MarianAmber: Tapering off Lamictal after 17 years of psych meds

[MarianAmber]

I’m so glad to have found this site! 

 

I have a long long history of taking psychiatric medications that began when I was 16. I was on Celexa and Wellbutrin for about 15 years. I went cold turkey off of Wellbutrin, which in hindsight, set me up for a major depressive episode months later. I was so scared and desperate to feel better, that I went to a psychiatrist and went back on meds — Latuda and Lamictal.

 

I have been off of Latuda for about a year. I stopped taking Neurontin for sleep about 4 months ago. About two months ago, I slowly began tapering down on my one remaining drug, Lamictal. I’m down to 132.5 from 200 mg.

 

I really, really am determined to live a life free of psych meds. I also really want to get pregnant, and it’s important to me that my baby not have to be exposed to medication and possibly go through withdrawal.

 

I am here to learn from you all, and I am particularly interested in hearing the stories of women like me who tapered in order to get pregnant. I want to be mindful about timing, etc., in order to set myself up for success, and at the same time, feel very eager to begin trying and a little disappointed about having to wait.

 

Oh! And here’s what I have been doing to recover: 

 

— exercise classes 4x week since September 17

— really limited sugar intake (2 desserts a month) since October 17

— really limited alcohol (3-4 drinks a month) since October 17

– acupuncture 3x month since November 17

– energy healing sessions 2x month since March 18

 

[MarianAmber]

I realized, after I had the chance to read more and more posts on here, that I didn't really outline much about my experience with withdrawal and what I'm struggling with so far! 

 

Themes I'm struggling with:

 

I think there are two major, overarching things that have hovered over this whole process for me. In my searching on-line, etc, for answers and guidance, a lot of people talk about a return to normal functioning. It makes me a little sad to say that I feel confused about what my normal level of functioning truly is and what life could truly be like free of medication. I have such a long, long history of depression and anxiety and have at this point been taking psychiatric medications for over half of my life. My first, in earnest memory of being depressed was when I was about 5 or so. I grew up in a house with a lot of physical violence. I think that this, combined with the fact that I was a very sensitive child, led to multiple episodes of depression throughout childhood and adolescence. When I began taking anti-depressants at age 16, it was during my fourth episode of depression. 

 

I really want to become pregnant soon. I am really trying to make a decision about remaining on medication and continuing to taper throughout pregnancy versus tapering quickly for the sake of pregnancy. I have been following a tapering schedule laid out by my psychiatrist (12.5 mg reduction every 1-2 weeks) -- and she did note that this would likely become much harder toward the end. I am wondering about what would be in the best interest of my own mental health as well as the physical and emotional well-being of my baby. I should note that I was, about a year ago, briefly pregnant (pregnancy only went to 6 weeks), and that during this brief time, I felt noticeably more calm and relaxed. That brief taste of pregnancy and how I felt was encouraging to me.

 

Also, I feel so annoyed even taking any medication every morning! I hate taking this medication that I just want to be off of.

 

Withdrawal symptoms:

 

I never connected any of the weird experiences I had before with withdrawal. Psychiatrists have explained to me that I am the profile of a person who likely "needs" to be on medication for the rest of my life (strong family history, early age of onset, multiple episodes of depression) -- most mood swings, dissociative feelings, irritability, lack of energy, etc. that I have experienced prior to this year, I chalked up to my being a "depressed person." I thought that these were all manifestations of a lifelong, chronic condition.

 

A brief history: after being on Celexa and Wellbutrin (various combination amounts that were tinkered with, as well as some time when I was just on Celexa or just on Wellbutrin) for roughly 15-16 years, I stopped taking Wellbutrin when I basically began skipping doses and halving doses with no schedule or assistance. This was between October and December of 2015. I first noticed that I would become incredibly reactive, angry, and flooded with irritability and anxiety on an intermittent basis beginning around December. In hindsight, it seems so clear, but I honestly didn't connect this to withdrawal at the time. I thought it was the re-emergence of what the medication must have been treating all along, and I decided to try to "deal with" these issues on my own (therapy, etc.)

