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Optomistic: They say there are no Lithium withdrawal symptoms!


Optomistic

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Hi,

 

They say Lithium has no withdrawal effects other than rebound symptoms. Then others say it has some, but they are mild and short lived. They say it can cause permanent brain/CNS damage as well. I'm wondering what else it can damage. I'm wondering if anyone has heard of or experienced what has happened to me with Lithium withdrawal. Before Lithium withdrawal, I did have toxic symptoms but not what I am listing below.

 

To repeat my signature:

 

Had chronic Lithium toxicity. Was abruptly withdrawn in ER with IV fluids. Within days, experienced severe electric shock sensations, skin tingling/crawling and various hard to describe nervous system sensations. Lost emotional control, felt near suicidal. Admitted to hospital psychiatric for 3.5 months, stabilised somewhat on new medications but still experience symptoms. Could not sit or sleep, had to be sedated at night. Physical sensations were never really addressed or treated and persist to a lesser degree to this day.

 

I forgot to add, some sounds (even people talking) send a sharp pain through my nerves now sometimes... it's getting better though. I experience overwhelming flooding of sadness that I'm not familiar with and I don't recall ever having before along with long crying spells. I get a strange feeling that I can't breath right off and on (all the time before), but I can actually breath fine... I can feel this in my head! It's impossible to describe except it doesn't feel like anxiety or my lungs. This is usually accompanied by severe sadness and negative thoughts - perhaps understandably? In hospital I could barely control my "sadness" at all sometimes. Again, could be a bipolar thing. 

 

Every doctor I've dealt with is at a complete loss as to what to do... even at a special mental health hospital, they were scratching their heads (4 doctors, 3 students, 1 intern, some docs in the ER, many nurses). I was never successfully treated for these symptoms, I was left to suffer with them. They tried benedryl, cogentin, clonazepam, propranolol - none worked. Divalproex was given to me for my mood and seemed to help the physical sensations as a side effect, but not enough. Of course divalproex helps with nerve pain, anxiety and such too, so that could explain it. 

 

I'm bipolar, so I did have rebound mania and eventually rapid cycling along with severe anxiety that had to be dealt with... they were capable of that. I've seen 3 neurologists who all seem to think this is not permanent damage, rather something else but then they offer no help or suggestions on what to do (because they think it's a psychiatrists problem). One neurologist didn't seem surprised at the symptoms, but still blamed it on an "organic cause" that she felt was best taken up with my GP or psychiatrist. She said Lithium's effects can take a long time to resolve. EMG pad tests found nothing, but a needle test did... but the neurologist blamed it on a pinched nerve - I don't buy that for one second. I'm in the blurry grey area between neurology and psychiatry. I hate it. My psychiatrist and GP have no idea what is going on either - my GP suggests it's "chemical". They all seem to think this is temporary and I should wait, but it's been 7 months so far. That's a long time to wait. It makes me wonder if someone experienced/educated enough could help me find relief.

 

I'm curious if restarting Lithium would just fix the problem like I've heard you can do with antidepressants. But my doctors can't tell me if that will work or if it's safe either. One of the oldest and best researched drugs out there and nobody knows anything!

 

I'm more stable on Synthroid 75mcg, divalproex 2000mg, clonazepam 1mg, and moclobimide 450mg now. Lately I feel improved mood and anxiety, less restless and can sleep and sit down. I get tingling/burning skin on my legs, arms, hands and back off and on - it seems like moclobibide may have exacerbated this after it was improving. Just before leaving the hospital in April 1016, I started getting significant muscle and joint pain. This started getting worse as time went by and now I experience it often, but intermittently. Again, doctors are not helpful with regards to this. I suspect divalproex is the cause, but there is no way to determine that just yet. Again, the doctors are in no rush to do anything about it.

 

So, I'm in better mental health now. And is physical pain and discomfort everyday. Even on a good mood/anxiety day, the physical sensations get to me. The best suggestion I've gotten so far is "take ibuprofen" and exercise. The psychiatrist at the hospital advised me to exercise and eat extremely healthy. I think this is what doctors say when they have no idea what to do. I'm trying out 800mg ibuprofen today, I'll see how it goes. I use a 0.5% lidocane gel sometimes, but it barely works. Experimenting with a homemade capsaicin oil but it burns :(. Voltaren Emugel barely works and is expensive.

 

Summary of withdrawal symptoms:

- paraesthesia / neuropathy / akathisia / ? Basicaly all related from what I can tell - all over body, even in my mouth!

- anxiety, horrible sensation when breathing or being short of breath

- more significant depression than ever

- sound sensitivity

- severe muscle and joint pain (could be divalproex)

 

I know it's complicated because some of this is returning or worsening bipolar/anxiety stuff, but the pain/neuropathy - no way... this is nuts. 

 

I'm hoping to find some answers, help, suggestions, shared experiences... a name of a doctor who knows what they're doing?

 

Thanks for reading, I hope this helps someone or someone can help me! I'm sick of all the the information out there about how Lithium has no withdrawal and everything will be fine... in my case it is absolutely not true. Lithium has withdrawal!

Edited by scallywag
highlight main question and current drugs and doses

Experience:

Had chronic Lithium toxicity. Was abruptly withdrawn in ER with IV fluids. Was sent home the same day. Within days, experienced severe electric shock sensations, skin tingling/crawling, inner sense of "buzzing", extreme restlessness, sound sensitivity and various hard to describe nervous system sensations. High anxiety, shortness of breath. Lost emotional control, felt near suicidal. Admitted to hospital psychiatric for 3.5 months, stabilised somewhat on new medications but still experience symptoms. Could not sit or sleep, had to be sedated at night. Physical sensations were never really addressed or treated and persist to a lesser degree to this day. Eventually started to develop transient severe muscle and joint pain.

 

Current medications: Sythroid 75mcg, Prevacid 15mg, Clonazepam 0.5 mg bid (1mg), Divalproex 500mg tid (1500mg), Moclobemide 150mg tid (450mg), Lithium carbonate 300mg bid (600mg)

 

Restarted Lithium Jul, 2016: Titrated week1 - 300mg, week 2 - 600mg. eventually 900mg

Stopped Ranitidine and tums (mostly) Jul, 2016

Increased Lithium Aug, 2016: 1200mg (original dose) blood level 0.96, experiencing occasional heart pains (started at 900mg but went away), creatinine level 120. May go down to lower dose.

Reduced Divalproex Aug, 2016: From 2000mg/day to 1500mg/day because it's too much combined with Lithium

Started Lyrica Aug, 2016: Titrated 25mg to 150mg in 1 week. Reduction in anxiety and paresthesia/neuropathy. Improved SOB. 

 

Currently: Reduction in paresthesia, neuropathy perhaps due to restarting Lithium - yet to be determined, Lyrica definitely helped but still not enough. Very infrequent shortness of breath, no more acid reflux, moderate mood/anxiety issues.

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  • Moderator Emeritus

Optomistic, Welcome to survivingantidepressants.
 
I'm sorry that you're having to deal with these physical symptoms and glad that you found us and posted.
 
Just a quick message to know that I've seen your post.  I'm going to do some reading and research, then consult with the moderating team.  One of the mod team will reply in full. :)
 

To help us understand your situation, please let us know

  1. When did were you treated with lithium and for how long? If you know the dosage(s), please post that too.
     
  2. Were you taking your current combination of drugs when you took lithium?

 
When a member is taking multiple medications, we ask that s/he post an interactions report.  You can do get the report here: Drugs_dot_com Drugs Interactions Checker

 

Just select the text, copy and paste it in a new post. Thanks!

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results

Cymbalta 60 mg 2012 - 2015; 2016: 20 mg to 7 mg exact doses and dates in this post; 2017: 6.3 mg to  0.0 mg  Aug. 12; details here


scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet

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Thanks for responding. I wish this was so simple and clear cut, but the more time goes on the more complicated it gets. Nothing in life is simple.

 

1. I was treated with Lithium from 2010 until November 2015. I was taking 1200mg/day. In 2010 my blood level was about 0.8. My blood level in March 2015 was 0.69 after a properly timed lab visit. A hospital caught it at 1.29 (not good) in June, but failed to notify me or my doctor. In November it was 2.49, a very toxic level. The toxicity was chronic, as I had increasing symptoms between about June and November that weren't caught right away.

 

2. No. This makes things complicated. I was taking Cipralex, Olanzapine and Synthroid for a few years.

I weaned off Cipralex in 2015 without much problems and felt excellent.

 

Then weaned off Olanzapine, again without much problems until I got to 2.5mg, then I stopped

... and got very I'll and had high anxiety. I started having "attacks" where I felt like I couldn't breath that would then disappear. Benzos were useless against these attacks.

 

So I restarted Olanzapine and it made me unstable (mixed, then manic, intrusive thoughts, obsessive thinking, anxiety). I wasn't taking it as a mood stabilizer, I was given it for panic attacks and it didn't work so this should not have happened (it made me manic when I first started it years before also).

 

The rest of the year was constant anxiety and obsessive thoughts... which got worse and worse as the year went on when the full-on Lithium toxicity kicked in.

 

I again stopped Olanzapine in August or so by accident, and decided to stay off it.

 

So, 2015 was a write off due to the Olanzapine stop and start, then Lithium toxicity in parallel. Even though I had problems like anxiety already, once I stopped Lithium it became much more severe - unparalleled to anything I could have ever imagined (think 24/7 panic attack)... literally hell on earth.

 

During this time of toxicity (maybe even when my blood level was low in March), doctors offered me benzodiazepines like lorazepam, clonazepam and bromazepam, all of which induced breathing problems immediately after dosing so I had to stop.

