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When do you notice seroquel kicking in for depression?


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I started on seroquel on Thursday (12.5mg) and so far it's only been very sedating (although first 2-3 nights I had insomnia as well), and all day I feel fatigued and foggy, almost like taking a painkiller. I know the sedation part is supposed to lesson over time.

 

I've seen lots of posts on how long the sedation kicks in, but for those taking it for depression, bipolar, etc., when have you noticed results? My doc said 2 weeks should be more than enough but usually you see some effect relatively quickly.

 

I was prescribed it for bipolar NOS/cyclothymia/depression.

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My understanding is that somewhere around 200mg is the dose for depression. I felt a little antidepressant effect around 100mg in a couple days. I don't think you will feel anything but sedated on 12.5mg. I don't think it takes three weeks to feel the effects of an antipsychotic. At 12.5mg it is just affecting antihistamine receptors which is what makes you so tired. At higher levels it affects serotonin and even higher dopamine. Or that's the theory. There are other atypical antipsychotics that are approved to treat depression that aren't as sedating and more effective at lower doses.

 

Is a GP prescribing or a psychiatrist? Psychiatrists tend to understand psych meds better.

 

*edited for spelling and missing word.

Edited by AnneMarie
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I noticed it a few weeks after I was on a dose of 400 mgs.

 

When I was taking 25 mgs - 50 mgs it was just a very effective sleeping pill.  That dose did not help

my bipolar symptoms.  Please note that I built up to that dose of 400 mgs very, very slowly. 

I am no doctor.  This is my experience.

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I've heard a lot that a small dose is mainly for sleeping... yes it was a GP that prescribed it, although I have to say he was more thorough in his evaluation than any psych I've ever had! He did recommend seeing a psych as well, but he thought adding it to my lamictal would help; he said in his experience just a "whiff" of seroquel was helpful for cases like mine, but we'll see :)

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Is Seroquel effective for depression?

Has it worked for others here?

I am taking it as well although originally I think it was for mania and psychosis.

 

 

I'm not sure; from what I've read it does seem to be prescribed a lot for depression, but maybe more the depressive episodes of bipolar.

 

I was diagnosed with cyclothymia, but I don't have many "manic" symptoms--maybe some of the negative type like anger, irritability and impulsive behavior, so who knows... and I don't notice any cycling at all, my symptoms seem consistent. But since AD's don't work and lamictal helps some symptoms, my doc thought it was worth a try.

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a GP ?  well I am glad you found him thorough and helpful

if you have a mood disorder than you probably need more than a "whiff" of Seroquel  LOL  that is hilarious

 

this is my guess, but a GP might find anti psychotics to be pretty serious drugs that he is not trained in

so.....he gave you the lowest possible dose because he is not properly trained in this medication

 

but HECK, he is trying to help you, that is a good thing

get an appt scheduled with a psychiatrist

 

while you are waiting maybe you can persuade your doctor to give you a nice sip, instead of a whiff

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if you have a mood disorder than you probably need more than a "whiff" of Seroquel  LOL  that is hilarious

 

...

 

while you are waiting maybe you can persuade your doctor to give you a nice sip, instead of a whiff

 

Yes. This above.

 

The link below is to the Seroquel website. To the left are links to PDF docs. One is for recommended dosing. You'll see that the manufacturer recommends 300mg for bipolar depression. That should more or less hold for MDD. Technically, Seroquel is not approved for MDD, but neither is Lamictal. Both are approved for "bipolar depression" and are used off label for MDD that doesn't respond so well to antidepressants. Research supports their use, it's just that the manufacturers haven't seen the cost-benefit of going thru the formal MDD approval process.

 

https://www.seroquelxrtouchpoints.com/bipolar-disorder/?source=SERH18190&WT.mc_id=SERH18190&umedium=cpc&uadpub=google&ucampaign=Seroquel%20XR%20Professional&ucreative=Seroquel%20XR&uindrive=bpd&ubrandrive=branded%20ga&pkw=seroquel%20xr

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I take 300mg and my pdoc mentioned that at that level it was approved for bipolar depression.  I can go up to 350 or 400 if I am agitated (i.e. mixed state) but that's not my favorite either.  But I am also on other mood stabilizers as well.  I am still not completely symptom free and have a constant mild depression going on each day, so no doubt  something will get shook up in a couple of weeks when I go back in for a routine appointment.

