Quetiapine?

[ParanormalChickenGeek]

I'm now off sick from work as things have taken a turn for the worse. I feel the lowest in mood I've ever felt, the anxiety and agitation has returned and the BDD is obviously still very prominent.

I saw my psychiatrist yesterday and he's prescribed me Quetiapine (I also take Venlafaxine)... I'm just not sure about it. I've never used an antipsychotic before and I'm not sure I need it.

Does anyone have any experience of using Quetiapine for anxiety/depression without psychotic symptoms?
Also- the weight gain side effect is a big fear for me. Anyone have any advice on this?

[Albus Dumbledore]

Hi,
I'm on quetiapine for anxiety and as a mood stabiliser.
I have had weight gain, and I feel more hungry than I used to. However, I know that some of the weight gain is due to me comfort eating. I have gained a significant amount of weight in the last 5 years since I first went on the quetiapine, and periods where I haven't been on it, I have managed to lose weight. I would suggest trying to do daily exercise and make sure you are eating a healthy diet. I have come to the conclusion that whilst I would love to lose weight, my mental health is far more important. If in the future my mental health calms down and I am able to gradually reduce the quetiapine, I will focus more on my weight then, but for now, I just have to accept things the way they are.

Because I'm on a relatively large dose, I do feel very sedated about 1-2 hours after I take it, so my psychiatrist has recently reduced my morning dose and increased the evening dose so I'm not so tired during the day.

It has been very good for my anxiety. Without it, I struggle to leave my flat, but when I'm taking it properly, I can just about manage to hold down a full time job. I haven't noticed a change in my depression with quetiapine though.

[tiptoes]

I take quetiapine mostly as an antidepressant and as a mood stabiliser. It has been very good at moderating my ups and downs as well as helping with the restlessness and agitation that comes with them. It has been the only medication that has come close to controlling my mood disorder.

I have gain very little weight on it. I recently had my dose increased and during the first week I put on weight in the first week but two weeks later I have already lost about half of the gain. For me it seems that it makes me crave fattier foods so I have to be a little mindful about the choices I make. I have been on it three years now and my weight has stayed approximately in the same weight range just more time at the higher end of that range than before.

It can be quite sedating but I did start to get used to it. If I find myself without it I can't sleep which is a good incentive for me to make sure I get repeat prescriptions in time and make sure I remember to take it with me when away from home.

It can be a bit scary when they suggest trying an anti psychotic but this drug is much more than an anti psychotic. Depending on the dose you are on there are a range of different receptors it can act on which means it can be useful for a fairly wide range of symptoms not just psychosis.

[ParanormalChickenGeek]

Thanks guys that's really really helpful.

I'm happy with the sedation aspect as I struggle to get to sleep/remain asleep. I took it last night (only 25mg) and I did feel relaxed and tired after taking it, slightly like a 'drunk' feeling. I'm guessing that'll wear off as I get used to it. My psychiatrist has only asked me to start and increase up to 50mg so hopefully a smaller dose will reduce the likelihood of negative side effects?

Can I ask a few more questions? -
Was the weight gain dose dependant? Would I be less likely to become hungrier on a lower dose?
Has Quetiapine caused constipation for anyone? I already have severe constipation from Venlafaxine so I don't want to exacerbate that problem; I already go 2 weeks on average without bowel movements!

I'm so lost, I really really hope this medication works. I can't go on like this, I'm breaking day by day.

[Arienette]

I'm on 300 for bipolar. It has helped stabilise my moods loads. I've also noticed things I wouldn't have expected, in a good way, like my thoughts are so much more consistent and normal I guess. And I've not been hearing voices.

I'm not on them for psychosis. Just the mood stuff.

The appetite increase is noticeable but totally controllable. It's not like olanzapine. I was initially on olanzapine but had to stop because the side effects were unacceptable for me, so I was put on Quetiapine instead. It has helped..

Negative effects are quite mild but for me they include:
- a bit of extra tiredness but I'll take that if I'm well in other ways
- a bit more appetite so I'm trying to eat more wholesome foods and lay off the chocolate
- I twitch and jerk sometimes but no one else has pointed it out and it's not very disruptive to me. Just a jerk here and there when I'm sat still.

Good stuff:
- more stable mood (no more mania or depression- properly anyway)
- more consistent and manaeable thoughts
- I'm stable enough to use everything I learnt in therapy
- no suicidal thoughts or moods

All in return for a little extre sleep and food.

Try it. And stick with it because to begin with I struggled with it but I adapted to it over time. The only really bad thing I've found is if I miss a dose because I forget to pick up my script or I go away, the withdrawal is pretty quick and unpleasant but it just reinforces that housed to take it I guess. And so I take it again pretty quickly so I'm not skipping meds for long and becoming unwell again. So I guess there's a silver lining right there. Xx

[Epicene]

I've heard of antipsychotics being used in people with severe body dysmorphia as it can help with the fixed beliefs and distorted self image. It's an off label use, but just so you know you're not alone in being prescribed it for BDD/anxiety.

