☼ mlrp: withdrawal syndrome from Wellbutrin? Also on remeron and lorazepam.

[mlrp]

Hello, all,

 

Hoping everyone is as well as can be and continuing toward recovery.

 

I've been away about five days (due to a very hectic schedule with a number of stressors) and must once again request suggestions and wisdom from the community. (I hope one day to be more of a contributor to solutions here...)

 

• I reinstated 12.5 mg Wellbutrin (2x/day) on May 11, which seemed to have given me a (moderate) boost from the crash I experienced.
• Beginning about May 23, I started experiencing an uptick in symptoms - not as bad as the initial crash - but worsening agitation (akathisia, especially in legs at night), a return of some repetitive thinking, general depression, tearfulness, neuro-emotions, severe internal unrest, etc.
• Also about that time, had to deal with a number of added stressors - a hectic Memorial Day holiday with more activity than I wanted; preparing to leave a job I love for a new job (promotion); training a replacement; starting new job on Monday; and tomorrow actually going on an interview for an even better job (my top choice for employer) that I had applied for about the same time as when I applied for my new job - the second place just took longer processing applications. I feel I need to pursue this opportunity despite a sea of emotions swirling around the ethics of possibly  switching out on my new employer. All this while having to be staring at a pc screen a lot of the time for my job, and having to deal with people a lot more than usual because of all the job stuff. As I type this, I can feel my forearms just bristling with cortisol, or whatever it is.
• I am otherwise continuing to faithfully practice self-care as much as possible - tracking symptoms (trying to find the best tracking tool among many good suggestions); good sleep hygeine; magnesium; trying to watch what I eat; etc.

 

My questions:

• Is it too early to tell whether or not I should perhaps increase my daily Wellbutrin to 37.5 mg? Are these symptoms due to reinstating at too small a dose - or to all these horrible added stressors? My original Wellbutrin dosage was 150 mg. before I began my klunky taper over 6-8 weeks.
• I know that I may also be experience rebound anxiety from taking .5 mg Lorazepam in a single nightly dose. Should I start trying to cut that .5 mg tab into 4 equal smaller doses every 6 hours? Or should I try to gain better stability on the Wellbutrin first?

I apologize for being yet another needy newbie. I am making a good faith effort to learn all I can here, and manage my own recovery but when the symptoms worsen (and with a new job to face on Monday), I really need to reach out for a life line.

 

I am continuing to practice my 12 step program, and to also hold onto the thought that my brain is working to right itself, even through the bad times. Yesterday, I had a five-minute window. First real window of any kind for many weeks. Five minutes. Better than none, I guess.

 

Thank you, thank you, all. I wish you all peace in your day.

[Rhiannon]

My thoughts:

 

Nobody can tell you exactly what will happen if you increase your reinstatement. I wish we could, but in withdrawal all bets are off. I would say that if you want to try an increase you'd be best trying a small one, not jumping all the way from 25 mg to 37.5 mg. Big changes in dose are destabilizing and it sounds like that's the last thing you need right now. 

 

Yes, I think it might be beneficial to break up your lorazepam dose and spread it out over the course of 24 hours. You may want to try that first on a Friday so that if you have some insomnia from not getting your usual nightly dose, it won't be a workday the next day. 

 

You're walking through a very challenging time, dealing with a lot of stress and a lot of changes. Be good to yourself, let yourself slack off anywhere you can (housework, gardening, or any other chores or obligations that can possibly be postponed, let them go). Get lots of hugs and support (sounds like you have a supportive husband).

 

Any changes you make in meds, try to make them slowly and in a controlled and orderly fashion, not "reacting" and making any kind of abrupt changes if possible.

 

Good luck! Hang in there, we're rooting for you!

[n1gm4]

Hello Mlrp,

 

 

One month later, I replied to your post: http://survivingantidepressants.org/index.php?/topic/6207-n1gm4-difficulty-going-off-mirtazapine/

 

Mieux vaut tard que jamais 

[bubble]

hello mlrp and nice to hear from you!

 

This is what I think: Since the initial reinstatement actually worked very well for you over a month, I wouldn't change the dose.

 

The stressors you are going through are really big and there are so many of them that they would have an effect on your nervous system even if it wasn't so vulnerable and only just started recovering from withdrawal.

 

Even without stressors,what you describe looks like a wave to which it is always best not to react with changing medication which destabilises your CNS even further.

 

It's human nature to want to achieve and pursue opportunities, but I really hope you will soon be able to rest because I believe this is what your CNS is screaming for at the moment.

 

I recently pushed myself too hard with an assignment and departed from my treating CNS gently approach. Nothing can replace rest and avoidance of stress and excessive stimulation except rest and relaxation techiques. i have an upset stomach now and simply can't put into it the food I otherwise not only like but which is healthy. My stomach can't digest it and I have no choice but to respect that. I hope you won't get cross with me for noting that it seems to me you simply have too much on your plate at the moment. I cram my plate full of delicious opportunities very often. And very often it's too much for me so I either give up on some or deal with the consequences. Drugs can give us some boost and make us stronger but we know very well they come with their own price.

 

I would just increase gentle self-care to maximum and promise myself a restful period very,very soon. Honestly, I would even consider giving up that additional opportunity if it brings so much stress. But in any case, I'd keep drugs out of the picture except for equal dosing of the benzo. That would be the only drug related change I'd introduce.

