Myla Posted November 17, 2011 Report Share Posted November 17, 2011 I thought I was pleased with the outcome (increase of existing AD meds and the addition of another med) until I got home and started googling. The psych has added quetiapine to my venlafaxine increase. Unfortunately I didn't think to ask any questions about the quetiapine at my appt and all I was told that it would probably make me feel groggy for a while. Now I don't want to take it but I'm scared to tell my gp (I've been discharged back) as don't want to be "difficult". But I really can't accept that the quetiapine is a suitable substitute for diazepam . The risks seem completely out of proportion to the anxiety for which I was desparate for something else. I've been happy with diazepam but gp, and now psych, are not happy for long-term use. But I'm not in a constant state of anxiety and the quetiapine seems completely over the top for someone with a depression/anxiety dx when literature says that it's usually prescribed for schizophrenia and bipolar! I don't know how to approach this with my gp. But I know I will not take the quetiapine. Should I just take the presciption and not swallow the pills or be up front? Any thoughts please? Link to comment Share on other sites More sharing options...
donnam Posted November 17, 2011 Report Share Posted November 17, 2011 hi i am on quitiapine, and it has really helped me, my moods were all over the place and while i still have lows etc, i can usually manage rationality with them, i have been a lot more stable on it, and i too am bpd, not bipolar or schizephenic (sorry bout spelling), but it does make me constantly tired, and have been on it over a year now Link to comment Share on other sites More sharing options...
Myla Posted November 17, 2011 Author Report Share Posted November 17, 2011 ty cadance. I'm not bpd though. Do you take it as a mood stabilizer then? For me, I don't like the sound of being constantly tired :( Link to comment Share on other sites More sharing options...
catsmother21 Posted November 17, 2011 Report Share Posted November 17, 2011 Hi Myla Could you ask the doc if you could take the quietipine on a PRN basis - so you only take it when you really need it instead of taking it every day? xx Link to comment Share on other sites More sharing options...
Insideoutgirl Posted November 18, 2011 Report Share Posted November 18, 2011 You sound quite concerned hun. Could you perhaps just chat with your g.p.to share your concerns and discuss benefit vs risk together? It might help clarify things or if you are still unsure come to an agreement together such as the one that cats suggests; If you do decide to take them after meeting at least you would hopefully come away feeling reassured. xxx Link to comment Share on other sites More sharing options...
DJJK Posted November 18, 2011 Report Share Posted November 18, 2011 Side effects lists on the internet...always enough to cause anxiety in itself! The only way you can know how it effects you is how you feel when you take it and all of these things are individual to whoever is taking it - pharmaceutical companies have to put everything down, even if it's only happened once, purely to cover their own backs... That said, if you feel strongly about it, you have a right to an input on your treatment, so you also have a right to say what is and isn't working for you...I'd always talk to my GP if I was unhappy with something they suggested that I didn't agree with... ...all in all, you're most qualified to know what works for you than anybody else - always worth asking why they think it's the right course of action...if you don't ask, you don't find out their reasoning and at the very least, it gets them to think about it too... KX Link to comment Share on other sites More sharing options...
carlylight1 Posted November 18, 2011 Report Share Posted November 18, 2011 hi myla, i'm in a very similar situation regarding the seroquel and diazepam situation. i'm very unsure what to do as in the past my depression has improved without meds and conversely at times got a lot worse on some meds. there is a question mark over my diagnosis right now. i might be naive but i'm hoping a lot of my psychosis or whatever they are symptoms will resolve on there own. my pdoc i think believes me not wanting to take meds is part of my illness. i don't know whats what and how far i can trust my own judgement anymore. last night i was really scared my flat would blow up because there could be a faulty gas system. i don't know if this kind of thing is anxiety or something else. its all so confusing and i know a lot of dr's believe things like this will get worse without treatment. i've just been to see my gp today who questioned me why i wasn't taking the seroquel and i said how if things got worse i would. he said i'm already at the point of being very disabled by my illnesses so should reconsider. i felt lucky today because i have a very nice, non-patronising dr who i feel safe being honest with. i think it is best to be honest, you are not 'bad' for having concerns about meds and should be able to feel comfortable talking. however i completely understand any reluctance as i have seen some dr's lately who made me feel like a time wasting, hypochondriac idiot and i never want to see those people again let alone talk about anything with them, best wishes xxxx Link to comment Share on other sites More sharing options...
