csm2014: Lamictal question

[csm2014]

Lamictal question (was only on for 3 mos.): Don't know quite how to read this one - but early this morning I awoke with palps/tachycardia and higher than usual BP reading. It has been exactly 7 days since stopping the Lamictal taper (I started from 100mg, cutting 25mg every 2 weeks until off as instructed). Each day since the final cut, I have noticed an increase in agitation/anxiety (as I also noticed during the taper, but this time it's not going away). Doc and pharmacist advised if I feel discomfort to backpedal on my last dose of 25mg every other day (or 12.5mg/day) and hold for a week or so until I stabilize and then wait 2 weeks to be clear of w/d before commencing the Klonopin taper. Great, now another obstacle to delay my K taper! 

Thoughts?

[cymbaltawithdrawal5600]

csm,

 

I moved your post into the Introductions forum as, unfortunately, you placed it in a thread that is "a general discussion about how to decide which drug to taper first. For case-by-case consideration of what YOU should do, please put your questions in an Introductions topic."

 

In order to answer you better would you please edit your signature to remove the < > code box? Just type in what you have and omit any spaces and dashes that aren't necessary. Your dates are a bit confusing with all of the dashes separating the numbers.

 

Unfortunately you were instructed by your doctor to reduce the drug far too rapidly and the symptoms you are feeling are no doubt due to the rapid withdrawal. Your body has gotten used to the drug even though it has only been 3 months.

 

You are not going to want to taper the K at all until you have reinstated enough of the lamictal to ease the withdrawal symptoms and stabilize. Then, and only then, might you think about tapering the lamictal first as the K will help cushion some of the withdrawal. We never recommend skipping doses as this greatly adds to destabilization.

 

How are you taking the less than 100mg doses of the lamictal? Are you breaking the tablets and just 'eyeballing' them?

[csm2014]

csm,

 

I moved your post into the Introductions forum as, unfortunately, you placed it in a thread that is "a general discussion about how to decide which drug to taper first. For case-by-case consideration of what YOU should do, please put your questions in an Introductions topic."

 

In order to answer you better would you please edit your signature to remove the < > code box? Just type in what you have and omit any spaces and dashes that aren't necessary. Your dates are a bit confusing with all of the dashes separating the numbers.

 

Unfortunately you were instructed by your doctor to reduce the drug far too rapidly and the symptoms you are feeling are no doubt due to the rapid withdrawal. Your body has gotten used to the drug even though it has only been 3 months.

 

You are not going to want to taper the K at all until you have reinstated enough of the lamictal to ease the withdrawal symptoms and stabilize. Then, and only then, might you think about tapering the lamictal first as the K will help cushion some of the withdrawal. We never recommend skipping doses as this greatly adds to destabilization.

 

How are you taking the less than 100mg doses of the lamictal? Are you preaking the tablets and just 'eyeballing' them?

I was instructed to taper from 100mg to 75mg (3 25mg tablets) for 2 weeks, then 50mg (2 tablets) for 2 weeks , then 25mg for 2 weeks, then off. On each cut I experienced mild symptoms for a couple days into the cut which got better until the next cut. These are also the instructions I read for most cuts regarding Lamictal so I assumed I was "in the clear". Guess not. It sounds like I will need to updose to find where I can stabilize, then taper at a much smaller dose, like 12.5mg at a time instead of 25mg. Thank goodness I was not on a huge dose like 300-400mg like some I read about. I originally wanted off the Klonopin first, but after reading the thread of tapering the AD first and taking the advice from my doc, I agreed to taper the Lamictal first. The whole brake (sedative)/accelerator (AD) thing made perfect sense to me.

 

Thoughts?

 

1) 10mg Valium average (some days only 5mg and up to 30mg but on only one day) for 21 non-consecutive days (prn)

2) .75mg Xanax average for approx. 22 non-consecutive days (prn)

3)  switched immediately to Klonopin 0.5mg average/day for 2 weeks (10-17-24-10-30-14); titrated to 1mg/day (0.5mg bid) (10-31-14 to present)

4) Lamictal: 25mg q.d. from 10-18-14 to 10-20-15; 50mg q.d. from 10-21-14 to 10-22-15; 100mg q.d. from 10-23-14 to 12-04-14; started tapering off 12-05-14 @ 25mg every 2 weeks; taper completed 01-15-14

5) Also taking meds for blood pressure (Coreg @ 6.25mg b.i.d. and Losartan @ 50mg b.i.d.) + for blood clot I had back in 2012 (Xarelto @ 10mg) + for hypothyroidism (Armour Thyroid @ 1grain q.d.)

