Healing89: Psychotic episode followed by multiple psychiatric drugs and feelings of Anhedonia and uneasiness/agitation

[Healing89]

Hello, this is my first post so it will probably be long.

In the fall of 2019 I was dealing with depression that got better soon after.

In the spring of 2020, I had a psychotic episode. I was diagnosed with Schizophreniform instead of brief psychotic episode because it lasted 5 weeks instead of 4 or less so I’m not sure if I actually have schizophrenia or not.

 

I was using a lot of different drugs leading up to the episode, some of the daily.

I went cold turkey on all of these (sertraline, weed, ketamine, steroids, nicotine) in the hospital and was put on risperidone 4mg. After this series of events, I ended up feeling terrible mentally.

The stress of the episode could’ve contributed to this as well. I started to have Anhedonia (unable to enjoy things) and a feeling of uneasiness/an agitated feeling. I suspected the risperidone might be partly to blame but my psychiatrist wanted me to stay on it so I did.

I tried lexapro that summer which helped for a week and then pooped out.

 

In the fall of 2020, I attempted suicide and for some reason in the hospital I began to feel a little better. I’m not sure why.

I started remeron in the hospital and discontinued lexapro. I also lowered my risperidone dose a bit.

Soon after, I switched to abilify 5mg.This period of time is the only time I’ve seen slight improvement.

I started taking adderall which also gives me slight improvement to this day. I feel like without it I would not be able to function well.

I tried Wellbutrin spring 2021 but then tapered off. I began to feel worse May 2021 when I tapered off remeron pretty fast and started tapering abilify. I went back on the abilify.

I suspect alcohol contributed to me feeling worse. I have been drinking occasionally since but when I do I feel terrible for days after.

I’m still dealing with the Anhedonia/agitation to this day since the psychotic episode. I’ve also tried benztropine and Trazodone which I still take today but don’t help me really.

 

I’ve been trying to quit porn since June and average 10 days at a time so that might be contributing to me being unstablilized mental health wise.

Recently, I switched from abilify to cariprazine and didn’t feel great so now I tapered down to .75mg of cariprazine and I’m not doing great.

I’m using a lot of nicotine and adderall currently. I’m up to 75mg adderall a day and vaping a lot of nicotine.

I haven’t felt okay since may and even then I wasn’t doing great, the adderall was helping me though.

Currently, I’m 10 days without porn also. I’m trying to reduce my stress too and not drink alcohol in hopes of

 

balancing out. I have a few questions that I would be grateful if someone answered:

1) Should I quit nicotine or taper? Should I balance out first or will this help? I haven’t been sleeping great and I suspect nicotine might be to blame. 
2)Should I try to reduce my adderall for now? In the long run should I taper off completely?

3)Should I balance out before I start another drug? I want to try an MAOI. 
4)Should I continue eating a good amount of sugar, taking cold showers, and exercising every day? Are any of these preventing me from stabilizing? 
5)How long should I avoid alcohol for?

6)Should I taper any other medications right now or wait until I hopefully feel better? I’m taking Trazodone and benztropine and a couple supplements such as L-Tyrosine. 
7)My psychiatrist thinks I just have negative symptoms of schizophrenia. Is this likely or are my feelings the result of other things such as stress or drug use?

8)Should I reinstate cariprazine at all or just ride it out? 
9)Is me struggling to quit porn causing further destablization?

 

Sorry for such a long post. I would be grateful for any advice. Thanks. 

Edited January 24, 2022 by manymoretodays
spacing for ease of reading

[manymoretodays]

Hi there Healing89 and welcome aboard,

 

We are primarily a site for safer discontinuation of psychoactive drugs, and WD(withdrawal) support.  Are you interested in learning more about your drugs, and then possibly going drug free one day/tapering off?

 

And oh my gosh, it sounds like it has been very hard for the last couple of years now.  I'm sorry.  And I see that you went from "depression" and then on to some psychotic symptoms as well.  And I am so glad that you have survived your suicide attempt and are here.  I am.  

 

One of the first things that we ask members to do, is to put together a signature.  You'll see others signatures just below their postings.  I do see that you have a great recollection of your drugs, and history and so.......that is great.  Just the drugs in the signature.  And then that gives us a nice reference to glance at wherever you might post on site.  Here is the link, with the how to, and further link to get you back to where you need to be to set that up.

How to summarize your drug history in your Signature

 

Nice introduction, first post narrative too, @Healing89.  I did go in, and as I was reading, just spaced only, or reformatted it a bit, for ease of reading.

And whoosh, what a merry go round of drugs to date.

When you do your signature, would you list the cariprazine with both possible names please.  I was not familiar with that one, and do see now that it also goes by the name of Vraylar(brand).  It's a newer AP(antipsychotic class), out in the U.S, since 2015 I see.
I'm just going to put the link to Wikipedia here now, for my own reference, on it too.  Cariprazine-Wikipedia

 

On 1/20/2022 at 8:01 PM, Healing89 said:

I was diagnosed with Schizophreniform instead of brief psychotic episode because it lasted 5 weeks instead of 4 or less so I’m not sure if I actually have schizophrenia or not.

