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Jshect major issues with Wellbutrin/Deplin and klonopin addiction


Jshect

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Hi, I am new to this site. I'll go more in depth to my history later, but I'll mainly focus with my medication issues now.

 

Most of my life I have had constant brain fog, mental and physical fatigue, depression, and anxiety. My mind would get fatigued very easily, which limited me to minimum wage jobs. I had problems with alertness and verbal communication (paradoxically) despite making good grades in school and having a high IQ. I have tried, which seems like, nearly every psychiatric med out there. 

 

3 years ago I added 15 mg of Deplin (isolated folic acid) to 150 mg of Wellbutrin. I am also on Trazodone, Loxapine (an antipsychotic), and Oxcarbazepine. After a couple of months the Deplin really revved up the Wellbutrin. I went from sleeping 10-14 hours a night to 5-10 hours a night. I became sort of manic for a few months and started working out 6 times a week. The Wellbutrin made me irritable, angry, and unstable. However, I welcomed the change because I lost about 35 lbs over a year and really felt alive for the first time in my life. Then, I started getting pain everywhere and had to stop working out. When I checked drug.com it listed calf aches, and musculoskeletal chest pain as possible symptoms. That is what i had, plus now, I also have back, shoulder and neck pain, so I am now limited to slow walking and light weightlifting for a workout.

 

I tried reducing the Wellbutrin from 150 mg SR to 100 mg SR. I started having up to 10 PVC's a minute. Luckily, the doctor said 10 PVC's a minute isn't harmful because I am still getting oxygen rich blood with those heart beats. However, the PVC's send a jolt through my body which cause extreme anxiety I can't seem to shake. 

The pain, and irritability immediately left when I reduced the Wellbutrin, but the anxiety I received from the PVC's was unbearable, so I went back up to 150 mg Wellbutrin, and the PVC's stopped. The pain and irritability immediately returned. 

 

Next, I tried raising the Oxcarbazepine (mood stabilizer) to counteract the effects of the Deplin/Wellbutrin. The same thing happened again(PVC's, anxiety), so I lowered the dosage of the Oxcarbazepine, and the PVC's went away. Next, I started shaving little pieces off of the Deplin. It takes about 4-6 weeks for your Deplin blood levels to change when you adjust your dose of Deplin. After 4-6 weeks of the lower dose of Deplin,  the pain and irritability left, back were the PVC's. The anxiety was unbearable so I started taking the full dosage of Deplin again. It would take 4-6 weeks for my Deplin blood levels to rise, so I was stuck with PVC's and anxiety until then.

 

My Psychiatrist prescribed Klonopin to deal with the anxiety. It worked and gave me relief for an hour or two. after 4-6 weeks my Deplin blood levels returned to previous levels. The pain, irritability and energy were back, but the PVC's stayed this time. After trial and error, I found a beta blocker that reduced the PVC's somewhat. Then, I tried to quit the Klonopin. The withdrawal symptoms were unbearable (nausea, fever-like feeling, anxiety). Luckily, I was on a low dose (.75 mg). Through much suffering I got down from 1 1/2 pills to 1 1/4 pills (.625 klonopin). 

Now I am stuck on .625 mg Klonopin, 150 mg Wellbutrin SR, 15 mg Deplin, a beta blocker, loxapine, oxcarbazepine. 

After a while my body even adjusted to the beta blocker, and the PVC's returned with up to 5 or 6 a minute at times.

 

I am now working with a dietitian, and have started reading about nutrition. I have been eating healthily for the last 2-3 weeks and my PVC's have decreased dramatically. Next week, I am meeting with an eastern medicine/acupuncturist who worked wonders with my friend who has MS. He took her from excruciating pain and 16 Western medication, to one Western medication and feeling better than she has in years. He did this with herbs, healthy eating, meditation, and acupuncture. So I feel like I am on the right track.

 

However, I am still on all of these damn medications and facing potential horrific withdrawal symptoms when I try to kick them. The medications are working synergistically with the Deplin and with each other. Recently, I tried kicking the Trazodone and I started getting around 10 PVC's/ minute, so I am stuck on this synergistic medication cocktail. It seems like my body and heart have gotten use to this adrenaline overdrive, and do not want to stray from the status quo. 

 

One other thing, I am afraid to return to my previous zombie-like, energy-less existence, so I almost don't want to go off the meds, but I know I must.

 

Please, please, please, if you can offer any good advice it would be greatly appreciated.

 

Thanks for reading, 

John

Meds I'm currently taperingDeplin 7.5 mg 

                                                Klonopin .25 mg +1/4(.25) (I did a fairly rapid taper down from around 2 mg Klonopin, but I've held at .25 for several months now, and even updosed a quarter of a pill to give myself 4 good nights of sleep and lift myself out of a depression

(about to start a micro-taper)

 

 

 

Medications I tapered off successfully: Bupropion 150 mg, Trazadone 150 mg, Oxcarbazepin 300 mg, Loxapine 20 mg

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I am running, John, but you might want to check out the thread here on methylation and b vitamins. Niacin really saved me at one point.

1st round Prozac 1989/90, clear depression symptoms. 2nd round Prozac started 1999 when admitted to dr. I was tired. Prozac pooped out, switch to Cymbalta 3/2006. Diagnosed with bipolar disorder due to mania 6/2006--then I was taken abruptly off Cymbalta and didn't know I had SSRI withdrawal. Lots of meds for my intractable "bipolar" symptoms.

Zyprexa started about 9/06, mostly 5mg. Tapered 4/12 through12/29/12

Wellbutrin. XL 300 mg started 1/07, tapered 1/18/13 through 7/8/13

Oxazepam mostly continuously since 6/06, 30mg since 12/12, tapered 1.17.14 through 8.26.15

11/06 Lithium 600mg twice daily, 2.2.14 400mg TID DIY liquid, 2.12.14 1150mg, 3.2.14 1100mg, 3.18.14 1075mg, 4/14 updose to 1100mg, 6.1.14 900 mg capsules 7.8.14 810mg, 8.17.14 725mg, 8.24.24 700mg...10.22.14 487.5mg, 3.9.15 475mg, 4.1.15 462.5mg 4.21.15 450mg 8.11.15 375mg, 11.28.15 362.5mg, back to 375mg four days later, 3.4.16 updose to 475 (too much going on to risk trouble)

9/4/13 Toprol-XL 25mg daily for sudden hypertension, tapered 11.12.13 through 5.3.14, last 10 days or so switched to atenolol

7.4.14 Started Walsh Protocol

56 years old

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There is also a thread on Deplin. The integrative-type practitioners believe the dose to be way too high.

1st round Prozac 1989/90, clear depression symptoms. 2nd round Prozac started 1999 when admitted to dr. I was tired. Prozac pooped out, switch to Cymbalta 3/2006. Diagnosed with bipolar disorder due to mania 6/2006--then I was taken abruptly off Cymbalta and didn't know I had SSRI withdrawal. Lots of meds for my intractable "bipolar" symptoms.

Zyprexa started about 9/06, mostly 5mg. Tapered 4/12 through12/29/12

Wellbutrin. XL 300 mg started 1/07, tapered 1/18/13 through 7/8/13

Oxazepam mostly continuously since 6/06, 30mg since 12/12, tapered 1.17.14 through 8.26.15

11/06 Lithium 600mg twice daily, 2.2.14 400mg TID DIY liquid, 2.12.14 1150mg, 3.2.14 1100mg, 3.18.14 1075mg, 4/14 updose to 1100mg, 6.1.14 900 mg capsules 7.8.14 810mg, 8.17.14 725mg, 8.24.24 700mg...10.22.14 487.5mg, 3.9.15 475mg, 4.1.15 462.5mg 4.21.15 450mg 8.11.15 375mg, 11.28.15 362.5mg, back to 375mg four days later, 3.4.16 updose to 475 (too much going on to risk trouble)

9/4/13 Toprol-XL 25mg daily for sudden hypertension, tapered 11.12.13 through 5.3.14, last 10 days or so switched to atenolol

7.4.14 Started Walsh Protocol

56 years old

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Welcome John,

 

Thank you for posting an introduction.  I have to admit, I was a bit overwhelmed reading about all the medications you are on.  I'm only familiar with some of them and had to search for others.  Someone with more experience should hopefully be along soon to offer some suggestions.  But generally, we recommend tapering off the most activating drug first and in your case I would think that would be the Wellbutrin.

 

We advise a 10% taper of one drug at a time, here are our tips specifically for Welbutrin:

 

http://survivingantidepressants.org/index.php?/topic/877-tips-for-tapering-off-wellbutrin-sr-xr-xl-buproprion/?hl=wellbutrin

 

There is a major drug interaction between Wellbutrin (bupropion) and loxapine:

 

http://www.drugs.com/drug-interactions/buproban-with-loxapine-440-15159-1494-0.html

 

so you probably shouldn't be taking both of those together.

