☼ ItsNearlyMedlessKateAgain

[ItsNearlyMedlessKateAgain]

Hi, I'm Kate. Hope I'm welcome here. I have successfully withdrawn from antidepressants and recently from an  antipsychotic but am in Lamictal hell.

 

I have a long history with the mental health system since the age of 5 - court ordered due to sexual trauma. I'm 37 and have had 25 years of therapy. I went to weekly therapy for 7 years from age 5 to age 12 when I refused to keep going and was sent to a group home. I think therapy did MUCH MUCH MUCH more harm than good to me as a child. I went back to therapy in 2002 and was in therapy continuously until October of 2015. I found I was dreading going and would become anxious the day before because I did not want to go talk about my problems without any therapist ever giving me any kind of insight or advice and so I quit. It was far more upsetting than helpful. I am so much happier since I stopped focusing on my problems and am doing other things to care for myself like diet (organic vegan for 4.5 years), exercise (for about the last 8 months I've been walking, practicing yoga, and swimming) and supplements (zinc, B-complex, and high dose DHA/EPA). 

 

Dx have included - Post-partum Depression, Bipolar Disorder, Major Depressive Disorder, Dissociative Identity Disorder, DDNOS, Panic Disorder, Generalized Anxiety Disorder, ADHD, C-PTSD, Borderline Personality Disorder. The PTSD and mild BPD are the only two that sort of make any sense. I do not and never have had DID despite doctors and therapists trying to bring out my "alters" for years. I believe the mania Dx as Bipolar is solely due to antidepressant use.

 

 

I have been officially disabled since 2002 but I believe this is due to the meds rather than severe illness. Instead of being offered help with my abusive situation, I was heavily medicated when I went to my PCP (who is actually an OB-Gyn) complaining of depression and extreme spousal abuse (actual pummeling and threats with guns). I also believe I was funneled onto the disability system by my psychologist who told me I would definitely be approved because his brother was an ALJ and he'd make sure it was approved. I was approved the first time in 7 months. I didn't realize until recently when starting to put the pieces together that my life fell apart after I was medicated wth Effexor and had a severe mania with psychosis which led to two major suicide attempts in two months. This was before the black box warning for young people. I was only 23. I have made four major suicide attempts while on antidepressants. This led to a complete breakdown after which my young daughter was taken from me. My current diagnosis is Bipolar 1 which I do not believe I have since I have only ever been manic when taking an antidepressant. I have been off antidepressants completely since August '15 and have not experienced either a mania or depression since that time.   I don't think I would qualify for any Dx at this point were I to be honest with my doctor about my symptom reduction since going off meds. When I stopped going to therapy and refused my psychiatrist's admonitions to continue, her response was "You don't listen to anyone!" which I heard in Cartman's voice from Southpark "Respect my authoritay!" After that I declined to tell her I've been tapering from my meds. It is not her decision and I no longer care about being a good compliant patient. My husband goes in with me to every appointment since I was experiencing memory loss due to the Latuda, so he has witnessed my psychiatrist basically dismissing my desires and telling me what my treatment will be. It was his idea for me to try going off meds to see what happened. We now have a script we use with the psychiatrist when we go in and know exactly what we will tell her to make her think I am still on meds and compliant. I will tell her after I am off the Lamictal and sure I am going to be able to stay off. At this point, that is looking like some time next year.

 

I am trying not to rush getting off Lamictal but I want the rest of my life back. I feel like the last 15 years have been stolen from me. I want to go back to work and do something with my life. I used to hold onto my identity as mentally ill because it made my fucked up life seem like it was not my fault. Now I know it was neither my fault that the trauma happened, nor my fault how I reacted to it, nor my fault for treatment providers putting me on drugs that drastically changed my behaviour, nor my fault in any kind of genetic or biological way. I can recognize where I've made truly awful decisions when I was younger but I have matured and my life does not even resemble anything like what it was then.

 

I have incredible support in doing this from my husband, my mother, and my best friend who all wholeheartedly agree with my assessment that this is medication induced. I went for ten years without treatment entirely as a teen and young adult until I cracked under abuse and then was treated as if I was the one with the problem. No one ever addressed my husband's abuse. I have recently been emboldened in my decision to quit psychiatry by websites like Mad in America and Beyond Meds. Let's do this! (Sorry if this was too much information...)

