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What Causes Drowsiness And Slurred Speech After Taking Lithium-450, Seroquel-300 And Zyprexa-5?

Posted on Mon, 2 Mar 2015

Question: Hi, my Dr. prescribed me Lithium 300 mg, Seroquel 300 mg XR, Zyprexa 5 mg, and Topamax 5 mg. I felt fine on that mixture, then the Dr attempted to raise Lithium to 450, I felt more drowsy that day and went back to 300. Then I started to feel drowsy on that set of meds, and went back to my previous cocktail which I took for 10 years which was Zyprexa 10, Wellbutrin 300 xl, and Topamax. I saw my Dr yesterday he told me to go back to Lithium 450 and Zyprexa 5 and Topamax was ok to take, he said. He said "I dont have to take Seroquel if it makes me too drowsy". However I did take Seroquel yesterday and then Lithium 450 and the rest as he prescribed, and ended up almost passing out, slurred speech, ended up in the ER. I am trying to understand what went wrong as I took all prescribed doses. Thank you.

Answered by Dr. Seikhoo Bishnoi (12 minutes later)

Brief Answer:
These symptoms are probably due to side effects of these drugs

Detailed Answer:
Hello Welcome to HEALTH CARE MAGIC

Seroquel is Quetiapine, Zyprexa is Olanzapine and both are second generation antipsychotic drugs. Lithium and Topiramate both are mood stabiliser drugs. All these drugs are known to cause sedation and can make individual drowsy.

You have been advised to take Lithium 450, Olanzapine 5 and Topiramate after you felt drowsy with your first prescription, but you took Quetiapine xr also along with these medicines.

Taking these drugs together has probably resulted in side effects of extra pyramidal syndrome or EPS. Though it is uncommon with second generation antipsychotic drugs but taking Olanzapine and Quetiapine along with high dose of lithium has probably resulted in that side effect and this resulted in slurred speech and other side effects. Quetiapine at 300 mg is known to cause significant sedation and this was the probable reason your doctor advise you to not to take the drug along with your prescription because the combination was making you drowsy. No need to worry with in some time on reducing the doses these symptoms will reverse.

Thanks, hope this helps you. Please ask again for more doubts.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Seikhoo Bishnoi (13 minutes later)

I understand, however what confuses me is that I actually was on that specific dosage (Seroquel 300, Zyprexa 5, Topamax 100, and Lithium 450) for 1 day and nothing short of yesterday happened. Could it be that because I went back to my old medicaions for 2 weeks, and then I started, (as per Dr advice), back straight to 450 Lithium, and added Seroquel? Because like I said, I was already on that combination before.

Answered by Dr. Seikhoo Bishnoi (10 minutes later)

Brief Answer:
Higher dose for two weeks of Olanzapine resulted in these symptoms

Detailed Answer:
Hello thanks for asking again

This can be explained by two possible reasons-

- One is that the EPS side effects can occur any time and these are not predictable. One individual may not develop such symptoms at one particular time and can develop at some other time. So this could be possible reason that you didnt develop symptoms before.

- Secondly Olanzapine is associate with little high risk of EPS as compared to Quetiapine and you took 10 mg Olanzapine for 2 weeks and then shifted to 5 mg Olanzapine and 300 Quetiapine. High dose of Olanzapine along with Quetiapine resulted in these side effects.

Thanks

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Above answer was peer-reviewed by : Dr. Prasad