Starting quetiapine

[pulisa]

I found diazepam worked best for mental akasthisia-80mg propanolol didn't do anything. Zopiclone wasn't terribly helpful either. It's a tricky situation because many of these meds just make agitation worse-one reason I don't take them!

[Dying_Swan]

Thanks both. I will see about that second opinion. I don't want to rock the boat but something has to change. I'm taking both propranolol and omeprazole to counteract side effects. I'm also in the process of getting off venlafaxine. Now down to 9mg daily! I'm tapering off more slowly than I was meant to as I'm really sensitive to ven withdrawal. I have said I want to reduce quetiapine but they said not at the same time as changes trazodone and ven, like you said PDU.

i will ask whether the trazodone is for sleep or AD, though the letter I got suggests its for sleep. I took zopiclone last night and slept through the akathisia. A relief. I've only got 14 so thought I'd try to use them only when I can't sleep. I do also have some lorazepam and diazepam, which can be helpful for agitation but not enough for sleep. I've suggested a general anaesthetic, but that's not an option I often think of you and that stun gun Pulisa! How does mental akathisia affect you?

[pulisa]

I'm unable to sit down or sit still, can't concentrate on anything, need to keep moving at all times, unable to sleep etc. Also a terrible sense of inner turmoil and restlessness-it just feels unbearable. I have never been able to understand how people can't get out of bed with anxiety-for me it's the opposite. I love the after effects of a general anaesthetic and that sense of relaxation

[Dying_Swan]

Oh wow, yes that's exactly it. It doesn't feel quite like anxiety to me, although similar, but there's a bit of a rage about it too. Immense frustration. I have told them that a punch bag would be more helpful to me than the usual warm bath/jigsaw puzzle/read-a-nice-book suggestions they inevitably come up with. Id love a trampoline I could use at 4am, although not sure how that'd work with low BP After some advice from mind today, not sure if I'm going to get another opinion, as if they change things again I might not get any further help. At the least I'm going to ask for the psych to see me again and explain his decisions. I'm sure that changing my mind won't go down well, but if the shrink can change his mind, I reckon I can too. Wishing you a peaceful and akathisia-free evening

[pulisa]

Thanks, DS. You too! I agree about the anger/rage factor. I still stand by my agitated depression diagnosis of 25 years standing plus a few "extras"!

[Dying_Swan]

I'm sorry you get it too. It's so hard to explain to someone who hasn't had it. Ive just had the CPN on the phone- they're sorting another opinion and tell me it won't impact on therapy they're offering (hmmm), and I should reduce quetiapine by 50mg at a time (not possible with the tablets Ive got) to whatever dose I want And they want a list of blood pressures, so I'll have to avoid zopiclone for a bit to "prove" I'm not making it up and it really does drop.

[pulisa]

Well that's certainly helpful advice re the quetiapine and it doesn't surprise me. I'm sure you will find some improvement by reducing the dose and you may feel better on less medication in general. Let us hope that the "alternative opinion" is a bit more clued up.

[Dying_Swan]

Well that's certainly helpful advice re the quetiapine and it doesn't surprise me

Thank you, that did make me chuckle. I didn't take zopiclone last night and was up half the night in order to record my low BP. I need to do it again too to get it while I'm standing up, if I can stand up. I'm sure there are some ethical considerations somewhere here.

I hope you and your son are doing ok. Thank you so much for your support

[pulisa]

Do they really mean that you should take your BP during the night? Surely it should be during the day only? I would have thought that the aim would be to get you back to a normal sleep/awake cycle with the prescribed meds combo working in your favour as opposed to against it?

Has any drug been better for you than others? I think you should have a say in what you would like to try next because you know how you react and having confidence in a med can be half the battle whether it's a placebo effect or not.

[Dying_Swan]

Maybe you're right and they only want daytime BPs, but it's in the few hours immediately after taking quetiapine that it plummets, and I feel like I need to prove it. If they could see my other medical records they'd have proof, but annoyingly they're on different systems. I'm not going to do this for any longer than I have to though.

Truthfully, none of the meds have done much for me, with the exception of benzos. Mirtazapine was initially fantastic for sleep but only for a couple of months. I've had a couple of weeks with different med combos where I felt better, but nothing has made a sustained difference, and they are saying now that meds are likely to only have "limited benefit". The private psych I was seeing previously felt I was calmer on quetiapine. I don't mind continuing it, as long as I can get the side effects sorted, so probably a lower dose. I do want to come off trazodone though, as it's never done anything for me. They've arranged a review with the shrink next week, so will see what he says. Thank you for your sound advice.