 

Here is my med history:

 

Meds as a child:

 

Elavil - 1991 - took for two months, quit cold turkey, no withdrawal

Lithium 1992 - took for 28 days, gained 49 pounds, withdrew cold turkey, no negative effects

Prozac 1992 - made me extremely aggressive, taken off after a few days

Thorazine 1992 - injection used nearly daily during ~8 month hospitalization for behaviour control (basically way too smart for my own good and got into trouble out of boredom)

There must have been more drugs as I remember taking a boatload of them, but I was too drugged to remember, or may not have been told what I was being given. To my parents credit, they never kept me on the drugs once I was released. I was drug and therapy free for ten years.

 

Meds as an adult:

 

Paxil - '00 - six weeks for PPD, didn't work

Wellbutrin '01 - three weeks to try to quit smoking, withdrew due to agitation, no withdrawal

Amitryptaline - late '01-'02, low dose no effect

Trazodone '2002 - no effect

Effexor - '02_'05 - became severely manic until put on Topamax, transitioned to Lexapro

Lexapro - '05-'15 - multiple depressions and manias during treatment, withdrawal uncomplicated over three weeks

Buspar '02-'03 - little effect, no withdrawal

Xanax & Klonopin - '02-'16 Developed extreme sensitivity, can no longer take, Took 2-3 mg a day at my highest

Concerta - '05-'07 no withdrawal, supposedly had ADHD during college

Straterra - '05 no effect

Depokote - '06 gained over 20 lbs in two weeks, quit

Topamax - '03 (and '10-'13) caused partial complex seizures above 100 mg

Suboxone - '10 - seven weeks while inpatient used as antidepressant, not for drug/alcohol treatment, quit once out of hospital, no withdrawal

Latuda - '14-'16 (only with zofran due to vomiting) withdrew in early April 2016 after developing delusions and hallucinations (I'm not schizophrenic) along with parkinsonism, akathesia, and mild respiratory dyskinesia

 

Withdrawal experienced with:

 

Seroquel - '06 -'09 Withdrew cold turkey, became manic for 8 months (while taking Lexapro) and '09-'12 withdrew over a few weeks, became somewhat manic for about 8 months before becoming severely depressed for two years, while taking Lexapro)

 

Gabapentin - '01-'15 Experienced Gabapetin withdrawal syndrome twice with emergency medical treatment twice before successfully withdrawing over three months in late 2015

 

Lamictal - '05-'12 withdrew too quickly over about two months, had to restart -- '12-'16, currently withdrawing at 1 mg/day

 

Currently only on Lamictal and hope to complete withdrawal within 6 months. I have tried doing step reductions and found that I got really angry and agitated for days after a 10 mg reduction, but as my husband is a chemist and able to weigh the pills to within a mg, so we tried a gradual taper by 1 mg a day and that worked so well that we tried to increase the taper to 1.5 mg a day and I became extremely irritable and snappy so we are currently holding for a few days at this dose and will try 1 mg a day again early next week.

 

If anyone is still reading at this point, you're a real trooper!

[scallywag]

Kate - Welcome to SA!  You'll find lots of experience and support here with ideas for you to reach your goal: NowMedlessKate.

 

You've been through a lot - trauma and then -- even worse -- docs experimenting with psychotropic drugs on you calling it "treatment."  Some European countries prohibit these drugs for children and teenagers, with a few limited exceptions.  I wish that the US and Canada did the same.

 

I read Anatomy of an Epidemic by Robert Whitaker, who also wrote Mad in America. In the chapter on anti-depressants he discusses your exact experience - iatrogenic, drug-induce bipolar disorder.

 

You've been on or gone off a few drugs in the last 2 years:

• Lexapro,
• Xanax & Klonipin,
• Gabapentin,
• Latuda with Zofran, and
• Lamictal -- last but not least your one and only remaining p-drug.

 

Providing more details about drugs you've taken will help the moderators help you. Specifically for each one of the ones listed and any I've missed, post and include in your signature three things (as best as you can remember):

• starting dose and ending dose
• month and year of last dose
• how you tapered (cutting dose amount, skipping days, cold-turkey)

Your experience and work at tapering are heroic. It's wonderful that your husband is so supportive. 

 

One note: daily dose reductions are a risky way to taper off a p-drug.  Have you read this thread about SA's recommended approach and the rationale for it: Why taper by 10%

[mammaP]

Hi Kate, welcome to SA. I am  speechless! I have read your story and am so angry on your behalf for being treated this way by doctors who are supposed to 'DO NO HARM' . You were a baby when you entered the system   . 

Congratulations on gaining control of  YOUR life!  You have had so many drugs that I can only imagine how sick they must have made you. 

