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Hearsbirds: Lithium to taper off neuroleptics?


hearsbirds

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My daughter wants to get off her psych meds.  She has been gradually tapering off klonopin, and is down to .25 mg once a day.  She plans to cut that in half at the end of this week and then stop entirely after two weeks at that dose.  She has not had any adverse reactions to that taper, and her symptoms of slurred speech and protruding tongue have gotten better.  She's also brighter and more alert, less depressed, since tapering the klonopin.

 

She met with her psychiatrist today and told him she wants to get off her "anti-psychotic" -- invega -- next.  He said he wants to put her on lithium if she goes off the invega so that she'll have "something to prevent psychotic relapse."  He warned her that 50% of people with "bipolar disorder" do relapse.  She mentioned to him the recent 20-year study showing that people do better longterm without neuroleptics.  He told her that was probably a study of schizophrenia, not "bi-polar disorder."  (Actually the Harrow study followed both, but the conclusions of the study concern schizophrenia.)

 

So, his plan for her is to put her on lithium and test her blood levels, and once that levels out, to start an invega taper to get her off that over the period of just one month.  She told him she thinks the taper off invega should not be so fast, but should be over several months.

 

I'm pretty frustrated that the doctor just wants to substitute one toxic substance (invega) for another toxic substance (lithium).  I'm also disturbed that he would have her on both at the same time, and that he would have her withdraw from the invega over just one month.  I also don't think she should start tapering a new drug until she finishes tapering the klonopin.

 

Problem is my daughter doesn't do the research herself, she relies on me to do it because she cannot really concentrate and lacks internet research skills.  Then she talks to her psychiatrist and doesn't know whether to believe what he tells her or not, since she hasn't read the studies, and she begins to doubt.  She's afraid the doctor won't let her go off the invega if she doesn't take the lithium. 

 

Any suggestions about what to do next?  I'm thinking we need to find her a new prescribing psychiatrist.  Trouble with that is that she is currently with the County mental health services, and if she goes outside that, then she might lose her eligibility for assisted housing support that she's trying to get into.

 

We' re in San Francisco, CA.  Does anyone have any suggestions about doctors and/or clinics she could work with?  She's on Medicare and disability.

 

Thanks.

 

~Mom

 

 

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  • Moderator Emeritus

Hi Mom,

Welcome and thank your for posting an introduction on behalf of your daughter.  I'm sorry your daughter is going through this and I completely agree that she needs a new doctor.

 

I'm not sure how the system works there, but I found a doctor from our list of recommended practitioners in your area:

 

Paul Abramson, MD, San Francisco, CA

 

Perhaps others will have some ideas which may help.

 

You will find a lot of friendly support here.

 

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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How did she arrive at a bipolar diagnosis? You can see from my signature that I am on the bipolar-from-antidepressant journey. It's complicated--I would be glad to write more if you can provide more details.

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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  • Moderator Emeritus

Hi Mom, I have a bipolar diagnosis too from when I was put on psychiatrisc drugs 20 years ago

and  had what I now know was terrible side effects. Doctors told me I had bi-polar and needed drugs

for life.  I am now almost drug free :)

 

I am so glad that your daughter has you to look out for her and fight her corner.  If it were me I would

just continue to get the prescription and taper on my own. Doctors rarely know how to taper and

themselves believe the hype that the drugs companies give them!  

 

If your daughter is up to reading I recommend Anatomy of an Epidemic by Robert Whitaker, it is 

a real eye opener! 

**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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  • Administrator

Welcome, Hearsbirds.

 

It sounds like your daughter has been suffering from a drug-drug interaction between Klonopin and Invega http://www.drugs.com/interactions-check.php?drug_list=1781-2498,703-357&professional=1

 

It also seems your daughter is experiencing tardive dyskinesia from the Invega. Klonopin may be helping control that http://emedicine.medscape.com/article/287230-overview

 

Your doctor should have been concerned about both types of adverse effects. At the appearance of TD, he should have immediately thought of reducing Invega.

 

If I were you, I might hold on the Klonopin taper for the time being, then switch to tapering Invega with a cooperative doctor.

 

Yes, you may need to find a different doctor.

 

How much Invega is she on? It comes in 1.5mg tablets http://www.drugs.com/pro/invega.html

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

Hi Hearsbirds, you have come to the right place.  There are so many wise people in here that I am grateful for.

