# Zoloft + Seroquel Progress



## A Sense of Purpose (May 8, 2011)

I would like to begin a thread detailing my progress with Zoloft and Seroquel for panic attacks and depression which i have begun taking again.

Some may remember in the past that i had great success with Zoloft 50mg (for a period of 4 months) in combination with seroquel PRN for sleep here and there.

Long story short, went off all meds. Felt amazing for a good 3 months and regretfully abused mdma/amps for about 2months.

Mood was great during this period except for right at the very end, and i landed myself in hospital with severe nausea and a week long migraine. Since then point Ive felt like a shadow of myself, lack of motivation/anhedonia and lost the benefits of zoloft. 

Add to this I had two friends pass away within 2 weeks of each other, one a freak accident and the other an OD.

Ive been back on Zoloft at 50mg for 2ish months now, but with zero improvement.

Recently (4 days ago) I was bumped up to Zoloft 100mg and have started taking no less than 100mg of Seroquel every now and then at night.

Since beginning the combination I feel myself starting to reconnect with the world again, as I'm starting to have motivation to read. This is promising.

Perhaps i need to take the two together (along with a higher dose of Zoloft) to get me in the right frame of mind. So far the side effects are minimal if not completely unnoticeable, even in the sexual department.

Will keep you posted sporadically for anyones curiosity.]

Cheers


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## riptide991 (Feb 1, 2012)

I'd stick with 100mg of Zoloft if it works. It's better to have some window for the future just in case you need to raise it. Good luck.


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## A Sense of Purpose (May 8, 2011)

Thats a good point. I will keep things the same for about 4 weeks and review the process then. 

For some reason I truly believe there is some form of synergy between the zoloft and seroquel that is boosting my mood. I do wake up a little sleepy but it fades rapidly and leaves me calm/content.

The aim of this thread will be an attempt to log my moods so i have an idea of how the fluctuate, and maybe give me some insight as to why.


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## istayhome (Apr 4, 2012)

Interesting thread, I'll keep up on it. I spent several months on the same combination and was miserable. That just goes to show how different we all are. I'm looking forward to reading your progress.


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## R86 (May 2, 2012)

I'll be following this thread with interest as well, along with kehcorpz's of course. I've been on 100 mg Zoloft for most of this year, with an initial diagnosis of social anxiety disorder. I'll be meeting with my psychiatrist in a few weeks as I'm wondering whether avoidant personality disorder (or even OCD?) might be a more accurate diagnosis, although in terms of treatment it might well be a distinction without a difference.

The Zoloft does help me to slow down and respond to things rationally rather than react without thinking, but I still struggle with intrusive thoughts and urges to escape or get angry about nothing. I got a sample of a 200 mg (!) Seroquel tablet that I promptly cut in quarters. Adding 50 mg Seroquel to the 50 mg of trazodone I already take at night results in the best sleep I may have got in my life, but unfortunately the effects last too long (about 16 hours). As others have said to me on kehcorpz's thread, the trick may be to take down either the Seroquel or the trazodone to 25 mg.

I'm still not sure whether the Seroquel helps me with these intrusive thoughts when the stupor phase wears off. But in the worst case, the Seroquel might be something I can add to trazodone rather than Z-drugs when the trazodone isn't enough to keep me asleep all night. From what I read, Seroquel seems much safer and less likely to cause dependence than Ambien or Lunesta.


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## ricca91 (Mar 11, 2012)

I'm going to follow this thread too, since I'm a seroquel lover and hope it'll help you. I use it as a mood stabilizer/antidepressant.

It's been 1 and a half years that I've been taking it, so if you have any questions, feel free to ask. Some heads up:

1) Seroquel is sedating, VERY sedating. It doesn't matter whether I take a stimulant and feel jittery at night, seroquel will knock me out. It leaves me a bit groggy in the morning, even when I was taking 25 mg. Tolerance to this effect didn't develop for me.

2) Sugar cravings are real. You'll feel a lot of reward by eating chocolate and sweets. Fortunately I was always lean no matter how much I eat, but be careful because the excess sugar can cause weight gain and diabetes long term. Have "bulky", non sugary foods at hand, such as fruit. Carrots and celery work too.