 

As you are now suffering the effects of all the drugs and quitting many of them your nervous system is struggling so I would recommend holding the dose you are at for now to let your brain and CNS settle down some before restarting the taper. We recommend tapering 10% of the current  dose with 4 weeks between cuts, but longer if there any any withdrawal symptoms. We find that when it is the last few mgs people need to slow down a bit. There is an excellent chart about occupancy levels  that you and your husband might find interesting and it explains why the last bit is hardest.

 

http://survivingantidepressants.org/index.php?/topic/6036-why-taper-paper-demonstrates-importance-of-gradual-change-in-plasma-concentration/ 

 

 

Here is our topic on tapering lyrica http://survivingantidepressants.org/index.php?/topic/2381-tips-for-tapering-off-lyrica-pregabalin/

 

We would be interested to know when you stopped the last few drugs and how you tapered as that could be part of why you are feeling withdrawal .

 

Please ask any questions and read the topics on the site, there is a wealth of knowledge here. I'm glad you found us now, you can get the life you deserve right now while tapering off the last of the drugs. I would love to be with you when you go to your psychiatrist well and happy, to tell him you are drug free and staying that way! If you haven't seen it already, one of our moderators has a very successful blog, beyondmeds.com where she shares her journey off  many psych drugs and is now fully functioning and pro active in letting doctors know what they are doing to people. She confronted her psychiatrist too! 

[Altostrata]

Welcome, NMK.

 

You are fortunate indeed to have loved ones supporting your decision to find yourself and go off drugs.

 

What is your current daily symptom pattern? How much lamotrigine are you taking now?

 

I agree with mammaP, please stop reducing lamotrigine for the time being, give your nervous system a vacation from drug changes and let it adjust.

[Shep]

Hi, Kate.

 

Welcome to the forum from me, too. There are a number of us here that entered the mental health system due to trauma, myself included. But I'm very glad you're here and coming off these toxic drugs.

 

There's a great book by Dr. Bessel von der Kolk called The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. It's the best book on trauma I've read so far. He explains why many of us do worse with certain types of therapy. Like you, I found therapy very harmful, but other ways of healing such as mindfulness work great. So there are lots of non-drug ways of healing and lots of hope. 

 

It sounds like you're doing a great job with coping skills by doing yoga, going for walks, and swimming. 

 

I'm glad you're here for support and information. 

[ItsNearlyMedlessKateAgain]

Thank you so much for the warm welcome.

 

Message heard about the tapering. I'll give it a while before reducing again.  I only just recently found these websites or I would have tapered off the Lexapro and Gabapentin slower than I did.

 

I wasn't really trying to go off my meds last year. I wanted to start taking turmeric as a supplement for pain and it has a mild interaction with SSRIs, so I decided to go off the Lexapro. Then I heard that my reflux could be caused by the gabapentin so I decided to try going off of that to see if it worked, which it did. But I was content to stay on the Lamictal and Latuda until my doctor refused to continue filling the zofran and told me to try over the counter meclizine. The meclizine didn't work and I took double doses for three days. I went off the meclizine and I also skipped the Latuda for a couple of days because it was making me vomit. Then  I began hallucinating and having delusions and that lasted for three days. That was when I decided to gut the Latuda.

 

When my brain started coming back online I realized how calm I was and that the Latuda must have been what was making me have angry rages every day. That had crept up so slowly that I didn't recognize it was happening due to the cognitive effects I was having. I could no longer think at all. But when I began to taper the Latuda I started researching meds and tripped over the Mad in America website. Now I've read both of Whitaker's books, plus How to Make a Schizophrenic, Crazy Like Us, and Our Daily Meds. I'm currently reading They Say You're Crazy and I have 9 other books on the shelf waiting. (Hey, I can read again! Who knew I still possessed that talent?)

 

I fixed my signature. I didn't add the benzos because I never really experienced any kind of withdrawal and I rarely took them in the past few years. I went from taking them almost daily to only every few months sometime in 2013. It's been months since I've had one and I don't anticipate taking another.

 

Daily symptoms are far less than they were when I was medicated. No manias or depression since the Lexapro. Except for earlier this week when I was very snappy after increasing my taper rate off the Lamictal, I have been extraordinarily calm. I had become so very angry all the time on the Latuda and that disappeared within days of my last dose. I have had periods of sadness as someone close to me received upsetting medical news. And I am dealing with periodic mild paranoia. I had never had paranoia before the Latuda/meclizine debacle (in my research I learned they both lower dopamine so when I stopped taking both of them and my dopamine facilities turned back up, I went slightly mad). Before I was medicated as an adult, most people would describe me as happy-go-lucky and that is what feels like is returning of my personality.

