Crh69: Lamictal

[Crh69]

Hey all,

 

I was put on lamictal 9/8/21 until 12/15/21. This was per a GP who assumed I was BPII but never formally diagnosed. I do have a history of depression and anxiety with a horror story from a LASIK surgery that caused such disastrous implications for my mental health. I weaned off the drug from 200-100 for roughly a week, then went to 50mg per day for 3 days before stopping the medication. I wasn’t on it a “significant” amount of time but I’m suffering some rather intense withdrawals that have slowly improved with time… but the neurotic emotions are not letting me believe I’m okay. The word finding, reading, brain fog, intense anxiety, depression and so on have been confounding any potential improvement. 
 

Will I recover ? Did I taper too quickly? Now that im 3 weeks off the drug should I not worry about reinstatement and ride this out? Im only 28 and thankful I stopped before I was on an extended period. However, im fearful of what’s to come. 
 

[Frogie]

Hi @Crh69

 

Welcome to SA. We are a volunteer run site that help members, like you in withdrawal and tapering from antipsychotic medications. I'm glad you found us, but sorry you are going through this.

 

This is your main page. This is where you can receive information, ask questions, make comments, and meet other members that are going through/have been through what you are experiencing. We ask that each member only have one page so we can keep all your information in one place.

 

Can you create a signature please:

 

Instructions:  Withdrawal History Signature

 

You were on Lamictal for a short period, but long enough to become dependent on it. Then you went through a fast taper. SA suggests a 10% per month. Unfortunately, most drs don't understand withdrawal and what it does to your body.

 

Tips for tapering off Lamictal (lamotrigine)

 

Dr Joseph Glenmullen's WD Symptoms Checklist

 

How do you talk to a doctor about tapering and withdrawal?

 

What should I expect from my doctor about withdrawal symptoms?

 

Because you have only been off a short time, you could try reinstating a very small dose and see if that would help. I'm going to ask the other mods what dosage would be good to start if you would decide to reinstate.

 

About reinstating and stabilizing to reduce withdrawal symptoms

 

We don't suggest supplements on here except 2 that seem to help.

 

Magnesium

 

Omega-3 Fish Oil

 

Please read the links at your leisure and please let us know if you have any questions or how we may help you.

 

 

Edited January 4, 2022 by Frogie

[Crh69]

Thanks @Frogie. 
 

I see you were on lamictal and also had a fast taper. How did you fair?

[Frogie]

I was on so many medications at the same time that the psychiatrist “ripped” me off of, I don’t know which one caused which symptom unfortunately.

 

I have asked other moderators for some help.

 

Hang in there, you came to the right place😊

[Crh69]

@Frogie

 

well, how did you fair after being “ripped” off of them? Anecdotes help especially since you seem to have recovered.

[Altostrata]

Welcome, @Crh69

 

How's your sleep? How have your symptoms changed in the last week?

 

Do you have any lamotrigine left? What dosage?

 

To help us out, follow these instructions Please summarize your drug and withdrawal history in your signature You may need to use a computer to do this.

[Crh69]

@Altostrata

 

In the last week I went through a waxing and waning of anxiety driven obsessions to overwhelming depression. Within the last two days I seemed to have turned a corner as I'm relatively functional at work. I naturally was not sleeping well. The doc had prescribed me very low dose abilify but I never took it consistently (2-5mg). I've been completely off the drug for 3 weeks and I'm passed the 2 weeks in which the drug should be cleared of my system. I do have Lamotrigine left. 25 and 100 mg tabs. 

[Altostrata]

It appears that you are recovering naturally from going off lamotrigine 3 weeks ago. Suggest you hang in for another 10 days, coping with symptoms, which may be intermittent. See The Windows and Waves Pattern of Stabilization

 

How has your sleep pattern changed in the last week?

 

Many people find fish oil and magnesium supplements helpful, see

 

https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

 

https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

You might try a little bit of one at a time to see how it affects you. Please let us know how you’re doing.

