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Lithium and Seroquel


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So tonight I went to the pdoc (you can read all about the experience in the Bipolar forum under "What do you guys think?") and he wants to start me on Lithium and Seroquel for OCD! He disagreed with a BP II rapid cycling diagnosis and says he believes my OCD is causing depression and this is the cocktail he wants me on.

Has anyone EVER heard of a Lithium and Seroquel combo (or either drug alone) being used to treat OCD? I don't think I ever have.

Echo

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Guest Guest_december_brigette_*

Hey,

I just logged off....but my pdoc said almost the same thing. I have been on seroquel 300 mg for longer than a month. and today he suggested adding lithium. i dont know about it. so i suggested we raise the seroquel and see what happens. he agreed.

so, i guess this is the combo d'jour.

i'd love to hear anyone else's opinion (as i stated on my springer thread).

really its me,

december brigette...aka deck bridge

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Hey,

I just logged off....but my pdoc said almost the same thing. I have been on seroquel 300 mg for longer than a month. and today he suggested adding lithium. i dont know about it. so i suggested we raise the seroquel and see what happens. he agreed.

so, i guess this is the combo d'jour.

i'd love to hear anyone else's opinion (as i stated on my springer thread).

really its me,

december brigette...aka deck bridge

<{POST_SNAPBACK}>

And you suffer from OCD as well? Or, what is your full dx?

I also have panic issues. Guess it's all the anxiety being interconnected.

OH! And how did you find the seroquel when you first started? How bout now? I'm so worried about somnolence. I have to drive an hour to and from work everyday. I'm scared about falling asleep randomly. What about any weight gain, hair loss, etc?

God, I am so scared of meds. Maybe I should just stay unmedicated.

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Hi Echo & All,

Last I asked, my official dx was depression & anxiety. although i think i am bp1. and the suggestion of lithium increased my perception that i am bp1. although i know people take lithium for a variety of reasons.

I first started the seroquel at 25 mgs and worked my way up to 300. If i remember correctly, i started it in april. i'd have to go check my paper records. and the 25 knocked me out. usually the 300 will knock me out. and since i'm trying more, i took 100 when i came home this evening and felt very sleepy. it took everything i had to stay awake. and now i'm stuck - awake.

i'm also taking paxil 80mg and xanax xr 1mg. in the past i've tried effexor xr 150 and felt horrible. i also took ambien for a while and then it pooped out on me.

i have a lot of sleep issues....it is really difficult for me to fall asleep. but now on the seroquel, i tend (except for tonight) to fall asleep right away. i usually sleep anywhere from 7-16 hours depending on what i've done during the day. i am currently not working.

december

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I'm on 900mg Lithium and I have taken Seroquel, for Bipolar not-yet-specified and its attendant insomnia. At first, my pdoc tried lithium monotherapy, then added 25 mg Seroquel to help compensate for frequent waking. Seroquel worked better some nights than others, leading to experiments with a few other options.

The 25 mg initially knocked me out for the night, which is precisely what I wanted. Very shortly, however, it stopped showing any consistent sedative effect. The sedation, for me, was transient.

No hair loss, weight gain, or other odd symptoms. It hasn't helped with my food issues, but I don't think the Seroquel worsened them, either. If you do begin taking Seroquel, keep an eye on changes in your eating patterns, as many people do find themselves craving sweets in particular. There is a thread devoted to the probability of Seroquel weight gain in the atypical antipsychotics forum.

Echo, I was terrified of meds myself. In the ten months which elapsed between my initial misdiagnosis ("fine!") and my eventual official diagnosis, I was hesitant to pursue reassessment because of what I knew that would mean: being labeled bipolar and put on any combination of terrible meds for life. Would it be worth it? How could we know anything? Wasn't psychopharmacology a giant crap shoot?

In my experience, it hasn't been all that bad. There are risks both major and minor, but for those of us with mental problems there are significant potential benefits. My mood shifts have been flattened. I generally don't make a public spectacle of myself with meltdowns. I have a flickering hope that I may be able to graduate, I may be able to hold a job I like for more than six months, and I might be able to figure out what is me and what is the disorder. I admit, I'm new to this (four months), but lithium and even the Seroquel have helped me so far. And I have a little collection of found marbles (from sidewalks and gardening) in my meds cabinet, just in case.

