Changing from anti depressants to anti psychotics

[wundress]

Hi

My wife has recently been prescribed quetiapine an anti psychotic used to treat BPD. She was previously on citalopram (completely wrong drug which made things worse) and was told to stop them immediately and take the new meds.

Since starting the new drugs my wife hasn't been able to dissociate and this is making her quite distressed because she isn't used to it. She is also having awful twitches and spasms when stressed. 

I wondered if anyone had any experience of their loved ones switching over meds and what their reactions were like?

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[KateCat]

Hi, wundress.

I don't have recent experience with a family member taking antipsychotics, but one thing I do remember from when I did is that spasms and twitches used to be considered something to report to the prescribing physician when a patient is taking this category of medicines. I don't know whether you can mention this to your wife or not for fear of alarming her unduly. If not, maybe you can locate the informational pamphlet that she received with her first order and see if there are any cautions about specific neurological symptoms when beginning use.

[unicorn2014]

How much seroquel? That's also used as a sleep aid. I think the twitches go away after a week or less.

[sweetheart]

Hello wundress,

My husband is on antipsychotics for psychotic symptoms.

The twitches should die down, but they can take a few months to level out. Are they only linked to stress ?

Not being able to dissociate must be difficult for her as this would be a coping mechanism. So now she will be left 'in the real world' so to speak. It will take her a while to adjust, and you. It is positive that your wife is noticing changes.

In my experience both professionally and personally antipsychotics damp down thoughts, slow them down, quiet the brains agitated state that happens in psychosis and dissociative states.

Like I said the accumulative effects can take up to three months to reach optimum levels in the brain.

If the twitches and spasms don't settle down or get worse make an apt to get this reviewed, do you have a date for a review? How is your wife being monitored ?

[wundress]

Thanks everyone. The twitching is worst when stressed but it happens at other times too.

She is due to be reviewed in four weeks and they have said to get in touch with any concerns. Will leave it until next week and see if things are any better.

She is only on 25mg at the moment

[unicorn2014]

Does she take it at night or during the day? Maybe the twitching is a drug interaction.

[wundress]

She takes it at night but the twitching happens at any time

[unicorn2014]

I am thinking it is a drug interaction or maybe that drug just isn't right for her.

[wundress]

Yeah she's going to call the psych today. Dyskinesia is a withdrawal affect from citalopram as well though. So could be that she needs to fully withdraw before they make a decision on the new meds. However her leg was vibrating and kicking out very badly last night

[wundress]

Psych said it isn't a side effect or interaction as neither drug causes those side effects. That's a load of rubbish though because everywhere I have looked it says both can cause that to happen and particularly the quetiapine.

[unicorn2014]

She's lucky she has you.

I think that's a low dose of seroquel to produce long lasting twitches. They should go away in a week. Have you asked around in other forums where people use that drug?

[wundress]

She saw the gp this morning. They have said that the quetiapine is causing the problems and doesnt agree with her. They've told her to stop taking it and have given her diazepam to take for tonight. Tomorrow the psych will call her to discuss other medication.

Bit disappointing for her as she thought it would bring relief but instead was rather frightening.

[KateCat]

Good for the two of you for staying on top of this important issue. (I too have seen the frightening aspects of use of this category of drug, at least in one person.)

Glad to hear the doctor thinks there are better, safer options for your wife.

[wundress]

Feeling rather annoyed because no one can decide what is causing the spasms. She was told to stop the quetiapine immediately by the gp and was given diazepam for four days to stop the spasms.

The psych called today and said it isn't the quetiapine but not to take it just in case. They also said they can't see her until January so she will have to manage without any meds until then.

Really worried because two mornings in a row my wife has been manic! Like literally bouncing around and not making any sense. I wondered if it was a serotonin spike from coming off citalopram? Am also worried about the stress of Xmas and new year and how that is going to affect her without any kind of medication! It's not a pretty sight when she is off all meds.

[unicorn2014]

She is fortunate to have you. Does she have to work?

[wundress]

Yes she has her own business so has to continue to work up until Wednesday and then is having 6 days off. I'm really not happy with the psych and gp but not sure what else I can do.

[TheRealJongoBong]

After being involuntarily admitted my wife was prescribed resperidone .25 mg, which is also an antipsychotic at a very low dosage. The effects were immediate and her description of it was that it made her feel very calm. It definitely stopped her dissociation. The main complaint was constipation and a vague description that "it didn't agree with my body". She took it for for about 6 -8 weeks before stopping (she pretty much bailed on all therapy/meds from that episode) but I would say the overall effect was still positive even now.

I was pretty nervous when she stopped as she was kind of psychotic before and I didn't want to experience that again. So far she's been pretty stable and it's been almost two months.

[sweetheart]

How long was your w on Citalopram for ?

[wundress]

She was on citalopram for about 3 months. Prior to that she was on amitryptaline and before that fluoxetine. Apparently both the ssri's can make BPD worse due to fluctuations in serotonin. The amitryptaline seemed fairly effective at minimising the dissociation but did little for the mood swings.

She started taking the diazepam but is only taking half the prescribed dose because it knocks her out and makes her feel sick during the day. The spasms seem to have died down though.

I wonder if she should restart the quetiapine next week once the withdrawal from citalopram has lessened?

[sweetheart]

I can hear you're really worried about your w not being on any medication. When was the last time she was medication free and how are things different without it?

[wundress]

She was without medication for 2 weeks in July when she refused  to take her meds. She was obnoxious, impatient, dissociated, had no empathy, had tantrums, disappeared for hours and was disrespectful. I ended up asking her to leave our home because she became violent.

[unicorn2014]

Wundress, she is very fortunate she has you as a partner.

[wundress]

Thanks but I feel a bit useless at the moment

[unicorn2014]

Wundress the fact that you care and are on top of things means a whole heck of a lot. Please do not minimize your contribution. Your wife is very fortunate she has a caring person such as yourself in her life.