Mithridites: tapering off St. John’s Wort

[Mithridites]

Firstly, my thanks to all the individuals who make this forum possible. You are unsung heroes in service to others. The wealth of information you have created on here has made me second guess my decision to start on prescription antidepressants. SJW has been my lesser evil.

 

I’ve been fighting depression and anxiety most of my adult life. Sometimes it’s merely an inability to enjoy anything, even when things are good, I’m almost afraid to feel happy lest something bad happen and take it away. When things are bad (like when I was 20 and injured my back and lived with the pain of that, misdiagnosed, for 5 years, or like when I injured my feet at 30 and the fractures took over 2 years to even START healing) I slide into full-blown depression. The foot clinic offered me antidepressants (Effexor) then and CBT in 2011.  I took the therapy but flushed the pills. I was THAT afraid of the side effects.

 

I researched and started taking SJW and made some progress toward health. I was able to go back to work, fall in love and get married.  It seems bad things happen to me every 10 years like clockwork,  because now I’m 40 and my husband of 3 years has left me for no reason I can fathom. I’m in a worse place mentally than I was in 2010, thinking he was my last chance to start a family and now my life is basically forfeit.

 

So I asked my doc to prescribe Wellbutrin for me but I haven’t started taking it because I’ve been taking SJW for a decade and realized the two are likely to clash. I’m seeking info on how I should taper off the SJW and advice on whether anyone thinks the Wellbutrin might help. 

 

I have very low energy, am utterly joyless, ruminating and having hypothetical conversations in my thoughts - things I could have said to keep my husband. I also have social anxiety and general anxiety, worrying all the time about STUPID scenarios that intellectually I can tell are unlikely. Like that a car will turn suddenly and run my dog over. The dog is on a leash and I should be enjoying our walk but I am constantly on guard. Getting up in the morning is torture, even though I wake up at 3:30AM and can’t fall back asleep.

 

Falling asleep at night is hard - I play guided meditations to try and stop the thoughts. Sometimes I feel like this is some nightmare that’s not real and I’m not real either. It’s all I can do to go through the motions of a daily routine to appear semi-competent and keep my job which is the only thing I’ve got going for me. But I broke down crying in my boss’s office a week ago and took a sick day today and now I’m worrying about that too. I’m sorry if I’m doing this wrong.

 

I halved my dose of the SJW on Tuesday from 600mg to 300mg and have had worse sleep, concentration and some anger spikes. Thank you for your time. 

 

 

Edited June 6, 2020 by ChessieCat
added paragraph breaks

[ChessieCat]

Hi Mithridites and welcome to SA,

 

Firstly I'll get the "tough stuff" over and done with.  Please don't take offense but it is necessary that we provide this information.  SA is a site for reducing/getting off psychiatric drugs.  If you feel you need drug treatment, your needs may be better met on forums such as depressionforums.org  or patientslikeme.com.  Also, I caution that you please do not ask other SA members for their recommendations.  Doing this will warrant a warning being issued.

 

My suggestion, instead of starting a new drug, would be to see a counsellor or psychologist to learn life coping skills.  Very few people are taught how to cope with the challenges that life throws at us.  I'm 62 and started on an AD at about 36 due to many stressful life events.  I now believe that if I had received appropriate counselling support and been taught appropriate non drug coping techniques and life skills that I would not have spent almost half of my life numbed by a psychiatric drug.  I'm nearly off mine now and over the last couple of years I have started feeling like my old self.  I have periods of my life on an AD that I have no memory of.

 

Please be aware that chemical imbalance was disproved at least 20 years ago.  See: again-chemical-imbalance-is-a-myth-stop-the-lies-please/

 

If you do decide to take a psychiatric drug, please ensure that you do your research BEFORE starting it.  On the drugs.com website you can research drug side effects https://www.drugs.com/sfx/.  And also do a drug interaction check for any drugs you are currently taking, including St John's Wort.  Here are the links to two that we use:

Drug Interactions Checker

 

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

 

If you do a search for St John's Wort you might find some other members tapering this substance.  This is SA's topic on St John's Wort:

 

st-johns-wort-hypericum-perforatum

 

This is your own Introduction topic where you can ask questions, journal your progress and connect with the community.

 

[ChessieCat]

From your drug signature:  Also to sleep I take 10 mg melatonin

 

10mg is a large dose of melatonin.  You might find that you can do all right with a smaller dose.  Please see Post #1 of this topic:  melatonin-for-sleep

 

Magnesium and fish oil are the only supplements which SA recommends.

 

From your drug signature:  magnesium 50mg/d and ramping up

 

Magnesium is best taken throughout the day.  I find that it helps reduce my anxiety.  I have proven that it works by going off it several times and restarting it.  Also be aware that magnesium should be about 2 hours apart from calcium.  Please see SA's topic for types of magnesium and dosing:  magnesium-natures-calcium-channel-blocker

 

From your drug signature:  Supplementing with omega3 600mg/d

 

This is a low dose.  Please see:  king-of-supplements-omega-3-fatty-acids-fish-oil

 

You might find this topic helpful:  the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable

 

 

Edited June 6, 2020 by ChessieCat

[ChessieCat]

7 hours ago, Mithridites said:

I halved my dose of the SJW on Tuesday from 600mg to 300mg and have had worse sleep, concentration and some anger spikes.

