Antipsychotics - do they help?

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I've recently been prescribed quetipine as an add on to mirtazapine, due to lingering depression, flatness of mood, no motivation, chronic overthinking, and anxiety. All further complicated by going through a very stressful time with an aging, ill parent and the toxic dynamics of my family. also premenopausal but can't take hrt which further exacerbate s matters. Started at 50mg a night, but I don't feel it's doing anything. My sleep is still awful and broken, and I feel fuzzy and dopey in the daytime. It's only been a week, am I expecting too much at this stage? how did it help you?

I take 150mg at night. I have severe depression but was never in psychosis. To be honest I find it’s amazing for helping me sleep through the night, before I would wake at 3am everyday in a panic and be awake for the day. Insomnia felt like it was killing me. I generally find sleep the only (but for me massive) benefit. Plus they don’t seem to mind me taking it ongoing whereas they had issues with me taking sleeping pills on a long term basis.

if I take it in the morning though, I’m a zombie, so I couldn’t do that.

50mg is a low dose, are they titrating it up?

That's quite a low dose. Anti psychotics kind of detach you from severe emotions and chill you out

Thanks for your reply. No, I don't think I've ever had psychosis either but insomnia has made my thinking paranoid and skewed, but I put that down to lack of sleep which would push anyone over the edge! Yes, just 50mg for now but a review next week so i presume gp will increase it. I don't know if I'm asking too much , but I was really hoping it would improve my mood and motivation. All its doing at present is stopping some of the looping thoughts but that's because I feel so dopey in the daytime, I haven't the mental energy to think.

MH meds do take 6-8 weeks to get into gear, so give it time to work, and then see how your symptoms change and how it goes. Your GP may likely increase the dose next week as well.

Thank you! I have been reluctant to even try them due to side effects, so I suppose I was hoping for a miracle when I probably do need to be more patient. I've gone as far as I can go on antidepressants so this is my last resort really.

I haven’t taken quetipine but have taken a small dose of another similar drug (which I have now totally forgotten the name of) alongside my antidepressants. My psychiatrist explained that it wasn’t because I showed any symptoms of psychosis but because there was some evidence that, in small doses, it helped the uptake of antidepressants. I have several medical studies on the subject he sent me about it. In the end, they gave me terrible acid reflux so I decided to go without them but I felt that they definitely helped me feel more balanced after a few weeks. I was annoyed that I had to come off them.

i take quetiapine, they help massively with MH issues, but I’ve put on a shedload of weight and I have “munchies” every night, and get out of bed to eat.

That would explain the empty packet of marshmallows next to my bed this morning!

It's good to hear it worked for you, although rubbish that you had to stop taking it. Yes, that was my understanding too - that it somehow augments the antidepressants and gives them a ' nudge'. No idea of how though.

To be honest quetiapine quietened my mind (and I’ve mentioned improved my sleep) but it hasn’t helped directly with the motivation, however I do take an SSRI which helps that. Without that addition I would struggle on just the quetiapine.

That's reassuring to hear you find it helpful for turning down the thoughts. Tbh, it's so hard to find a balance - something that lifts the depression but doesn't zombify you. I'll see how I go with an increase hopefully next week and then I've got a little wiggle room to increase the mirtazapine. I tried increasing it before but it just increased my anxiety, but maybe alongside the antipsychotic it would work. It's all such trial and error isn't it, and what works for one may not work for the other!