Sekai8894: Seroquel Withdrawal resulting in rebound insomnia

[Sekai8894]

Dear all,

 

I am 32 years old, currently living in Vietnam. On 18 August 2021, a psychiatrist prescribed me the following meds: Fluoxetine 20 mg and Dogmatyl 50 mg (taken twice a day), Seroquel 50 mg and Escitalopram 15 mg (taken at night before sleep). I stopped taking Dogmatyl, Escitalopram and Fluoxetine after a month and a half. (I did experience some withdrawal symptoms from this - mainly more sensitivity to muscle tension/pain/ache, sensitivity to light, blurred vision (though I suspect it could be a side effect of taking seroquel), emotional blunting, apathy etc.)

 

Seroquel was the only one I was consistently taking (every night) for over 5 months or so. I did not take the full 50mg Seroquel and only took around 18 mg nightly. My last dose of Seroquel was on Friday night 14 January 2022. I CT-ed instead of lowering the dose because my pschiatrist thought it would be okay. For the first three nights I went through withdrawal I hardly slept at all: only falling asleep around 4 a.m in the morning and waking up at 8 a.m. The sleep was not at all restful. I surmise at that point, Seroquel had not fully left my body yet. The next two weeks were slightly better: I took 0.5 mg melatonin a night (I only have the 5mg time release version and I know breaking it would just make it lose the extended release component of the drug but here in Vietnam, there are little options. They have to import supplements from overseas) and managed 6 to 7 hours a night (waking up twice or thrice a night). 

 

Then, around 7 days ago, I stopped taking melatonin altogether to see how I would fare with my "natural" sleep. I experienced something very strange: I waked up every hour that night. While I managed to go back to sleep soon after, this problem persists until now. It has been little over a week since my sleep is so fragmented. This is honestly so disturbing and stresses me out a lot. 

 

I would like to mention that for the last two nights, I also incorporated Valerian Root Extract 300mg into my nightly regimen. For the first night, I managed 6+ hours of sleep (waking up thrice). However, yesterday night, while I slept for a total of 7+ hours, I continued to wake up every hour. The thing is when I waked up, it was not in panic, it was as if I was aroused very subtly/slowly from sleep. Oftentimes, I would wake up after a dream (I have had so many strange dreams while taking melatonin)? Is this some sort of REM Rebound after quitting substance (though wouldn't I get REM rebound the first two weeks after quitting seroquel and not at the 3rd week)?

 

Aside from rebound insomnia, I don't think there is any other noticeable symptom. Perhaps some agitation/anxiety here and there but I try to not let it get to me. I do practice yoga and meditation on a daily basis, sunlight viewing, eating greens/healthy, going out with my mom/friends etc.  

 

I am not sure reinstatement of Seroquel would be a good idea at this point. One theory is that the way I'm taking melatonin atm is very counterproductive: https://www.webmd.com/a-to-z-guides/news/20110107/splitting-pills-may-have-risks#:~:text=“Not all formulations are available,PhD%2C of Ghent University in Another theory is that by stopping melatonin so abruptly, I have made my already sensitized nervous system even more vulnerable and even when I reintroduced melatonin into my system, it did not help much. 

 

I would love to receive any guidance / opinions from SA. Thank you so much in advance. 

Edited February 8, 2022 by hayduke
Remove real name for privacy

[Sekai8894]

Idk if I should reinstate or not bc aside from the broken sleep, I have no other major issue. So my reasoning is to wait a bit to see if that problem would resolve itself? But if this situation continues on or worsens I might have to reinstate at a very low dose?

 

I forgot to add that I probably used Seroquel XR version (I say "probably" bc my psychiatrist is never forthcoming with me when it comes to information. Very unethical behavior), so that's why when I quit Seroquel I have trouble staying asleep. 

 

Thoughts, please?

[hayduke]

Hi @Sekai8894 and welcome.

 

Please fill us in on your drug history by creating a signature.

