Kathrine: Respiratory depression (?) and coming off Sertraline, Vyvanse and Seroquel

[Kathrine]

I came off 50 mg Sertraline almost from one day to the next. Then threw away Vyvanse from one day to the next. Now, I am trying to come off Seroquel, but I am struggling. Went to the hospital twice in the last couple of weeks because I have a severe lung infection, but the doctors cannot understand why my body won't take in enough oxygen for my oxygen saturation in the blood to be normal. I suggested that it might have to do with the fact that I JUST came off several kinds of meds that had a severe impact on my breathing (I was hyperventilating all day every day), but they just looked at me funny. But it does make sense to me that I am now "hypo ventilating" because my body is out of balance? Am I totally off here? Right now, I wish I could just find a doctor who could let me know whether it is dangerous to "hypo ventilate". I have to sons, and I don't want to die...

 

[LotusRising]

Hi @Kathrine

 

Welcome to SA,

 

Could you help us out by modifying your signature? We're looking for dates you started/stopped medication. Please see this link How to Create a Signature 

 

These two links will help you to understand withdrawal syndrome:

 

What is Withdrawal Syndrome?

 

Video on Recovery from Psych Drugs

 

2 hours ago, Kathrine said:

Went to the hospital twice in the last couple of weeks because I have a severe lung infection, but the doctors cannot understand why my body won't take in enough oxygen for my oxygen saturation in the blood to be normal.

I'm not sure I follow what's happening. You had a lung infection and this could make your oxygen saturation low. Did the penicillin treat the infection? What is your O2 saturation? I wonder if you could describe what the breathing issues feel like?

 

I've had many breathing issues throughout my WD, but my oxygen saturation was never low. It felt like it would be because my breathing was shallow and it was hard to take a deep breath - some call this air hunger - but tracking my O2 helped alleviate some of the anxiety around this. 

 

If this is a WD-related issue, you won't die. I know breathing difficulties are uncomfortable, but they should ease with time.

 

This thread might have some relatable info:

 

 

Please feel free to post any updates or questions related to your specific situation right here in your thread. It's helpful to keep everything related to your tapering journey in one spot. 

 

Once again, welcome

 

LotusRising

[Kathrine]

Thank you so much for your time @LotusRising and your comments. I have updated my signature. Sorry, I didn't get it the first time around. I'll have a deeper look at the thread and the links. Thanks again. I am so happy this site exists! 

[LotusRising]

On 3/10/2024 at 1:10 PM, Kathrine said:

I am so happy this site exists!

Ditto! It was a lifesaver for me!

[Kathrine]

Hi!
I'm not at native English speaker, so I don't know which terms to search for regarding the following, so I apologize if this topic has been described before.

I am tapering Quetiapine (Seroquel) right now (225 mg), but I find that I get withdraw symptoms (mood swings, crying, feeling like giving up on life etc.) every day around 2 pm and until maybe 8 og 9 pm. (Actually, I realize that I have had this downward spiriling thing every day as the dosis from the night before wears off for as long as I have been on Quetiapine). The half life of Quetiapine is around 6 hours, and I take it at 9 pm, so it makes sense to me that I get a reaction when there very little of the drug left in my blood in the afternoon and night. So, I was wondering if anyone else tried to "push forward" the dose and/or kinda cut the dose into parts so that you take a little bit of the drug around the clock. Does that make sense? 

Anyway, my plan is to try the following:

STEP 1:

I will take the 200 mg. as a pill in the night, and then micro dose the last 25 mg. (in water)

9 pm: I take nothing. I go to sleep (and yes, I can normally do that better than without the drug?! The drug "turns me off", it does not let me fall asleep naturally)
3 am: I set an alarm, and I take 200 mg. 
[half life: 6 h]
9 am: 100 mg. is left in the blood
3 pm: 50 mg. left in the blood

Around 3 pm or later, if I get my acute withdrawal symptoms, I will try and "micro dose" the last 25 mg. slowly to see if that helps with the symptoms. 

STEP 2:

If Step 1 works out, I think I will try and split the dose into 4 doses a day or more (every 6 h cf. half life of the drug), and then reduce all the doses a microscopic bit at the time. 

I can't figure out if this makes sense to anyone else but me, but I hope it does, and if it does: Has anyone tried something like this?


