Please help me to reduce Antipsychotics.Is there something I can switch to,that would stabilise mood that is less sedating than quetiapine?

[Dolly292]

Hi all,

I have previously posted about aiming to come off antipsychotics for good (due to the negative side effects experienced + my belief/& my GPs, that I do not need them forever) ...but also wanting to stay well.

In general I have found (different to the perinatal team) that my adult mental health team are generally keen to keep patients/myself on medication with no discussion of lowering dose, possibility of coming off or consideration/ acknowledgement of the negative impact the effects of this medication has on my life (now that the most stressful time has passed).

Can anyone help with my particular situation? And does anyone have advice for getting off for good & staying well?

My GP, who I really trust and think she is brilliant, told me a long time ago she didn't think id need to be on Antipsychotics forever and is in support of a gradual reduction.

I had PPP after the birth of my son in Feb 21. Coming up almost 4 years ago now.

I had to take antipsychotics for roughly 18 months which I utterly hated. I was so sedated and struggled to process and accept what had happened to me. I was in an MBU "prison" during lockdown for 2 months immediately after birth which really was the worst experience of my life, having hoped to have a baby, family, go home with my baby etc..

After 18 months, I was off all medication for about a year & lost the 2& half stone I put on from the meds.

Then after a stressful time at work in October 2023 whereby the headteacher changed my job role significantly and was effectively bullying me to resign.....a long story short, I struggled sleeping and after a couple of weeks of minimal sleep had to start taking quetiapine.

I've been taking quetiapine for a year now. I'm now on 37.5mg (down from 100mg a year ago). However this reduction has only happened because I have pushed and pushed for reduction. Not once has my psychiatrist been in support of this, I have had to speak to my GP to get them to agree to reduce my dose. I think this is utterly disgraceful on the part of the NHS psychiatrist as I clearly have been able to cope and things have improved, so therefore there is/was no need for a higher dose so many months ago. Under any other circumstances no doctor would advocate for taking more medicine than required.

Of course, I know a gradual reduction with doctor guidance and monitoring is the only way off these drugs......but it can't come soon enough.

Fortunately things are on the cusp and about to change for the better. Whilst I've been off work for a year now, I've finally secured a part a part time job & I start in 2 weeks which is great news!

My psychiatrist has left the practice and I am due to have a psychiatrist appointment with someone new the day before I start my new job.

I would love any advice for this upcoming appointment. I want to be able to ask for either an alternative drug (but must be less sedating) or an agreement that reduction of medication will be the plan going forward.

I've taken a job as a teaching assistant (I am a qualified teacher) so I'm overqualified for this & the drop in pay is huge, but I know that being a class teacher would be too much at this stage. So this venture is bittersweet, but I'm trying my best to stay positive.

However, I still struggle with the sedation from the medication. I feel so tired& sedated by 9.30pm (after taking my tablet at 8pm). I don't feel like being close to my husband or going out to socialise due to 1. Needing 9-10 hours sleep in order to function 2. Loss of confidence and finding it harder than ever to socialise and feel "normal".

Even though I'm on a lower dose, I feel like effects from this medication are huge.

At times I feel withdrawn, emotionally numb, vapid and frankly a bit dead inside. I don't feel truly like me on this medication. I don't feel like I can really care or think about others in the way I used to, my emotions feel numb like they're switched off. I just feel like I don't have the same capacity to think ahead and manage everyday life (although I guess I am managing, but I suppose I feel like I'm scraping by rather than really enjoying life).

I feel like a fairly sedated version of myself. But everyone sees the exterior and thinks "you're fine".

Please help with suggestions. My aim is and has always been to be off these medications.

I do wonder if there is an alternative to quetiapine that is less sedating. I am nervous as I don't want to switch and find myself more sedated...

I do think I probably need something to stabilise my mood at the moment. But I wonder if there is an alternative that is less sedating. I didn't have a second experience of psychosis in Oct 2023 & I do wonder if the doctor made the right decision in terms of medication.

