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acetyl Asenapine (Saphris) Withdrawal hell


acetyl

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Hi all,

 

I don't have much energy and am so agitated, trying to type and remain calm is almost impossible. I'll try to detail the important points below and the advice I need. When I was in not quite as bad state I did a more detailed story and follow up posts at the below forum:

 

http://www.mentalhealthforum.net/forum/thread82463.html

 

- In the past I had been on Pristiq for ~6 months. Had no idea what withdrawals were and quit it cold turkey. Very fortunately I only experienced migraines and mild brain zaps for 5 days and then everything went back to normal.

 

- Had another depressive episode several years later, saw a psychiatrist who aggressively diagnosed me as bipolar (has since been overturned as I definitely never experience any 'up episodes' and have a far more unipolar form of depression). That psychiatrist put me on lithium and later on when I was struggling due to a relationship break up he put me on 10mg of the AAP Asenapine.

 

- Developed a tremor, foggy brain, faulty memory. Doctor suspected the Lithium, so we stopped that. No withdrawal issues at all, but none of the side effects subsided.

 

- Asked to be taken off Saphris (at this stage I had been on it for 6 months). Doctor gave me a tapering schedule of a 25% reduction every 4 days. Half way through taper I felt so agitated and was sleeping so poorly I stopped going to work. Thought I could just persevere and push through the pain, so continued with the rapid taper off the drug.

 

- 3 weeks off the drug completely the anxiety was so bad I became completely disabled by it, even simple tasks like getting dressed in the morning felt like climbing Everest. Also had total insomnia. Started to break out in total panic attacks during the day. This lead to my parents taking me to the psychiatric emergency care centre at the hospital. Spent 5 days there on benzos and a tiny amount of seroquel. Was released with a prescription for Doxepin 75mg.

 

- Took the Doxepin for a bit over a week, but it gave me extreme nausea and dizziness, so stopped taking it as I was convinced it could do nothing but make things worse.

 

- 5 weeks since stopping Asenapine I begged my psychiatrist to allow me to try reinstating it. He agreed that I could try taking 5mg. 30 minutes after taking 5mg I went in to convulsions followed by extremely severe akathasia that led to me being taken to ER in an ambulance. Once stabilised I was again shifted to the psychiatric care centre, this time they released me with a prescription for Mirtazapine 30mg.

 

- I didn't want to take the Mirtazapine but my parents were pissed at me for 'playing doctor' last time, as the doctors convinced them that if I had stuck with the Doxepin I would be well on the road to recovery by now. I was given the verdict by my parents of taking it as prescribed or they would admit me to the psychiatric wing of the hospital where I'd be forced to take it.

At this stage the anxiety was raging so out of control that I was feeling incredibly suicidal and was extremely desperate to escape the agony and for sleep. So the doctors also gave me a prescription for diazepam 2.5mg twice a day to be taken till the Mirtazapine kicks in.

 

- 3 weeks after taking the Mirtazapine (and 8 weeks since quitting asenapine) I have been able to at least get some sleep, but am noticing that is slowly fading as my body adapts and upregulates my histamine receptors. It has done absolutely zero for my anxiety though, if I don't take some diazepam I'am an absolute mess and start to drift towards suicidality. 

 

- I'm seeing a new psychiatrist next week, but not holding my breath that he will be any more understanding of my condition. He is meant to be more trained in CBT and hypnosis, so I'm hoping at the least I'll get some psychological tools out of him for better coping with the anxiety.

 

Really, really don't know what to do :( Understandably my parents disposed of all my Saphris, convinced that it is a drug from hell, so I have no access to it. I realise now I should have reinstated at a micro amount. It is a sub-lingually absorbed wafer, so I wouldn't be able to water titrate it and do a micro-withdrawal anyway, the lowest I could ever accurately go would be 1.25mg (quarter of a 5mg wafer). So as I see it I'm now stuck to ride out this hell for however long it lasts.

 

I don't think being on Mirtazapine is doing me any good, except for at least at the moment providing me with some sleep. I'm tempted to try lowering the dose so I'm mainly subjected to the sedative effects of it acting on histamine receptors rather than the serotonergic and adrenergic increases it causes at higher doses. However god have mercy on me if that causes any rebound anxiety.  