 

I would also be hesitant to "label" oneself, or to allow others to label you as some category of Mental Illness.  I don't find that helpful.  And yes, it does sound like you had psychosis symptoms, possibly a adverse effect of your AD(antidepressant), but even more likely from the combination of ? recreational and prescribed drugs that you were ingesting.  

And so in answer to one of your questions........I would just not add in alcohol right now, or drink. I would abstain completely for the time being or not drink at all.  It can interfere or enhance symptoms sometimes of WD as well.

How long have you been smoking cigarettes?  Of course that is not a healthy habit.  The prescriptions you are currently on are also not a real healthy habit either, if you want my opinion.........I'm sure you don't, so just saying.  We really don't condone rapid discontinuation of any psychotropics though......I mean I don't want you jumping off any medications, or psychotropes without a good plan.

Both nicotine and alcohol are considered psychotropic.  And I do see now that you are vaping, not smoking cigarettes.  So yes, for sure, start a slow reduction in the amount of nicotine vaped.  Just make an adjustment every week or so, until perhaps you are not vaping at all anymore.  

 

So.....while you work the signature, and get that done.  I'll leave you with a few more basics about tapering, and WD(withdrawal) below.  And hope you'll stick with us, and begin to form a plan, while further educating yourself, around medications, and then think possibly tapering, and getting rid of perhaps some unnecessary overmedication now.

 

Here at Surviving Antidepressants, it is recommended that a person taper by no more than 10% of their current dose with at least a four week hold in-between decreases.  The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs.

Why taper by 10% of my dosage?

 

What is withdrawal syndrome.

Brain Remodelling

The Windows and Waves Pattern of Stabilization

 

 

Dr.Glenmullen’s withdrawal symptom list.

 

When we take 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.  The CNS likes stability. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur. 

 

You've been on and off so many drugs now that it is very hard to distinguish I am sure, just what are not only drug effects, but also what might be WD from previous drugs tried.  

 

I am also going to give you this resource, via link now too:  Drugs.com  This is a great site to look up any drug individually, as well as to check interactions of your drugs.  I think you should check the interactions of your present "cocktail" of medications now too.  And then just copy and paste the results here, or link us to your results page.

 

I'm going to stop there, so as not to overwhelm you from the get go Healing89.  And welcome again.  Hope you stick around.  I know I did not get to all your questions yet.......I did just want to get you started today.  Sorry for the wait time in first post approval and response.  We do try to get to everyone in 24 -48 hours.  It can be a busy site most times.

 

Love, Peace, Healing, and Growth,

moderator manymoretodays (mmt)

Edited January 24, 2022 by manymoretodays
spelling,grammar, additional around vaping

[Healing89]

5 hours ago, manymoretodays said:

Hi there Healing89 and welcome aboard,

 

We are primarily a site for safer discontinuation of psychoactive drugs, and WD(withdrawal) support.  Are you interested in learning more about your drugs, and then possibly going drug free one day/tapering off?

 

And oh my gosh, it sounds like it has been very hard for the last couple of years now.  I'm sorry.  And I see that you went from "depression" and then on to some psychotic symptoms as well.  And I am so glad that you have survived your suicide attempt and are here.  I am.  

 

One of the first things that we ask members to do, is to put together a signature.  You'll see others signatures just below their postings.  I do see that you have a great recollection of your drugs, and history and so.......that is great.  Just the drugs in the signature.  And then that gives us a nice reference to glance at wherever you might post on site.  Here is the link, with the how to, and further link to get you back to where you need to be to set that up.

How to summarize your drug history in your Signature

 

Nice introduction, first post narrative too, @Healing89.  I did go in, and as I was reading, just spaced only, or reformatted it a bit, for ease of reading.

And whoosh, what a merry go round of drugs to date.

When you do your signature, would you list the cariprazine with both possible names please.  I was not familiar with that one, and do see now that it also goes by the name of Vraylar(brand).  It's a newer AP(antipsychotic class), out in the U.S, since 2015 I see.
I'm just going to put the link to Wikipedia here now, for my own reference, on it too.  Cariprazine-Wikipedia

 

 

I would also be hesitant to "label" oneself, or to allow others to label you as some category of Mental Illness.  I don't find that helpful.  And yes, it does sound like you had psychosis symptoms, possibly a adverse effect of your AD(antidepressant), but even more likely from the combination of ? recreational and prescribed drugs that you were ingesting.  

And so in answer to one of your questions........I would just not add in alcohol right now, or drink. I would abstain completely for the time being or not drink at all.  It can interfere or enhance symptoms sometimes of WD as well.

