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Olanzapine vs Quetiapine IR vs Quetiapine XR

crOOk

crOOk

Bluelighter
Joined
Dec 16, 2004
Messages
4,047
Location
Germany
My doc just switched me from Olanzapine to Quetiapine. I have only been on ~2.5mg Olanazapine, but loved what it did to my appetite and bodyweight, while the daytime tiredness seemed manageable at that dose. Now it seems my manic episode is pretty much a thing of the past and I've gone off the Olanzapine altogether. I'm pretty sure that the only reason I'm not falling into an abysmal depression right now is my daily amphetamine regimen combined with ~1000mg caffeine throughout the day. I feel tired and burnt out, having trouble focussing on anything and can't sleep too well either. Appetite is low, but not nearly as low as it was during mania.

Now I don't wanna go back into psychosis and most of you would probably recommend getting off the stimulants. My specific questions though are directed towards those who have experience with Quetiapine and Olanzapine for BP1 treatment. Initially I had imagined a phase prophylactic like Lamotrigine would be the next choice once I've stopped riding the mania wave (was more like a Tsunami really). Surprisingly the doc, who I really value very highly and who has paid the greatest attention to every detail of my life in the course of the integrated therapy approach that was his idea originally, has now suggested switching me to Seroquel XR. I'm kinda worried that the stuff is simply gonna knock me flat onto my ass and leave me incapable of doing anything.
I have a daughter I need to be there for roughly every other day and an important, cognitively demanding work project I need to stay on (after mania has taken every chance of me earning money any other way anytime soon). Really all I'm looking for is to
A Stay out of manic/mixed states and keep re-establishing my social life
B Have enough drive to keep working on my project and more importantly to be attentive towards my daughter's needs
C Keep me from losing weight due to lack of appetite

Most importantly I'd like to know,
-if Quetiapine can do the same thing for my appetite which Olanzapine has so successfully done.
-if Seroquel XR causes worse daytime sleepiness than regular Quetiapine Fumarate/Olanzapine.
-does Seroquel really possess antidepressant properties and at which dose have they started for you?
-how about lamotrigine? Any appetite increase? Did it keep depression at bay? Daytime tiredness?

The latter has been suggested by the doc as well, but it seems very hard to imagine right now. He is suggesting I start at 50mg and go up to 150 minimum within the following weeks. That's supposedly about the lowest level I'll see any antidepressant properties at. Right now, even amphetamine has a very hard time keeping me out of bed. I just feel so damn tired all the time. I usually down 500-1000ml of energy drink in the morning and ingest up to 100mg amphetamine phosphate so I'll be able to even take a shower and brush my teeth. This blows...

Hoping someone has some advice. Otherwise, I'll try to start taking the quetiapine tonight and will just have to see how that goes. Not expecting much there.

edit: I feel depressed as shit. Booze is becoming really attractive again. Thought I could just slide out of mania and not get to this place. Really, I'm thinking serotonergic drug, but no doctor in his right mind would ever prescribe anything along those lines. I just wanna get over this lethargy somehow and even amphetamine isn't doing shit.
 
I should probably replace my question by: "What the fuck am I gonna do against this depression creeping up?" I feel like fucking dirt and strongly doubt quetiapine is gonna make a change for the better there. Maybe I should just hospitalize myself, been long due anyway... Ugh this blows. I've probably had 200mg of amphetamine today, been off the olanzapine for a week, smoked only a tiny dose of pot last night, yet I feel tired and stiff like never before. I have been meaning to take a piss for an hour and cant get my ass up out of this chair. It takes an effort to lift my fingers of every key Ive pressed. Anything that could help???
 
just gonna try using this crap med now. at least ioll be sleeping. god i still hope this isnt happening for real.
 
hasnt kicked in yet and i couldnt feel any more zombified than i am now. i actually got pleasure out of the olanzapine sedation. this current feeling is unbearable though.i can barely hold my head up and have been moaning constnatly as if iwas running a fever since last night.
 
anyone whos been whre im going rihgt now, id really appreciate some shit like "its nto gonna last forever" etc. strength is faidng with every breathe i take. how the fuck could amphetmaine not cancel this out at all?! i thouht itd be my fail safe protection from depression but this is so overpowering,
 
God that day really seemed like hell on earth... I've never been so overwhelmed by depression before. Was just getting weaker and weaker, had trouble performing even the most simple tasks, like walking, putting my shoes on etc. For whoever might find himself in a similar situation someday with depression rapidly closing in after a long manic episode... This is how I got relief:
I bailed from the hospital on day 1, went to the pharmacy on my way home and bought some DXM. 90mg next morning brought 100% relief from the incoming depression. Now, two days later, I still feel fantastic. Also started on 200mg Quetiapine, daily at 6pm and I can't say it's working very well. Insomnia and akathisia all night long, extremely intense dreams, sweating and in the mornings my body feels like it had been run over by a truck. All this is very similar to days on which I haven't smoked any pot. I'm pretty sure it's somehow fucking with my endocannabinoid system, eventhough information I've found regarding potential interactions is very sparse. On top of all that, it seems to actually decrease my appetite. So weird, I had heard it'd increase appetite and induce sleep in most people... I'll stay on it though until my next psychiatrist appointment (the dreaming is quite enjoyable actually), then hopefully switch back to olanzapine which is a fucking godsent!! I don't even know why I was taken off it tbh... I love that stuff.

