IanM: introduction

[IanM]

Hello to all. This is my first post here, and I barely have the energy and mental stability to do it. 

About a year and a half ago, I had a complete mental breakdown, brought on by multiple life stressors. The breakdown was severe... I completely lost control of my thought processes. Every thought I had crashed inwards as if they were shattering glass. Very terrifying. A year and a half and six 3 hospital admissions later (see quote below showing correct information), I now find myself trying to get off Olanzapine, Klonopin and Gabapentin. I was on as high as 30mg of Olanzapine for a short period, but for the most part have been taking between 5 and 10mg. Through ignorance, I reduced my dose a month ago to 2.5mg, and just three days ago reduced it again to 1.25mg. After three days at 1.25mg, I am experiencing waking anxiety on a level I wouldn't have thought possible. I am now reinstating at 2.5mg, but may even go back up to 5mg. I'm utterly terrified by what's happening to me, and am looking for advice on what to do next.

Sorry for the disjointed rambling... it's all I can manage.

 

On 10/22/2018 at 8:43 AM, IanM said:

I just read my very first post, and noticed an error in it: I stated I was admitted to hospital 6 times, but it was actually 3...I have made 6 visits to emergency (and maybe more at this point), but was only admitted 3 times. Meaningless info, rely, but I needed to correct it anyway.

 

Edited October 28, 2018 by ChessieCat
corrected error made by member

[IanM]

I can't handle these withdrawals. I feel so weird I can't even describe it. I have reinstated to 5mg.

[Altostrata]

Welcome, Ian.

 

Yes, we recommend a much more gradual taper. You have found out why. Please see Tips for tapering off olanzapine (Zyprexa)

 

Good idea to go back to 5mg, how are you feeling now?

 

What times of day do you take your drugs, and their dosages? Do you have any side effects?

 

Please put ALL your drugs in the Drug Interactions Checker https://www.drugs.com/drug_interactions.php
and copy and paste the results in this topic.

 

 

[IanM]

Hi Altostrata. Thanks for the response. 

As noted, I am now back on 5mg of Olanzapine. I'm not sure what time of day I should take it, but for today I took it at 10am. I also take 0.125mg of Klonopin at 8am and 5pm (but today I took 0.5mg of Klonopin at the same time I took the 5mg of Olanzapine). I also take 400mg of gabapentin, four times a day.

 

Edit: I don't feel as weird and frightened as I did earlier, but I still very unwell. The drug increase made me sleepy but I can't sleep.

 

Here are the results of the drug interactions:

 

Major clonazepam  olanzapine

Applies to: Klonopin (clonazepam), olanzapine

Ask your doctor before using clonazePAM together with OLANZapine. This can cause low blood pressure, shallow breathing, weak pulse, muscle weakness, drowsiness, dizziness and slurred speech. This may be more likely to occur in older adults or those with a debilitating condition. You should be counseled to avoid activities requiring mental alertness until you know how these medications will affect you. If your doctor prescribes these medications together, you may need a dose adjustment or special tests to safely use these medications together. 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 gabapentin  olanzapine

Applies to: gabapentin, olanzapine

Using gabapentin together with OLANZapine 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.

[Madeleine]

It’s good to hear you are feeling a bit better already after reinsyating to 5 mg.  Try not to feel afraid. It is temporary.  You will no doubt stabilize more on the dose you are at now.  Then you can taper at a slower pace and making small reductions. 

 

[IanM]

Does anyone have any suggestions for how long I should stay on 5mg before beginning a taper? Also, I read the thread on tips for tapering Olanzapine, and there seems to be no concesus on how to safely do it, from the standpoint of how to measure and meter out cuts. Use a scale, use liquid suspension, compounding pharmacy at, etc. No satisfactory answers.

 

Thanks.

[IanM]

I’ve decided to hold at 2.5mg of Olanzapine for two or three months and hopefully stabilize enough such that I can organize a proper taper. I’m still not clear on what approach to take for the taper, but may just use a razor to shave off small pieces of my 5mg sublingual tablets.

[Gridley]

Scale, liquid suspension, compounding pharmacy are options for you to choose from, and they all work.

