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Zant808

Zant808: 17+ years of psychiatric drugging

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Zant808

I was given 20 mg of Prozac back in 1997 for depression.  I was still technically a minor back then.  I had an initial "high" from the Prozac which was mistaken for me not being depressed anymore.  A few months later, Prozac stopped working and I had completely lost my sexual functioning.  I told my doctor about this, so I was switched to Effexor.  I kept on being switched from medication to medication in an attempt to achieve the initial "high" of the Prozac and to reverse the sexual functioning but things just got worse.  One day I was put on a medication called Wellbutrin and that caused a manic episode from the first dose which caused me to have to be put into an inpatient facility.  I was now switched from just being depressed to having bipolar disorder.  I was put on Depakote which stopped the manic episode.

 

Depakote caused me a lot of suffering, so I decided to cold turkey the medication about 6 months later.  This led to another inpatient hospitalization and now I was polydrugged with Depakote and Zyprexa.  This was the first polydrug combination I was on.  This combination of medications was even worse because I was sleeping at least 16 hours a day.  After another 6 months or so, I cold turkeyed both of these medications and that led to another inpatient hospitalization.  I was fortunate in some ways to have the Zyprexa removed and be able to function somewhat ok on just Depakote and now Klonopin.  I stayed on Depakote for years but my sexual issues were never solved and I had a lot of other side effects from Depakote such as multiple sclerosis and Parkinson's disease like symptoms.

 

In around 2005, I discovered the first person who had described the same sexual issues I experienced.  It was called Post SSRI Sexual Dysfunction.  I discovered forums similar to this one, and consumed books by people like Dr. Breggin.  In 2007, I was able to successfully withdraw safely from all medications by switching over to lithium and valium and using a compound pharmacy to taper down.  I felt a lot better and recovered from some of the damages caused by the medications.  I began social drinking in 2008 because I felt like I missed out on such a big part of my life.  About 6 months later, I completely lost my ability to sleep probably due to the alcohol damaging what the benzos had already damaged.  I was forced into a state psych ward and given a diagnosis of bipolar NOS, psychosis, anxiety etc.

 

After 3 or 4 months in the state psych ward, I left on a combination of Depakote ER and Ativan.  I had to eventually updose the Depakote ER and switch to Klonopin again.  So for the last 3 years or so, I've been on 1250 mg of Depakote ER and 3 mg of Klonopin.  While I am not suffering nearly as much as I did when I was bombarded with antipsychotics like Haldol and Geodon, life isn't nearly as good as I know it could be.  That's why I want to get help in coming off of the Depakote ER and Klonopin safely.  My confidence level is a bit low because I feel like I may be damaged beyond repair due to being on dozens of psychiatric medications and due to the past experience with insomnia I freak out when I cannot sleep and that is what is happening now.  I started to taper off of Depakote ER on 11/24/2014 and I'm on 750 mg Depakote ER now and 3 mg of Klonopin.  That's my intro but I'm not sure what to do next...

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Petunia

Hi Zant808,

Welcome to SA, thank you for sharing your story, I'm sorry for everything you have been through.  I'm glad you found us, we will be able to offer you support while you safely taper off Depakote and Klonopin.

 

You may have been tapering too fast.  We suggest reducing by no more than 10% of the current dose every 4 weeks, this reduces the risk of withdrawal symptoms arising.  Please read through this which will explain why:

  

Why taper by 10% of my dosage?  (The general philosophy of gradual tapering)

 

I suggest you hold your taper for several weeks until you are feeling stable again and then continue at a much slower rate.  I don't have any personal experience with tapering off Depakote, but others may.

 

There is a question about whether its best to taper an anti-convulstant before a benzo, this thread has a small discussion about it:

 

Taking multiple psych drugs? Taper the antidepressant first!

 

Here is another link you may find helpful:

 

Guides to tapering off psychiatric medications

 

Here is the link to our symptoms and self care section, you may find some useful ideas to help manage symptoms as you recover.  Especially read the topics pinned at the top.

