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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 john anderton on February 13, 2007, at 21:00:20
Hi all. I am BP2 and have recently switched from 2.5 mg's of Zyprexa to 75 mgs of Seroquel. I had a great few days and now am back into a depressive state. My doctor says that 75mgs is really low and would like me to get to at least 300 mgs. My questions are these:
1. Is there more of an antidepressant response on higher doses?
2. Does the sedation and or drugged feeling wear off?
3. Will it stop the cycling from my Prozac?
Thanks and God Bless
Posted by Quintal on February 13, 2007, at 21:18:28
In reply to Seroquel in low vs high doses, posted by john anderton on February 13, 2007, at 21:00:20
>1. Is there more of an antidepressant response on higher doses?
I think there's more likely to be a greater emotional and cognitive blunting effect at higher doses that some may interpret as, and be satisfied with, as being an antidepressant/anxiolytic effect. It depends on your standards and preferences.
>2. Does the sedation and or drugged feeling wear off?
No, not really. You'll probably develop some tolerance to the antihistamine (groggy) effects so that it no longer makes you sleep, but never to the point of feeling undrugged.
>3. Will it stop the cycling from my Prozac?
Yes, most likely.
Q
Posted by munificentexegete on February 14, 2007, at 6:18:17
In reply to Seroquel in low vs high doses, posted by john anderton on February 13, 2007, at 21:00:20
> Hi all. I am BP2 and have recently switched from 2.5 mg's of Zyprexa to 75 mgs of Seroquel. I had a great few days and now am back into a depressive state. My doctor says that 75mgs is really low and would like me to get to at least 300 mgs. My questions are these:
>
> 1. Is there more of an antidepressant response on higher doses?
>
> 2. Does the sedation and or drugged feeling wear off?
>
> 3. Will it stop the cycling from my Prozac?
>
> Thanks and God Blesshave you like most people here, got your lab results back showing you have an oversupply of dopamine or serotonin?
the key is titration, and blood tests until the dopamine or serotonin drops to more normal levels, then you will feel a lot better. going too low can be disasterous just like diabetes, so make sure your doc doesn't send you into serotonin or dopamine shock, that could be life threatening. do you measure your serotonin and dopamine more than once a day?
some patients also do the same with their lithium levels. it all just depends on the imbalance really.
Posted by blueberry1 on February 14, 2007, at 9:09:37
In reply to Re: Seroquel in low vs high doses, posted by munificentexegete on February 14, 2007, at 6:18:17
Questions:
I wasn't aware most people here have lab tests showing oversupply of dopamine or serotonin, or any labs tests on dopamine serotonin at all. What lab tests are you talking about?
From things I've read at pubmed.com, antipsychotics increase dopamine levels, and are either neutral or increase serotonin levels. At the same time they partially block the receptors from sensing the dopamine serotonin.
How exactly do you measure your serotonin and dopamine on a daily basis?
Since everyone's genetics and wiring are so different, how does one know what "normal" sertonin dopamine levels are? Or if they are too high or too low? Seems kind of like the one shoe size should fit everybody kind of thing.
How do we explain when someone is not helped by serotonin dopamine manipulation, either up or down, but are helped by such things as lamictal, lithium, xanax, etc?
Please fill me in on these tests. Interested in learning more of your thoughts.
> have you like most people here, got your lab results back showing you have an oversupply of dopamine or serotonin? Or more than once a day?
>
> the key is titration, and blood tests until the dopamine or serotonin drops to more normal levels, then you will feel a lot better. going too low can be disasterous just like diabetes, so make sure your doc doesn't send you into serotonin or dopamine shock, that could be life threatening. do you measure your serotonin and dopamine more than once a day?
>
> some patients also do the same with their lithium levels. it all just depends on the imbalance really.
Posted by Phillipa on February 14, 2007, at 11:46:24
In reply to Re: Seroquel in low vs high doses » munificentexegete, posted by blueberry1 on February 14, 2007, at 9:09:37
Me neither I know they can test levels of TCA's but not the actual neurotransmitters. Love Phillipa
Posted by munificentexegete on February 14, 2007, at 16:50:55
In reply to Re: Seroquel in low vs high doses » munificentexegete, posted by blueberry1 on February 14, 2007, at 9:09:37
> I wasn't aware most people here have lab tests showing oversupply of dopamine or serotonin, or any labs tests on dopamine serotonin at all. What lab tests are you talking about?
sure, i thought everyone was getting treated for their imbalances and/or receptor problems? why else would one take medication?
