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Going downhill fast - Dr wants me on seroquel

*=Regulator=*

*=Regulator=*

Bluelighter
Joined
Jan 21, 2002
Messages
2,347
Location
Sydney
Hi guys,

I have a pretty long history of mental illness. It started with an ADHD diagnosis when I was around 12 (I wasn't one of those typical 'over-medicated' kids, I was out of control) and progressed to severe anxiety and major depressive disorder after I had an extremely bad experience with MDMA + an MAOI anti-depressant (there's a thread on here about it in the archive's, probably about 10 years old). A few years after this, I got hooked on codeine (don't laugh) and ended up going on Suboxone (as well as Effexor, Xanax and Ambien). I was pretty 'stable' during this period of around 4-5 years. I was able to hold down a well paying, professional job and basically get through life. Far from ideal but the best I've been able to function for an extended period. My doses of all medication were stable during this period.

About 8 months ago, I managed to get off the Suboxone and almost entirely off the benzos. Things were going reasonably well but I ended up relapsing and going back to taking an insane amount of codeine. I ended up in hospital as a result and decided to go back on Suboxone for the time being.

Fast forward to now and I'm on Suboxone (10mg / day) and Effexor (225 mg / day). Since I've been on the Suboxone, the anxiety has slowly crept back in but in a strange way. I'm fairly anxious during the day but not so bad that it's unmanageable. However, when I try to sleep at night, just as I can feel myself going from the 'closed eyes' to 'proper sleep' stage, I have a mini-panic attack that immediately jolts me out of sleep. It's the most frustrating thing in the world - I'll be dead tired, *this close* to 'real' sleep and all of a sudden my heart will crank up about five gears and pull me straight back into being fully awake. I put 'night' in italics because it only seems to happen when I try to sleep in the evening - I'm able to sleep OK during the day for some reason.

I've found that the only way to go to sleep is to get drunk (great, I know). It's the shittiest thing in the world but I find if I get drunk enough, I'll just pass out. I'm usually someone who hates drinking but I'll take binge drinking to insomnia + panic attacks every day of the week. For the past few weeks, I've been drinking far too much every night too 'take the edge off' but mainly so I can sleep at night.

Here's the tl;dr version:

Because I'm on suboxone and obviously have a history of drug abuse, my suboxone Dr. won't give me benzos. Instead, he has prescribed me Seroquel. I don't have an instant aversion to taking an anti-psychotic but I don't want to start taking something that could fuck my life up even more. As far as you can tell by my history, should I start taking Seroquel in an attempt to get off the booze and get some stability back in my life?

Thanks in advance for any help.
 
I think you should give the seroquel a go. I've kicked benzos and, recently, bupe, so I feel your situation. Panic at night-time/during sleep seems to be a pretty well documented phenomenon. It's never happened to me personally but I do have panic attacks daily.

It's important to understand that seroquel, although intensely effective in inducing sleepiness, also tends to make restlessness worse. At the moment it sounds like this isn't so much of a problem for you. But I would encourage you not to use seroquel if/when you decide to kick bupe again. It will make the withdrawal worse!

I used seroquel for a long time under similar circumstances; nobody would give me benzos on account of my history. During this period I never experienced insomnia once. It's a great drug with zero abuse potential and also has dopaminergic properties which assist during the day with anxiety and depression. Indeed, some doctors have reported success in treating unipolar depression and anxiety with seroquel alone.
 
Thanks, Suessmayr - I appreciate your reply. It's great to hear from someone who has been in a similar situation. I'm leaning towards giving it a go at the moment but want to make sure I'm not going to end up in another drug round-a-bout that I can't ever escape.
 
No, you won't. That sort of thing is impossible with Seroquel. As I said - and as most people seem to say - it has no 'abuse potential'. It just zonks you out. Not like benzos, which are (arguably) pleasurable and calming. It will just make you feel intensely tired. And hungry. And as far as I know it doesn't have any positive discontinuation syndrome, apart from mere re-emergence of the original symptoms upon cessation.
 
