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I'm having a weird issue where at the same hour every I start to feel light-headed, anxious, spacey, and even panicky...

I take Effexor XR at 3pm, and take Seroquel 50mg at 2am (I work nights)

My mood stays relatively the same until about 11pm where I start feeling those issues....Has anyone else on seroquel experienced this?  

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On 11/11/2017 at 11:32 PM, BrianOCD said:

I'm having a weird issue where at the same hour every I start to feel light-headed, anxious, spacey, and even panicky...

I take Effexor XR at 3pm, and take Seroquel 50mg at 2am (I work nights)

My mood stays relatively the same until about 11pm where I start feeling those issues....Has anyone else on seroquel experienced this?  

I've never taken Seroquel before but I have this problem with loxapine which is something I'm going to talk with my pdoc about on Thursday. Both quetiapine and loxapine have short half-lives, i.e. they "wear off" more quickly. So I find that the 10mg I take around 9PM doesn't last me all the way until my next dose and I have to take an extra 5mg sometime around 12PM.

My recommendation would be to switch to the XR since it's available as a generic now. Might help you to get better all-day coverage out of it. It should help with morning hangovers and might help with the weight gain as well. Most pdocs who start you on IR and then you experience side effects want to move you to the XR first before they give up on quetiapine altogether because remarkably the XR does improve tolerability for many people.

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14 hours ago, BrianOCD said:

Thanks Browri for response.

I have tried the XR in the past, but I didn't like it at all.

Didn't work for me like the IR.

Have you ever tried Zyprexa (olanzapine)? Stahl tends to group olanzapine, clozapine, quetiapine, and loxapine together as a group so if you respond well to quetiapine it can be reasonably deduced that you would respond well to other AAPs in that group. Since you're only taking 50mg of quetiapine IR, you would likely only need 2.5mg of olanzapine at night. It would help a lot with sleep. It has next to no affinity for the norepinephrine transporter so it shouldn't make you feel anxious or panicky like quetiapine can do in some people and it has a longer half-life of 30+ hours so it won't wear off late at night before your next dose the way quetiapine IR does.

Additionally, olanzapine is pretty similar to quetiapine when it comes to metabolic syndrome like increased blood glucose and lipids as well as weight gain, but at 2.5mg that should be negligible. I gained maybe 10-15 lbs taking 5mg. YMMV though. It's very calming. You might like it. Helps with obsessive ruminations as well.

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3 hours ago, Iceberg said:

Good suggestion...just beware the sedation some get it worse on seroquel some get it worse on Zyprexa 

Yeah depends how high you have to go. But 2.5mg didn't give me a hangover at all. And if there was a hangover at all at 5mg it was really mild.

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15 hours ago, BrianOCD said:

I tried Zyprexa, wasnt a fan...

Dry mouth and just didn't feel well on it...

The dry mouth doesn't surprise me. It's a pretty potent anticholinergic. But that's also conveniently why it causes far less akathisia. And that's also inconveniently why it has such a high risk of type 2 diabetes and general metabolic syndrome.

Even though I'm not sticking with loxapine. I would still recommend it to anyone as an augment to an antidepressant. And I would go back to it if there is ever a point in my life that I would want something more mild. Believe me when I say that if you are taking loxapine 10mg at night and nothing else it has almost no noticeable effect on you during the day. It's just subtle things that change. And the medicated feeling you get when you're sensitive to AAPs (which it sounds like you are, just like me)? Pretty much doesn't exist on loxapine. Sure you'll feel slightly doped up at night after you take it but the sedation isn't nearly as potent as other AAPs I've taken like Saphris, Latuda, Zyprexa, Fanapt. You can still drive even. Once you get into 15mg territory and up you probably shouldn't drive but 10mg and below is fairly mild. The unique thing about loxapine is that while it's "classified" as a typical antipsychotic, it was one of the newest typicals before they came out with the atypicals and is actually much more of a crossover. 10mg and below it mostly touches the serotonin receptors. The half life is short, so the dopamine blocking effects mostly happen while you're sleeping. But it has metabolites with longer half-lives that are stronger at serotonin and can act as an antidepressant booster. It might help to offset the jitters from Wellbutrin as well because it has mild to moderate blocking effects at adrenergic receptors similar to Seroquel.

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