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Dr. Bob is Robert Hsiung, MD,
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Posted by BarbaraCat on July 11, 2004, at 14:58:30
In reply to Re: Seroquel users: a couple of questions (HELP) » cpallen79, posted by Sad Panda on July 11, 2004, at 11:48:25
Got a burning question for you Panda. After my recent bad experience with Seroquel, I have to agree with you. AP's are a bit overkill if all one wants is to get some sleep, and who knows what else is brewing in the chemical soup. I'm very curious as to my extreme and immediate reaction. Very difficult waking up, much like when I was taking trazodone. I felt quite depressed and out of it the 4 days I was on 6.25 or 12.5 pm. Very lethargic but jittery at the same time.
My first thought was 'oh, I'm having a bad reaction to a reduction of dopamine - I need that dopamine'. Now, I realize that AP's reduce dopamine as part of their antipsychotic action, but I was under the impression Seroquel was not a heavy dopamine hitter. Also, none of these meds change neurotransmitter/receptor functionality that quickly, so dopamine doesn't seem a likely candidate. So perhaps the path is a similar 5Ht2-a blockade as w/trazodone and remeron, but we're still talking serotonin receptors and there's a lag time. It doesn't happen that quickly. My question is, is there also a histamine release which could account for the groggyness? Might this tie in with a possible dysfunction in my histamine levels? I haven't been tested for any of this but have been following the histadine/methylation theories. I'm also taking lithium and St. John's Wort (which is working surprisingly well). What could be at the root of the severe depression and restlessness I experienced immediately from Seroquel? After not taking it last night, I woke this morning fresh as a daisy and feeling sooooo much better. - Barbara
Posted by BarbaraCat on July 11, 2004, at 15:08:54
In reply to Re: Seroquel users: a couple of questions (HELP) » cpallen79, posted by Sad Panda on July 11, 2004, at 11:48:25
I loved nortriptyline. It was wonderful for severe anxiety, depression, and energy. Left me with appropriate emotional reponse, unlike the Stepford Wives Effect of SSRI's. Best AD I've ever had. Unfortunately, it caused extreme dryness and the constipation was becoming a real problem. I felt like I was becoming a prune - and I drink alot of water with the requisite electrolytes. I would have to say that it is not a sleep med, however. It gives a nice of jolt of NE which is quite smooth, but definitely energizing. Traz defintely has my vote for sleep, tryp for waking.
> If Trazodone does the job, then I would recommend you try Nortriptyline. Traz gives sleep via 5-HT2A & Alpha-1 blockade, Nort does this and is a good norepinephrine reuptake inhibitor. It would replace Buspar with ease, possibly reduce your Aderall consumption, fit in very nicely with Lexapro & add some extra antidepressant effect of it's own.
>
> Cheers,
> Panda.
>
>
Posted by BarbaraCat on July 11, 2004, at 15:25:38
In reply to Re: Seroquel users: a couple of questions (HELP) » BarbaraCat, posted by cpallen79 on July 11, 2004, at 3:49:08
Hi,
I also responded to Sad Panda's response to you and I second his suggestion. Nortryptaline is a very good antidepressant. I was surprised, thinking it was an 'old' one and not as effective as the 'new' ones. It helped me in every way, considering I was going through a terrible time. A year ago Christmas season my Mom was hit by a car while out for a walk and died 4 days later. It was an awful time and I was losing it to panic, disintegration, despair... well, you can imagine. Nortryp lifted me out of this frightening place where I could grieve appropriately, and I will bless it forever. The side effects were too much for me, unfortuntely, but I'm alot more sensitive to se's that don't normally bother other people. It's worth a try if you feel like considering another med. Certainly better than Buspar which made me feel icky. - BCat> Darn Barbara, I just submitted a long reply to this, but now it got lost, darn!
> In answer to your question, we don't think it's BP because A.D.D. runs heavily in my family (no reported or apparent cases of BP tho), and my depression/anxiety have been responses to issues with pretty bad OCD and GAD- both of which also run in the family. Both depressions I've endured have been because of a major stress response to a crisis situation because of my obsessing. I definetely will not rule out Bipolar though. Luckily Lexapro has lifted some of my problems. Adderall also helps me be more collected and relaxed and I can concentrate better. I think I want to dump the buspar and go for trazodone instead though.
Posted by cpallen79 on July 11, 2004, at 21:09:03
In reply to Re: Seroquel users: a couple of questions (HELP) » cpallen79, posted by BarbaraCat on July 11, 2004, at 15:25:38
Hey Barbara Cat- I agree about Buspar, It's dreadful and I'm going to taper off of the garbage, which I think my PDoc will want to kill me for... all it does is make me dizzy and agitated.
