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Butternubs: Hi there, I have quit imipramine and have questions


Butternubs

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I was on it for four (not entirely sure) years, 25-50mg. The first time I had to abruptly quit it was last year, 2020. I was in the hospital for 12 days and they would not give it to me there. That was when I was on 50mg.

 

Withdrawal effects from that year: I had to pee every couple hours at the most and every 15-30 minutes at the least and my oxygen levels dropped (normally they were 99-100 but then they were 92). I would wake up gasping for breath and generally feel very off.

 

This year: The imipramine quit working and was even making me feel worse, so I quit cold turkey from 25mg. Since then I have gotten a mysterious infection and was put on antibiotics, which I completed this morning. My primary doctor thinks I have an infection but could not find bacteria, just elevated white blood cells. I just had flu-like symptoms--headache, nausea, elevated temperature (about 100 degrees in the morning), fatigue, loss of appetite, weight loss, mild dizziness (which is improving) and visual hallucinations, which are not unusual because I also have schizophrenia. Doctor thinks COVID is unlikely, given lack of gastrointestinal issues and also lack of respiratory issues. Also I'm fully vaccinated and not very social.

 

Questions: Would it be a bad idea to take just a tiny bit of imipramine to see if this goes away? Or should I just press on?

 

Here is what I am more concerned about: I recently got a genetic test and do NOT have the MTHFR mutation (inability to process folic acid). But I will be taking Deplin, if insurance approves it, or generic methylfolate if it doesn't, starting with half of a 7.5mg--can it still help even if I don't have the mutation? I read that a lot of my health issues, like non-alcoholic fatty liver, poly-cystic ovary syndrome, depression, and schizophrenia can be helped with folate. I don't eat vegetables at all, and certainly no leafy greens, so is it possible I'm low in folate anyways?

 

I am not looking to change my diet at the time as I'm barely eating as is. Just the idea of eating makes me want to throw up most days. I know it would be good for me to eat better, but I just try and try and it feels like nothing changes. I do actually manage to eat in the afternoon when the nausea fades for a while and I get hungry. I've lost ten pounds in a few months and I'm at 139 now.

 

Thank you for reading!

2012: Risperdal and Citalopram

2013: Abilify (pills)

2013-2018 (I tried too many things to recall, including geodon, olanzapine, saphris, seroquel, lexapro, rexulti, imipramine, amitriptyline, trazodone, ativan, klonopin, metoprolol, doxepin, haldol, lithium, lamictal, remeron, and the worst of them all, cymbalta.)

2018-Present: Propranolol 40mg, Abilify Maintena 400 (monthly injection)

More recently: Quit imipramine 25mg after taking it for three and a half to four years. Worked great until it didn't.

Supplements: Magnesium Glycinate 300mg a day and citicoline 250-500mg as needed (helps with my minor TD symptoms).

Recently: Generic Deplin (Methylfolate, 7.5mg.) Doctor wants me to pick between effexor, trintellix, and wellbutrin if folate doesn't help.

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Welcome, @Butternubs

 

Going off an antidepressant suddenly can cause odd symptoms, but elevated white blood cells indicate a physiological issue probably not related to withdrawal. One should have a test for bacterial infection before taking antibiotics, which can have their own adverse effects.

 

Other than elevated white blood cell count, what other symptoms do you have that occurred shortly after you went off imipramine this last time?

 

On 8/13/2021 at 10:21 AM, Butternubs said:

The imipramine quit working and was even making me feel worse

 

How did the imipramine make you feel worse?

 

Are you still getting an Abilify injection? Why are you being treated with this? Please list all the drugs you're taking currently, the times o'clock you take them each day, and their dosages, including Deplin and Abilify.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Thank you for your reply!

 

It's too late because I already finished the round of antibiotics... I was on the fence about taking them and it's hard to say if they helped or if it just went away with time, but I do feel somewhat better. My headache is better, and my temperature is low 99 instead of 100 in the morning. I'm feeling less fatigue too, but that's hard to gauge because I just got my monthly Abilify injection and it takes a week to kick in fully. When that shot wears off at the end of the month I can get more tired.

 

I'm mostly having the headache, some fatigue, loss of appetite, mild nausea, and I was hearing voices yesterday (usually when I'm stable like this I only have visual hallucinations). The worst of it is this "spaced out" feeling and the inability to feel awake/conscious. Hard to say if I can focus or not, I'm writing this just fine, but I don't feel present. The chills are going away too and so are the muscle aches, but my joints are acting up. I've never had any pain in my knees before this. I just turned 26. It's also hard to say how much of this is from not eating enough, too. I try, but there's no appetite and when I force myself to eat I get nauseous. I lose my appetite a couple times a year for a few months at a time, so it's not unusual.

