JoJo1812: Tapering off Trintellix is very difficult

[JoJo1812]

30 days off of Trintellix 20 mg.
Prozac 20mg for 30 days
Welbutrin XL for 10 years
Gabapentin 12mg 6 months
Was on Prozac & Wellbutrin for 10 years, but 2 years ago I was switched to Trintellix because it seemed like Prozac was no longer effective. Now my doc changed me back to Prozac.

 

Seeking advice: I have stopped Trintellix twice in the last 12 months, with tapering per medical plan. The withdrawal symptoms are very hard to endure and I am asking for help or advice;

The first time I stopped Trintellix, I was on a tapering plan to stop all my medications which at that time included Trintellix, Wellbutrin and Seroquel; I tapered off gradually per medical advice and had one or two months when I felt pretty good. Then I started to have horrific withdrawals including brain zaps, body shakes, body temperature fluctuations, excessive sweating, extreme nervousness, anxiety, fear, panic attacks, etc. 

It was scary because my psychiatrist didn't tell me I was experiencing withdrawals so I didn't know what was happening to me. 

My family doctor told me that I'm having withdrawals and prescribed Gabapentin to stop the extreme physical symptoms. It worked at the time for a short period. Then I started bringing back Wellbutrin and Trintellix to stop the withdrawals. I never reached a point of balance and well-being again. My dr said let's go back to Prozac which seemed to work for me in the past for managing anxiety, except for sexual dysfunction. I am now back on Prozac, Wellbutrin and Gabapentin and I am experiencing horrible withdrawals from Trintellix still - dizzy, body shaking, extreme anxiety, temperature dysregulation AND I also have sexual dysfunction from Prozac (no ability to orgasm).

 

I would like to have some hope about the withdrawal symptoms - are they going to go away, when, what can I do to help myself...

and I would like to regain a state of well-being and improve sexual dysfunction. I am willing to taper slowly off meds but I'm not sure if that's the right thing for me especially after being in withdrawal hell for a year.

Any advice on brain rewiring programs? do they work for people who come off this type of medication?

The medications and withdrawals are making it hard for me to function well at work, socially and in my relationship.

 

Thank you for your advice

[Shep]

Hi, JoJo. Welcome to Surviving Antidepressants.

 

Quote

2003-2010 A little of everything

2011-2019 Prozac, Wellbutrin

2020-2022 Trintellix, Wellbutrin, Seroquel (stopped Seroquel Jan 2022)

2022 June: added Gabapentin 1200mg

2023 January: Prozac 20mg, Wellbutrin 300mg, Gabapentin 1200mg

1 week transition from Trintellix back to Prozac

 

Please add the month and year you made the transition from Trintellix back to Prozac in your signature. 

 

Also, your Wellbutrin history is unclear - did you stop Wellbutrin in 2022 and then add it back in in January 2023? What month in 2022? If you're able, please add in the months for the 2020 - 2023 drug changes. 

 

Please see the drug interaction report and note there are MAJOR and MODERATE drug interactions: 

 

Drug Interaction Report - Prozac, Wellbutrin, Gabapentin

 

What time(s) of the day do you take each of your drugs? Please list the time o'clock, the drug name, and the dose. Also, please add any supplements you're taking along with the dose and time you take them. 

 

 

[JoJo1812]

Thank you for the advice. I updated my signature. Hopefully, this clears things up.

[Shep]

Thanks, JoJo.
 

How often are you using clonazepam? Is it along the lines of "once a month for emergencies" or "two or three times most weeks"? Please note it's possible to become dependent on Clonazepam even with periodic use, so the more information you can provide, the better. 

 

Also, did you just start taking clonazepam during January 2023? Do you have the exact month, day, and year? This is needed to help gage your level of dependency. 

 

Please note I updated your drug interactions report to include the clonazepam and this added in another interaction, which you can see here:

 

Drug Interaction Report: Prozac, Wellbutrin, Gabapentin, and Clonazepam

 

Please start a drug and symptoms journal. The reason I'm asking for this is we'll likely recommend spacing out your drugs to prevent drug interactions before you begin your taper. Knowing how you're reacting to your drugs will be helpful. 

 

Here is the information on how to do a drug and symptoms journal, along with an example: 

 

Keep notes about your drug dosages and daily symptom pattern

 

Please do 24 hours of notes at a time (in one post). Also, please include your drugs and your supplements and let us know how many hours you sleep each night.

