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  1. Mod note: link to: Happy2Heal: Hope I'm doing this right (Introduction and update topic) I was just an 18yr old, a very confused, naive young woman, er no- more of a child, really- when I was given (by force) my first psych drug, stelazine, a major tranquilizer. that was the beginning of a long series- spanning almost 40 yrs!- of psych drugs and hospitalizations. All along the way, I was plastered with one diagnosis after another, or several heaped on at once. My physical health went downhill and I ended up a virtual shut-in, living my life all in my head, friendless, socially isolated to the extreme, my only contact with drs and therapists, leaving my house to go food shopping maybe twice a month. This wasn't living, and I knew it. But I didn't know how to change things. I didn't know what was wrong. I spent over two thirds of my life believing I was mentally ill and *needed* to be on those drugs. but at some point, it occurred to me that the drugs might actually be the problem, or at least, part of the problem. I knew I had to get off them. and I did. The process and the pain of that is reported on my thread, I don't care to go back over it, at least not now. I learned a lot along the way, but for now, I don't want to think about where I've been, I only want to think about where I am now, and the life I have before me. Here I am, now, one year off all drugs, of all kinds. I rarely even take a ibuprofen for a headache. I want to write my success story, but I'm not 100% ready yet However I do have to say that what I feel most of all, is a great deal of pride in having survived. I suffered all forms of abuse as a child, emotional, sexual, physical, verbal, went on to be a survivor of rape, of domestic abuse. I was abused within the mental health system. I've spent virtually all of my adult life in poverty, raising my daughter as a single mom on disability due to "mental illness". But today, I feel as if I've done more than just survive; I am thriving. I have friends. I have a very active social life. I volunteer and I feel like the work I do is making a difference, having an impact. while technically I am still 'poor' by income, I don't go without anything I need, with the possible exception of good dental care I have a good life. Is my withdrawal journey over? I'm not sure.While I took my last dose of lexapro over a year ago, I feel like I am still having some symptoms that must be related to the nearly 4 DECADES on psych meds. BUT you need to know, these symptoms are extremely mild. and after that long on so many different drugs, it stands to reason that there will be minor little tweaks that my brain will need to make, for some time to come. I'd like to say that all that has faded into the background of my life, but to be honest: I am more vigilant about them now, than at any time during active withdrawal- because I don't want to fall into a trap of thinking that any problems I may have mean that all those doctors were right, I'm permanently disabled by a mental illness and there's no hope for me. I am pretty sure that the only thing I suffer from is PTSD, and I don't see that as a mental illness so much as a natural reaction to extremely stressful, traumatic life events. so Today I feel Victorious. I've overcome a lot and need to soak in that feeling of doing a good job I don't often give myself credit for my achievements or feel like it's ok to feel good about them but today, I give myself permission to bask in this feeling. it feels like the right and honest thing to do. I guess I just have to be different, I don't want to call this a success story because that sounds to me like the end, when in fact it is not. It's not really a beginning, either, because the beginning of my new life dates back to when I first realized that the drugs were the problem. to me, this just feels like a victory over adversity- something to celebrate! so please, celebrate with me, and know that you are going to heal as well, those of you still going thru WD/recovery. it's worth it, believe me so very worth it!
  2. Hello everyone. I'm Vega. I started tapering my medication earlier this year after coming to the conclusion with my doctor that they weren't doing much for me and were negatively impacting my physical health. I fully went off Seroquel over the course of a few months, which was difficult but not impossible. I'm now tapering my Lithium. I started two months ago by going from 600mg to 300mg and the withdrawal was 10 tens worse than for the Seroquel. I've had nausea, intense migraines, flu-like symptoms, memory problems, the whole thing. This is seriously one of the most difficult things I've ever had to go through. My doctor agreed to taper me by 50mg next time, which I feel is encouraging. However, the symptoms from my first taper aren't fully gone yet and I don't know how long I should wait before tapering again. I have been searching for a forum like this for literal weeks and I'm overjoyed to have finally found an active forum dedicated to this topic. I'm sure all the info available on this forum will very useful to me on this awful yet necessary journey.
  3. Hi. I've been on SSRI meds for a long time. I'm currently tapering from Zoloft. I'm at 26 mg. I'm reducing at 2.5% every 2-4 weeks. My CNS is a mess and I can feel every taper. I'm so tired all the time and have no energy. I'm taking cal-mag citrate, Barleans Omega fish oil, Vitamin D3/K2, and an iron supplement for anemia. Sometimes I take Coq10. I'd like to know what has helped others with the inability to focus and with fatigue.
  4. Hi, I'm new to this site. As far as my background, in 2018, after 25 years of taking Paxil and feeling good and stable, I decided to reduce my dose of 40 mg. down to 20 mg. over the course of three months (May-Aug) as I wanted to get rid of sexual side effects. After some back and forth with the dose, I reduced my dose to 20 mg in August and began to experience bad SSRI withdrawal and particularly intense anxiety. It got so bad I eventually ended going back up to my baseline dose of 40 mg of Paxil but it no longer was working to control my anxiety, etc. In addition, I began to experience a new cyclical mood disorder, whereby I could feel fine for several weeks or a month or more and then I would have an episode where for 7-10 days I would wake up with intense suicidal depression that would generally start lifting a few hours after waking. I have been working with a cadre of psychiatrists and other healthcare providers to get stable again, my anxiety is under control but so far nothing has worked to address this mood disorder which has been diagnosed as an atypical presentation of cyclothymia and which has been life-altering. In addition to reinstating the 40 mgs of Paxil, I am now on Seroquel (300 mg), Lamotrigine (75 mg) and recently started Lithium Carbonate (300 mg). My questions: is it possible that my attempts to go off Paxil (including some back and forth with increasing and then lowering dose) after so many years could have instigated this new mood disorder I'm dealing with?
