Does this work for anxiety?

[olivia0703]

I noticed on my after-visit summary that my GP is considering this drug. My main issue is anxiety, although I have also been diagnosed with C-PTSD. Currently taking pregabalin and am supposed to be taking escitalopram as well. I take 7.5 mirtazapine at night for sleep. I am uncomfortable with taking this many psych meds as it is. Doesn't Seroquel cause movement disorders? Does it even work for anxiety? I was surprised to see this mentioned, as we did not discuss it at all.

[panic_down_under]

Currently taking pregabalin and am supposed to be taking escitalopram as well.

If I remember correctly, you stopped taking escitalopram earlier this year because you thought it wasn't working, but are now not sure. Might be time to revisit it, or ask for another AD.

I take 7.5 mirtazapine at night for sleep. I am uncomfortable with taking this many psych meds as it is.

You probably wouldn't need the mirtazapine because quetiapine is also fairly sedating.

Doesn't Seroquel cause movement disorders?

Quetiapine seems to be less likely to trigger them than other antipsychotics and may in some cases ease symptoms caused by earlier generation antipsychotics.

Does it even work for anxiety?

Yes, it may. But, as with all antipsychotics, it is not a first, second, or third line anti-anxiety med, imo, and the NICE Guidelines agree:

Do not offer an antipsychotic for the treatment of generalised anxiety disorder (GAD) in primary care

Sedating antihistamines or antipsychotics should not be prescribed for the treatment of panic disorder

I was surprised to see this mentioned, as we did not discuss it at all.

A SSRI or TCA would be a far better choice, imo.

[olivia0703]

Wow, you have a good memory. Yes, I stopped Lexapro in May. I thought it wasn't working as it was just blunting my emotions. But now I sort miss that feeling (or lack thereof). When I was taking it, I wouldn't obsess over things. Now I am back to worrying over every little thing, and find it hard to let go. My health anxiety is especially bad. I just don't ever want to go through withdrawal from them again. The head zaps were horrible.

I feel like Quetiapine is a pretty hardcore drug for anxiety

[panic_down_under]

I stopped Lexapro in May. I thought it wasn't working as it was just blunting my emotions. But now I sort miss that feeling (or lack thereof). When I was taking it, I wouldn't obsess over things.

Instead of escitalopram you could try citalopram. While they both contain the same active drug, the 'S' isomer of citalopram, aka escitalopram, citalopram also contains the mostly biologically inactive 'R' isomer of it and that difference can produce variations in their side-effects. No guarantees, but worth a shot, imo, if you want to give that AD another try.

I just don't ever want to go through withdrawal from them again. The head zaps were horrible.

How did you stop taking escitalopram, a taper or 'cold-turkey' and how long did the zaps continue?

I feel like Quetiapine is a pretty hardcore drug for anxiety

Yeah. It should only be considered if all else fails, imo, and you're a long way from that.

[olivia0703]

Yeah, I stopped escitalopram cold turkey. Brain zaps lasted a couple of weeks. I was on citalopram a few years ago. I can't remember why I stopped. It worked about the same as escitalopram from memory, maybe a little better. In between I tried sertraline, but I am a fast metabolizer of that drug apparently. In any case, I had a raft of side effects and nothing in the way of relief. Pregabalin works great for a few days, then I can't tell that I've taken it. But if I miss a dose or stop, the withdrawal is horrible. I get super depressed and anxious, and itch all over at night. I guess I am looking for that magic cure-all ... you know, the one which doesn't exist.

[panic_down_under]

Yeah, I stopped escitalopram cold turkey. Brain zaps lasted a couple of weeks.

Tsk, tsk, Olivia. No psych med should be quit cold-turkey.

Pregabalin works great for a few days, then I can't tell that I've taken it. But if I miss a dose or stop, the withdrawal is horrible. I get super depressed and anxious, and itch all over at night.

A slow taper off after you're stabilized on an AD, plus an antihistamine and maybe magnesium supplement for the itching should make it easier to quit. How much pregabalin are you taking?

I guess I am looking for that magic cure-all ... you know, the one which doesn't exist.

Aren't we all, though the one I'm taking has been fairly benign, at least in terms of side-effects...so far.

[olivia0703]

I'm taking 400mg at the moment, but it's only been since Monday. I tapered off it a few months ago, but have been taking it off and on when my anxiety peaks. How fast can I taper since it has only been a few days? Can I just go 300, 200, 100 off? Or do I need a couple of days at each dose?

[panic_down_under]

So you've only taken pregabalin for 5 days after being off it for several months? If so, you could probably just quit. Or do it the way you suggested if you'd be more comfortable doing it that way (when weaning off meds psychology can be at least as important as chemistry, and sometimes even more so).

[olivia0703]

So you've only taken pregabalin for 5 days after being off it for several months? If so, you could probably just quit. Or do it the way you suggested if you'd be more comfortable doing it that way (when weaning off meds psychology can be at least as important as chemistry, and sometimes even more so).

I'm been off consistent daily use for several months, but I have taken it off and for a few days here and there when my untreated anxiety has gotten too much. This time it's been four or five days. Each time I've sort of stepped down to be on the safe side (there are so many social media groups insisting you need to water titrate over months or years. big nope to that!). Anyhow, good to hear it's probably OK to just stop

[panic_down_under]

I'm been off consistent daily use for several months, but I have taken it off and for a few days here and there when my untreated anxiety has gotten too much. This time it's been four or five days.

Occasional use is very unlikely to trigger physical dependence so it shouldn't be an issue even after 4-5 days. However, as per my previous post psychological 'dependence' is another matter. Believe you will suffer greatly and an anxious mind is very capable of creating the whole catastrophe for you.

there are so many social media groups insisting you need to water titrate over months or years.

There is often a lot of nonsense preached at such sites, much of which has no physical basis. They often create the very problem they are trying to 'cure' through what amounts to brainwashing.