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Altostrata

How to talk to a doctor about tapering and withdrawal? What to expect?

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ChessieCat

I recently contacted PCCA - Professional Compounding Centers of America after another member had contacted compounding pharmacies in their area and was told that Pristiq could not be compounded (USA).  I am in Australia and have been getting my Pristiq compounded for the last 3 years.

 

I suggest that you contact the pccarx and ask them if your drug can be compounded.  Also mention that your doctor/psychiatrist says that it cannot.  If it is able to be compounded ask them to provide something in writing that you can give to the medical professional.  Also ask for contact details for the pharmacies in your area who can do the compounding.  

 

At least if you get the information from the pccarx you can then tell them that you have it from the horse's mouth that it can be done.

 

I have not provided Ranel's address because it may change in the future if this person leaves the organisation but this is the one I used and you can send it   Subject:   ATTN:  Clinical Compounding Pharmacist

 

customerserviceexternal AT SYMBOL pccarx DOT com

 

I received the following response:

 

Thanks so much for contacting us regarding this.  There are definitely some options on compounding this product [Pristiq] and we are happy to assist a pharmacy with the knowledge on how to do this.  We have many member pharmacies within the state of Washington that are PCCA members and would be able to assist this patient.  Do you know where in Washington State your contact is located?  If you can provide that information I can direct them to a pharmacy that is a PCCA member.  That pharmacy is welcome to contact me through our members only website or by calling customer service and I can assist them with a formulation. 

Thank you and have a wonderful day!

Ranel A. Larsen, Pharm D, RPh | Clinical Compounding Pharmacist

PCCA | 9901 South Wilcrest Dr. | Houston, TX 77099-5132

Ph: 800.331.2498    

Fax: 800.874.5760 | PCD Fax: 713-234-6009

www.pccarx.com

 


Being very patient.  I'll get there - slowly.  ETA mid 2021

ADs:  25 years - 1 unknown, Prozac (caused muscle weakness), Zoloft/sertraline; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after)

Pristiq:  50mg 2012, 100mg beg 2013 (mild Serotonin Toxicity)

Began tapering Oct 2015  Current from 17 Oct 2020:  Pristiq 0.56 mg (compounded + liquid)

My tapering program

My Intro (goes to my tapering graph)

My website - includes my brief history + links to videos & information on the web

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions.

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BfromNJ
1 hour ago, ChessieCat said:

I recently contacted PCCA - Professional Compounding Centers of America after another member had contacted compounding pharmacies in their area and was told that Pristiq could not be compounded (USA).  I am in Australia and have been getting my Pristiq compounded for the last 3 years.

 

I suggest that you contact the pccarx and ask them if your drug can be compounded.  Also mention that your doctor/psychiatrist says that it cannot.  If it is able to be compounded ask them to provide something in writing that you can give to the medical professional.  Also ask for contact details for the pharmacies in your area who can do the compounding.  

 

At least if you get the information from the pccarx you can then tell them that you have it from the horse's mouth that it can be done.

 

I have not provided Ranel's address because it may change in the future if this person leaves the organisation but this is the one I used and you can send it   Subject:   ATTN:  Clinical Compounding Pharmacist

 

customerserviceexternal AT SYMBOL pccarx DOT com

 

I received the following response:

 

Thanks so much for contacting us regarding this.  There are definitely some options on compounding this product [Pristiq] and we are happy to assist a pharmacy with the knowledge on how to do this.  We have many member pharmacies within the state of Washington that are PCCA members and would be able to assist this patient.  Do you know where in Washington State your contact is located?  If you can provide that information I can direct them to a pharmacy that is a PCCA member.  That pharmacy is welcome to contact me through our members only website or by calling customer service and I can assist them with a formulation. 

Thank you and have a wonderful day!

Ranel A. Larsen, Pharm D, RPh | Clinical Compounding Pharmacist

PCCA | 9901 South Wilcrest Dr. | Houston, TX 77099-5132

Ph: 800.331.2498    

Fax: 800.874.5760 | PCD Fax: 713-234-6009

www.pccarx.com

 

It wasn't that they said it can't be,  they weren't willing to even entertain it.  They pretended to not even know what compounding is. 