> How exactly do you measure your serotonin and dopamine on a daily basis? Please fill me in on these tests. Interested in learning more of your thoughts.
> From things I've read at pubmed.com, antipsychotics increase dopamine levels, and are either neutral or increase serotonin levels. At the same time they partially block the receptors from sensing the dopamine serotonin.right you are, some do, this is because some people have too much or too little dopamine/serotonin in their brains the classic chemical imbalance, while others have overactive or underactive receptors while other have structural damage to their dopmaine architecture as in the case of Parkinson's.
luckily they have many lab tests including urine, blood and spinal fluids, and mri and pet scans for receptor architecture, prevalence, occupancy and function.
Once they identify the problem, it is a matter of relevant treatment, by either trying to alter the amount of dopamine/serotonin in the brain, or trying to either suppress or increase the activity of the receptors.
if a dopamine or serotonin imbalance is detected and being treated for, urine or blood while not as accurate as spinal fluid tests, allows an individual to measure their catecholamines levels on a daily basis to ensure medication is working as expected:
http://www.nlm.nih.gov/medlineplus/ency/article/003561.htm
> Since everyone's genetics and wiring are so different, how does one know what "normal" sertonin dopamine levels are? Or if they are too high or too low? Seems kind of like the one shoe size should fit everybody kind of thing.it is largely a matter of measurement, analysis and statistics. In the same way that normal insulin levels are understood based on factors such as sex, age and weight, so too we understand what normal levels or serotonin and dopamine are. if your doctor told you about the chemical imbalance he no doubt pulled out a chart and showed you where your levels were relative to the normal range for your age, sex, height and weight.
> How do we explain when someone is not helped by serotonin dopamine manipulation, either up or down, but are helped by such things as lamictal, lithium, xanax, etc?
it depends on the underlying physiology involved really, if the patient has a serotonin or dopamine imbalance, then other medications won't really deal with the medical issue at hand and cannot be justified.
we are living in the space age, space stations sending research robots to mars, genetic cures for cancer, we cannot justify a "suck it and see" approach, it is a matter of science, and that means identifying the underlying medical cause and dealing with it appropriately.
Posted by Phillipa on February 14, 2007, at 20:01:39
In reply to Re: Seroquel in low vs high doses, posted by munificentexegete on February 14, 2007, at 16:50:55
Well if this true then we all should be on the right meds with no hit or miss approach which is what psychiatry is based on. Love Phillipa
Posted by blueberry1 on February 14, 2007, at 20:46:38
In reply to Re: Seroquel in low vs high doses, posted by munificentexegete on February 14, 2007, at 16:50:55
Yeah, the lab tests you are talking about sound interesting. And expensive. And not something someone would realistically do on a daily basis unless they make some kind of simple home test? Do they?
I had blood urine tests done once. Not much helpful. The treatments that looked appropriate based on the tests made me quite worse.
And no, not everyone here does these tests. Matter of fact, I don't think a single person does. Sure, they're all treating chemical imbalances, but not based on blood, urine, or spinal tests. I bet if I mentioned these tests, or ones that look at receptor function, to any psychiatrist in my area they would give me a blank stare.
Posted by munificentexegete on February 16, 2007, at 21:18:35
In reply to Re: Seroquel in low vs high doses » munificentexegete, posted by blueberry1 on February 14, 2007, at 20:46:38
> I bet if I mentioned these tests, or ones that look at receptor function, to any psychiatrist in my area they would give me a blank stare.
exactly. however, I am sure they could run them if they wanted to or if you insisted. I see no reason to distinguish a neurologist from a psychiatrist they are both supposed to deal with mental illness.
Posted by Larry Hoover on February 18, 2007, at 9:58:26
In reply to Re: Seroquel in low vs high doses, posted by munificentexegete on February 14, 2007, at 6:18:17
> have you like most people here, got your lab results back showing you have an oversupply of dopamine or serotonin?