 

I still had "attacks" where I felt I couldn't breath right that were so severe that I went to the ER many times. These severe attacks subsided after being off Lithium for some time and I can tolerate clonazepam again. I don't know if that breathing issue is related to what I'm experiencing now, or if what I feel now is different, or just anxiety... nobody does.

 

____________________

Drug interactions:

 

** There is no option for moclobimide (RIMA / MAOI) as it is not available in the USA. My pharmacist checked for me when I was first prescribed. It's hard to find detailed info about this online but it doesn't look like an issue.

 

Interactions between your selected drugs

Moderate clonazepam  divalproex sodium

Applies to: clonazepam, divalproex sodium

Before taking clonazePAM, tell your doctor if you also use divalproex sodium. You may need dose adjustments or special tests in order to safely take both medications together. This combination may affect seizure control and cause drowsiness. You should avoid driving until you know how these medications will affect you. It is important that you tell your healthcare provider about all other medications that you are using including vitamins and herbs. Do not stop using your medications without first talking to your doctor first.

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Moderate levothyroxine  food

Applies to: Synthroid (levothyroxine)

The timing of meals relative to your levothyroxine dose can affect absorption of the medication. Therefore, levothyroxine should be taken on a consistent schedule with regard to time of day and relation to meals to avoid large fluctuations in blood levels, which may alter its effects. In addition, absorption of levothyroxine may be decreased by foods such as soybean flour, cotton seed meal, walnuts, dietary fiber, calcium, and calcium fortified juices. These foods should be avoided within several hours of dosing if possible. 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. When levothyroxine is given during continuous enteral nutrition (tube feedings) for more than 7 days, the tube feeding should be interrupted for at least one hour before and one hour after the dose of levothyroxine. You may need more frequent blood tests to monitor levothyroxine levels.

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Moderate divalproex sodium  food

Applies to: divalproex sodium

Alcohol can increase the nervous system side effects of divalproex sodium such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with divalproex sodium. Do not use more than the recommended dose of divalproex sodium, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

 
 
Thanks
Edited by scallywag
insert white space - ease of reading and comprehension

Experience:

Had chronic Lithium toxicity. Was abruptly withdrawn in ER with IV fluids. Was sent home the same day. Within days, experienced severe electric shock sensations, skin tingling/crawling, inner sense of "buzzing", extreme restlessness, sound sensitivity and various hard to describe nervous system sensations. High anxiety, shortness of breath. Lost emotional control, felt near suicidal. Admitted to hospital psychiatric for 3.5 months, stabilised somewhat on new medications but still experience symptoms. Could not sit or sleep, had to be sedated at night. Physical sensations were never really addressed or treated and persist to a lesser degree to this day. Eventually started to develop transient severe muscle and joint pain.

 

Current medications: Sythroid 75mcg, Prevacid 15mg, Clonazepam 0.5 mg bid (1mg), Divalproex 500mg tid (1500mg), Moclobemide 150mg tid (450mg), Lithium carbonate 300mg bid (600mg)

 

Restarted Lithium Jul, 2016: Titrated week1 - 300mg, week 2 - 600mg. eventually 900mg

Stopped Ranitidine and tums (mostly) Jul, 2016

Increased Lithium Aug, 2016: 1200mg (original dose) blood level 0.96, experiencing occasional heart pains (started at 900mg but went away), creatinine level 120. May go down to lower dose.

Reduced Divalproex Aug, 2016: From 2000mg/day to 1500mg/day because it's too much combined with Lithium

Started Lyrica Aug, 2016: Titrated 25mg to 150mg in 1 week. Reduction in anxiety and paresthesia/neuropathy. Improved SOB. 

 

Currently: Reduction in paresthesia, neuropathy perhaps due to restarting Lithium - yet to be determined, Lyrica definitely helped but still not enough. Very infrequent shortness of breath, no more acid reflux, moderate mood/anxiety issues.

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Hello everyone.  I'm new to the group.  I've been on lithium for more than 3 years.  Lately, my memory loss has been worse, I've been having frequent nighttime awakening to go to the restroom because of the Lithium so over the past year my sleep has been off.  I am exhausted and extremely frustrated that they pushed a label on me to begin with when I was finally discovering myself.  In any case, I don't have a  lot of support from my husband or psychiatrist and my psychiatrist is recommending that I switch to Depakote because of the side effects of the Lithium.  So I know that in order to get off the medication without having a manic episode, I need to do it slowly and i obviously can't continue with lithium for that long.  Do I introduce Depakote in the meantime and drug myself up with both until I get to a stable dose?  Is Depakote hard to get off of? What do you recommend?

 

I don't get it.. I had infections both times that I had a manic episode, plus both times I got my period in the hospital.  Both times I was sleep deprived beforehand... and my psychiatrist even admitted to me that sleep deprivation causes people to lose some of their inhibitions. I was also going through profound transformations at the time and getting in touch with emotions and parts of myself that I hadn't allowed myself to be and what gives them the right to tell me I have bipolar when they can't even explain the physical/emotional components?  Plus I have MTHFR (a genetic mutation) and some other sensitivities and deficiencies like anemia (not iron deficiency).  

 

Thank you.  Looking forward to your input.

 

I can tell you from personal experience a bit about this. Please verify everything I say for yourself... this is based on my experience and personal research.

 

First off:

 

My experience:

  • I did this in reverse in 2010. I switched from 1000mg Divalproex (Depakote/Epival/etc...) to Lithium
  • My doctor started by adding 900mg of Lithium daily, which turned me into a zombie. I was so slow and zoned out it was terrible. The doctor said it was due to the combination so he reduced to divalproex to 500mg.
  • At some point (I really don't remember) I became very hypo-manic for about a month... I wish I could remember what caused it or when exactly... but it was around this time. Then things levelled out. Could be dropping the divalproex or from starting lithium - both can trigger mania (google it).
  • Eventually I felt much better, but still had some irritability so it was increased to 1200mg and I stayed at that dose until recently when I became toxic. 5 good years!
  • I developed hypothyroidism from the Lithium and had to be started on Synthroid. The damage is permanent and I need the Sythroid for life now. I wasn't warned about this!
  • I stopped the last 500mg of divalproex after a few years with no ill effects, while still taking lithium.

Other experiences:

  • Memory and attention problems can be a sign of chronic toxicity. It happened to me and I've found some references to it online as well.
  • Frequent urination is apparently common but is also a sign of  diabetes insipidus and can be an indicator that your kidneys are not handling the lithium well. I was peeing every 30-60 minutes for 5 years... turned out that was bad.
  • Doctors don't do Lithium or kidney function tests often enough (they say 6 months or 1 year) and may not inform you of the results unless you ask. Lithium toxicity is common and kidney damage is almost guaranteed with time (according to my Dr. in hospital). I got toxic because nobody tested for it for 6 months... I wouldn't go more than a month without lab tests now. It's not worth risking your life to save money or whatever. Get copies of your bloodwork and understand it. Eventually finger prick tests for home use may be available: https://www.medimate.com/en/check-your-lithium-level
  • If there is a kidney problem, a nephrologist may be able to help - they mentioned to me at some point that there were ways of dealing with limited kidney function but my memory is foggy
  • When I was younger, if I missed my dose of divalproex too many days in a row (like 5 days) I would get very volatile, angry, sad, anxious, aggressive... restarting it would resolve those issues in a few days to a week. I never noticed an actual withdrawal, just bad rebound bipolar symptoms.
  • I gained a lot of weight on divalproex when I first started it before lithium, so be careful. It's common.

My personal opinion about Lithium:

It's the "gold standard" for bipolar and it worked well for me, so no surprise there. I found it gave me excellent control over my mood and I never (rarely) felt "sad". I was not sedating at all, I had much more energy but had a some lack of motivation. It's dangerous though. I've read lots about it (please verify for yourself): It shouldn't be mixed with many types of meds, including antipsychotics (even though docs do it all the time) as it can increase chances of CNS toxicity. Apparently some drugs or changes in medications can allow lithium to enter the CNS (there are papers out there about it). It is unlikely that someone can take it forever as they will eventually develop health issues that force them to a different drug. Acute toxicity is noticeable (been there once) but chronic toxicity creeps up on you and may go unrecognised. The low end of the therapeutic (blood level) range is like 0.4, but doctors always want to go higher (0.8-1.0) and people might start getting sick around 1.2-1.3, but doctors might ignore that or purposefully leave you at that level because labs and some literature say it's safe. 1.5 is considered getting dangerous and anything beyond that is definitely toxic. 2.5 is brain and CNS damage. Higher can mean death. There are many papers and articles about how people can become toxic at regular therapeutic blood levels, so blood tests mean nothing if you are getting symptoms (and many doctors don't seem to know this). Some people respond at quite low doses - apparently this is not uncommon for people with brain injuries. Lithium will very likely permanently damage your thyroid, requiring you to take hormone replacements for life. I found Lithium improved my cognitive function, attention, stopped me from biting my nails and most importantly significantly improved my depression. I've read a few places that if you stop lithium and decide to go back on it, it may not be as effective... again, please verify this yourself. If that's true, it means no changing your mind when things don't work out.

 

My personal opinion about divalproex:

It is calming and for me has a better anti-manic effect than lithium. However, it is sedating, especially at higher doses which might be required for symptom control and has it's own side effects (look up Epival Prescribing Information) such as sudden liver failure and death among other things. I had breathing problems and loss of balance at 2500mg. I get muscle and joint pain at 2000mg but I'm not sure if divalproex is the cause just yet. Side effect likelihood increases with dose. Divalproex seems to have much less effect on depression, so you might end up needed an antidepressant or something which isn't optimal. I need to take an antidepressant now. Doctors think it's a safe medication but it can kill you, so educate yourself about blood tests, side effects, etc... and keep up on them. Doctors can be lazy about that stuff. I have hair loss that might be caused by it, but I don't care... maybe you care? Dosing is supposed to be based on response, not some random or target dose. If they give you 1000mg and it doesn't work, then it's likely just not enough. The therapeutic blood level range is large, so there's no need to sit at a low ineffective dose. I used to take 1000mg and never did so great (for like 8 years). Now I'm at 2000mg and have no "high" moods at all... hmm... if they had just increased it back then I may have had less problems in life.

