karenp: my story so far ... and thanks for reading

[karenp]

Hi Everyone,

 

I am grateful to have found this forum a few days ago. I have been in withdrawal for most of the last 9 months. Currently I am withdrawing from Lamictal and still have Prozac and Mirtazipine to discontinue. I'll back up a little and give some background.

 

I have been taking an antidepressant of one sort or another since I was 22--I'm now 42. I was on Zoloft for much of that time and through my 2 pregnancies. It wasn't until 4 years ago that things started to get really awful and complicated. My dad had just died, my marriage was falling apart, and then my closest friend of twenty years died tragically. At that time I was put on Lorazepam which I took every day for almost 4 years. Over the next 3 years I continued to have upheaval and difficulty and my symptoms mostly just kept getting worse. Since my late teens I have been interested in fitness, health, nutrition, and spirituality, so I do have a solid grounding in knowing what is good for me and staying fit and strong and I was still brought to my knees by this perfect storm of events and medications. I began having chronic yeast infections over these last four years which I had never had before. Last winter I was practically debilitated by a somewhat mysterious pain in my neck and back which had me trying all sorts of alternative therapies as well as narcotics (none of which did anything).

 

I had been put on Effexor last summer and my doc just kept raising the dose. Eventually when I still wasn't feeling well she basically said that I was a lost cause and should try to attend an outpatient behavioral program to manage the anxiety and depression. I switched doctors and luckily found a kind and somewhat alternative Nurse Psychiatrist. She suggested Lamictal and Mirtazipine and I got off of the Effexor. She has been very supportive of the path I'm on now and with helping me (sort of) to come off of the Clonopin (which I had switched to from Lorazepam as a strategy to more easily withdraw).

 

The yeast infections continued to worsen and each time I would get one I would have more and more symptoms (extreme foggy brain, awful anxiety, abdominal discomfort). I started researching and learned about systemic candida. I am convinced now that my physical maladies are very connected to taking these medications and that many of my systems have been stressed and compromised leading to various ailments.

 

I am now at 17.5 mg of Lamictal, down from 100 in several stages. This last drop from 25 to 17.5 was just awful--I was really terrified. I am waiting to hear whether my insurance will approve the compounding pharmacy. My doc has written me scripts that will take me down by 10% each time. Hopefully that will make a difference.

 

My diet is now extremely clean as well--no sugar, wheat, red meat (20 years now), very little fruit (b/c of the candida), and a regimen of supplements prescribed by the naturopath. I hope that I can start to get my gut back in balance and begin to start eating more normally again. This is such a frustrating experience. I just want my life back!!!.

 

Thanks for listening.

 

Karen

[Altostrata]

Hi, karenp. Thanks for joining us.

 

I've got some experience tapering Lamictal. Why did you decide to taper it first rather than mirtazapine or Prozac?

 

How did you make the switch from Effexor to Prozac? How did you feel afterwards?

[Shanti]

Hi Karen. Nice to meet you. I hear ya, I can't wait to get my life back too. You'll like this place, good people here and helpful.

[karenp]

Hi. Thanks for your welcome. My dr. suggested it as it seemed to be the med that was least helpful and that I had been taking for the shortest amount of time. But I am learning that she just has very little experience with people like myself who are super sensitive to these drugs. She says she's never met anyone with such a fine tuned nervous system. She also said she has only seen one person have any trouble getting off Lamictal. Go figure....I get to be the lucky one with the hyper-sensitive ns!

 

Can't remember when we added in Prozac--part way through the taper--maybe half way.

 

 

Hi, karenp. Thanks for joining us.

 

I've got some experience tapering Lamictal. Why did you decide to taper it first rather than mirtazapine or Prozac?

 

How did you make the switch from Effexor to Prozac? How did you feel afterwards?

 

[karenp]

Thanks Shanti. I really need the support of people who can understand the intensity of this experience. Peace

[karenp]

Hi, karenp. Thanks for joining us.

