pianoman: A long road home

[pianoman]

Greetings,

 

I have been coping with the effects of an extremely traumatic childhood, including physical and severe mental abuse, for my entire life. Unfortunately, this has featured a lot of prescriptions from a lot of psychiatrists. I really want to get off the psych med crazy-go-round, but feel I will need to get some stability and structure in my life before I can begin. I hear you folks have the knowledge, experience, and skills to help people with problems like mine. I thank you in advance for whatever you can do to help me get out of a dark, scary place.

 

Right now, I am experiencing increased symptoms (social anxiety, agoraphobia, insomnia with nightmares, depression, etc.) after stopping Paxil suddenly six weeks ago. A friend has suggested this “cold turkey” may be the cause and recommended this site to me. I would very much like to make contact with others who are or have been in a similar situation, and could give me some information and guidance about how to heal myself.

 

Thank you for listening to me, and for caring,

 

pianoman

[SquirrellyGirl]

Hi Pianoman, 

 

Your friend is very wise and pointed you in the right direction!  

 

A cold turkey is NOT advised; even the drug makers put in their inserts that sudden cessation will cause "discontinuation syndrome." All the symptoms you have listed are well-known psych drug withdrawal symptoms.  What would help the mods and everyone who might have experiences to share would be for you to fill out your signature block with your drug history, including dates and dosages to the best of your ability.  You can get instructions for how to do this by going here:

 

http://survivingantidepressants.org/index.php?/topic/893-please-put-your-withdrawal-history-in-your-signature/

 

Your signature block serves as a quick glance way for people dropping in to your thread to see what your history is.

 

Since most people don't really understand what these drugs do to the nervous system and why it is important to do a slow taper off, it would be helpful to read this topic:

 

http://survivingantidepressants.org/index.php?/topic/603-what-is-withdrawal-syndrome/

 

Since you have only been off Paxil for six weeks, it is very likely that reinstatement is your best bet, and a moderator will be along shortly to give you specific recommendations.  Most people really don't want to go back on, feeling they want the poison out of their system, but your symptoms are occurring precisely because your nervous system became dependent on the drug's presence to operate somewhat "normally," remodeling to take its action into account, and now that the drug isn't part of the equation, the machinery cannot work properly, so to speak.  Reinstatement is usually a very small dosage compared to what you were on, just enough to alleviate symptoms without triggering start up side effects, since your system will have changed a bit since coming off.  Reinstatement is not a failure but a harm reduction approach, with the goal being to stabilize and then commence a slow taper to come off with fewer problems than a cold turkey or fast taper cause.  You can learn more about reinstatement here:

 

http://survivingantidepressants.org/index.php?/topic/7562-about-reinstating-and-stabilizing-to-reduce-withdrawal-symptoms/

 

That is probably enough material for now!  Give those topics a read, and then ask any questions you have here on your intro thread; your thread is a place to ask questions, document your progress, and give updates.  

 

I'm glad you found your way here.  You are not alone!

SG

[Petunia]

Welcome Pianoman,

I'm glad your friend recommenced our site, there is a lot of good information and friendly support for people who are looking to safely taper off their psychiatric drugs.

 

As SG wrote, going CT off psyche drugs is not a good idea, it will often cause withdrawal symptoms, which then get diagnosed as a return of the original illness or diagnosed as a new one. We would normally suggest reinstating a small amount of the drug and then tapering slowly.

 

But it sounds like you have already started taking 2 new drugs, its this correct?  When did you start taking Effexor and Remeron? How long have you been taking Ativan? How are you feeling now?

 

Please put ALL the drugs you take in the drugs.com Drug Interactions Checker at:

 

Drug Interactions Checker

 

You may post the results here in your thread.

 

I'd highly recommend reading Anatomy of an Epidemic by Robert Whitaker. Psych meds can cause harmful side effects and long term, they can worsen health, increasing the risk of other illnesses.

 

Just so there's no misunderstanding, we are a site for helping people safely taper from their medication and to provide help and support for anyone recovering from withdrawal syndrome after stopping too fast. Are you wanting to come off these new medications in a safe way?

 

Here is the link to our symptoms and self care section, you may find some useful ideas to help manage any current symptoms.  Especially read the topics pinned at the top.

