Will Posted July 23, 2011 Share Posted July 23, 2011 I'm on Seroquel XR 300. Monotherapy. No other meds. Last manic episode = Feb thru April 2011 (Ouch!). Take my 1 pill at 6 pm, altho I forget sometimes to take it then because I am used to taking lithium at bedtime. Sleeping 10 hours at night. Need to sleep less because I am working again. Suggested to pdoc that I go back on Depakote and lower Seroquel dosage. Right now he wants to keep me on monotherapy, saying don't worry about sleep. So, I'm thinking about taking the pill at 5 pm. Or, do you think sleep will regulate after I take this a while longer? Link to comment Share on other sites More sharing options...
tryp Posted July 23, 2011 Share Posted July 23, 2011 How long have you been on it? The sedation does get better with time, although I do find that I still need more hours of sleep than I did before, I'm just less groggy in the morning. It's worth trying to mess around with the dosing time to see if it helps. Sometimes it does - I've messed around with mine a few times. Link to comment Share on other sites More sharing options...
Will Posted July 23, 2011 Author Share Posted July 23, 2011 About 3 weeks. The Seroquel seems to define where I am on the spectrum. I can take more than 300 XR and not sleep much at all during mania. Edit: And because of this, I sometimes wonder if Seroquel is helping much with my mania and my sleep issues during mania. But it does seem to help some with ruminations and anxiety when I am not in mania. Link to comment Share on other sites More sharing options...
bpladybug Posted July 23, 2011 Share Posted July 23, 2011 I combine ER with regular which seems to help me get up in the morning. I take 200 mgs ER and 100 mgs regular in the evening. I can get up, and as long as I have strong coffee I can work. When I was on 300 or 400 mgs ER I was very groggy and slept a long time. Personally I found the difference to be quite extreme. Of course I had to play around with a few prescriptions to work this out - which is expensive even if just a co-pay. OH, I find that four 50 mgs ER taken at bedtime is less sedating during the day as one 200 mgs Seroquel ER taken at the same time. For me it is a delicate alchemy. But other people might have different reactions. Just tossing out a few ideas from my experience for you to consider with your doctor. Link to comment Share on other sites More sharing options...
Will Posted July 23, 2011 Author Share Posted July 23, 2011 I think you're right, bplb. It's something that may need adjustment. I like Seroquel. My main problem with it (in addition to sleeping too much right now) is the fact that I don't seem to be able to sleep much when on it (plus Depakote) when manic. When manic I would take 400 XR at night, and then take 50 mg IR maybe 2 or 3 times during the day as needed to control incipient panic. (I have chronicled my manic issues on this board --- ad nauseum to everyone else but me I'm sure.) Really, it seems to work better for me for depression, obsessive rumination, and anxiety at the 300 XR level when not manic, than it seems to help for mania at higher dosages. It may be that my circuits are fried however. Lots of top end episodes. Link to comment Share on other sites More sharing options...
december_brigette Posted July 24, 2011 Share Posted July 24, 2011 Note that some people need more than the advertised 8 hours of sleep. In my completely non-scientific assessment: maybe you do need more sleep than you used to. MI funkiness can do stuff to our brains. Thus, more sleep. Just something to think about, db Link to comment Share on other sites More sharing options...
SashaSue Posted July 24, 2011 Share Posted July 24, 2011 I think you're right, bplb. It's something that may need adjustment. I like Seroquel. My main problem with it (in addition to sleeping too much right now) is the fact that I don't seem to be able to sleep much when on it (plus Depakote) when manic. When manic I would take 400 XR at night, and then take 50 mg IR maybe 2 or 3 times during the day as needed to control incipient panic. (I have chronicled my manic issues on this board --- ad nauseum to everyone else but me I'm sure.) Really, it seems to work better for me for depression, obsessive rumination, and anxiety at the 300 XR level when not manic, than it seems to help for mania at higher dosages. It may be that my circuits are fried however. Lots of top end episodes. If I'm understanding correctly, the most seroquel you'll take when manic is about 550mg/day. I'm not at all surprised that it's not doing as much as it could for your manic symptoms, as that's a relatively low dosage, for someone in a manic episode. You can go up to 800mg, without even being off label. So next time, try going up higher, and see if that helps. Also wondering why you're taking seroquel to squash panic attacks, rather than a benzo? And, last but not least, I'm wondering why you're taking the XR, and how long you've been on it? I've tried the XR a few times, and always seem to have more trouble waking up than on the IR. Link to comment Share on other sites More sharing options...
