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teasprout: after the akathisia, I want to be done with medications. In need of advice


teasprout

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I made this account last year but for some reason I could never get this intro done or participate here until now. If I disappear ever, don't worry too much about me as I guess I'm just mentally incapable of following through with things or keeping in contact (maybe this is another withdrawal symptom... I don't know, my brain is ***** up right now)

 

My (very abbreviated) history...


In 2012 I was first prescribed Abilify to supplement my antidepressant. In September 2019 a new psychiatrist recommended I go off of it because of the risk of tardive dyskinesia. Two weeks after my last dose of Abilify, the akathisia hit me like a truck. I thought it was "restless legs but all over". I slept maybe two hours every OTHER night. After two weeks of this torture, I finally went to the doctor and asked her to help me with my "restless legs" and she prescribed carbidopa/levodopa, which didn't really work well, so then she prescribed Mirapex. It helped at the minimum dose, but not enough, so she increased the dose to 0.25mg, which is what I'm at today.

 

In early 2020, the Mirapex caused a months long manic episode, after no prior history of mania, that I wasn't even aware was happening. In the midst of this, I was obsessed with figuring out what happened to me because restless legs didn't really seem to fit. Finally found akathisia, and presented this to my psychiatrist and she agreed with me about the diagnosis. She seemed doubtful that the mania was caused by Mirapex even though she had no alternative explanation, I'd never had mania before, and if you google medication-induced mania Mirapex is right there near the top of the list. Obviously I still think it was the Mirapex.

 

The Mirapex never really took care of the akathisia completely, so since the beginning of this year I've been using medical cannabis to help because it helps me sleep through the breakthrough akathisia at night, and it does help a little at keeping it away too.

 

The past two years have been miserable. I feel like my mind hasn't been the same since. I can't focus, I can't get anything done, I can't properly socialize... I'm just not the same. I've since attempted to taper both sertraline (my antidepressant) and Adderall, though I did it mostly at the advice of my psychiatrist. She never agrees with me about how slowly I want to taper, and I probably should have tapered the sertraline and Adderall WAY more slowly.

 

Currently...

 

I'm down to one medication now (plus cannabis).

 

At my last appointment with my psychiatrist, I requested to start tapering Mirapex. She agreed and told me to take one and a half pills (instead of my normal dose of two). I proposed the slower way by using liquid but she said that the full dose is so tiny already that half a pill should do nothing to me. I knew she was wrong but I don't really have much fight in me, so tried it. Of course, that was way too large of a jump and I can't sleep now the akathisia is so bad. I don't know if this counts as withdrawal from Mirapex itself, or if the akathisia is just coming back because I'm reducing the medication that's keeping the akathisia away. I don't want Mirapex anymore because I think it's still messing with my brain (even though I'm not longer manic), which she doesn't believe it is either. Maybe my brain is just broken from the Abilify, sertraline, and Adderall still. I just want to be me again.

 

I'm going to be trying the 10% reduction per month with Mirapex. Hopefully my psychiatrist agrees but if she doesn't I'm just going to ask for my original dose back and do it anyway. Any and all advice is super appreciated.

 

I have no idea what's the withdrawal and what's just me and my stupid nervous system anymore, but here's what I'm concerned about right now:

  • akathisia
  • the (probably) inevitability of Mirapex augmentation
  • my executive function is approximately at zero right now
  • I'm really depressed
  • I want to keep up with/help my family more and actually be able to work/do my job
  • and honestly just keep up with daily life like caring properly for my pets and not living in the most cluttered non-hoarder apartment you've ever seen.

 

I feel like I'm missing a bunch of stuff because I feel absolutely awful and the explanation above doesn't feel like it properly describes that but oh well...

 

Questions (In no particular order)

 

  • If you're familiar with Mirapex, is the 10% per month thing the right way to go?
  • Is there any hope that I'll be able to get off of Mirapex completely?
  • Do you have any self-care tips to make this easier on myself and my body?
  • Are there any supplements I should add to my routine that could help?
  • Any tests for deficiencies that I should get just to make sure I'm not low on something?
  • Would starting to exercise help me or just add more chaos to my system?

 

I'll probably have more questions later but it's still hard to think so I guess I'll leave this for now

Edited by arbor

2009 - 2021    Zoloft (sertraline)

2008 - 2021    Various stimulants (ritalin, vivance, focalin, adderall, adderall ER)

2012 - 2019    Abilify 2mg

2019    Mirapex (pramipexole) Nov. 0.125mg Dec. 0.25mg

 

Currently just going to try to get off of Mirapex (my only current prescription medication) after previously not tapering meds correctly because I'm hoping the akathisia can go away eventually. 

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  • Moderator

Welcome again, @teasprout, to SA.

