arewether...I am prescribed 300-600 mg Seroquel PRN for sleep. I am also prescribed 100mg PRN up to 3x a day for anxiety. Tuesday night instead of taking 2x 300mg I took 6x100mg. I am very certain that I took 6 and only 6 as I remember counting them twice. I stayed downstairs until I started to feel uncomfortable then I went upstairs to bed. Once in bed I started hallucinating, my chest began to hurt and my heart began to race. I felt like if I were to not keep a conscious effort to breathe that I would stop breathing. I (then) thought that there has got to be a difference between the 100mg pills and 300mg pills and that they have to be like time-released differently or something so I got up, went to to sofa outside my husband's office, tried my best to explain this, and told him to the best of my ability to call poison control and ask them if there was a difference between the two pills that would explain why I was reacting this way. Things went downhill really quickly from there and ended up with my husband driving me to the ER, Poison Control called them in advance to tell them I was coming. Apparently my husband and poison control thought it might have been possible that I either took the wrong medication, or took too many, or both, because they didn't really trust that someone exhibiting the symptoms that I was having could have really just taken the correct dose of the correct medication. At the ER in triage my heart rate was 145 and that was actually better than it was at home. My blood pressure was bad too but I don't remember what it was. Anyway I peed in a cup then they took me right back and a doctor and 3 nurses were all over me even as I was undressing... The doctor was very skeptical of what I was saying, he said Poison Control and my husband both told him it was possible that I could have taken an overdose and I tried to explain that it was not possible. Having a history of two prior intentional overdoses probably didn't help me out in this case, but those OD's were serious though; and without a doubt deliberately intentional and meant to end my life. At any rate they drew my blood and started an IV, and wanted me to drink the activated charcoal (which I have never had to do before). I tasted the stuff, and I probably would have appeased them if it wasn't flavored and sweetened, but as it was - no way! Plus with my medical background, I knew that I didn't have anything in my system that needed to be neutralized... because *I KNEW* that I had taken the correct dose of the correct med, and I wasn't drinking that stuff just because everyone else didn't trust me. At any rate, my blood and urine came back clean, which I knew it would. However my potassium was 2.7 and they gave me some pills, which I took. I was feeling better at this point and I just wanted to go home and sleep, about 3 hours had passed by now, maybe 4 (I think I slept through some of it). I want to know what the hell happened. I have taken 1200 mg Seroquel, taking 12x 100mg pills on 2 or 3 seperate occasions, just to mentally check out (the last time was back in February of this year) and that didn't cause anything like this! in fact somebody called 911 on me back in February even though I told them I was just fine, and I sat out in my backyard and waited for everybody to get there. The EMT's took my vitals, I was fine. It was also quite easy to convince the EMT's that I was not trying to hurt or kill myself, since I wasn't.
At any rate. What the heck happened? I hadn't been drinking. I am not on any new meds. I have done a lot of stupid things with a lot of different drugs. I have felt really shitty from taking an overdose of a drug, but I have stayed OK and ridden it out. But this time I was fairly convinced I was going to die. And I didn't even misuse anything.
LaurieShay
OMG I just replied and my laptop hit the back button and it erased everything. Dammit, frustrating! Laurie, thank you so much for taking the time to reply to me.
OK, long story short, I don't see how hypokalemia alone could have caused such a rapid onset and intensity of symptoms that I had. That being said, there is no difference between the 100 and 300 mg pills.
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Also, thinking back, here's the progression of symptoms. I went to bed as soon as I started feeling groggy. First I was lying on my side and my chest felt tight and I felt like I was struggling to breathe so I turned over on my back with my neck positioned so my airway would be open. Then I started to hallucinate and my heart started racing. That is when I got up and went to my husband. Within 2 minutes I went from slurring my speech to not really being able to talk very well at all, which was very frustrating because I was VERY aware of what was going on. So initially I do not believe anxiety played a part.
I have taken an overdose of many different kinds of pills before, including the 1200 of Seroquel and I have had all of these same symptoms that I had on Tuesday, just nowhere near this extreme. So to me this points more towards the Seroquel than the hypokalemia? But I don't know, could they have simply antagonized each other? What is interesting is that I am so far remembering how I seriously felt that I was dying, and that I was very scared and I asked for help. I don't know why but that realization has made things just a little bit brighter for me, even though I don't know what to do about that yet.
I doubt that the hypokalemia explains it all either. Honestly can't say for sure. If you have chest pains again with slurred speech please call 911 or get to the hospital asap. Since they did blood work and an EKG I assume and everything came out normal except the potassium, I wouldn't worry though.
My husband was on the phone with poison control when things worsened quickly and I felt like I needed help, like now because my heart was trying to pound out of my chest. I kept saying, Help me call help now but I couldnt make the words come out, meanwhile he was trying to ask me what other medications I was on and I got out an exasperated "I don't know" (I honestly at that moment didn't and at the same time couldn't fool around with crap like that when I felt like I was in dire need of medical attention) and finally he drives me, all I could think was this is how I am going to die, in the car, because he doesn't understand that I am REALLY freaking serious when I said call an ambulance before we walked out the door and he said no, let's go. because we don't get cell signal in the car half way to the hospital so if something were to happen i would be totally screwed because he doesn't know CPR...
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I knew this and I was really totally convinced I was going to die in that car with him. In marriage counsoling yesterday I told him all I could think, but I couldn't say it, was that he was going to be really effing sorry he didn't listen to me when I died in his car on the way there, and he said, oh no, you told me that... I'm like, oh, great... sigh... Add one more episode of PTSD to my list!