Posted by cpallen79 on July 11, 2004, at 21:12:53
In reply to Re: Seroquel users: a couple of questions (HELP) » cpallen79, posted by Sad Panda on July 11, 2004, at 11:48:25
Panda, thank you very much for your reply. I called my PDOC today, an absolute mess from the Seroquel still sitting in my system from Saturday... the restlessness alone was causing me panic. We're going to up my lexapro, add in trazodone, and she even offred me Ativan, which I accepted but will use very sparingly. I also plan on getting off that darn Buspar as it can interfere with Trazodone and all it does is make me dizzy, blah.
Cheers,
Chris
Posted by Sad Panda on July 12, 2004, at 11:02:43
In reply to read this one, y'all... » Sad Panda, posted by chemist on July 11, 2004, at 12:53:46
> > I've believe that the antipsychotics have no place as sleep meds. Seroquel at low doses is a bit like Remeron at low doses in that it only binds to H1 receptors. If all you want is some H1 blockade, then dirt cheap Doxepin or OTC Benadryl are all you really need to pay for.
> >
> > If Trazodone does the job, then I would recommend you try Nortriptyline. Traz gives sleep via 5-HT2A & Alpha-1 blockade, Nort does this and is a good norepinephrine reuptake inhibitor. It would replace Buspar with ease, possibly reduce your Aderall consumption, fit in very nicely with Lexapro & add some extra antidepressant effect of it's own.
> >
> > Cheers,
> > Panda.
> >
> >
> hello there, from chemist.....this is far more panda's territory than mine, i politely defer and suggest that you load up panda's in-box in re: this topic [sorry, panda, but that's what you get for being an expert:) ]....all the best, chemist
>
>Thanks Chemist, but I'm not an expert, I'm just a nosey parker with an opinion. :) If Seroquel blows your hair back, then that's fine with me & it does have less chance of causing weight gain than Zyprexa, Remeron & probably the sedating TCA's.
Cheers,
Panda.
Posted by Sad Panda on July 12, 2004, at 11:09:35
In reply to Nortryp and traz, posted by BarbaraCat on July 11, 2004, at 15:08:54
> I loved nortriptyline. It was wonderful for severe anxiety, depression, and energy. Left me with appropriate emotional reponse, unlike the Stepford Wives Effect of SSRI's. Best AD I've ever had. Unfortunately, it caused extreme dryness and the constipation was becoming a real problem. I felt like I was becoming a prune - and I drink alot of water with the requisite electrolytes. I would have to say that it is not a sleep med, however. It gives a nice of jolt of NE which is quite smooth, but definitely energizing. Traz defintely has my vote for sleep, tryp for waking.
>You are probably right about Nort not being a sleep med, but it maybe just enough for a lot of people & can kill alot of birds with one stone.
Cheers,
Panda.
Posted by Sad Panda on July 12, 2004, at 11:23:40
In reply to Re: Seroquel users: a couple of questions (HELP) » Sad Panda, posted by BarbaraCat on July 11, 2004, at 14:58:30
> Got a burning question for you Panda. After my recent bad experience with Seroquel, I have to agree with you. AP's are a bit overkill if all one wants is to get some sleep, and who knows what else is brewing in the chemical soup. I'm very curious as to my extreme and immediate reaction. Very difficult waking up, much like when I was taking trazodone. I felt quite depressed and out of it the 4 days I was on 6.25 or 12.5 pm. Very lethargic but jittery at the same time.
>
> My first thought was 'oh, I'm having a bad reaction to a reduction of dopamine - I need that dopamine'. Now, I realize that AP's reduce dopamine as part of their antipsychotic action, but I was under the impression Seroquel was not a heavy dopamine hitter. Also, none of these meds change neurotransmitter/receptor functionality that quickly, so dopamine doesn't seem a likely candidate. So perhaps the path is a similar 5Ht2-a blockade as w/trazodone and remeron, but we're still talking serotonin receptors and there's a lag time. It doesn't happen that quickly. My question is, is there also a histamine release which could account for the groggyness? Might this tie in with a possible dysfunction in my histamine levels? I haven't been tested for any of this but have been following the histadine/methylation theories. I'm also taking lithium and St. John's Wort (which is working surprisingly well). What could be at the root of the severe depression and restlessness I experienced immediately from Seroquel? After not taking it last night, I woke this morning fresh as a daisy and feeling sooooo much better. - Barbara
>
>Seroquel block Alpha-1 NE receptors the most, so I would possibly blame that. Coming in a close second is it's H1 blockade. At low doses I would say that's all it does as the next receptor is blocks is actually M1, so you'd probably notice a little dry mouth & constipation before 5-HT2A & D2 blockade ever comes to the party.
