KittyCat: finally engaging

[KittyCat]

Hi, I'm 39 years old and have been lurking on this site intermittently for at least seven of the eleven years I've been on polypharma. I've never posted. The reasons I ended up on the meds I'm on are different than I've seen from anyone else, which has felt isolating. So for those who have the patience to read my story, I'd love to know if you share commonalities with me.

The short version: escitalopram, buspirone, bupropion for 11 years. Mirtazapine for 8, following an unsuccessful too-fast escitalopram taper. Meds prescribed for terminal insomnia after ten years of cortisol-related early AM waking and being unable to go back to sleep, except bupropion, which was prescribed to counter side effects.

 

Here's the long story, if you want.

 

Rewind a bunch. I'm seventeen years old. I've been on depo-provera for a few months, which I don't realize is making me terribly depressed, because I have such little self-awareness. It's my first night away at college. Also one of my first few times very, very drunk. I don't know that it makes you dehydrated. I don't know that there's a cortisol spike in the AM hours, and that drinking makes that higher and earlier. I don't know much of anything, especially about how to take care of myself in a world full of interesting opportunities to experience altered states. I wake up at 4am with my heart racing. I can't get back to sleep for hours.

This has never happened before. My childhood insomnia was about falling asleep, not staying asleep. The 4am wakeup and long sleepless period happens every single night, beginning that first night at college. Even the nights I don't drink. I try melatonin, Benadryl. Nothing helps. I develop anxiety around sleep, but I don't realize that's happening. I'm too young and have too little self-awareness. Drinking quells the anxiety enough that I can go to sleep. I don't realize it's making the cortisol cycle worse.

-

Now I'm in my early 20s. I dropped out of college to drink and take a lot of all different kinds of illicit drugs. It's mostly in an attempt to medicate depression and sleep issues, but I'm starting to realize that the drugs and drinking are making it worse. I am pretty sure I've done some damage to myself somehow by now, especially with MDMA. I'm still waking up at 3-4am. Sometimes I drink myself back to sleep. I spend part of a year taking prozac. It doesn't seem to help me. I stop taking it. If I have withdrawals, I don't notice them, probably due to drinking.

 

Eventually, after a beloved pet disappears, I check myself in to the psych ward, suicidal and having panic attacks, but unwilling to admit that my primary issue is alcoholism. I've already convinced a psychiatrist to diagnose me with Bipolar I and send me home with Depakote and Seroquel. Being in a psych ward seems a logical next step.

 

After I'm released, I find that shaking from the Depakote interferes with my ability to pour beer from pitchers, so I stop taking it. The seroquel makes me balloon up in weight (I've always been naturally very thin), binge on fast food, sleep 14 hours a night (still with a 4 am wakeup), and be unable to get off the couch when I am awake. I eventually stop taking it too. I don't notice withdrawals. I'm drinking far too much to notice something like that.

-

I've just turned 25. I haven't worked in years. A sequence of awful events leads me to get sober. I'm not on any psych meds. I don't take any drugs. Sobriety gives me so much, hard as it is. I'm still waking at 4 am, heart pounding, sleepless for long periods. My recovery friends tell me it gets better. I practice ridiculously impeccable sleep hygiene. I exercise regularly, but not too hard. I go to acupuncturists, naturopaths, cranio-sacral practitioners, therapists. I check into a sleep clinic. I wake up 164 times that night. They tell me they can't find a reason for my insomnia.

 

Two years pass. I still wake at 4 am, can't get back to sleep for over an hour. I am in college. I am working. I am pulling my life together. But I feel awful every single day from sleep deprivation. In the middle of yoga class, I fall asleep once doing downward dog, waking as I collapse on the floor. I am exhausted. I am desperate. I still don't drink, don't use drugs.

 

I am 27. I get referred into the closed private practice of a neurologist. At my request, he tries tons of supplements first. I do not want to go on medications. I did not get sober for that. He is happy to work with supplements. He's past retirement age and clearly cares about his patients. He does this for love, not money. I am grateful. The supplements do not help. We try many. I am too poor to raise my dose more with some of them, even though he sells some of them to me at cost - the ones he can get at wholesale prices. Medications are cheaper. I cave in. He writes a prescription for Lexapro and buspirone, which I fill.

