Bpforlife73 New here and tapering off of Seroquel and Abilify

[Bpforlife73]

I am beginning a very long journey. I have bipolar disorder and I am 42 years old. I am being tapered off of 400 mgs of Seroquel and 30 mgs of Abilify. I have never felt so sick and confused in all my life. My brain is literally not even the same before the tapering began. I am currently on 10 mgs of Zyprexa, 30 mgs of Restoril, and 600 mgs of Trileptal. I do see my psychiatrist monthly.

 

I have been experiencing some really weird emotions and physical symptoms. Never in my life I ever felt so many things at one time. I hope to gain insight from all of you along this journey.

[nz11]

Welcome BPforlife73,

 

So you are taking seroquel abilify and zyprexa all at the same time? Thats 3 antipsychotic drugs at the same time.

Thats some cocktail. And yet its not limited to these alone! Restoril - a benzo and and trileptal - an off label unapproved mood stabiliser

Be worth running these through the drug interactions checker....

 

How are they tapering you off the seroquel?

 

this is the tapering advise on this site

http://survivingantidepressants.org/index.php?/topic/1707-tips-for-tapering-off-seroquel-quetiapine/?hl=%2Btips+%2Bseroquel

 

I am sorry you are in this difficult situation. The med profession have been very disappointing.

Why do you think you have BP ..how was that decided?

 

Your drug may be your problem by P Breggin , may be very insightful and informative.

[Altostrata]

Welcome, Bp.

 

Please explain more how you are going off Seroquel and Abilify. Are you being ramped up on 10 mgs Zyprexa, 30 mgs Restoril, and 600 mgs Trileptal at the same time?

 

Why are you taking Restoril and Trileptal?

 

Please put ALL the drugs you take in the Drug Interactions Checker http://www.drugs.com/drug_interactions.html and copy and paste the results in this topic.

[Bpforlife73]

I am being tapered off of Seroquel at 200 mgs and Abilify at 30 mgs.  I still take the 600 mgs of trileptal and I just started the 10 mgs of Zyprexa on Thursday.  I am now tapering off the 30 mgs of Restoril as well.  I am taking all of this medication at the same time.  I was taking the trileptal for mood swings and manic episodes and the restoril for sleeping issues.  I am so sorry about the confusion in my previous post.  I hope this helps explain things a little better.  I am having a really hard time typing all of this, it seems my brain is slower at processing things right now. 

 

I am not able to copy and paste the information from the website you gave me or I would have included that. 

[nz11]

So are you saying you dropped from 400 mg of seroquel to 200 mgs one week ago?

When did you start taking the seroquel? two weeks ago? two years ago?

So your doc is giving you zyprexa to cover the wdl off seroquel.?

 

Are you able to tell us when you started these other ones as well?

 

Sorry it is not easy for you to answer .....its not surprising after  taking all these drugs/

[Bpforlife73]

So are you saying you dropped from 400 mg of seroquel to 200 mgs one week ago?

When did you start taking the seroquel? two weeks ago? two years ago?

So your doc is giving you zyprexa to cover the wdl off seroquel.?

 

Are you able to tell us when you started these other ones as well?

 

Sorry it is not easy for you to answer .....its not surprising after  taking all these drugs/

Yes, I am saying that about the Seroquel. I have been on Seroquel for over 10 years at so many different dosages I cannot even remember.  The Zyprexa is supposed to be taken for mood swings and manic episodes.  The doctor did not say it was for the wdl off of the Seroquel.  I am having a really bad day today with all of the symptoms of the wdl.  I am trying to answer all of your questions to the best of my ability and I appreciate you taking the time to respond to my posts also.  I started the trileptal about six months ago at 600 mgs.  The restoril was started about six months ago also at the 30 mgs for sleep. 

 

Zyprexa was just started at 10 mgs on Thursday of last week for manic episodes and mood swings.  I swear my life on that it seems I started the manic episodes and the mood swings right around the time I was put on Abilify 30 mgs, that was started when the drug first became available, so I would say about 3 years ago to best of my ability to remember.  I was starting with psychotic symptoms over a month ago.  I was seeing and hearing things that are not really there.  This is why my doctor is tapering me off of the Abilify and Seroquel. I really do apologize for not being very thorough in all of my details.  It is just so hard to even remember things at all anymore.  I will do the best I can with the details of you have any further questions.

