Can stop abruptly Quetiapine (25mg daily) after 37 days of use?

[Luisitosax]

I was taking 25mg of quetiapine (Seroquel) at night for one month. My doctor told me to stop taking it without reductions because of severe fatigue and somnolence during the day. I am not sure if I am going to have withdrawal problems. Any suggestions?

[lindseymxrgan]

As someone who has been taking Quetiaoine daily for a while, I would not encourage any kind of sudden stopping of this medication at all. Granted, I’ve been taking it for much longer than a month, and my dose is relatively high. I also take it along with Trazodone at night. I can pretty confidently say that I have a much much stronger dependency on it than you probably do. There have been actually several instances where my pharmacy made stupid mistakes which left me without any of my medications for over a week, and let me tell you, I was ready to sue my pharmacy and give them some pretty nasty feedback about how their mishap left me EXTREMELY ill in bed for nearly an entire week, with nasty symptoms lasting for several more even after I got my refill. If you look up Quetiapine withdrawal symptoms, the list is LONG and contains extremely unpleasant physical and mental side effects. I don’t reslly know why your doctor wouldn’t have you slowly come off of it with such a strong medication and I’m not surprised that you felt really crappy. In my opinion it’s not only unwise in respects to your process of overcoming your illness, but very dangerous with the withdrawal symptoms it can give. I am being treated for several illnesses, Quetiapine prescribed for major depressive disorder, and despite being very healthy and happy for almost a year and a half, those withdrawal symptoms were bad enough that within days of running out I was totally ready to die again. You should always try and stick with a medicine like this one for as long as you can, and I can tell you that just a month on it isn’t enough time to feel better. HOWEVER, this medicine for me was my saving grace, and after three other failed antidepressants and six other failed antipsychotics, I was finally able to get better and live my own life.
As always, everyone reacts differently to each medicine they get put on, and especially with antipsychotics, if the side affects are unbearable as they so often can be, and it might not have been right for you. Obviously I don’t know your specific situation, all I’m saying is that this one medicine really saved my life and, and unless you couldn’t deal with the effects, I would encourage you to try and stick with it longer.
It seems as though you’ve already gone off of it but in case anyone else comes here looking for advice,
DO NOT STOP TAKING QUETIAPINE COLD TURKEY!!

[Paxiled]

Nobody can tell you this, unfortunately.  People have different reactions.  Tapering off is always the safest option, although one month isn't much time being on it so that reduces the chances of getting bad withdrawal symptoms.  Still, why not do it the safe way?  And this is why it's usually best to see a psychiatrist who seems to understand these meds rather than a regular doc, which is what you seem to be referring to -- I mean, this is basically what Seroquel does unless you get used to it over time -- the manufacturer tried to use this to make lemonade out of lemons by marketing it as a sleep remedy until it got sued and fined by the FDA for doing that.  It sedates most people.  

[Luisitosax]

Thanks Paxiled. In fact my doctor is a Psychiatrist. I asked him about the possibility of a withdrawal reaction and he assure that one month at low dose (25mg) is not going to have any bad impact. I stopped taking the seroquel one week ago and I am feeling very fatigued, depressed and lack of motivation. It seems like it is a withdrawal symptom from seroquel, but I am not sure really.

[Paxiled]

It's hard to say.  If it lingers, I'd go back on the Seroquel at the last dose at which you felt fine and do the taper.  And get a new psychiatrist -- you want one who is always looking out for you, not one who is in a hurry.  Anyone can have a withdrawal reaction, as it's so individual a thing, even if the conditions are such that most people won't get them.  Maybe you were one who did.  For a psychiatrist to say it can't be withdrawal, well, I went through that once and it cost me my life.   Now, that isn't going to happen here, it was a much more difficult med I was on for a long time, years, but it forced me to research this stuff more than I cared to and the one consistent thing about these meds is how inconsistent they are.  A psychiatrist should be open to that possibility.  But as you say, it is hard to know when the symptoms we get from withdrawal are often intensified versions of what we were feeling anyway that brought us to the drug in the first place.  Trust your instinct, you know if you feel something different than what you felt before.

[Luisitosax]

Thanks. In fact when I stopped the seroquel I had maybe 5-6 days of improvement on my depression, motivation and energy. But after 6-7 days the symptoms returned but with less intensity. With seroquel I was on bed almost all day crying and suffering. Now I still have lack of energy and mild depression, but the crying and time in bed have diminished a bit.

[AnxiousNoMore]

You didn't say how you were before you started taking the med. Did you have lack of energy and mild depression?

[Luisitosax]

I was just anxious and depression was mild. I did not have lack of energy or lack of motivation.

[AnxiousNoMore]

Anxiety and depression feed off each other in a vicious circle escalating the problem, so it can be difficult for the poor victim to figure out which problem he really has or which is the worst. Going off the med can be difficult to analyze because of the above.

[Paxiled]

If you stop a medication and right afterward get symptoms you've never had before, it's withdrawal most likely -- never overlook the obvious.  Your doctor will, so you have to look out for things.  The fact the symptoms are diminishing may mean the withdrawal is passing, assuming that's what it is.  We often feel great upon quitting a med because it has been making our brains work in an artificial manner and there are side effects we might not notice especially if the improvement in our mental state is good.  When we quit, there's that time of clarity that comes with a properly functioning brain, but if you suffer withdrawal, it will overwhelm that small window of clarity.  If your original symptoms come back, that will also overwhelm that moment of clarity.  The clarity you felt is the real you, provided you were able to actually cure the thinking that made you need the drug in the first place.  But some of us need medication, nothing else works, and we do the best we can with it.  All these meds will tell you to only stop them with a slow taper off in the materials that come with them or on their websites.  That wasn't always the case, but litigation and regulation force them to say that now.  It would be better if doctors would tell us that and act on that, but doctors are what they are, very busy people who are trying to maximize their income and time like every other business person.  We need to advocate for ourselves with out docs when they seem to be not paying attention.  Nobody can diagnose you over the internet, it's really hard to tell sometimes if one is suffering withdrawal or just the thing that caused them to go on the med.  Since your symptoms are different, assume it's withdrawal, but if it's dissipating, you might be heading for clear skies.  If it lingers, then you need to take action so it doesn't become the new you.  

[Luisitosax]

Wow, Paxiled, that was a very helpful input, thanks a lot. What I am seeing is that before I took Cymbalta, I was on just only 0.5mg of clonazepam daily, and that was enough to my anxiety, but not for my depression. Now that I am on Cymbalta 60mg and clonazepam 1.5mg daily I do not feel really calm, and my depression is still there, mild, but it is there. And my anxiety is not controlled in a constant manner. I think withdrawal from quetiapine is messing with the combo. 12 years ago I used the same combination (60mg of cymbalta and 1.0mg of clonazepam daily with good success). Hope I will improve in a copuple of weeks once the quetiapine leaves.

[Paxiled]

There is another possibility.  Sometimes when we go back on a drug we quit before it doesn't work the same.  Cymbalta is in a class of drugs that is intentionally stimulating, more so than ssris, and when someone has an anxiety problem the snri class can make them more anxious because of this.  The fact it didn't do this to you the first time doesn't mean it won't the second, as these drugs are just weird because our brains are not well understood.  Just a possibility.  

[Luisitosax]

You are right. Maybe this time my brain is not "accepting" the same way the cymbalta. Who knows. I tried before Zoloft, and I was a mess, all day in bed crying for 20 days. I think I was dying. That was when my Dr change to Cymbalta. Now I am not sure at this momernt if it is possible to change to another AD. My main problem always since I was very young (I am 51 now) has been anxiety, not depression.