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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by UgottaHaveHOPE on April 27, 2006, at 10:33:14
I was diagnosed with Generalized Anxiety in 1997 and took 30+ meds over the past eight years. Mostly SSRIs and benzos, and none of them really seemed to do anything.
Then, almost by mistake, I tried Seroquel. I told a pdoc that my grandmother was bipolar, so they let me try Seroquel even though they said I was not bipolar (or haven't shown any symptoms).
Anyways, the Seroquel was like a dream. It took away the excessive rage of energy that I felt. It took the edge off. I started last summer at about 100mg, and after a couple of months was all the way down to 25mg, which is the level I basically stayed at for the last seven months.
Then about three weeks ago, I had some upsetting things happen to me. I couldn't calm down. My mind was racing too much. I went up to 100mg, and now 200mg, and the pdoc has given me temporary permission to go to 300mg. I am still so worked up about those upsetting things that I dont know if there is any med that would calm down.
Do you think I will calm down eventually? Do you think I should stick with Seroquel because it has been so great to me for so long? Do you think Seroquel has worn out its welcome because some say its effect does not stay the same over time? Has that proven to be true? What else would you try?
Posted by UgottaHaveHOPE on April 27, 2006, at 12:41:48
In reply to SLS, Med-Empowered, others ... your opinion please, posted by UgottaHaveHOPE on April 27, 2006, at 10:33:14
nm
Posted by SLS on April 27, 2006, at 19:47:45
In reply to SLS, Med-Empowered, others ... your opinion please, posted by UgottaHaveHOPE on April 27, 2006, at 10:33:14
I'm assuming that you have tried Paxil and Effexor.
Some people go up to 800mg with Seroquel to treat bipolar disorder.
You might profit from a drug like Depakote. It is an anticonvulsant mood stabilizer used to treat bipolar mixed-states. That might be what you are currently experiencing. The other thing you could try is to switch to Zyprexa. You could first add it to the Seroquel and see how you respond to it.
Hang in there. I doubt you will need to go through another 30 drugs.
- Scott
Posted by Phillipa on April 27, 2006, at 19:50:06
In reply to ??????? PLEASE HELP, posted by UgottaHaveHOPE on April 27, 2006, at 12:41:48
I can't answer about the seroquel except to say that if there are things going on in your life you can't at the moment change than it probably isn't the med. I am in a similar situation and no matter what I combine or try nothing helps. I can't even read I read so fast it feels like my eyeballs are being pulled out of my head. Are you experiencing like this too? Love Phillipa
Posted by blueberry on April 27, 2006, at 20:47:57
In reply to SLS, Med-Empowered, others ... your opinion please, posted by UgottaHaveHOPE on April 27, 2006, at 10:33:14
I wonder sometimes how these antipsychotics behave. I had a backwards effect with zyprexa where it was very sedating and calming at low doses (2.5mg to 5mg), but it became uncomfortably stimulating with insomnia at higher doses (7.5mg to 10mg).
I hate anxiety. I wish I had something to offer you. You could try just a day or two of xanax or klonopin along with the seroquel just to see. I liked zyprexa. But honestly, I fought all the way to keep the dose low. I would never suggest anyone creep up to higher and higher doses. A midrange dose is as high as I would go.
Posted by Caedmon on April 28, 2006, at 10:27:24
In reply to Re: SLS, Med-Empowered, others ... your opinion please » UgottaHaveHOPE, posted by blueberry on April 27, 2006, at 20:47:57
I second Scott's suggestion to look at anticonvulsants.
- C
Posted by UgottaHaveHope on April 28, 2006, at 10:43:04
In reply to Re: SLS, Med-Empowered, others ... your opinion pl » UgottaHaveHOPE, posted by SLS on April 27, 2006, at 19:47:45
Thanks so much for responding to my post. I always value your opinion, and thanks to the others too.
What is a bipolar mixed state? I have never been diagnosed as bipolar, although my grandmother was. What would be the symptoms of that?
Why do you think Dep would be better that Ser? You own personal experiences? Thanks and I really appreciate it.
