Simon: Introduction

[simon]

Hi, Ive been on and off anti depressants for most of my adult life and cant really believe that ive left it so long to really make an effort to get off them.

I take Citalopram 20mg, MIrtazapine30mg and Lithium 600mg. The Lithium apparently augments the effect of the 2 anti depressants.

About 8-10 weeks ago I gradually began tapering the Cit, with my GPs go ahead and had no discontinuation syndrome in the initial weeks. I think I took about 6 weeks to get off them completely and that was all easy. But then about 4 weeks later I began to get the old symptoms of depression and anxiety. this is without any drug remaining in my body. So I went back on them, 10mg for 5 days and then the full dose. This happened about 3 -4 weeks ago and im still in a depressed state.

However, to complicate matters, while I was off Cit and feeling fine, I had an infection caused by drinking contaminated water and this led to severe diarrea and nothing was staying in my body for 6 days. Id forgotten all about this episode in the meantime but, later as I got depressed again it struck me that during that infection the other meds that I take were probably not staying in my body. So it was like cold turkey for the Mirtzapine and the Lilthium for 6 days.

So now I do not know for certain if this caused my set back or the coming off the Citalopram. My Gp thinks the infection thing rings true. Has anyone any experience of this,ie thinking that youre taking a med but in fact it slipping through your system?

The GPs advice is to get stable again and then try again in about 4 weeks. From looking at this forum it looks like I should be doing things more slowly.

Any comments valued.

Thankyou

Simon

[bubble]

Hello Simon and welcome to SA,

 

After years of failed tapers assisted by my doctor I have found here so many valuable information which made sense of many things for the first time and made things a lot easier for me. So I'm glad you found us.

 

I don't have much knowledge about absorption of drugs except that it makes sense that diarrea would affect it. Others will probably be able to say more.

 

Regardless of that, our brains have a remarkeable ability to fix themselves but they take time and stable environment. You are right: what we found to work in minimising withdrawal is a lot slower taper than you tried out. This prevents what happened to you and many of us before we came here: we suffered so much that we ended up on more drugs and higher doses.

 

After too fast tapers our brains take time to bounce back, so it's no wonder you are still feeling some lingering symptoms. Also, as you noticed yourself withdrawal kicks in some time after the drug left our system.

 

What you can do now is to just stay put and wait for the symptoms to subside just as your GP said. You can use this time to educate yourself on how to taper properly.

 

There are quite a few threads I'd recommend. They will explain lots of things. 

 

What is antidepressant withdrawal syndrome?

http://survivingantidepressants.org/index.php?/topic/603-what-is-antidepressant-withdrawal-syndrome/

 

What will help us give you advice and suggestions is putting your drug history in your signature: 

 

http://survivingantidepressants.org/index.php?/topic/893-please-put-your-withdrawal-history-in-your-signature/

 

Why taper by 10% of my dosage?

http://survivingantidepressants.org/index.php?/topic/1024-why-taper-by-10-of-my-dosage/

 

Since you are taking multiple drugs it would be good to check their interactions:

 

Please put ALL the drugs you take in the Drug Interactions Checker  http://www.drugs.com/drug_interactions.html  and post the results in this topic.

 

This will give you more information on the drug you are taking and how to taper it (when the time comes): http://survivingantidepressants.org/index.php?/topic/2023-tips-for-tapering-off-celexa-citalopram/

 

We recommend tapering the most activating one first and somebody with more knowledge on that will be able to tell you whether Citalopram is that one from the combo you are taking.

 

Sorry for bombarding you with so much information but believe me, I actually restricted myself There is more

 

I will just add that your GP seems a lot more knowledgeable about tapering and withdrawal than an average doctor. 

 

Once again, welcome. You will find  lots of friendly support and I believe somebody will soon make a comment on the things I left unanswered.

 

Best,

bubble

Edited September 5, 2014 by Petu
no privacy issue

[simon]

Many thanks Bubble for your quick reply to my introduction.

I don't know how to write my medical history in my signature, do I just write it out at the end of my post?

Its really eye opening all this talk about getting off ADs slowly. Ive never come across it before and yet its starting to feel right when I think about how delicate the brain is and also reading the testimonies of so many on the site which cant really be doubted.

I really have been on these drugs so long that what lies beneath, if I ever get off them is a total mystery. They must have moulded me in so many ways.. Half of me thinks that its too late to change, but half is determined to give it a try in the proper way.

In the past ive treated ADs almost in a take it or leave it way and if ive run out from time to time then ive not bothered to take them for days at a time. So this is damaging if im to believe what I read here. Its quite hard to get my head round.But it seems to make sense.

At the moment I don't know whats happening, as, ive gone back on the full dose of all I take and, after about 4 weeks im in a depressed state and continuing to slow down mentally and physically, concentration very poor and anxiety strong.

Over the past year ive had 2 relapses into depression, but as I was getting into mindfulness meditation and doing the 8 week course, I was able to get feeling ok again in quite a short time and the depression was not at all severe. (that was all while not altering my drugs). But this time, having come off Cit, for that short time the depression is severe and doesn't seem to be responding. I have a feeling that the drugs im taking have somehow come to the end of their usefulness and are not doing the trick anymore. That's when ive found the practise of mindfulness so vital and I really believe it is a powerful force.But now im realising how these drugs have a hold on me and its pretty scary.

Im finding at the moment that meditation is very hard to do,as there are so many thoughts flying around and bringing attention to the breath and being in the present is almost impossible.

Anyway , my medication history is roughly;

From 1982 til 2007, various tricyclic and SSRIs

2007 combination of Mirtazapine 30mg, Citalopram20mg, and Lithium600mg (im taking these now plus lorazepam if needed

Also had 3 short stays in hospital ( about 3 weeks each time) in 84, '97 and'99 one dose of ECT

I kept no record of medication in the early days im afraid, but I know I had Venlafaxine

Sorry its all so sketchy, the state of my mind if not helping at the moment.

 

[mammaP]

Hi Simon, how long were you off citalopram? I noticed that you went back on 5mg

first then the full dose. How did you feel on the 5mg? I am asking because

sometimes the full dose can be too much after being off the AD for a while.

You have also started lorazepam, which you may also need to taper. Lorazepam

is benzo and they are highly addictive when taken regularly. I am wondering

if it is adding to the problem! Do you have any pattern to your symptoms?

Do you feel worse in the morning, after taking the drugs, a few hours after?

This is a lot of questions but trying to get an idea of what can be causing your

current symptoms. Its a good idea to keep a note of symptoms on paper, when you

take the drugs and how you feel through the day. Not detailed but a simple log

that will help to pinpoint what is side effects and what is withdrawal.

 

As for the food poisoning, I have had experience of that and it did mean I was not

absorbing the drug. I became very I'll and was in hospital, all kinds of invasive

tests for what I later learned was withdrawal on top of the sickness and diarrhoea!

[simon]

Many thanks for the reply mammaP it really amazes me how these forums work and I can tell you its such a joy  to know that someone out there is listening and has been there.

Thanks for telling me about the food poisoning it really helps solve what was playing on my mind, but I don't know if that was the cause of the depression returning or the lack of Cit in my system.