 

Take care, best of luck with everything and I really hope to hear about a resting period soon;)

[mlrp]

Hello, all,

 

I am sorry to have been away, and I hope all have been well and having good luck with their medication issues.

 

Bubble, and Rhi, thank you for your replies. I am going to take to heart your recommendations about keeping self-care and gentleness with the CNS as a top priority. (I responded to n1 separately.)

 

That said, I have had something of a hellish month.

• In early June, my 27-year-old niece unexpectedly succumbed to a sepsis infection that had rather suddenly become systematic. She wasn't expected to survive the night she collapsed but the doctors resuscitated her. She suffered very serious brain damage and has only a 10% chance of showing any improvement over the next six months. I don't wish to enter into an ethical discussion about her situation but suffice to say we are praying for a miracle, as well as for the strength to accept our Higher Power's will, whatever that may be. We are trying to offer as much support as we can to my sister and her other two children. We have visited them and, needless to say, I am devastated and beyond heart-broken. I have had long bouts of profound grieving and crying - which is only natural under the circumstances. Oddly, the day we were to go to the hospital to visit her, I woke up in the hotel, not with my usual cortisol morning symptoms, but with a bright, clear window. I hadn't forgotten at all about my niece and I certainly can't say that I was in a "happy" mood, but it was a window  moment for sure. I was clear-headed and, as with most windows, had a sense of purpose and wanting to get things done. For me, windows always come with a feeling of being happily motivated - not stressed or rushed - just the happiness of once again being about the business of living, and with a pleasant feeling of wanting to make up for "lost time." Unfortunately, this window lasted all of about 5 minutes. I think it had something to do with waking up in a clean, quiet hotel room. It was all too brief, but it was definitely a window.
• A couple of months ago, my primary care physician had about a gallon's worth of blood drawn from me because she wanted an overall profile of how I've been doing since recovering from my own bout of sepsis last winter. She called me in to her office to tell me that I am now just on the brink of qualifying as pre-diabetic (my grandmother had adult-onset diabetes) - almost certainly due to the G*ddam Remeron. She said something about "metabolic syndrome," and now that I seemed to be "thriving," maybe we should think about weaning me off of it. She has no idea whether or not I'm "thriving!" She wasn't even the prescribing physician! It is true that over the past year or more I've been eating everything in sight and have gained about 35 pounds. And I guess there is a concern that even if I do drastically change my diet (and I'm going to have to, but the Remeron does make the craving for simple carbs almost obsessive), I may not be able to lose the weight as long as I'm taking that horrible pill. I'm also challenged somewhat in the exercise department because I am experiencing a heightened sensitivity to exercise - even a long walk can sometimes wear me out and make me very emotional. I had no idea this was a symptom of withdrawal syndrome until I read here about it here and realized that I'd been experiencing the same thing. I won't even go into how angry I am about this. My primary care even had the gall to say something akin to the risk of developing metabolic syndrome being worth the "benefit" of the antidepressants! Because she was also being rather blithe about how easy it should be for me to taper off the Remeron! Grrrrrrrrr!!! But, first things first. I will change my diet and start some form of gentle exercise. And perhaps I will look toward tapering off the Remeron as soon as is practical, but I know that I'm going to have to stay the course and not rush anything. 
• I did not (as far as I know) get the second, "more desirable" job for which I interviewed. But I do think it's worked out as it should have done, because my new job is fine - challenging and interesting but with a balanced workload, and the commute is much better than the job I recently left. 
• I very recently started taking my lorazepam in a twice daily .25 mg dose and I do think it's an improvement over the single .5 mg dose - I don't seem to have the anxiety peaks that I had been having, even in the midst of dealing with my niece's situation. Thank you for the suggestion to do that. I have learned so much here that I would never have heard from any doctor.
• I continue my a.m. ritual of epsom salt soaks, and take about 125 mg of magnesium citrate, in addition to a heaping spoonful of fermented cod liver and skate oil (do I know how to live it up, or what?). 

I'm still taking approximately 12.5 mg of Wellbutrin 2x/day - chopping up the pills, which is so inaccurate. My next order of business is to research on these boards how to make a Wellbutrin solution so that I can very specifically monitor the dosage. I need to get serious - without rushing myself - about getting off the Wellbutrin so I can tackle the bloody Remeron. 

 

Thank you all, as always, for being here, and for the wisdom, courage, and camaraderie you share every day. 

 

Love and light.

[Altostrata]

Yes, Remeron is known to cause increased appetite.

[mlrp]

Hello, everyone,

 

I hope all are doing as well as possible.

 

I am going to attempt to log in here daily as a means of tracking my progress.

 

CLINICAL: Have finally started making a solution of Wellbutrin in order to be more precise in dosing. I am in the middle of a really nasty wave (8+ days) and I think it may have to do with the fact that my attempts to cut a 75 mg tab into sixths were becoming more and more imprecise. The pill cutter may have been blunted. Anyway, it only dawned on me after the wave hit that I may have been playing ping-pong with the dosing by taking these variously sized shards and, even at my very small dose (12.5 mg twice a day), or perhaps because of the small dose, variances of 1 or 2 mgs. here and there were probably battering my brain.  