 

I sleep through the night. It has been ten years since I got a good night's sleep. I wake in the sunshine in my high-ceilinged room, blocks from the university where I'm about to begin attending classes to finish my bachelor's degree. Everything feels like it is finally falling into place.

 

I don't sleep through the night again, but every morning when I wake at 4am, I immediately fall back asleep. I am rested. I'm able to learn, to make use of my therapy and all my internal work. I've lost huge parts of my sexual functioning, which activates trauma from younger years, but I don't care enough to go off the meds. Sleep is too important. I do ask my neurologist if there's anything that can help. He prescribes bupropion. It sort of helps, a little. Maybe.

 

I'm 29. I've lost a lot of my sexual functioning. I've also become disconnected from my spirituality, which was a fundamental part of my life since...since forever. It will take a few years before I attribute the latter to my medications. I'm still on three meds and a bunch of supplements.

 

Now I'm 32. I've met the man I plan to spend the rest of my life with. We are talking about children. I am advised by several doctors not to have kids when I'm on this cocktail unless I'm certain I'm willing to go through whatever they may experience as a result of me being on them - which is a huge unknown. They may be born healthy. They may be born needing a lifetime of 24/7 care. I know I have to get off the meds. I find this site. I do a half-hearted six month taper off of ten mg of escitalopram. As I come off the last of it, I can taste my spirituality again and my sexuality begins working again. But none of that matters, as I lose my grip on sanity at the same time. I work with my neurologist to try a ton of other kinds of meds. None of them work well for sleep or mental health, but mirtazapine seems to help a little for sleep. So I stay on it. My neurologist runs out of things he can and will prescribe to a former addict. I go back on the escitalopram too. Then I raise the dose of the escitalopram from 10mg non-generic to 20mg generic, because the generic doesn't seem to work as well. I can sleep again. I exhale. No babies for me, no orgasms, no spiritual connection, but at least I can sleep.

 

One time, when camping, I miss taking my lexapro in the dark. I don't realize it's still in my pill case. I have an overwhelming suicidal episode that lasts until that night, when I discover my mistake, take my dose, and am fine-ish the next day. I now know this is not a medication I can easily change.

 

It's 2018. I'm 38. I have the dubious luxury of being between careers and the indisputable luxury of having someone else who can pay the bills, if barely. I am hearing scary things about antihistamines, which is what mirtazapine mostly does at the 7.5mg dose I'm on. It is drying me out. I know this cannot be good for me. I am still sleeping. I want to see if I can be on less of my meds and still sleep. Maybe I can get some of my sexual functioning back. Maybe some of my spiritual connection. Maybe just a healthier life in ways I can't identify for sure.

 

Slowly, carefully, following the 10% or less rule, holding when I feel unstable, I begin to taper my mirtazapine. The lower I go, the worse my sexual functioning gets. I know the escitalopram has to be reduced.

 

Last night, I took 18mg of carefully made liquid escitalopram instead of the 20mg tablet I've been taking for the last eight years.

In the past few months, to deal with being on less mirtazapine, I've been carefully experimenting with CBD. I'm not afraid to trade off one thing for another, if I can sleep and have a side effect profile I'm ok with. I smoke and vape it to avoid the first pass metabolism interactions with my meds. I'm not sure if that actually works that way, but it seems to interact with them less than when I take it orally. I know this method of consumption isn't ideal, because it incurs health costs too. I feel concerned about my options. But I am determined to be on less of the meds that are giving me these side effects. Maybe someday I can reduce or get rid of the CBD too. Maybe the side effects from it are just not as frustrating.

 

I'm not anti meds. I believe they saved my life. I was suicidal from ten years of daily terminal insomnia. And the meds still work for me. But want off of them, as much as I can be and still mostly sleep. I don't know if I get back my sexuality or my spirituality, at any dose or no dose. But when I quit lexapro before, it looked like I might, and I miss the life energy those things gave me.

 

So I'm here to offer support, and to receive it. I'm sure I'll need to do both to make it through this process. I'll add meds to my sig later, when it's not so dang late.