 

Have a good look through our section on tapering, it will give you some ideas about how to safely construct a plan for tapering, along with the reasons behind what we suggest.

 

http://survivingantidepressants.org/index.php?/forum/14-tapering/

 

Its great that you are now using alternative methods to improve your health, many of us here find that improving diet, meditation and acupuncture helps a lot with withdrawal symptoms.

 

Are you having any symptoms at the moment?  You should be able to safely taper off your meds if you take it slowly, it may take a while though.

 

Petu.

I'm not a doctor.  My comments are not medical advise. These are my opinions based on my own experience and what I've learned. Please discuss your situation with a medical practitioner who has knowledge of tapering and withdrawal...if you are lucky enough to find one.

My Introduction Thread

Full Drug and Withdrawal History

Brief Summary

Several SSRIs for 13 years starting 1997 (for mild to moderate partly situational anxiety) Xanax PRN ~ Various other drugs over the years for side effects

2 month 'taper' off Lexapro 2010

Short acute withdrawal, followed by 2 -3 months of improvement then delayed protracted withdrawal

DX ADHD followed by several years of stimulants and other drugs trying to manage increasing symptoms

Failed reinstatement of Lexapro and trial of Prozac (became suicidal)

May 2013 Found SA, learned about withdrawal, stopped taking drugs...healing begins.

Protracted withdrawal, with a very sensitized nervous system, slowly recovering as time passes

Supplements which have helped: Vitamin C, Magnesium, Taurine

Bad reactions: Many supplements but mostly fish oil and Vitamin D

June 2016 - Started daily juicing, mostly vegetables and lots of greens.

Aug 2016 - Oct 2016 Best window ever, felt almost completely recovered

Oct 2016 -Symptoms returned - bad days and less bad days.

April 2018 - No windows, but significant improvement, it feels like permanent full recovery is close.

VIDEO: Where did the chemical imbalance theory come from?



VIDEO: How are psychiatric diagnoses made?



VIDEO: Why do psychiatric drugs have withdrawal syndromes?



VIDEO: Can psychiatric drugs cause long-lasting negative effects?

VIDEO: Dr. Claire Weekes

 

 

 

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  • Administrator

Welcome, jshect.

 

It sounds to me like you might never had a psychiatric problem. You had a folate deficiency.

 

The marketing of Deplin as an "adjunct" psychiatric treatment is a major hoax, see http://survivingantidepressants.org/index.php?/topic/1328-deplin-the-l-methylfolate-swindle/

 

However, I don't believe Deplin is a problem for you.

 

What you are physiologically dependent on:

 

.625 mg of Klonopin (Clonazepam)

150 mg Wellbutrin

50 mg Trazodone

2.5 mg Bystolic (a beta blocker)

Loxapine

Oxcarbazepine

 

You are taking a massive amount of drugs, irresponsibly prescribed. All of these drugs need to be tapered to go off properly. The PVCs are from autonomic instability caused by too-fast changes in your drugs.

 

We suggest going off the most activating or problematic drug first, see http://survivingantidepressants.org/index.php?/topic/2207-taking-multiple-psych-drugs-taper-the-antidepressant-first/

 

In your case, it sounds like Wellbutrin should go first. Since you have demonstrated you are sensitive to dosage changes, please consider a conservative 10% taper, see http://survivingantidepressants.org/index.php?/topic/877-tips-for-tapering-off-wellbutrin-sr-xr-xl-buproprion/

 

You may also be suffering from adverse drugs reactions and drug-drug reactions, as Petu observed. Put all your drugs into this Drug Interactions Checker http://www.drugs.com/drug_interactions.html

and let us know what you find out.

 

You might also consider a lawsuit or at least a complaint against the doctor who got you into this pickle, see http://survivingantidepressants.org/index.php?/topic/365-filing-a-complaint-about-your-doctor/

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 for all of the good advice and support!!!!! I really appreciate it.

I am trying to taper off of the Wellbutrin now. I am on 150 mg SR. I tried tapering with the XL, but for some reason the XL makes me feel absolutely terrible, even when I take an equivalent dose to the SR.

Luckily, there is a local compounding pharmacy, and they said they can compound the SR. How quickly do you think I should taper off of the SR? 

I just hope I don't start having 10 PVC's a minute again, because the anxiety is absolutely horrific.

Someone said taper by 10%, so I guess I could go from 150 mg SR to 135 mg SR for 2 weeks, then 120 mg SR for 2 weeks etc. Or maybe it would be safer to taper off by 10 mg per 2 weeks.

I don't know what I'll do if I start having a ton of PVC's. I can up the beta blocker, but that is a pretty sedating medication, and it lowers your blood pressure. I do not want to get stuck on a high dose of that potent medication. 

 

Also, at .625 mg Clonazepam, I am having withdrawal symptoms. It was pure hell getting from .75 mg to .625 mg, but I don't want to have withdrawal symptoms, such as PVC's, from the Wellbutrin and Klonopin's brutal withdrawal symptoms at the same time, so maybe I should up the Clonazepam to .75 mg until I get off of the Wellbutrin. Oh, what a mess.

 

Most of the medications I am on have moderate interactions according to drug.com. I hope I don't collapse and have a seizure. 

 

I am having the MTHFR genetic flaw test done, and I have a feeling it will turn out positive, because of my strong reaction to the Deplin. 

 

Oh brother, what have I gotten myself into?

Meds I'm currently taperingDeplin 7.5 mg 

                                                Klonopin .25 mg +1/4(.25) (I did a fairly rapid taper down from around 2 mg Klonopin, but I've held at .25 for several months now, and even updosed a quarter of a pill to give myself 4 good nights of sleep and lift myself out of a depression

(about to start a micro-taper)

 

 

 

Medications I tapered off successfully: Bupropion 150 mg, Trazadone 150 mg, Oxcarbazepin 300 mg, Loxapine 20 mg

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  • Moderator Emeritus

How long have you been at .625 mg Clonazepam.  If you are having withdrawal symptoms at the moment, you should probably hold where you are until you stabilize again, and have been symptom free for a couple of weeks, then you could begin a slow, safe taper off Wellbutrin. If you go slow enough, you should experience minimal symptoms.   Here is the link again for how to do it:

 

http://survivingantidepressants.org/index.php?/topic/877-tips-for-tapering-off-wellbutrin-sr-xr-xl-buproprion/?hl=wellbutrin

 

It may take a while, but you will be able to safely get off these drugs, there are many members here who are on several meds, tapering them one at a time.

 

You will find a lot of help and support here.

I'm not a doctor.  My comments are not medical advise. These are my opinions based on my own experience and what I've learned. Please discuss your situation with a medical practitioner who has knowledge of tapering and withdrawal...if you are lucky enough to find one.

My Introduction Thread

Full Drug and Withdrawal History

Brief Summary

Several SSRIs for 13 years starting 1997 (for mild to moderate partly situational anxiety) Xanax PRN ~ Various other drugs over the years for side effects

2 month 'taper' off Lexapro 2010

Short acute withdrawal, followed by 2 -3 months of improvement then delayed protracted withdrawal

DX ADHD followed by several years of stimulants and other drugs trying to manage increasing symptoms

Failed reinstatement of Lexapro and trial of Prozac (became suicidal)

May 2013 Found SA, learned about withdrawal, stopped taking drugs...healing begins.

Protracted withdrawal, with a very sensitized nervous system, slowly recovering as time passes

Supplements which have helped: Vitamin C, Magnesium, Taurine

Bad reactions: Many supplements but mostly fish oil and Vitamin D

June 2016 - Started daily juicing, mostly vegetables and lots of greens.

Aug 2016 - Oct 2016 Best window ever, felt almost completely recovered

Oct 2016 -Symptoms returned - bad days and less bad days.

April 2018 - No windows, but significant improvement, it feels like permanent full recovery is close.

VIDEO: Where did the chemical imbalance theory come from?



VIDEO: How are psychiatric diagnoses made?



VIDEO: Why do psychiatric drugs have withdrawal syndromes?



VIDEO: Can psychiatric drugs cause long-lasting negative effects?

VIDEO: Dr. Claire Weekes

 

 

 

Link to comment

I stabilized at .625 mg of Klonopin a few months ago, however the nature of addictive drugs is that after a while you can start to get withdrawal symptoms at a dose you were once stable at, and need a higher dose to get the original effect and get rid of the withdrawal symptoms. There is a term for that, I will try to find it.

Also, someone mentioned Niacin, are you guys using that, and how would that help me?

Sorry, there are links to many long threads and articles and I'm having a hard time absorbing it all. I'll go through and reread these links again more slowly.

