![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by TheMagicPill on August 30, 2005, at 17:48:51
I love the Seroquel. It has calmed me down unlike any medicine. However, I find myself groggy for hours in the morning, Caffeine helps, but I was wondering if anyone knew of any meds that would awaken me. Thanks!
Posted by Phillipa on August 30, 2005, at 20:11:59
In reply to When med helps with grogginess from Seroquel??????, posted by TheMagicPill on August 30, 2005, at 17:48:51
How about the magic pill? But seriously I tried seroquel and nothing took that feeling away from me. That's why I like benzos better. Fondly, Phillipa
Posted by TheMagicPill on August 31, 2005, at 1:48:37
In reply to Re: When med helps with grogginess from Seroquel?????? » TheMagicPill, posted by Phillipa on August 30, 2005, at 20:11:59
i take seroquel and klonopin, it works but i am very groggy. anyone else know what could perk me up after i am awakened for a couple of hours?
Posted by RetiredYoung on August 31, 2005, at 10:59:24
In reply to Re: ANYONE else have an OPINION????? SLS????, posted by TheMagicPill on August 31, 2005, at 1:48:37
Hello - I've taken Seroquel in the past and know exactly what you mean. I now take 10mg of Zyprexa and I never really feel awake. I've tried Adderall up to 70mg (helped for a while, but effect faded), Provigil up to 400mg (helped some, but not much), and caffeine/energy drinks by the gallon. Even though I don't get much of a boost from anything, I often seem to experience the crash after a few hours where I end up feeling even more out of it.
My pdoc wants me to go down on the Zyprexa to help with the fatigue/sleepiness, but its been doing a good job with my treatment-resistant depression, so I'm reluctant to alter my dosage.
Regards,
Jim
Posted by TheMagicPill on August 31, 2005, at 13:38:11
In reply to Re: Zyprexa has made me a stimulant black hole, posted by RetiredYoung on August 31, 2005, at 10:59:24
i hate to give up seroquel, because it has been a miracle drug for my anxiety. it just knocks out that rage of nervous energy i have felt for years. on the other hand, it is starting to make me feel tired about 90-percent of the day. however, i am willing to accept that as long as it takes away the anxiety. i wish there was a way to not feel as groggy as long.
right now my only solution is a lot of caffeine.
Posted by Bill LL on August 31, 2005, at 16:09:01
In reply to When med helps with grogginess from Seroquel??????, posted by TheMagicPill on August 30, 2005, at 17:48:51
I take 400 mg Provigil. It works well for me and counteracts tiredness that I get from Lexapro 15 mg. It also helps with my ADD. Provigil and Lexapro are the only 2 psychoactive drugs that I take. Actually one more, Lunesta.
Caffeine sometimes gets a bad rap. But as far as I can tell from reading medical articles, there should be no problem with taking large amounts of caffeine as long as you are not getting insomnia from taking it late in the day.
I have heard some people say that they take Seroquel earlier in the evening to avoid morning grogginess. I'm not sure but does Topomax give energy?
> I love the Seroquel. It has calmed me down unlike any medicine. However, I find myself groggy for hours in the morning, Caffeine helps, but I was wondering if anyone knew of any meds that would awaken me. Thanks!
Posted by yxibow on September 1, 2005, at 5:36:34
In reply to Re: When med helps with grogginess from Seroquel??????, posted by Bill LL on August 31, 2005, at 16:09:01
> Caffeine sometimes gets a bad rap. But as far as I can tell from reading medical articles, there should be no problem with taking large amounts of caffeine as long as you are not getting insomnia from taking it late in the day.It doesn't mix well with anxiety but if a reasonable amount is used earlier in the day it shouldn't be too much of a problem; insomnia as you say is a downside.
>
> I have heard some people say that they take Seroquel earlier in the evening to avoid morning grogginess. I'm not sure but does Topomax give energy?I am groggy through the afternoon because I take Seroquel too late, I am attempting to scale it back at times and it does make a difference when I take it. If you say, took it at 1030 or 11, it would probably hit you with the grogginess of its intense H1 receptor binding at midnight. I dont know if you're taking it twice or once daily, I'm assuming once daily (a number of people can get by with once). But its worth a try to scale it back in the evening when it is possible.
Posted by med_empowered on September 1, 2005, at 5:59:53
In reply to Re: When med helps with grogginess from Seroquel??, posted by yxibow on September 1, 2005, at 5:36:34
hi! Sometimes breaking up the dose helps. 2X dosing is standard for schizophrenia, and 3X dosing helps with the drowsiness...you can usually do small doses AM, big dose PM (ex: 50 50 100). Provigil is good stuff, so that might be worth pursuing. I wouldnt recommend caffeine, because caffeine raises the blood levels of most neuroleptics...it could (theoretically) increase your risk of cognitive impairment and EPS. Adding a stimulating antidepressant might help...Wellbutrin, Effexor, Cymbalta, etc. I'd avoid Tricyclics b/c of their side effects and b/c they can supposedly compound the EPS thing. And you could switch...low-dose Abilify was good stuff for me, at least for a while. Risperdal is also less sedating than seroquel, although its probably the harshest of the atypicals in terms of EPS...Symbyax might be a good option, since low-dose Zyprexa (in the 6/25 or 6/50 pills) is less sedating than seroquel anyway, and with the activation of prozac, the sedation is probably even less pronounced. Good luck!