 

I am extraordinarily fortunate to have the support I need and also the resources to be able to afford things like a swim club membership. I try not to take anything for granted in my life now. I hope when I wrote my intro that it was clear I was talking about two different men when I said my husband. My current husband would never abuse me. My ex was a long long time ago. I have a very different life now. I am confident I will get off this last drug and thrive.

 

Thanks again for the welcome.

[nick1990]

Your the trouper NearlyMedlessKate! go you!

[JanCarol]

Hey Kate - 

 

I love the way you and your husband play out a special little drama for the psychiatrist, telling him what you believe he needs to hear, to get your needs met.  What an awesome conspiracy between you two!  I giggled just to read it, and look what good it has done you!

 

I'm adding a lamictal link - I think the Lyrica link that Mamma supplied may be a typo:  Tips for Tapering off Lamictal

 

I agree with everyone else here - you went through a lot of drug changes earlier this year.  Until those have settled down a bit, it's probably best to hold on your current taper of lamictal.

 

You wrote:  

I wasn't really trying to go off my meds last year. I wanted to start taking turmeric as a supplement for pain and it has a mild interaction with SSRIs, so I decided to go off the Lexapro. Then I heard that my reflux could be caused by the gabapentin so I decided to try going off of that to see if it worked, which it did. 

 

Me, too!  I was content to stay on my lithium and SNRI.  For me it started with a stomach acid drug, a PPI.  My consulting pharmacist warned me that it was not for long term use.  I didn't even know to taper but didn't have any problems (got lucky).  From there, I thought, maybe the parathesia (numb down side of leg) was from the statin - then I read about brain effects of statins, and hormonal effects - it's far greater than just the CoQ10 that statins rob you of.  Each time I went off a drug I got better.

 

THEN I got a hold of Anatomy of an Epidemic and decided - I was unhappy on the drugs, I could be just as unhappy off of them.  I was comfortable with depression, having had it all my life.  I had coping strategies and was not in danger of harming myself or others.  In Victorian times they would've called me "melancholic" or some such.  So I decided that it was okay to be depressed and starting coming of the SNRI.

 

(my SNRI, Reboxetine, was never approved for use in the USA.  It was rapidly banned in Europe, and while I was tapering it, it was banned in Australia, as well).

 

Months later, after being free from the SNRI - the fog was lifting, like you said.  I decided - against all medical advice - that the lithium had to go.  I could feel it draining my health away.  Perhaps 3 of my surgeries were because of this "salt."  I'll never know for sure.

 

The more I tapered, the more the fog lifted.  I even made some serious dosing mistakes (I was dry cutting).  I had a few crashes, and I may still have some yet to come - but I'm never going back. I am no longer depressed; I am no longer in withdrawal.  

 

I'm sure you understand the feeling!

 

So I just wanted to chime in, emphasize that waiting until you feel better before tapering the Lamictal is probably a good plan - and to let you know - there is hope.  You cannot get your 15 years back - but you can get your future back!

 

I hope you see the Sun today.

[Altostrata]

Good to hear your withdrawal symptoms are minimal, NMK. You may be one of the fortunate people who can go off these drugs relatively quickly.

 

If I were you, unless you have adverse effects from it, I would hold on tapering lamotrigine for several months at least and assess your new nervous system environment. Please let us know how you're doing.

[ItsNearlyMedlessKateAgain]

I don't know where to post this question so I hope it gets seen here.

 

Latuda caused me to become overheated extremely easily. I basically didn't go outside last summer. I've been off the Latuda a month or five weeks now and now that the weather is heating up, I still feel like I'm still having trouble regulating my temperature and become unreasonable very quickly when I'm out in the heat. Not just cranky but confused and hard to follow along. Is it possible I'm still experiencing that physical side effect or is it all in my head? It'd be nice if I could psych myself out of this but I just can't seem to handle the heat.

[Shep]

Yes, temperature dysregulation is common during withdrawal.

 

Here's a thread that explores this:

 

http://survivingantidepressants.org/index.php?/topic/2271-body-temperature-dysregulation-fever-chills-shivering-too-hot-too-cold/

 

It's definitely real and not "all in your head". But it will get better in time. Hopefully next summer will be much better.

 

 

[Altostrata]

It sounds like your nervous system still has some recovering to do. Please avoid stressing it in the heat.

[ItsNearlyMedlessKateAgain]

So after reading more on this site, I'm putting together a more comprehensive list of current withdrawal effects that I had not previously attributed to withdrawal.

