Simon: Introduction

[Altostrata]

The proportion of drugs is irrelevant to how they interact.

 

Do it the way you feel most comfortable, Simon. I don't feel I can explain any more.

[simon]

Thanks for your reply. I realize that one cant be too exact about whats happening with all these drug interactions. Just thought id throw out a few feelers in case there was some logic here.

Im feeling better over the last week, seem to have hit a sort of plateau and stabilized a bit.

My situation though is that im gradually reducing diazepam down to about 4 or 5 (on 8 at the moment) and from what ive gleaned about half lives, it seems that reductions don't register for several days so fingers crossed.

Ive got my GPs full support for what im doing, ie not taking the psychs advice, and doing tapers of the various drugs im on. I was quite pleased about that but slightly annoyed that he seems to have altered his stance on the period of time needed to get off drugs. 4-6 weeks was his advice for the citalopram, now that is many months. Still, its all experimental and ill forgive him for not realizing that a long term user like me would need much longer. At least hes prepared to live and learn. I just hope I can show him over the next (years?) that it is possible. Im so glad I found this site, although 6 months ago would have been preferable!

I must say though that my experience of the local psychiatrist was rather dismal, as all he could recommend was to increase an change medications. What a job! I cant imagine a lot of job satisfaction from that. You can see the mind set of these guys and how its all experimental. You feel like a guinea pig being tried on one of the same old list of chemicals for the rest of your days.

Ive also done a 10% reduction on citalopram, I felt it important, almost symbolic, to get the ball rolling and reductions at the top end of the dose are slightly less risky than further down the line.

Im also grateful to Rhi et al for banging on about the slowness of slow tapers, as im just the sort of character who would forge on ahead and hit a wall. Its useful to be reminded (nagged at) from time to time!

Im also finding that, as things calm down I am more able to meditate, which for me is vital. it seems to need a certain calmness of mind before you can get back to that, but always worth the effort. Also mindful general living, which means finding ways of staying in the present moment and getting off auto pilot as much as possible. ( to do during walking, eating,and all the general mundane activities of life)

Suicidal ideation is a really strange one I find. Its a sort of state of mind that says; well thank god there is a way out, planning meticulously, fantisizing  because any of this is a relief from the pain youre feeling at the moment. I feel a bit of a coward really as, there are many on this site suffering more than me who don't seem to have these get out clauses. And then it lifts and you are aware (quite casually) that last Monday you actually could have done it if not for pure chance of something intervening. You just get a glimmer of hope and your mindset changes to a state which says, ok, give it another chance.

I find following the threads of peoples experiences on this site very useful too: just reading through and picking up on tiny points of experience (even the very negative) I hope I can be of use too in encouraging others,a thing that lack of any experience so far, has meant ive been unable to do. I cant really imagine going through this without an online community as, where else could you find the breadth of experience and anecdote in the 'real' world.?

[simon]

Seem to have reached a sort of stabilization in the last week of so. So that's taken 3 months following the crap advice to taper in 4-6 weeks.

What ill do now is take a second cut in the diazepam from 8 to 7, then stop at 4or 5 and concentrate on the other stuff.

Sleep is good ,appetite is fine, concentration is better, suicidal ideation retreated. I have little stress to cope with at the moment. Exercise is ok and I get the feeling that the 2 supplements advocated here are suiting me. No withdrawal symptoms as yet.

Talking of which, I looked at some videos yesterday from a link from Beyond meds, about a dietition who extols various vitamins and often in high doses. I read here that taking such things can often be too stimulating in withdrawal. Actually I it seemed a bit too good to be true really but I wondered if anyone else has come across the guy? Think for depression he suggests Vit B3 and Vit C in bucket loads. (Cashew nuts being especially good) Cant remember his name, but he looks quite well known.(from NY State)

[simon]

Can anyone help me with the following.?

I know someone 31yrs old who has just become pregnant and is taking Venlafaxiine. She wants to get off and is  2 months into the pregnancy.

Ive advised her of the benefit of a slow taper, but that means shell still be on the drug,even if all goes well, at full term.

What are the risks involved to  the baby and what can she expect from the baby when it is born? Withdrawal? and what does that mean for the baby. Theres also the factor of post natal depression in her case too.

At the moment all is fine, but is there anything she can do to make things easier? and what further reassurance can I give her. Obviously its not an ideal state of affairs, but that's life.

Shes made the decision to come off and did infact try last year but took the usual doomed advice from her GP to get off in a couple of months and had 6 months symptom free then hit a wall. She did attribute this to relapse herself but I tend to think otherwise. She reinstated at the previous dose, which is where she is as of now.

