Phandy: Taper Quetiapine 450mg Question

[phandy]

Hi, I have already become free of Mirtazapine (45mg), Venaflaxine (75mg), and Lithium (1200mg). I have Quetiapine (450mg) and Lorazepam (1mg) left to taper.

 

My aim is to begin tapering Quetiapine on 1st December. I have read the articles and posts on this subject as a 'lurker' for some time. If I follow the 10% rule, I should start decreasing my dose of Quetiapine by 45mg a month. My question: should I just drop 45mg on the 1st of the month and remain on that dose for 1 month? Or, should I decrease by 12.5 per week for the first month? So, by the end of the first month I would have reduced by cc 50mg?

 

I tried to start decreasing quetiapine about six months ago. I initially dropped the dose by 50mg in around 2/3 weeks - over confident and little research. This threw me into a complete state of anxiety/ panic for about 8 weeks so I stopped my taper and returned to my previous dose of 450mg. That was 6 month's ago and now it is time to taper again.

 

Any advice appreciated.

 

James

[simon]

Hi James

Just wondered how you got on coming off Mirt and Lithium, as these are 2 drugs which I will eventually start to taper. Do I get the impression that Lithium is quite straight forward.? I only say this because in the past 6 years I have experimented with the dose to no ill effect. (im now on a sub-therapeutic dose of about 600mg) Its meant to be augmenting the effects of the other 2 ADs.(The Americans on this site don't seem to have experience of this function) MIRT  has the effect off sleep problems I think? How long did all that take?

All the best with the rest of your tapers.

 

Simon

[mammaP]

Hi James, I'm really sorry that you have slipped down the page before getting replies! Your post was moved here to

introductions from tapering, this is your thread to add to and ask questions about your specific taper. 

 

Well done for tapering the other drugs, that is quite an achievement!  How long is it since you finished tapering them?

If it is recently then it would be better for you to hang on for a few months to allow your nervous system to stabilise

properly before starting the quetiapine taper.  If you reacted badly to the cut of 50mg that means the cut was too much for you

and you would be best cutting by a much smaller amount, then waiting at least 4 weeks before another cut. You have been

on a lot of drugs and successfully tapered from several that can be difficult and that could also be why you had the withdrawal

symptoms when you cut the quetiapine.  You have done your homework here and that is great, you may have seen the thread

for tapering quetiapine but in case you have missed it here is the link. 

 

http://survivingantidepressants.org/index.php?/topic/1707-tips-for-tapering-off-seroquel-quetiapine/

 

It would be helpful for us to have your meds history in your signature strip so we can see at a glance what you have

been on and tapered.  Doses and when you tapered would be very helpful too. Here is how to do that.

 

http://survivingantidepressants.org/index.php?/topic/893-please-put-your-withdrawal-history-in-your-signature/

[Rhiannon]

Just want to add my voice to mammaP's, please give us your med and taper history--what doses were you on, how did you taper, how recently did you come off the other meds? Thanks, we really need to know this in order to answer your question.

 

Also, welcome to the forum, and congratulations on your commitment in getting off those meds--not an easy thing to do!

[phandy]

Hi, apologies for the delay in replying. It took me most the day to workout I needed to be in Desktop View, not Mobile View to add a signature. I have tried to complete my signature as best I can. Rather difficult in twelve lines but hopefully the information will be of use.

 

Simon, I will try to reply to your post tomorrow.

 

Thank you for the welcome Rhi and MamnaP

[simon]

Hi Phandy , yes your signature shows the tapers you did and how fast they were (from the point of view of this forum) But I guess part of the reason for that success is that you weren't on the drugs for any long period (fortunately)

I personally did a taper of 6 weeks for one of the meds im on and crashed after 6 weeks off it , although the intervening period was a welcome relief to near normality I must say and gives me some hope that when this slow, slow taper gets moving, I will again have the capacity to feel emotion and have improved cognition. Both things that the SSRIs have robbed me of.

Did you feel no withdrawal symptoms coming down off the Lithium and the Mirt?

Best of luck with the remainder of your taper, looks like youre out of the woods!

 

Simon

[phandy]

Hi Simon, sorry for the late reply. I did not feel well whilst withdrawing from any of the medications.

 

I might be different as part of my psych is that I think I deserve to be in pain (a long story which I won't cover here) so whilst withdrawaling can be difficult it is something I feel I deserve to endure.

 

I started my taper of quetiapine on the 1st. I am reducing by 12.5mg every two weeks so I will be reducing by 25mg a month. Please jump in with advice. At this rate it will take me over a year to come off quetiapine.

 

I can cope with most the pain of withdrawl except the panic attacks as they stop me from being able to function.

[simon]

Thanks for that . I wish you well.

Im just starting a 10% taper of Lithium and glad to feel im at least at the start of a positive move.

All the best

 

Simon

[Satch]

I hope you have a safe symptom free withdrawal.

[phandy]

Thank you both. A question on the 10% rule. When you reduce by 10% every two or four weeks, are you then supposed to have a stabilisation period before you taper by another 10%?

 

Ex. Decrease quetiapine by 10% over three weeks, then stay on that dose for three weeks before tapering another 10%? I am a little confused on this point.

[tgirl]

Hello Phandy,

Welcome!

[mammaP]

Thank you both. A question on the 10% rule. When you reduce by 10% every two or four weeks, are you then supposed to have a stabilisation period before you taper by another 10%?

