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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Zana on July 17, 2009, at 16:43:44
As some of you have already read, I have been trying to taper my dose of seroquel from 150mg at bedtime to whatever. I got to 100mgs and crashed-weeping, despondent.
I keep feeling I am on too many meds and that my feelings of deadness and dullness are medication induced. But when I try to reduce anything, my depression comes galloping back. I gave it a week on 100mgs of seroquel and all week I got progressively worse even though when I was taking just remeron and seroquel I was still very depressed. So I didn't think the seroquel was doing me much good and might be dulling me down.
Do I have to feel so deadened to stave off the depression? Is the deadness part of the depression that's not being treated?
I could try to taper the remeron. I take 45mgs at bedtime. It gave me no AD benefit when I was on it alone. But my pdoc says it's supposed to be a good combination with pristiq. Should I try to drop out the resperadone? It didn't feel like it did anything when I started it- good or bad. Could it be dulling me?
I am so dishearted and confused.
Any suggestions will be appreciated.
Zana
Posted by SLS on July 17, 2009, at 17:18:19
In reply to Seroquel Taper a Bust, posted by Zana on July 17, 2009, at 16:43:44
> As some of you have already read, I have been trying to taper my dose of seroquel from 150mg at bedtime to whatever. I got to 100mgs and crashed-weeping, despondent.
> I keep feeling I am on too many meds and that my feelings of deadness and dullness are medication induced. But when I try to reduce anything, my depression comes galloping back. I gave it a week on 100mgs of seroquel and all week I got progressively worse even though when I was taking just remeron and seroquel I was still very depressed. So I didn't think the seroquel was doing me much good and might be dulling me down.
> Do I have to feel so deadened to stave off the depression? Is the deadness part of the depression that's not being treated?
> I could try to taper the remeron. I take 45mgs at bedtime. It gave me no AD benefit when I was on it alone. But my pdoc says it's supposed to be a good combination with pristiq. Should I try to drop out the resperadone? It didn't feel like it did anything when I started it- good or bad. Could it be dulling me?
> I am so dishearted and confused.
> Any suggestions will be appreciated.
> Zana
At higher dosages (above 100mg), the metabolite of Seroquel becomes important. It is a norepinephrine reuptake inhibitor, just like nortriptyline. I had some luck combining Effexor with nortriptyline. You might consider using nortriptyline as a substitute for Seroquel and combine it with Pristiq.Pristiq + nortriptyline + Remeron should be a potent cocktail for depression.
- Scott
Posted by Phillipa on July 17, 2009, at 17:20:40
In reply to Seroquel Taper a Bust, posted by Zana on July 17, 2009, at 16:43:44
Zana so sorrry. How horrible for you. Did you let the pdoc know how horrible you feel? They do say seroquel has some ad properties. Since your're on the seroquel is it possible the resperidol could be over kill so to speak? Love Phillipa
Posted by Zana on July 17, 2009, at 17:45:17
In reply to Re: Seroquel Taper a Bust, posted by SLS on July 17, 2009, at 17:18:19
My pdoc is on a 3 week vacation but that sounds like a good idea. I'll make a note to ask him about it when he's back.
Thanks,
Zana
Posted by Zana on July 17, 2009, at 17:47:40
In reply to Re: Seroquel Taper a Bust » Zana, posted by Phillipa on July 17, 2009, at 17:20:40
Thanks for your concern, Phillipa. I did let him know and he thought it made sense to increase the seroquel again. I didn't ask him about the respirasone but yeah, I think it could be over kill. I'm just afraid to experiment too much and I don't know how to decrease it. I'm on 1mg.
Zana
Posted by Phillipa on July 17, 2009, at 20:57:19
In reply to Re: Seroquel Taper a Bust, posted by Zana on July 17, 2009, at 17:47:40
Zana don't blame you. Might try just cutting a bit of the resperidol pill off see if makes a difference. Not having ever taken it I don't know but I do that with benzos. Phillipa
Posted by Zyprexa on July 18, 2009, at 4:54:02
In reply to Seroquel Taper a Bust, posted by Zana on July 17, 2009, at 16:43:44
I think you should stick with the seroquel. If you respond that badly coming off it, you shouldn't. I would next try the remeron and then the risperdal. One at a time.
