Cleerity: clonazepam, alprazolam, aripiprazole & mirtazapine

[Cleerity]

On 10/27/2018 at 10:57 AM, Altostrata said:

Welcome, Cleerity.

 

Good to hear the benzo reduction went well and you're feeling better on a lower dosage.

 

I'd like to get a bit more information about your drug situation as a whole. Why did you choose to reduce the clonazepam first? What was your daily symptom pattern?

 

In what ways has your symptom pattern improved since reducing clonazepam? How are you feeling now?

 

What's with the metformin?

 

What is your daily drug schedule, with times of day and dosages? Do you feel better or worse at any particular times of day?

 

We're not much for diagnoses here, either.

 

Thank you for the welcome, Altostrata.

 

It really was not “my” choice/decision to work first on the clonazepam.  When I told my psychiatrist that I would like to work on coming off the medications, she agreed, and then told me to just take ½ the clonazepam dose. That is how/where I started.  

 

My symptoms before reducing the clonazepam:  I came to realize that I have been “sedated” for years.  I needed strong coffee to jump start me in the morning … I still do, but I am not drinking as much since the reduction.  I developed a lack of interest in life and the things and ideas that motivated me.  My mind has became duller, not as sharp and laser focused like it once was.  I was often lethargic.  I also stopped being able to “feel” the way I used to.  This seemed to increase sometime after the Remeron was added…and then, later, the Abilify.  Despite this, I was able to return to school and completed a Bachelor’s degree with a stellar GPA, though some days I felt like I was moving through mud.

 

My acute withdrawal symptoms with the 50% cut of clonazepam was a little more difficulty getting to sleep a few nights…took me a bit longer to fall into slumber.

 

My peak withdrawal symptoms (days15-21) met me with some irritability, headache (most days), one night of insomnia, a few days of mild depression, some free-floating anxiety…and something I failed to mention in my initial post here was also two occasions of short-lived dizziness.  

 

I felt stable and better than my old self once again as of day 22 and onward. I was more alert and continue to feel more alert, now.  Not hyper-alert, but more awake, with more presence of mind.  Oh, I also became once again aware of my heart center, the feeling and quality of energy there…strong, present, compassionate.  This was something I lost awareness of along the way, consistent with the advent of Remeron and Abilify in my life.  I am glad to have this back!  I’m very interested in rediscovering myself without the medications and am looking forward to the possibilities of the future, instead of feeling apathetic.

 

When I tried to resume tapering the clonazepam at a 25% decrease (which I was spreading over 14 days), my acute symptoms were somewhat similar to the peak symptoms of the 50% decrease in that I was feeling irritable, anxious and sensitive to external stimuli, but there was no constant headache, sleeplessness or dizziness.  I am back up to the .5 mg now and recovering from trying to move at too fast a rate.  

 

How I feel now: The positive gains already mentioned are still present (alertness, looking forward to life, feeling my heart center again).  I am not overly anxious (I think some anxiety is normal in various life circumstances), but I am still somewhat irritable, preferring peace and quiet verses too much external stimuli.  Relaxing music is okay, but nothing rambunctious.  Loud sounds are still bothersome.  I took my granddaughter to the zoo today and found the animals and nature very comforting and soothing to my senses.

 

The Metformin:  I am borderline type II diabetic.  I don’t take as much as prescribed because I don’t need more to keep my blood sugar below the border (A1C of 6.5).  I am only taking one 500 mg pill a day and my A1C, as of last check (about one month ago), was 5.6.  I am tempted to not take it at all.  And I believe that once I am able to eliminate the psychotropic medications, I will not need it.  

 

My daily drug schedule:

 

6:00 AM – 2 mg of Abilify

4:00 PM – 500 mg Metformin

7:30 PM - .5 mg Clonazepam and 15 mg Mirtazapine

 

No more Alprazolam

 

I take the bulk of my supplements in the morning, with the Abilify.

 

I take a second dose of calcium and magnesium along with the Metformin (which is at dinner).

 

I tend to feel about the same all day, except that I have been a bit more tired feeling after my work day for the past week.  It’s maybe worth mentioning that I don’t quite have normal hours, as my work day starts at 6:00 AM, so try to be in bed by 7:30 (on week nights) and wake at 3:30-3:45.  And my work is very demanding, so tends to be stressful.

 

I have probably shared more than I needed to, but was doing my best to answer your questions.  I hope I have.  Thank you.

 

[Cleerity]

1 hour ago, RubyJ said:

I've come to believe that the current system we have where the pharmaceutical companies are the main source of information on their own drugs and doctors just believe everything told to them by the companies is a big problem.