 

POSSIBLE VARIABLES CONTRIBUTING TO THIS WAVE: The wave hit after a period of about two+ weeks that were increasingly "window-like." Considerably less anxiety in the mornings, increased ability and motivation to get things (beyond the absolute basics) done. I may have overdone it - even by simply adding a few very slow, easy jogs, or that afternoon of strenuous weeding, or going to see the Monty Python farewell + socializing, increased social activity, generally. (Which is sad because I seem to have to keep it to near-zero in order to feel stable. Very lonely, and contributes to anxiety/agoraphobic tendencies.)

 

It could also be hormonal. The start of this wave coincided with lots of hormonal symptoms (feeling as if I was going to have a period, though clearly am in menopause).

 

It could be the pre-pre metabolic syndrome that (I believe) the nasty Remeron is causing. I HATE being on Remeron because something in my gut tells me that it's the real culprit here. But I don't dare even think about tapering that until I can get the Wellbutrin under some kind of control.

 

It is so frustrating that so many variables could affect the state of my recovery at any given time, and there is really no way to pinpoint what is doing what.

 

This forum is, like my correspondeing 12-step program, the one place I trust for encountering people who understand what I am going through. It is the place I turn to for reassurance that I am NOT GOING "CRAZY." And, for excellent analysis and thoughts on how to best manage my recovery.

 

I wish I could spend more time here and become more involved as a community member. It's just very difficult for me with my new job, and when just feeding the cat and driving to work feel like insurmountable, stressful tasks.

 

Please know that, as always, I wish everyone well, and blessed relief and increased recovery.

 

 

Today's numbers

Depression: 7/10

Anxiety: 8/10

[bubble]

Just to quickly say it's nice to hear from you

 

It seems the new job is going well!!! And I believe it will get easier as the initial stress of change resolves. Definitely: these drugs get nastier at lower doses so I think that would be the main culprit but then again everything you listed probably contributes. We are just so raw that everything affects us ...

 

look forward to hearing from you when you have the time.

 

take care

 

bubble

[Athena]

Hi Mlrp,

 

I can relate to what you are experiencing, since I am going through Wellbutrin withdrawal as well right now. Like you said, it is getting harder for me too as the amount gets smaller. At the beginning, I actually was reducing Wellbutrin as a "break" from my Paxil withdrawal, but it is more difficult now and I need to take REAL breaks from time to time!

 

I have the joint pain as well, but for me they were side effects from W as much as tapering symptoms. I also have the "inside restlessness" , the insomnia and the spasms when I am going to sleep or just relaxing my body.

 

BUT the symptoms all get better after a while and yours will too!!

 

Take good care of yourself. Winds of hope from the north!

 

Athena

[mlrp]

As promised (to myself), a brief check-in.

 

Still in the midst of a wave, which started in earnest on 20 July. I think it's beginning to lift somewhat.

 

Today's symptoms:

• moderately severe cortisol morning, but tolerable compared to the last few days. some success talking myself down.
• cog fog has greatly improved; in part, because the debilitating, near panic-attack level of anxiety has decreased as of about last night
• as of 4 p.m., depression 6/10, anxiety 6/10

Medications/supplements:

• usual dose of Wellbutrin solution (may i just say how utterly vile tasting is a solution of Wellbutrin and water?)
• divided my .25 daytime dose of Lorazepam into two .125 doses, at 9 a.m. and 3 p.m. - may be an improvement
• Hyland's Calms tablets - 1 at about 6 a.m., and again at about 9 a.m. - they make me sleepy, but do seem to help
• Bragg's vinegar tonic at about 7 a.m.
• Trying to lessen sugar consumption
• Wondering about lactose intolerance - tried almond milk today

Went for a 20 minute walk at lunch. It went well, but had a small uptick in depression/anxiety upon my return. May have been too rushed.

 

Thus endeth the lesson.

[mlrp]

Checking in... hope everyone is doing as well as possible.

 

Today's symptoms:

• somewhat improved, but still a coritsol morning. Managed to converse with the cat before leaving for work, so that's a good sign.
• 3:40 p.m. - depression 5/10; anxiety 5/10

Meds/supplements:

• Day two of dosing with Wellbutrin solution
• Again cut the daytime dose of Lorazepam in two - hard to believe a crumb of a pill could make a difference, but I think it may help to spread it out this way
• One Calm's at about 6 a.m., magnesium citrate at 10 a.m. and 3:45 p.m., 13.5 mg Iron at 3:30 p.m. (iron deficiency resulting from prolonged intravenous antibiotics last winter)
• Bragg's vinegar tonic at 7 a.m.

Sat in the sun at lunch. Realizing more than ever the importance of close monitoring of the nuances of w/d symptoms. Yesterday's lunchtime walk resulted in an uptick of symptoms that were very subtle but definitely present. And, unfortunately, a signal to take it a little easier with how much I walk today.

 

During my recent window, I hit upon how not only had I been a very fit, active person before my breakdown, but that this was a huge part of my self-identification. A lifetime of being conditioned to discount my achievements had resulted in my not taking ownership of my athletic accomplishments, marathons and talent as a dancer. So, it's become important to me that I one day recover my fitness as a means of recovering my identity, my life. Of course, I realize that fitness is all relative and I may have to accept some limitations. But it pains and saddens me to see how the very thing that would have helped me feel better in that past - vigorous exercise - can now actually worsen my symptoms. Not to mention the hinderance it places on losing the weight that I've gained on Remeron which is now potentially endangering my health further (pre-pre diabetic diagnosis). My intention is not to whine, but to register my progress while also claiming the ways that I have been injured by these meds, and owning my anger and frustration in regard to that.

