Blackm0zart Tapering From 50 mg Seroquel

[Blackm0zart]

Hey everyone! I’ve been taking Seroquel 200mg for 8 years and have finally decided I’d like to discontinue my use of the drug. Initially, I was taking seroquel as an antipsychotic to silence voices and delusional mania I was experiencing during my early adulthood. Now I’m disinterested in the drug and have tapered down to 50mg. It’s almost been a month and no withdrawals. From here I plan to microtaper my dose from 50mg to 0 over the course of 2 years. I’ve never used a liquid solution and have no experience measuring my doses myself. If anyone could please assist me in my hyperbolic taper I’d be quite thankful and relieved because my psychiatrist was very aggressive, refusing to request a compounding pharmacy to assist me. He had firmly stated that he cannot lower my dose using the hyperbolic method and the next available dose was 25mg. Over 2-3 years I plan to slowly taper this last bit of seroquel and live my life drug free. Understandably I’ve read research regarding seroquel’s dose dependent uses and have come to the realization that 50mg is only effective as a sleep aid, not a mood stabilizer or antipsychotic. If I’m not experiencing any symptoms here I feel comfortable taking myself off the drug completely. Much love to everyone and greatly anticipating this new chapter of my life!

[Altostrata]

Welcome, @Blackm0zart

 

Good to see you want to taper properly. Here are our Tips for tapering off quetiapine (Seroquel)

 

While 50mg isn't a particularly strong antipsychotic dose, if you go off too fast, you might get withdrawal symptoms that could be mistaken for psychosis, which you would want to avoid.

 

Any doctor can prescribe these drugs, it doesn't have to be a psychiatrist. Would your GP order the liquid for you?

 

To help us out, follow these instructions Please summarize your drug and withdrawal history in your signature You may need to use a computer to do this.

[Blackm0zart]

10 hours ago, Altostrata said:

Welcome, @Blackm0zart

 

Good to see you want to taper properly. Here are our Tips for tapering off quetiapine (Seroquel)

 

While 50mg isn't a particularly strong antipsychotic dose, if you go off too fast, you might get withdrawal symptoms that could be mistaken for psychosis, which you would want to avoid.

 

Any doctor can prescribe these drugs, it doesn't have to be a psychiatrist. Would your GP order the liquid for you?

 

To help us out, follow these instructions Please summarize your drug and withdrawal history in your signature You may need to use a computer to do this.

They might be able to prescribe them, but have not spoken with them on the matter yet. How expensive will it be to order the liquid doses in 10% increments? Will my insurance cover it? I’m assuming they would not, so if I have to create the liquid solution myself how would I do it and are there any ways of achieving the same doses without using liquids and by cutting the pills myself?

[hayduke]

22 hours ago, Blackm0zart said:

They might be able to prescribe them, but have not spoken with them on the matter yet. How expensive will it be to order the liquid doses in 10% increments? Will my insurance cover it? I’m assuming they would not, so if I have to create the liquid solution myself how would I do it and are there any ways of achieving the same doses without using liquids and by cutting the pills myself?

 

You just measure out how much liquid you would need once you've worked out what your target dose is.  We can't speak for insurers, but on the face of it it's the same drug anyway.

 

Many of us prepare a suspension from tablets and measure it out in the same way.

How to make a liquid from tablets or capsules
 

Some use scales and measure powder by weight, but it can be finicky and inaccurate.  I found making a liquid preferable.

[Blackm0zart]

6 hours ago, hayduke said:

 

You just measure out how much liquid you would need once you've worked out what your target dose is.  We can't speak for insurers, but on the face of it it's the same drug anyway.

 

Many of us prepare a suspension from tablets and measure it out in the same way.

How to make a liquid from tablets or capsules
 

Some use scales and measure powder by weight, but it can be finicky and inaccurate.  I found making a liquid preferable.

I’ll read more about it, I’ve already read quite a bit. The only thing stopping me right now is the money to get the prescription filed in liquid form if the insurance would not cover it. Also, doing it myself seems to be the probable choice for me at the moment since I can just suspend it and do everything myself with the insurance still covering the cost of the pills. I’ll be speaking to a doctor about this very soon. Here is where I have sourced the information regarding seroquel’s dose dependent uses which finds the effects of seroquel to be dependent on how much is taken. 

 

https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp-rj.2022.180207

[hayduke]

1 hour ago, Blackm0zart said:

I’ll read more about it, I’ve already read quite a bit. The only thing stopping me right now is the money to get the prescription filed in liquid form if the insurance would not cover it. Also, doing it myself seems to be the probable choice for me at the moment since I can just suspend it and do everything myself with the insurance still covering the cost of the pills. I’ll be speaking to a doctor about this very soon. Here is where I have sourced the information regarding seroquel’s dose dependent uses which finds the effects of seroquel to be dependent on how much is taken. 