3) Especially during the first days, stand up slowly when seated or in bed, since Seroquel is an alpha-1 antagonist and can cause fainting and dizziness if you stand up too quickly.

4) Seroquel can give you dry mouth and sinuses, so have a bottle of water at hand. Sinus congestion is quite annoying when it happens, if it bothers you, use some isotonic solution and topical decongestants, but no more than 3 days in a row.

5) It may be that during the first days, you'll feel out of it and brain fogged, but it goes away.

6) Be prepared for some crazy dreams. Usually they are pleasant.

Good luck!


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## istayhome (Apr 4, 2012)

^^^very good advice for anyone planning to take seroquel regularly.


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## A Sense of Purpose (May 8, 2011)

ricca91 said:


> I'm going to follow this thread too, since I'm a seroquel lover and hope it'll help you. I use it as a mood stabilizer/antidepressant.
> 
> It's been 1 and a half years that I've been taking it, so if you have any questions, feel free to ask. Some heads up:
> 
> ...


Appreciate the advice! I have used Seroquel in the past up to 150mg for sleep and know how effective it is for sedation.

Now in combo with zoloft it feels less sedating and more balanced. I havent decided whether or not ill be taking Sero 100-150mg every night, but i envisage taking it at least 3-4 times a week as i am noticing steady and increasing moods.

*Another really pleasing thing that ive noticed since starting this combo and upping zoloft is that words come to me a lot easier. Especially when in a sentence and trying to explain my thoughts or tell a story. 
*
Its like my brain is less held back and words come a lot more naturally to me. Quite hard to explain. My word recall and selection seem to have improved.

Also on a side note Ricca, I have been taking dexchlorpheniramine for hayfever/allergies recently. I noticed you made a post explaining the different types of antihistamines and their effects on cognition/mood. Is it possible that this med is interacting in a positive way with the Zoloft and Seroquel? Just a thought.

Cheers


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## R86 (May 2, 2012)

ricca91 said:


> 6) Be prepared for some crazy dreams. Usually they are pleasant.


I certainly did notice that. On Seroquel, my dreams almost seem productive in a way, like I'm working stuff out, if that makes any sense.

Not noticing any dizziness yet, only extreme sleepiness long after it's time to get going with my day. I have only one more 50 mg dose, and I think I'll take it at 3:00 p.m. one day. That way it should wear off around 7:00 the next morning, or at least the tiredness should.

I don't find it to be acting as much like an antipsychotic or mood stabilizer as I'd hoped, but I realize it's pretty hard to tell after only 3-4 trials. I'm a bit worried that my pdoc will ask me to increase the Zoloft to 150 or even 200 mg rather than adding anything to it, though part of me wouldn't mind so much since I'd rather be on fewer drugs than on more drugs.

In any case, thanks again for the advice!


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## ricca91 (Mar 11, 2012)

A Sense of Purpose said:


> Appreciate the advice! I have used Seroquel in the past up to 150mg for sleep and know how effective it is for sedation.
> 
> Now in combo with zoloft it feels less sedating and more balanced. I havent decided whether or not ill be taking Sero 100-150mg every night, but i envisage taking it at least 3-4 times a week as i am noticing steady and increasing moods.
> 
> ...


Unfortunately there aren't many studies about antihistamines and mood effects, but anecdotally dexchlorpheniramine at 4 mg has a slight mood-lifting effect. Thing is, chlorpheniramine and older antihistamines are dirt cheap so there aren't really motivations to spend money on studies, it's a shame.

But indeed is possible that chlorpheniramine is having a beneficial effect pn you, but it's hard to determine to what extent. Chlorpheniramine is my antihistamine of choice during allergy season too!


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## ricca91 (Mar 11, 2012)

R86 said:


> I certainly did notice that. On Seroquel, my dreams almost seem productive in a way, like I'm working stuff out, if that makes any sense.
> 
> Not noticing any dizziness yet, only extreme sleepiness long after it's time to get going with my day. I have only one more 50 mg dose, and I think I'll take it at 3:00 p.m. one day. That way it should wear off around 7:00 the next morning, or at least the tiredness should.
> 
> ...


