broomtree33: Withdrawal tapering off of Lithium

[broomtree33]

Hello, I'm new to the site. I'm currently experiencing withdrawal from tapering off of lithium and providing my medication history through present for context. Along with what's helped me.

 

Throughout my adult life, I have seen psychiatrists and psychologists for PTSD and anxiety stemming from trauma. On or around 2008-2010?, my then psychiatrist prescribed 50mg of Zoloft and I had a severe reaction. My pupils were dilated, I felt like I was "crawling out of my skin" and could not function at work the next day. I took the day off and called my doctor (GP), who switched me to 10mg of Lexapro after discussing my hypersensitivity to medication. I seemed to tolerate the medication better with no serious, adverse reactions.

The "Medication Lasagna"

I'll call this next section, the "Medication Lasagna" as this is where one medication would cause issues leading to additional medications to be layered in.

From 2015 - 2017, due to some triggering events occurring in my life at that time, I began using drugs to self medicate. I stopped taking all illicit drugs 3 months prior to the following events with the exception of marijuana (which I discontinued shortly thereafter).

 

In November 2017, I stopped taking the Lexapro. This was not intentional, I was leaning more on the marijuana and forgot to take it for several days. Without going into all of the details of the event, I ended up being hospitalized for a week and put on the following medication:

 

• Lithium 900mg
• Quetiapine 25mg
   

Once I was released from the hospital I began seeing a new psychiatrist where I advised that I couldn't even hold onto a pencil, it was like I had lost all strength in my hands. Along with, severe depression and anxiety.
 

I was prescribed 300mg of Gabapentin for the anxiety.
 

After much advocating on my behalf about the shaking hands and tremors, the Lithium was lowered from 900mg to 600mg and I was prescribed Guanfacine 1mg for the tremors.

After speaking my with family doctor at the time, blood tests were conducted showing that the Lithium was also causing hypothyroidism and I was put on Levothyroxine 100mcg. All in all, it took over a year to fully stabilize and pull out of the deep depression that I fell into after my hospitalization and introduction of new medications.
 

My complete list of medications from 2017 to present is as follows:

• Lithium 600mg
• Quetiapine 25mg
• Gabapentin 300mg
• Guanfacine 1mg
• Levothyroxine 100mcg
• Fenofibrate 48mg (for high cholesterol)

Present:

I am currently tapering off of the Lithium under guidance from my current psychiatrist due to the risk of long-term use to the liver and kidneys.
 

Lithium tapering schedule:

• 600mg to 450mg (January 2024 - April 2024)
• 450mg to 300mg (April 2024 - present dosage)
   

I had been working an extremely stressful, high-pressured job with a lot of anxiety which I recently left in June 2024 for mental health reasons. Within a month or so of leaving my job, I began to notice changes in my mood and body that had gone unnoticed due to the level of daily stressors.
 

Symptoms include:

• Agitation and irritability (this seems to have subsided for now)
• More sensitive, cry easily
• Periods of depression and feelings of hopelessness
• Intense periods of anxiety
• Hypersensitivity to stressors. If I get upset, even a small amount, it feels like my nervous system overreacts. I get shaky, heart racing, anxiety.
• Feelings of intense paralyzing fear and panic, especially at night (this lasted for about a week).
   

After discussing with my psychiatrist, I am holding on tapering further over the winter as it is already a difficult time for me and to allow my body some time to regulate. From there, we'll be going at a much slower taper rate thereafter. I'd like to taper off of other medications, but that will be very conservatively, over a long period of time in the future.
 

Self care:

• Leaning into God, prayer, reading the bible, worship music
• Journaling (having a pen in hand and writing seems to really help ease anxiety and worry)
• Power walking 3 times a week for an hour
• Eating healthy
• Limit caffeine
• Practicing mindfulness to curb worries and letting go of things I have no control over

[LotusRising]

Hi @broomtree33

 

Welcome to SA,

 

Here's our topic on tapering lithium:

 

Have you already read the recommendations about tapering by 10% of current dose each month? Why taper by 10%

 

These two are helpful as well:

The Windows and Waves Pattern of Stabilization

Keep it simple, slow and stable

 

Let us know if you have any questions.

 

LotusRising

[broomtree33]

Hi @LotusRising, Yes thank you! I’ve been reading and researching to prepare for when I begin tapering again.