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svr

Which medications can compliment Quetiapine before sleep?

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Hi,

I take generic Quetiapine 200 mg for anxiety and insomnia. There was a lot of improvement but I still suffer from anxiety/panic attacks. My doc tried increasing the Quetiapine dose up to 400 mg but I didn't notice any improvement. Looks like 200 mg is the optimum dose.

If my sleep quality is good, the day will be very calm and relaxed.

I observed that if I take Quetiapine 200 mg + Diazepam 10 mg before sleep then my anxiety/panic attacks are totally under control. Sleep quality was very good. There was no daytime drowsiness either. It was just perfect. But the problem is that benzodiazepines are not for long-term use.

So, we have been trying to find other medications that can augment Quetiapine just like Diazepam did.

  1. Quetiapine 200 mg + Trazodone 50 mg caused a lot of drowsiness and daytime dizziness. I could not take the combination for more 5 days.
  2. Quetiapine 200 mg + Tegretol 300 mg actually reduced the sleep quality and increased anxiety (Tegretol and Trileptal reduce the effectiveness of Quetiapine).
  3. Quetiapine 200 mg + Lithium caused a lot of daytime drowsiness but there was no improvement in my anxiety/panic attacks.

What other medications can I take along with Quetiapine before sleep to further improve the sleep quality?

Is anyone taking any medications in addition to Quetiapine before sleep?

Thank you for your responses.

Edited by svr

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Low dose remeron, gabapentin, topamax, vistaril, Benadryl 

Also low dose of the z-drugs (ambien, lunesta etc.) 

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Also, different doctors have different philosophies, but some will use a bento on a regular basis.  Mine does and I’m by far not the only one.  If nothing else does the charm nearly as well, it’s at least worth considering.

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2 hours ago, dancesintherain said:

Also, different doctors have different philosophies, but some will use a bento on a regular basis.  Mine does and I’m by far not the only one.  If nothing else does the charm nearly as well, it’s at least worth considering.

Thank you for the response. Asking my doc is not an issue but I am more worried about developing tolerance to benzos pretty quickly. If I may ask, how long have you been taking? Do you take every day? 

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Sure—I’ve been taking Ativan on a daily basis since I got out of the hospital in November 2017, but I’ve been on either Ativan or Klonopin most times since 2008.   I think there’s actually a separate thread on this topic...i would search for it but I’m on my phone.

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I'm another who's been on a benzo long term.  I take .5 mg Klonopin (Clonazepam) and have been for about 13 years!  I have had to up this dose ON OCCASION, but never for more than a couple months at a time.  My pdoc is perfectly fine with my taking this dose indefinitely (and perhaps even a slightly higher dose).

I am also on Trintellix - 10mg.  I'm not sure of you have the same issues as I do, but they sound similar.  I have sleep anxiety (but ordinarily am a great sleeper, thank goodness).  I also have GAD.  This combo has been working great for me.

Prior to this, and for quite a few years, I was only on .5 mg Klonopin but did need something else to quell the anxiety further, hence the addition of Trintellix a little over a year ago.  I have also been on Seroquel for sleep/anxiety before but was on 25-50mg and just for a short period of time until my sleep anxiety was under control again.  My understanding is that lower doses of Seroquel are best for sleep - ?

Definitely bring it up with your pdoc and take care.

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I would not say they are only for short time use. What the PI says concerning dose for most people is that short term is best and longer term use requires regular reevaluation. 

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On a related note, I’ve taken one dose or another of Ambien every single night for over ten years. I don’t abuse it. It’s the only thing that has ever worked. So here I stay. And I take 100 mgs of quetiapine at the same time. 

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