Jump to content


Click here to find a mentally interesting date at No Longer Lonely Keep Crazymeds on the air. Donate some spare electronic currency you have floating around The Cloud



Some Crazymeds mugs to help you wash down your meds. Get mugged for at Straitjacket T-shirts for more. 11oz mugs are $13. 15oz mugs are $14.
Mentally Interesting mug
Mentally Interesting
Medicated For Your Protection mug
Medicated For Your Protection
Team Bipolar mug
Team Bipolar
Brain Cooties Aren
Brain Cooties Aren't Contagious
Photo

Quetiapine IR vs. XR For Anxiety?


  • Please log in to reply
10 replies to this topic

#1 historymum

historymum

    DIY Trepanist

  • Members
  • Pip
  • 161 posts
  • Diagnoses:Bipolar II
  • Current Meds:200mg lamotrigine; 300mg quetiapine IR; Agomelatine, 50mg; thyroxine, 125mg
  • Location:U.K.

Posted 15 April 2012 - 06:38 AM

I've trawled my way through earlier threads for information on this, but couldn't find anything that directly addressed this issue; apologies if I've missed something.

I'm having to reduce my quetiapine down (IR, currently 250mg), but the anxiety is increasing again. I was wondering...can the XR version work better for anxiety? My thinking is that, if there's a consistent amount of the drug in your system, it will be regulating the anxiety constantly. (In contrast to the IR, where it hits you in one go, and then presumably has a much lower level later in the day, thereby allowing anxiety to increase.) Is that a possibility, or is that not how quetiapine works?

My thinking is to replace some of the IR with XR to see if that improves things.
  • 0
Previous dx: postnatal depression

Failed med's: Sertraline, Citalopram, Trazodone, Olanzapine, Quetiapine XR, lithium, Abilify



Enable Crazymeds to keep ranting about being crazy and taking meds. Donate some spare electronic currency you have floating around The Cloud


Stick to your treatment plan with buttons and magnets. 2.25″ $4 & 3.5″ $4.50 at Straitjacket T-shirts Some designs available in packs of 10 and 100
Pile of Pills buttons at Straitjacket T-shirts
Pile of Pills
Vaccines
Vaccines Cause Immunity
Medicated For Your Protection magnets at Straitjacket T-shirts
Medicated For Your Protection
Mentally Interesting buttons at Straitjacket T-shirts
Mentally Interesting

#2 kaylisbubba

kaylisbubba

    DIY Trepanist

  • Members
  • Pip
  • 14 posts
  • Diagnoses:bi-polar 1, GAD, SAD
  • Current Meds:lamictal 200mg, geodon 160 mg, xanax 1mg (3 times a day PRN), seroquel 50mg, lunesta 3mg
  • Location:ny

Posted 22 April 2012 - 02:36 PM

i am having the opposite problem. i am presently taking seroquel xr and it doesn't fit into my schedule. since my seroquel still makes me sleepy by pdoc says that i should take it 3- 4 hours before bed. this would be a simple fix but i have a 6:10 train to take in order to get to a 7:30 class and really don't fel like taking my seroquel ay 5:30 in the evening. My pdoc has never even mentioned taking the ir....i am goinng to call him tomorrow and be very firm about suggesting it. ho[e it works. any suggestions?
  • 0
DX: Bipolar 1, GAD, SAD


Current Meds: Lamictal 200mg, Geodon 160mg, Seroquel XR 50mg, Xanax 1mg (3Xday PRN)


Former Meds: Paxil, Zoloft, Prozac, Deseryl, Depakote, Zyprexa, Effexor

#3 martasi2

martasi2

    Ready for the MCAT

  • Members
  • PipPipPipPip
  • 2,210 posts

Posted 22 April 2012 - 04:25 PM

Kaylisbubba,

There's another current topic in the Seroquel forum called "Seroquel Advice Needed." You might find some other suggestions in that topic.
  • 0

#4 Rockie

Rockie

    Amateur Psychopharmacologist

  • Members
  • PipPip
  • 377 posts
  • Diagnoses:Depression, panic, agoraphobia, bipolar features, IBS
  • Current Meds:Valium 5 mg QD and 5mg PRN, Calcium and Magnesium Supplements

Posted 22 April 2012 - 06:31 PM

Seroquel has a pretty short half life -- 6 hrs.

@historymum It's worth a shot, especially since it sounds like you're taking the IR in one dose. Not sure what your previous dosage was, but another thing to consider is that 250mg is around the dosage where the AP effect/mood stabilization begins. So the increased anxiety may also be due to loss of mood stability. Just sayin'.

@kaylisbubba At that dosage, safe to say that you're taking it for sleep (though I suppose it could also be helping a bit with depression and/or anxiety)? Given the short half life, yes, I'd give the IR a try. If it's also for depression/anxiety, I'd say to try a lower dosage of XR. Unfortunately, it looks like 50mg is the lowest dose pill, and cutting it would probably make it IR.

