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Thread: Starting quetiapine

  1. #131
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    Re: Starting quetiapine

    Updating this as a sort of diary I guess. Today I have seen the psychiatrist, CPN and psychologist. Full on. As it seems there was no consensus between the private and NHS psychs on diagnosis, I'll go for the second opinion and am assured it won't affect the therapy I'm waiting for.I took a strip of 100mg quetiapine with me, to prove you can't halve them. I hate feeling that I have to prove everything, but I do. Anyway, meds-wise I said I didn't want to change everything at once (came off venlafaxine 4 days ago and still getting head shocks). So I've got to taper down and stop trazodone, start pregabalin, and stay at 600mg quetiapine for now. Shrink says pregabalin will help with sleep, but I'm not convinced so might ask GP for more zopiclone. Other future possibilities are clomipramine or promethazine, although I'm reluctant to try further antihistamines.
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  2. #132
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    Re: Starting quetiapine

    I'm so sorry that there was no consensus re diagnosis but this is typical of psychiatrists. Doesn't help you one iota of course. Your best bet may be the promised therapy-meds are such a lottery and it's often down to each psychiatrist's personal preference regardless of your particular circumstances.

    My son has tried most of the sleep "aids"-have you ever tried melatonin on prescription? One psychiatrist prescribed amitryptiline 25mg as a knock out drug whilst another said they had never used it as a sleep inducer...It's all so confusing and unsettling when you just want an informed and definitive opinion. But nothing is straightforward with mental health, is it?

  3. #133
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    Re: Starting quetiapine

    You're quite right, it really isn't! Thanks P. I haven't tried melatonin but had considered buying it online. Was it any good? I had a small dose of amitriptyline years ago, and my mum swears by it, but they won't prescribe it for me and said clomipramine would be better if the pregabalin doesn't work out. I definitely agree that therapy is more likely to help than meds.

    I was hoping the shrinks would agree, but apparently not, so will do the long drive to see what the third one says. I'm wondering if the NHS teams will "stick together" though. The psychologist says she doesn't use labels at all, whilst I've lost track of what labels I do and don't have. The case continues
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  4. #134
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    Re: Starting quetiapine

    I suspect the NHS teams will stick together. One NHS psych told me that when you pay to see a private psych you have more time so they have to diagnose you with more stuff so that you feel you are getting your money's worth....She was pretty clueless though and we have progressed to "higher" levels of competence!

  5. #135
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    Re: Starting quetiapine

    That's interesting, and the opposite to my experience. The private psych gave me fewer labels than the NHS, although it took a long time to get the NHS to take me seriously. I had more faith in the private one, simply because he was older and I think more experienced, and seemed more quietly confident to me, but it became prohibitively expensive and I could see how it wasn't going to work having both involved. I'm almost hoping the next one I see will just stick with things as they are as don't know if I can cope with everything being changed again. We shall see. Thanks P, as ever you have been a huge support x
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  6. #136
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    Re: Starting quetiapine

    I hope you get some sort of agreement in treatment procedure, DS. Really unsettling when you have to suffer as a result of meds changes which could have been avoided with a clear and definitive diagnosis in the first place but we are dealing with psychiatrists here and anything goes because they are covered for every eventuality due to the unpredictability of mental health.

  7. #137
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    Re: Starting quetiapine

    Quote Originally Posted by pulisa View Post
    we are dealing with psychiatrists here and anything goes because they are covered for every eventuality due to the unpredictability of mental health.
    Such a scary thought. So much of it seems to be guesswork but the impact of getting it wrong is so potentially damaging. Thank you for your good wishes x
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  8. #138
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    Re: Starting quetiapine

    Just wondering if anyone still follows this thread. I need some advice about quetiapine. Was started on 25mg immediate release twice daily, mainly for sleep. Found it too sedating for during the day but the night time dose helped my sleep. i was on that dose for two weeks, anxiety still bothering me so dr switched me to 50mg once daily of the slow release. I found ti didn't help my sleep the same and i was a little groggy the next day.
    Any advice on what i should do? I've been changing between the two and not sure which is working better. I guess i should stick to one over the other. The 25mg of the immediate release isn't making me as drowsy as it originally was.

  9. #139
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    Re: Starting quetiapine

    Quote Originally Posted by emma6981 View Post
    I need some advice about quetiapine. Was started on 25mg immediate release twice daily, mainly for sleep. Found it too sedating for during the day but the night time dose helped my sleep. i was on that dose for two weeks, anxiety still bothering me so dr switched me to 50mg once daily of the slow release. I found ti didn't help my sleep the same and i was a little groggy the next day.
    Immediate-release quetiapine has a half-life of about 6 hours so more that half of a night time dose will be metabolised out of your system by the next morning while there's still about half of the slow-release being released into the bloodstream the next day hence the daytime grogginess.

    Any advice on what i should do? I've been changing between the two and not sure which is working better. I guess i should stick to one over the other. The 25mg of the immediate release isn't making me as drowsy as it originally was.
    I guess it comes down to what your priority is. Sleeping better, or trying to ease the anxiety. The latter isn't really what quetiapine is designed to do though it might be useful as a short term measure while another primary med is initiated. Unfortunately, tolerance to meds which sedate by blocking histamine receptors can build fairly quickly as you seem to be discovering.

    You're also taking the recommended maximum 200mg dose of sertraline for anxiety which is apparently no longer working so what has your doctor proposed to do about this?
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  10. #140
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    Re: Starting quetiapine

    Well i was on 150mg of sertraline and it was increased to 200mg 7 or so weeks ago.
    My priority is sleep to be honest as i function much better when i have a good night. I took 50mg of the immediate release last night and found i slept well but groggy today, i guess it's a trade off between sleeping well and feeling not great the next day.
    I went to the psychiatrist who I don't think listened to anything I said ( I also work for the NHS so am not bashing it, my GP and others various counsellors have been great just his guy wasn't). It was my first meeting with him and i thought he would take a history etc, but I was in and out in 15 mins, when the appointment letter said to allow an hour for the first appointment. I was having a bad day that day and he suggested me going onto aripiprazole, but I had only been taking the quetiapine for 2 weeks so was reluctant to do that, hence the switch to slow release quetiapine from immediate. I just wish he had sat down and took the time to go through all I was feeling and how it came about. He started me on the quetiapine after a phone consultation with one of the specialist nurses.

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