 

GPs are not qualified to diagnose any kind of bipolar disorder, and even less qualified to treat it. If I were you, I would not take psychiatric advice or psychiatric drug prescriptions from this doctor.

[Crh69]

@Altostrata

 

This is overwhelmingly positive and I can't thank you enough. As I was originally tapering off my cognition was fried and I often second guess my self now due to OCD and the waxing and waning of symptoms. As all our CNS are typically dismantled from these medications, I know that the neuro emotions make recovery much more difficult than it needs to be. I often second guess my "reality", which is often confounding my progress as a whole. I get situated with a therapist tomorrow. Positive thought processes and techniques are the key to a significant stable recovery (I'm a clinical social worker by trade).

 

My sleep is fragmented as it always has been, and this contributes to a lot of my baseline emotional lability. I'm not bipolar, but I know i'm significantly hindered by my inability to have gotten quality sleep over these last... 12-15 years. 

 

I take Fish Oil, Vitamin B, and a complex of Zinc, Calcium, and Magnesium. 

 

This physician was one I USED to trust. He actually wrote me off today, so I lost what I thought was a support. I recently saw a psychiatrist who told me that roughly a month I'd notice rather improvement. The neuro emotions are by far the most difficult part. 

[Altostrata]

Good to hear you're looking for a non-drug solution. You may be able to strengthen your sleep:

 

What is the sleep cycle?

 

Waking with panic or anxiety -- managing the morning cortisol spike

 

Tips to help sleep -- so many of us have that awful withdrawal insomnia

 

Path to Better Sleep FREE online for everyone from the US Veterans Administration

 

Music for self-care: Calms hyperalertness, anxiety, aids relaxation and sleep

 

White noise devices for sleep

 

Melatonin for sleep: Many people find it helpful

 

TV or computer use in evening can disrupt sleep: Bright light signals the brain that it's daytime

[Crh69]

@Altostrata

 

Thank you so much.

 

is it relatively normal to feel that derealization or heightened fear of that, along with rumination? That’s the biggest piece for me. 

[mstimc]

10 minutes ago, Crh69 said:

@Altostrata

 

Thank you so much.

 

is it relatively normal to feel that derealization or heightened fear of that, along with rumination? That’s the biggest piece for me. 

Hi Crh69

 

During WD, its absolutely normal to have a heightened fear of derealization or "losing your mind", as well as ruminations, increased anxiety and other intrusive thoughts and behaviors.  One of the really unfortunate consequences of a quick taper is that it leaves you very little time to prepare any coping skills to help you handle the feelings.  I found a "toolbox" of cognitive-behavioral therapy techniques, along with a supportive therapist, were the keys for me.  I really think learning coping skills is the best drug-free way to handle what we've experienced.  

[Crh69]

@mstimc

 

This is very true. I'll occasionally take .5 ativan just to relax. I didn't expect this to shock the system to badly, but once I realized it wasn't necessarily helping me anymore there was no reason to keep on it. As long as what I'm experiencing isn't abnormal to the fast taper. I'm sure I'll be okay but it'll be a hellish next couple weeks since the drug is finally out.

 

Any additional tips?

[mstimc]

31 minutes ago, Crh69 said:

Any additional tips?

Yes!  Be kind to yourself while you're in WD.  You'll have good days and not-so-good days.  Progress isn't linear--its more like a rollercoaster.  Don't blame yourself for not recovering "fast enough" or for having a bad day.  And don't get caught up in the "I should have known" game.  You trusted your doctor and other experts to serve your best interests, and they gave you advice based on what they've been told as well.  Stay away from the blame game for all involved. 

 

Be your own best friend and give yourself the patience and support you'd give someone else in this situation.

 

[Crh69]

@mstimc

 

thank you very much! I had another rather odd question… given the amount of time I’ve been on it and how aggressively I tapered off… am I at risk for long term/permanent brain damage? 

[mstimc]

2 minutes ago, Crh69 said:

@mstimc

 

thank you very much! I had another rather odd question… given the amount of time I’ve been on it and how aggressively I tapered off… am I at risk for long term/permanent brain damage? 