 

 

Edited July 1, 2019 by Shep
added new username to title

[manymoretodays]

On 6/27/2019 at 12:59 AM, KittyCat said:

Slowly, carefully, following the 10% or less rule, holding when I feel unstable, I begin to taper my mirtazapine. The lower I go, the worse my sexual functioning gets. I know the escitalopram has to be reduced.

 

Last night, I took 18mg of carefully made liquid escitalopram instead of the 20mg tablet I've been taking for the last eight years.

In the past few months, to deal with being on less mirtazapine, I've been carefully experimenting with CBD. I'm not afraid to trade off one thing for another, if I can sleep and have a side effect profile I'm ok with. I smoke and vape it to avoid the first pass metabolism interactions with my meds. I'm not sure if that actually works that way, but it seems to interact with them less than when I take it orally. I know this method of consumption isn't ideal, because it incurs health costs too. I feel concerned about my options. But I am determined to be on less of the meds that are giving me these side effects. Maybe someday I can reduce or get rid of the CBD too. Maybe the side effects from it are just not as frustrating. 

 

I'm not anti meds. I believe they saved my life. I was suicidal from ten years of daily terminal insomnia. And the meds still work for me. But want off of them, as much as I can be and still mostly sleep. I don't know if I get back my sexuality or my spirituality, at any dose or no dose. But when I quit lexapro before, it looked like I might, and I miss the life energy those things gave me.

Hi KittyCat and welcome aboard,

 

Are you still on the buspirone and bupropion?

 

I think that you have had some withdrawal(WD) symptoms mixed in with your original insomnia. 

 

I'm not sure exactly, what is going on with your sexual functioning or if that is related to your mirtazapine taper or use of high dose Lexapro.  At age 38 now,  for you, it's possible that you may have some fluctuation in hormones, due to peri- menopause.  A bit early, but many of these medications do effect hormones too, when used long term.  Or that's what I found, as far as my own experience with having menopause on the early side.

 

 

What is withdrawal syndrome?

Dr. Glenmullen's withdrawal symptom checklist

When we take medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made.  The CNS likes stability. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur. And sleep is really important during withdrawal.  Insomnia is no small deal.  As I'm sure you are aware.

 

The signature will be really helpful for us to see.

*Please put your withdrawal history in your signature

 

I'm going to add some of our key topics here, as well below, stars/asterisks by those, which might have higher priority, for now.  You may already be familiar with some of these topics, after 7 years looking in and onto the site.  I'm happy that you have decided to engage.

 

*Why taper by 10% of my dosage?

*Taking multiple psych drugs? Which drug to taper first?

* The Windows and Waves Pattern of Stabilization

 

Again, chemical imbalance is a myth. Stop the lies please.

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system.  

 

Magnesium, nature's calcium channel blocker 

Omega-3 fatty acids (fish oil) 

 

I'm not really understanding, at this moment, too much about your use of CBD to avoid first pass metabolism interactions, with your meds/drugs.  Not much is known, as far as withdrawal and the use of CBD oil.  And do keep in mind that after polypharmacy or prolonged usage of psychotropic medications/drugs, many of us have become very sensitive to the usage of more psychotropics.  Or maybe we were sensitive from the get go.  I don't think it's about being fearless per se, as much as just being prudent and perhaps allowing ones body to work with, what it naturally has for healing.  

 

And of course, another link for you:

Cannabis, marijuana, THC, and CBD or Hemp oil

 

*Could you plug all your meds/drugs into the Drugs.com interaction checker,  and then copy and paste it for us, here on your introduction.

And I certainly agree, that your move to a safer combination of medications/drugs may be the way to go.  And perhaps considering coming off or lowest possible dosages of some. 

 

All for this post. 

 

Welcome again. This is your introduction/journal page where you have now introduced yourself to the community, you can ask questions here regarding your tapering, give updates, and just keep a record of your journey too.

 

Love, peace, healing, and growth,

manymoretodays(mmt)

 

 

 

Edited July 2, 2019 by manymoretodays
additional thoughts

[manymoretodays]

More links to information from our tapering section:

Tips for tapering off mirtazapine(Remeron)

Tips for tapering off Lexapro(escitalopram)