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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by LlurpsieBlossom on December 30, 2006, at 18:47:26
Had too much appetite for the last few months. I have gained about 10-15 lbs and am about to outgrow my pants :(
I think it´s seroquel induced. I take 300mg daily, because I have bad thoughts about hurting myself and stuff like that. pdoc says some other options are abilify and geodon. (or strict diet...) what are other´s weightish experiences regarding these?
Llurpsying about... more lurping than lurpsying, actually.
p.s. I also appreciate the sleep inducing qualities of seroquel, as I´m an insomniac when I´m out of whack. are the other 2 options any good for sleep inducing?
Posted by laima on December 30, 2006, at 19:13:09
In reply to ¡ I´m FAT :( !, posted by LlurpsieBlossom on December 30, 2006, at 18:47:26
Un diet no es mucho helpo con los atypicalos.Some can supposedly alter metabolism. Abilify is said to not cause any weight gain, but when I tried it it kept me wide awake.
Possiblamente geodon?
Posted by Phillipa on December 30, 2006, at 22:50:58
In reply to Re: ¡ I´m FAT :( ! » LlurpsieBlossom, posted by laima on December 30, 2006, at 19:13:09
Valium or klonopin as they don't cause weight gain no benzo does. Love Phillipa
Posted by med_empowered on December 31, 2006, at 2:46:25
In reply to Re: ¡ I´m FAT :( ! » laima, posted by Phillipa on December 30, 2006, at 22:50:58
if you're not actually psychotic, you dont need an antipsychotic. Even if you are psychotic, you still may not need an antipsychotic.
So..with that in mind..have you tried other meds? Mood stabilizers, like lithium, depakote, tegretol/trileptal, keppra, and lamictal are all possible options. Trileptal, keppra, and lamictal tend to be pretty neutral in terms of weight (although you could lose what you gained on other meds). Depakote and Lithium tend to product weight gain, which can sometimes be considerable.
If you need help sleeping, taking most of your mood stabilizer at night (for example, 900 out of 1200mgs trileptal) might help. Benzos might help, as may other drugs (vistaril, neurontin,lyrica, trazadone, benadryl, melatonin, herbs, ambien, sonata, rozerem, lunesta, surmontil). Over time, mood stabilizers may make you able to better self-regulate your sleep/wake cycles, so you end up less dependant on sleep meds.
Posted by yxibow on December 31, 2006, at 10:49:12
In reply to Re: ¡ I´m FAT :( !, posted by med_empowered on December 31, 2006, at 2:46:25
> if you're not actually psychotic, you dont need an antipsychotic.
Unfortunately sometimes you do -- I have a nonpsychotic Somatiform disorder and I do take Seroquel for mild anti-D2 reasons, and it is a contributor towards weight gain which is why I try my best to control food intake, although I dont always succeed, and I go to the gym, mostly to keep the pounds down -- a little muscle isn't a bad thing either, but that's not priority one. Sometimes I struggle with motivation to go but I know waistline is one motivator. Of course ironically going to the gym gets my anxiety disorder pumped up a bit but that's a short term condition.
Even if you are psychotic, you still may not need an antipsychotic.
>
> So..with that in mind..have you tried other meds? Mood stabilizers, like lithium, depakote, tegretol/trileptal, keppra,
From what I've heard about Keppra, it can actually make nonpsychotic or borderline people, psychotic. But as they say, your miles may vary. Its not one tried on me yet anyhow, yet, so I can't vouch.
and lamictal are all possible options. Trileptal, keppra, and lamictal tend to be pretty neutral in terms of weight (although you could lose what you gained on other meds). Depakote and Lithium tend to product weight gain, which can sometimes be considerable.
>
> If you need help sleeping, taking most of your mood stabilizer at night (for example, 900 out of 1200mgs trileptal) might help. Benzos might help, as may other drugs (vistaril, neurontin,lyrica, trazadone, benadryl, melatonin, herbs, ambien, sonata, rozerem, lunesta, surmontil). Over time, mood stabilizers may make you able to better self-regulate your sleep/wake cycles, so you end up less dependant on sleep meds.I always prefer "real" sleep agents like several you mention -- ambien, lunesta, sonata (in order of need of larger dosing typically). Rozerem is a curious one -- it is about 17 times more powerful than OTC melatonin -- I did try OTC 5mg melatonin and I woke up during a REM cycle, I was petrified the whole night with hypnagogic/hypnapompic hallucinations. But of course again, some people benefit from it. I'm probably a bit overtolerant to sleep agents being rather in the insomniac spectrum.