Absolutely not!  Other members and mods can attest that any symptoms, no matter how unpleasant and how long they may last, are not permanent. It takes time and patience to heal.  And, IMO, a plan; that is adopting the right tools and attitude to help you recover.  As I mentioned, for me it was CBT, but the point is you want to do things to support your recovery rather than just waiting to "get back to normal".  Based on my experience with others who've tapered quickly or gone CT, I would say you feel WD more intensely and more quickly, but you can recover just as well as those who've tapered.  You really will recover!

[Crh69]

An informal discussion with a Neurologist said that the cognitive impacts of stopping the medication indicate that it was "working" and that I could potentially be having "seizures". I'm still very tired... anxiety is waxing and waning.. Anhedonia is bad but that's moreso because of my anxiety. I'm fearful being that this Wednesday will be 4 weeks off the medication. I don't know if it makes sense to go to the hospital or not... but I'm feeling exhausted and restless all at the same time. Any suggestions? or Should I continue to ride this out. I'm still so incredibly upset I ever even took this drug without looking into it. I should've known after my LASIK disaster. I'm fearful I will lose my entire life. 

[Altostrata]

Very few doctors know anything about tapering and withdrawal from psychiatric drugs, and many don't know enough about drug adverse effects. I would not take advice about psychiatric drugs from your neurologist acquaintance.

 

Nobody seems to like withdrawal syndrome. Unfortunately, it takes patience and fortitude to get through it.

 

You appear to be recovering naturally, but if you want to make this more complicated, you can go to the hospital, where they probably will dump other drugs on you and send you home, as well as the increased exposure to covid-19 etc. at the hospital.

 

If you go on other drugs, please discuss any adverse reactions with your prescriber. Let us know when you want to taper off.

[mstimc]

Crh69

Altostrata is right- few doctors recognize or even believe in AD withdrawal; many recommend very short tapers, if any at all. The idea that you're experiencing withdrawal symptoms as a sign the meds were working seems almost medieval in its thinking.   It takes time, effort and patience, but you can recover naturally.  The admins, mods, mentors and members here have a wealth of knowledge and empathy that can help you get through this. 

Edited January 10, 2022 by mstimc

[Crh69]

I also forgot to mention that I was prescribed Ativan .5 to help with the anxiety... I still have some left and didn't take them consistently and it was prescribed over a month ago. Am I okay just to stop those? 

[Altostrata]

How often have you been taking Ativan? How many doses per day?

[Crh69]

I had a total of 20 pills and took 16.5 of them over the period of a month. They weren’t usually consecutive days, but the dosing was usually .25-.5

[Altostrata]

On 1/4/2022 at 7:05 AM, Crh69 said:

The word finding, reading, brain fog, intense anxiety, depression and so on have been confounding any potential improvement. 

 

What effect does the Ativan have on these symptoms?

 

When did you last take Ativan? Please add the Ativan information to your signature.

[Crh69]

I took it last night. All the Ativan did was intended to do was calm me down to sleep. That's the only reason why I took it in the first place. It barely worked and in some instances made the anxiety worse.

[Altostrata]

It is possible you are having bursts of symptoms, such as anxiety, activation, and insomnia, because of the way you've been taking Ativan. You may be having rebound symptoms hours later, when it wears off. In short, the Ativan is causing some of your problems.

 

Please keep daily notes of times o’clock you take your drugs, their dosages, and your symptoms throughout the day. We need to know how you feel before and after taking each drug, and your symptoms in between. Post 24 hours of notes at a time in this topic, in a simple list format with time o’clock on the left and notation (symptom or drug and dosage) on the right. This can show if your symptoms are adverse effects from one of your drugs.

[Crh69]

But based on how I've been taking it and that I haven't even actually taken 10mg worth, should I just stop it? 

[Crh69]

I'm not taking any other medication. That was simply taken PRN if I felt I needed it and so I could potentially sleep. 

[Altostrata]

Yes, we understand you were taking it PRN, as directed. If you stop taking Ativan now, you might get withdrawal symptoms. These might include surges of anxiety and insomnia for x days. It's possible you're not thoroughly physiologically dependent on it and quitting would be easier, we can't tell. Your decision.

