MattNNN - Working on Seroquel taper, mental health struggles

[MattNNN]

Today is my 41st day at this dose.

 

My step mother had surgery today. I thought that she had cancer and would die soon, but was going to die, but the surgery went well, they removed a growth, and so far it appears that it was not cancerous.

 

In hindsight, it seems that part of why I was feeling bad was worrying about her, not so much withdrawal. When I first found out she might be dying two months ago, I didn't feel anything, but as time went on my emotions really started to kick in. I was already an emotionally cold person before I was medicated, but I wonder if the meds make me even colder than I would be naturally.

 

I'm planning to stay at this dose of medication until Day 61, unless something comes up that would force me to wait longer.

[Altostrata]

Psychiatric drugs are well-known for narrowing emotional range. Good to hear you're seeing some improvement.

[MattNNN]

I wonder if inaccuracy in the way I cut Zoloft pills could lead to too much fluctuation in the daily dose.

 

I'm taking one whole 25mg pill plus one piece of a pill that is supposed to be 6.25mg. The 25mg pills are scored so as to be evenly cuttable into halves but not into quarters.

Is that inaccurate enough to cause problems?

[Altostrata]

Are you feeling odd intermittent symptoms?

 

It's probably not significant at the 31.25mg level, but you'd probably want to be more precise and consistent with dosing when you taper.

[MattNNN]

First let me briefly recap how I got to this point. From November 2022 to April 2023, I was tapering my Seroquel way too fast, stopped cutting Seroquel in April, and then increased the Seroquel a little bit. After increasing the Seroquel didn't get rid of depression, I increased the Zoloft dose to over 37.5mg (late May), but became a little manic and had to quickly cut it below 37.5mg in order to end the manic episode.

 

Last time I posted, I was severely depressed (and moderately anxious), and it seemed to be getting worse. After 50 days at 31.25mg, I decided to go back up to 34.4mg and have been at that dose for 8 days. I still have depression and anxiety but the depression is much lower and the anxiety is about the same. 34.4mg is 1 pill + 1/4 pill + 1/8 pill, so accuracy could become an issue. It also makes it so that whenever the graph of my mood (over the course of many days) is not a straight line but rather up and down and up and down, I begin to wonder if the last dose I took was too big or too small.

 

I need to come up with a strategy in terms of when it will be ok for me to cut the Zoloft dose again.

You mentioned more accurate dosing. I've seen people write about how to compound at home but I think I'd need to see a video in order to get the hang of it.

[Altostrata]

It's hard to tell what's going on because you were changing Seroquel and Zoloft doses at about the same time.

 

If the symptoms you call "depression" and "anxiety" occurred after dosage reduction, they probably are drug withdrawal symptoms, but we cannot tell from which drug. 

 

If you feel better having restored Zoloft to 34.4mg, 

 

11 hours ago, MattNNN said:

whenever the graph of my mood (over the course of many days) is not a straight line but rather up and down and up and down, I begin to wonder if the last dose I took was too big or too small.

 

Withdrawal symptoms tend to be intermittent. Typically, withdrawal anxiety comes in spontaneous waves. This is not relapse.

 

It's likely that after any dosage reduction, you may get a few days of odd symptoms. Odd symptoms that are severe or last longer than a few days may indicate the reduction was too much.

 

Mood goes up and down anyway, so this is not a good marker for assessing taper progress. Did your sleep pattern changed while you were tapering?

 

11 hours ago, MattNNN said:

34.4mg is 1 pill + 1/4 pill + 1/8 pill, so accuracy could become an issue.

 

Yes, when you're down to cutting 1/4 and 1/8 tablets, accuracy is poor. You may wish to take the 1/4 and 1/8 tablet portion in liquid form. Here's more about making your own liquid

 

 

Combining tablets or capsules with liquid to taper

 
How to make a liquid from tablets or capsules

Using an oral syringe and other tapering techniques

Pharmacy liquids to make suspensions

 

Questions and answers about liquid medications

[MattNNN]

I don't see how Seroquel could make a difference. I've been on this same dose of Seroquel (162.5mg) since June 2nd.

 

From October 6 to October 16, I was on 34.4mg of Zoloft using the old (cutting) method. From Oct 17 on I have been on that same dose in liquid form (using a syringe to liquify a 12.5mg half of a scored 25mg pill, then mixing with water and drinking 3/4 of it to make 9.4mg).

 

Every day I oscillate between moderate optimism and deep pessimism. I had just spent 50 days at 31.25mg before giving up and updosing, so part of me wonders if it is possible for me to become happy without updosing again.

 

You asked about sleep patterns. About a year and four months ago, I started to do biphasic sleep (getting half my sleep in the middle of the day and half at night). I intentionally started this method of sleeping because before I started biphasic sleep (we're talking summer of 2022), I had the problem that it would take me hours to get to sleep at night and then I couldn't take a nap in the middle of the day. This was back when I was on 300mg of Seroquel, and when I started to do biphasic sleep, I began to take 150mg at night and 150mg midday. My current dose of Seroquel is 125mg at night and 37.5mg midday. At this point Seroquel doesn't seem to affect my sleep schedule at all; the big night dose doesn't make me any sleepier than the small midday dose does, if it affects my sleep at all.

 

Over the past year, I've had a rotating sleep schedule, sometimes sleeping about 8 hours at night, sometimes sleeping 8 hours in the middle of the day, and sometimes sleeping about 4 hours at night and 4 hours midday.

