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YellowRoses

YellowRoses: The beginning of the end of psych drugs

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YellowRoses

Hi, my signature has a potted meds history, there were others I don't remember. I recently spoke to my prescribing doctor (pdoc) and she agreed to assist with withdrawal from quetiapine (Seroquel XR) but when I tried by reducing 50% over the fifth day I unravelled completely so went back to full dose feeling like I a failure. She seems not to have a handle on what to do, so it is up to me to get informed. Have been on quetiapine since mid-2014 with a brief hiatus when a psych added Lithium which was disastrous, huge anxiety spikes and meltdown in public. But the psychiatrists said the response may have been psychological, rather than the lithium. I stopped the lithium anyway. I feel I am under a constant mental and physical oppression, I developed tinnitus in 2016 when I was briefly on another brain med, can't remember which one, the tinnitus continued when I stopped it. I struggle to be creative, I want to write, paint and create meaning in my life but mostly can't be bothered. I cycle through hypomania and despair with regular monotony. The drugs seem to do nothing to stop the bipolar cycle, although truthfully the lows are not as low since the mirtazapine increase last year, and the highs are not as high nor as prolonged as they used to be before the quetiapine/Seroquel. The only plus side is it regulates my sleep well most of the time.

I found this forum via Mad in America when I searched for quetiapine withdrawal on that site.

Brief on physical health: I am in my mid 50's. I have gained 30 to 35 kilos since 2014 I had a full hysterectomy and oophorectomy so instant menopause and also went onto quetiapine at that time mid-year. I am SO hungry all the time, I try to eat sensibly, but I eat too much and as I have a back injury and neuropathy in one leg, walking is difficult - I can do 1 to 1.5 km a day that's it. I started swimming again to try to reduce weight but both shoulders developed bursitis. So exercising is in the 'light exercise" range. I really want to lose most of the drug-induced weight gain.

My goal is to come off Quetiapine all together eventually and reduce mirtazapine back to 30 mg.

Because I am on an XR coated Seroquel the lowest dose available to reduce is 50 mg at a time I see from the information pages you recommend 10% at a time. I don't really know how to go about making a long-acting tablet into a 10% reduction. I am wondering if I could try to reduce 50mg (I went straight to 100mg skipping my morning dose and that didn't work) for 6 weeks and see how I go?

I have read some of the advice here. I forgot I also have 25mg IR quietipine as a PRN but have not used it for some time. Perhaps I could do this and see.
Drop 50 mg of XR and take 25 mg of IR so = 1 x 50 mg XR + 1 x 25 IR in the morning and the two 50 mg XR (=100mg) at night for say a month, to see what the effects are, keeping track of any withdrawal symptoms, then drop the 25 IR so only on 1 x 50 mg SR in morning for a month, watch and wait, drop that to 25 mg IR for a month, then stop the moring dose for a month.
Then possibly go to the same formula as all that - repeated at night. Does that sound possible or sensible to begin?

 

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ChessieCat
YellowRoses

Thank you ChessieCat - lots to process here, feeling unwell will come back to all another day now.

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ChessieCat

Yes, it can be a bit overwhelming when you first get the information.  Just go through it bit by bit as you are able to.

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YellowRoses

Have read all the recommended parts and watched the video.
Discussed with my partner and will proceed to have a chat with my p-doc about compounding chemist script for  10% reduction in Seroquel. Don't see P-doc until end of the month. In the meantime will prepare myself for the changes. Thanks for all the info. Will taper Seroquel first, was not intending to taper mirtazapine, but see the info there and will consider once I am out the other end of Seroquel after a period of settling and having my brain re-set. Have found a compounding chemist on a route home from my doctor's office to make it easy to get the 10% reduction made up (hope they do it there.) Thanks for everything. will come back when needed. ta.

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YellowRoses

Since I discovered this fabulous site and set my mind on a course of action, knowing it is doable to come off tthe anti-psychotic meds I feel SO much more in control of my life and have hope that I can get mySelf back.

 

Thank you to the founders and the admins who run such a professional lived experience site.

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YellowRoses

TAPERING OFF SEROQUEL - Quetiapine XR 
In preparation for talking to my Dr later this month and to get my head around what this means and what compounds I will require, I have just done a spreadsheet reducing my dosages from 200mg to 2 mg of Seroquel XR at a calculation of 1 month per reduction. (2mg being 1% of the overall starting dose.) On the understanding it is not an exact science and some may go slower and some faster than a month per incremental taper depending on waves and windows and my responses and what else is happening in my life too probably.

Calculating that it If I start 1 November 2018 it will be November 2021 before I am off the Seroquel at 10% increments.