I understand. You must have been very scrared and frustrated. What did the hospital finally say to explain what happened?
They did not. They sent me home with the "Adverse Drug Reaction" Form sheet, I guess because they didn't know what other form to send me home with.
Did they recommend you follow up with the prescribing doctor?
They did. I did not, because I am between prescribing doctors right now. I was in a hospital out of state for 2 1/2 months just a short time ago. When I was discharged the physician there sent me with 30 days of meds. I saw a new doctor here once to get a new prescription when I was about to run out and I really do not like the doctor at all. I wanted to see someone local because it is such a strain on me to drive into the city to the big hospital to see the doctor that I was seeing. I think I am just going to have to go back to him even though it is over an hour drive. I may try one or two other local doctors from our small hospital here but I just get so tired of having to start all over again with someone new. I guess I would rather do that though if I can find someone rather than make that really long drive. Sorry to rattle on and on...
You are not rattling on, just need to talk which is fine. I must impress upon you that you can't just stop the seroquel without having withdrawals. You really need to follow through with a doctor especially given what happened.
I was never warned about withdrawls. Although I am prescribed the 300-600 at night for sleep, I use it as a PRN, and I only take it 2-3 times a week, max. I told the new doctor this (she is the one who said we can go as high as 900mg if I needed to) so she knew I was not taking it as a regularly scheduled med. My primary care MD also knows I am using the 300-600mg as a PRN as well. Also I only take the 100mg maybe once or twice a week even though it is a PRN and I can take it up to 3 times a day, I just don't like how sleepy it makes me. When I do take 300 or 600 of the seroquel at night the next morning i hallucinate mildly (seeing trails, faintly) for about the first hour I am up, and my vision is a little blurry. also if I drive within the first hour I have felt like at times I have almost blacked out, but I am not sure if that was a real feeling or I was imagining it. So I am sure I don't have to drive right away when I get up the next morning after I take it.
Seroquel is usually titrated up over several days then maintianed at a steady dose. PRN is ok at lower doses but higher doses is going to cause more side effects such as you are experiencing. Why are you taking the Seroquel, for bipolar mania, depression or schizophrenia? I suppose taking in low dose prn would be ok, but honestly prn at higher doses is not. Also, stopping it after being on it consistently will cause withdrawals like nausea and diarrhea, etc.
Well that explains what happened yesterday perhaps... I was driving and I almost had an accident... I had to rush home and I had really bad diarrhea... I am prescribed the 300-600mg of the Seroquel at night for sleep. At first I was prescribed it in combination with 2mg klonopin. The klonopin totally whacked me out and I had to stop it. It made me suicidal. I was started on 100 mg Seroquel PRN up to three times a day for anxiety. My psychiatrist told me if needed he could raise the dose to 300 mg up to three times a day. This is the head psychiatrist at a nationally renowned psychiatric treatment facility that I resided at for 6 months. This is the same psychiatrist who took me off of 60 mg adderall/day that I had been on for 3 years. He did not titrate me off of it. He just took it away. I went through horrible withdrawls and was absolutely miserable. I pled with him that it was inhumane. I pled with my husband that it was inhumane.
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But who was I? I was mentally ill, so who would listen to me? Nobody!!! I am also diagnosed with narcolepsy. I now take Nuvigil for it and it works a little bit, but not as good as adderall did. Anyways that's me rattling on again... I hope I answered your question.
what would be the problems with taking PRN at higher doses as I am doing? and why the hell hasn't any doctors told me that's a problem when I told them that was how I was taking it? Do they just not care or are they not listening to me? I often think that.
Can't really answer why the doctor is telling you to take prn at a high dose, but I can tell you what the maker of seroquel recommends and what the prescribing literature says which is to slowly go up on dosage then maintain, not prn.
To quote the literature:
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Adults
Acute Treatment of Manic Episodes in Bipolar I Disorder
Dose Selection—When used as monotherapy or adjunct therapy (with lithium or divalproex), Seroquel should be initiated in twice daily doses totaling 100 mg/day on Day 1, increased to 400 mg/day on Day 4 in increments of up to 100 mg/day in twice daily divided doses. Further dosage adjustments up to 800 mg/day by Day 6 should be in increments of no greater than 200 mg/day. Data indicate that the majority of patients responded between 400 mg/day to 800 mg/day. The safety of doses above 800 mg/day has not been evaluated in clinical trials.
Acute Treatment of Depressive Episodes in Bipolar Disorder
Dose Selection—Seroquel should be administered once daily at bedtime to reach 300 mg/day by Day 4.
I realize you are taking for anxiety and not for manic episodes or for depression, but the titration is the same. Start at 100mgs a day, increase by 100mgs a day upto desired dosage.
PRN is ok for low doses, not the high ones you are on. Just be careful.
Hmm, thanks Laurie. I am going to try what you said. last night I only took 100mg before bed. I will try to get back on it as a scheduled med I suppose.
ok, take care
I don't know if there is any kind of relation here or not, but I had an intentional overdose of Depakote (plus 3 other meds). In ICU my potassium was 2.9 and my heart was throwing PVC's on the telemetry monitor as a result. Once I was stabilized and in the psych ward I asked the internist about the low potassium and she said it was most likely caused by the extremely large amount of valproic acid (depakote) I had ingested actually pushed the potassium out of me. I now take Seroquel instead of the meds I was on and was just increased to 400mg daily at bedtime. Geeze I hope it doesn't cause low potassium...