 

And I agree with BPladybug.  It is something you build up to very, very slowly when you get into the higher doses.

 

And hey, if you like to sleep, well then this is the drug for you! LOL

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if you have a mood disorder than you probably need more than a "whiff" of Seroquel  LOL  that is hilarious

 

...

 

while you are waiting maybe you can persuade your doctor to give you a nice sip, instead of a whiff

 

Yes. This above.

 

The link below is to the Seroquel website. To the left are links to PDF docs. One is for recommended dosing. You'll see that the manufacturer recommends 300mg for bipolar depression. That should more or less hold for MDD. Technically, Seroquel is not approved for MDD, but neither is Lamictal. Both are approved for "bipolar depression" and are used off label for MDD that doesn't respond so well to antidepressants. Research supports their use, it's just that the manufacturers haven't seen the cost-benefit of going thru the formal MDD approval process.

 

https://www.seroquelxrtouchpoints.com/bipolar-disorder/?source=SERH18190&WT.mc_id=SERH18190&umedium=cpc&uadpub=google&ucampaign=Seroquel%20XR%20Professional&ucreative=Seroquel%20XR&uindrive=bpd&ubrandrive=branded%20ga&pkw=seroquel%20xr

 

Actually, Seroquel XR is approved to treat MDD as an adjunct to antidepressants at a dosage of 150-300mg/day.

 

https://www.seroquelxrtouchpoints.com/major-depressive-disorder/

 

climber47, I also think you should be seeing a pdoc. I had a bad experience with a GP prescribing me an antipsychotic. I don't think they are generally very experienced in using them, and as these drugs can have serious side-effects, you really need someone who knows what they're doing.

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Ditto to everything that's been said about 12.5mg being a teeny tiny dose.  Ditto too on the comments about GPs prescribing this kind of med.  Even my highly qualified GP (who holds a doctorate in surgery in addition to her basic medical qualification and registration as a general practitioner) calls the local university's drug information service when she needs to know something about my psych meds.  Psychiatrists not only specialise in this stuff, if they're good at what they do they're also up-to-date with the current trends and research in psychopharmacology. 

 

My apologies if this sounds like a lecture, but I feel it needs to be said: is there a reason why you're letting your GP manage your condition, especially when you say he's already recommended that you go to a pdoc?  I see you have a substantial list of previous psych meds in your signature - did you have a negative experience with a pdoc in the past? 

 

The thing is, you're really taking a risk here in getting help from a generalist rather than a specialist.  Time that you might waste being treated by someone who isn't fully trained in this area could be saved by seeing someone who does have the training.  It can take a long, long time to find the right combination of meds - why not work with someone who's made it their professional business to do this, and nothing else?  And I say this knowing full well from personal experience what it's like to work with a bad psychiatrist, but also with the knowledge of what it's like to eventually find the right one.

 

edited for clarity

Edited by miab
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Oh yeah, I know... Almost 8 years of trying meds and no luck so I know all about the process :( I have yet to find a psych who appeared to have much knowledge or didn't seem like they were using trial and error, though I know that's always part of the process. My last three have tried 2-3 meds and then dumped me saying we were out of options.

I was frustrated with my gp too so thought I'd try a new clinic and also their psychs, but they required I see a GP to establish care first; I actually didn't expect him to ask so much about my depression... But that's all he talked about so since he had ideas and id see a psych in a week, figured I'd give it a try and see what the podcast said.

Frankly I'll try about anything at this point :-/

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Oh well... whatever it's doing it's not helping and probably making my depression worse. It's really hard to remember lately since it's always so bad... it's kind of either miserable all day or miserable all day with crying. I don't get to that point most days, but the last 3-4 days have been worse, lots of crying. 

 

*sigh* was pretty hopeful for this one... well hopefully the pdoc will have some ideas, maybe a higher dose will help

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Oh well... whatever it's doing it's not helping and probably making my depression worse. It's really hard to remember lately since it's always so bad... it's kind of either miserable all day or miserable all day with crying. I don't get to that point most days, but the last 3-4 days have been worse, lots of crying. 

 

*sigh* was pretty hopeful for this one... well hopefully the pdoc will have some ideas, maybe a higher dose will help

 

Honestly, it's probably doing nothing more than sedating you, which is not what you need when you're struggling like this.  I'm sorry you're suffering, and I hope you get the help and relief you need soon.  Don't give up.

