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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by tonyz on May 23, 2009, at 13:22:31
My doc thinks the best way for me to get better is to combine Seroquel and Nortriptyline. This combination has worked well for me in the past. I was in a very bad state a year ago and went into a hospital as an outpatient. I was barely functional; couldn't do anything. The combination of meds that they gave me vastly improved my condition.
However, as mentioned before in other threads I have a tremendous fear of taking any neuroleptic. My doctor has admitted that some of his patients who take Seroquel have lost some of their creative abilities while on the drug. I don't know the dosage or time period.
When I was in the hospital I think they started me with 400mg. During the past year I have had several recurrent episodes. They were treated with Seroquel and Notriptyline and a benzo (either diazepam or clonazepam).
I don't think I have an alternative to taking the Seroquel at this point I have gone into serious relapse - I don't think I will have to take it the Seroquel for more than a few months. For the past 6 months my sleep pattern has been a mess and I've accomplished very little, also having a lot of memory problems.
I can't objectively evaluate whether it is the meds, the lack of sleep or the depression - I suspect a combination of all three.
What would really encourage me right now is to hear some positive responses about Seroquel used as an adjunct for major depression. I worry that this drug may have permanent cognitive side effects. I was on it for a few months last year - didn't have any problems tapering off and as far as I knew I was fine, but then an event in my life occurred which caused me to relapse into a deep depression.
Similar combination of meds was used but when I tapered off I relapsed. Went back on the drugs got better, tapered off and relapsed. In the past the relapses have never been this quick. I don't like staying on the drugs for the long term because of side effects.
So if someone has some postive stories they can share about their temporary use of Seroquel in combination with an AD and how they got back to normal and were fully functional in their career that would be great to hear. And also if you wouldn't mind telling me what dosage you were on. It is not to self medicate. I am following docs instructions -- it is just to gain some additional assurance. Thank you.
Posted by Zana on May 23, 2009, at 14:51:55
In reply to Problems with taking Seroquel, posted by tonyz on May 23, 2009, at 13:22:31
I had been taking 300mgs of seroquel for about 6 months and am now tapering off. I can't quite put my finger on it but there was something about it that I didn't like. I think it made me feel blunted and not like myself. I am down to 150mg now, tapering at 50mg every 3 weeks. I too am worried that without it I will relapse. I was not too worried about cognitive side effects but it does have a pretty crummy side effect profile for diabetes and cholesterol.
If it is the only thing that is keeping you from relapsing... its a tough choice. Have you tried any of the other atypicals? I have tried them all and got some benefit from Abilify. I honestly don't know if they are more likely to cause long term side effects than any other class of med. Sounds like you've had a very hard time of it and staying stable on a med that works is probably worth it. Has your pdoc had any other suggestions about other meds?Zana
Posted by tonyz on May 23, 2009, at 15:28:46
In reply to Re: Problems with taking Seroquel, posted by Zana on May 23, 2009, at 14:51:55
Thanks for your reply - I guess because I had such a good response when I was in the hospital that was the reason. I was told this will make you better faster. Generally when I go off my meds completely I feel great but unfortunately I don't stay that way for a long time. I also am concerned about diabetes and other side effects, but I started back at 50mg last night. When I was in the hospital as an outpatient I took Nortriptyline, Seroquel, abilify and valium. I had discussed a reduction plan with my doctor, I think the first thing to go was the abilify, then the valium (not sure I would have to check), then the seroquel and lastly the Nortriptyline. The combination of the Nortriptyline and Seroquel makes me shaky. Actually the Nortriptyline by itself tends to do that at the dosages in the range of 150 for me. Doc also thought the abilify can have that effect,
To my surprise I had no problems reducing the Seroquel and no relapse from not taking it. If it is helpful for you I will gather up my notes and post a follow up of exactly what I did, i.e. how the medications were tapered and how long I was on them. I need to do this anyway because the doctor I have been seeing is out of network and getting too expensive. Were you just taking seroquel or taking that in combination w/ something else?
Posted by Phillipa on May 23, 2009, at 17:36:25
In reply to Re: Problems with taking Seroquel, posted by tonyz on May 23, 2009, at 15:28:46
Were your levels of nortriptalline within normal range for the med. What diagnosis? Phillipa
Posted by tonyz on May 23, 2009, at 17:57:07
In reply to Re: Problems with taking Seroquel » tonyz, posted by Phillipa on May 23, 2009, at 17:36:25
> Were your levels of nortriptalline within normal range for the med. What diagnosis? Phillipa
Recurrent major depression, blood levels were in the normal range, but I tapered off that along with other meds. Docs know I don't like taking meds - always looking for an alternative. Had mentioned in another post that I had taken SAM-e for a while, but there is not a lot of experience with that and the levels required to lift a major depression would add to the insomnia.