 

Simon

[simon]

Wow, you have to be in the right frame of mind to read the standard 'texts' on the subject of this forum.

Its only really in the last week that ive waded through the Whittaker book and just starting a Peter Breggin book.

I remember a couple of months ago getting the Epidemic book and being unable to read it for fear that the next page was going to deem me a hopeless case or a non-starter in the  chances of getting off these drugs and avoiding irreversible brain damage.

Eventually though you have to face up to the whole package really and its not a nice story at all.

Most of all you have to face up to the disappointment that its only now that you've come across them and not 10 years ago. You realize, with despair how you've given in to superior knowledge and lamely taken the medicine.

Without the internet these stories would still be hard to get at. The net is a source of great freedom for everyone to get the facts.

If I were coming afresh to this site I don't think id want to have those books in my face all at once. You need a little gentle approach before the awful reality! But eventually you have to read them.

One thing hit me about the Breggin book 'your drugs...' is how ive managed so far to avoid any physical symptoms of the cocktail ive been taking. I consider myself very lucky there, though ive always loved physical activity so I guess its kept me fit. Though 7 years taking Lithium should have slowed me down and I don't know how ive managed to keep going. Maybe theres a drug interaction going on which activates me inspite of the drowsiness.

I also like the concept of 'medical spellbinding', the idea that once on a drug your reasoning can take a downward shift such that you don't have the resolve to do much about your condition. Talk about a rock and a hard place!

 

Simon

[Petunia]

Hi Simon,

Just stopping by your thread to say hello, I'm glad you are feeling a little better.  What you wrote here really resonated with me:

Eventually though you have to face up to the whole package really and its not a nice story at all.

Most of all you have to face up to the disappointment that its only now that you've come across them and not 10 years ago. You realize, with despair how you've given in to superior knowledge and lamely taken the medicine.

 

I'm also in the process of working through my despair and grief over the choices I've made because of being mislead by false beliefs I bought into.  I was looking for a cure for an illness which never really existed, and now I'm so much worse than I ever was before taking a psyche drug.

 

I also like the concept of 'medical spellbinding', but the irony of it is that when someone is spellbound, its impossible for them to grasp the concept of it, its only when the spell is broken that you can grasp the concept.

 

Petu.

[simon]

Hi Petu, sorry youre going through a rough patch at the moment,

I guess the whole regret issue, one has to deal with in much the same way as someone who has a chronic desease might. Its just life and unfortunate that it happened to strike that person.

I suppose that, in the past there must have been many instances of people getting ill through ignorance, but then that led to advances in medicine etc.

The trouble with psychiatry (the biological type) is that its all guess work and is in its infancy but pretends to really know what its about. Hence we are all guinea pigs,(especially someone like me on a cocktail of drugs, in which the interactions have never been medically tested.)

I wish you all good things

 

Simon

[simon]

So I have reached some sort of plateau now, 3 months down the line from too fast taper of citalopram (reinstated to original dose) and a gastro-type problem which at the same time washed out the lithium and mirt from my body for 5 days.

Now im very hopeful of getting a good tapering plan into action and have done lots of research both here and in the recommended reading.

 

The diazepam which I have got down to 7mg per day (only been taking that at various doses -mainly lower than that for 3 months) is bugging me a little, as I intended to get that down to 5mg and then leave it and concentrate on the rest of the cocktail. But I realize that if I leave that at 5, I wll still be taking it a couple of years down the line if my general taper turns out to be a slow one (and I think it will).

So what im asking is, is it not wiser to get rid of the benzos first, and if necessary when things get tougher in the future months , take the odd bit of it during the AD reduction?

Ive had no probs reducing the benzo yet and feel quite hopeful that the obvious addiction over the past 3 months can be overcome.(famous last words!) I know it has a long half life.

 

Ive come to terms now with the fact that im going to get nowhere with my psych. Had I taken his advice and kept to it (one month ago) I would now be taking 150 venlafaxine and 12 mg of diazepam in addition to Lithium and mirtazapine at a full dose. Hes a nice enough chap, but  I feel like im a guinea pig and cant understand his reasoning. He  is either 1) incompetent, 2) looking at my plight in a statistical way and concluding that a person in this situation is basically a hopeless case and must have vast quantities of drugs just to maintain a basic sort of existence. or 3) correct.

 

Well now I realize that it is all pure guess work, and I must say that nowadays, they don't seem to sulk when you don't heed their advice. Its more a collaboration. But surely they must be aware at a certain level, that something is going vastly wrong in the psychiatric system.

 

Anyway I anyone could help with the benzo question and the above post 76 I would be most grateful

 

Simon

[Altostrata]

Read this:

Taking multiple psych drugs? Taper the antidepressant first!