Please help advise how anyone got off for good? I feel like this quetiapine stuff is poison & I want to get off for good one day.

Please help 🙏

[Zebunisa_at_APP Moderator]

Hi Dolly292 ,

I just want to say thank you for sharing your story with us and explaining your predicament. I too had PP in 2021 and since then relapsed two more times (2022,2023). It was only after the last relapse did I accept that I needed medication to recover and be stable. I am still on medication till this day. It is part of the process to my recovery.

I can imagine the doctors are being wary and will eventually reduce your dosage. I know that you are not happy with your current dose/medication but perhaps when you meet your new psychiatrist you can mention this to them and also list why it is affecting you. You can both work together to make a plan of action in regards to your medication.

It’s good to hear that you are getting back to work and I hope your first day goes swimmingly

Please remember be kind to yourself and don’t put too much pressure on your self x

[Lizzo30]

Of course you must titrate from antipsychotic medication with the help of your GP but yes there are natural alternatives the most important one is probably natural progesterone cream I buy it online from a recognised brand

I am a big fan of the late Dr Katherina Dalton who made groundbreaking progress in her research on PPP and PMS in fact NHS practiced the "Dalton protocol " for women vulnerable to PPP with great success but sadly big pharma got rid of it

Dr Katherina Dalton advocated natural progesterone cream to treat PPP and PMS it would also apply to PMDD which has only recently been recognised

Other natural remedies that people find helpful include

Magnesium

Melatonin

and GABA

[Jenny_at_APP Partner]

Hi Dolly292,

Thank you for sharing here. I think meeting a new psychiatrist is a great opportunity to have a further discussion about your medication.

I took quetiapine when I experienced PP and then took a low dose after having my second child (no PP fortunately) - I did find it sedating and think all antipsychotics probably have that flattening effect, but overall I didn't have too many issues. Both times I knew there was a timescale and plan for how long I'd be on the medication, so that definitely helped too and it must feel very difficult not having that.

I think it's perfectly reasonable to share your questions and concerns with the new psychiatrist - perhaps write them down and take them to your appointment (what you've written here could be a helpful prompt).

With regard to alternatives to medication, supplements etc., I would encourage people to talk to their doctor if considering this too. More research is definitely needed.

Take good care and I hope you find some helpful shared experiences here. I hope the new psychiatrist listens and take your views and concerns very much on board so you can find a way forward that you are happy with.

Sending very best wishes,

Jenny x

[WonderWomanUK]

Hi Dolly292 , thanks for sharing and congratulations on your new job!

I know how you feel about the antipsychotic making you feel sedated, I was on Olanzapine.

You mention about probably needing something to stabiliser your mood, (I’m not a professional just my own experience) but can you suggest a mood stabiliser? I was on both and still on a mood stabiliser now.

I think you should be open with your new psychiatrist, explain the reduction you had before and your keen to continue reducing or like you say be provided with a plan for this.

All the best with the appointment and starting your new role!

[Redtap Volunteer]

Hi Dolly292,

Congratulations on the new job.

I can really empathize with the way the medication is making you feel. I had PP nearly 22 years ago and I still remember that feeling. It is definitely worth speaking to your new psychiatrist to see if a less sedating medication could be suggested. The medications have probably changed since I had PP but I do remember them changing me from Sulphide to Amisulphiride which didn't make me feel quite as washed out. Doctors need to remember that you need to be able to function on these tablets.

If it helps write down all the points you made in your post. It is probably worth mentioning the fact that the job is part time and you are a qualified teacher, two factors which I think point to the fact you have put things in place to reduce stress levels. You could take your partner or someone else you trust to the appointment for back up if that helps.

It might be worth noting down all the side effects that you've noticed on the medication. I had a strange thing with one of my hands, the fingers were always held sort of splayed.

I hope you get the help you need when you see your new psychiatrist.

Also, good luck in you new job.