Working withdrawal, Suelyn

[suelyn]

I am a week into stopping Wellburtrin cold turkey. The pdoc said that I should not have much trouble and if I did to call. Well 2 days into it the headaches started followed by the muscle/joint pain. On top of everything I have to work full time, which I have been leaving eary the last few days because of feeling bad. Now a little history as to why I am where I am. I have PTSD, MDD and chronic pain from degenerative disks throughout my spine. All of which was made worse 15 years ago when I suffered TBI after being kicked in the head by a horse. I currently take Abilfy15mg, Adderall 30mg X3 day, Effexor XR 150X3 day, Trazadone 50mg, Nuvigal 250mg, Xyrem 9gm and several meds for asthma. I shoud also mention that I have Narcolepsy. So that is the short simple side of my story, if I have missed anything let me know and I will fill in where I need to. For the most part I think I just need a place where people know what I am going through and can give me feed back and support. Suelyn

[Nadia]

Wow! That is one huge drug cocktail! It must make it difficult to know where one side effects ends and another begins, or what is helping or hurting.

 

Welcome to the forum!

[Altostrata]

Welcome to our community, Suelyn.

 

Given your chronic pain situation and excessive medication burden, sudden changes in medication might cause unpredictable reactions.

 

What dosage of Wellbutrin were you on, and what type?

 

To relieve withdrawal symptoms, you might go back on a half-dose and taper more slowly from there.

 

Has any doctor reviewed all your medications to see if any are interacting? This could be causing symptoms misdiagnosed as MDD, ADD, etc.

 

Given all those psychiatric medications, I strongly suggest you get a second opinion about your entire medication schedule.

[suelyn]

The pdoc that has me stopping the Wellburtrin sr 300mg is my second opinion. The pdoc I was seeing prior is the one who kept adding meds on. When one med wouldn't work he would increase it or add another. After 9 years of seeing him (why it took so long I don't know) I started questioning him as to how many I was taking. He got upset with me and acted like I had no right to question him. Well that was the last time I saw him. A friend suggested a new pdoc that he had heard of and that is who I am seeing now. This new pdoc is totally different, my appts last at least 1/2hour where with the old pdoc I was lucky to get 5min. This guy really seems interested in how I do, he even keeps in contact with my gp and my narcolepsy doc. It was my gp that first became worried about all the meds and that is why I started questioning the first pdoc. As for the mdd I have aways had trouble with depression and the stimulates are for the narcolepsy not add.

[Altostrata]

You can cut tablets of Wellbutrin SR in half and it still retains the SR quality.

 

I suggest you take a half-dose and see if the new pain is relieved. Stay on it for 2 weeks, then take a quarter dose for 2 weeks, then quit.

 

I am relieved to hear your new psychiatrist is conscientious. You should report the old one to your state medical board.

 

What is the next drug you're going to discontinue, Suelyn?

 

I'm not a doctor, but in my humble opinion the Abilify, Effexor, and Trazodone are questionable. What's the trazodone supposed to be doing for you? You're already taking antidepressants and sleeping medication. Effexor is stimulating, but you're taking Adderall for that. Abilify is vastly oversold.

 

The more drugs you take, the more likely they are interacting in ways that are not good for you. And the asthma drugs participate in this, too.

[suelyn]

The effexor is next on the hit list, my pdoc says as soon as things level out from the Wellburtrin he wants to take me down 37.5mg per month until I can get off the effexor. Of course that's providing the depression does not get in the way. After that the abilify will be next, as for the Trazadone I take that at night with the xyrem for sleep. I know its crazy but just taking xyrem does not make me sleep at night. I am careful not to take any stimulates after 2p not even caffeine and still my sleep is not right.

[Altostrata]

Suggest you discontinue caffeine altogether. It can have a very long half-life.

 

I find it incredible that you're taking 150mg Effexor XR THREE times a day. That's an excessive dosage of any kind of Effexor, and this type is extended-release. It's a noradrenergic -- stimulating. Do you think that might be affecting your sleep?

 

Note http://www.drugs.com/pro/effexor.html

In outpatient settings there was no evidence of usefulness of doses greater than 225 mg/day for moderately depressed patients, but more severely depressed inpatients responded to a mean dose of 350 mg/day. Certain patients, including more severely depressed patients, may therefore respond more to higher doses, up to a maximum of 375 mg/day, generally in three divided doses (see PRECAUTIONS, General, Use in Patients with Concomitant Illness).