 

I've been  valium for 3 weeks now. I really, really did not want to become a benzo addict and started off for the first 1.5 weeks by taking just 1.25mg twice a day. However I now have to take 2.5mg twice a day to stay semi-calm, thanks to what I'm guessing is a tolerance starting to build. I've now succumbed to the fact that there's probably no way out of this without developing a valium addiction. At least I'll be informed on how to sensibly withdraw from that when the time comes. 

 

I just wish (like I'm sure so many others have in my situation) I knew when things are going to start to become a little bit more bearable. In the 2 months I've been off asenapine I've had Zero windows, absolutely not a minute of my life has been anything other than agony. 

 

..  Wow I've surprised myself with how calm I managed to remain to get all this typed up.

 

 

 

 

Past use of Pritiq, Escitalopram, Lithium and Valproate. All ceased with no withdrawal experienced. 

07/2013- Started 10mg Asenapine (Saphris) an AAP 

01/2014- Given 2 week taper by doc

02/2014- Experienced absolutely excruciating anxiety and insomnia

02/2014- Tried reinstating at 5mg but had akathisia attack that hospitalised me

03/2014- Prescribed Doxepin and then Mirtazapine and Diazapam for 'agitated depression'

04/2014 - New Psychiatrist. Willing to empower me to get drug free. Started 50mg Chlorpromazine as an alternative to reinstating Asenapine. Rapidly tapered off the Doxepin and Mirtazapine.

  Currently: 45mg Chlorpromazine, 2.5mg Diazapam. 

  Supplements: Fish oil, Vitamin E, Vitamin C, Magnesium

 

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  • Administrator

Welcome, acetyl.

 

I'm very sorry you've gone through this. It sounds like you had adverse reactions to asenapine from the start, and going on and off drugs has additionally hurt your nervous system.

 

Often, we suggest going back on a tiny amount of the drug, such as 0.5mg to quell withdrawal symptoms such as sleeplessness, etc. -- but in your case, I hesitate to suggest it.

 

You need a physician champion. You might be able to consult with Dr. Rob Purssey http://survivingantidepressants.org/index.php?/topic/988-recommended-doctors-therapists-or-clinics/?p=47108

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

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Thank you Alto.

 

I've emailed Rob, fingers crossed he gets back to me soon.

Past use of Pritiq, Escitalopram, Lithium and Valproate. All ceased with no withdrawal experienced. 

07/2013- Started 10mg Asenapine (Saphris) an AAP 

01/2014- Given 2 week taper by doc

02/2014- Experienced absolutely excruciating anxiety and insomnia

02/2014- Tried reinstating at 5mg but had akathisia attack that hospitalised me

03/2014- Prescribed Doxepin and then Mirtazapine and Diazapam for 'agitated depression'

04/2014 - New Psychiatrist. Willing to empower me to get drug free. Started 50mg Chlorpromazine as an alternative to reinstating Asenapine. Rapidly tapered off the Doxepin and Mirtazapine.

  Currently: 45mg Chlorpromazine, 2.5mg Diazapam. 

  Supplements: Fish oil, Vitamin E, Vitamin C, Magnesium

 

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  • Moderator Emeritus

Hi Acetyl, I am really sorry that you are going through this and hope Dr Purssey can help you.

**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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Dr Rob Purssey has gotten back to me and is willing to commence Skype sessions on Tuesday. This feels like a big gamble, relying on a psychiatrist over the internet, but it may be my only way out of this mess.

Past use of Pritiq, Escitalopram, Lithium and Valproate. All ceased with no withdrawal experienced. 

07/2013- Started 10mg Asenapine (Saphris) an AAP 

01/2014- Given 2 week taper by doc

02/2014- Experienced absolutely excruciating anxiety and insomnia

02/2014- Tried reinstating at 5mg but had akathisia attack that hospitalised me

03/2014- Prescribed Doxepin and then Mirtazapine and Diazapam for 'agitated depression'

04/2014 - New Psychiatrist. Willing to empower me to get drug free. Started 50mg Chlorpromazine as an alternative to reinstating Asenapine. Rapidly tapered off the Doxepin and Mirtazapine.

  Currently: 45mg Chlorpromazine, 2.5mg Diazapam. 

  Supplements: Fish oil, Vitamin E, Vitamin C, Magnesium

 

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Hi,

 

I'm in severely protracted withdrawals from the AAP Asenapine. My psychiatrist refused to acknowledge this and diagnosed me having severe agitated depression and prescribed 30mg Mirtazapine. I obliged and have taken it now for 3 weeks, but besides the initial sedation it provided which helped with sleep it has done nothing to halt the severe anxiety that wd is causing. 

