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  1. I am in my mid-thirties, and I've been on some form of antidepressant since adolescence. As a socially awkward, bullied young person in the throes of puberty, I hit a wall of apathy and sadness sometime in my sophomore year of high school. I no longer had the drive to make the Dean's List or pursue the activities I once enjoyed. This is when a pivotal conversation with my primary care provider occurred. He rolled toward me on a medical stool, pointing at printed charts illustrating neurotransmitters and a faulty brain chemistry. I think I was prescribed Zoloft, but I don't recall the details. I do remember that my parents remarked on the difference the medication made in my mood, and truth be told I was thankful at that time that I'd found the help I needed. Throughout college and into my twenties, my doctor adjusted my medication(s) several times. These adjustments usually corresponded with various hardships and bumps in the road inherent to living a human life. But I was fully bought into the idea that my brain was unbalanced, and feeling "okay" was just a matter of finding the right med or mix of meds to temper the discomfort. In my late twenties, I fought hard to get sober, recognizing that alcohol was causing far more harm than good in my life. Around the same time, I was prescribed Ambien for sleep (as needed). In the true fashion of an alcoholic, "as needed" soon became "every night." A couple years later, for reasons unknown to me or unremembered, my doctor prescribed Temazepam for my nightly sleep regimen to replace the Ambien. I had no understanding of benzodiazepines, their risks, or the withdrawals often associated with quitting them. I remained on a cocktail of Pristiq/Wellbutrin for depression paired with Temazepam to slow my brain at night for nearly five years. Honestly, I didn't think much of it. I trusted my doctor, and had no reason not to. I moved to a new city in 2016, started a new career, and felt in many ways that I was hitting my stride. In 2019, my then girlfriend suggested that I try and see what things might be like if I tapered off of the medication. Herself a trained therapist, she was particularly concerned that I relied on something to sleep every night. I agreed, and thought I'd like to see if these drugs were really necessary anymore. I was sober, I certainly wasn't depressed, and I had a good support system in place. In partnership with a new doctor and with my therapist on board, I made a plan to taper off of the medication. First the Wellbutrin, which we dropped over the course of a month or so. Then the Pristiq, which we tapered down over the course of a couple months. Then, snowed in on a November day and down to my last 30mg dose of Temazepam I thought, "I'll just stop taking this and be done with these meds completely." During the antidepressant tapering process, I was a bit more irritable and had some trouble focusing, but I was mostly functional. The symptoms were mild to moderate. Even in the immediate days and weeks after dropping the Temazepam, I felt okay. I slept fine, and I was mostly just excited to no longer be chained to a monthly sack of prescription refills to fix my "broken" brain. Fast forward to just after Christmas 2019. Some challenges in my relationship were giving me anxiety, but it was anxiety like I'd never felt before. And the strength of the anxiety was entirely disproportionate to the reality of the situation. It wan't long before I wasn't sleeping. Soon, I felt unsafe spending nights alone, fearing for my own safety. Thoughts of suicide cycled through my brain with regularity. A couple of weeks passed, and even basic tasks became insurmountable. I was in a near constant state of fight-or-flight. One Sunday evening I opened up my laptop to try and catch up on some things at work that I'd fallen behind on, and I couldn't focus my eyes to read an email. Panic began to set in, and I dialed my physician and then my therapist to try and make sense of what was happening. At the time, I placed much of the blame on my relationship, but I see now that I was in acute drug withdrawal. I fought my way through a haze of psychiatric evaluations, doctor's visits, emergency therapy appointments, the dissolution of my relationship, and a car accident (in which thankfully nobody was hurt). Eventually, at my own insistence, I found my way back to the original three medications I'd been taking, thinking that would be my best shot at finding some sense of stability. It's only been in the last month or so that I've felt some degree of what I would call stability, and I'm operating at about 75% of the mental capacity I once was, trying to pick up the pieces of my life and make sense of everything that happened. That search to make sense of everything is what led me here. I know that I do not want to be on a cocktail of medication for the rest of my life. I don't want to medicate my feelings or rely on a drug to fall asleep or live detached from my emotional experience. But I also know that right now, the right thing to do is to wait. I have to wait until my nervous system stabilizes and I can set up the proper plan and support system (the latter of which is made more complicated by the global pandemic we're all experiencing). If you have any advice for how I should go about tapering these medications based on my history, current dosage, and the experience described above, I am all ears. I look forward to actively participating in this withdrawal process alongside all of you, even if I need to wait a bit before I set out again. Much love.