On this page is a pretty good table showing the differences: http://www.vh.org/adult/provider/psychiatry/CPS/04.html#table2
Cheers,
Panda.
Posted by Sad Panda on July 12, 2004, at 11:28:56
In reply to Re: Seroquel users: a couple of questions (HELP) » Sad Panda, posted by cpallen79 on July 11, 2004, at 21:12:53
> Panda, thank you very much for your reply. I called my PDOC today, an absolute mess from the Seroquel still sitting in my system from Saturday... the restlessness alone was causing me panic. We're going to up my lexapro, add in trazodone, and she even offred me Ativan, which I accepted but will use very sparingly. I also plan on getting off that darn Buspar as it can interfere with Trazodone and all it does is make me dizzy, blah.
> Cheers,
> Chris
>
>Hi Chris,
Sounds like a good plan. Traz will probably give you a little dizziness too. It has a 12 hour half life, so you should be OK in the morning, but a lot of people say it gives them morning groginess, so I would start on a small dose & take it early just in case.
Cheers,
Panda.
Posted by BarbaraCat on July 12, 2004, at 12:00:08
In reply to Re: Seroquel users: a couple of questions (HELP) » Sad Panda, posted by cpallen79 on July 11, 2004, at 21:12:53
Chris,
A little word to the wise from a former traz user. It will definitely make you groggy, extremely woozy. So yes, start very low, 10mg is not too low to start. For sleep, I never went above 50mg. For depression I was up to 200mg at one time.The groggyness is severe for the first few days and you'll just have to live with it for a short while. The morning groggyness never completely goes away and it was always a challenge for me, who is never a 'wake up and jump out of bed' kind of person. You'll have to make yourself get up but then you'll feel like you need to lie down again just to get over the woozyness. The way to beat it is to FORCE yourself out of bed and then immediately do some situps and pushups, whatever you can manage, to get some adrenaline and deep breathing going and some muscle engagement. Then take a shower and it will be gone. It's also a great incentive for getting those 6-pack abs.
But it's worth it. Traz saved my life at a time when I was very depressed and anxious. I used it for years as an AD and then at a lower dose as a sleeper. I don't understand why it's not used more. Good luck.
Posted by BarbaraCat on July 12, 2004, at 12:01:46
In reply to Re: Seroquel users: a couple of questions (HELP) » BarbaraCat, posted by Sad Panda on July 12, 2004, at 11:23:40
Thank you, thank you! That link is exactly what I've been looking for! - Barbara
> > Got a burning question for you Panda. After my recent bad experience with Seroquel, I have to agree with you. AP's are a bit overkill if all one wants is to get some sleep, and who knows what else is brewing in the chemical soup. I'm very curious as to my extreme and immediate reaction. Very difficult waking up, much like when I was taking trazodone. I felt quite depressed and out of it the 4 days I was on 6.25 or 12.5 pm. Very lethargic but jittery at the same time.
> >
> > My first thought was 'oh, I'm having a bad reaction to a reduction of dopamine - I need that dopamine'. Now, I realize that AP's reduce dopamine as part of their antipsychotic action, but I was under the impression Seroquel was not a heavy dopamine hitter. Also, none of these meds change neurotransmitter/receptor functionality that quickly, so dopamine doesn't seem a likely candidate. So perhaps the path is a similar 5Ht2-a blockade as w/trazodone and remeron, but we're still talking serotonin receptors and there's a lag time. It doesn't happen that quickly. My question is, is there also a histamine release which could account for the groggyness? Might this tie in with a possible dysfunction in my histamine levels? I haven't been tested for any of this but have been following the histadine/methylation theories. I'm also taking lithium and St. John's Wort (which is working surprisingly well). What could be at the root of the severe depression and restlessness I experienced immediately from Seroquel? After not taking it last night, I woke this morning fresh as a daisy and feeling sooooo much better. - Barbara
> >
> >
>
> Seroquel block Alpha-1 NE receptors the most, so I would possibly blame that. Coming in a close second is it's H1 blockade. At low doses I would say that's all it does as the next receptor is blocks is actually M1, so you'd probably notice a little dry mouth & constipation before 5-HT2A & D2 blockade ever comes to the party.
>
> On this page is a pretty good table showing the differences: http://www.vh.org/adult/provider/psychiatry/CPS/04.html#table2
>
> Cheers,
> Panda.
