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Seroquel Onset Of Drowsiness/dose Timing

seroquel

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9 replies to this topic

#1 larkspur

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Posted 17 February 2012 - 11:47 AM

I was just started on Seroquel XR yesterday. We are doing a rapid titration, so last night I took 50mg, tonight I'll take 100, the next night 150, then 200, then 250, then 300. Each night the dose increases by 50mg, hopefully stable on 300mg/night.

I know that drowsiness is the limiting side effect with Seroquel. However, last night I took it at around 7pm and was awake until 2am. Taking it much earlier than 6 or 7pm isn't really plausible. I take it during my evening meal along with Depakote. The morning hangover from Seroquel is something else... I'm so sleepy and groggy, I'm typing this from bed!

Is it normal for me not to feel drowsy until 5 or so hours after your dose? Was it because I took it with food? Will it start to creep up on me faster as my dose goes up?

Seroquel XR was prescribed to me for bipolar ii with predominant depression. I just came out of a hypomania, so I was on Zyprexa 10mg for a week and Depakote 1000mg. We will be switching Depakote to Lamictal next week, so I'm titrating that down as the Seroquel goes up. This will be my third AAP (atypical antipsychotic) after being on Abilify beforehand. Long term, I will hopefully be stable on Lamictal , the Seroquel, and a stimulant (I posted about Nuvigil recently, or Dexedrine).

I'm still new to the world of bipolar meds. Before now I was always considered unipolar but refractory depression. Thanks in advance for any guidance from the bipolar vets!

Edited by larkspur, 17 February 2012 - 11:49 AM.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Current Dx:
Bipolar II;
Recurrent Major Depression, Severe, Non-Psychotic; Generalized Anxiety Disorder; Obsessive-Compulsive Disorder; Social Phobia; Primary Insomnia; ADHD - Inattentive Type

Current Rx:
Depakote ER (divalproex sodium) 250mg q. pm
Seroquel XR (quetiapine fumarate) 300mg q. pm

lithium carbonate 300mg b.i.d.
Nuvigil 150mg q. am
Xanax (alprazolam) .5mg p.r.n.

#2 Spiritual_Wanderer

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Posted 17 February 2012 - 11:52 AM

Hi. I don't know a whole lot about Seroquel, but I have heard people say that the higher up you go with Seroquel, the less drowsy. However, I don't know if that is correct or not. Everyone reacts differently. Some people will hardly be able to stay awake on one med and then someone else will have terrible insomnia. It's too early to say. I'd give it more time before deciding when to take it. If it gets really bad, call your doc and explain what is happening, and maybe he/she will have a suggestion or give you something to help you sleep?

I am Lamictal and think it is a great med.
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#3 Shattered Soldier

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Posted 17 February 2012 - 01:37 PM

I'm taking Seroquel XR 400mg. It didn't seem to make me drowsy until I got up to the 200mg dose. My doctor told me that it takes four hours to make you drowsy. That being said, no matter what the dose, sometimes it would put me to sleep in two hours, when at other times it would not work at all. Sometimes I would take it then go to bed at my usual time, even though it felt as if the drug wasn't working I was able to fall asleep rather quickly. There were other times where I would be up late and then feel the hangover the next morning. I feel as if it is an unpredictable drug, you never know if and when it will work.

As an anecdote, I work weekends from 9am to 11pm. Since I want to go to bed by 12:30pm I bring my dose of Seroquel with me. Last week I took my dose at 9pm and it actually kicked in at 9:30! My mind was swimming and I had a very hard time maintaining my composure. It was a pretty scary feeling, the drug feels very unpleasant if you try to stay awake on it.

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#4 larkspur

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Posted 17 February 2012 - 02:11 PM

Hi. I don't know a whole lot about Seroquel, but I have heard people say that the higher up you go with Seroquel, the less drowsy. However, I don't know if that is correct or not. Everyone reacts differently. Some people will hardly be able to stay awake on one med and then someone else will have terrible insomnia. It's too early to say. I'd give it more time before deciding when to take it. If it gets really bad, call your doc and explain what is happening, and maybe he/she will have a suggestion or give you something to help you sleep?

I am Lamictal and think it is a great med.


Thanks! I'm going to keep taking it in the evening with dinner until I talk to the doc next. I think it will stay there. As far as giving me something to sleep, I have refractory insomnia too...so most sleep meds have little effect on me after years of using Ativan or Benadryl to get to sleep. I still have some Sonata, and can take 20mg up until like 2 or 3 in the morning without feeling hungover the next day. I'm trying hard not to use it though, and since I'm off work for mental health disability until March 5th, there's not a lot on the line there. Thanks for your feedback on Lamictal, I think it will be a great med for me as well... my fingers are crossed that it's activating and helps keep the depression away.

I'm taking Seroquel XR 400mg. It didn't seem to make me drowsy until I got up to the 200mg dose. My doctor told me that it takes four hours to make you drowsy. That being said, no matter what the dose, sometimes it would put me to sleep in two hours, when at other times it would not work at all. Sometimes I would take it then go to bed at my usual time, even though it felt as if the drug wasn't working I was able to fall asleep rather quickly. There were other times where I would be up late and then feel the hangover the next morning. I feel as if it is an unpredictable drug, you never know if and when it will work.