I went back on 10mg of Citalopram after being clear of it for about 6 weeks. GP said to go backon the full dose of 20mg. which I did 5 days later. I can only say that I got gradually worse over the next 3 week, up til now when im at rock bottom. If I knew that a smaller dose would be better...then I would do that but I thought to be safe, get back to the original.

I don't keep records but can see that I will have to begin from what you say.

Ive never had any trouble getting off a small dose of lorazepam ,having used it before when the anxiety has increased and then left it behind when the mood lifted. However from trying to get my tired head around your philosophy on this forum I assume that I may have been paying for that addiction later in withdrawal? Its extremely hard when you have a good doctor like I have,who you trust, and he is relaxed about such drugs as long as its not for more that a few weeks. But you people have probably more anecdotal evidence of these drugs than he.!

I haven't noticed any particular pattern through a day and find that there are so many variables that its impossible to pinpoint what mood comes from what, but I will try from now on. In the past ive been very laid back about my drug taking, almost in denial really not wanting to admit that ive been on them for so long. Even now I feel the task is daunting as the time scale for someone with my history is so long.

What I cant get my head around yet is, how do you really know that the withdrawal symptoms are not simply a return to depression that was always latent? Don't  some people taper off and then discover that they are depressed, just like they were before? I know this is a very basic question and shows the slowness of my thinking at present and I have been reading the accounts of others on the forum. Somehow the penny hasn't yet dropped. But I really want to believe that your theory is right. Forgive my doubts at the present moment. I wish id found this forum earlier and then all the theory would have sunk in more readily.

Thankyou again for all your concern and support

Simon

[mammaP]

Thanks for answering the questions Simon. It does look like the 20mg is too much for you having been off for 6 weeks.

I think I would maybe try 17.5mg and see if that helps any.  I had to reinstate effexor and then make a cut because it was

too much after being without for a while.  Doctors don't have a clue about the drugs they are prescribing, they only know

what the drug companies tell them and they don't want anyone to stop their drugs!   

 

As for the depression, I can tell you that it is not your depression that has returned. The chemical imbalance theory is now

proved to be just that, a theory perpetuated by  big pharma to sell their drugs. What you are experiencing is withdrawal. 

 

If you can get hold of it I recommend reading Anatomy of an epidemic by Robert Whitaker, it will really open your eyes! 

 

Some links for you to read. http://survivingantidepressants.org/index.php?/topic/5667-ten-myths-about-depression-and-psycho-pharmacology-httpwpmep5nnb-amv/

 

http://survivingantidepressants.org/index.php?/topic/5667-ten-myths-about-depression-and-psycho-pharmacology-httpwpmep5nnb-amv/

[Petunia]

Hi Simon, welcome from me too. I'm glad you found us and I hope you will stay in touch, so that we can support you through a safe taper off your medications, if that's what you decide to do.

 

My original diagnosis was an anxiety disorder and I was put on Zoloft to cure the 'imbalance'.  I felt much better for about 2 weeks, but then I started to get symptoms of depression.  But in reality the cause of my problems were childhood emotional neglect/abuse, unhelpful patterns of thinking/behaving, being in an abusive marriage and some unresolved trauma from several violent events.  Unfortunately, I now have protracted withdrawal from psychiatric drugs and a destabilized nervous system to add to my list, but I'm glad I found this site and started educating myself about the truth.  My real recovery started just over a year ago when I stopped trying to fix my problems with drugs.

 

What I cant get my head around yet is, how do you really know that the withdrawal symptoms are not simply a return to depression that was always latent? Don't  some people taper off and then discover that they are depressed, just like they were before?

 

Don't worry, it takes most of us a while to understand the truth about what's really going on with 'mental illnesses', the drugs which 'treat' them and the confusion surrounding the side effects and withdrawal effects of those drugs themselves.

 

I also recommend the book MammaP suggested, it will answer a lot of your questions.

 

If someone was feeling depressed, irritable, sad or experiencing grief before going on an anti-depressant, then there is a chance that when the emotion suppressing drug is stopped, the unpleasant emotional state will still be there. It really depends on what was causing the emotions (sadness, loss, hopelessness, fear etc) in the first place.  Depression is not an illness, its a normal emotional/physical/mental reaction to some kind of unwanted change or difficult situation.  That change could be hormonal fluctuations at puberty, the loss of social support from friends and family when going to college, job loss, work pressures, loss of loved one, loss of beliefs or way of understanding life etc.  The list of things which cause 'depression' and anxiety is endless.  Some of these issues are temporary and would resolve over time anyway.  Other causes are more long term, like being raised in a family where physical or emotional needs weren't met, or having experienced something traumatic like abuse or violence and not having been able to properly recover from it.  Sometimes 'depression' is caused by unconscious patterns of thinking and acting based on early childhood learning from the family of origin.  Sometimes 'depression' is caused by a combination of factors which accumulate over time causing an overload of stress.

 

Lumping all these difficult life events together under one convenient illness, based on a collection of symptoms,  makes it simple and fast for a doctor to diagnose and prescribe a drug which will not cure anything, but will sometimes suppress the symptom or emotion which the original situation/event caused. 

 

These drugs 'work' by changing the way the brain naturally functions, causing an imbalance in chemistry, to which the brain then reacts in ways which are not fully understood.  Sometimes the effects of these changes seem helpful, other times they make life worse, sometimes there is no noticeable change at all.

 

Quite often there is a placebo effect or the original cause of the problem resolves naturally, but the patient attributes feeling better to the drug and continues taking it.

 

Over time the brain and nervous system changes in response to the new 'balance' being caused by the drug, so stopping the drug/s suddenly, causes the system to go into chaos, this is withdrawal or officially recognized as discontinuation syndrome. Withdrawal can go on for weeks, months or even years in some cases, as the changes made by the drug induced imbalance are slowly reversed.  Some of the symptoms of withdrawal are similar to those called depression or anxiety, but there are others, it can be confusing and often looks like a return of the original problem, but usually its not, especially if the original problem was caused by something of a limited nature or has resolved.

 

If the original cause of the depression was never resolved via therapy, or other means, then when the drugs are stopped it could be a combination of withdrawal and an original problem, but its still not a return of an illness called depression, its withdrawal combined with an unresolved life problem.  It can be very complicated, much too complex for most doctors to have time for in a 10 minute consultation.  I think that most of them mean well, but they are busy and their knowledge is limited to the biased, self interested information supplied by the pharmaceutical companies which supply the drugs. 

 

When you start seeing the big picture of what's going on, its not pretty. Drug companies want to sell more drugs, staying in business and making ever larger profits is their only agenda, so there is an obvious conflict of interests when they are the only source of information for the doctor who prescribes their drugs.  Most doctors don't have the time to do their own research, so they rely on what they are told by the drug reps and in promotional material.

 

Please see: What should I expect from my doctor about withdrawal symptoms?

 

Please look around, read links and learn as much as you can, there is a lot of good information here.  Feel free to write whenever you want.

 

Petu.

 

 

 

 

[simon]

Thankyou mamma p for the advice about maybe reducing the Cit to 17.5mg I will try that out. and thankyou Petu for you detailed letter about the difference between WD effects and underlying causes.