 

* adrenaline rushes and heart palpitations. These seem to come out of nowhere and suddenly I'm shaking allover and my heart feels like it's not pumping correctly, like all four chambers are trying to pump at the same time. It doesn't feel like it racing, but it's hard and violent like it could just pump right out of my chest. This has happened half a dozen times since my last dose of Latuda

 

* diarrhea. This has been daily for at least five or six weeks now, maybe longer, I have been trying to keep a record but I'm not always good at connecting the dots

 

* night sweats. This only started last week when I tried to increase my taper rate but has continued even since I stopped tapering and held at 175 mg. It's happening every night. I wake up sheets and bedclothes soaked.

[JanCarol]

Hey Kate - 

 

Is it any wonder that these drugs get prescribed for normal menopause?  I don't know where you are in your hormonal journey, but many of the symptoms of withdrawal look a lot like menopause "symptoms":   http://survivingantidepressants.org/index.php?/topic/10740-female-hormone-issues-perimenopause-menopause-wd-or-something-else/

 

Also, if you are interested in tracking symptoms, many of them have been listed here.  There is even a sheet you can printout to track changes in your symptoms:  

http://survivingantidepressants.org/index.php?/topic/2390-dr-joseph-glenmullens-withdrawal-symptom-checklist/

 

As for the adrenaline surges - it was menopause which taught me about them.  If I had a near miss in traffic, it was always followed by a hot flush.  I learned to feel the surge of adrenaline chasing across my skin, surging through my heart, that always preceded a hot flush.

 

Do your adrenaling surges have a pattern?  Cortisol shifts throughout the day, and many people have an early morning surge that jolts them out of bed. http://survivingantidepressants.org/index.php?/topic/33-waking-with-panic-or-anxiety-managing-cortisol-spikes/  You may also find that the surges don't always come out of nowhere - that they are triggered by noise, light, emotion, and more.  Learn what your triggers are, and try and manage them before they get to your body.

 

And the Gut.  Well.  Yep.   Many of us struggle / have struggled with the gut.  Most of your body's serotonin is in the gut, it's called the "enteric brain" and it is connected to your cranium brain by the Vagus Nerve, a huge nerve which links all of our emergency and operating systems together.  Originally a survival mechanism, it is the source of that "gut feeling" or intuition that guides you.  

 

You can read more about the gut in withdrawal here:

http://survivingantidepressants.org/index.php?/topic/3413-digestive-problems-nausea-diarrhea-bloating-gerd/

 

I haven't posted it anywhere but Varro Tyler reckons that a tea steeped with cinnamon is good for acute diarrhea.  I tried it, and it was quite bearable (1t to a glass)  My own diarrhea got so bad that I took enemas, especially if I wanted to go somewhere, and not be a mess.  It is better now, the enemas (a mixture of black tea, coconut oil, salt, yogurt starter, and clay) seem to have "fixed" it.  BUT I was NOT in withdrawal, like you are - your best method will be to wait it out, listen to your body, eat what you can, avoid what makes it worse.

I also take a bone broth when my tummy is really bad, and it helps immensely.  I was never able to do the full GAPS diet (it is too strict, but you can read more here: http://survivingantidepressants.org/index.php?/topic/890-scdgapspaleo-diets/ ) but the bone broth really feels good, and I've found ways - fresh turmeric and ginger root grated into the broth - to make it tasty.  It make so much sense!  In olden days, when someone got sick, Mom or Nurse would put them on a broth diet for a few days until they were better.  Simple, natural, effective.

 

Some here have survived on diets of triscuit and peanut butter, others have been limited to only 5-6 foods while in the worst of withdrawal - all of these extreme, acute conditions pass with time, and eventually the diet can normalize as you get better.

 

It sounds like you are doing really well, for where you are after your tapers.  Keep holding, keep learning - it does get better!

 

 

http://survivingantidepressants.org/index.php?/topic/2390-dr-joseph-glenmullens-withdrawal-symptom-checklist/

[ItsNearlyMedlessKateAgain]

Next week will be a month on the dose I'm on - 87.5 mg - and I'm planning on tapering another 10% but I'm still having quite severe diarrhea. I can make it to the bathroom just fine but I'm seriously dehydrated with dry split lips and so thirsty all the time. But I just pee the liquid right out and then the diarrhea compounds the problem. My husband has been after me to take Immodium but I've been resisting putting *any* medication in my body at all. I have been reluctant to even take Tylenol. My trust in the pharmaceutical system has been completely eroded and I don't want to take anything anymore. But it's probably also not good to be so dehydrated either. Should I take the Immodium? (Sorry, I'm vegan so bone broth is out of the question.)

 

Also, should the diarrhea stop me from reducing again? I feel like this could go on for months and I don't want to wait a ridiculously long time to taper again hoping it will get better.

