Knock, Knock. Who’s There? Oh It’s You, Seroquel. 

I said I’d keep everyone posted on my recent decision to come off of Seroquel. (As you recall, I was dealing with weight gain side effects.)

Well I’ve been completely off for 2 weeks (after weaning down for 2 weeks) and it’s been a struggle. My moods are all over the place, I’m certainly not sleeping, and it’s put a strain on my family. My wife has endured additional stress and we have been fighting more. I feel badly about it, and of course I also wish she could be more supportive of my decision. But when it comes down to it, our long-time agreement has been in order for this marriage to work, I must stay on meds. 

When it comes down to it, I am excited about losing 5lbs. The scale hasn’t budged in so long, and this gave me hope. But I’ve weighed out my situation (no pun intended..) and have decided to go back on the Seroquel. I gave it a try, but I can’t help that my illness requires certain medications. I admit I feel defeated. But I also know this is just me being responsible. 

Thanks for listening to my saga. I know many of you have experienced Seroquel side effects and I thank you for sharing your experiences with me. Best of wellness to all of you. 

  

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Buh Bye, Seroquel

So, I’ve made a decision to come off of Seroquel. The weight I’ve gained with it has overstayed it’s (non-existent) welcome.

Bipolar weight pills

I know what you must be thinking. And before you lecture me on quitting meds, please know I am making this move based on careful consideration. I have been on Seroquel for about two years now, along with Lithium and Abilify. My current dose is 200mg. When I first started taking it, I just noticed my extreme sleepiness. This was good, since I am a natural insomniac. I started on only 100mg, and after some time, went up to the current dose. I know people on higher doses, and folks on lower doses. Every individual is different. Dosages are based on brain chemistry, body weight, interactions with other meds, etc.

The Cost of Side Effects

I certainly don’t want to scare anyone out of taking Seroquel because it is a really effective drug, and it has absolutely saved my life in many ways. It’s just that I am at a point where the side effects are not worth my time anymore. Seroquel is known for weight gain as a side effect (several psych meds have this quality), and I have been researching many sources and forums, as well as discussions with my psychiatrist, and it is an unfortunate fact. I put on 20 pounds with this medication. Many other folks have put on 40-50 pounds. On my 5’1″ frame, 20 pounds is kind of a lot.

It’s a Personal Thing

I definitely battled with this decision. I already have insomnia, and Seroquel has helped rock me to sleep each night since taking it. I also haven’t had any full blown manic episodes since being treated with it. So, yes, coming off of it does frighten me a little. But, conversely, I am becoming quite dismayed at stepping onto the scale and not seeing it budge. I have completely changed my eating habits, which includes pretty much all health food, and small portions. I even signed up for a gym membership. Yet my jeans still don’t fit. I feel discouraged and it’s bringing me down.

Keeping Up With Progress

So far I have cut my dose in half and I am having a hard time falling asleep at night. I am not experiencing any mania or psychotic episodes, luckily. My wife is fully aware of my plan, and is on board. This helps with monitoring my moods, especially with the changing season.

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I have not yet spoken to Dr. B. about this. I plan to at our next appointment, which isn’t until May. Honestly, I want to see how well I do without his input right now. Also, I’m a little shy of trust for him and his office after the urinalysis incident. I just thought I’d share my current experience with you guys. We all know what a pain in the ass it is to find meds that work out for us in all areas.

Sources:
Seroquel XR Side Effects Study
(Just Google Seroquel and weight gain/side effects. There is a world of information on the topic.)

Take a Chance with the Side Effect Dance

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I know I’ve written about side effects in the past, and this is one topic we all seem to be on the same page about. Side effects suck! My latest endeavor has been trying to lose weight. Over the last year, I have put on a bit of weight, and am having a more difficult time than usual in getting rid of it. I examined my timeline of events- I went on my current cocktail of Lithium, Abilify, and Seroquel about a year and a half ago. And then last fall/winter my wife was pregnant and I know I can attribute some of my tummy to joining her in prego eating. Okay, between those two variables, I put on about 30 pounds. I realize to some, this doesn’t seem extreme. However, I am only 5’1″ and I have a petite frame. None of my clothes fit. I feel uncomfortable. The CDC rates my BMI as overweight. Yeah it’s time to take action.

I gave up sweets and other junk food. I stopped drinking soda. I don’t eat red meat, and I adopted a strict regimen of vegetables and fruits and lean protein. Nothing fried enters my mouth. I exercise. After a few months of this lifestyle change, I dropped barely 5 pounds. I couldn’t believe that my weight was hardly moving despite my efforts. I was really discouraged and trying not to become depressed.

