Brief Answer:
The drug is available in SR form in 100-300 mg doses.

Detailed Answer:
Hello again,

Quetiapine is available in SR (sustained release) formulation in 100-300 mg doses. For the dose of 25-50 mg the drug is available in plain formulation.

Better to take the 25 mg dose at nights without any worries. This will control the anxiety and help in sleep also. The morning drowsiness will be avoided then.

Thanks.

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Brief Answer:
Yes you can take 25 in evening

Detailed Answer:
Hello again

Yes you can do either of both these things. You can take 25 mg in evening today and this will help in sleep and will help in better functioning.

Thanks

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Brief Answer:
Its better to take in evening.

Detailed Answer:
Hello again and thanks for asking a follow up

Quetiapine is inwon to cause sedation and this sedation will not reduce much with time if you continue to take the drug in morning in my opinion. I usually advise my patients to take the drug in evening hours preferably. So its better if you start taking the drug in evening time.

Thanks.

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Brief Answer:
Other drug can be tried

Detailed Answer:
Hello again

Yes most probably the cause of constipation is Quetiapine. If this become intolerable then better to go with some other medicine.

One option for anxiety is Buspirone. The drug doesn't affect sleep quality and will not cause much effects on bowel functions. You can think of starting this drug. Or alternatively you can wait for a couple of weeks to see effects of Quetiapine.

Thanks

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Brief Answer:
Wait for some days

Detailed Answer:
Hello again

One option is to reduce the dose of Mirtazapine to 15 mg again and this will help you. Other option is to wait for some days. This will result in development of tolerance and thus will reduce the constipation.

Try to remain relaxed, in a week or two you will start seeing improvement.

Thanks

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Brief Answer:
Abrupt stoppage is not advisable

Detailed Answer:
Hi, I am sorry for replying late because busy with national conference of Psychiatrists.

Since you have reduced the dose of Mirtazapine slightly and stopped Quetiapine and are feeling better so in my opinion no need to stop these drugs and starting Vilazodine after stopping these drugs cold turkey is not a good idea. This might result in withdrawal because you are very sensitive to dose changes.

Wait for some days, if symptoms become worse or doesn't improve the you can think of changing the drug to Vilazodone.

Cross-tapering can be done. Mirtazapine dose can be reduced over 4 weeks and in the same time Vilazodone doses can be increased to optimum doses.

This would not result in much worsening of symptoms. Vilazodone is a new drug in XXXXXXX markets and had serotonergic actions but safe in terms of side effects. I have not used the drug much to my patients but literature says the drug has promising results.

Thanks, please don't hesitate to ask again for more doubts.

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