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Thread: Starting quetiapine

  1. #91
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    Re: Starting quetiapine

    Definitely wait to see the psychiatrist before increasing, and don't increase too much if you do it without their guidance (please don't). I've also felt pretty irritable and not sure if it's depression or the meds, or both. I guess it took about 4 weeks to get down from 225 to 75mg venlafaxine. I have wondered about mood stabilisers too and you're right that it's reassuring to think there are other things that can be tried. Sometimes it just feels like nothing will work which is disheartening.
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  2. #92
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    Re: Starting quetiapine

    Quote Originally Posted by Jo79 View Post
    iím now thinking I should ask my psychiatrist if I can change one of my drugs to a TCA, probably the mirtazapine and keep taking the venlafaxine and quetiapine for now. Is that a do-able combination?
    Depends on the TCA as, unlike the SSRIs, they don't all do the same thing. The serotonergic biased TCAs, i.e. amitriptyline, imipramine and especially clomipramine would conflict with venlafaxine, but the noradrenergic TCAs, desipramine, nortriptyline and lofepramine could work.

    Iím reluctant to change the ven as I know it can be rough to get off.
    Perhaps, but taking a med that isn't working because it could, repeat could, it is not a certainty, be difficult to discontinue is unwise, imho, especially if it prevents getting on a med that could be the answer for you. Quitting venlafaxine directly can be problematic. Switching to the long half-life fluoxetine and weaning off it is usually easier.
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  3. #93
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    Re: Starting quetiapine

    Thanks PDU, will definitely chat to my psychiatrist before changing anything just reassuring to hear your views.

  4. #94
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    Re: Starting quetiapine

    Should have added to my previous that it might be possible to switch from venlafaxine to a new med by cross-tapering which could negate much of any withdrawal response. It depends on what it chosen and how competent and confident your psychiatrist is. Don't let him/her just pick a med out of a hat (which admittedly in many circumstances is often as good a method as any other), but have these other factors considered too.
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  5. #95
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    Re: Starting quetiapine

    Hello all. I have a couple of queries that I'm hoping PDU (or anyone who might know) will see.

    Just to update - I'm still on 600mg quetiapine at night, am down to 37.5mg/day venlafaxine (supposed to stop soon but I'll probably halve it again), and was put back on trazodone, currently at 100mg, supposed to go up again to 150-200. I'm fully under NHS care now, and things have been difficult as we disagree about a number of things.

    Anyway, due to various factors I keep missing my quetiapine, and I've noticed the main withdrawal symptom I get is hot and cold flushes, and a flushed face. It almost feels like I'm getting flu, though I checked my temperature during one of these episodes and it was normal. Does anyone know anything about that?

    My other question is whether, when I've missed a dose, is it best to go straight back to 600mg at night, or to split it, or to say go back to eg 300 and increase it up? I've missed it for about 4 days now. I tried taking 200 yesterday afternoon but it knocked me out (so I missed the 400 later on), and I took 100 this morning to try to avoid the temperature issues, so I'll take 500 later I guess. Another issue I have though is akathisia, which comes on an hour or two after taking it if I'm not asleep, and it is one of the most horrible sensations ever. It seems the most I can tolerate in the morning is 100, or it plunges my BP and knocks me out. I haven't taken trazodone for days either. It isn't intentional, it's just how things have worked out.

    Im sorry this is so long and probably doesn't make a lot of sense, but I'd be really grateful if anyone has any thoughts.
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  6. #96
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    Re: Starting quetiapine

    Quote Originally Posted by Dying_Swan View Post
    Anyway, due to various factors I keep missing my quetiapine, and I've noticed the main withdrawal symptom I get is hot and cold flushes, and a flushed face. It almost feels like I'm getting flu, though I checked my temperature during one of these episodes and it was normal. Does anyone know anything about that?
    Flu like symptoms are fairly common withdrawal symptoms of many meds, not just antidepressants, anti psychotics and benzodiazepines. I don't know why this is.

    My other question is whether, when I've missed a dose, is it best to go straight back to 600mg at night, or to split it, or to say go back to eg 300 and increase it up? I've missed it for about 4 days now.
    Is the 600mg taken in an extended/slow-release, or immediate-release formulation?

    My basic rule of thumb for meds generally is to take the missed dose asap if it is 12+ hours until the next scheduled dose, skipping it if <12 hours.

    However, missing doses for 4 days is a different kettle of fish. I'd take 300mg for 2 nights and then back to 600mg, but this probably won't be side-effects free. I don't think they can be avoided no matter what you do. Skipping doses is fraught. Maybe set an alarm on your watch or phone as a reminder.

    I haven't taken trazodone for days either. It isn't intentional, it's just how things have worked out.
    How long have you been taking it and how long at 100mg if you started on a lower dose?
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  7. #97
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    Re: Starting quetiapine

    Do you have any faith in the new psychiatrist, DS? I can't comment about the choice of meds but I'm wondering whether they just make you feel worse.

  8. #98
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    Re: Starting quetiapine

    PDU- thank you so much. I've not been able to find any mention of these hot and cold flashes on anything about quetiapine withdrawal, but that's reassuring. I'm on 600mg immediate release, I took 100 yesterday morning and 500 last night, and luckily slept through any side effects. My sleep has been so messed up though, which is partly why I keep missing it (one night I'll crash out on the sofa for 15 hours, the next I'll be up all night with akathisia and agitation). Maybe slow release would be a better option. I asked about reducing it but they advised against it as I'm reducing ven.

    I've been on 100mg trazodone for a week or so (missed doses aside), and started on 50. I'll probably go up to 150 tonight or tomorrow night, and I can go up to 200 if needed, although it doesn't seem to work for me.

    Thank you Pulisa. I don't have much faith in this psychiatrist. I don't think he listens, and he changes his mind about things. I did like the previous one but am stuck with this one for now. I'm going to ask about another opinion. How is your son getting on?
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  9. #99
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    Re: Starting quetiapine

    You are within your rights to request to see another psychiatrist-just put it in writing to the Service Head of your CMHRS. I hate psychs who are ditherers-really doesn't give you confidence when you most need it because these drugs aren't smarties!

    My son was hospitalised for nearly 3 weeks (NHS) but is home now on ven and risperidone. It has all been pretty horrendous just living in fear of what he will do next. He is starting EMDR therapy next week providing he can keep himself safe.

  10. #100
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    Re: Starting quetiapine

    Quote Originally Posted by Dying_Swan View Post
    I've been on 100mg trazodone for a week or so (missed doses aside), and started on 50. I'll probably go up to 150 tonight or tomorrow night, and I can go up to 200 if needed, although it doesn't seem to work for me.
    Have you been on trazodone before? If so what was the highest dose taken?
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    The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.

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