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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 Crazydiamond on June 7, 2008, at 23:44:48
Ugh! Where do I draw the line?
I was hating Seroquel, I had taken it for about a month: 25mg am/75mg pm.
I was just so frustrated! Seroquel stopped my distorted thinking, but caused me to be sleepy all the time. Sleeping midnight - 9am, and napping 4pm-7pm. No drive to do anything. Depression... didn't have enough energy to speak.
I also got put on cogentin to treat the muscle rigidity side effect of Seroquel. Medication to treat the side effects of another medication?! I was pissed. Since it helped my distorted thinking, pDoc wanted me stick with it.
On the flip side, I would be totally okay taking medication to counteract weight gain caused by the drugs. How does this differ from being so pissed about cogentin?
I decided to discontinue, reducing by about 25mg a day with out the guidance of my pDoc.
So now that I've been of Seroquel and Cogention for a few days, I feel loads better!
I have an appointment with pDoc on Wednesday. I have never discontinued a medication without her supervision. Is she going to pissed?!
Now here's the deal, my distorted thinking has not comeback! I think it may have been a part of bipolar episode of somesort. Yeah sure, it will probably happen again, but seroquel is not fantastic for me. Ahh. Was discontinuing the right thing to do???
I feel loads better but not sure what means in the long run!Thank you!
---
past drugs:
lexapro
prozac
risperdal
lithium
ritalin
ativan
[seroquel w/ cogentin]currently:
Klonopin 0.5mg bid
Lamictal 150mg big
Vit B12 Supplement.Please excuse me if I did this wrong, I'm a n00b.
Posted by Zyprexa on June 7, 2008, at 23:58:40
In reply to Cogentin for Seroquel and being fed up!, posted by Crazydiamond on June 7, 2008, at 23:44:48
Why not just tell your doc that you were having this problem and how you fixed it. Which dose did you cut 25mg off of, the am or pm.
Posted by Crazydiamond on June 8, 2008, at 0:06:23
In reply to Re: Cogentin for Seroquel and being fed up!, posted by Zyprexa on June 7, 2008, at 23:58:40
I cut back to 62.5pm/25am for a few days
then 50pm/25am
then 37.5pm/12.5
then 25pm
then 12.5pmI guess it was more like 12.5mg a day!
Posted by yxibow on June 8, 2008, at 6:26:09
In reply to Cogentin for Seroquel and being fed up!, posted by Crazydiamond on June 7, 2008, at 23:44:48
> Ugh! Where do I draw the line?
>
> I was hating Seroquel, I had taken it for about a month: 25mg am/75mg pm.
>
> I was just so frustrated! Seroquel stopped my distorted thinking, but caused me to be sleepy all the time. Sleeping midnight - 9am, and napping 4pm-7pm. No drive to do anything. Depression... didn't have enough energy to speak.
>
> I also got put on cogentin to treat the muscle rigidity side effect of Seroquel. Medication to treat the side effects of another medication?! I was pissed. Since it helped my distorted thinking, pDoc wanted me stick with it.
>
> On the flip side, I would be totally okay taking medication to counteract weight gain caused by the drugs. How does this differ from being so pissed about cogentin?
>
> I decided to discontinue, reducing by about 25mg a day with out the guidance of my pDoc.
>
> So now that I've been of Seroquel and Cogention for a few days, I feel loads better!
>
> I have an appointment with pDoc on Wednesday. I have never discontinued a medication without her supervision. Is she going to pissed?!
>
> Now here's the deal, my distorted thinking has not comeback! I think it may have been a part of bipolar episode of somesort. Yeah sure, it will probably happen again, but seroquel is not fantastic for me. Ahh. Was discontinuing the right thing to do???
> I feel loads better but not sure what means in the long run!
>
> Thank you!
>
> ---
> past drugs:
> lexapro
> prozac
> risperdal
> lithium
> ritalin
> ativan
> [seroquel w/ cogentin]
>
> currently:
> Klonopin 0.5mg bid
> Lamictal 150mg big
> Vit B12 Supplement.