  5. JanCarol ☼ Reboxetine first, then Lithium I’ll start with the Success Part, before I unfold the story. I am a classic poster-girl story of “Why You Should Taper.” I thought I couldn’t come off the drugs, I was convinced I was a “biological bipolar” – but by using SA’s conservative 10% or less tapering system, I hardly had any withdrawals this time, and could control my symptoms and make space for my stressors by holding. I’m a living example of why anyone should taper and hold in order to come off. And there is no such thing as too slow. I attribute my success to the SA taper, and a number of coping strategies. I got support. I had a psychologist, who was wholly supportive. I bullied my psychiatrist to do the taper “my way” instead of her way. She actually had helpful suggestions for lifestyle changes, too. I got an acupuncturist, a massage therapist, and later added an orthomolecular doctor and osteopath. I told my husband and all of my friends. I prepared for my taper. I owe so much to those who walked this path before me: AltoStrata, GiaK, Rhiannon, Petunia, BrassMonkey, MammaP, Bubble, Dalsaan, MeiMeiQuest, CymbaltaWithdrawal5600, and many more. And – to go further afield – Robert Whitaker for his excellent book, “Anatomy of an Epidemic,” and Will Hall for the “Icarus Harm Reduction Guide to Coming off Psychiatric Drugs” for showing me that it could be done, and how. And for helping me to accept that I may be different – but that different is not a medical condition. I got curious and read everything I could on the web, and learned a lot. I learned the most from SA and Beyondmeds.com. Most of what I have written as a moderator is not original – but is something I learned here or in my researches, that I applied to my life, and which I found effective. My psychiatrist resisted my desire to taper, but she told me she would support me if I put some things in place. We established a contract with my hubby, so that if I went off the rails, he would be able to get help for me. She would not taper me unless I made a commitment to take sun walks for light therapy and mood stabilization. I also eat meat and fish for mood stabilization & brain nutrition. I took up a tai chi practice and found a yoga studio which supports me. My karate mates have always supported me, even when I was too sick to participate. Meanwhile, my psychologist went to hear Robert Whitaker talk, and she came to realize how many of the cases she saw were people suffering from drug effects. She wrote glowing letters of progress to my psychiatrist, who really had no choice but to say, “Okay, I guess she’s doing well.” Nuts and bolts, I took a year to come off a low dose of reboxetine (it’s the least effective SNRI in the world, actually less effective than placebo), and another 2.5 years to come off the lithium. As I was suffering lithium toxicity (diabetes insipidus), I alternated some of my SNRI tapers with lithium tapers. I tapered 10% per month, or if while dry cutting, I had to drop by 15% (my largest taper), I would hold an extra month. I held an extra month if I had any upsets or stressors – funerals, travel, illness, bad news, etc. I held 3 months after the SNRI was gone before tapering the lithium again. My tapers were relatively symptom free. Most of my symptoms were from worry that I really was crazy – and there were mood spikes until I learned to manage my mood on my own. That’s what I should’ve learned when I got diagnosed 20 years ago. Nobody tells you that you can manage your own mood. In fact, nobody tells you that you are the only person who can manage your own mood! I greatly reduced gluten, especially wheat, and dairy. I cut the coffee way back. I start my day with protein (good for adrenals), and finish my day with carbs. I take magnesium baths whenever I feel "crunchy" and after every exercise session. I have raw food smoothies 2x a week. I take a number of supplements to manage my health without drugs. Most important: magnesium and fish oil. For mood & energy: NAC. I couldn’t take up meditation exactly, because of cult abuse in my past, but I can do tai chi and yoga, and I love breathing and mindfulness meditation. I found a great benefit to shamanic practice, because it is not worship of any foreign deity or guru, and my own inner experience is the guide to what I am learning and how I am growing. I took up creativity practices, like music, coloring, drawing, painting and writing. I took up correspondence with special people here on SA and in other places, so I could learn and grow by sharing with others. I was well supported by all of these people and practices, and I feel I have a web which will catch me if I ever fall down again. Sometimes now, I miss a practice. I might not get all the sun walks in, or I might eat wheat or dairy. But now I am well enough – I am buoyant enough – and I have enough practices – that missing one or two Jenga blocks doesn’t make the tower fall. (it also helps to not have a tall tower - our society asks too much of us, I believe, it's inhuman sometimes) When I come back, I’ll give more of my history – how crazy, abused, wild, suicidal, depressed, with unrelenting fatigue, and how I was convinced I was “bipolar.” Now, I have no diagnosis (I leave it on the medical charts so that I can refuse drugs – “No doctor, you can’t give me that, I’m bipolar!”), my body is broken from surgeries, abuse, accidents and pain. My major lasting drug effect is metabolic and autonomic dysfunction but those are compounded by surgeries, too. I still have severe delayed cycle sleep (but I always did: it is my difference), and unrelenting tinnitus. But my mental and emotional life is healthier than I’ve ever been before. I have compassion for my fellow human in a way I couldn’t before. I have passion for what I am doing, and a sense of purpose. I am driven to create, to share, to learn, to grow. I love meeting with people and listening, and feel so incredibly fortunate. I’m older and wiser than ever before, and I still have a lot of healing to do. But I am awake, alive, and grateful to be so.
  6. Hi all, I've been following and reading the forums for awhile now, probably a few years when I finally decided I should sign up as I have unsuccessfully tried to taper off my meds twice in the past which lead to extremely severe withdrawal symptoms that landed me in the hospital both times I tried to taper off. The two times I've tried to taper off I knew nothing about how fast tapers can have such a strong effect on the nervous system. I basically CT off the first time because I knew next to nothing about tapering and the second time, I tapered off under the supervision of my then psychiatrist who also knew next to nothing about doing a slow taper. He had me skip doses every other day, make fast and drastic cuts, and basically CT me off of my meds- he basically had me do everything I wasn't supposed to. The 2nd CT taper made me have really SEVERE w/d symptoms to the point where I had a really bad manic episode, was in the hospital for 6 weeks, and was then given the label/diagnosis of bipolar- in which they added in Lithium 1800mg as they now considered me 'bipolar.' I was initially labeled/diagnosed with depression and only took Abilify, when I initially started taking psych meds. Fast forward- it's been 4 years since that hospitalization and I've slowly tapered off my Abilify and Lithium, am now on 5mg Abilify (Was on 10mg originally post-discharge from the hospital) and 600mg Lithium (originally was on 1800mg). I did taper off my Lithium (from 1800mg--> 600mg now), in my opinion too quickly which led me to have strong w/d symptoms for at least a year, but now my brain and NS are stabilized. I'm going to be tapering off slowly (learned SO MUCH from those past 2 traumatic CT tapers), I think first my Abilify then the Lithium. I am planning on doing a liquid taper b/c from what I've read from others in the layperson community, it is easier and more precise, especially when you are at very low doses. I have all the equipment including different size syringes. I even bought a jewelry scale and everything else for dry tapering, but I tried it but couldn't seem to understand exactly how to do it (not the best with math/being good with my hands). And liquid tapering w/ water seems to work well and be easier to control with for most people who's forums I've read on here. Just so that I can OK to go for the liquid, would anyone know if I could do a liquid taper for Abilify and Lithium using just water. I know it'll be a suspension not a solution, so I'm guessing it would be OK and from what I've read on here, but I just want to be on the safe side and really sure that I'm not going to be messing anything up w/ the liquid taper. Thanks for reading, and hoping and praying for everyone's taper to go smoothly and safe.
