Mere: help with tapering

[Mere]

Mere is my daughter. With her permission, I started this account so she could begin tapering off psych drugs. She'll be 26 years old in 3 months.

 

I believe her problems started when we moved hundreds of miles away from beloved grandmother and aunts when she was almost 5. She went from a hot, humid climate to a cold and dry climate. She hates the cold. We had no support system when we moved up here.

 

She had anxiety about school ever since first grade. The principal had to pull her out of the car at beginning of 1st grade (she was kind about it but Mere was definitely very emotional). She missed many days of school due to stomach aches (anxiety). She also started saving wrappers from fast food and all kinds of trash. This lasted about a year.

 

She's been on anti-depressants since she was a teenager. This was for anxiety and depression.

 

In college she went to a psychiatrist. She was convinced she was Bi-polar II (hypomania--may have been caused by anti-depressant). The psych basically took her word for it and confirmed it with the DSM. And then she started on a mood stabilizer. This lead to all kinds of meds being prescribed. She drank heavily starting in her sophomore year. She quit cold turkey when she moved home in 2019. She went on a birth control a year after her med changes at college (it was a shot that lasted for 3 months; she did that 2x). This is when things really went south. Her personality changed. She started having major panic attacks, had to skip tons of classes, became very demanding and yelling at my husband and me, behaving terribly and irrationally. She was also in a bad relationship and got a puppy (poor judgement and added so much stress to her life).

 

She's been hospitalized 2x since then. Ultimately she dropped out of college just shy of finishing and moved back home at end of 2019. Now she uses marijuana in order to cope, it does seem to keep her on an even keel. She needs to get off this, of course. Any suggestion about whether she should get off that 1st or start tapering 1st? Or do it simultaneously? She is definitely dependent on the pot to keep her sane. 

 

I am gathering her past medical records from all of her psychs. I will have a list of all the meds., and I'll post them as soon as I get them but she wants to get going on tapering from her current meds.

 

The most debilitating side effect of Divalproex ER 500mg: diarrhea, upset stomach, changes in her menstrual cycle, weight changes (weight went up). Chlonodine's 0.1mg side effects include loss of appetite, nausea and vomiting (these are less common side effects supposedly but she has these).

 

The side effects she may be having from Venlafaxine ER 75mg capsule are: feeling anxious, sleep problems, fast heartbeat, unusual dreams, nausea, vomiting, diarrhea, changes in weight or appetite (she was anorexic but she has gained a lot  of weight since moving home).

 

She's out of Ativan Rx and has no refills. She took it for anxiety since 01/2021. She's probably consumed at least 60 pills over the course of this time. She will be seeing a new nurse practitioner at end of Oct. Her PNP just retired.

 

Her current drugs are:

 

• Divalproex ER 500mg
• Clonidine 0.1 mg tab
• Venlafaxine ER 75mg capsule
• Ativan/Lorazapam 1mg (prn) Takes 3-4mg each time and has been taking since early 2021 but now she is out of them.

 

Could you give her advice which drug to start with? Depakote seems to give her the most trouble thinking and feeling physically well.

 

Thank you.

Edited October 29, 2021 by Kiasofia
Text was in "about me" instead of intropost.

[Kiasofia]

Welcome @Mere

I copied what you wrote in "about me" and posted it here. This is your introduction topic where you can ask all questions and keep everything gathered in one place.

I'm so sorry for all your daughter has been through.

 

We like to get as clear a picture of the situation as possible before making suggestions. It would be helpful if you could create a drug signature by following these instructions: https://www.survivingantidepressants.org/topic/24613-how-to-summarize-your-drug-history-in-your-signature/

 

I don't know how much you have searched this forum but here are some links that might be helpful regarding tapering:

Taking multiple psych drugs? Which drug to taper first?

Preparing to taper

NEVER SKIP DOSES TO TAPER

Why taper by 10% of my dosage?

 

I’m glad you found us, we’re here to support you and your daughter!

