Mental Health Replacement For Low Dose Quetiapin

[andrey]

From 2020 to 2023, I was suffering from severe panic attacks. I started taking benzos and spiralled into addiction. Near the end of 2023, I decided to turn my life around and went to rehab and withdrew from benzos. There, I was placed on quetiapine for the sleeping issues and some other problems from the benzo withdrawal.

Overall, they kind of help me to fall asleep, but I got used to it; and I cant really deal with the horrible side effects. I have episodes of food cravings, have bad constipation, cant sit still, had a tachycardia episode for literally hours after taking my seroquel dose when I was sick and I noticed that when I went to bed my tongue started twitching and pressing against my teeth(wtf? Are these really extrapyramidal symptoms?). However, I only take a very low dose. For the first year, I took 25mg, and since last christmas Im cutting the pill into a 8-12mg dose.

So, Im going to see a psychiatrist soon. I tried twice to quit them, but the nauseau I got was unbearable. And I profoundly believe that I need some psych med to deal with all my issues. Is there something you guys could recommend?
Im also addicted to opioids, and Im in OST, and I heard that a lot of people take doxepine and are satisfied with it. Hence, I will most likely ask to get switched to it.
Aside of that, if there is anything else you could recommend me, I would be happy to hear your opinion, advice or input on my situation.

 

[streaM Freak]

Hm, it sounds like there could be a lot going into the equation here so I'll just keep it simple and based off of the information given.

Have you talked to a doctor about something like trazadone or zyprexa?

They aren't fun and glamorous, but it may be worth bringing up with the doc.

 

[andrey]

Hm, it sounds like there could be a lot going into the equation here so I'll just keep it simple and based off of the information given.

Have you talked to a doctor about something like trazadone or zyprexa?

They aren't fun and glamorous, but it may be worth bringing up with the doc.

Oh yeah, Im sure it till take some time until there will be an appropriate solution. I will try breaking it down a bit more.

Basically, I have the following current conditions:
- heart rhythm problems(tachycardia, pvc…)
- anxiety disorder/panic attacks
- moderate insomnia/very mild depression
- opioid use disorder

The insomnia and depression is something I even had before the heart stuff. Since Covid, I started having episodes with severe tachycardia(up to 190) and PVC. The anxiety and panic attacks followed or are the cause of this heart related stuff. Ive been checked by countless ecg, echo and blood tests and there seems to be nothing wrong with the heart.
I started taking the benzos and opioids more and more to counter the tachycardia episodes. Later I went to rehab, withdrew from benzos and got into OST.
At that point I got prescribed a beta blocker and seroquel. Since that point, my symptoms almost completely disappeared aside of one to three episodes in a year.

So this means I take these meds:
- metoprolol
- seroquel
- morphine

Now, to come back to the replacement. I have to be careful to choose the right med due to my heart rhythm issues, and I also dont really like to take another antipsychotic(like olanzapine) because I think that these meds are pure poison with a lot of long term side effecte(like my tongue twitching).
Hence, I believe something like a TCA, or doxepine might be a good solution. It would be great if it has still a sedating character to it.

Trazodone sounds like a fitting option, I will keep that in mind!

 

[streaM Freak]

Oh yeah, Im sure it till take some time until there will be an appropriate solution. I will try breaking it down a bit more.

Basically, I have the following current conditions:
- heart rhythm problems(tachycardia, pvc…)
- anxiety disorder/panic attacks
- moderate insomnia/very mild depression
- opioid use disorder

The insomnia and depression is something I even had before the heart stuff. Since Covid, I started having episodes with severe tachycardia(up to 190) and PVC. The anxiety and panic attacks followed or are the cause of this heart related stuff. Ive been checked by countless ecg, echo and blood tests and there seems to be nothing wrong with the heart.
I started taking the benzos and opioids more and more to counter the tachycardia episodes. Later I went to rehab, withdrew from benzos and got into OST.
At that point I got prescribed a beta blocker and seroquel. Since that point, my symptoms almost completely disappeared aside of one to three episodes in a year.

So this means I take these meds:
- metoprolol
- seroquel
- morphine

Now, to come back to the replacement. I have to be careful to choose the right med due to my heart rhythm issues, and I also dont really like to take another antipsychotic(like olanzapine) because I think that these meds are pure poison with a lot of long term side effecte(like my tongue twitching).
Hence, I believe something like a TCA, or doxepine might be a good solution. It would be great if it has still a sedating character to it.

Trazodone sounds like a fitting option, I will keep that in mind!

Understood about APs, I too only use them when I absolutely need to.

So yeah trazodone would be worth it to talk about and also, I know you didn't mention bipolar or seizures, but depakote (divalproex sodium) is somewhat sedating and treats epilepsy and may be interesting to talk to a doctor about irregular movement and such.

But, I'm sort of thinking way outside the box - I'm sure doctors have a list of new generations antidepressants that would be worth a try.

 

[streaM Freak]

Anyone on Bluelight have experience with Doxepine??

 

[andrey]

Understood about APs, I too only use them when I absolutely need to.

So yeah trazodone would be worth it to talk about and also, I know you didn't mention bipolar or seizures, but depakote (divalproex sodium) is somewhat sedating and treats epilepsy and may be interesting to talk to a doctor about irregular movement and such.

But, I'm sort of thinking way outside the box - I'm sure doctors have a list of new generations antidepressants that would be worth a try.

Sorry for responding so late, but due to the holidays I was quite busy. Trazodone really sounds quite promising, the only downside
I heard is one of its metabolite, called MCPP. Seems like it actually induces more anxiety and other uncomfortable side effects.
Apart from that, it really sounds appropriate for my case. I will ask the psychiatrist about it.

Thankfully, the movement disorder is only happening very rarely. Im quite sure its a long term side effect from the quetiapine
Because I never had this type of symptom before and I already have akathisia from it. I believe they wouldnt give me such meds so easily due to my addiction disorder, and the symptoms are also bearable. Definitely, thanks for recommending though.

 

[streaM Freak]

@andrey , yeah I guess a metabolite could do something. And perhaps the movement was from Seroquel (I wonder how many times it happened).

Nothing will be perfect - good luck

 

[andrey]

@andrey , yeah I guess a metabolite could do something. And perhaps the movement was from Seroquel (I wonder how many times it happened).

Nothing will be perfect - good luck

It happens over night, so I dont really notice it every time. Although, sometimes I wake up and then I notice that Im pressing my
Tongue against my teeth. Sometimes, this can really hurt. Additionally, I also have bruxism. My teeth are even deformed due to it.
And antipsychotics are known for this type of side effect, so Im sure its the seroquel.

Unfortunately youre right, that there will never be a perfect solution, but seroquel is really known to cause a myriad of side effects
Whereas doxepine or trazodone have less and their partly officially indicated for insomnia/anxiety etc.

 

[streaM Freak]

Ah I see @andrey - well you are doing the right thing, you can never have too much information about things like this.

For what it's worth, I got restless legs once my Seroquel was upped to 300mg.

Still hoping @someone knows about your original ask of 1st hand knowledge on Doxepine

 

[Shinji Ikari]

Mirtazipine maybe? It's prescribed as an anti depressant and off label for insomnia. Gave me restless legs but a lot of people find it helpful for insomnia. Notorious for causing weight gain though. As always ask your doc.