What im also considering now is that the combination of drugs ive been taking over the last7 years have begun to have little positive effect. I remember times like this before when ive had to change to new medication. Maybe that's whats happening now, as this is the 3rd time in the last year that the 'depression' has broken through . It happened after life events really,such as having problems with Menieres syndrome which effects balance and has resulted in no further driving and having to reduce a lot of activity I was keen on before. But because I discovered mindfulness meditation I got through all that very quickly. This time the meditation is far more difficult to do.

Also im a little overwhelmed by the thought of going through all this tapering and my mind cant really grasp the reality of it. Im on so much medication that idont know where to start!

If the drugs are no longer working in my system then how can I go through this tapering without the crutch of the medication?

I hardly dare ask how I am going to taper this lorazepam as it seems that its all I have at the moment that makes me feel reasonably ok.

I really appreciate you people and I am trying to get my head round the advice, believe me.

[simon]

Ive been looking up the reinstatement info on this site and wonder if, having been clear of Citalopram for 6 weeks, I should be taking a smaller dose and not the full20mg that ive now been back on for 3 weeks. Im very depressed and slowing down from  day to day. I have no new physical symptoms apart from feeling weak, its the anxiety that's getting me.

Also I was given Lorezepam to get me over this hard patch and have been on that for about 4 weeks at a max dose of 1mg per day. What do I do about that? keep taking it but a smaller amount?

Shall I try reducing the Citalopram by a few mgs per week, say?

I feel very nervous about asking for this advice as, im so used to trusting my GP and although there are so many testimonies on this forum, im still a bit hesitant about taking action.!

Many thanks

Simon

[Altostrata]

Welcome, Simon.

 

Have you been on 20mg citalopram for only 3 weeks? If so, I might try a step down to 17.5mg and see how that goes.

 

It is possible 10mg is all you need, but reducing to 17.5mg will help you to test the waters. Then you can see what to do from there.

 

The burden of psychiatric drugs causes our nervous systems to become numb. That, and possibly withdrawal symptoms, might explain your bouts of "depression."

 

Many people here have long histories of drug-induced problems.

[simon]

Thanks for the reply Altostrata, ive done that this morning and will assess what it feels like

[simon]

My symptoms are not improving. Ive started to get insomnia and GP has advised to increase mirtazapine from 30 to 45 to deal with that temporily. Things tend to get a little better in the evening.What has surprised me is that ive found im able to read, which is strange, but I guess as a distraction it cant be a bad thing. Its strange because, mentally ive become very slow and getting words out and remembering simple things is a problem.

He s also suggested Diazepam instead of Lorezepam as I was worried about addiction.

Smoking , which I never do normally has increased.

I can see that im desperately looking for any temporary relief from the anxiety that's almost constant.

Its like being in a parallel universe, hard to remember what it felt like to be in the real world. But ive been here before and I know it can quite quickly slip back and the relief is huge.

The effect upon relationships, with spouse is great because it all effects both of you and creates instability. The temptation is to remain on the meds and anything for a quiet life, but in the short time I was off Citalopram I felt really good in myself and a sense of joie de vivre, especially as I had managed to get into mindfulness meditation and see the healing power of that.If only I could get into that in a bigger way at the moment.

The main thing I noticed though at that time was I felt content to be on my own for longer periods of time. Before, I would get bored or annoyed with myself due to shallow thinking and forgetfulness. But now there was a great feeling of possibilities, that things could be different, that I could experiment.

So the thought of being back in a box is unpleasant to say the least.

Sorry if it sounds self pitying but there you are.

I guess with the tapering method you just do one step at a time and see how it feels. So surely theres nothing to loose and a lot to perhaps gain.

My GP said that a 6 week taper from Citalopram was by no means to fast. And implied that hes seen it done ok. How many people do you think get away with that sort of taper? They wouldn't appear on this forum but could they be in the majority and the folk who post here are the unfortunate few who have to battle like hell?

[Altostrata]

simon, I know it's difficult, but you need to give each drug adjustment more time. Making changes in one drug or another is destabilizing for your nervous system.

 

Reinstatement often doesn't immediately fix the problem. You probably will continue to get waves of symptoms for some time. Hang in there through them to let your system adjust.

 

Diazepam is as addicting as Lorezepam, but the interdose withdrawal or rebound effects are further apart. It's best to use any benzo very, very sparingly, not every day, if you can help it.

[simon]

Thanks again for the advice. Hopefully ill be able to cut down on the benzos and see what the reinstatement of the citalopram does.Im going the keep the Mirtazapine at the current level of30mg and find other ways of getting a good nights sleep.

[Addax]

Hi simon. Welcome!

 

Your question about how to know whether it's withdrawal or the return of previous symptoms. I was prescribed fluoxetine (Prozac) to treat an eating disorder. No history of depression or anxiety. My first experience with those came the first time I stopped taking Prozac, so back on I went having no idea it was withdrawal. This happened a handful of other times I tried to quit. With such a pattern of course I was convinced I had developed a mood disorder. It wasn't until a horrible withdrawal experience a couple years ago that it really all clicked. This slow taper has been very mild compared to my other attempts. I still sometimes wonder what's me and what's withdrawal. Because Prozac was so numbing for so many years there are times when I wonder if my emotional reaction is normal but unfamiliar, or over the top. (I'm realizing they are normal but unfamiliar). In fact after a recent drop in dosage I wasn't sure if I was sick or if I was experiencing the flu-like symptoms often associated with withdrawal. I will say this, there seems to be a lot of questioning and discovery during withdrawal.

 

Going so slow does seem overwhelming. I was initially overwhelmed by the idea of it as well as the idea of making the liquid solution from my pills. It just sounded so daunting and complicated and I anticipated being overwhelmed by it. Its a bit tedious if anything, but making the liquid took all of 5 minutes to make and a year has passed since I started this taper. The year would have passed even if I hadn't started a taper. The same will happen over the next, so since a year will come and go again regardless of what I do, I mind as well taper.

 

I encourage you to take time to remind yourself why you want off the meds when you're questioning whether tapering is worth it, and to follow the advice here on SA.

 

I'm glad you found this site.

[simon]

Thanks for that reply Addax.

Its been hitting me since joining this forum that, from the first time I took ads, 30 years ago until now, I may have been having WS which would lead to a GP recommending increasing the dose, followed by reducing  an AD and getting withdrawal which looks like anxiety or depression and then trying a new AD etc. If this were true then its mind boggling.

Is it possible that I could have been on this type of journey for so long? Over the years I have had therapy and it was always while in a state of anxiety or fear. We never really got to the bottom of what ailed me in my adult life. I really had one horrendous year in my very early 20s when, several people close to me died or suffered in various ways and I was too young to shoulder it. Then began the meds. But the therapists I spoke to could have been seeing me uniquely during problem times with drugs, and being that era would have had no concept of what is talked about on this forum.

Are there others on the site who think a similar fate might have been in play?

I have no problem about doing a slow taper and your talk about how soon a year passes is encouraging, that you might as well just do it.

