DgrNL Posted March 3 Posted March 3 (edited) Hi everyone, I’m a 40 year old male at the moment coping with nasty issues after the use of one tramadol tablet half January this year. let me first start where my problems with psymeds started. In the year 2016 i got prescribed Amitriptyline for neuropathic pain in a 10mg dose in the upcoming years to 2019 the dose was upped to 30mg per day. In 2019 i noticed the amitriptyline did not do anything for me anymore except that it made me sleep well. In 2019 i tapered amitriptyline based on a schedule one week 30mg next week 20mg and last week 10mg and 2 weeks after 10mg with skip days as suggested by my GP. This worked but i noticed erectile disfunction after stopping. Later i found out that this could be pssd. since the disfunction was mild and i’m in a stable relation with my partner it wasnt a real problem. the disfunction got better in the upcoming years and even had a newborn son in the meantime. until last january 24 where everything changed for me, i used one tablet of tramadol and i woke up with numb genitals the next day, in the upcoming 2 weeks i got emotionally numb, severe ED, decreased sense of touch on my skin, anhedonia, insomina, waking up and cannot sleep anymore, smell and taste got bad and my vision is not clear. I went for help at my GP who says im depressed, i prescribed me quatepine for sleep and after 3 days taking this i got suicidal ideations, so i stopped it. But the suicidal ideations did not go away. GP still says depression, and prescribes me Amitriptyline in a low dose for sleep, after a few days i feel my genitals getting number again so in 2 weeks i stopped the amitriptyline again from 40mg to 30mg to 20mg to 10mg and the stopped in one week. my GP now sent me to a psychiatrist who at the moment put me on olanzapine 5mg. my sleep is now better and suicidial ideations are in the background. ( in day time i use 3 * 10mg oxazepam to keep calm) now for upcoming week i have a new appointement again with the psych to talk about new antidepressant to go on. im not sure what to do because i think it is pssd or some sort of withdrawal im coping with. gp and psych says depression. at the moment i cant do my job or look after my family because of all this. does anybody have some advice in my situation? Could a new Antidepressant give some relieve of the symptoms im experiencing and not make them worse? Edited March 5 by bunchesofoats Edited title to include username 2016 - 2017 10mg amitriptyline 2017 - 2019 30mg amitriptyline tapered over one month. 2024 January 50mg tramadol - crash 2024 3 days quetapine 2024 February 40 mg amitriptyline - tapered to 0 over 3 weeks 2024 February 5mg olanzapine
Mentor bunchesofoats Posted March 3 Mentor Posted March 3 Hello and welcome to SA @DgrNL. Thank you for posting details on your experiences as well as creating a signature. Please add the other medications you've taken to your signature, particularly the recent ones to help others better understand potential interactions. Tramadol does have some impact on serotonin reuptake, so it is not surprising it exacerbated preexisting symptoms. I would not suggest a new antidepressant as most come with the side effects of genital numbing and suicidal ideation. Here is an easy link to many of the most useful non-medication options for symptom mitigation: Here is a resource list of tapering information including assessing drug interactions: 2005 - 2016 on & off methylphenidate and bupropion; short terms trials of other medications; tried many supplements 2016 Nov - 2017 Mar citalopram ramp up 0-->30mg (4 months) 2017 Mar - 2018 Jan held at 30mg (11months); taking 1.5x 20mg tablets, cutting 20mg tablets in half. inconsistency in split tablet led to extreme side effects. 2018 Feb - 2018 May taper 30mg-->20mg (3months), ~2.5mg/month, cutting tablets; at 20mg side effects (vertigo, headache, etc) disappeared 2018 May - 2019 Apr held at 20mg (11months); attempted taper from 20mg; tried ~17.5mg cutting tablets but symptoms too strong 2019 Apr - 2021 Jun tapered 20mg-->10mg (26months); ~5%/month dissolving tablets in water and pipetting with syringe; min lorazepam 2-3x/mo to mitigate symptoms 2021 Jun - 2023 Nov held at 10mg (29months) 2023 Nov - Nov 7 10mg solid to liquid; Dec 7 liquid 10mg; Dec 14 9.9mg; Dec 21 9.8mg; Dec 28 9.75mg; Jan 27 9.65mg; Feb 3 9.53mg; Feb 18 9.45mg