[cymbaltawithdrawal5600]

What was the last dose you were taking every day? This is the dose you may want to start your taper from, I gather that your last day of this dose was the 15th? If I have got it wrong, please tell me. You went from something to nothing on the 15th, right?

 

You would be better doing a much more gradual taper of no more than 10% of the CURRENT dose every 4-6 weeks as long as your body feels stable on the last dose.

 

Is anxiety the only symptom you seem to be feeling? It helps to keep track of your symptoms on paper each day so you can see the effect tapering has on you.

 

Thank you so much for editing your signature too!

[cymbaltawithdrawal5600]

I forgot to ask why you were put on lamictal to begin with. When did you start the valium, when did you end it and why was there a switch? These things should be in your sig too. We look at when you stopped and started drugs in addition to what their doses were.

 

And I see I spoke too soon about the signature: if you look at the instructions in my signature you will se a lonk on how to ddo one. Hyst take the info you wrote above:

 

 

1) 10mg Valium average (some days only 5mg and up to 30mg but on only one day) for 21 non-consecutive days (prn)
2) .75mg Xanax average for approx. 22 non-consecutive days (prn)
3)  switched immediately to Klonopin 0.5mg average/day for 2 weeks (10-17-24-10-30-14); titrated to 1mg/day (0.5mg bid) (10-31-14 to present)
4) Lamictal: 25mg q.d. from 10-18-14 to 10-20-15; 50mg q.d. from 10-21-14 to 10-22-15; 100mg q.d. from 10-23-14 to 12-04-14; started tapering off 12-05-14 @ 25mg every 2 weeks; taper completed 01-15-14

5) Also taking meds for blood pressure (Coreg @ 6.25mg b.i.d. and Losartan @ 50mg b.i.d.) + for blood clot I had back in 2012 (Xarelto @ 10mg) + for hypothyroidism (Armour Thyroid @ 1grain q.d.)

 

and put it in there. That way it will attach itself to every post you make on the site and be a ready reference of your history and status.

[csm2014]

What was the last dose you were taking every day? This is the dose you may want to start your taper from, I gather that your last day of this dose was the 15th? If I have got it wrong, please tell me. You went from something to nothing on the 15th, right?

 

You would be better doing a much more gradual taper of no more than 10% of the CURRENT dose every 4-6 weeks as long as your body feels stable on the last dose.

 

Is anxiety the only symptom you seem to be feeling? It helps to keep track of your symptoms on paper each day so you can see the effect tapering has on you.

 

Thank you so much for editing your signature too!

Yes, last dose was on the 15th @ 25mg. Moderate anxiety/agitation and some mild fatigue/depression seem to be the only symptoms. There's no way I can do a 10% taper from this dose + drag it out far too long + force me to remain on Klonopin longer than I have to since I can't taper both at same time.

[cymbaltawithdrawal5600]

Did you mean to just quote a post? I don't see a question or an answer.....

[csm2014]

I forgot to ask why you were put on lamictal to begin with. When did you start the valium, when did you end it and why was there a switch? These things should be in your sig too. We look at when you stopped and started drugs in addition to what their doses were.

 

And I see I spoke too soon about the signature: if you look at the instructions in my signature you will se a lonk on how to ddo one. Hyst take the info you wrote above:

 

1) 10mg Valium average (some days only 5mg and up to 30mg but on only one day) for 21 non-consecutive days (prn)

2) .75mg Xanax average for approx. 22 non-consecutive days (prn)

3)  switched immediately to Klonopin 0.5mg average/day for 2 weeks (10-17-24-10-30-14); titrated to 1mg/day (0.5mg bid) (10-31-14 to present)

4) Lamictal: 25mg q.d. from 10-18-14 to 10-20-15; 50mg q.d. from 10-21-14 to 10-22-15; 100mg q.d. from 10-23-14 to 12-04-14; started tapering off 12-05-14 @ 25mg every 2 weeks; taper completed 01-15-14

5) Also taking meds for blood pressure (Coreg @ 6.25mg b.i.d. and Losartan @ 50mg b.i.d.) + for blood clot I had back in 2012 (Xarelto @ 10mg) + for hypothyroidism (Armour Thyroid @ 1grain q.d.)

 

and put it in there. That way it will attach itself to every post you make on the site and be a ready reference of your history and status.

 

 

Doc switched me from Lexapro (bad side fx) to the Lamictal for mood stabilization and help with anxiety. Originally, I was taking the Xanax until the Lexapro kicked in, but that never happened and that when I was switched to the Lamictal/Klonopin combo (I re-edited my signature - see below).

