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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by TonyZ on February 28, 2008, at 13:23:40
At first I will cut to the chase of what I am currently taking and then following I will explain the details. I am having a rough time as I am sure we all are:
Current meds:
sam-e 800mg (sadenosylmethylionine - a natural compound produced in the body)
valium 10 mg/ day
lithium 600 mg/ day (just started 2 days ago)
seroquel 200mg /day (just started taking 8 days ago... dosages were 50,100,100,150,200,200,300,200mg)
lunesta 2-3 mgSleep has been a big issue while I slept ok last night. I am very nervous about the combinations of meds. My doc felt the sam-e wasn't working so after increasing the dosage for a while he added other drugs.
Given I've only been on the seroquel for a few days what is the best way to taper off??
For those that have the time or interest to read the whole story here is the recent history. Suffered a seris of major depressions over the years and typically responded well to the tricyclics although given the side effects I would prefer to avoid that route now.
Sam-e had appeared to be effective in treating me for the past 2 years. (That is all I had been taking) The dosage was 1200mg. I started to experience anxiety and fell quickly into a deep depression, valium had been effective in the past and that was presecribed at 10-30 mg/day. After taking it for a month at an average dose of about 10mg / day, doc said I could just stop it cold. I don't think this is right. While taking the valium increased sam-e to 1600 mg/day. Then added deplin which is a synthetic folate - I mentioned something about the concern that excess folate could interfere with the natural production of sam-e in the body so he substituted cerofolin which contains b vitamins and some other stuff and also added geodon first at 20mg then dropping down to 10mg because I complained of lack of sleep. Although there may have been a few incidents where I felt better I was not comfortable with the mix and thought the geodon would be causing too much agitation. Doc simultaneously cut the sam-e in half to 800mg substituted seroquel, which makes me feel uncomfortable and fuzzy but had initially seemed to help with sleep.
Recently doc gave me a choice of upping the seroquel and adding lithium or stopping the seroquel cold and adding the lithium. I only bumped the seroquel to 300mg for one night added the lithium and with the lunesta got maybe 1 hour of sleep, although at the end of the day I did feel a bit better and had less brain fog but this was near bedtime.
So complaining about the lack of sleep doc said to keep everything the same except increase Lunesta from 2 to 3mg - it is very hard to split this small pill - so I probably wound up with a bit less than 3mg but sleep was good.
Today I am foggy and concentration is not as good as it was last night.
It is hard to tell if it is the reduction of the seroquel to 200mg (but I slept better) or just the combination of the meds. Doc dropped the sam-e because he thought it wasn't working and I probably complained that I wasn't getting any better, but I am wondering if that was a good strategy.
So for those have taken the time to read this far I thank you and ask about tapering off the seroquel given that I have only been on it for a short period of time, what is the best way ? Again here are the dosages taken each day 50,100,100,150,200,200,300,200mg. I am thinking of dropping 25-50mg a night if I can figure out how to split the pills.
Posted by bleauberry on February 28, 2008, at 18:36:36
In reply to Seroquel Withdrawal when taken for 1 week, posted by TonyZ on February 28, 2008, at 13:23:40
I think your gut instincts on how to wean off seroquel are probably right. It shouldn't be too hard, though you will feel no matter what. Heck I can get withdrawals after just 2 days of something. Withdrawals should be shorter though and less intense. I would say you will not be completely seroquel free, even though the drug will be long gone, until perhaps 2 to 4 weeks after the final dose.
I am like you in that I am always trying to tweek things, overthink things, and not just give something a good long trial before moving on. Maybe that's good, maybe not.
Not sure if you are into international medicines. If so, I would bring up the name Milnacipran (Ivex). It is like a tricyclic, except without the antihistamine anticholinergic stuff. A tricyclic without tricyclic side effects. Fairly cheap. Easy to order. Popular and well studied in 30 countries. I've tried it and have nothing bad to say about it. Actually it is hard for me to think of anything in the USA that works as good. I mention it only because you said you responded to tricyclics but didn't like the side effects. Google it to find out more.
Posted by TonyZ on February 28, 2008, at 21:11:07
In reply to Re: Seroquel Withdrawal when taken for 1 week, posted by bleauberry on February 28, 2008, at 18:36:36
Thanks bleauberry. While I type this I'm trying to think of how much to cut back tonight, I think I'll do it slowly at 25mg a night. I'll do the lithium thing for a week or so unless I start feeling a lot better - seeing the doc in a few days. I'm thinking it was a big mistake to cut back on the sam-e. I've heard anecdotally about medication poop out for some people but I have never experienced that for myself since I never stayed on anything that long - I would always taper off gradually and be fine for a certain period of time. In recent years, the depressions have occurred with greater frequencies although 2 years with the sam-e is not bad. The question is why do these medications stop working after a while. It is a philosophical dilemma - you are told the more often you have a depression the greater the chance of a relapse, but even if you stay on the medication there is no guarantee. It takes a lot of time and energy to figure out what to do. I guess it is a challenge we all face.
I tried an acupuncture session today, even in my severely confused state it did seem to relax me a bit - only problem is it is a bit pricey and not covered by my insurance.
This is the end of the thread.
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