Also congratulations for getting down to one drug.  That's a big feat.  I'm sorry though that you're dealing with withdrawal symptoms.  I would agree with you that you probably ended up tapering too quickly.  It's unfortunate that doctors aren't more knowledgeable.  To address your questions, I recommend you consider holding a while longer before starting your taper off Mirapex since your system is already dealing with withdrawal from Abilify, the various stimulants, and Zoloft.  When you are feeling stable, I suggest a very slow taper off Mirapex.  If it were me, I would not take the risks your doctor is suggesting.  Once your system is strongly disturbed  during withdrawal, it can take a long time to re-stabilize.  By going slowly, you can try to avoid that further.  When the time comes these links can help you with tapering Mirapex completely:

tapering dopamine agonist drugs - Tapering

Why taper by 10% of my dosage?

 

The Brassmonkey Slide Method of Micro-tapering

 

In the meantime, I support your interest in self care and stabilizing since your recent withdrawals.  Have you seen any of these links:

symptoms and self care

Non Drug Ways to Cope with Withdrawal Symptoms

The Windows and Waves Pattern of Stabilization

 

 

We don't suggest many supplements, but 3 that many of us find helpful are magnesium, omega-3, and melatonin. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you.  

Magnesium

Omega 3 Fish Oil

Melatonin

 

Here is another link that addresses your questions about supplements and tests:

Important topics about tests, supplements, treatments, diet

 

Yes, gentle exercise is recommended.  You want to avoid anything too strenuous as it can be too activating for the nervous system in recovery.  I personally find walking, especially in nature, soothing.

 

This is your Introduction site where you can ask questions and connect with other members.

I'm glad you've found us, and I encourage you to share here and keep us updated.

All my best to you,

Arbor

Zoloft: 1995 - 2015

Prozac: 2015 - 2018 (tapered from 40mg x day on July 31 to 30mg on August 31 to 20mg on September 31 to 10mg October 31 to 0mg on  December 15, 2018

Gabapentin: 2016 to 2019  (tapered from 300mg x day to 150mg on August 31, 2019 to 75mg on September 15 to 50mg on September 31 to 25ishmg on October 15 to 0mg on December 1, 2019

Enalapril: 2010 - 2019

Lipitor: 2017 -2017

Metformin: 2000 - 2020

Liothyronine: 2007 - 2019

Levothyroxine: 2000 - 

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Exercise.     My advice is to try it. If you get an instant effect after, like a feel good feeling, be wary.   Exercise shouldn't be a drug should it.  My body gets drained too much. If you spend alot of time in the house sitting alot, be careful doing too much exercise.

 

And the cluttered house, that's me too.lol

 

The person above who said walking in nature. I agree.  Try and do it when you feel like it. Don't just force yourself, otherwise you are chasing a result. 

Social Anxiety diagnosis at root.

 

Born. 1983.

 

2001 - 2003  olanzapine and risperidone. 

 

2003 - 2007 Seroxat and prophanol. Cold turkey. Went on venlafaxine straight after.

 

2008- 2014. Venlafaxine. 6 month taper, crushing tablets powder form.

 

end 2014 - present. No meds.

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Thank you so much for all the insight! You provided so many helpful links!

 

When you included Abilify in this list:

Quote

since your system is already dealing with withdrawal from Abilify, the various stimulants, and Zoloft

Are you saying I'm probably still dealing with withdrawal from a pill I last took two years ago or did you mean to include Abilify in that list? I believe you either way I just want to make sure I'm interpreting this correctly. 

 

Quote

When you are feeling stable, I suggest a very slow taper off Mirapex.

How do I know when I'm feeling stable enough? I'm afraid I don't know what normal even feels like anymore and I won't be able to tell when it's time... Any recommendation for how long I should just wait to start tapering? I've been off of Adderall (the last one I quit) I think for twoish months but everything is hard for me to keep track of anymore... I feel like my brain is at half power all the time but it's been like this most of the past two years to a varying degree.

 

Originally I was going to taper more slowly off of Adderall but my body suddenly decided that the Adderall was going to make me extremely fatigued (plus some symptoms that are hard to describe, so it's easier to just say fatigued) all day and I couldn't stand it because it was doing the opposite of what helped my ADHD

 

I think I had more to reply to from your post but my brain isn't having it right now so you might get a second reply to this someday

2009 - 2021    Zoloft (sertraline)

2008 - 2021    Various stimulants (ritalin, vivance, focalin, adderall, adderall ER)

2012 - 2019    Abilify 2mg

2019    Mirapex (pramipexole) Nov. 0.125mg Dec. 0.25mg

 

Currently just going to try to get off of Mirapex (my only current prescription medication) after previously not tapering meds correctly because I'm hoping the akathisia can go away eventually. 

Link to post
  • Moderator

Hi @teasprout,

 

8 hours ago, teasprout said:

Are you saying I'm probably still dealing with withdrawal from a pill I last took two years ago or did you mean to include Abilify in that list?