 

https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp-rj.2022.180207

 

Yes, there is a more light hearted article here explaining the general principle.  I had to hold during my taper during some of those noticeable receptor affinity changes.

[Blackm0zart]

On 8/18/2023 at 4:10 PM, hayduke said:

 

Yes, there is a more light hearted article here explaining the general principle.  I had to hold during my taper during some of those noticeable receptor affinity changes.

I’m very grateful you shared that article. It has invoked a confident conclusion that I’m no longer taking an active dose and that if I’m without any symptoms it’s safe to begin tapering from here. I began eating a whole foods plant based diet two years ago, which I’m attributing to the absence of symptoms. There is a handful of research proving it can reverse cancers, diabetes, kidney failure, and cardiovascular disease and are testimonies of others reversing schizophrenia this way as well. It may sound far fetched, but I think I may have just been malnourished prior to taking medication for my condition. Do you think I would’ve began experiencing symptoms by now? Such as hallucinations or mood swings.

[hayduke]

Stability is what you're looking for in this process, and it sounds like you've found a balance.

 

Can you please get this done for us:

 

On 8/17/2023 at 4:03 PM, Altostrata said:

To help us out, follow these instructions Please summarize your drug and withdrawal history in your signature You may need to use a computer to do this.

 

[Blackm0zart]

13 hours ago, hayduke said:

Stability is what you're looking for in this process, and it sounds like you've found a balance.

 

Can you please get this done for us:

 

 

Finished adding my pharmaceutical history.
 

I know what you’re thinking, “Reversing ‘irreversible’ diseases, yeah he’s symptomatic”. It’s quite ironic to have a former schizophrenia diagnosis while making such an outlandish claim, but I’ll substantiate it with cited research so you know I’m not just delirious:

 

WFPB Diet Reversing Heart Disease:

https://www.thelancet.com/journals/lancet/article/PII0140-6736%2890%2991656-U/fulltext

 

WFPB Diet Reversing Stage 1 Prostate Cancer:

https://zero.sci-hub.se/6882/e1f19a826dffe4189987dfd7cbb603cf/ornish2005.pdf?download=true

 

Dr Brooke Goldner WFPB Schizophrenia Testimony:

 

 

 

[hayduke]

@Blackm0zart I agree that very positive changes can manifest from non mainstream medicine.  If your diet is working for you that's great.  Personally I have found many benefits from fasting, particularly reversing a prediabetic state that olanzapine had induced several times.

 

Thanks for posting your signature.

[Blackm0zart]

@hayduke Just a brief update, I couldn’t find a doctor who’d order the compounded doses, but my psychiatrist has changed my one 50mg tablet a night dosage to three 25mg tablets a day so I can take one 25 mg tablet and liquid suspend the second tablet for a more accurate, more consistent dose. I’m going to be making 5% reductions. What should be my exit dose from here? No symptoms on 50mg so far after about 2-3 months. 

[hayduke]

@Blackm0zart good to hear things are steady.  Liquid suspensions are a reliable and proven method for many of us.

 

You're a long way from having to worry about exit dose.  There is a good discussion of it here.

 

One thing I wish I had known to heed, given that we are both dealing with neuroleptics ("APs") was to hold when I started noticing twitchiness in my hands.  I would have liked to have given my dopamine levels more time to adjust towards the end of my previous taper.

[Blackm0zart]

On 10/8/2023 at 7:07 PM, hayduke said:

@Blackm0zart good to hear things are steady.  Liquid suspensions are a reliable and proven method for many of us.

 

You're a long way from having to worry about exit dose.  There is a good discussion of it here.

 

One thing I wish I had known to heed, given that we are both dealing with neuroleptics ("APs") was to hold when I started noticing twitchiness in my hands.  I would have liked to have given my dopamine levels more time to adjust towards the end of my previous taper.

Okay, I’ve read through everything. Thank you for the resources! As an update, I drank two large ginger roots down with a kale/fruit smoothie which to my surprise inhibited seroquel metabolism. Had a sleepless night, followed by some semi sleeplessness which I countered by taking 75mg of seroquel, returning to 50mg the very next night. Ever since I took the ginger root I’ve been feeling somewhat odd, but I think over time things will normalize again. For anyone interested it’s because ginger inhibits liver enzyme activity of CYP3A4, which is also a primary seroquel enzyme. 
 

One thing I wanted to ask you: if I sleep 6-7 hours straight then continue to repeatedly wake up afterwards (Wake up, fall asleep for 30-60 minutes, repeat), is that a sign I should up my dose? Or should I just wait for my body to adjust? I’m aware that 7 hours of sleep is healthy, and in some cases ideal even compared to 8-9 hours. I was doing just fine on 50mg before the ginger root incident. Still mostly fine, but at night when I take the drug I’ve been having some strange anxiety and saw a flash followed by my arm lunging as I fell asleep (Kind of like a hypnic jerk). Also, it feels as though there’s a slight nausea in my stomach through certain points of my day.  I’ve previously sustained a concussion and have post concussion syndrome from the incident. Thought I’d mention. 

