Jump to content
mutley

Tips for tapering off Seroquel (quetiapine)

Recommended Posts

RubyTuesday

I just unfollowed this topic because when I get notifications by email, with questions that I have answers for, and I then follow the thread back to the forum and can't find the question I was trying to answer, it feels like a big waste of my time. Also, I don't like having my posts moved around and not being able to find them. If I could find them, that would be one thing. But I can't. This has  been going on for quite a long time. I just now decided to say something about it. Unfollowed.

Share this post


Link to post
Share on other sites
Altostrata

Sorry to hear that, RT. Sometimes we do move posts, most often to Intro topics, because they're more appropriate there. Discussions of individual situations would take this topic off-topic, as it's mostly a reference topic about tapering.

 

Your experience with Seroquel is very valuable. Perhaps you might look for people tapering Seroquel in the Intro forum and post in their topics?

Share this post


Link to post
Share on other sites
MNgal1960

Thank you, Shep. I tapered my Q from 25mg down to 17mg and found I had anxiety and neuropathy. I am also on Valium with one previous failed taper attempt. I wondered if the Q taper was causing my symptoms or if it was somehow tangled up with the Valium. The gabapentin is supposed to help with Restless Leg Syndrome and neuropathy but doesn't seem to do much. I particularly wonder about the neuropathy because I have it from an illness, also, but it was particularly bad during the taper. It makes it so hard to know if I'm tapering too fast or if it's just my "typical" neuropathy flaring up. Grrrr.

 

At any rate, I am pausing my Q taper here and going to try an ultra-slow taper of the V to get it lower. I wonder if it will be similar to the Q (which was also ultra-slow). Wish I could get all the way off the Q because it messes up my mornings, I can't drive or function until at least 10AM even though I'm awake at 6AM.

 

I'm so tired and so frustrated by how slow this process is.

Share this post


Link to post
Share on other sites
rapunzel2

question about seroquel. when the withdrawal insomnia passes, will the sleep actually improve with lower seroquel dose? if it has been taken only for sleep with doses 25-50mg?

 

is it like antidepressants, which may induce depression when taken long term, then depression is withdrawal symptom, and then when all that resolves, depression gets better. 

Share this post


Link to post
Share on other sites
VitaminB

Just some information from another post. My son had his first psychotic break when trying to come off Seroquel. Phillip Seeman has published a number of papers on Seroquel and why it is so difficult to come off it. Although it has been years since I read up on the drug, I believe that Seeman's work indicated that, like Clozapine, Seroquel binds poorly to the dopamine receptors and, when cutting back, it is easily displaced by Dopamine (American Journal of Psychiatry 1999; 156:876-884).

 

The so called, "therapeutic" level is right around (give or take 50 Mgs) 250 Mgs. It is right around this dosage that reductions should be very conservative, 10% or less. Doctors do not understand withdrawal and frequently recommend reductions of Seroquel of 50 Mgs or more. People on this site, who know far more than I do, will give you better advice.

 

I know receptor occupancy is far from the whole story, but I do think that knowledge of them can point to some of the "cliffs" to avoid. Any doctors advice about bouncing the drug up and down depending on how you are feeling is just plain wrong. My son was once on 1200 Mgs of Seroquel when he was in the hospital (years ago). The psychiatrist there responded to my alarm by telling me he had had people on 2,000 Mgs. My son is stable today, and will soon be starting to withdraw from his current med (Abilify). It would also probably help some people trying to understand how Seroquel works (or doesn't) to look at a post on "thelastpsychiatrist" from 2007. The guy can be a smart aleck and, at times, inappropriate, but seems to know his science. Be well, Ed

 

 

 

Sadly, I am in the same boat as your son in terms of landing back in the hospital trying to go down from 250mg. 

I have read that article from the last psychiatrist too... I haven't really stayed at 600mg for long and haven't been dosed higher than that... maybe at 800mg for a while. 

Share this post


Link to post
Share on other sites
simack

Hello all I just have a quick question regarding tapering Seroquel. I recently made the switch from a 50mg instant release tablet to 50ml of liquid Seroquel. I did this simply by letting one 50mg tablet dissolve into 50ml of water then drinking it.

However doing this caused me to become destabilised... Is it safe to taper this way? I know this can happen switching to liquid medication, but does anyone know what's happening here? Am I experiencing an increase our decrease in dose?

Share this post


Link to post
Share on other sites
VitaminB

I read through this thread completely today. Is there anyone out there who as gone off Seroquel from high doses of 600? 

