Merls: Doctor changing my meds. Unsure what to do.

[Merls]

I’m unsure on the right terminology because I’m not sure what I believe anymore so please bear with me.

 

last year after ten years on citalopram I had a sudden relapse in depression and anxiety (you could say I pooped out but who knows). The relapse has crippled me and it’s immeasurably worse than the first time around. It’s consumed me and I feel like I’ve lost my identity. Through this period the doctor changed me to sertraline and again to venlafaxine. Both of which had zero effect. I wanted to look at exploring more naturalistic remedies (not sure how appropriate it is to discuss this on this format so I will leave that there- but happy to hear people’s stories and experiences of doing that) but I’ve had a really tough Fortnight and when I went back to the docs this week he wanted me to try mirtazipine. I have taken that for two nights but after a chat with my therapist this morning who’s very critical of medications and the role of seretonin in all this I’m questioning if it’s the right thing. It’s all so hard when you are extremely desperate and just want relief 

 

really interested to hear everyone’s views and experiences

[LotusRising]

Hi @Merls

 

Welcome to SA,

 

We are a peer-run volunteer site dedicated to a harm reduction tapering approach in an effort to minimize withdrawal symptoms. As you may have read, we suggest tapering by no more than 10% of your most recent dose each month. See  Why taper by 10%. 

 

7 hours ago, Merls said:

last year after ten years on citalopram I had a sudden relapse in depression and anxiety (you could say I pooped out but who knows).

Are you certain it was a relapse? How did you taper from citalopram? Sometimes, tapering too quickly can result in symptoms of depression and anxiety. 

 

Could you help us out by adding a signature, which will ensure your drug history appears at the bottom of every post, making it more efficient for those trying to assist. 

 

How to Create a Signature 

 

These two links will help you to understand withdrawal syndrome:

 

What is Withdrawal Syndrome?

 

Video on Recovery from Psych Drugs

 

When we take medication, the CNS responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS must then undo all the changes that were made. As the changes are undone, symptoms may occur. You can expect that they will follow 

The Windows and Waves Pattern of Stabilization .

 

7 hours ago, Merls said:

Through this period the doctor changed me to sertraline and again to venlafaxine. Both of which had zero effect.

There seems to be more and more evidence coming out that suggests these medications are often not any better than placebo. 

 

I can't speak to the natural remedies, as we don't recommend a lot of supplements here. If you were curious about a specific supplement, you could always try a site search to find other members' experiences.

 

7 hours ago, Merls said:

’m questioning if it’s the right thing. It’s all so hard when you are extremely desperate and just want relief

I don't know that you'll find anyone on the site that would tell you this is the right thing.  I think you'll find when you look around here that you've found a large group of people that are struggling to come off medication, some experiencing very difficult withdrawal symptoms. 

 

Please feel free to post and questions right here in your thread.

 

And again, welcome.

 

LotusRising

[Merls]

@LotusRising thanks for commenting. I was still on the drug when it happened. I continued to take the drug for a couple of months until the doctor changed me over to sertraline. So the ‘relapse’ came before the withdrawal.

[LotusRising]

@Merls

 

Then yes, it's quite possible this was poop-out. I'm assuming you've read the thread on this?

 

Am I correct that you are currently off all meds right now?

[Merls]

@LotusRising  yeah that’s right. Off all meds now and feeling horrid. I have had a bit of a look on there. Is there a specific bit you were referring to? Appreciate your input 

[LotusRising]

Specifically, this part

 

"Also see this post by Brassmonkey who successfully tapered out of poop out from Paxil and developed the Brassmonkey Slide taper method and his post  Tachyphylaxis, Reaching Tolerance or as It's Lovingly Known “Poop-Out”". It's partway down the page in the above thread and has some good links.

 

Tapering out of "poop out" is possible. Have you considered doing this? Do you have a gut feeling about what might be the right course of action?

