Meehai intro

[meehai]

Hey folks, I've been struggling with meds for a while now, history below:

this first started with substance "abuse" (anytime i mention this, I wouldn't classify it as abuse, in the sense of how frequent I used), serotonorgic class, max 2 times a month for a few months, choice was made to "self medicate" ( i was doing pretty bad, but somehow still bearable)

surprisingly this got me out off the loop of negative thoughts, was quite surprised to see this part of the world, but soon enough realized I am VERY senzitive to such things

Start of 2021:
first "treatment", risperidone, depakene, sertraline, took them around 3 months when I felt better than I cold turkey-ed for the substance abuse again.

Mid 2021:
SA lasted for a while, a few months later used a different thing (dopamine agonist), twice, which in a month made me go into psychosis
doc appointment again, risperidone, sertraline 100mg, buspirone, combo didn't work (thought I was going insane)

different appointment again, olanzapine, lorazepam, sertraline (great combo, back to "normal in a few days)

Autumn 2021:
after a few months, stopped taking the meds, but occasionally taking sertraline as I remembered, till i dropped them around in the spring of 2022, few months pass

summer 2022
Feel bad, dissociated, no mood for things, no motivation

doc appointment, paroxetine, got me back to stable but the sexual side effects were horrible, after 5 months
Winter 2022

stopped as doctor advised (because was feeling well except the side effects), back pain, hard to breathe, heart aches, eye pain all due to withdrawal + dissociation, social isolation, not feeling like talking

couldn't make it, doc appointment again spring 2023, sertraline 25mg, fixed me
couldn't stand the sexual side effects, cold turkeyd again, after a few weeks, anxiety that started to increase periodically, until one night when I started seeing traces and visual stuff, felt like being high but very weird, anxiety was horrible,

that was not how I ever felt before starting any of these
Got scared ^ continued with the sertraline until
April 2023

doctor appointement, wanted something different, got tianepetine and trazadone
first month was good (probably due to stopping sertraline soon enough or because of the trazadone), couldn't take trazadone anymore as it was too sedating
after 1-2 months started feeling bad again but I didn't let it get to worse
June 2023 (here I stopped quitting meds, and realized it's serious)
another appointment at different doc, tried mirtazapine, horrible.
tried 10mg vortioxetine, weird side effects at first, weird dizziness and mental sensations, but kept going, stabilized after a month

felt ok, but anxiety was killing,
August 2023
decreased at 5mg and tried to use some gabapentine for anxiety, not the greatest but I'm stable and sex drive is decent

Present: 5mg vortioxetine, 300mg gabapentine at night

I'm just so confused, because the first time I quit the meds, it took around 3 months for me to get into widthdrawal (progressively got worse, until I couldn't stand it). But the fact that it took that long to feel bad, was just making me wonder, maybe that's just how I am? Paradoxically I'm not having any negative thoughts compared to the past, I'm very happy with my life (except all those meds messing me up with side effects).

I am tempted to start a slow taper, but the calculations to make solutions seem pretty hard.

I'm hoping you can give me some friendly advice about, withdrawal vs that's just who I am...

 

 

[Emonda]

Hi @meehai, and welcome to S.A.

 

Thanks for including your drug signature. It looks like you had quite a few changes over the past few years. This would likely be quite unsettling for you.

 

So, you've been sitting comfortably at 5mg of Vortioxetine and 300mg of Gabapentin since August? No unpleasant WD symptoms? Maybe take a look at the WD symptom checklist to check possible symptoms.

 

The comment below...this is how you've felt previously, not now? Just making sure I understand.

 

On 11/17/2023 at 12:39 AM, meehai said:

I'm just so confused, because the first time I quit the meds, it took around 3 months for me to get into widthdrawal (progressively got worse, until I couldn't stand it). But the fact that it took that long to feel bad, was just making me wonder, maybe that's just how I am?

 

For some, it can easily take 3-6 months for WD symptoms to hit you. So, I'm not sure I'd take feeling progressively worse when you've quit meds in the past as a sign that "that's just who I am". I reckon when you glance at the WD symptom checklist above, it'll lead you to believe you've previously experienced WD symptoms, not a relapse as such.

 

As to tapering, if you feel settled now, then you should read about the maximum 10% monthly taper we use here

 

 

It's advisable to only taper one drug at a time. That way, if you have unpleasant WD symptoms, you know what the cause is.

 

This link outlines the process of deciding what to taper first. I would start tapering Vortioxetine first.

 

 

 

As to tapering Vortioxetine, is there a liquid version where you live? I take the same AD, and we only have tablets where I am, with the smallest tablet being 5mg. I simply crush/pulverise the tablet into a very fine powder, use a funnel to get the power into a 20ml syringe, add 10ml of water, shake viciously for a while, then taper/remove the unwanted amount with a 0.5ml syringe.

