Don74: I want off these drugs

[Don74]

Hi everyone,

 

I am so happy to have come across this website, there is such a wealth of information here.

 

I'm 43 years old and have been on various cocktails for the past 25 years. I was diagnosed bipolar after going manic after being introduced to Zoloft and have been treated as such ever since. I have come to question everything about my treatment and have decided that it's time to try life without these medications. I believe that they are responsible for stunting me in numerous ways - I have become dumber, my memory is awful, I have trouble learning and keeping my concentration, my emotions are muted, I suffer from anxiety.. the list goes on. Unfortunately my psychiatrist seems to think that adding a new drug is the solution every time I become depressed, and says that going off meds is the wrong thing to do while I'm in a depressed state. I've decided to explore a holistic approach involving mindfulness, nutrition, exercise and so on.

 

But before I do anything, I have one important question:

 

Can anyone recommend a psychiatrist in the Washington, DC area who can help me taper responsibly, and who I can trust? I have been doing a lot of research on my own and have been trying to find a psychiatrist specializing in integrative and functional medicine and have found a couple who look great but unfortunately aren't taking new patients. Any guidance would be much appreciated.

 

Thanks!

 

ps. I know I'm supposed to list my current med history in my "signature," but I don't see where to do that. Here's a list:

 

Lithium (900mg) - 20+ years

Seroquel (200mg) - 10+ years

Wellbutrin (450mg) - 10+ years

Lamictal (300mg) - 8+ years

Latuda (40mg) - 1.5 years

 

pps. Any suggestions as to which I ought to taper off of first? 

 

[Don74]

Sorry, in case my post was confusing - I am on all 5 of these meds now:

 

Lithium (900mg) - 20+ years
Seroquel (200mg) - 10+ years
Wellbutrin (450mg) - 10+ years
Lamictal (300mg) - 8+ years
Latuda (40mg) - 1.5 years

[ChessieCat]

Hi Don and welcome to SA,

 

It really great that you have found this site before commencing your taper.  As you said there is a wealth of information here and it's good to have the support of other members who understand what you are going through.

 

Thank you for providing your drug information.  Here is how to do your drug signature.  Please show the year you started each drug instead of how long you have been on it.  This way the information will make sense in future years.  Also, please remember to update it whenever you make a change.

 

A request: Would you summarize your history in a signature - ALL drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly?

• Please leave out symptoms and diagnoses.
• A list is easier to understand than one or multiple paragraphs. 

• Any drugs prior to 24 months ago can just be listed with start and stop years.
• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago)
• Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016.
• Link to Account Settings – Create or Edit a signature.

 

Because you are taking various drugs please use the Drug Interactions Checker and copy and paste the results in a post.

 

I will give you some links to check out:

 

Before you begin tapering what you need to know

 

Why taper by 10% of my dosage?

important-topics-in-the-tapering-forum-and-faq

 

 

How do you talk to a doctor about tapering and withdrawal?

What should I expect from my doctor about withdrawal symptoms?

 

Keep Notes on Paper

Rate Symptoms Daily to Check Patterns and Progress

 

Tapering Calculator - Online (can be saved)

Tapering Calculator - Download

 

Brain Remodelling

Video:  Healing From Antidepressants - Patterns of Recovery

 

This is your own Introduction topic where you can ask questions and journal your progress.

 

 

[Ali4]

Your currently on all those drugs? Welcome to S.A. you will get a lot of guidance and help here, your not alone that's for sure. Take care and again welcome. Ali 

[Don74]

Yes, I'm embarrassed to say that I'm currently on all of these drugs. Believe it or not my psychiatrist actually wanted to add Zoloft to the list the last time I saw him. I feel ashamed that I let myself fall into this pharmaceutical trap. 

 

I left out some important things in my intro: without getting into too much detail - I have a past history of drug abuse and alcohol consumption, which I recently ended. I am also going through some major life changes - a divorce and the end of my current career. I have no idea what I will be doing next. I've been told that it's a bad idea to go off of meds in the midst of so much turmoil, but I feel like there will never be a "good" time. Fortunately I can support myself financially for the next few months while I make these changes. I feel like this is the right time.

 

Unfortunately I don't have good records of my medication history,  I can only make guesstimates for most of it (my memory is awful). I recently got a copy of my doctor's notes but they are undecipherable. I will do the best I can to compile a detailed history of the past couple of years.

