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oona: Severe Seroquel withdrawal, please help

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oona

Hello, this is my first post, it’s nice not to just float out in space with this very difficult experience.
 

My story is that I had been on 250 mg of Seroquel in combination with Lithium for about 8 years which kept my bipolar II in pretty good control since 2012.
 

I then had a hypomanic episode in November 2019 (after one of the toughest years of my life, finally cutting contact with my abusive family of origin and the related trauma) that lead to my psychiatrist raising my Seroquel from 250 to 350 mg to help me sleep as I was not sleeping for 3 nights (not to control the hypomania itself). It’s an understatement to say that turned out to be a terrible misjudgment as after about 2 weeks on the significantly higher dose, I started to have severe vertigo as an adverse reaction.

 

This same psychiatrist would not believe my adverse reaction/toxicity was due to the sudden jump in Seroquel, so I ended up switching psychiatrists after feeling talked down to and essentially abandoned. The new psychiatrist believed me and is a reasonable, compassionate person. He and I agreed I must come off Seroquel and quickly due to the vertigo toxicity which had me basically immobilized.

 

In 3 days, I came down from 250 mg to 50 mg. The vertigo disappeared but within days after, I started to have insomnia (I am now sleeping with sleep meds), nausea and acid reflux, headaches and now about 6 weeks in to the withdrawal, the headaches are replaced by terrible dizziness and even more severe nausea, reflux has abated with help of meds.
 

It’s really frightening and painful going through this to say the least, especially not knowing when it will improve. I work full time and have a family to take care of and my husband and I are frozen in a state of perpetual anxiety and a deep sense of crisis. 
 

Anyone experienced anything like this with Seroquel/Quetiapine or other atypical antipsychotics? Psychiatrists seem to know next to nothing about this issue. As a side note, I feel unable to raise the Seroquel level due to the severe  vertigo issues I had while on it at the higher dose.


Thanks in advance for pretty much any guidance or rays of hope, this is hell and I feel I’m on my own.

Edited by manymoretodays
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Gridley

Welcome to SA, oona.  We are a site for tapering off psychiatric medications and helping members cope with withdrawal.  You are not on your own.  You'll find the moderators and members here supportive and compassionate.

 

You are suffering from withdrawal stemming from your fast taper of Seroquel which we understand was necessary.  The symptoms you describe are typical of withdrawal.

 

What is withdrawal syndrome.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

When we take psychiatric medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.  

 

These explain the healing process really well:

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

 

   On 8/30/2011 at 2:28 PM,  Rhiannon said: 
When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay. When the drug is removed, the remodeling process has to take place in reverse. SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. It's a matter of, as I describe it, having to grow a new brain. I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long. 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium (glycinate is a good form) and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Add in one at a time and at a low dose in case you do experience problems.

 

Are you going to stay on the 50mg Seroquel or are you intending to taper?  Whatever you do is fine with us.  If you wish to taper, we can help you with that.

 

What dose lithium are you on?  What sleep medication are you taking and at what dose?

 

There is, unfortunately, no way to predict how long these withdrawal symptoms will last.  We do know you will heal.

 

This is your Introduction topic, where you can ask questions and connect with other members.  We're glad you found your way here.

 

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oona

Thanks for that very useful reply, Gridley.

 

I intended coming completely off Seroquel using several techniques: had a solution made, bought a microgram scale, cut the pills with pill cutter and exacto knives, etc., but could not get reliable sleep at 43.75 mg (long story how I got to that dose) and withdrawal symptoms were  getting worse so I just recently decided on staying at 50 mg until I’m a bit better.

 

During the height of the steep Seroquel withdrawal, I was prescribed 15 mg Ambien (had gone from my chronic 5 mg to 10 mg and was not working) at bedtime and 1 mg Ativan for breakthrough insomnia in the middle of the night.  There would be essentially complete insomnia otherwise. I also take 0.5 mg Ativan at noon and 0.5 mg Ativan in the evening. I am concerned about the high Ambien dose and definitely intend on microtapering off but am in survival mode now and even one night of poor/no sleep can be critical.  I do wonder about dizziness and Ambien, just FYI.

 

Thanks very much.

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Gridley

It looks like you've got a good handle on the situation.  It's a good idea to hold now.  I understand survival mode.

 

Dizziness is a known side effect of Ambien.

 

You're probably aware that we recommend tapering no more than 10% of current dose every 4 weeks. Your drop to 43.75 was a bit more than that.  

 

Why taper by 10% of my dosage?

 

Once you're feeling better, you may need to taper more slowly.  5% of current dose every 4 weeks is an option.  Other options are explained in the following links:

 

A micro-taper is the gentlest way to come off these drugs. 

 

Micro-taper instead of 10% or 5% decreases

 

The Brassmonkey Slide is a way of making micro-taper reductions weekly, as opposed to a larger reduction once a month. 

 

The Brassmonkey Slide Method of Micro-tapering

 

Regarding the Ativan, dependency occurs within 2 to 4 weeks of daily use.  After that, you no longer get the original benefit and are just staving off withdrawal.  (That's my own situation now.)

 

This link is specifically about tapering Seroquel.