  2. Looking for advice, or support from others with like experiences. We are helping a friend. Here is what we know of her history: Past history of lyme disease (Believed to be resolved years ago... neurologist says friend may still have it, but I personally don't believe the symptoms commonly diagnosed as lyme disease are actually lyme disease). More recently diagnosed with multiple sclerosis (about a year or so ago). December 2018 – Began steroids, and then doctor prescribed restoril to balance steroid effects. Beginning of July, 2019 – Friend wants to taper off both restoril and steroid. Doctor (DPC) began a 5mg taper starting a few days ago (dose was 20mg, so would now be 15mg). Says steroid must be tapered first, and 5mg was the smallest amount that could be tapered. After beginning, friend saw her neurologist who said she shouldn't have began tapering, but should have tapered. A few months ago, the neurologist had offered friend antidepressants, but friend refused saying she was not depressed. She had tried to taper off steroids before, but experienced vision problems and trouble walking. Could this be prevented, or decreased, by tapering more slowly? Does anyone have advice for tapering steroids and restoril? Does anyone have experience with these neurological symptoms, or the effects of steroids and tapering them?
  3. Sorry this is complicated, but this is a general overview of my history with antidepressants. Overall the main problem I've dealt with most of my life is trouble sleeping. One part of it is that I can have a lot of difficultly quieting down my thoughts. Another current aspect is that my friends/roommates stay up all hours of the night, and I've been getting influenced by this way too much. Over the past number of years I feel that I gotten too dependent on doxylamine/diphenhydramine for sleep, and it can be limited in how much it helps due to how fast the tolerance builds up. My overall reactions to antidepressants suggest that I have some form of bipolar. I did try a number of antidepressants around 1997-2000, and I tolerated them just fine, although I'm not sure if they really helped. The next time I tried an antidepressant was 2008, which was 20mg of cymbalta. This made me completely wired with racing thoughts, and unable to sleep for 3 days. In 2012 I was given temazepam for sleep (30mg), and I was told that it would be fine to take continuously. After about a month I started feeling strong tingling sensations through my whole body, and I this hunger that would not stop no matter how much I ate. I told my doctor and he said to just stop taking it. Once I did, my brain just went haywire. I started getting rapidly alternating bouts of severe anxiety followed by calmness. This turned me into complete emotional wreck over the next month. I went to my doctor and he said me that withdrawal is not a problem with temazepam, so he sent me to a psychiatrist. The psychiatrist told me the same thing about temazepam, he thought something else was going on. I was given 7.5mg of remeron, and this solved everything after the first pill. It was able to put me to sleep quite well for the first two weeks, but then the sedation wore off. He upped the dose gradually to 22.5mg over a course of a month, and it eventually shifted to feeling like some sort of crazy stimulant. He had me stop it immediately, and afterwards I didn't sleep for 3 days while not feeling at all tired, and my mood was quite good. This is something I'd never felt before. If took me about 5 months to settle out and start feeling normal again. I found that during this time I was immune to all the sleep medications that had worked before. Also, if I had anything that had any amount of caffeine, it felt maybe 10 times as powerful as it should. In the beginning of 2015 some majorly stressful events happened to me, and a different physician sent me to another psychiatrist because I just couldn't sleep with all the stress. I've always found that long periods of sleep loss can send me into an emotional meltdown, and once I start sleeping again my mood resolves itself. I was given 50mg of amitriptyline, and it worked great for sleep for 2 weeks, but then the the sedation wore off. They were quite surprised that I was no longer getting any sedation, but they wanted me to keep taking it anyway. I had the same issues with caffiene feeling dramatically more powerful at any amount. I've been strictly avoiding it ever since. I stayed on the amitriptyline for about 3 months, until I started feel this building anxiety with this anger and frustration towards the end of the day. When I would take the amitriptyline, this feeling would disappear. This was another new thing that I hadn't experienced