CrippleAndStarfish Posted November 18, 2011 Report Share Posted November 18, 2011 hi myla. I've been on quetiapine off and on for maybe 3 years now, and i was initially prescribed for psychosis, but then once that ep passed, i had noticed a huuuge improvement with regards to my anxiety, and the pdoc agreed that i could stay on it. Apparently it's quite common to prescribe anti-ps such as quet for anxiety, as it's sedative. Also, when you start it initially, it will hit you like a bus, yeah, but i've found that this improves massively after a few weeks, and i can wake up early okay, and my sleep isn't really any different other than i sleep a little deeper and i don't wake up on a morning with the beginnings of a panic attack as happens a lot when i'm not taking medication for it. I do get a bit of a "hungover" feeling on the mornings for a few weeks following a dosage change though, but other than that, it has really helped me with anx. xx Link to comment Share on other sites More sharing options...
Roses Posted November 18, 2011 Report Share Posted November 18, 2011 Hi there, I'm BPD but been on quetiapine for years now (only got BPD dx couple of months ago). To be honest it's great and if I'm totally honest it is a great replacement for diazepam. I've not been on diazepam as I refuse to take anything ending in "pam" cos of the addictive nature of the drugs. They are addictive and the more you take the more you need whereas quetiapine is a mood stabiliser which is completely different. Quetiapine is used for many, many things beside bipolar and schizophrenia which you mentioned. It is widely accepted as a valid treatment for any mood disorder where the person is high and low or just normal and low. If your mood is continually low/anxious and you are needing diazepam to get by every day it is much better for you to take quetiapine regularly to prevent the mood dip rather than just react every time with a drug that blottoes you out like diazepam does. Is it that you are really scared of quetiapine or just that you will miss the effect that diazepam has just making things quiet and dull for you??? I'm sure if you googled diazepam there would be lots of scary stuff on there just like with quetiapine. In fact I believe the side effects of the "pam" drugs are much worse than quetiapine. Just think it over hun. Personally, I think you should take the prescribed meds and come off diazepam. xxx Link to comment Share on other sites More sharing options...
Christine001 Posted November 18, 2011 Report Share Posted November 18, 2011 Hi Myla I take venlafaxine 300mg and had quetiapine added by 50mg over a few weeks to 150mg, this is used to increase the effects of the venlafaxine and I take it at night, both drugs are slow release. the quetiapine does help me sleep and did help my mood to lift. I say did as I was still slightly depressed and they added a mood stabalizer ( lamotrogine ) and that worked as well. I was drowsy very slightly when the quetiapine was introduced, I dont sleep more that 5-6 hours during the week but much more at weekends ( but that is just me) I tolerate most drugs with out many side effects. well my point is that for me the quetiapine works but everyone is different but you dont know until you try. Link to comment Share on other sites More sharing options...
Roses Posted November 18, 2011 Report Share Posted November 18, 2011 http://www.drugs.com/sfx/diazepam-side-effects.html http://en.wikipedia.org/wiki/Diazepam http://www.drugs.com/sfx/quetiapine-side-effects.html http://en.wikipedia.org/wiki/Quetiapine Link to comment Share on other sites More sharing options...
Myla Posted November 18, 2011 Author Report Share Posted November 18, 2011 Deleted bizarre double-post! Link to comment Share on other sites More sharing options...
