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How long for quetiapine to work? Am I just being stupidly impatient?

(3 Posts)
Psion Tue 26-Apr-16 16:24:50

Brief potted meds history. Starting taking 100mg of Trazadone 5 weeks ago, was then upped to 150mg 3 weeks ago. But mood has stayed very depressed, and anxiety just as bad. Sleep improved a little bit though (but always awake by 4.30am, feeling very anxious).

Told my CPN last week that I just didn't feel the Trazadone was helping me at all, so I was prescribed Quetiapine a week ago to help. Started on 25mg at bedtime and 25mg at breakfast. Then after 3 days upped to 50mg at bedtime and 25mg at breakfast. But still waking at 4.30am feeling very anxious, though cat-napping now for a couple of more hours. Felt so horribly depressed over the weekend, but sleepy at the same time.

Yesterday I saw the Crisis Team doctor for a meds review, and I told him I still didn't feel any improvements, and that I felt the Trazadone/Quetiapine wasn't doing anything other than perhaps aiding my sleep.

But he just suggested upping my Trazadone to 200mg at bedtime + 75mg of Quetiapine, then 25mg of Quetiapine at breakfast. I felt really upset, and feel that my meds are just being upped and upped, but they're just not going to work on me.

Last night (but before I took the new meds regime) I suddenly felt much calmer, and enjoyed a lovely evening with DH just being 'normal'. This also happened last Thursday afternoon, no idea why?

This morning I woke at 4am, but fell back to sleep until 6.45am, without cat napping. But within minutes of waking the anxiety pounced, and has stayed all day. Have been crying on/off too. I have zero motivation, everything seems pointless, though have forced myself to do some laundry and a quick tidy up.

But WHEN can I expect to feel consistently more well? After 5 weeks on Trazadone + one week on Quetiapine I was expecting to have more improvement than this. By now, perhaps a couple of good days followed by a bad day etc. I don't think I'm asking the impossible am I? Everything I read about ADs now, says you can expect signs of improvement after 2-3 weeks! But clearly not for me!!!

Or is it just too early days yet to expect anything more really? Are those few hours last night, and last Thursday all I can reasonably expect so far? My depression and anxiety has been with me, untreated, to a greater/lesser extent for over 2 years. So am I expecting too much to feel more well than this after just 5 weeks?

It's just that the bad days are so unbearably bad. It's more like despair than depression to be honest. Most days I don't know how I can possibly make it through the next 15 minutes, let alone until the end of the day. But somehow I do.

Thank you for listening to my moanings xxxx

Mandatorymongoose Tue 26-Apr-16 18:13:00

The dose of quetiapine you are on is still low are they increasing it? 300mg - 600mg a day is the BNFs usual dose.

I think in practical terms, the Trazadone should be working by now but obviously wasn't working for you at the previous dose / alone. So you need to give it a bit more time for the higher dose + quetiapine to start working. Not quite starting over, but another step to work from.

I'd want to give it maybe 2 weeks after your dose of both is at a stable level to fully assess the effects. That doesn't mean you wouldn't see improvements in that time, just that it wouldn't be fair to judge it fully until then.

I know that might seem like a long time when every minute is a struggle but hopefully it will be getting gradually easier and you'll have more calm periods.

You will get through this, you already are doing.

Psion Tue 26-Apr-16 18:59:26

Thank you so much for replying Mandatory.

Is 100mg still a low dose of Quetiapine, if it's just being prescribed as an adjunct to an AD? I am being treated for just standard depression/anxiety and don't have bi-polar.

I am praying desperately for more calm periods, over the next few days, as I really don't know how I am dragging myself through each day. I really don't. I get to the end of each day and I'm stunned that I'm still here and functioning.

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