before. I went off of it and then this feeling was gone within 3 days. This past winter was particularly bleak. I had next to no social contact and I got severely depressed. My sleep became very restless where I would get maybe 1 hour of sleep a night for 4 days. I started getting the same bouts of anger that I got from the amitriptyline. I might be able to sleep well for a few days and start to feel normal, but then I would crash hard. This was extremely alarming, because once again I had never experienced anything like this before. I went back to the psychiatrist and I was put on lamotrigine and paxil. I started with 25mg of lamotrigine and that was upped to 50mg. For paxil I started at 5mg which was brought up to 15mg. I was able to start sleeping again around the 5-10mg dose. Once I got to the 15 dose, I started getting a lot of muscle twitching. With in a day or two, my whole body was shaking uncontrollably. This unbelievable amount of anxiety came out, and I was having a complete emotional breakdown. I could sleep for maybe a hour after a few days when my body would sort of drop from complete exhaustion. Another thing that happened is my pupils got really dilated, colors got incredibly bright, and I started getting hallucinations: where things would moving around and I was seeing faint, shimmering geometric patterns in objects. This was an utterly horrifying experience. I was given a bottle of temazepam (15mg) to help deal with this, and I think this is the only way I managed to survive this. The psychiatrist was only available through email and she told me to just keep taking the paxil. Once I got them on the phone, I got the shout down treatment. They called BS on this being any form of bipolar, and they told me to get to work to take my mind off things and that I was sitting around worrying myself to death, however I did finally manage to convince them that antidepressants were not for me, and they had me stop taking the paxil. I eventually got in contact with my work and explained the situation, and I decided to leave the hospital completely and switch health insurance. I visited a new physician that looks to be a very good one, and I discussed the temazepam with him, which I had been taking for about 3 weeks. The only reason I had continued to take it that long is because I was afraid of the withdrawal. The physician told me that some people can take it for a very long time and not have any withdrawal, while a smaller group of people can have quite a lot of trouble after only two weeks. Temazepam, is proving to be very difficult to get off. I've been trying for the last couple of months to balance getting rested, getting my life and work back together, figuring out of the new medical system, while trying to taper off the temazepam. For a good long while I felt that I was totally back to normal. I found that anytime I lowered the dose, the anxiety and sleeplessness would come back. I did have 3 days when I was out of temezapam and I couldn't get anymore due to an insurance/pharmacy mix up. I ended up getting powerful tingling sensation all through my body, along with sensation of things crawling across my skin. Visually, I was seeing exaggerated after images. Sleep was not happening. This stopped once I was got more temazepam. So, I'm about two and a half months into temazepam. The tingling sensations and anxiety are continuously getting worse as I take it. I went back to physician, and he sent me to a new psychiatrist, though he said with the new medical system he's on, he doesn't know the people he's referring the patients to, and he doesn't know if they're any good. The new psychiatrist dismissed that the tempazepam could be a problem. They interpreted the issues I had when I couldn't get tempazepam as a bipolar episode, and I'm having trouble buying into that. They want me to up the dose of lamotrigine (bringing it eventually to around 300mg), which I'm on 50mg of and to keep taking the tempazepam. I do agree with the bipolar stuff to a point. Any description I've read of full mania is not something I can relate to in any way. Hypomania only really fits how I felt after I stopped taking remeron, but I can't say ever felt like that otherwise. Some things fit, like the difficulty with turning thoughts off, and taking on too many projects. Atypical depression best fits the type of depression I get. The elevated mood and euphoria is not something I can relate to. But things get tricky when they say patients have a poor ability to recognize these things. So, this is the point I'm at, and I'm not sure what move to make next. (There are probably a lot of errors. Sorry, writing is not my strong point.)
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