 

Hi Ruby and thanks again for stopping in.  I agree with what you said above.  

 

1 hour ago, RubyJ said:

One thing that was suggested to me when I thought the premixed liquid wasn't available was using a compounding pharmacy.  As I understand, the upside to that route is that you get a solution that is mixed by professionals even if you don't have the script for the retail liquid -- although I'm not sure what kind of script they do require?  They may only need the script for the pills -- but the downside is that it can be quite pricey.  Prescription insurance doesn't always cover things from a compounding pharmacy.  If you have the monetary resources and a compounding pharmacy nearby it would save you the headache of doing your own calculations.  I honestly don't know enough about how it works but since you're going to wait to do the Abilify taper for several weeks, you have time to look into it if you're interested.

 

 

Thanks for mentioning this, but I really feel fine with mixing it myself.

 

1 hour ago, RubyJ said:

It's so hard to wait when you've realized what you need to do -- you want to just do it as soon as possible!

 

Yes, true, especially when I have always been one to tackle any project I set my mind to!  But, I am not in a hurry any longer.  I will heal, in time.

 

1 hour ago, RubyJ said:

I hope you continue to normalize and good luck at your interview next week!

 

Thank you very much.  I do trust that I will stabilize.

 

I haven't looked back to your thread/topic today.  I was wondering how you did/are doing with your next step...  I will have a quick peak there before I head off to bed, to see if you have updated 

 

Best wishes,

 

Cleer

 

[Cleerity]

21 hours ago, Shep said:

This is a blog written by a long time survivor of psychiatric drugs. You may find some of the articles and videos very helpful. Here is her archives for yoga during psychiatric drug withdrawal:

 

Beyond Meds - yoga archives

 

 

At this moment, I am just being a bit chatty.  I went to the website Shep suggested, and as a way of getting to know its hostess, I watched her video, "A Message to Those Labeled by Psychiatry."  At about the 10:20 point in the video, she begins talking about how mental health professionals cannot handle sitting with extreme emotions and end up pushing pills at people so those extreme emotions will go away and the mental health person will not have to deal with them.  That is what happened to me in 2010 & 2012 when the Remeron and Abilify were added!   Sad also that I became conditioned enough to be willing to add these meds, when in years past I rejected offers for additional medications.

 

I always refer to the time I became "ill," as the time I "began healing."  At that time, 2001-2002, it seemed the clonazepam and alprazolam (which, as I said, I never took frequently) did not do anything for me.  My emotions were raw.  I have described the weeping in the early years of my healing as being like I was pulling up grief from the bowels of the earth.  

 

As I child, I was naturally very contemplative and wanted to understand the reason for suffering in the world - the suffering in my home (which included all of sexual, physical and emotional abuse, all of which also = spiritual abuse).  I turned to deep introspection/contemplation on the matter of suffering.  It was like I was searching the universe for love.  Where was it?  I wanted to know.  I was very empathic and also naturally attuned to the spiritual world and had profound, otherworldly experiences.  These experiences were amplified when I hit puberty and a day came when I prayed fervently that they go away.  I was 17 and had no framework of understanding for bilocation of my consciousness, seeing of auras, astral traveling, channeling of spirit, ecstatic dancing, unitive consciousness, a feeling of being known and loved by the universe...all of which I spontaneously experienced after years of contemplation.  My prayer that these experiences subside seemed to be answered, as I was able to focus on the mundane aspects of life...and soon after (at 18 years old) I joined the military, where I spent the next 17 years of my life.  The regimentation of the military gave me needed structure and a sense of safety, though the contemplative/spiritual aspect never really left me.  I always had the experience of the "Other" abiding with me, a witnessing consciousness, and I remained contemplative.  When I was 34, my spiritual nature reasserted itself in a big way.  I experienced a powerful, spontaneous kundalini awakening.  Initially, it was vey blissful, much like Eckhart Tolle talked about in his first book, "The Power of Now," which was a life-saver for me years ago.  But within about 6 months, my subconscious began to unload (which I refere to as the opening of Pandora’s box) and I had to begin dealing with all the pain of my childhood, which I initially had no idea how to manage because I did not have loving and nurturing role models in my parents.  All of this old pain was coming up as the kundalini raged through my mind, body and spirit, producing all manner of symptoms and spiritual experiences.  It is not something I would wish on anybody.  It was too much, all at once.  In the course of a short period of time, I lost my career and identity, my marriage, my home, and my son, because I could not then care for him and had to send him to be with his father.   Anyhow, I was admitted to a trauma treatment center after telling a military psychiatrist that I was not feeling safe.  I was in fact worried that I was going crazy.  I learned very quickly, though, to not share my otherworldly experiences with the mental health professionals, as they surely would have “diagnosed” me with more labels and prescribed more meds.  The trauma treatment center was good in that they were accustomed to people with intense emotions.  My Jungian therapists were better than most therapists and I did feel comfortable sharing “all” my experiences with them, but I could tell they also sometimes found themselves not knowing what to do.  People want to move to do something, when all we really need sometimes, is to “be with” whatever is arising without trying to stop it or run from it. So, I came to know that I had to be the one to sit with most of my pain, but my Jungian therapists were very helpful in other ways.   Now, when I weep, I always feel an inner, nurturing presence.  But it took years to get here.  I hope this remains true as I wean myself from the medications and encounter whatever symptoms come my way.

