Mental Health Seroquel for BPD and climbing doses

[SmokingAces]

Ok so here is my situation. It's worth noting I am based in the UK

So my doctor LEAVES A VOICEMAIL MESSAGE on the house phone 13 days ago. "Oh btw can you increase your doses upto 150mg per night". That is all the idiots leave me with, also my specialist doctor I had to phone after no appointment made by them for 3 MONTHS. Now I will admit as you can probably gather from the caps I am pissed the fuck off. No information as to why they increasing my dose, I haven't even seen the guy in 3 months, how would he know what I need? And no information about how to increase it, though I am presuming small increments.

So what my question is, IS THIS A BAD ROAD TO GO DOWN? Will it do me any good? I am starting to weigh up should I just ask to be tapered off and sack them off completely, they cause me as much stress as the condition. And their decisions do not seem like they are being made on the basis of individually studied information.

I was diagnosed BPD in August. I am male, mid 20's. The Seroquel helped maybe but I am on 50mg per night now. What I worried about is this could just become a game of ever increasing doses until it hits the ceiling dose and then isn't working, then just a nightmare to come off.

Any input would be helpful.

 

[Sprout]

Right, from the outset; my diagnosis is Schizoaffective Disorder, I have very strong personal views on this matter and my own experiences are no substitute for actual engagement with a registered MH professional.

It would help to know about your moods recently and over the last year, particularly the last few times you sat down with your P.Doc.

I'm afraid a few Psyches seem to distrust the patient's view on their own condition, and if there was any suspicion that your mood was reaching clinical poles then a precautionary increase in your Quetiapine regimen is fairly standard. I know in my case that a poorly controlled Manic episode will fuck up my life a lot more than a period of normal mood but dealing with an increase in side effects from my meds.

I simply have to concede that my Psyche is an educated professional and so may pick up on things I don't and make a call based on something other than my simple telling him I am fine.

When I was given Seroquel, his plans for both short and long term dosing regimens were made very clear, but only once I asked and genuinely engaged with my treatment. It seems very common to gauge the correct dose as the point the side-effects are just under unbearable. Always ask your Psyche as many questions as possible, they simply may have forgotten to tell you something.

While a voicemail message is just piss poor for medical advice, it's not uncommon to be seen less frequently once you are in receipt of appropriate medication.

It is very common to feel like fucking them off, I have spent no more than a year total actively in contact with MH staff over my life, but getting sectioned taught me to at least try what is offered, but be completely assertive if it doesn't help.

You know I love you, Sid.
Look after yourself, fella'

 

[paranoid android]

It's abit worrying that you see him that little that much i know. My doctor won't increase the dose or lower the dose of any of my meds (except if it's a emergency) unless i see him personally and I've never known a doctor to just call in a fucking dose increase. But id say stick it out with the Seroquel as i thought it was shit when i first went on it to. But it's not until you hit the higher doses (200mg's+) that the actual anti-psychotic effects kick in at all. Before that it's mostly just acting as a anti-histamine hence why it's so sedating.

 

[silverwheel]

^Agreed. It's a little weird that you're not seeing him more frequently. However, you're not on anything close to a theraputic dose right now, and you'll need to be on one to properly gauge how the Seroquel is doing for you. Call and ask for clarification on how to taper up, and ask for more detailed description about the long-term dosage he has in mind for you. I wouldn't worry about possibly going off of it - I've tapered off Seroquel before without any withdrawls, and if you had to, you'd still be tapering off on a schedule with plenty of time to acclimate to each lower dosage.

 

[SmokingAces]

This is the problem already. I can't think. It's driving me fucking crazy now, like the level I used to be able to operate at I can't because my thought process hits a brick wall. Learning anything new and even trying to look into this problem is so hard it makes me feel stupid which I was anything but, manic and depressed for sure but this is like being dead behind the eyes.

