Dallesky: Polydrug Dependency, Oh What to Do?

[Dallesky]

I am posting this basically as an introduction to my situation and perhaps just to find some sort of support or encouragement from the excellent people here. 

 

After being on a myriad of psychiatric medication for 13 years, I discovered the untold dangers of these drugs when I started feeling that they were taking a toll on my normal functioning and cognition. 

 

I spent most of these years going back and forth from one drug to another, in varying doses (see my use history below). I was never really able to identify withdrawal symptoms when coming off some of the drugs (despite the fact that several were fast tapered) apart from my withdrawal from Xanax, Valium and most lately, Fluoxetine. I had no idea about proper tapering until discovering this forum. 

 

Currently, I am a psychological mess who is on a cocktail of drugs and about to enter a psychiatric hospital for the fourth time. The past two weeks have been a hellish experience: unbearable anxiety and depression, an inability to think clearly or perform everyday tasks, complete loss of appetite, inability to converse with people, anhedonia, disrupted sleep, poorer coordination, of and alcohol misuse to numb the pain, to mention a few. During the past few months, I have simply been looking forward to night time, when I can take my 150mg of Trazodone and 10mg of Zolpidem to feel relief from it all. 

 

Unfortunately, the past few nights have seen me increasing the dosage of these drugs. Yesterday morning, I started straight back on 20mg of Fluoxetine (again, I had no idea about the possible kindling effect until I happened to come across it later in the day). After switching drugs several times and stopping and starting, I can only imagine that I am certainly susceptible to this effect? 

 

Tonight, I found myself awake after only 1 hour of sleep, despite taking 10mg Zolpidem and 250mg Trazodone. My nervous system feels overexcited (I am thinking probably from the reinstatement of the Fluoxetine?) and with the terrible restlessness this brought I found myself taking another 10mg Zolpidem to try and knock me out. It has not helped and I am still wide awake. I realise that increasing the dosages of these drugs is a recipe for long-term disaster but the pain is horrendous. 

 

I know that tomorrow, when I get into the hospital, I will most likely meet a new psychiatrist who will be the same as most of the rest and want to increase dosages or rapidly switch things up. I will let her know that this is not the route I want to take and hope that she is informed and empathetic to my concerns. I have a deep sense of hopelessness at my situation right now and feel completely trapped.

 

At the same time, I don't feel like I am ticking any of the right boxes to be able to taper down. 

 

So my thinking is that the first step needs to be restarting on the lowest dose of fluoxetine (here in South Africa I believe this is only available at 10mg) in order to try and 'stabilise' the reinstatement and possibly get back into productivity that will allow me to save my very valued job and relationships. 

 

Of course, my biggest concern is that I have dosed highly on the Trazodone and Zolpidem for the past three nights, and that alcohol has also played an insidious role in my life for the past few months. In addition, I had ketamine infusions in December due to thoughts of ending all the pain, so this further complicates this terrifying situation. I truly want to be off the drugs and other treatments but I realise that my case is particularly complicated and I don't know how to go about solving it. 

 

Any thoughts and observations would be deeply appreciated. 

 

2008 - Escitalopram 20mg
2009 - 2011 Epitec 200 mg (fast tapered, no noticeable WD symptoms) and Seroquel 200 mg (fast tapered, no noticeable WD symptoms).
2012 - 2019 Intermittent use of Escitalopram 20mg. Prescribed Xanax 1mg for anxiety in 2018. Was on them for 2 years. Developed tolerance, cravings and withdrawal when attempting to stop. Tapered off with Valium bridge in 2021. Fast tapered off Valium after six weeks.

2020 - Trazodone 150 mg and 10mg Zolpidem nightly (still taking).

2021 - Fluoxetine 20 mg (fast tapered, experiencing delayed withdrawal six weeks later). IV Ketamine infusions for debilitating depression.

2022 - more frequent overuse of Trazodone and Zolpidem, together with alcohol. Reinstatement of 20 mg Fluoxetine caused insomnia and akithesia on night 1.  

Supplements: Vitamin B Complex; Magnesium Glycinate; Vitamin C; Lions Mane Mushrooms; Omega 3. 

[Kiasofia]

Welcome @Dallesky

How long had you been off Fluoxetine when you reinstated at 20mg? How long have you been taking 20mg fluoxetine? You are right about kindling being a danger. You have gone off and on so many drugs and are changing dosages.

 

The main thing that needs to happen is to take consistent doses of all the drugs you are taking now, no making changes day to day. Make sure to take them at their set time each day and allow things to settle down.

Keep it simple, slow and stable

 

Also, abstain from alcohol. It should not be combined with these drugs, and certainly not with tapering.

