Quetiapine - is the drowsiness worth it?

[BettyInc]

I've been prescribed 100mg at night for my severe anxiety, along with fluanxol in the day.

I'm only taking 50mg so far and sleeping SO MUCH I can't cope at all. Take it at 730, out at 8pm til around midday then have a nap later on too.

Help please, I'm so low and can't work out if I just need to persevere or give up on it. It's only been a week but I'm meant to be going back to work soon and there's no way I can.

Also- I have a long term sick meeting at 9am. If I take the Q there's no way I can go, no way I can possibly drive. Can I just skip a night or will I get ill?

I am not a medical professional btw.

Agree with erinaceus.

I've had friends who've been put on.. eccentric.. choices of antidepressants (old style ADs as a first line treatment) and things by GPs who haven't kept up with current practice.

@erinaceus he's a private psychiatrist. Best hospital in London apparently!

I don't know what to ask for. My primary issue is severe anxiety, which causes horrendous panic attacks, which in turn all cause depression.

The fluanxol doesn't seem to make much difference and the quetiapine was life ruining.

What else should I ask for?

A new psychiatrist.

I'm not being flippant. Your psychiatrist is not in charge of your treatment. You are. Ask for a referral to a colleague of his.

Psychiatrists in private practice have their pros and their cons. One of the cons is that they have no obligation to adhere to evidence-based treatment guidelines. NHS clinicians are not, strictly speaking, obliged to do this either, but they work from more of a framework.

Your Doctor ought to find a treatment regimen that works for you. It is not the responsibility of you, nor of MN.

I get a bit soapbox-y on this issue.

A beta blocker to help with the physical symptoms. I take propranolol for this.

I'm on flouoxitine, beta blockers and quetiapine. I only take 50mg at night and it knocks me out.

I'm slowly building up to 400mg per day to treat borderline bi-polar 2.

I guess the thing is @BettyInc - what do you think your primary difficulty is? You mentioned they had suggested you were possibly BPD, do you agree with this? And f so if you therapy helping?

If you are unsure about medication you can google the NiCE guidelines for whatever difficulty you wish and they will tell you what is generally recommended?

I'm not a medical expert, but I know a lot about Quetiapine. It's primarily an anti-psychotic, although it has good anti-depressant qualities and is used to augment anti-depressants. It's not a particularly great anxiolyticI find that it helps anxiety via being like a brick to the head (as in it knocks you out so much, you're too dopey to feel anxiety). If your pdoc hasn't given you a clear explanation for prescribing Q, I would be thinking about whether they are interested in developing a collaborative approach to medicationfindimg the right treatment to mental illness is trial and error. There's no way of knowing for sure how someone will respond to a med. so if you've given it a good go and Q isn't working for you, tell him/her. Ive found that you need to commit yourself to being an active part of your treatments ans educate yourself. Only you know how you are being affected by a medication

@blue2014 my main issue is anxiety and panic attacks. I can't go to a supermarket without risk of one. I've been having intense CBT four days a week and the therapists there suggested the BPD diagnosis which my psych agrees with, so I now start DBT instead this week.

Medication wise I've tried hard not to google because every med seems to have someone saying it made them sick, and I'm phobic of that. I was trying to leave it to the professional but it seems he isn't helping me.

I've got to be firm and ask for something else.

Thanks @iveburntthetoast I definitely think it's trial and error and I'm sure Q isn't for me. As well as being so groggy I couldn't function, I still had awful panic attacks anyway.

Do you agree with BPD Betty? Although DBT can also help for panic.

Thinking of you

Thanks @blue2014 I'm not sure. I've read the list of charecteristics and it definitely fit me in my twenties, not so sure now that i've 'outgrown' the self harm and the resultant behaviours. However, in pre-commitment sessions my therapist has reassured me DBT can and will help for panic attacks too.

It sounds great if it'll help for the panic

Just my personal experience, but only lithium has made me sick. Carbamazepine made me a bit nauseous but it's not been something I've had/heard of very much. Zombiness has been by far the most common side effect from the 11 different medications I've taken.

@erinaceus I (in my thirties! :blush: ) took my dad with me today which helped and I really feel like (for the first time) the psych listened to me. He's given me beta blockers to try (atenolol).

If you feel like your psych listened to you for the first time today and your dad had to be in the room for that to happen, I would seriously ask for a referral. I am picky though and have masses of issues with power, authority, feeling heard, gender and psychiatry.

I hope that the atenolol helps.

Without wanting to cause alarm, antipsychotics can cause brain damage so I wouldn't have thought they'd be a good choice as a first line treatment for anxiety or indeed any non-acute condition?

Hi there, I'm not a medical professional but I do have a lot of experience with a dh with severe mental illness.

Quetiapine is hugely sedating and is usually prescribed as an anti psychotic. It is not effective against anxiety. It has slight anti depressant qualities.

I've not heard of fluanxol.

From your posts and others I would suggest a second opinion. As someone said above, betablockers can be helpful. Sertraline, an ssri anti depressant is also good for anxiety and psychs well-known if others.

Wishing you all the best.

God it sounds like you're seeing my London Pdoc OP - has he mentioned pregabalin?!

Actually pregabalin might be an option, it's off label but worked pretty well for me. I had a BPD diagnosis too but none of the behaviours since my twenties just like you. CBT etc never worked for me either. Got ASD diagnosis a couple of months ago instead.

No i've not heard of pregabalin.

I can't switch doctors- I tried but Bupa wouldn't let me. I'm feeling a bit more optimistic after yesterday's appointment, and in part him not listening to me is my fault as I clam up and often don't say what I need to. My dad prompted me, which helped.

Have you tried asking your psych to recommend that you get a second opinion? It is possible that Bupa will listen to him where they will not listen to you.

You not feeling listened to him by you is his fault, not your fault. One of the roles of a psychiatrist - indeed, any medical doctor - is to facilitate the doctor-patient relationship.

I hadn't, but I feel a bit better after yesterday's appointment. I'll continue to take my dad with me as he can be more assertive than me, and make lists of what I want to say/ask for as that really helped.

@erinaceus you've been super helpful, thanks for taking the time to offer your support to me. I appreciate it

It sounds as if you have a plan

No problem, glad to have helped. MN helps me a great deal. I like to pay it forward.