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Suggest Treatment For Bipolar Disorder, Fatigue And Numbness
Question: I am bipolar, and manic right now. Started last week. I have had my my Seroquel xr raised from 300mg, to 500mg as of yesterday. I did actually sleep last night with the increase. But I feel alittle fatigued, or numblike feeling. I don't feel sick or anything. I was also concerned with the weight gain. I am not quite sure why this medication causes weight gain. I have lost and gained weight alot this year. I am trying to eat healthy and get some exercise. Right now I am overweight. but am having a hard time losing it. I also take 20 mg of prozac, 4mg of klonopin, and 150mg of trileptal, which my new doctor is weaning me off of because she doesn't like it. I also take 40 mg of pepcid for gerd a day. I have taken the seroquel xr for 2 years now.
Brief Answer:
discontinue prozac; consider using valproate.
Detailed Answer:
Hello
Welcome to HCM.
Seroquel (antipsychotic drug) 500 mg is pretty high dose. The feeling of fatigue or numbness can due to heavy sedation caused by seroquel or due to asthenia and low blood pressure which is another side effect of seroquel. So, I would sugget you to get your blood pressure monitored regularly if you take such high dose of seroquel.
Seroquel is has H1 receptor antagonism which is responsible for causing weight gain. Lifestyle and dietary modification are necessary with seroquel to control weight. If this does not work, metformin (prescription drug) is specifically indicated for anti-psychotic induced weight gain.
I would suggest an immediate discontinuation of prozac as it will increase manic severity.
Trileptal might have been used as a mood stabiliser. But its efficacy as a mood stabiliser is questionable. Valproate would be a better option in my opinion.
Klonopin 4mg is needed only if seroquel does not control your anxiety and insomnia.
Here, I would like to mention that all the drug/dose changes are to be only under your doctor's supervision. Kindly keep a regular follow-up with your doctor.
Feel free to discuss further, if you have more queries.
Kindly close the discussion if you are satisfied with the responses. A feedback would be highly appreciated.
You can also ask a direct query at your convenience.
I wish you good health.
Thanks.
Dr. Shubham Mehta, MD (Psychiatry)
discontinue prozac; consider using valproate.
Detailed Answer:
Hello
Welcome to HCM.
Seroquel (antipsychotic drug) 500 mg is pretty high dose. The feeling of fatigue or numbness can due to heavy sedation caused by seroquel or due to asthenia and low blood pressure which is another side effect of seroquel. So, I would sugget you to get your blood pressure monitored regularly if you take such high dose of seroquel.
Seroquel is has H1 receptor antagonism which is responsible for causing weight gain. Lifestyle and dietary modification are necessary with seroquel to control weight. If this does not work, metformin (prescription drug) is specifically indicated for anti-psychotic induced weight gain.
I would suggest an immediate discontinuation of prozac as it will increase manic severity.
Trileptal might have been used as a mood stabiliser. But its efficacy as a mood stabiliser is questionable. Valproate would be a better option in my opinion.
Klonopin 4mg is needed only if seroquel does not control your anxiety and insomnia.
Here, I would like to mention that all the drug/dose changes are to be only under your doctor's supervision. Kindly keep a regular follow-up with your doctor.
Feel free to discuss further, if you have more queries.
Kindly close the discussion if you are satisfied with the responses. A feedback would be highly appreciated.
You can also ask a direct query at your convenience.
I wish you good health.
Thanks.
Dr. Shubham Mehta, MD (Psychiatry)
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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