 

How were you reducing the dose of seroquel to 18mg?  The XR version is packaged for slow release, so don't work as designed if the tablet is altered.

 

If you did want to reinstate a small amount you would do better not to leave it much longer.  

 

The good thing is that you were on quite a small dose, so you might find you can ride it out without needing to.  Not sure why you stopped melatonin if it was improving your sleep, but yes, chopping and changing back doesn't always get you back to where you were.  Gentle and one thing at a time is the way.

 

Many people in withdrawal find magnesium helps a lot.  I always sleep better after a nice long soak in epsom salts, my favourite way of ingesting it.  Omega 3 in fish oil is the only other supplement we generally suggest as well.

 

Tips for tapering off quetiapine / Seroquel

 

Tips to help sleep

 

Cheers

 

[Sekai8894]

Hi @hayduke

 

thank you for the warm welcome. Really appreciate it ❤️. I cut the Seroquel pill into very small, equal pieces to get the 18 mg. On Seroquel I always managed to sleep, very consistently from 10:30-11 P.M to 7:30-8 A.M, wake up and sometimes go back to sleep until 9 A.M, without fail. Though I'm terrified of growing dependent on it (needless to say I was so very dependent on it).

 

I stopped using melatonin bc I thought "lets see how I would handle without any sleep aid whatsoever." I get a bit overconfident 😭.

 

I'm thinking of tapering off / lowering the dose of Valerian Roots very slowly and staying on melatonin for some months to see how things go. 

 

have you heard of any incident where melatonin could wake ppl up more frequently during the night? The thing is I don't want to increase my melatonin dose. I'm a lightweight so I would wake up very groggy if I take more. Last two nights I managed to sleep from 11 p.m till 7:30 a.m but unfortunately, still waking up multiple times a night though. I would want to add that: I left my phone outside of my bedroom, as to not check how often I waked up / the time. I just didn't want to micromanage my sleep and made me even more stressed. If I waked up, I would just breathed deeply and went back to sleep. Luckily for me *knocks on wood* I tend to manage to go back to sleep after a short while.

 

I guess I'm anxious about my sleeping pattern. Will that resolve itself over time? I have heard interrupted sleep is a Hallmark symptom of Seroquel withdrawal. This Friday will mark a month since I stopped Seroquel. 

[hayduke]

Melatonin doesn't keep you asleep.  It's a natural hormone that signals your body to fall asleep.  If your sleep is disturbed, there's no sedating effect from it to keep you under like there would be from a sleeping pill.  This is also why it doesn't tend to make you groggy in the morning, and why it's probably safer to take for longer than sedatives too.

 

It's still ideal not to get habituated to these sorts of things but conscious occasional use can be beneficial.

 

It is completely normal to experience poor or lighter sleep when discontinuing this class of drugs - they're not called major tranquilisers for nothing.

 

If you are managing ok with less sleep during this time, you might prefer just to ride it out than reinstate.  Typically it will improve as your body processes the withdrawal and finds its own balance again.  There's a lot you can do to improve "sleep hygiene", you can find a lot more about that in the links I posted in my previous reply.

It sounds like you have a good basic routine with exercise, good food, yoga, meditation and so on.

 

Cheers

[Sekai8894]

Thanks for the quick reply. Appreciate that you took the time to reassure me when dealing with withdrawal yourself. The staff on this forum is so compassionate and generous, truly.

 

Yeah i guess melatonin functions more as a "hypnotic". Its effect is very subtle, I've noticed.

 

And I agree that dependence on something even as benign as melatonin is not recommended in the long term. So i'm mindful of my melatonin intake. I have only been using it for less than a month so I hope that's okay.

 

I don't know if my body just metabolizes drug very slowly or something but I experience slight lightheadedness the day after. That feeling clears up in the evening. So maybe even 0.5mg melatonin is a little bit high for me.

 

Is lightheadedness a withdrawal symptom from seroquel use?