 

My take is that this whole thing was was induced by certain blood pressure meds interacting with my thyroid meds and causing panic attacks/rebound hypertension throughout last year that led to a over-sensitized nervous system sort-of breakdown which was when the ER doc gave me a scrip for Valium for the first time. I tried every OTC natural remedy before resorting lastly to benzos and ADs. Now, we hope the underlying issues are on the mend and are ready to taper the meds. I do not have any prior history of psych issues, anxiety or depression, or bipolar, and have never used any psych meds before in my life. So had to fight fire that had to be put out with yet another fire which will need to be put out. I learned my lesson the hard way that pharmaceuticals are not the answer for me. I treated my hypertension naturally for many years before deciding to try blood pressure meds and this is the result of it. I unintenionally took the wrong fork in the road, got myself fairly stabilized in the last 2 mos., made it throught the holidays, and now I have to bite the bullet and get myself out of yet another rabbit hole.

[cymbaltawithdrawal5600]

Alright, so you tapered off the lamictal too rapidly and your system is probably not in any shape to taper off any of your meds any further. What is it that we can help you with then? I am not sure what to advise you because I am not sure that you really want to go back on or taper another drug?

 

Perhaps another mod will check in or you can elaborate on what you mean by:

 

 

So had to fight fire that had to be put out with yet another fire which will need to be put out

 

Is your thyroid now stable?

[csm2014]

Alright, so you tapered off the lamictal too rapidly and your system is probably not in any shape to taper off any of your meds any further. What is it that we can help you with then? I am not sure what to advise you because I am not sure that you really want to go back on or taper another drug?

 

Perhaps another mod will check in or you can elaborate on what you mean by:

 

So had to fight fire that had to be put out with yet another fire which will need to be put out

 

Is your thyroid now stable?

 

 

Sorry to confuse. What I meant was that it was a combination of meds (blood pressure and thyroid meds) that got me into this mess and then it took yet more meds - and ones with brain-altering side fx - to stabilize, but am paying the price now to have to suffer coming off them. That's what I meant by fighting the fire with yet another fire.

 

Yes, my thyroid still has a ways to go but is definitely in much better shape now than when all this mess started. Appreciate your advice. I just had no idea that coming off the Lamictal would be a big deal like a benzo, so this caught me a bit by surprise. I will take your suggestion and go back on the last dose of 25mg to hopefully stabilize and take it slowly down from there. How slow, I don't know yet. What's crazy is that my friend's sister took Lamictal for 2 years and just stopped it CT and had no w/d symptoms.

 

On a side note, both hypothyroidism and hyperthyroidism can definitely cause anxiety, panic attacks, depression, and mood disorders, amongst a bevy of physical symptoms. A lot of people are mistakenly put on psych meds when all they do many times is mask an underlying thyroid or adrenal problem.

[csm2014]

Alright, so you tapered off the lamictal too rapidly and your system is probably not in any shape to taper off any of your meds any further. What is it that we can help you with then? I am not sure what to advise you because I am not sure that you really want to go back on or taper another drug?

 

Perhaps another mod will check in or you can elaborate on what you mean by:

 

So had to fight fire that had to be put out with yet another fire which will need to be put out

 

Is your thyroid now stable?

 

 

This is my 2nd day back on my last dose of 25mg and although I got to sleep ok, I again awoke early with tachycardia, palps, and elevated BP, and couldn't get back to sleep. As soon as I'm up, the symptoms subside. I guess I must give myself more time to re-stabilize then? I've never been through a psych med taper before so have no idea. It scares me that it's something else, like tolerance to the K or another undiagnosed health issue?

[Rhiannon]

I was going to suggest you reinstate at something a little lower than the 25 mg. At this point, it's hard to say, since you've already restarted at the 25 mg, and often the best thing to do is just stick with a dose until you've readapted to it. But if you really feel the 25 mg is too much you might try 15 or 20 mg. I do fine with making a water suspension with my Lamictal.

 

It seems like there's a lot of variation in how Lamictal affects people coming off, from "no problem" to "the worst drug withdrawal experience I've ever had." I find it pretty tricky to taper and get symptoms with cuts as low as 1-2 mg (I'm on 50 now and holding while I taper other stuff). Gianna of Beyond Meds had a terrible time with getting off Lamictal and her post "Lamictal taper from hell" has gotten more hits than anything else on her blog since she posted it. So you are not alone.

[csm2014]

I was going to suggest you reinstate at something a little lower than the 25 mg. At this point, it's hard to say, since you've already restarted at the 25 mg, and often the best thing to do is just stick with a dose until you've readapted to it. But if you really feel the 25 mg is too much you might try 15 or 20 mg. I do fine with making a water suspension with my Lamictal.