 

You can use this thread as your ongoing journal to track progress and communicate with the community, add to it whenever you want, you will find a lot of friendly help and support here.

 

Petu.

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Zant808

Hi Zant808,

Welcome to SA, thank you for sharing your story, I'm sorry for everything you have been through.  I'm glad you found us, we will be able to offer you support while you safely taper off Depakote and Klonopin.

 

You may have been tapering too fast.  We suggest reducing by no more than 10% of the current dose every 4 weeks, this reduces the risk of withdrawal symptoms arising.  Please read through this which will explain why:

  

Why taper by 10% of my dosage?  (The general philosophy of gradual tapering)

 

I suggest you hold your taper for several weeks until you are feeling stable again and then continue at a much slower rate.  I don't have any personal experience with tapering off Depakote, but others may.

 

There is a question about whether its best to taper an anti-convulstant before a benzo, this thread has a small discussion about it:

 

Taking multiple psych drugs? Taper the antidepressant first!

 

Here is another link you may find helpful:

 

Guides to tapering off psychiatric medications

 

Here is the link to our symptoms and self care section, you may find some useful ideas to help manage symptoms as you recover.  Especially read the topics pinned at the top.

 

You can use this thread as your ongoing journal to track progress and communicate with the community, add to it whenever you want, you will find a lot of friendly help and support here.

 

Petu.

 

Petu,

 

Thank you very much for your reply.  I believe you are correct that I am going too quickly.  The smallest pill for Depakote ER is 250mg and it cannot be split safely with a pill splitter and cannot be mixed at a compound pharmacy.  So unfortunately, the taper would have to be 1250 mg to 1000 mg to 750 mg to 500 mg to 250 mg to 0 mg.  It's just a matter of how long to hold.  I thought I was doing ok when I dropped to 1000 mg because technically that is still within the "therapeutic range" but now that I've dipped below it, I can no longer sleep.  I'm not sure if I should updose back to 1000 mg and see if that fixes my sleep, wait a month and then try going down to 750 mg.  I will continue to read more here on the forum.  However, it seems like most places either concentrate on getting off antidepressants or benzos.  I have yet to see anywhere that deals in depth with the valproates and other bipolar medications.

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Petunia

If you are not sleeping, maybe it would be a good idea to try going back up to 1000mg.

 

I was looking for some information about how to slowly taper from Depakote and you are right, there doesn't seem to be much information 'out there', but I did find this:

 

http://www.drugs.com/pro/depakote-capsules.html

 

Administration of Sprinkle Capsules

Depakote Sprinkle Capsules may be swallowed whole or may be administered by carefully opening the capsule and sprinkling the entire contents on a small amount (teaspoonful) of soft food such as applesauce or pudding. The drug/food mixture should be swallowed immediately (avoid chewing) and not stored for future use. Each capsule is oversized to allow ease of opening.

 

If you wanted to try tapering slower, perhaps you could change to the sprinkle capsules which can be divided.  Please let us know if you decide to try this, your experiences and progress reports would be helpful for others trying to taper off Depakote.

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Rhiannon

Given your history (started at young age; bad reactions to coming off meds too fast in the past leading to multiple hospitalizations; many meds over a long period of time) I think it is absolutely crucial (if you want to succeed this time) that you find some way to come down in smaller increments and do it slowly, no more than 10% of your current dose at a time.

 

I'd look into those sprinkles. Let's see if Alto has any other suggestions too.

 

Does the pill dissolve in water? if you can dissolve the pill, you can make an aqueous suspension and go down at your own rate.

 

Again, given your history, it's going to be crucial, if you want to do this and not end up in the hospital and back on more meds, for you to find a way to go down in smaller increments.

 

Whether or not it's a "therapeutic dose" is irrelevant to withdrawal effects. You can get withdrawal at any dose. If I were in your shoes I would definitely go back to the 1000 mg, and then stay there until I found a way to cut by no more than 10% at a time.