Posted by Zana on July 18, 2009, at 8:29:19
In reply to Re: Seroquel Taper a Bust, posted by Zyprexa on July 18, 2009, at 4:54:02
Hi and thanks for the input. Would you try to decrease the remeron even though it's supposed to work well with pristiq (effexor redux?) What kind of schedule would you follow?
Thanks again,
Zana
Posted by 49er on July 18, 2009, at 18:17:56
In reply to Seroquel Taper a Bust, posted by Zana on July 17, 2009, at 16:43:44
> As some of you have already read, I have been trying to taper my dose of seroquel from 150mg at bedtime to whatever. I got to 100mgs and crashed-weeping, despondent.
> I keep feeling I am on too many meds and that my feelings of deadness and dullness are medication induced. But when I try to reduce anything, my depression comes galloping back. I gave it a week on 100mgs of seroquel and all week I got progressively worse even though when I was taking just remeron and seroquel I was still very depressed. So I didn't think the seroquel was doing me much good and might be dulling me down.
> Do I have to feel so deadened to stave off the depression? Is the deadness part of the depression that's not being treated?
> I could try to taper the remeron. I take 45mgs at bedtime. It gave me no AD benefit when I was on it alone. But my pdoc says it's supposed to be a good combination with pristiq. Should I try to drop out the resperadone? It didn't feel like it did anything when I started it- good or bad. Could it be dulling me?
> I am so dishearted and confused.
> Any suggestions will be appreciated.
> ZanaHi Zana.
Most antidepressants should be tapered at 10% of current dose every 3 to 6 weeks.
That means that meds like Seroquel need to be tapered more slowly at 5%.
The reason you had depression when tapering the Seroquel is you tapered too quickly. Withdrawal symptoms do not mean a return of the illness.
By the way, if you decide to taper the Remeron, please do it slowly. I successfully tapered off of Remeron at 10% of current dose every 3 to 6 weeks. The few times I went too fast, I regretted it.
If you're interested, I can tell you how to do it. I forget to check for followup responses so if I don't come back, send a babble mail and I will respond.
49er
Posted by floatingbridge on July 18, 2009, at 22:02:50
In reply to Re: Seroquel Taper a Bust » Zana, posted by 49er on July 18, 2009, at 18:17:56
I'm sorry Zana--how frustrtaing and disheartening--hope you get some good info and brainstorming--and don't give up!
fb
Posted by Zyprexa on July 18, 2009, at 23:10:24
In reply to Re: Seroquel Taper a Bust ))Zyprexa, posted by Zana on July 18, 2009, at 8:29:19
I was just thinking if you think the remeron is not doing anything, you won't miss it when its gone. You should find out pretty quickly. Try half the dose for as long as you can tolerate. Then decide which way to go next. No point in taking too many meds. I could be wrong and you still need the AD, unless you are taking anouther one, which would be the best way to go. I'm also starting to think you would be better taking the risperdal away first. Just because I know you are on anouther AP. Its just a test don't worry too much if you don't get off them. YOu may realy need them. I don't know if you notice when you are getting psychotic or depressed. I usualy can tell with myself.
Posted by Zana on July 19, 2009, at 14:37:01
In reply to Re: Seroquel Taper a Bust ))Zyprexa, posted by Zyprexa on July 18, 2009, at 23:10:24
I don't get any psychotic symptoms, never have. I just got way more depressed when I decreased the seroquel. I was thinking the same thing about the risperadone or whatever it's called. Larry Hoover has warned me that there can be bad rebound insomnia from decreasing remeron so I have been shy of doing that. I hate to think I need all this stuff... I'm interested in Bleauberry's post about nortrypiline or however it's spelled. Unfortunately my pdoc is away for three weeks...
Zana
Thanks for the imput. I appreciate it.
This is the end of the thread.
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