 

I am on lithium, and I have that dreaded "bipolar" tag stamped on my forehead.

 

The problem with lithium is that once you are on it, no psych doctor worth their weight in Prozac will ever let someone off of it without first introducing another awful medicine - like another neuroleptic or lamotrigine (anti-seizure med).

 

Only our special "Mad In America" and "SA" doctors will even CONSIDER removal of lithium.  This is the battle I am facing in my own journey.  Every time I go to my pdoc, we vacillate between "you're doing very well," and "I would NEVER do THAT" (taper the lithium).

 

And here's the rub:  I've only ever had one manic episode, with small visits to hypomania land.  BUT - NOW THAT I AM ON LITHIUM, if I discontinue it, I am 4x to 10x more likely to experience a manic episode,than before the drug and it is likely to be more intense than anything I experienced before the drug.  That tells me that what it does to my brain is less than helpful.

 

You have to decide for yourself and your daughter.  Lithium is also neuroprotective - and might heal some of the damage done by the neuroleptic.  You might look at www.psycheducation.org - while I do NOT agree with everything he says, it is an exhaustive look at the dominant studies and thinking about bipolar and lithium.  He has a lot of suggestions for diet, light and dark therapy, and information about lithium, dangers, side effects, and benefits.

 

And yes, a different doc is a stellar idea, and if there's one suggested here it is worth any extra driving you may have to make.

"Easy, easy - just go easy and you'll finish." - Hawaiian Kapuna

 

Holding is hard work, holding is a blessing. Give your brain time to heal before you try again.

 

My suggestions are not medical advice, you are in charge of your own medical choices.

 

A lifetime of being prescribed antidepressants that caused problems (30 years in total). At age 35 flipped to "bipolar," but was not diagnosed for 5 years. Started my journey in Midwest United States. Crossed the Pacific for love and hope; currently living in Australia.   CT Seroquel 25 mg some time in 2013.   Tapered Reboxetine 4 mg Oct 2013 to Sept 2014 = GONE (3 years on Reboxetine).     Tapered Lithium 900 to 475 MG (alternating with the SNRI) Jan 2014 - Nov 2014, tapered Lithium 475 mg Jan 2015 -  Feb 2016 = GONE (10 years  on Lithium).  Many mistakes in dry cutting dosages were made.


The tedious thread (my intro):  JanCarol ☼ Reboxetine first, then Lithium

The happy thread (my success story):  JanCarol - Undiagnosed  Off all bipolar drugs

My own blog:  https://shamanexplorations.com/shamans-blog/

 

 

I have been psych drug FREE since 1 Feb 2016!

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  • Administrator
.... BUT - NOW THAT I AM ON LITHIUM, if I discontinue it, I am 4x to 10x more likely to experience a manic episode,than before the drug and it is likely to be more intense than anything I experienced before the drug.  That tells me that what it does to my brain is less than helpful.

 

You have to decide for yourself and your daughter.  Lithium is also neuroprotective - and might heal some of the damage done by the neuroleptic.....

 

JanCarol, psychiatric drug discontinuation studies generally do not take into account withdrawal symptoms, which are counted as "relapse." As for "neuroprotective" -- that may be a myth as well. SSRIs are also claimed to be "neuroprotective."

 

I agree with you, though, taking lithium may be jumping from frying pan to fire if you want to go off psychiatric drugs.

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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  • 4 months later...

Thanks, all for your replies.  To fill you in since April -- my daughter did get off the Klonopin as scheduled.  Two weeks later she started having chest pains and rapid heart beats that frightened her -- thinking she was having a heart attack.  I took her to emergency room twice for racing heartbeats.  Fortunately, the ER doc thought it was probably withdrawal symptoms from the Konopin and didn't drug her up with Ativan, as first suggested.  After that passed, a couple of weeks later -- mid-May -- she had a period of "paranoid ideation" where she believed that evil people were coming in a car to get her.  This lasted for about 2 weeks.  We were able to get through that together with "reality checks" in the driveway to see that there was no one there, and she was able to soothe and "talk herself down" after doing it with me several times.

 

Also, her psychiatrist switched her from Invega to Risperidone when the paranoid thinking started.  When next she saw him and told him she was better, he said he thought it was the drug change.  She said "No, I calmed myself down."  Bless her heart!