 

What I'd like to try:

A very very low dose of Lithium (like 0.4 or less), combined with 1000mg-1500mg of divalproex. Best of both worlds without becoming a zombie. Plus maybe moclobimide (which I currently take) or a traditional MAOI like Parnate.

  • Lithium: Mood control, antidepressant effect, non-sedating (for me)
  • Divalproex: Strong anti-manic, calming, anti-anxiety, anticonvulsant (seems bipolar could be related to this type of activity to me)
  • Moclobimide: Increases serotonin, norepinephrine and dopamine without doing any funny business with receptors in your brain like other antidepressants. Improves depression, anxiety, social anxiety, attention and chronic fatigue. Low risk of side effects, including sexual side effects. Low risk of manic switch or cycling (apparently). No dietary restrictions. No washout period after discontinuation. Many medication interactions.
  • Parnate: Like moclobimide, but way more effective if you can tolerate it. Same studies show up to 80% response rate. Rapid onset. Dietary changes are necessary due to risk of hypertensive crisis.

 

Hope this was helpful!

Experience:

Had chronic Lithium toxicity. Was abruptly withdrawn in ER with IV fluids. Was sent home the same day. Within days, experienced severe electric shock sensations, skin tingling/crawling, inner sense of "buzzing", extreme restlessness, sound sensitivity and various hard to describe nervous system sensations. High anxiety, shortness of breath. Lost emotional control, felt near suicidal. Admitted to hospital psychiatric for 3.5 months, stabilised somewhat on new medications but still experience symptoms. Could not sit or sleep, had to be sedated at night. Physical sensations were never really addressed or treated and persist to a lesser degree to this day. Eventually started to develop transient severe muscle and joint pain.

 

Current medications: Sythroid 75mcg, Prevacid 15mg, Clonazepam 0.5 mg bid (1mg), Divalproex 500mg tid (1500mg), Moclobemide 150mg tid (450mg), Lithium carbonate 300mg bid (600mg)

 

Restarted Lithium Jul, 2016: Titrated week1 - 300mg, week 2 - 600mg. eventually 900mg

Stopped Ranitidine and tums (mostly) Jul, 2016

Increased Lithium Aug, 2016: 1200mg (original dose) blood level 0.96, experiencing occasional heart pains (started at 900mg but went away), creatinine level 120. May go down to lower dose.

Reduced Divalproex Aug, 2016: From 2000mg/day to 1500mg/day because it's too much combined with Lithium

Started Lyrica Aug, 2016: Titrated 25mg to 150mg in 1 week. Reduction in anxiety and paresthesia/neuropathy. Improved SOB. 

 

Currently: Reduction in paresthesia, neuropathy perhaps due to restarting Lithium - yet to be determined, Lyrica definitely helped but still not enough. Very infrequent shortness of breath, no more acid reflux, moderate mood/anxiety issues.

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Parnate is similar to Parnate (irreversible vs selective reversible MAOI) so I did a full interaction check including it and got this. Moclobimide should have less side effects than Parnate.

 

Moderate tranylcypromine  divalproex sodium

Applies to: Parnate (tranylcypromine), divalproex sodium



Using tranylcypromine together with divalproex sodium 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.

Experience:

Had chronic Lithium toxicity. Was abruptly withdrawn in ER with IV fluids. Was sent home the same day. Within days, experienced severe electric shock sensations, skin tingling/crawling, inner sense of "buzzing", extreme restlessness, sound sensitivity and various hard to describe nervous system sensations. High anxiety, shortness of breath. Lost emotional control, felt near suicidal. Admitted to hospital psychiatric for 3.5 months, stabilised somewhat on new medications but still experience symptoms. Could not sit or sleep, had to be sedated at night. Physical sensations were never really addressed or treated and persist to a lesser degree to this day. Eventually started to develop transient severe muscle and joint pain.

 

Current medications: Sythroid 75mcg, Prevacid 15mg, Clonazepam 0.5 mg bid (1mg), Divalproex 500mg tid (1500mg), Moclobemide 150mg tid (450mg), Lithium carbonate 300mg bid (600mg)

 

Restarted Lithium Jul, 2016: Titrated week1 - 300mg, week 2 - 600mg. eventually 900mg

Stopped Ranitidine and tums (mostly) Jul, 2016

Increased Lithium Aug, 2016: 1200mg (original dose) blood level 0.96, experiencing occasional heart pains (started at 900mg but went away), creatinine level 120. May go down to lower dose.

Reduced Divalproex Aug, 2016: From 2000mg/day to 1500mg/day because it's too much combined with Lithium

Started Lyrica Aug, 2016: Titrated 25mg to 150mg in 1 week. Reduction in anxiety and paresthesia/neuropathy. Improved SOB. 

 

Currently: Reduction in paresthesia, neuropathy perhaps due to restarting Lithium - yet to be determined, Lyrica definitely helped but still not enough. Very infrequent shortness of breath, no more acid reflux, moderate mood/anxiety issues.

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  • Moderator Emeritus

To find others who may be dealing with similar complications and/or the same prescriptions the fastest way is to use a web search tool, such as Google. For example, if you want to read accounts from SA members who are or have taken depakote/devalproex, use the search terms (omitting the quotation marks): "survivingantidepressants" "depakote" OR "devalproex"

We have threads on individual symptoms such as:
Parathesia
Akathesia
Akathesia vs restlessness
Breathlessness

 

You may find it useful to browse the Symptoms forums for relevant discussion topics.  I know there's a thread about doctors who understand psych drug withdrawal but can't find it after several searches. When I do find it, I'll post the link. 

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results

Cymbalta 60 mg 2012 - 2015; 2016: 20 mg to 7 mg exact doses and dates in this post; 2017: 6.3 mg to  0.0 mg  Aug. 12; details here


scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet

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  • Moderator Emeritus

You've definitely had challenging ride over the last 18 months. It looks as if your taper of Cipralex and the first taper/discontinuation of Olanzapine were rapid, within 2-3 months. Those changes with the subsequent on and off plus lithium toxicity have most probably sensitized your nervous system. You are almost certainly "bang on" with your conclusion that the pain & neuropathy you're experiencing are symptoms resulting from withdrawal, i.e.a sensitized nervous system.

What is withdrawal syndrome

_________
I'm summarizing in list form for easier reference:

  • prior to 2015 and throughout you were taking Synthroid
  • early 2015: tapered off Cipralex, felt excellent
  • next: tapering Olanzapine,
    • original Rx for panic attacks, was ineffective
    • jumped off at 2.5 mg, became ill and had high anxiety,
    • restarted,
    • had symptoms: mixed, then manic, intrusive thoughts, obsessive thinking, anxiety
    • August 2015 discontinued/jumped off unintentionally and stayed off
  • meanwhile your Lithium blood levels were rising to toxic levels
    • 0.69 - March 2015
    • 1.29 - June 2015 problematic, lab did not notify you or your doctor
    • 2.49 - November 2015 **very toxic level**
    • stopped Lithium after toxicity discovered
  • throughout 2015: you were prescribed benzodiazepines (lorazepam, clonazepam, bromazepam) to alleviate anxiety and panic; they were ineffective.
  • after Lithium was stopped at some point you were established on your current prescriptions:
    • divalproex 2000mg (Depakote)
    • clonazepam 1mg, (Klonopin)
    • moclobimide 450mg - reverse inhibitor of MAO;
      brand names: Amira, Aurorix, Clobemix , Depnil and Manerix; not approved by FDA for use in USA
    • Synthroid 75mcg,

From your first post:

Summary of withdrawal symptoms:

  • paraesthesia / neuropathy / akathisia / ? Basically all related from what I can tell - all over body, even in my mouth!
  • anxiety, horrible sensation when breathing or being short of breath
  • more significant depression than ever
  • sound sensitivity
  • **severe** muscle and joint pain (could be divalproex)

I know it's complicated because some of this is bipolar/anxiety stuff returning or worsening , but the pain/neuropathy - no way... this is nuts.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results

Cymbalta 60 mg 2012 - 2015; 2016: 20 mg to 7 mg exact doses and dates in this post; 2017: 6.3 mg to  0.0 mg  Aug. 12; details here


scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet

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Welcome, Optomistic.

 

Do your symptoms follow any daily pattern? Keep notes on paper about symptoms, when you take your drugs, and their dosages.

 

At what time do you take Klonopin?

 

Please list your current drugs and their dosages in your signature.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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There's not much if any pattern... way more detail below (sorry I can't stop typing once I start :)).

 

I take .5mg clonazepam first thing in the morning, then again around 5-7pm. It has no noticeable effect on me.