Thing is, in general antidepressant and mood stabilizing effects begin to kick in at 100-200 mg, that is when seroquel touches serotonin and to a lesser extent, dopamine receptors. Its mood stabilizing effects are more apparent at 300+ mg, when a significant amount of dopamine receptors are being blocked.


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## jim_morrison (Aug 17, 2008)

ricca91 said:


> I'm going to follow this thread too, since I'm a seroquel lover and hope it'll help you. I use it as a mood stabilizer/antidepressant.
> 
> It's been 1 and a half years that I've been taking it, so if you have any questions, feel free to ask. Some heads up:
> 
> ...


This sums up me experience with Seroquel pretty well. Out of curiosity have you compared the IR vs the XR version? Personally I found the XR version had less of a 'knock out effect' which could be expected due to the slower peak, however I didn't notice much of a difference in terms of next day grogginess even though my doctor at the time claimed the XR form to have 'no hangover effect'.


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## ricca91 (Mar 11, 2012)

jim_morrison said:


> This sums up me experience with Seroquel pretty well. Out of curiosity have you compared the IR vs the XR version? Personally I found the XR version had less of a 'knock out effect' which could be expected due to the slower peak, however I didn't notice much of a difference in terms of next day grogginess even though my doctor at the time claimed the XR form to have 'no hangover effect'.


No, I just take the IR version since XR is waaaay too expensive for me, although my psychiatrist told me that it would be more appropriate since it lasts all day and quetiapine has a fairly short half-life.

Yeah, I agree with you, I think it would have less knock out effects but at the same time I would expect more grogginess during the day, since you'd have a constant level of quetiapine in the body.


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## A Sense of Purpose (May 8, 2011)

Had a very productive day today. Early start, went to the docs for an all round checkup and get all my levels tested.

Feel slightly euphoric.... seems too good to be true. /Query Bipolar II.
Needless to say im not complaining in the slightest. There is just such a dramatic positive improvement from 2 weeks ago.

*I was thinking today, now that im taking an Antipsychotic quite frequently that ill want to start taking some protection with it. The question is, what in theory is good for preventing free radical damage caused by AP's (aka EPS and TD)? Is it the racetams that im thinking of? Im hoping someone with experience / literature evidence will chime in on this as it'd be something i'd pm Crazymed about*.


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## A Sense of Purpose (May 8, 2011)

ricca91 said:


> Thing is, in general antidepressant and mood stabilizing effects begin to kick in at 100-200 mg, that is when seroquel touches serotonin and to a lesser extent.


This sounds promising/may be why im finding the two so useful. Im curious theoretically.... what would happen if i upped the seroquel to 300?

Would it potentially negate any of the dopaminergic activity of the zoloft? Because that would be the last thing i'd want to do.


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## ricca91 (Mar 11, 2012)

A Sense of Purpose said:


> This sounds promising/may be why im finding the two so useful. Im curious theoretically.... what would happen if i upped the seroquel to 300?
> 
> Would it potentially negate any of the dopaminergic activity of the zoloft? Because that would be the last thing i'd want to do.


If you up the dosage to to 300 mg you'll have 5-HT2A and 2C receptors antagonized, 5-HT1A agonized, some D2 receptors antagonized and inhibition of the reuptake of NA because of seroquel's metabolite desalkylquetiapine. This would result in anxiolysis and antidepressant effects.

I don't think it will interfere with zoloft's effect on dopamine since seroquel reduces tonic dopamine but doesn't have a big effect on phasic dopamine (anyone correct me if I'm wrong).


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## R86 (May 2, 2012)

ricca91 said:


> Thing is, in general antidepressant and mood stabilizing effects begin to kick in at *100-200 mg* ... mood stabilizing effects are more apparent at *300+ mg*....


In a word, "Yikes!"  I guess that's why you start on a small dose and work your way up. It will be interesting to see what my pdoc suggests in any case. I wonder whether simply increasing the Zoloft would do any good.