Do you have references to supply for this procedure? I've never heard of most people obtaining such data.
> the key is titration, and blood tests until the dopamine or serotonin drops to more normal levels, then you will feel a lot better.
Again....references?
> going too low can be disasterous just like diabetes, so make sure your doc doesn't send you into serotonin or dopamine shock, that could be life threatening.
Life threatening? I am shocked to contemplate such an outcome. I really would like some references.
> do you measure your serotonin and dopamine more than once a day?
????
Lar
Posted by Larry Hoover on February 18, 2007, at 10:06:05
In reply to Re: Seroquel in low vs high doses, posted by munificentexegete on February 14, 2007, at 16:50:55
> if a dopamine or serotonin imbalance is detected and being treated for, urine or blood while not as accurate as spinal fluid tests, allows an individual to measure their catecholamines levels on a daily basis to ensure medication is working as expected:
> http://www.nlm.nih.gov/medlineplus/ency/article/003561.htmI really don't know why you have posted information which falsifies your stated premises, but:
1. the blood test referenced is to presumptively detect one of two rare cancers, pheochromocytoma or neuroblastoma.
2. the blood is not tested for serotonin levels (according to this reference).
3. it is not conducted daily.
4. it is not done by the individual patient, even if it was done daily.I am uncomfortable with finding posts such as yours here, as there could easily be confusion as to the correctness of the information contained therein. If this is misinformation, intended as a joke? or sarcasm?, it should be labelled in some way.
Lar
Posted by AuntieMel on February 19, 2007, at 15:01:17
In reply to Re: Seroquel in low vs high doses, posted by munificentexegete on February 14, 2007, at 16:50:55
I had always heard that dopamine/seratonin testing was useless as the blood levels had no relation to the levels on the other side of the blood/brain barrier.
Interesting news. Could you please point me to some information on this? I'd love to check it out.
Posted by fayeroe on February 20, 2007, at 17:41:16
In reply to Re: titration....references? » munificentexegete, posted by Larry Hoover on February 18, 2007, at 9:58:26
> > have you like most people here, got your lab results back showing you have an oversupply of dopamine or serotonin?
>
> Do you have references to supply for this procedure? I've never heard of most people obtaining such data.
>
> > the key is titration, and blood tests until the dopamine or serotonin drops to more normal levels, then you will feel a lot better.
>
> Again....references?
>
> > going too low can be disasterous just like diabetes, so make sure your doc doesn't send you into serotonin or dopamine shock, that could be life threatening.
>
> Life threatening? I am shocked to contemplate such an outcome. I really would like some references.
>
> > do you measure your serotonin and dopamine more than once a day?
>
> ????
>
> Larpray tell..........you mean you don't measure your serotonin and dopamine every day???????? :-)
Posted by Larry Hoover on February 20, 2007, at 17:51:21
In reply to Re: titration....references? » Larry Hoover, posted by fayeroe on February 20, 2007, at 17:41:16
> pray tell..........you mean you don't measure your serotonin and dopamine every day????????
:-)Don't need to. I'm a cyborg. My docking station has meters built into it.
£@®
Posted by fayeroe on February 20, 2007, at 17:59:59
In reply to Re: titration....references? » fayeroe, posted by Larry Hoover on February 20, 2007, at 17:51:21
> > pray tell..........you mean you don't measure your serotonin and dopamine every day????????
> :-)
>
> Don't need to. I'm a cyborg. My docking station has meters built into it.
>
> £@®slapping own forehead! how could i have forgotten? sorry, i'll get it together soon.......
>
Posted by Dr. Bob on February 24, 2007, at 11:35:00
In reply to Re: Seroquel in low vs high doses, posted by munificentexegete on February 16, 2007, at 21:18:35
> I see no reason to distinguish a neurologist from a psychiatrist they are both supposed to deal with mental illness.
Sorry to interrupt, but I'd like to redirect follow-ups regarding distinguishing a neurologist from a psychiatrist to Psycho-Babble Social. Here's a link:
http://www.dr-bob.org/babble/social/20070223/msgs/735727.html
Thanks,
Bob
This is the end of the thread.
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