 

I am at 425 (100 morning) (325 at night)...... can I dissolve a 100mg pill and take a solid 200mg pill when I get to below 300 at night? The taper might be way easier at a slow 3% pace by liquid titration. 25's and 50's are mentioned in the liquid titration process, has anyone done 100mg pills?  I could taper my morning dose this way too. 

Share this post


Link to post
Share on other sites
MNgal1960

I have read in other places about switching to liquid being destabilizing to some people and then you have to wait to stabilize to actually taper.

 

I don't know anything about getting off high doses except I have read people doing it. The problem with the larger pills is it either makes a very strong suspension or you have to use a ton of water. I tried liquid for awhile and used 100ml of water for 25mg Seroquel tablet. The stronger the liquid, the more you are affected my tiny errors in measuring.  The weaker, the less. Maybe someone who has used larger tablets could chime in.

 

I think Seroquel doesn't actually dissolve, only disintegrates. You have to be sure to shake and shake before doing a pull out of the medication because the tiny particles are just floating around in the water and not actually dissolved, so they could sink back to the bottom.

Share this post


Link to post
Share on other sites
scallywag

When changing from a tablet to liquid formulation, it can be helpful to make the switch in steps. Liquids are absorbed more quickly in our digestive systems.

 

Start with a small portion of your dose as liquid and take the rest in tablet/capsule. For example, If you're taking 200 mg, take 50 mg as liquid and the remainder as the tablet. Do that for a few weeks *or* longer, then go to half liquid half tablet.

 

If you have questions about your specific dosage please post your questions in your intro thread.

Share this post


Link to post
Share on other sites
VitaminB

I have read in other places about switching to liquid being destabilizing to some people and then you have to wait to stabilize to actually taper.

 

I don't know anything about getting off high doses except I have read people doing it. The problem with the larger pills is it either makes a very strong suspension or you have to use a ton of water. I tried liquid for awhile and used 100ml of water for 25mg Seroquel tablet. The stronger the liquid, the more you are affected my tiny errors in measuring.  The weaker, the less. Maybe someone who has used larger tablets could chime in.

 

I think Seroquel doesn't actually dissolve, only disintegrates. You have to be sure to shake and shake before doing a pull out of the medication because the tiny particles are just floating around in the water and not actually dissolved, so they could sink back to the bottom.

 

Thanks for the tip on it being destabilizing. I am on 100morning and 325night right now, so maybe I could dissolve the 25mg at night to see how it effects me. 

 

I saw that seroquel does come in a liquid from one of Alto's posts. I will have to look into that if the tablets are going to be stubborn dissolving. 

 

 

 

 

scalawagWhen changing from a tablet to liquid formulation, it can be helpful to make the switch in steps. Liquids are absorbed more quickly in our digestive systems.

 

Start with a small portion of your dose as liquid and take the rest in tablet/capsule. For example, If you're taking 200 mg, take 50 mg as liquid and the remainder as the tablet. Do that for a few weeks *or* longer, then go to half liquid half tablet.

 

If you have questions about your specific dosage please post your questions in your intro thread.

 

 

Ok. I will go back to intro thread. Thanks for the heads up on taking it slow. 

Share this post


Link to post
Share on other sites
MNgal1960

Does anyone have any reliable data on whether or not Seroquel will remain stable in water or Ora-Plus or any liquid so one could make up a few days supply at a time? Thanks.

Share this post


Link to post
Share on other sites
scallywag

MNgal: Alto's post on the first page answers a lot of questions, including the one you're asking.

 

Her answer is that the liquid is "probably stable for 24 hours." Please also read the part where she talks about switching over to liquid in stages -- initially taking most of your dose in tablet form then gradually increasing the amount you take as liquid.

 

Alto's post about Seroquel

Share this post


Link to post
Share on other sites
freespirit123

I wasn't on for that long so maybe that had something to do with it, a few months. But I have a digital scale and just chipped away each night. I was on Lunesta at the time so I'm sure that helped

Share this post


Link to post
Share on other sites
MNgal1960

Thanks Scallwag. I wasn't sure. I thought that the 24 hours was referring to the extended release form. My brain isn't working so well. I will try to read it again.

 

FreeSpirit, I have been trying to use a digital scale and dry cutting, but I find it so frustrating and my scale is hard to calibrate. I was hoping I could make up a batch of liquid more easily. But if I have to make a fresh batch every day, that will also be too difficult for me. I'm not in good shape and am usually alone.

Share this post


Link to post
Share on other sites
MNgal1960

I have been holding and dry cutting for weeks and have been continued to experience a big spike in my neuropathy. Could the inaccuracy of dry cutting Seroquel cause neuropathy? I have heard suspensions are more accurate, but I don't know if I'm mentally up to figuring out how to make a suspension. The directions are so confusing and I can't afford OraPlus.