At present though I am still trying to reinstate myself on th15mg of citalopram, and from what ive been going through in the last few days, the last thing my spouse wants to hear about is reducing on meds! Im still not stabalized,  and am at rock bottom. even after 4 or 5 weeks.

But I can tell you, my life has been in a sort of gradual decline while on this stuff. While I was briefly off the Cit a few weeks ago I was talking to someone and was surprised to feel myself shedding a tear and actually feeling. It felt good and made me realize just how much emotion is blocked behind these chemicals. And creativity and ......god knows what else.

Simon

[simon]

Im still in the thick of it getting stabilised on the former dose of ADs and the anxiety and lack of sleep have been almost overwhelming.Its like im tired out yet wired and sleep doesn't come in the daytime either.

Ive always found lack of sleep a killer in the past and I wonder if it is damaging in any way.

I meditate,and that helps. Today I was trying a mindfulness technique where you breathe'into' the area of the body where you feel the problem. Then you stay with it and explore it and accept it really. Then as the breath releases you say something like 'softening' or the like. Its about holding a feeling in awareness, ie not ignoring it and not being averse to it. Just giving it a bit of time and space it needs and then relaxing. I think I find this useful even though I don't feel a lot in my body, I can just imagine the parts where, say anxiety manifests itself when it is bad and use that in the meditation.

Today we tried to locate some medical help but its about getting refered and waiting ages. Then realised that I have to be patient to get stable and theres no little pill which is going to help me through this period.

Physical activity is also useful even though at a snails pace at the moment.

Social interaction is very difficult, but I realise that its because im ashamed of whats happening to me and that I cant 'perform'.

Oh for a good nights sleep tonight.

[simon]

Im feeling the need to use this site as a sort of blog, although that seems an indulgence in a way. But I will attempt to put down what happens each day and then I can look back and see what progress takes place.

When I last wrote my spouse and I had just returned prematurely from a short break by the sea because anxiety and insomnia were getting to crisis point and we needed to be near medical help at home.

Anyway we phoned one or 2 doctors out of hours and got some suggestions about medication. Sleep began to improve a little (drug induced). I sort of hesitate to mention that I was taking small doses of lorazepam as the advice on this forum is not to add anything extra, but lack of sleep has always been a killer for me. I continued my mindfulness meditation which was difficult due to lack of concentration. I was still reading a bit but the odd thing is that I could not read anything with any violence in it as in this fragile state I seem to take it all to heart . I normally like these books, but now left it unfinished. Frightened by the content. So I re read a travel book by Michael Palin and as I had visited parts of the sahara  found I could visualize from the text and that proved a good distraction.

Ive always been a bit of a news junkie mainly on the radio, but found I couldn't follow the thread of it and kept comparing my state to those of all those competent people in the media. I tend to have radio 4 on most of the day when im in (that's a current affairs channel) I even had difficulty recognising the voices of familiar presenters, contributers etc. So weve  switched to classic FM, and no TV except the i player where you can choose what you look at instead of having rubbish thrust at you.

Im a gardener these days and its my (small) living. A lot I had to give up cos of menieres , a balance, vertigo, drop attack, syndrome. But those that i continue with (had to give up driving) ive pushed myself to go to and have cancelled others. The few gardens ive tended ive tried to do in a mindful way, which is apt at the moment as my movements are so slow anyway. I don't know how much all this can last, as i write i haven't been able to get out there because of the danger of using machinery.

But activity does help and gives a sense of achievement as long as you don't compare too much with normal life and start beating yourself up about it.

Anyway my own GP was away, sleep was nothing like enough and on the 18th i was at a new crisis point For the whole morning i was in a state of panic and terror, impossible to sit still or do anything. This is especially difficult for my spouse to see and although shes marvellous in her attitude, its not fair on her.. Got through to a duty doctor and he at once realized i had Lorazepan  withdrawal. ( i had finished it about 36 hours before and had instead taken what i now realize was a tiny dose of diazepam instead)

He at once put me on what i now know to be an equivalent dose of diazepam, slower acting and said that i would have to taper down after a while.

Things got slightly better and sleep improved a little., By now it was the weekend and we tried to get in touch with local mental health services as i became convinced that i would have to go into hospital. But that process doesn't exist anymore and the need to keep you at home is the new thing around here.

The 18 mg of diazepam certainly calmed things down and i remaind on this for 5 days, then reduced to about 12mg.

When i eventually saw my Gp and he had talked to the Psychiatrist, i was recommended to increase mirtazapine from 30 to 45 and reduce diazepam downt to 6 mg per day. In the normal scheme of things i would have been quite happy with that advice but since being on this forum i have lost confidence in medics when it comes to these rapid changes in meds.

I certainly have had a good 2-3 days now and am sleeping well, doing small things around the house. Not wanting to meet people (but when i do it can feel good)

A question i wanted to ask (though it may be more relevant for the benzos section) is this. Given that i got addicted for a short time to Lorazepam and then transferred straight away to an equivalent dose of Diazepam, should i consider myself in a position where i should be tapering down gradually , or do i see this as all quite short term and not  worry about withdrawal? I know we are all different, but do you consider 5 weeks on between 1 and 1.5 mg of lorezepam per day as being something to get concerned about? Obviously if i ask my Gp about this, his answer will be predictable. Maybe there is no answer and i just need to wait and see.

In the meantime i continue to keep in place all the other things i can still do, meditation, gentle exercise, read. I started taking those supplements of magnesium and fish oil too.

Luckily too this week ive met up with the people at MIND and the main worker there has been an absolute gem. They have therapies and i had a hot stone back massage which is so soothing you don't want it to end. Also Tai Chi (concentration lacking a little there, but rest ful) and finally they do a little meditation.

A coulple of friends i met up with who understand 'depression' also turned up and theres no comparaison  talking to someone like that compared to one who hasn't been through it.

 

Books ive read before in previous times of illness ive  been looking at again. Richard Mabeys, Nature Cure, Lewis Wolperts Malignant Sadness and one or two self help books, I used to find Dorothy Rowe quite useful but now feel shes too sort of hard on you. Books by people who have had direct experience of this are the best. Mabey at one point describes music going round in his head, a different tune in each ear! I also get this, but only one tune, but all the time. Then the tune might change when you hear another one. And you wake up in the morning with the same old tune still playing! Im now putting that down to extreme tiredness of the brain. Its like whats sometimes called an 'earworm'. Im counteracting this by listening to soothing music during the day. Maybe its a sign that i need to get into participating in music, being more creative, But what im getting at is, that reading that from somebody else takes away the worry. He healed, and so will I.

 

Books and utube videos on the subject of mindfulness, especially Jon Kabat Zinn are vital to me and the 8 week course i did in mindfulness i considerer the best thing i have done for years. CBT i find a problem but i know it has very valuable wisdom. (its just that i prefer to stick to one thing at present)

Thanks again for the replies ive got from members of the forum.All really appreciated

Simon

[Petunia]

Hi Simon,

Its fine to use your thread as a blog, that's kind of what its for, or one of its purposes anyway.  Many people read these threads and even if they don't post, it can be helpful to read about the experiences of other people who are coming off these drugs, it can be a lonely journey when so few people really understand what its like.