 

I guess I have shared this as a way to extrapolate a bit on how and why I resonate with the author of Beyond Meds website.  I am going to explore her site more because I believe I will find more helpful information there.

 

All these years of being on the medications has blunted me…and I truly want to return to who I am supposed to be, who the universe intends for me to be, without the medications.  The road of withdrawal and recovery will not be easy, but it is one I need to travel.  

[Altostrata]

Good observations!

 

Seems like you did okay cutting the benzo by 50%. If I were you, I'd hold on reducing the benzo and start on the aripiprazole in a month.

 

16 hours ago, Cleerity said:

6:00 AM – 2 mg of Abilify

4:00 PM – 500 mg Metformin

7:30 PM - .5 mg Clonazepam and 15 mg Mirtazapine

 

As it seem you always took a benzo at night, why was the mirtazapine added? What effect does it have on you?

 

16 hours ago, Cleerity said:

The Metformin:  I am borderline type II diabetic.  I don’t take as much as prescribed because I don’t need more to keep my blood sugar below the border (A1C of 6.5).  I am only taking one 500 mg pill a day and my A1C, as of last check (about one month ago), was 5.6.  I am tempted to not take it at all.  And I believe that once I am able to eliminate the psychotropic medications, I will not need it.

 

It sounds like you are aware that aripiprazole is probably the cause of your insulin dysregulation. Since you cut the benzo and are feeling the benefits of being more clear-headed, I would reduce the aripiprazole next -- it is a far greater danger to your general health.

 

If you stabilize on your current benzo dose over the next month, you might start reducing aripiprazole. See Tips for tapering off aripiprazole (Abilify)

 

Please let us know how you're doing.

[Cleerity]

Thank you, Altostrata.

 

That Mirtazapine was added at the same time my psychiatrist increased me from .5 to 1 mg of Clonazepam.  I was going through a crises and feeling a lot of anxiety at the time and was having trouble sleeping.  That combination definitely put me to sleep.  I wish now that I would have just persisted longer with what I was experiencing.  I think my sleep would have returned without the additional medication, but she thought I was depressed in addition to being anxious, hence the mirtazapine.  Still, now, even with the reduced Clonazepam (back now at .5 mg), it’s like a sleep cocktail to me.  I never noticed the mirtazapine to be doing anything more than putting me to sleep, but know it’s affected my brain chemistry and I believe it is part of the reason I have felt so sedated.

 

I will work on the aripiprazole next.  If all is well over these next four weeks, I will start after the thanksgiving holiday.  I’m intending to make my own liquid preparation using the Ora Plus.

 

I will keep posting on the forum so that I will benefit from the guidance and encouragement!

[Altostrata]

We don't know if you might be able to sleep without the mirtazapine. But for now, I would go after the aripiprazole, insulin dysregulation is serious.

 

Mirtazapine can also cause weight gain, have you experienced this?

[Cleerity]

I definitely want to go after the aripiprazole.

 

Yes, I have experienced weight gain, 20-25 pounds...would be more (was more) if I didn’t watch what I eat.  I stick with a low carb diet to help.  

 

I will just have to wait to see where my sleep is once I get around to working on the mirtazapine.  I will remain hopeful that natural sleep will return to me.

[RubyJ]

16 hours ago, Cleerity said:

Thanks for mentioning this, but I really feel fine with mixing it myself.

 

That's great!  I was kind of afraid to, myself, although I'm not entirely sure why.

 

On ‎10‎/‎27‎/‎2018 at 8:04 PM, Cleerity said:

I was wondering how you did/are doing with your next step...

 

I'm going to start tapering again tomorrow, is the long and short of it.

 

Be well!