Meds I'm currently taperingDeplin 7.5 mg 

                                                Klonopin .25 mg +1/4(.25) (I did a fairly rapid taper down from around 2 mg Klonopin, but I've held at .25 for several months now, and even updosed a quarter of a pill to give myself 4 good nights of sleep and lift myself out of a depression

(about to start a micro-taper)

 

 

 

Medications I tapered off successfully: Bupropion 150 mg, Trazadone 150 mg, Oxcarbazepin 300 mg, Loxapine 20 mg

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  • Moderator Emeritus

I stabilized at .625 mg of Klonopin a few months ago, however the nature of addictive drugs is that after a while you can start to get withdrawal symptoms at a dose you were once stable at, and need a higher dose to get the original effect and get rid of the withdrawal symptoms. There is a term for that, I will try to find it.

Also, someone mentioned Niacin, are you guys using that, and how would that help me?

Sorry, there are links to many long threads and articles and I'm having a hard time absorbing it all. I'll go through and reread these links again more slowly.

Hi Jshect and welcome to the forum. I've come off benzos, took 3.5 years to taper off 3 mgs K. I held for a year during the process with NO ill effects. Please read the following link.. We have had a lengthy discussion about tolerance withdrawal on this site. http://survivingantidepressants.org/index.php?/topic/2233-benzo-tolerance-withdrawal-during-tapering-does-it-exist/

 

You should not taper an AD or anything else requiring a taper, at the same time you reduce the K, at least not until you have a good understanding about how to taper. And it's best to taper the most activating med first, and from what I can see, that is not clonazepam. As Alto suggested, read this thread. http://survivingantidepressants.org/index.php?/topic/2207-taking-multiple-psych-drugs-taper-the-antidepressant-first/

 

Again, welcome aboard.

 

PS.. you might also want to read this recent post by Marie who is feeling better as a result of holding K. http://survivingantidepressants.org/index.php?/topic/5286-long-klonopin-hold-going-on-return-of-some-sx-whats-happening/page-2#entry80380

As always, LISTEN TO YOUR BODY! A proud supporter of the 10% (or slower) rule.

 

Requip - 3/16 ZERO  Total time on 25 years.

 

Lyrica: 8/15 ZERO Total time on 7 or 8 yrs.

BENZO FREE 10/13 (started tapering 7/10)  Total time on 25 years.

 

Read my intro thread here, and check the about me section.  "No matter how cynical you get, it's almost impossible to keep up." Lily Tomlin

 

 

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  • Administrator

Please keep notes on paper of your daily symptom pattern and drug doses. This will help you figure out what's causing what.

 

The heart symptoms may be because when you reduce Wellbutrin, something else is having a different effect. You may be having a paradoxical reaction to the beta blocker, for example.

 

You don't have to go to a compounding pharmacy to titrate Wellbutrin, see http://survivingantidepressants.org/index.php?/topic/877-tips-for-tapering-off-wellbutrin-sr-xr-xl-buproprion/

there are plenty of options for tapering it.

 

Have you contacted any other psychiatrists near you to see if any are reasonable about tapering?

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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The heart symptoms may be because when you reduce Wellbutrin, something else is having a different effect. You may be having a paradoxical reaction to the beta blocker, for example.

 

 

No, I had the heart palpitations, I mean PVC's, way before the beta blocker. The beta blocker was prescribed to reduce the PVC's, which it did at first. I've also reduced them by eating a relatively low glycemic, healthy diet. 

 

The thing you need to understand is that any minor change to my current medication regiment causes PVC's, which give me an unbearable anxiety, that I can't even function with. When I'm having 10 PVC's a minute, I'm in a constant near-panic attack state. 

 

So the thing that will be difficult is finding a way to get off these medications without triggering a million PVC's. I'm on 2.5 mg of Bystolic (beta blocker). The doctor said it's safe to go up to 10 mg. I'm afraid to up the beta blocker because it is very sedating, and (I'll do a separate post on my history later) I'm afraid to return to my pre-Deplin/Wellbutrin days where I had no energy and constant never-ending brain fog (+ face even more sedation from the beta blocker). I mean before the Deplin/Wellbutrin I could barely function as a human being. I'm really in a conundrum. 

 

I didn't realize that cutting the Wellbutrin SR would turn it into immediate release form (although it makes sense), and a while ago, I tried cutting a tiny piece off of the Wellbutrin (taking it from 150 mg SR to, maybe, 140 mg IR) and I took the whole thing and at first I felt fine, but after a couple of hours, I had PVC's like mad. 

 

I tried Wellbutrin XL and it made me feel terrible for some reason (almost sick and disoriented). Even my psychiatrist said some people don't handle XL very well, but do fine on SR.

 

So, I could try cutting my 150 mg Wellbutrin SR tablets into quarters, and then chip a little off of one of the quarters, making it around 140 mg IR. Then I could take a quarter pill every few hours, except one of those quarters would be smaller. 

 

 

But, if that doesn't work I could get compounded SR doses from a local pharmacy (but who knows how much that will cost). That might be the best solution, given how sensitive my heart is to minute medication alterations. I seem to tolerate the Wellbutrin SR better than XL and IR. 

 

I see an Eastern practitioner/ acupuncturist, so maybe he find a more natural way to reduce or deal with the PVC's without having to trade one drug for another.

 

Thanks guys for all of your help. I really mean it. I've written threads on numerous other forums over the last three years and gotten absolutely nowhere. Finally, I feel like I've found a forum where people actually understand what I'm going through. On most of the other forums, people are trying to get advice on which psychiatric medications they want to try next, instead of trying to get off of them and find more natural ways to deal with their problems.

Meds I'm currently taperingDeplin 7.5 mg 

                                                Klonopin .25 mg +1/4(.25) (I did a fairly rapid taper down from around 2 mg Klonopin, but I've held at .25 for several months now, and even updosed a quarter of a pill to give myself 4 good nights of sleep and lift myself out of a depression

(about to start a micro-taper)

 

 

 

Medications I tapered off successfully: Bupropion 150 mg, Trazadone 150 mg, Oxcarbazepin 300 mg, Loxapine 20 mg

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  • Administrator

Were you taking other psychiatric drugs when you started the beta blocker?

 

Do the PVCs predate your use of psychiatric drugs?

 

Is this the same doctor who's prescribed all the drugs for you? If so, I would be wary of his or her advice about these neurologically active drugs.

 

If you were on

 

.625 mg of Klonopin (Clonazepam)
50 mg Trazodone
2.5 mg Bystolic (a beta blocker)
Loxapine
Oxcarbazepine

 

prior to taking Wellbutrin and Deplin, any of those drugs could cause a lack of energy, which in combination would be an understatement.

 

It's a wonder you're still upright.

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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"Were you taking other psychiatric drugs when you started the beta blocker?"

Yes, I was taking all of those meds listed

 

"Do the PVCs predate your use of psychiatric drugs?"

No. The PVCs started when I 1st tried to lower the dosage of Bupropion. I went from 150 mg SR to 100 mg SR when they started. When I went back up to 150 mg Wellbutrin SR they went away. Next, I upped to dosage of Oxcarbazepine to reduce the effects of the Bupropion, then the PVCs returned. When I lowered the Oxcarbazepine to the original dosage, they went away. Next, I tried chipping a bit off of Deplin, the agitation, pain, and mania disappeared, but the PVCs returned. This time they returned for good. My family practitioner gave me a beta blocker, that helped. I changed my diet recently, that also helped, but I still get them. 

I'm tired of being irritable, and in pain, so I'm going to try to taper off of the Wellbutrin, again, and manage the inevitable PVCs.

 

"Is this the same doctor who's prescribed all the drugs for you? If so, I would be wary of his or her advice about these neurologically active drugs."

No, I grew tired of the psychiatrist who prescribed most of these meds and am now seeing a new psychiatrist. Hopefully, my last psychiatrist if I can kick the meds.

 

If you were on

 

.625 mg of Klonopin (Clonazepam)

50 mg Trazodone

2.5 mg Bystolic (a beta blocker)

Loxapine

Oxcarbazepine

 

prior to taking Wellbutrin and Deplin, any of those drugs could cause a lack of energy, which in combination would be an understatement.

 

It's a wonder you're still upright.

 

I had low energy, brain fog, poor memory before these meds. The Wellbutrin has given me more energy than I've ever had in my entire life.Unfortunately, it gives me pain, and agitation, and makes me mean, so I'm getting off of it, PVC' or not. 

Meds I'm currently taperingDeplin 7.5 mg 

                                                Klonopin .25 mg +1/4(.25) (I did a fairly rapid taper down from around 2 mg Klonopin, but I've held at .25 for several months now, and even updosed a quarter of a pill to give myself 4 good nights of sleep and lift myself out of a depression

(about to start a micro-taper)

 

 

 

Medications I tapered off successfully: Bupropion 150 mg, Trazadone 150 mg, Oxcarbazepin 300 mg, Loxapine 20 mg

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  • Administrator

I know it might be complicated -- can you say when you went on each of the drugs you're taking now, and for what symptoms?

