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nicklesprout

Nicklesprout - Zyprexa, Valium, Lamictal, Prozac taper

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nicklesprout

I recently consulted a well known doctor about tapering off of my meds. She suggested that the best way is to go very slowly, but reduce all the meds at the same time rather than one at a time. I'm currently on:

 

10mg Zyprexa

15mg Valium

50mg Lamictal

40mg Prozac

 

Does anyone have any thoughts on if my taper schedule is safe enough? I plan on decreasing the zyprexa and valium by 1mg every two weeks, the lamictal by 25mg every week, and the prozac by 2mg every week. any input or advice is much appreciated.

 

Nicklesprout

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peggy

welcome Nickelsprout!

I have no experience tapering multiple medications, but it sounds like the Doctor has you on a fast taper regardless. Someone with more experience will be along soon to give you some solid advice, but there are some threads here on tapering multiple meds and which one to tackle first.

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Altostrata

Welcome, Nicklesprout.

 

That is a very optimistic tapering regime. It assumes none of those medications will cause withdrawal symptoms.

 

Your plan for Lamictal is way too fast.

 

We recommend tapering one medication at a time to establish your tolerance for tapering and isolate the medications that might need slower tapering. For example, taper the Zyprexa 1mg per week for a month. If no withdrawal symptoms, continue. If withdrawal symptoms, slow down.

 

And so forth.

 

What symptoms do you have now from this drug combination?

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nicklesprout

my symptoms are thoughts of suicide and harming others, constant feeling of anxiety, i need some relief soon. i just consulted another doctor who said i should decrease 1 med every 3 months which would take a year to taper since i'm on 4 different meds. thoughts?

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Altostrata

That sounds like overstimulation. If I were you, I'd reduce Prozac first.

 

I suggest a 10% reduction (about 4mg) per month for 2 months to see how it goes. See http://survivingantidepressants.org/index.php?/topic/1024-why-taper-by-10-of-my-dosage/ If all goes well, you can speed up to 10% every 2 weeks.

 

Then I would tackle the Zyprexa, in the same way.

 

Another alternative would be to go down half-way on the Prozac. If your symptoms abate, then reduce Zyprexa as it is a pretty serious health risk.

 

Do the "brakes" last. Maybe go down half-way on Lamictal, then the benzo. See http://survivingantidepressants.org/index.php?/topic/2207-taking-multiple-psych-drugs-taper-the-antidepressant-first/

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Rhiannon

Hi Nickle, I commented on this in the "tapering multiple meds" thread.

 

Basically, yes, that's way too fast a taper, probably off any ONE of those drugs let alone all of them at once.

 

Getting off four psych meds in one year without problems is a very optimistic and in my opinion unrealistic expectation. It does depend on your individual history, however.

 

But anyone who's on that many meds at once usually already has a complex history with meds (doctors don't usually just put someone straight onto four meds who's never been on psych meds before). With a complicated med history, usually tapers have to be pretty slow. I think a good rule of thumb is a year per med; you might be able to do it faster, but it's better to start slower and speed up than to go too fast and crash and have to recover and get stable again before restarting the taper.

 

I think that unless you're willing to go very very slowly it's probably better to only taper one med at a time, although I think you can alternate meds and work on one for a while and then another for a while.

 

By the way, Lamictal is strongly associated with suicidality. More so even than ADs, apparently, or at least the FDA thinks so, for what that's worth.

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nicklesprout

Thanks for the replies, but if Prozac or Lamictal or whatever else I'm on is causing me suicidal ideation, then how can i bear to take a whole year to get off of them. what do i do to manage my symptoms in the mean time? This is pure hell as you already know. I've already weaned down the Lamictal from 200mg to 50mg over the past few weeks with no side effects, so i plan on getting off of it in the next few weeks. i do plan on taking the other ones very slowly though. Right now, i've been tapering the Prozac down by 2mg every week, but i can slow that down if needs be. note that i've only been on this much medicine since January. Prior to that, i was only on Valium and did a cold turkey cut with an addition of Ibogaine and that threw me into extreme withdrawal. that's why i got put on so many more meds. since i haven't been on the meds for too long, then shouldn't i be able to come off of them a little quicker than 1 a year?

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Altostrata

How long have you been on each of those medications?

 

The "harming others" and anxiety indicates to me Prozac is the main culprit.

 

I would go slower on the Lamictal. It also has a withdrawal syndrome.