 

Ruby

[Cleerity]

6 hours ago, RubyJ said:

On 10/27/2018 at 9:04 PM, Cleerity said:

I was wondering how you did/are doing with your next step...

 

I'm going to start tapering again tomorrow, is the long and short of it.

 

Hi Ruby:  Slow and steady, we will get there!   You will have finished sooner than me and it will be good to see you achieve your finish off the Abilify!

 

 

[Cleerity]

I bought my journal yesterday, something small enough to carry in my purse.  So, here I am practicing my daily log:

 

Sunday, Oct. 28

6:00 AM -  Wake: feel a bit groggy, have two cups of coffee

7:00 AM - Bowel movement

8:00 AM - 20 minutes gentle yogic stretching

8:30 AM - Breakfast + supplements + 2 mg Aripiprazole

10:00 AM - Out shopping:  am aware of some lingering irritability

12:00 PM - Back home

12:30 PM - Lunch

1:00 PM - Start laundry and house chores

4:30 PM - Dinner + Metformin (One 500 mg ER tab)

5:00 PM - Relax with a bit of television

7:30 PM - Bed + .5 mg Clonazepam + 15 mg Mirtazapine

 

The irritability has been improving over the previous few days, not aware of it at the moment of this writing.  No anxiety and the wonky feeling around my crown is gone.  I remain focused on my heart center.  I look forward to a good day at work.  

[Shep]

Thanks for continuing your journal, Cleerity. Please also include the number of hours you sleep at night.

 

It sounds like you are doing better and recovering from your recent benzo reduction. I hope this continues. 

[Cleerity]

11 hours ago, Shep said:

It sounds like you are doing better and recovering from your recent benzo reduction. I hope this continues. 

 

Thank you, Shep.  Me too.

 

Feeling a little under the weather today (tired), probably due to two factors:  babysitting my 5 year old granddaughter over the weekend (think she wore me out) and waking twice in the night, last night.  I never really returned to good sleep after the second wake up.  On a good note, there was/is no anxiety or irritability today.  

 

I will begin including the quantity and quality of my  sleep when I post today's log, tomorrow.  

 

Cleer

[Cleerity]

Monday, Oct. 29, 2018

3:40 AM - Wake after ~8 hour sleep period

                - My sleep was interrupted by two wake-ups (one at 12:30 AM and another at about 2:00 AM.  I felt like I never entered deep sleep after 12:30).

4:00 AM - Begin sipping coffee (total of two cups by 5:00 AM)

5:00 AM - Bowel movement, incomplete

6:00 AM - Arrive at work

6:30 AM - Breakfast + supplements + 2 mg Aripiprazole

8:30 AM - Strange feeling of mild pressure in my brow, as if tension needs to be released (not a headache)

9:00 AM - Period of hot flashes ensues (lasted for about an hour)

10:45 AM - Bowel movement

11:00 AM - Lunch

12:00 PM - Feeling pretty tired, not as "on task" as I normally am

3:15 PM - Depart work (45 minutes later than usual)

4:00 PM - Dinner + 500 mg Metformin ER (+ Calcium and Magnesium)

6:00 PM - Gentle yogic stretching 

7:30 PM - Bed + .5 mg Clonazepam + 15 mg Mirtazapine

8:00 PM - Asleep

 

I remained aware of and focused in my heart center most of the day, but was lesser so in the afternoon when a feeling of tiredness set in.  

 

No anxiety, no irritability, no feeling of edginess and no wonky feelings around my crown area.

 

Except for the one night of insomnia (when I woke several times in the night) during the peak withdrawal period of the 50% Clonazepam reduction, I have been able to sleep well.  So, not sure what the waking up was about...but it sure did leave me very tired feeling through my day.

 

Regarding the period of hot flashes:  This is "maybe" a withdrawal symptom?  I don't know.  Or, perhaps some hormonal activity is reawakening after the .5mg reduction of Clonazepam.   I have been post menopausal since 2012 - 2013 and while I used to get raging hot flashes, their severity subsided about 1.5 - 2 years ago.

 

Wishing everyone peace and healing,

 

Cleer  

 

[Cleerity]

Just a couple quick questions before I retire for the evening...

 

1.  Should I post my daily notes each day?  

 

I don’t want to clutter the forum with unnecessary information, but do want to provide what will help all of you to give me the best assistance.

 

2.  Are my notes adequate so far, or am I missing information that would be helpful?    Foods eaten, etc?  

 

Thank you!

 

[ChessieCat]

Yes you can post them each day.

 

At this stage you probably don't need to include foods.

[Cleerity]

Thank you, Chessie!

...

