AboutMary E Scott, RPh, CGP Expertise I am a certified geriatric pharmacist with over 23 years experience as a long-term care consultant to nursing homes. I also do community-based consulting on an individual basis. My facility-based monthly newsletter on pharmacy topics is read by nurses in over 200 long-term care facilities in 5 states.
Experience I received a BS in Pharmacy in 1980 with post-graduate work in public health. I have had a Consultant Pharmacist license since 1984.
Organizations American Society of Consultant Pharmacists .I received certification in geriatric pharmacy in 1998.
Question QUESTION: "i have been put on seroquel for anxiety plus mirtazapine can you let me know the side effects of coming off these medications as i believe i was wrongly diagnosed as delusional and psychotic. Doctors tried to fool me into thinking i was put on them for anxiety i am on 60mg of mirtazapine a day and 25mg of seroquel. I have been on these meds for around 9 weeks, my anxiety has not improved but gotten worse and now i actually do feel depressed i was on ativan and had a seizure after coming off it under a drs guidance. does this make me more likely to have problems coming off stated drugs? Is seroquil really used for anxiety and if not psychotic can it cause me to become so by going off it? How can a dr get things so wrong all i was suffering was extreme anxiety i am 55 yrs of age and have never had a mental illness unless you count anxiety as such. Are the two drugs safe to take together? I have found this has ruined my life and some days cannot think straight mainly due to the worry of being put on them. Can i safely cut the mirtazapine down to 30mgs? Thank you for any help you may offer Angie"
ANSWER: Hi,Angeline,
Normally, mirtazepine is used for depression and/or insomnia. It is not usually used for anxiety and 60mg is a pretty high dose. 15-45mg daily is recommended for depression
Seroquel (quetiapine) is an antipsychotic med used for schizophrenia, bipolar disorders. It is not used for anxiety.
I think you need to get a second opinion from a psychiatrist especially if you are not getting relief from the anxiety you are experiencing.
I would not cut down the mirtazepine to 30mg, but you could try to decrease to 45mg until you can get an appointment with another doctor. I would not recommend going off either med without a doctor's OK.
Hope this helps, Mary
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QUESTION: thank you for your advice i am so scared about being on this meds it was a psych who put me on this med but i know i was so wrongly diagnosed i do not have a mood disorder or schizophrenia but was terribly anxious i am even more so now knowing what these meds could be doing to me i wake every morning in terrible dread and find it harder to get through the days i can hardly concentrate and am sick in stomach every day from the anxiety what im worried about is that if dr knows my anxiety is worse they will just up the dose of seroquel which they did before they cannot see that it is only natural that i am so anxious when i have the worry of what these meds could be doing to me their answer for my anxiety is to take a valium thus this presents another problem any other advice would be appreciated
Answer Hi,Angeline,
First of all, I would not be scared of being on these meds. They are not helping your symptoms,but on the whole, they are not harming you. They are just unnecessary for your anxiety. Please do not get more anxious worrying that they are harming you because they aren't.
If the doctor ups the Seroquel because of increased anxiety, like I said before, you need to see ANOTHER DOCTOR- Seroquel is not recommended for anxiety and doesn't treat anxiety.
If he changes the Seroquel to Valium or Ativan or Buspar,or any other antianxiety med, then he will be treating your anxiety. Valium is a very effective antianxiety medication. I would not recommend it for older patients (over 65 yrs of age) because it tends to accumulate in their system,but it is very effective for someone your age,PROVIDED the dosage is not exceeded,and you do not mix alcohol with it. The bad reputation Valium has gotten is because people have exceeded the dose,then went off it cold turkey, and experienced horrendous side-effects. Because it stays in your body a long time, you have to be weaned off it gradually. That does not mean it's a bad drug.
I don't want to tell you what to do,but you need to ask this doctor why he is prescribing Seroquel for anxiety. Show him my answer to your questions if you wish. Ask for a written statement from him as to what your diagnosis is.
Don't stop questioning him until your anxiety is being adequately treated or find another doctor and let him know what the 1st doctor said about your diagnosis. Let me know how it goes. Hope this helps, God bless, Mary
Hope this helps, Mary
