LoisLane: desperately wants to get off Saphris - looking for support

[LoisLane]

I want to get off Saphris. I was taking 2.5 mg and tried to taper it down over the course of four months, went with three-quarter to one half to one quarter. Became suicidal and so anxious that I almost had several panic attacks. Was manic, and I'm not bipolar. Felt pressure to do things, mostly react with extreme emotions. Went back up to one. Now want to taper down and desperately want to get off of this hellish drug. I also take lamictal (300 mg), Viibryd (40 mg), and Mirtazipine (7.5 mg). I want off of all of them and am horrified at how long it is going to take me. I so want to hurry my taper. I also just quit drinking, after tapering down on alcohol over the course of a week. I've been an alcoholic for years. I am now, today, two days sober. I am going to remain sober. 

 

My diagnosis is Depression and Generalized Anxiety disorder.

 

One thing I've noticed is that I have so much rage over the doctors who put me on all of these meds - they just kept shoving more and more meds at me, and never told me about the scary side effects. I want to sue one in particular. The other thing I've noted is that I just hate myself for letting them put me on the meds. My mother said, when she learned of all that I am on: You dropped the ball! She was horrified, and rightly so. I am horrified at myself. Like I said, I hate myself for letting this happen. So mad for ruining my life. So there's this rage and horror at the doctor and at myself. There is also this manic anxiety and decision making problems for myself, problems that I worsen by my anxious reactions.

 

I've been back on a whole dose for a while, but every few days I get scared, and try to take only 75% of a dose. It's not really working out for me. For the last two days, I have felt very suicidal. It's nuts. This is not me. I don't know what to do. That's why I've come here. I am desperate, and very, very afraid. 

 

 

I hope that I've done this intro thread right...

Edited February 8, 2019 by ChessieCat
edited triggering content

[ChessieCat]

Hi LoisLane and welcome to SA,

 

I'm sorry to read that you are feeling so desperate at the moment.

 

Before we can offer any suggestions we need to get the details of your drug history.  Once we have this information we will be better able to assist you.

 

 

Please create your drug signature using the following format.   Keep it simple.  NO diagnoses or symptoms please - thank you.

• details for last 2 years - dates, ALL drugs, doses
• summary for older than 2 years - just years and drug/s

Account Settings – Create or Edit a signature

 

 

This is your own introductions topic where your can ask questions about your own situation and journal your progress.

Please see this topic:  for-those-who-are-feeling-desperate-or-suicidal

 

If you are feeling suicidal we encourage you to seek local support. 

 

[LoisLane]

Thanks, ChessieCat. I have edited my information and hope that it is alright to post now. If not, please let me know what else I need to do. I am looking forward to getting started.

[ChessieCat]

Thank you for creating your drug signature.

 

This is SA's topic:  tips-for-tapering-off-asenapine-saphris

 

[ChessieCat]

I've asked the other mods for their assistance.

[Altostrata]

Welcome, LoisLane.

 

On 2/7/2019 at 6:24 PM, LoisLane said:

I want off of all of them and am horrified at how long it is going to take me. I so want to hurry my taper. I also just quit drinking, after tapering down on alcohol over the course of a week. I've been an alcoholic for years. I am now, today, two days sober. I am going to remain sober. 

 

In order to go off the drugs, you need to get into a patient frame of mind. Doing risky things because you're angry will only hurt you, not the people you're angry at.

 

First off, you need to forgive yourself for taking the drugs. Your doctors probably thought they were helping you. Are you familiar with "dual diagnosis"? 

 

Did you experience any withdrawal symptoms when you quit alcohol? What side effects do you attribute to the drugs? If we can identify the drug causing the worst side effects, it would make sense to reduce that one first.

[ChessieCat]

Drug interaction reports (2 different drug checkers).