 

If you're going to shave off pieces, you need to get a scale so that your taper is accurate.  Many members use the Gemini-20 scale.  Jumping around in dosage due to inaccurate measuring is destabilizing.

[IanM]

Thanks Gridley. I will look into getting that scale.

[IanM]

Does anyone have any suggestions for how long I should stay on 5mg before beginning a taper? Also, I read the thread on tips for tapering Olanzapine, and there seems to be no concesus on how to safely do it, from the standpoint of how to measure and meter out cuts. Use a scale, use liquid suspension, etc. No satisfactory

[IanM]

Hello all. I am looking for more advice on how to handle tapering from the various drugs I'm on. Should I taper off the 0.25mg of Klonopin first, or the 2.5mg of Olanzapine? I'm pretty sure the Klonopin is doing nothing for me, so was thinking it should be the first to go. 

 

Any thoughts? And thanks.

[IanM]

It's been a very rough week for me, with massive anxiety being my major symptom, along with DP/DR. I am struggling emotionally/intellectually with making a decision about how much of each of my drugs I should be taking, when I should take them, and how long I should wait before considering a taper.

 

I am very unwell, and haven't worked in over a year and 4 months, and except for a 4.5 kilometer walk every day, accompanied by my wife for a feeling of security, I am basically house-bound. I am extremely agorophobic.

 

I'm starting to think that this is the way I'm going to be forever, and am feeling very hopeless. I am almost out of energy to keep fighting... very dark times.

 

My current drug regimen is as follows (sorry... can't figure out where/how to enter signature info):

 

- 800mg Gabapentin, reduced from 1600mg over the last 1.5 months, a taper schedule OKed by my pharmacist.

- 0.0625mg Klonopin, twice a day. Yesterday, I did take a full 0.5mg as my anxiety got to be too much to handle.

- 2.5mg Olanzapine, but as of today, I am bumping it up to 5mg, and am going to hold for several months (although I am very frightened to do this, as all the reading about these drugs makes be terrified of them, and it's hard to resist the urge to cold-turkeyed ALL of it).

 

Feeling very tire and lonely, and the weight of a long, slow 10% taper off three drugs seems very overwhelming. I just want my life back.

[IanM]

Hi all.

 

In an act of sheer desparation, I decided to take what I thought was a small dose of mirtazapine last night for sleep -- 7.5mg -- and while it did knock me out for about 8 hours, I woke up with the deepest, darkest despair I have ever felt, and it has stuck with me all day. Does anyone know why this might happen? An interaction with Lamotrigine perhaps? I did an interaction search for all the drugs I'm on, and nothing significant showed up.

 

I hope others are progressing favourably with their tapers.

[ChessieCat]

24 minutes ago, IanM said:

 

Hello erer. So glad to read your story, as mine parallels yours almost exactly. I have been on various doses of Olanzapine for over a year, and am currently at 2.5mg for the last three months or so. I am deeply agorophobic and have been pretty much completely housebound for almost a year. And the 'head' aspect of being on the drug continues to threaten my life... deep, dark depression on a level that words cannot properly describe, along with bouts of horrible rage that take every ounce of my soul to control.

I would really like to hear more of your story, and what symtoms you had and how you coped with them. I'm feeling hopeless and desperate at the moment, and looking for hopeful lifelines.

Thanks.

Edit: could you provide more details about your taper, like how much your drops were and how frequently? 

 

I've moved your question to erer to her intro topic which you can find here:  erer-ct-from-cymbalta-and-in-trouble-with-zyprexa-diazepam-and-valdoxan

[IanM]

I'm down to 2.0mg of Olanzapine, and my situation continues to be terrifyingly bleak. I am getting no relief from the 'head' symptoms, which continue to make me afraid to even exist. I can't believe what is happening to me. I am firmly locked in my mind with no way to escape myself. I am deeply agorophobic, and spend minute after minute, hour after hour, day after day laid up on my couch, and it's been that way for the better part of a year and a half. I don't know how to survive anymore... perhaps I will increase my Olanzapine.

My wife has been amazingly supportive, but she is becoming extremely exhausted...I don't want to do this to her anymore.