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Skyler

Thanks for the replies, but if Prozac or Lamictal or whatever else I'm on is causing me suicidal ideation, then how can i bear to take a whole year to get off of them. what do i do to manage my symptoms in the mean time? This is pure hell as you already know. I've already weaned down the Lamictal from 200mg to 50mg over the past few weeks with no side effects, so i plan on getting off of it in the next few weeks. i do plan on taking the other ones very slowly though. Right now, i've been tapering the Prozac down by 2mg every week, but i can slow that down if needs be. note that i've only been on this much medicine since January. Prior to that, i was only on Valium and did a cold turkey cut with an addition of Ibogaine and that threw me into extreme withdrawal. that's why i got put on so many more meds. since i haven't been on the meds for too long, then shouldn't i be able to come off of them a little quicker than 1 a year?

 

Hi nickle.. did you have suicidal ideation to anywhere near the extent you do now when you were on the valium. The problem is, if you trigger significant withdrawal symptoms, they will challenge you, and the fear is how that will effect your mental status. Post withdrawal symptoms can go on for many months and be VERY difficult. You only have one nervous system, and want to keep from damaging it as you kick free of these meds.

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nicklesprout

How long have you been on each of those medications?

 

The "harming others" and anxiety indicates to me Prozac is the main culprit.

 

I would go slower on the Lamictal. It also has a withdrawal syndrome.

 

since about January i've been on different meds, with my current combo being for the past 2-3 months.

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nicklesprout

 

Thanks for the replies, but if Prozac or Lamictal or whatever else I'm on is causing me suicidal ideation, then how can i bear to take a whole year to get off of them. what do i do to manage my symptoms in the mean time? This is pure hell as you already know. I've already weaned down the Lamictal from 200mg to 50mg over the past few weeks with no side effects, so i plan on getting off of it in the next few weeks. i do plan on taking the other ones very slowly though. Right now, i've been tapering the Prozac down by 2mg every week, but i can slow that down if needs be. note that i've only been on this much medicine since January. Prior to that, i was only on Valium and did a cold turkey cut with an addition of Ibogaine and that threw me into extreme withdrawal. that's why i got put on so many more meds. since i haven't been on the meds for too long, then shouldn't i be able to come off of them a little quicker than 1 a year?

 

Hi nickle.. did you have suicidal ideation to anywhere near the extent you do now when you were on the valium. The problem is, if you trigger significant withdrawal symptoms, they will challenge you, and the fear is how that will effect your mental status. Post withdrawal symptoms can go on for many months and be VERY difficult. You only have one nervous system, and want to keep from damaging it as you kick free of these meds.

 

no, it's way worse now. yeah i definitely don't want to damage my nervous system anymore, i just don't know how to handle these symptoms in the mean time while i'm coming off the meds super slowly.

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Skyler

 

no, it's way worse now. yeah i definitely don't want to damage my nervous system anymore, i just don't know how to handle these symptoms in the mean time while i'm coming off the meds super slowly.

 

Alto will chime in here, but the degree of suicidal ideation might be dose dependent.. so you would not need to get all the drug out of your system to have some relief.

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Altostrata

Yes, my guess is the bad thoughts are dose-dependent.

 

Nickle, did you take this batch of drugs to treat withdrawal symptoms from the prior drugs?

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nicklesprout

Yes, my cold turkey of valium threw me into a tailspin last November and by January I had to get on something because i was losing my mind. hoping that this prozac/lamictal taper will help me feel better.

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Altostrata

Well, Nicklesprout, your nervous system has probably become sensitized by your previous bad experiences with psychiatric drugs.

 

It may take less than a year to go off Prozac and Zyprexa, but you should go carefully so as not to further damage your nervous system.

 

Read this Taking multiple psych drugs? Taper the antidepressant first!

 

The Lamictal is a "brake," it may be damping down other symptoms. At high doses, it can cause paradoxical reactions, but at low doses, it's more reliable.

 

To me, the Prozac and Zyprexa are the drugs most likely to cause you problems. I suggest you hold everything else and concentrate on tapering the Prozac. That way, you can tell if reducing Prozac by 2mg per week is working for you.

 

Tapering another drug at the same time confuses the issue -- you don't know which is giving you withdrawal symptoms.

 

If you clear the decks, concentrate on the Prozac, you may find you get no withdrawal symptoms and you can reduce faster, maybe by 2mg every 3 or 4 days.

 

You've been taking 10mg Zyprexa since May? When you get down to a level of Prozac that relieves some of your symptoms, you may want to hold Prozac, taper fairly quickly off Zyprexa, then go back to tapering Prozac.

 

You'll be okay, these bad thoughts will go away, just hang in there, be patient and systematic.

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nicklesprout

thanks for the advice and encouragement, patience patience, and more patience is what i need right now.

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nicklesprout

Hi, I'm wondering anyone's opinion as to what to do. I wake up every morning with inner trembling and anxiety. It gets a little better throughout the day but i'm not stable. i'm currently tapering off of Prozac (2mg a week), while holding steady with my 15mg Valium a day and 7.5mg Zyprexa a day. I'm wondering whether I should quit tapering off of the Prozac until the trembling stops and i get a little more stable? thoughts anyone? it seems to me that staying on the medicine isn't going to help the shakes go away and it's just something i have to suffer through as part of the taper process. any help is appreciated.