 

I think the best thing to do is get off this drug, because if anything I feel it is harming my recovery from asenapine withdrawal. However it would be good to get some advice from people here on a) whether to continue or discontinue it at this stage and B) how to go about getting off it (can I afford a relatively fast taper having taken it for only 3 weeks?)

Past use of Pritiq, Escitalopram, Lithium and Valproate. All ceased with no withdrawal experienced. 

07/2013- Started 10mg Asenapine (Saphris) an AAP 

01/2014- Given 2 week taper by doc

02/2014- Experienced absolutely excruciating anxiety and insomnia

02/2014- Tried reinstating at 5mg but had akathisia attack that hospitalised me

03/2014- Prescribed Doxepin and then Mirtazapine and Diazapam for 'agitated depression'

04/2014 - New Psychiatrist. Willing to empower me to get drug free. Started 50mg Chlorpromazine as an alternative to reinstating Asenapine. Rapidly tapered off the Doxepin and Mirtazapine.

  Currently: 45mg Chlorpromazine, 2.5mg Diazapam. 

  Supplements: Fish oil, Vitamin E, Vitamin C, Magnesium

 

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  • Moderator Emeritus

Hi acetyl,

I moved your post in tapering here to your thread, this is the best place to discuss your particular situation because it has all you background information.

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

Is the mirtazapine helping your sleep at all?

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'd say the sedation is what allows me to fall asleep each night.

Past use of Pritiq, Escitalopram, Lithium and Valproate. All ceased with no withdrawal experienced. 

07/2013- Started 10mg Asenapine (Saphris) an AAP 

01/2014- Given 2 week taper by doc

02/2014- Experienced absolutely excruciating anxiety and insomnia

02/2014- Tried reinstating at 5mg but had akathisia attack that hospitalised me

03/2014- Prescribed Doxepin and then Mirtazapine and Diazapam for 'agitated depression'

04/2014 - New Psychiatrist. Willing to empower me to get drug free. Started 50mg Chlorpromazine as an alternative to reinstating Asenapine. Rapidly tapered off the Doxepin and Mirtazapine.

  Currently: 45mg Chlorpromazine, 2.5mg Diazapam. 

  Supplements: Fish oil, Vitamin E, Vitamin C, Magnesium

 

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  • Administrator

What about the diazepam? Did that alone help you sleep?

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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It's hard to say as they were both prescribed at relatively the same time.

 

My gut instinct says I'll be sleeping very rough if the Mirtazapine is withdrawn, for how long though I don't know.

Past use of Pritiq, Escitalopram, Lithium and Valproate. All ceased with no withdrawal experienced. 

07/2013- Started 10mg Asenapine (Saphris) an AAP 

01/2014- Given 2 week taper by doc

02/2014- Experienced absolutely excruciating anxiety and insomnia

02/2014- Tried reinstating at 5mg but had akathisia attack that hospitalised me

03/2014- Prescribed Doxepin and then Mirtazapine and Diazapam for 'agitated depression'

04/2014 - New Psychiatrist. Willing to empower me to get drug free. Started 50mg Chlorpromazine as an alternative to reinstating Asenapine. Rapidly tapered off the Doxepin and Mirtazapine.

  Currently: 45mg Chlorpromazine, 2.5mg Diazapam. 

  Supplements: Fish oil, Vitamin E, Vitamin C, Magnesium

 

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  • Administrator

It may take a while for your nervous system to settle down, even with all that sedation.

 

Please let us know about your conversation with Dr. Purssey.

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 travelled up to Brisbane to have my appointment with Dr Robert Purssey in person.

 

All I can say is thank you so much Alto for putting me in contact with him. He was extremely knowledgeable on psycho-pharmacology and withdrawal and was appalled at the treatment I'd received through 'modern psychiatry'. He has provided me with an extensive amount of resources on topics to help me through this tough time and to better my life once I'm more stabilised. 

 

He acknowledged what I suspected all along, that Asenapine's high Dopamine D2 receptor affinity is responsible for the extremely agitated state I'm stuck in currently. 

 

For medication regime he has laid out the following:

 

1.       DIAZEPAM 2.5MG twice a day; and can use another 2.5mg bd as required.

 

 

2.       MIRTAZAPINE 15MG AT NIGHT

 

 

3.       LARGACTIL 50MG AT NIGHT to begin with, this should substitute for the 15mg mirtazpine.

 

 

If you’re still really struggling to sleep, use another 50-100mg of LARGACTIL. See also www.thesleepschool.org and the resources there.