 

I feel a tad rushed to get this posted before I leave work. The kind of thing that would never have even registered with me before, now brings a little surge of adrenalin, anxiety, and that little "thud" of depression behind my eyes.

 

Things will improve. They already have, and they will get even better.

 

Peace.

[Athena]

Hi mlrp!

Thank you for responding on my thread! Your words are kind and soothing to me. We have a lot in common indeed, even dance!

 

I am not sure what a wimp is, but I am sure you are not one. In fact I don't think there are many "wimps" here!!

 

About the social events you were talking about that make you tired... I understand that very well too. I have noticed that, for me, I still need very much to see the people I love, but maybe not all at once. Sitting and talking with only one person at a time is the best, in a quite place.

 

I like how good you are at putting down in a clear form where you're at every day.

 

Keep going, you're on the right track. Winds of hope to you!! And if you want to talk about dance, feel free to send me a private message!

 

Athena

[mlrp]

...and so it goes, and so it goes, and so it goes, and so it goes

but where it's goin' no one knows...

 

Ok, so I have a little snippet of a Nick Lowe song running through my head. I'll take that as a good sign, considering I was having severe difficulty functioning at work four days ago (Monday). And the Friday before that I actually had serious thoughts that I would have to leave work early.

 

Today's symptoms:

g r a d u a l improvement. cortisol morning. kept my head down and soldiered on. still verrrrry sensitive to light upon waking.

3:40 p.m. - depression 5/10; anxiety 5/10

 

Pretty much the same med/supplementation as yesterday. let me add that I have one cup of black tea w/cream and sugar in the afternoon. Maybe it's just the comfort of a lifelong tradition, or maybe it's the theanine, but I find it slightly uplifting/soothing.

 

OH, the importance of daily tracking of symptoms in all their subtle splendor. When did I "become" my symptoms? It galls me the time I must put in to tracking, monitoring, preparing meds/supplements, arranging my blinking existence around this syndrome. But not even three months in, I see the reason why it must be done.

 

Three months...? It feels a lifetime ago I first logged on here seeking help. And two lifetimes since I was first prescribed these nasty pills. I am only now becoming aquainted with the windows/waves pattern of recovery. If only... I had resisted and someone had been able to just whisk me away for care, rest, quiet, reassurance, compassionate therapy. But that's dwelling in the past, and I only have today. Now.

 

I guess I'm almost happy to have experienced a window of a couple weeks or so, followed by this #*%(%! wave. Now I've been through it (or nearly so, please God), I'll hopefully know to be cautiously optimistic during the next window, and to stay the course through the next (*sigh* inevitable) wave.

 

Speaking of nuances, I'm going to pay more attention to what happens to my body after I consume dairy (which I love). I think it's contributing to a lot of bloating and other unhappiness in my G/I. TMI. But this is my thread. :-P Incidentally, this last wave included a bunch of G/I cramping and other unpleasantness. That was new. <-- Note to self.

 

I'm becoming concerned about my weight gain (esp. in light of my blood sugar numbers). I haven't dared step on a scale in months. I think it's time to face and monitor the numbers. I'm afraid (and by "afraid," I mean "scared to death") that it may end up becoming necessary for me to start tapering Remeron before I'm done with the Wellbutrin. I hope not, but we'll see...

 

Plus, my depression only increases when I catch my reflection in a shop window and see what I have become. Fat, sad looking, and lethargic.

 

All that said, I'm doing ok. Which is miles better than last Monday, and worlds better than last week. Yay.

[Muddles]

I was always very slim before mirtazapine (and quite clever), but put weight on just looking at a cake while on it. Was so difficult to shift any weight, no matter how hard I tried. I've heard it's a drug often given to anorexic's....how cruel is that!!

 

I do hope you see a window soon.

[Athena]

Hi Mlrp!

Are your blood sugar numbers getting worse? Do you think you are still gaining weight? Or has it stabilized?

I am really no expert but maybe the recent changes are affecting the blood sugar numbers?

I also experienced weight gain while on Remeron.

I am not sure if it's the best method for everybody, but I have been alternating meds to taper in the past and I think it has helped. I am thinking about doing it again. Maybe when you are stabilized try to make a tiny drop in Remeron?

But not right now! I think we should try and focus on our actual "task" and not think too much about what will come after. You are doing the right thing, and you are doing it well!! Hang in there, and try to do nice things for yourself, things that you enjoy!!

Hang on Mlrp!!

Athena

[mlrp]

Thank you, Athena, warrior goddess! :-)

 

Muddles, I very much feel for your recent struggles. If I get a bit of a window soon I will gladly share some of it with you and Athena.

 

When I had my breakdown in 2013 (long story), I briefly went anorexic. It wasn't anything to do with body image. It was just a sudden, uncontrollable aversion to almost all food (plus I was having severe stomach pain - but all of this was stress-induced). Oddly, the only things I could eat for a while were very mild or clean foods: tuna, sweet red peppers, tinned peaches. But I was eating so little I lost about 20 pounds in two months.

