i need scotland yard not a pdoc

i am back from my mania, a bad and unsafe trip. Possibly i am having a gentle landing but is it only a stop over, i.e.  eventually shall i plunge into depression my extended trip. nobody knows.

i tried lithium, lamictal and with no success, it seems i am addicted to the antipsychotics or that is how i was brought up and fed upon.

i read in wikipedia that seroquel can be used as monotherapy, meaning good also for depression and approved by the FDA. Whether it's the usual release or the XR only i don't know. In egypt we have the usual one only.

my dose before the mania was 50mg to prevent me from getting manic along with 1mg risperidone (it helps too) and 2mg stelazine (a typical AP). I wanted to stop the last one for its side effects so like a baloon throwing sand i went up immediately and took 3 weeks to go down. While up i was on 200mg of seroquel but now i began to be lethargic. If i lessen my dose will it still work as monotherapy or only antimanic. I phoned my pdoc this morning whom he set a date to see me on saturday, he is busy taking another free trip sponsored by the pharm comp, so he can't miss it of course. I even phoned astra zeneca branch in egypt and pretended to be a pdoc who has a patient very difficult to treat and need to know more information about seroquel. They promised to send a person from their sales' office to meet with me in my clinic so i replied that the phone conversation is enough. i know how they promote well especially that while sitting in any pdoc clinic a bunch of different sales representatives come and go, the assistant even let them meet the doc before the patients since they offer a lot of goodies. the last conference was in sharm el-sheikh.

so which dose for me you think is good for depression. also WHY a small dose 50 makes me sometimes lethargic and needs reduction while the pdoc gave me 200 during my mania and it worked OK . Of course that was diuring the mania but i am slipping down so i don't need that much but i fear if i go back to 50 say it won't be of any use but only a sedative. What is the starting dose foir helping in depression.  should it be the XR, or would a kind person you folks can assure me that he used the normal one and it helped him
thx  

[ILADVOCATE]

Well ideally you should speak to your doctor about it but you don't need to ask to speak to a person from the company (regardless of returning calls they would only speak to a doctor within their regulations). Go to the medication website and go to the section of the information about Seroquel that is meant for physicians. That would of course not in any manner substitute for  a psychiatrist's advice but it would give you the full information. Seroquel can be used as an adjunct antipsychotic but I believe for its standard use as an antipsychotic and mood stabilizer the starting effective dose is 300 mg. but a psychiatrist would have to explain this in full and of course each person responds differently and some people need more so that's clinically complex. All of the atypical antipsychotics are FDA approved as mood stabilizers as well and some are less sedating than others and each person responds differently so its a matter of finding the right one. As always with antipsychotics its best to have one at an effective dose then several at a subclinical dose for reasons of safety and efficacy but as for which antipsychotic and what dose you'd have to discuss that with your psychiatrist. Seroquel is not used as an anti-depressent alone but for it to have full mood stabilization properties including on depression as well as mania it would have to be at a working dose.

[ILADVOCATE]

Well ideally you should speak to your doctor about it but you don't need to ask to speak to a person from the company (regardless of returning calls they would only speak to a doctor within their regulations). Go to the medication website and go to the section of the information about Seroquel that is meant for physicians. That would of course not in any manner substitute for  a psychiatrist's advice but it would give you the full information. Seroquel can be used as an adjunct antipsychotic but I believe for its standard use as an antipsychotic and mood stabilizer the starting effective dose is 300 mg. but a psychiatrist would have to explain this in full and of course each person responds differently and some people need more so that's clinically complex. All of the atypical antipsychotics are FDA approved as mood stabilizers as well and some are less sedating than others and each person responds differently so its a matter of finding the right one. As always with antipsychotics its best to have one at an effective dose then several at a subclinical dose for reasons of safety and efficacy but as for which antipsychotic and what dose you'd have to discuss that with your psychiatrist. Seroquel is not used as an anti-depressent alone but for it to have full mood stabilization properties including on depression as well as mania it would have to be at a working dose.

[adel_ezz]

Thank you IL as always come to help

I was on 200mg along with 1mg risperidone and 1mg stelazine. I killed my mania with 300 seroquel. Then i descended, not yet depressed, but started to feel lethargic and suffocated by the high dose especially that i never exceeded 50 before the mania. so i reduced it to 150 and started to feel great and i had already cut the stelazine.

but yesterday it was awful full of anxiety and fears and agitated, so i said to myself why not to take the stelazine. I took it in the afternoon and life was smiling back at me. Somehow the stelazine not only an AP but it is kind of tranquilizer and it has always been like this for me. Besides 1mg is minimal i know a person who takes 15.

>>Seroquel is not used as an anti-depressent alone
i don't get you. does it mean i shall use anyway an AD to go along with it?
thx

[ILADVOCATE]

No I meant Seroquel has full mood stabilization properties, not just anti-depressent properties.

[starbunny]

When treated for the depression the pdoc changed my seroquel from quick release to XR. Immediately I found it difficult to sleep and it triggered a mild hypomania, but nothing serious. However it lifted me out (if a bit too quickly) of the depression. If you are finding the sedative effects of seroquel beneficial for sleep you may lose this with the XR.