I have heard this from more than one pdoc that I should be on a mood stabilizer. I just don't know. These are difficult choices that we all have to make.
Anyone ever try cognitive therapy and found that to be effective?
Posted by Zana on May 24, 2009, at 11:49:50
In reply to Re: Problems with taking Seroquel, posted by tonyz on May 23, 2009, at 15:28:46
I have never taken seroquel without another med. I think the fewest meds I was taking with it included remeron and klonopin. I never liked it but it did give me some relief when I was most depressed. And, as I said in my last post, I am hoping to be able to get off it without any recurrence of the depression.
Why do you keep going off your meds?
Sounds like you get your depression under control and then right away go off the meds? Maybe you need to find a combo that works and that you can stick with. I hate being on meds too and am always thinking about what I can drop. But then sometimes I catch myself and think, hey, if I'm feeling pretty good, why mess around with it?Zana
Posted by tonyz on May 24, 2009, at 19:29:19
In reply to Re: Problems with taking Seroquel, posted by Zana on May 24, 2009, at 11:49:50
Zana,
Appreciate your kind words. Generally when I get off my meds I feel great, but unfortunately it doesn't last. I get off because of the side effects. I keep hoping for an alternative, but I haven't found one yet. Now I am a wreck. My body just feels so much better when I'm off the meds and I usually don't relapse that quickly. This year has been especially terrible. All meds carry some risk and yet there is no guarantee that you will not have a relapse even if you stay on them.Sometimes I think of my depression as just a bad pattern that my brain has developed and keep hoping to be able to break the cycle, but I foolishly think that once I get better it will never recur. Very foolish I know. I worry a lot about the side effects from the drugs.
Looking at my notes from last year was up to 400mg of Seroquel. I had started in Feb of 2007 at 50mg got up to 200mg and then stopped it. I was taking sam-e at the time and was worried about that combination. About mid-march started at 300mg a lot of adjustments up and down, hospitalized in April of 2008 once I got better the reduction of the Seroquel was 25mg every 4 days. Now I am ramping up to 200mg started with 50mg also increasing Nortriptyline as well. In May of 2008 when I got off the Seroquel I didn't have any problems. My hope is that the augmentation of the Seroquel with the Nortriptyline will do the trick, then I'll back off on the Seroquel and the valium and will have to hold the Nortriptyline for a longer period of time at least at around 125-150mg. I will have to deal with the shakiness.
Then consider a mood stabilizer or something. The consensus seems to be lithium or lamictal - neither is attractive. Also thinking about cognitive therapy and perhaps some very unorthodox methods. I've been taking yoga for a few years now and I thought that helped a bit with this last bout, but it wasn't enough to stop it. There are some elaborate breathing techniques that are designed for different illnesses. I'm told the effects are subtle, but they do work and this is from someone who has a deep medical background. I don't know if there is something specific for depression. That is what I will investigate.
Sorry long answer to your short question. I hope you are doing ok with your meds and as I mentioned I had no problems tapering the seroquel last year. This year I'm not sure why things didn't work out as well probably wasn't on it long enough.
When I was in the hospital the doc I had mentioned L-tryptophan and he advised taking it to help for sleep. If you check for drug interactions with this and Nortriptyline there is kind of a red flag but I didn't have any problems. I may suggest that with my doctor now.
Now I am just very fuzzy and going downhill, lots of memory problems. Hard to watch a movie. This has happened before I just hope I recover.
Anyway good luck to you and others that are in similar predicaments.
Just curious are you taking the Seroquel as an augmentation for depression or for something else?
> I have never taken seroquel without another med. I think the fewest meds I was taking with it included remeron and klonopin. I never liked it but it did give me some relief when I was most depressed. And, as I said in my last post, I am hoping to be able to get off it without any recurrence of the depression.
> Why do you keep going off your meds?
> Sounds like you get your depression under control and then right away go off the meds? Maybe you need to find a combo that works and that you can stick with. I hate being on meds too and am always thinking about what I can drop. But then sometimes I catch myself and think, hey, if I'm feeling pretty good, why mess around with it?
>
> Zana
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