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if you have a mood disorder than you probably need more than a "whiff" of Seroquel  LOL  that is hilarious

 

...

 

while you are waiting maybe you can persuade your doctor to give you a nice sip, instead of a whiff

 

Yes. This above.

 

The link below is to the Seroquel website. To the left are links to PDF docs. One is for recommended dosing. You'll see that the manufacturer recommends 300mg for bipolar depression. That should more or less hold for MDD. Technically, Seroquel is not approved for MDD, but neither is Lamictal. Both are approved for "bipolar depression" and are used off label for MDD that doesn't respond so well to antidepressants. Research supports their use, it's just that the manufacturers haven't seen the cost-benefit of going thru the formal MDD approval process.

 

https://www.seroquelxrtouchpoints.com/bipolar-disorder/?source=SERH18190&WT.mc_id=SERH18190&umedium=cpc&uadpub=google&ucampaign=Seroquel%20XR%20Professional&ucreative=Seroquel%20XR&uindrive=bpd&ubrandrive=branded%20ga&pkw=seroquel%20xr

 

Actually, Seroquel XR is approved to treat MDD as an adjunct to antidepressants at a dosage of 150-300mg/day.

 

https://www.seroquelxrtouchpoints.com/major-depressive-disorder/

 

climber47, I also think you should be seeing a pdoc. I had a bad experience with a GP prescribing me an antipsychotic. I don't think they are generally very experienced in using them, and as these drugs can have serious side-effects, you really need someone who knows what they're doing.

 

 

Totally missed that. Thanks for clarification.

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Oh well... whatever it's doing it's not helping and probably making my depression worse. It's really hard to remember lately since it's always so bad... it's kind of either miserable all day or miserable all day with crying. I don't get to that point most days, but the last 3-4 days have been worse, lots of crying. 

 

*sigh* was pretty hopeful for this one... well hopefully the pdoc will have some ideas, maybe a higher dose will help

 

Honestly, it's probably doing nothing more than sedating you, which is not what you need when you're struggling like this.  I'm sorry you're suffering, and I hope you get the help and relief you need soon.  Don't give up.

 

 

I agree with miab.

 

The good news is that the only mood stabilizer that you've tried, Lamictal, has brought some benefit. Your past meds are antidepressants mostly or benzos. There are other antipsychotics approved for depression that work for many who didn't respond to ADs. None are not as sedating as Seroquel. But really, even Seroquel at an effective dose might help you out. You'd just want to take some time getting there.

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  • 3 months later...

This is a pretty old post, but just my 2c for what it's worth.

I'm BP2 for 20 years.

Had my first real 'breakdown' 2 years ago, lots of rage and depression, starting to get suicidal.

I saw a 'duty' psyc who put me on 25mg seroquel.

It did help the rage (mostly because it put me to sleep most of the day and night), but depression was getting worse. I did some research and found the BP depression dose is 300mg. I confronted him about it and he asked if I think it would be worth trying? (I walked in saying I want to die, and if you don't help me, I likely will), and he hadn't thought to put me on a dose appropriate for depression????

Within 4 days I was a different person.

I don't know why others suggest slow increase? Officially it's done from 50 to 300 in 4 days...

There is a bit less sedation at the higher dose, so it actually feels better to me to rise quickly (I'm experimenting with it again now, as my rages and depression are coming back)

Basically low doses are not officially recommended anywhere for treating depression, BP or otherwise, so why are so many of us being 'treated' like this.

It's a pretty dangerous drug in my opinion, with several noticeable and potentially life affecting long term side effects to be using in low doses just for sedation (unless nothing else works I guess).

I just don't get why? All you need to do is read the official leaflet to get the doses right (and very easy to find the trial data that shows why this is recommended)

I am pretty amazed by something that can take away my deep depression in just 4 days, with manageable side effects. (I have far less side effects this time than last time I was on it - barely notice that I am taking it most days)

I am not too happy to be taking this long term, and it doesn't seem to totally fix me, but it was a lifesaver. But only at the correct dose!

I could have committed suicide quite easily in the time I was waiting for my 25mg to help my depression, wondering why it wasn't working.

Needless to say, I never went back to that doc again....

Edited by GregFisk25
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