Replacing Decade-long Quetiapine With Cyproheptadine (bipolar Sufferer)

[mujuro]

Hi folks,

Just placing this thread here, more or less as a placeholder for developments in this journey as they arise. Not much to disclose so far, as I'm less than a week into this "experiment", for lack of a better word. The reason I have begun this now and not any time prior is because I've come upon a seriously permanent change in circumstance. The "COVID-19" crisis, my 30th birthday, and my father's retirement from the family business, all coincided around the exact time of early March. I don't want to get into much but it has profoundly changed my circumstances and therefore, since March, I have since come upon a lifestyle that finally allows me the room to give myself a chance to wean from this powerful drug which, in all frankness, I absolutely despise and will not take for the rest of my life.

As haidut has (repeatedly) mentioned, the origin of the hypothalamic stress response (CRH > ACTH > CORT) begins at the 5HT2 family. There are few extant studies on the effectiveness of cyproheptadine in bipolar/mood disorders, but there are a few that detail the potency of cyproheptadine to completely suppress nocturnal GH, cortisol and prolactin elevations. Quetiapine is a strong antagonist of D2 receptors and 5HT2 sub-types. If you take a cursory look at the reviews on anti-psychotic history, there has for a long time been lingering doubts about whether or not the anti-psychotic action is effected via the dopaminergic or the serotonergic pathways. Since most of the first and second-generation anti-psychotics augmented both receptor families, and the drugs have yielded relatively successful therapeutic results, I guess there's not been much incentive to narrow down where the magic happens.

So, as it happens I am in a position to enjoy very stable work and family life that can facilitate this kind of experiment so that I can move past this drug and start living my life anew.

Thanks for reading.

 

[ecstatichamster]

I wish you great success and am glad you are sharing your journey.

 

[rei]

I think the doubts are only in what is presented to the masses. The original quetiapine drug is called sero(tonin)quel(l). They are rubbing it in our face.

Best of luck in switching to something not as lethal. The only "benefit" you might lose is the sedative antidopamine effect if you use it to 'help' sleep. Bipolar waves can be significantly affected by sleep patterns. Try melatonin if there is any issue to get enough sleep. Cypro might inhibit endogenous production.

 

[yashi]

I have a friend who got suggested quetiapine by her doc for bipolar, sleep problems and lack of hunger. Can you tell me how quetiapine and cypro have affected you in those areas and how you feel on them? Also how much do/did you take of each?

 

[rei]

I have a friend who got suggested quetiapine by her doc for bipolar, sleep problems and lack of hunger. Can you tell me how quetiapine and cypro have affected you in those areas and how you feel on them? Also how much do/did you take of each?

quetiapine is a moderately useful sedative/sleep agent at very low doses. It has paradoxical effect when you increase dose and at least linear increase in side-effects.

The smallest tablet 25mg halved in dire need or quartered for normal use seems to be good for many uses, even managing excess serotonin. The only real negative effect i ever felt was a slightly runny nose. This of course assuming the zombie/sedative/sleepy effect was desired.

I once took the full tablet in the evening and did not feel normal for a day.

 

[mujuro]

I have a friend who got suggested quetiapine by her doc for bipolar, sleep problems and lack of hunger. Can you tell me how quetiapine and cypro have affected you in those areas and how you feel on them? Also how much do/did you take of each?

Quetiapine, for as long as I've taken it, has induced seriously potent "munchies", 30-45mins after ingestion, despite the dose. It's really just a race to get to sleep before the hunger sets in. Doesn't matter if it's 25mg or 200mg, the ravenous appetite I felt is the same. On some occasions I'd experience elevated heart rate, to the point where I'd avoid certain foods or substances that compete with CYP3A4 which would elevate serum quetiapine levels. If you get past that, you may experience akathisia, which will further complicate any efforts to get to sleep. The toss-up with anti-psychotics is the following: ravenous hunger, akathisia, weight gain, or QT prolongation. Choose one. Those are your options.

So far, cyproheptadine has been a GODSEND. I don't even recall falling asleep, and upon waking I feel the natural drowsiness I have not felt since childhood. No munchies, no akathisia, no elevated heart rate, no zombie-like grogginess. I am currently on 12mg, before bed. Moods are stable as they were before. Diurnal appetite is up, libido is up, aggression is up, self esteem is up, energy is up, and those ever-present puffy nipples (prolactin elevations due to quetiapine) are gone. Studies I've read have reached up to 24mg per day. I think it's really up to the individual, but as I've seen, studies for mood regulation/Cushing's have used between 8-20mg per day.