 

Many find that B-Vitamins make them worse.

Important topics about tests, supplements, treatments, diet

 

Are your current drugs: Trazodone 150 mg, 10mg Zolpidem and fluoxetine 20mg? What did you raise the Trazadone and Zolpidem doses to the last few nights?

 

Can you please put the overview of your drug history in your signature here and add the date you quit fluoxetine and the date you started it again.

 

Are you in the hospital now?

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

 

This is your Introductory topic, where you can ask questions and connect with other members.  We're glad you found your way here.

Edited January 20, 2022 by Kiasofia

[Dallesky]

Hi Kiasofia

 

Thank you so much for your reply, I deeply appreciate it. I was very on and off the fluoxetine, some days taking and some days not. I had been on it for about 10 months before I started using it less and less frequently (I unfortunately do not have an exact timeline for you), until I tried to go completely off it for about six weeks. 

 

Thank you for your advice about the alcohol (which of course I knew was never a good idea!!!) and the B-Vitamins (had no idea they might be quite activating). And thank you for all of your invaluable links. 

 

Yes, tonight is my sixth night in hospital. Predictably, the doctor very quickly clung onto a diagnosis of bipolar attached to me 13 years ago, when I had a manic and then psychotic break after marijuana use (I have had absolutely no manic, hypomanic or psychotic episodes since, just spells of deep depression). She is of the opinion that the failure of these drugs, and my current condition, is due to me being treated for chronic depression, when in fact I need to be treated for bipolar. She has cut me cold turkey from my Urbanol (benzo), added in 25mg of Seroquel 3x per day and 25mg of Epitec, cut my Trazodone immediately down from 150mg to 100mg, and reinstated my Fluoxetine at 10mg. I was hoping to find a doctor who might be sympathetic to the idea of me wanting to taper off everything, but she simply scoffed and said "so you want me to sit here and do nothing to treat your condition?" 

 

I feel very, very trapped now. I am adamant that I will resist her inevitable suggestions to steadily increase the doses of Seroquel and Epitec. But my family (my only support system) wants me to trust the doctor's diagnosis, so I am in an extremely tough spot now. So far, I can already feel the Seroquel numbing my brain even further than it already was, and my emotions too. 

 

I am terrified of being trapped in the vicious claws of psychiatry. At the same time, I simply HAVE to stabilise if I want any chance of saving my job and relationship. 

 

Perhaps it is best for me to give you an update after I am out of the hospital, as I know that the reply will be that the doctor has approached this all wrong. But I really feel like I have no option but to give it a go for now. 

 

 

 

 

 

 

 

 

 

 

 

[Kiasofia]

Yes, this is indeed not a good strategy. Can they force you to take the drugs? How long will you be in hospital for? If possible say that you are concerned about interactions and side effects and want to see how reinstating fluoxetine affects you without making more changes. Agree to taking 10mg Fluoxetine and Trazadone.

 

What happened to zolpidem? If you had been using it regularly it should be tapered.

Tips for tapering off Z drugs for sleep (Ambien, Imovane, Sonata, Lunesta, Intermezzo, etc.)

 

Taking 25mg seroquel 3x a day is not a good way to become functional. Taking 25mg at night helps for insomnia (with many reasons to still avoid it though!). But any more than that is just going to make it harder for you to function and manage your job/relationship. It is a major tranquilizer cleverly marketed as "anti-psychotic" but does not treat mental illness.

 

What is Epitec?

 

How long were you taking Urbanol? (please add to signature)

 

Cold Turkey off a benzo and reducing trazadone is irresponsible. You may get withdrawal symptoms that are then mistaken for psychiatric symptoms. See attachment and this link:

What is withdrawal syndrome?

 

I understand you are in a tough spot. Damage control is to try to keep taking as much of your current drugs as possible (avoid withdrawal) and add inn as little as possible at as low a dose as possible.

 

And educate yourself on what these drugs truly are and how they "work":

Anatomy of an Epidemic by Robert Whitaker (interview) 

A straight talking introduction to psychiatric drugs

The Council for Evidence based Psychiatry

https://medicatingnormal.com/

How Psychiatric Drugs Remodel Your Brain 

 

Hope you are able to stabilize soon.

Drglenmullen_withdrawal_symptoms.pdf

[Dallesky]

Hello everyone

 

Time for an update from me. I didn't think it was really possible for things to get very much worse, but I had no idea. 

 

And I am absolutely and completely clueless as to what to do. After the cold turkey of Urbanol, the addition of Seroquel and Epitec, the adjusting of several doses, and my prior history with meds and alcohol, I am absolutely and totally devastated mentally, without being able to envisage a path forward. 