 9/2018- lexapro for 5 days - was low- dose rigid muscles

11/3/2018- zoloft 2 days, starting dose is.intrusive thoughts

11/7/18  - 11/15/18 - Prozac 9 days, from 10 mg for week, to 20 mg 

11/16  inpatient put on Lexapro for a few days,  Cymbalta, 2 days

11/24-12/8 - gabapentin 100 mg 3xs per day - a very fast taper

1/7 - t buspar for  three days- blurry vision, jerky eye

1/17/19 - 2/15/19- mirtazapine 15 mg - started taper on 1/30 fast

2/15/19 - inpatient .2/17-abilify, topamax given.  next day changed

2/20/19 gabapentin 600 mg, 6/5 -545 mg ,8/21  494 mg , 9/30 444mg, 11/14 399 mg, 12/10- 360 mg, 1/21-342 mg, 2/11- 324 mg (current)

2/20/19 - seroquel 25 mg 

2/20- luvox (generic) 25 mg, 4/6- 18.75 mg (current)

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ChessieCat

If you want to get your drug compounded you are going to need to be assertive and/or find another doctor.

 

If you get the information from the pccarx you can present them with it, it in writing, and they won't have any excuse.


Being very patient.  I'll get there - slowly.  ETA mid 2021

ADs:  25 years - 1 unknown, Prozac (caused muscle weakness), Zoloft/sertraline; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after)

Pristiq:  50mg 2012, 100mg beg 2013 (mild Serotonin Toxicity)

Began tapering Oct 2015  Current from 17 Oct 2020:  Pristiq 0.56 mg (compounded + liquid)

My tapering program

My Intro (goes to my tapering graph)

My website - includes my brief history + links to videos & information on the web

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions.

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BfromNJ
19 hours ago, ChessieCat said:

If you want to get your drug compounded you are going to need to be assertive and/or find another doctor.

 

If you get the information from the pccarx you can present them with it, it in writing, and they won't have any excuse.

Well then I suppose I have to find another doctor.   Because those two will not help me.  


 9/2018- lexapro for 5 days - was low- dose rigid muscles

11/3/2018- zoloft 2 days, starting dose is.intrusive thoughts

11/7/18  - 11/15/18 - Prozac 9 days, from 10 mg for week, to 20 mg 

11/16  inpatient put on Lexapro for a few days,  Cymbalta, 2 days

11/24-12/8 - gabapentin 100 mg 3xs per day - a very fast taper

1/7 - t buspar for  three days- blurry vision, jerky eye

1/17/19 - 2/15/19- mirtazapine 15 mg - started taper on 1/30 fast

2/15/19 - inpatient .2/17-abilify, topamax given.  next day changed

2/20/19 gabapentin 600 mg, 6/5 -545 mg ,8/21  494 mg , 9/30 444mg, 11/14 399 mg, 12/10- 360 mg, 1/21-342 mg, 2/11- 324 mg (current)

2/20/19 - seroquel 25 mg 

2/20- luvox (generic) 25 mg, 4/6- 18.75 mg (current)

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BfromNJ

Ive hit a roadblock with my regular GP and psych nurse.  I will not be going back to my psych nurse, my last visit was upsetting to say the least.  He would not even answer me when I was speaking with him, just typed away on his computer looking for another me to put me on.  no way.   The way I am feeling, I was not in the frame of mind to argue with him and ive had it with his condescending, invalidating way.  Taking phone calls during my session and texting on his phone.     Nothing I say is taken seriously, just written off as yet more anxiety or my ocd.  So if I cannot find another doctor to help me with a taper, I need to do so myself.   I am frustrating and sick of being on meds that are making my symptoms worse everyday.  I feel that time is running out and I will be like this forever. 


 9/2018- lexapro for 5 days - was low- dose rigid muscles

11/3/2018- zoloft 2 days, starting dose is.intrusive thoughts

11/7/18  - 11/15/18 - Prozac 9 days, from 10 mg for week, to 20 mg 

11/16  inpatient put on Lexapro for a few days,  Cymbalta, 2 days

11/24-12/8 - gabapentin 100 mg 3xs per day - a very fast taper

1/7 - t buspar for  three days- blurry vision, jerky eye

1/17/19 - 2/15/19- mirtazapine 15 mg - started taper on 1/30 fast

2/15/19 - inpatient .2/17-abilify, topamax given.  next day changed

2/20/19 gabapentin 600 mg, 6/5 -545 mg ,8/21  494 mg , 9/30 444mg, 11/14 399 mg, 12/10- 360 mg, 1/21-342 mg, 2/11- 324 mg (current)

2/20/19 - seroquel 25 mg 

2/20- luvox (generic) 25 mg, 4/6- 18.75 mg (current)

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carefulprayerful

Not sure if this is the right forum for this.  I haven’t read the whole thing through. 
 

