600mg seroquel still not sleepy

I am supposedly manic (and it is awful, I ranted on at my psychiatrist, so irritable, not happy, just so cross at the time) so I was given 600mg of seroquel to take each day. 400 at night, 200 in the morning. He said I would be in for a drowsy week. But the thing is I am not at all. I am not sleeping more than three hours and feel full of energy.

My mood keeps switching from unbearable racing to really happy. I really need to sleep and get out of this episode. My psych said I was literally a paper thin line away from hospital so I am really worried about that. I need to sleep. I should ask him for something to help me rest.

Do you think it is because I am manic that it is not working to knock me out? I don't feel manic. Surely it should knock anyone out. Is it weird to not get drowsy or is it a sign that I am really very manic?

I don't know.

The only reason I can think of is that you are still in some sort of mania. I would try taking your nightly dose with an ativan as well at that might help combat whatever mania you have. I was on 600mg at night and 300 mg XR of seroquel in the day and the night time dose had eventually stopped making me drowsey.

Seroquel works best as a sleep aid at lower doses, so it does not surprise me that you are not sleeping well on 400mg at night.

I'd call your psychiatrist and tell him/her what's up. Were there any other suggestions?

If you are here in the states, you would not be kept in the hospital more than a few days - just to get you stabilized - and trust me, they have meds that WILL make you sleep, no matter what.

I am guessing from your post that you are outside the US, so I am not sure what a hospital visit will look like for you.

I can tell you that it's not always the worst thing - they will stabilize you and stop the mania. If you have a PRN that calms you down, you might want to try that first, but you'll want to beware of becoming dependent on a benzodiazepine to help you sleep.

Jennifer

Hi,

I'm sorry you're struggling with this and I know only too well how torturous a lack of sleep can become. I agree that your underlying mood must still be high and that's what is potentially causing the problem. If I were you, I'd contact your psychiatrist for an emergency appointment to discuss this.

When I was last hospitalised in 2011, it was for 3 days, for full blown mania with psychosis- and I was very much out of control at that point. I was given 10mg of Olanzapine per night which I found extremely fast acting and effective at calming me down. At first I was also given an injection of an antipsychotic (possibly Haloperidol, but the details are hazy!) and this knocked me out cold for almost a full day.

Like batpoopprincess says, a hospital visit isn't necessarily the worst thing. I found it frightening at the time but now appreciate that at least I was safe and they kick started the treatment that continued to help as an inpatient.

I hope you find relief somehow very soon. Take care.

I would definitely contact my doctor! When I was manic last time my p-doc gave me 100mg seroquel to take at night and 10mg diazepam. That combination knocked me out for the night. You're not getting enough sleep, and that tends to make your mood even worse. Don't wait until you can't take it anymore, call your doctor. Maybe adding something to the seroquel will be enough to get you to sleep. I hope you can avoid the hospital, so I'd say the sooner you get some sleep the better!

I'm also wondering if your nighttime dose of quetiapine is too high? Usually, it is prescribed at a dose of 200mg or under for insomnia issues. And you are taking the IR at night, not the XR? I agree you should get in contact with your Pdoc right away and discuss your lack of sleep and ask for something else to help you get to sleep and stay there for awhile. Good luck!

Thanks for replying guys!

I am still not sleeping and have mentioned it to my Mental Health Team. They say that my mood is hypomanic, not manic, that the seroquel must be working. I am just to hang on in there over the weekend. So hopefully things will be okay.

The seroquel isn't the extended release one so not sure if that affects it? I did the other night take promethazine along side it hoping it would knock me out and I did manage a few hours sleep but the next day I literally couldn't walk without nearly falling over.

So, I do feel better, not so out of control. I believed I had been chosen by God. I apoarently was just ranting and making no sense. I kept insisting I was fine. The Dr had to keep saying that he was the psychiatrist and I was manic and if I continued then it was hospital. I felt like a child.

But now I am more happy and settled, no irritability, just maybe talking a little loudly. Here's hoping it stays this way.