As an anecdote, I work weekends from 9am to 11pm. Since I want to go to bed by 12:30pm I bring my dose of Seroquel with me. Last week I took my dose at 9pm and it actually kicked in at 9:30! My mind was swimming and I had a very hard time maintaining my composure. It was a pretty scary feeling, the drug feels very unpleasant if you try to stay awake on it.


Thanks for your feedback. Once it did kick in, I was out like a light and down for the count for seven solid hours. It felt like the deepest sleep I've had in ages. It's good to know that it can vary in terms of timing though - I want to go to bed at around 11pm, and if your doc's four hour figure is right, then taking it at 7pm is just right for me. That gives me some sort of benchmark to go off, and I'll keep track in my journal if it kicks in too much earlier or later. :)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Current Dx:
Bipolar II;
Recurrent Major Depression, Severe, Non-Psychotic; Generalized Anxiety Disorder; Obsessive-Compulsive Disorder; Social Phobia; Primary Insomnia; ADHD - Inattentive Type

Current Rx:
Depakote ER (divalproex sodium) 250mg q. pm
Seroquel XR (quetiapine fumarate) 300mg q. pm

lithium carbonate 300mg b.i.d.
Nuvigil 150mg q. am
Xanax (alprazolam) .5mg p.r.n.

#5 Avian86

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Posted 18 February 2012 - 09:09 PM

Seroquel XR has peak plasma levels around 4-6 hours after taking it, so take it 4-6 hours before bedtime. The hangover effect of Seroquel XR even at 50-100mg is way too much for me. I used to be able to tolerate 20mg of Zyprexa in addition to an insane amount of CNS depressants, but not anymore, my tolerance is mostly gone. I'm just in a daze on day two of Seroquel XR, unable to drive anywhere, and I really am sick of sleeping 19+ hours a day. I want to be able to go out so that i can get some grocerys and get on with my life. ugh....

#6 1099

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Posted 18 February 2012 - 09:30 PM

I take 100mg Seroquel primarily for sleep, but the darn med is always playing tricks on me. Sometimes I'm drowsy within an hour, other times it takes up to four hours to put me to sleep. There seems to be no method to the madness. I have learned to take it one hour before bedtime, just in case. If it works, it works. If not, at least I tried. I am sticking with Seroquel, as all other sleep meds have not worked a penny for me. I am grateful that it works well some days.
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Manic-Depression (Bipolar 1, rapid cycling)

Lithium: 1500mg, Lamictal: 300mg, Abilify: 10mg, Latuda: 40mg, Seroquel: 100mg

#7 larkspur

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Posted 18 February 2012 - 10:44 PM

So there's a big difference in the drowsiness between the XR and IR? I ask because, of course, quetiapine IR will be available generic in a few months and if I could get a little MORE sedation out of it, that would be great! I barely feel the XR.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Current Dx:
Bipolar II;
Recurrent Major Depression, Severe, Non-Psychotic; Generalized Anxiety Disorder; Obsessive-Compulsive Disorder; Social Phobia; Primary Insomnia; ADHD - Inattentive Type

Current Rx:
Depakote ER (divalproex sodium) 250mg q. pm
Seroquel XR (quetiapine fumarate) 300mg q. pm

lithium carbonate 300mg b.i.d.
Nuvigil 150mg q. am
Xanax (alprazolam) .5mg p.r.n.

#8 Lady Mozzer

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Posted 19 February 2012 - 02:31 PM

I take seroquel xr and regular seroquel.My pdoc told me to take 300 of xr at 5:00 pm and then take 600 of reg seroquel at bedtime and with that 1mg of lorazepam.It usually takes an hour for them to kick in.That was the usual thing.Sometimes it takes a bit longer though.At first I was afraid to take the 5:00 pm dose but it seemed to be working out okay.I started sleeping like a normal person.

Now that I`m going through cymbalta withdrawal hell my sleep patterns are going crazy again.Like someone else said trying to stay up when seroquel starts to kick in again it can be funny.People can think your drunk or something.

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#9 i am a cat

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Posted 21 February 2012 - 05:09 PM

Seroquel XR kicks in in about 3 hours for me, but I may have fast metabolism.

Normal Seroquel took about an hour.
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#10 larkspur

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Posted 21 February 2012 - 11:21 PM

Thanks everyone for the replies. While XR is fine, I think IR will work better for what I need, based on this feedback. After getting used to it, the Seroquel helps me sleep quite well, but I have to take it around 6pm. Mornings are actually now my most productive part of the day - I wake up, and I'm UP! But I get sedation mostly in the afternoons once my initial energy after waking up has worn off. If it all hits me at once, and I can sleep it off and then get up and around my day, I think that will be ideal.

One dosing question - going from XR to IR, is it just straight dosing, 300mg XR = 300mg IR, or would the IR dosage need to be higher to maintain blood plasma levels and etc.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Current Dx:
Bipolar II;
Recurrent Major Depression, Severe, Non-Psychotic; Generalized Anxiety Disorder; Obsessive-Compulsive Disorder; Social Phobia; Primary Insomnia; ADHD - Inattentive Type

Current Rx:
Depakote ER (divalproex sodium) 250mg q. pm
Seroquel XR (quetiapine fumarate) 300mg q. pm

lithium carbonate 300mg b.i.d.
Nuvigil 150mg q. am
Xanax (alprazolam) .5mg p.r.n.





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