I have a psychiatrist who knows about what I am doing and is collaborative, for which I try to be grateful. (I will ask if I can share her name online.)  I have not told her the full extent of my symptoms yet.  I usually smile and nod to a wide extent. 

I currently get to work from home a couple days a month.  Without the commute and stressful environment, my WD symptoms are much lighter.  
 

I would like to work from home (WFH) more, but this is not really done at my company (except for people that live in other states).  My employer is moving in the direction of more WFH, but there has been no policy change yet.  
 
I was thinking about asking my psychiatrist for a note, but then my employer would know her specialty. 
 
I was thinking maybe I could ask my PCP for a note since he knows about my WD experience (I was actually in the ER recently for fainting for a few seconds and vomiting unconscious.  The ER attributed the vomiting to WD.).
 
When I first started tapering, my psychiatrist said to me when I asked about this, « I don’t think that would help you. ».  Since then of course I have landed in the ER, and I still haven’t fully described to her the list of symptoms I have (mostly physical).  
 
I know someone at another organization who had a baby and simply asked to WFH.  They said yes.  
 
Of course maybe this is all wishful thinking.  
 
I mean the truth is my colleagues would probably ask me why I was working from home more, and it would be awkward. I’d have to make something up. 
 
I guess want to look able bodied and able minded if I can, tho I think I could taper faster if I could WFH.  
 
Any thoughts welcome.  
 
Thank you. 

Jan. 2018:     900 mg  Lithium      1.0 mg Risperidone            250 mg Lamotrigine

Jan. 2019:     0 mg Lithium           0.625 mg Risperidone        175 mg Lamotrigine

Jan. 2020:     0 mg Lithium           0.260 mg Risperidone        175 mg Lamotrigine

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Altostrata

Best not to bring up seeing a psychiatrist with your employer or anyone in your employer's human resources department.

 

Can you ask for more WFH because of covid-19 risks?


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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carefulprayerful

What I actually did one day in January was I simply decided to start working from home.  I took to heart what I had heard, "be the CEO of your own life."  The next day I went to my primary care doctor to ask for a note, which he agreed to write.  My company switched everyone to WFH in March!

 

My primary care doctor said he could write me prescriptions for Lamotrigine so I wouldn't need to go to a psychiatrist.  He said it is not a complicated meditation.  I have enough Risperidone to last a year and a half (before it expires), but I figure I could get that from him, too.

 

I canceled my most recent appointment with my psychiatrist.  I emailed her to say I'd reschedule with no intention of doing that, but she said she would like me to reschedule now.  I don't need her for Rx, but honestly I am considering making one more appointment to present her with academic journal studies, just to speak truth to power in a respectful way.  I think the $100 for the appointment would pay for itself for the fact that I could use my voice.  I think I have Stockholm syndrome, and it is hard for me to speak truth to her because I bear some affection for this person.  

 

Alto, do you think this is worth it?  She has been collaborative in this tapering process, but I think I need to speak the truth in order to feel empowered.  I have found it easier to speak up to a bully than to speak up to authority, but it may be time to grow up in that sense.  With global protests concerning police brutality, I just don't want to be like a sheep.  The money may be a paltry fee for the satisfaction I'd derive.  My psychiatrist is basically a good person, she just made a misguided choice of career.  I can say things in a very non-conflictual way.


Jan. 2018:     900 mg  Lithium      1.0 mg Risperidone            250 mg Lamotrigine

Jan. 2019:     0 mg Lithium           0.625 mg Risperidone        175 mg Lamotrigine

Jan. 2020:     0 mg Lithium           0.260 mg Risperidone        175 mg Lamotrigine

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Altostrata

Save yourself $100. Just mail her the studies with a note that you don't believe her advice has been helpful, though you think she means well.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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carefulprayerful

@AltostrataThank you for that wording and money-saving tip 😃.  I just sent the letter.  I included copies of the following:

  • Book: Anatomy of an Epidemic pp. 194-195 concerning a study by Martin Harrow.  "...here is how the long-term outcomes stacked up, from best to worst: manic-depressive off meds, schizophrenia off meds, manic-depressive on meds, and then schizophrenia on meds."  
  • Drug label for Risperidone: "...there are no systematically obtained data to support the use of RISPERDAL in such longer-term treatment (i.e., beyond 3 weeks)."
  • Journal article: Effects of 10 to 30 years of lithium treatment on kidney function.  "About one-third of the patients who had taken lithium for 10–29 years had evidence of chronic renal failure but only 5% were in the severe or very severe category." 
  • Journal article: Schizophrenia, neuroleptic medication Schizophrenia, neuroleptic medication and mortality and mortality.  "Irrespective of chronic somatic diseases. Irrespective of the factors modelled, the relationship the factors modelled, the relationship between number of neuroleptic drugs and between number of neuroleptic drugs and mortality remained strong and statistically mortality remained strong and statistically significant….Obviously there are other factors associated Obviously there are other factors associated with mortality in schizophrenia and the with mortality in schizophrenia and the association with neuroleptic drugs was very association with neuroleptic drugs was very clear."
  • Journal article: Congruencies in Increased Mortality Rates, Years of Potential Life Lost, and Causes of Death Among Public Mental Health Clients in Eight States.  "Deceased public mental health clients had lost decades of potential years of life; averages varied from 13 to more than 30 years depending on the state and year...Most public mental health clients died of natural causes in all six states. The leading causes of death for mental health clients are similar to those found nationwide and statewide; they include heart disease, cancer, and cerebrovascular, respiratory, and lung diseases."
  • Journal article: Predicting the long-term risk of tardive dyskenesia in outpatients maintained on neuroleptic medications.  "Results: On the basis of 5 years of follow-up, we estimate the risk of persistent TD to be 32% after 5 years of neuroleptic exposure (95% confidence interval [CI] = 23%-43%), 57% after 15 years of exposure (95% CI = 47%-66%), and 68% after 25 years of exposure (95% CI = 58%-77%). For patients with 10 years of previous neuroleptic exposure, the risk is 15% after 5 more years of exposure (95% CI = 7.2%-27%) and 38% after 15 more years of exposure (95% CI = 24%-53%). Our results fall within the wide range of results found in other studies of TD incidence. Differences in incidence across studies may be explained in terms of patient characteristics and other methodological factors."
  • Book: Psychiatric Drug Withdrawal by Peter Breggin. pp. 120, 124, 125, 127. 
  • News article: The Impoverishment of Psychiatric Knowledge.  The Psychiatric Times. (entire article)

I found all the studies online without membership to any database.  I sent the cover page of the book or first page of the article, along with the selected pages where I underlined the above quotes.  

 

Putting together the letter and enclosures brought up some sadness and bitter feelings.  I just got back from the post office, however, and I feel free.


Jan. 2018:     900 mg  Lithium      1.0 mg Risperidone            250 mg Lamotrigine

Jan. 2019:     0 mg Lithium           0.625 mg Risperidone        175 mg Lamotrigine

Jan. 2020:     0 mg Lithium           0.260 mg Risperidone        175 mg Lamotrigine

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Glosmom

Way to go @carefulprayerful!!  Proud of you and what a good list of evidence.   Hugs, glosmom

 

 


2016 - Oct -Daughter started Risperdal (for steroid induced psychosis that never went away after stopping prednisone)

Nov - dose increases stopped at 1.5mg in Dec

2017 - Jan- weaned from 1.5 to 1.0 in 2 weeks then 1.0 to .5 in two weeks and then off. Feb. 3 weeks of increased psychosis, pacing, insomnia, other awful symptoms so late Feb  - Back on 1.5 mg Risperdal. May  - decrease to 1.25mg, two weeks later 1.0mg - symptoms started again. June - held steady at 1.25mg for 6 weeks and switched to liquid (3 ml syringe). July - started 10% taper every 3 weeks, October -  .8 mg, December - .7 mg .

2018 -Jan- 0.65 mg,  Feb- 0.59,  Mar-0.50, late April - .40mg, July- .36 mg, Aug - switched from 3 mL syringe to 1 mL syringe for more accuracy (her dad and i were not sure we were giving her the same dose when in between the 'dashes' on the 3 mL syringe.) Aug -.30 mg (3mL syr)/.44 mg (1 mL syr) difference due to med in the tip of both syringes). Sept- .28 mg (3mL syr)/.42 mg (1 mL syr). Oct - .16 mg (3 mL syr)/.30 mg (1 mL syr). Nov.- .06mg (3mL syr)/.20 mg (1mLsyr). Dec. - tip only/unmeasurable (3mL syr)/.10 mg (1mLsyr)

2019- Jan -.06 mg (1 mL syr), Feb- .025 mg (1 mL syr), Feb 27, 2019 - jumped to zero!!

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Altostrata
5 hours ago, carefulprayerful said:

I just got back from the post office, however, and I feel free.

