Quetiapine (Seroquel) Experiences

[HLon99]

Dear Forum,

Following on from my previous post I am currently debating whether I should stick with aripiprazole (abilify) as my main antimanic and antipsychotic agent or switch to something else. As I previously stated, aripiprazole works great for me and I have virtually no side effects, apart from ONE which REALLY REALLY causes me a problem.

That problem being is that it completely blocks out my ADHD medication. Hence, after doing some research I considered Depakote (Sodium Valproate), however after reading your comments I have decided that this is not the right drug for me due to its long term toxicity to the liver and lack of antipsychotic effect. Also not lithium for similar reasons.

I was about to give up all hope when an idea struck me like an apple from a tree, which my old psychiatrist (now retired) implied (albeit very subtly) to me (God bless him). Why not use a short acting antipsychotic in the evening (like Seroquel) and then take my ADHD medication in the morning once it wears off. You see the problem with Aripiprazole is that it is extremely long acting (half-life 72-94 hours) whereas Quetiapine is only 8-12hrs. Hence, if I take my drugs right, I will have perfectly balanced ying-yang effect. However, I want to know more about the drug before I try it.

TL;DR: How effective is Quetiapine for Mania, depression and psychotic features? How does it compare with Aripiprazole? Any side effects I should be aware of?

Thanks in advance
-H

P.S. I will prob only have to be on a low dose, because I am predominantly depressive type (Stable on Lamotrigine) and have very mild psychotic symptoms. I would also consider other short acting antipsychotics such as Amisulpride.

 

[On Fire]

Amisulpride causes breast growth and lactation. I would not touch it!
I found Quetiapine not very effective, even at antipsychotic dosages 300mg/day to 400mg/day. Quetiapine is also extremely drowsy, with a hangover effect, even though it's half life is, as you say, short.
I don't think you will beat Aripiprazole.

 

[HLon99]

Amisulpride causes breast growth and lactation. I would not touch it!
I found Quetiapine not very effective, even at antipsychotic dosages 300mg/day to 400mg/day. Quetiapine is also extremely drowsy, with a hangover effect, even though it's half life is, as you say, short.
I don't think you will beat Aripiprazole.

Thanks again, On Fire, for taking the time to respond. I've heard that about amisulpride as well so prob best not to try it at this stage. What do you mean by not very effective, did it not work for the mania, the depression or the psychosis, or all? I know its a drowsy drug, but I'm not a sound sleeper so perhaps a low dose before bedtime won't hurt. My ADHD drug is a stimulant, so it should counteract it during the day and suppress my appetite. Does the hangover effect tend to pass in the day, and if so how long?

 

[On Fire]

At the low dosages of Quetiapine it does not work as an antipsychotic, more of an antihistamine, if I remember correctly.
Quetiapine was not effective for my psychosis, and I had breakthrough psychosis even at 400mg/day.
Quetiapine is extremely drowsy, it does pass, just hangs around in the morning.

 

[daffy]

Ive been on both but the aripiprizole made me shake dreadfully and have a shuffling gait so i was taken off it. I then went on quetiapine and was on it successfully for years but i found it really did flatten my mood. I felt neither high or low. Seemed to forget how to laugh but it did stop the psychosis.
A couple of things to be aware of tho is that its notorious for making you gain weight. I gained almost 3 stone and developed T2 diabetes which is linked to the medication
Ive now come off it and lost most of the weight but ive still got diabetes. But i was on the max dose 800mg for a few years then spent the 7 yrs on 650mg.
It is a good medication but has a lot of side effects at high doses. You should have regular glucose and weight monitoring if you are on a high dose

 

[On Fire]

What do you take now then @daffy

 

[daffy]

I just take duloxitine and mirtazipine but a load of diabetic meds

 

[manicmonday]

I’ve had both aripiprazole and quetiapine when I was hospitalised and neither of them got rid of my psychosis. The quetiapine made me severely constipated and gave me a rash.

 

[Debaura500]

It's a shit drug to shut u up

 

[HLon99]

Ive been on both but the aripiprizole made me shake dreadfully and have a shuffling gait so i was taken off it. I then went on quetiapine and was on it successfully for years but i found it really did flatten my mood. I felt neither high or low. Seemed to forget how to laugh but it did stop the psychosis.
A couple of things to be aware of tho is that its notorious for making you gain weight. I gained almost 3 stone and developed T2 diabetes which is linked to the medication
Ive now come off it and lost most of the weight but ive still got diabetes. But i was on the max dose 800mg for a few years then spent the 7 yrs on 650mg.
It is a good medication but has a lot of side effects at high doses. You should have regular glucose and weight monitoring if you are on a high dose

Glad to hear a more positive experience. Thank you for bringing my attention to the negative physical side effects, I'll definitely keep that in mind. I'm prob gonna be on a lower dose, but I'll still go fo regular health checks. I'll try keep my appetite in check and exercise regularly if I decide to go down that route.

 

[HLon99]

At the low dosages of Quetiapine it does not work as an antipsychotic, more of an antihistamine, if I remember correctly.
Quetiapine was not effective for my psychosis, and I had breakthrough psychosis even at 400mg/day.
Quetiapine is extremely drowsy, it does pass, just hangs around in the morning.

Good to know. What I meant by low doses is something between 150-300mg, not something completely tiny. Hearing that it didn't work for psychosis is troubling, but I guess everyone's system is different. I'll chew it over some more, I have 10days till my next pdoc appointment.

And yes I agree, you really cannot beat Aripiprazole. Its just a shame its not compatible with my drug regiment

 

[Jam1990]

I use quetiapine 300 mg every night for major depression with psychotic features. I find that it works well for me. It’s harder to wake up in the morning but once I get out of bed it quickly wears off and I feel normal. I do find that I want to snack more on quetiapine but you just have to be disciplined and not have bad foods in the house. Hope you find the one that works best for you.

 

[HLon99]

I use quetiapine 300 mg every night for major depression with psychotic features. I find that it works well for me. It’s harder to wake up in the morning but once I get out of bed it quickly wears off and I feel normal. I do find that I want to snack more on quetiapine but you just have to be disciplined and not have bad foods in the house. Hope you find the one that works best for you.

Thank you so much for this. Does the appetite effect last throughout the day or just the night/early morning?

 

[Jam1990]

It lasts throughout the day but it really isn’t that bad. You just have to not have sugary snacks in the house because you’ll crave them.

 

[keith74]

For a time, my wife was on a mix of 500mg Epival and 100mg Seroquel. She felt that the 100mg Seroquel made her feel a bit drowsy after she took it. When she was upped to 150mg, she said it gave her a bit of restless leg syndrome when she tried to sleep. Her doctor suggested that the extended release version may help prevent that but she never got a chance to try it. My wife never had the other side effects of weight gain or the feeling of flatness all day - but again she was on quite a low dose 100-150mg.