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Zant808

I am only sleeping about 2 or 3 hours a night.  I am feeling horrible.  I noticed some minor myoclonic jerking which I remember getting from back when pdocs used to cold turkey me off meds.  I think I'm going to go back up to at least 1000 mg of Depakote ER tonight to see if that does anything.  As I mentioned earlier, with any ER medication, there is no way to alter the dosage.  So, 250 mg pills are the smallest made for Depakote ER.  Information about regular Depakote, Depakote Sprinkles and Depakote XR is not relevant to my case because they are totally different than Depakote ER.

 

If I'm ever able to get off these medications, I agree I need to be able to come off in much smaller doses like you mentioned.  However, there are no psychiatrists I know of that are willing to do this for me.  When I did a successful withdrawal back in 2007, I was switched from regular Depakote to lithium.  I was taking a benzo too, either Ativan or Klonopin and was able to switch to Valium.  However, I cannot take Valium anymore because it shuts my lungs down.  I have no idea how I would react to taking regular Depakote or lithium again but those medications were hell.  So, right now I need to get myself "stable" again so I can sleep.  Then I need to find 100% complete and absolute support from a pdoc that knows what else I can be switched to so I can make the small cuts.  I also need 100% support of my family which I do not have.  I also need a lot of time and money to do this.  I have none of these resources right now.  What am I supposed to do?  If I still had the ability to feel emotions, I'm sure it would be hopelessness right now.   :(

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Zant808

I went back up to my original dose of 1250 mg Depakote ER and 3 mg of Klonopin.  I was still only able to sleep about 2 to 3 hours.  I still feel hypomanic.  I don't know what to do at this point.  Telling this to my pdoc will surely mean going to the state mental hospital.

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mammaP

I'm so sorry that you are still feeling bad Zant, I agree with Petu and Rhi that you need a way to taper

with smaller cuts.As I understand it the depakote er is extended release and the sprinkles are rapid

release which would need several doses through the day. Maybe a doctor would allow that if you had

3 or 4 doses a day to keep levels stable. It's worth checking out with them. 

 

If you hold your dose you should start to feel better again, at least to the level you were before starting

to taper. I hope you feel better soon and don't need to go to hospital.  Doctors rarely know anything about

tapering and withdrawal and may be very reluctant to support your taper, but many doctors will agree to 

tapering to a level where you are at the lowest possible dose as opposed to getting off.   When 

you reach that dose you can then think about tapering the rest of the way. You are feeling unstable now

because of cutting too much too soon. I hope you feel better very soon.

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Zant808

I'm so sorry that you are still feeling bad Zant, I agree with Petu and Rhi that you need a way to taper

with smaller cuts.As I understand it the depakote er is extended release and the sprinkles are rapid

release which would need several doses through the day. Maybe a doctor would allow that if you had

3 or 4 doses a day to keep levels stable. It's worth checking out with them. 

 

If you hold your dose you should start to feel better again, at least to the level you were before starting

to taper. I hope you feel better soon and don't need to go to hospital.  Doctors rarely know anything about

tapering and withdrawal and may be very reluctant to support your taper, but many doctors will agree to 

tapering to a level where you are at the lowest possible dose as opposed to getting off.   When 

you reach that dose you can then think about tapering the rest of the way. You are feeling unstable now

because of cutting too much too soon. I hope you feel better very soon.

 

Thank you for your concern.  I hopefully will stabilize with the updose and then after some time I will make a decision as to whether I want to come off everything again.  I'm convinced the only way that I can get off is to switch from Depakote ER over to regular Depakote or lithium since they can be compounded to any dose.  If I wanted 1249 mg of Depakote, it can be possible.  The problem is how do I convince my current psychiatrist to do the switch and give me the doses that are small enough to compound?  If the psychiatrist is unwilling to do the switch, where can I find a doctor that can prescribe these?  I feel it's a human rights violation to not allow me to taper off safely.  I suppose I will have to get lawyers involved or escalate the situation to their medical directors so if they don't comply, they will get fired.