Edited by Rockie, 22 April 2012 - 06:39 PM.

  • 0

Previous Meds
AD's: Prozac, Zoloft, Paxil, Luvox, Celexa, Cymbalta, Effexor, Lexapro, Wellbutrin, Remeron, Emsam, Imipramine, Nortriptyline,Trazodone, Viibryd, Nefazadone
AED's: Topomax, Trileptal, Klonopin, Ativan, Lamictal, Oxazepam, Triazolam
AP/AAP's: Seroquel
Other: Buspar, Ambien, Nadolol, Propranolol, Pramipexole, Hydroxyzine

"The pink ones keep you from screaming".
- Grandpa Simpson


#5 AnxietyGirl74

AnxietyGirl74

    DIY Trepanist

  • Members
  • Pip
  • 107 posts
  • Diagnoses:OCD, panic without agoraphobia, general anxiety, depression
  • Current Meds:Prozac, Abilify, Wellbutrin, Klonopin
  • Location:Coast of NC

Posted 24 April 2012 - 03:42 PM

I've been on Seroquel XR for anxiety for a while now, and recently was upped to 600 mgs XR. I think for me it does a lot better using the XR because the IR does not stay in my system nearly as long.
  • 0
"I'm not crazy, I'm just a little unwell, I know, right now, you can't tell, .but wait a while and maybe then you'll see, a different side of me." Matchbox Twenty

#6 Her

Her

    Would-be Neurologist

  • Enabler
  • 649 posts
  • Diagnoses:bipolar l, migraines, Autism spectrum
  • Current Meds:Seroquel (XR and IR), topiramate, lamotrigine, Ambien CR, Cymbalta
  • Location:American tundra

Posted 24 April 2012 - 04:33 PM

I take the XR and the IR. The XR in a split dose, 50 a.m. and 50 p.m., and the IR at bedtime, an hour to half an hour before I want to sleep, but I'm taking it with Ambien and topiramate so YMMV. The XR is working to manage both anxiety and irritation reasonably well (the morning dose is new and the jury is kind of still out). For breakthrough freakouts I still take small (25 mg) doses of the IR to calm me down. Works quite well. You can cut the 100 mgs IR pills all the way down to 25 mgs with a good pill cutter, a steady hand, and practice. The XR pills do only come as small as 50 mgs, and I had this conversation with my pdoc recently: don't cut them up. It does make them IR.
  • 0

Give us this day our daily meds: 150 lamotrigine, 75 topiramate, 150 Seroquel XR, 100 Seroquel IR, 12.5 Ambien CR,  60 mgs Cymbalta

 

4000 i.u. Vit. D3,

 

Etodolac 400 mgs  2x/daily and Votaren Gel 2 grams 2x/daily for joint pain NOS

Azelastine nasal spray 2x/per nostril 2x daily

 

Cyclobenzaprine and Midrin PRN

Past, failed attempts: Effexor XR, Celexa, amitriptyline, Depakote, escitalopram, Geodon, klonopin, ativan, bupropion, busipirone, lithium, trazodone, Lunesta, Rozerem, gabapentine, mirtazapine, Wellbutrin, Temazepam, Sonata.

Never doubt that a small group of thoughtful, committed citizens can change the world: indeed, it's the only thing that ever has. -Margaret Mead


#7 historymum

historymum

    DIY Trepanist

  • Members
  • Pip
  • 161 posts
  • Diagnoses:Bipolar II
  • Current Meds:200mg lamotrigine; 300mg quetiapine IR; Agomelatine, 50mg; thyroxine, 125mg
  • Location:U.K.

Posted 25 April 2012 - 09:30 AM

Seroquel has a pretty short half life -- 6 hrs.

@historymum It's worth a shot, especially since it sounds like you're taking the IR in one dose. Not sure what your previous dosage was, but another thing to consider is that 250mg is around the dosage where the AP effect/mood stabilization begins. So the increased anxiety may also be due to loss of mood stability. Just sayin'.


I've been moving back and forth between 250mg and 350mg to try to find a dose that works. I'm sure that the increased anxiety is partly a reflection of the lower quetiapine dose, but the anxiety only really became a problem when I stopped taking citalopram in January.

Just to update this - I started taking 50mg of XR. The original idea was to be taking 200mg of IR + 50mg XR, but the anxiety and loss of sleep was getting to me so I'm currently trying 250mg IR + 50mg XR.

The verdict....my anxiety is a lot better. I felt an improvement the first morning after the change. However, anxiety is still a problem and I'm feeling very, very low right now. Not sure where that leaves me with the quetiapine for now - perhaps add another 50mg XR.

