ciasim: citalopram up and down in short time - severe withdrawal symptoms

[Colonial]

7 hours ago, Shep said:

You're taking a drug that causes apathy and the inability to make decisions, so please consider that some of your procrastination may be coming from the drug. 

 

Great point Shep!

For so many reasons these meds make the decision making process harder to not take responsibility to move forward.

We have to try to remember that and not default to "worry" about destabilization for a justified dosage drop. 

[ciasim]

Hi @Shep and @Altostrata

Sorry for not being here for a while. 

I have stayed off with the intention to see if symptoms ramp down even more before I start to reduce Quetiapine 150 mg. 

I wars very traumatized in October- March of medinduced symptoms and ignorant doctors, powerabuse etc so honestly I just felt very scared to taper down more when still unstable. 

However, symptoms have calmed down quite a bit. 

I only have one remaning symptom: perception out of sync, as if eyes not registering surroundings correctly. Maybe a slight bit of derealisation also, I think its hard to differ them apart. 
 

Its still quite distressing but I am glad the other symptoms ( involuntary mouth shivering, electrical feeling in spine, feelings of legs walking by themselves have gone away) 

I am now slowly planning for the next move, reducing 150 mg quetiapine and have researched what options there is. As I see it there's 3 options: 

 

1. tapering strips   - ask doctor if she can prescribe tapering strips from company in Holland. 
    
2. Special dosage of Q from compounding pharmacy. Learned from a doctor in Sweden who is helping people tapering psychiatric drugs that a doctor can order a specific dosage of a medicine to a pharmacy which then produce it. He had used it a lot for SSRI:s but was unsure how the procedure was for antipsychotics. ( He can unfortunately not help me since there has to be a physical meeting before, which is impossible at these times. ) So I will  ask my doctor if she can make a request to pharmacy of 125 mg quetiapine
    
3. Take 50 mg ER Quetiapine at night and 25 mg Instant Release at morning as you suggested, @Shep. When speaking to psychiatrist she said I should take the 25 mg in the night, because "otherwise it will make me extremely tired at day". Im not sure about that? Do you think she's right? I also have a question regarding this method, what would you think of dividing the 25 mg IR and distribute it over the day? Like one quarter when waking up, one quarter midday, one quarter early evening and the last one before bedtime?  

I have meeting with psychiatrist tomorrow. 
What is your take on above alternatives? 
Thank you so much for being here. 
All the best 

Cecilia 

 

[Shep]

4 hours ago, ciasim said:

Take 50 mg ER Quetiapine at night and 25 mg Instant Release at morning as you suggested, @Shep. When speaking to psychiatrist she said I should take the 25 mg in the night, because "otherwise it will make me extremely tired at day". Im not sure about that? Do you think she's right? I also have a question regarding this method, what would you think of dividing the 25 mg IR and distribute it over the day? Like one quarter when waking up, one quarter midday, one quarter early evening and the last one before bedtime?  

 

Taking 25 mg quetiapine in the morning is like taking a dose of Benedryl in the morning, so yes, it may make you drowsy. At that low dose, Seroquel is heavy on the anti-histamine effect. 

 

Yes, you could divide it out throughout the day, especially since the immediate release has a half-life of just 6 or 7 hours. 

 

It's best to slowly move the dose one hour a day, so you'll want to gradually move the 25 mg immediate release from the nighttime to earlier in the day. The one-hour-per-day rule is the gentlest on the nervous system. 

 

Once you decide which method you're going to use, we can go into more details and set up a schedule. 

 

Two additional comments on this method: 

 

• I don't know what timeframe you're thinking of tapering, but method number 3 will delay getting started on a taper because you'll need to move the drug completely before you begin tapering. I don't know if that's important to you or not, but wanted to mention it. 
• There's a "moderate" drug interaction between sertraline and quetiapine - (see Drug interaction report - sertraline and quetiapine) so you'll need to space these drugs at least 2 hours apart. 

Please let us know how your appointment goes and which method you choose. 

[Colonial]

4 hours ago, ciasim said:

symptoms have calmed down quite a bit. 

 

That's great News! 

Been watching your progress and hoping for you to post that eventually!  😍

 

[Altostrata]

Good to hear you're feeling better.

 

On 4/4/2020 at 11:05 AM, manymoretodays said:

Hi again ciasim,

Here's the Tips for Tapering Seroquel topic again.

It doesn't look like the XR comes in 100 mg, but it does come in 50 mg.

Please take a look at the section on tapering the XR form too.  You can cut them, but it may require dosage adjustments.  You'll see more about the "matrix" formulation in topic there.  And then you could also switch to immediate release and take it twice a day.

....

 

On April 4, we directed you to read the Tips for Tapering Seroquel for the fourth time. This is the fifth time. We want you to read it.

 

9 hours ago, ciasim said:

So I will  ask my doctor if she can make a request to pharmacy of 125 mg quetiapine

 

You're taking 150mg quetiapine, correct? A 10% reduction, which is what is recommended in Tips for Tapering Seroquel, would result in a dosage of 135mg, not 125mg.

 

If your doctor can write you a customized prescription for 125mg, she can write you a prescription for 135mg. Why would you ask for 125mg?

 

What is your current daily symptom pattern? For what reason would you want to take "50 mg ER Quetiapine at night and 25 mg Instant Release at morning"? Are you thinking of cutting your 150mg daily dosage in half?