How long have you been smoking cigarettes?  Of course that is not a healthy habit.  The prescriptions you are currently on are also not a real healthy habit either, if you want my opinion.........I'm sure you don't, so just saying.  We really don't condone rapid discontinuation of any psychotropics though......I mean I don't want you jumping off any medications, or psychotropes without a good plan.

Both nicotine and alcohol are considered psychotropic.  And I do see now that you are vaping, not smoking cigarettes.  So yes, for sure, start a slow reduction in the amount of nicotine vaped.  Just make an adjustment every week or so, until perhaps you are not vaping at all anymore.  

 

So.....while you work the signature, and get that done.  I'll leave you with a few more basics about tapering, and WD(withdrawal) below.  And hope you'll stick with us, and begin to form a plan, while further educating yourself, around medications, and then think possibly tapering, and getting rid of perhaps some unnecessary overmedication now.

 

Here at Surviving Antidepressants, it is recommended that a person taper by no more than 10% of their current dose with at least a four week hold in-between decreases.  The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs.

Why taper by 10% of my dosage?

 

What is withdrawal syndrome.

Brain Remodelling

The Windows and Waves Pattern of Stabilization

 

 

Dr.Glenmullen’s withdrawal symptom list.

 

When we take 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.  The CNS likes stability. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur. 

 

You've been on and off so many drugs now that it is very hard to distinguish I am sure, just what are not only drug effects, but also what might be WD from previous drugs tried.  

 

I am also going to give you this resource, via link now too:  Drugs.com  This is a great site to look up any drug individually, as well as to check interactions of your drugs.  I think you should check the interactions of your present "cocktail" of medications now too.  And then just copy and paste the results here, or link us to your results page.

 

I'm going to stop there, so as not to overwhelm you from the get go Healing89.  And welcome again.  Hope you stick around.  I know I did not get to all your questions yet.......I did just want to get you started today.  Sorry for the wait time in first post approval and response.  We do try to get to everyone in 24 -48 hours.  It can be a busy site most times.

 

Love, Peace, Healing, and Growth,

moderator manymoretodays (mmt)

@manymoretodaysThank you for taking the time to read my post and with the reply which is very helpful. To answer your first question, I would like to taper off all medication eventually but whatever is best for my mental health. A lot of the medications I’m on don’t really benefit me with the exception of adderall. I changed my signature to include vraylar and I agree it was probably a combination of things that caused my psychotic episode. I am going to abstain from alcohol for a while. Thank you that advice/encouragement. Do you think it is okay to taper nicotine now or wait until I stabilize a little more? I quit for 1-2 months in October/November but have been vaping since November. I agree it is unnecessary over medication and would like to taper off most drugs eventually. This seems like a great forum and I’ll likely be sticking around. Thank you for the links, those are helpful. No worries about the wait time. I did the drugs.com interaction checker and there was 10 moderate interactions and they mostly said the same thing. I included an image of what it said. What would you recommend I change at the moment? If you could help me get started with a tapering plan that would be great. I have been taking valerian root for only a few weeks so maybe I could taper that soon and stop it? I haven’t been back on nicotine long so maybe I can taper that soon? I should probably hold off on tapering cariprazine (vraylar) until I stabilize more, right? I have also been taking high doses of adderall so maybe lowering that a little for now since I have just increased my doses recently? I was taking around 60mg a day in December and now I’m taking 75mg. I feel like my Anhedonia/symptoms might improve if I lower Trazodone or cariprazine and maybe the other medications I’m on. I realize now that I was probably tapering/making changes too fast. If you could offer more advice/wisdom that would be great. Thank you.

[manymoretodays]

Hi Healing89,

Good job on the signature and getting the interactions all done.

So current load is:

Trazodone 100 mg

Cariprazine(Vraylar) 0.75 mg

benztropine 2 mg

adderall 75 mg

gabapentin 300 mg

 

Wowser Healing89, that IS some cocktail of medications.

Would you first go ahead and list the times on the left, and then your drugs, as well as supplements on the right.  Make sure to note the drug and supplements names and dosages.

And then tell me what a day is like for you at present.

If you can, you can tell me what a day is like in the form of a daily drug and symptoms diary or Notes.  Here's more about how to do that:

daily notes

 

Just keep the times over on the left hand side, and then note the drugs, supplements, symptoms on the right.  Keep noting times on the left and also note your sleep, activities, periods when you feel pretty normal, as well as times when you feel symptoms of WD, or drug side effects.

Then post a couple of days notes all in one reply box.  You can post them daily, but then do also post a series of days together too.  They will be really helpful to you and us now.  Thank you.

 

Do you think you are experiencing any WD, after looking at Glenmullen's symptom list?

Why were all these drugs started?

 

I'd say consider this time now, as our period of getting to know your case a little better, and don't go too quickly to make any changes right now.  I hope that's okay. 

With just the few weeks of Valerian root.......I think you could do a rapid taper off of that one.  Just reduce it by 1/4 dose every couple of days, if recently started. 