As for off agents that I think are worthwile -- Remeron tends to promote interesting dreams at least from my trials and probably good REM sleep, but it is very weight gaining; its unclear whether its the agent alone or the refrigerator emptying feeling it compels.
I'm gathering the original poster is of the female persuasion so I don't have to mention that priapisms are not as uncommon as one thinks on Trazodone. Otherwise, well, its groggy, one has to eventually reduce the dose because it can cause escalation and return back to its original dose (otherwise you're actually getting in the serotonergic range, which I suppose isn't terrible if one is depressed but its rather sleep making at that point.)
-- tidings
Posted by Jeroen on January 1, 2007, at 14:21:48
In reply to ¡ I´m FAT :( !, posted by LlurpsieBlossom on December 30, 2006, at 18:47:26
hi, i too take seroquel
btw how do you take your dosage?
Posted by LlurpsieBlossom on January 1, 2007, at 19:06:34
In reply to i too take seroquel, posted by Jeroen on January 1, 2007, at 14:21:48
The original poster is of the female persuasion lol.
I take 300 mg of seroquel at night, when I also take 120 mg of cymbalta (which makes my heart pound within an hour of dosage, and yet also makes me fall into cataleptic nappy stupor every afternoon. Hence 200mg of provigil in the am.
Once upon a time (now some 8 months ago?) I had a very classic presentation of severe depression. Some mild hallucinations, of course the usual delusions of self-disgustingness and anhedonia and hopelessness and plenty of intention to kill or maim myself given the opportunity (and somehow the world was my ... opportunity...)
thats when I lost 5 pounds from not eating (no appetite) and waking up 3 or 5 hours early night after night was not so good for my psyche either. pdoc put me on 60 mg cymbalta, then 90. also seroquel 25 mg to help me sleep.
Then my case got a little more complicated... now anti-depressed, I was having intrusive thoughts (waking nightmares) of the sort frequently chronicled in R-rated movies involving¨(domestic) violence... and nightmares. and distractions of ill-portent. And some flashbacks of scenes from my preverbal days. Yes. the infant mind is a plastic organ, but given enough trauma, even some early events can be scarred into a form of memory.
Hence 300mg of seroquel. And my moods stabilized from having these flashbacks followed by a day or so of dissociation and feeling out-of-body... to being mildly depressed. and then I upped cymbalta to 120 mg. Told pdoc about the anxiety attacks (related to flashbacks, or over-sensitivity to environmental triggers) and I also got klonopin .5mg as needed.
And I got a new diagnosis post-traumatic stress disorder. yep. I graduated from major depression to PTSD.
So, I´d like to continue the work I´m doing in therapy right now, which is talking about how my parents and siblings contributed to feelings of powerlessness and self-hatred. I´d like to continue exploring the effect that violence has on me, and to figure out what my role was in the family, and how I can stop perpetuating a cycle of powerlessness, passive aggression and learned helplessness.
I am also talking about this stuff for the first time with my parents and siblings. It´s incredibly difficult. I fall into the mode of wanting to die sometimes, and not all of my coping mechanisms are things that I´m able to sustain.
So, I´m concerned about the weight gain, you bet. I also need something to keep the anxious ruminating voices out of my head. The ones that say things like ´´you stupid loser, how could you say that, you are worthless, what you did was so shameful´´ or worse, the intrusive feelings that I am paralysed, disembodied, amputated, etc. These thoughts and feelings have disappeared 95% since taking seroquel at 300mg dose.
thank you all for your thoughtful responses. I´m not sure that I´m motivated enough to go to the gym 4 times a week. I can try to do better on my diet, but seroquel does give me munchies for sweets. That i cannot deny. And of course, eating is one of my coping mechanisms. bummer, huh?
oh as far as anti-psychotics are concerned, I have family history of paranoid (super psychotic) schizophrenia, and one of my siblings was hospitalized for a while with psychosis during bipolar depression. I have a lot of self-control though. I´m not sure that I would allow myself to go that direction were I in trouble. I would probably just try to shrink myself to a dot and stop breathing. after I pass out a few times I usually give up and go to bed.