>
Posted by cpallen79 on July 12, 2004, at 12:11:59
In reply to Re: Seroquel users: a couple of questions (HELP) » BarbaraCat, posted by Sad Panda on July 12, 2004, at 11:23:40
Hi Panda, I was taking a tiny dose of Seroquel for sleep and a dab during the dayfor anxiety. I did well at first, but then after about a week I became very very restless and my anxiety levels really increased. Was this akathisia? I stopped takign the Seroquel Saturday but still have not felt well, what in the world happened?
Posted by Sad Panda on July 12, 2004, at 13:33:49
In reply to Re: Seroquel users: a couple of questions (HELP) » BarbaraCat, posted by Sad Panda on July 12, 2004, at 11:23:40
> > Got a burning question for you Panda. After my recent bad experience with Seroquel, I have to agree with you. AP's are a bit overkill if all one wants is to get some sleep, and who knows what else is brewing in the chemical soup. I'm very curious as to my extreme and immediate reaction. Very difficult waking up, much like when I was taking trazodone. I felt quite depressed and out of it the 4 days I was on 6.25 or 12.5 pm. Very lethargic but jittery at the same time.
> >
> > My first thought was 'oh, I'm having a bad reaction to a reduction of dopamine - I need that dopamine'. Now, I realize that AP's reduce dopamine as part of their antipsychotic action, but I was under the impression Seroquel was not a heavy dopamine hitter. Also, none of these meds change neurotransmitter/receptor functionality that quickly, so dopamine doesn't seem a likely candidate. So perhaps the path is a similar 5Ht2-a blockade as w/trazodone and remeron, but we're still talking serotonin receptors and there's a lag time. It doesn't happen that quickly. My question is, is there also a histamine release which could account for the groggyness? Might this tie in with a possible dysfunction in my histamine levels? I haven't been tested for any of this but have been following the histadine/methylation theories. I'm also taking lithium and St. John's Wort (which is working surprisingly well). What could be at the root of the severe depression and restlessness I experienced immediately from Seroquel? After not taking it last night, I woke this morning fresh as a daisy and feeling sooooo much better. - Barbara
> >
> >
>
> Seroquel block Alpha-1 NE receptors the most, so I would possibly blame that. Coming in a close second is it's H1 blockade. At low doses I would say that's all it does as the next receptor is blocks is actually M1, so you'd probably notice a little dry mouth & constipation before 5-HT2A & D2 blockade ever comes to the party.
>
> On this page is a pretty good table showing the differences: http://www.vh.org/adult/provider/psychiatry/CPS/04.html#table2
>
> Cheers,
> Panda.
>Ooops, Ignore what I said about Seroquel probably causing antimuscarinic dry mouth & constipation. Most other websites say it doesn't block M1.
Cheers,
Panda.
Posted by Sad Panda on July 12, 2004, at 13:51:08
In reply to Re: Seroquel users: a couple of questions (HELP) » Sad Panda, posted by cpallen79 on July 12, 2004, at 12:11:59
> Hi Panda, I was taking a tiny dose of Seroquel for sleep and a dab during the dayfor anxiety. I did well at first, but then after about a week I became very very restless and my anxiety levels really increased. Was this akathisia? I stopped takign the Seroquel Saturday but still have not felt well, what in the world happened?
>
>Possibly, Akathesia is said to be a feeling of inner agitation which makes you fidgety & unable to sit still. Perhaps there was a drug interaction involved? Some drugs can raise the levels of other drugs & vice versa if they share the same liver enzyme. It's an ideal question for Chemist. :)
Cheers,
Panda.
Posted by cpallen79 on July 12, 2004, at 14:22:05
In reply to Sounds like a question for CHEMIST!, posted by Sad Panda on July 12, 2004, at 13:51:08
Hi Chemist, what do you think?
I currently take 12.5 MGs of Lexapro, 15mgs of Buspar, and was also starting to take 7.5 mgs of immediate release adderall (was adderall taking XR before). The reason I went on meds was for anxious depression, OCD, and ADD. things had gotten a bit better (but still had problems with hypervigilance, etc... from anxiety), but then i added in Seroquel. After starting that Seroquel,I did well for about a week, but then I slowly began to notice nighttime agitation and restlessnes... it got worse and worse until I felt like I was back in a high anxiety state. I feel like the cast put on me for my "broken brain" was stripped off and rebroken! I still do not feel well, I stopped taking the Seroquel on Saturday. I'm so upset as I feel like any progress I made went right down the tubes. Maybe it's just me, I think I put alot of hope in the Seroquel for a good night's sleep, and my hopes were dashed, thus sending me into panic mode. Another time this occurred was when I tried to increase my Buspar, I felt so agitated, restless, and panicky that had to drop back down to the lower dose. I've been at this for months and I feel so discouraged, I jsut want a day to come where I peacefully wake up, look around, and say "what a great day!"
