Falling Asleep at the Wheel-Overmedicated

I guess I'm writing this for support as I go through this process.

I have a 2 hr and 15 minute commute to work (3 days a week/part-time work) and for the last couple months I've been nodding off at the wheel which has turned into really falling asleep at the wheel. It's so so dangerous and I've been very lucky to not have been in an accident. I have to get up extremely early for work, which contributes.

I'm overmedicated. I must be. I used to take high doses of Seroquel, but I managed to get it down to only 25mg about a year ago. But about 6 months or so ago it was increased to 100mg when I got in a depressive episode (along with increasing Lamictal). Not too long afterwards, I tried lowering the Seroquel due to sedation, started to get depressed again and increased it again.

I'm planning on tapering the Seroquel starting tonight to 75 mg for a week, and so on, until I get to 25mg again. As I said, the last time I tried to do this I started getting depressed again, so I upped it again. This time around, I feel like I just need to push through any mood issues (meditation, support, whatever) and get it down for my own safety. I also know there are safety issues with lowering the dose causing mood issues.

I'm really scared about this journey, this taper, but as I say, I feel it's essential for my safety, and if I could be okay on 25 mg before, I can again. I feel like my last depressive episode was so long ago that maybe I won't revert to that this time around on tapering the Seroquel. My last hypomanic episode was about a year and a half ago, last manic episode, 3 years ago.

My next pdoc appointment isn't for another couple of weeks, but I'm going to start this now anyway because I'd do it anyway no matter what she says (and she may well agree with me).

FYI, I also take Abilify and Klonopin (never felt side effects from either).

Can anyone share any experiences re tapering down Seroquel?

I'll keep you guys posted on this tapering journey, you're the only ones who would understand it and its effects...

I don't know about the tappering stuff, but can tell you that if you're overmedicated while driving, you can be charged with driving while intoxicated. And even worse than that, you can kill someone. Please don't risk your life and everyone else's until you get this under control.

My husband is a firefighter/EMT and is on these horrific calls where people are killed by intoxicated drivers. They're terrible tragedies for everyone involved. And if you're not taken to the hospital, you'll be arrested on the spot as many of the drivers of accidents my husband's been on are. Please don't endanger other people--call a cab--it's cheaper than a defense attorney.

I'm so sorry you are dealing with this. I really think you need to contact your doctor right away and take time off work. People's lives are in terrible danger.

This happened to me years ago. My commute was only 10 minutes and I nodded off several days in a row when starting lamictal (it's usually activating but wasn't for me). Plus I was depressed which makes one tired. I took time off....I could never live with myself if I killed some poor unsuspecting family...plus you could easily injure yourself. I hope you get the help you need quickly and safely.

You need to talk to your pdoc about changing meds. Not only might you fall asleep at the wheel and kill someone (or yourself) in an accident, you could be arrested for driving under the influence. It doesn't matter that you're taking a prescribed medicine, it's still a DUI.

Seroquel is notorious for causing excessive drowsiness. You might need to try Geodon or something less sedating. It would be better if you could come off one of your APs, but of course some of us need more than one AP to manage our illness, so that may not be possible. But it's definitely worth discussing with your pdoc. Please be careful!

I had the same thing with seroquel. I only had a half hour commute but I had to leave at 7am and it wasn't enough time for me to sleep off the sedation from the seroquel. I would struggle to keep my eyes open while driving. It was really scary and really dangerous. I chose to go off seroquel completely after just one month, even though it pulled me out of a severe depression. I would get off of it asap. See if you can find another med for depression. You're playing with your own life, as well as the lives of others. No medication is worth your life, no matter how well it works. I hope you find a solution soon.

I can't take off the weeks of work it would take to do a normal taper, for various reasons.

Has anyone come off of Seroquel cold turkey? Maybe it would be safer to do this and then come up with something else with my pdoc to replace it?

I know it's very dangerous to myself and others; I didn't mean to scare anyone, I'm scared to death myself and am trying to find a solution for this.

Okay, I just left a message for my pdoc. Meanwhile I'll be going down to 25mg starting tonight. I don't go back to work until Wednesday, so I'll have some time to start to both get used to the new dose and possibly get a new -non-sedating- replacement from my pdoc.

Keep us posted....I can only imagine how scared you must be.

Just wanted to add that I had been taking steps to try to stop this before I decided to taper (and now abruptly lower) the Seroquel. I started bringing with me one of those Starbucks cans of double espresso in the car to drink on the way, and I've been talking to my mother -hands free- on the phone during my whole commute back to keep me awake --the trip home with my mother has been effective, but the additional double espresso on the way has not. Hence resorting to lowering Seroquel. It's been my last resort in part because at the end of the day if I were to go into a hypo/manic episode and driven that would be dangerous as well, and we all know that we're not always in our right mind to not drive while hypo/manic-intoxicated. I hope this clears up a bit my rationale as this has been playing out. It's more complicated than it may sound.