LlurpsíeBlosçom
Posted by Phillipa on January 1, 2007, at 20:02:34
In reply to thank you all- general follow-ups **sucide trig?, posted by LlurpsieBlossom on January 1, 2007, at 19:06:34
Hi Sweetie you're doing great you will know when it's time for a change and you have tackled so many things so fast that take others years. Be proud of yourself. Love Jan
Posted by Jeroen on January 2, 2007, at 0:08:50
In reply to thank you all- general follow-ups **sucide trig?, posted by LlurpsieBlossom on January 1, 2007, at 19:06:34
hi, about the heart racing for an hour
i have it too with seroquel if i take 300 mg
i hope it helps , i think its the best med
Posted by yxibow on January 2, 2007, at 1:29:31
In reply to to llurpsie, posted by Jeroen on January 2, 2007, at 0:08:50
> hi, about the heart racing for an hour
>
> i have it too with seroquel if i take 300 mg
>
> i hope it helps , i think its the best medSeroquel can cause that because of postural changes, it affects blood pressure. So does Cymbalta probably in some people -- I guess I have enough benzodiazepines in me that 120 doesn't put my normal pulse much above 80 -- don't remember what it was before, probably high 60s anyhow due to anxiety.
As to the previous question, I take 800mg of Seroquel, Jeroen, actually tapering down now at 750, of Seroquel, all at night.
As for the weight gain, I can understand your concern -- just as a layman comment I would say that 300mg probably has a bit less weight gain than I work against at 750. It doesn't carry the higher lipid gain among more people like Zyprexa, but it does have some.
When I was really overweight, and that was actually mostly due to the results of being on Remeron, which helped, but caused, as you have well observed, a desire to eat. Eating can be, unfortunately for the metabolically challenged, a problem, because when one is depressed, one either doesn't eat enough, or sometimes eats too much.
Nonetheless, keep track of what sorts of food you eat and how much and what sort of weight gain if any you have. I dropped a lot of body cholesterol (and I'm a vegetarian) from going to the gym. And that's not to look like a dolt in the bowflex commercials, its to lose weight and maybe have a little muscle.
I'm not saying go sign up for a membership or that will lose your problem -- I still struggle, and can't believe I'm in the weight range I am -- on the other hand, I have made strides. So its not impossible, its just an inconvenient attribute of a variety of quasi-antidepressant category items.And be proud of yourself to be talking openly about your PTSD to a therapist. And ordinary folks. It sort of sounds like the ruminating thoughts tend to fall in the OC Spectrum classification somewhat -- and I'm sure Seroquel if it has abated it that much is a good drug so I'm not at all saying to switch to anything else.
On the other hand, there are OCD agents like high dose Luvox or especially Anafranil which also help with ruminating thoughts. In fact if you took a higher dose of Luvox and a lower dose of Seroquel, it might work too. But that's for your and your doctor.Best wishes '07
- Jay
Posted by Jeroen on January 2, 2007, at 7:44:01
In reply to Re: to llurpsie / Jeroen » Jeroen, posted by yxibow on January 2, 2007, at 1:29:31
hi, i took benzo tranxene with seroquel, and it didnt work at all,
now that i am off the benzo the seroquel works
i know because i took them a year with it and now i'm off and i start feeling better for the first time...
Posted by LlurpsieBlossom on January 5, 2007, at 9:36:15
In reply to Re: to llurpsie / Jeroen » Jeroen, posted by yxibow on January 2, 2007, at 1:29:31
That´s interesting about the luvox and anafranil.
Isn´t it fascinating that different combinations of drugs often have such a strange synergistic effect. Nonlinearity & nonadditivity. That is, drugA and drugB taken together have very different effects than drug A alone plus drugB alone. funny.
I´m tempted to try something with less effects on blood sugar than seroquel. My mom and dad have both had diabetes due to overweight and/or medication side effects. My mom keeps her diabetic tendency under control with diet and exercise but she´s very hypothyroid, so her metabolism is really slow (my thyroid checks out normal, by the way). I don´t think I´m anaemic right now, as I have been eating red meat several times a week (a day?) since going on vacation. All I know is that everytime I increase my seroquel dosage, my appetite increases. Perhaps not linearly (that is, going from zero to 25mg caused much more appetite gain thana from 275 to 300. But when I taperd up from 25 to 300 my appetite increased. I was voraciously hungry particularly for sweets right when I wake up. This has somewhat abated, but I still have more appetite than ever before. And cravings too ugh!
Well, pdoc has me on provigil, and this should help with fatigue from starting an exercise routine and or course from fatigue induced by various soporific medications, including cymbalta, a few klonopin every week, and seroquel.
Í´m interested to see what pdoc thinks at my next appt.