 

Petunia.

[Jerome]

Squirrelly girl,

 

Your simple yet accurate description of how psych meds change the nervous system in ways that prevent it from functioning without the med should be pinned somewhere — it's great! You say "ask any questions you have here on your intro thread; your thread is a place to ask questions, document your progress, and give updates." I'm a little unclear; when you refer to "your thread" and "your intro thread", do you mean this thread, titled "a long road home"?

 

Pianoman,

It's very handy to have someone who will point out posts relevant to your specific situation. It saves a lot of time paging through threads. I have always thought reinstatement was a major option, but didn't want to say anything about it for the reason Squirrelly girl mentions: I mean, you go to a site that's about helping people taper off psych meds and the first thing they tell you is "take more drugs"? Of course, that's not what they're telling you, but it can look that way, especially to someone who's confused and frightened and has been lied to by many "experts".

 

Jerome

 

[SquirrellyGirl]

Squirrelly girl,

 

Your simple yet accurate description of how psych meds change the nervous system in ways that prevent it from functioning without the med should be pinned somewhere — it's great! You say "ask any questions you have here on your intro thread; your thread is a place to ask questions, document your progress, and give updates." I'm a little unclear; when you refer to "your thread" and "your intro thread", do you mean this thread, titled "a long road home"?

 

 

Hi Jerome, 

 

Yes, for Pianoman, his intro thread, a long way home, is where he can post about his own experience.  You can post under other topics, but mods may merge them into your intro thread if they feel it belongs there instead.

 

As for pinning the topic about what happens on to the nervous system on the drugs, it is pinned at the top of the Symptoms and Self-Care forum, one of the Read This topics at the top, What is Withdrawal Syndrome?

 

http://survivingantidepressants.org/index.php?/forum/8-symptoms-and-self-care/

 

I'm glad you found it helpful!

 

SG

[Shep]

Hi, pianoman. Welcome to the forum from me, too.

 

I was initially placed on a cocktail of psych drugs when I was 17. I also came from an extremely traumatic childhood, but my trauma was misdiagnosed as manic depression. That was 30 years ago. I'm now almost 10 months off all drugs and recovering slowly but I'm doing okay.

 

I read a book called "The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma" by Dr. Bessel van der Kolk. It's the best book I've read so far. He also has some lectures on YouTube. Just google his name and they come up. Definitely worth looking into because he mentions several non-medication ways of healing from trauma.

 

I've found mindfulness to be the best way to cope so far. I never did well in CBT and Dr. van der Kolk explains why many people dealing with trauma will not do well with CBT. I really understand a lot more of what happened and how to cope off of drugs.

 

Here is a link to a great site for a free 8-week long online mindfulness course. http://palousemindfulness.com/  That site helped me get started with a really good mindfulness practice. 

 

I hope this information is helpful to you. Wishing you much success in your recovery. There really is peace at the end of the road. 

 

 

[Altostrata]

Welcome, pianoman.

 

If you take Ativan regularly, you will become dependent on it. How long have you been taking it?

 

When did you start taking Effexor? Did you start taking them together?

 

What is your daily symptom pattern now?

[pianoman]

Altostrata, Thanks for your response and sorry it took me so long to reply. Jerome is helping me learn to navigate the website. I only took a few Ativan and have stopped taking it knowing how addictive it is. My anxiety is through the roof right now and wish that was not the case since it really takes the edge off! Will 1mg taken every 3 or 4 days get me hooked? I started on the Effexor and Remeron 10 weeks ago with the same results as all the other SSRI`s I have tried. Nada. My psychiatrist says that I have way too many `external` problems in my life right now for any of them to work. Not sure what you meant by `daily symptom pattern` but I have suffered from severe insomnia my whole life NOW accompanied by the worst nightmares imaginable when I do sleep and pray for an end to this existence every minute I am awake. I appreciate your feedback and hope you are doing well!  Pianoman

[Altostrata]

Please keep daily notes on paper about when you take your drugs, their dosages, and your symptoms. I need the times of day for all.

 

Effexor can be activating, causing anxiety, agitation, insomnia, etc.

 

Please put ALL the drugs you take in the Drug Interactions Checker http://www.drugs.com/drug_interactions.html and copy and paste the results in this topic.
 

