![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by crepuscular on March 12, 2002, at 13:04:29
Anybody else out there having good luck with Seroquel as mood stabilizer? I'm finding with a seroquel+zoloft+klonopin combo i'm getting regular sleep, the hypomanic dysphoria has been quenched, and i'm not descending into a depression. this effect seems to be getting better & better the longer i stay on this regimen. I sometimes get flashes of feeling like I felt ten years ago, before my moods began cycling so quickly.
Anybody else having luck with seroquel?
Posted by TSA West on March 12, 2002, at 16:03:37
In reply to Seroquel for bipolar, posted by crepuscular on March 12, 2002, at 13:04:29
Antipsychotic medication is safe and effective in the treatment of mania. When compared to conventional antipsychotics, atypical antipsychotics carry a lower risk of extrapyramidal side effects and tardive dyskinesia. Some of these agents appear efficacious in the treatment of mania, like Quetiapine. Here is an excerpt from an article I found on Quetiapine in treatment-resistant mania:
"Quetiapine is an atypical antipsychotic that is effective for the treatment of schizophrenia. However, to our knowledge, there are no published reports of quetiapine used in the treatment of bipolar disorder. We report the use of quetiapine as an adjunctive therapy in combating treatment-resistant bipolar disorder.
Ms. A was a 39-year-old married woman who was hospitalized for worsening mania after reduction of her trifluoperazine dose from 15 to 12 mg/day. Her symptoms included insomnia, racing thoughts, sexual preoccupation, impulsivity, irritability, increased energy, pressured speech, flights of ideas, paranoid ideation, auditory hallucinations, and suicidal ideation. She was also taking valproic acid, 2000 mg/day, and lithium carbonate, 1200 mg/day. Her blood levels of these drugs were 116 µg/ml and 1.2 meq/ml, respectively. Ms. A's bipolar disorder had begun during her 20s, and she had initially responded to treatment with lithium carbonate. After several relapses, she started experiencing breakthrough symptoms while taking therapeutic doses of lithium, which required augmentation with both valproic acid and antipsychotic agents. These medications were poorly tolerated, causing weight gain, alopecia, hirsutism, mild oral tardive dyskinesia, and parkinsonism, both with standard antipsychotics and with olanzapine and risperidone. ECT had been minimally effective.
At admission Ms. A began treatment with quetiapine, which was titrated to 75 mg t.i.d., while she continued maintenance treatment with valproic acid, lithium carbonate, and 6 mg/day of trifluoperazine. Her manic symptoms decreased rapidly with minimal sedation. After discharge she was unable to immediately follow up with outpatient treatment and was readmitted 10 days later with an exacerbation of mania. Her quetiapine dose was increased to 150 mg b.i.d. and 200 mg at bedtime over 4 days. The trifluoperazine and valproate doses were decreased to 4 mg and 1500 mg at bedtime, respectively, to minimize sedation and sialorrhea. Ms. A was discharged after 8 days of hospitalization with full remission of her manic and psychotic symptoms. Over the next 6 months her doses of trifluoperazine and valproic acid were tapered off and discontinued. Her quetiapine dose was adjusted to 200 mg in the morning and 400 mg at bedtime, resulting in weight loss and a decrease in sedation. She has remained clinically stable with combined lithium and quetiapine therapy.
This case suggests that quetiapine can be safe and effective in the treatment of the manic and psychotic symptoms of bipolar disorder."
--The American Journal of Psychiatry
Volume 157(8) August 2000
Posted by johnX2 on March 13, 2002, at 7:01:08
In reply to Seroquel for bipolar, posted by crepuscular on March 12, 2002, at 13:04:29
Hey, this is fantastic! ;))))))John
> Anybody else out there having good luck with Seroquel as mood stabilizer? I'm finding with a seroquel+zoloft+klonopin combo i'm getting regular sleep, the hypomanic dysphoria has been quenched, and i'm not descending into a depression. this effect seems to be getting better & better the longer i stay on this regimen. I sometimes get flashes of feeling like I felt ten years ago, before my moods began cycling so quickly.