 

Over the next few days, we'll review your notes and help come up with a game plan for getting you off these drugs safely and as comfortably as possible.

 

[FireflyFyte]

Hi JoJo, glad you found your way here as this site has a lot of invaluable resources.

 

Looking at your signature, it appears that you take your Prozac and Gabapentin at the same time but you might want to start spacing them apart as there is an interaction between the two drugs according to Drugs.com -

 

Treatment with FLUoxetine may occasionally cause blood sodium levels to get too low, a condition known as hyponatremia, and using it with some anticonvulsants can increase that risk. In addition, FLUoxetine can cause seizures in susceptible patients, which may reduce the effectiveness of medications that are used to control seizures such as gabapentin. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. You should seek medical attention if you experience nausea, vomiting, headache, lethargy, irritability, difficulty concentrating, memory impairment, confusion, muscle spasm, weakness or unsteadiness, as these may be symptoms of hyponatremia. More severe cases may lead to hallucination, fainting, seizure, coma, and even death. Also let your doctor know if you develop seizures or experience an increase in seizures during treatment with FLUoxetine. Additionally, because these medications may cause dizziness, drowsiness, and impairment in judgment, reaction speed and motor coordination, you should avoid driving or operating hazardous machinery until you know how they affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

 

I learned this from this site so I now take my Gabapentin at 7:30 AM and my Prozac at 9:30/10:00 AM to avoid any potential issues. 

[JoJo1812]

I updated my signature to more accurately reflect my medical history, including that I am micro dosing with Psilocybin for the Trintellix withdrawals (transitioned off 1/1/2023).  The Psilo has some effect, but usually for only an hour or so.  My shakes and panic are getting worse every day.  

[Shep]

On 2/20/2023 at 4:38 PM, Shep said:

Please start a drug and symptoms journal. The reason I'm asking for this is we'll likely recommend spacing out your drugs to prevent drug interactions before you begin your taper. Knowing how you're reacting to your drugs will be helpful. 

 

Here is the information on how to do a drug and symptoms journal, along with an example: 

 

Keep notes about your drug dosages and daily symptom pattern

 

Please do 24 hours of notes at a time (in one post). Also, please include your drugs and your supplements and let us know how many hours you sleep each night.

 

Over the next few days, we'll review your notes and help come up with a game plan for getting you off these drugs safely and as comfortably as possible.

 

Please go ahead and start this journal. The above link will show you what we need. Also include your Psilocybin micro-doses, as well. 

 

 

[JanCarol]

Hey JoJo - 

 

Welcome to SA!

 

Nobody here has yet mentioned that the likely reason you are suffering is too-fast medical tapers.  Physicians are trained that withdrawal only lasts 3 weeks, and so a 3-6 week taper (or cross-taper) is considered "conservative" by the medical profession.

 

We taper much more slowly here:  Why Taper by 10%?   This is called harm reduction.  If only 30% of people suffer from a too-fast medical taper, then that's too many.  We taper everyone much more slowly to prevent the possibility of this happening, the way it did to you.  The reality is, more like 80% have trouble coming off Trintillex, while "only" 44% suffer coming off of Prozac on a typical medical taper.   We don't want trouble, we don't like trouble, so we go s-l-o-w-l-y to avoid the nasty side effects of coming off the drugs.  (I struggled with Wellbutrin in the 90's - fast tapers don't work!)

 

By tapering only 10% off the current dose, you get a gentle curve - and hopefully you can sneak out from under the drug without your body noticing.  Then you wait 3 weeks for the changes in neurotransmitters to take place, and another week for symptoms to settle before you do it again.  This means what a doctor says you can do in 6 weeks - really takes about 18 months or more for your body to catch up to.  This is how people get destabilised.

 

I wrote to another member ages ago (different drugs, but same message):

Quote

Think of the Saphris (or any drug for that matter) as a wolf or a bear.

 

When you are in the wild and you encounter one of these things, the FIRST thing you must do is: KEEP CALM.  (yeah, I know, the meme and all, but it's true)  The next thing you do is DON'T MOVE!

 

If it is a total standoff and you want to get away, you CANNOT run.  It's you and the bear.  If you run, the bear and wolf have a hard-wired instinct to chase, and you will lose.

 

The goal in a standoff with a bear is to sneak.