 

I didn't mention in my first post that she was also taking Isoniazid since last September as a result of a positive TB test.  The protocol for that is to take it for 9 months and then cold turkey off of it.  However, through some research on my part I discovered that it is an MAOI, in fact one of the first MAOI ever used for depression, though it is no longer used for depression.  So, when her 9 month course of treatment was over at the end of July, I convinced her primary care physician to taper it off at 10% reductions.  Doctor wanted to do 10% reduction every week.  We compromised at 10% reduction every 2 weeks.

 

At that point (end of May) she was taking 3 mg/day of Risperidone and 300 mg/day of Topiramate + 30 mg/day of Isoniazid.

 

On July 30th she switched from tablet to liquid Isoniazid and reduced her dose to 27 mg/day for 2 weeks with no issues.  Then reduced to 24 mg/day on August 4th.  She started having chest pains on Aug 13th and had them every day for the next week and her pulse was going up to around 110-115.

 

We decided not to reduce her Isoniazid dose until she stabilized.

 

Then, in the morning on 8/24, her pulse went up to 143 & I called the paramedics.  By the time they came her heart rate was down to 120.  She thought she would be OK and decided not to go up to the ER.  About an hour later she started having hallucinations of the devil.  We worked together to calm her down and do reality checks -- but she was having trouble holding on to it.  We spent most of the day sitting together, with me calming her, and her becoming frightened again.  She slept with me that night.  She got up in the morning before me and after awhile she woke me up saying "Mom, I'm dead."  Again, we worked all day to try to keep her calm and get her back to reality, but she became progressively more and more frightened of the devil, and was suffering terribly.  She kept saying "I want to go to heaven.  Why can't I go to heaven."  But she was also afraid that God would never forgive her for her "sins" and that she would go to hell forever.  I told her I could strangle whoever taught her such things.  That God forgives everything, and that she had done nothing wrong.  But she could not be consoled. 

 

Around dinner time I had a fritatta in the oven in a cast iron skillet.  She suddenly got up and went into the kitchen, opened the oven, and grabbed the frying pay with her bare hads -- burning her fingers.  I stopped her and took the frying pan out of the oven myself and put it on top of the stove.  Then she lunged towards with both hands.  I was able to stop her & she collapsed on the floor.  So, I called 911 and had the emergency medics come.  They took her to psych emergency.  She was eventually heavily sedated there, and was sleeping most of the next 24 hours.  Then she was transferred to an inpatient psychiatric hospital.  She told them she wanted to die and would kill herself if she could figure a way to do it.  So, they put her on "line of sight" watch for the next 3 days. 

 

They also raised her Risperidone from 3 to 4 then to 7 then to 9 mg/day.  She asked them to keep raising he dosage because she was so terrified of the psychosis -- she just wanted it to go away, which it did after a couple of days.  The doctor was reluctant to do it because of the Tardive Dyskinesia, which she recognized, but said "the last thing she needs right now is to feel like her doctor isn't listening to her."  Doctor also put her on Trazadone to help her sleep.

 

She was discharged from hospital last Monday, 9/1, with prescriptions for:

 

9 mg/day Risperidone

200 mg/day Topiramate

50 mg/day Trazadone

Plus continuing her Isoniazid at 24 ml/day.

 

She started their "partial hospitalization program" on Tuesday -- which a daily program from 9 to 3:30 and is primarily a group CBT program.  On Thursday she told them that she couldn't sleep so the doctor prescribed an additional 15 mg/day of Mirtazapine to help her sleep.  But I looked it up and found that it has a warning NOT to take it with any MAOI as there can be dangerous drug interactions.  I called the doctor and told her and she said "Thank you!  I had forgotten that the Isoniazid was an MAOI."  She said she could up her dosage of Trazadone and/or take some Melatonin to help sleep.

 

On Friday they called me in for a "family meeting" and said this program wasn't a "good match" for her.  My daughter had said the same thing -- that she really didn't have anything to say there and that it wasn't doing her any good.  REally all week after he discharge she could talk very little.

 

Also, on Friday, I looked up Trazadone which I had failed to do before -- and found that it has the same warning as Mirtazapine -- contraindicated to take within 14 days of any MAOI -- dangerous drug interactions.  I called the doctor to ask her about this.  She called me back and left a voice message that "even though it says that in the book it's OK for her to take the Trazadone."  I said to myself, "the hell it is" and took her off the Trazadone.  She's taking Melatonin and that is helping her to sleep better.

