Lamalein: polydrugged - lorazepam, Pregabalin, quetiapine and mirtazapine

[Lamalein]

I am a 41 year old woman from Germany, 20 years ago I was in a psychiatric hospital for 5 months, got out of it after 2 lorazepam withdrawal tries (last one with valium) with Quetiapine and Valproat. Tapered down to 0 meds in 6 years. 14 years lived my life without medication. Then mid of 2020 after leaving my job, anxiety showed up again and I got retraumatized. I had the belief I have to go in a hospital again and have to get medication. They started with sertraline, I got suicidal and then I got 60 mg Valium and the horror began. 15 meds were tried out, I was nearly on 0 Valium at the beginning of 2021, but then I got in 4 other hospitals and everytime they experimented with other meds and I got on lorazepam again.

In autumn 2021 I got out of the last hospital, traumatized with PTBS and had this horrendous mix (I know, it is so aweful, please have empathy with me - I punish myself every minute, day by day. But I got also mistreated by the hospitals. :-(

Lorazepam       0.5mg - 0 - 0.5mg - 0
Pregabaline      75mg - 75mg - 75mg - 0
Quetiapine ret.   50mg - 50mg - 200mg - 0
Mirtazapine        0 - 0 - 0 - 45mg

Now I tapered off (last reduction on 27th July 2022):

Lorazepam       0.5 - 0 - 0.5 - 0
Pregabaline      75 - 75 - 75 - 0
Quetiapine ret.   0 - 0 - 200 - 0
Mirtazapine        0 - 0 - 0 - 30

I don't know how to go on. Should I built down Quetiapine 150 mg per day and Mirtazapine 15 mg per day before to start with Lorazepam reduction? And then my question is, again Valium? With Valium I had depression, also 20 years ago. I had also a small seizure 20 years ago during lorazepam withdrawal.
2 years ago I was a normal woman with a life. Now I am a wreck unable to work, single, depressed, with so many meds, and Quetiapine and Mirtazapine are causing leucopenia, bad side effect, why they have also to go.

 

My withdrawal symptoms are depression, anxiety, running thoughts and, when the step was to big, agitation.
 

[Lamalein]

Hello all, I have read the whole post of "polydrugged and which one to taper first" - it's aweful when I see my cocktail.

 

I am not sure how to go on. 

 

Best wishes,

Lamalein

[Altostrata]

Welcome, @Lamalein

 

What drugs are you taking now, at what times o'clock and dosages?

 

On 8/22/2022 at 2:05 PM, Lamalein said:

My withdrawal symptoms are depression, anxiety, running thoughts and, when the step was to big, agitation.

 

When did this last occur?

 

On 8/22/2022 at 2:05 PM, Lamalein said:

Quetiapine and Mirtazapine are causing leucopenia, bad side effect, why they have also to go.

 

Please put ALL your drugs in this Interactions Checker and post the report or a link to it in this topic.

[Lamalein]

Dear @Altostrata ,

 

This is my medication throughout the day:

 

                       9.30h         14.00h    19.00h         0.30h
Lorazepam       0.5mg -      0 -       0.5mg  -       0
Pregabaline      75mg  -     75mg -  75mg  -       0
Quetiapine ret.   0 -             0 -      200mg -       0
Mirtazapine        0 -             0 -          0 -            30mg

 

Right now I am suffering from withdrawal (or maybe also corona infection, which I got on 14th august 2022). Last reduction was on 27th July 2022 for the Quetiapine 25 mg (from 225 to 200 mg). Symptoms which started in the last 5 days: depression, fear, agitation. But actually I have these symptoms until I get the evening dose of Quetiapine, Pregabaline and Lorazepam. When this kicks in, then I am literally like drunk. The depression etc is gone, but I am sedated.

 

Best wishes,

Lamalein

[Lamalein]

Dear @Altostrata,

 

Quote

Please put ALL your drugs in this Interactions Checker and post the report or a link to it in this topic.

 

I did this, but I cannot put in 4 meds parallely - I had to make it several times to get all the combinations by only 3 meds. I got for every combination a "moderate" risk. In Germany we have also one checker and there is a high risk for the combination "mirtazapine" and "quetiapine" - the others ones are fine in Germany.

 

So I think first of all, I have to reduce Quetiapine retard and Mirtazapine.

 

Best wishes,

Lamalein

 

[Altostrata]

4 hours ago, Lamalein said:

the evening dose of Quetiapine, Pregabaline and Lorazepam

 

These are, in fact, 3 sedating drugs, as is mirtazapine.