 

 

This is NOT for long term, simply to find a sustainable replacement dose prior to beginning the taper.

 

I'll begin this regime tonight and have a follow up appointment with him via skype on Thursday.

 

 

He mentioned that you write some terrific blogs Alto. Thanks so much again for putting me in contact with him.

Past use of Pritiq, Escitalopram, Lithium and Valproate. All ceased with no withdrawal experienced. 

07/2013- Started 10mg Asenapine (Saphris) an AAP 

01/2014- Given 2 week taper by doc

02/2014- Experienced absolutely excruciating anxiety and insomnia

02/2014- Tried reinstating at 5mg but had akathisia attack that hospitalised me

03/2014- Prescribed Doxepin and then Mirtazapine and Diazapam for 'agitated depression'

04/2014 - New Psychiatrist. Willing to empower me to get drug free. Started 50mg Chlorpromazine as an alternative to reinstating Asenapine. Rapidly tapered off the Doxepin and Mirtazapine.

  Currently: 45mg Chlorpromazine, 2.5mg Diazapam. 

  Supplements: Fish oil, Vitamin E, Vitamin C, Magnesium

 

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  • Administrator

Very interesting. So glad Dr. Purssey was understanding. It sounds like he's using good reasoning.

 

He's organizing a group of doctors worldwide to aid in withdrawal.

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'm learning excellent skills and being provided with a wealth of really good information, documents, books and materials to really better me as a person through Dr Purssey. It's the type of treatment I really wish I'd received years ago when I first went to see psychologists/psychiatrists. If I wasn't in extremely protracted withdrawals, I think I'd already be experiencing significant improvements in my life and the way I go about handling my emotions and thoughts on a daily basis.

 

The Largactil after 2 nights sadly hasn't lessened my constant anxiety and agitation though. There's some room to up the dose but I'm afraid it may more be a case that 2 months was too longer time for reinstatement to be effective. 

 

The plan now is to discontinue the Mirtazapine. As Largactil hits basically all the receptors (and more) as Mirtazapine, it's not envisioned discontinuing should cause any major issues. The low diazapam usage is to continue at the moment, till the anxiety hopefully becomes more controlled. 

 

Expecting a few more rough days, but hopefully over the coming weeks I'll start to have some windows of peace...

Past use of Pritiq, Escitalopram, Lithium and Valproate. All ceased with no withdrawal experienced. 

07/2013- Started 10mg Asenapine (Saphris) an AAP 

01/2014- Given 2 week taper by doc

02/2014- Experienced absolutely excruciating anxiety and insomnia

02/2014- Tried reinstating at 5mg but had akathisia attack that hospitalised me

03/2014- Prescribed Doxepin and then Mirtazapine and Diazapam for 'agitated depression'

04/2014 - New Psychiatrist. Willing to empower me to get drug free. Started 50mg Chlorpromazine as an alternative to reinstating Asenapine. Rapidly tapered off the Doxepin and Mirtazapine.

  Currently: 45mg Chlorpromazine, 2.5mg Diazapam. 

  Supplements: Fish oil, Vitamin E, Vitamin C, Magnesium

 

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  • Administrator

Very good to hear!

 

Please keep notes of your daily symptom pattern on paper, plus when you take your drugs and their dosages.

 

It's possible you're also experiencing a paradoxical reaction or rebound from the benzo.

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'm starting to stabilize. It took a good 4 days of being on Largactil before the anxiety started lowering and I sleep went back to normal. On a scale I'd say I now feel like a 6/10 whereas only a week ago I was a 1/10. The last 2 days I've taken just a smidgen of diazapam (~0.5mg) morning and night and haven't noticed any worsening of the anxiety or cravings of any kind. Dr Purssey is away for the Easter break but once I've had another session with him I think we should be able to drop the diazapam and then give it a few more weeks before starting a very slow taper off Largactil. Unfortunately being back on a dopamine blocker has meant my tremor has flared up again, but still not near the level when I was on Asenapine. 

Past use of Pritiq, Escitalopram, Lithium and Valproate. All ceased with no withdrawal experienced. 