 

The PVCs started when I 1st tried to lower the dosage of Bupropion. I went from 150 mg SR to 100 mg SR when they started. When I went back up to 150 mg Wellbutrin SR they went away. Next, I upped to dosage of Oxcarbazepine to reduce the effects of the Bupropion, then the PVCs returned. When I lowered the Oxcarbazepine to the original dosage, they went away. Next, I tried chipping a bit off of Deplin, the agitation, pain, and mania disappeared, but the PVCs returned. This time they returned for good. My family practitioner gave me a beta blocker, that helped. I changed my diet recently, that also helped, but I still get them. 

I'm tired of being irritable, and in pain, so I'm going to try to taper off of the Wellbutrin, again, and manage the inevitable PVCs.

 

 

I would not change the Deplin, I don't believe it's a health issue.

 

What does your current psychiatrist say about changing your dosages? Does he know anything about tapering?

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 know it might be complicated -- can you say when you went on each of the drugs you're taking now, and for what symptoms?"

 

Oh goodness. I've on and off just about every psychiatric medication made. I started out on an SSRI about 13 years ago. They triggered minor manic episodes. Then, I got a temperature of 102 and had a major manic episode on the SSRI. My psychiatrist put me on risperdal and maybe a mood stabilizer. The mania left. After that I tried so many things and nothing helped.

Before being on the mood stabilizers, I remember trying Wellbutrin, staying up all night, then fainting the next day. I immediately got off it. Later on I got on it again, off the SSRI's, but I always stayed on some combination of mood stabilizer and antipsychotic since my major SSRI-induced manic episode (I am not bipolar). Eventually, with my last psychiatrist, I sort of randomly switched to Oxcarbazepine and Loxapine 4 or 5 years ago. My last psychiatrist liked the antipsychotic Loxapine because it was low on side effects and didn't cause weight gain. 

So when I took the Welbutrin with the Oxcarbazepine and Loxapine, everything really just cancelled everything out and I was the same as I had been my whole life: Brain fog, poor memory,  depression anxiety, poor communication skills...

Then I got on the Deplin 7.5 mg (three years ago) . It worked well for a week, then petered out. 4-6 weeks later it kicked in but then stopped working again.  He put me on 15 mg of  Deplin. After 4-6 weeks I became eventually became manic. I went from sleeping 10-14 hours a night to 5-10. I started working out 6 times a week. I lost 35 lbs over a year. I was irritable, angry, mean, and half -crazy, but I felt alive. Then the pain started and I couldn't exercise and I became even more angry. Then i tried to get off it and the PVCs started...

 

but I've tried everything. I've tried all of the ADHD stimulants, Lamictal, gabapenton, Abilify, Saphris, the SSRIs, Latuda, Effexor, Risperdal, Carbazepine, Lithium... You name it, I've probably tried it.

 

Lamictal, Gabepenton, and Abilify had the most positive effects on me, but the side effects were unbearable. Lamictal caused a pleasant mania, where I was witty, intelligent, and polite. Wellbutrin causes an unpleasent mania, where I am agitated, irritable, but extremely energetic. I feel as though I could run 20 miles on it. That's probably why it's messing with my heart so much. The worst part about being on it is having so much energy, but not being able to exercise because of the pain! I love athletics so having the energy to work out 6 times a week was a dream come true. 

 

I think it's finally time ditch psychiatry. But I'm terrified of returning to my previous brain dead state.

Meds I'm currently taperingDeplin 7.5 mg 

                                                Klonopin .25 mg +1/4(.25) (I did a fairly rapid taper down from around 2 mg Klonopin, but I've held at .25 for several months now, and even updosed a quarter of a pill to give myself 4 good nights of sleep and lift myself out of a depression

(about to start a micro-taper)

 

 

 

Medications I tapered off successfully: Bupropion 150 mg, Trazadone 150 mg, Oxcarbazepin 300 mg, Loxapine 20 mg

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Oh, I've been prescribed Trazadone for a long time. I only started taking it regularly at night to get to sleep when the Deplin/Wellbutrin gave me so much energy. I was also prescribed Klonopin 4 or 5 years ago. I only started taking that regularly when the PVCs started occuring. Now, I'm hooked on Klonopin. 

 

Thanks for listening (or Reading I should say)

Meds I'm currently taperingDeplin 7.5 mg 

                                                Klonopin .25 mg +1/4(.25) (I did a fairly rapid taper down from around 2 mg Klonopin, but I've held at .25 for several months now, and even updosed a quarter of a pill to give myself 4 good nights of sleep and lift myself out of a depression

(about to start a micro-taper)

 

 

 

Medications I tapered off successfully: Bupropion 150 mg, Trazadone 150 mg, Oxcarbazepin 300 mg, Loxapine 20 mg

Link to comment
  • Administrator

So the order your drugs were prescribed was:

 

50 mg Trazodone <---- why was this prescribed?

.625 mg of Klonopin (Clonazepam) <---- why was this prescribed?

150 mg Wellbutrin

2.5 mg Bystolic (a beta blocker)

Loxapine <---- why was this prescribed?

Oxcarbazepine <---- why was this prescribed?

 

THIS IS IMPORTANT:

....

You may also be suffering from adverse drugs reactions and drug-drug reactions, as Petu observed. Put all your drugs into this Drug Interactions Checker http://www.drugs.com/drug_interactions.html

and let us know what you find out.

Please post the report from the Drug Interactions Checker here in this topic.

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.

Link to comment

Drug Interaction Report

Drug interactions for the following 8 drug(s):

Drug List: My+Drug+List caffeine clonazepam loxapine oxcarbazepine trazodone Bystolic (nebivolol) Deplin (l-methylfolate) Wellbutrin (bupropion) Interactions between your selected drugs
(Major interaction)bupropion ↔ trazodone Major Drug Interaction

Applies to: Wellbutrin (bupropion), trazodone

Talk to your doctor before using buPROPion together with traZODone. Combining these medications may increase the risk of seizures, which may occur rarely with either medication. In addition, buPROPion can increase the blood levels of traZODone, which may increase other side effects. You may be more likely to experience seizures with these medications if you are elderly, undergoing alcohol or drug withdrawal, have a history of seizures, or have a condition affecting the central nervous system such as a brain tumor or head trauma. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. You should avoid or limit the use of alcohol during treatment. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

(Major interaction)bupropion ↔ loxapine Major Drug Interaction

Applies to: Wellbutrin (bupropion), loxapine

Talk to your doctor before using buPROPion together with loxapine. BuPROPion alone can cause seizures, especially at higher dosages, and combining it with loxapine may increase that risk. You may be more likely to experience seizures with these medications if you are elderly, undergoing alcohol or drug withdrawal, have a history of seizures, or have a condition affecting the central nervous system such as a brain tumor or head trauma. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. You should avoid or limit the use of alcohol during treatment. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

(Moderate interaction)bupropion ↔ clonazepam Moderate Drug Interaction

Applies to: Wellbutrin (bupropion), clonazepam

Excessive use or abrupt discontinuation of clonazePAM after long-term use may cause seizures in patients taking buPROPion. Talk to your doctor before using these medications together. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

(Moderate interaction)trazodone ↔ nebivolol Moderate Drug Interaction

Applies to: trazodone, Bystolic (nebivolol)

Nebivolol and traZODone may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

(Moderate interaction)clonazepam ↔ nebivolol Moderate Drug Interaction

Applies to: clonazepam, Bystolic (nebivolol)

Nebivolol and clonazePAM may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

(Moderate interaction)bupropion ↔ nebivolol Moderate Drug Interaction

Applies to: Wellbutrin (bupropion), Bystolic (nebivolol)

BuPROPion may increase the blood levels and effects of nebivolol. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if you experience increased side effects or your condition changes. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

(Moderate interaction)loxapine ↔ oxcarbazepine Moderate Drug Interaction

Applies to: loxapine, oxcarbazepine

Using loxapine together with OXcarbazepine may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

(Moderate interaction)trazodone ↔ oxcarbazepine Moderate Drug Interaction

Applies to: trazodone, oxcarbazepine

OXcarbazepine may reduce the blood levels and effects of traZODone. Contact your doctor if your symptoms worsen or your condition changes during treatment with these medications. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

(Moderate interaction)clonazepam ↔ oxcarbazepine Moderate Drug Interaction

Applies to: clonazepam, oxcarbazepine

OXcarbazepine may reduce the blood levels and effects of clonazePAM. Contact your doctor if your symptoms worsen or your condition changes during treatment with these medications. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

(Moderate interaction)trazodone ↔ loxapine Moderate Drug Interaction

Applies to: trazodone, loxapine

Using traZODone together with loxapine may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

(Moderate interaction)clonazepam ↔ loxapine Moderate Drug Interaction

Applies to: clonazepam, loxapine

Using clonazePAM together with loxapine may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

(Moderate interaction) clonazepam ↔ trazodone Moderate Drug Interaction

Applies to: clonazepam, trazodone

Using clonazePAM together with traZODone may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

loxapine ↔ nebivolol (MODERATE INTERACTION) Moderate Drug Interaction

Applies to: loxapine, Bystolic (nebivolol)

Loxapine and nebivolol may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Meds I'm currently taperingDeplin 7.5 mg 

                                                Klonopin .25 mg +1/4(.25) (I did a fairly rapid taper down from around 2 mg Klonopin, but I've held at .25 for several months now, and even updosed a quarter of a pill to give myself 4 good nights of sleep and lift myself out of a depression

(about to start a micro-taper)

 

 

 

Medications I tapered off successfully: Bupropion 150 mg, Trazadone 150 mg, Oxcarbazepin 300 mg, Loxapine 20 mg

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Well, it appears most of my medications are interacting with each other. In fact, it seems like every single medication is interacting with every other medication I'm taking. What a mess! They only talk about seizure risk and sedation, but I wonder what other problems these interactions may cause or potentially cause? I wonder how this complex interaction triggers PVCs as a withdrawal symptom? Obviously, they are screwing with my heart's electrical system.

