makeadiff77: Introduction - In need of some guidance

[makeadiff77]

Hello:

 

I was admitted recently (5/18/2021) to a mental health facility for psychosis. I had hallucinations of the government wanting to kill me because of a owed debt. It got to the point where I told my family that I had to sacrifice myself.  My family was concerned about self harm and took me to the facility and so I was admitted and was held on a 72 hold that then turned into a 5250 hold until 6/3/2021 when I discharged. 

 

While there, they administered Resperidone for the auditory hallucinations at first along with Vistaril and notripyline. The delusions left but during this time I began having right leg pain. I kept complaining about my leg and was given Tylenol for it. The drugs were then changed and I was injected with Invega Sustenna 234 along with taking Lithium for mood, Levothyroxine for Bipolar, and Venlafaxine for depression. The day of discharge from the facility, my right leg had swollen. I was given the option of staying there or going to the ER myself, I decided the latter, I just wanted out of that place. The ER informed me I had a blot clot in my leg so on top of all these other meds I am now on a blood thinner. I have since my release read a great deal on Resperidone and I am starting to think this is what contributed to me getting a clot. All of this has just been a literal nightmare.

 

After going to the ER, I met with my Primary Physician about the clot and informed of him my admittanence in the mental facility and he advised me to get off the Lithium as soon as possible. He has concerns about it effecting my kidneys & thyroid. He stated that is why the mental facility had also placed me on thyroid & blood pressure medication. So he has advised me to discuss the removal of the Lithium with my psyhciatrist. 

 

On top of this, I was just notified by my health insurance that they cannot cover the antipsychotic Invega which I have continued take in the pill form since leaving the facility, which in turn; will mean I will more & likely be placed on another antisychiotic. I am fearful the hallucinations will come back or I will have other severe side effects once changed.  All of these prescriptions expire in 30 days and I know for a fact that its not in by best interest after reading this site to go Cold Turkey on any of these. Therefore, I have scheduled an upcoming appointment this week with the Psychiatrist from the mental facility being that he is aware of my medication history. Not sure if that is the smartest thing to do here,  but I am at a lost since its hard for me to find a decent psychiatrist in my area. All the ones I have called in my area are either not accepting any new patients or they seemed to be rated pretty low when looking at reviews.

 

So due to all of the above I am desperately in need of some guidance. I know for sure I don't want to be on such a large drug load, so my question is - will it be wise of me to tell this psychiatrist upfront when we meet of my goal of wanting to be on the lowest effective dosage possible? I want to gain some form of control here in what seems to be a dire situation that I am now in, and hopefully once I stabilize, I may be able to get off but for now I just need some form of cohesive game plan that will allow me to see a little light in this dark tunnel, if that makes sense.  I know its alot to make sense of but any advice will be greatly appreciated because I am really in need of some direction right now!!!

 

[Shep]

Hi, makeadiff77.

 

Welcome to Surviving Antidepressants (SA). 

 

Here is some information on finding a doctor who is informed on proper withdrawal techniques:

 

Recommended doctors, therapists, and clinics

 

Mad in America - Provider Directory

 

Some tips:

 

How do you talk to a doctor about tapering and withdrawal?

 

 

 

On 6/21/2021 at 12:26 AM, makeadiff77 said:

I was admitted recently (5/18/2021) to a mental health facility for psychosis. I had hallucinations of the government wanting to kill me because of a owed debt. It got to the point where I told my family that I had to sacrifice myself. 

 

When I've had problems with so-called psychosis in the past, it was really due to sleep deprivation caused by taking an antidepressant and having an adverse reaction. Around 80 - 90% of people going through these types of experiences are dealing with sleep deprivation caused by taking a medication or a recreational drug or being very stressed from trauma, working too hard, poor nutrition, etc. In other words, the hallucinations / delusions are a side effect of insomnia. You don't need to post anything personal or specific, but you may want to reflect on this and see if it relates to your own experience. 

 

The problem with psychiatry is it looks at the experience of psychosis as if it is a disease instead of a symptom. It's usually a temporary crisis state that will resolve on its own in time with proper rest, nutrition, and being in a safe, healing space. Eat healthy, drink plenty of water, practice good sleep hygiene, take walks in nature, etc. 