 

I've had the same experience as you, of having to be very careful what kind of media I expose myself to.  I've given up TV completely, for a while I was even finding the most benign shows disturbing, possibly for the reason you mentioned, that I was comparing myself to 'normal' people.  Not that there's really anything normal about what gets shown on TV, but still, the contrast was too much for me to handle.  Fear based commercials would push me over the edge too,  all the adverts trying to sell insurance and funeral plans and security systems would have me in a state of panic. 

 

Like you I had to stop reading a book. Actually, I was listening to it, an audiobook, got half way through and the violence was too much, everything seems close to home.  I used to love horror, so its difficult to understand really.

 

 

A question i wanted to ask (though it may be more relevant for the benzos section) is this. Given that i got addicted for a short time to Lorazepam and then transferred straight away to an equivalent dose of Diazepam, should i consider myself in a position where i should be tapering down gradually , or do i see this as all quite short term and not  worry about withdrawal? I know we are all different, but do you consider 5 weeks on between 1 and 1.5 mg of lorezepam per day as being something to get concerned about? Obviously if i ask my Gp about this, his answer will be predictable. Maybe there is no answer and i just need to wait and see.

 

Are you currently taking Lorazepam or Diazepam?  Would you please update your signature with this if its different from what you have there.

 

Lorazepam is short acting.  It peaks out in your bloodstream in less than three hours and then begins to fall. We find that with short acting benzos people can then get withdrawal symptoms as blood levels fall (anxiety, tremulousness, panic). This is called "interdose withdrawal", or rebound anxiety.  For short acting benzos, we usually suggest spreading your dose out evenly between 4 or 5 doses through the day.

 

If you are in fact still taking Lorazepam you may want to consider talking to your doctor about trying a longer-acting benzo like diazepam or clonazepam and taking it regularly to keep blood levels even, or tapering down off it which might be tricky at this point.  You are most likely dependent on it by now, two weeks of regular use is considered to be the longest amount of time for safely being able to just stop taking it, after that, the body becomes dependent and the drug needs to be tapered.  We recommend tapering only one drug at time, usually the antidepressant or the most activating first.  I don't know for sure what to advise but I don't think you need to be concerned, the important thing is that you become stable by taking the same medications at the same doses every day.  Then you will be able to safely taper off one at a time.  We usually suggest leaving the benzo for last because it can help protect sleep and minimize anxiety effects of withdrawing from other drugs, but it will need to be carefully tapered from eventually.

 

If you did want to stop taking your benzo now, I would recommend holding your other taper and posting in the benzo support forum here for advice:

 

http://survivinganti...ing-discussion/

 

Because you have only been on it a short time, you may be able to do a fairly fast taper at this point, so that's something to consider, but the benzo forum is the best place for advice on that.

 

Petu.

 

 

[simon]

Dear Petu

I cant  thank you enough for replying to my post and identifying with those odd little experiences I am getting. They sound so stupid expressed to somebody who is 'well' and its a blessing to know that on this site I can be free to express details like that which are important at the time. Actually I spent some time last week at MIND locally and the director there was saying that some members of the staff don't connect with media, so its not just an 'illness' topic. They probably realize that their own mental health is eventually compromised by hearing and seeing things about which you can do nothing, feel frustrated and just end up being a voyeur. Theres so often the sellfish reaction of loving the sensationalism being shown and the ridiculous feeling of 'thank god that wasn't me' (in that car crash or whatever) You just cannot feel endless sympathy for people and events happening thousands of miles away. I remember Ruby Wax saying something like, Yes I care what my neighbour might be up to or my mother, or maybe the person at the end of the road......but can I really feel sympathy for people and events thousands of miles away? You just don't have the capacity.

I cant work out how to update my signature , cannot find the little arrow by my name which accesses a drop down menu.

But to answer you question about benzo, 10 days ago, I was put on an equivalent dose of diazepam to get me off Lorezepam. 18mg per day if needed..which it  was. Then after 5 days reduced to12mg per day. now the advice 4 days later is go down to 6mg per day.

I wrote to myGP today and told him I am going on 10mg per day and taper down at 1-2 mg per week.This advice I gleaned from the Ashton information. But what I don't know is if I really got addicted in my 5 weeks on Lorezepam, after all it was a small dose,albeit a very concentrated drug.

I notice that on this forum you taper ADs first and then Benzos, but she (Ashton) favours the opposite.

In my case, as ive been on them such a short time, im going to taper the Diazepam first.

Anyway I will post on the Benzos site and see what happens.

Again many thanks for responding

Simon

[simon]

So today I had a reply from my GP that my tapering idea of10mg diazepam reducing by 1-2mg per week and then slowing down when I get down to 5mg, is fine by him. I still don't know if I got addicted to it (or Lorazepam) and perhaps I never will. there seem to be so many variables in all this multi-drug use that I think I must just be cautious and see what happens.

I do feel ive devoured a vast amount of information from this forum since joining about 3 weeks ago and feel confident that there are extremely competent people here to offer advice should things go badly.

My life has been returning to normal over the last 3 days and im tentatively  trying to resume my activities. I know full well that its drug induced and so  I have no illusions about what might be around the next corner. That sounds very negative I know but you have to be realistic. in the past ive known this state and it feels familiar from previous occasions. Its easy for those around you to think, 'well hes over all that'.!

If and when I get over the benzo fiasco I do really want to begin to taper on the Citalopram and get the feeling that I am progressing. its going to be no mean feat as ive been on the stuff so long. The problem will arise that my spouse will be catergorically  against the idea, as she has suffered so much during these times and had to look after me and to a certain extent, pick up the pieces. ~The fear of that happening again could well lead to our breakup and in a way I think this could be justified from her point of view. She would rather have me a I am , on ADs because they put right my problematic brain chemistry and let me lead a normal life. (everyone has their cross to bear anyway)

But I know for certain (and its always hard to explain this to 'well' people) that emotion, cognition and general development are all affected by being on ADs. The reply you often get is, 'yes but were all getting older, forgetful etc, look at so and so, youre so much better than him, look how bad you could be'. If not for those ADs you might be languishing in a mental hospital for years with no hope of recovery'

All that may be true, but I often cant help thinking that im like one of those characters in The Matrix film ! Itching to get out and live in the real world. (ok that's an exaggeration but you know what I mean.)

What I notice in my life on ADs is that I have to sort of 'inject' excitement, thrills, do rather extreme things to get any real kick out of life., compared to the average person around me. The normal day to day life is so limited,  (probably because I don't feel emotions in the same way as the average person) I think if your emotional life is stunted then you tend to look for other ways of getting meaning out of life,and for me this has been lots of physical activity. Ive been able to travel, sail, kayak white water, swim, run cycle long distance, have small holiday retreat abroad (all on the cheap) And yet some little voice tells me that a lot of this is a sort of compensation activity,an escape if you like.

Mindfulness has enabled me to see that ive been' running' and has enabled me to sit and meditate, which is good. But it has also shown me that I do not feel emotions in my body, and during the course I did my main problem was not being able to FEEL the parts of my body where the emotions become bodily sensations. I belong to a forum on mindfulness and quite honestly I feel stuck at the moment because a lot of the valuable meditation involves noticing bodily sensations caused by thoughts and feelings, and then being with them in the body and accepting what you find. Well I don't feel or find much at the moment even though I can see the absolute beauty of the concepts and they do work.

