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Combating Seroquel Drowsiness


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#1 rhino_survived

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Posted 04 August 2011 - 02:30 PM

Seroquel simultaneously saves and ruins my life at the very same time.

BACKGROUND:

I've had Bipolar Disorder 2 since the age of 7, and was only diagnosed aged 17.


I'm 20, and for the last 2 1/2 years I'm on:
300mg lamictin (lamotrigine) - 200mg AM & 100mg PM
8mg Endronax (reboxetine) - a Pfizer drug, antidepressant, not available in the USA.
600mg Seroquel

My problem: Emotionally I feel better than I can ever remember, literally. However the Seroquel hangover is still a toxic poison in my life. It affects my productivity too much.

I drink 600mg Seroquel at 9:30PM and fall asleep at 10:10PM.

MY PROBLEM:

Every morning I will set my alarm for 6Am. That's 8 hour's sleep. Solid sleep. However, here is the problem. (In no random order, with no common variable).
Morning A, the ideal morning (20% of the time): At 6AM I hear my alarm and am out of bed within 10 minutes. Awake, bubbly, I'm showered and ready by 6:30AM. I have no hangover.
Morning B, 40%: My alarm starts ringing at 6AM. I don't hear it. At 7AM my secondary alarm goes off, I don't hear it - still fast asleep. Between 10:00AM and 12:00AM I wake up with the help of no alarms. I feel a bit tired, but have no hangover
Morning C, 40%: I hear my alarm, and get myself out of bed by 7AM. I feel drowsy, hungover, fatigued and struggle to stand up straight. I get out of bed with effort, and have some cereal. It's a hangover morning, and subsequently I need to sleep more to get it away. I go back to bed and wake up at between 9:30AM and 11:30AM. For the rest of the day, I feel depressed and slightly fatigued. This week, it has happened four days in a row.


I need to manage my sleeping better. I can't wake up 80% of the time in the middle (or near the end of the morning) of the morning, when the day is pretty much over. Next year I am going to university, I'm not going to get through it unless 80% of my mornings are Morning A's.

Does anyone have any advice on what I can do? I don't think my psychiatrist realises how bad it is, because he constantly compares it with how depressed i was before. Currently, studying from home, and even now I don't get enough time to do everything.

I started taking Seroquel XR last night, and took a dose a few hours ago. I don't like it. I might feel a bit better when I wake up, but since I took it at seven until 9 I feel "out of it", can't concentrate and it isn't a practical solution: what do I do on nights that I go out and have to drive?


I have done (and do) the following:
1.) Eat a meal when I take my meds.
2.) Exercise 4 times a week minimum.
3.) Eat healthily, trying to stick to a Low GI diet as far as possible.
4.) Reduce my dosage Seroquel: the same happens if I take 200mg, or 600mg.


What now? My psychiatrist is willing to move me over to zyprexa. I am worried that if I change it might cause a relapse: I can afford it at the moment. Has anyone moved from Seroquel to Zyprexa?

Any advice would be appreciated. Thanks!


#2 squirmy

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Posted 04 August 2011 - 03:21 PM

I got my pdoc to put me on Ritalin instant release and it knocked a lot of that hangover feeling out it wasn't just for that I'm a little ADHD and I wasn't completing my tasks at work on time I basically was walking around looking for a wrench that I had in my hand all along its terrible moving past the speed of light and not getting anywhere

Schizoaffective, bipolar type----- Effexor, lithium, Risperdal , Adderall, clonazepam,-------

 


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#3 rowan77

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Posted 04 August 2011 - 03:22 PM

The only way I have found to prevent Seroquel Hangover is simply taking it at 8pm. If I take it much later than that I simply CANNOT waken up in the morning

DX: Bipolar Disorder, Social Anxiety Disorder

Current RX: Lithium Carbonate 800mg, Seroquel XR 800mg, Lamictal 100mg x2 daily, Procyclidine 5mg, prozac 40mg 

Also Yasmin 0.3/3mg for PCOS and Losec 20mg for Hiatus Hernia

 

Previous RX:
Anti-depressants: dothiepin, clomipramine, paroxetine, mirtazepine, lofepramine, venlafaxine, escitalopram, agomelatine
Anti-psychotics: thoridazine, risperidone, olanzapine, haloperidol, aripiprazole, chlorpromazine
Mood Stabilisers: carbamazepine, sodium valproate,
Anxiolytics: alprazolam, diazepam, lorazepam, clonazepam
Hypnotics: lormetazepam, temazepam, zopiclone, zolpidem, flurazepam
ECT: 6 Treatments in 2003; 11 Treatments in 2005

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#4 SashaSue

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Posted 04 August 2011 - 04:13 PM

I've been back and forth and bounced around between all the AAP's. I don't think you'd be likely to have a relapse, going from seroquel to zypreza, based on my own experience. And it's definitely much lsss sedating. The downside with zyprexa is the potential for weight gain. For some people, it's nothing. For others, it makes it impossible to stay on the med.