 

From:  https://reference.medscape.com/drug-interactionchecker

Serious - Use Alternative

• mirtazapine + vilazodone

  mirtazapine, vilazodone. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

Monitor Closely

• vilazodone + asenapine

  vilazodone, asenapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

• lamotrigine + vilazodone

  lamotrigine increases toxicity of vilazodone by unspecified interaction mechanism. Modify Therapy/Monitor Closely. CNS depressants may increase the toxic effects of selective serotonin reuptake inhibitors; psychomotor impairment may be enhanced.

 

 

 

From:  Drug Interactions Checker

 

Interactions between your drugs

Major

mirtazapine vilazodone

Applies to: mirtazapine, vilazodone

Using mirtazapine together with vilazodone can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention if you experience these symptoms while taking the medications. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

 

Moderate

lamoTRIgine asenapine

Applies to: Lamictal (lamotrigine), Saphris (asenapine)

Using lamoTRIgine together with asenapine may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
 

Moderate

mirtazapine asenapine

Applies to: mirtazapine, Saphris (asenapine)

Using asenapine together with mirtazapine can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether together or alone. 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.

 

No other interactions were found between your selected drugs.
Note: this does not necessarily mean no interactions exist. Always consult with your doctor or pharmacist.

Other drug and disease interactions

• Lamictal (lamotrigine) interacts with more than 200 other drugs and 7 diseases.
• mirtazapine interacts with more than 500 other drugs and more than 10 diseases.
• vilazodone interacts with more than 300 other drugs and 6 diseases.
• Saphris (asenapine) interacts with more than 500 other drugs and more than 10 diseases.

Drug and food interactions

Moderate

lamoTRIgine food

Applies to: Lamictal (lamotrigine)

Alcohol can increase the nervous system side effects of lamoTRIgine such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with lamoTRIgine. Do not use more than the recommended dose of lamoTRIgine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

 

Moderate

mirtazapine food

Applies to: mirtazapine

Alcohol can increase the nervous system side effects of mirtazapine such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with mirtazapine. Do not use more than the recommended dose of mirtazapine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

 

Moderate

asenapine food

Applies to: Saphris (asenapine)

Alcohol can increase the nervous system side effects of asenapine such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with asenapine. Do not use more than the recommended dose of asenapine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

 

Moderate

vilazodone food

Applies to: vilazodone

Do not drink alcohol while you are taking vilazodone. It can increase some of the side effects including dizziness, drowsiness, and difficulty concentrating. Food significantly increases the absorption of vilazodone. You should take vilazodone with a meal, preferably at the same time each day. Taking it on an empty stomach may lead to inadequate blood levels and reduced effectiveness of the medication. Talk to your doctor or pharmacist if you have any questions or concerns.

Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

 

Duplication

Central Nervous System (CNS) Drugs

Therapeutic duplication

The recommended maximum number of medicines in the 'Central Nervous System (CNS) Drugs' category to be taken concurrently is usually three. Your list includes four medicines belonging to the 'Central Nervous System (CNS) Drugs' category:

• Lamictal (lamotrigine)
• mirtazapine
• vilazodone
• Saphris (asenapine)

Note: The benefits of taking this combination of medicines may outweigh any risks associated with therapeutic duplication. This information does not take the place of talking to your doctor. Always check with your healthcare provider to determine if any adjustments to your medications are needed.

Duplication

Antidepressants

Therapeutic duplication

The recommended maximum number of medicines in the 'antidepressants' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'antidepressants' category:

• mirtazapine
• vilazodone

Note: The benefits of taking this combination of medicines may outweigh any risks associated with therapeutic duplication. This information does not take the place of talking to your doctor. Always check with your healthcare provider to determine if any adjustments to your medications are needed.

 

[LoisLane]

I appreciate the information. I will try to be patient. I have not experienced any withdrawal symptoms from alcohol. The withdrawal symptoms: extreme depression and extreme anxiety, were due to reducing the drug saphris. I am now tapering again. I have an appointment with a psychiatrist in 11 days. 

 

I am familiar with dual diagnosis. 