>
> Anybody else having luck with seroquel?
Posted by kookycat on April 23, 2002, at 18:35:08
In reply to Seroquel for bipolar, posted by crepuscular on March 12, 2002, at 13:04:29
I just started on Seroquel as a mood stabilizer also and I seem to be doing well with it. I'm on Seroquel+Prozac+Buspar. What dose of Seroquel are you taking?
Posted by Cressida on April 25, 2002, at 1:28:45
In reply to Re: Seroquel for bipolar, posted by kookycat on April 23, 2002, at 18:35:08
Hi kookycat,
I was prescribed Seroquel again about a month and a half ago. I've taken it in the past , at a dosage of 25-50mg, which I took at night for sleep. I also take it now for sleep, and anxiety. The dosage needed to help me sleep is 125mg; and for anxiety I take 25mg in the morning. So, total it's 150mg. That seems like a high dose, but it's not when compared with the target doses for schizophrenia / psychosis - something in the ballpark of 400-600mg; my pdoc informed me that some people are so agitated they have to take 1000-1600mg. In addition to Seroquel, I take 40mg of Paxil and 36mg of Concerta. The Concerta has lost a lot of it's strength since I started taking Seroquel. Oh well. FYI I used to take BuSpar for anxiety. Anyway, it's good to know I'm not the only one getting helped by Seroquel. Seems to be a good drug with few side-effects; dry mouth and occassional leg twitching. It's tolerable. Well, good to hear it's helping you with your mood. You take it for bipolar disorder? My diagnoses are ADD and OCD.
Posted by sparkinark on June 19, 2002, at 16:56:53
In reply to Re: Seroquel for bipolar, posted by kookycat on April 23, 2002, at 18:35:08
> I just started on Seroquel as a mood stabilizer also and I seem to be doing well with it. I'm on Seroquel+Prozac+Buspar. What dose of Seroquel are you taking?
I've been diagnosed with BPII-Cyclothymia and nothing so far has seemed to work for me to control the hypomania and cycling. My pdoc just upped me to 400mg of Seroquel per night. I'm also taking 300mg Serzone because I cannot tolerate any of the other anti-depressants.
So far (up to 300mg) I've noticed a small but not really significant decrease in my cycling and hypomania (which includes some horrible anxiety and just plain pain in the cycles). Let's hope going up to 400mg will help even more.
I'm not sure what my other options are if this doesn't work other than trying Depakote or Tegretal (or maybe Lamictal). I've tried Topomax in the past and while I felt really good on it in the beginning, it turned into a really bad experience, only agitating me worse and creating a really nasty 24-hour anxiety state. I finally had to drop taking it completely. If the Seroquel doesn't work I guess I'm going to lobby for one of the mood stabilizers and see how things go with it.
By the way, the Seroquel pretty much knocks me out sleep-wise for 12-hours or more each night, although I'm finding that the longer I take it the less I'm sleeping and the less groggy in the morning I feel.
Anyone with BPII (with or without ultra-rapid cycling) taking more than 400mg of Seroquel? Has it worked for you?
sparkinark
Posted by BarbaraCat on June 20, 2002, at 23:42:27
In reply to Re: Seroquel for bipolar, posted by sparkinark on June 19, 2002, at 16:56:53
Wow, sounds like we have similar symptoms! I'm dx'd with Bipolar II mixed-states and like you, have very uncomfortable anxiety and pain along with depression. Every now and then a fun hypomania splurge comes along and I have unlimited energy and enthusiasm for all kinds of ideas, but then comes the inevitable crash. I can take the depression, but I cannot handle the anxiety and panic along with it. It wrings me out.