> > Hi Panda, I was taking a tiny dose of Seroquel for sleep and a dab during the dayfor anxiety. I did well at first, but then after about a week I became very very restless and my anxiety levels really increased. Was this akathisia? I stopped takign the Seroquel Saturday but still have not felt well, what in the world happened?
> >
> >
>
> Possibly, Akathesia is said to be a feeling of inner agitation which makes you fidgety & unable to sit still. Perhaps there was a drug interaction involved? Some drugs can raise the levels of other drugs & vice versa if they share the same liver enzyme. It's an ideal question for Chemist. :)
>
> Cheers,
> Panda.
>
Posted by BarbaraCat on July 12, 2004, at 14:47:30
In reply to Re: Sounds like a question for CHEMIST!, posted by cpallen79 on July 12, 2004, at 14:22:05
HI Chris,
Let's pursue this one. I'm right there with ya and will post a separate question to Chemist. In the meantime, have you tried Ambien for sleep? It's what I'm currently on and find it very helpful. I have fibromyalgia along with bipolar depression and I NEED my sleep and can't take anything that interferes with Stage IV delta sleep. Ambien is great for this and there is absolutely no hangover. It does occasionally poop and I have to take more, but it hasn't been a problem.As with your experience, my recent foray into Seroquel was a nightmare, but a real good clue into what my personal chemistry is doing. It might have something to do with histamines. Keep you posted on anything interesting I dig up. - Barbara
Posted by chemist on July 12, 2004, at 14:48:13
In reply to Re: read this one, y'all... » chemist, posted by Sad Panda on July 12, 2004, at 11:02:43
> > > I've believe that the antipsychotics have no place as sleep meds. Seroquel at low doses is a bit like Remeron at low doses in that it only binds to H1 receptors. If all you want is some H1 blockade, then dirt cheap Doxepin or OTC Benadryl are all you really need to pay for.
> > >
> > > If Trazodone does the job, then I would recommend you try Nortriptyline. Traz gives sleep via 5-HT2A & Alpha-1 blockade, Nort does this and is a good norepinephrine reuptake inhibitor. It would replace Buspar with ease, possibly reduce your Aderall consumption, fit in very nicely with Lexapro & add some extra antidepressant effect of it's own.
> > >
> > > Cheers,
> > > Panda.
> > >
> > >
> > hello there, from chemist.....this is far more panda's territory than mine, i politely defer and suggest that you load up panda's in-box in re: this topic [sorry, panda, but that's what you get for being an expert:) ]....all the best, chemist
> >
> >
>
> Thanks Chemist, but I'm not an expert, I'm just a nosey parker with an opinion. :) If Seroquel blows your hair back, then that's fine with me & it does have less chance of causing weight gain than Zyprexa, Remeron & probably the sedating TCA's.
>
> Cheers,
> Panda.
>
>
>
well, your nose is deeper in the flora than mine, and i have a lousy track record with providing useful and/or factual info on certain meds....thus, you and SLS and King Vultan and Larry are getting the buck passed your way :).....cheers to you too, chemist
Posted by chemist on July 12, 2004, at 15:00:55
In reply to Ooops, Seroquel doesn't block M1, posted by Sad Panda on July 12, 2004, at 13:33:49
> > > Got a burning question for you Panda. After my recent bad experience with Seroquel, I have to agree with you. AP's are a bit overkill if all one wants is to get some sleep, and who knows what else is brewing in the chemical soup. I'm very curious as to my extreme and immediate reaction. Very difficult waking up, much like when I was taking trazodone. I felt quite depressed and out of it the 4 days I was on 6.25 or 12.5 pm. Very lethargic but jittery at the same time.
> > >
> > > My first thought was 'oh, I'm having a bad reaction to a reduction of dopamine - I need that dopamine'. Now, I realize that AP's reduce dopamine as part of their antipsychotic action, but I was under the impression Seroquel was not a heavy dopamine hitter. Also, none of these meds change neurotransmitter/receptor functionality that quickly, so dopamine doesn't seem a likely candidate. So perhaps the path is a similar 5Ht2-a blockade as w/trazodone and remeron, but we're still talking serotonin receptors and there's a lag time. It doesn't happen that quickly. My question is, is there also a histamine release which could account for the groggyness? Might this tie in with a possible dysfunction in my histamine levels? I haven't been tested for any of this but have been following the histadine/methylation theories. I'm also taking lithium and St. John's Wort (which is working surprisingly well). What could be at the root of the severe depression and restlessness I experienced immediately from Seroquel? After not taking it last night, I woke this morning fresh as a daisy and feeling sooooo much better. - Barbara
> > >
> > >
> >
> > Seroquel block Alpha-1 NE receptors the most, so I would possibly blame that. Coming in a close second is it's H1 blockade. At low doses I would say that's all it does as the next receptor is blocks is actually M1, so you'd probably notice a little dry mouth & constipation before 5-HT2A & D2 blockade ever comes to the party.