 

Yesterday, I resigned from my job. I am currently in a psychiatric recovery centre trying to stabilise, but things have deteriorated rapidly and I now fear for my life. 

 

I have completely forgotten how to LIVE. And it is on a much deeper level than psychological. It is as if my brain has lost the ability to function. It's like it has given up on me. It's lost the ability to speak about anything. It's lost the ability to convey emotions to my own body. It's lost the ability to look forward to things. It's lost the ability to feel any sense of accomplishment, even a simple sense of accomplishment. Actually, it's lost the ability to accomplish anything meaningful at all. It's lost the desire for any food at all. It's lost the ability to experience and properly taste food. It's lost the ability to exhibit facial expressions. My body often feels frozen, or when I do something it's these sharp, jerky movements that I can't really keep track of and I have to wonder what I just did. It's lost the ability to think if what I'm wearing is appropriate, or to look in the mirror and 'connect' with myself. 

 

I cannot 'feel' my body, I don't really know when I'm cold or when I'm hot, I don't get hungry or thirsty, or feel the pleasant sensation of a shower's warm water on my body. 

 

Normal things like showering, packing clothes, eating normally, moving around, require the highest levels of concentration. I constantly have to remind myself of what I am doing at any particular time, so that my body can respond appropriately. I have to continually orientate myself to my surroundings. Challenging myself to do something or attempt to engage in conversation with people just makes me more aware of how difficult everything is to do. I cannot get into any sense of accustomising to my environment, to people, to tasks, or to a routine. I am unable to learn any new things. Or even to do the things I know I am usually capable of doing. 

 

Every minute feels like a completely new minute, no continuity of time. 

 

I am confused by people's sentences and I am not really aware of what is coming out of my mouth anymore. I have no confidence that what I am saying makes sense. When I do speak, I know that my words are stilted and jumbled, a reflection of my disjointed mind. 

I look back on WhatsApp messages from January and it shocks me how much things have regressed. I thought I was feeling desperately bad then, but that was nothing.

Even two weeks ago, I felt a minimal drive that came from my goal of getting off medications, and I was fairly certain it was the right path to follow. And I was able to convey some of this to my family, medical staff, and others. I am not able to clarify these thoughts at all anymore or make any decisions. I am frozen when it comes to making basic decisions, let alone solving problems. 

 

Ive completely lost my ability to interact with people. I cannot look anybody in the eye, I cannot follow what they are saying or even comprehend or try to reason with what they are saying. All I can do with any form of certainty is say 'yes' or 'no'. My self-confidence isn't even low, it has vanished completely. 

 

It is literally as if my brain has lost the ability to reason, to question things, to THINK! And when you don't have any emotions to guide you on anything, how do you make any decisions, how do you get yourself to do anything at all? 

I feel so utterly and completely self-absorbed. I know that I am naturally an empathetic person, but that is gone. There is nothing I can speak to anyone about. There is no flow to conversation and no ability for me to form any kind of relationship whatsoever. No cameraderie, no shared understanding, no mutual respect. Just a few short words to questions, or a jumbled response, and the absolute shame that comes with it. The staff and patients here have tried to connect with me, and I have desperately tried to connect with them, but my brain just does not allow me to do it. They try to show me caring, and I respond with pure coldness. They must think I am either the biggest stuff-up on earth. 

 

Even writing this right now, I have to ask whether I have written something down already. I have to go back and read this piece over and over and over again and it still doesn't properly sink in. 

 

Looking at the time is starting to just look like numbers now. Im losing connection with how time is progressing and what a specific time means for a specific day. 

 

My memory recall is gone. I cannot recall properly what was discussed in a psychiatrist meeting or in a group meeting or in conversation. It's like I know I had the experience and there's vague pictures of me being in the chair, but it's all very disjointed, like there is absolutely no continuity from one memory to the next. It is the same with my thoughts and with the words I try to speak. Everything is disjointed. I cannot for the life of me remember what I had for supper last night. I lose a sense of awareness of who and what is around me.

 

And the worst thing is that my brain has lost the ability to be able to find a way of doing anything about it. That underlying feeling of urgency that everyone has, that motivates them to do something, is gone. There is no internal voice reminding me that 'oh ja I must remember to do this or do that'. 

 

The receptors in my brain have been consumed and cannot produce any normal feelings anymore, or any logical thought processes. Anything that makes me feel human.

 

I am absolutely trapped. With the complication of my situation, it feels completely impossible to emerge from this. 

 

I know that there are not any easy answers. I guess I was just wanting to offload here...my family is sick to death about hearing me repeat the same things over and over again.