I have an issue, I take 3mg Rexulti at 8 am and 400mg Seroquel at 7pm. For the past several months I have still become psychotic predictably at around the time I take the Seroquel. Before that it was unpredictable, setting in at any time of the day.
When this happens I feel intense dysphoria and fear which typically goes away after taking more Seroquel, sometimes up to 800mg and beyond.
I’ve been on up to 800mg Seroquel daily, I found at that dose that I was unable to reason and be intellectually productive, so I quit it.
Is being psychotic for a few hours three to four times a week enough to cause long term damage? It is always very emotionally stressful for me.
Is it normal to still be psychotic on high doses of medication. I would increase the doses but it makes me unable to function, which I have to for my community college classes.
Have you experienced psychosis on high doses of medication? Am I just wierd?
I met a guy in the psych wards who was taking a dose of seroquel well past the healthy recommended limit. It just didn’t work that well on him. His doctor didn’t want to try a different drug, she just kept jacking up his dosage. I was concerned for his kidneys, but he said seroquel was the one drug that could mute the voices (but even then he heard them, they just weren’t as unbearable).
Some people are medicine-resistant, meaning they don’t respond the same to one drug as the majority do. It’s not weird at all, it’s just variations in their biological responsiveness to a particular medicine.
It sounds like you are not free from psychosis, despite big doses. Maybe a new drug? Maybe an additional drug? Maybe a long chat with your doctor about the pros and cons of raising doses so high?
Yeah, when I was taken off Trilafon (Perphenazine) in 1975 and went drug free for three months, then it took three years on maximum dosages before I was right again.
@Jayster what were your experiences with Trilafon? I’ve asked my doctor to prescribe it for me if I don’t get better with the Seroquel and Abilify combination.
I’ve taken 400 x 2 daily of Seroquel for over ten years. I don’t feel it. I don’t know if it has any effect at all. I am scared just to quit it, though. Maybe, for the sake of the American tax payer, I should re-evaluate this drug’s medical effect on me.
I’ve been psychotic on and off for about 25 years. Mostly on. Psychotic right now, but it’s low grade and I shove it into the background and keep going. Mainly voice commentary and some delusional thinking. Meds reduce the symptoms to where they are manageable and then my habits kick in.
I’m currently on a low dose of Rexulti. I have experienced psychosis on high doses of other meds at times and at other times I’ve gotten a respite from the symptoms.
I’ve been psychotic for MONTHS at times and I’ve still managed to become very high functioning. I think a recovery oriented attitude can help a person push past a lot.
My theory here is that it is not the meds causing it but rather the meds not fully doing their job. If you are getting periods lasting 3-4 hours there is likely some outside trigger for these events, a stressor or something that reminds you of past delusions, etc. The meds should be preventing this from triggering a mini-episode but in your case they are not. Being on two APs this is surprising, you really must be med resistant…unfortunate.
In your case I’d recommend looking at possible environmental triggers for these episodes. Were you watching a specific show when it happened? Did something stressful happen? Etc. Once you recognize the triggers you can either avoid them or brace yourself when you know you have to face them.
For me psychosis is also a constant; however, I find that there are periods several times a week where it becomes completely acute. While acutely psychotic I find it impossible to function as thought disorder progressively makes it impossible for me to be productive. At other times while mildly psychotic on meds I am like you, able to function to an extent, perhaps not 100% but enough to get by.
3 mg Rexulti which I am on is maybe the equivalent of 3mg risperidone or Vraylar. 4mg is the high dose. I am also on a medium dose of Seroquel so the combination of the two is a high dose of antipsychotics. I could definitely be more drugged up but then I wouldn’t be as productive, so I have to bear the psychoses.
In all my time having this illness I have never been triggered by a stressor and resultantly became psychotic. Even when I had my first episode there was absolutely no stress involved. I can honestly say at this point that I don’t have any real triggers. The only time things trigger me is while I am acutely psychotic and having my intrusive thoughts, then everything seems threatening. I did have a lot of triggers when I was just out of the hospital though, I literally couldn’t handle anything, anything and everything triggered me at that point.
But you were stable on Abilify for several years, right? Rexulti and Abilify are very similar. Rexulti is a bit more similar to other antipsychotics than Abilify though.
Yeah I think that I will give it a shot.
My psychiatrist wants me fully stabilized on Risperidone before making the switch.
Maybe going to try it in the Spring sometime.