[scallywag]

Diarrhea is something you need to address.  Hydration is the 2nd most important nutrient, air/oxygen being the first. Have you tried any of the gentle remedies JanCarol suggested?

 

I've dealt with diarrhea in the past by taking probiotics (good bacteria), prebiotics (coconut oil), and pediatric electrolyte rehydration fluids, brand name Pedialyte, Some chain pharmacies have their own comparable house brand product. With both the probiotics and prebiotics, I had to start with small amounts and then increase. I drank the Pedialyte as needed. 

[ItsNearlyMedlessKateAgain]

Yes, the bone broth is not vegan so that's a no-go. I'm allergic to cinnamon, I have never found ginger helpful in digestion and the taste is too strong for me and makes me nauseated. I do take turmeric every day in the form of golden paste but turmeric is more likely to cause diarrhea than to stop it - though usually that is only in the beginning and if you take too much too quickly. I have cut down substantially on the turmeric and that has not helped.

[ItsNearlyMedlessKateAgain]

Oh also, I am taking probiotics. I hadn't thought of pedialyte but that's a great idea. Thanks so much!

[ItsNearlyMedlessKateAgain]

Thank you again, Scallywag for recommending Pedialyte. I picked some up this morning and was so pleased to find an unflavored version. I had been avoiding sports drinks like gatorade because of the massive sugar content. Unflavored Pedialyte is perfect and it doesn't even taste terrible refrigerated.

[scallywag]

Thanks for letting us know that the unflavored product is tolerable taste-wise. Like you I'm not a fan of super-sweet beverages, often cutting them with mineral or soda water.

[ItsNearlyMedlessKateAgain]

Not only is it tolerable, it seems to have helped the diarrhea which I wasn't expecting at all. But by Tuesday, I was starting to have slightly formed poop and by this morning it is totally normal. I'm wondering if the diarrhea was psychosomatic as drinking Pedialyte should not by itself stop diarrhea (according to their website) but it spontaneously "cleared up" within days of starting "treating" it.

 

I also tapered (10%) on Tuesday morning so fingers crossed it won't return. 

[scallywag]

If nothing else, you've got a good placebo.

[ItsNearlyMedlessKateAgain]

Right? You gotta have a sense of humor about these things. I don't care if it's all in my head as long as it works.

[ItsNearlyMedlessKateAgain]

My husband and I are arguing about whether or not to take a missed dose if it is almost time for the next dose. I'm only taking Lamictal and I space my doses 10-12 hours apart. If I forget a dose, I will take it if there is 6 hours from my next dose. He argues that 4 hours is enough space to make up a missed dose and that skipping is worse than closely spaced doses. He's even said I should take a partial dose rather than skip altogether. I don't know what to do. I've had it drilled into my head over the years to never double up or take doses too close together. But I know skipping is bad too. Any suggestions?

 

(note: I get severely irritable if I miss a dose, so I understand his frustration. I just don't know if his approach is safe or recommended.)

[scallywag]

Kate, I've moved your question to your intro thread. Although the answer to your question will likely apply to other SA members, it's best to post your questions about your individual situation here.

 

I don't know what the "cut off" is for taking a missed dose.  Could you ask your doctor or pharmacist?

 

Here's some math I ran on Lamictal:

 

I looked up the prescribing information on Lamictal on drugs.com for peak concentration and half-life data. About 40% of the way down the page, under the Pharmacokinetics sub-heading in table 14:

 

For 179 healthy volunteers taking no other medications, on multiple daily doses of lamotrigine,

• peak plasma concentration occurred at 1.7 hours after dosing and
• half-life was observed to be 25.4 hours (average), with a range of 11.6 to 61.6 hours. 

Using the average half-life of 25.4 hours: 85% of the absorbed dose is still available after 6 hours, and 72% is available after 12 hours. With that information if I were you, I'd take the full dose up to 6 hours after scheduled and a partial dose thereafter. If your doctor or pharmacist gives you a different answer, take their recommendation.

[ItsNearlyMedlessKateAgain]

Thanks scallywag, I didn't post it here because I figured a missed dose was something would apply to others as well.

 

I will ask my doctor but I don't see her for two months. Thank you.

[Altostrata]

My guess is 4 hours is close enough. You could also take a partial dose to get by until your next full dose.

[ItsNearlyMedlessKateAgain]

Thanks, Alto. I'm being really diligent about not missing doses because of how unreasonable I become so quickly.

 

I've taken up running and it is helping immensely. I've never been big on exercise, really ever in my life. But I read that it helps greatly with depression and started last week and I am feeling wonderful. So much, in fact, that my husband is pushing me to go down again on my dose even though it's only been like 9 days. I told him I'd go until next week to make two weeks but he is really pushing me hard to accelerate my taper, mostly because of the instability when I miss a dose. Seemingly, he wants it out of my system more than I do.