Any idea if that did anything for you?

Here's our topic on it:  Valerian root

 

I think you could reasonably work down on your vaping now too.  It's possible that the nicotene interacts with the metabolism of some of your other drugs too, and so just go slow with that taper.  Keep the notes, not only for us to see, but for you too........to be able to see perhaps what is doing what right now.

Keep it simple, slow, and stable, the rule of 3 KI's

^ excellent rule

 

So just go with one or the other now, the vaping decrease or the Valerian rapid taper.  I think since the Valerian root was most recently added, if it was me, I'd work on that first.

 

And then a bit more on tapering, when multiple drugs are involved:

Taking multiple psych drugs? Which drug to taper first?

 

Yes, I agree........that's a lot of adderal.  Let's look at the notes first though before you start changing that.  It looks like you are on more brakes than accelerators right now.  You'll understand what I'm saying once you get a look at the link above.  And usually yes, we'll go with tapering accelerators first, leaving the brakes or more sedating drugs for last......as they can sometimes help cushion any WD symptoms that may occur.  And then, the harm reduction tapers are the best too, starting any taper at 10% or less from the previous dose.

 

Okay, and best,

L, P, H, and G,

mmt

 

 

[Altostrata]

Welcome, @Healing89

 

On 1/20/2022 at 7:01 PM, Healing89 said:

I went cold turkey on all of these (sertraline, weed, ketamine, steroids, nicotine) in the hospital and was put on risperidone 4mg.

 

Quite the combination of drugs you were on. Steroids alone can cause psychotic-like symptoms. Generally, psychiatrists are supposed to avoid give people a diagnosis of psychosis when they're experiencing adverse effects of drugs, but doctors are always pressed for time, so it's convenient to just call them all psychotic and put them on drugs for the rest of their lives -- or until they decide to define themselves otherwise.

 

On 1/24/2022 at 5:21 PM, Healing89 said:

A lot of the medications I’m on don’t really benefit me with the exception of adderall.

 

Not unusual, many people like the amphetamine analogs, that's why the drug class is so popular off-prescription.

 

5 hours ago, manymoretodays said:

Trazodone 100 mg

Cariprazine(Vraylar) 0.75 mg

benztropine 2 mg

adderall 75 mg

gabapentin 300 mg

 

As I understand it, this is your current drug intake (helpfully summarized by @manymoretodays), and you're troubled by dulled emotions. What was the date you started each of the drugs you're taking now? Which was increased most recently, what dates and dosage?

 

On 1/20/2022 at 7:01 PM, Healing89 said:

I’m using a lot of nicotine and adderall currently. I’m up to 75mg adderall a day and vaping a lot of nicotine.

 

You have a long history of quasi-recreational drug use and alcohol use, plus psychiatric psychotropics. You're also occasionally drinking alcohol and have a steady nicotine habit?

 

We're serious about helping people go off drugs but we're just volunteers, we can't help people who are always introducing new psychotropics. It's like bailing out a rowboat with a big hole in the bottom. If you want to cause your own problems by taking more drugs, you can, but we can't help you with those problems. We're about reducing drugs, this is a supportive community but it's not a free online recovery program. (Though many people here find their ways to recovery.)

 

Most people here question their psychiatric diagnosis or anyway want to shed an identity as a psychiatric patient. We call this "unpatienting yourself". Is this your interest?

 

The method we use requires change in only one drug at a time so we can all see what arises from that change, which usually is a dosage decrease. This will require you to stick to a schedule and do some carefully measuring and note-taking. You cannot just up your dosage because you feel like it. Are you willing to do this?

 

I answered your questions in bold below:

 

On 1/20/2022 at 7:01 PM, Healing89 said:

I have a few questions that I would be grateful if someone answered:

1) Should I quit nicotine or taper? Should I balance out first or will this help? I haven’t been sleeping great and I suspect nicotine might be to blame. 

 

You also increased Adderall at the same time. Yes, both drugs may be affecting your sleep. Yes, you might taper off nicotine while we're discussing a potential deprescribing plan. It appears nicotine makes you feel bad, the goal is to make you feel better.

2)Should I try to reduce my adderall for now? In the long run should I taper off completely?

 

We need to find out which drugs you've increased recently. These dosage increases probably can be reversed fairly easily. The antipsychotics you're taking most likely are your highest-risk drugs, but identifying this requires looking at your symptom pattern. 

On 1/20/2022 at 7:01 PM, Healing89 said:

3)Should I balance out before I start another drug? I want to try an MAOI. 

 

Why do you want to try an MAOI? This would be adding a drug. It's is a dealbreaker for going off drugs. You don't need peer support for this -- you'll find plenty of psychiatrists who would be happy to prescribe any cockamamie combination of psychiatric drugs you want. Let us know when you want to reduce drugs.

 

4)Should I continue eating a good amount of sugar, taking cold showers, and exercising every day? Are any of these preventing me from stabilizing?