Myla Posted November 18, 2011 Author Report Share Posted November 18, 2011 ty all for your thoughts . I've got an appointment Monday and I think I just need to try hard to discuss it with my gp in a calm, rational manner. I think I'm likely to meet some resistance to her going against pdoc instruction/advice (??) xx Could you ask the doc if you could take the quietipine on a PRN basis - so you only take it when you really need it instead of taking it every day? xx That's a good idea cats. I didn't realise this was possible. I would certainly feel happier since I can go weeks (maybe even a month) without diazepam and never more than 3 or 4 days in a row. You sound quite concerned hun. Could you perhaps just chat with your g.p.to share your concerns and discuss benefit vs risk together? It might help clarify things or if you are still unsure come to an agreement together such as the one that cats suggests; If you do decide to take them after meeting at least you would hopefully come away feeling reassured. xxx Side effects lists on the internet...always enough to cause anxiety in itself! The only way you can know how it effects you is how you feel when you take it and all of these things are individual to whoever is taking it - pharmaceutical companies have to put everything down, even if it's only happened once, purely to cover their own backs... That said, if you feel strongly about it, you have a right to an input on your treatment, so you also have a right to say what is and isn't working for you...I'd always talk to my GP if I was unhappy with something they suggested that I didn't agree with... ...all in all, you're most qualified to know what works for you than anybody else - always worth asking why they think it's the right course of action...if you don't ask, you don't find out their reasoning and at the very least, it gets them to think about it too... KX Yes I'm rather concerned. I knew as soon as I'd googled I probably shouldn't have done but I am glad I did. I'm concerned about the newness of the drug in comparison to diazepam which was developed in the 60s so has a very long period of 'real life' use, including vast knowledge on side effects and long-term health conditions etc. It is about risk/benefit and if I was seriously suffering non-stop then I'm sure I'd have a completely different view. The biggest worries for me are the following potential side effects: 1. increased risk (X3) of diabetes (both my mum and maternal grandmother are diabetics); 2. uncontrolled muscle movement side effects; and 3. rebound problems on ceasing treatment. vivien, it's a real dilmna! I think docs are trained to believe that things will get worse without treatment. I do feel like I'm being ackward though about taking vs not taking meds because of my history of starting and ceasing ads. My gp has had a real battle with me to get me to start taking them again this year and I even recall her saying she thinks I should stay on them long-term. So I guess I don't want to "rock the boat". Glad you found a nice unpatronising doc though. ty for sharing your experiences Crippie, Roses and Christine. I certainly appreciate it even though you might think I'm being unnecessarily negative about the drug. I suppose having used diazepam for 8 or 9 years with good success I'm nervous of the change. I'm not good waking/getting up in the mornings so would be a disaster if quetiapine made that even harder. Roses, I completely agree than diazepam is addictive but personally it hasn't been for me because I don't take enough, regularly enough (I don't even take it every day). Since taking the ad my mood fluctuates dramatically but I put that down to a side effect of the ad. I even said to cpn once that I preferred just feeling depressed because at least it was stable. But yes I do like the quiet and dull effect of the diazepam. Does Quetiapine not do that? Also, I hadn't seen a couple of the links so thanks for those. Link to comment Share on other sites More sharing options...
donnam Posted November 19, 2011 Report Share Posted November 19, 2011 hi i am on it for anxiety and seeing things in peripheral vision that not there and sometimes when just wake up, but i also take a mood stabilser. for me quietiapine dulls the thoughts in my head, stops the constant racing, so much so that if i dont take my night time dose, my heads starts racing and i cant sleep, i need the quietness of my head etc, tho have sleepers on prn. though i have to say i have v vivid dreams that can be so realistic i am not sure if by morning that had really happened or not? and sometimes not sure Link to comment Share on other sites More sharing options...
Roses Posted November 19, 2011 Report Share Posted November 19, 2011 Hi there hun, thanks for replying to me. I'm sorry if I came across as patronising I didn't mean that. I've seen a lot of people on MH wards using diazepam and they literally seem to become a ghost of themselves when they take it. Yes, quetiapine can dull it all down (especially in first few weeks) but generally I don't feel like that and I'm on 100mg in morning and 300 at night now. At first I was very worried. I'm glad that you have researched them and it is a case of better the devil you know sometimes but I guess the professionals are looking from the outside in whereas you are seeing what has worked and are scared to change (which is understandable). I guess your mooed is fluctuating since the ad cos you are having some better days? It sounds like it's trying to work but is not enough on it's own. Can I ask which as they have put you on? I've been on an awful lot of different ones til they found the one best for me and now I'm not even on that. Just stabiliser, anti-psychotic and sleeper which works even better for me and even though I get so terribly low (they considered ECT at one point) these drugs help me a lot and I feel less out of it with all the different meds to take all day. Link to comment Share on other sites More sharing options...