07/2013- Started 10mg Asenapine (Saphris) an AAP 

01/2014- Given 2 week taper by doc

02/2014- Experienced absolutely excruciating anxiety and insomnia

02/2014- Tried reinstating at 5mg but had akathisia attack that hospitalised me

03/2014- Prescribed Doxepin and then Mirtazapine and Diazapam for 'agitated depression'

04/2014 - New Psychiatrist. Willing to empower me to get drug free. Started 50mg Chlorpromazine as an alternative to reinstating Asenapine. Rapidly tapered off the Doxepin and Mirtazapine.

  Currently: 45mg Chlorpromazine, 2.5mg Diazapam. 

  Supplements: Fish oil, Vitamin E, Vitamin C, Magnesium

 

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  • Administrator

When with Dr. Purssey be back?

 

Did he think that dosage of Largactil was approximately the same as the Saphris? Is it possible to take a little less to reduce the adverse effects?

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

Be careful with dropping that diazepam so fast. You've been taking high enough amounts for long enough to develop dependence. Valium has long-acting metabolites that produce a sedative effect for days. So the fact that you feel okay two days later doesn't mean much. It's five to seven days later that you need to be looking at.

 

If you have any increase in anxiety symptoms over this next week, I'd recommend tapering it. You might do okay with shorter holds and larger cuts. The problem is, like I say, with Valium, you can't really tell by how you feel the next day or even the next few days, whether or not you've cut too much. You won't really feel the withdrawal until many days after cutting it. Usually by about a week or two is when people really get hit.

 

Please be cautious. You've come through a very rough time and you're starting to settle. I'd hate to see you knock yourself back down.

 

If you have more questions about this, start a thread in the benzo section and PM me and let me know that you did, and I'll meet you over there.

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

 

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

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I've got my next appointment with him on the 24th. He approximated that 50mg would equilibrate things, but was inclined to suggest it may take even more (rather than less) to really settle things down. Having taken 50mg for a week now, I'm finding it's enough that I don't have a melt down, but it's still far removed from a comfortable or even functional existence. So the plan is to at least maintain 50mg and live with a tremor until my next appointment.

 

 

That's a bit disheartening to hear Rhi :( When I was prescribed diazapam 4 weeks ago I was adamant not to let myself fall in to addiction. For the first 2-3 weeks I would be given 2.5mg, break off a crumb, take that and flush the remainder down the toilet. Only for approximately 10 days, when things got really scary did I cave in and start taking 2.5mg twice a day. If there's a notable step backwards in the coming week, I'll succumb to having developed some dependence and determine how much I need to take to stabilise and taper from.

Past use of Pritiq, Escitalopram, Lithium and Valproate. All ceased with no withdrawal experienced. 

07/2013- Started 10mg Asenapine (Saphris) an AAP 

01/2014- Given 2 week taper by doc

02/2014- Experienced absolutely excruciating anxiety and insomnia

02/2014- Tried reinstating at 5mg but had akathisia attack that hospitalised me

03/2014- Prescribed Doxepin and then Mirtazapine and Diazapam for 'agitated depression'

04/2014 - New Psychiatrist. Willing to empower me to get drug free. Started 50mg Chlorpromazine as an alternative to reinstating Asenapine. Rapidly tapered off the Doxepin and Mirtazapine.

  Currently: 45mg Chlorpromazine, 2.5mg Diazapam. 

  Supplements: Fish oil, Vitamin E, Vitamin C, Magnesium

 

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  • Administrator

Yes, it might take some time for you to stabilize on 50mg. I worry about that tremor, though. You've already discussed it with him?

 

I agree with Rhi, I would hold on changing the benzo dosage while you're stabilizing. Benzo withdrawal symptoms could complicate things immensely. What did Dr. Purssey say about that?

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'll raise it again with him, particular that the tremor has increased. Still though it is honestly nothing like what it was like when I was on Asenapine. It's not tardive dyskinesia, it's like an essential tremor that is only present when performing fine motor skills. It's frustrating though, I use to have great fine motor skills as were needed when I worked in a laboratory doing mammalian cell culture and transfections  :(

 

In terms of the diazapam, Dr Purssey's directions were I could try tapering it slightly, but not to worry if I found that too hard. So I' am guilty of tapering more than what could be considered slightly. The thought process in my mind was that 2-4 weeks is considered by the medical profession as the longest time you can be on a benzodiazepine before dependency develops, so I want to get the hell off it whilst that window still exists without having to do a long taper. Because I don't need it now, I'm literally only taking it in-case there are some withdrawal symptoms, in which case I'd like to establish what the smallest dose possible is to prevent them. But I do completely understand how complicated and ugly things could become if the brain is thrown in to further chaos with benzo withdrawal. 