  7. Moderator note: link to Kristine's benzo thread - Kristine: Protracted clonazepam withdrawal? Hello, I am new to this site and would firstly like to extend my gratitude to all the people who have shared their stories and support. I now know I am not alone. My story is long and complex so I will attempt to condense it. I am 43 years old and was introduced to antidepressants 10 years ago after being diagnosed with MDD, GAD and PTSD (l do not feel comfortable with labels) by my psychiatrist. During the first 8 years of treatment multiple antidepressants and other psychotropic medications were prescribed. I will fast forward to October 2015 when I attempted to end my life (I had never been suicidal prior to taking antidepressants). I had to resign from work and was hospitalised for 1 month. At the time I had been taking citalopram for a number of years and had reached the maximum dose. My intuition told me it was not helping. I wanted to stop this medication and my psychiatrist was supportive of this decision. However, it is obvious to me now that she was inexperienced and uneducated with this process. The citalopram was ceased over one week and due to severe anxiety I was commenced on seroquel and diazepam. After leaving hospital I managed to taper off the seroquel and diazepam but became increasingly unwell both mentally and physically. My psychiatrist convinced me that my mental illness had returned and I was commenced on Parnate which was increased in dose over 3 months. Instead of improving my mental and physical ailments worsened and my psychiatrist sort a second opinion. I was hospitalised again in May 2016 under the 'care' of another psychiatrist. This was the beginning of an indescribable hell where I was treated like a human lab rat. Looking back the medications he prescribed were beyond belief and I was the victim of poly pharmacy without adequte professional rational. Unfortunally, like so many others, I was vulnerable and trusted his guidance. He treated me as both an inpatient and out patient over a one year period. Over this time I was prescribed over 14 psychotropic medication some of which were abruptly ceased and crossed over with other medications. If this wasn't enough I was subjected to 15 sessions of unnessaccery ECT. Not surprisingly, I was in a zombified state, unable to function and unable to return to work. My anxiety and depression was not alleviated and I was plagued with tremors, nausea, vomiting, fatigue and migraines. By April 2017 I ceased my appointments with this psychiatrist (he had little belief in withdraw symptoms or side effects of the medication he prescribed - he resorted to blaming me) and returned to my previous psychiatrist. Over the past eight months I have the mammoth task of withdrawing from multiple medications. These include escitalopram (completed reduction), Lithium (competed reduction), clonazepam (partial reduction), bupropion (completed reduction), seroquel (completed reduction), dexamphetamine (partial reduction) and fluoxetine (no reduction). My withdrawal symptoms are horrendous and relentless. My psychiatrist has been unable to advise me along a comfortable path. She appears to be in denial and her support has mostly evaporated. I feel abandoned, alone and frightened. I was forced to seek information independently (for which I am grateful), which continues to be a hideous realisation that for years I was in a constant state of drug withdrawal, side effects and drug interaction. I also feeling very angry about my treatment. I am tapering at the 10% rate now (one medication at a time) but even though I know road ahead will be long and rocky, I feel a sense of empowerment from educating myself. What I am experiencing is common and I am finally breaking free from the clutches of psychiatry.
  8. In fall, 2019 out of the blue, without warning, I had two vertigo attacks (different weeks). For 4 days after I had dizziness while driving to work. I learned about maneuvers to re-set ear particles and those helped. 4 days after the 2nd vertigo attack I had my first ever panic attack. Typical first-timer story: had no idea what was going on, went to the ER. All tests came back negative. Was diagnosed with GAD, even though I've never had an anxiety problem or depression diagnosis my whole life (middle aged here). 3 days after panic attack was prescribed lexapro. That's when the hell began. I've never had to take any medications at all my whole life, save for a daily multivitamin. For a few months I took some thyroid medication to reduce some elevated antibody levels but that solved that (about 7 yrs ago). Never been on any psychiatric med at all. The 9 weeks and 2 days I was on lex was the worst experience of my life. At times, unbearable anxiety, exhausted, dizzy every single day I was on it, random intrusive dark thoughts, brain fog... An anxiety attack 4 weeks into lexapro sent me to a psychiatric hospital for 4 days the first time when it caused intrusive passive suicidal thoughts (first time in my life). While there a psychiatrist prescribed a low dosage of lithium for "mood stabilization". After learning what sent me to the hospital the psychiatrist urged me to stop lexapro asap. We agreed on a taper...a very rapid taper. I went from 10mg to nothing over the next 5 wks or so. I couldn't wait to get off- unlike others, I never "settled" on lexapro...every day was bad and the introduction of the dark thoughts was the straw that broke the camel's back. Have been off lex for 5 wks now. For 3 wks main side effects while on the drug dissipated gradually (anxiety, dizziness, brain fog, dark thoughts). Then, in the last two wks, new problems: random nausea (no vomiting yet), often in the morning, but can happens at other times, too. Bladder issues: pain and feeling like I have to pee every 5 min. Insomnia. Random shivering chills, even though my apt is 72 degrees. Dizziness is now back, stronger than ever. Days/parts of days when I'm so exhausted and tired I can barely move around the apartment- a 5 minute walk outside is way too much. Periods of depression every day, with passive, vague dark thoughts. A Dr-on-Demand psychiatrist said to quit the lithium cold turkey about 10 days ago- did that too. Can't tell if some of what I'm experiencing now is from lex or lithium w/d. Am thrilled to be off all these terrible psychiatric drugs but have no idea what my journey will be like moving forward. Missed 6-7 wks of work while on lexapro. Am now working from home due to COVID (a blessing in disguise?). Can't believe that I'm still having problems when I was only on these drugs for a short period, but am now reading about people who never recover and have problems after only being on psychiatric drugs for as short as 3 weeks. That terrifies me. Never been diagnosed with bi-polar or any other mental illness. Have been to the ER 9x since Jan- almost every test you can imagine has been run...everything comes back negative/pristine/clear. I've never felt so awful and am not someone who runs to the ER when I get a paper cut but am tired of hospital Dr's yelling at me when I've gone ("You don't belong here! You have nothing wrong with you! Could you consider these problems are self-created?") even though I've felt I had no other option. Am grateful the blood, lithium, thyroid, CAT, MRI, blood culture, etc. tests