 

Beginning in June of 2016, I noticed increasing irritability, anger, and dull sadness. My concentration was shot. I would feel very anxious socially, and just walking around the city. My startle response was extremely exaggerated. Finally, in October of 2016, at my therapist's strong recommendation, I went back to a psychiatrist. This psychiatrist prescribed me Prozac and this began one of the WORST and most disturbing to me periods of time in my life. I became depressed and hypomanic, alternatively. I experienced a few mixed states. The depressive periods lasted about a week or 10 days and they would be followed by 2-4 days of extreme agitation, restlessness, talking over people, racing thoughts, and panic. My psychiatrist said that this was an unmasking of bipolar disorder. He prescribed me Latuda. This almost immediately (like within 2-3 days) made me feel incredibly calm and muted. At the time, I was so so so grateful to stop spinning through that cycle of ups and downs that was brought on by the Prozac. I stayed on the Latuda from December 2016 to March 2017, at which point I tapered off Latuda and on to Lamictal within a time frame of 4-6 weeks. I was also given Neurontin to help with sleep, that I took on an "as needed" basis.

 

Fast forward to the present. I stopped taking any Neurontin on March 4. I honestly noticed very little change in how I felt. In the beginning of April, I began tapering off of Lamictal. I was on 200 mg a day at the time. My psychiatrist advised me to go down 12.5 mg/every two weeks at first. I did this and felt very dizzy, out of body, and disoriented. I began to experience the "windows and waves" that this site describes. A wave might last anywhere between half a day to 5 days. The windows are...freaking great. I feel clear headed, calm, rational, and able to concentrate. The waves are not so good. I can be really irritable/snap at people, have difficulty concentrating, feel restless, feel apathetic, really not want to be around people, etc. I also jump out of my skin at loud noises and touch. I feel dizzy a good deal of the time, and I dissociate not every day, but many days. I have mostly been barreling through this, hoping to get completely off and become pregnant.

 

Some questions:

 

If I were able to greatly reduce the amount of medication that I'm taking through tapering, and then become pregnant, would it stand to reason that I could minimize any potential effect on my baby?

 

If I were to taper too quickly, it would probably put me at greater risk of postpartum mental health issues, right?

 

How has my brain development been impacted/delayed given how long I've been on medications and that a lot of this was in pretty formative years? Is it possible to catch up? 

 

I've read that Lamictal interferes with folate absorption. Wouldn't that be harmful for a fetus?

 

Are you guys sure there's not way to come off of these medications faster...?  (I'm just kidding, it's so clear you all have been around the block and know what's up. I just wish....)

 

[mammaP]

Hi MarianAmber, welcome to SA.  Sadly we see many many people here who were drugged very early in life, some as very young children. The good news is that people can and do go on to have normal lives. The human brain is a remarkable organ and thanks to neuroplasticity it can grow and regenerate. 

It is good that you are carefully planning to be off drugs before becoming pregnant but you are right to be looking at the possibility of going into withdrawal later.  Coming off fast can mean that your pregnancy will be miserable, or it could be that the pregnancy hormones help you through it. We have seen this before, but we have also seen some in terrible withdrawal while pregnant. No two people are wlike, everyone is different and bodies react differently. Right now, from what you have explained, I would recommend holding the lamictal to let your brain catch up and your nervous system settle down. Every time there is a drug change, or a dose change, your nervous system is rocked and has to settle down again.  This doesn't mean you have to wait years, but possibly a few months. You can listen to your body and know when it is ready to restart tapering again.   Pushing ahead while suffering withdrawal symptoms never goes well in our experience. We recommend tapering no more than 10% of the current dose, with at least 4 weeks between cuts.  