 

Has anyone ever heard of tapering Seroquel causing neuropathy? It could be something else. I've had it in the past from other triggers. I am trying to figure out what the trigger could be. I'm barely functioning.

 

Sorry if I asked this elsewhere and forgot. My memory is shot.

Share this post


Link to post
Share on other sites
Justin

I have been holding and dry cutting for weeks and have been continued to experience a big spike in my neuropathy. Could the inaccuracy of dry cutting Seroquel cause neuropathy? I have heard suspensions are more accurate, but I don't know if I'm mentally up to figuring out how to make a suspension. The directions are so confusing and I can't afford OraPlus.

 

Has anyone ever heard of tapering Seroquel causing neuropathy? It could be something else. I've had it in the past from other triggers. I am trying to figure out what the trigger could be. I'm barely functioning.

 

Sorry if I asked this elsewhere and forgot. My memory is shot.

 

Hi MNgal1960,

Sorry to hear about your difficulties.  I have been following some of the previous instruction in order to cut down on Seroquel.  Specifically, every 2 weeks or so I reduce the dose by 5%.  This is a slightly more conservative way of reducing 10% per month as others on this board recommend.  This approach works well for me.  I'm using the following scale in order to weigh the pills:  https://amzn.com/B0012TDNAM.  I use a razor blade to cut them.  If you have trouble with the cutting being inaccurate and the target weight is difficult to achieve you could have your doctor prescribe you with multiple pills of smaller doses and cut down the smaller mg pills (for instance, rather than cutting down 50mg pill I find it easier to cut down a single 25mg pill and take that along with a whole 25mg pill in order to get back to the 47.5mg range..)

-Justin

Share this post


Link to post
Share on other sites
MNgal1960

 

I have been holding and dry cutting for weeks and have been continued to experience a big spike in my neuropathy. Could the inaccuracy of dry cutting Seroquel cause neuropathy? I have heard suspensions are more accurate, but I don't know if I'm mentally up to figuring out how to make a suspension. The directions are so confusing and I can't afford OraPlus.

 

Has anyone ever heard of tapering Seroquel causing neuropathy? It could be something else. I've had it in the past from other triggers. I am trying to figure out what the trigger could be. I'm barely functioning.

 

Sorry if I asked this elsewhere and forgot. My memory is shot.

 

Hi MNgal1960,

Sorry to hear about your difficulties.  I have been following some of the previous instruction in order to cut down on Seroquel.  Specifically, every 2 weeks or so I reduce the dose by 5%.  This is a slightly more conservative way of reducing 10% per month as others on this board recommend.  This approach works well for me.  I'm using the following scale in order to weigh the pills:  https://amzn.com/B0012TDNAM.  I use a razor blade to cut them.  If you have trouble with the cutting being inaccurate and the target weight is difficult to achieve you could have your doctor prescribe you with multiple pills of smaller doses and cut down the smaller mg pills (for instance, rather than cutting down 50mg pill I find it easier to cut down a single 25mg pill and take that along with a whole 25mg pill in order to get back to the 47.5mg range..)

-Justin

 

Thanks, Justin. I am trying to cut down the smallest tablet available using a filet-type knife that is almost as thin as a razor blade and a mg scale. I'm just really bad at it. On multiple meds. Tired and clumsy, so my manual dexterity isn't the greatest.

 

I'm below 25mg and have been going v-e-r-y slowly. I also have an autoimmune disorder so sometimes it's impossible to tell if the illness is causing the symptoms or the taper is too fast. Or if I'm just the world's worst dry cutter! :P

 

I'm glad to hear things are going well for you so far. It sounds like you are a good dry cutter.

Share this post


Link to post
Share on other sites
genlady

From personal experience, coming off Seroquel was a nightmare.  I was on 600mg. and tapered by 25mg. per month and still had sweating/chills, vomiting, mood swings, hallucinations, pychotic epidoses, head burning sensations, dizziness, sensitive to light and sound, vision problems.  Be very careful if you are sensitive to chemicals like I am .  While on anti depressants I was very sensitive to the side effects as well.  

Share this post


Link to post
Share on other sites
genlady

I have been holding and dry cutting for weeks and have been continued to experience a big spike in my neuropathy. Could the inaccuracy of dry cutting Seroquel cause neuropathy? I have heard suspensions are more accurate, but I don't know if I'm mentally up to figuring out how to make a suspension. The directions are so confusing and I can't afford OraPlus.

 

Has anyone ever heard of tapering Seroquel causing neuropathy? It could be something else. I've had it in the past from other triggers. I am trying to figure out what the trigger could be. I'm barely functioning.

 

Sorry if I asked this elsewhere and forgot. My memory is shot.