Posted by Jay on April 28, 2006, at 12:45:06
In reply to SLS, Med-Empowered, others ... your opinion please, posted by UgottaHaveHOPE on April 27, 2006, at 10:33:14
> I was diagnosed with Generalized Anxiety in 1997 and took 30+ meds over the past eight years. Mostly SSRIs and benzos, and none of them really seemed to do anything.
>
> Then, almost by mistake, I tried Seroquel. I told a pdoc that my grandmother was bipolar, so they let me try Seroquel even though they said I was not bipolar (or haven't shown any symptoms).
>
> Anyways, the Seroquel was like a dream. It took away the excessive rage of energy that I felt. It took the edge off. I started last summer at about 100mg, and after a couple of months was all the way down to 25mg, which is the level I basically stayed at for the last seven months.
>
> Then about three weeks ago, I had some upsetting things happen to me. I couldn't calm down. My mind was racing too much. I went up to 100mg, and now 200mg, and the pdoc has given me temporary permission to go to 300mg. I am still so worked up about those upsetting things that I dont know if there is any med that would calm down.
>
> Do you think I will calm down eventually? Do you think I should stick with Seroquel because it has been so great to me for so long? Do you think Seroquel has worn out its welcome because some say its effect does not stay the same over time? Has that proven to be true? What else would you try?
>You have a few options..but none are "for sure" to be perfect. You may have to take your time a bit. The good thing is, you wil know within a few days if these meds work.
- add a high potency benzo, like Xanax, or a long half-life, like clonazepam (at proper doses..4 or so mg's a day)
-Along with above option, try adding a small dose of an ssri like Prozac or a tricyclic like amitriptyline or even nortriptyline.
-try *adding* (yes, two antipsychotics) another antipsychotic...an atypical like Zyprexa or Risperdal at at lower doses to start.
-As a *last* resort, I would say add a mood stabalizer..but I found that route just created more bad side-effects and no good ones.
-if you have access to nefazedone, give it a shot as an antidepressant/anti-anxiety due to it's 5ht2a antagonism.
Let us know what you think, and how you make out.
Best,
Jay
Posted by SLS on April 28, 2006, at 12:54:01
In reply to Re: SLS, posted by UgottaHaveHope on April 28, 2006, at 10:43:04
> What is a bipolar mixed state?
A mixed state can be thought of as a combination of mania and depression. It is a difficult state to characterize, but can include racing thoughts, irritability, anger, anxiety, agitation, impulsivity, sleep disturbances, depressed mood, dysphoria, excessive energy, pressured speech, rage, and even suicidal ideation. It affects females more often than males.
> I have never been diagnosed as bipolar, although my grandmother was. What would be the symptoms of that?
Whenever there is a clear case of bipolar disorder in first degree relatives, it is likely that there will be a bipolar component to any mood illness present.
> Why do you think Dep would be better that Ser?
Depakote has been shown to be more effective than lithium when treating mixed-state bipolar disorder. I think it works well as a mood stabilizer. As such, it works to prevent future episodes from happening. Seroquel is helpful when treating the episode once it is triggered. It might also have some mood stabilizing properties, but it isn't currently recognized as being such.
> You own personal experiences?
I found Depakote to work very fast when I experience a mixed-state. 1000mg usually does the trick. Depakote is prescribed in dosages that vary widely. Some people feel that 250-500mg acts to stabilize their mood while others clearly need 1000-2000mg. People's experiences with Depakote also vary greatly. Some people find it somewhat depressing while others find it neutral or even antidepressive. Some people gain a lot of weight with it while others don't. I never had a problem with weight gain.
I guess you can try to increase the Seroquel first, but if things continue to be uncomfortable, I would consider adding a mood stabilizer. Of those that are currently available, I think Depakote would be the best choice if you are indeed suffering a mixed-state.
- Scott
Posted by UgottaHaveHope on April 28, 2006, at 22:02:50
In reply to Re: SLS, Med-Empowered, others ... your opinion please » UgottaHaveHOPE, posted by Jay on April 28, 2006, at 12:45:06
Do I try one of those at a time? Or all of them now? You have a very scientific knowledge of all this.
This is the end of the thread.
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