This is when I decided to go further, and research my medications. I learned that two of the three meds I’m on have a tendency to contribute to weight issues. These weight issues include gaining of weight, and/or difficulty in losing excess pounds. Immediately I flashed back to about 12 years ago when I was an inpatient in the psych hospital, and I had gained a good 30 pounds within a month’s time. But that time Depakote was the culprit. I never want to go back to that feeling again. So I knew at that moment I had to consult with my psychiatrist. I hate the way I look. I’m tired of feeling bloated. If I can’t look good, then I don’t feel good.

I decided to ask him about alternatives to Seroquel. This was scary because the Seroquel really does seem to be a miracle drug for me. I figured the Seroquel had to be the problem child since I am on a medium to high dose. I am on a very low dose of Abilify so I didn’t think it was contributing as much. When I went to my last appointment, I expressed my concerns and explained the efforts I have been trying. He asked me to honestly tell him which of the two helps me more. Of course his question presented a battle internally for me- my own self-fueled convictions say “Seroquel makes you fattest”- but I knew the truth, and that was Seroquel helps me the most. Nights when I don’t take it, I cannot sleep and the next few days I’m completely thrown off. If I skip Abilify, I barely notice. I was honest with him. Clearly this resulted in his decision to wean me off of Abilify, and continue my Seroquel.  He even informed me that Abilify is actually more prominent in weight issues than Seroquel, even at a low dose. He also mentioned that Zyprexa (which I had been on in the past) is not a good alternative to Seroquel when weight is a concern because it’s even worse thatn the other two.  He said to continue what I have been doing in regards to eating and exercise, and in a couple of months I should notice a difference in my weight.

So, it has been a week. I’m watching what I eat and weighing myself. I came off the Abilify pretty smoothly. At this point we shall see. I’ll keep posted. If anyone has any stories of weight gain as a side effect, please share!

 

Lithium’s Ugly Side Effect: Acne

Occasionally I bring up the topic of medication side effects, and this is one that affects my daily life. I’m referring to acne as an irritating side effect of Lithium. Screen shot 2014-02-03 at 5.38.09 PMLithium is the most widely used and studied medication for treating bipolar disorder. Lithium helps reduce the severity and frequency of mania and helps stabilize moods. It has a list of common side effects, including hand tremors, increased thirst, weight gain, drowsiness, muscle weakness, hair loss, decreased thyroid function, and acne.  While the side effects are not always easy to live with, Lithium can be a life-saving medication for so many people. The side effect I want to focus on is one that is often overlooked because it is not always considered medically troublesome. This side effect is acne.

I have been taking Lithium for almost a year and a half now and my skin hates me for it! Prior to taking this medication, I would have an occasional breakout, but nothing like I do now. At the time of being prescribed the Lithium, my psychiatrist didn’t really explain any side effects. I think this is due to the fact I was in crisis mode, suffering a severe mixed episode. He also prescribed two other medications to take with the Lithium, while discontinuing the meds I was already on. There was a lot of change going on and I probably wouldn’t have been able to fully comprehend anything too detailed anyway.

When I first started noticing my skin breaking out, I didn’t connect it to my medication. I used several different drugstore brand cleansers and ointments. I make sure to drink plenty of water and eat healthy. I wash twice a day and remove all makeup at night. I learned how to use concealer and other makeup tricks. I cried on occasion and I sometimes avoided going out with friends. My biggest problem wasn’t necessarily that I had the acne, but I really wanted to know why I had it. Then I started thinking that maybe things I put on my face aren’t working because it has to do with what I put in my body. The chemicals I put in my body. Since I don’t smoke or drink or anything like that, the only chemicals I’m really ingesting are my medications. After doing some research, I found that acne, sometimes chronic, is definitely a side effect of Lithium.

Not everyone who takes lithium develops acne, but many do. The reason lithium triggers acne is counterintuitive. It increases the activity of the immune system which in turn increases skin inflammation.

Lithium causes a condition called leukocytosis. The technical definition of leukocytosis is an increase in white blood cell (WBC) count due to any cause. When people who have bipolar affective disorder take lithium, the drug causes them to produce more stress hormones (which is actually a good thing) when they are depressed. These stress hormones make it easier to find the energy to function day by day.