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## A Sense of Purpose (May 8, 2011)

ricca91 said:


> If you up the dosage to to 300 mg you'll have 5-HT2A and 2C receptors antagonized, 5-HT1A agonized, some D2 receptors antagonized and inhibition of the reuptake of NA because of seroquel's metabolite desalkylquetiapine. This would result in anxiolysis and antidepressant effects.
> 
> I don't think it will interfere with zoloft's effect on dopamine since seroquel *reduces tonic dopamine but doesn't have a big effect on phasic dopamine* (anyone correct me if I'm wrong).


Good to hear!


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## riptide991 (Feb 1, 2012)

ricca91 said:


> If you up the dosage to to 300 mg you'll have 5-HT2A and 2C receptors antagonized, 5-HT1A agonized, some D2 receptors antagonized and inhibition of the reuptake of NA because of seroquel's metabolite desalkylquetiapine. This would result in anxiolysis and antidepressant effects.
> 
> I don't think it will interfere with zoloft's effect on dopamine since seroquel reduces tonic dopamine but doesn't have a big effect on phasic dopamine (anyone correct me if I'm wrong).


But isn't Seroquel a post synaptic antagonist so even if it doesn't interfere with release of dopamine it still occupies the receptors that dopamine would normally attach to and keeps it from doing its job no?


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## ricca91 (Mar 11, 2012)

kehcorpz said:


> But isn't Seroquel a post synaptic antagonist so even if it doesn't interfere with release of dopamine it still occupies the receptors that dopamine would normally attach to and keeps it from doing its job no?


Yes, but as I understand, it has a "loose binding" to the dopamine receptors, the Ki is quite high as I understand (626 nM), so it binds and dissociates very quickly from D2 receptors. And this allows dopamine to bind to the receptor and do its normal "job" for example in the nigrostriatal and tuberoinfundibular pathways and reducing the parkinsonism and prolactin increase. While it blocks tonic dopamine surges in the mesocortical pathway, reducing negative symptoms of schizophrenia.

However, I'm at the beginning of understanding neurophysiology, so it's very likely that I'm making mistakes. Please correct me if I'm wrong!


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## riptide991 (Feb 1, 2012)

ricca91 said:


> Yes, but as I understand, it has a "loose binding" to the dopamine receptors, the Ki is quite high as I understand (626 nM), so it binds and dissociates very quickly from D2 receptors. And this allows dopamine to bind to the receptor and do its normal "job" for example in the nigrostriatal and tuberoinfundibular pathways and reducing the parkinsonism and prolactin increase. While it blocks tonic dopamine surges in the mesocortical pathway, reducing negative symptoms of schizophrenia.
> 
> However, I'm at the beginning of understanding neurophysiology, so it's very likely that I'm making mistakes. Please correct me if I'm wrong!


Nah you would probably know more about seroquel than me. I wouldn't get that deep into it unless I was going to take it. I always thought it had a high affinity for D2 but looks like you're right. Although at higher doses it may have this antagonistic affect.

D1 (IC50 = 1268nM), D2 (IC50 = 329nM), D3, and D4 receptor antagonist
5-HT1A (IC50 = 717nM), 5-HT2A (IC50 = 148nM), 5-HT2C, and 5-HT7 receptor antagonist
α1-adrenergic (IC50 = 94nM) and α2-adrenergic receptor (IC50 = 271nM) antagonist
H1 receptor (IC50 = 30nM) antagonist

Talk about a high h1 affinity. It doesn't even touch 5-ht1a either unless super high doses.


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## ricca91 (Mar 11, 2012)

kehcorpz said:


> Nah you would probably know more about seroquel than me. I wouldn't get that deep into it unless I was going to take it. I always thought it had a high affinity for D2 but looks like you're right. Although at higher doses it may have this antagonistic affect.
> 
> D1 (IC50 = 1268nM), D2 (IC50 = 329nM), D3, and D4 receptor antagonist
> 5-HT1A (IC50 = 717nM), 5-HT2A (IC50 = 148nM), 5-HT2C, and 5-HT7 receptor antagonist
> ...


Yeah, it's at 400-800 mg that it begins to block a significant amount of D2 receptors, hence the antipsychotic effect.

IIRC quetiapine is the most potent antihistamine after olanzapine and remeron maybe. I surely feel it since it knocks me out better than Mike Tyson.