Data attached showing the rough guide by months AND -the compound medicine I would need for the first year.
I take my 200mg dose spaced evenly morning and night - currently, 100mg am + 100mg pm. (Which is an unusual way to take it apparently).
Just saving this here as my first foray into this relatively complex process.


A Maths thing!
I also learned something about maths today LOL! I
You can reduce 10% infinitely! 😆I was still going up to line 50 something before my partner said... "Ummm, there might be a cut off point, why don't you ask."
So I checked and read this Why Taper by 10% of my Dosage? page and found the answer.
 

Quote

"Mathematics whizzes may recognize that the 10% reduction formula is a geometric progression (asymptote) approaching but never equaling zero. At a very small dosage, likely less than 1mg, when reductions no longer cause any withdrawal symptoms, you may want to simply stop."

 

More here about: Tips for tapering off Seroquel (quetiapine)
 

YELLOW-ROSES---TAPER-DATA-First-calculations.jpg

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ChessieCat

When to end the taper and jump to zero?

 

If the amount you want to measure is a "difficult" number it can be easier to round the number - round UP, not down.  The next reduction will need to be calculated on the dose you took (ie the rounded up amount).

 

It is important to throw out the calendar and listen to your body.  If you are going through a stressful time, eg holidays, sickness, etc, it is better to hold for longer.  

 

Stabilising After a Reduction - What Does That Mean?
 

Withdrawal Normal Description

 

One of the mods created this:  Tapering Calculator - Online
 

Keep it Simple, Slow and Stable

 

This topic has links to various symptom lists which you can either print out or download.  Dr Joseph Glenmullen's Withdrawal Symptoms


Rate Symptoms Daily to Check Patterns and Progress

 

Keep Notes on Paper

 

Unfortunately during tapering there will most likely be times when you feel discomfort.  It is important not to panic and to try and stay as calm as possible.  We recommend learning and using Non-drug techniques to cope

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YellowRoses

😆 Thanks Chessie Cat.
I sure could have used that spreadsheet took me hours to do mine. <LOL>. But I learned something important and really got my head around what the reductions look like by doing it all with a calculator and punching it into a spreadsheet. Thanks so much for the next round of in-depth knowledge. Will peruse over next week. ta.

Understood the time is all based on my tolerance and reactions and that slowly is the key. I am prepared that there will be setbacks etc. 

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ChessieCat
8 minutes ago, YellowRoses said:

slowly is the key

 

It is very easy to get impatient and want to go faster.  I've experienced it several times myself and I've noticed the same thing with other members who have been plodding along and then suddenly have the urge to hurry.  So be prepared for that.  One tip is to look at how much you've reduced by, not how far you still have to go.

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YellowRoses

Then there is the compulsive thoughts like this morning before I have even started...
"Look, it's gonna take years that way. Let's try dropping 50mg in the morning and see if we cope".
"Umm, nope, been there done that before remember! Unravelled in the first week. This is a MUCH more sensible approach and all that lived experience knowledge and strength in SA telling us how to do it, chose that."
 

'slowly is the key' must become my new mantra.

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YellowRoses

My brain is not working very well this am -  if the initial 10% taper brings on withdrawals that don't stabilise, perhaps I should have a further compound in the cupboard so I can add back in say 5mg.

Perhaps it would be best if I have two compounds made - 1 compound equalling the 40mg needed + a standby 5mg? and if that works to stabilise the withdrawal stay on the 50mg+40mg+5mg for a few weeks (4-6 whatever) then drop the 5mg. Perhaps better to have that 5mg on hand to begin with to save having to jump straight back to 50mg or spin-out and rush off to doc (who is miles away) and organise yet another compounding. If I don't use them though they could be held for when I am at a multiplication of 5mg.

 

Does that sound like a sensible approach?

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YellowRoses

Conversely, from the leap in and be damned approach above, the next moment I am clutching my meds mentally saying "Why play with the danger!" and "Can you cope with (potentially) years of destabilisation?"

So I googled "pros and cons of 10% taper from psychiatric drugs."

Found a very helpful site to help prepare: https://withdrawal.theinnercompass.org/taper

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YellowRoses

I am going overseas to a new destination I have never been before in Asia early next year. It occurs to me with all the reading about withdrawal perhaps the best thing is to wait until I get back before starting the taper. OR - If I start in November - that's nine weeks to January to stabilise. Hold on that reduction through the trip and then taper when I get back. 
 

Travel always rocks my sleep patterns although the time difference where I am going is not the day is night, night is day I usually have when going to the opposite side of the world in the same hemisphere. 

A consideration.

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