 

I'm very glad you found this site so soon after being placed on these drugs. 

 

Here are some links to get you started:

 

Why taper by 10% of my dosage?

 

Taking multiple psych drugs? Which drug to taper first?

 

The Windows and Waves Pattern of Stabilization

 

Here are links specific to your drugs: 

 

Tips for tapering off venlafaxine (Effexor)

 

Tips for tapering off paliperidone (Invega)

 

Tips for tapering off lithium

 

Please advise what day in May you were placed on the drugs listed in your signature. The reason I'm asking is because it takes about a month to become dependent on antipsychotics and antidepressants, so having a specific timeline will help us guide you in your taper. 

 

Please list the time(s) of day you take each of these drugs and any supplements you may be taking.  Please also list any symptoms you are having. How is your sleep? 

[Shep]

On 6/21/2021 at 12:26 AM, makeadiff77 said:

I have since my release read a great deal on Resperidone and I am starting to think this is what contributed to me getting a clot. All of this has just been a literal nightmare.

 

 

You are correct to suspect this drug in forming the clot. Another moderator, DataGuy, shared this document:

 

FDA - risperidone

 

Quote

Other adverse events reported since market introduction, which were temporally related to RISPERDAL® but not necessarily causally related, include the following: pancreatitis, pituitary adenoma, pulmonary embolism, precocious puberty, cardiopulmonary arrest, and sudden death.

 

@makeadiff77  How are you feeling? 

[makeadiff77]

Hi Shep:

 

Thank you for replying and apologies for delayed response. I updated my signature with the dates as you suggested. Concerning the times I take the drugs, I updated that as well in the signature section if that is okay? Concerning supplements, I do not take any. Before the psychosis took place my stress level was at an all time high. I was experiencing problems at work and then left that job but then took another position with another company. In my personal life, my divorce was recently finalized where custody issues were involved all the while getting little sleep if any so it just seemed like a lot was weighing on me before my world came crashing down.

 

Today, I am actually feeling okay, thanks for asking! However, I do have symptoms which I believe stem from all of these drugs (i.e. increased appetite & thirst, dry mouth, in the beginning small tremors, restlessness at times, weakness in hands when trying to open something). With sleep, I am able to get anywhere between 6-7 hours a night but there are still times where I feel tired during the day.

 

I think with me now having the blood clot, its harder since I cannot do much until it gets better. I went for my follow-up for the clot the other day and my doctor told me I will have to take the blood thinner for 6 months. It just seems like so many drugs to be taking...

 

Please know that I really appreciate you taking the time to assist and I am so glad I found this site for some direction, its a godsend!

 

 

 

 

 

 

[Altostrata]

Welcome, @makeadiff77

 

No one wants to have that drug burden. If I were you, I'd find a psychiatrist who will review every element of your kitchen sink cocktail and assist you in minimizing your drugs. Whoever is treating you with these drugs should take the blot clot very seriously. In my amateur opinion, at least 4 of the 5 drugs you're taking are unnecessary.

 

We don't treat psychosis here, so no one here can advise you what drugs, if any, you might want to take to control your symptoms, if that's what you want to do. Some people are very sensitive to lack of sleep; this can cause symptoms of psychosis. They need to be careful about getting enough sleep.

 

Suggest you put ALL your drugs in this Interactions Checker and post the report or a link to it in this topic. This may indicate which drugs are at highest risk to your health. 

 

Lithium is a high-risk drug that could damage your kidneys. You may wish to go off lithium first, as your GP recommended.

 

On 6/20/2021 at 9:26 PM, makeadiff77 said:

On top of this, I was just notified by my health insurance that they cannot cover the antipsychotic Invega which I have continued take in the pill form since leaving the facility

 

Your doctor needs to argue with the insurance company to get this drug covered.

[Shep]

@makeadiff77

 

Thanks for updating your signature. Very helpful. 

