"Do you think I should start taking seroquel again? I've been on seroquel remeron combination once before about 5 months ago, also the doc did give me a choice of remeron or seroquel"

Obviously that is your decision, but I think that, if you are doing well on mirtazapine/remeron and seroquel/quetiapine was giving intolerable sexual side effects, it's probably worth staying as you are and see what happens.

Psychosis is a spectrum, and paranoia, even bad paranoia, in the absence of hallucinations and delusions is towards the milder end of the scale. Personally I don't worry much about hallucinations and delusions either until it gets debilitating, but maybe that's just me.

All that to say that you don't necessarily 'need' an antipsychotic (AP). If remeron/mirtazapine is helping, stick with that. Besides, seroquel/quetiapine is quite a weak AP in terms of its actions on dopamine receptors compared to other APs. It is very sedating though, but so is remeron/mirtazapine, if that suits you.

With the mirtazapine/remeron though, watch for any signs of mania if you've had AD-induced mania in the past. Though, as I said, it's quite a sedating AD (antidepressant) so there should be less of a risk.

Also, I don't know if Avalon is another brand name for mirtazapine, like Remeron is?? If so, no mirtazapine isn't an AP, but that doesn't mean that it can't help you.

One last thing, as you are concerned about Christmas coming up, watch your stress levels. Stress can induce paranoia and dissociative experiences, and even full blown psychosis, so it's important to work on self-care strategies to manage your stress levels, especially until you've fully recovered. We can offer suggestions if you are struggling to think of things to do to help.

And I'm glad to hear that you are going to stay away from drugs. All the best

*Willow*