 

Ex. Decrease quetiapine by 10% over three weeks, then stay on that dose for three weeks before tapering another 10%? I am a little confused on this point.

We recommend tapering no more than 10% of the current dose with at least 4 weeks between cuts.  So if you take 50mg you would cut to 45 then hold for 4 weeks or more before making the next cut which would be 4.5mg.  If you are feeling any withdrawal symptoms following a cut it is best to hold until they have passed and your brain has caught up. It is about listening to your body rather than following the calender.  When you are experiencing side effects from a drug they will lessen as the dose gets smaller as side effects are usually dose related. 

[phandy]

Ok. My plan is this. Drop by 12.5mg for 15 days (I started on 1st) then drop another 12.5mg for the next 15 days (take me to Dec 30th). Therefore dropping 25mg in one month. I don't want to drop by 25mg and stay on that dose for one month.

 

On my plan I will have incrementally dropped by 25mg in one month.Then on the 1st Jan I intend to follow the above tapering plan. Drop another 12.5mg for the first 15 days, then another 12.5mg for the next 15 days, thereby dropping another 25mg in Jan and bring my total taper at the end of Jan to be 50mg. I will then be on 400mg of Quetiapine, down from 450. I intend to follow this schedule until I get to 0.

[Satch]

How are you feeling after your first drop.

[phandy]

To be honest it has only been a few days...no noticeable changes. I expect to feel different once I have dropped by a 100mg. It is just so hard to tell.

[Satch]

How are you doing.

[mammaP]

Hope the taper goes well for you Phandy, it seems like you have worked it out well and it is under the 10% that

we usually recommend per month and hopefully you wont get any withdrawal symptoms. 

[phandy]

Hi, so two years have passed since i last posted. I have recently completed by Lorazepam taper after about 11 months of tapering. The 13 months prior to that were spent tapering off 450mg of Quetiapine. I am now medication free. I feel content and stable, and for me, coming off my medication was a gamble and struggle that payed off. I realise I have only been off the benzos for about 5 weeks, but it has taken close to a year to get to this stage. I think I was on them for about 5 years. 

 

I am posting to say, you can do it. It is a struggle, and for long periods I felt very ill. The only advice I can give is: SLOW, SLOW, SLOW. That's to taper as slowly as possible. When I was coming off some of the medication - listed in my signature - I was impatient, and tapered far too quickly and became ill very quickly. After my withdrawl experiences, I started to stop creating short term withdrawl plans for myself and just chilled, and said to myself, if it takes a year to taper off 1mg of lorazepam, it takes 1 year. If it takes 2 years, it takes 2 years. 

 

There are no magic answers or pills to make it easier, just take it slowly. If it takes 20 years, it takes 20 years.

 

I hope this post shows that there is some light at the end of the tapering tunnel.

[jmncrr]

Phandy

 

Which medication was hardest to taper?

 

How long did it take to taper your quetiapine, and did it get harder at lower doses?

 

Thanks

[salaw]

Phandy,

 

I'm so glad to hear that you've successfully tapered of 450mg of seroquel. It's give hope for tapering of 300mg of seroquel which i'm planning to do as soon as I stabilizes. My question is did you have help from your doctor or did u do it on your own like cutting up pills and making liquid suspension?

[phandy]

Phandy

 

Which medication was hardest to taper?

 

How long did it take to taper your quetiapine, and did it get harder at lower doses?

 

Thanks

Hi, I would say the hardest to withdraw from were Mirtazapine and Lorazepam. 

[phandy]

Phandy, I'm so glad to hear that you've successfully tapered of 450mg of seroquel. It's give hope for tapering of 300mg of seroquel which i'm planning to do as soon as I stabilizes. My question is did you have help from your doctor or did u do it on your own like cutting up pills and making liquid suspension?

Hi, in the UK so liquid variants of medication are not the norm unless you are in Hospital. I tapered by reducing the physical pills, the smallest being 25mg. Obviously if you cut that in half you get 12.5mg etc.  There was not much help any doctor could give, so after I informed them I was tapering from 450 to 0 , I just went ahead and started to taper.

 

I knew I had to go through the pain of withdrawl and what I did not want, and what the doctors can only offer, is more pills to help with the withdrawl. My personal mantra, is that is you need more medication to cope with the side effects of the medication you are tapering from: you are tapering too quickly, 

It took me around 12 months to get to 0. I did not have a strict taper schedule, I just managed drops of around 12.5mg every week or so. 

[salaw]

Phandy,

 

We're u on the extended release seroquel?

 

When I begin my taper I want to start by cutting the pills but is concerned with dosage dumping as i'm taking the 300mg extended release one. My doctor is no help as she doesn't believe in slow tapering so I may have to do this alone. I had ask her to switch me to the immediate release seroquel but she refuses. So if u succeed with cutting up extended releases seroquel it would be good information for me to know.

 

Thank you

 

[phandy]

Hi Salaw, yes I was using the extend release Quetiapine. I think it was called Quetiapine XL on the box. If I remember, mine came in 25mg/50mg/150/mg/300mg and 400mg.

 

You need to get your monthly prescription of 300mg in 25mg tablets so it easier to begin your taper. 

[hopeful7]

Well done phandy!! I'm on my 10 day of coming off quitiapine. It's a challenge but l'm up for it.

 

Warm wishes

 

hopeful

[phandy]

Good luck mate. 

[Altostrata]

Hello, phandy, how are you doing?