Can someone please off words of encouragement?

[ChessieCat]

Hi Ian,

 

Here is the link to the drug signature:  Account Settings – Create or Edit a signature

 

It would be more helpful if you could provide details for the last 2 years of the dates, drugs and doses so we can see the changes at a glance.  Thank you.

 

Example:

 

Gabapentin - date & dose, date & dose, date & dose

Olanzapine - date & dose, date & dose, date & dose

Lamatrigine - date & dose, date & dose, date & dose

Klonopin - date & dose, date & dose, date & dose

Lithium - date & dose, date & dose, date & dose

 

[ChessieCat]

Have you been keeping daily notes on paper?  If you have please provide the most recent of these as a post here in your Intro topic.

 

If you haven't, please start taking them so the mods can assess your situation.  Please include supplements.  This is an example of the format:

 

6 a.m. Woke and vomited
8 a.m. Took 2.5mg Lexapro
10 a.m. Had diarrhea
10:30 a.m. Ate breakfast
11:35 a.m. Got a headache, lasted one hour
12:35 p.m. Ate lunch
4 p.m. Stomachache
5 p.m. Took 2.5mg Lexapro
6 p.m. Ate dinner
9:20 p.m. Headache
10:00 p.m. Took 50mg Seroquel
10:20 p.m. Headache got worse
10:30 p.m. Fell asleep
2:30 a.m. Woke, took 3mg Ambien (NOT "took 1/2 tablet Ambien")
2:45 a.m. Fell asleep
4:30 a.m. Woke with headache

[IanM]

2 hours ago, ChessieCat said:

Hi Ian,

 

Here is the link to the drug signature:  Account Settings – Create or Edit a signature

 

It would be more helpful if you could provide details for the last 2 years of the dates, drugs and doses so we can see the changes at a glance.  Thank you.

 

Example:

 

Gabapentin - date & dose, date & dose, date & dose

Olanzapine - date & dose, date & dose, date & dose

Lamatrigine - date & dose, date & dose, date & dose

Klonopin - date & dose, date & dose, date & dose

Lithium - date & dose, date & dose, date & dose

 

 

Hi ChessieCat. I have updated my signature to the best of my ability...my record-keeping has not been great, and only goes back to June of this year, even though I've been taking most of the listed drugs for well over a year. Also, I started journaling in July, but the net sum of the 300 some-odd pages amounts to nothing more than repeat entries affirming how deathly ill I am, so there's nothing useful there to report on.

 

Edit: I take gabapentin, klonopin and olanzapine at 8am, and gabapentin, klonopin and lamotrigine at 5pm. No rhyme or reason for the times.

 

Edit 2: I should also add that I have never been stable on any combination of drugs, just varying degrees of extreme instability. Sometimes I feel well enough to get out of the house for a walk (always accompanied by my wife), but most of the time my mind is so 'wrong' I am terrified to go outdoors. 

[IanM]

A third edit to my above post: I have been to psychiatric emergency 6 or 7 times over the last year and 8 months, and on 3 of those visits I was admitted for 2 weeks. But as of my last visit, they told me there was nothing more they could do for me and sent me home with instructions to "eat right and exercise." I have no options for medical assistance any more. I do have a pdoc looking after me, but I see him once every 1.5 months and I often cancel because I'm afraid to go outside.

[ChessieCat]

1.125mg lithium orotate every 3 days for the past 4 months

 

So you are CURRENTLY taking lithium orotate 1 day and missing 2 days?

 

If this dosing schedule is correct, who advised you to take it this way?

 

Did you start taking lithium orotate 4 months ago?  Or were you taking it before that?

 

Edited October 21, 2018 by ChessieCat
added orotate

[IanM]

24 minutes ago, ChessieCat said:

1.125mg lithium orotate every 3 days for the past 4 months

 

So you are CURRENTLY taking lithium orotate 1 day and missing 2 days?

 

If this dosing schedule is correct, who advised you to take it this way?

 

Did you start taking lithium orotate 4 months ago?  Or were you taking it before that?

