Lindsey75: urgently need help

[Lindsey75]

I'm new to this site. My sister referred me (mod note:  see sister's post here sister-of-saradee-help-needed-urgently-in-nj

 

I'm 45 and have been on meds for bipolar, major depression, Bpd, Attention deficit, social phobia, Gad, panic disorder, dependant personality disorder, etc. I have been taking meds throughout my adult life and am have found no relief. In fact I think I believe these meds are making me sick, keeping me stuck, and making life unbearable. I've been on more antidepressants, tranquilizers, antipsychotics, mood stabilizers than I can remember and am currently taking ketamine for my treatment resistant antidepressant. I am also a "recovering" addict, although Im just as addicted to the drugs prescribed by my doctor as I ever was to street drugs. Heroin was my drug of choice, and I have been on suboxone for over 15 years now. In addition to the suboxone, I'm prescribed wellbutrin, xanax, Adderall, and Tamazapam and Ketamine. I literally take a pill to wake up, to go to sleep, to go to eat, and to go to the bathroom. Every day feels like a balancing act and I feel lucky when I get a few minutes that I feel well enough to get out of bed to get to my overwhelmingly long and over due to do list. I really am not functioning on any level and am having trouble finding hellp. I'm trying to get treatment but I can't seem to find a place who has a doctor who will work with me to get off the meds either because they aren't qualified or because I don't have a good enough support system in place for such a drastic change. So I have considered detox which scares me because 3 to 10 days does not seem adequate to get off a lifetime of meds. I would like to go to rehab as well, but would have to detox First. The other traditional option would be a psych unit, however, I'm afraid that that will just be more of the same...throwing medication at a problem that meds don't seem to be helping. Anyhow, I don't know if this is appropriate, or if I'm posting in the right place, but I just really need help. I feel like a huge burden to everyone especially my family, my daughter should be the focus and although my fiance is there for her, it's just not ok. I want this to stop but I just don't know what to do. Thank you in advance for taking the time to read this. Any ideas or insight would be greatly appreciated. 

 

 

Edited April 13, 2021 by ChessieCat
added like to sister's post

[Gridley]

Welcome to SA, Lindsey75.

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.  Drugs, dosages and dates in a list format is best.

 

Account Settings – Create or Edit a signature.

 

We're a site for going off psychiatric drugs and for dealing with withdrawal from those drugs. We don't put a lot of stock in DSM psychiatric diagnoses, which tend to be arbitrary and vary from doctor to doctor.   In this initial response, I'd like to give you some basic information and encourage you to ask questions once you've gone through the material.  To start, we recommend tapering by no more than 10% of your current dose every four weeks.  

 

Why taper by 10% of my dosage?

 

We recommend tapering off only one drug at a time, starting with the most activating (called accelerators) and leaving the more sedating drugs (called brakes) in place to help preserve sleep to be tapered off last.  Suboxone is outside the realm of what we do here.  Regarding ketamine, I encourage you to Google "SurvivingAntidepressants.org ketamine" to get some background on this drug. 

 

Taking multiple psych drugs? Which drug to taper first?

 

Doctors know nothing about safe tapering and don't believe in the existence of withdrawal, often misdiagnosing withdrawal as "return of the underlying condition" and throwing more drugs at their patients.  Here is some information on withdrawal and the healing process.

 

What is withdrawal syndrome.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

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.  

 

These explain the healing process really well.

 

Brain Remodelling 

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

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. Get supplements that are single ingredient (not mixed with other types of supplements).

 

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

 

 

 

 

 

 

 

 

 

 

 

 

 

[ChessieCat]

HI Lindsey and welcome to SA from me too

 

I'm the mod who responded to Saradee and I am very pleased that you have joined SA.  See:  sister-of-saradee-help-needed-urgently-in-nj

 

As well as creating your drug signature as requested by Gridley, please give us the details, in a post (not signature) of the times and doses you are taking your drugs.

 

Also please start to keep daily symptoms notes (to start with we need 3 consecutive days) and post 24 hours at one time so that your situation can be assessed.  See this post which explains the format required as well as explains the reason for notes being requested.

 

Keep Notes on Paper

[ChessieCat]

Hi again,

 

Please also do a drug interaction check and copy and paste the results here in a post in your Introduction topic.  Thank you.

 

You will need to register but it is free to do this.

 

Drug.com Interactions Checker

[Lindsey75]

Drug Interaction Report

 

This report displays the potential drug interactions for the following 5 drugs:

 

• Xanax (alprazolam)
• ketamine
• Suboxone (buprenorphine / naloxone)
• Adderall (amphetamine / dextroamphetamine)
• temazepam

 

Major (5)

Moderate (3)

Minor (0)

Food (4)

Therapeutic Duplication (2)

 

Interactions between your drugs

 

Major

ALPRAZolam  ketamine

Applies to: Xanax (alprazolam), ketamine

Using ketamine together with ALPRAZolam may increase side effects such as dizziness, drowsiness, confusion, difficulty concentrating, excessive sedation, and respiratory depression. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with ketamine. Also avoid activities requiring mental alertness such as driving, operating hazardous machinery, or engaging in potentially hazardous activities until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