 

Below are the results of my Drug Interaction Report:

 

Major

lithium  bupropion

Applies to: lithium, Wellbutrin (bupropion)

BuPROPion may rarely cause seizures, and combining it with other medications that can also cause seizures such as lithium may increase that risk. You may be more susceptible if you are elderly, undergoing alcohol or drug withdrawal, have a history of seizures, or have a condition affecting the central nervous system such as a brain tumor or head trauma. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. 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. 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

Major

bupropion  quetiapine

Applies to: Wellbutrin (bupropion), Seroquel (quetiapine)

BuPROPion may rarely cause seizures, and combining it with other medications that can also cause seizures such as QUEtiapine may increase that risk. You may be more susceptible if you are elderly, undergoing alcohol or drug withdrawal, have a history of seizures, or have a condition affecting the central nervous system such as a brain tumor or head trauma. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. 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. 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

Major

bupropion  lurasidone

Applies to: Wellbutrin (bupropion), Latuda (lurasidone)

BuPROPion may rarely cause seizures, and combining it with other medications that can also cause seizures such as lurasidone may increase that risk. You may be more susceptible if you are elderly, undergoing alcohol or drug withdrawal, have a history of seizures, or have a condition affecting the central nervous system such as a brain tumor or head trauma. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. 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. 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

lithium  lamotrigine

Applies to: lithium, Lamictal (lamotrigine)

Using lithium together with lamoTRIgine 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

Moderate

lithium  quetiapine

Applies to: lithium, Seroquel (quetiapine)

Using QUEtiapine together with lithium can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a rare side effect. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether together or alone. Avoid driving or operating hazardous machinery until you know how the medications affect you. 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

lithium  lurasidone

Applies to: lithium, Latuda (lurasidone)

Using lithium together with lurasidone 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. Rarely, a syndrome consisting of weakness, lethargy, fever, tremors, confusion, abnormal muscle movements, and increased white blood cells and other lab values has also been reported during combined use of these medications. 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

 

Moderate

lamotrigine  lurasidone

Applies to: Lamictal (lamotrigine), Latuda (lurasidone)

Using lamoTRIgine together with lurasidone 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

Moderate

quetiapine  lurasidone

Applies to: Seroquel (quetiapine), Latuda (lurasidone)

Using QUEtiapine together with lurasidone may increase side effects such as drowsiness, blurred vision, dry mouth, heat intolerance, flushing, decreased sweating, difficulty urinating, abdominal cramping, constipation, irregular heartbeat, confusion, and memory problems. Side effects may be more likely to occur in the elderly or those with a debilitating condition. 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

• lithium interacts with more than 600 other drugs and more than 10 diseases.
• Lamictal (lamotrigine) interacts with more than 200 other drugs and 7 diseases.
• Latuda (lurasidone) interacts with more than 400 other drugs and more than 10 diseases.
• Seroquel (quetiapine) interacts with more than 600 other drugs and more than 20 diseases.
• Wellbutrin (bupropion) interacts with more than 300 other drugs and 8 diseases.

Interactions between your selected drugs and food

Major

lurasidone  food

Applies to: Latuda (lurasidone)

Avoid consuming grapefruit or grapefruit juice during treatment with lurasidone, as it may increase blood levels of the medication. This can increase the risk of side effects such as Parkinson-like symptoms, abnormal muscle movements, seizures, high blood sugar, diabetes, high cholesterol, weight gain, sex hormone irregularities, and heat-related disorders such as heat intolerance or heat stroke. In addition, you may be more likely to experience side effects associated with low blood pressure such as dizziness, lightheadedness, headache, flushing, fainting, and heart palpitations. You should also avoid the use of alcohol while being treated with lurasidone. Alcohol can increase the nervous system and blood-pressure lowering effects of lurasidone. You may experience increased drowsiness, dizziness, difficulty concentrating, and impairment in thinking and judgment. Talk to your doctor or pharmacist if you have any questions or concerns. Lurasidone should be taken with food consisting of at least 350 calories. Avoid driving or operating hazardous machinery until you know how the medication affects you, and use caution when getting up from a sitting or lying position.