 

 

Yes, I am currently taking the LO that way, and nobody advised me...I just chose that schedule by myself. I started taking it about 5 months ago at a daily dose of 5mg, but found it made me feel even worse, so cut it way back to the smaller dose every 3 days. I sort of looked at it as a 'maintenance' dose that would give me a 'trace' amount of a trace mineral. I can't imagine it's causing what's happening to me now.

[Altostrata]

Hello, Ian.

 

The lithium orotate is the over-the-counter lithium, correct? The one that's sold as a supplement? Suggest you stop taking it, it might just be confusing things.

 

What times of day do you take your drugs, and their dosages?

 

From your earlier posts, it looks like your day-to-day drug schedule has been somewhat inconsistent, particularly when it comes to the benzo. Your use of Klonopin could be the key to your condition. Those daily notes will be very important in seeing whether your symptoms are caused by Klonopin.

 

Going up and down in dosage of the other drugs could also be a factor.

 

Why did you add lamotrigine? What effect does it have on you?

[IanM]

20 minutes ago, Altostrata said:

Hello, Ian.

 

The lithium orotate is the over-the-counter lithium, correct? The one that's sold as a supplement? Suggest you stop taking it, it might just be confusing things.

 

What times of day do you take your drugs, and their dosages?

 

From your earlier posts, it looks like your day-to-day drug schedule has been somewhat inconsistent, particularly when it comes to the benzo. Your use of Klonopin could be the key to your condition. Those daily notes will be very important in seeing whether your symptoms are caused by Klonopin.

 

Going up and down in dosage of the other drugs could also be a factor.

 

Why did you add lamotrigine? What effect does it have on you?

 

Hi Altostrata,

 

Yes, the lithium is over-the-counter, and I'd be happy to stop taking it.

 

My benzo use has been very stable for some time, as mentioned in my signature. I take 0.0625mg, twice a day, but sometimes extra on bad days, maybe every 4th or 5th day.

It's my olanzapine use that is very erratic, as can also be seen in my signature. 

 

I take gabapentin, klonopin and olanzapine at 8am, and gabapentin, klonopin and lamotrigine at 5pm. No rhyme or reason for the times.

 

I added lamotrigine because I read on this site that it can be helpful during withdrawal. I started at 25mg, but it made my symptoms worse, so I cut it back to 12.5mg, then to 9.75mg. I would love to just CT it at this point, but fear the repercussions.

[Spideygsm]

IanM

 

Just be careful with Benzodiazepines. They’re horrible to get off of too. In my story, I had to do a very rapid taper for health reasons. I tried sleeping pills, diazepam and nothing worked. I don’t recommend trading one addiction for another. Sleeping pills and Benzodiazepines are both very addicting. 

 

I would do whatever you have to do to get off Zyprexa. I highly recommend a slow taper without adding drugs. I have yet to read about any easy way to quit Zyprexa. The safest way is a slow taper.  Lots of water and exercise 

 

Good luck

[IanM]

15 minutes ago, Spideygsm said:

IanM

 

Just be careful with Benzodiazepines. They’re horrible to get off of too. In my story, I had to do a very rapid taper for health reasons. I tried sleeping pills, diazepam and nothing worked. I don’t recommend trading one addiction for another. Sleeping pills and Benzodiazepines are both very addicting. 

 

I would do whatever you have to do to get off Zyprexa. I highly recommend a slow taper without adding drugs. I have yet to read about any easy way to quit Zyprexa. The safest way is a slow taper.  Lots of water and exercise 

 

Good luck

 

Thanks Spideygsm. I am already on a low dose of a benzo (I'm taking 1/4 of the full dose I was prescribed), and have been for many months (eight, maybe?), so all I would do is up my benzo intake to my prescribed amount, but only if I need it.

 

I know that a slow taper is recommended, but I am desperate and hopeless enough at this point to try a fast taper. 

[Spideygsm]

IanM

 

I’m not a Dr so I can’t tell you the correct medical thing to do. However, I’ve been on mental health drugs for a very very long time and I do have experience stopping and starting drugs. 