 

Does your therapist explore other factors that might be contributing to how you feel, such as diet, exercise, job, social connections etc?

 

 

 

 

[Merls]

@LotusRising I’ve had a look yeah but will look over it again. Am I right in thinking it’s suggesting to back on the drug and taper off? To clarify I was on citalopram for 10 years but haven’t been on that for nearly 6 months now. I straight switched to sertraline in that time and then tapered that to transition to Venlafaxine.

 

a very brief outline of what happened when this started. I was on a stag do and had been drinking and on a hot the day before. I woke up feeling like I was on the boat still. The feeling stayed tow two week and crippled me. I struggled to walk and couldn’t focus. I was 8 weeks away from my wedding, I was in the best place I had ever been in my life, cracking social life, mint job that I loved working with people I adore and having a real sense of purpose. In the lead up to my wedding which I was buzzing for and very active in the planning of. I was fit and healthy. Christ I ran a marathon a couple of months earlier. It felt like someone had been in my brain and rearranged **** over night. I also had an MRI but that returned all clear. 

[LotusRising]

@Merls

 

33 minutes ago, Merls said:

a very brief outline of what happened when this started. I was on a stag do and had been drinking and on a hot the day before. I woke up feeling like I was on the boat still. The feeling stayed tow two week and crippled me. I struggled to walk and couldn’t focus.

This is when the depression and anxiety started, what you call 'relapse'? Or this happened once off all the drugs? 

 

 

[Merls]

I was still on the citalopram and all was going great until it wasn’t. I was actually considering coming off shortly after I’d gone on the stag but the universe had other ideas. 

[LotusRising]

Do you normally drink? I wonder if this disrupted your nervous system and you needed time for it to regulate.

 

18 minutes ago, Merls said:

I was actually considering coming off shortly after I’d gone on the stag

 

Was this because you were feeling better?

 

How soon after the above event did you get switched to sertraline?

 

 

[Merls]

@LotusRising yeah best place I’d been at in my life. Everything was great.

 

it was a good 3-4 weeks. 

[LotusRising]

So, just to be clear, you were okay on the citalopram right up until you had your stag? There was then a lot of drinking and the next day, you had the above symptoms. The symptoms persisted and you were subsequently switched to sertraline and then venlafaxine?

[Merls]

@LotusRising that’s correct mate yeah (other than that particular stag do been for a mate not mine). We drank but for a stag do it was pretty tame tbh. The symptoms persisted and got increasingly worse. What started as dizziness and a bit of disorientation turned to horrible anxiety and depression with panic attacks

[LotusRising]

It really sounds like this was all brought on by drinking, but has been exacerbated by adding in and taking away other drugs. 

 

I think you have a couple options. You could wait it out and manage the best you can while your CNS returns to homeostasis. Or, reinstatement of a very small dose of the original drug can sometimes help to alleviate withdrawal syndrome. Unfortunately, no one can give you an exact timeline as to when you'll start to feel better, or if you even will. While some will notice immediate improvement, for others it can take many months or longer and for some it doesn't work at all.

 

Reinstatement isn't a guarantee for everyone, but it's the best tactic available, aside from waiting it out. Since you are outside the 3 month timeframe where reinstatement reliably works, it might work and it might not. If you decide that reinstatement is an option for you, we would recommend a much smaller reinstatement dose than your last dose. These drugs are strong and your system has become sensitized and if you take too high a dosage, it may be too much for your brain. I guess it comes down to deciding how bad the WD symptoms are for you. 

 

Have you been using any coping skills? How is your sleep? Have you noticed a windows and waves pattern at all, see my first post.

 

If you would rather wait it out, I'd recommend sticking with a healthy diet, limiting sugar and avoiding alcohol and caffeine.

 

Some people find magnesium helpful, but I find it quite subtle. If you decide to try it, start low and go slow. Some people can become sensitive during WD.

 

Please keep us updated in your thread.