ContentIAM

[ContentIAM]

I'm so glad I finally found this forum, some very helpful information on here. Hello to all you fellow psych med sufferers. My diagnosis has gone back and fourth between schizoaffective disorder and bipolar disorder.

 

I've been on various meds since 2009; anti depressants, anti convulsants, antipsychotics and sedatives. I have been sectioned three times since then, once whilst I was on a high dose of paliperidone depot injection. None of them have improved my quality of life but some of them have helped keep psychotic symptoms at bay and keep me relatively stable, or so the doctors would attribute this to the meds. When I was discharged from hospital the last time I was only on a mood stabilizer - sodium valproate 1600mg. I was on this without any antipsychotics for about two months before my doctor insisted I go onto the aripiprazole depot. I have been on this for two years now with no dose change and feel it is time to slowly taper off, however my psychiatrist is reluctant so I may have to take matters into my own hands. I am on the 400mg abilify maintaina depot once a month. As the half life of abilify is around 46 days for 400mg it could take two months or more for it to be out of my system. Is this a safe taper rate or do I need to go back onto tablets or liquid and taper down? Also how can I work out when is the best time to start taking tablets again after some of the injection is out of my body?

 

I have come off abilify before when I was taking 15mg tablets, I was no longer under the support of a psychiatrist so tapered off myself over the course of two months. I was fine for 8 months without too many withdrawal symptoms until I started having sleep problems which led to delusions and psychosis once more. I had the capacity to notice this and voluntarily admitted myself to hospital... which led to being committed for 4 months

 

This time I am hoping to taper with support from doctors which could include some emergency tablets such as promethazine for sleep and benzos for anxiety. Also I will try to be prescribed a fast acting antipsychotic in case I feel I need it. Which med would be the best for this? I have been on olanzapine before and that seemed to stop psychosis dead in its tracks, on the other hand abilify didn't seem to have much effect on it for a while. Is it a case of the shorter the half life, the faster acting the med is? 

 

I want to be careful this time and gather as much information and support as I can, I can't be ending up on a ward again. Psychiatric meds have ruined my 20s but they can't take my 30s!

[Songbird]

Hi ContentIAM, welcome to SA.  We're glad you've found us, too!

 

It will help us to help you if you could please create a signature containing a summary of your med history, including all drugs, doses and dates (starting and stopping).  Your signature appears below every post you make, and allows us see your situation easily without having to read your topic from the top every time.   You could look at my signature for an example.  Instructions for creating your signature are here: Please put your withdrawal history in your signature.  You can edit your signature here: edit your signature in Account Settings.

 

On 6/7/2019 at 5:15 AM, ContentIAM said:

I have been on this for two years now with no dose change and feel it is time to slowly taper off, however my psychiatrist is reluctant so I may have to take matters into my own hands. I am on the 400mg abilify maintaina depot once a month. As the half life of abilify is around 46 days for 400mg it could take two months or more for it to be out of my system. Is this a safe taper rate or do I need to go back onto tablets or liquid and taper down? Also how can I work out when is the best time to start taking tablets again after some of the injection is out of my body?

 

Please read this topic thoroughly:  Tips for tapering off Abilify/aripiprazole.  You will find information in this topic about tapering by converting from the injection onto liquid or tablet.  You'll need to find a doctor who'll prescribe it for you.

 

On 6/7/2019 at 5:15 AM, ContentIAM said:

This time I am hoping to taper with support from doctors which could include some emergency tablets such as promethazine for sleep and benzos for anxiety. Also I will try to be prescribed a fast acting antipsychotic in case I feel I need it. Which med would be the best for this? I have been on olanzapine before and that seemed to stop psychosis dead in its tracks, on the other hand abilify didn't seem to have much effect on it for a while. Is it a case of the shorter the half life, the faster acting the med is? 

 

We generally do not recommend adding meds here.  We are not doctors and only provide information about tapering and withdrawal.  We also strongly encourage  using non-drug techniques for dealing with symptoms such as insomnia and anxiety.  For example:

 

 

Non-drug techniques to cope with emotional symptoms

Tips to help sleep - so many of us have that awful withdrawal insomnia

The Dr. Claire Weekes method of recovering from a sensitized nervous system

Relaxation exercises, guided meditations, calming videos, sleep hypnosis

 

Please post all your updates and questions about your situation here in your introduction topic, and we will try to help you as best we can.

