Uncontrollable Rage & Seroquel, Zyprexa
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Q:  Uncontrollable Rage & Seroquel, Zyprexa

I am Bipolar II and because I suffer from racing thoughts, doctors have prescribed anti-psychotics for me.  First Seroquel and then Zyprexa worked really well in the very beginning, but soon gave me the scary side effect of uncontrollable rage, so I discontinued the medicine.  Both times, I was on very low doses.  It seems counterintuitive that this class of drugs should essentially make me psychotic.  Can you explain what may be going on?

Dear Jen -- 
(First thought, parenthetically:  are you also on an antidepressant?  if so, I'd look in that direction first for what might cause phases of "uncontrollable rage", particularly if you'd been on the Seroquel or Zyprexa for a while before this kind of thing happened)

I guess that parenthesis, now that I think about it a bit further, would be my only real guess as to "what is going on".  If you're not on an antidepressant, I guess we'd just have to say "wow, you have something really unusual" in terms of your reaction to these medications.  Since "uncontrollable rage" can of course be caused by what we're trying to treat, there's a strong temptation to ascribe such episodes to the underlying illness rather than an unusual medication reaction.  However, as my friend Dr. B' says, "medications are guilty until proven innocent". 

Perhaps what you're wondering is something like "Dr. Phelps, have you ever seen this kind of reaction?"  The answer is:  yes, but as above, it's always hard to tell if the episode is from the medication or from the illness.  On the whole, I may have seen a few such reactions that looked like the medication, but usually in retrospect it turns out more likely to be the illness (e.g. continued such episodes on subsequent very different medications).  

However, to be complete, there are case reports of both SeroquelLykouras and ZyprexaAubry causing manic symptoms.

Dr. Phelps

Published October, 2004


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