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mammaP

Any doctor can prescribe what you need. I would not tell them you are trying

to get off the drugs, just that you want to reduce them. They get very worried when people say they are getting off meds

because many go downhill fast with withdrawal, doctors are then under fire for allowing it.  They believe it is a relapse or return 

of illness when it is most often withdrawal, which can be avoided with a slow taper.  

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Zant808

...part of me feels I am going to be double crossed by my pdoc.  My last visit a few weeks ago resulted in me having to threaten with legal action unless I was given exactly what I wanted and the pdoc agreed to a slow over for the rest of the year.  Later today I will be meeting with the pdoc to discuss a long-term safe taper plan.  So basically the deal is that I'll be getting .5 mg Klonopin pills instead of the larger 2 mg and 1 mg pills.  I will also be switching from Depakote ER over to regular Depakote which has smaller 125 mg pills and can be compounded.  I just don't want to be double-crossed.  Already, the pdoc and pdoc's associates failed to deliver on documents they promised earlier this week.  What happens if the pdoc just BSed me last session and now discontinues my treatment for non-compliance?  I'm hoping things go smoothly.  I could have already been 2 months into a taper if it weren't for resistance from pdocs.  Any advance would be appreciated.

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dalsaan

Zant, I moved the above thread into your into one because it rates to your personal situation    please use this intro thread to keep us updated with whats happening for you

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cymbaltawithdrawal5600

Please note mammaP's reply above. Any doc can write a Rx for the medication, it does not have to be your pdoc. This should make it much easier for you.

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Altostrata

Hello, Zant.

 

Do you have a better rapport with your GP? Perhaps it would be better to work with that person regarding tapering.

 

Do not count on a psychiatrist knowing how to taper Depakote or any other psychiatric drug, or to be helpful in assisting you to go off the drugs. The best you can get is an agreement to minimize the drugs.

 

It sounds to me like you have a long history of adverse drug reactions rather than bipolar anything. However, when you do go off, you will need to take responsibility for dealing with your symptoms with non-drug therapies, or you'll go back into the "system."

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Zant808

Hello, Zant.

 

Do you have a better rapport with your GP? Perhaps it would be better to work with that person regarding tapering.

 

Do not count on a psychiatrist knowing how to taper Depakote or any other psychiatric drug, or to be helpful in assisting you to go off the drugs. The best you can get is an agreement to minimize the drugs.

 

It sounds to me like you have a long history of adverse drug reactions rather than bipolar anything. However, when you do go off, you will need to take responsibility for dealing with your symptoms with non-drug therapies, or you'll go back into the "system."

 

It's been two months since I've been on here.  To answer your question, my GP refuses to work with me regarding any psych stuff.  I managed to convince my pdoc to research how to do a successful crossover from Depakote ER to Depakote.  It is not a 1 to 1 mapping.  Over the past 2 months, I've hit some rough patches but that was mainly because I had to get surgery and then take pain killers, anti-inflammatories mixed with Klonopin and Depakote ER.  I no longer need the additional drugs but I'm still in pain and need to recover and should in a few months.  As for my taper, I've decided to go off Klonopin first and I've been working on that in one of the benzo-specific communities.  I'm already down to 1250 mg of Depakote ER and 2.625 mg of Klonopin with minimal w/d symptoms.  At the pace I'm currently going at, I should be medication free at the end of August 2015.