 

Consider it a closure ritual.

 

I'll bet she'll love the reading matter.

 

How are you feeling now that you're on a minimal dose of risperidone? (It could get more minimal, of course.)


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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carefulprayerful

Thanks @Glosmomfor the encouragement!  💛

 

On 6/20/2020 at 9:34 PM, Altostrata said:

How are you feeling now that you're on a minimal dose of risperidone? (It could get more minimal, of course.)

I am feeling much better.  Things that used to cause a wave--exercise, having to get up early for something and not getting a full night's sleep, my menstrual cycle--no longer have much effect.  I rarely have symptoms, and when I do, they are mild and momentary (abdominal pain, stomach ache, headache, ears ringing, muscle tension).  I feel almost normal.  I'm so grateful to be writing that. Current dose is 0.185 mg risperidone.  I am currently microtapering for a total of 10%/month.  I'm not sure when to start tapering at a faster rate.


Jan. 2018:     900 mg  Lithium      1.0 mg Risperidone            250 mg Lamotrigine

Jan. 2019:     0 mg Lithium           0.625 mg Risperidone        175 mg Lamotrigine

Jan. 2020:     0 mg Lithium           0.260 mg Risperidone        175 mg Lamotrigine

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madmert9

Most of you are luckier than me. I was given Sertraline + Aripiprazole since the beginning of my treatment.I have never got the chance of using antidepressants alone.I always trusted my doctor and I'm feeling betrayed now for sure.I still can't understand what the reason was for using an antipsychotic in my treatment plan.Maybe it was just about money.You know abilify was a money maker for most doctors.

 

The problem is, I didn't even know what withdrawal was. When I stopped taking both of them I didn't feel anything bad.But after a few months I was left with mania.And the next year the same thing has happened to me one more time.Of course my doctor didn't say that It was about withdrawal.First he prescribed me an antipsychotic and after I used it for 5 years when I decided to come off it I had a manic attack.Even if the same pattern has occured 2 times, my doctor didn't say anything about withdrawal.

 

I was trapped because of abilify and they always behaved me like I was bipolar.My reason to go to a psychiatrist was not related to psychosis or mania.I was just a little bit obsessed with some kind of thoughts.

 

Tomorrow I'm gonna talk to him about this.And I will sue him because of the things which he did.I'm alone on this road.My family doesn't support me in this process at all.

Wish me luck :)


2012 - 2016

Sertraline (50 mg) + Aripiprazole (5 mg) (Both CT) (After CT I had my first mania attack.)

2016 - 2017

Sertraline (50 mg) + Aripiprazole (5 mg) (Both CT) (After CT I had my second mania attack.)

October 2017 - January 2018

Sertraline (50 mg) + Aripiprazole (5 mg) (Both CT) (After CT I had a movement problem)

March 2018 - April 2018

Bupropion (150 mg) + Aripiprazole (5 mg) (Both CT) (My movement problems were resolved but I became angrier than usual while I was using them)

April 2018 - July 2018

Prozac (20 mg) + Aripiprazole (5 mg) (Both CT) (After I CT'ed because of different problems which were related to my vision and finger jerks my movement problem came back.)

September 2020 - ...

I'm on Sertraline (50 mg) + Aripiprazole (2.5 mg).

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ChessieCat

 

This has been added to Post #1 of this topic:

 

You can PRINT OUT the "Stopping antidepressants" leaflet:

 

48 minutes ago, Shep said:

 

From CEPUK, 9/24/2020:

 

Major milestone: Royal College releases new guidance on stopping antidepressants

 

And here is the leaflet from Royal College of Psychiatry website: 

 

Stopping antidepressants

 

Might be useful to print out and take to doctors ignorant of withdrawal. May also be helpful for helping family members understand. 

 

 


Being very patient.  I'll get there - slowly.  ETA mid 2021

ADs:  25 years - 1 unknown, Prozac (caused muscle weakness), Zoloft/sertraline; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after)

Pristiq:  50mg 2012, 100mg beg 2013 (mild Serotonin Toxicity)

Began tapering Oct 2015  Current from 17 Oct 2020:  Pristiq 0.56 mg (compounded + liquid)

My tapering program

My Intro (goes to my tapering graph)

My website - includes my brief history + links to videos & information on the web

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions.

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CCFB

My 2 cents:

 

You are the patient ("client").  Physicians answer to you.  You don't answer to them.  If a doctor gives you advice that doesn't make sense or refuses to cooperate with a slow taper (i.e. "cut the pill in half," "liquid taper is unnecessary," etc.), respectfully find a second opinion.  You can always fire a doctor. 