Usually, with concomitant illness or multiple medications, dosage is lower.

 

See Tips for tapering off Effexor and Effexor XR (venlafaxine)

 

Since it seems you're feeling withdrawal effects from Wellbutrin, I suggest you be very cautious about reducing Effexor -- stick to the 10% guideline -- and reduce the evening dose first. At your current dosage of 450mg (!!!!) a day, a reduction of 37.5mg per month is 10% or less for the first 3 reductions, then it progressively becomes a larger and larger percentage reduction.

 

As you reduce dosage, you want to maintain a dosage reduction of 10% or less of the last dosage. When you hit 337.5mg, you will want to reduce by 10% or 33.75mg.

 

You can get specially weighed capsules made up by a compounding pharmacy.

[suelyn]

Yor advice makes a lot of sense, I will need to call the pdoc in the am because I am out of Wellburtrin. Then I will start spllitting them in half, hopefully that will help. With the effexor I take it once a day in the am.

Also I don't know if the effexor interferes with my sleep. I have taken it for so long its hard to tell, all I know for sure is that I am tired all the time even with all the meds.

My biggest fear is that my depression will become worse again. As it is now some days it takes everything i've got just to make it through the work day. I cant miss work because I am a single mom and barley make it check to check. Thank you for listening to my complaints its hard to find anyone who has a clue.

[Altostrata]

How much Effexor XR are you taking each day?

[suelyn]

I take 450mg effexor xr every am

[suelyn]

W.hen I saw my Chiropractor today & he suggested a supplement called 5-HTP. He said to run it by my pdoc first of course. But he said from what he read about antidepressant withdrawl it might help. I was wondering if anyone had ever heard of it or used it.

[bubbles]

Suelyn, there is a thread on 5-htp, which I've just found. It was also suggested to me: http://survivingantidepressants.org/index.php?/topic/656-5-htp-5-hydroxytryptophan/page__pid__18305#entry18305

 

Bubbles

[suelyn]

Thanks Bubbles I will check it out, I'm working 3rd tonight and I will have some time to kill.

[Barbarannamated]

Hi Suelyn~

You've been thru alot and„as a horse person„ I'm stunned just thinking about getting kicked in the head by one ~WOW~ im speechless

What treatment or changes in treatment happened as a result of that ~

I dont know much about TBI but understand it could manifest in many ways -

Ive only learned a bit about narcolepsy recently and gather it's a frequently missed diagnosis -glad to learn that yours was recognized -

Regarding the 5HTP„ I would be extremely cautious about adding anything in especially because 5HTP is related to serotonin and you are already on a very high dose of Effexor plus trazodone which is serotonergic -

 

I just wanted to pop in and day hi and offer my support -

 

Barb

[suelyn]

Hi Barb and thank you, getting kicked really did change my life. I went from being someone who could and would stand up to anyone who crossed me. To a person who avoids confrontation as much as possible. As far as dealing with depression I could handle it before I got kicked. But over time afterwards it just to the point where I could hardly get out of bed. I couldn't think enough to go about daily llife much less take care of 2 young girls. So that's when I started with the meds, nothing seems to work for long. Even now with all I take now I still have a lot of depression, some days I am not sure if I'll make it.

[Barbarannamated]

I cant imagine …im so sorry for what you've been through and how profoundly it's changed your life - I would never claim to understand your journey although I do have many times of feeling that I'm not going to make it - a feeling of defeat -

 

Hang in there - I have a feeling when you get your dose down on some or the meds you'll feel better - not that there wont be tough days along the way as you already know -

B

[suelyn]

Thanks for the encouragement it really helps, anyway I should probability get back to work even if I don't want to. 3rd shifts are hard the first 2 hours is busy then 4 hours of not much to do followed by 2 hours of really busy. Hope to keep in touch, suelyn

[Dani]

Welcome to the forum. You will find lots of help & support here!

[Altostrata]

Suelyn, I second Barb's caution. 5-HTP should not be used with any serotonergic, such as Effexor.

 

Your chiro is well-intentioned but like most health professionals, knows nothing about withdrawal.

[Rhiannon]

Just want to add a couple of things::

 

When I was on multiple meds my depression and suicidality were much worse than they are now after tapering them down (very slowly). You may find that getting down to lower med doses, if you do it slowly, actually improves your depression rather than making it worse. These drugs mess with our body chemistry in ways that aren't really direct and predictable and they can often have the opposite effect at higher doses.