 

It seems that the sleep schedule goes something like this:
1) Sleep 8 hours at night for 2 weeks
2) Sleep half at night and half in the middle of the day for 1 week

3) Sleep 8 hours in the middle of the day

4) Repeat the cycle

 

I'm not sure if you have ever worked with someone who intentionally did biphasic sleep.

[Altostrata]

2 hours ago, MattNNN said:

I'm not sure if you have ever worked with someone who intentionally did biphasic sleep.

 

No, I haven't. Are you taking Seroquel to enable this sleep method? You're changing your Seroquel dosing schedule every week?

 

 

[MattNNN]

No, since the beginning of June the schedule and dose of Seroquel have been the same: 37.5mg in midday and 125mg at night. I always take the midday dose at about 11am, and the night dose at around 10pm. And I always take Zoloft (the full dose, not divided) between 8pm and 12 midnight.

============================

As far as biphasic sleep goes, the ideal goal is not to have the rotating sleep schedule that I have, but ideally to sleep in the same 4-5 hour chunks at the same time every day.

=========================

I wonder if the sleep problems I had a year and a half ago were caused by having such a high dose of Seroquel, as well as by taking all of it at night and none midday.

[Altostrata]

3 hours ago, MattNNN said:

Every day I oscillate between moderate optimism and deep pessimism. I had just spent 50 days at 31.25mg before giving up and updosing, so part of me wonders if it is possible for me to become happy without updosing again.

 

What you're describing are not withdrawal symptoms, but your own habits of mind. We cannot help you with that.

 

Other than this, what symptoms do you currently have that might be withdrawal symptoms?

 

We often use sleep pattern as a marker for withdrawal but, given your unusual sleep pattern, this is not going to be possible.

[MattNNN]

Ten days ago I had to updose the Zoloft again, this time from 34.4mg to 37.5mg. I still feel withdrawal symptoms, but, although unpleasant, they are clearly manageable. I plan to hold this dose for three months. In the past my strategy has been to throw myself straight into hell as soon as I have one good day. From now on, I plan instead to taper so slowly that I barely feel any withdrawal.

By the way, is there a thread on this site for people on an SSRI and an antipsychotic (and nothing else) talking about which to taper first? I know there is a thread of which to taper first, but that one seems to be dominated by talk about combinations of meds that includes Benzos (I've already read most of it but I don't think it is relevant to my case). I need to know an exact ratio of Seroquel to Zoloft in which Zoloft becomes to stimulating.

I'm under the impression that tapering the antipsychotic would bring massive improvement to my quality of life, whereas tapering the SSRI would only lead to slight improvement, although perhaps I am simply ignorant of how much the SSRI is harmful. (But I won't be tapering for three months anyway).



 

[MattNNN]

From December 16th to January 4th, I changed the time that I take my Zoloft from all at night to all in the morning. Then, since January 5th, I have been transitioning from taking some Seroquel midday and some at night to taking it all at night (without changing the total amount).

I'm still getting used to the new timing. Even though the doses have not changed, simply changing the timing of the doses has created it's own "withdrawal" symptoms.

I will probably make the next cut, a 5% cut to my Zoloft, starting January 16th. That will be 60 days after these changes began.

[Vancouver1986]

Hi there, OP.

 

I'm about to start a slow taper off of 50mg I.R. Seroquel. I just wanted to say hi and show camaraderie. I'm almost 38, F, & Vancouver Canada if it matters!

 

> "Over the past year, I've had a rotating sleep schedule, sometimes sleeping about 8 hours at night, sometimes sleeping 8 hours in the middle of the day, and sometimes sleeping about 4 hours at night and 4 hours midday."

 

From what I've read about Seroquel late last year (H1 & D2_ and histamine information recently, changing circadian rhythms can be caused by tampering with histamine that happens during Seroquel withdrawal. This happened to me in late 2022 when I got home from my 3rd in-patient stay within 6 months and they had to add 50mg X.R. Seroquel because I was withdrawing so severely from a few things at the same time - dangerous! My circadian rhythm completely flipped for like a month. Infuriating.

 

I've unsuccessful slowly tapered by 1/4 a pill 11x now either with my own pill-splitter or at an in-patient facility with an industrial one, and now I know why: t was a 12.5% drop. Since July 2021, nobody ever suggested a liquid. Nobody was ever able to help me, other than decrease one of the two 25mg pills by 1/4. Shocking and pathetic. I've been stuck on this god-forsaken anti-psychotic with dangerous myoclonus and severe tranquilizing until mid-day the next day. I want my life back. I've been gas-lit, dismissed, and emotionally violated the whole time while my body autonomy was taken from me by this anti-psychotic.

 

I'm hopeful that a low-histamine diet (recently learned on my own) will reduce the stress/withdrawal symptoms. I can resume my normal eating in a few years once I'm off the 50mg I.R. Seroquel, or whatever mg I no longer have myoclonus & extremely tranquilizing on. It's not up to me how long this taper will take. It's entirely up to my nervous system. I don't drink, smoke, or weed.

[MattNNN]

Update: On Feb 5th, my Zoloft dose was 37.5mg, but I was overstimulated by that high dose. I cut the dose down to 35.625mg, but that was too big of a cut so I brought it back up and stayed at 36.25mg for a while. Now I have gotten it back down to 35.625mg. I will stay at this dose until June 1st, then I plan to cut 5mg over the course of the next year. Unfortunately I can't cut it any quicker than that while remaining stable.