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Have I been on the wrong meds all this time?


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Hi. I was diagnosed with Bipolar II about two years ago. For my entire life that I can remember I've suffered from blissful highs followed by dramatic lows.

 

So after my diagnosis I was put on Seroquel XR. First 150mg, then 300mg and then 400mg. From the start I felt like this was the wrong medication - I asked about Lamictal and my psychiatrist sort of dodged my interest in it and said something that encouraged the Seroquel XR instead. After months of sleeping 10-12 hours a day and feeling totally drained and sluggish I was put down to 150mg, which I currently take and feel dependent on.

 

I've felt so pressured because of this drug. I can't hold a job because I fear I'll always sleep in or be out of it due to the sedation and recently it just clicked: The Seroquel XR has helped because it is simply sedating me, causing me to not think as much, face moods, etc. The mood swings are still there. They never really went anywhere. It just became more bearable on Seroquel. If anything Seroquel is a trade off...

 

Feel totally sedated and useless but have few mood swings, or have constant mood swings and feel totally anxious on no meds.
 

After reading stories of Lamictal and how BP2 is commonly misdiagnosed and treated incorrectly, I have to say I'm floored and feel like a mood stabilizer is what I needed from the start and now I feel pressured as to how I can explain this to my pdoc somehow because she been so insistent on Seroquel XR despite the troubles I've had with it.

 

All I know is I shift moods rapidly and have since I was 10 years old. Sedation helps, as you think it would, but the mood swings still occur daily, on top of irritability and constant drowsiness and lack of motivation.

Edited by Nalak
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I would say to the pdoc, next time you are, there that the side-effects of Seroquel are intolerable and you have put up with them for some time now, but you are not prepared to do so any longer. Then ask if you can't just TRY the Lamictal?

 

This might be easy for me to say, I don't know your relationship with your pdoc. But you are allowed to have limits to what you will put up with. It's hard to be assertive when you are used to taking the doctor's advice. I find it hard as well. But there comes a point when a medication is just a deal-breaker and you are allowed to say no.

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If you go to your pdoc, and say you have given this med *much more* than a fair trial, the side effects interfere with your daily life, and it is not working, she has to let you come off of it. She can't *force* you to take a med. It is true that Seroquel is used to treat bipolar illness, but it isn't really the first line treatment. Lamictal has a really good reputation for BP II, and after the initial titration, which admittedly can be rough, sedation is not a problem I hear around here too much.

 

If possible, you might want to think about finding another pdoc. Someone this unwilling to accept your input is bad news. There is no perfect med that will treat everyone equally well, and it kind of sounds like that is what her thought process may be.

Edited by crtclms
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Seroquel is the only AAP that's also classified as a real mood stabilizer. . . it's been on the table for me, but I refuse to take it. 

 

But yeah, I've come off PLENTY of meds because the side effects were awful and I've felt just like you. The dumb trade-off isn't fair at all. I've tried so many and now I'm on something that MAY work. I was on Abilify for a long time and mood was fine, but the side effects were awful. I couldn't take it. Since I've been off that, we're trying whatever the hell now. It's not fair. Lithium was great for my manic symptoms, on the flip side, I was so apathetic on that drug. Lamictal by itself and I'll still become hypomanic and that isn't always fun. Blah. 

 

Either way, any med that I gave a good chance OR the side effects were too much from the get go, none of my five p-docs to date have made me stick with. They understand when it's too much bullshit and we move onto the next thing.

 

You'll find something that's at least tolerable, hopefully. 

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  • 3 weeks later...

Just figured I'd update.

 

I ended up getting my Seroquel XR dose reduced to 50mg, which I may even taper off completely. I also got a prescription for Lamictal, starting at 25mg.

 

Here's to hoping that Lamictal helps either by itself or with this combo. I'm curious whether people add antidepressants to Lamictal as I have my doubts of my depression lifting.

Edited by Nalak
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I have been taking Lamictal for several years now. I am not taking any antidepressants with it. Lamictal stabilized my moods very well without one. Lamictal does take a while to titrate up and for you to feel some relief from your symptoms, so hang in there. Personally I love the stuff. Good luck and I hope you're feeling better soon!

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I've heard that Lamictal is often used with a lot of success for BP II. Lamictal + an AD made me go pretty high, but of course everyone's experiences are different. At the very least, I found it very effective against depression. I'm sad that it doesn't seem to work as an anti-manic for me, because it really seemed to keep the depression away, IIRC.

 

People sometimes get a little manicky during the titration phase, and, as SugarBooger said, it can take a while to get relief from your symptoms. Hang in there.

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My depressive episodes have lessened very significantly since I started taking Lamictal a couple of years ago. I have to have another mood stabilizer with it all the time though, it seems or I will be hypo pretty quickly without one, for some reason. 

 

Would be cool if the Lamictal is what works for you! I hope it does! 

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I LOVE Seroquel.  But.  I take no more than 37.5 mg on any given day.  What I really love is Seroquel combined with my mood stabilizers.  That's a hell of a dose for bipolar 2.  I couldn't function on it, I know that.  I'd just tell her, straight up.  Ultimately, you ARE the consumer, and if you aren't happy with her reaction it's your right to go elsewhere.

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