 

It seems like there's a lot of variation in how Lamictal affects people coming off, from "no problem" to "the worst drug withdrawal experience I've ever had." I find it pretty tricky to taper and get symptoms with cuts as low as 1-2 mg (I'm on 50 now and holding while I taper other stuff). Gianna of Beyond Meds had a terrible time with getting off Lamictal and her post "Lamictal taper from hell" has gotten more hits than anything else on her blog since she posted it. So you are not alone.

Yes, have read her blog. Thank God I wasn't on it long and at huge doses. Gotta feel for those folks. Lots of variables with each person; I was very surprised to learn of this in my education on psych meds. My symptoms on each cut (which was 25mg) weren't as acute nor lasted as long as I've experienced the last two days, but I think that's expected as I reached a point where the metabolites were finally exiting and my brain chemistry/CNS/neurotransmitters hadn't quite yet made the adjustments, hence, more acute and classic w/d. Doc today suggested I resume @ 50mg for a week and go from there. That was a level I did farily well on the latter part of the cut and probabl;y should've held a while longer before cutting another 25mg. In my case, I am an athlete, and vigorous exercise (strength training & cardio) really helps reduce w/d symptoms. Yoga too. Also, eating a healthy diet free of wheat, gluten, sugar and junk food + using key supplements helps keep it together. I always feel better coming out of the gym even on days like today when I didn't think I could do it.

[cymbaltawithdrawal5600]

 

Doc today suggested I resume @ 50mg for a week and go from there.

 

And how might that affect the symptoms you are now getting from a 25 mg dose? Your body will never again be the same body as it was on a higher dose, time has passed and it has already made adjustments to the change in doses you have made. You can't 'go back' and re-taper without your body reacting. We never recommend changing your doses as your doctor is recommending. That is ofter a recipe for an increase in unwanted symptoms and possible de-stabilization.

[csm2014]

 

Doc today suggested I resume @ 50mg for a week and go from there.

 

And how might that affect the symptoms you are now getting from a 25 mg dose? Your body will never again be the same body as it was on a higher dose, time has passed and it has already made adjustments to the change in doses you have made. You can't 'go back' and re-taper without your body reacting. We never recommend changing your doses as your doctor is recommending. That is ofter a recipe for an increase in unwanted symptoms and possible de-stabilization.

 

1)I am assuming these are w/d symptoms from having stopped the med after my taper (since I observed an increase every day once I stopped), but how do I really know this? How do I know it's not something else? I can only assume it is from w/d.

 

2)I see what you're saying, but I was only on the 25mg dose for 2 nights, so how is that long enough to judge? If my symptoms were getting worse during the 7 days after I completed my taper and off the Lamictal, I was already de-stabilized, so wouldn't I want to at least go back on the last dose or updose and give it more time for me to re-stabilize? I can't tell if the 25mg was making me feel worse because I only resumed it for 2 days. Also, as Rhi posted, "At this point, it's hard to say, since you've already restarted at the 25 mg, and often the best thing to do is just stick with a dose until you've readapted to it."

 

This is all so confusing and I don't know what to do now. I followed my doc's advice and took the 50mg dose last night. I don't feel any better or worse today so far. Can't talk to doc until next week.

[csm2014]

cymbaltawithdrawal5600 -

 

Doc today suggested I resume @ 50mg for a week and go from there.

 

And how might that affect the symptoms you are now getting from a 25 mg dose? Your body will never again be the same body as it was on a higher dose, time has passed and it has already made adjustments to the change in doses you have made. You can't 'go back' and re-taper without your body reacting. We never recommend changing your doses as your doctor is recommending. That is ofter a recipe for an increase in unwanted symptoms and possible de-stabilization.

 

Update: Well, I definitely experienced worse symptoms after I last posted the rest of today and tonight (increased tachycardia, BP, pulse, anxiety, body aches), so you were right. That 50mg definitely did not relieve me! I am so new to all this, so please bear with me. I think I should err on the side of caution and re-attempt resuming the last dose I was on (25mg) and just bear with it until Mon. Don't know what else to do. Fortunately, I have BP meds to somewhat control the BP and tachycardia and the Klonopin to help lessen the anxiety, but they don't eliminate the symptoms entirely which I'm surprised.

[Petunia]

Hi csm2014,
I just read through your thread, I'm sorry you have ended up on psychiatric drugs unnecessarily, but I'm glad you found us and have some support with getting off them safely.
 

This is all so confusing and I don't know what to do now. I followed my doc's advice and took the 50mg dose last night. I don't feel any better or worse today so far. Can't talk to doc until next week.

Unfortunately, most doctors don't have a clue about the effects of these kinds of drugs or how to come off them safely.
 

Update: Well, I definitely experienced worse symptoms after I last posted the rest of today and tonight (increased tachycardia, BP, pulse, anxiety, body aches), so you were right. That 50mg definitely did not relieve me! I am so new to all this, so please bear with me. I think I should err on the side of caution and re-attempt resuming the last dose I was on (25mg) and just bear with it until Mon. Don't know what else to do.