[Altostrata]

When you put all your drugs in the Drug Interactions Checker, you can post the link for the results here.

 

You may be able to see why you had an adverse reaction to the combination of Seroquel and Abilify -- two antipsychotics.

 

We do not take whatever psychiatrists say as gospel here. There's a lot of misdiagnosis and mismedication.

[Bpforlife73]

When you put all your drugs in the Drug Interactions Checker, you can post the link for the results here.

 

You may be able to see why you had an adverse reaction to the combination of Seroquel and Abilify -- two antipsychotics.

 

We do not take whatever psychiatrists say as gospel here. There's a lot of misdiagnosis and mismedication.

http://www.drugs.com/interactions-check.php?drug_list=233-109,2153-1402,1979-1274,1765-1129,1744-1113

[Altostrata]

Have you been feeling flat and dopey?

[nz11]

Interactions between your selected drugs
Moderate
temazepam olanzapine

Applies to: Restoril (temazepam), Zyprexa (olanzapine)

OLANZapine should not be used with temazepam without first talking to your doctor. This combination may cause low blood pressure or slow heart rate. Low blood pressure can cause dizziness or feeling like you might pass out, especially when getting up from a sitting or lying position. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

 

 

Moderate
quetiapine aripiprazole

Applies to: Seroquel (quetiapine), Abilify (aripiprazole)

Using QUEtiapine together with ARIPiprazole may increase side effects such as drowsiness, blurred vision, dry mouth, heat intolerance, flushing, decreased sweating, difficulty urinating, abdominal cramping, constipation, rapid heart beats, confusion, and memory problems. Side effects may be more likely to occur in the elderly or those with a debilitating condition. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

 

Moderate
quetiapine oxcarbazepine

Applies to: Seroquel (quetiapine), Trileptal (oxcarbazepine)

OXcarbazepine may reduce the blood levels and effects of QUEtiapine. Contact your doctor if your symptoms worsen or your condition changes during treatment with these medications. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

 

Moderate
olanzapine aripiprazole

Applies to: Zyprexa (olanzapine), Abilify (aripiprazole)

Using OLANZapine together with ARIPiprazole may increase side effects such as drowsiness, blurred vision, dry mouth, heat intolerance, flushing, decreased sweating, difficulty urinating, abdominal cramping, constipation, rapid heart beats, confusion, and memory problems. Side effects may be more likely to occur in the elderly or those with a debilitating condition. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

 

moderate
olanzapine oxcarbazepine

Applies to: Zyprexa (olanzapine), Trileptal (oxcarbazepine)

Using OLANZapine together with OXcarbazepine may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

 

Moderate
olanzapine quetiapine

Applies to: Zyprexa (olanzapine), Seroquel (quetiapine)

Using OLANZapine together with QUEtiapine may increase side effects such as drowsiness, blurred vision, dry mouth, heat intolerance, flushing, decreased sweating, difficulty urinating, abdominal cramping, constipation, rapid heart beats, confusion, and memory problems. Side effects may be more likely to occur in the elderly or those with a debilitating condition. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Moderate
temazepam aripiprazole

Applies to: Restoril (temazepam), Abilify (aripiprazole)

Using temazepam together with ARIPiprazole may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Moderate
temazepam oxcarbazepine

Applies to: Restoril (temazepam), Trileptal (oxcarbazepine)

Using temazepam together with OXcarbazepine may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Moderate
temazepam quetiapine

Applies to: Restoril (temazepam), Seroquel (quetiapine)

Using temazepam together with QUEtiapine may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Moderate
oxcarbazepine aripiprazole

Applies to: Trileptal (oxcarbazepine), Abilify (aripiprazole)

OXcarbazepine may reduce the blood levels and effects of ARIPiprazole. Contact your doctor if your symptoms worsen or your condition changes during treatment with these medications. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

No other interactions were found between your selected drugs.
Note: this does not necessarily mean no interactions exist. ALWAYS consult with your doctor or pharmacist.
Other drugs that your selected drugs interact with

    Abilify (aripiprazole) interacts with more than 500 other drugs.
    Restoril (temazepam) interacts with more than 300 other drugs.
    Seroquel (quetiapine) interacts with more than 500 other drugs.
    Trileptal (oxcarbazepine) interacts with more than 400 other drugs.
    Zyprexa (olanzapine) interacts with more than 400 other drugs.