[Crh69]

How do we differ from natural lamictal withdrawal from potential withdrawal Akathisia?

[Altostrata]

You have not reported any symptoms remotely like akathisia.

[mstimc]

1 hour ago, Crh69 said:

How do we differ from natural lamictal withdrawal from potential withdrawal Akathisia?

Hi Chr69

My advice, based on every kind of withdrawal symptom imaginable and helping people here and on another site....don't spend too much time trying to differentiate one symptom from another or what may be causing them.  It's natural to want to know the cause of our symptoms, but that can really take you down a rabbit hole.  I think you'll find learning and practicing coping skills will give you relief and empower your recovery. 

[Frogie]

@Crh69

 

I'm copying the from a PM with permission:

 

Hey Frogie,

 

I wanted to reach out because I saw you had experience with benzodiazepines. I was given a script for 20 tabs of .5 Ativan to take as needed every 12 hours for anxiety due to my lamictal withdrawal. This was prescribed 12/14 and I had taken 16.5 tabs over the course of this past month. Sometimes I would cut them in half to be .25. Last dose. I took was on 1/10 and I haven’t had any since. I’m fearful of benzo dependence but I was desperate for some small relief from the anxiety from lamictal. Am I in any danger ? My anxiety seems to be the same despite the fact I’m ruminating on this. 

______________________________________________________________________________________________________________________________________________________________________

 

You can become dependent on a benzo in as little as 2 weeks, if taken regularly.

 

Did you feel relief when you were taking the Ativan? Or, how did you feel when you were taking it? Was there any relief?

 

I would watch my symptoms over the next few days and see how you are doing. Post the notes on here and we can see if you feel you became dependent on it.

 

Keep Notes on Paper

 

You can't ruminate on this. I know that's hard to do, but try and just go on the same as you were and we will see how you are doing in the next few days.

[Crh69]

I felt very mild relief but it didn’t last but maybe a couple hours. I usually took it to sleep. Even when I did take it id wake up anxiety.

 

odds are I’m okay because I didn’t take it every day. Some days were back to back but I obviously didn’t use 20 pills. I’m scared, because now I feel like I’ll never get back to my pre lamictal days.

[Frogie]

@Crh69

 

It is pretty good odds that you did not become dependent on it then.

 

You will stabilize again. It just takes time unfortunately. 

 

Just do lots of self care and you'll make it back to "normal".

[Crh69]

Saw psych today who said he’s confident I’ll be fine off the Ativan. He said I could gradual taper if I felt it was needed, however it’s been 3 days without any and I still feel the same as when I initially stopped lamotrigine.

 

he did report that the dose I was on, how quickly i titrated to 200 then back down to 0 definitely shocked the brain. He said after reviewing case studies he anticipates that roughly 2.5-3 months would acknowledge some improvement. I’m hoping for the best. I’m still kicking my own ass for the Ativan, but when you’re scared you want that small quick fix. 
 

I appreciate everybody’s responses and kind words. I’ll keep you updated.

[Altostrata]

That sounds reasonable to me. Recovery from psychiatric drug withdrawal symptoms is frustratingly halting and gradual. In 3 months or so, you'll probably feel a big difference. Your biggest problem appears to be worry. Do what you can to stay calm and surf the waves. See

 

The Windows and Waves Pattern of Stabilization

 

"Is it always going to be like this?"

 

The importance of recognizing you're feeling good

 

Progress! What withdrawal symptoms have gone away for you?

 

Non-drug techniques to cope with emotional symptoms

 

Easing your way into meditation for a stressed-out nervous system

 

Music for self-care: calms hyperalertness, anxiety, aids relaxation and sleep

 

Ways to cope with daily anxiety

 

Health anxiety, hypochondria, and obsession with symptoms

 

 

Many people find fish oil and magnesium supplements helpful, see

 

https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

 

https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

You might try a little bit of one at a time to see how it affects you. Please let us know how you’re doing.