 

You must have a physician though—would strongly advise against "going it alone."  

 

As for how to talk to doctors, I would suggest the following:

 

(1) Relentlessly educate yourself about your issues (peer support online, G Scholar, Pub Med, Examine, etc.), then confidently ask difficult questions. 

 

Don't assume the "white coat" comes with superpowers. 

 

A great many doctors are not too bright or informed about particular issues.  Doctors don't know everything, and they are expected to do a lot.  If you "become [an expert] on the thing that is threatening you," you will know what pointed questions to ask.

 

(2) I would suggest against trying to convince a treating physician about the existence of a systemic problem like "antidepressant" withdrawal.  (Others may disagree.)

 

For a physician, it's much easier to dismiss one patient, than to face the cognitive dissonance of having unknowingly prescribed harmful or addictive substances for many years.  

 

A better approach from my experience is to communicate that you yourself are extremely sensitive to medications and dose changes.  (After all, this is the truth.)  Listen to what your body is telling you.  If you react strongly to a dose change, that's probably a sign that something in your body isn't going the way that it should be going.  Communicate that.

 

If you can form a good relationship with a doctor over time (formed on trust and knowledge of goals), you will be better off.  The doctor will know the effect of a dose change on you based on how you were last month, last year, etc.

 

(3) The advice on this site about tapering gradually and avoiding impatience is solid.  This can play into your relationship with doctors.

 

If you change "antidepressant" doses too quickly, there is a chance that you may become temporarily emotionally unstable, which is a bad place to be.  Reinstatement after dramatic dose reductions is unpredictable, can cause awful side effects, and sometimes does not work at all.

 

If you consult an ill-informed doctor with whom you do not have a good relationship after a too-rapid dose reduction, he or she may simply suggest that you go on another medication.  In a bad place, you may make bad decisions out of desperation.  This can set you back.

 

From my personal experience, it's better to remain in a stable place, reduce symptoms, remain as healthy & productive as you possibly can, and allow the "antidepressant taper" part of your life to fade in the background.  Again, from my own experience, the withdrawal symptoms are really not too bad if you don't rush it.  If you do—then, yeah... it's bad.

 

 

 


Celiac, Cluster Headaches.

 

Escitalopram ("Lexapro") (previously) - dangerous substance, do not start taking this:

  • 03-05/2018 - 10mg
  • 05/2018-12/2019 - successful monthly recursive dose reduction to 0, tracked with spreadsheet

 

Current Regimen (maintenance):

  • Topiramate 100mg/day
  • Memantine 20mg/day
  • Modafinil 25mg/day PRN (in morning)
  • Cetirizine 10mg/day (in evening)
  • Life Extension "Migra-eeze" (Butterbur/Ginger/B2) - 2 capsules/day (standard dose)
  • Feverfew (Nature's Way) - 760mg/day
  • Magnesium Citrate (Pure Encapsulations) - 600mg/day
  • D - 3000IU/day
  • DHA Omega 3 (Nordic Naturals) - 4980mg/day
  • CoQ10 - 200mg/day
  • Multivitamin (Thorne) - 2 capsules/day (standard dose)
  • Nigella Sativa (ND) - 200mg/day
  • Berberine (Toniiq) - 1000 mg/day
  • NMN - 500 mg/day
  • ALCAR (Double Wood) - 500mg/day
  • NAC - 1000 mg/day
  • C - 1000mg/day
  • Quercetin - 250mg/day
  • Chamomile (tea)
  • Lion's Mane Mushroom capsules (ND 8:1 extract) - 2000 mg/day
  • Bacopa Monnieri (ND Synapsa or Bacognize) - 2 capsules/day (possibly serotonergic, advise against combining with "antidepressants")
  • 5HTP (Thorne) - 150mg/day (50mg with each meal) (DO NOT take precursors with any "antidepressant" or other serotonergic - serotonin syndrome can be fatal)
  • Panax Ginseng (ND "GS15-4") PRN - 1 capsule in morning (DO NOT take with any "antidepressant")
  • Melatonin (Natrol) 5mg/day

 

This is not medical advice.  Suppplements are unregulated in the United States.  Brands are included only for reference—this signature does not constitute an endorsement.  What is appropriate for me may not be appropriate for you.  Educate yourself about your problems (peer support groups, Examine, G Scholar, and Pub Med are gold).  

 

Always consult a qualified medical professional before taking any substance.

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