 

How the heck is eating a lot of sugar on your plan for good health? What are you doing for exercise? 

 

5)How long should I avoid alcohol for?

 

For as long as you're taking a psychiatric drug cocktail and probably a few years after that. It will continue to make you feel sick.

 

6)Should I taper any other medications right now or wait until I hopefully feel better? I’m taking Trazodone and benztropine and a couple supplements such as L-Tyrosine. 

 

Change only one thing at a time. Need to know the dates you started or increased these substances.

7)My psychiatrist thinks I just have negative symptoms of schizophrenia. Is this likely or are my feelings the result of other things such as stress or drug use?

 

An elephant would have dulled emotions taking your combination of drugs. Except for Adderall, which is used to keep people awake when they're overload with "brake" drugs, all of those drugs are intended to slow you down to a crawl.

 

8)Should I reinstate cariprazine at all or just ride it out? 

 

When did you go off cariprazine? Which of your symptoms do you attribute to going off cariprazine?

 

9)Is me struggling to quit porn causing further destablization?

 

You've been on and off a million drugs. I doubt that porn one way or the other is causing your symptoms. However, if it makes you feel guilty, self-blaming, and obsessive, you're stuck in a habit of mind cycle as well. A psychotherapist can help you with that.

[Healing89]

On 1/26/2022 at 2:43 PM, manymoretodays said:

Hi Healing89,

Good job on the signature and getting the interactions all done.

So current load is:

Trazodone 100 mg

Cariprazine(Vraylar) 0.75 mg

benztropine 2 mg

adderall 75 mg

gabapentin 300 mg

 

Wowser Healing89, that IS some cocktail of medications.

Would you first go ahead and list the times on the left, and then your drugs, as well as supplements on the right.  Make sure to note the drug and supplements names and dosages.

And then tell me what a day is like for you at present.

If you can, you can tell me what a day is like in the form of a daily drug and symptoms diary or Notes.  Here's more about how to do that:

daily notes

 

Just keep the times over on the left hand side, and then note the drugs, supplements, symptoms on the right.  Keep noting times on the left and also note your sleep, activities, periods when you feel pretty normal, as well as times when you feel symptoms of WD, or drug side effects.

Then post a couple of days notes all in one reply box.  You can post them daily, but then do also post a series of days together too.  They will be really helpful to you and us now.  Thank you.

 

Do you think you are experiencing any WD, after looking at Glenmullen's symptom list?

Why were all these drugs started?

 

I'd say consider this time now, as our period of getting to know your case a little better, and don't go too quickly to make any changes right now.  I hope that's okay. 

With just the few weeks of Valerian root.......I think you could do a rapid taper off of that one.  Just reduce it by 1/4 dose every couple of days, if recently started. 

Any idea if that did anything for you?

Here's our topic on it:  Valerian root

 

I think you could reasonably work down on your vaping now too.  It's possible that the nicotene interacts with the metabolism of some of your other drugs too, and so just go slow with that taper.  Keep the notes, not only for us to see, but for you too........to be able to see perhaps what is doing what right now.

Keep it simple, slow, and stable, the rule of 3 KI's

^ excellent rule

 

So just go with one or the other now, the vaping decrease or the Valerian rapid taper.  I think since the Valerian root was most recently added, if it was me, I'd work on that first.

 

And then a bit more on tapering, when multiple drugs are involved:

Taking multiple psych drugs? Which drug to taper first?

 

Yes, I agree........that's a lot of adderal.  Let's look at the notes first though before you start changing that.  It looks like you are on more brakes than accelerators right now.  You'll understand what I'm saying once you get a look at the link above.  And usually yes, we'll go with tapering accelerators first, leaving the brakes or more sedating drugs for last......as they can sometimes help cushion any WD symptoms that may occur.  And then, the harm reduction tapers are the best too, starting any taper at 10% or less from the previous dose.

 

Okay, and best,

L, P, H, and G,

mmt

 

 

@manymoretodays Thank you for the reply. Sorry it took a little bit for me to reply, I have just been focusing on relaxation and reducing stress the past week. I think I am a little sensitive to stress at the moment so I’ve been working on reducing stress and trying to stabilize a little. I edited my signature with times on the left if that is what you meant. Here is what the average day has looked for me recently:

 

8:00AM-Wake up and breakfast, take 22.5mg adderall, 1mg benztropine, 500mg l-tyrosine, multivitamin, fish oil, vitamin d

12:00PM-22.5 mg adderall and 1mg benztropine 

4:00 PM-15mg adderall

7:00PM-15mg adderall

10:00PM-100mg Trazodone, 300mg gabapentin, .75mg vraylar(Cariprazine), 1g valerian root

Sleep: I’ll wake up once at probably around 2-3AM, hit my nicotine and go back to sleep, wake up at 6-7 hit my nicotine then sleep until 8AM, maybe it’s withdrawal from nicotine Why I wake up? My body has probably gotten used to that also. I also use nicotine steadily throughout the day. 
 

