Seroquel – Effects and Side Effects

Here’s my recommendations on what to expect if you are going to take Seroquel.

First off, if you are planning to take this, you are going to sleep a lot. So much so, that you should assume that you won’t be able to do anything for the first 5-7 days after you start taking it. No work, no social activities, no anything. The only thing I did in the first 5 days is sleep, stagger groggily around the house, sleep more, feed the dogs, eat, and then take meds and go back to sleep.

Really. For 5 days. It started improving somewhat after the 5th day, but slowly.

If you decide to take Seroquel, I recommend that you (a) take vacation for at least 2 weeks, (b) tell people that you will not be able to attend any social activities for two weeks, and (c) hand over all tasks that you do at home to someone else. If you have responsibilities elsewhere, hand them over temporarily to someone else for 2-3 weeks. If you have children or pets, you will not be able to supervise or take care of them for at least a week, so make sure someone else is able to do so.

I am not kidding. You’ll be so groggy that you’ll be non-functional for the first week or so.

I’d also recommend that you discuss with your psychiatrist about slowly ramping up in 50 mg steps every 2 days until you reach the desired dosage. That way you body has some time to get used to the meds. If you start off by taking a 200 mg or more dosage at the beginning, there’s a good chance you’ll sleep for upwards of 20 hours the first night (I slept for 32 hours).  Sleeping for so long is both scary and traumatic and is likely to cause you to stop taking the Seroquel.

Unfortunately, if your dosages is 300 mg or higher, slowly increasing your dose extends the amount of time you’ll need to be on vacation. Assume 1-2 days extra for each increase in medication step that you do.

Once things sorta settle down and you aren’t sleeping or groggy all day, what’s next?

Well, you’ll still be sleeping a lot.  Here’s my typical 24 hours.

I take my dosage of Seroquel XR (200 mg) on an afternoon around 6:00 – 6:30 pm. Once I  take it, the Seroquel will knock me out within 2-3 hours, so that I am usually in bed between 8:00 pm and 9:30 pm.  But it’s not quite so simple.  I usually do have some time between when I take the medication and when I pass out – the 2-3 hours I mention above. However, the time is pretty variable and the Seroquel has taken effect in as little as 1 hour or as long as 4 1/2 hours.

Critically, there is very little time between when I realise the Seroquel is going to knock me out and when it actually does – it’s about 15 minutes between I start feeling groggy and when I completely pass out. What this means is that after I take medication I can’t drive at all – I may pass out at the wheel. It also means that if I want to do any social activities after 6:00 pm, someone has to provide transport and I may very well pass out at a restaurant or in the cinema or at a cocktail party. And since the time to passing out is so variable, I can’t accurately predict how much “safe time” I have. I’ve found it easier to simply stay at home.

Yes, I could take the medications later. But there’s a catch. With the meds, I consistently sleep for about 9-10 hours every night. If I take meds at 6:00 pm as I do now, and pass out at around 8:30 pm, then I will get up at about 5:30 – 6:00 am. Which is good for me. If I take them at 8:00 pm and pass out  at 10:30 pm, I’ll wake up 7:30 – 8:00 am.

But notice something – if I take the meds at 6:00 pm, I have no night life. But if I take them at 8:00 pm, I still have no night life because I have to be home by 8:00 pm – and very few social activities on evenings finish by 8:00 pm. Hell, I can’t even go to the cinema at 6:00 pm. If I want to stay out reasonably late, to go to dinner with friends and reach home at 10:0o pm, then I have to take my meds at 10:00 pm, pass out at 11:30 pm and wake up at 8:30 am – which starts getting late on a morning to be getting up. If dinner runs late because we are having a good time chatting, and I don’t fall asleep until midnight, then I’ll wake up somewhere between 9:o0 and 10:00 am.

And it’s actually a bit worse than that.  After I get up, I’m still somewhat groggy and I usually need about 1-2 hours to get myself moving and ready for the day. This happens every day, by the way. So, really, if I went to bed at midnight, I’m not actually ready to face the world until somewhere between 10:00 and 11:00 am the following day. See the problem?

I take my meds at 6:00 pm because the combination of the amount of sleep that I do plus the time it takes to get focused on a morning leaves me ready to face the world at around 8:00 or so. Which is an acceptable time for me. With Seroquel, there’s a trade off between having more awake time on an evening vs. on a morning.

So, once I’m moving, what do I do with the time between 8:oo am and 6:00 pm. So far, I’ve been fairly productive (though the final decision isn’t in on that yet). However, for the first week or so after I stopped sleeping all day, I still felt groggy during the day. In fact I felt like falling asleep every time I sat down, though it didn’t interfere with the stuff I wanted to get done.

For me, Seroquel acts a lot like a more powerful version of Tegretol. In both cases, taking medication allows me to decide on tasks and make them happen. Seroquel doesn’t feel like an antidepressant so much as something to increase my productivity, a focusing and doing aide, if you will. Seroquel also noticeably makes me less fearful of people – so I’m more likely to call someone, answer my phone, send or reply to an e-mail, write a business letter, call a friend, or feel comfortable talking to people generally.

One of the odd side effects of Seroquel during the day is that I have to have sugar every one and a half to two hours – if I don’t get the sugar, I get wan, light headed, and groggy enough to pass out. This means that when I wake up, I have a cup of sweet hot chocolate (2 heaping teaspoons of sugar), and then throughout the day I drink hot chocolate every two hours or so. Or have biscuits (Pepperidge Farm Brussels cookies, yum!). Or Coke.

It’s a pretty high sugar intake daily and it seems to be necessary. Oddly enough, coffee doesn’t seem to have a noticeable effect in stopping the grogginess. Nor does a regular meal like lunch, unless I have a Coke or juice with it.

Even so, I’ve found getting out of chairs to be an effort all day – it requires two hands on the arm rests and a deliberate effort to stand up. I also tend to lean against things rather than just stand up.

The other noticeable side effect has been if I don’t drink enough fluids, I get chapped lips and dry hands. Given that I drink so much hot chocolate, this hasn’t been a big deal, but I’d still recommend that you keep a lip balm close by because the chapped lips can be painful.

I also can’t exercise on mornings. The grogginess on mornings affects my coordination and leaves me staggering about, very much like a drunken man. The effect wears off during the day, so the best time to exercise is the 3-4 hours before I take my medications. These days though, that time is spent walking the dogs and doing odd and ends.

So  my day is wake up in the morning, have a hot chocolate and stagger around the house doing small tasks for an hour or so, change and go to work, finish work, walk doggies, take medication, feed dogs and watch television or read until I go to bed at around 8:00 or 9:00 pm. It’s not an exciting life and it currently has no social activities or exercise, but during the day my productivity is such that it’s still worthwhile in catching up on things not done in the last 6 months. In the next month or so, I will have to change it to include exercise and going out with people or I will really become a recluse.