 

[Altostrata]

Welcome, Content.

 

Here are our Tips for tapering off aripiprazole (Abilify)

 

A depot injection wears off, do you ordinarily get withdrawal symptoms towards the end of the month? If so, the link above will explain how you might switch to a very low tablet dose in order to complete your taper off aripiprazole.

 

On 6/6/2019 at 10:15 AM, ContentIAM said:

This time I am hoping to taper with support from doctors which could include some emergency tablets such as promethazine for sleep and benzos for anxiety. Also I will try to be prescribed a fast acting antipsychotic in case I feel I need it.

 

Not sure why you would need these. You're still taking sodium valproate 1600mg, correct? You might just let the injection wear off for 30 days, if you start getting withdrawal symptoms or odd sensations after that, you can effectively switch to aripiprazole 2mg daily; if that's enough, rest on that for a month or two, then taper off with a liquid.

 

[ContentIAM]

Thank you for your replies. I will add my med history when I'm on my PC.

 

I don't tend to notice withdrawal symptoms at the end of the month. I'm close to it now and don't feel much different to the beginning.

 

I wanted to have some emergency pills in case I feel myself slipping into delusions or paranoia and insomnia. The main issue last time was lack of sleep which with the reintroduction of aripiprazole tablets didn't seem to improve. I put this down to aripiprazole being a more wakeful antipsychotic than others such as olanzapine. 

 

I am all for non drug methods of treating withdrawal symptoms especially insomnia but it would give me piece of mind if I had drugs on standby just in case. 

 

I am not on sodium valproate anymore. I was tapered off that a while ago with the doctor.

[manymoretodays]

Hey ContentIAM,

Welcome from me too.  It looks like you got your signature done too!

Can you go to Account Settings, and just clarify what medications that you are on now, along with the dosages.

E.g. 

On 6/6/2019 at 11:15 AM, ContentIAM said:

I am on the 400mg abilify maintaina depot once a month

Just note the year and date.

And then here's an example signature too:

Example:

2001–2002 paroxetine 
2003  citalopram 
2004  paroxetine
2008  paroxetine slow taper down to 2016 Aug off paroxetine
2016  citalopram May 20mg  Oct slow taper down
2018  citalopram 13 Feb 4.6mg 15 Mar 4.4mg 29 Apr 4.2mg

 

Yours is good though, just a bit more detail.  It really helps us out too.

Okay?

 

Love, peace, healing, and growth,

manymoretodays(mmt)

[Altostrata]

10 hours ago, ContentIAM said:

I don't tend to notice withdrawal symptoms at the end of the month. I'm close to it now and don't feel much different to the beginning.

 

This means there's still enough aripiprazole in your system to forestall withdrawal symptoms. It's wearing off. This might be a sufficient taper for you.

 

You may wish to have 2mg aripiprazole tablets on hand if you start to get odd symptoms in the next month, they might be withdrawal symptoms. Or you may have no withdrawal problems at all.

 

For some people, symptoms of psychosis emerge when they don't get enough sleep. You may want to nurture your sleep with

 

Tips to help sleep -- so many of us have that awful withdrawal insomnia

 

Music for self-care: Calms hyperalertness, anxiety, aids relaxation and sleep

 

What is the sleep cycle?

 

Melatonin for sleep: Many people find it helpful

 

TV or computer use in evening can disrupt sleep: Bright light signals the brain that it's daytime

 

White noise devices for sleep

 

If you've had symptoms of psychosis before and find them disturbing, if you get them again, the very lowest dosage of a rescue drug for a short time might be sufficient to calm things down again. Please don't be discouraged. Many people do this.

[ContentIAM]

20 hours ago, Altostrata said:

 

This means there's still enough aripiprazole in your system to forestall withdrawal symptoms. It's wearing off. This might be a sufficient taper for you.

 

 

That's what I was hoping, I think the only withdrawal effects I get are anxiety especially social anxiety, however I have that most of the time anyway. Are there many supplements that can help with anxiety? I know magnesium is one and I have doctor's best chelated magnesium 100mg although I am running out. Do you know of a specific brand that has proven to be better than the rest?

