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    Dr. G - Time-scale for recovery from replapse of depressive episode of Bi-bolar II
    Carl_1970 posted:
    Hi Dr. G,

    I have been well for over 3 years, but from recent high levels of stress at work, I've had a depressive relapse.

    Please could you advise me on steps to take to aid my recovery. Please note that My medication has been increased from 300mg (on which I was stable) to 400mg of Quetiapine.

    Many thanks in advance,

    Joseph F Goldberg, MD responded:
    Dear Carl,
    The manufacturer's studies with Seroquel for bipolar depression compared 300 and 600 mg/day and found no greater antidepressant effect with 600 than 300 mg/day. If I had a patient of my own who had been well on Seroquel 300 mg/day but had a depression relapse, in addition to proposing a psychotherapy to address the stresses in the picture, I would probably add a 2nd medicine with known antidepressant properties that was not redundant with Seroquel's mechanism (eg, lamotrigine, Nuvigil, Provigil, possibly lithium, or possibly an antidepressant depending on the individual circumstances of the patient in terms of their candidacy for an antidepressant). See my video under "Resources" re. treatments for bipolar depression; and above all, pose this question to your own doctor for his or her own treatment recommendations.

    Dr. G.

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