 

Why are you taking pregabalin?

 

Did you ever tell your doctors you felt this combination was too sedating?

 

4 hours ago, Lamalein said:

Symptoms which started in the last 5 days: depression, fear, agitation.

 

These may be from covid. If you have covid, that presents a difficulty, as we cannot tell symptoms of covid from similar withdrawal symptoms.

[Lamalein]

Hi @Altostrata

 

they gave me pregabaline to get the valium out and because they thought, I have a generalized anxiety disorder.

Actually I had in the last 2 years only the withdawal problems and no one realized that. If I could turn back time, I should have waited after I was on 0mg valium at the beginning of 2021, but I went again in a hospital and the only thing, what they can do, is to give me lorazepam and so on.

 

I am now since october 2021 at a ambulant psychiatrist and yes, he knows, that I am so tired, that my liver has problems and also my leucopenia isn't really funny with these meds. And I have gained so much weight (20 kilo) since I take mirtazapine and quetiapine. But he is also with me, that we have to reduce the meds, especially the quetiapine and the mirtazapine.

 

Today my depression got better, slept also until 12h, but the anxiety and depression got better throughout the day. Hopefully it was the corona stuff, because in 2 weeks I want to go on with the reduction of Quetiapine. Want to get until october on 150 mg Quetiapine.

 

Best wishes,

Lamalein

 

[Altostrata]

21 hours ago, Lamalein said:

9.30h         14.00h    19.00h         0.30h
Lorazepam       0.5mg -      0 -       0.5mg  -       0
Pregabaline      75mg  -     75mg -  75mg  -       0
Quetiapine ret.   0 -             0 -      200mg -       0
Mirtazapine        0 -             0 -          0 -            30m

 

How long have you been taking lorazepam on this schedule?

 

How long have you bee taking pregabalin on this schedule?

[Lamalein]

Hi @Altostrata,

 

on Lorazepam in this schedule I am since 6/2021. On pregabaline first with 50 mg from 10/2020 until 12/2020 and then with 225 mg since 01/2021 until now. 😞 I am pretty sure addicted to it. They tried to withdraw in two hospitals the lorazepam since 6/2021 twice, but with too big drops (0,25 mg steps in some weeks) and failed everytime. I really don't know how to withdraw the lorazepam again. If I do it again with valium (via drops) or if I try Clonazepam (10 drops, because you can get here a solution too)? Or should I stay on lorazepam? Are there people who stay with lorazepam and made a successful taper? I heard, that lorazepam is not easy at a certain reduction level, because you get the between withdrawal.

 

The other question is, when should I do it. Winter is coming now and I should reduce before Quetiapine (to 150 or 100 mg) and Mirtazapine (to 22,5 or 15 mg) maybe, but I think it's maybe too ambitious . And then in spring I would like to start the lorazepam taper.

 

When I taper a benzo, I have such big problems with depression, anxiety, intrusive thoughts like suicide and agitation. I have to find a way, how I can minimise these things in the best way.

 

Best wishes

Lamalein

 

 

[Altostrata]

Did your doctors not assist you in tapering?

 

All of your drugs are redundant, but quetiapine is the drug with highest risk of serious adverse effects. f I were you, I'd start reducing quetiapine. Your first reduction could be by 10% of 200mg, to 180mg. See Tips for tapering off quetiapine (Seroquel)

 

Please let us know how you're doing.

 

[Lamalein]

Hi @Altostrata,

 

I started in January this year with tapering off from 300 mg to 200 mg in 3 steps with the quetiapine. Last reduction was on 27th July from 225mg to 200 mg via 25 mg unretarded Quetiapine. 

 

I have a psyiachatrist, but he asks me, what I want to reduce. The doctors in Germany are not very well in knowing to reduce meds. I have to get my information out of boards like this. Or books.

 

When I reduce Quetiapine, I have agitation, racing thoughts and not sure about it depression.

 

Yes my next step is to reduce to 150 mg Quetiapine. But my actual feelings throughout the day are aweful. Not sure, if I am still on withdrawal.

 

I have the feeling, that when I take the Pregabaline, my legs are like rubber. 😔

 

[Altostrata]

19 minutes ago, Lamalein said:

Last reduction was on 27th July from 225mg to 200 mg via 25 mg unretarded Quetiapine. 