Also, its alpha-1 antagonist effects are strong, that causes orthostatic hypotension. When I began taking it and got up quickly I felt really dizzy and almost fainted once. Now it's not a problem anymore.

You are right, quetiapine doesn't bind to 5-HT1A receptors, but it seems like its metabolite desalkylquetiapine does, but it's still in discussion. Here there is a nice diagram that shows the comparison between quetiapine and its metabolite regarding affinities. Gotta love quetiapine pharmacology!

http://www.nature.com/npp/journal/v33/n10/fig_tab/1301646f2.html#figure-title


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## riptide991 (Feb 1, 2012)

That diagram is trippy. I mean it pops at you like crazy, it feels like it's 3d.


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## ricca91 (Mar 11, 2012)

kehcorpz said:


> That diagram is trippy. I mean it pops at you like crazy, it feels like it's 3d.


Haha, well, that's how nature psychopharmacology rules!


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## A Sense of Purpose (May 8, 2011)

Is there anyone that knows about neuroprotection while on antipsychotics?

Preventative supplements that reduce tardive dyskinesia etc...?


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## GotAnxiety (Oct 14, 2011)

A Sense of Purpose said:


> Is there anyone that knows about neuroprotection while on antipsychotics?
> 
> Preventative supplements that reduce tardive dyskinesia etc...?


Only thing that comes to mind is Nac. But it is hard to do research on my phone. Maybe you can find some studies.


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## A Sense of Purpose (May 8, 2011)

For the past 4 or so days i have stopped taking seroquel due to the shaking/tremor ive started to develop in my hands. Im curious to see whether it subsides over the next week or so as a means of determining the onset.

Mood has been consistent in that ive had several hours of each day being energized and motivated as well as waxing and waning into fatigue and restlessness. 

Not sure if this is the fading effect of the seroquel or if its just the natural flow.

I have noticed an increase in drinking which i should start monitoring closely.


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## A Sense of Purpose (May 8, 2011)

Have been abstaining from Seroquel since last post.

No difference in tremor at this stage and as a result am not sure what to think.

Last night i took another seroquel (only 25mg) and it did its job in putting me to sleep. Today i monitored the shakes and it seems to be not that much different.


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## R86 (May 2, 2012)

I guess I'll take over this thread then, at least for now. I've been on 100 mg Zoloft each morning and 50 mg trazodone at bedtime, plus either Z-drugs or benzos as needed. My psychiatrist has prescribed 100 mg Seroquel at night (or maybe mid-afternoon? I will have to work with the timing) to replace the trazodone, or else 50 mg of each. He has also prescribed some 50 mg Zoloft so that I can up that dose to 150 mg if I wish to try doing so.

I mention working with the timing because 50 mg each of Seroquel and trazodone seemed to last 15-16 hours, not all of which I'd spend sleeping, but during which I wouldn't be eager to drive, let alone teach a class. 50 mg Seroquel by itself didn't result in terribly good sleep. I haven't tried 100 mg by itself.

I think I'll have to learn to tolerate doses of Seroquel well above 100 mg if I hope to get any mood stabilizing and/or antipsychotic effects, but it's a good start. This is a good month to experiment since I teach only afternoons until February.

I would love it if I could discontinue even my occasional use of Z-drugs and benzos, except in emergencies. Neither of the two seem to do any good for intrusive thoughts and mood swings, and besides, I'd rather take as few drugs as possible. So if I eventually wind up on 150-200 mg Zoloft each morning plus as much Seroquel as I can tolerate at night (or in the evening or late afternoon?), I think I would be fine with that outcome. Of course I'd have to find it helpful first.


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## A Sense of Purpose (May 8, 2011)

I have been a bit sh**y lately at logging my moods. I think that its because they have been all over the place that ive been not bothered in trying.

Im currently considering whether 150 zoloft would be an option as ive almost been at 100mg for a month now without any major significant improvement.

I may start using seroquel prn for sleep again as the hand shaking and body twitching has subsided somewhat since my last post.


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## jim_morrison (Aug 17, 2008)

R86 said:


> I think I'll have to learn to tolerate doses of Seroquel well above 100 mg if I hope to get any mood stabilizing and/or antipsychotic effects, but it's a good start. This is a good month to experiment since I teach only afternoons until February.