 

Also:

Sythroid + prevacid (forgot that one) first thing in the morning, along with clonazepam

Divalproex + moclobemide after breakfast

moclobemide after lunch

Divalproex and moclobemide after dinner

 

Many symptoms were constant, then became intermittent:

 

  1. The depressive symptoms were occurring while I was (hypo)manic at first, which confused my first doctors until I was seen by a mood specialist. So I'd be in an above average mood (in some ways), social, hyper and very vocal about being annoyed, loud and stressed, etc... to suddenly breaking into tears at the drop of a pin when talking to a doctor, my family or when a specific thought arose in my head. I was in a lot of pain/anxiety and pushing it to the back of my mind when interacting with co-patients, but not with the docs, family, or alone.
  2. I was told Lithium withdrawal was the cause of the hyper dysregulation in mood (and memory, did I forget that before?) and that it would get better
  3. I eventually started to rapid cycle and noticed improved anxiety and physical sensations during those short times of depression (hours) but they were not absent. The depression was marked with severe psychomotor retardation which may sort of explain it. The doctors were curious about this and had no explanation.
  4. I had some periods of mixed mania, during these times the physical sensations were so severe and unbearable (due to the mood) I wanted to rip my skin off or bang my head on a wall
  5. Sound sensitivity mostly occurs when it's quite, at night - like in bed... any sound I hear can send shocks through my body. Though there were many times just peoples voices talking to me did the same thing during the day before, it's not so bad now. Last night my wife talking to me in bed was mildly bothering me in this way.
  6. The muscle and joint pain seems random and didn't start to become a huge problem until months after hospital. It wasn't an immediate symptom so it's hard to say if Lithium caused it at all. My elbows hurt a lot this morning. Yesterday I was ok but had a general back ache (which is more common for me). It can be very severe, then be gone. Or switch from arms to legs within a day. This was a near daily problem before and it now very random.
  7. The nerve issues seemed to change over time, becoming slowly better over months. These last few days or week I've noticed almost no internal buzzing sensation that was driving me mad. A few weeks ago I would have said 10% of day 1. 1 month ago, I was having suicidal thoughts directly due to this symptom. I've been getting tingling and burning on my legs, arms, back and a bit on my stomach that seem to randomly come one day and be gone the next. They are becoming less intense with time. I didn't feel anything yesterday. 
  8. As for "anxiety", I don't like to use the word because I don't feel that's really what it is, not in the usual sense. The electric "shocks" eventually became only noticeable in anxiety provoking situations (though, everything was causing anxiety) and they are GONE now. My breathing bothers me in one way or another everyday. Sometimes it just feels uncomfortable, sometimes I feel short of breath like not getting enough air, sometimes I feel like I'm running out of air talking, I'm more fidgety than ever, biting my nails and frequently getting up and down to do things because I just feel uncomfortable sitting for too long. My ability to sit and concentrate on something (like right now, on my computer) was gone before (very distressing to me), but I can do it again for limited amounts of time... then I need to get up. My attention isn't very good because of all this either. So I feel constantly stressed. There have been some times where this improved. Sometimes when I first wake it's better, I think time in general is helping, I think moclobemide is helping... last week I noticed an improvement in mood and anxiety at the same time. One day I felt soo calm, for no reason (I was in a good mood, outside, busy, sunny?).

Definite connection

I can see there is some connection with the bipolar disorder, mood cycling, over excitement and anxiety. I don't think I've been manic this entire time but part of the time I was and I think a bipolar brain can perhaps still be wonky even after all signs of (hypo)mania are gone (I feel depressed now almost all the time). My doctor seems to feel this way. And I agree, bipolar is not just up or down, there is more going on sometimes. Divalproex helped with the buzzing, restlessness and discomfort to some degree, but it's not a surprise as it used to tread both bipolar and nerve pain. 

 

I left a few things out because they could have nothing to do with Lithium at all

 

  1. Unusual thinking - this could be caused by returning symptoms, from Olanzapine withdrawal, antidepressant withdrawal, psychological factors (being tortured for more than a year and a half. But I have constant thoughts of a medical nature (psychiatric mostly, ruminating, problem solving, thinking of the future) to the point of being something like OCD. I know details about tons of medications, diagnosis details, treatments, etc... for everything I'm dealing with as well as other psychiactric disorders and some other medical conditions due to constant reading and thinking. I've been sucking up this info like a vacuum. Having this info is helpful when dealing with doctors and such but it's an obsession that seems to be running on autopilot. I didn't have this before 2015. I was always a bit obsessive when manic, but in a very different way and shorter bursts and they were generally pretty positive, goal oriented thoughts. This is ongoing and never stops. The thoughts are more positive when my mood improves, but they are still there. Even in my sleep and first awaking. My mind has taken to playing "music" to interrupt these thoughts sometimes subconsciously. I actively distract myself, but it really doesn't work that well. I tend to indulge in the thoughts instead. I find these thoughts to be out of my control, and I also don't find them particularly anxiety inducing unless I'm remembering my hospitalisation or other stuff that really bothered me. It's taken me a while to realise how messed my brain got in this regard and I really don't know how it happened.
  2. Fatigue - When I fist wake up I'm pretty alert after a bit and energetic enough. Though, even when in a good mood, I'm so damn tired all the time. I can't make it 1/2 the way through a day, but I force myself most of the time in order to keep my rhythm straight. I blame this on divalproex (+ mood sometimes). I had to be put on a considerable dose to stop cycling, 2x the dose I needed when I was younger. And I can't drink much coffee to stay awake or it just makes things worse. Yesterday I was probably awake less than 10 hours. The moclobemide also seems to reduce quality of sleep a bit, like more dreaming and rolling around, etc... I also do things like sleep 5 hours at night, get up and eventually need to sleep again later.. I don't know why I don't/can't sleep longer at night.

Experience:

Had chronic Lithium toxicity. Was abruptly withdrawn in ER with IV fluids. Was sent home the same day. Within days, experienced severe electric shock sensations, skin tingling/crawling, inner sense of "buzzing", extreme restlessness, sound sensitivity and various hard to describe nervous system sensations. High anxiety, shortness of breath. Lost emotional control, felt near suicidal. Admitted to hospital psychiatric for 3.5 months, stabilised somewhat on new medications but still experience symptoms. Could not sit or sleep, had to be sedated at night. Physical sensations were never really addressed or treated and persist to a lesser degree to this day. Eventually started to develop transient severe muscle and joint pain.

 

Current medications: Sythroid 75mcg, Prevacid 15mg, Clonazepam 0.5 mg bid (1mg), Divalproex 500mg tid (1500mg), Moclobemide 150mg tid (450mg), Lithium carbonate 300mg bid (600mg)

 

Restarted Lithium Jul, 2016: Titrated week1 - 300mg, week 2 - 600mg. eventually 900mg

Stopped Ranitidine and tums (mostly) Jul, 2016

Increased Lithium Aug, 2016: 1200mg (original dose) blood level 0.96, experiencing occasional heart pains (started at 900mg but went away), creatinine level 120. May go down to lower dose.

Reduced Divalproex Aug, 2016: From 2000mg/day to 1500mg/day because it's too much combined with Lithium

Started Lyrica Aug, 2016: Titrated 25mg to 150mg in 1 week. Reduction in anxiety and paresthesia/neuropathy. Improved SOB. 

 

Currently: Reduction in paresthesia, neuropathy perhaps due to restarting Lithium - yet to be determined, Lyrica definitely helped but still not enough. Very infrequent shortness of breath, no more acid reflux, moderate mood/anxiety issues.

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Optimistic.  Welcome.  You are in a place of empathy and understanding. My brain can't deal with all this information tonight , but I wanted to welcome you and reassure you that you are in the right place for help . This is your thread to ask questions and journal progress. I have experienced the withdrawal insomnia for a long period , but it does get better with time. It requires patience and then more patience !

You have a long and involved history, but we'll get through it . The main thing is that you found us and are here and we can walk you through this .

Ali 

Many SSRI's and SSNRI's over 20 years. Zoloft for 7 years followed by Effexor, Lexapro, Prozac, Cymbalta, Celexa, Pristiq, Valdoxan, Mianserin and more - on and off. No tapering. Cold turkey off Valdoxan - end of May 2014

 

                                                  Psych Drug - free since May 2014
.
         

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Optomistic, please run the Drug Interactions Checker http://www.drugs.com/drug_interactions.html
again with ALL your drugs, even the ones you don't think are doing anything, and copy and paste the results in this topic.

 

Terms such as "depressive," "rapid cycle," "mixed mania" etc. don't mean much to me. They are all terms used by psychiatrists to describe bipolar disorder. If you describe yourself in those terms, you don't have any choice but to see it adds up to bipolar disorder.

 

Many, many people here have been diagnosed with some variety of bipolar disorder (a remarkably elastic category) when what they had was withdrawal symptoms, which tend to come in waves.

 

Please keep daily notes on paper about your symptoms, when you take your drugs, and their dosages.

 

For example, you take clonazepam "first thing" (time???) in the morning. What are your symptoms until 5-7 p.m., when you take it again? What are your symptoms after you take your drugs in the evening?

 

How long have you been taking Prevacid, and what for? Long-term use of stomach acid blockers can have a large effect on your "psychiatric" condition. Also, Prevacid might interact with your other drugs.

 

Please re-do the Drug Interactions report. Thank you.
 

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Wow. I don't know how to respond to that. Those are terms all doctors use for good reason. I have no problem using them. I had those bipolar symptoms way before I ever took medication for anything. I need to use those words to describe what I experienced, sorry if you have trouble with that. I think you know exactly what I mean when I use those terms, even if you feel they could be caused my something else. Feeling like you're being electrocuted for 7 months straight (and other nervous system problems) is not a bipolar symptom and that is my main complaint.

 

I explained clearly about how things correlate to symptoms... I can't find a connection with time of day. I don't wake up and take meds on a specific schedule. The medication regime I'm on now made me feel better quite a bit better, not worse. Aside from the muscle/joint pain which has gone unexplained. I'm aware PPIs can cause issues but thanks for reminding me. It's funny no doctor suspects it could exacerbate things, but it's likely because of the other culprits are way more obvious. But I can't just stop taking prevacid whenever I want (I could manage a day if I swapped it with zantac). It's something I've been discussing with my doctor though. Like all the medications I take, I take it for a reason. I started trying various PPIs after olanzapine withdrawal in February 2015 because it destroyed my stomach. It was so long ago I can't say if experienced issues after starting them but I would imagine I would have noticed. I switched from Tecta to Prevacid in hospital, December 2015 after I completely lost it - prevacid. The switch was because I wanted off everything I was taking and to start fresh - paranoia, for good reason. 