 

Quote

 

May 26, 2021 - Present - Lithium Carbonate, 300 mg, 2 x day - Take @ 8:30AM & 8:30PM

May 19, 2021 -Present - Propranolol 10mg tablet, 2 x day - Take @8:30AM & 8:30PM

May 19, 2021 - Present - Levothyroxine, 25 mcg oral tablet - Take @ 7:30AM
May 26, 2021 - Present - Venlafaxine, 37.5, 1 x day - Take @ 8:30AM

June 4, 2021 - Present - Paliperdone, 3mg, 1 x day - Takes @ 8:30AM

 

 

Here are the drug interactions for this cocktail:

 

Interactions between your drugs

Major

lithium  venlafaxine

Applies to: Lithium Carbonate ER (lithium), venlafaxine

Talk to your doctor before using lithium together with venlafaxine. Combining these medications can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should contact your doctor immediately if you experience these symptoms while taking the medications. 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

propranolol  lithium

Applies to: propranolol, Lithium Carbonate ER (lithium)

Propranolol and lithium may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. 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

propranolol  paliperidone

Applies to: propranolol, paliperidone

Paliperidone and propranolol may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. 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

lithium  paliperidone

Applies to: Lithium Carbonate ER (lithium), paliperidone

Using lithium together with paliperidone 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. Rarely, a syndrome consisting of weakness, lethargy, fever, tremors, confusion, abnormal muscle movements, and increased white blood cells and other lab values has also been reported during combined use of these medications. 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

venlafaxine  paliperidone

Applies to: venlafaxine, paliperidone

Using venlafaxine together with paliperidone can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). Talk to your doctor if you have any questions or concerns. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether together or alone. 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

Minor

propranolol  levothyroxine

Applies to: propranolol, levothyroxine

Information for this minor interaction is available on the professional version.

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

propranolol  food

Applies to: propranolol

Food can enhance the levels of propranolol in your body. You shoud take propranolol at the same time each day, preferably with or immediately following meals. This will make it easier for your body to absorb the medication. Avoid drinking alcohol, which could increase drowsiness and dizziness while you are taking propranolol. Propranolol is only part of a complete program of treatment that also includes diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely.

Switch to professional interaction data

Moderate

lithium  food

Applies to: Lithium Carbonate ER (lithium)

Alcohol can increase the nervous system side effects of lithium such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with lithium. Do not use more than the recommended dose of lithium, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

Switch to professional interaction data

Moderate

levothyroxine  food

Applies to: levothyroxine

The timing of meals relative to your levothyroxine dose can affect absorption of the medication. Therefore, levothyroxine should be taken on a consistent schedule with regard to time of day and relation to meals to avoid large fluctuations in blood levels, which may alter its effects. In addition, absorption of levothyroxine may be decreased by foods such as soybean flour, cotton seed meal, walnuts, dietary fiber, calcium, and calcium fortified juices. These foods should be avoided within several hours of dosing if possible. 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.



When levothyroxine is given during continuous enteral nutrition (tube feedings) for more than 7 days, the tube feeding should be interrupted for at least one hour before and one hour after the dose of levothyroxine. You may need more frequent blood tests to monitor levothyroxine levels.

Switch to professional interaction data

Moderate

venlafaxine  food

Applies to: venlafaxine

Alcohol can increase the nervous system side effects of venlafaxine such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with venlafaxine. Do not use more than the recommended dose of venlafaxine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

Switch to professional interaction data

Moderate

paliperidone  food

Applies to: paliperidone

You should avoid the use of alcohol while being treated with paliperidone. Alcohol can increase the nervous system side effects of paliperidone such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. Paliperidone may be taken with or without food. Talk to your doctor or pharmacist if you have any questions or concerns.

[Shep]

Please start a drug and symptoms journal. 

 

A drug and symptoms journal will help us see your symptoms within the context of when you take your drugs. It's possible that some of your symptoms are adverse reactions and we may first suggest changing the timing of when you take the drugs before advising a taper. This will mitigate any drug interactions caused by taking interacting drugs too close together. 

 

Here are the instructions for your journal. Please post here in your Intro/Update thread so all of your information is in one place. 

 

On 9/27/2016 at 2:49 PM, Altostrata said:

In the course of discussion in your Introductions forum topic, you may be asked to keep notes on paper of your daily symptom pattern, including when you take your drugs, their dosages, and any symptoms. We ask this because there may be something we can do to reduce the symptoms.