 

[Erimus]

Firstly, please read the topic on Tips for tapering off quetiapine (Seroquel) if you haven't already. Due to the very short half-life of quetiapine IR it is recommended to split your dose, as you have already worked out. Personally I would initially split the dose in to two parts, and slowly shift them until they are 12 hours apart. You can choose to splt into four further down the line if you find symptoms are still challenging.

 

For example, you split your dose of 225mg into two doses of 112.5mg and slowly move one of them by an hour every day or so. E.g. Day 1: 112.5mg 8pm & 112.5mg 9pm; Day 3: 112.5mg 7pm & 112.5mg 9pm; Day 5: 112.5mg 6pm & 112.5mg 9pm; until you reach: 112.5mg 9am & 112.5mg 9pm

 

After stabilising on the new dose regime you can then begin tapering by reducing each dose by small amounts. You can start by reducing both doses by 6.25mg, which can be made by cutting the 25mg tablets into quarters. So you would take: 9am 106.25mg & 9pm 106.25mg.

 

All the answers you are looking for regarding tapering and antidepressant withdrawal are on this site. Please search around and continue to read as much as you can manage. Use the site search function to search for specific words or phrases, such as drugs or symptoms.

 

Here are a few of the most useful links:

 

Micro tapering

 

Why taper by 10% of my dosage?

 

Taking multiple psych drugs? Which drug to taper first?

 

How to make a liquid from tablets or capsules

 

Using a scale to weigh and measure doses

 

We only recommend two supplements. Omega 3 Fish Oil and Magnesium. Both should be introduced separately and increased slowly.

 

Regards

Erimus

Edited March 22 by Erimus

[Kathrine]

Dear Erimus,
Thank you so much. I have read the links and used the search function a lot (but missed the part you are describing, sorry). I am so happy to hear that you can validate my experience (and sad that my psychiatrist never told me – I have been struggling for years). I will try to do what you describe as soon as I have the energy to do so. Only thing... am I not gonna feel tired and sleepy after taking it in the morning? 
Regards, 
Kathrine

[Erimus]

18 hours ago, Kathrine said:

Dear Erimus,
Thank you so much. I have read the links and used the search function a lot (but missed the part you are describing, sorry). I am so happy to hear that you can validate my experience (and sad that my psychiatrist never told me – I have been struggling for years). I will try to do what you describe as soon as I have the energy to do so. Only thing... am I not gonna feel tired and sleepy after taking it in the morning? 
Regards, 
Kathrine

You will have to monitor if it makes you sleepy.

[Erimus]

Please don't start multiple threads each time you have questions. Post everything in here.

[Kathrine]

I am so sorry! I don't know what I am doing wrong though. 😕 What should I click to do it correctly? Right now I am going below your answer in the box that says 'submit reply', but that is wrong? 

I will do my best to follow your guidelines! I promise.

I hope it is okay in the meantime to mention that I am going to reinstate 0,5 mg. of Sertraline, because I went almost cold turkey from 50/25 mg. back in January, and I have these waves of suicidal ideation and intense shame and panic that I can hardly counter. (I now realize that I have had this the other times I followed psychiatry's directions and went off Sertraline, and it went on for months). That doesn't seem safe. And yesterday I had to take a benzo to not run off in the middle of the night. It seems absolutely crazy today. I have two kids and a husband that I love SO much, so it is scaring me. Also, I had a strong reaction to altering the time I take my Quetiapine, so for now I am stabilizing that at 200 mg. at 9 pm and 25 mg. in water that I "microdose" during the late afternoon/evening when the crash from Quetiapine appears while I have to do all the dinner and getting kids to bed stuff... (Still can't believe I got an ADHD diagnosis for crashing in "family hours" when it is so obviously a Quetiapine crash 😧 ...) 

[Erimus]

On 3/24/2024 at 9:21 AM, Kathrine said:

I am so sorry! I don't know what I am doing wrong though. 😕 What should I click to do it correctly? Right now I am going below your answer in the box that says 'submit reply', but that is wrong?

That is fine. Just keep posting in the box at the bottom of this thread. Last time you managed to start a new thread in the "Tapering" forums. Don't worry about it.

 

On 3/24/2024 at 9:21 AM, Kathrine said:

Also, I had a strong reaction to altering the time I take my Quetiapine, so for now I am stabilizing that at 200 mg. at 9 pm and 25 mg. in water that I "microdose" during the late afternoon/evening when the crash from Quetiapine appears

Just keep doing what works best for you. Don't try to change the dose of quetiapine if you're reinstating sertraline. One thing at a time.