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Zant808

I was doing well with my Klonopin taper until a few weeks ago.  I made it down to 2 mg from 3 mg with only a few minor bumps in the road.  Then I was unable to sleep for four days straight and basically lost my mind from the lack of sleep and anxiety building up.  I wanted to avoid being hospitalized in a psych ward again, so I updosed back to 3 mg.  Unfortunately, I'm only getting about 3 hours of sleep a night.  I'm seeing my pdoc today and I am unsure what to do about my insomnia.  I think my brain is permanently damaged from being polydrugged for so long that I cannot recover.  If I cannot sleep, I cannot recover.  Staying on meds means living a crappy life.  Going off meds is my dream but there is such a huge roadblock there.  So what can I do to fix my insomnia?  I feel like I'm the only person who cannot be fixed at this point.

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Petunia

Hi Zant,

I'm sorry to hear you had to updose back to 3mg, but its good you are getting some sleep now, even though its not enough. How did you taper down to 2mg? If you would like some help with your Klonopin taper, please would you start a topic for yourself in our benzo forum:

 

Members-only benzo forum

 

What time of the day do you take your medications?

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Zant808

Hi Zant,

I'm sorry to hear you had to updose back to 3mg, but its good you are getting some sleep now, even though its not enough. How did you taper down to 2mg? If you would like some help with your Klonopin taper, please would you start a topic for yourself in our benzo forum:

 

Members-only benzo forum

 

What time of the day do you take your medications?

 

I was forced into an inpatient psychiatric facility shortly after my last message.  It was a nightmare in there.  I am now only 1250 mg of Depakote, 3 mg of Klonopin and 50 mg of Doxepin.  The doxepin supposedly helps me sleep but it has its own set of side effects that are pretty bad like rapid heart beat etc.  I will try and join the benzo forum.  I think at this point I need to get a doctor who is 100% with me when it comes to managing a long-term withdrawal.  Until then, I have no idea what to do other than suffer on these meds forever.

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Altostrata

So sorry to hear that, Zant. If I were you, I'd reduce the doxepin right away. That sounds like a bad side effect.

 

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

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vetdoc

Hi Zant

 

I agree with Alto about tapering down Doxepin right away.  I have  experience with doxepin  to help with sleep. 

If it is going to be used as a sleep aid rather then anti depressant, then low dose doxepin is what has shown to work best.   I am talking  6-10 mg maximum dose is recommended.  I'm not certain why but it's paradoxical,  lower dose on doxepin is much more effective then higher doses with far less side effects for sleep. 

 

I was on 6-7 mg doxepin and it helped my sleep a lot, during my valium taper. 

 

If you are going to continue with the doxepin, It comes in liquid 10mg/ml generic so you can titrate smaller doses then the capsules.  I'm surprised your P doc hasn't heard of the name brand silenor which is doxepin marketed as strictly a sleep aid, in 3 and 6 mg tablets.  It is very expensive.  The generic liquid doxepin is very inexpensive.  I wouldn't start at higher then 6 mg and see how it works for you.

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Zant808

So sorry to hear that, Zant. If I were you, I'd reduce the doxepin right away. That sounds like a bad side effect.

 

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

 

 

clonazepam <-> doxepin
 
Using doxepin together with clonazePAM may add to dizziness, drowsiness, breathing problems, and other side effects. This may be more likely to occur in older adults or those with a debilitating condition. Talk with your doctor before using clonazePAM together with doxepin. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
 
clonazepam <-> divalproex sodium
 
Before taking clonazePAM, tell your doctor if you also use divalproex sodium. You may need dose adjustments or special tests in order to safely take both medications together. This combination may affect seizure control and cause drowsiness. You should avoid driving until you know how these medications will affect you. It is important that you tell your healthcare provider about all other medications that you are using including vitamins and herbs. Do not stop using your medications without first talking to your doctor first.
 
doxepin <-> divalproex sodium
 
Before using doxepin, tell your doctor if you also use divalproex sodium. This combination may cause uneven heartbeats, extreme drowsiness, dizziness, confusion, blurred vision, and seizures. If you take both medications together, tell your doctor if you have any of these symptoms. You may need a dose adjustment or special tests if you take both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Zant808

Thanks, vetdoc. Please add your wisdom to Tips for tapering doxepin (Sinequan, Zonalon)

 

Zant, I would reduce the doxepin by 25% to start and another 25% in 4 days.