all come back looking so good, but that somehow doesn't help how I feel. Hired a nutritional coach who had me try all kinds of supplements, most of which I reacted badly to: seriphos, tryptophan, melatonin, l-phenalalynine, amino acids, inositol. The only things that have helped me (mainly as I tapered) were nutritional supplements: magnesium, vit-C, omega-3, daily multi. Take 4mg zofran if nausea gets bad. Occasionally take .5 ativan if my anxiety is out of control and all my mindfulness, meditation, diaphragmatic breathing, etc. tools don't work. If dizziness and nausea is bad at bedtime will take a 12.5mg meclizine, but it tends to zombie me out the next day so I try to avoid that. L-theanine helps calm me a bit but I don't take those regularly anymore. Have tried chinese herbs- that mix didn't do anything. Have had 5 acupuncture treatments: 3 helped a great deal. Two didn't really do anything, and I actually felt worse in the day/s after (could have been overpowering effects of w/d, vs. the acupuncture treatment itself- can't know for sure). Have 4 acupuncture treatments coming up because those are the only things that seem to move me forward at all, when they do work. I get that most of the serotonin in the body is in the GI, so my current issues may be just the latest place lexapro w/d has decided to manifest itself. Tired of feeling I can't get a break. Tired of feeling that 1 ok day means 4-5 awful days after. Tired of feeling that at times I'm just trying to survive and fixing myself my next meal is a herculean effort. How long can I expect this parade of various side effects to continue after such a short lexapro history? Am I really bound to a lifetime of issues from 9 weeks of one pill? Just moved to NV 10 mths ago from central USA to take a new job. Love the job and new home but don't have any close friends out here yet and am single and alone. My faith in God is sometimes the only thing holding me together. Have never had such a disruptive or frustrating or debilitating health-related experience in my life. Desperately love (and miss) working out, but dizziness prevents me from doing most exercises and many days I'm so exhausted I can barely walk downstairs to pick up the mail. Does anyone on here have a lexapro recovery story involving awful w/d after only being on the drug for a couple of months? Would love to hear from you. Thank you for reading about my struggles.
  9. I had been on some form of anti-depressant and mood stabilizer/anti-psychotic since high school, 2002 or 2003. Initially I was put on Zoloft for depression which caused me to become "manic" which lead me to be put on Lithium, Abilify and Risperdal (not sure doses or when). Starting around 2008 I was put on Cymbalta and Lamotrigine/Lamictal. I got off the Cymbalta & Lamictal cold turkey on my own in 2011 and it resulted in brain-zaps and then a deep deep depression. I reluctantly got back on my meds. Beginning in 2020 (exact date I'm trying to find), my psychiatrist agreed to help me taper off my meds. I was able to get off the Cymbalta it seems fairly easily, which I have been off since the end of the Summer 2020. After getting off that I began tapering off the Lamictal ... I'm trying to find information on how much I lowered initially, etc., and don't have it right now. I do know I got down to 100mg by November 2020 and had to go back up to 150mg over the winter due to debilitating depression. Starting in ~March 2021 I began tapering again (again don't have exact dates/dosages as of now). I have detailed records of my tapering beginning in May 2021 when I began using the 25mg tabs to taper: 5/18/21 (May 18) - 6/13/21 (June 13): I alternated daily between 87.5 mg one day and 100 mg the next day (87.5mg/100mg/87.5/100) 6/14/21 - 6/21/21: 87.5mg each day 6/22/21 - 7/11/21: 75mg/87.5mg/75/87.5 7/12/21 - 7/26/21: 75mg each day 7/27/21 - 8/8/21: 62.5mg/75mg/62.5/75 8/9/21 - 8/30/21: 62.5mg each day 8/31/21 - 9/12/21: 50mg/62.5mg/50/62.5 9/13/21 - 9/26/21: 50 mg/day 9/27/21 - 10/10/21: 37.5mg/50mg/37.5/50 10/11/21 - 10/24/21: 37.5mg/day 10/25/21 - 11/7/21: 25mg/37.5mg/25/37.5 *On November 1, 2021, my dog and best friend of 10+ years, the Big Guy (110lb. half boxer/half mastiff), died after a brief fight with cancer... in retrospect I should have ceased tapering at this point; instead I continued my tapering in earnest and began to self medicate excessively with alcohol and cannabis 11/8/21 - 11/21/21: 25mg/day 11/22/21 - 12/5/21: 12.5mg/25mg/12.5/25 12/6/21 - 12/20/21: 12.5mg/day 12/21/21 - 12/31/21: 0mg/12.5mg/0/12.5 January 1, 2022 - Present: Off Lamicital Completely I had no idea about this site or a couple days ago. I have been realllllly struggling this whole year but especially the past couple weeks. Some days I am so depressed I can hardly get out of bed. Some days I am "functional." I have major brain fog where I can hardly think most of the time (which is not good for my job!). I can't hardly make even the most basic decision. It is bad. I am desperate. I do not know what to do. I really don't want to get back on the Rx. I'm looking for suggestions on how to cope with the withdrawal symptoms. I have been sober (no alcohol or cannabis) since January 1st as well. I workout, do Wim Hoff breathing, garden, meditate/pray and eat mostly organic. Supplements: EMPowerPlus Lighting Sticks, 5-HTP, Vitamins C, D, B-complex (6&12) & K2, Magnesium Glyinate, Kyolic Aged Garlic Extract; Just started taking St. John's Wort a couple weeks ago I don't really recall withdraw symptoms (depression) prior to my Dog being diagnosed with cancer in September 2021 (which coincides with me getting down to 50mg/day)--since he was diagnosed and then passed Nov. 1st, I have been mostly depressed. The brain fog didn't really start that I recall until ~January of this year when I was totally off -- but I could be wrong. Since November of last year, it has kind of been a blur. On another note, while not directly related to withdrawal, I am very unhappy with my current career and have been for some time. I think doing something that goes against my values and not really knowing what my purpose is has a big impact on me feeling depressed. However, right now with my brain fog and depression, I am having a really hard time doing any work whatsoever. So my purpose now is to get past these withdrawal symptoms so I can find my purpose in this world and what gift I can offer to other people. I am VERY wary of getting back on any RX and do not want to go that route if at all possible. Thank you if you read this far and I appreciate any advice on how I should proceed!! -Will
  10. Hi everyone, I am excited to have this group as support as I start to get off paxil! I had a history of several debilitating depressive episodes 1996-2001. Part of the depression may have been that I was developing untreated Hashimoto's - autoimmune thyroid disease. I have not had a depressive episode since going on psych meds. I had no withdrawal symptoms from my multi year slow taper off lithium. After so many years, and given the severity and duration of my depressive episodes, I am concerned about withdrawal from paxil and would like the support of a medical professional who has successfully helped many long term uses get off paxil. Where can I find a list of vetted, recommended professionals? Thanks!