 

That's what a taper is.  Sneaking away from the wolf.  You've seen a cat stalk - it waits until the prey is not looking, then moves a bit (maybe 10%?)  then it waits.  And waits.  And waits.  Holding will save your life, when you are in a standoff with a bear.  And Saphris and olanzapine are a bear and a wolf respectively!

 

Before, you dropped your berries and ran away, and the bear caught up to you.  Didn't work. 

 

The goal is to sneak the drug out of your system sooooooo slowly that your brain hardly notices it's gone.  And doesn't chuck a wobbly like before.

 

 

Are you spacing out the gabapentin and Prozac as @FireflyFytementioned?  That's good advice.

 

I'm here because I'm the resident researcher on Plant Medicines.  Many people have gotten some benefits from microdosing, however:  all plant medicines interfere with the same neurotransmitters as the psych drugs.   I question the potential conflicts.   You may be perturbing the system as you try to heal.

 

The way to heal is more about stillness than throwing things at your distress.  SA University teaches you to expand your capacity and explore and be curious about your distress, rather than doing everything you can to shut the symptoms down.  You are gonna have symptoms.  It's better to work with yourself (rather than Plant Medicine) and your ability to deal with distress than to throw stuff at symptoms.

 

Psilocybin microdosing might be immeasurably helpful once you no longer have the neurotransmitter perturb-ers called "antidepressants" and "mood stabilisers" in your system.  Like 3 years or more from now.

Now let's see if I can get some facts for you.

Here's the first one:  You also need to make sure you separate your Wellbutrin and Prozac:

 

Quote

 

Interactions between your drugs

Major

buPROPion  FLUoxetine

Applies to: Wellbutrin (bupropion), Prozac (fluoxetine)

Talk to your doctor before using buPROPion together with FLUoxetine. Combining these medications may increase the risk of seizures, which may occur rarely with either medication. In addition, buPROPion can increase the blood levels of FLUoxetine, which may increase other side effects. You may be more likely to experience seizures with these medications if you are elderly, undergoing alcohol or drug withdrawal, have a history of seizures, or have a condition affecting the central nervous system such as a brain tumor or head trauma. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. You should avoid or limit the use of alcohol during treatment. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

 

 

 

Okay - looking more at the psilocybin - what I see is that modern medicine has shifted yet again in the past few months, and they are touting psilocybin microdosing as efficacious during tapering.  HOWEVER, what I know about modern medicine practitioners is that they love intervening.  Lord, save me from my doctor's interventions!

 

What happens is the psilocybin decreases the connection of your drugs to your neurotransmitters.  Just starting the psilocybin microdoses is decreasing the affinity of your drugs to your neurotransmitters.  So - if you are tapering 10%, if you are tapering 10% with psilocybin, the effect would be more like a 20% drop (I'm guessing, but it would be greater than if you weren't using the psilocybin).  This will make tapering tricky and difficult to measure.

There are people here who, in their tapers, have mis-measured their taper by as little as 1 or 2% and felt the difference, either having to updose to avoid symptoms, or otherwise.

 

The psilocybin is a variable that we at SA are incapable of dealing with.  We don't know how much it decreases Wellbutrin (probably less, because it's less serotenergic), how much it decreases Prozac (more significantly).

I see that you mention mg and take it 2x a day.  It was my experience with microdosing that you do something like 3 days on, 2 days off.  Or every-other-day, because of the "psychedelic reset."  So I'm curious about this 2x a day schedule - is this prescribed medicine?  Under the care of a doctor?  Or do you get it from the street?  If you get it from the street, how do you know the strength of it?

 

I can't tell you to stop it, but I can tell you it's a variable - we don't really know what it's doing.  When the goal in withdrawal is 3 KIS's Keep It Simple, Slow, Stable - I can't help but to see it as a pertub-er rather than a helper.

 

Your log may help - as you separate your conflicts:  Prozac, Wellbutrin, Gabapentin - keep them 1-2 hours apart in your daily doses.

 

And think about the doctor who prescribed them to you - and how could they possibly miss these major interactions?  If this is the doctor who prescribed your psilocybin - perhaps you want to rethink the process.  It's doctors who got you into this mess.  It is our goal to get you out.

 

Please look at Non-drug techniques to cope with emotional symptoms to help expand your capacity to learn from your symptoms.