 

I only have the 25 mg type of pills of Doxepin.  I was on 50 mg of Doxepin for maybe 7 days total.  I dropped down to 25 mg last night.  I will probably drop to 0 mg tonight because I have not had this in my system for that long unless you think I should do otherwise.  I cannot get any other dose other than 25 mg or 50 mg capsules and I cannot cut the capsules.

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Zant808

I'd give the 25mg 4 days and see how you feel.

 

You can make a liquid from the capsules, please read Tips for tapering doxepin (Sinequan, Zonalon)

 

I was able to sleep 5 hours last night.  However, I'm feeling a lot of random anxiety and nausea today.

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Altostrata

It may take your system some time to settle down. Maybe your exit from doxepin should be slower.

 

At what times of day do you take your drugs, at what dosages? Do your symptoms have any daily pattern?

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Zant808

It may take your system some time to settle down. Maybe your exit from doxepin should be slower.

 

At what times of day do you take your drugs, at what dosages? Do your symptoms have any daily pattern?

 

The exit from doxepin probably should have been slower.  However, in the mental state I'm in now, I'm not able to comprehend how to create the custom liquid form.  I've already reached 0 mg.  Ever since my hospitalization, I've been taking my meds between 9:30 PM and 10:30 PM.  I'll have to take them soon.  There's not really a daily pattern for symptoms.  The nausea is gone completely and anxiety has gone down a lot.  If I can stabilize at 1250 mg of Depakote and 3 mg of Klonopin for now, I'll take it.

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Altostrata

Why were you forced into the hospital?

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Zant808

Why were you forced into the hospital?

 

I had my mother attend the pdoc appointment with me because she needed to fill out paperwork regarding healthcare privacy.  Instead of doing the paperwork, my pdoc asked my mother questions regarding my behavior and my mother said things that were obvious red flags such as I wanted to commit suicide, harm others etc. even though such statements were not true at the time.  I was merely anxious about the lack of sleep and wanted a solution.  It was my word vs. my mother's and the pdoc sided with my mother and thus I was forced into inpatient.  I was fortunate enough that they botched things internally and I was able to sign myself out of the hospital voluntarily instead of having to wait for a court hearing as is supposed to be the case with committed mental patients in the USA.

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Altostrata

Why does your mother need to fill out paperwork for you? Is she your guardian?

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Zant808

Why does your mother need to fill out paperwork for you? Is she your guardian?

 

She needed to fill out forms for HIPPA so she can get my medical information if I'm in the hospital.  She isn't technically my guardian but is the only family member alive capable of handling a complicated case such as myself right now.

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Altostrata

How have the circumstances of your latest hospitalization affect your relationships with your mother and your psychiatrist?

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Zant808

How have the circumstances of your latest hospitalization affect your relationships with your mother and your psychiatrist?

 

I would say very poorly.  Both of them no longer want to support my withdrawal even though they never really looked at any of the dozens of resources I showed them.  They insist that the meds are helping me, I was born with a biological illness of bipolar disorder and that I should remain on permanent disability for the rest of my life.  At my last psychiatrist visit, I got ignored when I asked for my official DSM diagnosis.  I was also given the lame statement where diabetics take insulin and I am the same with my mental illness.

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Altostrata

Perhaps discussing your inner life with your mother is something you might avoid.

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Zant808

Perhaps discussing your inner life with your mother is something you might avoid.

 

It's a complicated matter.  With that said, I think I will start using this thread as a daily progress log for coming off my meds.

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Zant808

After a long struggle this year, I've managed to find a reliable withdrawal pdoc and I am down to 375 mg of Depakote (the regular kind, not ER) and 3 mg of Klonopin.  I should be off of Depakote completely by December 31, 2015 and will focus on coming off the 3 mg of Klonopin in 2016.

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