 

 

Over the last 2 weeks, how have the withdrawal symptoms from this reduction changed ?

 

19 minutes ago, Lamalein said:

When I reduce Quetiapine, I have agitation, racing thoughts and not sure about it depression.

 

Yes my next step is to reduce to 150 mg Quetiapine.

 

A reduction from 200mg to 150mg would be a 25% reduction. We recommend much more gradual 10% reductions. See Tips for tapering off quetiapine (Seroquel)

 

[Lamalein]

Hi @Altostrata

in the last two weeks I also had Covid - I think it has provoked withdrawal like symptoms. Fatigue, agitation, depression - it felt like withdrawal, not sure, if it was withdrawal. I hope I dont get long covid, but the only thing I can do, I can wait. Today I had horrendous headache - needed to take paracetamol, otherwise I couldnt sleep.

 

Yes, the tapering of Quetiapine I try to do with 10 %, the last time I used 25 mg unretarded for the step in between - would do it this time again like this.

 

Best wishes

Lamalein

[Altostrata]

If I were you, I would not make drug changes until you recover completely from covid. We can't tell covid symptoms from withdrawal symptoms, so we would not be able to offer you meaningful guidance while tapering.

 

[Lamalein]

@Altostrata

Good to know, that withdrawal symptoms can be like covid symptoms. Then I will wait, there is no other choice. But I think, the deep depression has gone. But still very fast without power and so on.

Hopefully it's not destroying my heart.

 

Best wishes

Lamalein

[Lamalein]

Hello all,

 

since two days the depression and agitation got better. Hope this will be better and better the next days. 

 

What is frighten me, is my heart. Corona infection and Quetiapine are bad for the heart. I have heart palpations and stumbles since some days. And especially after taking the quetiapin the heart beats are faster afterwards. That's why I want to check my heart and I got a doctors date on friday. I want to make an ECG and maybe Ultrasound. 

 

If my psychological condition stays like that, I want to go on with the Quetiapine reduction in two weeks, after my period also, becuz this triggers, too.

 

Best wishes,

Lamalein

[Lamalein]

Some questions about withdrawal of polydrugged people

 

Dear all,

 

I have 5 questions concerning the withdrawal, which are pretty frighten me...

 

 

• when I am reading through the experience stories, I realize everytime, that there are many many people who got away from the meds step by step, but I couldn't find stories, where people after a polydrugged longterm withdrawal have a normal life again - who are not handicapped, unable to have a job, living in a bunch of symptoms, suffering. Am I wrong with that? Getting away from the drugs is one thing, having a normally reacting body without symptoms afterwards the other thing.
   
• I am in the good position, that my nervous system calmed down since June and when I reduce, then I have withdrawal, but I only have to wait some days or weeks, and the nervous system calms down. Is it possible, that it stays like that until my tapering ended in some years?
   
• Are there people, where the withdrawal got "easier" from time to time?

 

• Especially with the benzo and the pregabaline I am so concerned. Does this happen with any of you, that during the tapering process of the benzo the nervous system calmed down and stabalized in between? Is there hope? I only here especially there of waves and windows for many months.

 

• And what is also disturbing for me, one of my withdrawal symptoms is depression. When I have to go through depression every little reduction for some years, can this happen, that the depression is getting chronic?

 

I would be so glad, if someone can answer me to that.

Best wishes,

Lamalein

 

Edited September 7, 2022 by ChessieCat
added topic title before merging with intro topic

[ChessieCat]

Shep - Drug free May 22, 2015 after 30 years of neuroleptics, benzos, z-drugs, so-called "anti"-depressants, and amphetamines 

Shep works full time and is an admin here at SA.

 

GiaK - withdrawn from a cocktail of 6 psychiatric drugs that included every class of psych drug.

 

JanCarol

 

[Lamalein]

Dear all,

 

since one week I am stable again. Depression is gone, soon I want to go on with the tapering of Quetiapine from 200 to 150 mg.

 

The next steps are calculated from my side like this:

 

19.09.2022: 150 mg retarded evening + 30 mg non-retarded afternoon (150mg + 25mg +10 ml of 25 mg unretarded in 50 ml water dissolved) - Reduction of 8 %
24.10.2022: 150 mg retarded evening + 15 mg non-retarded afternoon (150mg + 30ml of 25 mg in 50 ml water dissolved) - Reduction of 9 %
28.11.2022 150 mg retarded evening - Reduction of 10 %

 

I wonder what I can do against the depression, which is then coming again. 😞

 

Best wishes,

Lamalein

 

[Altostrata]

On 8/27/2022 at 2:05 PM, Altostrata said:

A reduction from 200mg to 150mg would be a 25% reduction. We recommend much more gradual 10% reductions. See Tips for tapering off quetiapine (Seroquel)

 

[Lamalein]

@Altostrata

 

Hi all,

 

since september I am stable on my meds for the first time since mid 2020, when the horror started.

