Seroquel/Quetiapine

[bellbird]

What dosages + timings of dosages of quetiapine have people found the most helpful for management of symptoms?

I'm currently at 225mg at night, and aside from making me drowsy enough to fall asleep (which I suppose is one good thing), it's not doing anything for my nightmares which are a primary issue currently. + my depression has been pretty severe the past month so presumably it's not having any impact for mood either, although that could just be a half-life issue.

@blackemerald1 you mentioned this in another thread:

Take it gently on Seroquel. It can work wonders and then bite you. Depends what dose you are on.

and I was wondering if you could elaborate on what you meant by the bite you part?
I hope you don't mind me quoting your post here, I just felt if I was to reply to it in the original thread, it would have taken the thread off topic.
:)

 

[blackemerald1]

Hey @bellbird - on a tiny mobile device so sorry about the disjointed writing in advance! And don't worry about quoting me, I understand :)

I started on quite a low dose. 25 mg prn. But within weeks this dose was no longer working at all. Dosage was subsequently increased. But the same problem occurred again & continued repeatedly. So whilst it was working for me for some symptoms, it didn't stay that way & I was in this cycle of good effect, no effect, destabilize, higher dose, good effect etc.
Side effects, massive weight gain, (metabolic). Visual disturbances, sleep walking, vivid dreams, constipation, fluid retention, liver function test's came back abnormal, jaundice, reduced reflex, memory retention issue's, completely shut me down emotionally... no emotional response at all to anything. Pretty much cooked my brain. Slow blink reflex...causing dry eye syndrome. Dry mouth causing gum, teeth infections. Dry skin. shortness of breath, General malaise.

There was more but I'm sorry I cannot recall them all right now.

Getting off this drug was a major challenge. Please don't do this without medical support.

I was on it for 8 years. That's 8 years of my life I lost. I know it sounds like I should have stopped taking it or never started, known better but a whole crowd of doctors told me it was my only option. They were wrong. I'll never take drug's like this again. I was desperate & all the side effects were treated in isolation & not attributed to this drug until my liver began to fail.

Once off it (which was a very bad withdrawal experience) I was hit by a tsunami of ptsd symptoms, anxiety & depression - I had to be hospitalised.

So even when I thought it was working, I'm not sure it was... it's a haze tbh but yeah for me, and I do stress, for me, bc others seem to handle it really well & do very well on it but not for me in my individual situation.

Hope this helps. If I remember any more I'll post it. :)

 

[joeylittle]

I'm currently at 225mg at night, and aside from making me drowsy enough to fall asleep (which I suppose is one good thing), it's not doing anything for my nightmares which are a primary issue currently. + my depression has been pretty severe the past month so presumably it's not having any impact for mood either, although that could just be a half-life issue.

How many hours of restful sleep do you think you are getting? Are the nightmares waking you up, and can you explain a typical night in a little more detail?

It's not surprising to hear that it's not helping with mood - you're correct about the half-life on that. You'd need to be probably taking it twice, not once, and split in such a way that it might not help with drowsiness anymore. How's the other stuff going, like therapy, and/or non-pharma ways to work on depression and trauma processing?

 

[bellbird]

Hey @bellbird - on a tiny mobile device so sorry about the disjointed writing in advance! And don't worry about quoting me, I understand :)

I started on quite a low dose. 25 mg prn. But within weeks this dose was no longer working at all. Dosage was subsequently increased. But the same problem occurred again & continued repeatedly. So whilst it was working for me for some symptoms, it didn't stay that way & I was in this cycle of good effect, no effect, destabilize, higher dose, good effect etc.
Side effects, massive weight gain, (metabolic). Visual disturbances, sleep walking, vivid dreams, constipation, fluid retention, liver function test's came back abnormal, jaundice, reduced reflex, memory retention issue's, completely shut me down emotionally... no emotional response at all to anything. Pretty much cooked my brain. Slow blink reflex...causing dry eye syndrome. Dry mouth causing gum, teeth infections. Dry skin. shortness of breath, General malaise.

There was more but I'm sorry I cannot recall them all right now.

Getting off this drug was a major challenge. Please don't do this without medical support.

I was on it for 8 years. That's 8 years of my life I lost. I know it sounds like I should have stopped taking it or never started, known better but a whole crowd of doctors told me it was my only option. They were wrong. I'll never take drug's like this again. I was desperate & all the side effects were treated in isolation & not attributed to this drug until my liver began to fail.

Once off it (which was a very bad withdrawal experience) I was hit by a tsunami of ptsd symptoms, anxiety & depression - I had to be hospitalised.

So even when I thought it was working, I'm not sure it was... it's a haze tbh but yeah for me, and I do stress, for me, bc others seem to handle it really well & do very well on it but not for me in my individual situation.

Hope this helps. If I remember any more I'll post it. :)

Goodness. So sorry for your experience and thanks for sharing.
How you feel now if you don't mind my asking? Do any of those side effects it caused remain?

How many hours of restful sleep do you think you are getting?

Gosh good question, I would actually have no idea how much of my sleep is restful given the nightmares.
It's not something I've really thought about, and I'm having quite bad brain fog at the moment so I'm not sure I can give a clear answer to this sorry.