Will Posted July 24, 2011 Author Share Posted July 24, 2011 db: You may be right and I may need more sleep than 8 hrs. I'm hoping I will regulate down from 10 hrs to 8 hrs because my work involves deadlines. I have a lot to deal with during the day, as I do my work and some housekeeping jobs. Plus I like to exercise every day. So, if I can take the quel earlier and get up earlier plus sleep a little less that would be best. Sasha: I am taking the XR since what? February? The 300 XR covers my obsessive thinking and anxiety during the day. I don't have much trouble after I get up. It's the getting up that is the issue. One reason I'm thinking of switching pdocs is that my current pdoc may not have moved me up high enough on the dosage during the episode. (Yeah, I know you will probably put some of the blame on me for not suggesting that I go up on the dosage, but I kept thinking I could get a handle the episode better than I ever did.) Plus the current pdoc seems to not to have understood my level of distress. Other than having fun talking with you and other folks on the board, I have chronicled how much rage I had to deal with during this last episode. So, I'm seeing a resident at the University, but he is overseen by a pdoc and they consult on everything. It's a way of hopefully being assigned ultimately to a pdoc at the U that I will like. The benzos I avoid because of a short history of alcohol abuse. I am afraid to be reliant on it. Enough about me. Take care, both of you. Link to comment Share on other sites More sharing options...
SashaSue Posted July 24, 2011 Share Posted July 24, 2011 Sasha: I am taking the XR since what? February? The 300 XR covers my obsessive thinking and anxiety during the day. I don't have much trouble after I get up. It's the getting up that is the issue. One reason I'm thinking of switching pdocs is that my current pdoc may not have moved me up high enough on the dosage during the episode. (Yeah, I know you will probably put some of the blame on me for not suggesting that I go up on the dosage, but I kept thinking I could get a handle the episode better than I ever did.) Plus the current pdoc seems to not to have understood my level of distress. Other than having fun talking with you and other folks on the board, I have chronicled how much rage I had to deal with during this last episode. So, I'm seeing a resident at the University, but he is overseen by a pdoc and they consult on everything. It's a way of hopefully being assigned ultimately to a pdoc at the U that I will like. The benzos I avoid because of a short history of alcohol abuse. I am afraid to be reliant on it. Enough about me. Take care, both of you. I don't think it's remotely reasonable for any manic person to be expected to have good ideas about what to do with his or her meds, or to offer a realistic assessment of how severe the episode is. There's that whole lack of insight thing, you know? I wonder if it would be possible to meet with your current pdoc's supervisor, to address some of your concerns? Link to comment Share on other sites More sharing options...
Anna Posted July 24, 2011 Share Posted July 24, 2011 I agree that the ER at bedime might be worth a shot. You MAY get less sedation in a few weeks, but I never have, and I've been on quel for years. I HAVE to take mine at night there is no other option. With that said, the danger of switching to ER might be taht you don't get controlled coveraege the next day, etc. Going up can LESSEN sleep issues in some folks (never does for me) going below 300 isn't really going to make you less sleepy and sedated at all, as even at extremely low dosages, quel is highly sedating. Anna Link to comment Share on other sites More sharing options...
Will Posted July 24, 2011 Author Share Posted July 24, 2011 I took the 300 XR earlier in the evening and was able to get up earlier. It was a bit of a struggle to get past the 2-3 hour mark after taking it, but I did and went to bed at my normal midnight. I just need to take it earlier I think. Sasha said: "I wonder if it would be possible to meet with your current pdoc's supervisor, to address some of your concerns?" I think I just need to change doctors. I am in the process of doing that. It's probably 1 episode too late to make the change, but better late than never. Anna said: "the danger of switching to ER might be that you don't get controlled coveraege the next day, etc." I call it IR for immediate release but I know what you mean. No, I think I need to stick with XR for the controlled coverage. Maybe if I get hypo I will go to a combination of XR for the extended coverage, and IR for sleep. Bottom line, I think Seroquel works for me, I just need to tweak how I take it a little bit. Link to comment Share on other sites More sharing options...
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