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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Rosh on February 22, 2005, at 21:11:53
Trying to get some input on what to expect by weaning off of Seroquel. Started on 25mg a couple years ago and now am up to 100mg. Have gained 20 lbs. and stayed tired/sleepy all the time. Doc put me on it since I couldn't sleep on Wellbutrin XL 300mg and increased it over the last few months as I was waking up early AM and not going back to sleep. Am also taking 20mg of Prozac. I need to get off of at least one of them but not sure which one.
Posted by med_empowered on February 22, 2005, at 21:11:53
In reply to Weaning off Seroquel, posted by Rosh on February 22, 2005, at 18:11:23
hey! I'm not a big fan of neuroleptics, so I'd personally recommend getting off the seroquel..but, really, its your call. Do you have a good idea as to which one is causing the most problems? My advice would probably be to get off the seroquel, and if the prozac/wellbutrin combo is causing problems, try an SSNRI (selective serotonin neurepinephrine reuptake inhibitor). New SSNRIs include Effexor and Cymbalta; the older tricylic drugs (elavil, tofranil, pamelor, etc.) seem to have a similar mechanism of action, but have more side-effects....one of the big side-effects being drowsiness.
Posted by linkadge on February 22, 2005, at 21:11:53
In reply to Re: Weaning off Seroquel, posted by med_empowered on February 22, 2005, at 19:00:57
How can you "not" be a fan of one pharmachological intervention to mental illness, (neuroleptics), and a fan of another (antidepressants).
Sure neuroleptics are nasty, but schisophrenia is nastier.
Lnkadge
Posted by med_empowered on February 22, 2005, at 21:11:53
In reply to Re: Weaning off Seroquel, posted by linkadge on February 22, 2005, at 19:39:43
hey! I don't think this poster is schizophrenic...the doses of seroquel would indicate that its being used as a sleep aid, in which case there may be other alternatives.
As for neuroletpics as a treatment for schizophrenia...
My concern is that, without evidence that schizophrenia is in fact a true "brain disease," we have abandoned the potential for other treatments...drug, non-drug, whatever. This is a big deal when you also consider the side-effects of neuroleptics, new and old. My other problem is that neuroleptics haven't done so great a job...even schizophrenia experts readily admit that only 1/3 of treated patients are "much improved," 1/3 are "improved", and a full third stay about the same. There's no reason to abandon research into the biology of schizophrenia, but there's also no reason to shelter this research from hardcore scrutiny OR abandon other alternatives. If we are seriuos about helping these people, then we should be serious about improving lives--not just "treating disease".
Posted by linkadge on February 22, 2005, at 21:11:53
In reply to Re: Weaning off Seroquel, posted by med_empowered on February 22, 2005, at 19:52:20
I say the same goes for depression.
I would imagine that you are on some medication of some sort.
only 1/3 of treated patients are "much improved," 1/3 are "improved", and a full third stay about the same.Unfortunately, I think the statistics are worse for depression. Not to mention some of the most recent data that suggest that AD medications might actually worsen the outcome of depression in the long run.
Based on the potentiall risks of neuroleptics vs. AD medications, AD's seem to have the advantage. But in terms of ethics, and quality of life, I don't think taking one psychiatric med is any different than taking another psychiatric med.
I mean the Serotonin/norepineprine hypothesis to depression is just as bunk, as the dopamine hypothesis is to schitophrenia.
Linkadge
This is the end of the thread.
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