 

Please, please take this all very slowly. You're doing shift work which is stressful in itself (I do it too so I know!). You have a small child who needs you to be stable. You have a history of TBI which can have all sorts of effects that most people don't even know about, on various aspects of your body and endocrine system and other things. You're on a large and complex cocktail of high doses.

 

And you don't yet have much experience with how your system is going to respond to this whole withdrawal thing.

 

Please, please go very very slowly and conservatively, at least at first, until you have more experience with the withdrawal process and you know what you can handle.

 

Don't even consider starting another taper until you've stabilized from quitting Wellbutrin, which could take many months. CT off 300 mg is not a great idea and I highly recommend going back up to at least 150 and then tapering down (personally if it were me, given your circumstances, I would go up to 250, stabilize, and then begin a slow taper). With psych drug withdrawal the worst of the withdrawal usually doesn't kick in right away; there's a lag time effect. With ADs it can be months.

 

I hope this doesn't sound discouraging. Given the extreme number of meds you're on and the doses you're on, it's important to be safe and careful, but you will undoubtedly be healthier on lower doses. Please do continue the process of getting off the meds, or at least reducing to a more reasonable and safe regimen. It's probably going to take a few years all together but it will be SO worth it, I promise! and your daughter will get her mother back.

[suelyn]

Hi Rhi, I think I confused things a little my girls were little when the meds all started. They are now 22 and 16, my oldest now lives on her own and my 16 yr old lives with me.

I will definitely take your advice and go slow, the pdoc and I figured about 2 years give or take. I am thankful for finding this site, I have learned alot in just the few days I have been here. The support is great as there is no one around me that I could share this all with.

 

As for work I love what I do but you are right it is stressful. While I only work a couple of 3rds a month I average 48 hours a week. Then from April thru December I work a second job teaching horseback riding to disabled kids and adults. Because of this it is very important for me to do this right. I need to be able to be there for those who depend on me and right now I am having trouble doing this.

[suelyn]

Wow I'm glad I listened to Rhi and everyone here about the Wellburtrin. I called my pdoc and asked for a Rx for Wellburtrin 150mg. I woke uup last night with one of the worst headaches I've ever had and I was super sick on top of it. It was so bad that it was all I could do to call work and tell them I was not going to make it in the am. There is a bug going around the residents at work which is similar but without the headache. Also I was very restless which also makes me think it could have been withdrawl. So I was up all night again and my head still hurts to bad to go to sleep. All I can say is this sucks and its going to be a long 2 years.

[Barbarannamated]

Wow I'm glad I listened to Rhi and everyone here about the Wellburtrin. I called my pdoc and asked for a Rx for Wellburtrin 150mg. I woke uup last night with one of the worst headaches I've ever had and I was super sick on top of it. It was so bad that it was all I could do to call work and tell them I was not going to make it in the am. There is a bug going around the residents at work which is similar but without the headache. Also I was very restless which also makes me think it could have been withdrawl. So I was up all night again and my head still hurts to bad to go to sleep. All I can say is this sucks and its going to be a long 2 years.

 

Suelyn,

Feel better soon!

Just fyi...many of us have found that we're much more sensitive to meds, supps, foods, so if you take any OTC products, try a small dose first.

Do you work with Residents of the MD-in-training variety or Skilled Nursing Facility residents? (just curious-no intention to be nosy)

 

Perhaps when you're feeling better, you could tell more about the work you do with horses. That's AWESOME! Ive wanted to get involved in Equine Assisted Psychotherapy or Hippotherapy (I may be using terms incorrectly), but it fell to the 'cannot put plan into action' pile. Big pile.

 

You are INSPIRING!

B

[suelyn]

Hi B,

your not being nosy, I shoud have been a more clear. I work at a group home for developmentaly disabled adults. There are 16 residents at the home, 8 ladys and 8 men. I have worked there for over 10 yrs and love my job. Also I have a good working relationship with my boss, who is also a mental health counseler. The nice thing about this is he understands when depression gets the better of me. He has turned me on to a really good counseler and also recommended the pdoc I am now seeing. Anyway I tend to run on about my life and am sorry.

