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Switch from Seroquel XR to IR inducing hypomania?


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I'm a first-year grad student and quite a ways from home and thus my usual pdoc and GP. In need of a refill I saw the psychiatrist at our student counseling center. Claiming that the XR was nothing but a cheap attempt to extend the patent, he switched me from 300mg XR to 300mg IR. My wallet loves it, but I don't. I'd been more or less episode-free for three years but I've recently experienced a roaring return of anxiety, my subthreshold panic attacks, and hypomanic symptoms. I chalked it up to midterms, general grad school stress, or just being a weak baby, and after going home to see my GP this week, we decided to try increasing the dose to 400mg to see if that would reign things back in. But it's just dawned on me that the onset of the return of my symptoms lines up fairly well with my switch to the IR. I've seen a lot of people posting about transitioning from the IR to the XR, but not much about the other way around. Anyone else had the IR train dropped on em?

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I am not on seroquel now, but knowing you went from XL to IR says a lot.  The XR slowly delivers the med to your body over time.  When you take an IR, the med comes out all at once, which could cause a person to feel hypomanic (not everyone, but for some people).  It happened to me with Wellbutrin, but it went away as my body got used to the med.

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I prefer XR when acute, IR for maintenance.  Cost is a factor for me.  But if you have more confidence in XR, and it has worked well for you, I would think you could/should go back to XR at least until you are in a less stressful period of life.  If there is any way to discuss this with your usual pdoc, it would be worth the effort to get in touch.  Also, the school doc would reconsider the change in meds upon reconsultation.   


 

   

Edited by Will
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I was on IR for years and years and finally got my pdoc to change me to the XR. I like the XR better. I feel I'm doing better on it. I was taking the IR 3 times a day and at one point 4 times a day. It's much easier to take it once a day IME. 

I'm not quite as tired and have been able to even lose some of the zyprexa weight, although very slowly. 

Are you taking the IR once a day? The half life of IR is not long at all. IR's half life is 6 hours it says. So you may be experiencing symptoms because of lack of coverage from IR. 

I loved the cost of generic IR a lot too. But paying for XR is worth it for me.  

Hope that makes sense. And as always discuss all of the above with your pdoc. 

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On November 6, 2015 at 11:24:55 PM, Will said:

I prefer XR when acute, IR for maintenance.    

That's funny-I feel exactly the opposite way. (Not saying you're wrong, Will, everyone is different.) I took the XR for years and loved it, and I pile on the IR when shit starts gettin' weird all up in my brain. 

My point is I do think they work very differently, and feel very different, and if you do better on the XR, stay on it.

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