Have you discussed other options with your pdoc? Risperdal, or maybe abilify, for instance?
Dx: Bipolar I, ADHD<br />
Rx: Seroquel, 800mg, Lamictal, 150mg, Effexor, 325mg, Wellbutrin, 450, Dexedrine ER, 60mg

#5 bpladybug

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Posted 04 August 2011 - 04:15 PM

I have to carefully time when I take my 'quel. I do find the ER easier to manage. You obviously are committed to your treatment, and your education - that is wonderful. It took some experimentation to manage my Seroquel. And I take a combo of regular and ER.

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Treatment: 900 mgs Lithium, 900 mgs Neurontin, 400 mgs Seroquel, Xanax prn, Temazepam, fish oil, vitamins, Vit. D 5, 000 IU, exercize, some talk therapy and CBT Therapy. Exercize helps as does the Light Box; 30 mins every morning. I also have physical health challenges.


#6 grousemouse

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Posted 04 August 2011 - 09:56 PM

I had to pack all my seroquel into an evening dose because it is like a mallet to the skull for me. If I take it during the day I almost have to wipe drool off my chin. It is a fantastic drug though. Amazing. Comes down on my anxiety like a hammer.

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#7 losdodgers

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Posted 04 August 2011 - 10:58 PM

have you tried xr? i started on ir but it made me way too sleepy during the day
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#8 rhino_survived

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Posted 05 August 2011 - 02:46 AM

Thanks for your replies :)

Just woke up now from second night taking Seroquel XR. Same problem as before, waking up at nine having completely ignored alarms.

@Spuirmy: My psychologist thinks that Ritalin would help me as well, however my psychiatrist refuses to put me on it. He argues that stimulants generally aggravate bipolar symptoms. I could go for a second opinion I guess, but the doctor I see is regarded as the best in his field. (He's dean of the psychiatric health faculty at the university I'm going next year.)

@Rowntree: The problem with taken my Seroquel earlier, is that within 20-30 mins I'm knocked out. Bang. The Seroquel XR I take at 7, but I'm pretty much unproductive from 8-10.



@SashaSure
Well, I was told I was going to pick up weight on the Seroquel, and I lost instead. I exercise a lot, and I know some people who have taken Zyprexa and picked up weight, but none of them exercises as much as what I do. Haven't heard of Risperdal, have been on Abilify: it made my anxiety worse. Geodon is also an option, but my mom was on it (she has bipolar 1, bipolar and depressin runs in the family) and it just caused her to have a relapse. I think I will move to the Zyprexa the day my exams finish.

@bpladybug: I have considered combining Seroquel IR and XR. I'll try that tonight. However the problem with that is is that if that works, I'll have to either pay for the XR or IR myself, as it is not covered by my medical aid. And Seroquel is really really expensive. Well, here anyway.

@grousemouse: Seroquel is indeed great for anxiety!

@losdodgers: Trying the XR at the moment. Still experiencing the same problem. :(

#9 Velvet Elvis

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Posted 05 August 2011 - 04:30 AM

Moved to AP board.

The deal with treating ADHD when you have bipolar is that you've got to be pretty much 100% stabilize the bipolar before it's safe to look at taking stimulants. There are non-stimulant treatments available, however. Intunive, Strattera, desiprimine and wellbutrin are a few of them. Actually, the reboxitine might work better than any of those. I want some.

When I was on seroquel I absolutely had to allow myself 10 hours of sleep a night and only take it at night. After that it was nothing that a couple cups of coffee and some jumping jacks couldn't take care of though. 8 hours just isn't enough though.

Pretty much all side effects for any med will get better over time.

600 mgs is about where you need to start looking at breaking your dose up and taking some during the day if you can handle it. It works better and actually might kick your ass less if you take 200 in the AM and 400 at night.

Did you start at 600 or work your way up?

Everyone is different, but it's unlikely things will be much better on zyprexa.

De-gnosis: ADD, recurrent depression (or maybe bpII in the guise of such), Asperger's, OCD, social anxiety
Today's Pill Menu: Dexedrine, Wellbutrin (Budeprion), Strattera, Celexa, Risperdal, and clonazepam

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#10 Becks

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Posted 05 August 2011 - 07:11 AM

I take 150mg of the Seroquel Immediate Release and the only way I can combat the day time drowsiness is to just get my butt up and moving. Of course, I don't have much of a choice, there's 6 kids that make sure I get my tush out of bed in the morning. But on the weekends, when Hubs is home and he thinks he's doing me a favor by letting me sleep, I'm groggy and grouchy for a good part of the morning. Like everyone else, I had to play around with the dosage time a little bit and found that if I take the Seroquel 10 hours before I want to be up, then I do feel a lot better in the morning, it's just a matter of pushing myself to get moving. Also, the sedation didn't kick my butt yet like it has others. I still wake up at the drop of a feather and sometimes I find myself sitting in the kitchen at 3am wondering what the heck is the matter with me and why can't I sleep.

