Old People With Unipolar Depression on Seroquel 800mg
I inherited a dump of a case in the outpatient setting. 74 yo on Seroquel 800 (14 years), Trazodone 200, Prazosin 1mg AM, 2mg HS, Ativan 0.5 bid prn. Has an obviously high tolerance to the sedating effects of her regimen. Unipolar depression per the last treating psychiatrist of years, oh and a and a touch of ptsd. How slowly would you shave off Seroquel? It’s 90% being used as a sleep aid only.
Formerly w/ an iatrogenic sedative hypnotic use d/o in full remission until it was decided...
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Source: Student Doctor Network - July 20, 2023 Category: Universities & Medical Training Authors: clement Tags: Psychiatry Source Type: forums
Seroquel--the worst antipsychotic?
People seemed to like my Sunday morning musings last week so here's another.
I dislike seroquel intensely. Which doesn't mean I don't use it. But, reasons I hate it--
1. Makes people fat. Recently was looking through data on metabolic effects and was shocked in the literature it's not shown to be one of the worst. My experience is people gain tons of weight.
2. Orthostatic hypotension. I do a lot of geri and CL, so seroquel is obviously often a theoretical first line for pts with...
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Source: Student Doctor Network - April 3, 2023 Category: Universities & Medical Training Authors: Celexa Tags: Psychiatry Source Type: forums
Lamictal augmentation for unipolar depression
Covering for an NP today and her overall diagnoses and management is driving me f*cking insane, doing things like diagnosing BPD as bipolar, and starting Lamictal for irritability.
Have seen multiple patients of hers with MDD only today, resulting in her starting low dose Prozac, Seroquel 25 mg QHS for sleep, and Lamictal AT THE SAME TIME.
Here are 4 patients of hers I saw today, all MDD:
Patient 1: Trintellex 10 mg once daily, Ritalin 30 mg once daily, Lamictal 150 mg
Patient 2: Prozac 10...
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Source: Student Doctor Network - January 27, 2023 Category: Universities & Medical Training Authors: yoloswagpoop42069 Tags: Psychiatry Source Type: forums
Dosage of Quetiapine for acutely manic patients?
Almost every guidelines I read, suggest that if you want to start Quetiapine for Acutely Ill Manic (or Psychotic in general) patients who have severe behaviour disturbance, you start 200-300mg on day 1, and you move upwards for day 2.
I have a feeling that 200 or 300mg will not be enough for a manic patient and he will be very agitated in the clinic.
What is you experience with it? Are 200 -300 mg enough?
Can you start it on higher doses?
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Other than that, whats your go-to drug...
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Source: Student Doctor Network - June 5, 2022 Category: Universities & Medical Training Authors: Iparksiako Tags: Psychiatry Source Type: forums
Quetiapine XR vs IR
Curious people's experience w/ Seroquel XR vs IR. I have only seen IR used, with the rationale that the medication can still be used once daily QHS due to the active metabolite and possibly just a regional experience. I recently inherited a patient that was switched to XR at the same dosage (200mg) and has seen an increase in day-time somnolence. Clearly peak somnolence is increased with IR dosing, patient's family was told that XR would better control symptoms throughout the day. I have...
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Source: Student Doctor Network - May 5, 2022 Category: Universities & Medical Training Authors: Merovinge Tags: Psychiatry Source Type: forums
I'm sad
I just needed to vent. Sorry in advance. Looking for sympathy.
Admitted 40s M with schizoaffective do. His med list from the midlevel provider outpatient: Trinza, Seroquel, Abilify, Rexulti - all at healthy Christian doses. If that was not enough, also takes Adderall, Elavil, and a squirt of Requip. I thought he was pulling my leg when he reported that. Sure enough med rec came back spot on. to his report. I feel sorry that he is going to have a few days of not knowing if he is...
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Source: Student Doctor Network - October 20, 2021 Category: Universities & Medical Training Authors: xavier2000 Tags: Psychiatry Source Type: forums
Switching from Buproprion/quetiapine to an MAOI
I brought up a TRD patient the other day that I was considering trying an MAOI on but have limited experience with the use of these agents. I was pleased with some of the discussion on this forum and found it helpful, but I have some additional questions I was hoping to get help with. Shout out to @Stagg737 @splik and @clausewitz2 for their help/previous contributions.
