Advice on Quietapine meds

[Nbpp]

Hi All, I'm hoping you can help me as I'm at a loss what to do.

I had PPP in 2020 after having a traumatic birth, I was put on a section for 8 days then was discharged. I had support for the 1st year through the perinatal team but my experience coming off the Olanzapine was a nightmare. I wasn't given any proper support and found it hard coming off it the end of last year. I eventually got help through work via an occupational health nurse and councilling via work and a new trauma based team who diagnosed me with PTSD.

The new team has helped me massively coping with my symptoms however, due to both my husband and myself changing jobs at the same time and the mortgage being up for renewal I believe this triggered a relapse and was sectioned for 3 weeks.

I have since been discharged but I'm not happy with the dose of Quietapine I'm on as the side effects are horrible. I'm on the maximum dosage modified release and my GP doesn't agree that I should be on this dose either. The issue is the original psychiatrist has washed his hands of the situation and from what my GP says no-one is accepting responsibility either. She wants to continue on the meds until someone accepts responsibility but I'm not happy with this outcome as I wanted to go back to work next week on a phased return to work. Money is still an issue but I feel like I'm ready to go back to work, they have been really supportive but I'm at my wits end.

When coming off the meds from 800gm MR what is the next increment to come down to?

Thanks in advance xx

[hgallo Volunteer]

Hi Nbpp, I'm hannah one of the volunteers at app. I take quitiepine for bi polar but I'm on quite a low dose. That sounds very frustrating. I know the SR come in increments of 50 mg so usually they can gradually decrease you. That is a big dose and you've every right to ask to decrease it.If your gp refuses I'd be tempted to ask to speak to the practice manager. Also PALS maybe able to advocate for you. Good luck with it all. Here when you need x

[Nbpp in reply to hgallo]

Hi hgallo,

Thanks, it is the GP who owns the practise who's looking after it. I had made several complaints whilst I was an inpatient so I think the next step is PALs as I don't want to wait another 2 weeks to be told the same thing.

Thanks for your support.

X

[Ellie_at_APP Partner]

Hi Nbpp

I'm sorry you're having trouble seeing a psychiatrist so that you can reduce your medication. It must be hard being on such a high dose.

I had a relapse earlier this year, but have been discharged from the mental health team, but I've been told I can request a medication review through my GP, so they can advise me on reducing medication. I don't know if this is possible for your GP to do?

if they're having problems doing that, there is a second opinion psychiatry service with National Centre for Mental Health who may be able to advise you. It is a free service, but you need to be referred by your GP or psychiatrist. Dr Ian Jones is the specialist in PP and bipolar.

ncmh.info/resources/cups/

I hope this is helpful, take care,

Ellie

[Nbpp]

Hi Ellie,

Ah ok, I didn't realise that service was available nor do I think my GP is aware of it either. If I don't get a response from PALS then I'll try asking my GP for the referral.

Thanks for your help. X

[Jenny_at_APP Partner]

Hello Nbpp,

This sounds like a very frustrating situation for you. I think it can be quite complicated when it comes to prescribing and management of medication between primary and secondary care, but of course this isn’t something you should have to worry about as the patient.

PALS is a good option, as is contacting the second opinion service as already mentioned if it can’t be resolved locally. I used to work in an NHS commissioning organisation and these kinds of issues between primary and secondary care would be referred to the medicines management team (via the GP surgery or via the PALS attached to your local NHS commissioning organisation) – the GP surgery could try obtaining advice from their local medicines management team if they haven’t already, if not around the medication itself then the issue of who needs to take responsibility. This may well be something they've already tried and/or the route PALS takes but I thought I'd mention it just in case it's at all helpful.

I hope you can get this resolved.

Best wishes,

Jenny x

[Fixanothercrown93]

hi Nbpp - I realise you posted this a while ago so I hope you managed to get sorted.

If not then my next advice would be for your GP to speak with community mental health team and get you assigned to a CPN and community psychiatrist.

We had a similar problem with transitional care when my wife was discharged back to the GP x