[simon]

Yes Alto ive read those notes and see the point being made.

Just that I wondered if its not better to be off the benzo and then use it from time to time if the AD withdrawal becomes intolerable. At least I wouldn't then be addicted to it.

And if you leave the benzo til last then that's in effect what youre doing, ie, using it as a back up against AD withdrawal problems.

But I know its my decision and ill see how things pan out.

 

Incidentally I came across another forum re. ADs and waded through the section on one drug (citalopram) It was interesting to compare with this site. What I noticed was that it had a less strong 'editorial' content and people were just describing their experience of getting off (and on, in some cases!) There was a lot less advice and fewer people helping each other and less of a method espoused for getting off the meds. So you get cold turkeys that sometimes work, lots of reductions following doctors orders (coming off in a few weeks) and accounts of people saying what a lot of good the drug has done them.

Its full of horror stories too and people trapped in nasty withdrawals. It would make the average member on this site incredulous. The idea of a slow taper rarely comes in. I must admit that lots of the members seemed quite young and had only been on the drug  up to a few years, and by the nature of the forum, were only on the one drug. Theres really a big range of experience and some lucky people do get off easily . But, as is often pointed out on this forum, you cant really know if youre a lucky one until it may be too late.

 

But it made me realize what a good site you've created here in that it does offer a lot of help and peer support, you don't feel out on a limb and on your own.

[Petunia]

Just that I wondered if its not better to be off the benzo and then use it from time to time if the AD withdrawal becomes intolerable. At least I wouldn't then be addicted to it.

 

This isn't a good idea, once you have become addicted and gone through withdrawal, its very easy to trigger withdrawal symptoms arising again, possibly from just one use of the substance, its called the kindling effect...

 

(15) Question: After I have withdrawn from benzos can I take them occasionally?

 

Answer: No you can't. Once your body has been addicted to a drug you can't re-expose it to the drug without consequences. Most of you readers will have heard of smokers who have quit for years or even decades and they have one cigarette and all their withdrawals and cravings come back and they are back on the smokes. This is true for other drugs of tolerance and dependence such as alcohol and unfortunately also benzos. This is a physiological problem not a psychological problem. Many people think that they can just take one and use their determination to keep it to occasional usage and don't understand that the body stays hypersensitive to the drug for years afterwards with persisting tolerance. A lot of people find that withdrawal effects return and they are worse after taking the occasional benzo than before they took it in this scenario. The brain stays tolerant to the drug and sensitised to the drug. So often taking the drug will typically cause a return of withdrawal effects after the benzo dose wears off and set your recovery back in time. Sometimes withdrawal effects can return very strongly after taking an occasional benzo.

 

http://www.non-benzodiazepines.org.uk/benzo-faq.html#Question15

 

 

And if you leave the benzo til last then that's in effect what youre doing, ie, using it as a back up against AD withdrawal problems.

 

In a way, yes, a benzo can sometimes cushion some of the symptoms of AD withdrawal, but through a different mechanism.  The same is true of some antidepressants, they can sometimes reduce some of the symptoms of benzo withdrawal and are sometimes (unfortunately) prescribed for this.

 

The most common and significant antidepressant withdrawal symptoms are nervous system activations (indicating a too-fast taper): hyper-alerting, sleeplessness, abnormal anxiety, agitation, etc.

 

Withdrawal sleeplessness is a symptom you want to avoid. It makes tapering much harder and post-withdrawal syndrome more difficult to recover from.

 

If you reduce the antidepressant while taking a sedating drug, the sedating drug may help alleviate the activating withdrawal symptoms.   Taking multiple psych drugs? Taper the antidepressant first!

 

But ultimately, you have to taper off everything, if that's what you decide to do, and the question is, which is the best way to do it.  The last drug to go, whichever one it is, is going to be the most difficult, because there is no 'protection' from symptoms by other drugs.  This is where the very slow, careful tapering comes in, its the only way left to protect from potentially overwhelming withdrawal symptoms.

 

But like you wrote, its your decision and you have to do it in the way that works best for you.

[simon]

Thankyou  Petu for  your reply.

Its a very important point you make about the benzo and one I hadn't come across until you brought it up. I makes sense, just like drink and alcohol.

I had come across the term 'kindling' but didn't know what it meant, now I do.

 

So really I think what ill do is get down to about 3mg diazepam if possible and then start slowly an the ADs ( probably switching from one to the other) if that works.

Actually im seeing my psych today and will ask what his take is on Lithium,as there is little info on this site about that. I get the idea its used much more in the uk than elsewhere.