 

Tuesday, October 30, 2018

3:30 AM - Wake from ~ 7.5 hours of uninterrupted sleep.  

                - Have a headache due to poor neck posture. 

4:00 AM - Begin sipping coffee (total of 2 cups by 5:00 AM)

                - Begin stretching my neck to help relieve the headache

5:00 AM - Bowel movement

6:00 AM - Arrive at work

6:30 AM - The headache is gone

6:30 AM - Breakfast + supplements + 2 mg Aripiprazole

8:00 AM - Period of hot flashes ensues, last about an hour

11:00 AM - Lunch

2:30 PM - Leave work

3:00 PM - Home and begin painting one of the living areas of my home

4:00 PM - Dinner + 500 mg Metformin ER + Calcium + Magnesium, then resume painting

6:00 PM - Gentle yogic stretching

7:00 PM - .5 mg Clonazepam + 15 mg Mirtazapine

7:30 PM - Bed + asleep before 8:00 PM

 

It was a very good day in every way, even had the after work energy to commence the painting of another room in my home.  I was more alert and with a clear mind.  Experienced pleasant and positive interpersonal relations at work.  No anxiety, no irritability.  I remained focused in my heart center.  I believe the wonkiness I was feeling around my crown was due to the rewiring and repair that was occurring.  The yogic stretching is helping me.  I love (and have missed) the feeling of inner space it creates.  The body feels more able to release and allow flow, and I am waking up not as tight and stiff as I previously was.  

[Cleerity]

I discovered an error I made:  When I arrived on this site and was in the midst of attempting to titrate down from the .5 mg of Clonazepam, I was endeavoring to move by a 25% decrease over a two week period.  Last night, I was looking at my syringes (I have 1 ml and 5 ml) and observed that when I should have been taking 3/4 of a .5 mg tablet + 1.15 (day 1) then 1.05 (day 2) and .95 ml (day 3) of the liquid solution, I was actually only took .115, .105 and .095 of the liquid preparation, respectively.  Big difference there!  So, I wanted  to share this because it surely accounts for some of the withdrawal effects I began to experience.  

 

Best,

Cleer

[Cleerity]

Wednesday, October 31, 2018

3:15 AM - Wake after ~7.45 hours of sound sleep

3:45 AM - Begin sipping coffee (2 cups total by 4:45 AM)

4:45 AM - Bowel movement

6:00 AM - No work today (have interview at 9:00 AM, so I took a day for myself)

6:30 AM - Breakfast + supplements + 2 mg Aripiprazole

8:15 AM - Period of hot flashes again (lasted about an hour)

8:25 AM - Anxious over pending interview  

               - Sitting at my desk where I will make the call, consciously breathing to calm my self.  It "worked" - until the moment I dialed the number!              

9:00 AM - Somewhat anxious through the 45 minute interview conversation

9:45 AM - I got the job ... and feel very excited

11:00 AM - Lunch

12:00 PM - Mild headache that lasted a few hours

3:00 PM - Meeting with my Analyst

4:15 PM - Dinner + 500 mg Metformin ER + Calcium + Magnesium

6:30 PM - Gentle yogic stretching

7:15 PM - .5 mg Clonazepam + 15 mg Mirtazapine

8:00 PM - Asleep

 

The job interview is a good example of when, in the past, I would have taken a dose of Alprazolam (in advance) without a second thought.   In between all of the above, I continued to work on painting my home.  I was well-hydrated, so not sure of the headache?  Am guessing it may have come on because of the anxiety?  After the excitement of being told I got the job, I then had to think about the whole job change process (which is a stressful event).  

 

[Shep]

Congratulations on the new job, Cleer. 

 

 

[Cleerity]

Thank you so much, Shep!  

 

I was so excited yesterday, I almost came to post the news here immediately, as I already think of you guys as part of my extended family.  No, that's not the right term.  More like, "my people."  Someone with whom one has commonality and camaraderie.  I have not posted much here, but I read a lot and I see many kind and caring souls here.

 

Aside from my one son and two grandchildren, I really have no other "family"...even though six of my siblings are still living.  I had one sister (with whom I shared a very dear and close bond in early life) die at too young an age due to AIDS (many years ago now) after a life of intravenous drugs, prostitution and crime.  It is very sad that I am not close with my remaining siblings...and I have shed many tears over this.  As I grew and healed more, I tried to build a bridge back to all of them, but they were not able to respond or "meet me" in the truth of our shared history/pain.  I understand this, for healing is hard and messy work and their spirits and lives have been so disenfranchised that they just are not up to the task.  I still love them and keep them in my prayers.  But, I have had to learn to stand mostly alone in life, as well as accept the tragedy of my loss of family.  