 

Interactions between your selected drugs and food
Moderate
olanzapine food

Applies to: Zyprexa (olanzapine)

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

 

Moderate
oxcarbazepine food

Applies to: Trileptal (oxcarbazepine)

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
Moderate
aripiprazole food

Applies to: Abilify (aripiprazole)

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.
Duplication
Non-phenothiazines

Therapeutic duplication

The recommended maximum number of medicines in the 'non-phenothiazines' category to be taken concurrently is usually one. Your list includes three medicines belonging to the 'non-phenothiazines' category:

    aripiprazole (active ingredient in Abilify)
    quetiapine (active ingredient in Seroquel)
    olanzapine (active ingredient in Zyprexa)

Note: The benefits of taking this combination of medicines may outweigh any risks associated with therapeutic duplication. This information does not take the place of talking to your doctor. Always check with your healthcare provider to determine if any adjustments to your medications are needed.
Duplication
Psychotherapeutic agents

Therapeutic duplication

The recommended maximum number of medicines in the 'psychotherapeutic agents' category to be taken concurrently is usually three. Your list includes five medicines belonging to the 'psychotherapeutic agents' category:

    aripiprazole (active ingredient in Abilify)
    quetiapine (active ingredient in Seroquel)
    olanzapine (active ingredient in Zyprexa)
    temazepam (active ingredient in Restoril)

Note: The benefits of taking this combination of medicines may outweigh any risks associated with therapeutic duplication. This information does not take the place of talking to your doctor. Always check with your healthcare provider to determine if any adjustments to your medications are needed.
Duplication
CNS drugs

Therapeutic duplication

The recommended maximum number of medicines in the 'CNS drugs' category to be taken concurrently is usually three. Your list includes six medicines belonging to the 'CNS drugs' category:

    aripiprazole (active ingredient in Abilify)
    quetiapine (active ingredient in Seroquel)
    olanzapine (active ingredient in Zyprexa)
    temazepam (active ingredient in Restoril)
    oxcarbazepine (active ingredient in Trileptal)

Note: The benefits of taking this combination of medicines may outweigh any risks associated with therapeutic duplication. This information does not take the place of talking to your doctor. Always check with your healthcare provider to determine if any adjustments to your medications are needed.

[Bpforlife73]

Have you been feeling flat and dopey?

I have been feeling that way forever.  I am very forgetful also. 

[nz11]

Don't worry Bpfl73 you are doing well answering the questions.

Are you able to answer Altos question..ie What was the reason for the taking of trileptal 6 months ago?

 

I'd be tempted to ditch the zyprexa and updose the seroquel to stabilize because the taper is too fast however the doc may have  reasons for wanting to get you off the seroquel quickly if tardive dyskinesia or other side effects (psychosis, diabetes ...Parkinsonism?, mental deterioration) are manifesting.  Perhaps he has hit the panic button as he recalls some previous Oaths made.

I am sorry you are now between a rock and a hard place.

The conundrum is one cant get off this stuff quickly. At 10% per month of previous dose, from 400mg of Seroquel it will take 4.8 years (58 months) to get to 1mg. Yet it sounds like your doc is wanting to do this in a few weeks?

Be interesting to hear what others think.

[Altostrata]

BP, are you near Pittsburgh? You may want to see this doctor http://survivingantidepressants.org/index.php?/topic/988-recommended-doctors-therapists-or-clinics/?p=60340

[Bpforlife73]

Don't worry Bpfl73 you are doing well answering the questions.

Are you able to answer Altos question..ie What was the reason for the taking of trileptal 6 months ago?

 

I'd be tempted to ditch the zyprexa and updose the seroquel to stabilize because the taper is too fast however the doc may have  reasons for wanting to get you off the seroquel quickly if tardive dyskinesia or other side effects (psychosis, diabetes ...Parkinsonism?, mental deterioration) are manifesting.  Perhaps he has hit the panic button as he recalls some previous Oaths made.

I am sorry you are now between a rock and a hard place.

The conundrum is one cant get off this stuff quickly. At 10% per month of previous dose, from 400mg of Seroquel it will take 4.8 years (58 months) to get to 1mg. Yet it sounds like your doc is wanting to do this in a few weeks?

Be interesting to hear what others think.

The reason for taking the trileptal six months ago was for a supposed ongoing manic episode. 

[Bpforlife73]

BP, are you near Pittsburgh? You may want to see this doctor http://survivingantidepressants.org/index.php?/topic/988-recommended-doctors-therapists-or-clinics/?p=60340

Actually, I am no where near Pittsburgh.  I live pretty far away from there. 