In my case its meant to 'augment' the effects of the 2 SSRIs. However ive heard that when bi-polar people come off it too fast it sets off a manic reaction. So that should be fun.

Citalopram is more alerting that Mirtazapine so it makes sense to reduce on that to a greater extent.

 

Think ive got my mind around the slowness of tapering by now and at present I seem to have stabilized after my fiasco on too fast tapering on the Cit.

 

I was making the point in a post somewhere that I came across a forum for ADs. There was no real encouragement to get off slowly yet quite a lot of the members there seemed to have got off successfully. I can only assume that 1, they were quite young,2, they hadn't been on the drugs very long. But its also half full of people (as on this site) stuck in withdrawal. Lots of CTs, too. There were few warnings about over fast tapers and far fewer replies to the questions that folk were asking. More just testimonies of what people did.

 

What I like about this site(maybe because its smaller) is that you nearly always get support and advice when you need it.

Again, many thanks for putting me straight on the above.

 

Simon

[simon]

So today was an appointment with the shrink.

This particular one has none of the old fashioned authoritarianism that you used to get over here. In fact, so far hes just gone along with my plans and seems quite supportive. I feel underneath though is the obvious reliance upon drugs and biology. Likes the phrase 'discontinuation syndrome' to 'withdrawal' and I think believes someone with my history will need to be on drugs for life. He quoted the well known stats that once someone has had x number of depressive episodes, then the chance of another one is almost certain. But to give him his due he did offer advice on which drug to taper first and why; not to multi-taper,etc.

I think he is pro choice if you know what I mean. Or else he knows that hes got nothing to loose, its my gamble.

 

When he asked me why I was so ok now I replied that it had taken me 3 months for my system to become stable from the too-short taper off citalopram. ( I could also have added , 'because I chose not to go onto 150mg of venlafaxine and remain on 12mg of diazepam, as he had suggested 3 weeks ago), but I didn't.

Hes of the opinion from what i can  make out, that once the brain has become dependant on chemical source of serotonin, then it cant do without it and you need to stay on the stuff. Didn't get into neuroplasticity because I get out of my depth.

 

But we decided to try to get off the Lithium, as I suspect that this is the drug that makes the practise of mindfulness difficult for me; the nhs is all for that practise over here. I think hes of the opinion that such things are to do with the pre-frontal cortex of the brain and in the realm of psychology, so not his department. But I know theres lots of talk of how the brain can change itself through meditation and feel quite optimistic about that. Wish I could grasp more of the science! Maybe too much Lithium!

What surprises me though is how they are so much of the opinion that you can get off something fast, and I found myself suggesting to him that 6 months to taper off Lithium was too short. Anyway its all up to me in the long run, but its interesting to know what these guys are about.

 

If anyone knows if dividing up Priadel (lithium) pills is dodgy,could you let me know, as I need to do that. In fact I have done that before, but he thought that a bad idea and I need to find out if they come in 100mg tablets.

[mammaP]

Your psychiatrist sounds like he is open to learning, and it's good that he talks about discontinuation syndrome because 

it means he accepts that is why these drugs are hard to get off and it isn't just that the y are needed. I reckon you will 

be educating him as you go!  He has been taught about drugs from the drugs reps, like most doctors but hopefully will 

take note of what you are doing and discover that people CAN get off these drugs! I'm glad he is supporting you. 

 

Priadel seems to be available in 200 and 400 slow release tablets. Maybe your doctor would give you lithium carbonate

liquid to taper with.  Here is the topic for tapering lithium http://survivingantidepressants.org/index.php?/topic/2976-tips-for-tapering-lithium/?p=36863

[simon]

Yes I meant the talk of 'discontinuation syndrome' ironically actually, sort of psych-speak, but I take your point!

Also I notice that the 200mg tablets are scored down the middle which must imply they are useable in halves.

many thanks

Simon

[LoveandLight]

Simon I've seen you mentioning mindfulness meditation..is there one in particular you would recommend?

[simon]

hi Joannad

I did one of the courses in MBCT, mindfulness based cognitive therapy, which is a course of 8 two hours sessions spread over 8 weeks. It takes place in our local Uni, but there are others as well and they are based on the original Jon Kabat-Zinn  MBSR (stress) in the US.

In the UK its mainly Mark Williams from Oxford and others who formulated it and they have book called 'The Mindful Way through Depression' which contains most of what is taught in the courses.

Most people seen to think that doing a course with a good teacher is the best way, I had already digested a lot of it before the course, but glad I did it as it brought out the correct emphasis on areas of it that wouldn't come over in the book.