Past use of Pritiq, Escitalopram, Lithium and Valproate. All ceased with no withdrawal experienced. 

07/2013- Started 10mg Asenapine (Saphris) an AAP 

01/2014- Given 2 week taper by doc

02/2014- Experienced absolutely excruciating anxiety and insomnia

02/2014- Tried reinstating at 5mg but had akathisia attack that hospitalised me

03/2014- Prescribed Doxepin and then Mirtazapine and Diazapam for 'agitated depression'

04/2014 - New Psychiatrist. Willing to empower me to get drug free. Started 50mg Chlorpromazine as an alternative to reinstating Asenapine. Rapidly tapered off the Doxepin and Mirtazapine.

  Currently: 45mg Chlorpromazine, 2.5mg Diazapam. 

  Supplements: Fish oil, Vitamin E, Vitamin C, Magnesium

 

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  • Administrator

It could be you'd do as well with a little less Largactil.

 

If I were you, I'd hold on tapering the benzo, and not worry about dependency for the time being as reducing it may make stabilizing on Largactil more difficult.

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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It'd be nice to think so, as I was doing the Math last night and 50mg - 0mg will take 13 - 18 months.

Past use of Pritiq, Escitalopram, Lithium and Valproate. All ceased with no withdrawal experienced. 

07/2013- Started 10mg Asenapine (Saphris) an AAP 

01/2014- Given 2 week taper by doc

02/2014- Experienced absolutely excruciating anxiety and insomnia

02/2014- Tried reinstating at 5mg but had akathisia attack that hospitalised me

03/2014- Prescribed Doxepin and then Mirtazapine and Diazapam for 'agitated depression'

04/2014 - New Psychiatrist. Willing to empower me to get drug free. Started 50mg Chlorpromazine as an alternative to reinstating Asenapine. Rapidly tapered off the Doxepin and Mirtazapine.

  Currently: 45mg Chlorpromazine, 2.5mg Diazapam. 

  Supplements: Fish oil, Vitamin E, Vitamin C, Magnesium

 

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  • Moderator Emeritus

You might also do okay on a smaller dose of Valium. 5 mg to zero is a big drop. You could maybe cushion that. In the US it comes in a 2 mg tablet and you could take one of those or even half of one.

 

The business of official windows is far from precise and the science is poor. People vary a lot even if it's the only neuroleptic they've ever used, and those studies were not done on people already in withdrawal from other drugs and already sick. I have found with people in withdrawal, where benzos are concerned, all bets are off. Not to say it won't work for you, just be aware.

 

Pay attention to your symptoms--reinstatement works if it's done right away, but with benzos it's even iffier than with ADs if you let too much time lapse.

 

Dr. Purssey sounds trustworthy to me.

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

 

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

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  • 2 weeks later...

Another good session with Dr. Purssey in terms of learning new psychological techniques for dealing with these difficult emotions and thoughts. However I feel even he underestimates how debilitating the anxiety and feeling of being lobotomised is for me. On a scale I feel like  the absolute highest anxiety I ever experienced prior to this, such as before sitting a finals exam, was a 4/10. During the 8 weeks I was essentially cold turkey off Asenapine the anxiety was a 10/10. Now having started Largactil it's down to a 8/10. He's talking about getting me back in the workforce within a month, which I just feel would require something close to a miracle to be possible. 

 

He actually said I could try dropping the Largactil from 50 to 25mg. I thought this was a bit extreme so I asked if we could go slower and it was decided to drop to 40mg (still a 20% drop!). I did this last night and still slept fine, so that's a relief. Now this morning I feel like my agitation is a bit higher than it was yesterday, but it's hard to say if that's a result of over-analysing it or due to actual the dose drop. I guess if it gets markedly worse over the next 4-5 days I'll know that was too bigger drop.

 

In terms of diazapam. I did start to feel quite queasy after 5-6 days off it, so I reinstated at 1.25mg twice a day. This got rid of the nausea within 24 hours. The rough plan will be to maintain this for another week, then just 1.25mg at night, then 1mg, then 0.5mg and off probably over the next 4-8 weeks. 

Past use of Pritiq, Escitalopram, Lithium and Valproate. All ceased with no withdrawal experienced. 