Does the Remeron help you sleep? Do you have any Paxil left?

[ChessieCat]

Just helping out:

 

Interactions between your selected drugs

 

Major venlafaxine mirtazapine

Applies to: Effexor (venlafaxine), Remeron (mirtazapine)

Using venlafaxine together with mirtazapine can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention if you experience these symptoms while taking the medications. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

 

Moderate lorazepam venlafaxine

Applies to: Ativan (lorazepam), Effexor (venlafaxine)

Using LORazepam together with venlafaxine may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

 

Moderate lorazepam mirtazapine

Applies to: Ativan (lorazepam), Remeron (mirtazapine)

Using LORazepam together with mirtazapine may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

[Jerome]

Hi ChessieCat,

 

Thanks very much for checking the interactions between these drugs. I have two questions. Did you check for reactions between all of the drugs mentioned, which would mean of them all, only Effexor, Remeron, and Ativan have significant interactions. Also, what is the source of this information?

 

Again, thanks very much,

 

Jerome

[ChessieCat]

Hi Jerome,

 

I only checked the ones that Pianoman appears to be taking currently, ie Effexor, Remeron and Ativan (from his signature:  He agreed, and Rx'd 75 mg of Effexor in the morning and 45 mg of Remeron at bedtime. I also take 1 mg of Ativan about every three days).

 

Drug Interactions Checker http://www.drugs.com...eractions.html 

 

Also, this is a Symptoms Recording Chart for noting symptoms throughout the day.  You will need one for AM & PM (just cross out or circle which is applicable at top left) and you can add the dates across the top.  It is broken down into 1/2 hours blocks and is for a period of 1 week.

[pianoman]

My new friends,  I take Remeron usually around 4pm daily and Effexor around 4am. My anxiety, depression and insomnia are worse than ever. I have no Paxil left and no longer take Ativan. My psychiatrist has had me on 7 different SSRI`s the last 18 months with zero tapering etc. between each. I have gone off one and started the next immediately after so you can imagine my confusion over which is causing my worsening symptoms. The Remeron does not help me sleep and I take it when I wake up as prescribed....  Thanks to you all!

[Fresh]

Hi pianoman , in the past week , what has your sleep pattern been?

 

I wonder if you'd mind having a go at redoing your signature in the format similar to ChessieCat , Shep and SquirrellyGirl above - a summary of dates and dosages. It makes it easier for readers to understand at a glance. Instructions are here http://survivingantidepressants.org/index.php?/topic/893-please-put-your-withdrawal-history-in-your-signature/

 

Best wishes , Fresh

[Altostrata]

My guess is you need to reinstate Paxil. Also, you need a new doctor.

 

Please be aware a side effect of antidepressants can be emotional anesthesia, which can last long after quitting.

 

Why do you take Effexor at 4 a.m.? How do you feel before taking it and how do you feel after taking it? When do you go to bed?

[pianoman]

Thanks again everyone,  I will talk to my psychiatrist about reinstating Paxil at a lower dose to see if that helps. I have been a professional pianist in SF 5-6 nights a week for the last 30 years and get home MUCH later than most people from work. I`m also the musical director for a recording studio so tend to compose music after that since very `amped` up after performing. I have NEVER been able to fall asleep before 4 or 5am even when I went off to college or had 9-5 jobs and assumed it was due to viscous alcoholic parents forcing me to stay awake ALL night 7 nights a week for my first 18 years since I was 6 months old. I feel no difference before or after I take Effexor and usually go to bed around 8am these days due to my increased anxiety.

[Altostrata]

If I were you, I'd get a prescription for liquid Paxil. You might tell your doctor you wish to cross-titrate up so as not to do a cold switch.
 
This means taking a small amount of Paxil, perhaps 3mg, wait a few days, then start reducing Effexor. Or, you might take this opportunity to switch to liquid Prozac, which may or may not compensate for Paxil withdrawal syndrome, but might be a little easier to reduce than Paxil.
 
Do you have the kind of Effexor XR that contains tiny beads in a capsule?
 