You can get refered (as I was onto a course and then its free of charge) because its accepted by NICE as an evidence based therapy and has a lot of positive reports in preventing relapse into depression amongst those who have already had one or more spells.

Its taught as a psychological technique rather than part of any religion, so its not controversial in any way.

I belong to an online forum called 'Everydaymindfulness.org, based in the UK and if you look at that youll see that the practise is used by many types of folk really as a way of life and  a method of living more in the moment rather than on 'autopilot'.

Hope that answers your question.

All the best

Simon

[simon]

Sorry to come back to a previous topic of mine, but I would really value advice on ADs and pregnancy and didn't get a reply to this one.

Its my daughter actually, ( maybe she should open her own thread, but its all too close to home at the moment) whose on Venlafaxine and has recently found she is pregnant.

Ive found that there are risks involved (baby having withdrawal etc) but she has not the timescale now to get off the drug in the safe tapering way.

Anyone been in this situation? Would it be best just to begin to reduce slowly and be on a lower dose as the months go by.

She had the usual (doomed) advice a year ago to come off in a matter of weeks and it didn't work. So she obviously needs to do it very slowly.

Simon

[mammaP]

Hi Simon, thank you for stopping by my thread, I will answer your question here in your thread. 

 

Hi mammaP

I wondered if you could help me resolve a conundrum that keeps bugging me.

When I first came on the forum in September you very kindly replied with some advice; I had gone through a too fast taper of Citalopram and crashed, but during the short 4 weeks off that drug I got a very extreme infection that caused the 2 remaining drugs (lithium and Mirt) to completely wash through my system.

 You said you once had a similar problem.

Do you think (from what you might have gleaned from this forum over the years) that 5 days sudden CT in effect could have been enough in itself to de-stabilise my CNS? My GP,and psyche for that matter, both said that it would have had an effect, but only for a couple of weeks, as I would have got back on it 5 days later. But I have little faith in such judgements.

Im only really interested in this because im now in a position to begin a very slow taper, and im starting with Lithium.

Ive reached a place of stability (after 3 long months) and am looking forward to taking some first tentative steps.

Simon. 

 

Yes I do think that would have been enough to destabilise your nervous system. Doctors actually admitting it has surprised

me a bit but I'm not sure that it would be just for a few days, they believe that withdrawal only happens for a matter of 2 or 3 weeks 

and we all know that is nonsense here!  It took me a few weeks to settle again but I knew nothing about withdrawal at that time so

thought it was the illness that had destabilised me.  It is great that you are feeling stable now and ready to start your taper, I hope

it goes well for you. Keep in mind the 3 KIS, keep it simple, keep it stable and keep it slow. 

 

SSRI's and pregnancy, sadly ssris are known to cause problems in pregnancy but not everyone is affected, and it is different for

everyone. Any damage is usually caused in the first few weeks of pregnancy when the embryo is developing. Birth weight can be 

low but that can be dealt with these days and low weight babies can do well. The truth is that we really don't know very much, there 

are no real studies and there probably never will be.  I've been online trying to look this up and came across Dr David Healey's site

with a topic on SSRI's in pregnancy. It seems that even if a woman quits SSRIs before becoming pregnant there can still be problems

because of the nervous system damage that is caused by them in long term use. 

http://davidhealy.org/theres-something-about-mary/

 

I think that the slow taper that we recommend might be the best for your daughter, so that the drug is at a lower level when the baby

arrives. This will avoid withdrawal which will certainly not be good for mum or baby, but that is just my opinion, others may disagree

and I would be interested to see their views.  I'm sorry I can't be more help and sorry that she is in this situation, it must be worrying

for her. 

 

 

[simon]

Well ive had about 2.5 weeks of relative stability now and most days have been good ones with a return to normal mood and activities.

Im both happy to state this and also more realistic now, as I know for certs that there will be difficult days ahead. So slightly nervous about the next few weeks but very relieved that I can at least feel my old self again.

I don't feel that this is merely a benzo induced ok feeling as was the case about 6 weeks ago when I was taking far too much diazepam for a period.

So now I'm getting out and about, doing a little (self-employed) work, lots of exercise, which ive decided shall be walking instead of vigorous sorts (I use to run and cycle a lot). I note that most people here withdrawing favour the more gentle types of exercise. So its mainly coastal  path walking with dog or friend, plus little cycling.

I read a lot and find that's great for the mind and distraction, hardly any TV,(too over-stimulating and trashy) a little radio and music. Veg growing and making meals, DIY and catching up on the stuff I have let slide in the awful last 3 months. I can think more clearly most of the time, too.

Sleep has been good

.