 

So, yep, the pdoc decided Remeron would be a good AD to help me gain weight. Nevermind my family history of diabetes, or the fact of my having had an hourglass figure before the "troubles" started.

 

Fast-forward to now and recent blood work reveals that I am nearly pre-diabetic. Which is too close for me. And I can barely exercise without risking a wave, so that's lovely.

 

Anyway, wishing you both, and anyone else stopping by, healing, peace, love.

[Heart]

Hi mlrp

I love the way your organize your posts. And you manage to manifest so much energy. What a kicker that you can’t exercise - I am so impressed by anyone who has been able to finish a marathon. And, let me get this straight, when you were really going through it, your body specifically steer you towards healthy foods but now, after the Remeron you’re Jonesing for sugar packets. Oh – that’s such an improvement - I’ve saved you a bowl of my imaginary ice cream in commiseration - no calories.  

By the way, are you able to dream again yet? 

[Rhiannon]

Hi mlrp--

 

I have been enjoying seeing your contributions round about on peoples threads, helpful and positive. We mods appreciate our team of great members! 

 

I relate so much to so much of what you're saying. I too was always athletic before withdrawal; I gained weight during the years on the drugs and had trouble losing any, but I was able to stay very active anyway, working out and dancing. But since I've been tapering, like you I no longer tolerate intense exercise on a regular basis like before, and between that and working nights I've ballooned up 30 pounds in four years. And that's without Remeron (which, during the short time I took it, definitely had a huge effect on my appetite.)

 

It's actually been good in a way, in that I've been forced to practice a lot of self-love and learn to base my self-esteem on qualities of my character other than my appearance. I think that's something that is actually a good thing for women to do and in fact nowadays I cringe when I hear girls and women being complimented on their appearance all the time, because I know that building your self-esteem on something that you did not actually work to earn, something that is not deep and essential about your character, and something that you are inevitably going to lose eventually, is not really such a winning strategy in life. Just another way sexism manifests--even though it seems nice or complimentary, to actually focus on the appearance of even the most stunning woman is not really doing her any good. I have two gorgeous daughters and I am working hard on, every time I want to say something about how they look, finding something else to say about them instead, complimenting them on something they have accomplished, or said, or done, or some quality of their personality.

 

I'm definitely also learning to be less judgmental about the appearance of other women, especially weight! Or at least to be more conscious of that kind of yammer yammer talk when I hear it in my head. 

 

I am concerned that you are having some concrete and potentially serious health effects from taking Remeron and I agree with Athena that you may want to consider an alternating taper. That is, once the waves settle down and you're feeling more stable, you might consider making a cut in the Remeron next, then once you settle from that, take off a bit more Wellbutrin, etc. It's a balancing act between two devils and only you can really determine what's best. But it's something to think about.

 

Also, I'm glad you're breaking the lorazepam down more. I have actually seen the best success in preventing interdose WD with lorazepam come with doses about five or six hours apart (although if you're sleeping eight hours straight I would not break up that stretch, just take some before bed and some more in the morning). It's short acting, as you know. You can make a liquid out of it and divide that up in separate bottles, or just put the whole day's dose into one bottle and sip from it at appropriate intervals. The main idea is to try to keep blood levels smoother and not so roller coaster.  Peak plasma levels of lorazepam are achieved two hours after dosing and then it begins to fall gradually with a half life of twelve hours. (This may be a little slower in people over 60.)

 

You're doing great, particularly given that rapid taper as recently as May, and all the stress you are still managing to cope with, and being able to work and maintain your life in so many ways in spite of the limitations. Hang in there and accept the limitations for now. This period will pass. You will get more stable, the waves will become less frequent and smaller, and you'll be able to choose your cuts and control your taper so that you can hold doses during stressful times and push it a bit during times of more slack.  That will allow you more flexibility in planning your life and enjoying a bigger range of activities. At least, I think that's how it will go, because you're doing such a great job now of taking control of your dosing and keeping track of things and taking care of yourself and doing everything that we have found seems to work well for people in your position.

 

I think you're actually doing very well for this early stage of stabilizing and tapering, and I think that bodes well for the future for you.

 

Hang in there, and post when you can, it's fun getting to know you.

[dalsaan]

I can attest to the weight gain from remeron.   I think it comes from two things - intense cravings (and not for broccoli) and a slowing of the metabolism - throw an inability to exercise on there and boom.

 

I have been able to get weight off with a low cal/low carb diet but it is very difficult to sustain.  You need a lot of discipline and I am using mine for other things at the moment.  I also agree with what Rhi said above

[Heart]

Please disregard my post. I reread your posts a little more closely.  I hope you get some relief soon.

[mlrp]

Thanks for stopping by, folks!

 

sweetHeart, quite the contrary, I think you hit the nail on the head on two counts. It was only in hindsight that I saw the last-ditch, desperate attempt to heal itself that my body was making by having me only be able to tolerate simple and whole foods. But by then I was "out of my mind" with sleep deprivation and emotional loss, as well as abuse. I was so vulnerable by the time I ended up in that psych's office and, after a couple of weeks of resisting, I was essentially "scared" into taking the meds.