I also tried Topamax, mainly because my other meds were making me gain weight. It was horrible. Tension and agitation and it did nothing for the weight. Currently I seem to be stable on 75mg Remeron (similar to Serzone which I've also tried), 600mg lithium, and Ativan as needed. I recently started Neurontin for fibromyaligia pain and as an additional mood stabiliser. It's a little too early to tell, but I think it's going to help further smooth things out. Oh, and I also take 10mg Ambien for sleep. Just recently the pain and sorrow feelings have begun to break through and I'm concerned - don't wanna go there no more. So I've upped my exercise even though I don't feel like it. This BP2 with anxious overtones is one nasty item! You take care. - BarbaraCat
Posted by sparkinark on June 21, 2002, at 14:37:38
In reply to Re: Seroquel for bipolar » sparkinark, posted by BarbaraCat on June 20, 2002, at 23:42:27
I never seem to get the "fun" hypomania. It's just racing thoughts, anxiety, dysphoria, extreme unease, pain, etc. Then it seems to cycle all over again. Perhaps one or two days out of this cycle I get some relief and feel "OK", although not really what I would classify as "good". I can take Klonopin for the manic days and it seems to help some, but it doesn't do anything for the other feelings.
I also have periods, like you mention, when it just hurts like all getout -- kind of like a really bad headache but not really -- and I'm basically on the couch all day feeling sick to my stomach. Then it just seems to go away later for no reason at all. The Seroquel seems to be helping this so far but as I mentioned I don't think I'm taking enough of it yet. I wonder if I'm the only BPII person who has no fun "ups" associated with the cycling, just all bad feelings.
My guess is that the pain/sorrow feelings you have need to be addressed with some sort of mood leveler. Perhaps Neurontin will do the trick for you. The Serzone does a wonderful job of taking away the sorrow but doesn't seem to have any positive effects at all on the cycling or associated feelings. I also got the extreme tension and agitation from Topomax although it did eventually come to curb my appetite, too much actually.
Much luck to you.
sparkinark
> Wow, sounds like we have similar symptoms! I'm dx'd with Bipolar II mixed-states and like you, have very uncomfortable anxiety and pain along with depression. Every now and then a fun hypomania splurge comes along and I have unlimited energy and enthusiasm for all kinds of ideas, but then comes the inevitable crash. I can take the depression, but I cannot handle the anxiety and panic along with it. It wrings me out.
> I also tried Topamax, mainly because my other meds were making me gain weight. It was horrible. Tension and agitation and it did nothing for the weight. Currently I seem to be stable on 75mg Remeron (similar to Serzone which I've also tried), 600mg lithium, and Ativan as needed. I recently started Neurontin for fibromyaligia pain and as an additional mood stabiliser. It's a little too early to tell, but I think it's going to help further smooth things out. Oh, and I also take 10mg Ambien for sleep. Just recently the pain and sorrow feelings have begun to break through and I'm concerned - don't wanna go there no more. So I've upped my exercise even though I don't feel like it. This BP2 with anxious overtones is one nasty item! You take care. - BarbaraCat
Posted by BarbaraCat on June 21, 2002, at 21:30:47
In reply to Re: Seroquel for bipolar » BarbaraCat, posted by sparkinark on June 21, 2002, at 14:37:38
Why do you think you have BPII and not major depression with anxiety/agitation? I thought at least some mania was the hallmark of BP diagnosis. Is your brand of mania more the dysphoric mania type?
I'm not familiar with Seroquel. It's one of the few meds I haven't tried. I'm interested in your med history and why Seroquel seemed a good choice for you. I've typically not responded to most of my meds after a while but now that I've been 'upgraded' from clinical depression to BPII with the resulting adding of mood stabilizers, I'm hoping things will hold better. You mention you're on Klonopin. I've just recently switched from generic Klonopin to generic Ativan and I think I prefer it. It seems to chill me out better than clonazapam.
Is Seroquel supposed to help physical pain? I'll be very interested if it helps yours. I get pretty desperate when I'm floored with that whole body ache. I never know anymore what is somatic symptoms from depression and what is the fibromyalgia, or if they're one and the same. Hmmmm, all this is seeming to me very much like a viral agent is at work. I'm familiar with the Borna virus theory and wouldn't be surprised if others are implicated as well.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.