Read
 
Tips for tapering off Paxil (paroxetine)
 
Tips for tapering off Effexor (venlafaxine)
 
The Prozac switch or "bridging" with Prozac

 

The Prozac topic discusses the principle of cross-tapering to switch drugs.

 

Your inverted sleep cycle may be contributing to "depression."

[pianoman]

Hello, So very confused about reinstatement of the Paxil since the other 6 SSRI`s I have tried the last 18 months have left me feeling the same exact way after I stopped them plus haven`t taken Paxil for 10 weeks now. Could it just be my depression is becoming worse? Should I stop the Effexor or the Remeron to bring the Paxil back in for reinstatement? Just need to make sense to my psychiatrist with this new way of thinking for him. Unclear whether I am going through withdrawls or just need meds that work for me.  Thanks to you all!!

[Fresh]

"If I were you, I'd get a prescription for liquid Paxil. You might tell your doctor you wish to cross-titrate up so as not to do a cold switch.

 
This means taking a small amount of Paxil, perhaps 3mg, wait a few days, then start reducing Effexor. Or, you might take this opportunity to switch to liquid Prozac, which may or may not compensate for Paxil withdrawal syndrome, but might be a little easier to reduce than Paxil.
 
Do you have the kind of Effexor XR that contains tiny beads in a capsule ?"

[Altostrata]

It sounds to me that you are experiencing Paxil withdrawal syndrome and Effexor isn't helping at all.

 

In these situations, we often suggest reinstatement of the original drug. "Cross-taper" means you add a little Paxil while you reduce Effexor until you are on Paxil only.

 

We're talking about reducing your withdrawal symptoms. We can't address your underlying "depression," you'll have to find non-drug ways to cope with that.

[pianoman]

My psychiatrist was not happy that I searched for ways to help myself outside of his domain. He has thrown his hands up regarding my condition and is the only `welfare` psychiatrist in my county. At a loss as what to do next since I am unemployed for the first time in my 55 years. All other psychiatrist have treated me the same way since severe PTSD/depression seems to be a crap shoot to all of them. I just feel like giving up on trying to treat this TERRIBLE condition which has gone on for 53 years now. Just wish life was like it was before I was born. Peaceful without the constant pain.

[SquirrellyGirl]

Sadly, nowadays psychiatrists only know how to do one thing:  prescribe.  They don't do psychotherapy anymore, leave that to the therapists.  

 

You are in Pacifica, CA?  Being unemployed, this may be tough, but I recommend a program called EBT, Emotional Brain Training, cofounded by Laurel Mellin at UCSF.  This would definitely help you with the depression/PTSD.  This program is web-based, with tele groups.  I'm not sure if Laurel still does actual groups, as she did before they launched EBT, but you might look into it.  My tele group leader, Barbara Gabriel, also practices in SF, so she might be one to try to see privately.  

 

EBT is about neuroplasticity and breaking old stress circuits, re-wiring new, healthier ones.  It is about processing emotions, which many of us never learned to do effectively.  It teaches "tools" that help us cope.  I would say it is some form of CBT/DBT.  I'm not marketing for them, but just sharing what has worked for me.  I think what is super beneficial about EBT is that it creates a feeling of community through doing phone connections with group members, a safe environment where you can process emotions with others witnessing without judgement. That has been invaluable to me because I don't have much of a support system, and it truly helps to be heard.

 

Meanwhile, it may be time to ditch the p-docs and find a naturopath or sympathetic GP who can prescribe and work with you to get the meds so that you can take control and get stabilized.  Many of us have had to learn the hard way to not try to get our doctors to agree with our new-found realization about the meds, to just USE them to get the drugs and then do what we must do without their active participation.

 

I'm lucky in that my p-doc knows I want off and am tapering, far too conservatively in his opinion.  But, he is willing to prescribe as needed.  I've read of people being "fired" by their p-docs because they didn't agree with what the patient was trying to do in tapering.  Geez.

 

I hope this helps!

SG

[Altostrata]

Any doctor can prescribe psychiatric drugs, it doesn't have to be a psychiatrist. Do you have a better relationship with your GP?

[ChessieCat]

Hi Pianoman,

 

Posting links for you to read if you haven't already:

 

What should I expect from my doctor about withdrawal symptoms? How do you talk to a doctor about tapering and withdrawal?