 

I've got some experience tapering Lamictal. Why did you decide to taper it first rather than mirtazapine or Prozac?

 

How did you make the switch from Effexor to Prozac? How did you feel afterwards?

/quote]

 

The Prozac did seem to mitigate some of the despair and anxiety brought on by the wd. But now I don't know if it really did anything but just coincided with the timing of the wd and the way the symptoms were playing out. It's all very confusing. So now I am taking 60 mg of Prozac....ugh.

[Altostrata]

How long have you been taking the Prozac? Are you still taking Clonopin.

 

I'm thinking, if I were you, I'd hold on the Lamictal and work on the mirtazapine.

 

Lamictal might help dampen some withdrawal problems you might have from mirtazapine.

 

When did you start tapering?

[karenp]

Been taking Prozac since June I think. And no I finished the Clonopin about 6 weeks ago which is when I started the Lamictal decrease. I will tell my doc about your recommendation. Any thing that will help!

[Altostrata]

Hmmm, let's talk more before you discuss with your doctor.

 

What were the symptoms when you had this rough patch tapering Lamictal?

[karenp]

Symptoms started intensifying on day 4 of the last decrease and were the worst on days 5 and 6. Rising anxiety, feelings of unreality and shakiness, weird brain feelings, intense worry and cogitation about nothing in particular, obsessing. But the worst was the feeling of utter despair and that I was trapped with no way out. I do not have a history of suicide attempts or planning, but on that day I really thought about it. I still had a part of me that knew it was the medication but it seemed near impossible to bring that part to the forefront.

[Altostrata]

How long did these symptoms last? Are they gone now?

[Shanti]

Symptoms started intensifying on day 4 of the last decrease and were the worst on days 5 and 6. Rising anxiety, feelings of unreality and shakiness, weird brain feelings, intense worry and cogitation about nothing in particular, obsessing. But the worst was the feeling of utter despair and that I was trapped with no way out. I do not have a history of suicide attempts or planning, but on that day I really thought about it. I still had a part of me that knew it was the medication but it seemed near impossible to bring that part to the forefront.

 

I know that feeling well. I had it bad and if it weren't for my kids, I probably would have checked out. It's just so aweful what we go through with these withdrawals. Just know that it will get better and the world will seem like a good place again. I know it's like a veil over reality and it paints the world as very ugly. It's temporary and you'll get better. I've read a lot of success stories. I'm totally over that horrible feeling now and haven't had it since the beginning. Now I just have physical symptoms but not that gloomy anxiety and depression.

[Phil]

Rising anxiety, feelings of unreality and shakiness, weird brain feelings, intense worry and cogitation about nothing in particular, obsessing. But the worst was the feeling of utter despair and that I was trapped with no way out. I do not have a history of suicide attempts or planning, but on that day I really thought about it.

 

Hi Karen, I can relate to all of what you wrote here. I've experienced it all. I can tell you that it does change and get better. You're not alone.

 

Btw, doctors don't usually know much about tapering off these medications, as many of us here have found out.

 

Welcome to the forum by the way!

[karenp]

Thank you Phil and Shanti. Being there for my kids is my biggest motivation right now. Today I feel pretty crappy-a kind of dull ache in my head with vague feeling of unease and some gi issues. I am 10 days out now from the last reduction in the Lamictal. Is this normal? Sounds like there is no "normal" but I guess I'm looking for some support. I will go to the gym in a bit as I do most days. I have no idea what mental/emotional shape I'd be in if I didn't do all the things that I do for myself--scary to speculate. Just have to keep plugging along I guess. My mental stamina is very low right now.

 

Thanks everyone,

Karen

[karenp]

How long did these symptoms last? Are they gone now?

 

 

Hi Alto,

 

The intense symptoms described lasted for about 2 days. I am back to a dull ache with a vague sense of unease which is still extremely uncomfortable.