  11. Good books or review papers on antidpressant withdrawal? Hi All, I'm new here and will spending time reading the many posts, but I'd like to know what are the best books on guiding someone through antidpressant withdrawal. I'm also looking for scientific studies. I have "The Antidpressant Solution" by Joseph Glenmullen, which is good, but is there anything more recent? Thanks Bruci
  12. Hello. Details below but I think I'm experiencing withdrawal symptoms, mainly intense anxiety and insomnia. Both seem to be geting better following the windows and waves pattern, but it's exhausting. Looking to make sense of what I'm going through and support. Brief med and treatment history 2002-2019 Lithium 900-1200 mg (0.6-9.0 mEq/L blood serum levels), 2018-2019 Prozac 20 mg. After trying various mood stabilizers following manic episode precipitated by Zoloft (very high 100mg+ dosage), I was prescribed lithium, which I took most of the period from 2002 until I stopped it in 2019. During that time I tried various other mood stabilizers, including depakote, lamictal, carbemazepine, and abilify in addition or instead of lithium. 2008-2010 became dependent and withdrew from benzodiazipes. Underwent ~20 ECT treatments in 2010 following hospitalization for depression which marked a turning point in course of "illness." Significant improvement in my life from 2010-2020 but some anxiety and depression symptoms remained. Tapering Started Prozac in early 2018 to help with continued chronic anxiety and mild depression. Prozac did help...most notably with the anxiety. I recall it seeming to lift a huge weight off my shoulders, allowing me to let go of the indecision, rumination and general anxiety. While on the prozac, I stopped lithium, tapering fairly rapidly, going from 900 mg/day to 600 mg, to 300 mg, dropping down after a couple months each step. In late 2019, I then went off the prozac, going from 20 mg to 10 mg for about 2 months, then to 0. I was not aware of this website or procedures to taper even more slowly. Current State - Withdrawal? Beginning in 2020 after being off prozac a couple months and lithium over a year, I began experiencing bouts of intense disabling anxiety, insomnia and intense emotions (crying for hours on occasion). All of these seem to be of a different quality than the anxiety symptoms that led me to take the Prozac and very different from anything before then. At the same time, I have also been experiencing periods of clarity and heightened consciousness, which feel like my brain and mind waking up after many many years. Also, have had some periods of calmness. Its hard to make sense of the mix of feelings and sensations, but for the closest experience to the clear periods, I have to go back to my teenage years before the diagnosis and before the pills. After reading the New Yorker profile on Laura Delano, I learned more about antidepressant withdrawal through this website and some of her work. I think it's probably the best explanation of what I am dealing with and am looking for help getting through this. I feel like I am on the precipice of regaining a full mind and life after 20 years in varying degrees of darkness. But this is also scary, hard, and it's difficult to keep things together. I am continuing to juggle a demanding career, parenting a two year old and five year old, and being a good husband....while caring for myself and trying to practice self-compassion as I go through what I view as a major life event. Looking for support and to hear more about others experience, hopefully to give me some confirmation that there's an end to what I'm going through. Up typing this in the middle of a stretch of anxiety and insomnia.
  13. I read that it is more difficult to withdraw from a drug with a short half life. It is suggested to switch to a different drug with a longer half-life of the same category (i.e., antipsychotic) before tapering off (mind.org.uk). I have been on Risperidone for 5 years. I started tapering in April at 1.0 mg and am now on 0.70 mg. I am considering asking my doctor about switching to Zyprexa, another antipsychotic, and then tapering off Zyprexa. Does titrating off one drug and onto another need to be done as slowly as withdrawing from a drug, i.e. 10% every month or something like that? Has anyone had experience titrating off an antipsychotic onto another antipsychotic? Since Risperidone has a short half-life, I am concerned that it will be hard to switch onto a drug with a longer half life. According to Medscape, the half-life for Zyprexa is 21-54 hours, and the half-life of Risperidone is 3-20 hours. Thank you!
  14. I want to know how to detox from all the psychiatric drugs that I took in order to make possible for my body not to need to take them anymore and to eliminate all the side effects that the psych drugs gave me. This is all the drugs that I took from psychiatrists: when I was 16 years old I took first paxil and rivotril (clonazepam) for a year and then only epival er (valproate semisodium) for a year and Then when I got 21 I took paxil and rivotril for 6 months. I changed to a 2nd psychiatrist he gave me symbyax (olanzapine and fluoxetine) I was with him for 4 months, then I went with a 3rd shrink that gave me lamictal and abilify for 6 months so then I changed with a 4th doctor which was a "neurologist" who gave me strattera for ADD and told me to go with his partner who is another psychiatrist (5th doctor) who added me sertraline, topamax (topiramate), olanzapine, lamictal, and because of the tachycardia that were produce by this drugs he added inderalici for my tachycardia. So after 7 months with this doctor I went with a 6th doctor that gave me paxil, rivotril, lithium and for my ADD he gave me methylphenidate (commercial name is tradea LP which is similar to Concerta). After 6 months with this doctor I changed to a 7th doctor that gave me sertraline in a very high dose and with this I decided to stop taking that pill a was taking but in a one day span it caused me to have a psychosis that made my father send male nurses to kidnapped and locked into a clinic (like hospitalization), in which the skrink that trated me was the one that treated me when I was 16 and he injected me haldol and gave pills more haldol, biperiden, triazolam and risperdal. I LIVED HELL WITH THESE DRUGS. Then the shrink after he saw that I recover reality, I was super depressed so he gave me citalpram but it didn't work so he gave me paxil and lithium. Then I started coming off meds and now I just take one quarter of a lithium pill every day in the morning. My actual side effects that I want to eliminate are: anxiety, very strong heart palpitaions or beats/beating that cause bad breathing and chest pain, difficulty to take decisions, nausea, extreme itching in my face, head, chest and back, buzz in the ears, difficulty to focus or concentrate, bad short-term memory, and wanting to pee all the time. Thank you very much.