 

We have a topic on tapering while pregnant, I will post a link for you. One of our members emailed Professor David Healey about this and kindly shared his replies with us, I will link to those too.  You obviously want to be in the best health possible to carry your baby, and  give birth to a healthy child. There are no trials during pregnancy, it would be unethical, and doctors will say that there is no evidence that links birth defects or problems, but there is no evidence that says that they are safe.  I know someone personally who got pregnant while taking psych drugs.  It was unplanned.  The GP told her that there is no evidence to link the drugs with problems or defects,  and said it could be more dangerous to the baby if she quit and became depressed. 

 

The obstetrician  said she has to have regular appointments and scans because of the possibilty of problems while taking the drugs, so they are obviously aware if the dangers but no one has told the GPs.  

 

It is a tough call and only you can make it, but we can share our knowledge of tapering and withdrawal.  

 

First, we ask all our members to fill in their signature,  you can find instructions how to do that here.... 

http://survivingantidepressants.org/topic/12364-please-put-your-withdrawal-history-in-your-signature/

 

Tapering lamictal 

http://survivingantidepressants.org/index.php?/topic/1122-tips-for-tapering-off-lamictal-lamotrigine/

 

Tapering in pregnancy, read the link to Davif=d Healeys topic, "Something about Mary" Which covers prescription drugs and pregnancy, it is in the first post. 

http://survivingantidepressants.org/topic/4394-antidepressants-during-pregnancy/

 

This is Pregnog's topic,  the link is the post with the emails from Dr Healey, bear in mind that Pregnog was already pregnant when she joined us. 

 

http://survivingantidepressants.org/topic/7800-pregnog-stopping-escitalopram-in-early-pregnancy-help/?do=findComment&comment=117317

 

 

 

Edited May 22, 2018 by mammaP

[MarianAmber]

Thank you for all the information and encouragement! These links are all so helpful.

[MarianAmber]

I am definitely in a "wave" period of time and today was very rough. From the time I woke up this morning, I felt so incredibly down and have had so little energy. It's hard not to get discouraged and think that this is just a return to the way that I "really" am. 

 

I had been planning with my psychiatrist to go down a dose every week, but I am deciding to hold off on that based on what I've been reading here, but more importantly, what my body is telling me. The fatigue and emptiness that I experienced today was really a lot, and I need to level off. 

 

As hard as today was though, I was able to take myself to the park and read. Reading was hard because I ended up re-reading the same page over and over again. But, it still was something that I could do for myself and it did work to lift me up just a little bit.

[Purplerain]

Hi MarianAmber and welcome to SA. I completely empathise with your position for a number of reasons. I also began my journey with psych drugs in my teens - I was on Prozac for a year between the ages of 15 and 16. I have been on Effexor for nearly a decade in total. I also have no 'normal functioning' to return to, because like you for me there has never been a normal, happy life. I was a depressed and very lonely child; a self-harming, substance-abusing teenager who hated herself. Then I started on Effexor. I have no idea what I am like off these drugs, and it can be confusing and sometimes even scary getting to see new aspects of myself while tapering and thinking "is this what I'm really like? Or is this just a side effect?"

 

I also felt compelled to respond to you as I like you was desperate to get pregnant four years ago. Because of my life circumstances at the time, I chose to remain on Effexor during pregnancy, though I tapered down to a very small dose of just under 10mg. My baby girl is now three and developmentally she is perfect. HOWEVER, I could not breastfeed her due to effexor being present in breastmilk (which in itself was completely devastating) and as a newborn baby, my daughter spent the first few months of her life in extreme discomfort. She would scream and scream for hours every single day for about three months, and there was literally nothing I could do to comfort her. The only time she was content was when she was asleep. She slept through the night from six weeks old because she was so exhausted from being in pain all day. The doctors told me it was colic, and I thought it might be acid reflux as it did seem to be connected to her stomach. In retrospect, with what I know now about withdrawal symptoms and how they affect the gastrointestinal system, there is no doubt in my mind that my baby was in withdrawal. Even from the 'tiny dose' that all of the doctors I saw said would have no affect whatsoever. What you choose to do with this information is up to you, but I had to let you know my experience. Feel free to private message me any time if you wish. Sending love and light xx