Posted by Paulbwell on September 1, 2005, at 7:02:17
In reply to Re: When med helps with grogginess from Seroquel??, posted by med_empowered on September 1, 2005, at 5:59:53
> hi! Sometimes breaking up the dose helps. 2X dosing is standard for schizophrenia, and 3X dosing helps with the drowsiness...you can usually do small doses AM, big dose PM (ex: 50 50 100). Provigil is good stuff, so that might be worth pursuing. I wouldnt recommend caffeine, because caffeine raises the blood levels of most neuroleptics...it could (theoretically) increase your risk of cognitive impairment and EPS. Adding a stimulating antidepressant might help...Wellbutrin, Effexor, Cymbalta, etc. I'd avoid Tricyclics b/c of their side effects and b/c they can supposedly compound the EPS thing. And you could switch...low-dose Abilify was good stuff for me, at least for a while. Risperdal is also less sedating than seroquel, although its probably the harshest of the atypicals in terms of EPS...Symbyax might be a good option, since low-dose Zyprexa (in the 6/25 or 6/50 pills) is less sedating than seroquel anyway, and with the activation of prozac, the sedation is probably even less pronounced. Good luck!
Get your Doc to script a stimulant, Ideally Dexedrine up to 30mgs in the morning 5mg IR tabs or SR Spansules a couple houres before you wake up, or Desoxyn if they are reachable (The most efficient).
Cheers
Posted by yxibow on September 1, 2005, at 17:11:29
In reply to Re: When med helps with grogginess from Seroquel??, posted by med_empowered on September 1, 2005, at 5:59:53
> hi! Sometimes breaking up the dose helps. 2X dosing is standard for schizophrenia, and 3X dosing helps with the drowsiness...
Except I dont know if the poster was taking it for a schizophreniform disorder. And it has been shown that 1x is possible. But you're right, the PDR generally says twice because of the low half life. Although its moot, I don't take it for schizophrenia, but even when I was taking Seroquel at lower doses, as much as 4x a day, I would be groggy while driving -- splitting it up too much can also be a problem. This was the same with Remeron.
>Adding a stimulating antidepressant might help...Wellbutrin, Effexor, Cymbalta, etc.
This may help -- I take Cymbalta.
>I'd avoid Tricyclics b/c of their side effects and b/c they can supposedly compound the EPS thing.Also good words
>And you could switch...low-dose Abilify was good stuff for me, at least for a while. Risperdal is also less sedating than seroquel, although its probably the harshest of the atypicals in terms of EPS...
Quite harsh, Geodon too somewhat, at least in my opinion, and unfortunately Abilify to some extent, as far as the akathisia form of EPS goes. But everyone is different. Unless if it was for schizophrenia and not an anxiety spectrum disorder I would stick to the least "harsh".
Posted by TheMagicPill on September 2, 2005, at 0:48:04
In reply to Re: When med helps with grogginess from Seroquel??, posted by yxibow on September 1, 2005, at 17:11:29
just got it today when i told the pdoc i was groggy most of the time.
do you think paxil is a good stimulant? thanks
Posted by yxibow on September 2, 2005, at 23:03:28
In reply to Re: My pdoc prescribed Paxil ... will it help????, posted by TheMagicPill on September 2, 2005, at 0:48:04
> just got it today when i told the pdoc i was groggy most of the time.
>
> do you think paxil is a good stimulant? thanksPaxil I believe is generally one of the more calming SSRIs, mildly sedating I believe. Luvox is more sedating. Prozac and Zoloft are more activating.
Or there is the SNRI Effexor if you can stand its highly activating (in my experience) profile, and the more recent gentler SSNRI Cymbalta which still has some activating properties especially at the beyond PDR dosages that some are being prescribed.
Posted by TheMagicPill on September 3, 2005, at 1:36:31
In reply to Re: My pdoc prescribed Paxil ... will it help????, posted by yxibow on September 2, 2005, at 23:03:28
yx:
i thought prozac and paxil were just about the same meds.
you are definitely right about effexor. that stuff kicks.
Posted by yxibow on September 3, 2005, at 21:27:41
In reply to Re: My pdoc prescribed Paxil ... will it help???? » yxibow, posted by TheMagicPill on September 3, 2005, at 1:36:31
> yx:
>
> i thought prozac and paxil were just about the same meds.Prozac came out earlier than Paxil as I recall, it is a less "cleaner" SSRI, with each successor being slightly more targeted, more or less, with the exception of Lexapro which is just a patent extending drug.
Everyone is different, but I found this chart of sedation and other comparisons (you'll have to scroll down in the PDF to the SSRI comments) of some of the SSRIs
>
> you are definitely right about effexor. that stuff kicks.definately, like an IV caffeine :)
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.