I love using this site. Its so easy to get around it. And the various replies ive had have been extremely useful. The more I look back over others threads the more clear it all becomes. A feeling of being in the same boat, albeit with people at greatly different stages.

Simon

[tgirl]

Good for you Simon!

That's GREAT news!

Hope it continues!

Best of luck,

Tgirl

[Rhiannon]

You're doing so well, Simon! It's great to hear it.

 

I'm concerned about how fast you seem to be coming down on the diazepam. Those are much more than 10% cuts you're doing. Please consider doing a slower taper; I've seen and heard some horror stories from people who came off benzos too fast, you don't want to be one.

 

About your daughter, I am so sorry. I don't have a good answer. The news is not good regarding babies born to moms who took ADs during pregnancy. There's an article about it on Mad in America right now which I just read yesterday. http://www.madinamerica.com/2014/12/antidepressants-pregnancy-says-safe/

 

On the other hand, as you know, once already pregnant it's a bit late to come off the meds too. So I guess I agree with mammaP, probably a slow taper to at least reduce the total dosage, but not too fast, because the last thing a new mother needs is to be in full blown med withdrawal. Baby doesn't need that either (needs a healthy mom, that is).

[simon]

Thanks for your reply Rhi.

 

Yes I'm aware of the rapid drop in Diazepam and thanks for drawing my attention to it. A bit of a rock and a hard place really as I so much fear the addiction on the one hand and the possible WD on the other. Ive got no plans to go further with it for long while and I have only been on it a relatively short time; albeit addicted.

 

Thanks for finding the info from MIA, I will go through it now. I think she may well try a slow taper and I know theres a problem with the pregnancy anyway, so it may miscarry. If that happens then she's still young enough to put it on hold for a while.

Found the articles by David Healy interesting too, via mammaP and passed them on to my daughter.

Hope youre getting over your rough patch.

Simon

[simon]

Ive just bought a SAD lamp to add one more weapon to my armoury. These are really short daylight hours in the UK! I notice I get a slight head ache to begin with; this apparently goes off in time. Its because of that sudden blast of sun. Morning is the best time to use it, for a couple of hours. I guess in the evening it tends to stimulate too much before going to bed.

 

Problem I have is that when things start to look up, I speed up my activities too much. Its been a common thread looking back. Last few days ive been doing a lot of heavy physical work and though I enjoy it, it is tending to get me too activated. Need to calm down.

 

The good thing is that I can get back to my meditation practice. I notice that's been a bit neglected over recent months as it takes longer to let go of intrusive thoughts (good or bad).If im not careful, meditation can become just thinking and planning for the day ahead, or mulling over the previous day. Its the present  that counts!

 

Sleep has been not as good last couple of nights, but just enough really.

 

I notice that people state the need to take meds at the same time each day,a thing I can get very forgetful about. I guess that maintains stability.

 

That crazy time of year is upon us again. I think when you've had Xmas more that 50 times before it begins it gets a bit monotonous.!

 

Simon

[simon]

Had a pretty lousy day today really.

So im going to learn from this. Its not going to be downhill all the way by any means..

Meditation hampered by lots of intrusive thoughts and irrational anxiety.

But ive had a good 3 weeks before this and am determined to go the course.

Because im just at the beginning of this new regime its hard to analyse causes, so will just keep my nerve and see what the next few days brings!

Simon

[Petunia]

Hi Simon,

I'm sorry you've had a bad day and I was sad to read that your daughter lost her baby.

 

I would send you all this sun from over here if I could, to be honest its been no benefit to me in my recovery.  Its too bright, too hot, too much, arrives too early in the morning and stays too late at night.  I feel much calmer on overcast days and at night.  I guess we are all different, but I feel calmed by listening to the sound of rain.  I was actually born in the UK and miss many things about living there.

 

Perhaps listening to some guided meditation would be more helpful if the intrusive thoughts become overwhelming.  Sometimes withdrawal effects are too strong and we need that added distraction of something else to focus our thoughts on to stop them from getting out of control.

 

That crazy time of year is upon us again. I think when you've had Xmas more that 50 times before it begins it gets a bit monotonous.!

 

Sigh.... yes, I agree.  For me this will be the third year in a row that I have a valid excuse to ignore it, withdrawal has one benefit at least.

 

I hope your wave passes soon and it really is important to take meds at the same time every day, it helps to keep blood levels even.

 

Petu.

[simon]

Im puzzled about whats been happening in the last few days.

Ive gone from having 3 weeks of feeling fine, confident and hopeful about the future to what feels like square one again.

All the old symptoms of depression seem to have come back with a vengeance. Sleep, appetite, thinking have all been affected and ive become very anxious. I haven't altered any drugs in the last few weeks but wonder if the baseline I set myself (after at first giving into my psychs advice) was a bit too low?

