[xRavenx]

So when I saw my pdoc this week, and I asked her if it would be okay to taper down on Seroquel. I am going to be taking 300 mg instead of 400 mg. In the winter, I was on 600 mg. The higher doses were making me feel too weird before bed: too lightheaded and powerful a feeling, although I absolutely need it for sleep. If I do not use Seroquel, I don't get any sleep, and that turns into mania real fast.

I do feel better on the lower dose of Seroquel, but just prior to my dose being lowered, I noticed I've been fighting more with family daily. Yes, my mother and I clash at times, but little things that normally I'd be able to brush off make me extremely angry, and I get louder, more agitated, reactive...and it's hard to de-escalate. I'm still on the highest dose of Lamictal, Gabapentin, and I take Klonopin as needed....but haven't even really taken it lately.

It's almost every day lately. Even today when my best friend said something that was irritating, I almost flew off the handle by getting defensive quick. I guess that's the word that describes me a lot: defensive. Anyway, I went from feeling decent to falling to pieces within a few hours today. Tears, anger, low self-esteem. I am definitely in need of support, and don't really know where to turn.

You've all been very helpful. I am wondering: do you think the fact my dose of Seroquel was lowered could be contributing to these mood swings? It was only lowered a couple of days ago. I don't know if I need to go back to my pdoc since I've just seen her Monday. It's hard keeping up with appointments with my work schedule and being able to match up with my pdoc's schedule. Has anyone experienced something like this before with a lower dose of an AP?

[BeyondtheRainbow]

Cutting back on Seroquel can be rough. One time when I had to have the dose reduced I remember being emotional and irritable and just generally out of sorts all the time until it leveled back out. The good thing is I think it did level out and I was adjusted to the new dose fairly quickly.

[xRavenx]

Originally Posted by BeyondtheRainbow

Cutting back on Seroquel can be rough. One time when I had to have the dose reduced I remember being emotional and irritable and just generally out of sorts all the time until it leveled back out. The good thing is I think it did level out and I was adjusted to the new dose fairly quickly.

Yes, I didn't think that going from 400 mg-300 mg would have caused that kind of reaction. I'd understand if going from 400 mg to 200 mg, however, would have induced those kind of mood swings. I guess medication can have something to do with it, even though it's not such a steep taper down?

[BeyondtheRainbow]

I've had meds that really tiny adjustments affect me. I'm stuck on a wimpy 25 mg of topomax. I think the goal dose was 100 mg (I started it for migraines but since I couldn't reach the dose to help them but did sleep better on it it was transferred to psych). If I go up I start feeling like I'm going to get akathesia. If I go down I don't sleep through the night. So I keep taking this ridiculous dose because I can't seem to make the world's tiniest dose change. My goal is to be off it by the end of the year even if I have to cut into 1/4ths.

Our bodies are pretty strange with what they get used to from these meds and what they demand of them.

[still_crazy]

I think the seroquel dosage reduction is contributing to this. I think Seroquel has a fairly short half-life, and 100mgs out of a 400mgs daily dose is a 25% cut, from day one. Add in to that Seroquel's effects--sedation, anti-agitation...tranquilizer stuff, basically (when you think about, Seroquel is basically cleaned up Thorazine, for the 21st century...)--and I think it makes sense, intuitively, that dropping the dose of a sedating tranquilizer could contribute to stuff like this.

I'm glad you've cut your dose a good bit. Over the long haul, neuroleptics should be at the LED--lowest effective dose. "Experts" figured that out once the TD lawsuits became a major issue. With the "atypicals," it seems that some doctors have chosen to go back to maintaining people on as much neuroleptic as the patient can tolerate (and sometimes more than that, as evidenced by the continuing popularity of cogentin...), which can actually cause a lot of problems--physical and psychiatric--over the long haul.

I dunno. Anytime psych drugs are reduced, there's a reaction, or at least that's how it's been for me and people I know. Most psych drugs suppress emotions, agitation, etc. to some extent, so when the dose of the drug(s) is cut, all that comes flooding back, plus whatever is going on in the brain.