Is it your goal to get mood stabilizing/antipsychotic effect from Seroquel?
If you can't tolerate it due to sedation I think a similar but less sedating antipsychotic like Saphris would be a better fit. However if your just using low dose Seroquel for insomnia then disregard this post.


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## A Sense of Purpose (May 8, 2011)

Taking 50mg Quel to see if i can fall asleep tonight. 

Last night i had a rubbish sleep but was in a pretty good mood for most of the day despite being 43 degrees C. 

This is a trend im noticing. The less sleep i get the better i seem to feel the next day.
Im not totally the most engaged person in the world but things seem better after less sleep.

Any way, will see how i go tomorrow if i get a few decent hours (4-6 i hope).
Night!


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## R86 (May 2, 2012)

So I took the 100 mg Seroquel at about 11:00 last night. I'm sure I was out by 11:30. Starting around 5:00 I went through a period of being unable to fall back to sleep. When I started to think I should just get up and make do with five hours' sleep, I conked out from about 7:00 to 9:00. This is actually a very typical pattern for me, and would often happen with only the 50 mg trazodone.

It's now about an hour later, and I still feel somewhat sedated, but not overwhelmingly so. With 50 mg each of Seroquel and trazodone, I'd be useless until about 2:00 p.m., whereas now I would feel comfortable driving, and could probably even teach a class. I am slowed down enough that I could maybe even listen to students' questions without taking everything personally and snapping at them. Crazy idea, I know.

The only thing is that I'll have an early morning class starting in about a month. So maybe I'll just have to go to bed at 9:00 or so in order to be functional earlier.



jim_morrison said:


> Is it your goal to get mood stabilizing/antipsychotic effect from Seroquel? If you can't tolerate it due to sedation I think a similar but less sedating antipsychotic like Saphris would be a better fit. However if your just using low dose Seroquel for insomnia then disregard this post.


I would say I'm interested in both. The question is whether I can learn to tolerate a 200-300 mg dose rather than just 100 mg. I have yet to read up on Saphris, but my pdoc thought Abilify would be too stimulating for me (and he is probably right).

I suppose another possibility would be to stick with trazodone at night, but at a much higher dose, though as far as I know this is only an antidepressant and is not used as an antipsychotic. I also can't recall reading about anyone here using it on-label as an antidepressant, rather than only off-label for sleep.


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## R86 (May 2, 2012)

Day 2 of replacing the 50 mg trazodone at bedtime with 100 mg Seroquel, and I've come to the conclusion that I don't like it. Falling asleep last night was really weird, as though my mind was ready to sleep but my body wanted to get up and run around the block a bunch of times. This morning I feel kind of the same way. Also I wonder if the pharmacy accidentally gave me the extended release form of Seroquel. The tablets are not scored, and appear to be enterically coated. I'm not sure my pill cutter could easily split them in two even if I tried.

My pdoc gave me the green light to try raising the Zoloft from 100 mg to 150, so I just took 50 mg additional Zoloft. Tonight I think I'll go back to the trazodone, and maybe try 100 mg. It seems trazodone is short-acting, but at higher doses it's supposed to have antidepressant effects. Plus I've heard it can counteract some of the side-effects from Zoloft.

If I feel better tomorrow, I will consider working my way up to 200 mg each of Zoloft and trazodone (morning and nighttime respectively). Will keep you all posted.


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## A Sense of Purpose (May 8, 2011)

R86 said:


> Day 2 of replacing the 50 mg trazodone at bedtime with 100 mg Seroquel, and I've come to the conclusion that I don't like it. Falling asleep last night was really weird, *as though my mind was ready to sleep but my body wanted to get up and run around the block a bunch of times. *


I get this but the next day after taking seroquel. Also, as im falling asleep i get those leg twitches that scare the sh** out of you and raise your heart rate.


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## R86 (May 2, 2012)

Great, sounds like I can look forward to more of the same tomorrow then, even without taking Seroquel tonight. 