 

Anyhow, the new job is also a promotion for me, so that's really cool.  They have phoned my references today and I know all will be golden with the feedback they provide.  I work in government public service and they move like pond water (slow, slow, slow), so it will probably be 3-6 weeks before I make the actual transition to the new agency and location.  But I am looking forward to the change!

 

Cleer

[Cleerity]

Thursday, November 1, 2018

2:00 AM - Wake with heartburn after ~ 6 hours of sleep (maybe it was the stuffed bell peppers I ate the day before)

                - I take a dose of Ranitidine.  No more sleep, but I lay in bed continuing to rest deeply

3:30 AM - Up and begin sipping coffee (2 cups by 4:30 AM)

4:40 AM - Bowel movement

6:00 AM - Arrive at work

6:30 AM - Breakfast + Supplements + 2 mg Aripiprazole

8:00 AM - Period of hot flashes (yet again)...lasts about an hour

11:15 AM - Lunch

2:30 PM - Leave work

4:00 PM - Dinner + 500 mg Metformin ER + Calcium + Magnesium

7:15 PM - .5 mg Clonazepam + 15 mg Mirtazapine

7:40 PM - Bed and asleep by 8:00 PM

 

It was very good day.  No notable symptoms and very positive interpersonal relations at work.  My supervisor shared with me the review he gave to the man who is the Director of what will be my new work site and my heart swelled with appreciation in response to his words of recognition.  I remained focused in my heart center.  No painting in my home this day, just took it easy and worked a bit on my monthly budget.

[Cleerity]

Because I will be changing jobs (which is a major life stressor) in the next few to several weeks, I am wondering if it might be wise for me to delay my plan to begin tapering the Aripiprazole...  I intended to begin after Thanksgiving.  But I do not want any upset with my psyche to interfere with my settling into my new role.  Might anyone have advice or opinion on this that they would share?  Specifically, might it be safe for me to at least make the switch over from pill to liquid?  And, then, wait until I feel comfortable in the new role before I actually begin decreasing?  

[Cleerity]

I must say now that I am reading more and more on this forum, I feel like I have been living in a bubble on the meds I have been taking for all these years.  In my mind, I came to accept them and made it "okay" to my self.  It is not okay.  The way they change us is insidious.  And the way doctors (mine included) think nothing of the harm they do to us is mindless.  After seeing it mentioned several times on the forum, I just order the book, "Anatomy of an Epidemic."  I trust I will find it edifying and eye-opening.

[RubyJ]

On ‎10‎/‎29‎/‎2018 at 3:09 AM, Cleerity said:

 

Hi Ruby:  Slow and steady, we will get there!   You will have finished sooner than me and it will be good to see you achieve your finish off the Abilify!

 

 

 

You are right!  Thanks, I'm counting on it   Belated congrats on the job!

[Cleerity]

7 hours ago, RubyJ said:

Belated congrats on the job!

Thank you, Ruby!  

[Cleerity]

Friday, November 2, 2018

3:40 AM - Wake after ~8hours of sleep

4:00 AM - Begin sipping coffee, have 2 cups by 5:00 AM

6:00 AM - Arrive at work

6:30 AM - Breakfast and realize I left my supplements and Aripiprazole at home

8:15 AM - Only a mild and shorter-lived warm spell today

10:00 AM - Feeling tired, yawing, not as sharp as I usually am

11:15 AM - Lunch

1:30 PM - Bowel movement

2:30 PM - Leave work

4:00 PM - Dinner + 500 mg Metformin ER + Calcium + Magnesium

7:15 PM - .5mg Clonazepam + 15 mg Mirtazapine

7:30 PM - Bed and asleep by 8 PM

 

I am embarrassed to share that I forgot my supplements and medication at home!  I am not sure why I felt dull and tired this day.  But, as I have never tracked my self before, like I am now doing with these notes, I am wondering if I missed the B Vitamins.  The tiredness persisted throughout the day.  I just was not as spritely as I normally am.  No anxiety or irritability, but I was a bit misty-eyed as I drove home, aware that the work day felt stressful to me.  I remain very aware of my heart center.  It is time for me to get curious about the feeling energy there, so sit with it meditatively and see what it might have to say.

 

I think it would be interesting for me to go without the B Vitamins a few more days, to see what effect they are actually having on me.  It might be that they help to counter the "brakes" I am on.  I say this because I have read here on the forum time and again that B Vitamins are activating.  So, it will be good for me to determine how they are affecting me personally, as that will be good to know when I do get to tapering the Abilify...and, later, the Mirtzazapine and Clonazepam.

