FloridaTortoise: Venlafaxine, Buproprion, Lamotrigine, Abilify

[FloridaTortoise]

  

Edited July 9, 2021 by FloridaTortoise
I was unsure of what I was doing and how to edit what I had posted and ended up posting twice so I wanted to delete this one but wasn’t sure how.

[FloridaTortoise]

     I’m a bit unsure of what I am doing and I hope I am doing this correctly. I don’t know what tags are but I know I’m supposed to introduce myself so here goes. I just hope I’m posting it right. 
     I don’t really know what kind of things I’m supposed to say about myself. I experienced a very painful family situation that had me depressed for years. I was self medicating with alcohol which landed me in the hospital and then baker acted a couple of times because of the poor decisions I made when drinking. After the second time I continued seeing the doctor that I saw in the hospital. He ended up putting me on Venlafaxine, Lamotrigine, Bupropion XL, and Abilify. That was about 14 years ago around 2007.  From where I sit now, years later, I realize that what I should have done was talk therapy to help me sort out and cope with my feelings. And of course, given up the alcohol, which only makes things worse. I gave up the alcohol for the most part when I started taking all the meds. And then gave it up completely several years ago. I am well over what had me depressed in the first place, I no longer drink alcohol and I want to get off all the meds. I tried twice in the past with my doctor and failed. I realize now that’s because he tapered them too quickly and I  ended up a complete wreck. The last time he said to me, “So are you ready to get back on your meds?”.  Now when I tell him that I want to get off them he doesn’t want to help me because I couldn’t do it in the past. He also gives me a prescription for Clonazepam that I simply leave at the pharmacy. I tell him I don’t want the Clonazepam but he won’t stop sending it into the pharmacy. He also thinks I take an extra 150mg of Bupropion XL in addition to the 300mg that I already take. When things weren’t going well he would up the dosages of the medicines. But I didn’t want to increase it (the Bupropion) so I just don’t take the 150mg tablet in the afternoon. I am now taking Venlafaxine 150mg twice a day, Lamotrigine 50mg twice a day, Bupropion XL 300mg, and Abilify 10mg. But in the last week I started shaving 10% off the Abilify and 10% off the morning dose of Lamotrigine. I am doing fine so far, but of course, it’s only been a week. I didn’t know in which order I should be eliminating them so I just picked those two. I think my plan is to eliminate the Abilify, then the Lamotrigine, then the Bupropion XL, then lastly the Venlafaxine. I just really want to be successful and get all these drugs out of my system. I have a very supportive husband but sometimes he looks at old photos of me and says, “Where did that person go?” I feel like I lost myself and lost my personality. I want so much to see who I would be completely off the drugs. 
     I am so glad I was introduced to this website because now I know there are lots and lots of other people that want the same thing and I know I will be able to get a lot of insight and support from others. 
 

I don’t remember the order in which I started taking these so I’m just going to list them.

 

Around 2007 I started taking:

Venlafaxine 150mg twice a day

Lamotrigine 50mg twice a day

Bupropion XL 300 mg

Abilify 10mg

Edited July 9, 2021 by Gridley

[Gridley]

Welcome to SA, FloridaTortoise.  We're a site for tapering off psychiatric drugs, and we're happy to help you taper off your drugs.  You were wise to leave the Clonazepam prescription at the pharmacy and not add another drug.  Don't worry about the double post.

 

To start:

 

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.  This will appear under all your lists and is very helpful to the staff.  You can simply copy the drugs as listed in your post.  Please indicate if the Venlafaxine is XR (extended release) or IR (immediate release).

Use the following link.  You'll need to use a computer rather than a phone and press "save" when you're finished.

 

Account Settings – Create or Edit a signature.

 

We recommend tapering only one drug at a time.  Otherwise, if problems arise you won't know the cause.  We advise tapering activating (stimulating) drugs first, leaving the more sedating drugs in place to preserve sleep to be tapered later.  

 

Taking multiple psych drugs? Which drug to taper first?

 

Venlafaxine and Buproprion are activating,and Lamotrigine and Abilify are sedating.  So the choice would be whether to taper the Venlafaxine or Buproprion first.  I'm going to give you our links on tapering the two drugs so you can read and see which you think you'd want to taper first.   This decision would also depend on your personal feelings about which drug you want to stop first and which (if you can tell) is having a worse effect on you.  Another point to consider is that Buproprion can generally be tapered a bit more quickly than other psychiatric drugs, sl that may be a factor in your decision.  Here are the two links:

 

Tips for tapering off venlafaxine (Effexor)

 

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

 

Before you do anything else, I would reinstate to full dose the 10% you shaved off the Lamotrigine and Abilify.  You don't want to have too many balls in the air.  It's only been a week, so this shouldn't cause too much an upset.  I'd let that reinstatement settle in for two weeks and see how you feel.  If you're feeling the same as before you shaved off the 10%, you can start your taper of either the Venlafaxine or Buproprion.