 

It’s gonna royally suck getting off Zyprexa to put it bluntly. If there was a magic bullet to make it easy, it would be prescribed and reported all over the Internet. SA would probably let people know what that magic bullet is. However, there is none. The least painful way is a slow taper as recommended by SA.

[Altostrata]

We need to see a daily report of what times of day you take your drugs, their dosages, and symptoms in between.

 

Taking any drug inconsistently can lead to symptoms. Never skip doses of olanzapine. Let's unravel this, it could resolve much of your discomfort.

 

What were the adverse effects you got from 25mg lamotrigine? What happened when you reduced it? What time of day do you take it?

[IanM]

42 minutes ago, Altostrata said:

We need to see a daily report of what times of day you take your drugs, their dosages, and symptoms in between.

 

Taking any drug inconsistently can lead to symptoms. Never skip doses of olanzapine. Let's unravel this, it could resolve much of your discomfort.

 

What were the adverse effects you got from 25mg lamotrigine? What happened when you reduced it? What time of day do you take it?

 

Hi Alto,

 

Forgive me if I sound rude, but I have already provided doses and times twice, but here they are again:

 

8am

- olanzapine, dosage all over the place, but as of today, 2.5mg

- gabapentin 100mg

- klonopin 0.0625mg

 

5pm

- gabapentin 100mg

- klonopin 0.0625mg

- lamotrigine 9.375mg

 

I feel suicidally ill all day and all night, but always gets worse as the day progresses...taking the drugs doesn't seem to change that.

 

The lamotrigine made my brain feel even worse than normal...sort of made me feel like I was losing control of my thought processes. It's very hard to explain, and very frightening. SSRIs do the same thing to me and they are also intolerable.

 

Thinking back now, my severe downturn began when I started taking the lamotrigine at the beginning of August. I was very unwell before that, but my severe unwellness really started to ramp up in August. I think I should get off lamotrigine before anything else.

 

Perhaps lamotrigine is interacting with one of my other drugs, or combination of drugs, and making me suicidal. Or maybe it's bad all by itself.

Edited October 21, 2018 by IanM
More detail.

[IanM]

53 minutes ago, Spideygsm said:

IanM

 

I’m not a Dr so I can’t tell you the correct medical thing to do. However, I’ve been on mental health drugs for a very very long time and I do have experience stopping and starting drugs. 

 

It’s gonna royally suck getting off Zyprexa to put it bluntly. If there was a magic bullet to make it easy, it would be prescribed and reported all over the Internet. SA would probably let people know what that magic bullet is. However, there is none. The least painful way is a slow taper as recommended by SA.

 

I really don't know how I'm going to proceed.

[ChessieCat]

52 minutes ago, Altostrata said:

We need to see a daily report of what times of day you take your drugs, their dosages, and symptoms in between.

 

This is the format that Alto is requesting:

 

We need a daily record of your symptoms, when you take your drugs, and their dosages. This includes anything you're taking "as needed." It is best presented as a simple list, with time on the left and notation on the right, one item per line.

 

Please also add sleep.

[Shep]

Ian, this is an example of what is needed:

 

On 9/27/2016 at 2:49 PM, Altostrata said:

 A diary, in chronological order, such as:
 
6 a.m. Woke and vomited
8 a.m. Took 2.5mg Lexapro
10 a.m. Had diarrhea
10:30 a.m. Ate breakfast
11:35 a.m. Got a headache, lasted one hour
12:35 p.m. Ate lunch
4 p.m. Stomachache
5 p.m. Took 2.5mg Lexapro
6 p.m. Ate dinner
9:20 p.m. Headache
10:00 p.m. Took 50mg Seroquel
10:20 p.m. Headache got worse
10:30 p.m. Fell asleep
2:30 a.m. Woke, took 3mg Ambien (NOT "took 1/2 tablet Ambien")
2:45 a.m. Fell asleep
4:30 a.m. Woke with headache

 

This will allow is to see your symptoms in context with when you take your drugs. 

 

As you post this over the coming days, we can better guide you in a taper plan. 

[IanM]

40 minutes ago, ChessieCat said:

 

This is the format that Alto is requesting:

 

We need a daily record of your symptoms, when you take your drugs, and their dosages. This includes anything you're taking "as needed." It is best presented as a simple list, with time on the left and notation on the right, one item per line.