Granted, I do realize that I really should have contacted my pdoc about this earlier.

In any case, as I said in my last post, I've left a msg for my pdoc and will be starting 25mg tonight and I appreciate all of the advice and reality-checks.

Thanks, I really needed to hear that (yes, along with the reality-checks) because I am scared ****less...

My heart goes out to you. I've dealt with this and remember how scary it is to "wake up" white driving. I was fortunate I had the choice to take time off.....my heart breaks to know you are stuck in this situation without that possibility (((hugs)))

I know how scary it is and I'm so sorry you're going through it too! It also suck to have to drop a medication that works well bc if side effects. I hope you can find something else that helps you. I didn't experience any ill effects from stopping cold turkey (I was on 150mg) but still it would be best to taper. But I understand if you can't.

See if your medical insurance would cover a cabulance to take you to and from work. I don't know what it takes to be eligible for the disabled vans where they come and pick up and take you wherever you need to go, but that would be another option if there's time.

I don't know anything about Seroquil, but there are supplements that will help lessen the misery of withdrawals by giving the brain what it needs to function properly. I wish I would have known about these supplements when I went off Effexor as I'm sure it would have made my life less stressful.

Here's an article on the subject:

How To Get Off Your Antidepressant Without Going Insane

Yeah, I've had patients who use those vans, you really have to be disabled. I also live almost an hour and a half away from the hospital where I work, so alternative forms of transportation -which I've looked into- just aren't there.

Thanks for the link, but Seroquel is an antipsychotic, not an antidepressant. I think I'm going to have to rely on my support system and maybe some meditation and whatever I can muster to get through any withdrawal from the Seroquel (and just no longer having its benefits). As for supplements, my mother's been getting on me about taking some (for my general health, not BP), and I'm planning on asking my pdoc about them to also make sure they don't interact with my current meds.

Thanks for your suggestions.

So I took only 25 mg of Seroquel last night (instead of 100) and I feel sooo much better!!! As if I had been a serious alcoholic or drug addict and suddenly woke up clean (without the withdrawals). The 25 mg still helped me sleep last night (without making me pass out), I got up at a decent time (instead of at 12 or 1, I don't have work today), my head isn't cloudy, I feel great.

My pdoc returned my call today and wanted me to take 25 on workdays and 100 on non-workdays, but I insisted on taking 25mg every day; I don't want to sacrifice my days off to this med, spending half the day in bed, waking up so groggy, etc.

I'm hoping this will help my job performance as well (which takes a great deal of focus, a very good memory -lots of energy) and I'll hopefully be able to go way down on caffeine (I was up to 5-6 double espressos a day to be able to do my job).

In any case, it should certainly help with what is most important, which is not getting in a car accident and potentially hurting or killing myself and/or others.

I'm keeping a mood diary. The idea is to increase it on non-workdays if something were to happen mood-wise. The Seroquel had always been prescribed to prevent/stop hypo/mania, so my only concern is that if I were to get hypomanic, would I not increase it because I felt so good? At least I have some people looking out for my mood, and could help me do what needs to be done, if it comes to that. It also helps with depression, and that's when I'm most likely to increase it again (on non-workdays), but if I were to start just feeling down, I don't want to jump immediately to increasing it, I want to try other modalities (meditation, turning to my support system, etc.) rather than that, at least if and until it gets really bad.

So I'm really happy about how things have played out so far. As I say, I'm keeping a mood diary and hopefully this will help my quality of life in so many ways.

I'm so happy to hear things are going better!!

With hypomania, the mineral supplement lithium orotate has worked wonders in controlling mine. It's not the drug lithium carbonate that has so many horrific side-effects--at least it did for me, but just an over-the-counter supplement that is much more readily absorbed by the body so you only need a little bit.

Here's a couple of articles on the subject. I take the lithium orotate mentioned here. The tablets say they're 120 mg of lithium, but are 4.5 mg of what's called elemental lithium that is what the body absorbs. I don't understand it fully as I'm not a scientist, but I can tell you that I've been using this for 4 years now, and my hypomania now consists of little more than being a bit wound up and not sleeping. When I started using the amino acid GABA to control the hypomania 9 years ago the racing thoughts stopped. I almost don't know I'm hypomanic unless I can't sleep, and then I take some extra lithium orotate and usually get a few hours of sleep. It's a huge blessing as I hate hypomania far more than I ever disliked be depressed as I could sleep with that.

Lithium Orotate The Safe, Unique Mineral with Multiple Uses

Natural Treatment for Bipolar Disorder and Alzheimer's Ignored! - Natural Health Blog | Holistic Health Blog

When I went back to work, lowering the Seroquel to 25mg didn't work. I've still been nodding off at the wheel. I called my pdoc last week and she wanted me to take 25 on workdays and 100 nonworkdays, I convinced her 25 every day, but it doesn't matter anymore.