Stress hormones in the skin, however, increase inflammation. They trigger the release of histamine from storage packets in the skin. Histamine is the same chemical that causes allergies. It breaks down skin cells or cells in the membranes lining the nose and throat to remove foreign bodies and germs. When the release of histamine is induced by stress, however, histamine destroys healthy tissue that has not been penetrated by foreign bodies or infected by germs. The result is redness, itching, and even pain in the skin that is worse in pores that are affected by acne. http://www.facingacne.com/lithium-acne/

Okay so now we have a cause for the ugly blemishes, but how do you get a handle on the situation?

If your acne is bothersome, decreasing your lithium dosage with your doctor’s consent can often help your skin improve. If that’s not possible, it’s best to consult a dermatologist about acne treatments, since lithium-induced pimples are generally harder to get rid of than other types of blemishes.

One possible treatment for this type of acne is tretinoin (Retin-A, Renova, Atralin), a topical drug that works by unclogging pores and promoting peeling of the affected skin. However, it is important to talk to your doctor about possible side effects before using this medication.

The drug isotretinoin (previously marketed as Accutane, but now available only as a generic) should be considered only if absolutely necessary, since its reported side effects include birth defects, depression, and psychosis (feelings of delusion and hallucination). This can be especially dangerous for someone with bipolar disorder. “You should proceed with caution so you don’t have some sort of manic or depressive episode,” says Amy Derick, MD, a dermatologist in Barrington, Ill.

Having a good anti-acne skin care routine can also be helpful in fighting breakouts while you are taking lithium. An over-the-counter cleansing product that contains salicylic acid, which reduces swelling and unclogs pores, should be used twice a day for optimum results.

When buying beauty products, such as moisturizer or foundation, be sure that the label says that the formula is “non-comedogenic,” meaning it has been formulated to not clog pores, which can lead to breakouts. Also, choose a sunscreen that uses titanium dioxide or zinc oxide as a physical barrier against the sun, rather than chemicals that absorb UV rays. “Those types of sunscreens are usually better for people who have acne problems,” Derick says.

Finally, try not to get too down about your acne. Some patients on lithium have found that their skin problems decrease after about six months of treatment, as their bodies adjust to the new medicine. “It can get better,” Derick says. http://www.everydayhealth.com/bipolar-disorder/when-lithium-causes-acne.aspx

So what am I going to do? While I would like to be able to decrease my Lithium, it simply isn’t an option. I will continue to practice healthy habits like washing twice a day, using clean towels and pillow cases, and eating healthy. I also ordered an acne cleansing system, Proactive Plus. (I do not endorse any products.) This product has gotten good reviews, so I figured it can’t hurt to give it a try. I don’t expect to get rid of the acne completely. I just want to feel attractive again. I hate being self conscious over my skin. I feel a little less stressed about my complexion since knowing the assumed cause of the issue. Hopefully this information helps out any of you with similar side effects.

Hair Loss Is Just Another Side Effect

Let’s talk side effects for a minute. Common ones are dry mouth, tremors, sleepiness, upset stomach, and weight gain. What about hair loss? I’m talking constant loose strands, hair falling to the floor every time I touch my head, handfuls when I shampoo. I keep a Swiffer vac by my side whenever I blow dry and straighten my hair because otherwise the bathroom is decorated with what has released from my scalp. For months now I have been attributing this to everything from what I was eating, to needing a haircut, using the wrong shampoo, not washing it enough, washing it too much, not brushing it enough, brushing it too much- you catch my drift.

Then it dawned on me that this began around the time my medication was switched and I started on Lithium. After doing a little research, I have now learned that I’m not alone in this situation. According to bipolar.about.com, Lithium and Depakote are common culprits in the hair loss manifesto.

Lithium can cause thyroid problems which are associated with losing hair. Other than that, it isn’t specifically known why certain drugs cause thinning hair, but what happens is a process called telogen effluvium. Normally, most hair is in the active growing phase, while a much smaller proportion is in the resting, or telogen, phase. Growing hair pushes the resting hair out. When a medication causes many more hair follicles to enter the resting stage than is usual, there is less hair growing and more to be pushed out — or pulled out, whether by shampooing, brushing and combing, or just running your hands through your hair.

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At this point, I am really getting tired of dealing with this. I also find it interesting that it is a side effect you don’t hear about very much. I have been on several different cocktails and have experienced a rainbow of side effects, but this is new for me. I just had an appointment with my psychiatrist and I didn’t think to mention it, but at my next appointment I definitely will see what he says. As for everything I’ve read on how to remedy this situation, decreasing or discontinuing the medication is the most effective solution. Unfortunately, this will not be an option for me right now. I feel better than I did 6 months ago, and I know the meds play a huge role in that. Now I’m just curious if anyone here else has experienced this and how you’ve handled it.