Feels a bit self indulgent, forgive me. But you get my drift, that ADs blunt emotions and then that seems to lead on to blocking memories and causing cognitive problems. the phrase emotional block' is relevant to me as its as if the emotions don't allow the thoughts to 'flow', and you end up feeling really thick!

I may have mentioned this but several weeks ago when I got off Citalopram for 5 precious weeks before crashing (and then finding this forum) emotion began to return and thinking became easier and deeper. That was even with mirtazapine and Lithium still in my system.

So that's my motivation to get off. But there may well be a price to be paid.

At least ive come just a little way along the path and learned by my mistakes (albeit psychiatrists' mistakes that I humbly went along with)

Simon

ps I still cant work out how to update my signature

[Petunia]

I wish I had time to write more, would love to comment on some of the things your wrote because I relate to your reasons for wanting to get off medication.

 

How to change signature:  Click on your user name at the top of any post, go to edit profile (top right), click on signature (left) change details and remember to save when you are done.

[simon]

Petu, Many thanks for telling me how to change my signature, so easy, when you know how.

I really look forward to your comments when you have the time, I find it a lot easier to express such thoughts on this forum than I would otherwise because I know that being such a large forum, there will be others who feel the same way. And im glad to know that you can relate to what ive said.

Ive decided to get hold of my medical records going back over the last 30 years and see if I can see any patterns between taking and getting off drugs. Because I never kept diaries and have no real idea about how much of that time was on or off ADs. It may help confirm to me connections between 'suddenly ' coming off an AD and then having to go back on one due to a 'relapse' of the condition.

Strangely, when ive had talking therapies in the past, which I found useful at the time, if only to see me through until the drugs started working, the psychologist was never interested in what meds I was taking . That simply wasn't their domain. Yet if the concepts on this forum are valid and when I saw him I was perhaps undergoing withdrwal symptoms from a drug taken haphazardly as if it were aspirin, then it would have been extremely relevant and we could have been talking for no real purpose. Maybe today they are more aware of all this stuff.

I really think that in all that time seeing a psychologist we went round in circles many times and the 'causes' of my depression, although seemed justifiable at a young age, now seemed a mystery. ie I should have got over it by now, there was no real reason for still getting 'depressed'. I could often sense his perplexity at why it was still happening.

The last therapy I ever tried was hypnotherapy that I had to pay through the nose for. The practitioner was incompetent and I realised that she was out of her depth and damaging. The  sole purpose seemed to be to get you back to when you had been sexually abused as a child, uncovering lost memories . I got to a point with her when she was against a brick wall and transferred me to a male collegue in another town. In 2 sessions with him he basically tried to to push me into admitting that my father had abused me (which was s***) and when this failed he had the stupidity to say that this was the first time his therapy had not resulted in a release and healing. Didn't I feel great to know that! When I later complained to them and said I had wasted £1000 of my limited resources, she volunteered to restart the sessions for free.! (I just wanted a refund but that never came) I think that those people are probably safe if you want to give up smoking, but little else.

Any that was a rant.

Looking back over that period I had been put on a dose of lithium to enhance the effect of the 2 ADs I take. I only started feeling better when I decided to reduce the lithium to a below therapeutic level. Oddly, psychiatrists don't seem to be able to say if a low dose (that im  taking) has any value at all.

Anyway im going to spend the day outdoors as we're having a good Autumn here in the UK.

[simon]

Is it possible,(Im asking this on behalf of someone who tapered for 6 weeks off Venlafaxine),to not feel any withdrawal for 6 months? She then went back on the drug and is back to square one. It seems a long period to me. Would this rather imply that its a relapse of the underlying condition or simply that the taper was far too fast?

Simon

[Petunia]

All that may be true, but I often cant help thinking that im like one of those characters in The Matrix film ! Itching to get out and live in the real world. (ok that's an exaggeration but you know what I mean.)

What I notice in my life on ADs is that I have to sort of 'inject' excitement, thrills, do rather extreme things to get any real kick out of life., compared to the average person around me. The normal day to day life is so limited,  (probably because I don't feel emotions in the same way as the average person) I think if your emotional life is stunted then you tend to look for other ways of getting meaning out of life,and for me this has been lots of physical activity. Ive been able to travel, sail, kayak white water, swim, run cycle long distance, have small holiday retreat abroad (all on the cheap) And yet some little voice tells me that a lot of this is a sort of compensation activity,an escape if you like.

 

Your reasons for wanting to get off ADs resonate with me and in hindsight I can say I've experienced similar, but at the time I didn't understand what was going on.  I've always had a rich inner life, have been sensitive and felt my emotions intensely, which has given me a kind of deep connection with the experience of life.  But about 2 weeks after starting on zoloft, for anxiety,  I was hit with a feeling of deadness and depression like I'd never had before.   My life suddenly felt completely meaningless.  I was in a terrible marriage, it was abusive in several ways, but previously, even though it caused a lot of anxiety, I had the drive to try and do things to improve the situation.  But on ADs I just stopped caring.  I slowly started changing, with regards to my marriage, I lost sight of the picture of us, my previous values started dissolving as I became focused on trying to regain some deep feelings of connection with something again, and not in particularly healthy ways.  I can't say it was all bad though.  The ADs got me into therapy, back to school and I think they enabled me to endure my bad marriage for longer than I possibly should have done, which provided stability for our daughter. She was never directly affected by the abuse and I wanted to preserve a stable family environment for her for as long as possible.  Through the ADs I lost touch with my spirituality and became what looked like a better functioning person, from the outside, but inside, it felt like I had been locked out of my own life and a slightly removed character was playing the role of me, while I watched.

 

So like you, there was some compensating going on and I definitely was ready to take the red pill, or I thought I was.  Its ironic how these drugs can help us to live what looks like more functional and exciting lives, but they deaden our ability to really experience these new improved lives. 

 

Is it possible,(Im asking this on behalf of someone who tapered for 6 weeks off Venlafaxine),to not feel any withdrawal for 6 months? She then went back on the drug and is back to square one. It seems a long period to me. Would this rather imply that its a relapse of the underlying condition or simply that the taper was far too fast?

Simon

 

Its difficult to say without knowing more details.  Its not unheard of for withdrawal to be delayed for several months.  In my own case, when I came off lexapro by a too fast taper, I thought I was doing ok for about 3 months.  Then I went through a very stressful period, and started to get symptoms again, but didn't consider that it may still be some residual withdrawal symptoms being triggered by the increased stress. I could have thought that it was a relapse of a previous condition, but I'd had lots of therapy in the mean time and no longer believed I had the 'illness' I had been diagnosed with.  Instead I got diagnosed with a new 'illness' and started on the meds for that.  I didn't actually believe I had this new illness either, but I thought the medication for it might help me cope with the stress so I could keep functioning the way I wanted to. 