 

I realise that I reduced Lithium to 500mg which is not in my signature, as I couldn't get hold of a liquid form of it and I had only upped to 700 for about 2 weeks.  So that was really a drop from  600 to 500.

The mirtazapine I had temporarily been at 45mg (again a few weeks) before then it had been at 30mg for about 7 years. So this I put at 35mg. for my baseline to start future tapering.

The citalopram which had been returned back to 20mg (same as the last 7 years) after my aborted short taper back in the summer, I have reduced to 18mg (dissolved in water, plus syringe)

The diazepam which I got addicted to (probably) during that Cit taper I have at 6mg (but this was for a very short while as high as 12mg, maybe 2 weeks)

 

So, have I done something wrong here and would it be showing up in whats happening now?

 

Should I reinstate something to get stable again or should I just tough it out? have I gone too fast?

Its just that before I got on this site and was at the 'mercy' of the GP and psyche I was going along with their ideas of calming things down, which is so vastly different from what is advised on this site. So it was quite hard to find a baseline to start at. I hope this isn't too confusing, having a problem concentrating at the moment.

 

Maybe this is what you all describe as a wave.? It was certainly very sudden and sharp.

Any ideas? I find it so hard to work out given all the variables and also being a novice at this task.

 

Simon

[simon]

I think I may have reduced on something too quickly. It was so hard to get a base line to start from, as I had Gps advice to up some of the stuff I take, but it was only for a short period (eg Mirtazapine from 30 to 45 mg to help with sleep. I didn't want to start my taper from that high dose as it would add so much to the time of the overall tapers.

Also there was advice to increase Lithium to 700 (this was all back when I did the too rapid taper of Citalopram which I then reinstated..Also the benzo was temporarily up to 12mg (advice from Psyche, but he saw that as a temporary solution and to go down on it ASAP. That's why I gradually brought it down to 6mg per day.

 

So if I was just for a short time on higher doses of these drugs that ive taken over the last 7 years, surely I would not taper from those higher doses?

Im very confused, as I noticed that Rhi was surprised that id come down so quick on the benzo, and I can understand that. But what to do now? ive just had 3 nights of very poor sleep, anxiety, loss of appetite and unable to distract myself from whats going on.

 

I think that I will put the Lithium back up to 600 and keep the rest at the same level. Does that sound a good solution? Am I right in thinking that when you reinstate something it takes about 4 days to get into your system?

Sorry if im repeating myself from the last post and its hard to clarify all those little changes I did before finding this forum.

 

Simon

[simon]

I wonder if anyone could reply to the above two posts. Quite desperate to know what to do about the situation.

 I put the lithium back up to 600 last night and took 2mg extra diazepam. It gave me a couple of hours extra sleep but not sure if this is the way to go.

Simon

[simon]

Ive just spent another day racked by anxiety and I have no idea why its returned. Im wondering if this is to do with the benzo that I took at quite a high dose for a short while when I took the psyches advice and then I reduced it too quickly. But I felt I couldn't stay on 12mg of diazepam and so. That was several weeks ago, back in November and then had a few weeks on 8mg and now on 6mg. Because it was all for a short time.and I didn't want to get addicted to that dose.

Is this whats called rebound anxiety? or the paradoxical effect of when you get tolerant of benzos?

I'm at real loss and very frightened by whats happening.

What do I do about the benzos now?

Please read the above 3 posts with this one to make more sense of it.

 

Simon

[Petunia]

Hi Simon,

I read your recent posts and I have to admit I'm a little confused, but that's most likely because of my own cog fog, which descended on me yesterday and hasn't lifted yet.  I'll do my best to explain what I think may be happening.

 

You have made several large changes over the last few months, including continuing to decrease the Diazepam while your nervous system was already in a state of instability.  I can understand you wanting to reduce it, but every change causes further destabilization.  None of this is your fault, but the reality is that stability is achieved by keeping things the same, or by making very small changes.

 

Read through this: 

The rule of 3KIS: Keep it simple. Keep it slow. Keep it stable.

.... and also read through the windows and waves topic again, there is a link to in inside that topic.

 

I really don't know what to suggest, apart from stop tapering the Diazepam for now.  This may just be a wave... see the windows and wave topic again.  Perhaps if this doesn't settle down in a few weeks, you could consider updosing the Diazepam a little, but you may just need a very long hold where you are and give your nervous system a chance to settle down, this will happen in a windows and waves kind of pattern.

 

Hang in there Simon, you will get through this.  Maybe Rhi might have a better idea about the Diazepam, perhaps you could post about this in the benzo section.