 

I agree that going back down to 25mg is a good idea.  But then you need to give yourself time to stabilize at that dose.  Every time you make a change, you are causing de-stabilization.

 

These two topics may help you understand:

 

About reinstating and stabilizing to stop withdrawal symptoms

 

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

 

I hope you start to feel better soon, do keep us updated.

 

Petu.

 

[csm2014]

Hi csm2014,

I just read through your thread, I'm sorry you have ended up on psychiatric drugs unnecessarily, but I'm glad you found us and have some support with getting off them safely.

 

 

This is all so confusing and I don't know what to do now. I followed my doc's advice and took the 50mg dose last night. I don't feel any better or worse today so far. Can't talk to doc until next week.

 

Unfortunately, most doctors don't have a clue about the effects of these kinds of drugs or how to come off them safely.

 

Update: Well, I definitely experienced worse symptoms after I last posted the rest of today and tonight (increased tachycardia, BP, pulse, anxiety, body aches), so you were right. That 50mg definitely did not relieve me! I am so new to all this, so please bear with me. I think I should err on the side of caution and re-attempt resuming the last dose I was on (25mg) and just bear with it until Mon. Don't know what else to do.

 

 

I agree that going back down to 25mg is a good idea.  But then you need to give yourself time to stabilize at that dose.  Every time you make a change, you are causing de-stabilization.

 

These two topics may help you understand:

 

 

About reinstating and stabilizing to stop withdrawal symptoms

 

 

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

 

I hope you start to feel better soon, do keep us updated.

 

Petu.

Really appreciate the advice, support & links!

 

This latest setback could've most likely been avoided had I not jumped @ 25, as my taper was going fairly well cutting by 25 every 2 weeks from 100.

[csm2014]

Hi csm2014,

I just read through your thread, I'm sorry you have ended up on psychiatric drugs unnecessarily, but I'm glad you found us and have some support with getting off them safely.

 

This is all so confusing and I don't know what to do now. I followed my doc's advice and took the 50mg dose last night. I don't feel any better or worse today so far. Can't talk to doc until next week.

Unfortunately, most doctors don't have a clue about the effects of these kinds of drugs or how to come off them safely.

 

Update: Well, I definitely experienced worse symptoms after I last posted the rest of today and tonight (increased tachycardia, BP, pulse, anxiety, body aches), so you were right. That 50mg definitely did not relieve me! I am so new to all this, so please bear with me. I think I should err on the side of caution and re-attempt resuming the last dose I was on (25mg) and just bear with it until Mon. Don't know what else to do.

 

I agree that going back down to 25mg is a good idea.  But then you need to give yourself time to stabilize at that dose.  Every time you make a change, you are causing de-stabilization.

 

These two topics may help you understand:

 

About reinstating and stabilizing to stop withdrawal symptoms

 

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

 

I hope you start to feel better soon, do keep us updated.

 

Petu.

 

Felt much better last night during and after my workout and slept much better than the last few nights, but still getting that morning anxiety which I attribute to a surge of cortisol. I still have other issues that I'm working on that contribute to my well-being (thyroid, adrenals, etc.). At this point, it doesn't matter if the meds were unecessary or not, for at the time (last Sept-Oct.) I tried everything natural to alleviate the symptoms to no avail and those symptoms had to be controlled first and I was desperate for relief so I followed my doc's suggestions. Now, it's time to get off them for many reasons. My hope was to be off the Lamictal long enough without symptoms to then start tapering the Klonopin. This setback unexpectedly delayed that which is disappointing, but it is what it is and I have no choice but to restabilize on the Lamictal. Hopefully, that wil not take a long time. Then, I've got to taper that one slow. The worst part of this is that it's holding me back from living my life and pursuing areas unrelated to just health issues.

[csm2014]

 

Hi csm2014,

I just read through your thread, I'm sorry you have ended up on psychiatric drugs unnecessarily, but I'm glad you found us and have some support with getting off them safely.

 

This is all so confusing and I don't know what to do now. I followed my doc's advice and took the 50mg dose last night. I don't feel any better or worse today so far. Can't talk to doc until next week.

Unfortunately, most doctors don't have a clue about the effects of these kinds of drugs or how to come off them safely.

 

Update: Well, I definitely experienced worse symptoms after I last posted the rest of today and tonight (increased tachycardia, BP, pulse, anxiety, body aches), so you were right. That 50mg definitely did not relieve me! I am so new to all this, so please bear with me. I think I should err on the side of caution and re-attempt resuming the last dose I was on (25mg) and just bear with it until Mon. Don't know what else to do.