 

You might consider updosing.  If things worsen after you reduce a dose that is a withdrawal symptoms from making too large a cut.  You could try taking 400mg or 450mg to see if that lessens the withdrawal symptoms.  It may take a few days to a week for the increase to take full effect.  It is better to start with a small increase and see how that goes.

[Mithridites]

Hi Chessie Cat,

No offense taken.  None. I appreciate you taking the time to speak to me as though I were your younger self, before you took prescription ADs. 

I have reached out to the therapist who helped me 10 years ago. Unfortunately the email address is no longer valid, so I have to think again what to do. It’s difficult to find someone to open up to. I had one mediocre therapist and one good one, and the difference was remarkable. I am working on the coping skills: good diet, sleep hygiene, yoga, meditation, a daily routine that doesn’t overwhelm. I’m rereading Eckhart Tolle’s “Living a Life of Inner Peace” and Byron Katie’s “A Mind at Home with Itself.” Any other suggestions for helpful coping tools are welcome.

I used the drug interaction checker. I’m really glad I did. It could have been bad mixing the SJW with the Wellbutrin my doctor prescribed. I also read the SA topic on SJW.

I tried a smaller dose of the melatonin (6mg) - on Friday night when I had an easy work-free morning ahead, and it did fine. So thank you and I plan to stick with the lower dose and maybe even decrease again to 3mg. Or do you think it’s too soon?

I purchased magnesium citrate powder for ease of increasing the dosage. I'm sipping the liquid a few times a day and watching the results. I’m overly regular, if you know what I mean, but not suffering. Does that reaction to magnesium pass with time?

I ordered larger dose capsules of the Omega-3 as recommended - planning on ramping up the dose to 3,000 mg/d.

I’ve considered up-dosing the SJW. Even made a half-dose capsule with the intent of taking it in the afternoon on Friday. However,   I’ve been feeling more calm since then and less gloomy. I still have a couple of moments a day where my concentration or short term memory lapses, but my mood has smoothed out considerably. So I might hold at 300 mg/d and keep monitoring my responses. Do you think that might be okay?

 

[ChessieCat]

On 6/8/2020 at 2:23 AM, Mithridites said:

I purchased magnesium citrate powder for ease of increasing the dosage. I'm sipping the liquid a few times a day and watching the results. I’m overly regular, if you know what I mean, but not suffering. Does that reaction to magnesium pass with time?

 

That's a sign that you are taking too much.  It would probably be a good idea to reduce the total daily intake.

 

On 6/8/2020 at 2:23 AM, Mithridites said:

I tried a smaller dose of the melatonin (6mg) - on Friday night when I had an easy work-free morning ahead, and it did fine. So thank you and I plan to stick with the lower dose and maybe even decrease again to 3mg. Or do you think it’s too soon?

 

You have to be careful not to make too many changes (ie adding in, subtracting, change doses up or down) within a short period of time.  If you make more than one change and things worsen you will not know what has caused the issue.   the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable

 

On 6/8/2020 at 2:23 AM, Mithridites said:

Any other suggestions for helpful coping tools are welcome.

 

Non-drug techniques

 

the-dr-claire-weekes-method-of-recovering-from-a-sensitized-nervous-system

 

This site has some excellent resources.  I've found it easiest to do a search specifically for what I am looking for (eg health anxiety, CBT, sleep) and include the website in the search term.  https://www.getselfhelp.co.uk

 

https://www.getselfhelp.co.uk/emergency.htm

 

First Aid for Panic from getselfhelp:

 

Female voice:  https://www.getselfhelp.co.uk/music/FirstAidPanicF.mp3

Male voice:      https://www.getselfhelp.co.uk/music/FirstAidPanicM.mp3

 

This is also helpful:

  

On 4/9/2020 at 10:31 AM, brassmonkey said:

AAF: Acknowledge, Accept, Float.  It's what you have to do when nothing else works, and can be a very powerful tool in coping with anxiety.  The neuroemotional anxiety many of us feel during WD is directly caused by the drugs and their chemical reactions in the brain.  Making it so there is nothing we can do about them.  They won't respond to other drugs, relaxation techniques and the like.  They do, however, react very well to being ignored.  That's the concept behind AAF.  Acknowledge, get to know the feeling involved, explore them.  Accept, These feelings are a part of you and they aren't going anywhere fast. Float, let the feeling float off as you get on with your life as best as you can.  It's a well documented fact that the more you feed in to anxiety the worse it gets.  What starts as generalized neuroemotinal anxiety can be easily blown into a full fledged panic attack just by thinking about it.

 

I often liken it to an unwanted house guest.  At first you talk to them, have conversations, communicate with them.  After a while you figure out that they aren't leaving and there is nothing you can do to get rid of them.  So you go on about your day, working around them until they get bored and leave.

 

It can take some practice, but AAF really does work.