 

Petu.

[simon]

Petu, thankyou for your reply.

Ive not kept the diazepam stable for the last few months at all. I gave in to the advice of doctors and have varied from 5mg up to 18 (just for a few days) to change from lorezepam. That was back in September; but since then it has been sometimes 10, a few days at 12 etc. I thought that I had stabilized at 6mg which im now taking, but it appears not to be the case.

Because I was so ill I just tried whatever was suggested to me and it looks like I am now really addicted.

Ive written a post in the benzos section, but it really looks like Im in big trouble here.

I do hope your cog fog improves in the coming days and thanks again for your support.

Simon

[JanCarol]

Hi Simon, I promised I'd read your thread, and it took a week, but here I am!

 

I will chime in with the Wise Ones of the forum:  keep it stable.  

 

the first rule is don't mess with the benzo.  Keep it the same every day for weeks and weeks.  If you are still having breakthrough anxiety, take half in am and pm.  Some people in here dose their benzo 5x a day to keep level.

 

The next one I would focus on is the citalopram.  Get rid of that sucker, while holding everything else stable.  LEAVE the lithium and benzo ALONE!  Just forget about them, focus on getting the citalopram down.

 

Here is what is special about mirtazapine, which I haven't seen here yet:  my pdocs had me on it for sleep.  But it's paradoxical:  higher doses (such as you are on) is stimulating.  But lower doses (say 10mg or below) can be sedating.  So once you get off the citalopram, bring your mirtazapine down.  To 10 mg or even 7.5 (I was on 7.5 mg for about 3 years).  When the mirtazapine is taken at that level at night, it should help with sleep and anxiety.

 

Then you can look at lowering the benzos - but not before!  Really!  And the mirtazapine and lithium will help cushion the pain of going off the benzo.

 

The only reason to consider the lithium sooner is if you feel trapped in a lithium cage or are suffering side effects (kidneys, dehydration, toxic response).  If the lithium isn't messing with you, leave it alone.  It will help.

 

The way I look at tapers, is I ask hubby, "have I been a nice person?" - I ask my psychologist (she seems to think I'm doing great, even when I'm just putting one foot in front of the other), and if I ****feel**** right, I will do the next taper.  I fill vitamin trays for 3-4 weeks at a time, so I can only CONSIDER a taper when the vitamin trays is "fill day."  If I haven't been great the 3 days before, or I have concerns or anxiety, the rule is:  no taper.

 

I don't care if it takes forever, I feel so much better than I did a year ago, even though I still suffer from kidney problems.  I'm confident I will get rid of them.  I'm also confident that the "common wisdom statement" of "if you go off lithium you are more likely to have an intense manic episode" - applies to the way the docs do it, not the Surviving Antidepressants Slow Taper method.

 

Maybe I'll be on lithium all my life - and there are benefits to low dose lithium.  It protects against damage from stroke, and even against alzheimers.  I will be approaching the halfway mark sometime within the next month.

 

You've always been an active guy.  And I know how my guy is, he likes ACTION.  This waiting and being stuff, well, it's just not as ACTION oriented!  And hey - did you know that when your thoughts intrude into your mindfulness meditation, YOU ARE STILL MEDITATING?  It's just part of the here and now.  Don't judge yourself when the thoughts come.  They are like clouds, let them come, let them go.  Trying to push them away will take you a step away from the meditation.

 

I'm thrilled that you found this site - this site is the most comprehensive resource and community for what you are trying to do.  And you've come so far already!  And you have more access to your mind and feelings - it's all good!  Sure, there will be hardships, but unlike other equations, the cost / benefit of coming off the drugs is definitely in favor of the taper!

 

Cheers, JC

[simon]

Jan Carol, Thanks so much for the above. Im sending you a pm it that's ok.

[WinningThrough]

Hi simon. U wrote on my thread and I keep meaning to read yours. Er..I'm afraid I haven't done it yet! But this is to say, in the meantime, I hope you're coping.

[simon]

WT, thanks for you kind thoughts.

Im a bit embarrassed about the way my thread has gone over the last few days and am amazed how things can change so quickly.

Its almost like letting others on here down because I have been so positive, but have just experienced one of the worst days of my life.

Have a read when you have the time.

I just have to come to terms with what GP and Psyche have led me into.!

Will keep in touch.

( I wrote a pm to Jan Carol, as I didn't yet want to share it with the community) But eventually I think I will.

Im just hanging in there at the moment and it really helps to get any small response. Just that 6 years ago I was on 1 med., now im on 4, and its very hard to come terms with it.

All the best to you

Simon