Bipolar 2 hypomania and anxiety worsening on Venlafaxine and increased quetiapine - advice please
Posted , 3 users are following.
Hi Everyone.
I've been on the forum previously regarding the venlafaxine but could do with some urgent advice and support.
I was diagnosed just over 2wks ago with Bipolar 2 by my psychiatrist. I was told by him that I was clearly hypomanic, did not have depression and should never have been treated with antidepressants but with quetiapine instead. I was given a prescription for 1 week each of 100, 200 and 300mg of quetiapine so that I could reach the therapeutic dose. He did not taper or stop my venlafaxine which is currently at 150mg XR. I began to improve but last night (after 6 days at 200mg of quetiapine) my anxiety is worse, feel I need to move about and feel like the inside of my head is really hot. I have decided to reduce from 150mg of Venlafaxine down to 100mg at lunchtime today as was feeling aggressive and to be honest quite scared. I think that the raised quetiapine is pushing up the effects of the antidepressants and making the hypomania out of control. Does anyone know what I should do for the best? Feel like quitting the ven cold turkey as I'm pretty worried with the way I'm feeling. Pretty stunned that the psychiatrist left me on the antidepressant when he said I had no depression and was hypomanic. Any help would be much appreciated as feeling a bit desperate and losing faith in medical profession after being wrongly diagnosed for so long.
0 likes, 4 replies
matthew52441 jacqueline66035
Posted
jacqueline66035 matthew52441
Posted
Hi Mathew . Thank you so much for your reply. It's much appreciated. I have discovered what the problem was after a rushed visit to hospital to see a CPN. He checked the psychiatrists follow up letter and discovered that my venlafaxine should have been dropped from 150mg to 75mg while the quetiapine was raised up. I went to the psychiatrist with a different CPN and the psychiatrist neglected to tell either of us about the dosage decrease so I've been unwittingly taking twice the recommended dose! The CPN today has said it's pushed me into a worse hypomania as both meds have lifted my mood. Have got to come back down now without help from meds as I have a paradoxical reaction to all benzos! Could be a long night! Thank you for your support. How are you managing right now? Hope you are in good health at the moment. Jackie
betsy0603 jacqueline66035
Posted
My question is, what were you feeling on the Ven that your doc then prescribed the Q? It seems that adding the Q is what has made everything worse, so why would you focus on coming off the Ven? I would go back to just Ven and reassess.
People who are put on antidepressants are often later diagnosed as bipolar and then an antipsychotic added to treat that, when in reality they never were bipolar before ADs - it is an iatrogenic condition caused by the meds!
What was your complaint that led to the hypomania diagnosis? Irritation? I was much more irritable, easily angered, while on higher levels of Venlafaxine. I have been tapering slowly over three years and am now on 3.75 mg, and I rarely have anger flashes compared to before.
The need to move is called akathesia and is another iatrogenic condition, caused by the meds.
I think your current situation is from being overmedicated, and that what really needed to happen was to come slowly off the Ven without adding anything. People end up on drug cocktails all the time because they go into tolerance withdrawal or have side effects from Drug #1, which Drug #2 is added to treat, but it causes other symptoms for which a third drug is added (for instance, a Z drug for drug-induced insomnia) and so on. Hard as it is to come off of one antidepressant due to withdrawal, it is even more difficult and time consuming to come off multiple drugs.
You've only been on the Q for six days so it isn't too late to back out of that one and reassess. I'd resume the full amount of Ven since a 33% drop can definitely worsen your symptoms through withdrawal!
Feel free to message me if you would like I know people here only want to hear positive stuff. Well, the positive is that your symptoms can actually get better through a sane, slow taper off of Ven!
jacqueline66035 betsy0603
Posted
Hi Betsy. Thank you so much for commenting. The bipolar diagnosis is correct. I was unwell last year. 6 weeks of 3hrs sleep a night which instead of making me tired made me full of energy. I felt amazing (apart from lying in bed for hours longing for sleep that is). I got a huge hike in libido and started a relationship with someone really unsuitable. I also had to be on the move the whole time and spent alot of money on sports gear and started cycling/walking - I am not a sporty person at all by nature! My sister could not understand my behaviour and told me I was acting out of character. I was put on mirtazapine to help with sleep and with the first tablet got an incredible high which I told the doctor about - they did nothing. After 5 weeks I was so agitated the doc switched me to citalopram. 6wks later I was so bad the doc told me to stop immediately (No taper). After 5wks of awful withdrawal they put me on ven (which didn't help). They gave me quetiapine which calmed things down. After a few months I was able to taper off everything but in spring this year the sleep problem came back and the same thing happened with spending, libido, new relationship. Was put on ven and have never felt so ill with anxiety, intrusive thoughts, aggression. That's when I got the bipolar 2 diagnosis and quetiapine was increased. Ven was lowered yesterday and I'm feeling more relaxed today. It's been a really awful experience and one that could have been avoided if the psychiatrist had told me to reduce the ven at my appointment.