Sazzy - going meds free

[Sazzy]

I have been on medication for over ten years. Initially just antidepressants at first but then I was diagnosed bipolar so mood stabilisers and antipsychotics were also thrown in the mix.

 

I decided to try to self manage a couple of months ago and my psychiatrist was not happy about it. She insisted my mother came with to my next appointment (I'm 33!)

 

Coming off the mirtazapine was pain free with no withdrawal effects. The next step is the lamotrigine. I am slightly concerned as I have read about people doing incredibly slow tapers but at my appointment today she said to reduce from 400mg (200mg twice a day) to 300mg. To then stick with that for two months and then to go back and review. Is this too quick?

[ChessieCat]

Hi Sazzy and welcome to SA,

 

There is a lot of excellent information on this site and I'll give you some links to check out.  It can sometimes be a bit overwhelming when you first join SA, but just take your time and check out the information as you can and ask any questions you may have.

 

Thank you for completing your signature.  It would be helpful if you could give details for the last 12-18 months of ALL drugs, dates doses and how you decreased/increased (eg skipped days, alternated doses, cold turkey) and a summary of drugs with month/year for anything prior to that.  Having these details will help us to see your drug history at a glance and offer suggestions based on your individual situation.  Please remember to update any time you make a change so it remains current.  Thank you.

 

Withdrawal symptoms can appear several months after stopping an AD.  It may be a good idea to wait 2-3 months before commencing tapering the next drug.  Once we have more details we will be able to offer suggestions about this.

 

"Initially just antidepressants at first but then I was diagnosed bipolar so mood stabilisers and antipsychotics were also thrown in the mix."

 

If you weren't bipolar prior to starting antidepressants it is quite possible that the bipolar diagnose came about from your use or discontinuation (ie withdrawal symptoms) of ADs.

 

SA recommends a 10% taper of the previous dose followed by a holding period of 4-6 weeks to allow the brain time to adapt to not getting as much of the drug.  These helped me to understand SA's recommendation:

 

Brain Remodelling (Rhi's Description of Brain Healing)

Video:  Healing From Antidepressants - Patterns of Recovery

 

Anyway here are some links with information:

 

Before you begin tapering what you need to know
 

Why taper by 10% of my dosage?

Dr Joseph Glenmullen's Symptoms Checklist

 

Taking multiple psych drugs? Which drug to taper first?

 

Tips for tapering off Lamictal (lamotrigine)

 

Tips for tapering off aripiprazole (Abilify)

 

You can ask questions here in your Intro/Update topic and as well as journal your progress.  Click "Follow" top right and you will be notified when someone responds.

[Sazzy]

Thank you for all of those links.  

 

First off I should clarify.  I was diagnosed bipolar when I happened to have an appointment with my psychiatrist when hypomanic and he then questioned my behaviour over the years.  We identified that these patterns had started long before starting any medication.

 

I am not intending to swear off medication for good.  I am prepared to take antipsychotics short term when I become hypomanic but not to remain on them after.  My psychiatrist is not supportive of this idea but others have been in the past so I know that it is possible. However I intend to entirely self-manage the lows as I have not found the medication to be effective for these anyway.

 

As I have been now been prescribed 300mg lamotrigine to be taken as 150mg twice a day I do not know how I would go about tapering any slower as these are the only tablets I will have access to.  I was thinking I could use the 200mg tablets I have left and use one of those a day and one of the 150mg a day.  That way only reducing 50mg in one go rather than 100mg like she has prescribed.

 

I will have a look at some of those links now.  Thank you again.