I want off it. I can't operate like this any longer and they want to up the dose? Without seeing me? The guy barely even knows me we've met twice. I am definitely BP which is maddening anyway but this medication and thinking problem is too much.

Sprout the last year has not been very good. It all went wrong with the death of another friend last Xmas day. Another has happened since but I couldn't even bring myself to be involved in that. I already definitely had problems with drugs before that - stims, but after that I got roped into hanging round with the wrong people even more. Massive coke abuse which lead to crack which eventually lead to a brief spell of IV, which thankfully I saw where that was heading 2 months ago and stopped coke completely haven't looked back since. I had been going off the rails though even without the coke before I was diagnosed, doing things that were out of character, flipping out and winding up suicidal over stupid things many times. I did try to kill myself a couple of times.

I had been having problems with depression and other things back and fore to the doctors since I was maybe 13, they just never seemed to call it right or listen to what I was saying. The specialist did and diagnosed it bipolar type 2. The seroquel did help to calm me at first, but the longer this is going on now I've cut off everyone either because of the drugs or because I hate this place and everything I lost along the way. I fucking can't stand it anymore I could rip the plasterboard off the fucking walls right now my head is a fucking mess. I did the right thing cutting everything off it was all a road to nowhere I blew everything I had that was worth having 4 years ago, but now there is nothing. These four walls and the Internet, my family who I love very much but I can't even express myself anymore and it's like I need my own life back but of course it doesn't exist anymore. I thought getting clean would help but more and more I find myself just wanting to escape it all now - not with coke, fuck coke that really is a shit drug.

The government for some reason (because I was honest maybe) decided not to pay me PIP. I have no money, only bills and debt. There is no way out of this place. I spend all my time frustrated and full of hate now. Maybe that is why this place also annoys me so much at times, it's just another form of something in relation to my life which is nothing to what it was 4-5 years ago. Who knows. The people who try and suggest things in real life only annoy me. I am fucking so sick of it all but I was honestly better self medicating on Valium at least I wasn't aware I was becoming stupid. And short term it seems to have a tangible effect of allowing me to function better. This is unacceptable I go down a line of thought and can only get so far, because my intelligence is being stumped. I would rather be manic insane depressed and able to think. Not to mention this stupid effect is making me so angry, it's like the worst side effect of any drug. Now I read what a nightmare it is to come off.

I'm not at the stage of calling it off; I'm there already. Fuck this shit the fact they even prescribe something like this is like a sick joke. Maybe it is only the way it effects me but I don't think so.

These last few days t's come to a point I can't even be around people. It was already that way before but now my own family it's so hard to hold a conversation because I can't think to express myself. Like I need to actually be away from them to formulate what I'm saying. I had to resort to actually texting my family what is going on when they asked me earlier about the seroquel and I went off the deep end.

I apologise if this is not well written the emotions probably scewed it somewhat and fuck my life I can't even think to formulate a post of bluelight. I'll take my coat

 

[nuttynutskin]

Sounds like you're overreacting, at least in regards to your doctors and medication. Just leaving a voicemail message is kind of tacky but not a reason to cutoff all your doctors IMO. Go for a walk, hit up a punching bag if you have or do something physical, then make a decision when you're in a better mind frame.

 

[silverwheel]

I know you're extremely angry and frustrated with your doctors and meds right now...but after reading your post a few times, I still think you should follow your doc's recommendation and taper up your dosage of Seroquel. What you're describing seems to be more the result of traumatic life events and very recently getting clean from heavy drug use, and from being on a dose of Seroquel that's too low to do much good. And the extreme amounts of anger you're feeling is exactly the thing that Seroquel is good at controlling (I speak from personal experience on that). I think with a theraputic dose you would find better relief from this, and wouldn't have this boiling animosity. Yes, your doc could stand to be more transparent and hands-on with you, but what he's recommending makes a lot of sense.