> >
> > On this page is a pretty good table showing the differences: http://www.vh.org/adult/provider/psychiatry/CPS/04.html#table2
> >
> > Cheers,
> > Panda.
> >
>
> Ooops, Ignore what I said about Seroquel probably causing antimuscarinic dry mouth & constipation. Most other websites say it doesn't block M1.
>
> Cheers,
> Panda.
>
>
>
panda, i'm not letting you off the hook so easily, having recently pronounced you the expert. my PDR white-sheet from astrazeneca says ``no appreciable affinity at cholinergic muscarinic and benzodiazepine receptors (IC_{50s} > 5000 nM).'' given an IC_{50} for D_{1} at 1268 nM and IC_{50} of 329 nM for D_{2}, what's an order of magnitude or two among friends? you're still in charge...... :) all the best, chemist
Posted by chemist on July 12, 2004, at 15:22:35
In reply to Sounds like a question for CHEMIST!, posted by Sad Panda on July 12, 2004, at 13:51:08
ahhh, the buck has been passed....thank you, panda...remind me not to play poker with you next time i'm down under.....the answer to the post is that, in my opinion, the seroquel dose was too small (i have to read the next one, so don't hold to this just yet) and it sounds like breakthrough anxiety. that said, i still think panda's answer is better than mine in that maybe yes, maybe no (what dose?) and what other drugs are on board that can inhibit/induce/act as substrates for isoenzymes that are also part of the seroquel metabolic route. see, i told you panda's the expert.....on to the next post, where i believe i glimpsed the meds list.....see you there, all the best, chemist
> > Hi Panda, I was taking a tiny dose of Seroquel for sleep and a dab during the dayfor anxiety. I did well at first, but then after about a week I became very very restless and my anxiety levels really increased. Was this akathisia? I stopped takign the Seroquel Saturday but still have not felt well, what in the world happened?
> >
> >
>
> Possibly, Akathesia is said to be a feeling of inner agitation which makes you fidgety & unable to sit still. Perhaps there was a drug interaction involved? Some drugs can raise the levels of other drugs & vice versa if they share the same liver enzyme. It's an ideal question for Chemist. :)
>
> Cheers,
> Panda.
>
Posted by chemist on July 12, 2004, at 15:36:55
In reply to Re: Sounds like a question for CHEMIST!, posted by cpallen79 on July 12, 2004, at 14:22:05
> Hi Chemist, what do you think?
i think panda secretly works for an HMO and is dividing his case load :)
seriously, i am not a fan of buspar: i have taken it, and would choose a lollipop over buspar if given the choice for an effective anxiolytic. my immediate guess is that your body got used to the little dabs of seroquel over the week or so and the buspar was not addressing the *transient* anxiety that can be experienced when titrating up on lexapro (note i wrote *transient*), that the adderall immediate release was a bigger surge of stimulation than you had had before with the extended release, and that you simply were/are overstimulated. in my opinion, the lexapro should slowly be taken to 20 mg - as your comfort level allows - and you should back off on your adderall for a while, or at least take in divided doses until things smooth out, and ditch the buspar. now, we will have you in some quasi-stable state, and sleep will likely need be addressed, as will breakthrough panic and/or daily anxiety. my usual line is, go with klonopin, perhaps 0.5 mg bid. if benzos are not an option, next up is trazadone, a drug i am not particularly fond of, but you can certainly tweak the dose for sleep and for daytime. my stance on trazadone has changed largely to favorable reports from other posters, and i think my experience is the outlier. finally, if you find that trazadone is making you too groggy, go with ambien for sleep and perhaps lower the lexapro for the anxiety. still, i am a fan of the benzos, but this may not be the case for you. please do let us know if this is of any use.....all the best, chemist
> I currently take 12.5 MGs of Lexapro, 15mgs of Buspar, and was also starting to take 7.5 mgs of immediate release adderall (was adderall taking XR before). The reason I went on meds was for anxious depression, OCD, and ADD. things had gotten a bit better (but still had problems with hypervigilance, etc... from anxiety), but then i added in Seroquel. After starting that Seroquel,I did well for about a week, but then I slowly began to notice nighttime agitation and restlessnes... it got worse and worse until I felt like I was back in a high anxiety state. I feel like the cast put on me for my "broken brain" was stripped off and rebroken! I still do not feel well, I stopped taking the Seroquel on Saturday. I'm so upset as I feel like any progress I made went right down the tubes. Maybe it's just me, I think I put alot of hope in the Seroquel for a good night's sleep, and my hopes were dashed, thus sending me into panic mode. Another time this occurred was when I tried to increase my Buspar, I felt so agitated, restless, and panicky that had to drop back down to the lower dose. I've been at this for months and I feel so discouraged, I jsut want a day to come where I peacefully wake up, look around, and say "what a great day!"