  15. Hi all, glad to be here. Relatively new to the world of psychiatric medication. Here is my journey so far. I was on Latuda for a few months for mood issues (formal diagnosis of bipolar 2) and the stability was very nice. I also was placed on Guanfacine for ADHD. Back in early July I sunk into a kind of depression, I realized I took no joy in anything in life, whether it was hobbies or even loved ones. I had flat affect and lack of motivation and couldn't gain pleasure from anything. On the night of July 13 when I was laying in bed about to sleep, I had what felt like a multiple hour panic attack, with intense shaking and thrashing around. I was begging my partner to take me to the hospital but they wouldn't get up and I was unable to drive. Since that night I have been unable to sleep. I am not sure what caused that attack but I feel like my body is stuck in a state of constant fight or flight and the insomnia is intense, I have no idea how to treat this. Psyc. doc. thought the episode was a manic break. Seroquel was added to help with sleep, but it's been hit or miss whether it helps me get sleep or not. The dose has been continually increase to help with the supposed mania. Latuda was fast tapered and I got off by the end of July. Psyc. doc. thought the sleep issues were due to mania so I was placed on Lithium 600mg recently. I do not believe I am manic, and I feel the sleep issues are a trauma response. Recently I have been taking the Seroquel at various doses from 75-200 mg. I hate the way 400mg made me feel, like I was drunk and still didn't help me sleep. I think my body is stuck sympathetic nervous system dominance. I never get that sleepy feeling. Last night I took 100mg Seroquel and spent the night in a light sleep state where I couldn't tell if I was awake or asleep all night. This is exhausting, non-restorative and common experience for me lately. The other day I talked to my primary care physician re: insomnia and they suggested to not go to bed until sleepy. I ended up staying up until 3am then took 75mg Seroquel and got 3 hours of sleep. I am trying to be pragmatic about the sleep issues and pursue two treatment modalities: Cognitive Behavior Therapy for Insomnia and Acceptance and Commitment Therapy for Insomnia. As far as personality, I am feeling more alive on the days that I am able to get some sleep, which might be once a week. I am just scared of being on Lithium, I don't think I need to be on it. I am worried I won't be able to sleep at all without the Seroquel but I hate taking a pill to sleep, especially since it is not even reliable. Tomorrow I have an appointment with my psyc. doc., we have been meeting about once a week since July because they say I am in crisis mode and I just don't know where to go from here.
  16. Help777

    Help777: journal

    Effexor x12 years. Added lithium in sept 2015. Added prozac in october to help bridge taper from effexor as i started having symptoms. Started withdrawing effexor in September 2014. Over last 4 months i went From 112.5 to 14mg as of last week.. Last week I seemed to all of a sudden hit a wall. Crying uncontrollably constantly. Shaking, nausea, extreme fear and overwhelming need to cry. Ive read your site. Ive reinstated to 20 mg of effexor for last 3 days but absolutely no improvement. Im so scared. I cant go to work like this. Continuing prozac 20 and lithium 300. Please help.
  17. Hi, I've been medication-free for 14 years and I've just written to the psychiatrist who originally diagnosed me with Bipolar 1 in 2002 to see if I can get the diagnosis overturned because my mania was caused by sertraline. I'd be very interested to hear from other members who were never manic before being on antidepressants.
  18. Hello, new family. I’m a 39 year old man, 14 months off benzos. I am not doing well; withdrawal continues. But I want to start coming off of this other crap that I’m sure is worsening my situation too. I trust what I’ve been told about you much more than I trust my psych alone about how to do this. BENZO/WITHDRAWAL HISTORY: I was on Klonopin about four years. In an voluntary inpatient setting I was taken from 3mg to .5mg in one week. This gave me a manic episode that I was then blamed for. (“You must not have been taking your bipolar meds.”) I was reinstated on equivalent Ativan and then tapered more reasonably although still too fast; ultimately found the Ashton Manual and tapered according to that for my final 1mg. 14 months out I’m still in hell; in fact, while I could work even in my first month, I haven’t been able to since Thanksgiving. I had a gravely serious setback last summer when I moved and overexerted myself physically and I think my system is still recovering. I had another bad setback in January when I was put on an antibiotic (for nothing.) Current physical symptoms include involuntary jaw movement / facial contortions that are incredibly distressing. Tinnitus. Tremor. GI distress. Involuntary eye movement. Bizarre hard to describe sensations in head and body. Heart palpitations. Hives. I’ve been sick with multiple bugs basically the entire fall and winter. This is the short list. Psych symptoms: intense depersonalization. Strange vision issue; I don’t think it’s quite derealization but a hyper-awareness of depth perception. It feels like I’m inside a Facebook 3D Photo, or that things are HD instead of SD. Racist thoughts. Frequent suicidal ideation. The worst anxiety of my life, far worse than anything the Klonopin was meant to medicate. CURRENT GOALS / REQUEST FOR HELP: I want off of everything now. I no longer believe in any of these drugs and believe psychiatry has done far more harm to me than help. I need to be careful as my system is so messed up. But I have come to suspect some significant part of what I’ve been calling benzo withdrawal 14 months after jumping must be due to gabapentin and lithium. Lithium - I had a manic episode in 2015; no history of mania or bipolar prior. I was told I was bipolar and had to take lithium the rest of my life. (I was also on Seroquel for a while but have been off for a couple of years.) This diagnosis is in question, given that bipolar emerges in the teens, I don’t have alternating periods of mania and extreme depression, etc. Whatever the case, my psych has given me clearance to taper down and I’m just trying to come up with the best plan of attack. He had said we could go down by 150 monthly and see. Gabapentin - I had been on 1200mg/daily since fall 2018 to help while I was tapering the benzo. I tapered very successfully (100mg/week) down to 900 in January but then held when things got bad with my antibiotic setback. My psych also said I should stay on the gabapentin, actually, as it could help with the lithium taper (is that true?) I dream of being off all psych meds by my 40th birthday in six months, but I of course don’t want to rush. Those are what I’m most concerned about, but I’m also on primidone 50mg for tremor that I’d like to drop (not sure if that drug comes up here or if it even needs to be tapered.) I do take 150-200mg trazodone for sleep which seems pretty non-negotiable right now though I also want to drop that eventually. (I also take allopurinol but that’s another story.) I’d appreciate any thoughts as to the wisest plan of action for ridding myself of gabapentin and lithium against a backdrop of ongoing benzo withdrawal. Thank you so, so much.