07/2013- Started 10mg Asenapine (Saphris) an AAP 

01/2014- Given 2 week taper by doc

02/2014- Experienced absolutely excruciating anxiety and insomnia

02/2014- Tried reinstating at 5mg but had akathisia attack that hospitalised me

03/2014- Prescribed Doxepin and then Mirtazapine and Diazapam for 'agitated depression'

04/2014 - New Psychiatrist. Willing to empower me to get drug free. Started 50mg Chlorpromazine as an alternative to reinstating Asenapine. Rapidly tapered off the Doxepin and Mirtazapine.

  Currently: 45mg Chlorpromazine, 2.5mg Diazapam. 

  Supplements: Fish oil, Vitamin E, Vitamin C, Magnesium

 

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An interesting table I found on a study that determined equivalent doses of all antipsychotics to 100mg Chlorpromazine (Largacti, Thorzaine). It gave me some comfort that 40mg is only the equivalent of 2mg of Zyprexa, which I consider relatively similar to Saphris in potency. 

 

www.scottwilliamwoods.com/files/Equivtext.doc 

Past use of Pritiq, Escitalopram, Lithium and Valproate. All ceased with no withdrawal experienced. 

07/2013- Started 10mg Asenapine (Saphris) an AAP 

01/2014- Given 2 week taper by doc

02/2014- Experienced absolutely excruciating anxiety and insomnia

02/2014- Tried reinstating at 5mg but had akathisia attack that hospitalised me

03/2014- Prescribed Doxepin and then Mirtazapine and Diazapam for 'agitated depression'

04/2014 - New Psychiatrist. Willing to empower me to get drug free. Started 50mg Chlorpromazine as an alternative to reinstating Asenapine. Rapidly tapered off the Doxepin and Mirtazapine.

  Currently: 45mg Chlorpromazine, 2.5mg Diazapam. 

  Supplements: Fish oil, Vitamin E, Vitamin C, Magnesium

 

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  • Administrator

Dr. Purssey might need more information about how withdrawal syndrome makes many people hypersensitive to all kinds of things. Please calmly work with him on this.

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've talked to doctor Purssey and we are at an agreement to go as slow as is necessary. However it's become an extremely delicate balancing act as this tremor and the muscle twitches especially in my jaw are starting to scarily resemble TD. 

 

My brain just needs some damn stability though, so the plan now is to give it a month without changing a thing. 

 

I made a video, it was quite therapeutic to do and hopefully it might help anyone who finds themselves in my situation.

 

Past use of Pritiq, Escitalopram, Lithium and Valproate. All ceased with no withdrawal experienced. 

07/2013- Started 10mg Asenapine (Saphris) an AAP 

01/2014- Given 2 week taper by doc

02/2014- Experienced absolutely excruciating anxiety and insomnia

02/2014- Tried reinstating at 5mg but had akathisia attack that hospitalised me

03/2014- Prescribed Doxepin and then Mirtazapine and Diazapam for 'agitated depression'

04/2014 - New Psychiatrist. Willing to empower me to get drug free. Started 50mg Chlorpromazine as an alternative to reinstating Asenapine. Rapidly tapered off the Doxepin and Mirtazapine.

  Currently: 45mg Chlorpromazine, 2.5mg Diazapam. 

  Supplements: Fish oil, Vitamin E, Vitamin C, Magnesium

 

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  • Administrator

Very brave, acetyl.

 

I think Rxisk.org might be interested in your video, also cepuk.com http://cepuk.org/recovery-stories/

 

I was struck by your description of the neurological basis of antipsychotic withdrawal starting at about 14:25. You may wish to join this discussion http://survivingantidepressants.org/index.php?/topic/6036-why-taper-paper-demonstrates-importance-of-gradual-change-in-plasma-concentration/

 

We suggest a taper schedule based on decreasing no more than 10% of the last dosage right off, maintaining the relative reduction. The absolute reduction gets progressively smaller. Rather than adjusting if severe withdrawal occurs, this avoids triggering neurological disruption, which can persist even if dosage adjustment is made.

 

Oh, meant to add: Perhaps you could reduce the Largactil 50mg by 2mg for the tremors?

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

Great video acetyl and lots of helpful advice.  You are young and haven't been on these drugs very long,  I'm sure you will recover completely and in the process, will learn some valuable skills to use for the rest of your life.