I experienced neuropathy while coming off Seroquel.  I have been off of it for five months and still have it, but not as severe.  

Share this post


Link to post
Share on other sites
MNgal1960

Hi gen. I'm sorry to hear you still have neuropathy. I decided to try liquifying my Seroquel so that my dosing was more stable and so I could make much smaller cuts in hopes of making my symptoms less severe. I just can't seem to make small enough cuts with my mg scale.

Share this post


Link to post
Share on other sites
lanah

I read that Shep only slept for 3 hours when she hit 12 mgs, i'm in the same place now also only sleeping 3 hours. I've been holding for three months now and i still get those 
nights. So i was wondering if this is typical around this dosage? 
 

Share this post


Link to post
Share on other sites
MNgal1960

I have read of people who have only taken half of a 25mg tablet for sleep, so 12.5mg. These people were not withdrawing though. It was their regular dose.

Share this post


Link to post
Share on other sites
dukke

In your experience, how much time should you wait after you have stabilized on a particular dosage, before you start tapering again? This might be a better indicator then the 1 month 10% taper rule..

Share this post


Link to post
Share on other sites
Altostrata

Most people will stabilize after a reduction within a week. We recommend reductions at monthly intervals to give the nervous system a good 3 weeks to settle down between cuts.

 

See

Share this post


Link to post
Share on other sites
dukke

Thank you very much Altostrata, I think I'm stabilized now, been so for 1 week. So I'll wait another 2 weeks to tapper like you suggest. 

 

 

Share this post


Link to post
Share on other sites
scallywag
On 2017-07-17 at 1:07 PM, dukke said:

In your experience, how much time should you wait after you have stabilized on a particular dosage, before you start tapering again? This might be a better indicator then the 1 month 10% taper rule..

 

On 2017-07-17 at 2:21 PM, Altostrata said:

Most people will stabilize after a reduction within a week. We recommend reductions at monthly intervals to give the nervous system a good 3 weeks to settle down between cuts.

 

There are some members who have reported that their symptoms didn't show up until close to 3 weeks after a dose decrease on an "anti-psychotic."  It wouldn't hurt to take longer holds than 3-4 weeks, especially at the start of your taper so that you learn your symptom pattern.

Share this post


Link to post
Share on other sites
rapunzel2

has anybody experienced weight gain when withdrawing seroquel? I know that mostly it causes weight gain while taking it. however, I have been very slim all my life and even taking seroquel didn't change that. but now I'm gaining weight, although I'm eating very healthily. I'm trying to understand, is this weight gain because of seroquel (which messes with metabolism pretty badly) or because of fluoxetine withdrawal. 

Share this post


Link to post
Share on other sites
JanCarol

I just found this article about the many doctors who prescribe Seroquel (off label!)  for sleep - 

 

National Post - Drug Safety Expert urges Doctors to stop Prescribing Antipsychotic (Seroquel) for Insomnia)

 

Yes, rapunzel - Seroquel causes metabolism and blood sugar imbalances which can remove appetite control (always hungry! never satiated!) and cause weight gain.

 

I would suggest that you not worry about your weight until you've been off the drugs for awhile - as it takes awhile to re-adjust your metabolism.  Focus on healthy eating and keep moving - work on improving your cardiovascular fitness and muscle strength and flexibility.  Some people have the weight melt away, some of us have to work harder at it after the drugs are gone (that's me).  You will never know which drug is the source of the problem, as all of them fiddle the endocrine system in some way.  

 

Looking at what is done is counterproductive.  Look instead at what you want to do.

Share this post


Link to post
Share on other sites
dukke

I'm using the Gem20 scale: http://www.betterbasics.com/guide/SW-GEM20-SIL

 

I'm currently at 46mg Seroquel, has anyone got experience of until when can one tapper successfully using this scale? Until what amount (mg)?

 

Where I live it's very difficult to get a liquid version of the medication prepared by a compound farmacy.

 

Thanks, best regards,

 

Share this post


Link to post
Share on other sites
ChessieCat

From the first page of this topic:

 

On 09/08/2014 at 5:55 AM, mammaP said:

 

You could ask your doctor to switch you over to immediate release tablets and make a liquid from them as above.  Many members make their own liquid from their tablets and get on fine with it. 

Share this post


Link to post
Share on other sites
Staz

I'm just about to re start my taper down on seroquel from 50mg which I've been on for 4 weeks or so. I'm not sure which method to go for as I have scales and also accurate lab standard measuring jars and syringes. Dry cutting seems to be too much of a pain and I got off Lyrica using the water titration method although that is water soluble.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

×

Important Information

By using this site, you agree to our Terms of Use.