 

Also you may be helped by using a chart to track your symptoms.  This is a chart of most common (though not all) symptoms of antidepressant withdrawal  http://survivingantidepressants.org/index.php?/topic/2390-dr-joseph-glenmullens-withdrawal-symptom-checklist/page-2?p=208544#entry208544  

 

What are your goals?  First - get stable, right?  Then what?  If it were me, I'd get rid of the Wellbutrin, first (most activating), then the Prozac.  Because of the affinity of Prozac and Gabapentin for the same receptors (doctors, I swear, how do they get away with prescribing these things?) - you may need to alternate tapers between those two.  That's if you want to be totally drug free.

 

Or maybe your goal is to reduce your drug load - what is your goal?  Why are you here?  This is a site for tapering off psych drugs, that's what we do.

 

I hope you see the sun today.

 

Edited February 22, 2023 by JanCarol

[JoJo1812]

DAILY DRUG JOURNAL

2/21/2023

6a   woke up, breakfast

       Prozac 40mg, Gabap 600mg, Wellb 300mg, 0.3mg

7a   psilocybin 0.3mg

10a snack - bagel

11a began to feel panic, heart racing - no reason

12p left work - 30 min nap at home

1p 0.2mg psilocybin

3p  gabapentin 600mg

6p  .25mL 1:1 THC:CBD drops

8p barely able to walk, nauseous

9p went to bed

 

2/22/2023 

6a   woke up, VERY shaky, had crazy dreams

       Prozac 40mg, Wellbutrin 300mg, Gabapentin 600mg

7a   psilocybin 0.3mg

       shaking all morning, fearful, high anxiety

8a   breakfast

12p lunch, still VERY shaky

2p  spoke with psychiatrist - he increased Gabapentin to 900mg/3 times per day

      Gabapentin 900mg

3p  began to calm down, mild shakiness

7p  dinner

10p sleep

[Altostrata]

@JoJo1812 Which of these symptoms do you think are withdrawal symptoms?

[JoJo1812]

The shakes and high anxiety

[Altostrata]

4 hours ago, JoJo1812 said:

Prozac 40mg, Gabap 600mg, Wellb 300mg, 0.3mg

7a   psilocybin 0.3mg

 

The batches of drugs you are taking together at the same time appear to be responsible for your "shakes and high anxiety". 

 

When you take too many psychotropics at too high doses, you can get what's called a paradoxical reaction, where the drugs do the opposite of what they're expected to do.

 

Your extensive drug use and dosing schedule is causing your problems. 

 

Quote

 

January 1, 2023: 1-week transition from Trintellix 15mg back to Prozac 20mg, still taking Wellbutrin XL 300mg, Gabapentin 600mg/600mg, Clonazepam 1.0mg 2x/wk

February 10, 2023: Prozac 40mg, Wellbutrin 300mg, Gabapentin 1800mg(AM, mid-day,PM), Clonazepam 1.0mg 2x/wk

 

 

Exactly what drugs and supplements have you ADDED in the last 2 weeks? If I were you, I'd stop them right now.

 

Exactly what drugs and supplements have you INCREASED in the last 2 weeks? From your signature, this appears to be

• Prozac (20mg to 40mg)
• Gabapentin (600mg 2x day to 600mg 3x day)

If I were you, I'd go back to prior dosages immediately -- 20mg Prozac and 600mg gabapentin 2x day. 

 

Most likely, you'll still be taking too much of everything, but not as ludicrously excessive as before.

[JoJo1812]

My ultimate goal is to be prescription psych drug-free.  For now, I would love to get stabilized - for me this means being free of constant fear and high anxiety so I can go to work and some evening classes.  I know this is going to take a while... months/years, but I am willing to slowly make the changes.

 

Thank you to everyone on here.

[Altostrata]

Please post daily notes after you reverse all the drug increases you've made in the last 2 weeks. Thank you.

[Shep]

@JoJo1812In your signature, some of the Wellbutrin mentions are "XL" and some are not. What formula of Wellbutrin are you currently taking - is it extended release? 

 

Also, you have "Clonazepam 1.0mg 2x/wk" listed in your signature. Please be sure you mention any time you take this drug, the time, and the dose in your daily notes. 

[Hanna72]

Hi @JoJo1812

Might also mention this increase in your signature. Hope I am not mistaken?

5 hours ago, JoJo1812 said:

2p  spoke with psychiatrist - he increased Gabapentin to 900mg/3 times per day

      Gabapentin 900mg

Hopefully things will settle for you soon.