 

You may find this link helpful:

 

 

In preparation for tapering, the following two links will be helpful for you:

 

 

 

 

We don't suggest many supplements, but two that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. Add one at a time and start with a low dose to see how it affects you. 

 

 

 

Avoid alcohol. 

 

Please post any updates here in your thread. It is helpful to keep everything related to your journey in one spot. You are very welcome to jump onto someone else's page and interact with them. The encouragement members give each other on this site is wonderful to see.

 

Sing out with any questions. 

 

Once again, welcome to S.A.

 

Emonda.

 

 

[meehai]

On 11/17/2023 at 5:18 AM, Emonda said:

The comment below...this is how you've felt previously, not now? Just making sure I understand.

 

On 11/16/2023 at 3:39 PM, meehai said:

I'm just so confused, because the first time I quit the meds, it took around 3 months for me to get into widthdrawal (progressively got worse, until I couldn't stand it). But the fact that it took that long to feel bad, was just making me wonder, maybe that's just how I am?

This is how I feel when I CT meds. Dropping from 10mg - 5mg vortioxetine was a change for the better (I believe 10mg was too much for me).

When I dropped sertraline from 50mg to 25 mg, I wasn't feeling extremely good, but I wasn't going crazy either.

I don't have a vortioxetine liquid version here either, but I think for now I can only use a 20ML syringe, fill it with 10ML, dissolve then remove 1 ML, from 5mg to 4.5mg.

Then further down the line, I could get it in the 0.5ML syringe too, but the math is kinda killing me,  or wait actually its pretty easy

10 ml ....... 5mg
x ml ....... 4.5 mg 
x = 10 * 4.5 / 5 = 9 ml for 4.5 mg

Would it be good to dissolve this in vodka? On the current vortioxetine instructions that I have, they mention a liquid solution although not sold, about having 96% ethylic alcohol - 1ml has 85 mg alcohol, but probably I couldn't do this because their solution is very concentrated, thus a very little amount of alcohol. The whole bottle for a month Im suspecting has 30ml, but we're dissolving one dose in just 10 ml. But shall I try to put some to help it dissolve?

Thanks a lot for answering, I really wish this is going to go well :V

 

[meehai]

As far as I read on here, vortioxetine is not very soluable in water, this is why Im wondering if just water is enough? And also, could you help me wit more details please about how you exactly crush the pill? Thanks again 😊

[Emonda]

15 hours ago, meehai said:

As far as I read on here, vortioxetine is not very soluable in water

 

So long as you crush the tablet into a fine powder, water has been just fine, in my experience. I wouldn't mix the tablet with vodka.

 

15 hours ago, meehai said:

And also, could you help me wit more details please about how you exactly crush the pill?

 

I crush the tablet between two soup spoons initially. Then, I use the tip of one spoon to further crush the tablet particles into even smaller pieces which are sitting on my second spoon. You can buy a mortar and pestle set online, which is another way of doing it. For me, two spoons was quick, cheap and easy.

 

Hope this helps.

[meehai]

Started 10% tapering, first day of 4.5mg. 🙃

[meehai]

I'm feeling really bad today, although some personal problems got in it.

Strangely, I've also took 2.5 mg and it wasn't that bad 🤔 will monitor up in the next days too

[meehai]

To make it clear, took 2.5mgs for a few days when I had really extreme anxiety as I didn't know the cause. Hopefully it's not because the tapering cause it wouldn't make any sense. Hard to differenciate if it's withdrawal or just life stuff. Ugh 

[Emonda]

I'm a little confused. You started tapering from 5mg to 4.5mg. That sounds fine.

 

Then you mention 2.5mg. Have I missed something, or did you just drop from 5mg, to 4.5mg, to 2.5mg? 

 

Personally, If I dropped like that, I would not be feeling very good at all! I'd be riddled with anxiety and all sorts of other WD symptoms.

 

I look forward to your clarification.

 

Consistency is key in terms of dose and time of day taken.

[meehai]

Hey no, before starting the taper, there was a period when I started having really huge anxiety, and because my doc was unavailable, I tried going to 2.5 for a few days (2-3 days) to see if that helps. I started feeling pretty bad, (but not as bad as the day I left that comment) and the anxiety was not reducing, so I got back to 5mg), hence the comparison between those dosages. (feeling worse on 4.5 than 2.5 wouldn't quite make sense)

 

The bad mood is gone, was just on that specific day, so problem was some thought induced bad mood or possibly the transition from pills to liquid*?

 

But yeah, back on track now, feeling good ☺️ Still going for 4.5, next month it's going to be 4.05 which I'm going to keep for 2 months to make sure things are stable.

 

Thanks very much for your support and being here 💙

 

 

[Emonda]

9 hours ago, meehai said:

transition from pills to liquid*?

 

I do know that transitioning from pills to liquids causes some grief, so this may well be the trigger. The fourth post down addresses the recommended change-over approach:

 

 

9 hours ago, meehai said:

But yeah, back on track now, feeling good ☺️

 

Excellent

[meehai]

Reinstated back to 5mg pill. Either I'm not doing something well, but I'm not feeling well. Also feeling dizzy and weird.

