Expert: Ivan Goldberg, M.D. - 9/16/2008

Question
Doctor Goldberg,

 I am a 39 year old man with the Bipolar Disorder under medication since the age of 26.  Having uses many traditional medication like lithium, valporex in conjunction with anti-depressant over a 10 years period without much success I have been using Seroquel for the last 3 years with very good success.

 I am normally stabilize at around 75 to 100mg per day. I do have to take now only 50mg per day.  The reason I have to lower my dosage is the sedation effect that Seroquel gives me.  It is quite easy to explain.  If I take 100mg I will have to sleep 12 hours/ 75mg about 10hours/ 50 mg 9hours and 25 mg 6hours.  This side effect for me takes about 30min to sedate me after taking my pills.

Since I am working 40-50 hours a week I can't afford to be sedated or drowsy the next morning. I will not wake up on time to go to work.

I would love to take my 100mg per day but my body does not tolerated it.

My question is what other Antipsychotic could I use with similar result but much less sedation effect?

Also there is about a 10 pounds difference in weight if I use  100mg  compared to my regular 50mg per day.  My present weight is 172 pounds.

Hope to have a response from the expert.

Best Regards,

Answer
Hi . . .

I cannot tell you what might or might not work for you, but I can tell you that the medications that often have similar effects on people with bipolar disorder as Seroquel, and that usually do not cause sedation or weight gain are Abilify and Geodon.

Best regards . . .

Ivan
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