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jr1985

Hopefully Alto will jump in, but in the mean time... I reckon you should pause your taper to allow your nervous system to adapt to the lower dose. My opinion on tapering is that any symptoms that arise are due to your nervous system being in distress, therefore, it is never a good idea to just "push through" them. You should try and minimise any withdrawal symptoms as much as possible. If I were you, I'd stop until those symptoms go away (however long it takes!), then taper at a slower rate (10% every 3-6 weeks).

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Jemima

Definitely hold where you are or even updose a milligram or two and wait until you feel stable before cutting the dose again.

 

The early morning shakiness may be due to a high level of Cortisol. Are you keeping your bedroom as dark as possible? Wearing a sleep mask? Avoiding bright light in the mornings? All of those set me off during early withdrawal, although my reaction was extreme irritation rather than anxiety. Cortisol is the hormone that wakes us up in the morning and triggers the "flight or fight" reaction in us. Unfortunately, there is something about withdrawal from antidepressants that exaggerates what ought to be a normal cycle of high and low cortisol in a 24-hour period.

 

In any event, pamper your nervous system as much as possible. There's no point whatever in setting a tapering record.

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nicklesprout

part of me feels like staying where i'm at isn't going to help the shakes go away because i was getting them before i started tapering.

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Altostrata

I merged your topics, Nicklesprout, you can better keep track in one topic and we can better understand your situation if it's all together.

 

When did the shaking start? What does it feel like?

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nicklesprout

I can't even remember to be honest when it started because it's been off and on for a long time, even before i started tapering off of the meds. it feels like my insides are shaking, maybe the meds have my blood sugar or cortisol levels all messed up. i have anxiety along with it as well. it seems to get a little better as the day progresses.

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Altostrata

Did it start when you added a medication? Was some other medication added to subdue this particular symptom?

 

In what order did you go on Zyprexa, Valium, Lamictal, and Prozac?

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nicklesprout

It started last November when I quit Valium cold turkey, my pdocs have added all kinds of meds since then to help "stabilize" me. I got on Valium first, along with Paxil which was later bridged over to Prozac, and the Lamictal and Zyprexa were added around the same time as the Prozac. I think I'll just stay where I'm at with the meds for a month and see if I start to feel better...thoughts Alto?

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Altostrata

That's a tough one, Nickle. It sounds like it's Valium withdrawal syndrome. Holding for a bit might help.

 

Did any of those medications reduce this symptom?

 

Jemima could be onto something, maybe this is a hypersensitivity aggravated by the rise of cortisol in the early morning. Putting up blackout shades or curtains in the bedroom and using a sleep mask might help, look in the Symptoms forum.

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nicklesprout

Yeah it does seem like benzo-withdrawal, even though i reinstated Valium at a higher dose than i originally was on before i quit cold turkey. I'm hoping that holding for a bit does help. None of the medications seem to have reduced this symptom. Thanks for the advice.

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Altostrata

Dosage changes in any of your other medications may aggravate the nervous system destabilization brought on by benzo withdrawal.

 

My guess is you'll have to slide off Prozac very, very gradually to avoid further exacerbation, a lot less aggressively than reducing by 2mg per week. Do you have liquid Prozac?

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nicklesprout

yes i do have liquid prozac. what about 1mg every week? also, any thoughts on why reinstating valium at a higher dosage than originally on when i quit cold turkey doesn't help the withdrawal syndrom to go away? it feels like i'm now stuck and at the mercy of God and that there's nothing i can do to get these symptoms to go away except wait it out for however long it takes which could be years.

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nicklesprout

it's now been 3 weeks since i've made any tapers on my meds, and i'm still having anxiety every day. how long should i stay at my current dosage before deciding to taper a little more? at some point, i just have to push on through, right? i don't expect to be stabilized with no anxiety any time soon. i'm on 7.5mg zyprexa, 13.75 mg valium, and 30 mg prozac right now. thoughts?

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Altostrata

No, you don't have to push on through. You need to figure out what's best for your nervous system.

 

Did you reduce the Valium?

 

You might also be suffering from quitting Lamictal.

 

Does your anxiety follow a pattern? It could be rebound from the Valium.

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nicklesprout

My anxiety doesn't really follow a pattern. it's there as soon as i wake up and stays with me throughout the day. the last taper i made 3 weeks ago was to reduce the prozac from 32mg to 30mg, i do think i have valium w/d anxiety, but i don't know how to stabilize it. taking more valium isn't helping.

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