 

I agree that going back down to 25mg is a good idea.  But then you need to give yourself time to stabilize at that dose.  Every time you make a change, you are causing de-stabilization.

 

These two topics may help you understand:

 

 

About reinstating and stabilizing to stop withdrawal symptoms

 

 

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

 

I hope you start to feel better soon, do keep us updated.

 

Petu.

 

Really appreciate the advice, support & links!

 

This latest setback could've most likely been avoided had I not jumped @ 25, as my taper was going fairly well cutting by 25 every 2 weeks from 100.

 

I seem to have a 12hr cycle in which I feel better from about 6-8p-6-8a; crappy from 6-8a to 6-8p. Peaks worst @ around 4-5p. Today, same thing. Started getting worse again around 2p - anxious/depressed/moody/fatigued/achey. Can't understand how being off it for only 7 days could've destabilized me and why I'm not restabilizing faster. Thoughts?

[Petunia]

You jumped off 25mg Lamictal after a too fast taper down from 100mg.  This would have caused destabilization which is going to take some time to recover from, even though you reinstated 7 days later.  Did you reinstate the 25mg on Jan 25?  If so, please would you add that to your signature.

 

If this is correct, it means you only reinstated 2 days ago.  It can take several weeks, possibly longer for stabilization to occur once the nervous system has become destabilized.  Did you read the links I posted?  They will help you to understand.

[csm2014]

You jumped off 25mg Lamictal after a too fast taper down from 100mg.  This would have caused destabilization which is going to take some time to recover from, even though you reinstated 7 days later.  Did you reinstate the 25mg on Jan 25?  If so, please would you add that to your signature.

 

If this is correct, it means you only reinstated 2 days ago.  It can take several weeks, possibly longer for stabilization to occur once the nervous system has become destabilized.  Did you read the links I posted?  They will help you to understand.

I updated my signature as you can see. I started reinstating Lamictal on Jan 22. During my taper, I only felt a moderate withdrawal (if that's what it was) which lasted 2-3 days max and then I'd feel better until the next cut. I just figured this was to be expected during a taper. It didn't even cross my mind that my taper was too rapid as I trusted my doc's instructions and also checked with a couple pharmacists.

 

I did read both links and understand what I'm faced with now. My focus was much more on getting to my tapering off the Klonopin once I was off the Lamictal. In fact, I wanted to taper the Klonopin first, but was advised by all not to - and after reading this thread: http://survivingantidepressants.org/index.php?/topic/2207-taking-multiple-psych-drugs-taper-the-antidepressant-first/. My additional concern is that waiting to restabilize will delay my Klonopin taper and keep me on it longer since I cannot taper it now while this is going on. I was much more concerned with getting off the Klonopin than the Lamictal. Extending the time on Klonopin will just make my taper off it that much harder I fear. I guess I have no choice now.

 

Thoughts?

[Petunia]

Thanks for updating your signature csm.

 

 Extending the time on Klonopin will just make my taper off it that much harder I fear. I guess I have no choice now.

Thoughts?

 

 

And beginning a taper off it when your nervous system is already destabilized would make it even harder and possibly cause you to have to reinstate.  Its completely your decision what you do, but I think this way may take longer, but will be less  painful.

[csm2014]

Thanks for updating your signature csm.

 

Extending the time on Klonopin will just make my taper off it that much harder I fear. I guess I have no choice now.

 

Thoughts?

 

And beginning a taper off it when your nervous system is already destabilized would make it even harder and possibly cause you to have to reinstate.  Its completely your decision what you do, but I think this way may take longer, but will be less  painful.

 

The destabilization definitely threw me for a loop, but I can't say I wasn't forewarned and didn't feel it coming on a few days beforehand (I was just hoping it would lessen, but it didn't), so it is what it is, and that's the way my body handled it, so I would now have to agree with you that a much slower taper of the Lamictal will be the least problematic. And Klonopin would not be one I would ever want to reinstate! Assuming I can restabilize @ 25, it shouldn't be too bad, but the jury's still out on that one. Also, I just learned there is a tiny chewable dose available as low as 2mg (this might help others that want to taper Lamictal that were unaware): http://dailymed.nlm.nih.gov/dailymed/archives/fdaDrugInfo.cfm?archiveid=13638

[csm2014]

New symptoms: getting hot spells/increased body temp/flushing/perspiration/increased heart rate/nervousness/body aches after my first meal of the day. Feels similar to the stimulatory effects of too much caffeine. I take certain supplements, but absolutely nothing with stimulants or fat burners. I can't tell if this is the continued adjustment I must go through before stabilization, a detox reaction, or if I need to adjust the Lamictal up or down. I am trying to hang in there and not have to raise my dose. Been back on 25mg now for 6 days. Have not consulted my doc yet (he wanted me to reinstate @ 50mg last week).