Myla Posted November 19, 2011 Author Report Share Posted November 19, 2011 ty cadance. This certainly does make me see potential benefits for me in using quetiapine as PRN. xx Roses, I didn't find your response at all patronising so no need for apology . I imagine that you seeing first hand diazapem used (excessively??) in a ward setting wasn't a good advert, lol! As for the quetiapine, my prescribed dose of 25mg taken at night sounds miniscule (compared with your 400mg total) so perhaps I'm worrying about nothing. But then is there any point taking 25mg if much higher doses are usually taken? Yes that's a good point about the mood fluctuations being because of having some better days. I feel a bit silly now for not making the connection before. It would be easier if the changes were more gradual as would be less of a shock to the system. I've been taking 150mg daily of modified release venlafaxine for almost 7 months, now increased to 225mg. I've tried a few over the years but none have ever been revolutionary - just generally out of the suicidal phase and a return to functioning. Glad you've found a combination that helps you. I'm definitely going to try harder this time. ty for your input xx Link to comment Share on other sites More sharing options...
Myla Posted November 19, 2011 Author Report Share Posted November 19, 2011 Sorry, my other concern is weight gain. Has anyone experienced this? And was it down to eating more (please be honest!!) or does it somehow mess with the metabolism? I really can't afford a new wardrobe :) Link to comment Share on other sites More sharing options...
Roses Posted November 20, 2011 Report Share Posted November 20, 2011 Hi there, yes it was probably excessive use on the ward that scared me. Weight gain hasn't been too much of a problem for me but a lot of people say it is but like you say at 25mg just to help you sleep I guess, it wouldn't affect you too much that way. Perhaps you should just try it and see what it does for a couple of weeks? x Link to comment Share on other sites More sharing options...
Insideoutgirl Posted November 20, 2011 Report Share Posted November 20, 2011 Good luck at the G.P. tomorrow! xxx Link to comment Share on other sites More sharing options...
Myla Posted November 20, 2011 Author Report Share Posted November 20, 2011 Roses, it's reassuring to hear weight gain hasn't been an issue for you. Thanks, Gem xx Link to comment Share on other sites More sharing options...
catsmother21 Posted November 21, 2011 Report Share Posted November 21, 2011 Hope your appt goes well xx Link to comment Share on other sites More sharing options...
Myla Posted November 21, 2011 Author Report Share Posted November 21, 2011 My appt went better than anticipated. My gp was happy not to prescribe the quetiapine today (as she hasn't yet received the pdoc letter so will wait to see exactly what was said). I explained my concerns and she didn't even try to persuade me to take the quetiapine, though mentioned that it is "being prescribed a lot at the moment for anxiety". The way she said it made me think she meant it was being over-prescribed. I've got to go back after taking the increased venlafaxine dose for a couple of weeks and she's going to check to see whether I can take the quetiapine as PRN as she didn't think I could. xx Link to comment Share on other sites More sharing options...
Myla Posted November 21, 2011 Author Report Share Posted November 21, 2011 Hope your appt goes well xx ty cats. xx Your suggestion of using the quetiapine as a PRN, is this something that some pdocs do? Link to comment Share on other sites More sharing options...
catsmother21 Posted November 21, 2011 Report Share Posted November 21, 2011 Hi Myla I know that I use my anti-p on a PRN basis which was prescribed by my pdoc - so I think it's worth asking about if that makes you feel more comfortable taking it. xx Link to comment Share on other sites More sharing options...
carlylight1 Posted November 21, 2011 Report Share Posted November 21, 2011 hi myla, i'm glad it went well at the gp's. there are some people who use it here as a prn and i was prescribed some different anti-p's to use as a prn a while back. i talked to my gp about the seroquel on friday and he thinks i definitely need to be taking it but did say he thought it was a high dose(200) and i got the impression that if he had been prescribing it he would've just done low daily doses. i know the pdoc is prescribing it at that level because i think he wants to experiment with seeing if any of my possible psychosis symptoms of hearing things responds well (apparently at lower doses less than 150 seroquel doesn't function as an anti-p its more a sedative) i'm still not taking it because i'm a big worrier and worry about side effects but have agreed to if things don't get better or get worse. i'm half tempted to because its meant to be good for balancing moods but i'm still wary. xxxx Link to comment Share on other sites More sharing options...
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