For the past week, I haven’t been doing much as I felt like reducing stress was the best thing to do at the moment for my mental health. I’ll workout, listen to a relaxing audiobook for most of the day, eat 3 meals, watch a podcast, chip golf balls in my backyard while listening to music.

 

I would say my symptoms are pretty steady throughout the day unless maybe I do something stressful. The feelings of Anhedonia and uneasiness (not feeling relaxed, content, comfortable) are there most of the day. When I wake up, they are the worst until 30 minutes later once the adderall kicks in. I also feel better earlier in the day when I take the higher dosages of adderall (1.5) and I take 1 at night twice. The effects last about 4 hours so that’s how often I take it. 
 

In regards to withdrawal symptoms, it’s kind of hard to tell but I think making changes fast causes me to feel worse in regards to the symptoms I have. I’ve basically been steadily declining since may when I started making changes and it’s hard to tell because I made changes so often. Now, I’m not going to make changes like that anymore. 
 

I started the Trazodone to help with sleep as well as the valerian. My psychiatrist started the benztropine because she thought it might help with the uneasiness(it doesn’t). The antipsychotics (vraylar now) we’re started after I had psychotic symptoms. The adderall I started myself to help with the anhedonia(now I have a prescription). The gabapentin I got prescribed to help with the uneasiness but I started to take it for sleep. I started the L-tyrosine to help with Anhedonia but it doesn’t. The vitamin d was recommended because those levels were low on a blood test.

 

I think I am going to work on the valerian taper soon or the nicotine. I will update. I was just a little bit weary of tapering the valerian because apparently it might increase the effects of Trazodone. I am also taking a lot of nicotine every day I just found out(I never really thought about how

much until recently when I looked it up). I’m taking 200+mg of nicotine a day with my vape which is probably not good for my mental Health. I’m not sure how to taper off that right now. Also, I’m not sure if it really is 200+mg because I’m not sure if I absorb all the nicotine from the vape but I think it is 200+.

 

Thank you for the reply again. 
 

 

 

 

 

 

 

[Healing89]

On 1/26/2022 at 8:47 PM, Altostrata said:

Welcome, @Healing89

 

 

Quite the combination of drugs you were on. Steroids alone can cause psychotic-like symptoms. Generally, psychiatrists are supposed to avoid give people a diagnosis of psychosis when they're experiencing adverse effects of drugs, but doctors are always pressed for time, so it's convenient to just call them all psychotic and put them on drugs for the rest of their lives -- or until they decide to define themselves otherwise.

 

 

Not unusual, many people like the amphetamine analogs, that's why the drug class is so popular off-prescription.

 

 

As I understand it, this is your current drug intake (helpfully summarized by @manymoretodays), and you're troubled by dulled emotions. What was the date you started each of the drugs you're taking now? Which was increased most recently, what dates and dosage?

 

 

You have a long history of quasi-recreational drug use and alcohol use, plus psychiatric psychotropics. You're also occasionally drinking alcohol and have a steady nicotine habit?

 

We're serious about helping people go off drugs but we're just volunteers, we can't help people who are always introducing new psychotropics. It's like bailing out a rowboat with a big hole in the bottom. If you want to cause your own problems by taking more drugs, you can, but we can't help you with those problems. We're about reducing drugs, this is a supportive community but it's not a free online recovery program. (Though many people here find their ways to recovery.)

 

Most people here question their psychiatric diagnosis or anyway want to shed an identity as a psychiatric patient. We call this "unpatienting yourself". Is this your interest?

 

The method we use requires change in only one drug at a time so we can all see what arises from that change, which usually is a dosage decrease. This will require you to stick to a schedule and do some carefully measuring and note-taking. You cannot just up your dosage because you feel like it. Are you willing to do this?

 

I answered your questions in bold below:

 

 

On 1/26/2022 at 8:47 PM, Altostrata said:

Welcome, @Healing89

 

 

Quite the combination of drugs you were on. Steroids alone can cause psychotic-like symptoms. Generally, psychiatrists are supposed to avoid give people a diagnosis of psychosis when they're experiencing adverse effects of drugs, but doctors are always pressed for time, so it's convenient to just call them all psychotic and put them on drugs for the rest of their lives -- or until they decide to define themselves otherwise.

 

 

Not unusual, many people like the amphetamine analogs, that's why the drug class is so popular off-prescription.

 

 

As I understand it, this is your current drug intake (helpfully summarized by @manymoretodays), and you're troubled by dulled emotions. What was the date you started each of the drugs you're taking now? Which was increased most recently, what dates and dosage?

 

 

You have a long history of quasi-recreational drug use and alcohol use, plus psychiatric psychotropics. You're also occasionally drinking alcohol and have a steady nicotine habit?

