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I am currently severely depressed at the moment, and have been for months.

I am currently on Trileptal 300mg, Risperdone 4mg, Zoloft 200mg, Ambien 20, with Dexidribe 5mg and Nuvigil PRN.

I have been considering when I have felt my best treating whatever it is that I have. (My Dr has said I may be mildly bipolar, and I agree with that. He has also, however said that he's not certain if my depression is bipolar and unipolar.) I recall feeling best on Seroquel as monotherapy. I was taking 125-150mg a night and I would feel fantastic until around 6 at night, when I would start to bawl. You could set your watch to it. My Dr thought that maybe I would need to take 25 mg in the afternoon, but at the time that wouldn't have been workable with Seroquel being as sedating as it is. So eventually we stopped the Seroquel completely and moved onto other mood stablizers. I am considering approaching my pdoc about starting Seroquel again.

So here are my questions:

Between Seroquel IR and XR, which one will knock me out more during the day? I need to be able to function.

I work and I am going to school and I am trying to plan this carefully. Im thinking of starting it over some vacation time. Lately I have also been taking 50mg of Seroquel at night because I am trying to eliminate Ambien to see if that improves my mood at all. Even at 50mg Seroquel, its not that sedating for me.

How long does it take to be affective on depression, and how much time should I allow?

Should I keep my Trileptal as my main mood stablizer or will the Seroquel be enough?

Can Seroquel manage the depression enough that Zoloft won't be necessary?

How does it affect you cognitively?

And finally, I am interested in hearing from those who are mainly on Seroquel. How has it been? Do you take just IR, just XR, or a combination? How has it been affective? Any details would be great.

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I'm on Seroquel with my SSRI. I started off just being on 150 mg at nighttime for sleep, along with Remeron. Then I switched from Remeron to an SSRI, which made me anxious. So I added some daytime Seroquel. I'm currently on 150 mg IR at night, and 100 mg XR in the morning.

I'm pretty tolerant to sedation - I can take IR in the daytime and not really feel it - but the XR is definitely less sedating, so it's good for daytime use. I like taking my Seroquel half and half the way I do, because I still get the sleep effect at night, and then a longlasting anxiolytic effect during the day. If you need a sleep aid and anxiety/mood control, I'd really recommend divided doses with XR in the morning and IR at night. It might not work for you if you have sedation issues, but it's been great for me.

I find that when I increase my dose, I feel it within a couple of days, but I remember that it took a few weeks to kick in in the first place, in terms of the anti-depressant effect. I think I started to feel an AD lift around 200-250 mg.

Anyway, Seroquel is a really good med for me - my brain just loves it. I take a little extra PRN for anxiety/agitation as well, and that's really good. It helps me with depression and anxiety, and sleep. I don't know how well I'd do on it without an SSRI and I wouldn't really want to try, but it's the real powerhouse of my cocktail, IMO.

I can't speak to what other meds you'll need while on it, but if it were me, I'd add some and see how it goes, and then if it goes well, look into juggling your other meds later.

Anyway, if there's anything else I can help with, feel free to PM me - I've never been above 250-300 mg, but I've done just about everything below that.


P.S. Oh yeah, cognitive stuff. I don't remember anything too bad. I had a bit of a hangover during the day for the first little while, and I think I had some trouble finding words, but nothing intolerable, and I'm in school too.

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