Quetiapine patient Information sheet
Quetiapine belongs to a group of medicines called antipsychotics which treat certain types of mental illness such as generally being annoying or not shutting the fuck up. These broad ranging symptoms are commonly known as schizophrenia.
It is thought that schizophrenia is caused by a chemical imbalance in the brain, with it producing too much dopamine, serotonin or maybe norepinephrine, to be honest were not really sure, so our top scientists said what the fuck ! And blocked the lot of them. We know that this is not ideal, but hey ! your schizophrenic, so we don't care and neither does anybody else.
Quetiapine comes in 25mg, 50mg, 100mg, 200mg and 300mg tablets. As you become more of a problem the tablets become progressively darker, with the 300mg tablets being black. If you become really annoying, your psychiatrist may decide to give you a long acting depot injection which is guaranteed to shut you the fuck up for at least 2 weeks.
As with all medications, Quetiapine may cause some unwanted side effects which are listed below.
1.) Extrapyramidal Symtoms: Quetiapine may cause your hands to shake or tremor, but hey !, look on the bright side, you can tell people you've got parkinsons disease instead of schizophrenia.
2.) Weight Gain: Quetiapine may cause you to put on weight, especially in the first few weeks. This could possibly lead to diabetes, but hey ! Don't worry ! We make drugs that can fix that as well.
3.) Sexual Dysfunction: Quetiapine may cause sexual dysfunction, but hey ! Your schizophrenic so won't have a girlfriend anyway.
4.) Blurred Vision: We thought it would be fun to make you blind as well as fat !
5.) Tardive Dyskenesia: In really, really rare cases, Quetiapine may cause an irreversible condition known as tardive dyskenesia. In order to make it easier for the general public to identify schizophrenic individuals, after 5 years of compliance or more, Quetiapine may cause involuntary muscle spasms of the face and trunk.
If you feel like your symptoms are worsening or you may be having a relapse do not hesitate to contact your mental health professional. Since we provide doctors with free holidays and theatre tickets, they will only be too happy to increase your dosage of Quetiapine or alternatively contact your nurse or key-worker, but since they can't prescribe we only give them free pens and cups. The Future is Bright ! Our top scientists are constantly striving to improve the outlook for schizophrenic patients. We do have a new medication in the pipework. When the patent runs out and Quetiapine becomes generic, this drug will become available.
Chlorpromazine 'The Mask'
'The mask was heavy and uncomfortable, perhaps lined with the dull grey of lead. Lead is perhaps a reasonable guess given the amnesia and slowing speed of thought, the growing hint of a tremor and impaired motor function. A guess is all I can make, as I cannot remember the masking, less still the reason behind such cruelty. Maybe it was thrust into place as a punishment of some sort, the penance for a heinous crime. The fit is intolerably tight, meshing intimately against flesh and bone, restricting the fine muscles; restricting expression.
Its exterior is equally difficult to describe, as I look into the mirror, the reflection is blurred and undefined. Is that me ? The detail is crude, looking to have been fashioned with blunted tools, a work of cruel irony ? The world has become dull and monochromatic, like a fish peering through the sedimentary water of a fish bowl. My feet do not look to be shackled but my steps are slow and ponderous. Although I am free to come and go, I am a prisoner nonetheless; Chlorpromazine is a cruel punishment indeed.'
After a two or three weeks I could no longer stand the medications side effects. At first I tried taking five tablets at night. The inner anxiety continued to eat away at my resolve. My stomach twisted and turned as the usual butterflies of anxiety transformed into an angry vespid colony. I would try to get comfortable in bed, unable to lie still, my legs pushing and sliding against each other. After a few minutes I would get up and walk around, perhaps even walk downstairs and sit in front of the television. After five or ten minuets I would get up again and go back upstairs. My parents would look at each other, uncertain what to say or do. Throughout the day the cycle would continue; upstairs in bed, writhing and turning; downstairs, sitting but not still; into the kitchen, pacing up and down; then back upstairs, back into bed. I was caught in an endless loop of perpetual motion.
What I was experiencing was a common side effect of anti-psychotic medication called Akathisia. These drugs are sometimes described as 'major tranquillizes' which suggests they have a calming or soothing effect, as does the literal meaning of 'neuroleptic'. It is true that initially, a dulling of ones thoughts and emotions is experienced, but the onset of Akathisia spins this on its head. Rather than allowing you to 'take hold of ones nerves' the medication pulls a hand-grenades pin and places the cocked explosive firmly in your grasp. This inner restlessness is both horrific and unrelenting. It is often described as 'crawling in your own skin'. In a vain attempt to rid yourself of this inner torture, you feel compelled to keep moving.
After another week I stopped taking the Amisupride altogether but continued on with the antidepressant and sleeping tablet. In the days after I began to vomit and stopped eating. By now my parents were getting very concerned. After one particularly bad evening my father called the family doctor. Within half an hour she arrived at the house.
“Graham, have you been taking your medication ?” she asked.
“Yes” I replied lying.