[Shanti]

Be careful not to overdo it at the gym. Too much exercise makes my symptoms worse. I don't know if that's true for everyone. This process does require a lot of rest imo. Exercise is good, just not overdoing it.

[Altostrata]

karen, did you have any uncomfortable symptoms while you were on a higher dose of Lamictal?

 

How are you taking 17.5 mg of Lamictal? In 5mg tablets?

[karenp]

I just went back up to 25 mg. in 25 mg tablets. I just feel too awful. I think trying to reduce Mirtazipine first and later trying again with Lamictal in a smaller percentage. What do members think?

 

Thanks,

Karen

[Altostrata]

That's what I was thinking.

 

Since you're sensitized to withdrawal, you might have to go very, very slowly on the mirtazapine. Why are you taking mirtazapine, specifically? Was it supposed to help with sleep problems after quitting the benzo?

 

Or, try the Prozac first. It comes in a liquid, and probably won't be as difficult as the others.

[karenp]

Started taking the Mirtazapine for depression and anxiety before we decided to stop the Effexor. Noticed a short-term positive effect but then was deep in the Effexor wd and that's when we added Prozac. Now I see that many of my symptoms were caused by constant rebound anxiety on the Lorazepam.

[Phil]

Hi Karen, I don't know much about mirtazapine but I think Alto could be right - tapering prozac first might be easier.

Does the mirtazapine help you with sleep? If so, it might help cover any insomnia problems if you decide to taper the prozac.

[karenp]

Hi Phil,

 

The Mirtazipine has helped with sleep somewhat although overall sleep is not too problematic for me. At this point I am very skeptical that any of these meds are helping but I guess I won't know until I'm fully off all of them.

[Altostrata]

Yes, sleep problems can be really difficult in withdrawal -- or lorazepam rebound.

 

I'm kind of confused. Your doctor had you taking mirtazapine with Effexor? Then mirtazapine, Effexor, and lorazepam? Then mirtazapine and lorazepam with Prozac? Then Lamictal with mirtazapine and Prozac?

 

Did she give you Prozac to get you off Effexor? How did that work? What was the Lamictal supposed to do?

 

How is the lorazepam rebound now?

 

Sorry to keep asking questions. Maybe you can give a summary of the entire sequence?

 

(I guess you know by now you've been taking too many psych drugs at once.)

[karenp]

Hi Alto,

 

So the sequence of the last 4 years goes like this:

 

2007-Zoloft and Lorazepam

2009-Zoloft, Lorazepam, and Mirtazipine

June 2010-Effexor, Lorazepam and Mirtazipine

September 2010-Effexor, Lorazepam

February 2011-start tapering Effexor, continue with Lorazepam, add Lamictal and Mirtazipine

May or June 2011-finish tapering Effexor, start Prozac, begin taper of Lorazepam, Lamictal, Mirtazipine

July 2011-Prozac, switch to Clonopin and continue taper, Lamictal, Mirtazipine

September-finish Clonopin taper, start Lamictal taper, Prozac, Mirtazipine

 

Wow......depressing. I want off these meds!!

[Altostrata]

karenp, I just spoke with a doctor whose opinion I respect.

 

He thinks this plan makes sense: Taper off Prozac first. Then mirtazapine and then Lamictal.

 

Hold steady on Lamictal, it may help dampen withdrawal symptoms from the others.

 

How about stabilizing on 25mg Lamictal for 3 weeks, then think about reducing Prozac.

 

How much Prozac are you taking?

 

My impression is your doctor has had you on a lot of meds in sort of random combinations. Do you like her? Will she work with you on tapering off?

[karenp]

Hi Alto,

 

I do like my doctor as a person although I am more and more dismayed by her lack of knowledge about withdrawal issues and about alternatives to psych meds. I'm surprised actually because her office is in a "healing arts" center and she is very compassionate and seemingly open-minded. I guess that speaks strongly to the bias of the field--it's so strong that some docs don't even know they have one!

