SailorDoctor: Intro- PWS after 4 years of Agomelatine and a CT-Medical Student in Distress

[SailorDoctor]

Greetings,

 

Started on 25mg of Agomelatine due to sleep problems and stress at the beggining of 2019 (at the age of 28) and my doctor CTed it at the end of 2022. Before the CT by the end of 2022 I suffered from low libido and emotional numbing but could not explain it, as I was not informed this could happen. In the end ,after the CT I had immediate (Withdrawal) symptoms like bizzare headaches, night sweats, erectile dysfunction and an amazing sense of anxiety that was building up. But I was trying to cope and manage and was still in somewhat good spirits. Then on the 6 month mark all the sypmtoms peaked and had severe anhedonia, an extreme sense of emotional and bodily numbing as well as muscle twitching all over and extreme pains on the face were emerging. Few months after that, sleep reduced to two or three hours daily so on the 10 month mark I went back to the same psychiatrist and he could not figure out anything of course.I instinctively suggested all this was from the abrupt disruption of the pill so he put me on the full 25mg dose again and only 1 out of 10 symptoms showed partial improvement (the erectile dysfunction), otherwise I felt worse, so after three weeks we stopped the medication again abruptly. Visited some other psychiatrists ,half of the them told me I had nothing to worry about and the other half wanted to put me on Vortioxetine which I refused. I finally gave in and took 150mg of Pregabalin on February 2023 as I was in extreme facial pain. Also some 10mg of Buspirone for 3 months which did not have any effect. At the summer of 2023 I discovered this forum through Mark Horowitz and bought the latest Maudsley Deprescribing Guidelines so after 6 months of Pregabalin I started tapering the medication as per the fast taper table of the book.

 

So, basically that's the gist of it. I am currenly on Waves and Windows with extreme brain fog and any Improvement is extremely gradual and painful. Almost two years in distress and a full year and a half on classic protracted WD symptoms. Sleep is so much better and I am currently tapering 5mg of Pregabalin, which in hindsight, starting on was a huge mistake because now I cannnot really differentiate between waves of symptoms from the initial CT of Agomelatine and/or the tapering of Pregabalin. Any thoughts of reinstatement which tormented me are gone beacuse I realize all the windows of opportunity are long gone. I figure I have to give my body a chance to reset and avoid any psychotropics, so took out caffeine from my life (which I took on while on Agomelatine cause I was feeling sleepy) and I am still figuring things out as you can see.

 

I am 7 courses away from my MD degree (got a BSC and MSC in Biology) and needless to say this experience shook me and made me doubt about any ideals and values I had for medicine and psychiatry...

 

 So...hello all

 

 

Edited December 14, 2024 by Emonda
Name to title

[Jane318]

Greetings @SailorDoctor and welcome to SA.

 

Thank you for completing your drug signature.

 

I am sorry for all you have suffered.  Thank you also for sharing your story.  Among other things, this reinforces the SA position that no AD taken for more than a couple weeks should be stopped cold turkey, despite what the "experts" say (for  example, 
https://pmc.ncbi.nlm.nih.gov/articles/PMC3244295/ states that Agomelatine has no discontinuation syndrome!).  

 

On 12/13/2024 at 2:57 PM, SailorDoctor said:

so after 6 months of Pregabalin I started tapering the medication as per the fast taper table of the book.

I commend you for your progress in getting off these drugs for good and grateful you found Dr. Horowitz and SA.    

 

Here at SA, we recommend the hyperbolic taper method, which you can read about here:  Why taper by 10% of my dosage?   This is slower than Dr. Horowitz's fast taper.  We would advise that if you develop unpleasant side effects from tapering, halt the taper, give yourself time to settle, and once stable, taper more slowly and by smaller amounts moving forward. The experience of others suggests that the lower you go in dose, the more slowly you need to go with tapering.

 

On 12/13/2024 at 2:57 PM, SailorDoctor said:

I am currenly on Waves and Windows with extreme brain fog and any Improvement is extremely gradual and painful. Almost two years in distress and a full year and a half on classic protracted WD symptoms. Sleep is so much better and I am currently tapering 5mg of Pregabalin, which in hindsight, starting on was a huge mistake because now I cannot really differentiate between waves of symptoms from the initial CT of Agomelatine and/or the tapering of Pregabalin.

That sleep has improved and that you are able to experience windows means you are healing!   Yes, when multiple drugs are started / stopped within a year or two, it can be difficult to attribute symptoms. It is certainly possible that you are experiencing protracted withdrawal from the Agomelatine cold turkey / possible kindling upon full-dose reinstatement; effects of the CT of buspirone; as well as Pregabalin withdrawal as you taper.  Given this, you might consider holding at current dose of Pregabalin for a while to allow your CNS more time to stabilize.  

 

On 12/13/2024 at 2:57 PM, SailorDoctor said:

Any thoughts of reinstatement which tormented me are gone because I realize all the windows of opportunity are long gone.

I agree that you are outside the window during which a small dose reinstatement of Agomelatine is most likely to help alleviate symptoms.