Meds I'm currently taperingDeplin 7.5 mg 

                                                Klonopin .25 mg +1/4(.25) (I did a fairly rapid taper down from around 2 mg Klonopin, but I've held at .25 for several months now, and even updosed a quarter of a pill to give myself 4 good nights of sleep and lift myself out of a depression

(about to start a micro-taper)

 

 

 

Medications I tapered off successfully: Bupropion 150 mg, Trazadone 150 mg, Oxcarbazepin 300 mg, Loxapine 20 mg

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  • Administrator

Yep, it's a mess. What does your current psychiatrist say about it?

My suspicion is that it's not Wellbutrin that's causing your heart symptoms (although it can be agitating), it's another drug or combination. When you reduce the Wellbutrin, which is an accelerator, the brakes (Clonazepam, Bystolic, Loxapine, Oxcarbazepine) have too much influence -- they slow your heart too much -- and you're getting PVCs as a paradoxical reaction.

Could you please answer the questions I asked above:
 

So the order your drugs were prescribed was:

50 mg Trazodone <---- why was this prescribed?
.625 mg of Klonopin (Clonazepam) <---- why was this prescribed?
150 mg Wellbutrin
2.5 mg Bystolic (a beta blocker)
Loxapine <---- why was this prescribed?
Oxcarbazepine <---- why was this prescribed?

 

 

Please answer the questions I ask here. My time is limited and it's frustrating for me to repeat them.

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.

Link to comment

 

So the order your drugs were prescribed was:

 

50 mg Trazodone <---- why was this prescribed?

.625 mg of Klonopin (Clonazepam) <---- why was this prescribed?

150 mg Wellbutrin

2.5 mg Bystolic (a beta blocker)

Loxapine <---- why was this prescribed?

Oxcarbazepine <---- why was this prescribed?

 

 

Please answer the questions I ask here. My time is limited and it's frustrating for me to repeat myself.

I did answer those questions in the rather (I apologize) long-winded paragraph above (sorry, if I am including too much info). I'm not entirely sure of the exact order I was prescribed these medications (it's complicated). I've been on some combination of antipsychotic, mood stabilizer and antidepressant for the last 14 years. I was first put on an antidepressant, had a manic episode, and was put on an antipsychotic and a mood stabilzer as a result of the manic episode. Nothing seemed to work so my psychiatrists would switch out antidepressants, mood stabilizers, and antipsychotics from time to time.

 

If I had to guess the order I was put on my current meds I'd say

 

Wellbutrin (to battle the brain fog, depression, anxiety)

 

Oxcarbazepine and Loxapine (because of an antidepressant-induced manic attack, so to balance out the stimulating effects of the Wellbutrin)

 

Deplin (because it's supposed to aide the Wellbutrin in reducing depression)

 

Trazodone (to help me get to sleep because of the overstimulation from the Wellbutrin/Deplin)

 

Clonazepam (1st, as needed for anxiety, then permanently because of anxiety caused by PVCs)

 

Bystolic (beta blocker) (prescribed because beta blockers can reduce PVCs)

Meds I'm currently taperingDeplin 7.5 mg 

                                                Klonopin .25 mg +1/4(.25) (I did a fairly rapid taper down from around 2 mg Klonopin, but I've held at .25 for several months now, and even updosed a quarter of a pill to give myself 4 good nights of sleep and lift myself out of a depression

(about to start a micro-taper)

 

 

 

Medications I tapered off successfully: Bupropion 150 mg, Trazadone 150 mg, Oxcarbazepin 300 mg, Loxapine 20 mg

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Yep, it's a mess. What does your current psychiatrist say about it?

 

 

My last psychiatrist was completely clueless about what to do. I am seeing a new psychiatrist and I have only seen him once and we haven't gone into everything I've shared with you thus far with him. I see him this Wednesday, and will thoroughly go through all of this info with him. I will print out the drug interaction summery and share it with him. I will let you know what course of action he wishes to choose after I see him Wednesday.

 

Thanks 

Meds I'm currently taperingDeplin 7.5 mg 

                                                Klonopin .25 mg +1/4(.25) (I did a fairly rapid taper down from around 2 mg Klonopin, but I've held at .25 for several months now, and even updosed a quarter of a pill to give myself 4 good nights of sleep and lift myself out of a depression

(about to start a micro-taper)

 

 

 

Medications I tapered off successfully: Bupropion 150 mg, Trazadone 150 mg, Oxcarbazepin 300 mg, Loxapine 20 mg

Link to comment

My suspicion is that it's not Wellbutrin that's causing your heart symptoms (although it can be agitating), it's another drug or combination. When you reduce the Wellbutrin, which is an accelerator, the brakes (Clonazepam, Bystolic, Loxapine, Oxcarbazepine) have too much influence -- they slow your heart too much -- and you're getting PVCs as a paradoxical reaction.

Interesting. I wonder in what order to taper off of these meds then, and how quickly? I'll share this info with my new psychiatrist.

 

Thanks allot!!!!!!

Meds I'm currently taperingDeplin 7.5 mg 

                                                Klonopin .25 mg +1/4(.25) (I did a fairly rapid taper down from around 2 mg Klonopin, but I've held at .25 for several months now, and even updosed a quarter of a pill to give myself 4 good nights of sleep and lift myself out of a depression

(about to start a micro-taper)

 

 

 

Medications I tapered off successfully: Bupropion 150 mg, Trazadone 150 mg, Oxcarbazepin 300 mg, Loxapine 20 mg

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  • Administrator
I was first put on an antidepressant, had a manic episode, and was put on an antipsychotic and a mood stabilzer as a result of the manic episode. Nothing seemed to work so my psychiatrists would switch out antidepressants, mood stabilizers, and antipsychotics from time to time.

 

 

This is a very familiar story!

 

You had an adverse reaction to the antidepressant, and possibly long-term withdrawal syndrome as well. Some people have a genetic predisposition to extreme adverse reactions to serotonergics within a few doses.

 

I would suggest going off the "mood stabilizers" Oxcarbazepine and Loxapine first. It seems you never needed them, and the "braking" action is affecting your heart rate.

 

They all need to be tapered, one at a time. What you might do is rotate them, 10% decrease of one for 2 weeks, then 10% decrease of another for 2 weeks, etc.

 

My guess is, reduce both by 20%, hold, then reduce the Wellbutrin by 5% at first.

 

You must go very carefully to avoid destabilizing the heart rate.

 

PS If your new psychiatrist did not suspect drug-drug interactions, he is an idiot.

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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  • Administrator

Digging a little further into loxapine, I found it's metabolized by CYP1A2, CYP2D6, and CYP3A4 http://www.ncbi.nlm.nih.gov/pubmed/21826677
 
It also produces active metabolites which can contribute to adverse reactions.
http://www.ncbi.nlm.nih.gov/pubmed/6122292
http://www.ncbi.nlm.nih.gov/pubmed/21993198
 
About oxcarbazepine
http://livertox.nlm.nih.gov/Oxcarbazepine.htm

induces CYP 3A4 and inhibits CYP 2C19 and can cause drug-drug interactions particularly with other drugs used for epilepsy that induce CYP 3A4 such as phenytoin and phenobarbital

 
so, the good news is oxcarbazepine and loxapine cancel each other out as far as CYP3A4 is concerned.
 
Still, it seems an awful lot of traffic is using up CYP3A4 and CYP2D6, so it's not surprising you're having adverse reactions to at least 5 out of 6 of these drugs :
loxapine CYP1A2, CYP2D6, and CYP3A4
oxcarbazepine CYP2C19, induces [speeds up] CYP3A4
trazodone CYP3A4, CYP2D6 (mCPP)
buproprion (Wellbutrin) CYP2D6, CYP2B6
clonazepam CYP3A4
nebivolol CYP2D6
 
http://livertox.nlm.nih.gov/Nebivolol.htm

Nebivolol undergoes extensive metabolism by the liver, is a substrate of CYP 2D6 and its excretion is largely biliary.