 

Funnily enough, during my recent window (mid-July or so), I started dreaming again for the first time in about 14 months. My therapist(s) like to tell me that I have been dreaming but that the meds "make me forget" my dreams. To which I want to scream B***S***!!! I have NOT been dreaming, full stop. I tend to dream rather literally, and sleep used to be a very restorative experience for me - I would work out everything from lesson plans, to relationships, to chicken recipes in dreams. The dreams I've had recently are, again, pretty literal. They're none too pleasant and all involve the death of my mother (still living) or maternal grandmother. Since the wave started, no more dreams. They weren't happy dreams (though I was once again working out some issues), but I take it as such a good sign that they returned during the window, and I'm hoping for more.

 

Rhi, your thoughts are so appreciated. You touched on a number of areas in my own life where I have been experiencing growth and a re-examination of my self-image and priorities. W/d has, in a way, left me fat and unhappy, sitting on the "sidelines" of life, observing the rest of the world and re-examining my place in it. I have most certainly gained increased humility and compassion for others, and a new perspective on things that I might once have thought I had "all figured out." It's definitely made me confront how much value and self-definition I have always placed on my appearance and that of others. There's no denying that one of the reasons I loved being fit was that I could wear what I liked, and I could deal in the world with confidence and a bit of swagger. I don't think those are bad things, per se, but for all the reasons you discuss, in healing from ADs, I suppose I am also becoming healthier in ways I never might have achieved otherwise.

 

I didn't ask for this syndrome and you will find me here occasionally sharing with others their anger, frustration, and despair over wanting their "old me" back. My better nature tells me that I will get her back. Not so much changed, altered, or slightly diminished - as the situation often seems to imply - but the "old me," with additional and deeper insight, compassion, wisdom, strength, courage, serenity, and joy. Before all of this happened, I was an unshakable optimist with just a hint of occasional melancholy. Somewhere, at my core, I know that optimistic, joy-filled spirit still exists, waiting to be free.

 

I really appreciate everyone's thoughts about a Remeron taper. I'll need to address that in the days ahead.

 

So, before today turns into tomorrow:

 

Today's symptoms:

Only five hours sleep due to a James Taylor concert the night before. I had some misgivings about being able to tolerate even poor Mr. Taylor's mellow sounds, but it went well enough, and I'm glad I made the effort. Some intensified emotions and ankle pain during the show that I know were w/d based. Moderately high cortisol morning. Particular sensitivity to light.  

 

The usual meds. Day 4 of liquid Wellbutrin solution. Instinct tells me this may be what I've been needing. Added a cup of black tea in the morning. No adverse reaction.

 

3:45 p.m. Depression: 5/10, Anxiety: 5/10

 

Got hit by a mini-wave after work: somewhat fitful nap, and anxious. Probably due to sleep deficit and needing to face the week-end with continuing Mom issues. Someone here recently posted the opinion that depression is more of a symptom of an underlying issue than a disease in itself. I find this to be true in my case. When I can parent myself, and tackle my relationship issues in a mature way (here's where 12-step, CBT, meditation, etc., come in), I will find relief. ADs have solved nothing, and only added new, serious problems. 

 

Tomorrow I go to my depression group therapy where I get to sit in a room with other depressed women (including one already overweight woman who was just put on Remeron and thinks it is helping her) and listen to them discuss medication while I bite my tongue in half. I derive lots of benefit from the group because we don't focus on meds, but rather CBT, talk therapy, etc. They know my "ambivalence" about ADs, but it isn't an appropriate space to air my "radical" stance against them.

 

Wishing everyone peace and continued courage. 

 

[alex]

You saw James Taylor on concert??

Wow!! I love him!! "Iv'e seen fire and I've seen rain..."

5 hrs of sleep is not bad at all for W/D

 

Hugs,A.

[Altostrata]

You go, grrrl. Thanks for your insightful posts!

[Athena]

Hi Mlrp!

 

Coming to check on you! How are you doing today? How is t he sleep?

 

Athena

[mlrp]

Alto, thank you for your encouragement. Sometimes it feels very much that I am talking-the-talk more than I am walking-the-walk, but I will persevere.

 

Athena, I stopped by your place and left a (long-winded!) reply. Big hug to you, Triumphal Goddess!

 

Saturday 08/02

Depression 5/10

Anxiety 4/10

 

Distressing news at my a.m. depression group concerning the relative of a group member. I know very few details, but ADs were involved.

 

The usual meds. Visited Mom - some associated anxiety. Amazingly, she shows occasional signs of enlightenment, wanting to work through her issues. I attribute this, in part, to the healthy Al-Anon detachment I have practiced, and my overall increasing health. "The family situation is bound to improve as we apply the Al-Anon principles..." 

 

Sunday 08/03

Depression a.m. 7/10, p.m. 5/10

Anxiety a.m. 6/10, p.m. 5/10

 

The usual meds.

 

Terrible cortisol morning. Possibly because my Saturday routine had been disturbed, plus I had to fit Mass into Sun. morning, when I usually go on Sat. evening. Still, this is an improvement because a week ago the wave was bad enough that I couldn't go to Mass.

 

 

Today

Day six of dosing with Wellbutrin solution. More specific/regular dosing. Probably should've been doing this since day one of reinstatement.

 

Slightly improved cortisol morning. For me, it really is in the details. I only whimpered twice upon waking (yes, how sad is it that I record whimpers?  ) before I was able to "catch" myself and stop it (CBT!) before it took over.

 

3:00 p.m.

