Venlafaxine and Quetiapine - now with added Mirtazipine

[Philup]

Hello all. I suffer from GAD and OCD. I have been on 150mg of venlafaxine for years. About 4 years ago I had 150mg of quetiapine (not modified release) presecribed which has now gone up to 300mg daily.

I have some 25s knocking about from previous dose alterations and am taking 375mg a day.

In addition I have now been prescirbed 30mg of mirtazipine a day. I am worried about serotoning syndrome.

I see the psychiatrist privately so this is not a concern which I can raise without forking out a load for another appointment. Sadly, it didn't occur to me during the appointment,

Quetiapine itself makes me sleepy the next day and has zapped any motivation. Ideally I would want off it but when I forget to take a dose I literally do not get any sleep.

If you were me would you skip the quetiapine to start taking mirtazipine instead?

I know that no-one here is my psychiatrist but wondering if anyone else could share any experience with these three meds.

Thanks for reading.

[Benjammin69]

I take mirtazapine, quetiapine with buspirone. All have serotogenic action but as mirtazapine has weak action against serotonin I need not worry. If you get the choice why don’t you drop quetiapine and add mirtazapine to venlafaxine which has a nickname of California rocket fuel . It’s meant to give everything a kick up the arse? Lol


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[Philup]

Hello, yeah, that is what I was minded to try, TBH. I think the quetiapine AND mirtazipine will absolutely conk me out the next day. Cheers for the reply.

But bit worried about not sleeping from leaving-off the quetiapine, still.

[Benjammin69]

I take 350mg quetiapine and 30mg mirtazapine and I
Get up for 5.30am for work no probs


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[Philup]

Ben what time do you take them?

If you were me - I know caveats apply - would yo try Venla + Mirt or all three?

[Benjammin69]

Ben what time do you take them?



If you were me - I know caveats apply - would yo try Venla + Mirt or all three?



Hi mate how you doing? I take my quetiapine 150mg about 6.30am alongside 20mg buspirone then I take mirtazapine,15mg buspirone and 200mg quetiapine about 7.00pm!

Skip the quetiapine and add venlafaxine and mirtazapine you shouldn’t need quetiapine in theory


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[Philup]

Thanks, mate. I am starting adding the Mirtazapine tonight...Wish me luck! :-D

[Bigboyuk]

Hiya Philup with any alterations to meds always try and run this by your Gp first, there are 'no' magic pills as such. Can I ask have you considered therapy of some sort too? I used to be a on a cocktail of meds years ago, but gradually came off them mate :) ATB

[Philup]

Hello, sorry for non-reply, had a family illness and been running around after hospital visits and chasing things up.

Would you check with a GP even though the psychiatrist prescribed?

I am just a bit worried about over-sedation and/ or serotonin syndrome.

I am going to do some ACT work on my own, I don't like psychologists much. CBT rules here and is seen as a panacea when I think it has obvious limitations.

[Bigboyuk]

That's ok mate :) Well no if your psychiastrist has prescribed the new doses then fine, but you could still ask your dr about the over sedation worry, if it's causing you some concern! Good luck :) ATB