 

Major

ketamine  temazepam

 

Applies to: ketamine, temazepam

Using ketamine together with temazepam may increase side effects such as dizziness, drowsiness, confusion, difficulty concentrating, excessive sedation, and respiratory depression. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with ketamine. Also avoid activities requiring mental alertness such as driving, operating hazardous machinery, or engaging in potentially hazardous activities until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

 

Major

ALPRAZolam  buprenorphine

Applies to: Xanax (alprazolam), Suboxone (buprenorphine / naloxone)

Using buprenorphine together with other medications that also cause central nervous system depression can lead to serious side effects such as respiratory distress, coma, and even death. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Do not drink alcohol or self-medicate with these medications without your doctor's approval, and do not exceed the doses or frequency and duration of use prescribed by your doctor. Also, you should avoid driving or operating hazardous machinery until you know how these medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

 

Major

ketamine  buprenorphine

Applies to: ketamine, Suboxone (buprenorphine / naloxone)

Using ketamine together with buprenorphine may increase side effects such as dizziness, drowsiness, confusion, difficulty concentrating, excessive sedation, and respiratory depression. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with ketamine. Also avoid activities requiring mental alertness such as driving, operating hazardous machinery, or engaging in potentially hazardous activities until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

 

Major

temazepam  buprenorphine

Applies to: temazepam, Suboxone (buprenorphine / naloxone)

Using buprenorphine together with other medications that also cause central nervous system depression can lead to serious side effects such as respiratory distress, coma, and even death. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Do not drink alcohol or self-medicate with these medications without your doctor's approval, and do not exceed the doses or frequency and duration of use prescribed by your doctor. Also, you should avoid driving or operating hazardous machinery until you know how these medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

 

Moderate

ALPRAZolam  temazepam

Applies to: Xanax (alprazolam), temazepam

Using ALPRAZolam together with temazepam may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

 

Moderate

ketamine  amphetamine

Applies to: ketamine, Adderall (amphetamine / dextroamphetamine)

Both ketamine and amphetamine can increase blood pressure and heart rate, and combining them may enhance these effects. Talk to your doctor before using these medications, especially if you have a history of high blood pressure or heart disease. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if your condition changes or you experience increased side effects. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

 

Moderate

ketamine  dextroamphetamine

Applies to: ketamine, Adderall (amphetamine / dextroamphetamine)

Both ketamine and dextroamphetamine can increase blood pressure and heart rate, and combining them may enhance these effects. Talk to your doctor before using these medications, especially if you have a history of high blood pressure or heart disease. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if your condition changes or you experience increased side effects. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

 

No other interactions were found between your selected drugs. This does not necessarily mean no other interactions exist. Always consult your healthcare provider.

 

Drug and food interactions

Moderate

ALPRAZolam  food

Applies to: Xanax (alprazolam)

Grapefruit and grapefruit juice may interact with ALPRAZolam and lead to potentially dangerous side effects. Discuss the use of grapefruit products with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor. Do not drink alcohol while taking ALPRAZolam. This medication can increase the effects of alcohol. You may feel more drowsy, dizzy, or tired if you take ALPRAZolam with alcohol. Talk to your doctor or pharmacist if you have any questions or concerns.

Switch to professional interaction data

Moderate

ketamine  food

Applies to: ketamine

Alcohol can increase the nervous system side effects of ketamine such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should not drink alcohol during treatment with ketamine. If you have received ketamine for anesthesia, you should avoid activities requiring mental alertness such as driving or operating hazardous machinery for at least 24 hours and until you know how the medication affects you. If you are taking ketamine orally, you should also avoid the consumption of grapefruit or grapefruit juice, which can significantly increase blood levels and side effects of the medication. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate

amphetamine  food

Applies to: Adderall (amphetamine / dextroamphetamine)

Using amphetamine together with alcohol can increase the risk of cardiovascular side effects such as increased heart rate, chest pain, or blood pressure changes. You should avoid or limit the use of alcohol while being treated with amphetamine. Let your doctor know if you experience severe or frequent headaches, chest pain, and/or a fast or pounding heartbeat. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate

dextroamphetamine  food

Applies to: Adderall (amphetamine / dextroamphetamine)

Using dextroamphetamine together with alcohol can increase the risk of cardiovascular side effects such as increased heart rate, chest pain, or blood pressure changes. You should avoid or limit the use of alcohol while being treated with dextroamphetamine. Let your doctor know if you experience severe or frequent headaches, chest pain, and/or a fast or pounding heartbeat. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

 

Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

 

Duplication

Central Nervous System (CNS) Drugs

Therapeutic duplication

The recommended maximum number of medicines in the 'Central Nervous System (CNS) Drugs' category to be taken concurrently is usually three. Your list includes four medicines belonging to the 'Central Nervous System (CNS) Drugs' category:

Xanax (alprazolam)

ketamine

Adderall (amphetamine / dextroamphetamine)

temazepam

Note: The benefits of taking this combination of medicines may outweigh any risks associated with therapeutic duplication. This information does not take the place of talking to your doctor. Always check with your healthcare provider to determine if any adjustments to your medications are needed.