[ciasim]

@Altostrata.  @Shep,  @Colonial

Thank you so much for your support and advice. 
9 days ago I lowered the Quetipine dose from 150 mg to 125 mg with the combination of ER tablets and IR tablets, as ju suggested. 
Special pharmacy could unfortunately not create a tablet with the dose 125 mg ER. 
However lowering has went well, so far. I havnt noticed any new symptoms and perception and eyesight has gradually improved over the last two weeks. Now its 75 % of normal functioning at worst, and 98 % at best. 
So I am very pleased by that! 

I am now eager to take next step in tapering, however, I also know its important to go slow. 
My next step would be to lower to 100 mg by taking away the 25 mg IR tablet. 
I have a plan of starting on Tuesday next week, 2 weeks after the last reduction. 

Any thoughts, comments? 
Thanks for being here and giving people hope and advice. 

[Shep]

 

9 minutes ago, ciasim said:

I am now eager to take next step in tapering, however, I also know its important to go slow. 
My next step would be to lower to 100 mg by taking away the 25 mg IR tablet. 
I have a plan of starting on Tuesday next week, 2 weeks after the last reduction. 

Any thoughts, comments? 

 

This is a 25% reduction, which is likely too fast. 

 

You've been on quetiapine since February, which is 3 months. You're likely dependent on it, so it's best to reduce by no more than 10%, which would be reducing to 90 mg. 

 

Is quetiapine the only drug you're on now? Please update your signature to reflect your latest changes. Your signature is here: 

 

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[Colonial]

What your considering would be an accumulative drop of 33%, from 150 down to 100, in a very short time.

It "seems" that for now you "got away", with the larger drop from 150 to 125, but you may have a delayed reaction to that drop coming.

Or, It may be that you could have been lucky in that percentage drop, but I would think it its a little to soon to know for sure.

 

People can have delayed reactions much further out than 2 weeks.  That's not to scare or worry you, but to caution you to go slow.

Many people, like myself, can seem to tolerate ONE larger percentage drop, say 15 to 20%, but than we need much longer holds than a month.

 

To drop 25 mg again is now a 2nd larger percentage drop than the last, and it's so close to the last one, I'm honestly a bit worried about that.

All I can tell you, is that whenever I got in trouble, it was when I made too large of  CUMULATIVE percentage drops over a period of time, say in either any 3 or 6 months period.

 

And again, 2 weeks is not enough time to "know" if your going to have an issue or not with the last drop from 150-125..

I would get smacked down anytime from 3 weeks to up to almost 2 months after a too large an accumulative percentage drop.

Your starting to do so much better, I'd hate to see you accidentally shoot yourself in the foot by dropping too soon again.

 

 

[ciasim]

Dear @Altostrata, @Colonial and @Shep

I have. had a long break from. here and I would first of all thank you for all the support you have given me while tapering Quetiapine and the med induced hell that was prior that. 

 

After my last post in  middle of May (  6 months ago) I finally somewhat stabilized.  
I then began a taper of Quetiapine down to 0. 

It has mostly gone well. I have tapered 12,5 mg every 3 week. I had really no other choice.  

Today Im mostly ok. Im still on Sertraline and I want to get of that drug as well. However I think I need to take a break of at least 6 months before star tapering again. 

My hell started in November 2019 and made me end up in a psychiatric ward. I was severely traumatized. Words can't describe the hell I endured at that place. The psychiatrist where throwing meds at me and I had no voice. 

I still have a long way. to go since Im on 75. mg sertraline. But for now I am so grateful that I am off Quetiapine. I. quit 3 weeks ago and I feel well. 

I saw a post on a FB forum about you asking for sucessstories, Mine is not a sucessstory. Yet.  Because Im am still on psychotropic drugs. ( Sertraline) - but I managed to survive the hardest battle of my life, And therefore I wanted to at least drop by here and tell you how I am doing and also thank you for having created this community and thank you for your help. 

My next taper - of Sertraline - .will be. a very slow one, 10 % at at time maximum. At the moment Im taking a break from tapering drugs. I might come back here when its time for Sertraline taper. Hopefully that ride will be much less eventful. 

Thanks for being here. 
 

[Altostrata]

Good to hear from you, ciasim.

 

How did you go off Seroquel? Why did you have to reduce by 25mg decrements? Did you have any withdrawal symptoms?

 

If I were you, I'd take a rest from tapering for a while -- let your nervous system get used to the new internal ecology.

 

 

[Colonial]

It's wonderful to see you again! I think a break until spring is a very wise idea considering all that you went through. I remember You had a very rough time.

I think waiting until March  or around then will be a good time to begin. I'm very happy You came in to let us know your doing well.  Let us know how your doing around the holidays!

 

[ciasim]

9 hours ago, Altostrata said:

Good to hear from you, ciasim.

 

How did you go off Seroquel? Why did you have to reduce by 25mg decrements? Did you have any withdrawal symptoms?

 

If I were you, I'd take a rest from tapering for a while -- let your nervous system get used to the new internal ecology.

 

 

 

Thanks @Altostrata and @Colonialfor your reply. 

I went from 150 mg Seroquel ( Quetiapine) to 0 over the course of 5 months. 
The lowest dose available was 25 mg which I chose to split in half and quarters as going lower. 
I had some withdrawal symptoms: extreme fatigue, nausea, upset stomach.  But they were all manageable. Fatigue being the hardest one to handle. 
Today the only symptom left is a low level tinnitus. 

All the best for now 

 

Cecilia