Thanks again, mate. The Dr. wants me to take 2 at night and 1 in the morning. Problem is, I have to be able to work a professional desk job during the day so I can't be "intensely tired". I'm already struggling with work so I can't even afford a day of being too out of it to do my job. Night is fine - all I want is to be able to sleep without having to hit the bottle but I can't fuck up my job. I'm in a city by myself with pretty much no support so I can't lean on family or friends to get through this. I've had a drink tonight so I think the best thing would be to do 'the usual' and then try the Seroquel over the weekend. It's only a few days but it will give me a bit of time to get used to it.
 
Hi Regulator, I'm sorry to hear of all the difficulties you've been through with substance abuse and anxiety issues. Insomnia can be so debilitating, and not to mention frustrating! I'm an alcoholic and I have crippling anxiety and insomnia whenever I don't drink so I can really relate. The shitty thing about drinking to get to sleep is that, whilst you might fall asleep/pass out more easily when you're drunk, the actual quality of the sleep that you get when you're drunk is so poor that you wake up feeling wayyy more tired than if you manage to get a few hours of sober sleep. But when you've spent 3 or 4 nights in a row staring at the ceiling and tossing and turning all night, I know you will do whatever you can to get off to sleep.

Anyway, all things considered I think it is worthwhile at least giving the seroquel a try. As seussmayr said, it has a low abuse and addiction potential (seuss I wouldn't necessarily say it has NO abuse potential, some people can abuse anything ;)) so you're reasonably safe in that regard (as long as you take it as prescribed of course). Just PLEASE do not combine it with alcohol or other depressant drugs.

Do you think you're going to give it a try? Has your doctor mentioned any other options for you, and have you told him/her that you're uneasy about trying Seroquel?
 
Hi n3ophy7e, thanks for the advice. I've only seen my current Dr. a few times but he seems really good and knowledgeable when it comes to addiction. He claims to be an 'expert' in the field and while I have no reason to doubt this, I haven't done any research to confirm his claim. I decided when I started seeing him to be absolutely 100% honest about all things relevant to my treatment. I have been less honest with Drs in the past because, well, I've always felt that I've had better insight into my condition than someone who has only seen me for a few hours so I would be better off treating myself. Of course, this approach assumes that the patient is knowledgeable and more importantly, rational, which is something that you can't rely on a drug addict to be. So, I decided to let this guy treat me rather than try to treat myself.

When I saw him today to tell him for the 2nd time that my drinking was getting unmanageable, his first thought was to try to get me into an inpatient detox program. While that might help, it would almost certainly cost me my job which would put me in a far worse position than I'm in now. After telling him that, I could tell his next 'move' was benzos because he started explaining why they wouldn't be appropriate for me. The next item on the list was Seroquel.

I think what has made me uneasy was that he settled on Seroquel only after rulling other things out. I know this is how a Dr works but it seemed kind of a flippant way to put me on a fairly 'hard' medication. It was kind of 'hmm, well the first two options probably won't work, so what the hell? Why don't we try Seroquel?'. It was probably this manner that made me feel a little bit uneasy - like it wasn't a highly considered choice. I did mention that I wasn't particularly comfortable with it, particularly when he said it had side effects like weight gain. Still, he maintained that it was worth a try.

What I'm worried about is ending up in a much worse place than I was when I was *only* taking bupe, xanax and an anti-depressant. Replacing the benzo with an anti-psychotic seems like more of a graduation than a treatment. I don't know, maybe I'm just trying to rationalise so I have a reason to keep using something that will fuck me up, even if it's something as destructive as booze.

I guess I'll give it a try over the weekend...
 
Hi guys,

I have a pretty long history of mental illness. It started with an ADHD diagnosis when I was around 12 (I wasn't one of those typical 'over-medicated' kids, I was out of control) and progressed to severe anxiety and major depressive disorder after I had an extremely bad experience with MDMA + an MAOI anti-depressant (there's a thread on here about it in the archive's, probably about 10 years old). A few years after this, I got hooked on codeine (don't laugh) and ended up going on Suboxone (as well as Effexor, Xanax and Ambien). I was pretty 'stable' during this period of around 4-5 years. I was able to hold down a well paying, professional job and basically get through life. Far from ideal but the best I've been able to function for an extended period. My doses of all medication were stable during this period.