>
>
> > > Hi Panda, I was taking a tiny dose of Seroquel for sleep and a dab during the dayfor anxiety. I did well at first, but then after about a week I became very very restless and my anxiety levels really increased. Was this akathisia? I stopped takign the Seroquel Saturday but still have not felt well, what in the world happened?
> > >
> > >
> >
> > Possibly, Akathesia is said to be a feeling of inner agitation which makes you fidgety & unable to sit still. Perhaps there was a drug interaction involved? Some drugs can raise the levels of other drugs & vice versa if they share the same liver enzyme. It's an ideal question for Chemist. :)
> >
> > Cheers,
> > Panda.
> >
>
>
Posted by chemist on July 12, 2004, at 15:45:42
In reply to Re: Sounds like a question for CHEMIST! » cpallen79, posted by BarbaraCat on July 12, 2004, at 14:47:30
see, chris? just as i finsh my post mentioning ambien, i see that barbara has already gone down that path. barbara's point in re: preserving stage 4 sleep might be amended with the following: benzos/benzo-derivatives don't, so if you're offered ambien over halcion, go with ambien, in my opinion.....see you on the next board, and all the best, chemist
> HI Chris,
> Let's pursue this one. I'm right there with ya and will post a separate question to Chemist. In the meantime, have you tried Ambien for sleep? It's what I'm currently on and find it very helpful. I have fibromyalgia along with bipolar depression and I NEED my sleep and can't take anything that interferes with Stage IV delta sleep. Ambien is great for this and there is absolutely no hangover. It does occasionally poop and I have to take more, but it hasn't been a problem.
>
> As with your experience, my recent foray into Seroquel was a nightmare, but a real good clue into what my personal chemistry is doing. It might have something to do with histamines. Keep you posted on anything interesting I dig up. - Barbara
Posted by cpallen79 on July 12, 2004, at 16:42:51
In reply to okay, here we go... » cpallen79, posted by chemist on July 12, 2004, at 15:36:55
Hi Chemist,
Thanks for the information! I've been on Lexapro at 12.5 for about a month or so now, so hopefully the anxiety isn't from that. My PDoc wants me to titrate up to 15 mgs. I'm a fan of the Lexapro because it's supposedly "cleaner" than other SSRIS, though I wish it was one that caused more sedation. I went back to a lower dose of adderall XR at 5mgs. I'm ditching the Buspar and will try Trazodone for sleep (PDOC called it in for me). I've also heard that it has mild anti-anxiety properties, but at this point I'm not keeping my fingers crossed. I just want some darn sleep and to have the agitation/anxiety stop. I was also given some ativan on hand but have had negative experiences with rebound anxiety from xanax so I'm a bit weary of them, plus there's the addiction potential of course.
What do you guys think? Think that I'll be able to actually settle down one of these days? ugh
Posted by BarbaraCat on July 12, 2004, at 16:46:26
In reply to Re: Sounds like a question for CHEMIST! » Sad Panda, posted by chemist on July 12, 2004, at 15:22:35
Must respectfully differ with you, Most Esteemed Chemist, but I don't think it has to do with too small a Seroquel dose and breakthrough anxiety. I had an experience similar to Chris' with Seroquel just last week and a few years back with Zyprexa. Was doing pretty darn good on lithium and pharmaceutical St. John's Wort and decided to go with Seroquel mainly for sleep and any additional benefits an AP might provide for my mixed-states bipolar bane.
Took 12.5mg/night for 4 nights and it was like I woke up on the far side of the Styx after the first dose. Agitated woozy weepy dysphoric clumsy hell. Plus a very uncharacteristic lust/frenzy for anything that hinted of cake or cookie. Kept expecting it to get better but it was getting worse. And I gained 5 lousy pounds for the priviledge.