[JoJo1812]

2/23/2023 - *spacing out meds and eliminating psilocybin

6a   woke up, slept ok, mild shakiness

       Gabapentin 900mg

7a   Prozac 40mg

8a   Wellbutrin XL 300mg

9a   breakfast

11   snack

12   shakes, shortness of breath

3p   Gabapentin 600mg

5p   Symptoms decreased, was able to go to class without any issues

10p Gabapentin 600mg

 

2/24/2023

6a   woke up, slept poorly

       Prozac 40mg

8a   Gabapentin 600mg

10a Wellbutrin XL 300mg

2p   Gabapentin 600mg

10p Gabapetin 600mg

 

2/25/2023

8a   woke up, very vivid dreams

       Prozac 40mg

10a  Gabapentin 600mg

11a  Anxiety and shaking while at a memorial service 

12a  Wellbutrin XL 300mg

1:30p Started having anxiety, increased to racing heart and chest hurting

2p   Gabapentin 600mg - this did not help with anxiety, shaking

 

Spacing out the drugs REALLY helped with morning anxiety. I am starting my day well now. I hit a wall mid day when I start to get anxious and shaky.

 

Last three days seem to have been better until today when mid-day anxiety is overwhelming and the Gabapentin dose hasn't touched it. I went to a memorial in a place that used to be special and where I experienced trauma two years ago and with people I hadn't seen in a while so it's possible that anxiety is worse because of the events.

 

I am wondering if I have a problem related to Gabapentin wearing off. I used to take Gabapentin only twice per day and since increasing to three times per day I was better except for today. Do I have a physical dependency on Gabapentin? I would like to be able to start tapering this. since this drug wears off 5-7 hours after taking it which is reflected in how I start feeling about 6 hours after I take a dose, I am wondering if should I split out the doses in 4 intakes instead of 3.

 

I am afraid to lower my doses abruptly now and would like to start slow tapering.

 

Questions:

- should I split Gabapentin in 4 doses to stay ahead of anxiety when this medication wears off

- which drug should be my first taper and how to start tapering? I can crush pills and blend them in liquid form and take whatever amount I need to take

- what should be my taper plan

 

 

 

Questions:

- what 

 

Which drug should I begin tapering first?

[littlebird]

2 hours ago, JoJo1812 said:

Spacing out the drugs REALLY helped with morning anxiety. I am starting my day well now.

 

I had the same experience! Spacing out Gabapentin and Wellbutrin was a wild change for my brain.

 

2 hours ago, JoJo1812 said:

I am afraid to lower my doses abruptly now and would like to start slow tapering.

 

If you choose to lower Gabapentin, go slow! I did a fast taper and it was all bad for my anxiety. It was rough, I'm still coming back from that. I noticed that emotional blunting/numbing I'd been experiencing faded a bit when I lowered Gabapentin. I didn't expect that! I started feeling happier, which was nice, but also started feeling everything more strongly.

[Altostrata]

Have you reversed all the drug increases you made in February? Why are you taking that whopping and inconsistent daily dose of gabapentin?

 

On 2/23/2023 at 2:49 PM, Altostrata said:

Please post daily notes after you reverse all the drug increases you've made in the last 2 weeks. Thank you.

 

[Shep]

@JoJo1812 I noticed you have "Garden of Life, Magnesium" in your signature. Please add when you take your supplements in your drug and symptoms journal. 

 

There's an interaction between magnesium and gabapentin, so you'll want to also space this supplement out, too. Please see: 

 

Magnesium, nature's calcium channel blocker

 

 

Quote

 

IMPORTANT:  There is an interaction between gabapentin and magnesium, see http://www.webmd.com/drugs/2/drug-9845-8217/neurontin-oral/gabapentin-oral/details/list-interaction-details/dmid-1207/dmtitle-gabapentin-aluminum-magnesium-containing-compounds/intrtype-drug.

 

Taking magnesium at the same time as  Neurontin/ gabapentin decreases the absorption of gabapentin.

 

Avoid taking aluminum or magnesium containing products (such as antacids) for 2 hours before your gabapentin.