 

Duplication

Benzodiazepines

Therapeutic duplication

The recommended maximum number of medicines in the 'benzodiazepines' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'benzodiazepines' category:

Xanax (alprazolam)

temazepam

Note: The benefits of taking this combination of medicines may outweigh any risks associated with therapeutic duplication. This information does not take the place of talking to your doctor. Always check with your healthcare provider to determine if any adjustments to your medications are needed.

 

 

Edited April 13, 2021 by ChessieCat
tidied up report for easier reading

[ChessieCat]

Hi Lindsey

 

I've merged your new topic with your Introduction topic.  Each member has 1 Introduction topic which is the best place to ask questions about your own situation and journal your progress.  This way all your history is in one place and you will not need to repeat yourself.  Please use the Reply Box at the bottom of your Introduction topic page to make a reply, ie you do not need to create a new topic (which is at the top right of the screen).

 

Thank you for providing your Drug Interaction Report.  I tidied it up so that it is easier to read.  Please have a look.  Having a familiarity with the interactions might help you to better understand and suggestions the staff make.

 

21 hours ago, ChessieCat said:

please give us the details, in a post (not signature) of the times and doses you are taking your drugs.

 

Please respond to the above request.  Sometimes taking 2 or more drugs at about the same time can make things worse but moving them apart might help to improve things a little bit.  Thank you.

 

[Saradee]

Posting for Lindsey75 because she’s having trouble navigating the site on phone.

 

Daily meds:

 

Adderol:

Started ~2010. Prescribed 30mg 2x daily. Taking 15mg 2x daily upon waking (between 5 and 11am)

 

Tomazepam:

Started 2021. Prescribed 30mg 1x daily for sleep. Taking as needed for sleep when having insomnia secondary to anxiety (about 11pm)

 

Alprazolam:

Started ~ 2000. Prescribed 1 mg  3 x daily

Taking as needed for anxiety; sometimes more or less than prescribed up to 6 mg/ day) at inconsistent times usually starting in afternoon 

 

Buprenorphine:

Started 2008 (took Methadone for 3 years prior). Prescribed 12 mg 1x day. Usually take 8 mg/ day. Sometimes 12mg as prescribed upon waking (between 5 and 11am)

 

Ketamine:

Started 2019. Prescribed 150mg / 1ml via nasal spray (4 sprays in each nostril 4 x daily). Taking first dose between 12 and 2pm; subsequent doses inconsistent, typically 3 does total with last dose around 10pm.

 

Bupropion HCL SR: 200mg 1x daily

Stopped early March 2021 after taking inconsistently for 1 year. 

 

 

[Altostrata]

Hello @Lindsey75.

 

First, you need to print out your interactions report and get a new doctor who is not prescription-happy. Then, you need to report the prescriber of all those drugs to his or her employer and make a complaint to your state medical society for reckless prescribing.

 

Clearly, the 3 "brakes" you're taking -- alprazolam, temazepam, and ketamine -- are a major health risk in combination. If you feel dopey, these 3 drugs are why. "Depression" is a common adverse effect of benzos such as alprazolam and temazepam.

 

The addition of 2 "accelerators", Adderall and bupropion to counteract that stew is equally stupid. 

Who was the idiot who did this:

On 4/13/2021 at 6:28 PM, Saradee said:

Tomazepam:

Started 2021. Prescribed 30mg 1x daily for sleep. Taking as needed for sleep when having insomnia secondary to anxiety (about 11pm)

 

Most likely, you are getting anxiety from overuse of your other "brakes" -- they're causing a paradoxical reaction.

 

We do not address physiological dependency on buprenorphine here. It needs to be gradually tapered, that's what addiction medicine doctors are paid to do.

 

It seems to me that ketamine is utterly superfluous, but  am hesitant to address your overuse of ketamine as well. It has a short half-life of less than 3 hours, what effect does a dose have on you?

 

It appears to me that you have been overprescribed benzodiazepines. You probably can't taper Adderall without getting dopey from the benzos. Therefore, if I were you, I'd very gradually taper off alprazolam (half-life of 6-20 hours) until you are taking half of what you're taking now, then taper Adderall half-way, then go off the rest of the alprazolam.

 

To be honest, I am reluctant to get involved at all with your tapering, @Lindsey75. As a person in recovery, you are now taking 4 drugs that are technically addictive: buprenorphine, alprazolam, temazepam, and Adderall, with excessive daily dosing of all of them. It appears you take them all "as needed", on an irregular schedule. To what extent are you willing to stick to a schedule and slowly and systematically reduce your drugs yourself?

 

 

[unblocktheplanet]

I had five Ketamine infusions ten weeks after my Mirtazapine wean. Still on Trazodone 50mg & Alprazolam 1mg. No doc mentioned interaction btw Ketamine & Alpraz. I think I was experiencing most of these 'symptoms' before Ketamine. Did they become worse during the three weeks of infusions? Hard to quantify. Yes, I'm elderly: 72. I certainly believe K to be far safer than long term psych meds. However, it has a 30% rate of non-responders: I am one. And it usually requires repeat courses.