  19. Hi I'm new here. Hoping to come off sertraline and lithium. I believe that my 13 years on lithium have caused me to have cognitive impairment and a severe lack of motivation and my executive functioning is just awful. I've only been on sertraline for about 10 months so I'm hoping it will be a bit easier. Any advice or encouragement would be really welcome. I'd also really like to start a support group for people here in Belfast but I've no clue how to do this. Bye for now and good luck to all
  20. New Member: A therapist/GP put me on Celexa in 2002 to help with occasional bouts of anger (not sadness). Then around 2014, my Celexa prescription transitioned to Lexapro/Escitalopram (20mg). This was my only prescription for many years as I was blessed with a healthy life until I decided near the beginning of 2020 to stop taking Escitalopram as I was feeling pretty good and wanted to be pharmaceutical free. Unlike myself, I didn't research the tapering process or ask for medical supervision. I took 20mg tablets when the headaches got bad. The times between headaches got further and further apart until I had not taken Escitalopram for about three-months. Then at the end of May or beginning June (2020), anxiety started to build more each day. At first I didn't understand it. Granted, this is when Covid hit and the world turned upside-down but I don't normally get too anxious about world problems. Then it hit me that this might be a reaction/withdrawal from Escitalopram. I restarted taking Escitalopram (20mg) and made a doctor's appointment. My recollection is that the anxiety was retreating for the few days I had gone back to it and I was still sleeping eight-plus hours each night. Upon my doctor's visit toward the beginning of June (2020), I told her that anxiety had kicked in a little but I was taking my Escitalopram again (I don't remember if I told her it was bringing down the anxiety). At this point she scrolled through an (Rx) app on her iPad and told me to stop taking Escitalopram and start Zoloft/Sertraline. Without questioning her I did as I was prescribed. Shortly after starting Sertraline my brain went berserk - I was getting anywhere from zero to six-hours sleep, shakes, "twitches," throbbing headaches, screaming tinnitus, severe anxiety, hours of pacing inside the house and unable to take naps. I used to be a productive person then I became a hermit rarely leaving the house. When I contacted my doctor to tell her what was going on, she seemed to minimize the urgency (my pain and agony). Usually she would just double the dosage or put me on a different prescription or tell me "she's got this." She had me take so many tests because she didn't believe it was mis-prescribing (her advice) causing the issue. She had me endure several blood tests, two CT scans (head and abdomen), a neurologist appointment (who did nothing but check if I could walk a straight line) and a hospital hosted overnight sleep study. This went on for almost five-months. I think all of the medicines can be seen somewhere on my profile. At some point, it seemed she - my general practitioner/internest - figured out that she had no idea what to do then recommended a psychiatrist to help with medicine management. He, the psychiatrist, told me stay on Escitalopram (20mg) and put me on Bupropion, Quetiapine and Lithium. At this point I'm taking four prescriptions. This is about the time my spouse found this site and learned I was not the only one going through this horrible experience. The notes and advice we found on this site seemed to make much more sense then what the doctors are/were saying or doing. At the moment, I am taking the following prescriptions: 1. Escitalopram (20mg), June 2002 - January 2020 (18-years), then back again August 2020, 2. Bupropion (300mg), Since October 2020, 3. Quetiapine (200mg), Since November 2020, 4. Lithium (300mg), Since November 2020, CURRENTLY TAPERING (down from 900mg). I want to reduce my reliance on prescription(s) as much as possible. Note that I still have the aforementioned symptoms; although, I am getting a little more sleep with a prescription (Quetiapine), that I wish to quit taking. Large parts of most days I am basically non-functional and spend time in bed with a pillow on my head. My questions include: 1. In which order should the medications be tapered? The "app" on this site wasn't much help. 2. How quickly may the medications be tapered? I see that 10% per month is common advice. Is this true for all medicines regardless of time taking? 3. Based on a few write-ups on this site, it appears going back to Escitalopram - full dosage - is "kindling" the withdrawal symptoms. So should I still slowly taper (10%) off of the Escitalopram or just get off of it quickly to stop the kindling? 4. Is there a doctor near me that has REALLY worked with someone in my predicament? My GP and Psychiatrist claimed to be experienced, but they weren't. Instead, they were experimenting with me and made it worse. 5. What should be my reaction if withdrawal or other symptoms begin - gut it out, restart the med(s) at a low dosage, high dosage, or other advice? Thank you for reading my long message and for any help you can provide.
  21. Hi there- been on Lithium 800 mg and Mirtazipine 15mg. absolutely hideous side effects - I'm not sure from which- are forcing me - with my doc's approval - to withdraw these drugs and possibly look at alternatives. Would love to hear some of your members' feedback on this.
  22. Hello, this is my first post, it’s nice not to just float out in space with this very difficult experience. My story is that I had been on 250 mg of Seroquel in combination with Lithium for about 8 years which kept my bipolar II in pretty good control since 2012. I then had a hypomanic episode in November 2019 (after one of the toughest years of my life, finally cutting contact with my abusive family of origin and the related trauma) that lead to my psychiatrist raising my Seroquel from 250 to 350 mg to help me sleep as I was not sleeping for 3 nights (not to control the hypomania itself). It’s an understatement to say that turned out to be a terrible misjudgment as after about 2 weeks on the significantly higher dose, I started to have severe vertigo as an adverse reaction. This same psychiatrist would not believe my adverse reaction/toxicity was due to the sudden jump in Seroquel, so I ended up switching psychiatrists after feeling talked down to and essentially abandoned. The new psychiatrist believed me and is a reasonable, compassionate person. He and I agreed I must come off Seroquel and quickly due to the vertigo toxicity which had me basically immobilized. In 3 days, I came down from 250 mg to 50 mg. The vertigo disappeared but within days after, I started to have insomnia (I am now sleeping with sleep meds), nausea and acid reflux, headaches and now about 6 weeks in to the withdrawal, the headaches are replaced by terrible dizziness and even more severe nausea, reflux has abated with help of meds. It’s really frightening and painful going through this to say the least, especially not knowing when it will improve. I work full time and have a family to take care of and my husband and I are frozen in a state of perpetual anxiety and a deep sense of crisis. Anyone experienced anything like this with Seroquel/Quetiapine or other atypical antipsychotics? Psychiatrists seem to know next to nothing about this issue. As a side note, I feel unable to raise the Seroquel level due to the severe vertigo issues I had while on it at the higher dose. Thanks in advance for pretty much any guidance or rays of hope, this is hell and I feel I’m on my own.