 

We're serious about helping people go off drugs but we're just volunteers, we can't help people who are always introducing new psychotropics. It's like bailing out a rowboat with a big hole in the bottom. If you want to cause your own problems by taking more drugs, you can, but we can't help you with those problems. We're about reducing drugs, this is a supportive community but it's not a free online recovery program. (Though many people here find their ways to recovery.)

 

Most people here question their psychiatric diagnosis or anyway want to shed an identity as a psychiatric patient. We call this "unpatienting yourself". Is this your interest?

 

The method we use requires change in only one drug at a time so we can all see what arises from that change, which usually is a dosage decrease. This will require you to stick to a schedule and do some carefully measuring and note-taking. You cannot just up your dosage because you feel like it. Are you willing to do this?

 

I answered your questions in bold below:

 

@Altostrata Dates for drugs I’m on now:

Started April 2020-Trazodone 100mg

 

Started December 7-10th 2021-Cariprazine/vraylar 4.5mg, switched from Abilify 5mg (Antipsychotics (risperidone)started March 2020)

Started September/October 2021- Benztropine 1mg, increased to 2mg about 1 month later

Gabapentin 300mg- started October 2020

 

Started December 2020-adderall(I think I took 90mg/day until March and then I lowered that to 45mg/day) I started upping the dose in November 2021 and the past month I’ve been taking 75mg

 

Started at the beginning of this month: Fish oil (1280mg omega 3) and Valerian root (1g)

 

Started Spring 2021: Vitamin d (5000 iu) and L-tyrosine 500mg

 

Spring 2020-started vaping nicotine, increased intake drastically January 2021, quit for about 1 month October/November 2021

 

I guess the most recent increases was the valerian/nicotine/adderall. Before that, the benztropine. I feel like adderall helps me at the moment but am willing to decrease a little bit potentially for now but I would rather the other drugs first. 
 

I have used a good amount of recreational drugs in the past and alcohol but Im working on changing. I was not as educated as I am now on psychotropics and I thought making changes is what I needed. It might have been a little habitual even but I am going to take more care with any changes now. I have also not been using recreational drugs for the most part (except nicotine) or alcohol recently. 
 

I like the idea of “unpatienting myself”. 
 

Yes, I’m willing to make one change at a time and stick to a schedule as well as monitoring my symptoms. 
 

 

 

[Healing89]

On 1/27/2022 at 12:47 PM, Altostrata said:

Welcome, @Healing89

 

 

Quite the combination of drugs you were on. Steroids alone can cause psychotic-like symptoms. Generally, psychiatrists are supposed to avoid give people a diagnosis of psychosis when they're experiencing adverse effects of drugs, but doctors are always pressed for time, so it's convenient to just call them all psychotic and put them on drugs for the rest of their lives -- or until they decide to define themselves otherwise.

 

 

Not unusual, many people like the amphetamine analogs, that's why the drug class is so popular off-prescription.

 

 

As I understand it, this is your current drug intake (helpfully summarized by @manymoretodays), and you're troubled by dulled emotions. What was the date you started each of the drugs you're taking now? Which was increased most recently, what dates and dosage?

 

 

You have a long history of quasi-recreational drug use and alcohol use, plus psychiatric psychotropics. You're also occasionally drinking alcohol and have a steady nicotine habit?

 

We're serious about helping people go off drugs but we're just volunteers, we can't help people who are always introducing new psychotropics. It's like bailing out a rowboat with a big hole in the bottom. If you want to cause your own problems by taking more drugs, you can, but we can't help you with those problems. We're about reducing drugs, this is a supportive community but it's not a free online recovery program. (Though many people here find their ways to recovery.)

 

Most people here question their psychiatric diagnosis or anyway want to shed an identity as a psychiatric patient. We call this "unpatienting yourself". Is this your interest?

 

The method we use requires change in only one drug at a time so we can all see what arises from that change, which usually is a dosage decrease. This will require you to stick to a schedule and do some carefully measuring and note-taking. You cannot just up your dosage because you feel like it. Are you willing to do this?

 

I answered your questions in bold below:

 

@Altostrata
 

Do you have any advice for me for tapering nicotine? I just looked into how much I’m vaping and apparently it is 200+mg of nicotine a day(I go through a 30mL bottle of 50mg vape juice a week). I’ll take 4 hits every 10-15 minutes. How should I go about this?

 

I’ve decided not to start an MAOI after reading your reply. I realize this would be a bad idea. I would like to taper my medications that I’m on. 

 

In regards to the sugar, I don’t eat added sugar. I’ll have fruit for breakfast and two protein shakes with milk. I guess it could help to reduce this in the future potentially? 

 

For exercise, I have been lifting weights 6x a week and doing cardio (HIIT (High intensity interval training)) 3x a week. I try to lift heavy by doing 4-6 reps per set when I lift. 

 

I am going to avoid alcohol for a while. 

