroquel? Is the Seroquel suppressing a chemical my brain needs? Does the Adderall make the situation worse?
Do most people take an antidepressant like Prozac to help with this?
Posted by Christ_empowered on May 5, 2011, at 11:21:12
In reply to ADD + Seroquel ?, posted by Sheilac on May 4, 2011, at 7:42:42
Call me old school, but I think that ideally, if you need something to help you sleep you should take...a sleeping pill.
Restoril, Xanax, Ativan, Lunesta, Ambien, Rozerem...talk to your doctor and see what would help.
Posted by desolationrower on May 5, 2011, at 18:04:57
In reply to ADD + Seroquel ?, posted by Sheilac on May 4, 2011, at 7:42:42
> I do also take Klonopin and it helps alot for hypomania.
>
> I had to stop Geodon because the combo of that and Adderall was giving me heart palps.
>
> If Seroquel at 50mg is not a good thing for ADD (even if I take Adderall), what med is?
>
> I still don't understand the crankiness in the morning from the Seroquel? Is the Seroquel suppressing a chemical my brain needs? Does the Adderall make the situation worse?
>
> Do most people take an antidepressant like Prozac to help with this?
>
>In theory, adderall could help or hurt. What happens in reality, though? Do you feel less irritable an hour after you pop the adderall? If you don't take it, do you feel better or worse?
are you sure it is the seroquel causing a side effect, as opposed to being an underlying part of the illness that is not being properly medicated? -> if you skipp the seroquel, do you feel less irritable the following morning that you normally do?
also have you tried other drugs in the past, and did they affect the irritability?
-d/r
Posted by mtdewcmu on May 5, 2011, at 23:15:13
In reply to Re: Upping Seroquel questions..., posted by SLS on May 3, 2011, at 22:54:21
> > that dosage of seroquel probably isn't doing much, other than helping put you to sleep. So i don't think it is directly causing a problem, but the underlying problem isn't really being dealt with on that regimine.
> >
> > Also, seroquel and its metabolite function as alpha2 antagonists, like mirtazapine.
>
> I wasn't aware of that.
>
> The active metabolite of Seroquel (quetiapine) is a potent NE reuptake inhibitor. (N-desalkylquetiapine / norquetiapine) It also is a partial agonist of 5-HT1a receptors.
>
> http://www.ncbi.nlm.nih.gov/pubmed/18059438
>
>
> - ScottWhat an insanely dirty drug. It's like dropping a bomb on your brain and hoping for the best.
Posted by SLS on May 6, 2011, at 6:38:39
In reply to Re: Upping Seroquel questions..., posted by mtdewcmu on May 5, 2011, at 23:15:13
> > The active metabolite of Seroquel (quetiapine) is a potent NE reuptake inhibitor. (N-desalkylquetiapine / norquetiapine) It also is a partial agonist of 5-HT1a receptors.
> >
> > http://www.ncbi.nlm.nih.gov/pubmed/18059438
> >
> >
> > - Scott
>
> What an insanely dirty drug. It's like dropping a bomb on your brain and hoping for the best.LOL
- Scott
Posted by Hombre on May 12, 2011, at 23:33:37
In reply to Upping Seroquel questions..., posted by sheilac on May 3, 2011, at 13:40:06
I take 100mg at night. I find if I take it too late, I will definitely have trouble getting up. Ideally, I take it by 9:30 and konk out by 11, wake up at 7 or 8 feeling good.
I also feel Seroquel may mess with your blood sugar, so sometimes you feel a bit low-blood sugar first thing. You have to sort of jump out of bed and go make breakast, then the wooziness subsides. It's like it's more in your head, not to say it isn't real, but once you actually do get up it gets better quick. But I've spent lots of time drifting in and out when I should have just gotten up and had a cup of tea or something.
This is the end of the thread.
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