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seroquel in low dose ?
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seroquel in low dose ?

I still don't understand how seroquel functions.

I know it's a strong antimanic I used it (300mg) last year to extinguish my mania and right now i am using it as a mood stabiliser in 100mg.

The reason why i kept reducing my dose from 300 to 100 is that i began to sleep monotonically and lose energy so i tried to up my dopamine. But strange my mood used to improve regularly as well, which i can't understand. I know it has some antidepressant effect in high doses like it's said in different sites, but what about in low doses ?

My problem is that I never understood the relationship dopamine seretonine. I know that atypical AP's like this one work on the dopamine only. So theoretically speaking by reducing the dopamine the energy gets higher, but I was always afraid that by increasing my energy i run the risk of a mixed state since i am widening the gap between the mood and the energy since this AP is not supposed to change the mood.

Now I am on 100mg and feel lethargic again, I reduced my dose by 25mg this afternoon. My energy was up but ALSO my mood. Of course if my symptoms return back then I shall rush to get back to 100mg again.

But my question right now: is by reducing my dose, BOTH my energy and mood will improve ??

I am relying on your experience i.e. clinical sense and not your readings.

finally another relevant question out of curiosity: Do the antidepressants in principle improve the energy or the mood ONLY or both ?.

grateful

Ezz    

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585414_tn?1288944902
  Actually Seroquel works on serotonin receptors as well. "Quetiapine (seroquel) is an antagonist at serotonin 5-HT2A receptors. It is also a low potency dopamine D2 receptor inverse agonist"  This has noted in standard clinical journals but they are just finding out more about it. Its not a matter of energy. Its a matter of promoting full mood stability than just treating depression only and creating the potential of mania (which can happen with anti depressents prescribed for bipolar especially on their own) and since Seroquel has been FDA approved as a full mood stabilizer and works in that regard (as I remember when I was prescribed it) it has full efficacy in this area but there is still continuing research (unlike its effect on schizophrenia which is known) to understand exactly why. You could discuss all this with your psychiatrist but like all medications to work it has to be at a working dose which you could ask your psychiatrist about as well.
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574118_tn?1305138884
>>> So theoretically speaking by reducing the dopamine the energy gets higher,

sorry i meant by reducing the seroquel the energy gets highert
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585414_tn?1288944902
  Actually Seroquel works on serotonin receptors as well. "Quetiapine (seroquel) is an antagonist at serotonin 5-HT2A receptors. It is also a low potency dopamine D2 receptor inverse agonist"  This has noted in standard clinical journals but they are just finding out more about it. Its not a matter of energy. Its a matter of promoting full mood stability than just treating depression only and creating the potential of mania (which can happen with anti depressents prescribed for bipolar especially on their own) and since Seroquel has been FDA approved as a full mood stabilizer and works in that regard (as I remember when I was prescribed it) it has full efficacy in this area but there is still continuing research (unlike its effect on schizophrenia which is known) to understand exactly why. You could discuss all this with your psychiatrist but like all medications to work it has to be at a working dose which you could ask your psychiatrist about as well.
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My doctor said, Seroquel "works as a tranquilizer" but "it is NOT a tranquilizer".  I take 400 mg of Seroquel, I sleep a lot.  My doctor said I can have one cup of cofee to help fight the fatique of Seroquel, but only one cup in the morning.  Some days, I have some energy, but a lot of times I am just wiped out and exhausted.  
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574118_tn?1305138884
Thank you very much IL, you've always been of great help.

YET, I didn't grasp your answer fully, you say it has AD effect, OK and at high doses (full or therapeutic), OK but my question was: DO i expect by reducing the dose as I actually did to up my mood along with my energy which actually improved. OR will only up my energy and leave the mood bad where I was

Sorry to bother you again
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574118_tn?1305138884
Correct of course
it's not the seroquel the BP
>>>Some days, I have some energy, but a lot of times I am just wiped out and exhausted.  

THIS is the BP my dear.

A colleague of mine explained to me that BP means deficiency in Gaba and a fluctuation in the dopamine. So you have a fluctuation in the energy. THAT's our damn illness
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585414_tn?1288944902
   Being that Seroquel functions as a mood stabilizer lowering the dose will lessen its effect in this regard. At lower doses it will be less sedating but won't be as effective. The concern as regards sedation should not be confused for the extreme overactivity in mania where a person is sped up which can include a person being over active physically (psychomoter agitation). The helpful effect of a mood stabilizer is to bring the over activity of the limbic system (emotional part of the brain) in bipolar back to normal as much as possible. The energy one feels when manic is from this. The sedation from a medication is a different concern. You could speak to your psychiatarist more about this.
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574118_tn?1305138884
I still don't understand this answer too. It seems I am becoming very dum.