I just left her another message. I'm not taking any Seroquel tonight, but am taking the day off from work tomorrow just in case. I don't know how long it stays in the system and I also don't know what not taking it will do to my mood. I'm already feeling really down, but I don't know if it has to do with the med directly or if it's the fact of having these problems. I'm confused and just don't know what to do anymore. I hope to hear back from my pdoc tomorrow, I hope she's good, hope she knows what to do. Seroquel is supposed to prevent hypo/mania in me and now I can't take it all. I'm at a loss. Maybe she'll replace it with something else, an AP that's non-sedating, is that possible? I'm already taking Abilify but my previous pdoc didn't think it was enough.

Anyway, I just hope she knows her stuff because I'm at a loss at this point...

The sedating part of Seroquel dosing only lasts until about noon on the day after, probably 16-18 hours after dosing - at least for me. On the second day, without dosing the night before, you should be fine.

I fully understand the frustration and feeling like you've hit a brick wall with your treatment. Be aware that there are alternative options to Seroquel. I no longer take Seroquel due to the sedation and weight gain, and seem to have found a decent alternative in Latuda. Whether or not that could be added to Abilify, I have no clue.

Good luck with your conversation with the doctor, I hope it goes well.

Thanks so much.

Hopefully my pdoc will call later today.

She's so focused on me not getting depressed again because of that one episode independent of hypo/mania but my main problem has always been hypo/mania with depression only as a result afterwards (which is why I was prescribed Seroquel). I hope I can leave it as just taking Abilify and no other AP's. Or of she, for some reason, wants to replace the Seroquel with something else, it needs to be non-sedating and good at preventing hypo/mania as well as depression. I'm not sure what would be best for me right now, though, I usually come in with suggestions of my own, which is why I'm counting on her to know her stuff. She's a fellow, not an attending, and I do hope she consults an attending before getting back to me.

Sorry to keep this thread going, but I'm scared.

My pdoc got back to me and her suggestion was something that just occurred to me last night --that this might be something physical and to get my thyroid checked and a CBC. The thing is, I had being taking 50 and then 25 mg of Seroquel for some time before falling sleep at the wheel, before being so tired/sedated.

So this may be something physical which scares the crap out of me. I called my PCP to get the order in so I can get the tests tomorrow. This way I'll have the results well before my pdoc appointment which is the Tuesday after next.

Wish me luck!!

Try not to panic. It's probably not something that can't be managed.

My neighbor was nodding off at the wheel, and it was sleep apnea.

Come to think of it, I had a sleep study a long time ago and I can't remember why. I don't remember if I was waking up gasping for breath (a common reason for doing it) or if I was really tired; in any case it came out normal. But maybe I need another one...

Sleep studies are definitely a good thing, especially if you're having issues without the Seroquel. I used to fall asleep in meetings, nod off at the wheel, and basically do whatever else is done by someone who is sleep-deprived.

Had a sleep study, and was diagnosed with severe sleep apnea. I started using a CPAP, and things got better very quickly. Not saying this is the issue in your case, but it was a revelation to me.

If you're looking for meds to suggest to your psychiatrist, my suggestion would be to look into Latuda. It's an atypical AP which is indicated for BP depression. It helped pull me out of a severe depression, and I've found no negative side effects from it. Definitely no sedation, which I know concerns you.

Best of luck with your medical doc, and with your upcoming psychiatrist visit.

Thanks so much for your support, guys.

I called my PCP again at 5:30 and she had already left, so either she hadn't gotten my msg or had ignored it, or whatever. I told the secretary that it had been very very important that she get back to me, I guess she called her because I got a call from my PCP some 10minutes later and she was REALLY short with me, uncalled for. She had already left (I guess) and couldn't leave me the order for the tests that day. I have Tuesday off and will pick it up and go to the hospital for the blood tests that day. Meanwhile, I'll be talking to someone on the phone -hands free- both on my way and way back from work to hopefully not fall asleep. The other thing is that I've been having a very hard time getting through work, I've been drinking multiple double espressos to get through.

I'm getting very depressed. It's as if there's this deafening silence in and around me, it's weird. But I'm feeling more and more down. Maybe stopping Seroquel so abruptly has messed with me, but I can't go back to it and make myself even more sleepy.

I already called my pdoc about something else yesterday and don't want to bother her too much. I'm going to see how I do in the coming days. I really feel like crap. I don't feel up to doing anything at all.

I used to take Saphris and I had this same problem. But I would fall asleep everywhere. I tapered down like you're doing but had significant mood issues. Eventually my pdoc had to switch medications which wasn't pleasant but now I take Abilify and I have finally adjusted and I have energy again. I would talk to your pdoc about all your options. It helped me to roll the windows down and listen to loud music I like to sing along to.