 

[Mere]

I'm Mere's mom, Amy, I am helping her, through this website, to taper off her current (3) meds. She wants to get off all of them all and see how things go. She believes, as do I, that she's been misdiagnosed with Bipolar II. Her symptoms appear to indicate ADHD with Autistic features. Thank you for your help.

[Kiasofia]

Hi @Mere

I've merged your new topic with your Introduction topic. SA works differently to many other forums.  Each member has their own Introduction topic (only one).  Your Introduction topic is the best place to ask questions specific to your own situation and where you can journal your progress. This keeps your history in one place and means that you do not have to repeat your story.

 

Is it possible  for your daughter to join the forum herself?

 

What symptoms have occurred from reducing divalporex from 500mg to 250mg? What symptoms is she currently having? How is her sleep?

 

Coming off these drugs can cause many different withdrawal symptoms, often leading to doctors thinking the original condition is returning or that another mental illness has emerged.

What is withdrawal syndrome?

Dr. Joseph Glenmullen's withdrawal symptom checklist

 

 

About tapering:

Tips for tapering off venlafaxine (Effexor)

Tips for tapering off sodium valproate and valproic acid (divalproex sodium, Depakote, Depakene)

Taking multiple psych drugs? Which drug to taper first?

Preparing to taper

NEVER SKIP DOSES TO TAPER

Why taper by 10% of my dosage?

 

As there are common misconceptions about how these drugs work I found this post helpful to understand what is going on and why a slow taper is important:

How Psychiatric Drugs Remodel Your Brain 

 

There can be many causes for the symptoms that get labeled ADHD. Anatomy of an Epidemic by Robert Whitaker (interview) documents the dangers of treating these symptoms with drugs. Once someone is taking psych drugs it's not possible to know what role their current drug regiment is playing with regards to their symptoms and what is "them". It is possible that the current drugs or tapering the drugs are causing these symptoms. So any new diagnosis while she is on drugs or coming off them isn't valid. The book Brain Maker shows the importance of treating gut health to deal with symptoms related to ADHD and autism.

 

I hope your daughter is able to safely withdraw from the drugs. As you see in this forum, it is important to take it slowly.

[Mere]

Hi @Kiasofia Per Mere, her symptoms since halving her dose of divalporex from 500mg to 250mg: she had a menstrual cycle for the first time in 6 months (accompanied by a terrifying screaming meltdown). That was one month ago. She had PMS (cramps, back pain) as if she would start on a normal cycle since then but she did not start.

 

At the beginning of dosage cut she said she was able to think full thoughts for the first time in a long time. She also reports tiredness and emotional disregulation (meaning over reacting to mundane daily interactions).

 

Sleep still varies. Sometimes she goes two nights without sleeping and then crashes for 14 hours. Recently she stays up all night then sleeps 6-12 hours during the day. She has a hard time eating because she is sensitive to textures of her food. And she has become very sensitive to sweetness in food. Also she seems to have developed lactose intolerance so she's cut out milk and cream.

 

I will continue reporting for her. When I first started her account, I wrote and rewrote her introduction 3 times. I thought there would be a submit button and that the last one I wrote would be published. I think the first one I wrote was published. Is that correct?

 

Thank you for your help.

[Kiasofia]

4 hours ago, Mere said:

When I first started her account, I wrote and rewrote her introduction 3 times. I thought there would be a submit button and that the last one I wrote would be published. I think the first one I wrote was published. Is that correct?

It was in the "about me" of profile information , so I added it to your intro post from Oct 29 and then merged your newest post with that. So from now on, just keep writing in this thread and it will all be gathered in one place.

 

Some more links:

Neuro-emotions

Tips to help sleep -- so many of us have that awful withdrawal insomnia

 

A fast taper at higher doses, as was done with divalproex, is often ok at higher doses, but at lower doses it is important to go slower. This link explains why:

Why taper? Importance of gradual change in plasma concentration