 

I would much rather use supplements to control the anxiety and withdrawal symptoms but I suspect I may need a rescue drug as you mentioned and for me I think that would be promethazine first as it is a slight antipsychotic and helps with sleep then as a last resort olanzapine 5mg as it is very sedating. Also I have been prescribed it before so the GP should be able to write a script for me ..instead of waiting 3 months to see the psychiatrist. 

 

Thank you for those links on sleep, I will be sure to try them first before taking any substance. I've had melatonin in the past and it has worked well.

[Altostrata]

I like the same magnesium you've gotten. It's best taken in small doses more than once a day.

 

A lot of people find omega-3 fish oil supplements helpful, see
https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

If you have social anxiety, you might do well with some coaching, to reduce the fear. You could find a therapist, or maybe join a hobby group. There's nothing like seeing a familiar circle of people regularly to reduce social anxiety.

 

Your plan to have a low dose of promethazine on hand as a rescue dose seems reasonable. The goal is to keep you stable and out of the hospital so you can get on with things.

[ContentIAM]

Good to hear I've got the right magnesium, will be getting more of the same.

 

I've recently bought some L theanine too so will see how that goes.

 

I am joining a hobby group soon - aircraft restoration so there should be my kind of people there. I think a lot of the time my social anxiety stems from irritability, which I have read that aripiprazole can cause. I find myself in social situations where the people I'm with irritate me disproportionately even if they have been good friends. It's also frustrating where I can't express myself properly and socialise how I used to. I'm convinced this is due to the dumbing down effects of antipsychotics, it feels like they've locked off parts of my brain that I need to find words and converse normally. I have barely any wit or confidence anymore.

 

I hope I can restore the majority of functioning but I know it won't be a rapid process.

 

I used to work as an aeronautical engineer, now I spend my days trying to find a break from doing nothing. But no use in dwelling on the past.

 

 

[Turmalina]

Hi @ContentIAM. I'm also on 400mg of Abilify Maintena (monthly injection) since 01 2016.

Reading your signature reminds me about everything I've taken so far, mostly every drug you also took.

 

I'm new to this forum. I'm also trying to gather information about tapering off Abilify Maintena...

 

Guess we are not alone anymore!

[ContentIAM]

Hi @Turmalina. Sorry to hear you've been put on the depot too. How long have you been on antipsychs? 

 

I was on the aripiprazole depot for about 18 months but have been off it for 3 months and so far so good. I have had some tablets of the drug on standby if I felt I needed them however due to the long half life of aripiprazole, I haven't taken them. I think the long half life also has helped with weaning off the drug. As it's about 46 days for the 400mg depot. I haven't experienced many withdrawal effects luckily. I do however have olanzapine 2.5mg tablets to kill any manic episodes that arise or help with sleep. I have used them a few times.

 

The most important thing with coming off these drugs is whether you have the insight to notice the symptoms and deal with them rather than let them snowball into something more severe.

 

I hope that helps!

[Turmalina]

Hey @ContentIAM. Thanks for sharing your experience.

So, you are still taking Abilify Maintena?

 

I'm preparing myself to come out of it. I made my own topic here and I've been on anti-psychotics since 2010 when I had a psychosis episode.

I once taper off Olanzapine (2015) too quickly (From 30mg gradually to 5mg then to nothing in less than 6 months) and had all kind of hangover symptoms which lead my psychiatrist to prescribe me Abilify Maintena 400mg which I've been taking since 2016.

So yeah, I'm much affraid of quit Abilify Maintena since the dosage is higher than the pills I took...

[ContentIAM]

Hey @Turmalina.

 

No I'm not on abilify maintena anymore. I have some tablets if I need to take them but haven't yet. I've only taken 2.5mg doses of olanzapine since May this year when I've felt I needed them.

 

I was also on a high dose of olanzapine once and came off cold turkey.. a very bad idea. Only took a month or two to lead to delusions and psychosis again (Probably tardive). My current regime is working well. It was very difficult to persuade my psychiatrist to take me off the depot but I'm in charge of what goes into my body not them. They can recommend but they can't force it as I'm not on section or a CTO.

 

400mg is higher than the pills I was taking when I was on oral but as I said because of its long half life and it being a depot, it takes a long time to get out of your system. I can't guarantee it will be the same for you, this is just my experience. 

 

I would recommend asking for olanzapine tablets if you do come off the depot as they work very well to overcome insomnia withdrawal symptoms and keep mania at bay.

 

Will have a read of your topic