 

These drugs don't cure anything, they suppress symptoms, or not really even that, they block out a percentage of our normal human emotions and for some people, this makes life easier to manage.  If a person hasn't learned healthier ways to manage life,or hasn't been able to improve their circumstances while being on antidepressants, then when they stop taking them, if life becomes difficult again, they may experience the same kinds of problems as before.  For some people there can be a fine line between withdrawal and experiencing difficulties with managing life again after getting off medication, especially for the first couple of years, because the nervous system can still be somewhat vulnerable for some people, especially if the taper was too fast.

 

In my opinion, 95% of the time, there was never an illness to begin with, just a normal person with unresolved trauma, an unauthentic lifestyle, too much stress or overwhelming life problems and not enough support or resources to improve the situation.  Most of the time the source of the 'illness' is a society which fails to support individuals who become vulnerable for a variety of reasons, few of which have anything to do with illness or defective brain chemistry.  So I'm finding it difficult to comment on your friend's possible 'underlying condition', when there probably wasn't one there to begin with.  I think calling these things 'previous circumstances' is more accurate.  If people don't resolve previous harmful circumstances, situations, beliefs, ways of thinking and acting, then those things are still going to be there when the drugs are stopped.

 

Withdrawal is very real.  Protracted withdrawal is real.  Discontinuation syndrome is real if you want to call it that.  But so is the return of unresolved life issues, if they haven't been addressed.  Sometimes it can be a complicated combination of delayed withdrawal and the return of a stressful situation, which then wrongly gets labelled as a relapse of an illness.

 

I'm sorry if I'm rambling in your thread Simon, I'm just trying to answer a difficult question in the most honest way I can.  Hopefully someone else can provide more clarity than me.

 

I enjoy reading your posts.

[Altostrata]

Simon, how much citalopram are you taking now?

 

"Depression" can be a side effect of benzos, as are rebound anxiety symptoms. Please keep notes on paper of your daily symptom pattern relative to when you take your drugs.

 

Increasing mirtazapine can increase adverse interactions with your other drugs. Please put ALL the drugs you take in the Drug Interactions Checker http://www.drugs.com/drug_interactions.html and post the results in this topic.

[simon]

OK, so I did that and there were moderate warnings, mainly about combining diazepam with mirtazpine, citalopram and lithium.

What im taking at the moment are MIrt.45mg, Citalopram 20mg, Lithium 500mg and Diazepam tapering down at 2mg per week from 8mg per day at present.When I get to 5mg I will slow down the taper.

If all goes well I intend to begin to taper Citalopram, the most active, at 10% per month.

The spanner in the works is that for the last ten days, my prescription for Mirt was increased from 30 to45mg after I crashed following an unwise rapid taper of citalopram(before I found this site) So I would have liked to reduce that back to 30mg. But doing 2 at the same time is seemingly unwise so guess I will have to leave that in place.

 

At the moment, my symtoms are slightly physical, in that I tire more rapidly than usual. Conversely, my mental side has improved very much and im finding that I can think and remember things more clearly albeit a bit more slowly. Concentration is good, motivation is good and I feel generally positive and more confident than usual.

Im under no illusions at all though and I realize that the above is drug induced and might well be temporary. Im on a big dose of drugs as you can see and im not proud of that at all

.

When the time comes to begin to taper, I might well be under family pressure to resist doing so, as in the past things have got to breaking point seemingly by trying to get off drugs and at times when I have been advised to change medications.

Ive become convinced over the last few weeks that gradually getting off , or nearly off these drugs is a must for me, mainly by corresponding on this forum. I know that , having been a long term user I may have to go very slowly indeed, but I need to go in that direction.

 

Thanks for your concern and for all the invaluable info you have provided in this forum

Simon

[Altostrata]

Please post the results of your drug interactions in this topic.

[simon]

I couldn't transfer the drugs.com info directly to this forum page but this is my copy of its results.

Citalopram 20mg oral tablet once in morning.................attention  .....7.8

Diazepam  2.5mg once every 8 hours........................attention 8.7

Lithium       600mg once at night.................................attention 8.1

Mirtazapine 45mg once at night...................................attention 7.8

 

Interactions and warnings;

3 recent FDA alerts for mirtazapine

Interacts with 3 of your other medications

Don't really  understand the nature of these warnings or how serious (or not) they are. Simon

[simon]

Petu

Thankyou so much for the explanation of how ADs affected you, and it, too resonates with my experience. Where else, but in a forum like this would I come across somebody with similar thoughts.........it would surely take a long time! Much appreciated. I hope that your 'unmistakeable improvements' mentioned in your signature continue to increase as time goes by.

 

I feel im living in a sort of fools paradise over the last week, as the present concoction  of meds im taking have enabled me to feel well and 'normal'. im able to look forward to things, see possibilities, less inhibited, less likely to take offense, can concentrate better and think things through better. Home life is better in that im tending to be more 'thoughtful' of others and finding it easier to communicate with others. Normally I get very frustrated when talking with others, as, the things that I know that I know, often disappear from my mind so that self expression, instead of having that satisfying , connecting feeling, is just not there and this causes me to retreat and give up. Maybe take refuge in a book, or as I mentioned earlier , some compensatory activity.

The reason of course that I know its not sustainable is the drugs that im taking and the knowledge that sooner or later things will go downhill. Im trying to be realistic,but from what ive gleaned from this site, you haven't arrived until youre on a very low dose or off the things completely.Even then, there may be surprises further down the road.

 

As far as facing the original problem or my condition, which you have explained very eloquently in your post, I don't really see why I should not have got over that by now. It really was a thing of years ago.

As a child, I was the peacemaker in my family. My mother had MS which caused immense uncertainty for us all (me from the age or 8) My father was a very dominant force in the family and became more so to hold us all together. My sister (my only sibling) was extremely rebellious and often fought (physically) with my father. My grandmother lived with us and my father had really disparaging attitude to her and they hardly spoke.

I meanwhile was a sensitive child and felt the need to keep my parents together, especially when they appeared to be on the point of splitting up on occasions. I remember at the age of perhaps 10 saying things like 'you do love mummy don't you?' to my father.

After the diagnosis for my mother, my father became more and more evangelical in what had been quite a nominal faith. My mother, less able to be herself, I feel was coerced into this deeper faith, and, to be fair it probably provided much solace for the 2 of them. I was drawn into it too, but hated the mocking of school friends. At this point it would have been natural to rebel, but because my sister was the rebellious one, somehow I couldn't be too. I had to hold things together. (God knows why looking back!)

Fast forward to the age or 17. I had experienced what I saw as sexual problems in my own development ( which I now know to have been quite normal) I couldn't possibly express these to my parents and found nobody else to confide in. They haunted me for years and my school acheivements suffered, lower marks, less interest.

I had at this point a religious conversion and this was very real . My parents were obviously delighted. I made lots of new contacts in this field and it really was for me the meaning of life.

Went off to college, got a girlfriend (now my wife)

(wow, I just deleted all the above by mistake, and then discovered how to restore it!)