 

 

[JoJo1812]

2/25/2023
8a   woke up, very vivid dreams
       Prozac 40mg
10a  Gabapentin 600mg
11a  Anxiety and shaking while at a memorial service 
12a  Wellbutrin XL 300mg
1:30p Started having anxiety, increased to racing heart and chest hurting
2p   Gabapentin 600mg - this did not help with anxiety, shaking
6p   Clonazepam 0.75mg - relieved anxiety and shakes
8p   Gabapentin 600mg

 

2/26/2023
6a   woke up, slept well
       Gabapentin 600mg
8a   Prozac 40mg
10p Wellbutrin XL 300mg
2p  Elevated levels of anxiety, stress, agitation
4p  Crying for no reason
10p Gabapentin 600mg

 

2/27/2023
6a   woke up, slept well
       Gabapentin 300mg
8a   Prozac 20mg
10a Wellbutrin XL 300mg
11a  Anxiety levels elevated, heart beating hard
12p Gabapentin 300mg
6p   Gabapentin 300mg
10p Gabapentin 300mg

 

2/28/2023
6a   woke up, did not sleep well
       Gabapentin 300mg
8a   Prozac 20mg
10a Wellbutrin XL 300mg
11a  Anxiety levels went up, agitated
12p Gabapentin 300mg
 

[Altostrata]

1 hour ago, JoJo1812 said:

11a  Anxiety levels went up, agitated

 

This is the interaction of Wellbutrin and Prozac. You started Prozac again at 20mg on January 1?

[JoJo1812]

Yes, I started again on Prozac January 1, 2023.

[Altostrata]

On 2/23/2023 at 2:49 PM, Altostrata said:

Please post daily notes after you reverse all the drug increases you've made in the last 2 weeks. Thank you.

 

It appears that you have not reversed all the drug increases you've made in the last 2 weeks.

 

Quote

 

February 10, 2023: Prozac 40mg, Wellbutrin XL 300mg, Gabapentin 1800mg (AM, mid-day, PM), Clonazepam 1.0mg as needed, usually 2x/wk.

February 26, 2023: Prozac 20mg, Wellbutrin XL 300mg, Gabapentin 300mg 4x/day (6A, 12p, 5p, 10p), Clonazepam 1.0mg as needed, usually 2x/wk

 

 

On February 26, you decreased Prozac but increased gabapentin? Why did you do that?

[JoJo1812]

I’m sorry for the confusion, but I already have returned to the dosages I was taking two weeks ago: Prozac 20, WellB 300, Gabapentin 1200. My log and signature show that I am taking Gabapentin 300mg four times a day.

[Altostrata]

Which of your current symptoms do you attribute to withdrawal?

 

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

[JoJo1812]

I believe I am still experiencing withdrawal due to the panic attacks, shaking in general most of the time, and fatigue.

 

My drug interaction report is attached to this post.

Drug Interaction Report_ gabapentin, magnesium glycinate, Multi Vitamin+, Prozac, Vitamin B Complex 100, Wellbutrin.pdf

 

Here's a link to your drug interaction report for the following:

gabapentin, wellbutrin, prozac, and clonazepam from Drugs.com

(I did not include psilocybin or vitamins)

 

(so we don't have to work with downloads, they are a pain)

Edited March 3, 2023 by manymoretodays
added direct link to drug interactions

[JoJo1812]

3/1/2023
7a   woke up, did not sleep well, restless night
       Gabapentin 300mg
9a   Prozac 20mg
11a Wellbutrin XL 300mg
1p   Gabapentin 300mg
6p   Gabapentin 300mg
8p   Multi-Vitamin, B-Complex, Magnesium
10p Gabapentin 300mg

 

3/2/2023
5a   woke up, did not sleep well, restless night
       Gabapentin 300mg
7a   Prozac 20mg
9a   Wellbutrin XL 300mg
10a  Anxious, want to crawl out of my skin. Left work for 2 hours.
11a   Gabapentin 300mg
5p   Gabapentin 300mg
10p Gabapentin 300mg
 

[Altostrata]

You took no clonazepam on these days?

 

My guess is that you are having fatigue and paradoxical reactions from clonazepam and overuse of gabapentin, which you do not take on a regular daily schedule, plus adverse reactions from or interaction among the massive doses you're taking of the other drugs.

 

Of course, sexual dysfunction is common when people take Prozac, and often addition of Wellbutrin does not help this.

 

In other words, your current symptom pattern is not withdrawal but because you're taking TOO MUCH of everything, and occasional psilocybin doesn't help.