On the plus side - I've found that the cognitive problems/feeling slowed down that I had on 100% IR have improved.
  • 0
Previous dx: postnatal depression

Failed med's: Sertraline, Citalopram, Trazodone, Olanzapine, Quetiapine XR, lithium, Abilify

#8 bengaltiger

bengaltiger

    Amateur Psychopharmacologist

  • Members
  • PipPip
  • 295 posts
  • Diagnoses:mdd, gad, ocd
  • Current Meds:Pristiq 100mg lamictal 150mg, klonopin 0.5mg, adderall 60mg, seroquel xr 50mg (sleep) abilify 5mg
  • Location:northeast u.s.a.

Posted 27 April 2012 - 02:09 PM

Seroquel has a pretty short half life -- 6 hrs.

@historymum It's worth a shot, especially since it sounds like you're taking the IR in one dose. Not sure what your previous dosage was, but another thing to consider is that 250mg is around the dosage where the AP effect/mood stabilization begins. So the increased anxiety may also be due to loss of mood stability. Just sayin'.

@kaylisbubba At that dosage, safe to say that you're taking it for sleep (though I suppose it could also be helping a bit with depression and/or anxiety)? Given the short half life, yes, I'd give the IR a try. If it's also for depression/anxiety, I'd say to try a lower dosage of XR. Unfortunately, it looks like 50mg is the lowest dose pill, and cutting it would probably make it IR.


So if seroquel is to be taken for depression/anxiety and not for antipsychotic effect, what is the dose range? 250mg and below? ATM I take 50mg xr and 25mg IR and do not feel much benefit.... Especially depression-wise.

Is my dose too low?

As for IR vs. XR ... for me, I much prefer XR. But for strictly sleep, IR is more effective IMHO.


  • 0

The truth has no friend


#9 Rockie

Rockie

    Amateur Psychopharmacologist

  • Members
  • PipPip
  • 377 posts
  • Diagnoses:Depression, panic, agoraphobia, bipolar features, IBS
  • Current Meds:Valium 5 mg QD and 5mg PRN, Calcium and Magnesium Supplements

Posted 27 April 2012 - 05:26 PM


Seroquel has a pretty short half life -- 6 hrs.

@historymum It's worth a shot, especially since it sounds like you're taking the IR in one dose. Not sure what your previous dosage was, but another thing to consider is that 250mg is around the dosage where the AP effect/mood stabilization begins. So the increased anxiety may also be due to loss of mood stability. Just sayin'.

@kaylisbubba At that dosage, safe to say that you're taking it for sleep (though I suppose it could also be helping a bit with depression and/or anxiety)? Given the short half life, yes, I'd give the IR a try. If it's also for depression/anxiety, I'd say to try a lower dosage of XR. Unfortunately, it looks like 50mg is the lowest dose pill, and cutting it would probably make it IR.


So if seroquel is to be taken for depression/anxiety and not for antipsychotic effect, what is the dose range? 250mg and below? ATM I take 50mg xr and 25mg IR and do not feel much benefit.... Especially depression-wise.

Is my dose too low?

As for IR vs. XR ... for me, I much prefer XR. But for strictly sleep, IR is more effective IMHO.


Yes, generally 250 or below if you don't want the AP effect. Anecdotally, 100+ seems to be the prescribed dosage for depression/anxiety, but it's really a YMMV. From it's mechanism of action, even low dosages could be helpful to some degree.
  • 0

Previous Meds
AD's: Prozac, Zoloft, Paxil, Luvox, Celexa, Cymbalta, Effexor, Lexapro, Wellbutrin, Remeron, Emsam, Imipramine, Nortriptyline,Trazodone, Viibryd, Nefazadone
AED's: Topomax, Trileptal, Klonopin, Ativan, Lamictal, Oxazepam, Triazolam
AP/AAP's: Seroquel
Other: Buspar, Ambien, Nadolol, Propranolol, Pramipexole, Hydroxyzine

"The pink ones keep you from screaming".
- Grandpa Simpson


#10 bengaltiger

bengaltiger

    Amateur Psychopharmacologist

  • Members
  • PipPip
  • 295 posts
  • Diagnoses:mdd, gad, ocd
  • Current Meds:Pristiq 100mg lamictal 150mg, klonopin 0.5mg, adderall 60mg, seroquel xr 50mg (sleep) abilify 5mg
  • Location:northeast u.s.a.

Posted 29 April 2012 - 12:58 PM



So if seroquel is to be taken for depression/anxiety and not for antipsychotic effect, what is the dose range? 250mg and below? ATM I take 50mg xr and 25mg IR and do not feel much benefit.... Especially depression-wise.

Is my dose too low?

As for IR vs. XR ... for me, I much prefer XR. But for strictly sleep, IR is more effective IMHO.