 

When I quit imipramine, I think the first thing I noticed was feeling out of breath, then feeling the flu-like symptoms, but it didn't take off until the day after my second COVID shot. Then I had a fever of mid 101 degrees and all this popped up in full force. I think that's why I'm so confused--could it be the imipramine withdrawal, a reaction to the COVID shot, did I catch COVID, am I just not eating enough, or is it a bacterial infection? All of the above? I got that second vaccine on the 20th of July.

 

In other news, insurance didn't cover the Deplin so I got generic methylfolate, 7.5mg. I started taking that this morning. I'll be taking that every morning at nine AM.

 

Everything I take is in my signature, idk if anyone can see it yet, but I take propranolol 40mg once a day at night/anytime from 8-10pm (otherwise my tremors are so bad I can't even drink from a cup, and legs too shaky to drive sometimes) and I get the abilify maintena injection 400mg every four weeks, which treats some of my depression and nearly all of my schizophrenia (delusions, hallucinations, paranoia, disorganization, and it helps with some dissociation, and prevents self-harm.) I do not drink, don't smoke, no other drugs, and I don't drink coffee or caffeinated sodas except once every few weeks.

 

The imipramine was working great, some of the best years in my life, and then it just stopped working and I started getting more moody, depressed, and feeling like I might hurt myself, and when I quit it cold turkey most of that went away. In my experience, antidepressants I've taken work well for a while and then make things worse like this. Usually it causes the doctor to want to raise the dose, which only makes the depression worse.

 

Thank you for reading!

2012: Risperdal and Citalopram

2013: Abilify (pills)

2013-2018 (I tried too many things to recall, including geodon, olanzapine, saphris, seroquel, lexapro, rexulti, imipramine, amitriptyline, trazodone, ativan, klonopin, metoprolol, doxepin, haldol, lithium, lamictal, remeron, and the worst of them all, cymbalta.)

2018-Present: Propranolol 40mg, Abilify Maintena 400 (monthly injection)

More recently: Quit imipramine 25mg after taking it for three and a half to four years. Worked great until it didn't.

Supplements: Magnesium Glycinate 300mg a day and citicoline 250-500mg as needed (helps with my minor TD symptoms).

Recently: Generic Deplin (Methylfolate, 7.5mg.) Doctor wants me to pick between effexor, trintellix, and wellbutrin if folate doesn't help.

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Thanks, @Butternubs

 

On 8/13/2021 at 10:21 AM, Butternubs said:

Doctor thinks COVID is unlikely, given lack of gastrointestinal issues and also lack of respiratory issues. Also I'm fully vaccinated and not very social.

 

Why did your doctor not order a covid-19 test? If I were you, I'd get a test for the antibodies. It may very well be you had mild covid and the antibiotics were unnecessary, the covid ran its course.

 

When did you last take imipramine? When did the headache start?

 

It is possible you had mild covid-19, the flu, or a cold AND you got imipramine withdrawal symptoms. Your doctor was remiss in not getting a test for bacterial infection and reflexively prescribing antibiotics, which can have lots of adverse effects on their own, particularly on the gut.

 

What is your current daily drug schedule (times o'clock), with dosages?

 

On 8/13/2021 at 10:21 AM, Butternubs said:

I don't eat vegetables at all, and certainly no leafy greens, so is it possible I'm low in folate anyways?

 

It's definitely possible. Fresh vegetables, particularly green leafies, are very, very good for humans and important to good neurological functioning. If I were you, I might titrate the 7.5mg methylfolate, a quarter-tablet to start, see if it has any effect over a week. Some people find B vitamin supplements make them nervous.

 

Deplin is a scam. Folate is not an antidepressant, though it may make you feel better overall. It is important for general body functioning and folate deficiency can be quite serious -- but your doctor was again remiss in not testing you for folate level.

 

On 8/13/2021 at 10:21 AM, Butternubs said:

The imipramine quit working and was even making me feel worse, so I quit cold turkey from 25mg.

 

What benefit did you feel from imipramine? How did imipramine make you feel worse? Did you ever accidentally forget or skip a dose? 

 

Why does your doctor want to prescribe another antidepressant? Is this your GP?

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Thanks Altostrata! 

 

I'm not entirely sure why my primary doctor didn't test me for COVID. I think I might go back for a test... maybe my insurance doesn't cover it, which I doubt, but I just don't know until I ask.

