Expert: Ivan Goldberg, M.D. - 4/2/2009

Question
Hi,
I have been on seroquel for a very long time for bipolar disorder. I have been on as low as 25mg and as high as 300mg for about the past 4 years. The reason we keep me on it is because I also do not sleep well and it is the one drug that actually puts me to sleep and keeps me to sleep. But I have an eating disorder, Bulimia, and Seroquel causes weight gain so my doctor is trying to get me off it. But I was wondering if you can tell me the dosage of Seroquel where the weight gain starts at. Because we keep trying to find different drugs other than seroquel to help me but nothing ever works as well as seroquel. Currently I am on Lunesta and 50mg of Seroquel for sleep and it was doing okay but the binging and purging was happening a lot and my doctor thinks its because of the Seroquel and put me on Topomax and said it helps suppress appetite and should help me sleep but I am not able to sleep.
So I just wanted to get another's opinion to see what dosage of seroquel would start making me gain weight and if you have any advice for me. Thank you. Sorry if this does not make sense I tried to make it.
Sincerely,
Karen

Answer
Hi Karen . . .

For some people weight gain is stimulated by taking 25 mg a day f Seroquel and some other people can take 400 mg a day and not gain an ounce. It is a very individualized thing.

I seldom prescribe antipsychotic medication for people with bipolar disorder unless they have psychotic symptoms such as delusions and hallucinations. IT is because of the risk of tardive dyskinesia that I am reluctant to prescribe antipsychotic medications.

You may want to take a look at the following links:

http://www.ninds.nih.gov/disorders/tardive/tardive.htm

http://emedicine.medscape.com/article/1151826-overview

http://www.ncbi.nlm.nih.gov/pubmed/10192407?ordinalpos=83&itool=EntrezSystem2.PE...

http://www.ncbi.nlm.nih.gov/pubmed/17853288?ordinalpos=10&itool=EntrezSystem2.PE...

Best regards . . .

Ivan
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