 

I went off cariprazine earlier this month. I started it early December. In the beginning of January I went from 4.5mg to 1mg/day for a week and then since then I’ve been taking .75mg a day. It’s hard to tell what has made me feel worse because I’ve been making a lot of changes and drinking alcohol/just not taking great care of myself. I am now not going to make many changes at once/too fast of changes and I’ve been working on taking better care of myself by reducing stress. 

 

Thank you for the reply/answers to my questions. 

 

Edited February 1, 2022 by ChessieCat
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[Healing89]

1 hour ago, Healing89 said:

@manymoretodays Thank you for the reply. Sorry it took a little bit for me to reply, I have just been focusing on relaxation and reducing stress the past week. I think I am a little sensitive to stress at the moment so I’ve been working on reducing stress and trying to stabilize a little. I edited my signature with times on the left if that is what you meant. Here is what the average day has looked for me recently:

 

8:00AM-Wake up and breakfast, take 22.5mg adderall, 1mg benztropine, 500mg l-tyrosine, multivitamin, fish oil, vitamin d

12:00PM-22.5 mg adderall and 1mg benztropine 

4:00 PM-15mg adderall

7:00PM-15mg adderall

10:00PM-100mg Trazodone, 300mg gabapentin, .75mg vraylar(Cariprazine), 1g valerian root

Sleep: I’ll wake up once at probably around 2-3AM, hit my nicotine and go back to sleep, wake up at 6-7 hit my nicotine then sleep until 8AM, maybe it’s withdrawal from nicotine Why I wake up? My body has probably gotten used to that also. I also use nicotine steadily throughout the day. 
 

For the past week, I haven’t been doing much as I felt like reducing stress was the best thing to do at the moment for my mental health. I’ll workout, listen to a relaxing audiobook for most of the day, eat 3 meals, watch a podcast, chip golf balls in my backyard while listening to music.

 

I would say my symptoms are pretty steady throughout the day unless maybe I do something stressful. The feelings of Anhedonia and uneasiness (not feeling relaxed, content, comfortable) are there most of the day. When I wake up, they are the worst until 30 minutes later once the adderall kicks in. I also feel better earlier in the day when I take the higher dosages of adderall (1.5) and I take 1 at night twice. The effects last about 4 hours so that’s how often I take it. 
 

In regards to withdrawal symptoms, it’s kind of hard to tell but I think making changes fast causes me to feel worse in regards to the symptoms I have. I’ve basically been steadily declining since may when I started making changes and it’s hard to tell because I made changes so often. Now, I’m not going to make changes like that anymore. 
 

I started the Trazodone to help with sleep as well as the valerian. My psychiatrist started the benztropine because she thought it might help with the uneasiness(it doesn’t). The antipsychotics (vraylar now) we’re started after I had psychotic symptoms. The adderall I started myself to help with the anhedonia(now I have a prescription). The gabapentin I got prescribed to help with the uneasiness but I started to take it for sleep. I started the L-tyrosine to help with Anhedonia but it doesn’t. The vitamin d was recommended because those levels were low on a blood test.

 

I think I am going to work on the valerian taper soon or the nicotine. I will update. I was just a little bit weary of tapering the valerian because apparently it might increase the effects of Trazodone. I am also taking a lot of nicotine every day I just found out(I never really thought about how

much until recently when I looked it up). I’m taking 200+mg of nicotine a day with my vape which is probably not good for my mental Health. I’m not sure how to taper off that right now. Also, I’m not sure if it really is 200+mg because I’m not sure if I absorb all the nicotine from the vape but I think it is 200+.

 

Thank you for the reply again. 
 

 

 

 

 

 

 

@manymoretodays

 

Reply posted above, unsure if tag worked. Thanks again for the reply. 

[Altostrata]

1 hour ago, Healing89 said:

I went off cariprazine earlier this month. I started it early December. In the beginning of January I went from 4.5mg to 1mg/day for a week and then since then I’ve been taking .75mg a day. It’s hard to tell what has made me feel worse because I’ve been making a lot of changes and drinking alcohol/just not taking great care of myself.

 

Do you drink alcohol every day?

 

What are your current most prominent symptoms?

 

2 hours ago, Healing89 said:

8:00AM-Wake up and breakfast, take 22.5mg adderall, 1mg benztropine, 500mg l-tyrosine, multivitamin, fish oil, vitamin d

12:00PM-22.5 mg adderall and 1mg benztropine 

4:00 PM-15mg adderall

7:00PM-15mg adderall

10:00PM-100mg Trazodone, 300mg gabapentin, .75mg vraylar(Cariprazine), 1g valerian root

Sleep: I’ll wake up once at probably around 2-3AM, hit my nicotine and go back to sleep, wake up at 6-7 hit my nicotine then sleep until 8AM, maybe it’s withdrawal from nicotine Why I wake up? My body has probably gotten used to that also. I also use nicotine steadily throughout the day. 

 

You're taking amphetamine 4 times a day and you're wondering why your sleep is fractured?