 

Sorry if this is too much for you.. it's too much for me too. It's hard to explain, too many details... too many med changes and overlapping issues. Should we get into all the meds they tried on me in the hospital that didn't work? This is a bit too much for me... I clearly had a reaction to withdrawing from Lithium. Perhaps there is/was more going on... but the Lithium thing is why I came here.

 

As before, I could not include moclobemide in the interaction check, so I substituted parnate which has much worse side effects and interactions (esp. food)... take it with a grain of salt. My pharmacist checks for interactions every time I am prescribed a new medication and my doctor is of course not trying to kill me.

 

Moderate clonazepam  tranylcypromine

Applies to: clonazepam, Parnate (tranylcypromine)

Using clonazePAM together with tranylcypromine may occasionally cause high blood pressure and flushing. Contact your doctor if you experience severe headache, blurred vision, confusion, seizures, chest pain, nausea or vomiting, sudden numbness or weakness (especially on one side of the body), speech difficulties, fever, sweating, lightheadedness, and/or fainting during treatment with these medications, as these may be signs and symptoms of excessively high blood pressure. 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.

Switch to professional interaction data

Moderate clonazepam  divalproex sodium

Applies to: clonazepam, divalproex sodium

Before taking clonazePAM, tell your doctor if you also use divalproex sodium. You may need dose adjustments or special tests in order to safely take both medications together. This combination may affect seizure control and cause drowsiness. You should avoid driving until you know how these medications will affect you. It is important that you tell your healthcare provider about all other medications that you are using including vitamins and herbs. Do not stop using your medications without first talking to your doctor first.

Switch to professional interaction data

Moderate tranylcypromine  divalproex sodium

Applies to: Parnate (tranylcypromine), divalproex sodium

Using tranylcypromine together with divalproex sodium 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.

Switch to professional interaction data

No other interactions were found between your selected drugs.
Note: this does not necessarily mean no interactions exist. ALWAYS consult with your doctor or pharmacist.

Other drugs and diseases that your selected drugs interact with Interactions between your selected drugs and food
Major tranylcypromine  food

Applies to: Parnate (tranylcypromine)

During and within two weeks after treatment with tranylcypromine, you must not consume any foods or beverages that are high in tyramine content. Doing so can raise your blood pressure to dangerous levels, a condition known as hypertensive crisis. The condition is potentially fatal and may cause symptoms such as severe headache, confusion, blurred vision, problems with speech or balance, nausea, vomiting, chest pain, convulsions, and sudden numbness or weakness (especially on one side of the body). You should seek immediate medical attention if you have any of these symptoms. Foods that are high in tyramine include, but are not limited to, air dried meats; aged or fermented meats; sausage or salami; pickled herring; anchovies; liver; red wine; beer; aged cheeses, including blue, brick, brie, cheddar, parmesan, romano, and swiss; sour cream; sauerkraut; canned figs; raisins; bananas or avocados (particularly if overripe); soy beans; soy sauce; tofu; miso soup; bean curd; fava beans; or yeast extracts (such as Marmite). You should avoid the use of alcohol while being treated with tranylcypromine, as alcohol may increase some of the nervous system side effects such as dizziness, drowsiness, and difficulty concentrating. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

Switch to professional interaction data

Moderate levothyroxine  food

Applies to: Synthroid (levothyroxine)

The timing of meals relative to your levothyroxine dose can affect absorption of the medication. Therefore, levothyroxine should be taken on a consistent schedule with regard to time of day and relation to meals to avoid large fluctuations in blood levels, which may alter its effects. In addition, absorption of levothyroxine may be decreased by foods such as soybean flour, cotton seed meal, walnuts, dietary fiber, calcium, and calcium fortified juices. These foods should be avoided within several hours of dosing if possible. 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. When levothyroxine is given during continuous enteral nutrition (tube feedings) for more than 7 days, the tube feeding should be interrupted for at least one hour before and one hour after the dose of levothyroxine. You may need more frequent blood tests to monitor levothyroxine levels.

Switch to professional interaction data

Moderate divalproex sodium  food

Applies to: divalproex sodium

Alcohol can increase the nervous system side effects of divalproex sodium such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with divalproex sodium. Do not use more than the recommended dose of divalproex sodium, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

Switch to professional interaction data

Experience:

Had chronic Lithium toxicity. Was abruptly withdrawn in ER with IV fluids. Was sent home the same day. Within days, experienced severe electric shock sensations, skin tingling/crawling, inner sense of "buzzing", extreme restlessness, sound sensitivity and various hard to describe nervous system sensations. High anxiety, shortness of breath. Lost emotional control, felt near suicidal. Admitted to hospital psychiatric for 3.5 months, stabilised somewhat on new medications but still experience symptoms. Could not sit or sleep, had to be sedated at night. Physical sensations were never really addressed or treated and persist to a lesser degree to this day. Eventually started to develop transient severe muscle and joint pain.

 

Current medications: Sythroid 75mcg, Prevacid 15mg, Clonazepam 0.5 mg bid (1mg), Divalproex 500mg tid (1500mg), Moclobemide 150mg tid (450mg), Lithium carbonate 300mg bid (600mg)

 

Restarted Lithium Jul, 2016: Titrated week1 - 300mg, week 2 - 600mg. eventually 900mg

Stopped Ranitidine and tums (mostly) Jul, 2016

Increased Lithium Aug, 2016: 1200mg (original dose) blood level 0.96, experiencing occasional heart pains (started at 900mg but went away), creatinine level 120. May go down to lower dose.

Reduced Divalproex Aug, 2016: From 2000mg/day to 1500mg/day because it's too much combined with Lithium

Started Lyrica Aug, 2016: Titrated 25mg to 150mg in 1 week. Reduction in anxiety and paresthesia/neuropathy. Improved SOB. 

 

Currently: Reduction in paresthesia, neuropathy perhaps due to restarting Lithium - yet to be determined, Lyrica definitely helped but still not enough. Very infrequent shortness of breath, no more acid reflux, moderate mood/anxiety issues.

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Opto

 

Speaking for myself, I've learned that psychiatric diagnoses are *attempts* to classify patient experiences and and name it for easy reference.  It's no different than calling a game "hockey" or a thing on a tree an "apple" instead of describing it in detail every time: "Two teams of 6, an ice rink, each team's players use sticks to move a hard black rubber disk across the ice trying to get the disk into nets guarded by a member of the opposing team." I'm not going to try to describe an apple. Just saying "hockey" or "apple" or "general anxiety disorder" "bipolar disorder II" is easier and faster than listing the essential description. Ha, I just noticed I forgot to mention skates in the hockey description. See?

 

From what I've seen in this forum it's always more useful to talk about specific symptoms than the name psychiatry has assigned to a group of symptoms, which if x symptoms out of total number listed are present constitute/confirm assigning the named/labelled diagnosis.

 

We ask you to track your symptoms because they are the best tool you'll have to guide you through the process of discontinuing psychoactive medications. Symptoms are to withdrawal as eyes are to the soul.

 

Thanks for running and posting the drug interactions report, and approximating the moclobimide with Parnate. What do you see after reading the full report? What questions, if any, do you have for us?

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results

Cymbalta 60 mg 2012 - 2015; 2016: 20 mg to 7 mg exact doses and dates in this post; 2017: 6.3 mg to  0.0 mg  Aug. 12; details here


scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet

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I feel the same about words... I use them when they represent what I want to convey.

 

I've been experiencing (from the interaction list): 

 

dizziness (mild), drowsiness (significant, mid-day and/or evening), and difficulty concentrating (spacey sometimes, short term memory). Impairment in thinking and judgement (makes it hard to deal with doctors face to face). Mild issues with balance only sometimes (falling into doorways, walls on the way up stairs or in hallways turning corners when I'm tired and not paying attention). Issues with motor coordination (dropping things when not paying close attention). These are annoying, but something I can live with for the moment. I was also pretty out of it before starting any of these meds.

 

Today so far

  • My blood pressure is currently 117/83, after having 2 smokes and a coffee, and walking around for a bit then sitting for 2 minutes. Upon standing it is 135/90. I don't believe moclobemide is likely to cause BP issues like Parnate. There should be no reaction to food and I don't eat Marmite and blue cheese just to be safe :).
  • This morning my mood is low but tolerable and my thoughts are still obsessive. By that I mean, upon waking, I have immediate thoughts about this psychiatric crap running in my mind as a sort of combination of monologue, or dialogue or memories as background chatter that poke and prod at my conscious mind until I do something like actively think about it or read something, do something. Some people might describe these as racing thoughts but they are nowhere as fast or overwhelming as what I would experience in a very (hypo)manic state. It bothers me because it's automatic, consuming at times and because I actually don't feel so bad otherwise and would prefer to think "hmm... I'm going to try out iSCSI on my file server today that should keep me occupied". The closest phenomena that I can relate to this is called Pure-O (OCD). To add complexity, this can be connected with PTSD. Bipolar disorder can easily include these types of symptoms as comorbid. Again, just terminology to describe something that I'm experiencing, not a diagnosis. 
  • My doctor increased my moclobemide yesterday from 450mg to 600mg (after 1 week). I noticed the same thing as every other dose increase - an increase in skin burning and general feeling of wanting to jump out of my skin. The last three times it was tolerable and improved in a day or two. Muscle/joint pain was present earlier in the day and disappeared when my skin started to really bother me in the evening, accompanied by a quite stimulated feeling (a little anxiety to go with it). I was also wide awake all night and slept much of the day - my fault, relapse in my attempt to control my schedule. My understanding is that MAOIs can be stimulating and that would explain a bit of issues with sleep and increased nervous system irritation.