Some brief DXM info for those who care: http://www.ncbi.nlm.nih.gov/pubmed/10064839
 
Quetiapine is a horrible drug. It's one of the most sedating antipsychotics and to be dropped onto 200mg is madness - I was started on 25mg and worked my way up to 200mg over three months. The side effects generally fade over months - and those months will be hell. You'll be almost permanently zombified, especially if you take it in the morning. Your mind wont be up for anything tenuous for a good six months - it just destroys mental processes. I personally dropped out of college when I started.

I've never found quetiapine to be that helpful with depression, however, and opt to take 5 HTP to keep my mood stable. I do recommend that you do get off quetiapine ASAP thought and back to Olanzapine. Be aware that you might get withdrawal when you change back, which can produce Schizophrenia-type symptoms which WILL pass. Hopefully you wouldn't have been on them long enough, however. As for the appetite, it will increase after a short period on the drug - When i started I felt very nauseous per manly, but it'll pass then you'll be eating a tonne.
 
Well, I just found another thread here:
http://www.bluelight.ru/vb/threads/582565-Olanzapine-withdrawal

The op describes how he went into a god-awful depressive episode upon discontinuing olanzapine. I would've expected some hypomania on discontinuation, but not depression of all things. That motherfucker crushed me like a fly. I've never ever felt so helpless before. My extremities felt as if they had weights attached to them, wouldn't have lasted two days in that state, no way. All these years I've been busy keeping depression at bay and just didn't see the manic state creeping up throughout the past 2-3 years. Now I'm scared shitless of becoming depressed again and have to watch out not to fall over to the other side.

The Quetiapine really didn't seem dosed that high. I started on 100mg, twice what my doctor had recommended on that depressed day because I felt so helpless (a single fucking day, how ridiculous is that. How does anyone manage to live like that?!). After it had kicked in and I realized it brought relief, but didn't get me nearly as tired as my 5mg olanzapine, I just threw in another 100mg (my doc asked me to slowly increase dosage to a maximum of 250mg). It felt "really healthy" ("good" is different though) while I was awake, but the insomnia, hip and lower back pain leading to constant tossing and turning in bed, muscle stiffness it brought on wasn't exactly what I expected. Funnily enough I woke up the next day feeling like I should do a million push-ups before brushing my teeth. It wasn't full-blown mania, nor hypomania, just the urge to move around really. This was before using the dextrometorphan, so it is most safe to say the q-thing just ain't working very well.

Anyway, I continued with 200mg the next day and lowered that to 100mg yesterday to see if I'd sleep better on a lower dose, but nay. Today I was clearly moving towards mania again and while it as an extremely productive day work-wise, I just switched back to Olanzapine again.

@Captain.Heroin
You seem to be 100% correct there. I think he might've heard about the benefits of quetiapine over other antipsychotics in patients with SUD. I told him I'm finally back to smoking pot every night without being worried about a decrease in my productivity and while he doesn't deny it's benefits in mania (contrary to the hospital's policy mind you), he felt very convinced he should switch me to seroquel. He's been pretty straight about most stuff I think, so I'll definitely ask about his honest reasons for switching me.

I have no idea why so many psychiatrists seem to think it'd be a good idea to lie to patients for their benefit. The only reason I bailed hospital was because they put me on this withdrawl unit while telling me they had to beause there aren't any beds on the psychosis station. I asked 4 staff members (1 doctor, 2 nurses, 1 ambulance man) if that is really the true story behind me ending up in there and asked explicitely for them to be honest. I wasn't planning on doing any self-medicating whatsoever (or otherwise I wouldn't even went there), but hearing hours later, that you aren't allowed to dose your own antipsychotics, aren't allowed to go for a smoke alone, aren't alone to leave for more than 15mins etc., pissed me off so bad that I didn't hesitate for a second to leave. "If you do not see any acute risk for self-harm I'd like to leave" was all I said. :/

How the fuck can any of those morons think a patient should be "tricked into medical care"?! Especially with a patient who's on his best way to become a doctor himself and has been working as medical staff in hospitals for years. The arrogance of some people knows no boundaries. Back to where I started now, at least I can trust my psychiatrist and am taken serious by him, or so I think. Olanzapine just is a godsent and I had used it before to attenuate or relief myself of acute psychotic states. All in all, I really can't say my self medicating has been a complete miss throughout all these years... Maybe I should just try to keep my eyes out for incoming mania with the olanzapine always at hand and continue the way I have before. Been fine for so many years like that.

And as so many times before, I'll close this post with "Sorry bout the rant"...
 
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