 

So loxapine is a prime suspect. However, reducing it first would give oxcarbazepine more room to speed up CYP3A4, which may cause 1) faster metabolism of trazodone into mCPP and reduced effectiveness (if any) of trazodone; 2) faster metabolism and reduced effectiveness (if any) of clonazepam.

 

In addition, reduction of CYP2D6 traffic may cause 1) faster metabolization of mCPP (a good thing); 2) faster metabolization and reduced effectiveness (if any) of bupropion (touchy); 3) faster metabolization and reduced effectiveness (if any) of nebivolol.

 

So, here's another guess at a plan: Reduce the loxapine first by 10% for 2 weeks, then trazodone by 10% for 2 weeks. These two actions will speed up the metabolism of bupropion and reduce adverse effects of mCPP. Then reduce oxcarbazepine by 10% for 2 weeks and repeat the cycle for the 3 drugs, monitoring carefully for weird symptoms.

 

This is important: You should keep notes on paper about the dosages, times you take the drugs, and symptom pattern for every day.

 

 

Unless otherwise indicated, info about P450 cyp substrates, inducers, and inhibitors is from a pharmacist site:
http://www.ppag.org/attachments/wysiwyg/3/Psych_Drug_Metabolism_Handout.pdf
and Genelex, a gene testing company http://www.genemedrx.com/Cytochrome_P450_Metabolism_Table.php

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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  • Moderator Emeritus

Hi J!

 

Was just reading your thread:what a story!

 

I knew by now that Alto is fascinatingly amazing but after reading about her last work on your situation, I'm speechless-what a genius!

 

I'm so happy you are cooperating so nicely and doing your best to follow the priceless advice.

 

Psychiatry has really put you in bad spot but with Alto's help,you will get out.

 

Don't worry about the return of your state before meds:for one,it was probably a lot more tolerable then this result of the attempts to fix it. And secondly, we grow,learn, change. After 14 years you are more equipped to deal with things in your life that caused you to be depressed.

 

You are on the right track and I'm glad I don't have to emphasise the need to listen to Alto's advice. It's a messy situation but unlike psychiatrists who treat as guineapigs she knows damn well what she is saying.

 

You will get there!

 

Best,

bubble

Current: 9/2022 Xanax 0.08, Lexapro 2

2020 Xanax 0.26 (down from 2 mg in 2013), Lexapro 2.85 mg (down from 5 mg 2013)

Amitriptyline (tricyclic AD) and clonazepam for 3 months to treat headache in 1996 
1999. - present Xanax prn up to 3 mg.
2000-2005 Prozac CT twice, 2005-2010 Zoloft CT 3 times, 2010-2013 Escitalopram 10 mg
went from 2.5 to zero on 7 Aug 2013, bad crash 40 days after
reinstated to 5 mg Escitalopram 4Oct 2013 and holding liquid Xanax every 5 hours
28 Jan 2014 Xanax 1.9, 18 Apr  2015 1 mg,  25 June 2015 Lex 4.8, 6 Aug Lexapro 4.6, 1 Jan 2016 0.64  Xanax     9 month hold

24 Sept 2016 4.5 Lex, 17 Oct 4.4 Lex (Nov 0.63 Xanax, Dec 0.625 Xanax), 1 Jan 2017 4.3 Lex, 24 Jan 4.2, 5 Feb 4.1, 24 Mar 4 mg, 10 Apr 3.9 mg, May 3.85, June 3.8, July 3.75, 22 July 3.7, 15 Aug 3.65, 17 Sept 3.6, 1 Jan 2018 3.55, 19 Jan 3.5, 16 Mar 3.4, 14 Apr 3.3, 23 May 3.2, 16 June 3.15, 15 Jul 3.1, 31 Jul 3, 21 Aug 2.9 26 Sept 2.85, 14 Nov Xan 0.61, 1 Dec 0.59, 19 Dec 0.58, 4 Jan 0.565, 6 Feb 0.55, 20 Feb 0.535, 1 Mar 0.505, 10 Mar 0.475, 14 Mar 0.45, 4 Apr 0.415, 13 Apr 0.37, 21 Apr 0.33, 29 Apr 0.29, 10 May 0.27, 17 May 0.25, 28 May 0.22, 19 June 0.22, 21 Jun updose to 0.24, 24 Jun updose to 0.26

Supplements: Omega 3 + Vit E, Vit C, D, magnesium, Taurine, probiotic 

I'm not a medical professional. Any advice I give is based on my own experience and reading. 

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  • Moderator Emeritus

Wow. This is quite a story of overmedication and creative cocktailing.

 

Alto, you're amazing.

 

I'm concerned about the rate of cut, 10% with just two weeks between, that seems a bit fast to me...you think that's okay Alto? I know they're different meds, not consecutive cuts of the same one, but there's so much overlap I would expect cumulative effects anyway.

 

As far as the clonazepam questions earlier, it's normal with benzo withdrawal to feel better for a while and then to get hit again, then to feel better, then to get hit again. It doesn't mean you need to change your dose. Usually changing doses doesn't really help with that. It's just withdrawal and should improve with time.

 

But it does concern me that if you're still having benzo withdrawal symptoms you should maybe cut these other meds a little less aggressively, at least for the first cut or two until you see how your body is going to react. Then again maybe the dangers of the meds themselves are a greater concern than withdrawal. That's always a tricky tightrope to walk. Alto, I'd like to know your thoughts about that, you don't usually recommend such aggressive tapers so I'm curious.

Started on Prozac and Xanax in 1992 for PTSD after an assault. One drug led to more, the usual story. Got sicker and sicker, but believed I needed the drugs for my "underlying disease". Long story...lost everything. Life savings, home, physical and mental health, relationships, friendships, ability to work, everything. Amitryptiline, Prozac, bupropion, buspirone, flurazepam, diazepam, alprazolam, Paxil, citalopram, lamotrigine, gabapentin...probably more I've forgotten. 

Started multidrug taper in Feb 2010.  Doing a very slow microtaper, down to low doses now and feeling SO much better, getting my old personality and my brain back! Able to work full time, have a full social life, and cope with stress better than ever. Not perfect, but much better. After 23 lost years. Big Pharma has a lot to answer for. And "medicine for profit" is just not a great idea.

 

Feb 15 2010:  300 mg Neurontin  200 Lamictal   10 Celexa      0.65 Xanax   and 5 mg Ambien 

Feb 10 2014:   62 Lamictal    1.1 Celexa         0.135 Xanax    1.8 Valium

Feb 10 2015:   50 Lamictal      0.875 Celexa    0.11 Xanax      1.5 Valium

Feb 15 2016:   47.5 Lamictal   0.75 Celexa      0.0875 Xanax    1.42 Valium    

2/12/20             12                       0.045               0.007                   1 

May 2021            7                       0.01                  0.0037                1

Feb 2022            6                      0!!!                     0.00167               0.98                2.5 mg Ambien

Oct 2022       4.5 mg Lamictal    (off Celexa, off Xanax)   0.95 Valium    Ambien, 1/4 to 1/2 of a 5 mg tablet 

 

I'm not a doctor. Any advice I give is just my civilian opinion.

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  • Moderator Emeritus

I noticed that too and my understanding was that because of the number of drugs and their dangerous interactions the usually recommended protocol of longer holds and one drug at a time should be somewhat modified.

 

It seems the situation might call for immediate discontinuation of at least 2 drugs which would cause further damage so in my understanding Alto suggested a middle way to reduce harm.

 

But would also very much like to hear about the reasoning behind this ingenious plan...

Current: 9/2022 Xanax 0.08, Lexapro 2

2020 Xanax 0.26 (down from 2 mg in 2013), Lexapro 2.85 mg (down from 5 mg 2013)

Amitriptyline (tricyclic AD) and clonazepam for 3 months to treat headache in 1996 
1999. - present Xanax prn up to 3 mg.
2000-2005 Prozac CT twice, 2005-2010 Zoloft CT 3 times, 2010-2013 Escitalopram 10 mg
went from 2.5 to zero on 7 Aug 2013, bad crash 40 days after
reinstated to 5 mg Escitalopram 4Oct 2013 and holding liquid Xanax every 5 hours
28 Jan 2014 Xanax 1.9, 18 Apr  2015 1 mg,  25 June 2015 Lex 4.8, 6 Aug Lexapro 4.6, 1 Jan 2016 0.64  Xanax     9 month hold

24 Sept 2016 4.5 Lex, 17 Oct 4.4 Lex (Nov 0.63 Xanax, Dec 0.625 Xanax), 1 Jan 2017 4.3 Lex, 24 Jan 4.2, 5 Feb 4.1, 24 Mar 4 mg, 10 Apr 3.9 mg, May 3.85, June 3.8, July 3.75, 22 July 3.7, 15 Aug 3.65, 17 Sept 3.6, 1 Jan 2018 3.55, 19 Jan 3.5, 16 Mar 3.4, 14 Apr 3.3, 23 May 3.2, 16 June 3.15, 15 Jul 3.1, 31 Jul 3, 21 Aug 2.9 26 Sept 2.85, 14 Nov Xan 0.61, 1 Dec 0.59, 19 Dec 0.58, 4 Jan 0.565, 6 Feb 0.55, 20 Feb 0.535, 1 Mar 0.505, 10 Mar 0.475, 14 Mar 0.45, 4 Apr 0.415, 13 Apr 0.37, 21 Apr 0.33, 29 Apr 0.29, 10 May 0.27, 17 May 0.25, 28 May 0.22, 19 June 0.22, 21 Jun updose to 0.24, 24 Jun updose to 0.26

Supplements: Omega 3 + Vit E, Vit C, D, magnesium, Taurine, probiotic 

I'm not a medical professional. Any advice I give is based on my own experience and reading. 

