Quetiapine

[RenegadeMasterx]

Hi all. So I tapered off of lithium (id been taking it for 3 years) around 8 weeks ago, haven't taken any for around 3 weeks. Feeling flat, irritable, emotional. Wasn't feeling much better on it either, and it was battering my kidney so I had to come off of it. My diagnosis is bipolar 2, but I've never experienced mania, just sometimes feel a little brighter than normal and it's short lived.
Anyway, my MH team want me on quetiapine. I am so apprehensive and feel sick at the thought of starting another medication especially being an anti psychotic. It feels a bit extreme considering I'm never manic and need a big serotonin boost and an anti anxiety medication, I don't know if quetiapine is necessary? I mean, they're hell bent on me having it but it shits the life out of me starting it. They wanna start me on 50MR to take of an evening but all I've been told by people on Fb is that I'll be heavily sedated (I have two kids so, not really ideal), and read about some really undesirable side effects, not to mention tapering off is utter hell.

I really don't know what to do. Sleep is an issue for me, I'm awake from 2am most nights, but I don't want to be a non functioning zombie.

Does anyone have any advice/experience with this drug please? X

I was put on the lowest dose. It did turn me into a zombie. I wasn’t able to function, could barely get out of a chair. My GP was horrified I’d been put on it. (Life event that left me depressed and suicidal, it was an extreme drug for the MHT to stick me on!) I weaned myself off it after a couple of months but even that was difficult tbh.

I’m on it now. I’m on the lowest dose. I feel slightly tired about an hour after taking it (although it is worse if I haven’t had enough sleep), but after that hour I feel normal. I’ve been on it for a few years.

If you have bipolar then it's not odd for them to put you on it. It will reduce your anxiety and also help to stabilise your mood.

I had finally accepted taking it properly for the last couple of years but am now trying to cut it down slowly.

Sorry to hear that, hope you're doing ok.
My GP was pissed they'd put me straight on lithium! It's a really harsh drug and I already have thyroid disease and honestly the stuff has battered my body, whilst no benefit to my mental health. They just seem to want to push these super hard drugs into people, I have never been admitted, never been in a&e in a crisis, I've defo gone lower than I am now and sometimes spend a little too much money to get a bit of a hit but never ever have I engaged in risky behaviour, done anything silly I don't drink alcohol or take drugs, it just feels scary and I'm really anxious about meds anyway. I'm sitting here looking at the box wondering whether to start it or not but my head and heart are having a row!

I was prescribed a low dose for unipolar depression. I took it at night and it makes me sleep brilliantly. I have a demanding job and could function at full capacity in the day.
Weaning off it was tough. In the end, I was forced cold turkey off it as it interacts with many other drugs and I needed something urgently so this was the kick I needed to get off it. Sleep hasn't been good since

How is that going? I've heard it's pretty rough hopefully you're doing ok.

I can kind of understand that if it was bipolar type 1 or I'd been manic or suicidal or engaging in risky behaviours etc but honestly 99% of the time my mood is as flat as a pancake and I'm tearful. I may have a day or two where I feel slightly more energetic never ever manic so I'm confused, and scared. I'm not in doubt I may need anti depressants and maybe something to help the anxiety (I'm hardly sleeping) but I don't think my illness requires this sort of drug x

I have been taking it for years. Without it, I cannot sleep AT ALL (could be up for days). It does send me to sleep, but I don't notice any side-effects during the day.
For me, it has been a miraculous combination (although I take an odd cocktail of drugs - Trileptal (Oxcarbazepine) - as more mood stabilizer, plus Cymbalta to lift me out of depressive episodes and for nerve pain. I am in the US. Prescribing in the UK is more controlled (probably a good thing!) but this weird cocktail has kept me stable, happy and productive for a long time now. I don't feel as if I have bipolar anymore, although the odd time I have tried to change or come off medicine, the mania and depression, then psychosis, came rushing back.
I wouldn't be afraid to give it a try.

I was prescribed it as an inpatient once- never had mania or psychosis just depression/anxiety. It was fine, didn't do anything for me and made me feel more grumpy/irritable so came off it pretty quickly but can't remember anything really terrible about it to be honest

Have your team discussed a tricyclic AD or even an SSRI if you are never manic and rarely hypomanic? Tricyclics would have sleep benefits too. It's a truism that you shouldn't use ADs with people with bipolar, but bipolar II is a very different beast and a lot less evidence against use of ADs in this population.

Dh took it for a few years when he was very depressed, he took it in conjunction with an SSRI(I can't remember which one now, it was a long time ago and he went through so many). He used to take it at night before bed and didn't really have any side effects. It was life-changing for him, he was on the verge of suicide before and tried lots of different things before this to no avail and within a few weeks was so much better. He has been off all meds for a long time but I don't think he would be here today if it wasn't for quetapine.