[mammaP]

I am really pleased that running is helping and you are feeling so good. Don't let hubby talk you into reducing doses, you are the one who will suffer the consequences and he will not be happy when you are ill from tapering too fast!  It really is good to see you doing so well  

[ItsNearlyMedlessKateAgain]

So I made it to three weeks today since my last taper, but I'm *extremely* nervous about my next taper. This past week has been a real rollercoaster. I've had widespread pain - all four quadrants, joints and muscles, reminiscent of the fibromyalgia I was once diagnosed with that hasn't bothered me for years. Also, seemed like every other day this past week was rough emotionally and then the weekend I just layed around crying and feeling sorry for myself not able to get it together. (You know the heavy sobs that burst forth no matter how much you try to calm down? That.) Yesterday was full of panic and fear. It's just been rough. Today has been better and I got out of the house to yoga class and then went for a run at lunch time. But I'm not feeling back to normal yet. 

 

Here's the thing: I am not really in a rush to taper given how I've been feeling physically and mentally. I am nervous about landing back in that dark place. Hubs on the other hand is really pressuring me to stick to the schedule so as not to drag out the misery for even longer than necessary. I managed to get him to let me go to a full three weeks without continually bugging me, thank goodness. But I don't know how/whether to proceed. I feel like he has a point about getting this poison out of my system, but I'm the one dealing with the effects. On the other hand, he is feeling the full brunt of my emotions so I get his position too. He works from home and my emotional state has certainly been disruptive.

 

On the plus side, other than being emotional, and the pain, I'm doing well. I haven't had any more adrenaline rushes. I'm sleeping well. I have a normal amount of energy. My blood pressure has been normal and stable. Physically, other than the unexplained pain, I am doing well. I'm just so damn afraid of the darkness in my head that I'm afraid to try to taper again.

 

I can hear your replies already telling me that I shouldn't taper until I am sure I'm ready. But what if this is my normal state? I don't really remember the degree of my emotional state from way back before the drugs 15 years ago and I can't say this isn't just how I am going to be without them. Good days and bad days (weeks?) So I'm conflicted and don't know whether to proceed or pause. Pausing feels like a setback to me right now.

[scallywag]

Kate, What feels like the right thing do? What is your gut telling you? 

 

Maybe there's a half-way solution: rather than cutting your dose by 10% of current dose, cut by 5% and see how you feel doing that.

 

Something else to consider: brassmonkey, a moderator, is using an approach he calls a slide. the rest of us call it the "brassmonkey Slide." If you want to cut your dose by 10%,  instead of doing the 10% all at once, you make 4 equal cuts weekly then hold.

 

Let's say your current dose is 80 mg, 10% = 8 mg, 2.5 % = 2 mg

1. Week 1, cut dose by 2 mg, dose = 78 mg
2. Week 2, cut dose by 2 mg, dose = 76 mg
3. Week 3, cut dose by 2 mg, dose = 74 mg
4. Week 4, cut dose by 2 mg, dose = 72 mg
5. hold at 72 mg
6. hold at 72 mg, evaluate symptoms and stability before making next cut.

If you searched the forum using the internal search tool loooking for posts by brassmonkey that contain the word slide, you'd find posts where he's details the slide and explains the advantages well.

[ItsNearlyMedlessKateAgain]

Kate, What feels like the right thing do? What is your gut telling you? 

 

Maybe there's a half-way solution: rather than cutting your dose by 10% of current dose, cut by 5% and see how you feel doing that.

 

Something else to consider: brassmonkey, a moderator, is using an approach he calls a slide. the rest of us call it the "brassmonkey Slide." If you want to cut your dose by 10%,  instead of doing the 10% all at once, you make 4 equal cuts weekly then hold.

 

Let's say your current dose is 80 mg, 10% = 8 mg, 2.5 % = 2 mg

1. Week 1, cut dose by 2 mg, dose = 78 mg
2. Week 2, cut dose by 2 mg, dose = 76 mg
3. Week 3, cut dose by 2 mg, dose = 74 mg
4. Week 4, cut dose by 2 mg, dose = 72 mg
5. hold at 72 mg
6. hold at 72 mg, evaluate symptoms and stability before making next cut.

If you searched the forum using the internal search tool loooking for posts by brassmonkey that contain the word slide, you'd find posts where he's details the slide and explains the advantages well.