My question is simple: after reducing the seroquel my energy was up or you can say i was less sedated but functioning better . So what's wrong with that. Should my mood also get better in principle or it shouldn't. You say the seroquel becomes less effective. Ok , so what . So long that I didn't become manic. If i feel there will be the possibility of psychomotor activity or becoming manic then i automatically raise the seroquel, which in fact i did several times before. But at least I won't be sedated and not being able to function. I remember in the course of last year when i was descending from my mania (seroquel was 300mg) i was reducing the seroquel when very sedated and sleepy until i function but then if i find i became hypomanic then i raise it a little until i was able to make it finally 100mg only and still functioning without being hypomaic. That's what i was trying to explain to you. Remember that I don't take any AD's right now so the possibility of mania is rare in a way

Sorry to bother you again, but i will abstain since you have dozens of other letters to answer considering that you are the authority here
thanks
ezz
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Hello I am on Seroquel too just gone up from 300mg XR to 400mg. I have reduced my meds before and tinkered about to find the happy medium, I have a box of the instant hit Seroquel that I use at times..

The thing is with altering the dose how do we know what effect is happening on certain receptors and what is just simply an effect of reducing the dose.. I feel instantly different as soon as I change the dose, but I find it hard to differentiate what is the BP and what is just a reaction of lessening a dose, so if anyone could answer this too?
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For me 400 mg of Seroquel leaves me tired but happy.  If I lower it then I have energy, but I become very angry. 400 is good for me.  

I'm not sure what the difference is with regular Seroquel and Seroquel XR.  
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574118_tn?1305138884
This conforms pretty well with the wave theory introduced here by moonpanda before, its link

http://www.psycheducation.org/depression/Waves.htm

by lowering seroquel you are upping the energy and widening the gap between the mood and the energy, thus you fall into mixed states. it also proves something else that by reducing seroquel it's the dopamine only which is up but the mood doesn't improve, otherwise the gap wouldn't have widened. And that's probably the answer to my question i was looking for, provided the wave theory is right.

seroquel works on the dopamine mainly. THUS useful in mania and mixed states only but NOT in depression contrary to what advertised by wiki. In fact the medicine brochure tells you it's a strong antimanic and doesn't mention anything about its AD property. So when one is depressed it won't help. for me it was God send for my mania and mixed states, but for the depression i took AD's. Now I don't take AD's for some reasons I don't know of, perhaps in my euthymia phase, so no need to up the seroquel.

Please if any of you have a better explanation of how seroquel functions in low doses, he can post it

thanks ezz
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Hi, the XR is extended release, it releases a little at a time throughout the day, where as the standard Seroquel is like an instant hit, it makes you very sleepy.

I wish there was a happy medium, 12 years later I am still searching.. my meds are constantly being tweaked, sometimes by myself which isn't advisable but I think a lot of BP sufferers are extremely aware of what helps and what doesn't...we are not given enough credit!
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Adel, another thing that I remember about Seroquel is that my primary doctor (not a psychiatrist)  uses Seroquel in low doses for Alzheimers patients.  She prescribes really small doses less than 75 mg for Alzheimers patients.  She thinks I am on an extremely large dosage, but it's working now for almost 7 years, of no hospitalizations for mania.        
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Avatar_f_tn
Oh extended release.  I didn't know that.  All the commercials on TV about the new Seroquel claim it helps with depression.  Even my psychiatrist said, he can't understand that since the Seroquel causes fatique.  The only good thing about the new Seroquel is that the old one will be a generic soon and will help save lots of money and more people will be able to afford it.  
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Avatar_n_tn
Seroquel is more sedating than other meds because it hits histamine sites very hard. But, because it has an affinity for dopamine and serotonin sites, it works as a mood stabilizer. Anything that works on serotonin is bound to make you groggy but meds that work on histamine sites put folks down hard. At smaller dose, you aren't as likely to get the sedating affect because it isn't antagonizing the histamine sites as much. But, it is still working on serotonin and dopamine so the mood stabilizing affect is there.

I couldn't tolerate Seroquel; the akathesia was bad. But I did find a happy medium between the dosages; 150mgs of XR a day kept me reasonably stable (with the exception of the akathesia) but I was still functional (i.e. awake..).



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Hi - Just thought I'd tell you a bit about what I'm finding/have found over the years - I've been taking seroquel for anxiety and sertraline for depression for quite a few years.  I used to be on 100mg a day of seroquel and my phciatrist had said that some people can be on 400/500mg (and even more than this) of this tablet and function fine/not be tired/dozy etc where as for other people lower does can be really good aswell and sometimes can be even more beneficial. I had found that during the week when I was concentrating at work, I was wide awake during the day but then on the weekends I would need to sleep lots (when I was on the 100mg/day) - this was because my anxiety was higher during the week and I didn't have as much need for the tablets on the weekend so they zonked me out - this is a good way for me to tell if I am on too much/how I am doing etc.  The better my mindset is getting (having had CBT counselling and mental health follow ups etc for quite a few years) I am now finding that the seroquel is making me so drained, I'm waking up exhausted, sleeping heaps and having difficulty concentrating.  For me I can reduce tablets (really gradually) 1/2 a tab at most at a time (one reduction a month or few months depending on energy/emotions/feelings and how I'm coping).  Mood-wise I have felt full of energy and happier within a day or so of reducing but in saying that do have to be aware of slipping back.  I really recommend talking to your doctor or mental health contact, they can help heaps and just be there as support if and when reducing or having tough times.  Being open with family and friends about whats happening with you tablet wise if you can I have found to be really good aswell as they can also watch out for you and be there as support if and when needed :-)
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