>
> Please excuse me if I did this wrong, I'm a n00b.
>
>Not wrong for not wanting to take an agent voluntarily that you think is causing bad side effects, I can't blame you there.
But discontinuing a neuroleptic that has been in your system for more than several weeks requires a gradual taper or WD, withdrawal dyskinesia can occur, which basically eventually resolves itself in most all cases but not pleasant to go through, not to mention the anxiety that could occur from dropping an AP all together (I did it for side effects and fears which I had a right to do but it caused extreme anxiety and other things I wont go into).
I do take it now again, it was always offlabel, but it is indefinite at this point, because it improves my functionality, not as much as it used to for unknown reasons but otherwise I have a lot of confusion issues (it is not for any disorder normally prescribed for).
The amount you were on was probably not significant but 12.5mg a day is a rough taper of 100mg of Seroquel, unless there's a reason (rare NMS which would mean instant discontinuation of anything for sheer safety sake regardless of what might interim), and its also AMA -- against medical advice.If you go to a doctor and you have a particular regimen, and hopefully the both of you discuss it -- it should not be a passive meeting, I wish more people spoke up to their doctors about their feelings even if the prescriber may disagree about what is suggested -- that is to be expected, and when a regimen is started, and a doctor doesn't know that it is stopped -- there's nothing they can do if an emergency occurs because psychotropics were dropped.
Anyhow, I'm not trying to lambaste this particular situation, I'm saying especially with complicated regimes, dropping all medications or part of them without consultation can land someone in the hospital, which is not a place actually where treatment is the best place because case history isn't known.
Anyway, best wishes with further therapy-- Jay
Posted by Phillipa on June 8, 2008, at 11:48:34
In reply to Re: Cogentin for Seroquel and being fed up!, posted by yxibow on June 8, 2008, at 6:26:09
I was on seroquel for one day in the hospital they took me off it the next day as I couldn't speak the words were in my head but wouldn't come out and almost fainted. Of course they had combined benzos and chloral hydrate this was four years ago. But I thought seroquel and that is not that high a dose didn't cause the side effects of the older aps like haldol so no cogentin would be needed. Same thing always happened to me go off a med and feel better guess the relief of being off the med caused it. So you're bipolar? Phillipa
Posted by Crazydiamond on June 8, 2008, at 12:02:01
In reply to Re: Cogentin for Seroquel and being fed up!, posted by Phillipa on June 8, 2008, at 11:48:34
The hospital put me on Seroquel too! They started at 100mg the first night, then 50mg in the morning. Shortly after, I fainted and hit my head on the bathroom tile floor after brushing my teeth. My blood-presser had dangerously dropped. They gave me 2 liters of saline and I had to have an EKG and CT scan. A wonderful day of my first and only hospitalization... about two months ago. FUN FUN.
Regarding my dx: I think it changes everytime! The only thing that is consistent is general anxiety disorder. I feel so awkward asking my pDoc what my diagnosis because I am nervous about what it will be.
Posted by Zyprexa on June 9, 2008, at 14:36:48
In reply to Re: Cogentin for Seroquel and being fed up!, posted by Crazydiamond on June 8, 2008, at 0:06:23
So. Your not taking it?
Posted by Crazydiamond on June 9, 2008, at 14:39:39
In reply to Re: Cogentin for Seroquel and being fed up!, posted by Zyprexa on June 9, 2008, at 14:36:48
No, not any more.
Posted by Zyprexa on June 9, 2008, at 14:48:29
In reply to Re: Cogentin for Seroquel and being fed up!, posted by yxibow on June 8, 2008, at 6:26:09
I think its a good idea to discontinue a AP that is not working, quickly, or quick as you are comfortable with. I was at a very high dose of Geodon and stoped it almost imediatly, with no ill effects. Also quiting abilify quickly. If it has a bad effect, you don't want to keep taking it. You want to quickly go back to one that is working.
Posted by Zyprexa on June 9, 2008, at 14:52:03
In reply to Re: Cogentin for Seroquel and being fed up!, posted by Crazydiamond on June 9, 2008, at 14:39:39
Sounds like you needed to quit it. But if you start to feel bad again you should take some. If not maybe you don't need it, or one.