 

[Emonda]

Dizziness is a stock standard WD symptom, Meehai. 

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

Have a read of the above list so you know what to expect when tapering, even when at 10%. 

 

You don't want to jump around with your dose. Your body needs stability. 

 

You may like to consider the The Brassmonkey Slide Method of Micro-tapering . This is the approach I take. I drop 2% per week for 4 weeks, then hold for a further 2 weeks. I've currently hit an unpleasant patch (wave), but I'll hold my dose and ride it out.

 

I hope these comments help.

[meehai]

Uh, I'm trying to make it stable, but today I felt really bad and also having waves and windows throughout the week.

 

I'm not feeling well at all on this med, the anxiety is making me so uncomfortable. Mostly the double heart beats, my psych just ignored me when I told her.

 

Anyways, this was definitely withdrawal. So is it okay if I try to fight it back? I don't want either to rush the process but I don't either feel well on this med.

[meehai]

Back to 5mg, stabilizing, huh, that was horrible. Will try again after I'm stable.

 

1. Try 5mg as liquid for 2 weeks, see if the liquid solution is working as expected

 

2. Taper 2.5% first two weeks, based on that either choose to go full month or go another 2.5% to make it 5% of initial dose

 

3. Taper off with 5% per month, may adjust more in time

 

Q: anything on here stating if small withdrawal appear should you fight them or just reinstate?

 

Very curious if (1) is going to be alright, I think that plays a role too.

[meehai]

Ditched off liquid tapering. Using a scale for now.

 

Started today 4.5mg.

[meehai]

Going well.

 

Anxiety is feeling more intense, probably a symptom of destabilization. Extrasystoles, but now I know they're caused by anxiety (got cardio checked).

 

Weird mood boost, I suspect it won't last long.

 

Hopefully I'll be able to stabilize the anxiety and continue the taper. 🤞

[meehai]

After a week after doing my first reduction, I observed some symptoms:

- increased anxiety

- extrasystoles

- increased heartbeat after eating to the point of being VERY uncomfortable

- blurry vision

- libido fluctuations

 

Glad to say those all stabilized over the course of a month and tomorrow I'm going down 10% more. 🙏

[littlebird]

1 hour ago, meehai said:

Glad to say those all stabilized over the course of a month and tomorrow I'm going down 10% more. 🙏

Hey, that heartrate thing makes me worry that 10% might be a bit of a bump. Please keep an eye on your health (especially anything heart-related). Could you do a slower taper, like the one you mentioned before at 2.5%?

[meehai]

On 2/17/2024 at 3:06 AM, littlebird said:

Hey, that heartrate thing makes me worry that 10% might be a bit of a bump. Please keep an eye on your health (especially anything heart-related). Could you do a slower taper, like the one you mentioned before at 2.5%?

Hiya, thanks for your input! Really appreciated!

Those increased heartbeats when eating have been going on for quite a long time, so I'm not surprised they have increased when I lowered my dose, although what I'm relying on to rule out if it was too much of a change, was that out of the full month, those lasted just a week, so I hope that was not too much of a disruption to my nervous system. 

I would like to see how I react to this next change also, and based on that I may need to do a slower taper, or just change the strategy to a 2.5% per week instead of 10% per month.

Already been to a cardiologist, they said everything is fine.

[meehai]

In the last 3 days I got a weird head / back neck tension with sometimes dizziness. And today a weird wave of sadness, that just made me click, it's probably withdrawal. Not sure why, but I always get delayed withdrawal.

 

I'll try to hold off for a few more days to see how it goes. I thought it's gonna go well 😩

[meehai]

Think I'm back to normal, might ve been dehydration/not eating enough.

[meehai]

Update after staying at 2.5 mg for more than a month. After a week or so since I got to this dosage, dizziness kicked in, daily, but it has been fading away as time passed, I don't really feel it anymore. After 1 week of disturbing dizziness, high anxiety kicked, meanwhile the dizziness was bearable. After a few weeks, I stabilized from those, but I'm starting to feel pretty sad/drained/feels like my brain is straining to function.

I won't do any reductions for a period of time, but when should I increase my dosage if things don't resolve? Thanks 

[meehai]

I think I stabilized now, thinking when to do the next cut 🤔

[LostInCanada]

On 10/19/2024 at 5:09 PM, meehai said:

thinking when to do the next cut

How are you doing @meehai?

Best to wait till your symptoms stop or lessen before making your next cut.

On 10/13/2024 at 6:29 AM, meehai said:

when should I increase my dosage if things don't resolve?

If dropping 10% of your current dose results in too many withdrawal symptoms, it might be better to reduce by a smaller amount. You could try 5% and see if that is easier. 

Let us know how you are doing. 👍❤️🙏