 

Missing information

Due my reduced mental capacity (above mentioned problems) and memory problems... I never mentioned to you that I was on oxcarbazepine 1200mg and mirtazapine 60mg while in hospital and a short time afterwards (in combination with everything I take now except moclobemide). Due to increased liver, pancreas blood levels and increasing muscle pain, their ineffectiveness, continued rapid cycling multiple times a day, etc... my doctor decided I should get off these meds. I've read mirztazapine in particular is known for paraesthesia and muscle/joint pain. I tapered quickly over weeks, each drug separately, mirtazapine first. Oxcarbazepine made no difference. Mirtazapine left me with some trouble sleeping (as expected) and eventually I stopped rapid cycling (it started before mirtazapine and divalproex, while on oxcarbazepine) and became depressed constantly. Restlessness, anxiety, skin sensations, sleep continued to improve at a gradual pace.

 

Questions

  1. I'm very curious what could cause the pain I experience in my joints and muscles. Can it continue months after stopping mirtazapine by any chance? I have poor recollection of the exact time I started experiencing this problem but I bet I was taking mirtazapine. Doctors are absolutely clueless (it was easy for me to find this in the consumer information sheet as a side effect), NSAIDs don't work or barely work and that's all I've been offered.
  2. Could neurological issues (of any kind) cause muscle/joint aches? A neurologist thought I could have a pinched nerve in my lower back and recommended physiotherapy but I'm reluctant to spend such money on that when it seems she could be wrong (though my back was really bad yesterday). I never mentioned to her I had muscle/joint pain and she didn't give me much time to talk to her and I was generally a bit out of it at the time. Maybe I hurt myself walking all the time for months on end? It wouldn't be my lower back though as I have problems with my arms, back, stomach, shoulders, legs... there's something off with her diagnosis.
  3. Can something like paraesthesia or other medication/withdrawal induced neuro problem be confused with a pinched nerve during a nerve conduction study? Has anyone had similar problems with a neurologist/psychiatrist playing ping pong with you (no overlap in diagnosis/treatment)?
  4. As for the general sensation of increased anxiety, buzzing sensation which is less noticeable now, restlessness... always feeling stressed... this seems to be getting better but it's been so long and I don't want my pdoc making it worse. It sounds very similar to an SSRI withdrawal. Is there anything effective to treat it or at least alleviate symptoms? My GP acknowledges there's a problem but doesn't know what to do except wait. My pdoc is pretty much just ignoring me like it's the first time he's heard of it and couldn't be bothered to look into it. At one point he said it sounded neurological and didn't feel comfortable treating it. Yesterday I mentioned how I was experiencing withdrawal and he said "from what?". I see this guy every week!
  5. Thinking in an obsessive manner is not totally uncommon to me so it could be something that was treated by an old medication (various SSRIs over my life, Olanzapine) or made worse by stopping one of them. I noticed some disturbing intrusive thoughts (memories or ideas about doing bad things) were appearing in my mind during Olanzapine tapering, this subsided. Any anyone experienced obsessive thinking due to withdrawal from an AD or AAP? Or can withdrawal symptoms be so severe that they cause you to be traumatised and develop thinking like this?
  6. What is the longest one could expect to experience anxiety from Olanzapine withdrawal? I stopped about 10 months ago I think.
  7. Has anyone know anything about starting new antidepressants in the presence of pre-existing paraeshesia/neuropathic or other AD/Lithium withdrawal symptoms? I feel I don't have much of a choice to take something. I've always been on some kind of AD or other med with AD effects and when I was off for a while things went to hell quickly. I will never take another AAP again.
  8. I've read anxiety and such symptoms occur in less than 1% of Prevacid users. Does anyone here have any reason to believe I should be too concerned with my PPI? How severe of an issue is this? All of my blood tests for vitamins and such check out fine. I mean, coffee causes anxiety in more people than that... I skipped my Prevacid today. I'll probably pay for it. I can't stop it for long or I'll just get rebound reflux. I need to taper. And I may discover I really still need a PPI.

Thanks for reading. It's unfortunate to have to come here for help. Doctors all seem to be clueless about this stuff or they don't try too hard. I even had to deal with the whole "this is just the natural course of your illness" and "you obviously have GAD" talks, which I know not to be completely appropriate for this situation due to my new and/or amplified symptoms.

Experience:

Had chronic Lithium toxicity. Was abruptly withdrawn in ER with IV fluids. Was sent home the same day. Within days, experienced severe electric shock sensations, skin tingling/crawling, inner sense of "buzzing", extreme restlessness, sound sensitivity and various hard to describe nervous system sensations. High anxiety, shortness of breath. Lost emotional control, felt near suicidal. Admitted to hospital psychiatric for 3.5 months, stabilised somewhat on new medications but still experience symptoms. Could not sit or sleep, had to be sedated at night. Physical sensations were never really addressed or treated and persist to a lesser degree to this day. Eventually started to develop transient severe muscle and joint pain.

 

Current medications: Sythroid 75mcg, Prevacid 15mg, Clonazepam 0.5 mg bid (1mg), Divalproex 500mg tid (1500mg), Moclobemide 150mg tid (450mg), Lithium carbonate 300mg bid (600mg)

 

Restarted Lithium Jul, 2016: Titrated week1 - 300mg, week 2 - 600mg. eventually 900mg

Stopped Ranitidine and tums (mostly) Jul, 2016

Increased Lithium Aug, 2016: 1200mg (original dose) blood level 0.96, experiencing occasional heart pains (started at 900mg but went away), creatinine level 120. May go down to lower dose.

Reduced Divalproex Aug, 2016: From 2000mg/day to 1500mg/day because it's too much combined with Lithium

Started Lyrica Aug, 2016: Titrated 25mg to 150mg in 1 week. Reduction in anxiety and paresthesia/neuropathy. Improved SOB. 

 

Currently: Reduction in paresthesia, neuropathy perhaps due to restarting Lithium - yet to be determined, Lyrica definitely helped but still not enough. Very infrequent shortness of breath, no more acid reflux, moderate mood/anxiety issues.

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I'm sorry Opto, that you've been through this.

 

Even the worst Bipolar I diagnosis (which was formerly known as "manic depression" and a "frustrated mess") doesn't usually need that many drugs.

 

I got diabetes insipidus from my 10 years of lithium, and still have to mind my dehydration and kidneys.  I also lost my thyroid totally, due to nodules / goiter.

 

But the symptoms you describe sound much more like "drug switching" of antidepressants and "antipsychotics" (we prefer to call them neuroleptics, because these drugs are more anti-brain, than they are anti-condition) accumulated over time, than they are from lithium toxicity or withdrawal.

 

I'm not sure what you want here, so I'll just go after your questions:

 

1.  When did you stop Mirtazapine?  The symptoms you describe sound like antidepressant withdrawal.  Yes.  Muscular pain is a symptom of fast tapers, drug switches and cold turkeys off of antidepressant drugs.  This would include Mirtazapine, Cipralex (yes, this far out!) and Olanzapine.  Please put all drugs, doses and dates in your signature. 

 

Additionally, muscular pain can be side effects of your current drugs.   For example, here is a discussion about foot and leg cramps from withdrawal:  http://survivingantidepressants.org/index.php?/topic/2139-foot-and-leg-cramps/  Some even say it feels like the worst flu you've ever had:  http://survivingantidepressants.org/index.php?/topic/8632-flu-like-wd-vs-a-flu-like-virus-how-to-tell/

 

2.  Yes, neurological issues could be involved, but psych drug withdrawal can mimic neurological issues.  Many of us have gone and gotten checked out and found out nothing was wrong.  A very few of us have permanent neurological damage by polypharmacy, another few of us have independent neurological issues. So if you want to get a neurological work up, go ahead.  It's good to eliminate real medical problems, if possible.  Sometimes, a neurologist is clever enough to look at your drugs and understand withdrawal, but that is rare, as well.  More often, they look at your diagnosis and not at you, and think, "bipolar crazy," and tune you out.  They don't mean to - but that is why we don't like diagnostic words here at SA.

 

3.  I still have parathesia from drugs.  I still don't know whether it was the SNRI, the statins, the stomach acid drug, or the lithium, or just my poor health.  Or all of the above.  It gets better, as your drug load diminishes.  Since I have a lot of pain, they talked about pinched nerves and physiotherapy, and everything except the drugs.  I had to decide on my own.  I still suffer pain, and am still in physiotherapy - because of my thyroid issues, it seems that tendon and collagen (all tissue) related injuries are very slow to heal for me.  I hope you do better.

 

4.  This is called akathisia.  It is a common symptom of drug changes, fast tapers, cold turkeys, and withdrawal.  http://survivingantidepressants.org/index.php?/topic/32-akathisia-vs-restlessness-anxiety-agitation/

 

5.  Yes, rumination is a normal human condition.  It is how we solve problems, like, how do we get enough water for the village?  Where are the herds going?  What do we do when it snows?  Some doctors like to diagnose excessive sticky rumination as "OCD," but it is a pattern of thinking and can be changed via CBT, DBT, and Mindfulness practices.   Additionally, it can become quite "sticky" and obsessive during withdrawal, as your brain is healing.  So yes.   http://survivingantidepressants.org/index.php?/topic/3882-ocd-obsessive-thoughts-compulsive-behaviors/

 

6.  I cannot give you a max time.  You have had a lot of changes in the past 12 months.  Think of this in terms of years.  In 5 years you can be so much better, if that is what you want, and work towards it.  But there are so many variables besides the Zyprexa - you have had fast AD switches, you are on a very broad MAOI drug, and you have tapered from lithium (my lithium taper only induced depression, no mania, and none of the "classic" AD withdrawal symptoms.  http://survivingantidepressants.org/index.php?/topic/9451-delayed-onset-of-withdrawal-symptoms/

 

There are a number of variables to consider in "healing time" - it's a more complex calculation than I could do.  How old were you when you were first put on drugs?  How long have you been on drugs?  How many times were you cold-switched from one drug to another?  How long were you toxic?  How many drug interactions have you been processing?  How many of those drugs are metabolized at the same sites in your body? What is your genetic profile towards metabolizing at those sites?  How long has it been since you quit drug a, b, c, d, e, etc.?  Shall I go on?  As you see, you have a number of confounding variables.  My crystal ball is out of order.