And I went on with the reduction on october 17th. I didn't follow the 10 % rule, because I really don't know how to work with water solution concerning the Quetiapine. First in september I went from 200 mg retard to 150 mg retard and twice 25 mg unretarded throughout the day. I felt a little bit withdrawal, but stablized soon.

 

Then in october I stopped one 25mg. Now I have 25 mg unretarded in the noontime and 150 mg retarded in the afternoon.

Since then I haven't had any withdrawal symptoms, which is an absolutely new experience for me! It's like a wonder for me.

 

In the mid of november I will stop the other 25 mg unretarded in the noon time.

 

Can this be, that at around 250/200 mg retarded Quetiapine there is some sort of a milestone - when you got this, it's getting easier to reduce? Are there some sort of experiences of that?

 

Besides that:

My biggest issues are right now the 44 lbs which I gained because of Mirtazapine. I am fighting with diet and weight training against it. It's tough.

And my liver got worse again - also because of the bad Mirtazapine.

 

My plan is to go down to 100 mg of Quetiapine until March 2023 - and then I want to reduce Mirtazapine again. I want to loose weight and also reduce liver problems. Maybe I get it until 15 mg of Mirtazapine in 2023, then going on with Quetiapine to stop it completely and afterwards tapering in 2024 the lorazepam with individual tablets of 0,1mg reduction from the pharmacy. I think at the end I will left with Pregabaline... hopefully that I can reduce it also one day.

 

Greetings,

Lamalein

 

[Altostrata]

11 hours ago, Lamalein said:

In the mid of november I will stop the other 25 mg unretarded in the noon time.

 

 

What has been your tapering schedule over the last 3 months?

[Lamalein]

@Altostrata

 

Reductions in 2022 I did:

Quetiapin retard 300 mg
31.01.2022: 250 mg
29.06.2022: 50 mg to noon + 200 mg in the evenig
01.07.2022: 200 mg ret + 25 mg unret.
27.07.2022: 200 mg ret
28.09.2022: 150 mg retard + 25 mg unret. +25 mg unret.
17.10.2022: 150 mg ret + 25 mg unret. at noon

17.11.2022: next reduction

Mirtazapin 45 mg - Water tiration
13.03.2022: 37,5 mg
16.04.2022: 33,75 mg
09.05.2022: 30 mg

[Altostrata]

On 11/1/2022 at 10:27 AM, Lamalein said:

Can this be, that at around 250/200 mg retarded Quetiapine there is some sort of a milestone - when you got this, it's getting easier to reduce? Are there some sort of experiences of that?

 

No, as you get lower in dosage, you need to taper more carefully.

 

Have you been tapering quetiapine and mirtazapine at the same time?

[Lamalein]

@Altostata

 

I know, I heard about that, that in lower dosages you need to be more careful. But for some reasons now the tapering does work much much better, because I am more stable, which makes no sense, but it's like that. I didnt get any withdrawal symptomes - even it was 12 % reduction of Quetiapine for the last step.

 

No, I didn't taper them at the same time. Only once at a time.

[Altostrata]

Please do not change any doses for now.

 

Aside from the weight you've gained, what symptoms do you have now that you attribute to the drugs?

[Lamalein]

Why? If everything stays stable like this, I would reduce the 25 mg Quetiapine at noontime at the end of November.

 

My liver blood values are not good, and my leukopenia is also a problem. These side effects are from Quetiapine and Mirtazapine.

[Altostrata]

On 8/25/2022 at 3:58 PM, Lamalein said:

Right now I am suffering from withdrawal (or maybe also corona infection, which I got on 14th august 2022). Last reduction was on 27th July 2022 for the Quetiapine 25 mg (from 225 to 200 mg). Symptoms which started in the last 5 days: depression, fear, agitation. But actually I have these symptoms until I get the evening dose of Quetiapine, Pregabaline and Lorazepam. When this kicks in, then I am literally like drunk. The depression etc is gone, but I am sedated.