Depression 4/10

Anxiety 4/10

 

This doesn't imply an increase in "happiness." I still struggle with anhedonia. And lots of simple things - innocent thoughts, memories, images - will trigger a dip into temporary depression.

 

OK... on to REMERON

 

All thoughts and opinions on the following are welcome:

 

For some time now, I've noticed that when I take the Remeron at 8:00 p.m., by 9:00 when I take the Lorazepam, I'm dopey/sleepy and just barely able to find the energy to wash my face and crawl into bed. More often than not, I will have some pronounced "restless leg syndrome" (Remeron side effect, not sure about Wellbutrin) before I fall asleep. Sleep through the night, and have been dreaming some in the early morning hours (not pleasant dreams, but a good sign).

 

I now weigh 152. That's easily 32 lbs. more than I should weigh. Blood sugar numbers are close to pre-diabetic. W/d makes vigorous exercise dicey.

 

I've only been on a Wellbutrin reinstatement since early May. I can't honestly say I've ever stabilized because I'm still trying to define for myself what that is (answers on a postcard to...). But, I am at least now somewhat accustomed to the window/wave pattern. Waves are horrible, scary, and uncomfortable, but so far, I've been able to hold on through them, knowing they will eventually lift - not necessarily into a full-blown window, but into some kind of tolerable, functional blah with occasional moments of light.

 

I thought I would do well to taper Wellbutrin first (cause of my w/d sx, and to distinguish it from Remeron taper sx), but I'm thinking maybe the way forward is to stay on 25 mg. Wellbutrin and begin a Remeron taper when I feel ready.

 

Because:

• weight/diabetes thing now potentially a game changer
• Remeron has never seemed to help my depression; could be making it worse
• if Remeron behaves the way it's supposed to, I'm going to have increased sleepy/dopeyness as I taper down and the little bit of Wellbutrin I'm still on might counteract that somewhat

 

I'm just fact-gathering right now. Going to spend the next week or more investigating community members' experience tapering Remeron, tips, etc. before I make a decision.

 

I have considerable concern about all of the potential side-effects: insomnia, nausea, allergy-like sx, increased depression, but I do NOT want to become diabetic. I get my blood checked again in October.

 

Thank you, all. What a wonderful community this is. Sending you love and light...

[mattinsmom]

Hi

 

I just had the opportunity to read your thread. My relationship with exercise fluctuates but one thing that does happen pretty consistently is that at the 3-mile mark (walking/snow shoeing) I find it necessary to talk about any/everything that is in my mind. I get emotional-philosophical and not in a pleasant way. I have friends that clock our walks so that we are finished before that mile  I even do it when I am out alone. 

 

As for your medication struggle, I am dealing with a medical issue too. My opinion, stabilize on the Wellbutrin (I hate even saying that) and deal with the Remeron. I've never taken it but I think diabetes is a more immediate threat than the crap that comes with Wellbutrin. 

 

I wish you well. 

[Athena]

Big hug to you too sweet Mlrp!

 

I know happiness is not there yet, but I like the way your numbers are getting better (depression & anxiety)!! Every little improvement is huge progress. You are getting there!

 

Yes, I too still believe your next (tiny) drop should be Remeron, when you are stabilized. And maybe then see what the effects are , and move from there?

 

I very much sympathize with you about the relationship with your mother. Family links are so complex, I can see how traumatizing it can be when a parent has a difficult personality. You have a lot of courage. I am not very familiar with the Al Anon's principles and would be interested in knowing more, especially the healthy detachment principle.

 

I wish you a peaceful and enjoyable day! Winds of hope your way!

 

Athena 

[mlrp]

Athena, Mattinsmom,

 

Thank you both for visiting - and for thoughtful, encouraging words.

 

I'm having a crummy, wavey morning. But "this too shall pass." I so appreciate everyone's support here. Will type more later (work to do - maybe the distraction will be good - that's what I'm telling myself  ).

[mlrp]

I feel a little selfish posting this to both my personal thread and this one, but I seek the combined wisdom of the group. A few generous folk have already weighed in on my thread with considerable knowledge - thank you!! I'm beginning to think I have my answer, but all views welcomed.

 

For some time now, after I take the Remeron at 8:00 p.m., by 9:00 (when I take Lorazepam), I'm dopey/sleepy, barely able to to wash up and crawl into bed. I have frequent, pronounced "restless leg syndrome" (Remeron sx, not sure about Wellbutrin) before falling asleep. Sleep through the night, and have been dreaming some in the early morning hours (not pleasant dreams, but a good sign). Mornings, if not "cortisol-like," (Wulfgar is helping me understand nuances here.) are always slow, groggy start. I could easily sleep 10 hours at a stretch, occasionally do.

 

Weight is now 152 - easily 32 lbs. overweight. Blood sugar numbers are close to pre-diabetic. W/d makes vigorous exercise dicey.

 

I've only been on a Wellbutrin reinstatement since early May. I can't honestly say I've ever stabilized because I'm still trying to define for myself what that is (answers on a postcard to...). But, I am at least now somewhat accustomed to the window/wave pattern. Waves are horrible, scary, and uncomfortable but, so far, I've been able to hold on, knowing they will eventually lift - not necessarily into a full-blown window, but into some kind of tolerable, functional blah with occasional moments of light.