 

That's a good question, I can't remember when I last took the imipramine. Looking through my journal, I see that I briefly switched over to amitriptyline 25mg when the imipramine stopped working. That was in mid June. Then I quit that as well because it wasn't helping the depression. I suppose I should have kept better records because my memory took a hit and I don't remember this. I wrote that I was feeling "fuzzy" and very out of it after quitting, but I don't have exact dates.

 

Yes, I think it might have been some sort of cold or minor COVID, I'm leaning towards minor COVID because I haven't ever had a cold last for weeks like that.

 

My daily drug schedule is Propranolol 40mg, at bedtime, usually nine PM. Then I get that monthly abilify maintena shot, but that's not like a pill I take every day. Then there's the methylfolate 7.5mg that I take with a huge glass of water when I wake up.

 

I'm feeling somewhat better since I started the methylfolate, but it's only been two or so days, and we'll see if it lasts or builds up. I have an iron-tough stomach (except with alcohol) so it doesn't cause any upset or anything. I haven't noticed anxiety. With the generic methylfolate I'm taking, they're capsules and I can't break them in half or I would have. I could open them and pour some of the powder out but then it would just go to waste.

 

Yes, I wish I could be tested for deficiencies but I've never heard of doctors doing anything like that where I live. I've asked for vitamin tests by name before, (I was on my period for two months and wanted my iron checked) but I just get a regular blood test/complete blood count. The primary care doctors (I just switched a month or two ago because my insurance changed) always tell me that if it's really important or serious, it'd be detected by a complete blood count, because it'd cause anemia. But I feel like there has to be more to it than that.

 

On 8/18/2021 at 4:30 PM, Altostrata said:

What benefit did you feel from imipramine? How did imipramine make you feel worse? Did you ever accidentally forget or skip a dose? 

 

 

I was in complete remission from my depression for a long time, sometimes I'd feel a little down but nothing severe, just normal sadness. When I get depressed it feels like my veins and heart are burning and that's when I know I'm really down. It didn't dull my emotions like SSRIs do, either. When it stopped working, I got more depressed and the burning feeling came back, and I'd sob at the smallest things. I never forgot doses, but near the end I skipped once or twice. I got the head zaps and they went away in a matter of days.

2012: Risperdal and Citalopram

2013: Abilify (pills)

2013-2018 (I tried too many things to recall, including geodon, olanzapine, saphris, seroquel, lexapro, rexulti, imipramine, amitriptyline, trazodone, ativan, klonopin, metoprolol, doxepin, haldol, lithium, lamictal, remeron, and the worst of them all, cymbalta.)

2018-Present: Propranolol 40mg, Abilify Maintena 400 (monthly injection)

More recently: Quit imipramine 25mg after taking it for three and a half to four years. Worked great until it didn't.

Supplements: Magnesium Glycinate 300mg a day and citicoline 250-500mg as needed (helps with my minor TD symptoms).

Recently: Generic Deplin (Methylfolate, 7.5mg.) Doctor wants me to pick between effexor, trintellix, and wellbutrin if folate doesn't help.

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What are the symptoms you attribute to withdrawal?

 

3 hours ago, Butternubs said:

When I get depressed it feels like my veins and heart are burning

 

This sounds like a very, very unusual feeling of depression.

 

Please note, we don't treat depression here. We do, however, see a lot of drug adverse effects.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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I think the biggest part of the withdrawal is feeling like I'm spaced out, or not in the zone. I feel dreamlike or fuzzy-headed often. There's the head zaps, which have fortunately passed. And then the frequent need to use the bathroom, which my primary doc thought was a bladder infection. And then I feel out of breath sometimes, but not as bad as when I first quit. 

 

I've heard that it's a very unusual symptom of depression, and I haven't encountered anyone else that feels the same way. But I do feel the burning feeling when I'm very depressed, and I know for certain that it's because of that. The pain gets so strong I can't get out of bed and barely breathe, and my heart might feel like it stops beating for a few seconds. If I feel for my pulse in my neck, there is nothing there in those moments. I wish there was someone who knew what this was. But that's besides the point. My heart tests every time I'm in the hospital are normal, but they've never tested me at the moment when the pain strikes. I know it all sounds outlandish, but it's always gone hand-in-hand with my depression.

 

Anyways. Is there anything to be done for the "out of it" and breathless feeling? Thank you again.

2012: Risperdal and Citalopram

2013: Abilify (pills)

2013-2018 (I tried too many things to recall, including geodon, olanzapine, saphris, seroquel, lexapro, rexulti, imipramine, amitriptyline, trazodone, ativan, klonopin, metoprolol, doxepin, haldol, lithium, lamictal, remeron, and the worst of them all, cymbalta.)