I´m happy to hear that Jeroen is doing well on seroquel (I think it´s a GREAT med, by the way) and Jay, your gym perseverance is inspiring. Phillipa thanks for being so positive. You have such a big heart :)
cheers,
Llurpsie
Posted by cgd092 on January 5, 2007, at 11:43:18
In reply to Re: ¡ I´m FAT :( !, posted by med_empowered on December 31, 2006, at 2:46:25
med_empowered wrote, "if you're not actually psychotic, you dont need an antipsychotic...have you tried other meds? Mood stabilizers, like lithium, depakote, tegretol/trileptal, keppra, and lamictal are all possible options."
I have a question about this assertion. Lamictal is an anti-seizure med. You would suggest off-label use for *it*, but not an off-label use for an anti-psychotic like Seroquel? Just wondering why that might be.I've been taking Seroquel (up to 100mg/day) for awhile now. It's pretty good as an anxiolytic. I do think it contributed to my weight gain. That, plus Celexa. I've gained about 20 lbs. in two years. I'm now 145 instead of the 125 I'd been at for 15 years without watching what I ate at all. A few months ago I tried weaning off of Celexa and Seroquel. I successfully weaned off them (without doctor's knowledge) but then depression came back within 1.5 months. I'd rather be 20 lbs. over than have those feeling again! I guess I'd better watch what I eat and do some exercise.
--Katy
Posted by cgd092 on January 5, 2007, at 11:52:14
In reply to Re: to llurpsie / Jeroen + Jay, posted by LlurpsieBlossom on January 5, 2007, at 9:36:15
Someone wrote, "Remeron is very weight gaining; its unclear whether its the agent alone or the refrigerator emptying feeling it compels."
Even on tiny doses of Remeron, it induced near hyperphagia in me. Never had that before. Normally I'm sort of intolerant of much sweets. I wasn't able to use Remeron as my antidepressant because it was so sedating and hunger-inducing. However, I still have a little bit left from years ago, and I take it as a sleep agent, or if I get a full-on depressive episode where I have zero appetite.-Katy
Posted by Phillipa on January 5, 2007, at 18:54:05
In reply to Re: ¡ I´m FAT :( !, posted by cgd092 on January 5, 2007, at 11:43:18
I'm not a med expert but I'll try. I was also just prescribed again as I had quit due to expense trileptal. It's categorized as a mood stabaizer it's tegretol with an extra oxygen ion. But it was prescribed for me for anxiety or to help. I had been prescibed seroquel but I have autoimune disesases hasimotos thyroiditis and seeing an endocrinologist who said no atypical antipsychotics cause of diabetes and diabetes is an autoimmune disease also. So I will try the trileptal again and see what happens . But no more seroquel. I do take valium, lunesta(new) and small doses of xanax. Love Phillipa
Posted by LlurpsieBlossom on January 6, 2007, at 14:04:05
In reply to Re: ¡ I´m FAT :( !, posted by med_empowered on December 31, 2006, at 2:46:25
> if you're not actually psychotic, you dont need an antipsychotic. Even if you are psychotic, you still may not need an antipsychotic.
>
> So..with that in mind..have you tried other meds? Mood stabilizers, like lithium, depakote, tegretol/trileptal, keppra, and lamictal are all possible options. Trileptal, keppra, and lamictal tend to be pretty neutral in terms of weight (although you could lose what you gained on other meds). Depakote and Lithium tend to product weight gain, which can sometimes be considerable.Thanks for your input, med_empowered.
I think that seroquel has been approved to treat the mania and recently also the depression of bipolar disorder. So, I think that it can now be classified as an atypical anti-psychotic AS WELL as a mood stabilizer. My pdoc even went so far as to say that it has a lot of promise as an antidepressant. This is certainly my experience. I felt so much less depressed when I didnt have recurrent and intrusive thoughts of my own loathsomeness and little fantasies of ways to end my life. Was I 100% psychotic? no. Was I delusional- yes, and it was interfering with my well being. Was I having a hard time controlling my thoughts and my behavior? yes. I'm sure Im not the only one who considers the presence of disordered and intrusive thoughts of suicide and worthlessness to be a symptom of depression. Even if my reality-checking is okay, and I dont have delusions of grandeur or thought broadcasting... well, theres still plenty of room for intrusive thoughts without meeting diagnostic criteria for psychosis. It sure was a relief when those thoughts just shut up one day.
Now, if I could only get the little voice out of my head that knows where the nearest source of carbohydrates is... the one that says: theres ALWAYS room for dessert lol
oh well. I had salad for lunch. thats progress, right?
Oh, and I have not tried any other medications besides what Im on right now. 300mg seroquel and 120 mg of cymbalta and 200mg provigil. now also .5mg klonopin when I feel flight or flight.
wish I could fly today instead of tomorrow. oh well
-ll
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