I realize that 12.5mg is more sedating than higher doses and this dysphoria might have eventually gone away, but the point is that something hit hard and very quickly. A very rapid switch into agitated depression and total relief after stopping. What jumps out at me is histamine. For one, the groggy sedation felt much like an anti-histamine, plus I understand that unbalanced histidine and therefore histamine levels have been implicated in depression. Mainly H3, and Seroquel seems to target H1 but jeez, mere technicalities. Perhaps I'm one of those 'histadelics' (it does feel like hysterical psychedelics for that matter). Perhaps methylation is a factor. I dunno. I only know that something caused this rapid switch into dysphoric agitation. There's a profound clue waiting to be discovered here. Just hope I don't have to go through any further personal testing to find out. I welcome any and all thoughts. - Barbara
> ahhh, the buck has been passed....thank you, panda...remind me not to play poker with you next time i'm down under.....the answer to the post is that, in my opinion, the seroquel dose was too small (i have to read the next one, so don't hold to this just yet) and it sounds like breakthrough anxiety. that said, i still think panda's answer is better than mine in that maybe yes, maybe no (what dose?) and what other drugs are on board that can inhibit/induce/act as substrates for isoenzymes that are also part of the seroquel metabolic route. see, i told you panda's the expert.....on to the next post, where i believe i glimpsed the meds list.....see you there, all the best, chemist
>
>
> > > Hi Panda, I was taking a tiny dose of Seroquel for sleep and a dab during the dayfor anxiety. I did well at first, but then after about a week I became very very restless and my anxiety levels really increased. Was this akathisia? I stopped takign the Seroquel Saturday but still have not felt well, what in the world happened?
> > >
> > >
> >
> > Possibly, Akathesia is said to be a feeling of inner agitation which makes you fidgety & unable to sit still. Perhaps there was a drug interaction involved? Some drugs can raise the levels of other drugs & vice versa if they share the same liver enzyme. It's an ideal question for Chemist. :)
> >
> > Cheers,
> > Panda.
> >
>
Posted by cpallen79 on July 12, 2004, at 16:57:36
In reply to Re: Sounds like a question for CHEMIST! » cpallen79, posted by BarbaraCat on July 12, 2004, at 14:47:30
Hey barbara, I haven't tried AMbien yet, I think I'll try Trazodone first (don't mind a good hangover every now and again), if that doesn't work, onto Benzos most likely, we'll see. I was sooo surprised by what the Seroquel did to me, I felt sooo good for a few days (except at nights- which would make sense as the adderall wore off- my doapmine levels would drop). This is why my PDOC suspects akathisia, even at uch a small dose.. because my dopamine levels weren't too great, initially she wanted me to increase the adderall ans spread it out, I just said forget the seroquel!
Posted by chemist on July 12, 2004, at 17:05:23
In reply to Re: okay, here we go... » chemist, posted by cpallen79 on July 12, 2004, at 16:42:51
> Hi Chemist,
> Thanks for the information! I've been on Lexapro at 12.5 for about a month or so now, so hopefully the anxiety isn't from that. My PDoc wants me to titrate up to 15 mgs. I'm a fan of the Lexapro because it's supposedly "cleaner" than other SSRIS, though I wish it was one that caused more sedation. I went back to a lower dose of adderall XR at 5mgs. I'm ditching the Buspar and will try Trazodone for sleep (PDOC called it in for me). I've also heard that it has mild anti-anxiety properties, but at this point I'm not keeping my fingers crossed. I just want some darn sleep and to have the agitation/anxiety stop. I was also given some ativan on hand but have had negative experiences with rebound anxiety from xanax so I'm a bit weary of them, plus there's the addiction potential of course.
> What do you guys think? Think that I'll be able to actually settle down one of these days? ughhello there, chemist here....i think your plan - and i highly endorse and commend your consultation with your pdoc, by the way - has all the potential to work just fine. lexapro is pretty clean, in that it is a pure, single active enantiomer rather than the more side-effect prone racemate that is celexa, and i think maybe more than one month is called for in re: getting adjusted. remember, these things take time. you're right about anti-depressant activity of trazodone (pardon my earlier typos), lovingly dispensed in the 1970s and 1980s as Desyrel for depression. your worries about ativan are, in my estimation, a little bit overblown, and if you keep it to prn dosing, you'll do fine. xanax is a real tough one to bounce back from (see my post to Buckeye Fan) and you can rest assured (literally) that trazodone will have you slumbering away. please keep us informed, will you? all of this information is of great value to all of us, as we jump from med to med to med......all the best, chemist
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