 

Thoughts?

[Petunia]

What supplements are you taking and do you take them with your first meal?  Do you have these symptoms after your other meals?

 

Some people can develop sensitivities to certain foods in withdrawal.

 

I put all your drugs in the interactions checker and there are no major potential problems, there is a moderate one if you are using a potassium-containing salt substitute, details here:

 

http://www.drugs.com/interactions-check.php?drug_list=1489-0,2189-1435,531-266,1430-848,3332-15382

[csm2014]

What supplements are you taking and do you take them with your first meal?  Do you have these symptoms after your other meals?

 

Some people can develop sensitivities to certain foods in withdrawal.

 

I put all your drugs in the interactions checker and there are no major potential problems, there is a moderate one if you are using a potassium-containing salt substitute, details here:

 

http://www.drugs.com/interactions-check.php?drug_list=1489-0,2189-1435,531-266,1430-848,3332-15382

I've maintained a modified paleo diet free of gluten, yeast, grains, sugar, soy, alcohol, or anything processed for decades and am very familiar with food and chemical sensitivities. Ironically, that and a chronic intestinal yeast infection that lasted years is how all my health problems originally began after being hospitalized from an acute and life-threatening antibiotic-induced bacterial infection. I've also used supplements of all kinds for various issues during this time as well. Resorting to pharmaceuticals was like being forced to convert from Chrisitianity to Satanism, lol. But I reached a point of desparation last year and felt I had no choice. That's the past and I must move ahead. Anyway, here's a fairly recent summary of my supplement regime: https://app.box.com/s/uba37yor65qov8gb6odfkqjfxl2w768h

 

I have pretty much the same supps with both meals and do not get the same symptoms to answer your question. From what I understand, Lamictal w/d can cause these symptoms:

http://www.theroadback.org/lamictalwithdrawal.aspx

I make sure and take my meds away from my supps. I have run all my supps through the drug interactions checker and my doc as well and nothing major. Lamictal screws up folate metabolism which in my case is really important since I have the MTHFR C677T +/+ genetic defect and need my methylated Bs even more now. I do not use supps that act as stimulants or anything with the excitatory amino acids glutamine or aspartatic acid as those are the main things Lamictal blocks when you're on it, and when you come off it, the brakes are off and your body's receptors are sensitized to those agents, although those amino acids are naturally-occuring in all protein foods and are essential to health. Lamictal is a different animal than straight SSRI/SNRI/Tricyclic ADs. It is an anticonvulsant/AED that works on entirely different receptors than those ADs, although it is said to have mild AD properties. My doc put me on it for mood stabilization as a replacement for Lexapro which gave me acute side fx and stopped it after 10 days. I do not have bipolarity, manic depression or GAD and feel for the folks that do. My psych med intervention was a result of blood pressure drug interactions that went out of control like a wildfire.

 

I also have some endocrine system issues that started well before I got on all these meds so this further complicates my issues. I had a parathyroid tumor removed last July that was the cause of hyperparathyroidism which can cause just about every symptom you can imagine, both mental and physical. That, as well as hypothyroidism. Both played a part in my "breakdown" last Sept. Removal of the offending tumor was a success and curative insofar as my calcium and PTH levels, but caused transient hyperthyroidism which weeks later swung to the extreme opposite end of having even worse hypothyroidism than I did before. On top of that, I quit my thyroid meds cold turkey out of desperation which was not a good idea. I made some real stupid judgment calls with my health last year and am paying for it now. We are still looking into the possibility of other hidden hormone or endocrine-related issues. At least my thyroid is slowly on the mend. Thyroid (and adrenal)imbalances play a huge role in mood disorders - both depression and anxiety, and most docs are ignorant of this.

 

If history has taught me anything, it's that meds have caused more grief and consequences in my life than they have helped. Here I am now 35 years later since being hospitalized and still reeling from the side effects of them. Not more than six months ago, I didn't even know what a benzo was. Many years back, I had a very stressful life event that dragged on for nearly seven years and I never felt the need to resort to any psych meds no matter how much anxiety and hopelessness I suffered from.

 

Sorry to have digressed, but I'm a complex case and there's more to the story that just going on and off these meds, what can I say

[Petunia]

I agree, you are a complex case csm.  When do you take your Lamictal?

 

I notice you are taking a lot of supplements, but if you take the same supplements with both meals, but only react after the first one, I wouldn't think it would be anything in the supplements.

 

The new symptoms which you're getting are common to withdrawal from most psychiatric drugs including ADs and benzos, not specific to Lamictal, but its puzzling why they are being triggered when you first eat.