 

Tips for tapering off Seroquel (quetiapine)

 

 

 

 

 

 

 

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ciasim

Iona, how are you doing? 

Also made a very fast taper on seroquel 

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oona

Hi ciasim,

 

Thanks for asking, I’ve gone slowly back up on the Seroquel the past 2 weeks and am better but with some residual dizziness and nausea.  My plan is to continue to very slowly go up as needed until withdrawal symptoms are manageable.

 

I hope you’re well.

 

Best,

Oona.

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ciasim
On 3/15/2020 at 4:11 PM, oona said:

Hi ciasim,

 

Thanks for asking, I’ve gone slowly back up on the Seroquel the past 2 weeks and am better but with some residual dizziness and nausea.  My plan is to continue to very slowly go up as needed until withdrawal symptoms are manageable.

 

I hope you’re well.

 

Best,

Oona.

Thank you - 

I was put on 300 mg seroquel while in withdrawals from celexa and sertraline. I was really unstable at the time. 

Being on 300 mg seroquel made all symptoms worse, so after being on them for 23 days, i halfed the dose to 150 mg. 

Will I be alright? What symptoms do you experience when you have withdrawals from seroquel? Thank you so much 

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oona
4 hours ago, ciasim said:

Thank you - 

I was put on 300 mg seroquel while in withdrawals from celexa and sertraline. I was really unstable at the time. 

Being on 300 mg seroquel made all symptoms worse, so after being on them for 23 days, i halfed the dose to 150 mg. 

Will I be alright? What symptoms do you experience when you have withdrawals from seroquel? Thank you so much 

It’s best for a psychiatrist to manage this rather complex situation, you may have to go back up on the SSRI’s and taper very slowly.  I have mainly dizziness and nausea as my Seroquel withdrawal symptoms, pretty typical.  I did withdraw from an SSRI in 2007 and it was very difficult and took 6 months, but I did it on my own and too fast.  

Unfortunately psychiatrists know next to nothing about withdrawal.  I’ve had to switch providers 3 times in 3 months and finally now have a knowledgeable psychiatrist.  Advocate for yourself and research as much as you can, many of us in withdrawal are sadly on our own.  You will make it though, don’t lose hope.

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ciasim

Thank you, 

 

can I ask, did you experience any anxiety when going down from high dose of Seroquel too low? 

 

Best regards

 

Cecilia 

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oona

Hi Cecilia,

 

I did have some anxiety but my dominant symptoms with the abrupt Seroquel withdrawal were insomnia, headaches, dizziness and nausea.

 

Hang in there!

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lxjuice

Sigh. No idea why the doctor didn't just try to lower you back to 250mg first where you didn't have this side effect. Are you still taking Ambien and how much quetiapine? Also given your history and it seems you have pretty much only just cut off ties from your abusive family, I have to wonder how much is due to quetiapine withdrawal per se and how much is the reduction in dose interacting with your mind to produce these symptoms. I would start therapy ASAP.

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oona

Thanks for your note.

 

The issue is that I experienced severe vertigo as an adverse reaction after 2 weeks on 350 mg (up from baseline dose of 250 mg) of this drug in 11/2019, so the idea was to stop the vertigo by coming off the agent rapidly with some fear that going back on it might cause problems again.  Admittedly, my psychiatrist at that time literally did not believe antipsychotic withdrawal exists.  I am currently slowly going back up on the Seroquel dosage after switching psychiatrists and feeling incrementally better but still with significant residual nausea and dizziness (currently at 162.5 mg).  I am on 2 mg Ativan per day in divided doses.


And yes, thanks for mentioning the significance of therapy.  I’ve been in therapy for many years and even more intensely in the past year after going “no contact” with my abusive family of origin.

 

I appreciate the support here, thank you.

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lxjuice
On 3/29/2020 at 7:59 PM, oona said:

Thanks for your note.

 

The issue is that I experienced severe vertigo as an adverse reaction after 2 weeks on 350 mg (up from baseline dose of 250 mg) of this drug in 11/2019, so the idea was to stop the vertigo by coming off the agent rapidly with some fear that going back on it might cause problems again.  Admittedly, my psychiatrist at that time literally did not believe antipsychotic withdrawal exists.  I am currently slowly going back up on the Seroquel dosage after switching psychiatrists and feeling incrementally better but still with significant residual nausea and dizziness (currently at 162.5 mg).  I am on 2 mg Ativan per day in divided doses.


And yes, thanks for mentioning the significance of therapy.  I’ve been in therapy for many years and even more intensely in the past year after going “no contact” with my abusive family of origin.

 

I appreciate the support here, thank you.

 

4mg Ativan a day is a fairly high amount. When you quit you will likely find that it was masking a lot of the quetiapine withdrawal symptoms even if you aren't dependent on the Ativan. If you do get dependent on the Ativan then you may not be able to tell where any symptom you have is coming from. I'm not going to say there aren't any problems worth getting a benzo dependence to fix but this is something you and your psychiatrist need to actively be talking about. The other consideration is that diazepam is much easier to taper than lorazepam.

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oona

I take 2 mg total of Ativan a day, not 4 mg.

 

Thanks for your input.

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