This last one was written after trying to reduce my medication
We were invited by the local community centre to a children's Christmas party. It had been snowing heavily all week. After getting the children ready we tentatively stepped outside. The ground was covered in thick, heavy snow. I tried pushing James in his pram, but the snow proved to be too deep and turned the pram into a miniature snow plough. Abandoning the pram, we took off towards the town centre. After twenty minutes of walking and carrying, we arrived rose-silly cheeked at our destination. The party was held in a local church hall. I banged the snow off my feet before opening the heavy arched church doors. The hall itself had been decorated but still looked a little austere. The children flung their coats in our general direction and scampered off in pursuit of balloons and fizzy pop.
We walked past a group of parents. A few glanced at us as we walked by and then continued their conversation. My step felt ponderous and unsure.
'It' moves from one to the next, gaining their favour, spreading the secret. One by one they fall in line, sniggering and gesturing, indulging 'its' perverse ego. I bow my head down low, squeezing my frame closer to the ground, hoping the foundations will swallow me whole.' We find a couple of seats and try our best to stow away the children's coats and bags. The group began to disperse and find their own seats around the hall. I recognise a few of the faces from the school run and our estate. Glancing towards the door, I notice an old friend of Jackie' holding up her camera phone. She nudged her friend who craned her neck to look at it. They both burst into laughter. I looked around the hall and noticed others doing the same, looking and laughing, passing on the picture and the message. A few looked towards us with beaming smiles, bitter sweet almond smiles.
I was convinced that Jackie's friend had taken my photograph and was sending it around the room. Each person was adding their own message to the picture and sharing in my humiliation.
'He is so ugly'
'Why does he have that expression on his face ?
'He's obviously retarded in some way'
'She could do so much better than that'
'He's not one of us'
'It would be better for everybody if he hung himself'
'Yes, better for everybody..us...his family...his own pathetic soul'
My wife is a big fan of paranormal television programs such as 'Ghost Hunters' and 'Paranormal Witness'. I'm quite a sceptic to be honest, but I sometimes find that I empathise with some of the lost spirits. The programmes usually portray the ghostly goings on as lost spirits caught in some kind of limbo. Due to the nature of their deaths or the hold of their surroundings, they are unable to 'move on' to a higher spiritual state. Seeing that I am still alive, how then do I identify with these lost souls ?
The answer lies in my attempt to come off my psychiatric medication. A strange analogy you might think, but please bear with me. I was diagnosed with schizophrenia a little over fifteen years ago and have been on a cocktail of antidepressant, anti-psychotic and sleeping medication ever since. During 2012 I was given the opportunity to try psychological therapy. I expressed my desire to reduce, and if possible, come off my medication. My psychologist was first class, and with his backing, my doctor grudgingly agreed to the reduction.
I started the reduction on 650mg Quetiapine (Seroquel), 300mg Venlafaxine and 10mg Zolpidem. It was explained that my chances would be better if I reduced one drug at a time. After a heated discussion, I agreed to reduce the Quetiapine by 50mg every two weeks. I eventually got down to 300mg but then began to struggle. I had been plagued with headaches, sweating and difficulty getting to sleep. Unpleasant as these things are, I had expected them. The difficulty getting to sleep turned into torturous insomnia. I became extremely paranoid and filled with anger. Sitting in front of the mirror one night, tears rolled uncontrollably down my face. In desperation I clenched my fist smashed it into my face, over and over again. The frenzy lasted a minute or so, I hated myself and the world.
My wife noticed the swelling and contacted my CPN. An emergency appointment was made with my psychiatrist and it was decided to put the Quetiapine back up to 600mg. The paranoia and insomnia quickly abated and I soon began to feel 'myself' again. The problem was, this 'self' was stabilized but listless, fat and breathless. After a decade and a half of medication, this was the only 'me' that I can remember. It felt that all the pain of the reduction had been for nothing, and I was back right where I started.
And this is where I feel akin to one of those lost spirits. I cannot definitively say how the relapse manifested itself. The catalyst was obviously the reduction in medication, but this is where the cause and effect becomes difficult to establish. Was the medication masking the symptoms of my schizophrenic illness ? Or was I experiencing some sort of tardive psychosis due to the medication itself ? My psychiatrist has no such problem with the nature of this setback.
“Is it possible that the medication has caused this ? Could this be dopamine super-sensitivity ?”
“No, dopamine super-sensitivity was a theory posed a while back and would not apply to Quetiapine anyway, as it acts on several neurotransmitters”. He replied
“But if you look at the internet, there are several studies that show this may be a possibility”
“The problem with these studies and the internet is that they take things out of context”
“Have you heard of a psychiatrist called Joanna Moncrieff ?”
His replies were unsurprising but place me in quite a dilemma. I believe my doctor is trying to act in my best interest, but as history shows, a lot of bad things have been done with good in mind. I feel trapped in some sort of limbo, living in the netherworld of mental illness. Am I living a lie ? The relapse placed enormous stress on my family. We have five children, the youngest being only two years old. I do not feel that I can put them through this again and to be honest, I do not have the will myself at the moment. They have previously had to pick the pieces up from a failed suicide attempt. Should I believe in my doctor and psychiatry or should I one day go through this process again ? I take my medication every day, but every pill begs the question, why ?