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Xr Increase From 200Mg To 400Mg


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7 replies to this topic

#1 nukesandchems

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Posted 22 November 2011 - 12:35 AM

Hello,

I apologize in advance for not knowing the correct clinical terms for what is going on with me right now. A few weeks ago, I started having panic attacks on a regular basis which turned into deep "death anxiety" with fight or flight response. Severe response, to the point where one night I got up and ran out of my house and down the road. I felt weird about it, thought maybe it was just a phase I was going through, so I didn't talk to anyone. But things got worse, and I found myself getting very depressed, and just about everything was making me sad. Finally talked to my pdoc today and he suggested bumping my Seroquel XR from 200mg to 400mg. I feel icky and scared about it, but then again these days I feel icky and scared about everything. I am very sensitive to anything activating or stimulating. I already take Requip for restless arms/legs, so I guess I shouldn't worry about this new dose being activating, but I worry anyhow. Has anyone else made this jump, and what were the general thoughts about it?

Thanks.
  • 0

Diagnosis: Bipolar Disorder, Panic Disorder, PTSD, OCD, Fibromyalgia
Meds Now: 300mg Lamictal, 1000mg Depakote ER, 200mg Luvox ER, 800mg Seroquel XR, 1mg Klonopin (at night), 1mg Klonopin prn
Meds Tried: Serzone, Paxil, Lexapro, Doxepin, Neurontin, Ativan, Seroquel, Tegretol, Topamax, Effexor XR, Geodon, Valium, Zyprexa, Abilify, Lyrica, Wellbutrin, Trazodone, Ambien, Remeron, Cogentin, Latuda, Lunesta, Propranolol ER

 

My cocktail has been tapered down to a few good meds! YAY!

 

 

 




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#2 Mr_West

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Posted 22 November 2011 - 04:46 AM

It should be a bit more calming. Probably not as much of an adjustment shock as moving through some of the other doses.
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Not a medical professional. I have been asked whether I am a magician or scientist. Maybe I am neither, maybe I'm both. Take things I've written more than a year or two ago with more than a couple grains of salt, because people learn. I mean who thinks that when the house cat finally catches that bunny rabbit in the yard the bunny is going to kick the cat's ass, but once you see it you have to reconcile it with your existing view of the world.

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#3 nukesandchems

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Posted 22 November 2011 - 04:13 PM

I decided to take the plunge last night and I've been sleeping all day today. I knew it would be sedating but wow, did not think this much! I'm not complaining though. I normally don't sleep well and wake up frequently, and this let me sleep a bit longer in between wake ups. I have noticed a bit more restless arms/legs going on though, so I am going to have to call to confirm if I can move up 1mg on the Requip.
  • 0

Diagnosis: Bipolar Disorder, Panic Disorder, PTSD, OCD, Fibromyalgia
Meds Now: 300mg Lamictal, 1000mg Depakote ER, 200mg Luvox ER, 800mg Seroquel XR, 1mg Klonopin (at night), 1mg Klonopin prn
Meds Tried: Serzone, Paxil, Lexapro, Doxepin, Neurontin, Ativan, Seroquel, Tegretol, Topamax, Effexor XR, Geodon, Valium, Zyprexa, Abilify, Lyrica, Wellbutrin, Trazodone, Ambien, Remeron, Cogentin, Latuda, Lunesta, Propranolol ER

 

My cocktail has been tapered down to a few good meds! YAY!

 

 

 


#4 Ophelia

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Posted 25 November 2011 - 04:05 PM

Seroquel is definitely not activating! It has strong sedative side effects and is great for both bipolar depression and anxiety (which is often actually a manic symptom for bipolars). You'll need to keep a close eye on your weight and blood sugar with Seroquel; there is a certain risk of weight gain and diabetes (especially if there is rapid weight gain), but I've lost weight and my blood sugar is lower - so you never know.

I found the regular Seroquel an excellent sleep aid even at 25 mg and also noticed that it reduced my anxiety and obsessive-compulsive behaviors markedly. I've adjusted to the sedative side effects somewhat and am now taking 100 mg of the XR at night plus more regular Seroquel in the daytime, partly to balance the Wellbutrin-induced hypomania.

Regular Seroquel does make my restless legs worse, but the XR doesn't (or it could be better because of Wellbutrin).

You may want to consider getting off the Doxepin. Antidepressants, even fish oil, are prone to induce mania, rapid cycling, and mixed episodes in bipolar folk, so this could be the root of your anxiety. Especially MAOIs, tricyclics, and SSRIs. Wellbutrin is less bad on that score but can still give just a little too much of a lift (Seroquel can dampen that nicely).

You may find that adding another anticonvulsant or boosting the Lamictal a bit will help; or you could add another atypical antipsychotic, especially Abilify. I notice you've tried Abilify; why'd you discontinue it?.