 

It is very, very hard to forgive myself. 

 

Thank you for all of the information. I look forward to seeing if the psychiatrist can help me at all with this.

[LoisLane]

I started a too-fast taper in October. Went from whole tablet to 3/4 tablet (November), 3/4 tablet to 1/2 tablet (December) 1/4 tablet (January, month 3). For rest of January, took 3/4 or one whole tablet. I now, especially from reading things here, wonder if I can go ahead to 3/4 tablet and try to stabilize on that for six weeks, then continue tapering at a much slower rate. Yes, I had severe withdrawal symptoms, but they did not get truly bad until December/January. 

 

Am I doing this posting thing correctly?

[simack]

Hi Lois, I hope all goes well with your saphris taper. In retrospect I wish i had have stayed on saphris and done a super slow taper instead of being switched over to zyprexa and seroquel and making things much much worse. If i were to offer advice it would be to pick a dosage and hold until things stabilise.  Hang in there

[LoisLane]

Hi, Simack. I am so frightened. My tongue has tremors. I am contemplating doing a fast taper to get off so that maybe my symptoms will improve. I am about to go to the emergency room and see if they will give me some admantine. I just read this study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3184560/.

 

I was put on this for treatment resistant depression. I never should have been put on it. I am terrified. I know we are not supposed to go off to fast, and that we may destabilize if we do, but I don't even care as long as I don't get dyskenisia. I have an appointment with a psychiatrist, but not for ten days. I've gone back to three-quarters of a tablet, at least, and will hold there for the next ten days, until I see the psych. 

 

How do you know when you are stabilised? Or unstabilized, for that matter?

[ChessieCat]

Drug Interactions for amantadine and current drugs:

 

Moderate

amantadine asenapine

Applies to: amantadine, Saphris (asenapine)

Using amantadine together with asenapine may increase side effects such as dry mouth, constipation, difficulty urinating, heat intolerance, confusion, and blurred vision. More severe side effects may rarely include hallucinations, seizures, irregular heart rhythm, and heat stroke. Side effects may be more likely to occur in the elderly or those with a debilitating condition. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. 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. 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.

 

Duplication

Central Nervous System (CNS) Drugs

Therapeutic duplication

The recommended maximum number of medicines in the 'Central Nervous System (CNS) Drugs' category to be taken concurrently is usually three. Your list includes five medicines belonging to the 'Central Nervous System (CNS) Drugs' category:

• amantadine
• Saphris (asenapine)
• mirtazapine
• Lamictal (lamotrigine)
• Viibryd (vilazodone)

Note: The benefits of taking this combination of medicines may outweigh any risks associated with therapeutic duplication. This information does not take the place of talking to your doctor. Always check with your healthcare provider to determine if any adjustments to your medications are needed.

[LoisLane]

Hi ChessyCat. It is so scary and frustrating to know what to do. I had a plan, but now I want to throw it all out the window. I can't keep my tongue still and it is terrifying me. 

[Altostrata]

LoisLane, did you tell your doctor about these tongue symptoms? If not, please do so immediately.

 

Exactly what are you taking now, at what dosage, and at what times of day?

[LoisLane]

I did tell my doctor and went to the ER and didn't get much help. They just agreed I had a tongue tremor but no advice. So finally, I found a psychiatrist who could see me (one and a half hours away). He took me off of the saphris. I had been taking 2.5 and he said to just stop. Then, to stop the remeron, which was only at a "sleep-aid" level, anyway, at 7.5 mg per night. So I've quit those two. Saphris two weeks ago, Remeron one week ago. I'm also now one month sober. 

 

Currently I take Viibryd, 40 mg and Lamictal, 150 mg, in the morning. 

Then, at night, 150 mg Lamictal. I'm also taking melatonin to help me sleep. 

My mood is down, but at least I am off the saphris and hoping it will improve. I am finally getting a little of my appetite back, and I see that as a good sign and that I am healing.