I take quetiapine for voices but did notice it also helped augment the venlafaxine mood-wise. I hope it works for you.

[tiptoes]

For me the weight gain has come from changing the dose whilst I get used to the different demands. I seem to be more susceptible to it when the dose is changed due to low mood rather than high mood but that is probably because I have a tendency to comfort eat when low anyway.

It can cause twitching and jerking like Arienette said, the only time I personally have had it was when I was on high dose following a manic episode. I self discontinued taking it not long afterwards so don't know if it would have gone away. I haven't experienced it at all the second time around at a range of doses.

[ParanormalChickenGeek]

Thank you for your replies, so far it's not affected my appetite so I really hope it stays that way.

I have noticed one awful side effect; restless legs. After taking the tablet I find it impossible to keep my left leg still and continually have to change positions. It is uncomfortable and really frustrating as I'm so tired I just want to sleep!!
Any ideas?

[Arienette]

When I get this I exercise. It helps get rid f the sensation for me.

[Anne with an e]

I take 25mg of quetiapine (as well as cipralex) for depression/anxiety, and I've never had an issue with weight gain.

I've had restless leg syndrome since I was a little kid, so the restless leg thing hasn't seemed unusual for me, but a side effect that does bother me is really weird dreams and restlessness (tossing and turning) through the night.

Despite the negative side effects, though, I love it. The sedative effects haven't worn off much over the 6 months I've been taking it, so I can actually sleep at night, which I've almost never been able to do before. And I don't know which of my meds is responsible for helping with my depression, since my dose of cipralex was increased the same time I started taking quetiapine, but my mood has gotten significantly better since that happened.

[Rosie3901505]

I took it for mood control and psychosis, but I've had issues with anxiety as well. It made me extremely depressed and I've had to get put on an ssri to combat that side effect. Its amazing for sleep though. But it makes you SO TIRED during the day. It was bad enough that they took me off of it because I was so tired and depressed. As far as weight gain goes I gained X in 8 months. I still take it sometimes for psychosis and mood as needed, but it's awful as a regular thing. I felt so slowed down and depressed but I was also on a very high dose. I was on 300mg at one point. 25mg is okay but if you have to move up I suggest extended release if you're crashing a lot or are very tired all at once

Hope this helps!

[ParanormalChickenGeek]

Thank you- you're all so helpful!

Arienette- I'll try the exercise thing, thanks!

Anne- I've noticed weird/distressing dreams and I wake up feeling like they're real and I have a headache. Half an hour later I feel a little better though. I hope this passes. I do like the sedation as it helps me get a good nights sleep, I'm just worried I'll be too sedated early morning when I do return to work!

[Bear]

Just thought I'd pop in and leave some ideas re restless legs.
I used to suffer with this terribly. I found if you have a board at the foot of the bed, pressing my feet against that helped.
Also cold helps, I used to fill a hot water bottle with really cold water and put that on my legs.
Hope you find something that works, I hate this side effect with a passion!
X

[Anne with an e]

I wish I could say the dreams will pass, but I haven't found that yet. Maybe they will for you, though!

I know exactly what you mean about waking up feeling like they're real. Sometimes I'll get this memory of a dream during the day, and it feels like a normal memory except it's usually really bizarre! And I've started to notice it's kind of like the dreams remember each other or they're connected somehow, because I'll have memories of other dreams while I'm dreaming, and the memories seem related to whatever I'm dreaming at the time.

...Okay, I think I'm starting to sound weird, now. Anyway, I hope they settle down for you.

As for waking up in the morning, I tend to find I wake up tired. And since I'm not in school or employed right now, I often sleep until noon or 1pm. The times I have had to get up earlier, though, I've found I'm a bit sleepy for a while but it's not too bad. That being said, I worry about when I have to start getting up for work as well. Let me know how you find it!

[ParanormalChickenGeek]

Anne- oh my god everything you said makes perfect sense! I keep dreaming about stuff and in that dream I think about stuff from other dreams I've had and it all seems so real!! What a bizarre side effect eh!!
I'm hoping I'll be back to work in four weeks or so, so of course I'll be updating on how it goes.

[Anne with an e]

It's the weirdest!! I'm so glad someone else relates!!

[Arienette]

I have really vivid dreams too - and sometimes i can get confused about what i dreamed and what happened in real life.

[tiptoes]

Now you mention it since I've had my dose increase my dreams have become more vivid and like real life with small aspects that are pretty twisted. How odd.

[Anne with an e]

Arienette, I experience the same thing! "Wait, did that really happen or was it a dream...?" I'm starting to think of it almost like having two separate lives - my real life, and the weird one in my dreams.

