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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Basia on January 29, 2008, at 10:38:08
HI
I would be so grateful if anyone could share similar experiences or offer advice on this.
I have been having a really hard time switching from Sulpiride to Seroquel recently. I had a five week cross over titration that began in early December and everything was fine - no depression, no hallucinations. However, in the past 3 weeks, although I am not delusional and retain insight, people have looked threatening , their body movements look as if they are a message to me and buildings seem paper thin and glowing with light around them, as do people. I also see trails when i move my hands slowly. I have taken a week and a half off work and am lucky as I can take up to 6 months' paid sick leave. However, I cannot leave my apartment and am getting very depressed and demotivated, as well as scared. I need to be around people to lift my depression a bit,but I cannnot go out as it is too surreal and scary. Luckily friends can occasionally visit. However, I am worried that this is going to escalate and I am not sure if it is the Seroquel causing this or bleed-through psychosis - I have a diagnosis of BP1 with particular emphasis on depression in the past few years, whereas in the 90s it was mainly psychosis. I was on Sulpiride for 10 years and am currently on 425 mg Seroquel (25mg in the am) and 400mg of Lamictal (since 2004 and it saved my life). Sorry it's such a long post but I just wanted to give the background!
Thanks so much for any feedback in advance!
Posted by Phillipa on January 29, 2008, at 13:14:06
In reply to Nasty switch from Sulpiride to Seroquel-any ideas?, posted by Basia on January 29, 2008, at 10:38:08
Welcome to babble is this your first time here? We're glad to have you. I'm sorry I don't have the answer to your problem. Someone is sure to answer your question but does you pdoc know about the problems you're having? Phillipa
Posted by torachan on January 29, 2008, at 23:22:59
In reply to Nasty switch from Sulpiride to Seroquel-any ideas?, posted by Basia on January 29, 2008, at 10:38:08
Can you tell me my friend what exactly do you experience as a psychosis? I believe I may have some form of psychosis as I do experience odd, disorganized thought, disordered perception, and I have a very introverted and suspicious view of the outside world. Although, I don't experience any visions, hallucinations, either auditory or visual.
I was diagnosed as having generalized anxiety many moons ago but I sincerely believe I have a more serious underlying problem. One diagnosis I received once was schizoid personality disorder. I'm scheduled to see a psychiatrist next week for another analysis.
Do personality disorders such as schizoid or schizoaffective classify as psychosis? And what is the most suitable treatment for these disorders?
Posted by Basia on January 30, 2008, at 0:19:44
In reply to Re: Nasty switch from Sulpiride to Seroquel)Basia, posted by torachan on January 29, 2008, at 23:22:59
> Can you tell me my friend what exactly do you experience as a psychosis? I believe I may have some form of psychosis as I do experience odd, disorganized thought, disordered perception, and I have a very introverted and suspicious view of the outside world. Although, I don't experience any visions, hallucinations, either auditory or visual.
>
> I was diagnosed as having generalized anxiety many moons ago but I sincerely believe I have a more serious underlying problem. One diagnosis I received once was schizoid personality disorder. I'm scheduled to see a psychiatrist next week for another analysis.
>
> Do personality disorders such as schizoid or schizoaffective classify as psychosis? And what is the most suitable treatment for these disorders?Hi
I am not a psychiatrist so I would not be able to help you with with the last two questions, other than look at the net. Your psychiatrist would be able to help and you can further familiarise yourself with it on the net. My experience of psychosis is one where I become very light-headed, grandiose, paranoid and I end up ticking all the boxes that lead to a diagnosis of BP1 psychosis. When I was delusional, which was a long while back, these fabulous stories involving conspiracy theories all seemed real and i was swiftly hospitalised. Classic symptoms.
Hope you get better!
Posted by Basia on January 30, 2008, at 0:25:18
In reply to Re: Nasty switch from Sulpiride to Seroquel-any ideas? » Basia, posted by Phillipa on January 29, 2008, at 13:14:06
Thanks Philippa! I was briefly on the board in 2004 but am now revisiting and find it very helpful and supportive. I hope somone has some ideas on my situation as it's a bit of a nightmare :(
Take care
Lyn
Posted by bleauberry on January 30, 2008, at 19:07:17
In reply to Nasty switch from Sulpiride to Seroquel-any ideas?, posted by Basia on January 29, 2008, at 10:38:08
I don't know why you had to leave sulpride. So maybe what I have to say is off course. I apologize if so.
First of all, 10 years on any drug is a long time. No matter how slow you switch over, it could probably be expected to take a long time to stabilize at some new place. It might never happen. Just being realistic here. After my 8 years on sulpride' sister zyprexa, it took me 3 months to find any stable ground, and literally a full year to say it was completely behind me.
I don't know. I've read tons of abstracts on all the antipsychotics and all the head-to-head matches comparing them. Overall, it is hard to beat sulpride in terms of controlling the positive symptoms (psychosis stuff), and really hard to beat its power against negative symptoms (the depression stuff).
Hey, here's an idea. You were doing fine during the transition? Maybe go back to that. Take your half dose of sulpride and your half dose of seroquel. Sulpride has indeed been combined with other antipsychotics for superior effects. So it wouldn't be odd and it wouldn't be the first time. Sulpride's uniqueness interacting with only specific receptors and not touching anything else is not achievable with any other drug.
I am biased and just don't like seroquel very much, but I guess you could always try to increase the dose. I've seen doses up to 800mg. But who knows, maybe seroquel itself at this dose is what is causing the depression, and maybe a lower dose with some sulpride added back in would be a good combo?
Just some thoughts.
Posted by Basia on January 31, 2008, at 1:58:08
In reply to Re: Nasty switch from Sulpiride to Seroquel-any ideas?, posted by bleauberry on January 30, 2008, at 19:07:17
Hi
Thanks for this. I think it's certainly a good idea to use a small amount of Sulpiride when it gets bad at the moment. The reason I can't take it any longer is because I developed hyperprolactinemia and my periods stopped for years. I had found that Sulpiride, as you say, is fantastic for psychosis and does not leave you like a drooling lump in the corner with no cognitive capacity, as Clozapine and Olanzapine did. After trying a few atypicals it was the first one that made me feel ok and made things look normal. However, due to my periods stopping, my bones started thinning so they put me on HRT (I am 34 so certainly didn't want to be put on it for decades). It was a band aid with nasty side effects so I am now off the Sulpiride. as we think it's best to tackle the root of the problem. Have actually felt better this last couple of days so may well stick to the Seroquel, which, according to my psychiatrist, has a low risk of causing hyperprolactinemia.
Fingers crossed!
Thanks again
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