 

If I were you, I'd seriously consider reducing your drug burden. Its complexity is a problem for peer support, particularly the  irregular dosing of clonazepam and gabapentin, and may be beyond our capacity here.

 

In the last 2 weeks, how often have you taken clonazepam? Was there a recent period when you took it every day.

[JoJo1812]

Based on the suggestions I have already received, my symptoms have improved, and I have done everything people in this forum have recommended me to do.  I greatly value the support I am getting from this site, which has been much better than my psychiatrists.

 

I am hoping to make a plan to significantly reduce and/or eliminate the drugs I have been prescribed.

 

Clonazepam: I have not taken it daily in 2023. On average, I take 0.5mg twice a week during major anxiety attacks.

 

Should I start a new Post so the topic is about reducing all my drugs rather than just the Trintellix?

[FireflyFyte]

On 3/5/2023 at 11:49 AM, JoJo1812 said:

Should I start a new Post so the topic is about reducing all my drugs rather than just the Trintellix?

 

From my understanding, it is one introduction post per person so you should continue to post here. My title references Latuda but am currently tapering Zyprexa.

 

On 3/5/2023 at 11:49 AM, JoJo1812 said:

I am hoping to make a plan to significantly reduce and/or eliminate the drugs I have been prescribed.

 

Remember that slow and steady wins the race when it comes to reducing these medications. Generally speaking, you should only reduce a single medication at a time and at a rate of no more than 10% per month. Usually, you would reduce the most activating drug first but there are exceptions to this advice. 

[Altostrata]

On 3/5/2023 at 8:49 AM, JoJo1812 said:

Clonazepam: I have not taken it daily in 2023. On average, I take 0.5mg twice a week during major anxiety attacks.

 

 

Good to hear. Was there a period in 2022 when you took it daily?

 

On 3/5/2023 at 8:49 AM, JoJo1812 said:

Should I start a new Post so the topic is about reducing all my drugs rather than just the Trintellix?

 

Nope, this is the place to discuss tapering any of your drugs.

[JoJo1812]

Clonazepam: I took 0.25mg daily in August and September 2022, but only occasionally since.

 

I saw a new psychiatrist yesterday (due to insurance change).  I shared about my plan to eventually be drug-free and that I was still struggling with anxiety, especially strong anxiety attacks.  She felt that I should first get stabilized and then we can start a plan to taper off.  Unfortunately, she believes I should increase my Prozac from 20 to 40mg and Wellbutrin from 300 to 400mg.  I don't think this is a good idea.

 

The clinic is also recommending TMS for my Treatment-Resistant Depression.  Any thoughts?  It is 100% covered by my insurance.

[Altostrata]

@JoJo1812 you have been on and off psychiatric drugs for 20 years. You are now taking substantial doses of 3 psychiatric drugs, one of then gabapentin 4 times a day. Your dosing of gabapentin alone is enough to mimic "treatment-resistant depression".

 

Most likely, what your doctors have been calling "treatment resistant" depression has been a series of adverse drug effects and periods of withdrawal syndrome for many years. If you have drunk alcohol, taken antibiotics, gotten covid, or skipped doses of any of your drugs, you could be making the unpleasant symptoms worse.

 

10 hours ago, JoJo1812 said:

she believes I should increase my Prozac from 20 to 40mg and Wellbutrin from 300 to 400mg

 

Ordinarily, these drugs do not act as anxiolytics. Both can cause insomnia. Wellbutrin is very well known for causing nervousness and anxiety. 

 

In fact, your symptom pattern in your daily notes shows a bout of "anxiety" regularly after you take Wellbutrin and Prozac together. Did you read your Drug Interaction report? This combination has a major interaction. Your new psychiatrist wants to increase doses of both of them. Do you think that's a good idea?

 

This is a site for going off psychiatric drugs. What is it that you want to do?

[littlebird]

8 minutes ago, Altostrata said:

Your dosing of gabapentin alone is enough to mimic "treatment-resistant depression".

 

This caught my eye, just wanted to say when I was taking the Gabapentin dose you're on, it was definitely making my depression worse and doing a lot of emotional blunting. I felt a lot better after lowering it, and have a greater range of emotions now. This includes happiness, and also processing of less pleasant emotions that had been numbed out that came up to the surface. Worth it for me.

 

10 hours ago, JoJo1812 said:

The clinic is also recommending TMS for my Treatment-Resistant Depression.  Any thoughts?  It is 100% covered by my insurance.

