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Q: Seroquel & Diabetes : Levodopa & Bipolar
I've been diagnosed with Bipolar II and have been prescribed 200mg of Seroquel
per day (at bed time only) along with 600mg of Tripleptal.
I found out that a recent study has linked Seroquel to a 3.34 x increased chance
of developing diabetes. Also, I've noticed an increase in my level of
restlessness. I've suffered from restless legs syndrome for most of my life.
Could Seroquel be making the problem worse?
Finally, given my situation as described above, should I consider changing my
meds from the current drugs (Seroquel & Trileptal) to simply Levodopa or another
dopamine agonist? Might such a change address my restlessness better and still
treat my bipolar II?
Dear Jon --
Seroquel and all the other "2nd generation antipsychotics" have been associated
with weight gain and an increased risk of diabetes, leading to a recent request
by the FDA that the manufacturers include a warning about this on their
labeling. I was surprised this was not an even more direct move by the FDA, like
one of their stricter "warnings", because of how obvious this problem has been
(especially with Zyprexa, but also somewhat with Seroquel, less with Risperidone,
etc.).
And yes, these medications have also been associated with restlessness
(though usually at higher doses; I'd wonder about the Trileptal, which is also
at very low dose relatively speaking, but which can change your blood sodium and
might somehow in that way be affecting your leg muscle tone; that's an easy
blood test to check out, or you might just talk with your doctor about moving
the dose up, because it's so low now, to see if when you do that the
restlessness gets clearly worse (then nab the blood sample at that point before
you lower the dose, e.g. after only a few days at that higher dose -- this would
give you a clearer answer as to whether any lab abnormalities you see are really
causing the symptoms). Even up to 900 would probably tell you something,
although a very conservative approach would be to check a blood test first
to make sure your sodium is okay for such an increase.
Levodopa is not a treatment for bipolar disorder, and by its action on
dopamine could conceivably make the bipolar disorder worse (that's more of a
problem in bipolar I, where we often see psychosis in association with such
dopamine treatments for Parkinson's).
(I've gotten behind on letters; pardon the brevity of this reply)
Dr. Phelps
Published October, 2003 |