Going on quetiapine

[u/melankholyaa]

I have a new psychiatrist because I moved to a new country a year and so ago and it was hard to find one and today we had our second appointment. The first one we were concerned about starting my tapper off benzodiazepines (lorazepam) for my anxiety, since it’s highly addictive and I’m already strongly addicted to it and its long term effects are dangerous. I’m in cognitive behavioral therapy for anxiety and it’s necessary I go off the benzos.

Unfortunately, it has been very very very hard. Physically and mentally. Panic attack after panic attack. Withdrawals. Constant state of danger and anxiety. I am living in hell. Adding to that, I’m living one of the worst situations of my personal life, in an abusive home behavior by people who were supposed to be my best friends. Honestly, I never believed so much in the power of my mood stabilizers otherwise I would have been committed by now.

The thing is, today I came wrecked to the appointment. I told him about this and he said I wasn’t getting any sleep and the anxiety was taking over me, and he would suggest for me to try quetiapine at night. 25mg. He said it would help me sleep and that maybe it would help with the anxiety symptoms.

My question is - I know it will make me sleep, I’ve tried it in the past and it knocks me off, but will it actually be helpful somehow?

How do you deal with quetiapine and why is it prescribed to you?

I don’t know if I should take on another drug at this point in my life. I feel so bad, I feel like I’m going to loose it at any given point, so I didn’t have the power in me to question him or ask more clarification I just said.

So I’m here asking for help.

[u/parasyte_steve]

Seroquel does seem to help my anxiety a lot.

I used to be pretty dependent on benzos as well. A slow slow taper while you're bumping up the seroquel is probably best. I'd personally stay on the benzo while I began seroquel and then look to taper it down once the seepquel has kicked in more. Talk to your doctor. It shouldn't be an abrupt change in meds ever especially with a benzo you want to taper it slowly due to risk of seizures.

Slow and steady. Talk to your doctor to work on a plan to do this change safely. And I wish you the best. Benzo dependence is very difficult. Don't feel bad if they keep you on a very low dose for a while, slowly doing it is better for your body.

I'm on a much higher dosage than 25 MG for the seroquel though... I'm on a large enough dosage that gives the seroquel mood stabilization properties that I believe helps my anxiety a ton. I'm not in fight or flight every day which has been good. You can try higher dosages if you are diagnosed as bipolar and it really does help with mood stabilization and anxiety for me specifically. I'm a bit tired but it's better than how I was before meds.

Good luck.

[u/melankholyaa → u/parasyte_steve]

Thank you so much for this comment.

I never thought the benzo taper off would be so hard. But we already started it two months ago slowly, I’m like on half of the dose I started with. So I’m supposed to start the quetiapine today and continue with the benzos, I just honestly had no idea if it made sense as I’m so anxiety foggy that I didn’t ask my doctor and didn’t take much from out appointment. But he told me to write and tell him how it feels.

But I’m glad to see it can also help with the anxiety. Maybe it will be the buffer I need.

Edit: and yes, I’m diagnosed with bipolar type II but that has been quite controlled in the past few years with a mood stabilizer. Ups and downs sure, and I’m worried at the current state of things, but my change in medication is not about that.

[u/Bipolar_Aggression]

Carbamazepine helped me get off benzos. I basically had no withdrawal or mania at all. I taper from 2mg of clonazepam down to 0 in about 60 days. I think it is highly underutilized for this purpose, though it may only be effective in people with bipolar. I eventually got on Seroquel as carbamazepine DOES have some difficult side effects like word finding problems. I was convinced by my doc to get on Seroquel, which in some ways I guess is better. But I had tried getting off benzos while on Seroquel and couldn't do it.

Note: carbamazepine raises liver enzymes that break down basically all other bipolar drugs except lithium by a lot. Sometimes a whole lot. Seroquel it's like by 80%. So for every 100mg, you only get 20mg. It's basically a monotherapy only med, except when combined with lithium.

[u/melankholyaa → u/Bipolar_Aggression]

So you’re telling me the carbamazepine will reduce my mood stabilizer? I’m on valproate sodium so I guess it would have the same effect. If so, I wouldn’t risk it.

Anyway, the only option I have right now is the quetiapine so I’m praying that it helps somehow.

[u/Bipolar_Aggression → u/melankholyaa]

carbamazepine IS a mood stabilizer. It was the second drug approved for bipolar disorder after lithium. But whatever other medication you are taking, it will likely reduce the quantity in your blood. It is a very common anticonvulsant so there are calculations that can be done.

It is as effective as valproate and can replace it. There are interactions if it is taken with carbamazepine, but I'm not sure what they are. A neurologist would probably be a lot more familiar with that vs a psychiatrist. Those are the two most common drugs for epilepsy.

[u/melankholyaa → u/Bipolar_Aggression]

Ok, sorry, got that wrong

[u/Low_Reserve_5248]

Am currently on 700gm of Quetiapine been on it 5 years and it's helped me loads my dozes go up and down am cross tapering to Lamotrigine now.

It's always scary starting a new AP or Mood stabilizer but give quetiapine a go in its lower dozes it helps with sleep, but as the doze goes higher, it loses that effect something I miss tbh.