About 8 months ago, I managed to get off the Suboxone and almost entirely off the benzos. Things were going reasonably well but I ended up relapsing and going back to taking an insane amount of codeine. I ended up in hospital as a result and decided to go back on Suboxone for the time being.

Fast forward to now and I'm on Suboxone (10mg / day) and Effexor (225 mg / day). Since I've been on the Suboxone, the anxiety has slowly crept back in but in a strange way. I'm fairly anxious during the day but not so bad that it's unmanageable. However, when I try to sleep at night, just as I can feel myself going from the 'closed eyes' to 'proper sleep' stage, I have a mini-panic attack that immediately jolts me out of sleep. It's the most frustrating thing in the world - I'll be dead tired, *this close* to 'real' sleep and all of a sudden my heart will crank up about five gears and pull me straight back into being fully awake. I put 'night' in italics because it only seems to happen when I try to sleep in the evening - I'm able to sleep OK during the day for some reason.

I've found that the only way to go to sleep is to get drunk (great, I know). It's the shittiest thing in the world but I find if I get drunk enough, I'll just pass out. I'm usually someone who hates drinking but I'll take binge drinking to insomnia + panic attacks every day of the week. For the past few weeks, I've been drinking far too much every night too 'take the edge off' but mainly so I can sleep at night.

Here's the tl;dr version:

Because I'm on suboxone and obviously have a history of drug abuse, my suboxone Dr. won't give me benzos. Instead, he has prescribed me Seroquel. I don't have an instant aversion to taking an anti-psychotic but I don't want to start taking something that could fuck my life up even more. As far as you can tell by my history, should I start taking Seroquel in an attempt to get off the booze and get some stability back in my life?

No dude. Go on disulfiram, acamprosate and some diazepam, slowly coming off it.
Click to expand...

Thanks in advance for any help.
Click to expand...

Deal with it. Your doctor doesn't want you taking benzodiazepines concurrently with Subuxone. Why?
Interactions between your selected drugs
alprazolam ↔ buprenorphine

Applies to: Xanax (alprazolam), Subutex (buprenorphine)

MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.

MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be counseled to avoid hazardous activities requiring mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
zolpidem ↔ quetiapine

Applies to: Ambien (zolpidem), Seroquel (quetiapine)

MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.

MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be counseled to avoid hazardous activities requiring mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
buprenorphine ↔ quetiapine

Applies to: Subutex (buprenorphine), Seroquel (quetiapine)

MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.

MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be counseled to avoid hazardous activities requiring mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
alprazolam ↔ quetiapine

Applies to: Xanax (alprazolam), Seroquel (quetiapine)

MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.

MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be counseled to avoid hazardous activities requiring mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
zolpidem ↔ venlafaxine

Applies to: Ambien (zolpidem), Effexor (venlafaxine)

MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.

MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be counseled to avoid hazardous activities requiring mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
buprenorphine ↔ venlafaxine

Applies to: Subutex (buprenorphine), Effexor (venlafaxine)

MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.

MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be counseled to avoid hazardous activities requiring mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
alprazolam ↔ venlafaxine

Applies to: Xanax (alprazolam), Effexor (venlafaxine)

MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.

MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be counseled to avoid hazardous activities requiring mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
buprenorphine ↔ zolpidem

Applies to: Subutex (buprenorphine), Ambien (zolpidem)

MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.

MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be counseled to avoid hazardous activities requiring mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
alprazolam ↔ zolpidem

Applies to: Xanax (alprazolam), Ambien (zolpidem)

MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.

MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be counseled to avoid hazardous activities requiring mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
venlafaxine ↔ quetiapine

Applies to: Effexor (venlafaxine), Seroquel (quetiapine)

MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.

MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be counseled to avoid hazardous activities requiring mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

No other interactions were found between your selected drugs.
Note: this does not necessarily mean no interactions exist. ALWAYS consult with your doctor or pharmacist.
Other drugs that your selected drugs interact with

Ambien (zolpidem) interacts with more than 300 other drugs.
Effexor (venlafaxine) interacts with more than 400 other drugs.
Seroquel (quetiapine) interacts with more than 400 other drugs.
Subutex (buprenorphine) interacts with more than 300 other drugs.
Xanax (alprazolam) interacts with more than 300 other drugs.


Dude, you'll pull through!
 
Good luck it sounds like something worth trying. Some people do take it just for sleep at night rather than dosing in the morning too. But might as well try what the doctor has suggested and see how it goes :) If it makes you too lethargic during the day then you can tell him and adjust if necessary.

I go through periods of insomnia and I know that can be hell so I hope you're able to get that resolved :)
 
If you take it only at night you will not be tired during the day - not after a day or so anyway.

I've noticed, reading the OP's posts, that he seems to think that quetiapine (seroquel) is somehow 'harder' than benzos. This couldn't be further from the truth!! Benzos are way more problematic. Seroquel is not physically or emotionally addictive. I had unlimited access to it when I was abusing shit like dextropropoxyphene and piss-weak opiates mixed with all sorts of shit. I never abused it. It is like being 'hit by a truck'.
 
Are you seriously considering taking this drug for fucking insomnia?

Do you really want to take a drug that's indicated for people with diagnoses such as "bipolar disorder" and "schizophrenia?" It's like trying to scratch a mosquito bite with a machete. You're going to end up inflicting more damage to yourself, where the alleviation of insomnia is secondary to a host of devastating side effects that will, more than likely, cause your situation to deteriorate beyond cessation of the drug.

There's A LOT of drugs that will induce somnolence, short of fucking with your head.

Why not start with weed, dipenhydramide, doxylamine succinate, 5-htp, melatonin... valerian, kava ... try adding exercise, as hard as it may seem. Exercise will make you physically tired and facilitate natural sleep. If all else fails you could try taking 0.5 mg of alprazolam or triazolam. There are, of course, drugs that are designed to promote sleep such as 'lunesta' and 'ambien.'

Stay away from seroquel.
 
suessmayr said:
some doctors have reported success in treating unipolar depression and anxiety with seroquel alone.
Click to expand...

you have any reading materiel on this? i would be very interested in certain aspects of anti-psychotics as a treatment form for unipolar anxiety//depression.
 
I suffer from sever depression and anxiety my entire life. I have been on and off a number of drugs. I take seroquel along with prozac. I was taking the prozac already for like 5 years and dr added the seroquel about a month ago. I dont know if I have given it enough time or no but I have not seen an improvement.

So, good luck.
 
I am currently taking seroquel for bipolar disorder to help keep down my mania that i sometimes get bad episodes of. I am mostly stable on just lamotrigine and wellbutrin but i still get some episodes of mania especially in summer and depression especially in winter. So i have just started taking seroquel again and i am taking 300mg's of it a night.

If you are just taking it for insomnia and if you suffer from depression you could try a sedating anti-depressant like remeron (mirtazapine) or a tricyclic anti-depressant such as amitriptyline or doxepin. Then maybe you could kill 2 birds with one stone so it's just a thought. I find seroquel to have anti-depressant properties but i get bipolar depression not unipolar depression. I have heard of doctors using it as a add on with anti-depressants to boost the efficiency of the anti-depressant.

As for what seroquel is like i don't find it to be that bad at all but it seems that i have a somewhat natural tolerance to the sedating effects of seroquel. I don't get the zombie effect that some other anti-psychotics namely risperidone cause me. Plus you would not be taking a anti-psychotic dose of seroquel for insomnia anyway or atleast i hope your doctor wouldn't give you that high of a dose. If you are taking 100mg's or less a night then you will just be getting the anti-histamine effects of seroquel which is what gives it it's knock out effect.
 
