Taking Seroquel: Expect This

You are going to sleep a lot!

If you are planning to take Seroquel, expect that you are going to sleep an awful lot. So much so, that you should assume that you won’t be able to do anything for 5-7 days after you start taking it. No office work, no social activities, no house work. Not even little everyday tasks.

The only thing I did in the first five 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 five days.

It started improving somewhat after the 5th day, but slowly. If you decide to take Seroquel, I recommend that you…

  1. Take vacation for at least 2 weeks,
  2. Tell people that you will not be able to attend any social activities for two weeks,
  3. Hand over all the tasks that you do at home to someone else. This includes tasks like taking out the garbage or doing dishes or cooking.
  4. Don’t expect to be able to drive.
  5. If you have responsibilities elsewhere, hand them over temporarily to someone else for 2-3 weeks.

You will not be able to supervise or take care of children or pets for at least a week, so make sure someone else is able to do so. I am not kidding. You’ll be that groggy.

Start with a low first dose and increase it slowly

I’d suggest that you discuss with your psychiatrist about starting with 100 mg Seroquel per day and slowly increasing in 50 mg steps every 2 days until you reach the desired dose. That way you have some time to get used to the Seroquel.

If you start off by taking a dose of 200 mg or more, 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 kinda scary and kinda traumatic and might cause you to stop taking the Seroquel.

If your desired dose is higher than 300 mg, slowly increasing your dose in steps extends the amount of time you’ll be out of commission for. Assume that for each additional 50 mg step past 300 mg, you’ll need 1-2 days extra vacation.

Seroquel increases my productivity

When I take Seroquel, it allows me to make decisions and make things happen. Seroquel doesn’t feel like an antidepressant, it feels more like something that helps 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.

For me, Seroquel acts a lot like a more powerful version of Tegretol.

…but still makes me groggy

So, if I can communicate with people more and get more done, then this is great, right? Well, it’s not quite a free ride. Even after becoming accustomed to the Seroquel, 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.

I have found that getting out of chairs can be an effort– it requires me to have two hands on the arm rests and to make a deliberate effort to stand up. I also tend to lean against things rather than just stand up.

and causes sugar cravings

One of the odd side effects of Seroquel 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 groggyenough 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.

and chapped lips

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 moisturising cream and a tube of lip balm close by because the chapped lips can be painful.

A dose of Seroquel makes me very sleepy

I take my dose of Seroquel XR (200 mg) on evenings around 6:00 – 6:30 pm. Once I  take it, the Seroquel causes me to fall asleep within 2-3 hours, so that I am usually in bed between 8:00 pm and 9:30 pm.

The time before I fall asleep is fairly variable and the effect has occurred within as little as 1 hour or extended as long as 4 1/2 hours.

Crucially, there is very little time between when I realise the Seroquel is going to knock me out and when it actually does – there’s about 15 minutes between when I start feeling groggy and when I fall asleep. The sleepiness is intense and it is extremely difficult to fight to stay awake.

and messes with my social life

What this means is that after I take Seroquel I can’t drive at all – I may fall asleep 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 fall asleep at a restaurant or in the cinema or at a cocktail party. Or I may stagger around groggily, looking very much as if I am drunk.

Since the time between when I take the Seroquel and when I fall asleep is so variable, I can’t accurately predict if I will be okay if I go out. After a few attempts at doing this, I found it easier to simply stay at home after taking the dose of Seroquel.

Yes, I could take the medications later than 6:00 pm. But how late? Suppose we say about 10:30 pm, so I can go out with friends for dinner.

…and screws up the next day if I take a late dose

With the Seroquel, I consistently sleep for about 9-10 hours every night. If I take the dose at 6:00 pm as I do now, and fall asleep at around 8:30 pm, then I will get up at about 5:30 – 6:00 am. After coping with the groggy morning, I am able to start the day about 8:00 am. Not too bad.

If I take the Seroquel dose at 10:30 pm and fall asleep immediately, I’ll wake up 7:30 – 8:00 am. Add in two hours of being somewhat groggy on awakening and I’m not ready to face the morning until about 9:30 – 10:00 am. That’s a little late to get the day started, and leaves me out of sorts and fairly unproductive for the rest of the day.

…really messes with my social life

Bottom line – If I go socialising with friends to even a moderate hour on evenings and take the Seroquel dose on returning home, I lose the following day. If I take the dose before going out with friends or while out with them, I may fall asleep while socialising.

After a while, I started suggesting to people that we meet for breakfast, or lunch, or a coffee at 4:00 pm.

I can’t exercise on mornings

It turns out that I also can’t exercise on mornings. The grogginess that bothers me on mornings affects my coordination and can leave me staggering about like a drunken man. It’s not a state conducive to exercise. The grogginess effect wears off during the day, so the best time to exercise is the 3-4 hours before I take my medications.

and travel requires careful planning

If you plan to travel, the grogginess and tendency to fall asleep matters. I had to travel and I had visions of falling asleep in the airport and missing my flight. Or having flight attendants being unable to wake me at the end of the flight. Or staggering up to an Immigration official as if I was drunk or drugged. The concern was sufficient that I stopped the Seroquel before starting to travel.

More prosaically, I wonder if people taking Seroquel who have subway or train or bus rides fall asleep and regularly miss their stops.

I suppose I could adjust the organisation of my day so that I can use my evenings more, but I am not sure how. With Seroquel, there seems to be a fixed amount of time that you spend asleep or groggy. For me that’s about 10-12 hours a day and that amount doesn’t seem to decrease with ongoing Seroquel use.  The only trade off seems to be between having more awake time on an evening vs. on a morning. Here’s my daily schedule

  • 6:00 am: Wake up.
  • 6:00 am – 8:00 am: Wander around the house groggily and out of focus.
  • 8:00 am – 6:00 pm: Do regular activities during the day
  • 6:00 pm – 6:30 pm: Take medication – Seroquel XR (200 mg).
  • 6.30 pm – 9:30 pm: Stay home and do stuff /  relax until I fall asleep.
  • 8:00 pm – 9:30 pm: Go to bed

Any time I go to sleep later, I get up later, and the regular activities of the day start later. It’s more like I am rotating the entire schedule rather than adjusting or fine tuning it. That rotation may work better for some of you, but I like the relatively early start of the day.

In Summary

Once, I get past the initial sleepiness, Seroquel does work as a mood stabiliser – it makes me more able to focus, and more able to get things done, and it allows me to interact with people more easily.  I get more done and I keep in contact with the people I need to.

However, balanced against the productivity is the sleepiness / grogginess that never went away and which remains an intrusive element in my life. I gain productivity, but I also lose half the day to sleep. If I am currently unproductive, that’s not a bad trade off, but in the long run, the sleepiness / grogginess seems to intrude too much into my life.

If you want additional information on Seroquel, check out the Crazy Meds website.

Note: I have found that if I take any medication on an ongoing basis, I develop a resistance to it, and it stops working. It was for this reason that I stopped taking Seroquel.

You might feel cold when coming off Seroquel

For about six days after I stopped taking Seroquel, I complained a lot about feeling cold. A lot. Didn’t matter where I was.

It’s hard to tell what causes each symptom you notice, and after coming off the Seroquel, I’d been getting very little sleep. But the complaints of being cold…

  1. Only started after I came of the Seroquel, and
  2. I’ve handled sleepless nights before with fairly mild aftereffects, and
  3. The temperature here had been 24-30 degrees Celsius (75-85 F).

I’ve put feeling cold as a possible side effect of coming off Seroquel. Any feedback in the comments would be appreciated.