 

Not a medical professional, just someone who knows a fair number of people who tried it. At best, it helped a lot, and at worst the people I know just had a neutral experience with it (aka "That took a lot of time, not sure it did anything"). Neutral is pretty darn good for a treatment, more than I can say for pills!

 

One person who felt better afterwards wondered if she was improved by the TMS, or by getting to go in every day of the week and talk with someone (when before she hadn't been getting enough therapy or social time). 

[JanCarol]

11 hours ago, JoJo1812 said:

The clinic is also recommending TMS for my Treatment-Resistant Depression.  Any thoughts?  It is 100% covered by my insurance.

Hey JoJo - 

 

"Treatment resistant Depression" is a phrase used when psychiatrists fail with their concoctions, as Alto describes above.  It doesn't mean that your depression is any better or worse or harder or easier than anyone else - it just means that "the drugs aren't working."  Alto, also says they want to INCREASE your drugs?  Sure, if this doesn't work, let's do more of it!  (see "insanity" quote, below)  (makes me want to cuss!).

TMS is slightly scary.  My bro-in-law had TMS at an internationally acclaimed neurology clinic (not a cowboy clinic, of which there are many popping up - psychologists & other healthcare practitioners take a weekend course and are rarin' to go).  His results were good - it was done in conjunction with fMRI to improve connectivity in his brain (not a mental illness - but helped with his "PTSD" and "ADHD").  HOWEVER - 

Before you consider TMS, please read the following:

https://www.madinamerica.com/2020/04/tms-damaged-my-brain/  (I have great respect for this author)

https://www.madinamerica.com/2020/12/seizures-constant-headaches-my-tms-experience/

https://www.madinamerica.com/2022/02/toxic-marketing-business-selling-tms/  (same author as first article)

 

littlebird's  suggestion that it "can't hurt" is not true.  It's fiddling the brain, possibly causing a sort of light brain damage (Peter Breggin seems to think so) that might "smooth your mood" a bit - but also may have a price which is dearer than you want to pay.

They are offering it to you because they are failing, and they know it.  Similar story with ketamine & often psychedelics.  Practitioner is desperate, and will throw anything at you.  Their toolkit is extremely limited - drugs and "treatments."  TMS is ECT lite.  Just because it's gentler, doesn't mean it's less disturbing to your brain.  Additionally - we have very little evidence about its use in conjunction with destabilisation in antidepressant withdrawal (which is you).  It could make things worse, very very easily.
 

Part of this is how you present yourself in the office.  How do you talk to a doctor about tapering and withdrawal?  I learned, over the course of my taper, to stop presenting "sick," and start presenting "well."  By doing so, the p-doc was more willing to work with me on tapering and other protocols.  If I truly expressed my inner self* (like we are encouraged to do) doc was happy to throw drugs at my distress.   There's always a distress that the p-doc could be interested in!  You don't need to reveal all your secrets in that room!   I never made it to "treatment resistant" - which basically means the doc has given up.  I've since evolved to believe that my mood is none of my medical team's business.  I'll manage that myself, thanks.

 

*that's what therapists are for - NOT p-docs!

 

Is this the new p-doc?  You said you were getting a new p-doc?   (it seems this is the case) 

 

This doesn't sound any better than the old p-doc.  They didn't notice the major interactions between your drugs when they reviewed them first visit!  We picked it up right away here at SA, and we're all peers, not specialists.  Someone who is trained in prescribing should notice this!

 

Remember - docs got you into this.  “We can not solve our problems with the same level of thinking that created them”   - Albert Einstein and "The definition of insanity is doing the same thing over and over again and expecting a different result."    - Rita Mae Brown

 

Think of your doctors as prescribers.  They are not healers, or fixers (that is your job) - they do want to ameliorate suffering, but really don't understand the connection between these drugs and suffering.  It's up to you to choose how you want to be drugged - and to carefully work your way in that direction.  If the doctor is not a partner or helper in what you want - sorry, try again.

 

(By the way, you never answered my questions about psilocybin - was it prescribed by a doctor?  Or are you using street drugs?  Your daily protocol is unusual for microdosing, and I fear you may have gotten further bad advice.  As if your psych drug conflicts weren't bad enough . . . )

 

How are you coming along with your Non-drug techniques to cope with emotional symptoms ?

 

I hope you see the Sun today!