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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Anxiety has gone to hell again, trying to stay alive is requiring all the effort I can muster... so scared, arghhh can this please go away, I don't want to die.

 

I saw an article you did Altostrata:

http://beyondmeds.com/2010/07/14/gabaglutamate/

 

I think that's what has happened to me, I just don't know how much longer I  can suffer from it before the urge to self harm overcomes me :(

Past use of Pritiq, Escitalopram, Lithium and Valproate. All ceased with no withdrawal experienced. 

07/2013- Started 10mg Asenapine (Saphris) an AAP 

01/2014- Given 2 week taper by doc

02/2014- Experienced absolutely excruciating anxiety and insomnia

02/2014- Tried reinstating at 5mg but had akathisia attack that hospitalised me

03/2014- Prescribed Doxepin and then Mirtazapine and Diazapam for 'agitated depression'

04/2014 - New Psychiatrist. Willing to empower me to get drug free. Started 50mg Chlorpromazine as an alternative to reinstating Asenapine. Rapidly tapered off the Doxepin and Mirtazapine.

  Currently: 45mg Chlorpromazine, 2.5mg Diazapam. 

  Supplements: Fish oil, Vitamin E, Vitamin C, Magnesium

 

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You're gonna be okay, Acetyl. I know right now it feels impossible to believe, but you are. The voice of withdrawal is trying to silence the truth which is that you're gonna be okay.

 

I can't advise on tapering as I'm very new and learning but I'm sure someone with better knowledge will be along.

 

Just wanted you to know that you have support. A window is coming. You're in the thick of it right now but it will get better in time. Keep walking through. There is a finishing line, you just haven't reached it yet.

 

Your video is great and inspiring. Your brain may feel completely fried (I have a mashed brain at the moment so I relate) but you come across as very intelligent and coherent.

 

The words 'at the moment' always help me. I try hard to think of things as 'at the moment'. This is all temporary. Better days are coming.

 

Take care.

The only way out is through.

 

Aug 2013 - Augmentin leading to akathisia

Sept-Nov 2013 - Citalopram 20mg, severe reaction, off at 5mg. Valium 4mg, prn

Oct 2013 - 5 zopiclone tablets, 7.5mg

End Nov 2013-end Feb 2014, Seroquel, top dose 150mg, off at 25mg

End Nov 2013-early march 2014, Zoloft 100mg top dose, off at 25mg

End Dec-2013-early April 2014, lorazepam 1mg prn

April 3rd 2014 zoloft 5mg for a few days. 18/4/14 - zoloft, 1mg. Came off at 0.35 mg,14th June 2014

29 June 2014 - 1mg lorazepam, last ever

29 June 2014 - med free

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  • Administrator

acetyl, hang in there. You'll get through this and show those bastids.

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
  • Moderator Emeritus

We are so used to healing from things being a linear process, that this strange back and forth pattern can cause a lot of confusion and added anxiety.  Every time I get worse after feeling a little better, it really knocks me back and I feel hopeless and discouraged, so I understand what you are going through.

 

But hang in there, one day at a time, one hour at a time and another window will come.  You will get through this and be stronger and wiser because of it.  Reading through the windows and waves topic again may help.

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

Thank you for the support.

 

This anxiety is just so intense and it doesn't come and go in waves, it is just absolutely constant. I know some of you on here have been in withdrawal for years and years and I just can't stand the thought of feeling like this for that long, it will kill me. So scared :(

 

I'm looking in to supplements again (phosphatidyl serine, L-theanine, L-glycine) but typical Australia , nothing is available or it's grossly expensive.

Past use of Pritiq, Escitalopram, Lithium and Valproate. All ceased with no withdrawal experienced. 

07/2013- Started 10mg Asenapine (Saphris) an AAP 

01/2014- Given 2 week taper by doc

02/2014- Experienced absolutely excruciating anxiety and insomnia

02/2014- Tried reinstating at 5mg but had akathisia attack that hospitalised me

03/2014- Prescribed Doxepin and then Mirtazapine and Diazapam for 'agitated depression'

04/2014 - New Psychiatrist. Willing to empower me to get drug free. Started 50mg Chlorpromazine as an alternative to reinstating Asenapine. Rapidly tapered off the Doxepin and Mirtazapine.

  Currently: 45mg Chlorpromazine, 2.5mg Diazapam. 

  Supplements: Fish oil, Vitamin E, Vitamin C, Magnesium

 

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