2018-Present: Propranolol 40mg, Abilify Maintena 400 (monthly injection)

More recently: Quit imipramine 25mg after taking it for three and a half to four years. Worked great until it didn't.

Supplements: Magnesium Glycinate 300mg a day and citicoline 250-500mg as needed (helps with my minor TD symptoms).

Recently: Generic Deplin (Methylfolate, 7.5mg.) Doctor wants me to pick between effexor, trintellix, and wellbutrin if folate doesn't help.

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1 hour ago, Butternubs said:

I think the biggest part of the withdrawal is feeling like I'm spaced out, or not in the zone. I feel dreamlike or fuzzy-headed often. There's the head zaps, which have fortunately passed. And then the frequent need to use the bathroom, which my primary doc thought was a bladder infection. And then I feel out of breath sometimes, but not as bad as when I first quit. 

 

This is not a good feeling, but it is not depression.

 

2 hours ago, Butternubs said:

But I do feel the burning feeling when I'm very depressed, and I know for certain that it's because of that. The pain gets so strong I can't get out of bed and barely breathe, and my heart might feel like it stops beating for a few seconds.

 

How often does this happen? This also does not sound like depression, though you might feel depressed during or after one of these events.

 

In my opinion, it's unlikely any antidepressant is going to fix this, it sounds like it could be an adverse drug reaction, such as to propranolol. This sort of thing can occur when the drug reaches peak plasma, when it's wearing off (related to half-life), or if you take it off-schedule (withdrawal symptom).

 

Beta blockers are notorious for causing depression and they of course affect heart rate and breathing. It may very well be you get this odd symptom when a dose of propranolol reaches peak plasma 1 to 4 hours after a dose -- the drug at that point being too strong for you.

 

It's not unusual for an uninformed doctor to mistake an adverse drug effect or a withdrawal symptom for a psychiatric symptom and attempt to treat it with psychiatric drugs for many years.

 

We can help you taper off a psychiatric drug that's causing you trouble, but you'll have to identify the drug. 

 

To find out, you'd keep daily notes of times of day you take your drugs, their dosages, and your symptoms throughout the day. We need to know how you feel before and after taking each drug, and your symptoms in between. Post 24 hours of notes at a time in this topic, in a simple list format with time of day on the left and notation (symptom or drug and dosage) on the right. This can show if your symptoms are adverse effects from one of your drugs. They will show up in a regular pattern.

 

Why are you taking propranolol?

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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I'm on the Propranolol for severe tremors, and it also helps with anxiety and akathisia. I think it's very unlikely that it's causing any emotional issues--seeing that I had the burning feeling probably a decade before I even started the propranolol. When I was in the hospital once, they told me the same thing--that propranolol was causing my depression, but I didn't see any improvement when I was taken off it (I was mostly there for psychosis and restlessness). When I was pulled off it for a couple weeks I had horrible nightmares.

 

I can't get by without it either, because it's controlling my tremors so well. Before I was on it, I was having such bad tremors that I couldn't even drink from a cup without a lid and straw, and I had trouble driving. Now my hands are still as can be on my 40mg a night. I've tried lowering it to 20mg, but I think I did it too quickly and the tremors came back along with the nightmares.

 

do have low blood pressure, however. I've been tracking it when I feel groggy and I've noticed that it has an impact on my dizziness and "out of it" feeling, but not a noticeable impact on my depression. I tend to hover a bit above 90/60 BP when I'm groggy and it goes up when I'm feeling more awake.

 

Can propranolol still cause low blood pressure even if my body is used to it, or does that effect go away with time the longer I'm on it? I might want to talk with my doctor about lowering to 30mg a day and see if that makes me feel any better, while still controlling my tremors. Is the 10% rule only for antidepressants or does it apply to this too?

 

Thank you again for your continued help!

2012: Risperdal and Citalopram

2013: Abilify (pills)

2013-2018 (I tried too many things to recall, including geodon, olanzapine, saphris, seroquel, lexapro, rexulti, imipramine, amitriptyline, trazodone, ativan, klonopin, metoprolol, doxepin, haldol, lithium, lamictal, remeron, and the worst of them all, cymbalta.)

2018-Present: Propranolol 40mg, Abilify Maintena 400 (monthly injection)

More recently: Quit imipramine 25mg after taking it for three and a half to four years. Worked great until it didn't.

Supplements: Magnesium Glycinate 300mg a day and citicoline 250-500mg as needed (helps with my minor TD symptoms).

Recently: Generic Deplin (Methylfolate, 7.5mg.) Doctor wants me to pick between effexor, trintellix, and wellbutrin if folate doesn't help.

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