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  • Administrator

Yes, I'm very concerned about the extensive interactions and the heart symptoms, which is why I'm suggesting a faster rate.

 

Also, these drugs are tightly intertwined. Reducing one causes the effects of others to increase, then they need to be reduced to maintain some kind of homeostasis.

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 a lot Alto. I will definitely share this info with my psychiatrist and give a donation to your site. In the meantime, should I have my liver functioning tested? I just hope my new psychiatrist listens.

Really, thanks, I was beginning to think my situation was hopeless.

How did you figure this out, while my psychiatrist, family practitioner, and a cardiologist couldn't? What is wrong with these people?

Meds I'm currently taperingDeplin 7.5 mg 

                                                Klonopin .25 mg +1/4(.25) (I did a fairly rapid taper down from around 2 mg Klonopin, but I've held at .25 for several months now, and even updosed a quarter of a pill to give myself 4 good nights of sleep and lift myself out of a depression

(about to start a micro-taper)

 

 

 

Medications I tapered off successfully: Bupropion 150 mg, Trazadone 150 mg, Oxcarbazepin 300 mg, Loxapine 20 mg

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I would like to ask for one more piece of advice:

 

I am worried about going to my new psychiatrist and giving him this info and saying this is how we are going to taper it. He seems like the type of guy that doesn't like to be told what to do. I can understand him being irritated with me coming to him with this messy situation and then me also telling him how we're going to fix it.

I guess the best thing I can do is explain the PVC situation as best I can, print out this thread, or maybe just cut and paste Altostratas comments, research, and potential solution, and then ask him what he suggests? Of course, if he suggests something radically different than what Alto suggests, like staying on the meds or switching to another antipsychotic etc, then I'll have to find another psychiatrist or go back to my old one. I have to let him know I want to get off of ALL of the meds and that he has to be OK with that.

 

This is all the more complicated by the fact that my mom has brain cancer and my dad has the beginning stages of dementia, and I don't want to be suffering too much with withdrawal symptoms around them. I have to drive her to a hospital an hour away occasionally.

I'm also worried that when I reduce the Loxapine and Oxcarbazepine, the irritability, anger and pain caused by the Wellbutrin will temporarily get worse. But, I guess keeping the heart stabilized is the most important thing right now.

 

Just so you know

I take a 10 mg capsule of Loxapine, so I'll have to make sure they have it in tablet form. 

The Oxcarbazepine is a 150 mg tablet so I can try my best to cut 15 mg off of that.

 

Thanks Alto, your a lifesaver!!!

Meds I'm currently taperingDeplin 7.5 mg 

                                                Klonopin .25 mg +1/4(.25) (I did a fairly rapid taper down from around 2 mg Klonopin, but I've held at .25 for several months now, and even updosed a quarter of a pill to give myself 4 good nights of sleep and lift myself out of a depression

(about to start a micro-taper)

 

 

 

Medications I tapered off successfully: Bupropion 150 mg, Trazadone 150 mg, Oxcarbazepin 300 mg, Loxapine 20 mg

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  • Moderator Emeritus

Hi Jshect, I'm sorry your mum and dad are not well, it must be very hard for you all and I think you

are amazing looking out for them while going through all this. 

 

I think if I was meeting a new shrink I would go in there, give a firm handshake and tell them that I want 

to work towards getting off all psychotropic meds and learn to deal with things without drugs. 

Then tell him how I would like to do it and ask if he would support me. 

 

The ones I've seen do not like people using the internet for research, they want us to hang onto their

every word and do as they say!  On the other hand yours might be cooperative and support what you

want to do, I hope so. Let us know how it goes. 

**I am not a medical professional, if in doubt please consult a doctor with withdrawal knowledge.

 

 

Different drugs occasionally (mostly benzos) 1976 - 1981 (no problem)

1993 - 2002 in and out of hospital. every type of drug + ECT. Staring with seroxat

2002  effexor. 

Tapered  March 2012 to March 2013, ending with 5 beads.

Withdrawal April 2013 . Reinstated 5 beads reduced to 4 beads May 2013

Restarted taper  Nov 2013  

OFF EFFEXOR Feb 2015    :D 

Tapered atenolol and omeprazole Dec 2013 - May 2014

 

Tapering tramadol, Feb 2015 100mg , March 2015 50mg  

 July 2017 30mg.  May 15 2018 25mg

Taking fish oil, magnesium, B12, folic acid, bilberry eyebright for eye pressure. 

 

My story http://survivingantidepressants.org/index.php?/topic/4199-hello-mammap-checking-in/page-33

 

Lesson learned, slow down taper at lower doses. Taper no more than 10% of CURRENT dose if possible

 

 

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  • Moderator Emeritus

Yes, I'm very concerned about the extensive interactions and the heart symptoms, which is why I'm suggesting a faster rate.

 

Also, these drugs are tightly intertwined. Reducing one causes the effects of others to increase, then they need to be reduced to maintain some kind of homeostasis.

 

Sheesh. Just when I thought I had seen the worst of the terrible overprescribing and dangerous misinformation and mixing of medications. 

 

I'm so glad you're here, Alto.  

Started on Prozac and Xanax in 1992 for PTSD after an assault. One drug led to more, the usual story. Got sicker and sicker, but believed I needed the drugs for my "underlying disease". Long story...lost everything. Life savings, home, physical and mental health, relationships, friendships, ability to work, everything. Amitryptiline, Prozac, bupropion, buspirone, flurazepam, diazepam, alprazolam, Paxil, citalopram, lamotrigine, gabapentin...probably more I've forgotten. 

Started multidrug taper in Feb 2010.  Doing a very slow microtaper, down to low doses now and feeling SO much better, getting my old personality and my brain back! Able to work full time, have a full social life, and cope with stress better than ever. Not perfect, but much better. After 23 lost years. Big Pharma has a lot to answer for. And "medicine for profit" is just not a great idea.

 

Feb 15 2010:  300 mg Neurontin  200 Lamictal   10 Celexa      0.65 Xanax   and 5 mg Ambien 

Feb 10 2014:   62 Lamictal    1.1 Celexa         0.135 Xanax    1.8 Valium

Feb 10 2015:   50 Lamictal      0.875 Celexa    0.11 Xanax      1.5 Valium

Feb 15 2016:   47.5 Lamictal   0.75 Celexa      0.0875 Xanax    1.42 Valium    

2/12/20             12                       0.045               0.007                   1 

May 2021            7                       0.01                  0.0037                1

Feb 2022            6                      0!!!                     0.00167               0.98                2.5 mg Ambien

Oct 2022       4.5 mg Lamictal    (off Celexa, off Xanax)   0.95 Valium    Ambien, 1/4 to 1/2 of a 5 mg tablet 

 

I'm not a doctor. Any advice I give is just my civilian opinion.

Link to comment
  • Moderator Emeritus

Hi Jshect, I'm sorry your mum and dad are not well, it must be very hard for you all and I think you

are amazing looking out for them while going through all this. 

 

I think if I was meeting a new shrink I would go in there, give a firm handshake and tell them that I want 

to work towards getting off all psychotropic meds and learn to deal with things without drugs. 

Then tell him how I would like to do it and ask if he would support me. 

 

The ones I've seen do not like people using the internet for research, they want us to hang onto their

every word and do as they say!  On the other hand yours might be cooperative and support what you

want to do, I hope so. Let us know how it goes. 

 

Yes they usually write off anything from the Internet or from anyone who's not an MD (and that's not just psychiatrists, that's partly a problem that all of medicine has, it's a self-reinforcing bubble that way). But Alto's information is so clear, I think if it were me I would print those posts off and bring them in anyway. And if he can't humble himself enough to consider that maybe he should think about what she says, I'd be looking for a different doctor.

 

Well, actually, I'd be doing that anyway, trying to find someone who's supportive of your plans and who's willing to work with you as a partner in your health, with you as the one who has the final say about things. But it can take a while to find that kind of doctor and you have your hands full with life stresses right now too, it sounds like.

 

Another option that people sometimes have to follow as a last resort is to not tell their prescribing physicians that they're actually tapering, and keep filling the prescriptions, and do the taper on their own with the advice of the knowledgeable and experienced people on this forum. It would be lovely if nobody ever had to do that but sometimes it's the only practical option.