 

On 12/13/2024 at 2:57 PM, SailorDoctor said:

I figure I have to give my body a chance to reset and avoid any psychotropics, so took out caffeine from my life (which I took on while on Agomelatine cause I was feeling sleepy)

 

Cutting out caffeine was wise.  We also advise avoiding alcohol and any other prescription / OTC drug or supplement that is psychoactive.  

We recommend only two supplements here - magnesium (glycinate is a good form) and omega 3 (fish oil). Many people find these to be calming to the nervous system.

Magnesium, nature's calcium channel blocker 

Omega-3 fatty acids (fish oil) 

 

An extended hold at current dose will also give your body a chance to rest.  

 

On 12/13/2024 at 2:57 PM, SailorDoctor said:

I am still figuring things out as you can see.

Here are some links to threads you might find helpful:

Tips for tapering pregabalin (Lyrica)

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) - a helpful summary of what many experience, especially when tapering too quickly.  You can use the following list of typical withdrawal symptoms to track the severity of your symptoms over time.  This can help you know when / how much for your next taper.

What is withdrawal syndrome.

Brain Remodelling 

Video:  Healing From Antidepressants - Patterns of Recovery

A video that I found helpful:  Psychiatric Drug Withdrawal - How can I survive/manage these withdrawal symptoms? https://www.youtube.com/watch?v=bf-0yVDBKlg&ab_channel=AndersS%C3%B8rensen

 

This site has voluminous amount of information.  To search, you can click through the topics listed on the home, browse the various forums (menu at top) or search the site.  One way to search this site for specific information is to use your favorite search engine. Type in survivingantidepressants.org then the symptom, treatment, supplement or information you wish to search for.   I use the search bar at the top of the site, but always make sure I am on the home page first, when I want to search the whole site.  OR - to search a specific form / thread, navigate to that page and use the Search bar there.

 

On 12/13/2024 at 2:57 PM, SailorDoctor said:

I am 7 courses away from my MD degree (got a BSC and MSC in Biology) and needless to say this experience shook me and made me doubt about any ideals and values I had for medicine and psychiatry...

The world needs physicians and other healthcare providers that are understand the risks of psychoactive drugs as well as how to get off them safely.  You can use your experience, as horrific as it has been, to help others in the future.

 

This is your introduction topic.  Each member gets one intro topic- please post updates and questions here, in this thread.  Let us know how we can support you further.

 

Again, welcome to SA and best wishes.

 

 

[Yichin]

I have found the following books eye opening: psychiatric drugs. The truth about how they work by Joanna Moncrieff, Deadly Medicines and organized crime by Peter Gotzsche, Sedated by James Davies. Mad in America posts. Rxrisk.org 
 

you will get better. 

[Yesyes123]

On 12/13/2024 at 7:57 PM, SailorDoctor said:

I figure I have to give my body a chance to reset and avoid any psychotropics, so took out caffeine from my life

 

If you drank coffee consistently it would be wiser to taper it off than to stop cold turkey. Not closely as bad as a psychiatric drug CT, but quitting coffee cold turkey can also lead to withdrawal symptoms like headaches, and/or intensifying your currently withdrawal symptoms from psychiatric drugs.

[SailorDoctor]

@Jane318 Thank you so much for the Information and support! I will study the links you sent thoroughly and yes I am currently holding the dose on Pregabalin! I should also just add that the Agomelatine I was taking was the Valdoxan brand just for search engine reasons (I see it's on the keywords) and yes it is still believed today by some psychiatrists that I have seen that it does not need any tapering unfortunately...

[SailorDoctor]

15 hours ago, Yichin said:

I have found the following books eye opening: psychiatric drugs. The truth about how they work by Joanna Moncrieff, Deadly Medicines and organized crime by Peter Gotzsche, Sedated by James Davies. Mad in America posts. Rxrisk.org 
 

you will get better. 

Thanks so much for the recommendations and the support!! I am already aware of Joanna Moncrieff and will check out the rest of them

[SailorDoctor]

11 hours ago, Yesyes123 said:

 

If you drank coffee consistently it would be wiser to taper it off than to stop cold turkey. Not closely as bad as a psychiatric drug CT, but quitting coffee cold turkey can also lead to withdrawal symptoms like headaches, and/or intensifying your currently withdrawal symptoms from psychiatric drugs.

Thanks for the info! I initially made an effort to switch from coffee to caffeinated beverages like coca cola zero and reduce the quantity gradually and it was still really reactive. I have been off caffeine for a couple of months now and some things have eventually chilled down luckily

[Yichin]

I also had to stop decaf coffee. Now I drink mint tea only. 

[Yesyes123]

7 hours ago, SailorDoctor said:

Thanks for the info! I initially made an effort to switch from coffee to caffeinated beverages like coca cola zero and reduce the quantity gradually and it was still really reactive. I have been off caffeine for a couple of months now and some things have eventually chilled down luckily

You’re welcome. I have heard from reputable sources that coca cola zero or any “zero” soda actually has about 14 harmful substances in it to make it still somewhat tasty without the sugar - it is actually much worse for your health in general, worse than regular coca cola.

 

I do enjoy regular coca cola and soda in general but I would personally never touch any zero soda.