 

I thought I would do well to fully taper Wellbutrin first (the cause of my w/d sx, and to distinguish it from Remeron taper sx), but I'm thinking the way forward may be to stay on 25 mg. Wellbutrin and start a Remeron taper when I feel ready.

 

Because:

• weight/diabetes thing now potentially a game changer
• Remeron has never seemed to help my depression; could be making it worse
• if Remeron behaves the way it's supposed to, I'm going to have increased sleepy/dopeyness as I taper down and the little bit of Wellbutrin I'm still on might counteract that somewhat (who knows with these things?)

 

Just fact-gathering now.

 

I have considerable concern about the potential side-effects: insomnia, nausea, allergy-like sx, increased depression, etc. I worry that a Remeron taper will affect my job. BUT I do NOT want to become diabetic. (Rock and a hard place.) I get my blood checked again in October.

 

I'm going to have to be as judicious as possible about current "stability" before proceeding (i.e., I'm having a pretty wavey morning, and last night's sleep was disruptive (unusual for me) with LOTS of restless legs).

 

Thank you for reading.

[bubble]

Hello mlrp!

 

I haven't been active much lately but was passively enjoying your thread and your contributions to other members and me in particular .So thank you very much

 

I liked what Wulfgar told you about trying to taper Remeron next. I can see that you are doing thorough research which is great and perfecting tapering techniques. It will probably be helpful to hold the things as they are for as much s you can and then go after that Rem. thing...

 

Quite a few members mention Al Anon principles, I even put one quote on it in the Best of SA. I would also appreciate to learn more about it as Athena. Maybe we could just google it

 

big hug

[bubble]

All I can say in addition is that many of us alternate tapers: taper one drug to a certain extent, hold and then go back to tapering the other.

 

Given the havoc any changes in these drugs cause I totally understand the need to get all the advice possible

 

I also think it's good to keep things as they are for some time now.

[Rhiannon]

If you can stand to hold I agree that it might be good to give yourself a bit more time to stabilize before starting to taper anything, but that's up to you.

 

I am inclined to agree that you might do best to start by tapering Remeron rather than Wellbutrin, since you're having medically dangerous side effects and it sounds like you're oversedated.

 

It's sort of a rock and hard place situation. I think it's perfectly reasonable to taper the Remeron down a bit, by a fourth or a third maybe, then work on the Wellbutrin, of course depending on how your body reacts when you do taper the Remeron.

[dalsaan]

I agree with Rhi.

 

A couple of extra points - I don't think remeron ever helped with depression for me other than helping me sleep which helped me deal with depression. I am not as hungry now as I was on higher doses. I used to be able to eat a horse and chase the rider. I also craved carbs. Given this might drop off for you it may be worthwhile tapering the remeron down a bit. I also didn't have much trouble dropping down the first 10mg or so but that was when I had stabilised. So all up I recommend holding a bit longer, avoiding carbs, tapering the remeron down by a third and reevaluating where you are at

 

D

[Heart]

Glad you've been able to dream again. 

Love your energy. Hugs

[mlrp]

Wishing everyone a day of peace and improved health.

 

Tue, 08/05

 

Fairly pronounced epinephrine morning (Wulfgar is helping me understand the distinction between cortisol and epinephrine and, because I'm on Remeron, my cortisol mornings may actually be epinephrine mornings. This especially makes sense since Wellbutrin is a epinephrine reuptake inhibitor. So, Remeron decreases my cortisol, my body secretes epinephrine perhaps to compensate, and Wellbutrin keeps it in my system longer than is beneficial or necessary.)

 

Depression 7/10, Anxiety 6/10

 

Lots of a.m. GI sx. Overall sx improved in late afternoon. Going for a walk and actually cooking a meal wore me out. Some increased anxiety before bed b/c of tingling/numbness that has been presenting recently in my left thigh. I'm an expert catastrophiser at this point, so was convinced this is diabetic nerve pain - when more likely it is just a pinched nerve due to weight gain. Find that I do better if I respect my current need for at least 8 hrs sleep.

 

I have also learned (thank you Wulfgar!) that Remeron is one of those meds that grapefruit stops the liver processing. I can't say precisely when, but not long before my current wave, we substituted grapefruit for orange juice for a couple of weeks. Wow. When the pieces fit, it's so helpful. It's no fun to be in a wave but to have solid information about what might have caused it is huge.

-----------------------------------------------------------------------------

Wed., 08/06

 

Somewhat milder epinephrine morning. No matter how much I sleep, it's never restorative. I can't remember the last time I felt "well rested." Never since this whole mess started in Jan 2013.  :-\  Though some mornings have been better than others.

 

Depression 5/10, Anxiety 5/10

 

----------------------------------------------------------------------------

 

Regarding Al-Anon, my friends, - thank you for asking! I started a Twelve Step thread in "Finding Meaning," and I'll post a bit about Al-Anon there.

[arwen]

Hi mlrp, I noticed that you had some trouble with the grapefruit juice. I think it interacts with a lot of drugs. My experience was with Paxil.

 

A couple of years ago, I was on 10mg at that time, and I ate one (only one) grapefruit. And I though I was smart (I researched on internet and there was no interaction Paxil-grapefruit). The next day after eating it my anxiety skyrocketed, plus other withdrawal symptoms, much worse than a "normal" dose decrease. It felt like I didn't take the pill at all, like a 100% drop.