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Another endorsement for the pair --

I am bp-probably 2, on Lamictal (and a little Wellbutrin, which I'm tapering) with lithium (variable dose, about 600-750 for maintenance, which is quite low for me, blood level probably about 0.4) and sometimes Seroquel 25-75.

While not OCD and not up to speed on its treatments, I've had plenty of anxious rumination, and been in a major-league depression for most of a year.

Lithium & Seroquel are both great for that.

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Thank you all for your replies.

I don't know what I am going to do.

I absolutely cannot be tired like that at any point. I must wake up very early and drive to work in rush hour traffic for about an hour in the morning. I then must stay awake all day preforming my duties for my job. I definitely can't handle being somnolent before, during, or even after work as my job depends to heavily on my being alert. I don't think I can try these meds. I don't think I will physically be able to handle it especially if the knock out effects of both can last for the entire course of treatment. The best I could do is start the meds on a friday evening or saturday morning and have the weekend to be all wonky but come Monday I would not be able to tolerate that.

Any advice?

I am seriously considering the fact that I should try and stay away from meds in general (again). As scary as this sounds, I just can't handle all the crazniness and un-stability that comes along with them. Unless I were on some sort of dissability, and not working, but I can't do that.

So....

*sigh*

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I take 1800mg of lithium daily and seroquel as needed. I don't find the lithium makes me one bit sleepy. Lithium might encourage a good night's rest at the very tail end of the night, but you would not have problems in the morning, at work, or during your drive home.

And lithium the least destabilizing thing I can think of. With the exception of situations of extreme duress (and even then it helps) it keeps me completely even-keeled most of the time.

As for Seroquel, it's likely to make you sleepy. That's just the way it is. But everyone's different. I'd advise checking it out over a weekend, preferably a long one like the one we just had.

If you know that you have MI issues and that you need a medical intervention, doing otherwise is, well, crazy. There are plenty of other places on the site to tell you the same thing. And you can't know for sure until you try.

Good luck

K

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If alertness is a major issue during the week, then going with a long weekend trial is likely your best bet. Lithium, for me, didn't cause drowsiness. I felt a little more worn down for about a week after each dose adjustment, but by and large it didn't affect my ability to function. Well, except for being more scattered than usual, but I am the queen of distractibility on the best of days, which likely contributed.

The worst drowsiness Seroquel can cause typically shows up in the first few days of treatment. For some people, this effect lasts longer, but not necessarily most people. If you titrate slowly, starting every increased dose right before the weekend, there's a good chance you'd be fine. If not, perhaps another solution can be devised. Just please don't consider lack of treatment a viable option. If you know there's a problem, fix it; don't hide it. We just need to find the right thing for you.

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Guest Echo unlogged

If alertness is a major issue during the week, then going with a long weekend trial is likely your best bet. Lithium, for me, didn't cause drowsiness. I felt a little more worn down for about a week after each dose adjustment, but by and large it didn't affect my ability to function. Well, except for being more scattered than usual, but I am the queen of distractibility on the best of days, which likely contributed.

The worst drowsiness Seroquel can cause typically shows up in the first few days of treatment. For some people, this effect lasts longer, but not necessarily most people. If you titrate slowly, starting every increased dose right before the weekend, there's a good chance you'd be fine. If not, perhaps another solution can be devised. Just please don't consider lack of treatment a viable option. If you know there's a problem, fix it; don't hide it. We just need to find the right thing for you.

<{POST_SNAPBACK}>

Thanks for your replies.

*sigh* I am so torn. I am so afraid to start meds. I am terrified. I don't know why. Too many unknowns.... I know I need to get better, but sometimes it seems like I'm not doing THAT bad unmedicated and I can function (go to work, etc.) so I may as well stay this way. But then at the same time I have been working so hard to try and get myself better.

Anyways, today is a bad day. I'm in the middle of an anxiety attack right now so it's probably not the best time for me to be thinking about stuff like this.

Thanks again for your insights.

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Hi,

I, too, appreciate everyone's input as it looks like i too will be taking lithium with my seroquel. i'm now up to 500 seroquel. i'm concerned about all the blood tests that are required when one's on lithium. i'm also afraid i wont drink enough water. but i guess those are my anxieties.

i'm on a vacation from my vacation - seinfeld line. once i go home then i'll start the lithium.

thank you so much....an if anyone else has any suggestions, or revelations, please post!!