Becca 

Author of Moorestorms A Guide for the Bipolar Parent

 

"And I never thought I'd say, that I'm weaker today than I was yesterday..oh man
But I'll fight as I always fight with whats inside of me.. this warrior spirit inside of me" - Sully Erna Broken Road


#11 rhino_survived

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Posted 05 August 2011 - 01:58 PM

For a very long time I was on 400mg Seroquel. I didn't have such a hangover problem then, although sometimes. It was manageable. All of a sudden I started getting tired during they day, normally after noon sometime. My psychiatrist decided that it was my bipolar was acting up, and increased the dosage to 500mg for a while, and then 600mg. I started feeling better during the day, emotionally as well as energy wise. I also didn't have such a hangover problem. There was no hangover for about a month. After that (the last two months) I started getting this hangover, and it got just worse and worse until where it is now. The worse thus far being this week.

I was overseas in April. And I found that I could get by on a lot less sleep, same dosage Seroquel and feel fine. I concluded, now, that it was the adrenaline.

I'm for my third night on XR, and not feeling so drowsy as the previous two nights. Hopefully it'll work.

A long time ago, I tried taking Seroquel in the morning. I couldn't cope with the sedation during the day.

The Seroquel is great for anxiety.

What about combining Seroquel and Zyprexa?

@Beckette: Do you find that if you wake up, brave the hangover (so hypothetically standing in the kitchen making sandwiches and running after children in the morning getting them dressed) it goes away after a few hours? After 45 minutes I give up and go back to bed. The feeling is too horrible. But I guess at the same time you could probably couch yourself to stay awake for two hours and wait for it to pass. I normally exercise in the afternoon - I could try and move this to the morning. Think it'll help? It'll just take organisation.

#12 Becks

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Posted 05 August 2011 - 02:17 PM

Yep! As long as I stay awake and get moving, within 45 minutes to an hour I feel better. I have my cup of coffee, check CB, tend to the kids and then do what's on my list for the day. I do get a little sleepy in the afternoon, around 2pm or so, but I think that's because I'm expecting and it's not from the Serq at all. But, I can't nap, because if I do, then even with the Serq I'm wide awake until 2am or 3am. I've moved my shower to the afternoon to try and combat the afternoon tiredness. Maybe you could try and move your exercising to the morning and it'll help. And I agree, Serq has helped with my anxiety as well. It's not as overwhelming as it had been before. I used to worry about everything to the point of getting sick and shaking all day. I've only had that happen once since starting the Serq in July.

Becca 

Author of Moorestorms A Guide for the Bipolar Parent

 

"And I never thought I'd say, that I'm weaker today than I was yesterday..oh man
But I'll fight as I always fight with whats inside of me.. this warrior spirit inside of me" - Sully Erna Broken Road


#13 Anna

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Posted 05 August 2011 - 06:51 PM

You'd be better off trying zyprexa on its own if you ask me, I found it similarly antidepressant and actually better for my sx in all ways... just... the eating thing. I'd prefer to be on zyprexa totally. The zydis tends to make ppl less sleepy and makes SOME people eat less, apparantly, but IDK.

Always better off with one AAP on its own if you can get away with it. Unless you NEED the quel to GET to sleep, in which case, combining MIGHT make sense.

You might ask yr doc about provigil instead? It's really only approved to treat sleep issues and some docs will go for it because it isn't technically a STIM. With the dreaded, feared stim label (stims do not set off my bp sx, ever, even when I'm unstable, as has been multiply demonstrated finally by my doc kindly allowing to stay on provigil this time, and the episode not really being that different, REALLY, other than I wasn't a lost confused mess and stuff. IDK. Maybe not. Who knows. But, I don't really fear stims too much.. .though they totally can set off episodes in SOME).

That said, if you are adjusting to the XR, just keep after that for awhile... you'll get more even coverage anyway and it seems the simplest solution to me.



Anna
BP I, Most Recent Episode Depressed, like suicidally depressed.

Currently on: neurontin,. seroquel, tienaptine, NAC, lithium, temazepam, latuda, provigil, a bunch of health meds/supps to deal w/ s.e. of crazy meds. (metformin, armour thyroid, Vit B 12 shots, magnesium, the list goes on, sigh, I feel like an OLD person, heh). Yeah, i am on a lot of crazy meds.

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