[property]

I've been on Q for two years now, at varying doses, my weight gain stopped awhile back, I did need to put weight on, I just really wasn't comfortable with it.
The dreams are still absolutely bonkers though. Which are frustrating, oh well. IRestless legs come and go for me.

I'm also managing somehow to work in Q. I'm night staff in a palliative care unit, and have found if I have a larger dose in the morning I can sleep and it helps change my sleeping pattern, I do want to talk to my doctor about this though.

One thing though, for me, Quetiapine and alcohol is rarely a clever idea, hangovers are just so much worse....

[ParanormalChickenGeek]

I'm sorry to bump this thread again but I've read quite a bit about Quetiapine online, I've looked at research papers and everything says that it affects your metabolism and you gain weight!
I absolutely CANNOT have this happen, it'll make me so much more depressed if I gain!
PLEASE tell me there's someone out there on Quetiapine who hasn't gained!? I've started to notice I'm feeling more hungry, but I don't know if that's me being paranoid...

[Anne with an e]

I'm only on 25mg, but I was on 50mg for a while and I have NOT gained any weight. I've actually lost some. I do know weight gain is a common side effect, but it's one that hasn't seemed to affect me. It might be because I'm on such a low dose, though. How much do you take?

[tiptoes]

I've been on it 2 and a half years and my weight has not fluctuated more than it would do normally.

When my dose is increased I do notice I get more hungry for the first few weeks but it settles down.

[ParanormalChickenGeek]

I'm only on 25mg, I'm due to increase to 50mg this week but I'm not going to as 25mg knocks me out, so I'll just continue on 25mg for a while. I'm so frightened it'll make me fat.

[Arienette]

probably depends on your dose.

I'm on 300 and have noticed a change but it's nothing that, with some effort and awareness, can't be controlled. (i think, it's early days yet in controlling my appetite, and weight on quetiapine)

for me i think it must over blood sugars or something bc i get very shaky very easily, even if I've eaten enough, so obviously i eat more. I'm exercising though to try and control my weight and keep it steady instead of climbing and climbing.

hugs. give it a go, and maybe have a little margin for adapting, but maybe after a certain amount that you agree with with your team, you can say, no, enough is enough??

at 150, there was no change to my weight or appetite. i stayed the same the whole time.
xx

[tiptoes]

Quetiapine is a little odd in that it is more sedating at lower doses than it is a higher doses and you do get used to the sedation.

I've recently had a 150 mg dose added in the morning and after about 2 weeks I barely notice that I have taken it.

[ParanormalChickenGeek]

Mine is immediate release, taken at bedtime. Does this make any difference? I've read on some forums that people who take it at night only don't feel the increased hunger as they're asleep and it's not present when awake.
I'm so scared that I'll be fat and sedated forever.
I'm desperate for this to work but I'm so so frightened.

[Arienette]

Give it time. When I was on immediate release I slept a lot but they changed it to extended release. In the long term I don't know the effects but definitely give it time and a chance. Xx

[tiptoes]

I'm on the immediate release and take it twice a day.

I know at first it feels like the sedation will never go but it will get easier. At first my head was so fuzzy for most of the morning and sometimes into the afternoon but now I'm used to my dose I've been up and alert since 8 am and actually have much more energy that before my dose was increased because I'm no longer sedated by my depression!

I used to have an eating disorder and was concerned about the weight gain too but I still fit into the same clothes as before I started on the quetiapine. It might be notorious for weight gain but it isn't an inevitability

[ParanormalChickenGeek]

Thanks guys, you're all so helpful.

Tiptoes - that's reassuring, thank you. I was thinking of stopping it today until I read your post. I'll keep on with it and see how I get on.

[starlightx0x]

Quetiapine is a good drug and works but is made me put weight on and its a bastard to get off especially if you go cold turkey. The withdrawl is horrendous.Your scalp itches, you shake, vomit, hot and cold sweats, have the shits. I'm glad I stopped taking it.

[Epicene]

I gained weight BUT with medication, the weight tends to drop off once you stop taking it. So if you gained weight and this panicked you, it's not something that's irreversible.

[Steel Maiden]

If you're only having a bowel movement every two weeks you really need to see your doctor; I had that on clomipramine and I took lactulose every day which helped.

[Arienette]

^^^ if that is the frequency of your bowel movements then yes you need to see a dr.

Irregular bowel movemet can have really bad consequences.

[tiptoes]

How are you getting on?

[ParanormalChickenGeek]

Re: the bowel movements, my GP is aware- it's a side effect from Venlafaxine and I'm prescribed Laxido but it rarely works so often I resort to suppositories :-(

I'm still taking the Quetiapine but it's making me so tired! As soon as I take it I'm knocked out within half hour, which is a pain as I never know when to take it because too early means I'm in need before 9, and too late and I can't get up before midday!
My anxiety has reduced but that may be because I've decided to leave my job, I don't know.

Regarding the weight- so far so good I haven't gained, but I am finding it hard to lose :-(