 

[paranoid android]

Quetiapine doesn't even start working as a Serotonin antagonist until you hit 200mg's atleast and a even higher dose is needed before it starts acting on Dopamine. I found it to work pretty good for depression and pretty decently for Mania though not as good as Olanzapine. The sedating effects wear off after a few weeks plus as Seroquel also acts as a Norepinephrine reuptake inhibitor (or should i say it's main metabolite does) this may be the reason why alot of people find higher doses less sedating then the lower doses. Plus tolerance to the sedative effects of anti-histamines wear off pretty fast.

So i would say stick with it and atleast give it a try. When i tapered up on Quetiapine i started at 100mg's and went up from there by 100mg increments every second day until i hit 400mg's a day.

 

[SmokingAces]

Did you ever get any long term effect from it that was positive? A few people I've been speaking to got diabetes from it. Also have you come off it now or are you still on it and is it still working if so?

Thanks for the replies people

 

[silverwheel]

I've been on the extended release version of Seroquel for almost a year now, and I've had great relief because of it. The extended release version doesn't have the drowsiness of regular Seroquel, and is much more effective as a mood stabilizier. And when I say mood stabilizer, I'm not talking about feeling the same all the time - I don't get any emotional blunting from it, and I still experience the wide and wonderful range of emotions. I actually experience my emotions much more fully now because they're not constantly being colored by some degree of agitation. As I got older, my "up" parts of the bipolar cycle became much more angry and agitated instead of euphoric or confident. Seroquel XR has fixed that.

 

[Chatative]

Hi Sid,

Bit late in getting around to replying to this thread.

I myself have never been on Quetiapine (Seroquel), nor do I have BP but I have been on APs on and off over the past few years for psychosis. Some of your experiences with your mental health professionals smacks of my early experiences with the mental health system here. My psychiatrist had increasingly less contact with me, only seeing me for 5 minutes or so each appointment to run through a set list of questions & he quite blindly upped my dosage of meds to the point where the side effects were worse than my problems. It's certainly a worry & can happen but can be avoided too.

As Sprout says, in crude terms the ceiling for dosing APs tends to be until side effects become too troublesome. The second psychiatrist I got, who I still see, is much better than the first & recognizes that it's not just about blindly treating symptoms but my overall wellbeing too. Therefore he has been much more open to me staying on the lowest effective dose, or even going medication free now.

I think the message I'd like to get across is that to some extent, you get out of the mental health system what you put in. Do your research, ask your doctor (psychiatrist?) lots of questions & try to get as involved as you can in the whole process. You'll have a much better experience then. It already seems to me that you have many pertinent questions & know in what areas things are lacking, so why not call your doctor? One thing I would say though is make sure to be bring up any side effects however small they may seem, as they might well affect any future dosage increases.

To reiterate what others have said, the dose your are on is not really therapeutic at all & is generally only used to help people sleep. It sounds to me like it's probably the sedating properties of the Seroquel that are causing your problems. Conversely though, I've heard some people say that they found higher doses of Seroquel less sedating... I can't speak to the validity of that statement, especially as the same AP can effect people very differently, but I wouldn't write it off without at least going to a therapeutic dose. If the benefits still don't outweigh any negatives, then you can always try another medication. As silverwheel says there is also an XR version of Seroquel that could be an option.

It really can be quite finicky trying to find an effective AP that doesn't have too many side effects. It's almost an inevitability that there will be side effects, but it's just a case of trying to minimize them by finding the right medication & dosage. It can take a while but don't lose hope, be your own advocate & you'll get there eventually. Meds can be a real help when you find the right one.

 

[paranoid android]

Did you ever get any long term effect from it that was positive? A few people I've been speaking to got diabetes from it. Also have you come off it now or are you still on it and is it still working if so?

Thanks for the replies people

It did level out my moods and mellow me out. It actually sort of reminds me of the effect Cannabis has on my mania which is "Stop and think about what your going to do you fucking idiot". I Come off it because i don't really need it now though with my depression returning i may go back on it. I had no weight gain or any long term side effects from years of being on Quetiapine.