 

Yes she will work with me for sure. I like your plan although I know I will be impatient to start with the Prozac. I'm already feeling a bit better this afternoon after going back up to 25, even though I felt like death warmed over this morning. Ah the mind is a funny thing....

 

Thank you so much for your support. I feel more confident in moving forward although I do feel some discouragement at having to back off of the Lamictal wd, but I have to be realistic.

 

Best,

Karen

[Altostrata]

What is the dosage of Prozac you're taking?

 

I'd like to suggest a 10% trial reduction for the first drop.

[karenp]

Taking 60 mg of Prozac

[karenp]

Will I be able to go down 10% without compounding? It would be much easier and cheaper if I could.

[Shanti]

Hi Karen. I couldn't buy the Paxil liquid because it was $600 at my pharmacy. Instead I bought a digital jewelers scale at ebay for $25. Got some razor blades and I shave off bits of the pill and weigh it down to 18%. You can get precise with a scale. If you get one, just be sure it measures as low as mg. I saw many at Ebay that only measured in grams.

[Altostrata]

Prozac comes in a liquid form. If your doctor writes a prescription for it, you should be able to get it for about $60 retail. Insurance may cover it.

 

You can combine the liquid with capsules to make an odd amount for tapering, such as 1 40mg capsule plus 14mg liquid to total a dose of 54mg (a 10% reduction from your current dose of 60mg).

 

You can also make your own Prozac solution, see http://survivingantidepressants.org/index.php?/topic/759-tips-for-tapering-off-prozac-fluoxetine/page__p__6498__hl__prozac__fromsearch__1#entry6498

 

Shanti, the amount your pharmacy said they'd charge for Paxil liquid was ridiculous. Either they made an error, or you should fill your prescription at another pharmacy. As I posted before, you can order from an online Canadian pharmacy for about $80.

 

It would be hard to use a jeweler's scale with Prozac. The stuff inside the capsules is fluffy and would easily blow away.

[karenp]

Thanks Shanti and Alto. Terrible day today so much despair and raw nerve feeling. Took a little bit more of the Lamictal this afternoon and that seemed to take the edge of a bit. Will continue to take 25 mg for now. Very discouraging day.

[Shanti]

Oh, I didn't know it was a capsule. I'm fine with cutting down the pills, it's no biggie.

[karenp]

Hi. An awful few days for me. Going back up to 25 mg. of lamictal from 12.5 didn't help my situation. I thought I could handle it but things got so bad yesterday I have never felt so suicidal. I made the decision to go up to 50 and by this afternoon I am feeling much better. I'm wondering a couple of things--did I not give my nv enough time to recover from the clonopin taper before starting the lamictal taper (only about 2 weeks) and also I must have gone down too much, too fast on the lamictal. I thought wrong that nothing could be as bad as the clonopin taper and so I cut 25% or more at a time (down from 100). Boy was I off!!!

 

Alto had suggested that I stay on the lamictal for now and then try to taper the prozac in a few weeks. I'm not sure what I should do now as I am really terrified of getting in that dark place that I was just in. Maybe stay at 50? Or maybe drop to 37.5 since one day at 50 seemed to make such a difference? I hate to be on more than I need but need to minimize chances of dipping so deep again.

 

I have 2 boys ages 7 and 10 and they were so sweet with me yesterday but I can't have them mothering me on a regular basis. This is so hard....

[compsports]

Hi Karen,

 

If you only allowed two weeks between tapers, you actually need to allow a minimum of 3 and perhaps even longer. That could be why you are having all those problems.

 

As an FYI, Remeron was one of the drugs I tapered off of so when you're ready to do it, feel free to ask questions.

 

Sorry if I am missing anything relevant.

 

CS

[karenp]

Thanks CS. How much Remeron were you on when you started tapering? I'm on 30mg and 60 of Prozac.

 

Karen