Tbird: How do I start tapering my medications?

[Tbird]

Hi. I’ve been on a variety of antidepressants, Benzodiazepines, and antipsychotics for the past 21 years. I see  the term poly drugged used frequently and I often wonder if that is what I have been living. But I’m not certain, as I’ve been trusting my Psychiatrists and following the recommendations given to me. Over the years I have tried many times to get off my medications as I feel the side effects and the combinations throw my body and nervous system into a fight within itself everyday but I have always been unsuccessful. I’m hoping this site can be beneficial to me. 

My current regimen:

Latuda 160 mg every day, Zoloft 300 mg everyday, Adderal 25 mg two times a day, Vistaril 100 mg as needed, Buspirone 30 twice a day, Ativan One mg every other day, Trazodone 200 mg every night, Topamax  100 mg at night and 50 mg every morning. 

My diagnosis is Bipolar type II, anxiety, ADHD, and PTSD. 

Edited February 17, 2018 by Tbird

[Gridley]

Hello, Tbird, and welcome to SA.  

 

You certainly have been polydrugged.  I ran your drugs through a drug interaction checker Drug Interactions Checker and found your have four major interactions among your drugs and five moderate interactions.  Three of the four major interactions can increase the risk of serotonin syndrome.  I have included the results below.

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.  You could use the information you provided in your post, putting it in a vertical list.  Please add previous psychiatric drugs and attempts to taper or cold turkey.

• 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. 
• Please leave out symptoms and diagnoses. 
• A list is easier to understand than one or multiple paragraphs. 
• Link to Account Settings – Create or Edit a signature.

SurvivingAntidepressants is a site dedicated to helping people taper slowly off psychiatric drugs, so you have come to the right place.  At SA, it is recommended that a person taper by no more than 10% of their current dose with at least a four week hold in-between decreases.  The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs.  Some people may have to taper at a more conservative rate as they are sensitive to even the smallest drops.
  
To get you started, and familiarized with the protocols followed by SA, I am linking a few topics so that you have a better understanding of what is recommended here. 

 

Before you begin tapering what you need to know

What is Withdrawal Syndrome?
Why taper by 10% of my dosage?

Brain Remodelling

 

Please mention side effects and other negative symptoms.  Could you please describe them?  With so many drugs, I'm sure it's difficult to determine which drug is causing what effect, but if you have any ideas about which drugs are causing you the most negative effects, please tell us.

 

Once we have received your signature and the answers to my questions, we can work on a plan to start getting you off these drugs.  Unless you are having an adverse reaction to one of the drugs, we generally recommend you begin tapering the more activating drugs first (also know as accelerators; most antidepressants are activating), leaving the more sedating drugs (known as brakes; benzos and antipsychotics are brakes) for later to act as a buffer during withdrawal.  However, the risk of serotonin syndrome in your case is also a factor to consider.  We generally recommend you taper only one drug at a time; otherwise, if there is a negative reaction to the taper it would be difficult to determine what's causing it.  This link describes the "accelerators and brakes" concept:

 

Taking multiple psych drugs? Which drug to taper first?

 

 

This is your introduction topic -- the place for you to ask questions, record symptoms, share your progress, and connect with other members of the SA community. I hope you'll find the information in the SA forums helpful for your situation. I'm sorry that you are in the position that you need the information, but I am glad that you found us.

 

Your drug interactions list is below.

 

Interactions between your drugs

Major

amphetamine  sertraline

Applies to: Adderall (amphetamine / dextroamphetamine), Zoloft (sertraline)

Talk to your doctor before using sertraline together with amphetamine. Sertraline may increase the effects of amphetamine, and side effects such as jitteriness, nervousness, anxiety, restlessness, and racing thoughts have been reported. Combining these medications can also increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should contact your doctor immediately if you experience these symptoms while taking the medications. 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

buspirone  trazodone

Applies to: buspirone, trazodone

Using busPIRone together with traZODone can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention if you experience these symptoms while taking the medications. 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. 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

buspirone  sertraline

Applies to: buspirone, Zoloft (sertraline)

Using busPIRone together with sertraline can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention if you experience these symptoms while taking the medications. 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. 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

trazodone  sertraline

Applies to: trazodone, Zoloft (sertraline)

Using traZODone together with sertraline can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention if you experience these symptoms while taking the medications. 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. 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

dextroamphetamine  sertraline

Applies to: Adderall (amphetamine / dextroamphetamine), Zoloft (sertraline)

Talk to your doctor before using sertraline together with dextroamphetamine. Sertraline may increase the effects of dextroamphetamine, and side effects such as jitteriness, nervousness, anxiety, restlessness, and racing thoughts have been reported. Combining these medications can also increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should contact your doctor immediately if you experience these symptoms while taking the medications. 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

buspirone  lurasidone

Applies to: buspirone, lurasidone

Using busPIRone 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

trazodone  lurasidone

Applies to: trazodone, lurasidone

Using traZODone 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

lorazepam  trazodone

Applies to: Ativan (lorazepam), trazodone

Using LORazepam together with traZODone 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

sertraline  lurasidone

Applies to: Zoloft (sertraline), lurasidone

Using sertraline 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.

 

Moderate

lorazepam  lurasidone

Applies to: Ativan (lorazepam), lurasidone

Using LORazepam 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

[Dalalea]

Welcome, Tbird!

I don't have the answers for you but we have Sertraline in common. I'll be thinking of you as you begin this process. You've come to the right place!

[Tbird]

Thank you very much! I will start working on it!