I know generally (from Stahl's, other sources) that you need a...
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Source: Student Doctor Network - June 23, 2021 Category: Universities & Medical Training Authors: luckrules Tags: Psychiatry Source Type: forums
Seroquel for Anxiety?
Hello. I need help with figuring out this choice of medications.
Patient is a ~35 yo M with no PMH, including no psychiatric history being seen in an IOP setting. He was referred by his employer for mild anxiety symptoms which appear performance type social anxiety. He has since starting receiving psychotherapy. The patient was also initially offered Seroquel (only) but was eventually started on Lexapro 5 mg. 4 days after starting treatment the attending psychiatrist commented if he wanted...
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Source: Student Doctor Network - March 24, 2021 Category: Universities & Medical Training Authors: PhuturePsychMD Tags: Psychiatry Source Type: forums
Atypical Antipsychotics and PD psychosis ?
I am confused about how clozapine works better for pts with PD.
What is the mechanism by which Clozapine and Quetiapine work better for psychosis in patients with Parkinson's disease?
Thanks (Source: Student Doctor Network)
Source: Student Doctor Network - March 24, 2018 Category: Universities & Medical Training Authors: susruta Source Type: forums
Referral: Medicaid, Fibro, EDS, PTSD...
30 year old female on disability with 3 kids: OXY/APAP 10/325 four QD, Mobic 15 mg, Lyrica 300 mg BID, OTC Aleve, & Seroquel QHS.
What's your next move...
View attachment 215823 (Source: Student Doctor Network)
Source: Student Doctor Network - March 7, 2017 Category: Universities & Medical Training Authors: drusso Source Type: forums
Starting clozaril in a patient with low baseline neutropenia
Patient wants clozaril and is on high dose seroquel at this time. ANC has been at 1.9 all year, am I justified in not starting a titration given the low baseline? (Source: Student Doctor Network)
Source: Student Doctor Network - February 10, 2017 Category: Universities & Medical Training Authors: sweetlenovo88 Source Type: forums
Unorthodox Use of Antipsychotics in Bipolar Disorder
Two questions:
1. I was reading UptoDate (Bipolar disorder in pregnant women: Treatment of mania and hypomania) and saw the following:
"The efficacy of haloperidol for treating mood elevated syndromes appears to be comparable to risperidone and olanzapine, and superior to quetiapine and lithium."
None of the attendings I work with prescribe typical antipsychotics for mania. Do you have experience doing so in non-pregnant patients? What was the result?
2. Do you use long-acting...
Unorthodox Use of Antipsychotics in Bipolar Disorder (Source: Student Doctor Network)
Source: Student Doctor Network - February 5, 2017 Category: Universities & Medical Training Authors: AD04 Source Type: forums
Chief Complaint: "My PCP says its a Federal Law I Come See You..."
60 year old with incomplete paraplegia and remote history of methamphetamine use and incarceration for distribution of the same...
Med list: Oxycodone 15 mg QID, Soma, Klonopin, Seroquel, Baclofen, and "high-CBD" cannabis...
Well, at least I'm glad that everyone is compliant with the Federal law these days... (Source: Student Doctor Network)
Source: Student Doctor Network - January 24, 2017 Category: Universities & Medical Training Authors: drusso Source Type: forums
Seroquel dosing?
Hi,
I was wondering how do you guys differ on how to start someone on Seroquel IR vs the XR formulation?
If you guys could give me some general trends. I'm looking to start someone on it who has bipolar depression. thanks (Source: Student Doctor Network)
Source: Student Doctor Network - January 24, 2017 Category: Universities & Medical Training Authors: bisell26 Source Type: forums
Official 2017 Rank Order List
Ayyyee, it's almost January 15 and time to start ranking so I figured we can start now. Feel free to post your thoughts about programs, maybe include how you would rank them and pros/cons so we know your thought process (especially if you didn't contribute to the review thread). If you wish to stay anonymous shoot me a message and I can post for you.
Edit: No anonymous posts please!! (Source: Student Doctor Network)
Source: Student Doctor Network - January 18, 2017 Category: Universities & Medical Training Authors: Seroquel Source Type: forums