 

Another thing I have lost since the advent of the Mirtazapine and Abilify is my passion for writing poetry.  I would like to find this again in my future.

[Shep]

14 hours ago, Cleerity said:

Because I will be changing jobs (which is a major life stressor) in the next few to several weeks, I am wondering if it might be wise for me to delay my plan to begin tapering the Aripiprazole...  I intended to begin after Thanksgiving.  But I do not want any upset with my psyche to interfere with my settling into my new role.  Might anyone have advice or opinion on this that they would share?  Specifically, might it be safe for me to at least make the switch over from pill to liquid?  And, then, wait until I feel comfortable in the new role before I actually begin decreasing?  

 

Yes, I think this is wise to settle into your new role before beginning a taper. That's a great idea to go ahead with the switch from pill to liquid. Do so gradually. SA recommends switching 25% at a time until you are 100% over to the liquid. Please post any questions you have about that. You could even go slower than 25% tablet to liquid, since you aren't in a hurry to begin your taper. 

 

35 minutes ago, Cleerity said:

I think it would be interesting for me to go without the B Vitamins a few more days, to see what effect they are actually having on me.  It might be that they help to counter the "brakes" I am on.  I say this because I have read here on the forum time and again that B Vitamins are activating.  So, it will be good for me to determine how they are affecting me personally, as that will be good to know when I do get to tapering the Abilify...and, later, the Mirtzazapine and Clonazepam.

 

 

Please be careful making abrupt changes such as suddenly stopping your B vitamins. 

 

Since you are doing well taking them, I would continue on. Are you a vegetarian? The B vitamins are so important, especially if you are on a restricted diet such as vegetarianism and are getting your B12 from supplements. 

 

You are right to be concerned about B vitamins having an adverse effect, but not everyone has that issue and usually it arises after the nervous system has been destabilized. Please have a read of this thread:

 

One theory of antidepressant withdrawal syndrome

 

This section of that thread speaks to what you are researching:

 

On 5/24/2011 at 10:59 PM, Altostrata said:

My guess is: The first phase of withdrawal, the acute phase, is the initial shock of withdrawal, with the most defined symptoms, such as brain zaps and nausea and possibly waves of unusually intense "depression" and "anxiety" -- actually, emotions generated by the neurological upset. Later, glutamatergic hyper-reactivity and autonomic instability take over. Often the autonomic instability causes wide hypersensitivity to drugs, supplements, and even foods.

 

If the B vitamins are helping you now, keeping you strong, and you're not suffering any adverse effects of taking them, I would be careful about removing them, especially suddenly.

 

If later on, as you remove some of the "brakes" you are taking and find that you are getting ramped up after taking the B vitamins, you could reduce them at that point. 

 

[Cleerity]

1 hour ago, Shep said:

Yes, I think this is wise to settle into your new role before beginning a taper. That's a great idea to go ahead with the switch from pill to liquid. Do so gradually. SA recommends switching 25% at a time until you are 100% over to the liquid. Please post any questions you have about that. You could even go slower than 25% tablet to liquid, since you aren't in a hurry to begin your taper. 

 

Thank you, Shep.  Because these 2mg Aripiprazole tabs are so tiny - and not scored - I am not going to be able to cut them more than once with any accuracy.  I am going to try to insert a couple photos to demonstrate their size and how badly they crumble when cut.  I used a razor knife and performed several trials with similar results.  As seen in the photo, even cutting them once leaves me with having to decide onto which half-dose I would need to add the crumbled bits to.  The third picture is the tab quartered and not at all accurately, I am afraid.  So, I may have to just do 50% tab and 50% liquid (with some accuracy) and compute in an extra 10% for compounding loss on the liquid preparation portion.  I will appreciate hearing your thoughts on this, or any of the other moderators' thoughts. 

 

Edited to add:  Because I will be computing and making a liquid preparation, I will prefer to keep things as practical as possible and not have to also work on grinding, measuring/weighing the tablet portion.  But, if it is recommended that I should, I shall.

 

 

[Cleerity]

I didn't know those pics were going to appear so large!

 

1 hour ago, Shep said:

Please be careful making abrupt changes such as suddenly stopping your B vitamins. 

 

Since you are doing well taking them, I would continue on. Are you a vegetarian? The B vitamins are so important, especially if you are on a restricted diet such as vegetarianism and are getting your B12 from supplements. 

 

No, I am. not vegetarian.  I love my meats!  

 

The link to Altostrata's post provided good, helpful reading.