All the drugs you've been prescribed can take more than a couple of years to fully recover from.  To complete your signature, could you also include the Adderall, dates and dosages.  Yes, it's true that Adderall can have a rebound effect, meaning it can cause the problem it's supposed to fix, in your case, ADHD, and perhaps Restless Leg syndrome.  Has your doctor discussed this with you?  This link can give you more information about how your taper off Adderall may now be affecting you:

Adderall - Tapering - 

8 hours ago, teasprout said:

How do I know when I'm feeling stable enough?

 

I would give yourself more time before posing this question.  Right now we know you're feeling pretty rocky.  Let your nervous system begin to adjust a little longer.  Maybe in a month check in with your body and see if it's ready  before imposing more changes.  See if your mind has cleared even a small bit.  Keep checking in with us, and we can assess how you're doing together.  These kinks may be useful for reading your symptoms:

 

Stability

 

WD Normal

 

It's hard to be patient with getting off these drugs.  Try to focus on one day at a time right now.  Have you checked out the success stories?  They really help me hang in there with the anxiety of how long this process takes:

 

Success stories: Recovery from psychiatric drug withdrawal

 

Glad you're in touch,

Arbor💜

 

Zoloft: 1995 - 2015

Prozac: 2015 - 2018 (tapered from 40mg x day on July 31 to 30mg on August 31 to 20mg on September 31 to 10mg October 31 to 0mg on  December 15, 2018

Gabapentin: 2016 to 2019  (tapered from 300mg x day to 150mg on August 31, 2019 to 75mg on September 15 to 50mg on September 31 to 25ishmg on October 15 to 0mg on December 1, 2019

Enalapril: 2010 - 2019

Lipitor: 2017 -2017

Metformin: 2000 - 2020

Liothyronine: 2007 - 2019

Levothyroxine: 2000 - 

Link to post

@arbor I'll try to figure out when I started Adderall vs the other stimulants I just wasn't sure when that was so that's why it's not in my signature exactly. There's also a ton of other psych meds I've been on in the past that I didn't include because this list is way too long, I don't have proper dates, and it seems like maybe those are too far in the past to matter. 

 

I appreciate the advice! At my appointment today I asked my psychiatrist for the old dose again and I'll stay on it for a bit and see see how I feel. I had already started at the old dose again this past weekend (because I had enough extra pills) and it took a few days but I'm feeling much better, at least physically with the akathisia subsiding, and therefore I can sleep. I guess I'm doing a little bit better mentally too, but like I've never been doing "great" since two years ago when I went off of Abilify. And I still think Mirapex is probably messing with my brain.

 

I didn't have the guts to confront my psych about what she said a month ago about how reducing the dose by that much wouldn't matter since the overall dose (in mg) is so small. She had also implied that the akathisia was just anxiety and that's frustrating... but at least she reinstated my Mirapex dose I guess.

You're so right about it being hard to be patient omg I want this OVER WITH but I will do my best. 

2009 - 2021    Zoloft (sertraline)

2008 - 2021    Various stimulants (ritalin, vivance, focalin, adderall, adderall ER)

2012 - 2019    Abilify 2mg

2019    Mirapex (pramipexole) Nov. 0.125mg Dec. 0.25mg

 

Currently just going to try to get off of Mirapex (my only current prescription medication) after previously not tapering meds correctly because I'm hoping the akathisia can go away eventually. 

Link to post
  • Moderator

Hi @teasprout  I want this to be over for you, too💜

Zoloft: 1995 - 2015

Prozac: 2015 - 2018 (tapered from 40mg x day on July 31 to 30mg on August 31 to 20mg on September 31 to 10mg October 31 to 0mg on  December 15, 2018

Gabapentin: 2016 to 2019  (tapered from 300mg x day to 150mg on August 31, 2019 to 75mg on September 15 to 50mg on September 31 to 25ishmg on October 15 to 0mg on December 1, 2019

Enalapril: 2010 - 2019

Lipitor: 2017 -2017

Metformin: 2000 - 2020

Liothyronine: 2007 - 2019

Levothyroxine: 2000 - 

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Foxclover6

I'm struggling too, and I do not have advice but I cried reading your post because of the helplessness that I can relate to so much,  not knowing what is what.  I just want to post and show support even though I have nothing much to offer. I still exercise, for a while I stopped after developing pain from my mess of a medication cease and what I tried during withdrawl but I have stated back.  It helps,  like you though I'm still struggling to find "me". Thank you for the comment about raynauds,  it was helpful and did make me feel hopeful. 

 

- 10 mg lexparo 1.5 years

- ativan for panic 0.5 , never more than once daily and not everyday 

Incorrectly tapered and now taking nothing since 6-10-21. 

Took buspar a few days and had severe muscle pain. July 26, 27, then 30.

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