Are the nightmares waking you up, and can you explain a typical night in a little more detail?

Yes, they wake me up.
A typical night probably has 3 sets of nightmares, each waking me, generally in nightsweats, with the third nightmare typically prompting me to get up and try and start the day.
They're very vivid, like you mention @blackemerald1 and I think a doctor may have mentioned that as a side effect to me but I really can't remember now. I suppose in the end I'll need to weigh up if the benefits outweigh this.
The quetiapine usually puts me to sleep within 90 mins, and if I don't take it I don't get to sleep.

You'd need to be probably taking it twice, not once, and split in such a way that it might not help with drowsiness anymore

Yeah, since my posting my psychiatrist has increased my dose. Starting at 50mg at midday and 250mg at night and titrating up fortnightly by 50mg at each dosing until I reach target of 300mg and 500mg midday and at night respectively.
Seems completely unfathomable that eventually my midday dose will be greater than that which currently puts me to sleep at night but my psychiatrist said the drowsiness should go away once I'm settled on it.

How's the other stuff going, like therapy, and/or non-pharma ways to work on depression and trauma processing?

Things have definitely been a lot more unsettled this past month-6 weeks with some repressed memories recalled that I wrote about in my diary. I'm seeing my T weekly, but will be changing to a clin psych in a few weeks once I can get an appointment as T just doesn't have the skillset to work through with me what's come up.

 

[blackemerald1]

Hi @bellbird - I think it took me over two years to feel physically well again.

I follow a fairly strict regime with what I eat and drink but I was always inclined to do so anyway even when I was taking Seroquel.

I recall there were moments when despite the drug holding me under, I had these moments of feeling like I had broken through the surface of water after having run out of air. This happened many times and I think it may have been when I was late taking a dose or when it stopped working and I was advised to take a higher dose.

The sedating effects were very strong for me too.

I recall being able to smell the Seroquel coming out of the pores of my skin after rigorous exercise. It has quite a unique scent - not a pleasant one either. Though I might be very biased about that. Anyway it took at least two years for that to stop happening. I know it sounds like I may have imagined it but I am sure I didn't. I found a packet of this drug in a suitcase about three years after I stopped and I could smell it and it was the same smell that had leached out of me. I am not troubled by it now so that is why I am sure it wasn't my imagination.

Mostly, I realised how little progress I had made in healing. How it stalled my life & things I could or would have done, I did not do. I am quite emotional about it. I know it is easy to blame a drug and perhaps I am being unfair because I have no idea how I would have managed without it. I was extremely unwell when it was recommended I be put on it.

It simply put me in a holding pattern mentally and I did not heal from my Trauma, did not learn anything new, was not offered or allowed to try new therapies because I managed to exist in the extremely closed and shut down world that this drug quietly held me in. Because of this, when I finally stopped taking it I was just as unwell, maybe worse than prior to going on it.

My friends and family told me I appear much more 'with it' and always looked 'drugged'. My children told me my eyes would roll like an opiate user. But now I appear normal again. So little do they know!!

Good luck with it. :hug:

 

[bellbird]

Gosh sounds like a very difficult experience @blackemerald1 . :hug: :hug:

Just an update from me: saw my psych today and asked to be taken off my daytime dosage and have my nighttime dosage reduced to 200mg.
The drowsiness it has given me during the day these past 2 weeks has left me feeling drugged, which then is very triggering of memories of when my ex used to drug me -> anxiety and adrenaline way up. And any anxiolytic effects were completely negated.
Hopefully things can settle down again after these changes take hold.

 

[blackemerald1]

It was difficult but I am way past it now. I have recovered so much!

I am very pleased you are reducing the dosage. If it was sedating you that isn't any good on a number of levels.

I hope you can reduce without any issues and the new level does what it is meant to do.
:hug:

 

[Lucycat]

I took it for 7 years. My maximum dose was 50mg 4 times a day, but that was for a short period - a few weeks. Most of those 7 years I simply took 25mg at night and an extra one at any time if required. It really worked well for me, and 25mg gave me great nights' sleep. However even on that small dose I struggled to wake the next morning, so I was pleased to get off it.

My sleep has never returned to 'normal'. I still have the occasional nightmare and I waken several times most nights. However I can now manage, whereas before the lack of sleep caused me to feel in a crisis.

 

[Sideways]

It’s interesting how much people’s experiences vary.

I currently take 300mg of extended release in the evening, and have had my dose as high as 1200mg/day. Definitely that higher dose made me a zombie, but my current dose doesn’t appear to make me particularly sleepy.

 

[blackemerald1]

t’s interesting how much people’s experiences vary.

^^^100 times this! It is so true and must be remembered when talking about medications.

I am, as a psydoc told me years ago, 'exquisitely' sensitive to any drug - not just psyc drugs. So yes, it is a very individual experience.

On the up side when I must take a drug I usually only need a very small amount to get the desired result. :)

 

[macbeth]

I 've been on 200 mg per night and 25mg as required for 5 years. It has worked well until this year and now that amount doesn't do much except causes muscle spasm which cause insomnia to add to my already long list of sleep issues that come with this disorder . Was reviewed by the psych last week and has now added a small dose of valium into the mix for a relaxant. Will start on Fri so hopefully will be effective.