[Altostrata]

Sorry, that the only doctor on our list in Pennsylvania. See http://tinyurl.com/7cp8l8v

[Bpforlife73]

Sorry, that the only doctor on our list in Pennsylvania. See http://tinyurl.com/7cp8l8v

I really appreciate you showing that there is a doctor in PA.  I just want to get off the majority of these meds and maybe one day feel a little normal, if at all possible. 

[Bpforlife73]

I am having intense itching since coming off my Seroquel and Abilify.  I am assuming this is normal.  I can't go back on these meds to taper off because now that I am on the Zyprexa my insurance is refusing to pay for anymore Seroquel or Abilify.   I have been fighting with them trying to get them to pay for it and it is just not going to happen.

[Petunia]

How are you doing now Bpforlife?

[westcoast]

BPFORLIFE, I was on some of those drugs at the same time, and it was terrible. Seroquel Abilify Trileptal, then Trileptal, Effexor and Trazodone. Trileptal was very bad. I only just found out I was on it. It gave me the only panic attack I have ever had, kept me in biFauxlar mode the whole time. Crying jags mixed with talkative, overconfident, careless and reckless mania. I wasn't on them as long as you by a long chalk but they did no good.

I'm also interested in the onset of your putative bipolar. If it started after the first time you took, or quit an antidepressant, that's a good sign it was drug induced.

 

another thing about trileptal: Novartis was fined $423,000,000 for off-label marketing of it. I've been looking for solid evidence that it helps in mania, but there really isn't any.

 

Before 2010

 

Oxcarbazepine as add-on treatment in patients with bipolar manic, mixed or depressive episode Alessandra Benedetti, Lorenzo Lattanzi, Stefano Pini, Laura Musetti, Liliana Dell’Osso, Giovanni B. Cassano

 

Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, University of Pisa, Pisa, Italy

 

DOI: http://dx.doi.org/00.1016/S0165-0327(02)00407-X

 

Despite several limitations, our study suggests the potential usefulness of OXC as adjunctive therapy to lithium both in acute and long-term treatment of bipolar disorder.

•••

 

Am J Psychiatry. 2006 Jul;163(7):1179-86.

A double-blind, randomized, placebo-controlled trial of oxcarbazepine in the treatment of bipolar disorder in children and adolescents.

Wagner KD1, Kowatch RA, Emslie GJ, Findling RL, Wilens TE, McCague K, D'Souza J, Wamil A, Lehman RB, Berv D, Linden D.

Oxcarbazepine is not significantly superior to placebo in the treatment of bipolar disorder in youths. While the overall adverse event profile was similar to that reported for patients with epilepsy, the incidence of psychiatric adverse events for both the oxcarbazepine and placebo groups was higher than that reported for the epilepsy population.

•••

 

 

Cochrane Database Syst Rev. 2008 Jan 23;(1):CD005171. doi: 10.1002/14651858.CD005171.pub2.

Oxcarbazepine in the maintenance treatment of bipolar disorder.

Vasudev A, Macritchie K, Watson S, Geddes JR, Young AH.

 

There is an insufficient methodologically rigorous evidence base to provide guidance on the use of oxcarbazepine in the maintenance treatment of bipolar disorder. Given the need for more efficacious therapeutic agents, there is a need for good quality randomised controlled trials examining the therapeutic potential of this and related agents in bipolar disorder.

 

 

•••

 

 

Oxcarbazepine Treatment of Bipolar Disorder: A Review of the Literature

Primary Psychiatry | January 1, 2002

 

In closing:

 

“These studies are encouraging because they suggest that the drug may have some mood-stabilizing effects. However, controlled studies and more clinical experience with oxcarbazepine in the United States are required before we can assess the potential utility of the agent with any clarity.”

 

 

•••

 

 

After 2010 (Cochrane Group)

 

7 December 2011

Oxcarbazepine for acute affective episodes of bipolar disorder

Vasudev A, Macritchie K, Vasudev K, Watson S, Geddes J, Young AH

The Cochrane Group (Common Mental Disorders)

From the few studies included in this review, oxcarbazepine did not differ in efficacy compared to placebo in children and adolescents. It did not differ from other active agents in adults. It may have a poorer tolerability profile compared to placebo. 

 

I hope you come back and let us know how you are doing.

wc