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Mood Disorder Community
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sbauer
Full Member (100+ posts)
139 Posts
Gratitude: 22
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 Posted - 07/17/2008 : 18:20:19
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| Hi - can anyone tell me the usual dosage of seroquel, as an adjunct to lithium? I was diagnosed as bipolar two years ago, and have been on lithium since, with good results...until I got a wee bit manic a few weeks ago and got put into place by being told that I was just getting disorganized enought that I was risking admission. Now, the embarassing part is that I am a physician, but in a field as far from psych as possible which is lucky, as nobody would notice or care if I was swinging from a chandelier). The deal was that my lithium got almost doubled, and seroquel added on as well. The seroquel is a bit of a strange drug, but I got put on a very low dosage for now, and as I seem to be behaving myself and settling down I'm not sure if it will change. I know that when used as an adjunct with lithium that the dosage is lower...but how low? Thanks. |
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| lynn2150
Super Incredible Member (10000+ posts)
21329 Posts
Gratitude: 2146
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Posted - 07/17/2008 : 18:57:40
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Hi, and welcome !
I wish I had an answer,
I was put on 100 mg of seroquel, along with the usual 900 mg of Lith, and had my paxil reduced to 20 mg from 40 mg.
I cannot handle the seroquel, I asked to have it lowered to 25 mg. I still hate it.
If I may ask, what doses of lith and seroquel are you on?
Are you on any anti depressants?
Glad to have you aboard, !
Lynn |
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| Zep
Incredible Member (2000+ posts)
2298 Posts
Gratitude: 536
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Posted - 07/17/2008 : 21:10:04
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Hi Sbauer. I don't know that there is a "usual" dose - I think it varies from person to person.
I only take seroquel short term, but I have taken as much as 300mg with 900mg slow release lithium. I dislike seroquel, but, as I recently told Lynn, I hate being psychotic more! I know that my shrink would like me to take it long term as a preventative, but I manage the way it is. And seroquel works better for me than other anti-psychotics have.
You would probably need to ask your own doc about specific dosages for you. Good luck with it.
Zep. |
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| sbauer
Full Member (100+ posts)
139 Posts
Gratitude: 22
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Posted - 07/18/2008 : 11:26:49
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Hi lynn and zep - thank you both for the replies. I guess seroquel is still relatively new for bipolar use, so there is still probably some trial and error in the dosages. I will ask my psychiatrist the next time I see him. I was initially diagnosed with depression and put on effexor and remeron. After two months, I became manic, and lithium was added. First 600mg, then 900. I was kept on the other two initially, although the remeron was lowered to 15 mg as I didn't enjoy the weight gain (at first, I was at 95 lbs so a bit was okay...). The effexor was dc'd 2 months ago (as I was mysteriously so much better!). As the feeling better evolved into mania, the lithium was increased to 1200 mg, and only 50 mg of seroquel was added. It seems to be a bit of a homeopathic dose - I have certainly settled down, but it seems to me that my PM seroquel makes me a bit drowsy the next day in the afternoon, but doesn't help that much with sleep at night. I've also been horribly irritable with outbursts - smashing plates against a wall is a bit over the top even for me - not sure if that's just the mania dissipating though. What sort of side effects have you had? |
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| Zep
Incredible Member (2000+ posts)
2298 Posts
Gratitude: 536
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Posted - 07/18/2008 : 13:06:17
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Nothing like that. Have you talked to your doc about these side effects?
The drowsiness is common...I wake up feeling sort of hungover and sluggish. The weight gain is difficult to live with.
All meds have side effects - they are worse for some than others. If you're new on seroquel, then I would suggest that you check all of these side effects out with a professional, just to be on the safe side.
Zep. |
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| sbauer
Full Member (100+ posts)
139 Posts
Gratitude: 22
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Posted - 07/18/2008 : 15:54:42
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| Thanks zep. I don't see my psychiatrist for a few weeks now - summer, so he assumes that I have enough common sense to call if there are big problems (not sure that's a good assumption!). The big drug books of course list tons of side effects, but sometimes someone else's description is more helpful. I have been thankful for relatively few side effects with my meds, have even avoided the dreaded tremor from lithium (that would be a deal breaker for me - simply can't afford that). I think that the seroquel is meant to let me get some sleep, as even my remeron was only giving me 1 hour. |
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| Zep
Incredible Member (2000+ posts)
2298 Posts
Gratitude: 536
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Posted - 07/18/2008 : 16:31:10
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Well, some side effects are considered serious, and I think that increased manic behaviour would qualify. So don't hesitate to ring your doc if these things don't settle down or if they get worse.
If you can't afford the shaky hands, then you are probably a surgeon. I can see how important it would be for you to stay in control of both symptoms and side effects. I'm sure your doc wouldn't mind if you contacted him to discuss your situation. Not sleeping can be dangerous for mania.
Cheers, Zep. |
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| sbauer
Full Member (100+ posts)
139 Posts
Gratitude: 22
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Posted - 07/18/2008 : 20:23:33
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Hi Zep - how fitting that you should mention the sleep and surgery...I've just come out of the OR after 13 hours of surgery, and I am also on call. (I actually assist at surgery, after not finishing my surgical residency, but as much of my assisting is cardiac, I actually do parts of the procedures myself, and help the surgeon for the rest - yes, need rock steady hands!) We have a case coming in now (transplant), and should be back in the OR about 1AM, and likely won't get out of there until around 8 or 9 AM. This has left me with a dilemma - Remeron and Seroquel are out of the question now, and so there will be no sleep at all tonight, maybe not for the whole weekend. And I am apprehensive about still not completely being down from the mania - but at least down enought that I shouldn't be causing any scenes as I did the week before! It's convenient that I don't feel the need to sleep now, but am painfully aware of the effect of lack of sleep on mania. I couldn't avoid being on call without jeopardizing my position...I have let one of my colleagues there know my situation (very understanding - a family doc who did a lot of psych, and he himself has recurrent depression and a family history of bipolar). So, no point in asking my psychiatrist what to do - likely he would tell me to scrap the call...so I'll hope that I get through the weekend and reassess things then (unlikely to reach by psychiatrist on the weekend anyway - I don't get any special treatment!) |
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| warblaster
Super Incredible Member (10000+ posts)
112498 Posts |
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| warblaster
Super Incredible Member (10000+ posts)
112498 Posts |
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| warblaster
Super Incredible Member (10000+ posts)
112498 Posts |
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| warblaster
Super Incredible Member (10000+ posts)
112498 Posts |
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| warblaster
Super Incredible Member (10000+ posts)
112498 Posts |
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| warblaster
Super Incredible Member (10000+ posts)
112498 Posts |
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| warblaster
Super Incredible Member (10000+ posts)
112498 Posts |
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| warblaster
Super Incredible Member (10000+ posts)
112498 Posts |
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question - seroquel dosage as adjunct