 

Please also add sleep.

 

Hi CC,

I don't have a daily record in a format you've described, but I can give an example from yesterday that is more or less representative of all days prior, for at least three months:

 

10pm - in bed, brain seriously malfunctioning*.

11pm - asleep.

2am - jolt awake with severe body anxiety, all muscles in my arms and back are 'on fire', feel like they're burning. Brain malfunctioning.

- Take 0.5mg melatonin, but only sometimes. May practice Prana Breathing.

3:30am - asleep again, but not fully asleep.

5am - jolt awake with severe body anxiety, all muscles in my arms and back are 'on fire', feel like they're burning. Brain malfunctioning.

- Practice Prana Breathing in bed, little help.

8am - 2.5mg olanzapine, 100mg gabapentin, 0.0625mg klonopin. Once every 5 days or so, I may take 0.125mg of klonopin.

10am - breakfast.

- the rest of the day is spent on the couch or in bed. I may get sharp pains in my temples, so I take one extra strength Tylenol.

- Brain dysfunction continues all day, but gets worse and worse.

1pm - lunch, maybe.

5pm - 9.375mg lamotrigine, 100mg gabapentin, 0.0625mg klonopin.

6pm - dinner.

- for the rest of the evening, my brain gets worse and worse, to the point of extreme suicidality.

 

This routine repeats day after day, with little to no variation.

 

*I can't really describe my brain dysfunction, but let's just say it's severe DP/DR, and an inability to control my thoughts without extreme effort.

[Altostrata]

Please take melatonin when you go to bed rather than 2 a.m.

 

When you take all those drugs at 5 p.m., do they make you sleepy? How do you feel between 5 p.m. and 10 p.m.?

 

Your drug interaction report does not show any interactions with lamotrigine. However, 25mg lamotrigine was too much for you, and made you feel worse. How have your symptoms changed since you reduced to 9.375mg? (Please note we suggest trying lamotrigine at 2mg or less, not 25mg.)

 

Any of your drugs can cause the symptoms you describe. While you had a bad reaction to lamotrigine, I don't think it's the bad guy.

 

I think just about anyone would feel pretty horrible taking olanzapine, Klonopin, gabapentin, and lamotrigine like you are. Those are 4 brakes, your poor nervous system is feeling crushed.

 

What effect does the gabapentin have on you? What symptoms were you trying to resolve by taking all these drugs?

 

Please keep all your dosing very regular. Take the same amounts at the same times each day. Those daily notes are crucial.

 

@Shep what do you think of Ian's taking the Klonopin 12 hours apart?

[Shep]

 

On 5/21/2018 at 4:21 PM, IanM said:

As noted, I am now back on 5mg of Olanzapine. I'm not sure what time of day I should take it, but for today I took it at 10am. I also take 0.125mg of Klonopin at 8am and 5pm (but today I took 0.5mg of Klonopin at the same time I took the 5mg of Olanzapine). I also take 400mg of gabapentin, four times a day.

 

Ian, please let us know:

• when did you reduce the Klonopin from .125 mg twice a day to .0625 mg twice a day? 
   
• when did you reduce the gabapentin from from 400 mg taken 4 times a day to 100 mg taken twice a day? 

 

1 minute ago, Altostrata said:

@Shep what do you think of Ian's taking the Klonopin 12 hours apart?

 

Yes, I think better spacing may help. Also, depending on when the reductions were made from .125 mg Klonopin taken twice a day to .0625 mg taken twice a day, a small updose may help and eliminate the need for so many periodic rescue doses. 

 

But an updose would only be appropriate if the reductions were made within the past month. This is why it's important to know the dates for these decreases, as much as you're able to provide. 

 

5 minutes ago, Altostrata said:

I think just about anyone would feel pretty horrible taking olanzapine, Klonopin, gabapentin, and lamotrigine like you are. Those are 4 brakes, your poor nervous system is feeling crushed.

 

Ian, it may help to read the first post in this thread, as it explains what Alto means by "brakes":

 

Taking multiple psych drugs? Which drug to taper first?