 

What we need to see for every single day over several days is what symptoms you get before and after you take your drugs. If you're not taking any drugs and have withdrawal symptoms, we still need to see your symptom pattern throughout the day:

 

The time of day, dosage, and severity of symptoms are essential information. Include

 

- Time and dosage for all drugs taken throughout the day, psychiatric and non-psychiatric.

- Following each dose, note any symptoms. If you are having a reaction to the drug, it may take hours for a symptom to show up -- that's why we ask you to keep notes all day long.

- If you're not taking any drugs, your symptoms throughout the day.

- Your sleep pattern. Since so many drugs disturb sleep, if you find you're waking in the middle of the night, it could be from a drug you took earlier in the evening. If you're not taking any drugs, there may be ways you can improve your sleep.

And so forth. A diary, in chronological order, looking something like this:
 

Example:

DATE:

 

6 a.m. Woke with anxiety
8 a.m. Took 2.5mg Lexapro
10 a.m. Stomach is upset
10:30 a.m. Ate breakfast
11:35 a.m. Got a headache, lasted one hour
12:35 p.m. Ate lunch
4 p.m. Feel a bit better
5 p.m. Took 2.5mg Lexapro
6 p.m. Ate dinner
9:20 p.m. Headache
10:00 p.m. Took 50mg Seroquel
10:20 p.m. Feeling dizzy
10:30 p.m. Fell asleep
2:30 a.m. Woke, took 3mg Ambien (NOT "took 1/2 tablet Ambien")
2:45 a.m. Fell asleep
4:30 a.m. Woke but got back to sleep

 

 

[makeadiff77]

Thank you both Altostrata & Shep for your replies. I will get started on the drug and symptoms journal today. Again, appreciate your guidance.

[makeadiff77]

Hello All:

 

Hope you are all doing well! I wanted to let you know I am making small progress in my goal to reduce my drug load. Its very frustrating at times but I am still determined.

My psychiatrist did taper me off the Lithium Carbonate, 300mg twice a day. I have been off since June 28th. I did experiencing some minor sleep issues & irritability but other than that I did okay. Just really thankful to be off of it.

 

I have discussed my next taper with my psychiatrist and its going to be Invega 3.0mg tablet in the next couple of weeks. I am experiencing bad side effect from it (i.e. missed menstrual periods, extreme weight gain, hand pain, cough, and restlessness at times). However, after our talk, I now have some hesitation about the whole thing, so I wanted to inquire with you about the plan. It was suggested that I taper to the 1.5mg tablets once a day but in my opinion that is too large of a decrease. Its 50% vs. the normal 10% taper that you strongly advise. I am fearful that its too large of taper and will trigger serious withdrawals. In addition to this, I have read that the efficacy of the Invega 1.5mg tablet has not been established in adult patients so that is also very worrisome.

 

I know there is the liquid form of Risperdone that can be used for doing small tapers but I have extreme anxiety about this drug. As I had mentioned earlier in my first post, it was first given to me in the mental facility when admitted and I stronglt believe its what triggered my blood clot in my right leg,  so there is huge anxiety about trying this as an alternative option. Any advice from you would be greatly appreciated right now because I feel I have sort of hit a brick wall here, and I'm really in need of some direction!!!

 

[makeadiff77]

Hello,

 

If anyone could read my post from above on 9/17 and possibly provide some feedback I would really appreciate it. Trying to see how I can taper Invega without switching over to risperdone which I feel contributed to a blood clot I got prior to me being prescribed invega tablets @3mg. Any suggestions given, I want to discuss those with my psychiatrist before I get started on my taper.Thanks!

 

 

[ChessieCat]

I did a search for both brand and drug name in the Introduction forum.  Below are the links.

 

You could go to the different members' topics to see how they tapered and/or post a question in their topic asking for more information about this.

 

https://www.survivingantidepressants.org/search/?q=invega&quick=1&type=forums_topic&nodes=3

 

https://www.survivingantidepressants.org/search/?q=paliperidone&quick=1&type=forums_topic&nodes=3