 

What are signs I need to return to a higher dose? Mind helping me out? I’d really love to get off this drug, and carefully so I don’t hurt myself. 

[hayduke]

If you were fine on 50mg before, I would try and stabilise there.  It suggests the other events you mentioned might be more the issue.  The "brain zap" doesn't sound like fun.  

The concussion might be a worry, I would be looking for good medical advice there.

[Blackm0zart]

On 10/25/2023 at 6:19 PM, hayduke said:

If you were fine on 50mg before, I would try and stabilise there.  It suggests the other events you mentioned might be more the issue.  The "brain zap" doesn't sound like fun.  

The concussion might be a worry, I would be looking for good medical advice there.

Okay, so it’s almost been a month and my sleep is very inconsistent taking two 25mg tablets (50mg total). It never returned to how it was before, so I’m thinking possibly the active ingredient isn’t distributed as well between two tablets. Currently, I’ll sleep for about 4-5 hours straight, lay in bed for about 30-60 mins, usually fail to sleep on my own before walking around my house and falling asleep after. I’m using the sleep hygiene trick where you get up and do something instead of just lying there. This seems to work okay, I’ll sleep another 1-2 hours at most. However I usually only sleep 5-6 hours total which doesn’t feel great. 
 

Should I up my dose or return to the 50mg tablet? It seems like I’ve either experienced a change in my metabolism or the drug isn’t as active when broken up into two 25mg tablets. 

[hayduke]

Why not try the 50mg tablet once daily?

These are things it's fine to experiment with yourself.

[Blackm0zart]

5 months ago I tapered from 100mg to 50mg. Didn’t have many side effects except maybe some broken sleep. Broken sleep has mostly gone away, actually I’d say it’s basically reverted to a normal 7-8 hour sleep and I don’t usually have trouble falling back asleep If I wake up. 
 

After 5 months of holding at 50mg my eyes have begun twitching chronically. It’s not disruptive, but it is chronic without hardly any breaks in between. One thing I’ll mention, the other day my mother made plant based muffins with cocoa powder, natural cocoa chips, coconut oil, flax seed mill, and squash which I noticed gave me a slight head-change (caffeine from the cocoa and the omega 3s I’m sure). I ate two, and a day or so later I began having this chronic eye twitch. I’m thinking it could have been dopaminergic because the oils, caffeine and flax seeds. I ate the muffin because my mother has been diagnosed with cancer so I’m encouraging her to eat more plants instead of processed foods/meats. It was my way of getting her involved, since I traditionally only eat a whole foods plant based diet (all plants, no oils, no processed foods, no meats, no dairy, cooked/raw and completely natural). I also supplement b12. I’ve always experienced occasional eye twitches every other week or so (only lasting for an hour at most), but now I’ve been experiencing chronic twitching in both eyes. 

 

Should I continue holding until the twitching subsides? Would tapering from here risk accumulated withdrawal symptoms? My plan is to begin water tapering 1mg every 2 months. I’ve read that for seroquel (quetiapine) a reduction of 2-4% is optimal, so theoretically if I taper 1mg every 2 months until I’m only taking 25mg, I could then taper the last 25mg at 0.5mg per 2 months without the reduction going beyond 4%. 
 

Please reeducate me if the “inconsistent” reduction (As in the percentage) would cause more harm than good. I’m aware that consistent doses are essential, but if this is also measured by the reduction amount (As a percentage) please inform me. I’m at such a low dose of seroquel that if I was really bipolar/schizophrenic/manic I would’ve shown symptoms by now. The drug is only 3-5% dopaminergic at 50mg. Effective dose for bipolar is 300mg (About 25% dopamine occupancy) while effective dose for schizophrenia would be around 800mg (About 35% or more dopamine occupancy). I’ve read all about it and just want to quit taking this drug for good. 
 

Thanks to everyone who’s willing to help! 

[Blackm0zart]

Hello brothers and sisters,

 

I’m going to begin tapering from 50mg of seroquel over the Summer. I have one very important question: To achieve a hyperbolic taper could I, in theory, reduce my dose by 1mg for the first quarter of my taper, .75mg for the second, .5mg for the third, then .25mg for the fourth and still achieve a successful taper? 
 

I’m basing this question off of the reduce by 2-10% rule. Essentially, I’d be reducing my dose by anywhere between 2-5%, but I wouldn’t be reducing my last dose by a consistent percentage every time. 
 

in short — how important is a consistent dose reduction when it falls within the hyperbolic range?