Yes, generally 250 or below if you don't want the AP effect. Anecdotally, 100+ seems to be the prescribed dosage for depression/anxiety, but it's really a YMMV. From it's mechanism of action, even low dosages could be helpful to some degree.


Thank you. Would taking abilify and seroquel at the same time... if the seroquel doesn't augment well enough... make sense, or be a good idea? I originally started seroquel to help with sleep, but found it helps some with depression.

Abilify helps depression, but gives me insomnia... which I have already. It's a catch 22. I'm not sure being on 2 AAP's is a good long term treatment plan.

If not, is one preferable over the other?

Any thoughts or opinions are very much appreciated.


  • 0

The truth has no friend


#11 Rockie

Rockie

    Amateur Psychopharmacologist

  • Members
  • PipPip
  • 377 posts
  • Diagnoses:Depression, panic, agoraphobia, bipolar features, IBS
  • Current Meds:Valium 5 mg QD and 5mg PRN, Calcium and Magnesium Supplements

Posted 29 April 2012 - 09:44 PM



So if seroquel is to be taken for depression/anxiety and not for antipsychotic effect, what is the dose range? 250mg and below? ATM I take 50mg xr and 25mg IR and do not feel much benefit.... Especially depression-wise.

Is my dose too low?

As for IR vs. XR ... for me, I much prefer XR. But for strictly sleep, IR is more effective IMHO.


Yes, generally 250 or below if you don't want the AP effect. Anecdotally, 100+ seems to be the prescribed dosage for depression/anxiety, but it's really a YMMV. From it's mechanism of action, even low dosages could be helpful to some degree.


Thank you. Would taking abilify and seroquel at the same time... if the seroquel doesn't augment well enough... make sense, or be a good idea? I originally started seroquel to help with sleep, but found it helps some with depression.

Abilify helps depression, but gives me insomnia... which I have already. It's a catch 22. I'm not sure being on 2 AAP's is a good long term treatment plan.

If not, is one preferable over the other?

Any thoughts or opinions are very much appreciated.


I'd go with upping Seroquel rather than doubling up since 1) you're already taking it, 2) you have insomnia, 3) Vyvanse should counter any over-sedation, and 4) Seroquel has a broader range of AD/anti-anxiety mechanisms than Abilify. Abilify also effects dopamine at lower dosages so you might as well not go there if you don't need to.

In terms of doubling up on AAP's, I'd imagine that most pdocs would try to avoid it from the side effects profiles alone. That said, Seroquel and Abilify are sort of oddball AAP's. Seroquel in that it's pretty much an AD/anti-anxiety med up to a certain dosage, while most (all?) of the others effect dopamine (antagonizes D2) at lower dosages. Abilify is an oddball because it's a partial agonist at D2, rather than an antagonist, so it works differently to achieve it's AP effect.

Given the above, I think an argument could be made for prescribing perhaps Seroquel and another AAP together, with the Seroquel-Abilify combo being the most benign (IMO), but I'd still put it near the bottom of my list of choices. There are just so many other med combos worth trying without the potentially serious side effects associated with taking two AAP's.

Edited by Rockie, 29 April 2012 - 09:56 PM.

  • 0

Previous Meds
AD's: Prozac, Zoloft, Paxil, Luvox, Celexa, Cymbalta, Effexor, Lexapro, Wellbutrin, Remeron, Emsam, Imipramine, Nortriptyline,Trazodone, Viibryd, Nefazadone
AED's: Topomax, Trileptal, Klonopin, Ativan, Lamictal, Oxazepam, Triazolam
AP/AAP's: Seroquel
Other: Buspar, Ambien, Nadolol, Propranolol, Pramipexole, Hydroxyzine

"The pink ones keep you from screaming".
- Grandpa Simpson



0 user(s) are reading this topic

0 members, 0 guests, 0 anonymous users


Shirts to swipe from Crazymeds' Clothes Line See more ways to let my meds express your feelings at Straitjacket T-shirts. Shirts, hoodies & more, $15-$51.
Batshit Crazy shirt
Batshit Crazy
Mentally Interesting shirt
Mentally Interesting
Medicated For Your Protection shirt
Medicated For Your Protection
Breakfast of Champions shirt
Breakfast of Champions
Bipolar Is NOT Contagious shirts at Straitjacket T-shirts
Bipolar Is NOT Contagious
Also available for other brain cooties.


Keep Crazymeds on the air. Donate some spare electronic currency you have floating around The Cloud




Keep up with Crazymeds and and/or my slow descent into irreparable madness boring life. Pick your preferred social media target(s):
Follow Jerod Poore on Facebook
Wear my StraitjacketBatshit Crazy Blog
Crazymeds | Promote Your Page Too
Play Dress-Up with your Imaginary FriendsCrazymeds: The Blog