[Kathrine]

Thank you. I understand. 🙂

Now, I will keep doing what I am doing for a week and evaluate. So, 225 mg. Quetiapine and the I take 1 mg split into two times 0,5 mg. Sertraline - one in the morning, one in the afternoon. I am unfortunately already getting my Sertraline symptoms of serotenergic syndrome (shallow breath, heart beating faster, sweating) and my PGAD (which I absolutely hate!) back. But that has come with other psychopharmacological changes too, so I am hoping it will pass during the next couple of days. I am hoping to stabilize here, and then at some point continue the withdrawal of Quetiapine before I try and get rid of the rest of the Sertraline some time in the future. I have eaten SSRI for 20 years, and Quetiapine for "only" 8 or 10. Also, I figured out that the symptoms I thought were related to tapering Quetiapine is actually probably protracted withdrawal syndrome from a too fast/cold turkey "tapering" back in January. It makes sense, as the other times I have followed psychiatry's guidelines and quit almost cold turkey, I have had severe symptoms for months and months on end until I wounded up in a psychiatric ward and was prescribed ... Sertraline of course. 😞

Anyways, you don't have to respond. I will not change anything for now. I am just happy to put my thoughts down to help myself keep my cool and maybe help others in my situation one day...

By the way, I do have actual asthma now. Got an inhaler etc. I wonder if it was there all along under the antihistaminic effect of the Quetiapine, or if it is yet another withdrawal symptom that will pass. I am hoping for the later, but expecting the first. Also, no menses for months. But I don't expect to be able to figure it all out. I can live with both...

 

[Peter23]

So sorry to hear that you're going through such a rough time Katherine. I can empathise with your situation having been suffering from protracted antidepressant withdrawal for 6 years and now suffering from polypharmacy after several misdiagnosis and 5 months in a psychiatric ward. I'm sure one of the monitors can advise you about tapering. I really do hope things will improve for you. You are truly not alone. With very best wishes Peter 

[Kathrine]

Hi Peter

Thank you so much for taking the time to write me, and I am so sorry to hear that you are going through something similar. It just is not fair. Are you out of the psychiatric ward now? I hope so. ❤️ I hope things will improve for you too. Soon, but slowly. 🙂

The moderators have been great. I feel safe in here. 

 

[Kathrine]

On another note, I am wondering if my 1 mg. Sertraline will keep improving over the course of six weeks like they say the so-called "real doses" do? 

[Kathrine]

So, I am better, but I think I need to do a 1 mg - 0,5 mg - 1 mg - 0,5 mg taper-like thing, because my PGAD is back, and I am irritated/agitated. Frustrating... Just afraid anxiety will set in big time, if I go down a bit again. Feel kinda stuck here, but I guess I just have to keep trying. 

[Kathrine]

Oh, this is too tough. I went out last night, had a bit of wine and got hardly any sleep last night. Now, I am stuck in anxiety, panic, shame – so much relentless shame rumination in my head – and suicidal ideation. It is too much...

[Erimus]

3 hours ago, Kathrine said:

Oh, this is too tough. I went out last night, had a bit of wine and got hardly any sleep last night. Now, I am stuck in anxiety, panic, shame – so much relentless shame rumination in my head – and suicidal ideation. It is too much...

Avoid alcohol indefinitely. It's a disaster waiting to happen.

Edited April 4 by Erimus

[Kathrine]

Okay, thank you! I will. (I felt fine with just something like 4 spoon full at night during easter, but come to think of it I did feel a bit unstable the following day... I'll avoid it for now. 

[Kathrine]

On another note, I have these 'holes' in my memory – e.g. when I am trying to write down the chronology of my time in psychiatry (for my new psychiatrist that I have an appointment with in February 2025), but also in other areas. It is like my brain just kinda sets out (which feels weird when the rest of the time, my head is over-agitated, over-thinking, over-concerned...), and there's just nothing there, and I cannot remember stuff long enough to put it into words. I wonder, if my memory and ability to focus will come back to me – if it is a WD symptom, something "underlying" my meds, or a new state. I've tried searching the forum and it seems other people mostly experience this when they are ON the drug... Anyways, I am joining an ACA group next week hoping to be able to remember my life's story if I have someone to share my traumas with (current trauma is my years in psychiatry, but the reason I ended up there was trauma brought about by my family of origin, so it is all kinda adding to this experience of coming off of psychotropic drugs). I am hoping!