 

7.  SA does not recommend drugs.  Ever.  If it were me, I think it would be foolish to keep bouncing your brain like a basketball by trying new combinations of drugs.  Your brain is trying to homeostacise all of the changes you've made up to this point.  Wouldn't you like to know who you really are, not the chemical you?  I'm not telling you to go off of your drugs, but evidence based medicine says that long term recovery is far more likely off the drugs than on - even in "Severe Mental Illness" such as Bipolar and Schizophrenia. (Read:  Robert Whitaker: "Anatomy of an Epidemic")

 

8.  PPI was the first drug my consulting pharmacist removed from my regime.  She said it was not for long term use, except in extreme cases.  She said it would leach calcium from my bones, cause osteoporosis, ruin my digestive tract, and maybe it did - I had IBS for nearly 10 years (but again, the PPI was only one variable in many, in my case, and in yours.)  This started my journey off the drugs.  It should be the easiest of all of your drugs to taper, and a good one for practicing cutting tablets and disciplining yourself to a taper.  (PPI taper can be faster than a psych drug taper)

 

9.  OH, are you done yet?  OK.  Here is a list of common symptoms of withdrawal.  I believe (and this is my belief, I have no proof, I don't know you) that yes, you have suffered lithium toxicity, but that your withdrawal symptoms are coherent with antidepressant and neuroleptic drug withdrawal symptoms.    Here is the list:  http://survivingantidepressants.org/index.php?/topic/2390-dr-joseph-glenmullens-withdrawal-symptom-checklist/

 

The list serves 2 purposes - you can check your symptoms against it and reassure yourself that this symptom, too, is withdrawal related.  Also, you can print out a stack and track your symptoms weekly (or daily or whatever floats your boat) and watch as your symptoms change over time.  They probably will, because fixing a brain and nervous system is a complex repair operation:  Healing from Antidepressants: Patterns of Recovery (Toxic Antidepressants)

 

10.  Unsolicited suggestion:  Please stop tapering your moclerbermide.  While it is a messy messy drug, you are going too fast, and are having symptoms.  Having symptoms means that your system is still upset from the last set of changes (even if they were 10 months ago!).  It is better to taper from a more stable place, and plan and prepare for it, than to do it impulsively or too fast.  We recommend tapering 10% of your last dose per month.  Why taper by 10% of my dosage?

 

Whew!  Welcome to SA!  I'm glad you got away from the demon lithium, but it sounds like you have a ways to go before you will feel better.

"Easy, easy - just go easy and you'll finish." - Hawaiian Kapuna

 

Holding is hard work, holding is a blessing. Give your brain time to heal before you try again.

 

My suggestions are not medical advice, you are in charge of your own medical choices.

 

A lifetime of being prescribed antidepressants that caused problems (30 years in total). At age 35 flipped to "bipolar," but was not diagnosed for 5 years. Started my journey in Midwest United States. Crossed the Pacific for love and hope; currently living in Australia.   CT Seroquel 25 mg some time in 2013.   Tapered Reboxetine 4 mg Oct 2013 to Sept 2014 = GONE (3 years on Reboxetine).     Tapered Lithium 900 to 475 MG (alternating with the SNRI) Jan 2014 - Nov 2014, tapered Lithium 475 mg Jan 2015 -  Feb 2016 = GONE (10 years  on Lithium).  Many mistakes in dry cutting dosages were made.


The tedious thread (my intro):  JanCarol ☼ Reboxetine first, then Lithium

The happy thread (my success story):  JanCarol - Undiagnosed  Off all bipolar drugs

My own blog:  https://shamanexplorations.com/shamans-blog/

 

 

I have been psych drug FREE since 1 Feb 2016!

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Thank you for the very comprehensive answer. I'm on my phone now so I'll have to go over it all later. I agree with you on all of this. I was actually titrating my dose up for moclobemide and it isn't working out... so I'll go back to my previous dose and keep it steady. I'm sitting at my new GPs right now to discuss these issues (again) as I'm really losing any trust I had for my pdoc. I'm hoping to find someone more knowledgeable and careful... educated, to help me out.

Experience:

Had chronic Lithium toxicity. Was abruptly withdrawn in ER with IV fluids. Was sent home the same day. Within days, experienced severe electric shock sensations, skin tingling/crawling, inner sense of "buzzing", extreme restlessness, sound sensitivity and various hard to describe nervous system sensations. High anxiety, shortness of breath. Lost emotional control, felt near suicidal. Admitted to hospital psychiatric for 3.5 months, stabilised somewhat on new medications but still experience symptoms. Could not sit or sleep, had to be sedated at night. Physical sensations were never really addressed or treated and persist to a lesser degree to this day. Eventually started to develop transient severe muscle and joint pain.

 

Current medications: Sythroid 75mcg, Prevacid 15mg, Clonazepam 0.5 mg bid (1mg), Divalproex 500mg tid (1500mg), Moclobemide 150mg tid (450mg), Lithium carbonate 300mg bid (600mg)

 

Restarted Lithium Jul, 2016: Titrated week1 - 300mg, week 2 - 600mg. eventually 900mg

Stopped Ranitidine and tums (mostly) Jul, 2016

Increased Lithium Aug, 2016: 1200mg (original dose) blood level 0.96, experiencing occasional heart pains (started at 900mg but went away), creatinine level 120. May go down to lower dose.

Reduced Divalproex Aug, 2016: From 2000mg/day to 1500mg/day because it's too much combined with Lithium

Started Lyrica Aug, 2016: Titrated 25mg to 150mg in 1 week. Reduction in anxiety and paresthesia/neuropathy. Improved SOB. 

 

Currently: Reduction in paresthesia, neuropathy perhaps due to restarting Lithium - yet to be determined, Lyrica definitely helped but still not enough. Very infrequent shortness of breath, no more acid reflux, moderate mood/anxiety issues.

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Moclobemide 600mg/day was intolerable. I dropped it back to 450mg/day and nervous symptom problems have improved drastically (in 2 days, not gone yet). I've been feeling better for about 4-5 days. Unfortunately this means I can't do too much as far as improving my mood issues for now. 

 

I tried cutting down my Prevacid from 30mg to 15mg (25% reduction would have been very difficult) and added famotidine 40mg bid + tums (Dr's suggestion on tapering) instead a few days later. Muscle and joint pain have significantly improved as well. It makes me wonder if Prevacid had something to do with it or if it was the above change. Muscle/joint issues started around the time of Prevacid and Divalproex dose increase while I was in hospital, around the beginning of April so I always wondered what caused it. I found this side effect can be caused by Prevacid so decided to give it a go. Unfortunately now I'm getting rebound reflux as expected - I hope it gets better fast. More frequent/prolonged shortness of breath - is reflux partly to blame? It's better than severe pain I think, for now.

 

Aside from shortness of breath which I was getting anyways, mild to moderate mood/energy problems and some reflux, I haven't felt this good in a long time. Things are moving forward.

Experience:

Had chronic Lithium toxicity. Was abruptly withdrawn in ER with IV fluids. Was sent home the same day. Within days, experienced severe electric shock sensations, skin tingling/crawling, inner sense of "buzzing", extreme restlessness, sound sensitivity and various hard to describe nervous system sensations. High anxiety, shortness of breath. Lost emotional control, felt near suicidal. Admitted to hospital psychiatric for 3.5 months, stabilised somewhat on new medications but still experience symptoms. Could not sit or sleep, had to be sedated at night. Physical sensations were never really addressed or treated and persist to a lesser degree to this day. Eventually started to develop transient severe muscle and joint pain.

 

Current medications: Sythroid 75mcg, Prevacid 15mg, Clonazepam 0.5 mg bid (1mg), Divalproex 500mg tid (1500mg), Moclobemide 150mg tid (450mg), Lithium carbonate 300mg bid (600mg)

 

Restarted Lithium Jul, 2016: Titrated week1 - 300mg, week 2 - 600mg. eventually 900mg

Stopped Ranitidine and tums (mostly) Jul, 2016

Increased Lithium Aug, 2016: 1200mg (original dose) blood level 0.96, experiencing occasional heart pains (started at 900mg but went away), creatinine level 120. May go down to lower dose.

Reduced Divalproex Aug, 2016: From 2000mg/day to 1500mg/day because it's too much combined with Lithium

Started Lyrica Aug, 2016: Titrated 25mg to 150mg in 1 week. Reduction in anxiety and paresthesia/neuropathy. Improved SOB. 

 

Currently: Reduction in paresthesia, neuropathy perhaps due to restarting Lithium - yet to be determined, Lyrica definitely helped but still not enough. Very infrequent shortness of breath, no more acid reflux, moderate mood/anxiety issues.

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  • Moderator Emeritus

That's good news about the moclobemide reduction -- diminished symptoms! Sadly, mood issues will be there to deal with later.
 
Sorry to hear about rebound reflux and shortness of breath. You've got an investigative adventure ahead of you, sorting out what's an unprescribed effect ("side effect") and what's a withdrawal symptom.