 

1 hour ago, Shep said:

If the B vitamins are helping you now, keeping you strong, and you're not suffering any adverse effects of taking them, I would be careful about removing them, especially suddenly.

 

If later on, as you remove some of the "brakes" you are taking and find that you are getting ramped up after taking the B vitamins, you could reduce them at that point. 

 

I will do as you suggest, maintaining my B Vitamins until such point in time when it may become apparent that they might be causing me to feel ramped up. 

 

Thanks, again!

[RubyJ]

2 hours ago, Cleerity said:

So, I may have to just do 50% tab and 50% liquid (with some accuracy) and compute in an extra 10% for compounding loss on the liquid preparation portion.  I will appreciate hearing your thoughts on this, or any of the other moderators' thoughts.

 

That's what I had to do when I switched from tablets to liquid for the exact same reason.  I'm sure that the uneven dose I had been getting from taking quarter pills contributed to the symptoms I had when I tried to stop at .5mg (I had been taking the 'quarter' pills about a month before I tried stopping there).  After that, I decided no more cutting the things into quarters.  Doing 50% tab and 50% liquid meant that I had some symptoms that I might not have had if I had been able to go slower, but they weren't too bad.  Also, when cutting them in half, I found that I usually had one usuable half and had to throw the other half away because of crumbling.   

[Altostrata]

Cleerity, did you skip an aripiprazole dose? How do you feel?

[Cleerity]

2 hours ago, RubyJ said:

Also, when cutting them in half, I found that I usually had one usuable half and had to throw the other half away because of crumbling. 

 

Hi Ruby:  Yes, they are just too tiny to cut accurately!

[Cleerity]

30 minutes ago, Altostrata said:

Cleerity, did you skip an aripiprazole dose? How do you feel?

Hi Altostrata.  Yes, I sure did miss taking my dose yesterday.  I felt tired and not as spritely yesterday.  I feel well now.   Nothing notable.  Am working on cutting and laying new baseboard moulding in my home office, so mental acuity all present.  

[Cleerity]

4 hours ago, Altostrata said:

Cleerity, did you skip an aripiprazole dose? How do you feel?

 

Hello again, Altostrata.  First, I wanted to come back to say "thank you" for checking in on me.  After I responded earlier and carried on with my room refinishing tasks, I felt poorly for having not said thank you.  I value the assistance I receive on this forum and I want everyone who stops in my thread to share encouragement, support and information to know that I truly appreciate all that is being done here, both for me and others.  On another note, I also made a trip to Home Depot to pick up some new vent registers and as I drove I realized I didn't quite feel to be my normal self.  It seemed I was not quite as alert, so I traveled carefully.  I paid more attention to this feeling (that I could not quite define) as I walked through the store and talked with an employee.  Back home, I continued to wonder how to describe what I am feeling.  Best I can say is that it is as if I was/am on the edge of feeling dizzy, maybe a little light-headed.  I guess I didn't expect that I would experience any effect with one missed dose.   As ever in life, I have always been one to "push through" things.   And I think I was pushing through what I was feeling as I busied myself with my tasks.  That pushing through in life served me well in many respects, but it is time for me to slow down and really pay attention to my mind and body as I continue to work on these meds.  Your act of asking how I was feeling helped me to "pay attention."  Thank you.

 

 

[Altostrata]

Could be the gap in aripiprazole. Please continue to keep daily notes.

[Cleerity]

Saturday, November 3, 2018

4:30 AM -  Wake after ~8 hours of uninterrupted sleep

4:50 AM - Begin sipping coffee - total of 2 cups by 6:00 AM

7:20 AM - Breakfast + supplements + 2 mg Aripiprazole

8:00 AM - Bowel movement

8:20 AM - Begin working on home refinishing tasks

12:00 PM - Lunch and return to tasks

2:30 PM - Drive to Home Depot and am aware of feeling not quite as alert as normal

3:40 PM - Back home and working again and trying to define how I was/am feeling.  It is as if being on the edge of dizziness, maybe a bit lightheaded

5:00 PM - Dinner + 500 mg Metformin ER + Calcium, Magnesium and Probiotic, then online for a bit

7:15 PM - Yogic stretching

7:45 PM - .5 mg Clonazepam + 15 mg Mirtazapine

 

Aside from what seems to have been some small degree of lightheadedness, it was a good and industrious day for me.  It could have been the missed Aripiprazole or perhaps dehydration (my bowel movements were later in the day the past two days), or, a combination of both.  No anxiety, irritability or other symptoms.  I will drink more water.  I finally got smart and began creating bookmarks for all the helpful pages/posts on this website!  This will be helpful.