But seriously, I guess this is what they mean by akathisia. In any case, tonight I'll just take my usual 50 mg trazodone and maybe try 100 mg tomorrow. I will ask my doctor at what dose I might start to see further antidepressant benefits, and also whether it might pay to take trazodone twice a day. It is somewhat sedating to be sure, but less sedating than Seroquel.


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## jim_morrison (Aug 17, 2008)

R86 said:


> I would say I'm interested in both. The question is whether I can learn to tolerate a 200-300 mg dose rather than just 100 mg. I have yet to read up on Saphris, but my pdoc thought Abilify would be too stimulating for me (and he is probably right).


The general consensus seems to be that Abilify differs from other atypical antipsychotics in that it tends to be somewhat stimulating rather than sedating.

The other Atypicals tend to be on the sedating side but to varying degrees with Seroquel generally being considered as the most sedating of the common ones (so excluding Clozaril and some of the more obscure older typicals).



R86 said:


> Day 2 of replacing the 50 mg trazodone at bedtime with 100 mg Seroquel, and I've come to the conclusion that I don't like it. Falling asleep last night was really weird, as though my mind was ready to sleep but my body wanted to get up and run around the block a bunch of times. This morning I feel kind of the same way. Also I wonder if the pharmacy accidentally gave me the extended release form of Seroquel. The tablets are not scored, and appear to be enterically coated. I'm not sure my pill cutter could easily split them in two even if I tried.


IRs (immediate release) tend to be round whilst the XRs are an oblong shape.

http://www.drugs.com/seroquel-images.html


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## R86 (May 2, 2012)

Well, it would be great to find another atypical antipsychotic other than Abilify that is not quite as sedating -- and preferably available generic. I plan to see my GP doctor in about a week for a routine checkup, so I'll see if he knows of any. In the meantime, after waking up at 5:30 and never being able to fall back to sleep (another common pattern of mine), maybe I won't write off Seroquel just yet. My pdoc said also to try 50 mg each of Seroquel and trazodone again. I've slept great on that combination before, the issue of course being at what point I can function the next day. Yet I'd certainly much rather add Seroquel every night to my trazodone than Ambien occasionally.

I've also increased Zoloft to 150 mg, but of course I won't fully know what that's doing for me (if anything) for at least 2-3 weeks.


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## A Sense of Purpose (May 8, 2011)

Updatin' time!

So in the past 2-3 weeks i have been skeptical about how my zoloft treatment at how 100mg was fairing.

Its just hit the month mark since ive been on 100mg and i think im starting to notice the difference in a positive manner again. The first few weeks felt confused, up/down and over all just a bit unpleasant.

However, now im feeling quite functional again and have regained my urge to read books. Im currently reading "Phantoms in the Brain." Its great.

Furthermore, i recently resigned from my hospitality job that i had been at for 4 years. I liked a girl there i met right at the start, but never considered that the feeling was mutual... (She's taller than me, by like a foot, and a couple years older).

Anyway, at the staff party i hooked up with her (which she initiated) and now im feeling quite euphoric as a result. We are catching up for drinks tonight ^_^

Im s*** scared/nervous, but at the same time, because ive known her for so long, and never though i'd ever have a chance, she knows the 'real me' (the one that jokes and doesnt hold back etc) because ive always just acted myself.

So in a way, the pressure is on for me to act myself, rather than some 'put on' / tip toe delicate persona.

Anyway, enough ramble. 

Verdict: Hypomanically Positive, reading again, little nervous and quite excited.

P.S. - have been taking seroquel maybe once or twice in the past 2 weeks only at 50mg. Perhaps this is working out better as opposed to 100mg.

Over and out.


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## A Sense of Purpose (May 8, 2011)

Also, i forgot to add that i'm back exercising again. Im doing a 5 day split with cardio 1 day a week. Just from the two days ive been i already feel like i have more energy. Definitely feeling the Anandamide high during and post workout too.


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## banskevie (Jan 9, 2013)

I wonder whether simply increasing the Zoloft would do any good.


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## A Sense of Purpose (May 8, 2011)

banskevie said:


> I wonder whether simply increasing the Zoloft would do any good.


For myself? Or for you?