 

The last 2 days have been bad and I now think what is going on is a combo of both. Whats going around at work and withdrawl. I have the gastro illness they have at work plus headaches worse than I can ever remember. I have read that withdrawl can cause gastro illness, but the bug at work ony lasts about 48 hours. While the stomach stuff is just about gone the headaches are not. Its taking a lot of excederin just to knock down the pain enough to be able to get out of bed. I know I need to be careful about how much otc pain meds I take. But I am desperate and don't handle headaches well.

 

Thank you for your kind words, I don't know about being an inspiration but I have a lot of fun doing what I do.

[suelyn]

Welcome to the forum. You will find lots of help & support here!

 

Thanks Dani I am really happy that I landed here when I was looking for help

[suelyn]

Ok I have another question, I am still having real bad headaches. Yesterday when I saw my sleep doc my blood pressure was high at least for me. That got me thinking maybe the headaches were from high blood pressure. So at work today I took it again and it was still high, so I had a coworker take it manually and its still high. So my question is has anyone heard of Wellburtrin withdrawl causing high blood pressure? I guess I should say that my B/P normally runs low averaged 100/68 and now its running averaged 140/94.

If anyone has heard of this please let me know, as I could not find anything about withdrawl and B/P on the web. Thanks, suelyn

[Barbarannamated]

Yes - very common but not documented in medical lit or prescribing info - I had both elevated BP and heart rate - ran very low prior to tapering ~

The dysautonomia can effect every body system -

I'll try to find threads with suggestions -

Aspirin coated with magnesium was helpful for me (Bufferin is one) but caution w/sensitive stomach --

 

Just wanted to give you that little bit of info - more to come -

[suelyn]

Thanks Barb, I know your not feeling to good right now so extra thanks for taking the time to share the info. Suelyn

[Altostrata]

I had high blood pressure in withdrawal; before mine was quite normal.

 

Suelyn, have you tried taking the 150mg Wellbutrin? It might help the headaches, etc.

[suelyn]

Yes I did start the 150 Wellburtrin 2 days ago (I think) but maybe that's still to big a drop. I don't know how long before I find out, but being as its Friday I guess it will be ok till Monday. When I can take my B/P again or my headaches go away. I do have blood pressure meds that I took for a while to help with an irregular heartbeat. It did not help with that but maybe it would help now. I would be afraid to try it with out first talking to my gp. Suelyn

[suelyn]

Ok so night before last I got desperate, my head hurt so bad I could not stand it. Nothing worked not Excedrin, not ice, not even imetrix. So after about 45min of my head pounding I took a bystolic 5mg and within 20min. The pain started to go away and I was able to go back to sleep. When I woke up my head barely hurt and as the day went on I forgot about it. Last night it started to hurt again but I took 2 Excedrin and that gave me enough relief to go back to sleep till I had to get up @ 2:45a to take my daughter to the airport. My head hurts now but its manageable and I can deal with it like this. Suelyn

[Barbarannamated]

Suelyn~

I had to look up Bystolic - hadn't heard of that beta blocker - glad to hear it worked for you ~

I have hx of headaches and have taken just about everything but beta blockers (opiates„triptans„TCAs„Neurontin…)- in retrospect it *seems* like beta blockers at low dose may be most benign/least harmful especially if taken prn -

I think that 'Whatever mentioned low dose propanolol for headache-

 

Just FYI -we got about 3" of snow in SoCal last nite - horses were romping all nite

[suelyn]

Sounds awesome, I miss having horses in my backyard. I lived on a small horse ranch in a little town call Pheland when I lived in So Cal. We would get 5-7 in total snow for the whole winter, now where I live its more like 5-7 in per storm. Suelyn

[suelyn]

ExcedrinWell another bad week, I went back to 300mg of Wellburtrin on Wednesday because Tuesday was awful. My head hurt so bad I couldn't think or move on top of that I had the shakes so bad I couldn't dial the phone. I took Excedrin, Advil, Tramadol and Naproxen and nothing was helping. It finally calmed down enough that I could call the Dr. He said to go back up to 300mg until for 2 weeks when I would see him again.

 

I am still really shaky, my head hurts and every time I move my head I get dizzy. Feeling like this makes everything a challenge especially driving. On top of that the depression is bad, I feel like a loser. I hate the fact that I couldn't handle the withdrawl.

[Barbarannamated]

Suelyn ~

please don't beat yourself up - I wish I had taken things much slower and been more emotionally and physically prepared - if I ever manage to taper off of Klonopin and trazodone I will be far more careful -

I honestly don't see that happening anytime soon or maybe ever -

Pain makes everything so much worse -

Barb