Yeah I'm quite afraid I'll get even more irritable and emotional than I am already. I'm scared of going either way cos I already feel pretty shitty. Sort of a relief to know you were put on it for depression and anxiety though, when they explained what sort of drug it was I was shocked as I haven't ever experienced psychosis or mania/etc xx

So sorry to hear your DH went through that. It's reassuring to read something positive about it though, I suppose that's the downside to the internet it tends to be full of doom and gloom. A 10 min read on drugs.com and I was hell bent I'd never touch the stuff. Hope DH is in a better place now x

Sorry could you explain what sort of drugs these are please? SSRI's have been pretty inaffective for me, they never seem to help me, if they do it's extremely short lived x

DH has been taking it for a while, he finds it helps with his sleep, but feels OK the next day. He does sleep till about 9:30, which might not be helpful with young DC. Although he does take it quite late at night.

Yes, I'm not personally a fan of SSRIs. Have you ever been on amitriptyline? That's a commonly used tricyclic. However, if your depression is more than moderate in severity I am not sure of the effectiveness.

Tricyclics are mentioned part way down this page. Where there is no suicide risk, they can be a viable option if a person wants. https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/medicines-and-psychiatry/antidepressants/overview/#:~:text=Tricyclic%20antidepressants%20(TCAs),effects%20than%20SSRIs%20and%20SNRIs.

Does anyone have any advice/experience with this drug please?
I have taken Quetiapine for about 18 years. It has been fine for me for all these years. I'm on what is considered a very lose dose (for BP like you) of 50mg and my formal medical notes show me to be "in remission" with this condition, which I didn't think was a thing. I have not had a single symptom after the initial diagnosis in 2001 - which followed one 'episode'. I even doubt now that I have BPolar as I don't recognise or show any of the classic symptoms. I would love to come off it but tried slowly a few times and just couldn't sleep. THAT is the only issue is that your body can come to depend on it. Have not experienced weight gain or anything either. I understand it is also used as a sleeping aid and not just for BP. But anyway I wanted to say that's my experience and it's, on the whole, a very positive one.

I have bpd, depression, anxiety, cptsd and I have been taking quetiapine for ages. It was introduced from a very low dose to eventually 300mg at night. I did not find it made me like a zombie. Yes at first I felt more tired but I timed it right and ensured I was in bed within an hour of taking it and I was ok. As time elapsed I felt it's effects less.

Yeah I’ve taken quetiapine on and off for ages. Used to be 25mg would send me to sleep but now I can take 100-150mg and not really notice it. Not sure I’ve noticed any particular benefits tbh but sometimes it’s useful to feel like I’m taking something to help on a bad day.

I'm on it as an adjunctive treatment for unipolar depression, alongside a tricyclic AD. My psychiatrist said it can be useful for people who have a lot of anxiety or agitation as part of their depression. I've found it really useful for dampening down the barrage of self-critical thoughts that depression can generate. It also helps me sleep better.

Don't be put off by it being labelled an antipsychotic - really, it's just a medicine that influences serotonin and dopamine transport in the brain, hence why it's useful for conditions other than psychosis.

I can kind of understand that if it was bipolar type 1 or I'd been manic or suicidal or engaging in risky behaviours etc but honestly 99% of the time my mood is as flat as a pancake and I'm tearful. I may have a day or two where I feel slightly more energetic never ever manic so I'm confused, and scared. I'm not in doubt I may need anti depressants and maybe something to help the anxiety (I'm hardly sleeping) but I don't think my illness requires this sort of drug x

I mostly have bipolar 1. It will act as a mood stabilizer, chill you out, help you sleep and reduce your anxiety.

They don't often put people with bipolar on antidepressants now as it can cause rapid cycling/destabilize their moods further unfortunately.

So they use these sorts of meds instead to help stabilize people.

@RenegadeMasterx I take Lamotrigine as well and it has worked miracles for me, so you could ask them about that one.

I was on Quetiapine 800mg (which is the max dose) and have now reduced it to 600.

I don't want you to put you off Quetiapine if you need it (which medical professionals would be more likely to know than us.) But if you like you could tell them your concerns about Quetiapine. And if you like, say a friend is on Lamotrigine and it has really helped her. It also helps with depression in bipolar.

My DD has been on it for a year and it’s been fine. I don’t think she’d be here without it either. It’s basically stabilised her mood so that she’s been able to do her exams and respond to therapy.

It made me really sleepy and I couldn’t function at work. Lamotrigine worked well for
me for a while and now I’m on aripiprazole which also seems to be working. Sometimes it is trial and error with these things.

I have bipolar 2 as well and have been on quetiapine for 14yrs. It completely changed life for me. I have never suffered psychosis but it was a great choice to help stabilise me. I take 400mg at night, which guarantees I sleep, so I’m not affected in the day.
Its definitely worth trying!

Sorry I think I meant to say it was mostly Bipolar 2 I had, not 1. In my area they don't seem to really differentiate. I've only had psychosis about once in 21 years of being diagnosed, and that was mostly due to me deciding to slowly come off one of the meds by myself.

If you have bipolar then as Lifeishard was describing, your medications will probably vary sometimes. It's trial and error and if they think something doesn't suit you, they'll try something else. Also, new meds will carry on being developed etc. The trick is to work with your consultant, tell them how you're feeling and what's going on in your life while you try a particular treatment.

As Username was describing, I mean.