 

When you are on a lot of sedating drugs, or "brakes", it dampens down your nervous system. And then your nervous system fights back to stay awake. This is probably what is causing you to jolt awake in the middle of the night.

 

As you keep providing daily drug and symptom journal notes, we can help tweak your dosing schedule to decrease these kinds of awakenings. 

 

[IanM]

23 minutes ago, Altostrata said:

Please take melatonin when you go to bed rather than 2 a.m.

 

When you take all those drugs at 5 p.m., do they make you sleepy? How do you feel between 5 p.m. and 10 p.m.?

 

Your drug interaction report does not show any interactions with lamotrigine. However, 25mg lamotrigine was too much for you, and made you feel worse. How have your symptoms changed since you reduced to 9.375mg? (Please note we suggest trying lamotrigine at 2mg or less, not 25mg.)

 

Any of your drugs can cause the symptoms you describe. While you had a bad reaction to lamotrigine, I don't think it's the bad guy.

 

I think just about anyone would feel pretty horrible taking olanzapine, Klonopin, gabapentin, and lamotrigine like you are. Those are 4 brakes, your poor nervous system is feeling crushed.

 

What effect does the gabapentin have on you? What symptoms were you trying to resolve by taking all these drugs?

 

Please keep all your dosing very regular. Take the same amounts at the same times each day. Those daily notes are crucial.

 

@Shep what do you think of Ian's taking the Klonopin 12 hours apart?

 

As noted in my previous post, I get worse as the day goes on, seemingly unrelated to drug times. I don't think the 5pm drugs make me tired, but I can't say for sure because I am so wrecked and exhausted from surviving the day. And I just get worse as the evening progresses.

 

I have, by my recollection, gone seriously downhill after starting lamotrigine, regardless of the dose. There was one 24 hour period maybe 3 weeks ago where I went from 12.5mg of lamotrigine to 6.25 mg, and ended up with a depression that was terrifying...I barely survived it. I immediately went to 9.375mg and have been there since.

 

The gabapentin is supposed to be for anxiety, and I was on 3600mg at one point before I quickly tapered down to 200mg (over a two month period, about 6 months ago).

 

There is no real reasoning behind the choice of drugs I'm on, but I started this whole mess with a complete mental and emotional breakdown, the likes of which I doubt doctors have seen before, and they didn't understand what I was describing to them. I'm too exhausted to repeat the story, as I've done so to probably 8 psychiatrists already. I did give a brief description in the first post of my intro thread.

 

Not much help to you, I realize, but it's all I've got in me ATM.

 

Edited October 21, 2018 by IanM
More detail.

[IanM]

25 minutes ago, Shep said:

 

 

Ian, please let us know:

• when did you reduce the Klonopin from .125 mg twice a day to .0625 mg twice a day? 
   
• when did you reduce the gabapentin from from 400 mg taken 4 times a day to 100 mg taken twice a day? 

 

 

Yes, I think better spacing may help. Also, depending on when the reductions were made from .125 mg Klonopin taken twice a day to .0625 mg taken twice a day, a small updose may help and eliminate the need for so many periodic rescue doses. 

 

But an updose would only be appropriate if the reductions were made within the past month. This is why it's important to know the dates for these decreases, as much as you're able to provide. 

 

 

Ian, it may help to read the first post in this thread, as it explains what Alto means by "brakes":

 

Taking multiple psych drugs? Which drug to taper first?

 

When you are on a lot of sedating drugs, or "brakes", it dampens down your nervous system. And then your nervous system fights back to stay awake. This is probably what is causing you to jolt awake in the middle of the night.

 

As you keep providing daily drug and symptom journal notes, we can help tweak your dosing schedule to decrease these kinds of awakenings. 

 

 

Hi shep.

 

I'm not sure of dates, but I'm pretty sure i reduced the klonopin at the beginning of June, and started a super fast taper of gabapentin in march, ending at 200mg on August 8. It's all a blur, but I did start making records at the start of June, and at that point I was on 0.0625mg klonopin twice a day, and 100mg gabapentin twice a day.

Edited October 21, 2018 by IanM
Wrong info