Switch to professional interaction data

 

Moderate

lamotrigine  food

Applies to: Lamictal (lamotrigine)

Alcohol can increase the nervous system side effects of lamoTRIgine 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 lamoTRIgine. Do not use more than the recommended dose of lamoTRIgine, 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

Moderate

bupropion  food

Applies to: Wellbutrin (bupropion)

Using buPROPion with alcohol may increase the risk of uncommon side effects such as seizures, hallucinations, delusions, paranoia, mood and behavioral changes, depression, suicidal thoughts, anxiety, and panic attacks. On the other hand, sudden withdrawal from alcohol following regular or chronic use can also increase your risk of seizures during treatment with buPROPion. If you are prone to frequent or excessive alcohol use, talk to your doctor before starting buPROPion. In general, you should avoid or limit the use of alcohol while being treated with buPROPion. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. 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

lithium  food

Applies to: lithium

Alcohol can increase the nervous system side effects of lithium 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 lithium. Do not use more than the recommended dose of lithium, 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

Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication

Central Nervous System (CNS) Drugs

Therapeutic duplication

The recommended maximum number of medicines in the 'Central Nervous System (CNS) Drugs' category to be taken concurrently is usually three. Your list includes four medicines belonging to the 'Central Nervous System (CNS) Drugs' category:

• lamotrigine (active ingredient in Lamictal (lamotrigine))
• lurasidone (active ingredient in Latuda (lurasidone))
• quetiapine (active ingredient in Seroquel (quetiapine))
• bupropion (active ingredient in Wellbutrin (bupropion))

Note: The benefits of taking this combination of medicines may outweigh any risks associated with therapeutic duplication. This information does not take the place of talking to your doctor. Always check with your healthcare provider to determine if any adjustments to your medications are needed.

 

Duplication

Antipsychotics

Therapeutic duplication

The recommended maximum number of medicines in the 'antipsychotics' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'antipsychotics' category:

• lurasidone (active ingredient in Latuda (lurasidone))
• quetiapine (active ingredient in Seroquel (quetiapine))

Note: The benefits of taking this combination of medicines may outweigh any risks associated with therapeutic duplication. This information does not take the place of talking to your doctor. Always check with your healthcare provider to determine if any adjustments to your medications are needed.

 

 

 

 

[ChessieCat]

Hi Don,

 

Unfortunately you are not the only one to have been poly drugged.  We have other members here in a similar situation to yours.

 

I'm really pleased that you didn't follow the psychiatrist's "advice" (I would love to use a different word here, maybe idiocy or lunacy?) and start on Zoloft as well.

 

The information which you provided about your drugs is fine for using in your signature.  Just add that you are on all drugs please.

 

I have asked the other mods for their opinion on which drug to start tapering first.

 

Because of your current life circumstances you might want to consider doing a different taper from the 10% x 4 week hold.  I suggest you check out these topics.  The Brass Monkey Slide, created by one of the moderaters, is a gentler way of making a 10% reduction.  It might also be possible to taper one drug to a lower dose and then taper a different drug.  Once you get your doses a bit lower you might start to feel better in yourself.

 

Rhi's "Start Small, Listen to Your Body" Taper Plan

 

Brass Monkey Slide

 

Micro-taper instead of 10% or 5% decreases

[Don74]

Thank you!

[MollyN]

Hi Don74! Welcome from me too - I hope you've been getting a lot out of reading the discussions in the links posted above  xxxmollyn

[Altostrata]

Welcome, Don.

 

It looks like Wellbutrin is involved in most of your potential adverse drug reactions. If I were you, I might taper Wellbutrin first.

 

Here's information about how to taper it Tips for tapering off Wellbutrin, SR, XR, XL (buproprion)

 

Were any of the other drugs added to counter sleeplessness or nervousness caused by Wellbutrin?

 

PS You need a new doctor. Any doctor can prescribe these drugs, it doesn't have to be a psychiatrist.

Edited November 6, 2017 by Altostrata
added ps

[Don74]

Thanks for getting back to me, Altostrata.

 

I don't remember if any of the other drugs were added to counteract the activating nature of Wellbutrin. 

 

By the way - in case it makes any difference - I'm taking the generic - Buproprion HCL XL (150mg+300mg=450mg). I corrected my signature.

 

I once tried chopping up the XL capsules and it was tough. Maybe I ought to switch over to the SR to make things easier.

 

In terms of what to expect in terms of withdrawal.. I should probably expect drowsiness, correct? That's a little concerning to me since everything else I'm taking is sedative and I'm already very low energy, but I guess that's the whole battle, marching through the side effects.

 

I'm going to wait until I find a doctor I'm comfortable with who will write me prescriptions. I don't want to give another penny to the shrink who put me on all of these!