  23. Hi! I am in search of some guidance... Since October I have been tapering Lithium and I am now doing fine (not whithout bumps in the road though...) For other reasons, in the last couple of months I have been seeing a GP practising alternative medicine and when I told him I was tapering lithium he gave me some advice, based on his experience with patients tapering psychiatric meds. He suggested me to take magnesium, which I was already taking, and also cannabis sativa oil (not cannabis indica). He seems to have had many patients in my conditions, but since this is quite an uncharted territory I would like to know if you see any potential negative interference with my taper. Thank you so much!
  24. Hi! I've been reading posts and discussions for a couple of weeks now, but I wasn't sure I really wanted to try again to get off my meds. I have always thought I am 'broken' and that these drugs are the only things that are keeping me together, but I am not so sure anymore. Here is my story and below I posted some questions about how to go on from here. Any suggestion and / or personal experience is welcomed! I have always been quite a sad child. In my teens and up to my early twenties I went through many typical distress-related problems (lack of selfworth and self confidence, eating disorders, drugs, staying in emotionally abusive relationships...) After a bad break-up with my then fiancee, I experienced a paralyzing and exhausting anxiety, preventing me to move, talk, breath. My GP prescribed my benzos to keep it under control and referred me to a Psychiatrist. After some weeks I received my first diagnosis from this psychiatrist: major depressive syndrome (based on a few question about my childhood/teens) and generalized anxiety disorder (based on the episode). He prescribed me antidepressants, told me to keep taking benzos before going to bed and that in a couple of years we would have started to withdraw. It was 2008 and since then I have been on various antidepressants and benzos, without ever being able to withdraw. My first (and quite naive) attempt at withdrawing was in 2009. A year after recovering from that anxiety episode, I felt very well. I graduated, landed my dream job, moved to an other city and made some new friends. I thought I didn't need my meds anymore and I started reducing them. In 4 weeks I got off paroxetine and alprazolam and not more than 8 weeks later I was devoured by anxiety about my work, could barely move, talk or eat. Sure it was a relapse of my mental illness, I resumed taking benzos and antidepressants and went back to the doctor, who told me that not everyone can get off, some people need them for the rest of their lives, like cardiopathics need cardioaspirin or diabetics insuline. After that I changed many antidepressants (paroxetine didn't seem to work anymore on me) and many psychiatrists, and tried to make peace with the fact that I may have needed my meds forever. I didn't want to risk an other break down, I knew I wouldn't be able to keep my nice job this time. In the meantime, I had an other toxic relationship and I started to work for a new company, where I felt useless and unappreciated by my bosses. I had a nervous break down (paralyzing anxiety, desire to die...) and I was hospitalized as a precaution. Weird thing: they didn't need to rise my meds, since as soon as I was hospitalized I felt so better. My psychotherapist says I just needed to give my worries and pain to someone else to handle. In a few weeks I was back to work and managed not to lose my job (even if it was definitely not fulfilling or good and was causing more harm than good). The second attempt at withdrawing was in 2019, under constant psychiatric control & advise, because my partner and I wanted to have a baby. But again, it was too fast: in less than two months I was at the minimum dose of venlafaxine and she advised me to get rid of alprazolam in one week. Also this attempt failed miserably, with me having three consecutive anxiety related break downs in the next 6 months. After the first I was back on antidepressants, sertraline this time, after the second I was prescribed also olanzapine and after the third also lithium. The psychiatrist told me they were supposed to work as 'enhancers' of the antidepressants (it looks like it is quite common here in Italy). I finally stabilized, gained 8 kg, lost any sexual desire, abandoned any idea of having children in the near future, lost my job. When I felt better, I asked for an other psychiatrist opinion and the new one told me that if I wanted children I had to either accept the risk that this meds have or try to suspend them for the first trimester. I decided for something in between: I wanted to get rid of what I perceived as the most 'toxic'ones, olanzapine and lithium. During the Italian lockdown (March) I stopped olanzapine (2.5 mq), while increasing sertraline (from 100 to 125 mg), as suggested by the doctor. I had withdrawal symptoms for two months (depersonalization, tinnitus, irritability) but I made it. I didn't worry too much because I was somehow sure that I was still overmedicated and nothing of those weird things could be a relapse. After some months of stability, 6 weeks ago I started reducing lithium (resilient 83, from one and a half tablet to one. Now I know it is too much but thais is what the psychiatrist told me to do). Not more than 3 days later I started experiencing withdrawal symptoms and I am still experiencing them. Mild anxiety, difficulty to breath, restlessness, early wake up, irritability, mild mood swings, headaches. So... how to go on from here? Since I have already reduced lithium too quickly, do you think I should wait for my withdrawal symptoms to vanish? Or I can resume tapering? I am now at 83 mg of Resilient (slow release lithium) An then there is sertraline. I am now at 125mg. What would be a reasonable time to get rid of both of them? Do you think that I should wait before having a baby? I am close to forty and I would like to be a mother, but now I am so afraid that my baby may become dependant from these drugs even before being born... If anyone has any experience about this... please share.
  25. Hi all, I searched this site for info on seroquel and lithium but didn't find much. Basically, what I want to do is try to lower my dose of Seroquel. I'm on 300 mg and have been on this dose for 7 years. Been taking seroquel for 13 years, first 3 years on 100 mg, then 3 years on 200 mg and then 7 years on 300 mg. I'm on it for bipolar disorder. I have had two psychotic breaks. Tried to lower the dose 2 years ago by tapering 25 mg every month. When I got to 200 mg I got very depressed and had severe insomnia. The dose was increased back to 300 mg but that didn't help so I was put on 400 mg of lithium. A little over 2 months ago the lithium was upped to 600 mg. Now that I am relatively stable, I want to try to lower my seroquel dose. See how far I get. Getting off it completely is probably a dream. My question: I also want to lower the lithium dose back to 400 mg. Which drug should I taper first? I don't know if lithium is a brake or accelerator, really, because I guess it does both. I hope someone can offer me some advise.
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