 

Optomistic -- the best place for you to post information about your experience with lithium is in this thread or or in the Tips on Tapering Lithium topic.  I have moved your posts in Maskbipolar's introduction topic to the linked topic.

Edited by scallywag
add comment re Lithium posts

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results

Cymbalta 60 mg 2012 - 2015; 2016: 20 mg to 7 mg exact doses and dates in this post; 2017: 6.3 mg to  0.0 mg  Aug. 12; details here


scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet

Link to comment
  • Moderator

Yes, PPI's can mess with all kinds of things.  We are meant to have stomach acid:

That Acid Reflux Pill May Be Causing Your Health Problems

Tips for Tapering Off Stomach Acid Blockers or PPIS - esomeprazole lansoprazole omeprazole

and

Non-Psych Drugs Causing Psych Symptoms

 

 

Rebound reflux can just clear up on its own, or you can help it with ginger, mint, or DGL (DeGlycinated Licorice).  I use all three, depending on whether I want heat (ginger) cool (mint) or soothe (DGL).

 

You may also find that you are now sensitive to foods that you were not before.  Perhaps your reflux will improve if you remove wheat or dairy or (insert possible allergen here).  

 

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

 

http://survivingantidepressants.org/index.php?/topic/4945-food-sensitivities/

 

I hear you about trusting doctors.  I try and stay calm and sane and try not to talk about "internet says" stuff too much - Doctors don't like "Doctor Google" very much.

 

Now that you've found a comfortable dose, please hold there for a month, so you can observe your symptoms, and we can maybe figure out what is the worst of your problems.

 

Wouldn't it be marvellous if taking away your PPI (careful of the other one - remember - our stomach is meant to be acid!) relieves most of your symptoms?

 

It does get better, I hope you see the Sun today.

"Easy, easy - just go easy and you'll finish." - Hawaiian Kapuna

 

Holding is hard work, holding is a blessing. Give your brain time to heal before you try again.

 

My suggestions are not medical advice, you are in charge of your own medical choices.

 

A lifetime of being prescribed antidepressants that caused problems (30 years in total). At age 35 flipped to "bipolar," but was not diagnosed for 5 years. Started my journey in Midwest United States. Crossed the Pacific for love and hope; currently living in Australia.   CT Seroquel 25 mg some time in 2013.   Tapered Reboxetine 4 mg Oct 2013 to Sept 2014 = GONE (3 years on Reboxetine).     Tapered Lithium 900 to 475 MG (alternating with the SNRI) Jan 2014 - Nov 2014, tapered Lithium 475 mg Jan 2015 -  Feb 2016 = GONE (10 years  on Lithium).  Many mistakes in dry cutting dosages were made.


The tedious thread (my intro):  JanCarol ☼ Reboxetine first, then Lithium

The happy thread (my success story):  JanCarol - Undiagnosed  Off all bipolar drugs

My own blog:  https://shamanexplorations.com/shamans-blog/

 

 

I have been psych drug FREE since 1 Feb 2016!

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  • 3 weeks later...

I finally caved and decided to start Lithium again since it's the only medication that's ever worked for me and I've tried so many. I'm also really hoping that reinstating it will put an end to some of the symptoms I have, similar to reinstating an SSRI after severe withdrawal becomes apparent. I began at 300mg/day wed jul 13 after a positive consult with a nephrologist. I increased to 600mg yesterday (1 week later) and will obtain a blood test next Monday to determine my level.

 

As of yesterday I have very little paresthesia and physical discomfort. I get a little tingle here and there... but nothing very bothersome. I'm hoping this is Lithium's effect and the trend continues. I am still getting some nasty anxiety and my breathing bothers me much of the time, with tightness in the chest - but I've been getting that for quite some time. I took a prn .5 clonazepam (I try to limit this as much as possible) and now I feel relaxed and comfortable, breathing comfortably! Amazing. Maybe it's temporary, but I'm crossing my fingers I've found a solution (at least partial) to this agony.

 

During this time I also began physiotherapy for general back/neck issues and they are aware of the neurological issues. They claim some of the treatments can help. I guess they get people with neuropathies all the time. I've had 2 sessions so far. Maybe the physio is partly responsible for this improvement as well. I plan to continue this as they seem very competent. I'm considering acupuncture as well if I can find someone that bases it on modern biology. I found electro-acupuncture in the past to be helpful, so maybe I can find that somewhere.

 

I also quit smoking and started using a 14mg (step 2) Nicoderm patch. It is very effective. I haven't smoked in about 5 days.

 

Things are looking well. I could take a dive tomorrow... but my hopes are up at the moment.

Experience:

Had chronic Lithium toxicity. Was abruptly withdrawn in ER with IV fluids. Was sent home the same day. Within days, experienced severe electric shock sensations, skin tingling/crawling, inner sense of "buzzing", extreme restlessness, sound sensitivity and various hard to describe nervous system sensations. High anxiety, shortness of breath. Lost emotional control, felt near suicidal. Admitted to hospital psychiatric for 3.5 months, stabilised somewhat on new medications but still experience symptoms. Could not sit or sleep, had to be sedated at night. Physical sensations were never really addressed or treated and persist to a lesser degree to this day. Eventually started to develop transient severe muscle and joint pain.

 

Current medications: Sythroid 75mcg, Prevacid 15mg, Clonazepam 0.5 mg bid (1mg), Divalproex 500mg tid (1500mg), Moclobemide 150mg tid (450mg), Lithium carbonate 300mg bid (600mg)

 

Restarted Lithium Jul, 2016: Titrated week1 - 300mg, week 2 - 600mg. eventually 900mg

Stopped Ranitidine and tums (mostly) Jul, 2016

Increased Lithium Aug, 2016: 1200mg (original dose) blood level 0.96, experiencing occasional heart pains (started at 900mg but went away), creatinine level 120. May go down to lower dose.

Reduced Divalproex Aug, 2016: From 2000mg/day to 1500mg/day because it's too much combined with Lithium

Started Lyrica Aug, 2016: Titrated 25mg to 150mg in 1 week. Reduction in anxiety and paresthesia/neuropathy. Improved SOB. 

 

Currently: Reduction in paresthesia, neuropathy perhaps due to restarting Lithium - yet to be determined, Lyrica definitely helped but still not enough. Very infrequent shortness of breath, no more acid reflux, moderate mood/anxiety issues.

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  • Moderator Emeritus

Good to hear from you Optomistic. Please don't look at reinstating as "caving." You made a choice aimed at maximizing your function and minimizing your symptoms.  It's great that the parasthesia symptoms are waning with the reinstatement and physiotherapy. That has got to be a relief.

 

Congratulations on making it 5 days without the cigs! That was a brave choice amid adjusting doses of the pharma psycho-actives.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results

Cymbalta 60 mg 2012 - 2015; 2016: 20 mg to 7 mg exact doses and dates in this post; 2017: 6.3 mg to  0.0 mg  Aug. 12; details here


scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet

Link to comment
  • 1 month later...

No more smoking, no more patches.

 

I'm back on 1200mg Lithium again, blood level 0.96 dead perfect. But, I may need to dial it down a little... I've been getting some heart pains. I also just started Lyrica 150mg and it helped my nerve sensations and anxiety... I tried to increase the dose to 225mg but it messed me up, I felt stoned and dizzy and had trouble remembering things that I knew very well. So back at 150mg. It's not enough for the pain/sensations (I still get all the symptoms) or anxiety so next I'm considering an antipsychotic test-drive which is very risky for me because I get so many side effects from them, but I need to do something. My P doc and I were talking about maybe an old first gen antipsychotic that's actually approved for anxiety (I can't take Seroquel, everyones fav AP for any problem you may have or I'll have a heart attack). I'm also cycling moods still, no hypo-mania, just weird agitated or happy moods and depressed moods, lasting 1 week minimum up to a few weeks I think. The Lithium was only recently increased, so that might stop it. 

 

I have to remind you, mood cycling is normal for me. Not some weird side effect or withdrawal symptom. At one point in my life I cycled every few weeks or months for at least 15. So yeah, normal.

Experience:

Had chronic Lithium toxicity. Was abruptly withdrawn in ER with IV fluids. Was sent home the same day. Within days, experienced severe electric shock sensations, skin tingling/crawling, inner sense of "buzzing", extreme restlessness, sound sensitivity and various hard to describe nervous system sensations. High anxiety, shortness of breath. Lost emotional control, felt near suicidal. Admitted to hospital psychiatric for 3.5 months, stabilised somewhat on new medications but still experience symptoms. Could not sit or sleep, had to be sedated at night. Physical sensations were never really addressed or treated and persist to a lesser degree to this day. Eventually started to develop transient severe muscle and joint pain.

 

Current medications: Sythroid 75mcg, Prevacid 15mg, Clonazepam 0.5 mg bid (1mg), Divalproex 500mg tid (1500mg), Moclobemide 150mg tid (450mg), Lithium carbonate 300mg bid (600mg)

 

Restarted Lithium Jul, 2016: Titrated week1 - 300mg, week 2 - 600mg. eventually 900mg

Stopped Ranitidine and tums (mostly) Jul, 2016

Increased Lithium Aug, 2016: 1200mg (original dose) blood level 0.96, experiencing occasional heart pains (started at 900mg but went away), creatinine level 120. May go down to lower dose.

Reduced Divalproex Aug, 2016: From 2000mg/day to 1500mg/day because it's too much combined with Lithium

Started Lyrica Aug, 2016: Titrated 25mg to 150mg in 1 week. Reduction in anxiety and paresthesia/neuropathy. Improved SOB. 

 

Currently: Reduction in paresthesia, neuropathy perhaps due to restarting Lithium - yet to be determined, Lyrica definitely helped but still not enough. Very infrequent shortness of breath, no more acid reflux, moderate mood/anxiety issues.

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