 

My gut tells me to wait another week. I injured my knee yesterday while running and now I'm definitely not feeling my perkiest mentally when I'm dealing with an injury and pain. Oh, and family drama. I'm forced to communicate with relatives I detest. It's totally necessary in this situation and completely miserable. So I'm going to wait and give it until next Tuesday at least. That will be four weeks. I'll reevaluate then.

 

I just might try smaller cuts. I'll look up Brassmonkey's method. Thanks.

[brassmonkey]

Hi Kate--  here is something I have posted on my intro thread that may be of interest:

 

I see WDnormal as the overall baseline of where you are in general. The place you are when you're not feeling good, but you're not feeling bad. Sorta a rolling average of the past couple of months between the windows and waves.  Watching the level of WDnormal is a good indicator that things are improving.  Over time you should be seeing a raising of the standard for WDnormal.  So how you're feeling now is better than say six months ago. It changes very slowly but is a really good indicator.

 

 Many people have the idea that stability is feeling good again, when in fact it's feeling the same level of blah day after day with no big swings to the better or bad. When a person does a drop in dose there will be a corresponding increase in WD symptoms over the next few days.  These symptoms will resolve themselves over the following several weeks and return the person to a slightly raised baseline of discomfort. The time frame and severity are dependent on a huge number of factors and end up being unique to each individual.  But the pattern remains.  This is why paying attention to your WDnormal is very important.  It is also referred to as listening to your body.  After a drop in dose and the symptoms have resolved to WDnormal the person then should wait a couple of more weeks to let things really settle out (there are a lot of little unfelt changer still going on) before considering doing their next drop.

 

During that waiting time people may think that they're not doing anything and want to get on with it.  When in fact doing nothing is very proactive.  It's those little unfelt things that need to be finished up before the next step can be taken.  It's letting the glue harden, the paint dry, the cement cure.  The things that need to be complete before the path is safe to walk on again.  If these details are ignored then they start to pile up and compound each other, then somewhere down the line the foundation slips out from under us and the whole thing collapses.

[ItsNearlyMedlessKateAgain]

Hi Kate--  here is something I have posted on my intro thread that may be of interest:

 

I see WDnormal as the overall baseline of where you are in general. The place you are when you're not feeling good, but you're not feeling bad. Sorta a rolling average of the past couple of months between the windows and waves.  Watching the level of WDnormal is a good indicator that things are improving.  Over time you should be seeing a raising of the standard for WDnormal.  So how you're feeling now is better than say six months ago. It changes very slowly but is a really good indicator.

 

 Many people have the idea that stability is feeling good again, when in fact it's feeling the same level of blah day after day with no big swings to the better or bad. When a person does a drop in dose there will be a corresponding increase in WD symptoms over the next few days.  These symptoms will resolve themselves over the following several weeks and return the person to a slightly raised baseline of discomfort. The time frame and severity are dependent on a huge number of factors and end up being unique to each individual.  But the pattern remains.  This is why paying attention to your WDnormal is very important.  It is also referred to as listening to your body.  After a drop in dose and the symptoms have resolved to WDnormal the person then should wait a couple of more weeks to let things really settle out (there are a lot of little unfelt changer still going on) before considering doing their next drop.

 

During that waiting time people may think that they're not doing anything and want to get on with it.  When in fact doing nothing is very proactive.  It's those little unfelt things that need to be finished up before the next step can be taken.  It's letting the glue harden, the paint dry, the cement cure.  The things that need to be complete before the path is safe to walk on again.  If these details are ignored then they start to pile up and compound each other, then somewhere down the line the foundation slips out from under us and the whole thing collapses.

 

That makes sense - the WDnormal, I mean. I think my husband is in far more of a hurry than I am. lol

[scallywag]

Hi Kate, how are things going for you?

[ItsNearlyMedlessKateAgain]

Sorry I haven't been around in so long! I deleted the email address I used for this account and so I could no longer get in. Ooops!!

 

As of November 4th, 2016, I am pharmaceutical free!  I spent two weeks at 5mg two times a day and was doing well so my husband and I decided to DC completely. I took my last dose last Thursday night. I am doing well. I definitely have a touch of grumpiness and I expect I'll be cranky for another day or two so I'm doing all the normal self-care stuff and keeping stress to a minimum. I am only really dealing with one side effect and that is, since yesterday, everything tastes like soapy dishwater. I love food so that is kind of annoying. I had a metallic taste for about a week after I first started Lamictal in '05, but it only lasted a week or so, and I'm sure this'll get better over the next few days too.

 

Otherwise, I am well. I am very grateful for the support I received here when I started tapering the Lamictal. I want to thank those who interacted with my posts and everyone for all the information on these forums.