Then I had one terrible year. My girlfriend was diagnosed with a psychotic episode that put her in hospital for 6 months (told shed be on anti-psychotics for life), My father died of bowel cancer, my mother withextreme MS to be looked after, wheelchair bound and my sister transferring her fight from my father to me (mainly in regard to what to do about my mother)

I remember going to a local GP and him suggesting I have some valium, (its a nice feeling, like being slightly drunk, he said) Hence began my experiments with ADs and the rest as they say is history.

However things gradually resolved; my wife by then recovered, we eventually had 3 kids, who are now living independently .

I lost my faith (at least the full-on Pentecostal type I had) but have always been searching and I know I think deeply about life the universe and everything! I see that religious few years back then as almost a 'magic' time and rather separated from reality. It was fundamentalism of a very risky type, because I know that the sort or trust it gave me could have ended me in trouble. It was all far too simplistic, dogmatic and I used it to paper over the cracks and avoid some issues that I should have sorted out in a more rational way.

But I don't really regret it and I know where people are coming from who hold those views. ive learnt from it, and it was part of me and I suppose, still is.

 

It all got me on to the drug bandwagon though and therapy .Some was useful at the time, but from what ive learned of late, I realize that because therapists ignore what medication you might be on, and because of the haphazard way I used to take it, they could really have been on a hiding to nowhere, in that every time I saw one, I may well have been in a state of withdrawal which was causing  my distress and not really having a 'problem', because that 'problem' may already have resolved itself. If psychiatry had been more in a state of flux, as it seems to be over here now, then somebody might have realized a pattern caused by this  'on,off' type of medication

.

Its been good to get this down in writing, indulgent I know, but I felt the need. Maybe it clears things in my own mind.

 

Simon

[Altostrata]

Please copy and paste the drug interaction report into a post in this topic. This can be done. Others have done it.

[simon]

I cant seem to puzzle out how that's done but will persevere, Altotrata. I did write it all down in my post of October 5th. But you obviously think its important to post the actual page from drugs.com.?l

Simon

[Altostrata]

Yes, or post a link so I don't have to do the work.

[simon]

Does anybody know about the tapering of lithium?

What ive never been able to understand is that , 7 years ago I was prescribed lithium as an augmenter for the other 2 ADs I was taking. For 6 months I lived in a sortof half life and it wasn't til I reduced the llithum to a much lower dose that  things began to improve. But this dose was below the 'therapeutic' level that the drug works at. Each time ive had a blood test it shows up a very low concentration, or at most just gets into the therapeutic zone.

Ive asked various medics over the years whether this is doing anything at all and no one seems to know.

If its not actually doing anything 'beneficial', then should I still consider it a drug to be tapered?

I feel the answer on this forum would be 'yes', because you would still taper other drugs that no longer seem to be working wouldn't you? Drugs that have pooped out.

However, if anyone has experience of lithium used as to augment the effects of other drugs. then please let me know.

When I get things together, the obvious one to begin to taper would be citalopram as its the more active one, but if lithium could reduce as well then so much the better.

 

Meanwhile im still holding together on the concoction of drugs im taking. Down to 8mg Diazepam per day, tapering at 2mg per week. Things are going well and im making the most of the time studying this whole subject.

 Im getting hold of my medical records to see if I can spot events in the past, medications, stopping medications, talking therapies,etc, that can give me clues as to whether the 'underlying condition' (I think you call it on this site), was in fact probably resolved years ago , and that the distress since then may have been caused by taking ADs. Whether this info can be gleaned from med records I don't know, but feel its worth a try. (anybody else done that) At the moment I don't know yet how far back these records go and many of them wil be paper ones as electronic didn't come in until maybe a couple of decades ago.You have to pay£50 if they include paper.

 

All the best

Simmon

[simon]

Im quite stable at the moment and those around me are obviously of the opinion that, as usual hes got through it like he always does!

I now know that not to be the case. Ive committed myself to eventually tapering and getting off these drugs. This will be a very difficult process from what ive read of others attempts to do so. Also, nothing has change, in that im still taking a hell of a lot of medication. But for the present, albeit drug induced I am calm, and that makes it less traumatic for family and friends.

 

At present I find myself in the classic medical situation of having gone for help and finding myself on a higher dose of one of the meds (mirtazapine) and having had to take benzos to bridge the gap caused by the crash caused by the too rapid taper off citalopram.

So whats happening now is that im tapering off diazepam, and because it was a short spell on this drug am going down at 2mg per week until I hit 5mg per day.(next week) Then I will slow down.

I don't know if I can then first taper the new, higher dose of mirtazapine from 45mg back to 30mg, or if I should concentrate on the more active drug, citalopram which is still at 20mg per day.?

At the end of the week I will get my medical records for the last 30 years and am hoping to see patterns caused by taking and coming off medications. Has anyone else done that? I don't know yet how detailed they are but im hopeful they will throw up something. To me its about taking the whole thing into my own hands, which somehow seems important.

 

At the end of the month ive got an appointment with the local psychiatrist. That could be interesting, as it seems hes quite open minded and has the backing of the director of the local MIND organisation. She tells me that psychiatry is at present in a state of flux; I guess alluding to the fact that ADs are being seen only as helpful as placebos these days. I suppose for these health professionals the question is , what on earth do you do when presented by someone in great distress ? They must realize that what theyre doing is damage limitation, a short term fix for people who will, months down the line return asking for more help. What sort of job satisfaction can that bring?

 

Which reminds me that 7 years ago, when I last had a consultation and was put on the present drugs I take, the then psycho pointed out that major depressive disorder (with which I was diagnosed)  can lead in later stages to Biplolar. That came out because she was giving me lithium to 'augment' the effects of the ADs. From reading the accounts on this forum, that sounds like a classic interpretation of the violent ups and downs of withdrawal, reinstatement etc.

I certainly don't notice any great highs, or feelings of euphoria, or doing anything particulally unwise while on these drugs.

Others notice that when I am 'well' I do work and move at a fast pace, but I always put that down to making up for lost time and building up my life and interests to buffer me against a future crash.

Normally, now in this 'stable' state I would be filling my life with activity and putting all the last 6 weeks behind me. Forgetting it. And you do forget don't you? I think if someone had taken a video of the anxiety state I have been in,I would get quite a shock to watch it. Memory plays tricks at these times. But memory is vivid for my spouse who has seen it all so many times before and I don't always take account of that and feel enough sympathy for her.

But this time I have to take it seriously; that's why im glad to have found this forum. At least now I can make a try at a new approach and see what happens, Whether I have the courage to go through with it remains to be seen. But I have nothing to loose and possibly much to gain.

So im not 'putting it all behind me' this time, im limiting my activity, making contact with more and more people who understand it and not being afraid to admit to the distress I go through. Sadly those who haven't experienced it don't have a clue, but that's always going to be the case. Health professionals can only guess at what goes on in your mind. I often wonder how many of them have taken these drugs themselves? There must be quite a few out there,as in surveys it seems that doctors are themselves at quite a high risk category for 'depression'

Simon

[Altostrata]

Those minimum "therapeutic" dosage levels are meaningless. If you look around here, you will see people reacting to minute amounts of drugs and even supplements.

 

I have never, ever heard of lithium as an "augmenter" of antidepressants.

 

I need to know about your drug interactions before I can answer any questions about further tapering.