Posted by yxibow on June 10, 2008, at 4:43:39
In reply to Re: Cogentin for Seroquel and being fed up!, posted by Zyprexa on June 9, 2008, at 14:48:29
> I think its a good idea to discontinue a AP that is not working, quickly, or quick as you are comfortable with. I was at a very high dose of Geodon and stoped it almost imediatly, with no ill effects. Also quiting abilify quickly. If it has a bad effect, you don't want to keep taking it. You want to quickly go back to one that is working.
As I pointed before -- and you can differ, you are lucky. There's reasons to stop immediately, Zyprexa did some things to me that I don't know how long will be around, it was as all medications outpatient are, voluntary, but extreme stiffness that could lead to unknown dystonia or possible TDy are reasons to stop immediately.
Some low blood pressure on Seroquel or other agents, other than fainting episodes that land you on your head, is not a reason to discontinue it immediately. And I'm sure there are other scenarios as such.
Withdrawal dyskinesia is a real possibility with abruptly stopping any AP/neuroleptic, and it is not a picnic ride, especially if one has high anxiety and has been on it for more than 2-4 weeks, as reverse anxiety syndromes can occur that can land someone in the hospital if they feel suicidal or for other reasons.
WD and the other implications could resolve itself in time, its unpredictable but could take a month depending on dosage. As for remaining anxiety, its worse than discontinuing Paxil abruptly or even any SNRI such as Cymbalta.
A taper off, going down in 25mg or 50mg increments for example for Seroquel, just as it is gone up, depending on your doctor's opinion, would have the best outcome, as I say unless there's a true emergency reason (bad stiffness that doesn't resolve, allergic reaction, torsades de pointes and QTc problems, possible emergent Tardive symptoms measured by AIMS or patient reporting, etc) to stop treatment with the AP medication alltogether.
Posted by Crazydiamond on June 10, 2008, at 8:24:18
In reply to Re: Cogentin for Seroquel and being fed up! » Zyprexa, posted by yxibow on June 10, 2008, at 4:43:39
> > I think its a good idea to discontinue a AP that is not working, quickly, or quick as you are comfortable with. I was at a very high dose of Geodon and stoped it almost imediatly, with no ill effects. Also quiting abilify quickly. If it has a bad effect, you don't want to keep taking it. You want to quickly go back to one that is working.
>
> As I pointed before -- and you can differ, you are lucky. There's reasons to stop immediately, Zyprexa did some things to me that I don't know how long will be around, it was as all medications outpatient are, voluntary, but extreme stiffness that could lead to unknown dystonia or possible TDy are reasons to stop immediately.
>
> Some low blood pressure on Seroquel or other agents, other than fainting episodes that land you on your head, is not a reason to discontinue it immediately. And I'm sure there are other scenarios as such.
>
> Withdrawal dyskinesia is a real possibility with abruptly stopping any AP/neuroleptic, and it is not a picnic ride, especially if one has high anxiety and has been on it for more than 2-4 weeks, as reverse anxiety syndromes can occur that can land someone in the hospital if they feel suicidal or for other reasons.
>
> WD and the other implications could resolve itself in time, its unpredictable but could take a month depending on dosage. As for remaining anxiety, its worse than discontinuing Paxil abruptly or even any SNRI such as Cymbalta.
>
> A taper off, going down in 25mg or 50mg increments for example for Seroquel, just as it is gone up, depending on your doctor's opinion, would have the best outcome, as I say unless there's a true emergency reason (bad stiffness that doesn't resolve, allergic reaction, torsades de pointes and QTc problems, possible emergent Tardive symptoms measured by AIMS or patient reporting, etc) to stop treatment with the AP medication alltogether.
I had extreme stiffness, that is why I was put on Cogentin.
Anyhow, It has been a few days since my last dose, and I feel much better. My highest dose was only 100mg which I hear is not a lot.Thanks!
This is the end of the thread.
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