DgrNL Posted March 3 Author Posted March 3 Thanks for the info, will look into it. would starting another ad, for example mirtazapine or another non ssri be a option in this case? Ps. Added the info to my signature. 2016 - 2017 10mg amitriptyline 2017 - 2019 30mg amitriptyline tapered over one month. 2024 January 50mg tramadol - crash 2024 3 days quetapine 2024 February 40 mg amitriptyline - tapered to 0 over 3 weeks 2024 February 5mg olanzapine
Mentor bunchesofoats Posted March 3 Mentor Posted March 3 Thank you for updating your signature. Non-SSRI antidepressants still come with side effects. I cannot conclusively advise you one way or the other, but I personally would not add mirtazapine. You can read about mirtazapine's side effects here, including the increased risk of suicidal ideation: https://www.drugs.com/sfx/mirtazapine-side-effects.html Mirtazepine will also come with its own withdrawal effects if/when you would decide to reduce the dosage. What are you taking now and at what time of day, and what are your symptoms before and after? 2005 - 2016 on & off methylphenidate and bupropion; short terms trials of other medications; tried many supplements 2016 Nov - 2017 Mar citalopram ramp up 0-->30mg (4 months) 2017 Mar - 2018 Jan held at 30mg (11months); taking 1.5x 20mg tablets, cutting 20mg tablets in half. inconsistency in split tablet led to extreme side effects. 2018 Feb - 2018 May taper 30mg-->20mg (3months), ~2.5mg/month, cutting tablets; at 20mg side effects (vertigo, headache, etc) disappeared 2018 May - 2019 Apr held at 20mg (11months); attempted taper from 20mg; tried ~17.5mg cutting tablets but symptoms too strong 2019 Apr - 2021 Jun tapered 20mg-->10mg (26months); ~5%/month dissolving tablets in water and pipetting with syringe; min lorazepam 2-3x/mo to mitigate symptoms 2021 Jun - 2023 Nov held at 10mg (29months) 2023 Nov - Nov 7 10mg solid to liquid; Dec 7 liquid 10mg; Dec 14 9.9mg; Dec 21 9.8mg; Dec 28 9.75mg; Jan 27 9.65mg; Feb 3 9.53mg; Feb 18 9.45mg
DgrNL Posted March 4 Author Posted March 4 At the moment i’m on olanzapine 5mg since 2 weeks take it at 9pm for sleep but still wake up at 4am. the olanzapine surpresses the suicidal ideation. During the day intake 3 10mg oxazepam tablets to cope with my symptoms since begin february my symptoms are. genital numbness on some spots, ED, reduced libido. emotional blunting, blank mind, anhedonia, sort off out of focus vision (maybe brainfog?) reduced tactile sensation on skin, reduced smell and taste. GP and psych. tell me that im depressed, dont know how that feels cause i have never been in my life before. 2016 - 2017 10mg amitriptyline 2017 - 2019 30mg amitriptyline tapered over one month. 2024 January 50mg tramadol - crash 2024 3 days quetapine 2024 February 40 mg amitriptyline - tapered to 0 over 3 weeks 2024 February 5mg olanzapine
Mentor bunchesofoats Posted March 5 Mentor Posted March 5 Do you notice a change in any symptoms throughout the day, from day to day, or after specific activities? 2005 - 2016 on & off methylphenidate and bupropion; short terms trials of other medications; tried many supplements 2016 Nov - 2017 Mar citalopram ramp up 0-->30mg (4 months) 2017 Mar - 2018 Jan held at 30mg (11months); taking 1.5x 20mg tablets, cutting 20mg tablets in half. inconsistency in split tablet led to extreme side effects. 2018 Feb - 2018 May taper 30mg-->20mg (3months), ~2.5mg/month, cutting tablets; at 20mg side effects (vertigo, headache, etc) disappeared 2018 May - 2019 Apr held at 20mg (11months); attempted taper from 20mg; tried ~17.5mg cutting tablets but symptoms too strong 2019 Apr - 2021 Jun tapered 20mg-->10mg (26months); ~5%/month dissolving tablets in water and pipetting with syringe; min lorazepam 2-3x/mo to mitigate symptoms 2021 Jun - 2023 Nov held at 10mg (29months) 2023 Nov - Nov 7 10mg solid to liquid; Dec 7 liquid 10mg; Dec 14 9.9mg; Dec 21 9.8mg; Dec 28 9.75mg; Jan 27 9.65mg; Feb 3 9.53mg; Feb 18 9.45mg
DgrNL Posted March 5 Author Posted March 5 Evenings seem a little better mood wise. activity”s that i normally like do not give me te positive feedback they used to. 2016 - 2017 10mg amitriptyline 2017 - 2019 30mg amitriptyline tapered over one month. 2024 January 50mg tramadol - crash 2024 3 days quetapine 2024 February 40 mg amitriptyline - tapered to 0 over 3 weeks 2024 February 5mg olanzapine
DgrNL Posted March 5 Author Posted March 5 I was also asking myself, the olanzapine i use in 5mg a day for 2 weeks now. Is it possible to quit that CT? Or do i still have to taper it. 2016 - 2017 10mg amitriptyline 2017 - 2019 30mg amitriptyline tapered over one month. 2024 January 50mg tramadol - crash 2024 3 days quetapine 2024 February 40 mg amitriptyline - tapered to 0 over 3 weeks 2024 February 5mg olanzapine
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