I hope things get better in your world. My personal advice would be to accept where you are now and just try to get thru it, so you can stay on the lower dose of Seroquel. I know that's easy for me to say (clearly...I'm not living it...), but it does seem that most people do better by either tapering off neuroleptics or managing on the lowest dose possible in their situation.

[xRavenx]

Originally Posted by still_crazy

I think the seroquel dosage reduction is contributing to this. I think Seroquel has a fairly short half-life, and 100mgs out of a 400mgs daily dose is a 25% cut, from day one. Add in to that Seroquel's effects--sedation, anti-agitation...tranquilizer stuff, basically (when you think about, Seroquel is basically cleaned up Thorazine, for the 21st century...)--and I think it makes sense, intuitively, that dropping the dose of a sedating tranquilizer could contribute to stuff like this.

I'm glad you've cut your dose a good bit. Over the long haul, neuroleptics should be at the LED--lowest effective dose. "Experts" figured that out once the TD lawsuits became a major issue. With the "atypicals," it seems that some doctors have chosen to go back to maintaining people on as much neuroleptic as the patient can tolerate (and sometimes more than that, as evidenced by the continuing popularity of cogentin...), which can actually cause a lot of problems--physical and psychiatric--over the long haul.

I dunno. Anytime psych drugs are reduced, there's a reaction, or at least that's how it's been for me and people I know. Most psych drugs suppress emotions, agitation, etc. to some extent, so when the dose of the drug(s) is cut, all that comes flooding back, plus whatever is going on in the brain.

I hope things get better in your world. My personal advice would be to accept where you are now and just try to get thru it, so you can stay on the lower dose of Seroquel. I know that's easy for me to say (clearly...I'm not living it...), but it does seem that most people do better by either tapering off neuroleptics or managing on the lowest dose possible in their situation.

Thank you. It's good to see someone agree with where I am coming from regarding my decision to lower the Seroquel a little bit. Since I'm already going through health anxiety on top of this, higher doses of Seroquel scare me. I've been through a lot throughout the year, going from 600 mg to 800 mg, back to 600, down to 400, and now 300 mg. I do not plan to reduce it any further since any less would only work as a sleep medication, when I need more of a stabilization effect without feeling Seroquel's risks outweigh the benefits.

Risk of side effects like TD, twitching (which I had a lot of), a drop in blood pressure, and risk of heart problems is enough to scare me. I know all meds have their side effects, but the lower dose makes me feel more confident. I hope I can manage on this dose. I'm going to give it time and hope my moods level out more, as I adjust.

[Sunflower123]

Do you think making use of your klonopin would help with this transition? My body chemistry is such that changes are apparent quickly....most within a couple of days. I totally agree it could be the Seroquel. I hope you adjust sooner rather than later and feel better soon. Best wishes.

[franz kafka]

I had a really bad time when I tried to reduce from 400mg to 300mg. The psychosis came back in spades and I had to up my dose again.

FYI, for the twitching, taking a multivitamin helped. I was skeptical when my pdoc suggested it, but he was right.

Lowering the dose of any med will throw side effects at you.....just got to wait to stabilize a bit. 100mg is quite the jump. What I've done before to help ease the transition is if needed...take 1/2 of the reduction....like 50 mg to get over the hump if it gets too bad to handle. Good luck!

[*Laurie*]

Seroquel can be a mood stabilizer, so lowering the dose could definitely cause the problems you've described...irritability, impatience, and such.

[xRavenx]

Thank you everyone for your input, support, suggestions, etc.

Originally Posted by Jennifer 1967

Do you think making use of your klonopin would help with this transition? My body chemistry is such that changes are apparent quickly....most within a couple of days. I totally agree it could be the Seroquel. I hope you adjust sooner rather than later and feel better soon. Best wishes.

Thank you. I do think I should start doing that. Fortunately, I thought to take it last night, and it gave me a sense of calm the next day. On the flip side though, it made me especially tired today. I would rather be calm and tired though then raging, so yes, I do think I need to take Klonopin more often.