 

You don't get these symptoms any more?

 

[Lamalein]

@Altostrata

 

Hi, not in that manner like before. I came to the conclusion, that I had a protracted Withdrawal from something which I got before this medication. Maybe the risperdal cold turkey or whatever. It took until this september 2022 until it got so much better and stable, that I didnt feel very much of the 25 mg reduction of Quetiapine in october 17th.

 

I had maybe a little bit depression, but the reason could be my PMS, too.

 

I changed my nutrition completely and I started with weight training, and I started to study again - only part-time, but these are my so called skills, I think. They distract me from thinking about medication all the time or trapped in my mind.

 

Greetings,

Sonja

 

 

[Altostrata]

On 8/25/2022 at 3:58 PM, Lamalein said:

Symptoms which started in the last 5 days: depression, fear, agitation. But actually I have these symptoms until I get the evening dose of Quetiapine, Pregabaline and Lorazepam. When this kicks in, then I am literally like drunk. The depression etc is gone, but I am sedated.

 

How have these symptoms changed?

 

What times o'clock do you take each of your drugs, with their current dosages?

[Lamalein]

Hi @Altostrata,

 

when I reduce now (the current one is Quetiapine), I have very smooth low symptoms. No agitation, just a little bit depressive, no fear, no running thoughts in my brain. I cannot explain this change. I pray a lot, going to emotions anonymous, getting distracted by my studies. Maybe these are my skills.

 

The times of the dosages:

 

9.30 h in the morning: 75 mg pregabaline, 0,5 mg lorazepam

 

14.00h afternoon: 75 mg Pregabaline, 25 mg unretard. Quetiapine

 

18.45h evening: 75 mg Pregabaline, 0,5 mg Lorazepam, 150 mg retard Quetiapine

 

24.00h night: 30 mg Mirtazapine

 

Greetings, Lamalein

[Altostrata]

Perhaps the 3 other brakes are controlling any withdrawal from Seroquel. 

 

Suggest you wait at least a month between each reduction. What is your plan if you should get withdrawal symptoms?

[Lamalein]

Hi Altostrata,

 

I am waiting every time 4 - 6 weeks. 

I reduced already from january until september in these steps. I had a bunch of withdrawal symptoms... the described ones. It was horrible.

 

I am actually very familiar with the symptoms - the only thing what I can do, when they are coming is to wait until they are gone. Made the experience that they go away after some time.

 

And going on in doing my things...studying, reading, praying, meeting with friends.

 

End of November I will reduce the 25 mg of unret. Quetiapine. Then I made a 50 % reduction of the ret. Quetiapine in one year - proud of it, but it was a lot of work.

 

Greetings

Lamalein

[Altostrata]

20 hours ago, Lamalein said:

I had a bunch of withdrawal symptoms... the described ones. It was horrible.

 

Please describe the symptoms you had when you reduced from January to September. You joined this site in August and said your symptoms were low and smooth.

[Lamalein]

Hi @Altostrata,

 

Please describe the symptoms you had when you reduced from January to September.

 

agitation, flashbacks of these bad experiences which I made in the 8 hospitals from 8/2020 until 9/2021, ptsd symptoms, derealisation, running thoughts, obsessive thoughts about medication and health problems like my leucopenia, fear of dying because of these drugs, depression, waking up in the morning with extreme heart pounding.

 

I reduced now on 21th november the 25 mg of quetiapine unretard in the noon time. I have no symptoms at all until now - keep you updated.

 

I really don't get this - I mean, yeah, I changed since september my life... but a different nutrition , starting university again to participate in the society, to get a new purpose, getting back to my believe in god - can this calm down my nervous system so much, that medication reduction is possible in that way?

 

I pray for it, that it stays that way. Actually it makes no sense, I had to go through so many bad Withdrawals in the last 2 years and also so many withdrawals which didn't wirk out - normally I should be so sensitive to every reduction of these drugs.

 

But yes, I don't see so many problems with the none-benzo ones, I am frightend about the withdrawal one day (round about 2024) of the lorazepam. How to do it, how to keep the stabilization of right now, how to withdraw it in a good way without getting in some sort of a anxiety psychosis and without these aweful depressions? I really don't know it.

 

Best wishes,

Lamalein

 

 

[Altostrata]

Your withdrawal symptoms may be minimal since you are now tapering more gradually.

 

When did you start lorazepam, what times o'clock do you take your doses, with their dosages?