Severe daytime drowsiness due to evening intake of Quetiapine
Hello,
I am 25 years old and male. I have been suffering from depression for about 10 years, with varying degrees of severity depending on the time period. Fortunately, for the past 2 years, I have been able to manage my emotions quite well; in terms of emotions, I almost feel like a healthy person. However, my main problem is extremely severe sleep disturbances, which have to be treated by my psychiatrist with an evening dose of 300 mg of Quetiapine. Since then, I have been able to sleep well again, but it also has a downside: I feel the sedating effect of Quetiapine quite strongly during the day; I can hardly get out of bed, it is extremely difficult for me to fulfill my tasks at work, my social life is severely restricted (I can rarely meet friends due to fatigue, even though I would like to have much more contact), and my last relationship failed due to constant and severe daytime drowsiness. However, all of this is easier to bear than not being able to sleep for nights on end; I'm being completely honest about that. I am generally a patient who reacts strongly to many medications. I have tried a lot of medications (all common antidepressants and atypical antipsychotics), and despite the extremely severe daytime drowsiness, I tolerate Quetiapine the best. The psychiatrist is certain that the daytime drowsiness is due to the medication and not psychological causes. I share this assessment, as I never had daytime drowsiness before taking Quetiapine, even during my worst depressive phases (excluding the fatigue from not being able to sleep, of course). My psychiatrist has tried to reduce the dose, but it was not possible due to the severe sleep disturbances. Based on years of experience with me, my psychiatrist also suggests considering a possible inpatient therapy for me with "extreme caution," as my health has unfortunately often deteriorated during past inpatient therapy attempts; I left the hospitals worse off than when I went in. I have always responded best to outpatient therapy measures. Due to the severe daytime drowsiness, I sometimes have to be signed off sick, as I can no longer work or drive due to it.
My questions:
1. According to the doctor, the Quetiapine cannot be reduced or discontinued at the moment. Are there any ways to somehow provide relief for me, i.e. reduce the daytime drowsiness?
2. My general practitioner (not a psychiatrist!) recently suggested a medication called "Modafinil" for the daytime drowsiness. Would this be a possible therapy method against the daytime drowsiness caused by Quetiapine?
3. Is it possible that, worst case scenario, I have to accept the daytime drowsiness as unchangeable?