I've been prescribed 50mg at night and 25mg during the day, paranoid android, so you're correct that it's a fairly low dose. I've just taken 50mg (about half an hour ago) and don't really 'feel' anything.

Quick question - I appreciate that you should not mix alcohol with this medication but is it along the lines 'you shouldn't mix benzos with a couple of beers' (which I know can be extremely dangerous but easily managed if you know what you're doing) or 'holy shit if you mix even a drop of alcohol with Seroquel you'll die instantly' (as in there is no room to touch any alcohol while on Seroquel)?

Snarky91: no offense but it doesn't sound like you even read my posts in this thread. I'm not contemplating taking this drug just for insomnia - I also have severe depression and anxiety and my Dr. is hoping it will help with that as well. Also, I've tried every single substance you suggested and they either didn't work at all for me or they are benzos and if you read my posts, you would know aren't an option for me.
 
Yeah I think you can probably ignore Snarky91's post as it seems highly prejudicial and not really based on anything. The fact that a drug is 'indicated' for a more serious condition doesn't mean that it can't be used for something else. This is medical paternalism. Morphine is indicated for pain associated with chemotherapy. But it can be used in smaller doses for any type of injury, and is also an anti-tissutive and anti-diarrhoetic.

I think that the first few nights of taking seroquel you should just avoid alcohol altogether. Seroquel is way more sedating than benzos and therefore, I think, far more dangerous in this context (i.e., with alcohol). How bad would it be if you fell into too deep a sleep and suffered respiratory depression and brain damage? Not worth the risk in my view.
 
^^ Don't mind Snarky. He has demonstrated in another thread that he is staunchly anti-psychmeds.

Snarky, as I said in the other thread, I completely respect your opinion but I would appreciate it if you weren't so aggressive in putting it forth. Please also try to not assume that no-one else knows about these meds but you. The majority of the people who discuss their meds here in The Dark Side (and indeed all over Bluelight) have done extensive personal research and discussed all their options with their doctor, and some have a lot of personal experience with their meds already, so they are not just going in to these situations with new medications blindly nor ignorantly. So please try not to make it sound like you know better than everyone else.


Regulator, to answer your question about Seroquel + alcohol, no it's not one of those "a drop of alcohol and you'll die" situations. But when you drink alcohol whilst taking Seroquel the side effects of both drugs will be vastly increased. You will likely be extremely drowsy, possibly dizzy, nauseated, that kinda stuff. It won't be pleasant. And as suessmayr also said, combining the two CNS-depressants can be very dangerous (i.e. deadly) if mixed in moderate amounts.

So it's just best to avoid alcohol entirely when you're taking Seroquel.
 
Hi-

This thread came up on Google and I just wanted to share that I have exactly the same problem with the "mini panic attacks" that jolt me awake just as I'm about to fall asleep. I'm taking Seroquel 400mg. I'm not on any of your other drugs other than Ambien.

The thing is, the panic symptoms are exacerbated for me by taking Seroquel. I have to take 5mg to 10mg of Ambien just for its anxiolytic effects or I get an anxiety reaction from the Seroquel. The thing is, Seroquel will make you very, very tired, and I think the panic comes from the feeling of slipping off into oblivion. I've also read that unpleasant side-effects like anxiety are known to be enhanced by a fresh dose of Seroquel.

Hope you're in a better place than you were when you started this thread...
 
Thank you for sharing! A few years ago doctors wanted to put me on seroquil for sleep which I declined - I feel like I may have dodged a bullet. I'm sorry you are getting anxiety from it, there is nothing worse than late night anxiety as you're trying to sleep - I deal with that regularly from other causes but then I panic thinking I have missed my opportunity to fall asleep and that I'll be up all night - don't know if you have similar anxiety when you have the attack.

Have you discussed this with your doctor - do you have any other sleep medication options?
 
I took Seroquel years ago for my bipolar disorder. My dose had to be adjusted so I wouldn't be sedated during the day. I took it at night and it helped my insomnia and I felt calmer during the day. Everyone experiences meds differently. Take care.
 
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