Started on Prozac and Xanax in 1992 for PTSD after an assault. One drug led to more, the usual story. Got sicker and sicker, but believed I needed the drugs for my "underlying disease". Long story...lost everything. Life savings, home, physical and mental health, relationships, friendships, ability to work, everything. Amitryptiline, Prozac, bupropion, buspirone, flurazepam, diazepam, alprazolam, Paxil, citalopram, lamotrigine, gabapentin...probably more I've forgotten. 

Started multidrug taper in Feb 2010.  Doing a very slow microtaper, down to low doses now and feeling SO much better, getting my old personality and my brain back! Able to work full time, have a full social life, and cope with stress better than ever. Not perfect, but much better. After 23 lost years. Big Pharma has a lot to answer for. And "medicine for profit" is just not a great idea.

 

Feb 15 2010:  300 mg Neurontin  200 Lamictal   10 Celexa      0.65 Xanax   and 5 mg Ambien 

Feb 10 2014:   62 Lamictal    1.1 Celexa         0.135 Xanax    1.8 Valium

Feb 10 2015:   50 Lamictal      0.875 Celexa    0.11 Xanax      1.5 Valium

Feb 15 2016:   47.5 Lamictal   0.75 Celexa      0.0875 Xanax    1.42 Valium    

2/12/20             12                       0.045               0.007                   1 

May 2021            7                       0.01                  0.0037                1

Feb 2022            6                      0!!!                     0.00167               0.98                2.5 mg Ambien

Oct 2022       4.5 mg Lamictal    (off Celexa, off Xanax)   0.95 Valium    Ambien, 1/4 to 1/2 of a 5 mg tablet 

 

I'm not a doctor. Any advice I give is just my civilian opinion.

Link to comment
  • Moderator Emeritus

I would like to ask for one more piece of advice:

 

I am worried about going to my new psychiatrist and giving him this info and saying this is how we are going to taper it. He seems like the type of guy that doesn't like to be told what to do. I can understand him being irritated with me coming to him with this messy situation and then me also telling him how we're going to fix it.

I guess the best thing I can do is explain the PVC situation as best I can, print out this thread, or maybe just cut and paste Altostratas comments, research, and potential solution, and then ask him what he suggests? Of course, if he suggests something radically different than what Alto suggests, like staying on the meds or switching to another antipsychotic etc, then I'll have to find another psychiatrist or go back to my old one. I have to let him know I want to get off of ALL of the meds and that he has to be OK with that.

 

This is all the more complicated by the fact that my mom has brain cancer and my dad has the beginning stages of dementia, and I don't want to be suffering too much with withdrawal symptoms around them. I have to drive her to a hospital an hour away occasionally.

I'm also worried that when I reduce the Loxapine and Oxcarbazepine, the irritability, anger and pain caused by the Wellbutrin will temporarily get worse. But, I guess keeping the heart stabilized is the most important thing right now.

 

Just so you know

I take a 10 mg capsule of Loxapine, so I'll have to make sure they have it in tablet form. 

The Oxcarbazepine is a 150 mg tablet so I can try my best to cut 15 mg off of that.

 

Thanks Alto, your a lifesaver!!!

 

Read through our Tapering section--you can get a milligram scale and use that to get precise reductions. If necessary you can remove some of the contents of a capsule and taper that way too.

 

Basically what you do is:

1.  Weigh your pill (I weigh five to ten of them and take an average)

2.  Calculate how much the reduced dose will weigh.

          If you're making a 10% cut you will be taking 90% of the original amount (you can adjust this to any percentage you want): 0.9 in this case

          Multiply the weight of the full size pill times that decimal number (whatever percentage you are taking)

          That is the weight of pill or powder that you need to take.

3.  Slowly remove a bit of the pill and reweigh until you get to the correct weight. (I use an emory board or nail file for tablets.)

 

Example:

 

Your pills average, say, 0.355 grams each, and each pill is 30 mg, and you want to cut 10% off of that (which will give you about 27 mg). Multiply 0.355 x 0.9 and you get 0.3195 which rounds to 0.32. Remove enough of a pill to get you as close as you can to 0.32.

 

Be sure you're measuring in the same units all the time. Those milligram scales usually have options to measure in grams, in ounces or something, in some jewelry units, and maybe something else. I think when I was using them I used grams. Just make sure you always use the same setting, whichever one you choose.

 

Good luck!

 

(If we don't already have a post describing this and somebody wants to put this in under the Tapering section please feel free, I have to go get ready for work now or I would check it out myself.)

Started on Prozac and Xanax in 1992 for PTSD after an assault. One drug led to more, the usual story. Got sicker and sicker, but believed I needed the drugs for my "underlying disease". Long story...lost everything. Life savings, home, physical and mental health, relationships, friendships, ability to work, everything. Amitryptiline, Prozac, bupropion, buspirone, flurazepam, diazepam, alprazolam, Paxil, citalopram, lamotrigine, gabapentin...probably more I've forgotten. 

Started multidrug taper in Feb 2010.  Doing a very slow microtaper, down to low doses now and feeling SO much better, getting my old personality and my brain back! Able to work full time, have a full social life, and cope with stress better than ever. Not perfect, but much better. After 23 lost years. Big Pharma has a lot to answer for. And "medicine for profit" is just not a great idea.

 

Feb 15 2010:  300 mg Neurontin  200 Lamictal   10 Celexa      0.65 Xanax   and 5 mg Ambien 

Feb 10 2014:   62 Lamictal    1.1 Celexa         0.135 Xanax    1.8 Valium

Feb 10 2015:   50 Lamictal      0.875 Celexa    0.11 Xanax      1.5 Valium

Feb 15 2016:   47.5 Lamictal   0.75 Celexa      0.0875 Xanax    1.42 Valium    

2/12/20             12                       0.045               0.007                   1 

May 2021            7                       0.01                  0.0037                1

Feb 2022            6                      0!!!                     0.00167               0.98                2.5 mg Ambien

Oct 2022       4.5 mg Lamictal    (off Celexa, off Xanax)   0.95 Valium    Ambien, 1/4 to 1/2 of a 5 mg tablet 

 

I'm not a doctor. Any advice I give is just my civilian opinion.

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  • Moderator Emeritus

When you go to see the psychiatrist  just bear in mind that this is YOUR life, YOUR health, YOUR suffering and should therefore be YOUR choice and YOUR decision.

 

If he has a problem with that, find another one.

 

They have already made too many vicious mistakes on you and nobody is held accountable, it's just you who has to pay the price. So it's about time you take charge of your 'treatment'.

 

good luck!

Current: 9/2022 Xanax 0.08, Lexapro 2

2020 Xanax 0.26 (down from 2 mg in 2013), Lexapro 2.85 mg (down from 5 mg 2013)

Amitriptyline (tricyclic AD) and clonazepam for 3 months to treat headache in 1996 
1999. - present Xanax prn up to 3 mg.
2000-2005 Prozac CT twice, 2005-2010 Zoloft CT 3 times, 2010-2013 Escitalopram 10 mg
went from 2.5 to zero on 7 Aug 2013, bad crash 40 days after
reinstated to 5 mg Escitalopram 4Oct 2013 and holding liquid Xanax every 5 hours
28 Jan 2014 Xanax 1.9, 18 Apr  2015 1 mg,  25 June 2015 Lex 4.8, 6 Aug Lexapro 4.6, 1 Jan 2016 0.64  Xanax     9 month hold

24 Sept 2016 4.5 Lex, 17 Oct 4.4 Lex (Nov 0.63 Xanax, Dec 0.625 Xanax), 1 Jan 2017 4.3 Lex, 24 Jan 4.2, 5 Feb 4.1, 24 Mar 4 mg, 10 Apr 3.9 mg, May 3.85, June 3.8, July 3.75, 22 July 3.7, 15 Aug 3.65, 17 Sept 3.6, 1 Jan 2018 3.55, 19 Jan 3.5, 16 Mar 3.4, 14 Apr 3.3, 23 May 3.2, 16 June 3.15, 15 Jul 3.1, 31 Jul 3, 21 Aug 2.9 26 Sept 2.85, 14 Nov Xan 0.61, 1 Dec 0.59, 19 Dec 0.58, 4 Jan 0.565, 6 Feb 0.55, 20 Feb 0.535, 1 Mar 0.505, 10 Mar 0.475, 14 Mar 0.45, 4 Apr 0.415, 13 Apr 0.37, 21 Apr 0.33, 29 Apr 0.29, 10 May 0.27, 17 May 0.25, 28 May 0.22, 19 June 0.22, 21 Jun updose to 0.24, 24 Jun updose to 0.26

Supplements: Omega 3 + Vit E, Vit C, D, magnesium, Taurine, probiotic 

I'm not a medical professional. Any advice I give is based on my own experience and reading. 

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