I'm right there with you echo. (except that i'm already on the seroquel)

love,

december

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Hi,

I, too, appreciate everyone's input as it looks like i too will be taking lithium with my seroquel. i'm now up to 500 seroquel. i'm concerned about all the blood tests that are required when one's on lithium. i'm also afraid i wont drink enough water. but i guess those are my anxieties.

i'm on a vacation from my vacation - seinfeld line. once i go home then i'll start the lithium.

thank you so much....an if anyone else has any suggestions, or revelations, please post!!

I'm right there with you echo. (except that i'm already on the seroquel)

love,

december

<{POST_SNAPBACK}>

December,

It's nice to know that someone else is there with me.

I'm glad you can benefit from this discussion also.

Tell me something - How did you find starting the seroquel? Were you extremely tired, groggy in the morn. etc? What dosages did you start at and increase by? How did it make you feel all together? Tell me all about it! (If you don't mind.)

Thanks so much,

Echo

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  • 3 weeks later...

Hi Echo,

sorry it took me so long to respond.

i started seroquel at 25 mg and it immediately put me to sleep. i now take 500 mgs of seroquel. i usually fall right to sleep...unless i'm manic (which is why i'm probably gonna get the lithium). and i sleep anywhere from 5-12 hours...depending on what i'm doing, stress, people in the house, etc.

i'm not working. i dont think i can work. i'm currently working on getting disability. so, if you can work, go for it. but if you cant work, like i did, i would seriously consider trying to get some form of disability. right now i'm living on faith & a divorce settlement.

good luck!

december

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I understand your hesitation about taking these crazy meds.  I think every one does. I went to a support group where a guy recovering from depression and drug addiction said, "I've been doing heroin for a year, and suddenly I'm staring at Paxil, worried for the first time about what a drug would do to my body!

Echo, the downsides to these meds are real, but keep in mind that when you're on these boards, people are posting here mostly because they're having problems.  They're all real problems, but it's a skewed sample.

I've been on crazy meds for about 18 months, and we've cycled through a number of different things.  The depression eased, but I was also tired and flat.  Then the doc wanted to try lithium, and it took me more than a week after filling the prescription before I had the guts to take it.  And suddenly....

Suddenly, I felt like I was waking up for the first time in my *life*.  Every single one of my friends, all of my family, have said the change was obvious, and they've never seen me doing so well.  I was grocery shopping the other day, and as I was walking down the aisle, I realized I was smiling, and that I was happy.  I pee a lot, I tremble, I need to get 8 hours between taking meds and needing to wake up, but these things are so unbelievable insignificant compared to how I've felt these last two months.

To wit, the downside is real, but so is the upside.

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I would have to say , I am a long time sufferer of being me! this has now been diagnosed as ADHD and Bipolar, they treated symptems first with Concerta, 6 months , had my family keep watch and then diagnosed the bipolar. treated with Lithium started with 600mg and now at 1800mg i feel healthy and alive at 1200 had slurred speach and felt mentally sluggish on occasion.  I was then given seroqual 25 mg. I for the first time in my life sleep for 5 to 7 hours with out waking up and i feel !!!!  I am far from well but i am willing to sacrifice my hair for the day to day hope. Enough said

thanks

Thank you all for your replies.

I don't know what I am going to do.

I absolutely cannot be tired like that at any point. I must wake up very early and drive to work in rush hour traffic for about an hour in the morning. I then must stay awake all day preforming the duties required for my job. I definitely can't handle being somnolent before, during, or even after work as my job depends to heavily on my being alert. I don't think I can try these meds. I don't think I will physically be able to handle it especially if the knock out effects of both can last for the entire course of treatment. The best I could do is start the meds on a friday evening or saturday morning and have the weekend to be all wonky but come Monday I would not be able to tolerate that.

Any advice?

I am seriously considering the fact that I should try and stay away from meds in general (again). As scary as this sounds, I just can't handle all the crazniness and un-stability that comes along with them. I seem to be damned if I do, damned if I don't. I'm crazy and unstable either way. If I were on some sort of dissability, and not working, that would be the best course of action for me to get better, but I can't do that.

So....

*sigh*

<{POST_SNAPBACK}>

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