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## R86 (May 2, 2012)

A Sense of Purpose said:


> So in the past 2-3 weeks i have been skeptical about how my zoloft treatment at how 100mg was faring. [...] have been taking seroquel maybe once or twice in the past 2 weeks only at 50mg. Perhaps this is working out better as opposed to 100mg.


Likewise I've increased the Zoloft in the morning from 100 to 150 mg over the past 4-5 days. I don't really notice much of anything from that yet. I'm also taking 50 mg Seroquel every night with my 50 mg trazodone, and though it's a bit difficult to get going in the morning, I'm definitely feeling more even and mellow throughout the afternoon. It's much easier to take students' questions without looking for ways to interpret everything as a threat or an attack. Granted I don't know for sure that it's due to the Seroquel rather than to the Zoloft, but that's my hunch at the moment.

I'm thinking I'll give 150 mg Zoloft another good 3-4 weeks before deciding whether to stay there. I really shouldn't have added the Seroquel at the same time as increasing the Zoloft, as it makes it hard to pinpoint the cause of any changes. But if I go back to 100 mg Zoloft, I might try increasing the trazodone to 100 mg at night.


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## A Sense of Purpose (May 8, 2011)

^ yeah for sure. You definitely want at least 3-4 weeks as im JUST starting to notice positive effects from raising the dose a month ago. Im still not at my target ideal zone so ill wait a little longer and perhaps go to 125 or 150mg zoloft.

In the mean time ill keep the seroquel restricted and for insomnia only. 
Does the trazodone not do enough on its own for sleep?


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## R86 (May 2, 2012)

A Sense of Purpose said:


> Does the trazodone not do enough on its own for sleep?


Well, I usually can sleep on just 50 mg trazodone alone. It does help me to fall asleep I think, but I wouldn't call it a surefire knockout. I've tried taking 100 mg in the past, and by my memory didn't notice much difference. On nights when I'm kind of wired, I'd also usually take 5 mg Ambien twice -- once on going to bed, and once when (not if) I woke up at 4:00 a.m. But my feeling is that Seroquel is 100 times better to take than Ambien, especially long term.

I'm hoping to get some mood stabilizing effects from the Seroquel as well on the following day. So far that seems to be the case, even at only 50 mg. I know my mother takes 200 mg Seroquel daily, but it took her a long time to titrate up to that dose.

I was able to get up to 100 mg Zoloft from 50 and 75 mg fairly quickly, so my guess is that you will also tolerate 100 mg just fine. I hear that additional benefits (along with side-effect risks) accrue for both Zoloft and Seroquel with increased dosages. I don't know whether the same is true for trazodone.


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## A Sense of Purpose (May 8, 2011)

So another poster on the forum has just raised an interesting point that i now understand about seroquel.

For the past few months ive been breaking out in hives (almost on a daily basis when i was taking seroquel each night for a period). They are really itchy, come in clusters and dont go away unless i take a strong antihistamine.

Up until now i just thought it was hayfever or an allergy to washing powder or something. 

Now it all makes sense. Ill review this with my psych and maybe talk about switching over to abilify or some kind of sleep aid.


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## R86 (May 2, 2012)

It's unfortunate about that side-effect. I'd heard that some of the antipsychotics (especially the older typicals) need to be taken with something to counteract the side-effects, either an antihistamine for allergic reactions, or something else for neurologic side-effects. I hadn't heard that Seroquel could cause allergic reactions, but it stands to reason that just about anything could happen in particular cases.

Since (like me) you seem to be looking for something sedating, that at least gives your pdoc something to start with. I don't know whether mirtazapine mixes with Zoloft, but as I recall that's a sedating one.

Meantime, I'm slowly getting used to Seroquel at 50 mg, in terms of being able to get going the next morning. I still can't know whether going up from 100 mg Zoloft to 150 mg is doing any good, but if in 2-3 weeks I determine it isn't making a lot of difference, I'll have to think about whether it's worth lowering the dose back to 100 mg. Part of me thinks that one should take as much of any of these drugs as one can tolerate, but a (probably larger) part of me isn't interested in dumping any more drugs into my body than is strictly necessary.


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## A Sense of Purpose (May 8, 2011)

I agree whole heartedly


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