If the depression is still not well-controlled by anticonfulsants and atypical antipsychotics, you could add Wellbutrin. With great caution.
Ophelia

Current Diagnosis: Bipolar disorder + PTSD
Current cocktail: Lamotrigine 287.5 mg, Seroquel XR 50 mg, Seroqel IR 50mg & PRN as needed, Wellbutrin SR 225 mg, Abilify 0.5 mg, Estradiol 1 mg, Aspirin 81 mg, Tegretol + Wellbutrin + Celexa, Methylin, Provigil, Depakote, Prozac, Pamelor, Dilantin, Tofranil, Elavil, Stelazine, lithium, Haldol, Desyrel, Valium, Nardil, and fish oil (for crying out loud! It threw me into a mixed episode)....
..........and others I can't remember
Supps: Calcium with Vitamin D, Vitamin D, Iron, Multi-Vitamin, Glucosamine with Chondroitin

#5 nukesandchems

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Posted 28 November 2011 - 08:52 AM

Thank you for answering! I appreciate everyone's opinions and experience.

Abilify, Geodon, etc. are VERY activating. Same thing with the Wellbutrin. I do believe I'm one of those people that have the opposite reaction of what is normally supposed to happen. I asked about the Seroquel being activating because of a past history of it doing just that. It has been slightly agitating. I had to up my Requip 1mg to deal with it, but that's nothing. The others made me want to crawl right out of my skin, and man, that's such a horrible feeling! I don't trust any SSRI's after what I went through with Effexor. I do not need another trip to the psych ward! :mad:

You could be right about the Doxepin though, although I hate to give that one up since it controls my Fibromyalgia pain well. I couldn't tolerate Lyrica. I'm extremely chemically sensitive so I'm guessing that's why I have such a hard time with different meds.

You may also be right about the Lamictal. I was going to ask him if that's my next move. It seems that whenever I adjust it, things get better. That drug is THE best thing to ever happen to me.

So far I've been on the new Seroquel dose for a week. Not much has changed, except for the fact that I am much more sedated at night. Still having panic attacks, still feeling extremely sad. Am I supposed to be noticing a change by now, or do I wait it out longer than this?
  • 0

Diagnosis: Bipolar Disorder, Panic Disorder, PTSD, OCD, Fibromyalgia
Meds Now: 300mg Lamictal, 1000mg Depakote ER, 200mg Luvox ER, 800mg Seroquel XR, 1mg Klonopin (at night), 1mg Klonopin prn
Meds Tried: Serzone, Paxil, Lexapro, Doxepin, Neurontin, Ativan, Seroquel, Tegretol, Topamax, Effexor XR, Geodon, Valium, Zyprexa, Abilify, Lyrica, Wellbutrin, Trazodone, Ambien, Remeron, Cogentin, Latuda, Lunesta, Propranolol ER

 

My cocktail has been tapered down to a few good meds! YAY!

 

 

 


#6 nukesandchems

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Posted 06 December 2011 - 01:24 AM

Just a follow-up. Things are not better for me. I have to call tomorrow to see if I can get in with my pdoc ASAP. Still having the awful panic attacks, still have the major sads. :mad:
  • 0

Diagnosis: Bipolar Disorder, Panic Disorder, PTSD, OCD, Fibromyalgia
Meds Now: 300mg Lamictal, 1000mg Depakote ER, 200mg Luvox ER, 800mg Seroquel XR, 1mg Klonopin (at night), 1mg Klonopin prn
Meds Tried: Serzone, Paxil, Lexapro, Doxepin, Neurontin, Ativan, Seroquel, Tegretol, Topamax, Effexor XR, Geodon, Valium, Zyprexa, Abilify, Lyrica, Wellbutrin, Trazodone, Ambien, Remeron, Cogentin, Latuda, Lunesta, Propranolol ER

 

My cocktail has been tapered down to a few good meds! YAY!

 

 

 


#7 Mr_West

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Posted 06 December 2011 - 10:40 PM

Just a follow-up. Things are not better for me. I have to call tomorrow to see if I can get in with my pdoc ASAP. Still having the awful panic attacks, still have the major sads. :mad:


Are you a veteran by any chance?
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________________________________________________________________________________
Not a medical professional. I have been asked whether I am a magician or scientist. Maybe I am neither, maybe I'm both. Take things I've written more than a year or two ago with more than a couple grains of salt, because people learn. I mean who thinks that when the house cat finally catches that bunny rabbit in the yard the bunny is going to kick the cat's ass, but once you see it you have to reconcile it with your existing view of the world.

CYP 2D6 *10, *39

#8 nukesandchems

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Posted 05 May 2012 - 11:38 PM

Sorry it has taken me so long to get back to this thread. Bad memory. No, I'm not a veteran.

I quit the Latuda and the doxepin. Now I'm having akathisia issues with the Seroquel to the point where I don't want to take it anymore. After going off the Latuda, the anxiety and sads are back. I can only imagine what things would be like if I stopped the Seroquel, but the akathisia is so horrible all I can do is cry. I'm at a loss right now.
  • 0

Diagnosis: Bipolar Disorder, Panic Disorder, PTSD, OCD, Fibromyalgia
Meds Now: 300mg Lamictal, 1000mg Depakote ER, 200mg Luvox ER, 800mg Seroquel XR, 1mg Klonopin (at night), 1mg Klonopin prn
Meds Tried: Serzone, Paxil, Lexapro, Doxepin, Neurontin, Ativan, Seroquel, Tegretol, Topamax, Effexor XR, Geodon, Valium, Zyprexa, Abilify, Lyrica, Wellbutrin, Trazodone, Ambien, Remeron, Cogentin, Latuda, Lunesta, Propranolol ER

 

My cocktail has been tapered down to a few good meds! YAY!

 

 

 



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