 

As you may be aware, we recommend tapering no more than 10% of your current dose every four weeks.

 

Why taper by 10% of my dosage?

 

Once you've decided which drug to taper first, we can go from there.  The links above on tapering Venlafaxine and Buproprion give very specific instruction on how to get the non-standard doses needed for a 10% taper, and we can talk about that further after you've reinstated the Abilify and Lamotrigine, waited two weeks to stabilize and made your decision about which drug to taper first between the Venlafaxine and the Buproprion.

 

To make sure I see your posts, you can tag me by typing @Gridley and when the rectangle with @Gridley appears, click on it and I will be notified that you've posted.

 

So that you have a better idea about the withdrawal you experienced in the past from tapering too fast (and likely more than one drug at once) and also about the healing process, here are some links for your better understanding of the process.  This is a lot of information, so take your time reading and absorbing it.

 

 

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

 

A delicate matter is how you handle your psychiatrist, who you said is not cooperative regarding your getting off these drugs.  However, you need him/her as a source of the drugs.  This matter I will leave to your discretion.  The vast majority of doctors know nothing about safe tapering and don't believe in the existence of withdrawal.

 

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.

 

 

 

[FloridaTortoise]

Thank you so much, Gridley. That is a lot of very helpful information. I will reinstate the Lamotrigine and Abilify, hold that for 2 weeks, and then begin to taper the Bupropion. I will also look at all the information you gave me. Thanks again!

[Greatful]

@FloridaTortoise  I wanted to stop by and say welcome.  You have a lot to look over the site.  I know it looks overwhelming, all the information.  You have great group of moderators that are going to guide you through your journey.  After you settle in and get more familiar with the site you will find there is a lot here that will help you.  

Post often, it helps other members to aid you when they can.  It also will help you feel less alone.  There are many members at different points in their journey off of meds willing to be there for you.☺️

 

 

 

[FloridaTortoise]

It is a bit overwhelming, all the information and navigating the site. Thanks so much for the welcome and thanks for the tips. 

[FloridaTortoise]

@Gridley Thank you so much for replying to me and for all the helpful information you gave me. I am going to reinstate the !0% I shaved off both the Lamotrigine and the Abilify this past week. My plan YESTERDAY was to start reducing the Bupropion XL after settling in for 2 weeks with the reinstated doses of Lamotrigine and Abilify.  THIS MORNING I have a huge concern about tapering off any of my meds at this time. I was hoping I could get your thoughts on this. Let me explain a little bit. I am 5’4” and I am 130 - 140 pounds overweight. I am 56 and have tried so many diets in my lifetime but have failed, so I have a consultation with a Bariatric surgeon coming up in about 3 weeks and I am hoping to have surgery for a gastric sleeve about 6 months later (February 2022). That is going to be a big event in my life and I want to be able to handle it without the worry of going through medication withdrawals at the same time. So while I am stable I began thinking that I should wait until I settle in after my surgery to begin tapering off anything. What do you think? I want so badly to get off my meds but I don’t want to take on too much at one time and then fail at everything. I feel like this is my last chance to get everything right in my life and I don’t want to mess it up. I want very much to both get off my meds, and have the surgery. Do you still deal with withdrawal symptoms when you taper so slowly? Or does doing it so slowly prevent the withdrawal symptoms? 

[Gridley]

5 hours ago, FloridaTortoise said:

So while I am stable I began thinking that I should wait until I settle in after my surgery to begin tapering off anything.

I would definitely wait until you've recovered from the surgery before tapering. You're right in not wanting to take on too much at once. You'd likely want to go ahead and reinstate the Abilify and Lamotrigine because the sooner the better with reinstatement and you want to have those squared away and back to original dose before you start your taper after the surgery.

 

5 hours ago, FloridaTortoise said:

Do you still deal with withdrawal symptoms when you taper so slowly? Or does doing it so slowly prevent the withdrawal symptoms? 

Even tapering slowly there are very likely going to be some withdrawal symptoms.  If you taper slowly enough the symptoms should be definitely tolerable and should fade before before the next 10% step of the tapering process.

 

Good luck with the surgery and we'll be here to help you when you're ready to taper.

 

[FloridaTortoise]

@GridleyThank you so so much! I will be back as soon as possible to begin my taper.