Geralt14: Feeling Trapped

[Geralt14]

I am in my mid-thirties, and I've been on some form of antidepressant since adolescence. As a socially awkward, bullied young person in the throes of puberty, I hit a wall of apathy and sadness sometime in my sophomore year of high school. I no longer had the drive to make the Dean's List or pursue the activities I once enjoyed. This is when a pivotal conversation with my primary care provider occurred. He rolled toward me on a medical stool, pointing at printed charts illustrating neurotransmitters and a faulty brain chemistry. I think I was prescribed Zoloft, but I don't recall the details. I do remember that my parents remarked on the difference the medication made in my mood, and truth be told I was thankful at that time that I'd found the help I needed.

 

Throughout college and into my twenties, my doctor adjusted my medication(s) several times. These adjustments usually corresponded with various hardships and bumps in the road inherent to living a human life. But I was fully bought into the idea that my brain was unbalanced, and feeling "okay" was just a matter of finding the right med or mix of meds to temper the discomfort. In my late twenties, I fought hard to get sober, recognizing that alcohol was causing far more harm than good in my life. Around the same time, I was prescribed Ambien for sleep (as needed). In the true fashion of an alcoholic, "as needed" soon became "every night." A couple years later, for reasons unknown to me or unremembered, my doctor prescribed Temazepam for my nightly sleep regimen to replace the Ambien. I had no understanding of benzodiazepines, their risks, or the withdrawals often associated with quitting them. 

 

I remained on a cocktail of Pristiq/Wellbutrin for depression paired with Temazepam to slow my brain at night for nearly five years. Honestly, I didn't think much of it. I trusted my doctor, and had no reason not to. I moved to a new city in 2016, started a new career, and felt in many ways that I was hitting my stride.

 

In 2019, my then girlfriend suggested that I try and see what things might be like if I tapered off of the medication. Herself a trained therapist, she was particularly concerned that I relied on something to sleep every night. I agreed, and thought I'd like to see if these drugs were really necessary anymore. I was sober, I certainly wasn't depressed, and I had a good support system in place. In partnership with a new doctor and with my therapist on board, I made a plan to taper off of the medication. First the Wellbutrin, which we dropped over the course of a month or so. Then the Pristiq, which we tapered down over the course of a couple months. Then, snowed in on a November day and down to my last 30mg dose of Temazepam I thought, "I'll just stop taking this and be done with these meds completely." 

 

During the antidepressant tapering process, I was a bit more irritable and had some trouble focusing, but I was mostly functional. The symptoms were mild to moderate. Even in the immediate days and weeks after dropping the Temazepam, I felt okay. I slept fine, and I was mostly just excited to no longer be chained to a monthly sack of prescription refills to fix my "broken" brain. 

 

Fast forward to just after Christmas 2019. Some challenges in my relationship were giving me anxiety, but it was anxiety like I'd never felt before. And the strength of the anxiety was entirely disproportionate to the reality of the situation. It wan't long before I wasn't sleeping. Soon, I felt unsafe spending nights alone, fearing for my own safety. Thoughts of suicide cycled through my brain with regularity. A couple of weeks passed, and even basic tasks became insurmountable. I was in a near constant state of fight-or-flight. One Sunday evening I opened up my laptop to try and catch up on some things at work that I'd fallen behind on, and I couldn't focus my eyes to read an email. Panic began to set in, and I dialed my physician and then my therapist to try and make sense of what was happening. At the time, I placed much of the blame on my relationship, but I see now that I was in acute drug withdrawal. 

 

I fought my way through a haze of psychiatric evaluations, doctor's visits, emergency therapy appointments, the dissolution of my relationship, and a car accident (in which thankfully nobody was hurt). Eventually, at my own insistence, I found my way back to the original three medications I'd been taking, thinking that would be my best shot at finding some sense of stability. It's only been in the last month or so that I've felt some degree of what I would call stability, and I'm operating at about 75% of the mental capacity I once was, trying to pick up the pieces of my life and make sense of everything that happened.

 

That search to make sense of everything is what led me here. I know that I do not want to be on a cocktail of medication for the rest of my life. I don't want to medicate my feelings or rely on a drug to fall asleep or live detached from my emotional experience. But I also know that right now, the right thing to do is to wait. I have to wait until my nervous system stabilizes and I can set up the proper plan and support system (the latter of which is made more complicated by the global pandemic we're all experiencing). 

 

If you have any advice for how I should go about tapering these medications based on my history, current dosage, and the experience described above, I am all ears. I look forward to actively participating in this withdrawal process alongside all of you, even if I need to wait a bit before I set out again. Much love. 

[Gridley]

Welcome to SA, Geralt14.  It sounds like you have a very good grasp of your situation.   We'll be happy to help you taper off these drugs when you're ready.

 

As you probably know, the "chemical imbalance" theory is a myth concocted by the pharmaceutical company and has been thoroughly debunked.  

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

So you have a better understanding of what you experienced after your very fast tapers and cold turkey, here is some information on withdrawal.

 

What is withdrawal syndrome.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

Brain Remodelling 

 

When we take psychiatric 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. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.  

 

Regarding your taper, we recommend tapering by no more than 10% of your current dose every four weeks.  Some have to go more slowly, for example 5% instead of 10%.

 

Why taper by 10% of my dosage?

 

The Brassmonkey Slide is a way of making micro-taper reductions weekly, as opposed to a larger reduction once a month. I used this for my Lexapro taper.

 

The Brassmonkey Slide Method of Micro-tapering

 

We recommend tapering only one drug and a time and that you start with the most activating drug first, leaving the sedating drug in place to act as a buffer to be tapered later.

 

Taking multiple psych drugs? Which drug to taper first?

 

In your case, if Wellbutrin has an activating effect, as it often does, that would be the drug to taper first, followed by the Pristiq and finishing up with the benzo, temazapam.  The following link is specifically about tapering Wellbutrin, including how to get the nonstandard doses of XL you'll need for your future taper.

 

Tips for tapering off Wellbutrin, SR, XR, XL (buproprion)

 

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) 

 

Add in one at a time and at a low dose in case you do experience problems.

 

This is your Introduction topic, where you can ask questions and connect with other members.  We're glad you found your way here.