 

Also on Friday, we went to see the family therapist we've been seeing for a year.  My daughter finally opened up there and let a lot of stuff out, including that she had been trying to commit suicide by drinking a lot of coffee to intentionally raise her heart rate.  She was trying to give herself a heart attack.  Then, when she thought she was dying, she was so afraid of going to Hell.  It was the most terrifying experience of her life.  She also said that she doesn't want to try to reduce her drug dosages in the future because she is so afraid that the psychosis will return.

 

But at least she is talking again.  And that is good.  She seems to be doing better.  Quiet, sitting on the patio and smoking, but not distressed that I can see or that she says.

 

We will be going to a new psychiatrist soon.  I'm hoping for the best -- someone who will at least take the Tardive Dyskinesia seriously.  I found some research that Abilify is less associated with TD than Risperidone, and that Risperidone is actually the worst of the "atypical antipsychotics" for TD.  So maybe he will switch her to Abilify, I don't really know what can be done, actually.  Another option is that very dangerous antipsychotic where they have to do blood tests every week because of agranulosis.  (I'm spacing out on the name right now and it's late.)

 

This was a looong post.  I had a lot to get off my shoulders.  Thanks for listening.  I'll appreciate any thoughts/advice you have.

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There are no words for how my heart goes out to you, and your daughter. But being mom is probably the hardest role right now.

 

I have had problems with rapid heart beat, and high blood pressure, going off a benzo...not even off. Panda not ODing with coffee.

 

I have a daughter adopted from China. She took INH for 9 months as a toddler...I had no idea. She is a precious handful, 16 now. I don't know if this is appropriate for you all, but what I would do in your shoes, and what I am doing this week with my daughter, is having testing through Mensah Medical. They actually have outreach clinics in California. I started a thread here on them. We are just doing testing and phone consult for our daughter, as it is cheaper and her situation is not complex. The lab testing is arranged through Pyroluriatesting.com. I am a patient there, if you want to read my thread.

 

All that said, it would be totally expected for your daughter to need minute tapering. It is hard to accept, but there really is no way around it when multiple drugs have been in play. Whatever you decide, we want to support you in any way possible.

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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One question I have is:  since they just raised her risperidone from 3 to 9 mg/day 2 weeks ago, can it be lowered again quickly in another couple of weeks?  Or does she have to do the long slow taper from 9 mg/day?  I thinking/hoping maybe she won't have developed dependence on that dosage after only 4 weeks or so on that dosage.

 

Another question:  If the doctor wants to take her off risperidone and put her on a different neuroleptic because of the tardive dyskinesia, should there be a graduated transfer from one to the other?  Does anyone know how that works?

 

In the past it seems to me that they have switched her meds without concern for tapering or withdrawal from one when they substitute another.

 

~Mom

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  • Moderator Emeritus

Hi Mom,

 

I'm so sorry to hear about what you have been going through, trying to care for your daughter, I can't imagine how hard it must be. 

 

Usually, if a dose of a drug has been raised very recently, then bringing it back down can be done faster than the 10% method, but your daughter's situation is complex, and I don't have any experience with anti-psychotics, so I'm reluctant to advise anything.  But I am glad to hear that you are getting a new psychiatrist, from what you have written, your current one sounds hopeless and dangerous.

 

We don't give advice about switching drugs, we are a support site for safety tapering off psychiatric medications, mainly anti-depressants.  If at some point your daughter decides to come off medication or taper down to the lowest possible dose, we can help her do that safely.

 

Please stay in touch and let us know how things work out with the new psychiatrist.  Maybe one of our recommended doctors is near you, have a look at our list here:

 

http://survivingantidepressants.org/index.php?/topic/988-recommended-doctors-therapists-or-clinics/

 

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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Thanks, Petu and Meimeiquest.  She was very frightened by this latest episode of psychosis.  I'm hoping that with time she will once again be willing to taper off her drugs.  I've seen her just get worse and worse the longer she stays on antipsychotics.  They take away her hope, her ability to think and feel, her initiative, and even to imagine a future for herself.  It's so sad.

 

~Mom

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I am sorry, I don't have the citation, but I think one study of taking people off found that there was a lot of relapse in the first year off, but after that people settled down. Have you checked out BeyondMeds.com? Monica is on this site as GiaK. At one point she wrote that one of her diagnoses had been schizoaffective disorder.

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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