[csm2014]

I agree, you are a complex case csm.  When do you take your Lamictal?

 

I notice you are taking a lot of supplements, but if you take the same supplements with both meals, but only react after the first one, I wouldn't think it would be anything in the supplements.

 

The new symptoms which you're getting are common to withdrawal from most psychiatric drugs including ADs and benzos, not specific to Lamictal, but its puzzling why they are being triggered when you first eat.

I take Lamictal right before bed. During the worst of the w/d, I woke up in the middle of the night a couple times with the aforementioned symptoms. Since reinstating, the pattern has been that I get to sleep fine now and sleep through the night, so in that respect, I have improved, but wake early with what a morning surge in symptoms (anxiety, negative thoughts, tachycardia, elevated blood pressure, no appetite). That's the first bout. Then, there seems to be a second one that occurs about an hour after my first meal. This was a typical response a few months back before I stabilized, by the way, although not as bad as then. The symptoms start to subside by around 8pm when I start getting my appetite back and feel more relaxed so that by bedtime, I am ready for sleep. I would definitely say the w/d is tied to my diurnal rhythm and has to do with my cortisol (which peaks in the a.m. and drops by night) and maybe other hormones. I should also mention that during my six weeks of tapering down, I did have a much lesser version of this and just accepted it as a part of the healing process of getting off the med. My best window while still on the full dose of 100mg was shortly before I started tapering off.

 

But now, it's been a week of resinstatement at the 25mg dose and I don't know if I should hold longer, drop the dose, or increase it. I know my doc already advised me last week to bump it to 50mg.

 

Based on my history and data, any thoughts as to what to do now? At least the symptoms were tolerable during the taper.

[Petunia]

I'm not sure csm, I will try and get some advice from someone more experienced.

[Pugknows]

Lamictal is an anti-seizure med like gabapentin, which is what I was told to CT by four drs. Your WD sxs are similar to mine. I destabilized from botched up and down taper in August. Jumped in November. Just now starting yo see some improvement. Still stuck with racing heartbeat, early morning cortisol surges, fatigue, breathlessness etc. Severity has lessened. (((Pug Hugs to you)) You'll be fine in time.

[Pugknows]

The mods on this forum care about you and want to help. They are angels.

[csm2014]

Lamictal is an anti-seizure med like gabapentin, which is what I was told to CT by four drs. Your WD sxs are similar to mine. I destabilized from botched up and down taper in August. Jumped in November. Just now starting yo see some improvement. Still stuck with racing heartbeat, early morning cortisol surges, fatigue, breathlessness etc. Severity has lessened. (((Pug Hugs to you)) You'll be fine in time.

Thanks for the vote of confidence Pug. How long were you on Lamictal and at what dose (I didn't see your signature) and how did you finally taper? I can't believe these docs. In my case, I was only on it for 3 months and followed a taper which I find out now was too rapid. The taper wasn't too bad; it was jumping off the last dose when the w/d really kicked in. And after this one, I have the Klonopin taper to look forward to????.

 

Are you able to exercise? For me, it is my saving grace. Strength training & cardio. I also added a little yoga into the mix recently.

[csm2014]

Lamictal is an anti-seizure med like gabapentin, which is what I was told to CT by four drs. Your WD sxs are similar to mine. I destabilized from botched up and down taper in August. Jumped in November. Just now starting yo see some improvement. Still stuck with racing heartbeat, early morning cortisol surges, fatigue, breathlessness etc. Severity has lessened. (((Pug Hugs to you)) You'll be fine in time.

Oops, my bad. In my brain fog, didn't see that you were on Gabapentin, not Lamictal. A lot of people use Gabapentin to help with benzo w/d. That won't be me after hearing your story.

[Fresh]

Hi csm , good to see things are starting to improve , so it's an upwards trajectory.   

As petunia said( 27 Jan.)     it can take several weeks , possibly longer , for stabilization to occur once the nervous system has become destabilized.    Are you able to stay on the 25mg for another week or two then reassess?   

 

Fresh

[Rhiannon]

My first thought is to hold where you are at the 25 mg and ride it out, if you can. Alternatively it would probably be okay to go a bit higher than that but I think all the way to 50 might be so big a jump it would just make you worse. If you want to consider going up a bit more I'd say try 30 (you will probably have to use a scale or dissolve the tablets, we have extensive info on how to do that in the Tapering area).

 

And then take notes daily of what time you take your meds, all of them, and supplements, and notes of when you have symptoms and what time, ranking them on a scale of 1 to 5 or so, and keep that journal.

 

Since your situation is complex it is all the more important to make only small changes at a time, to only change one thing at a time, and to keep careful observations of what happens when you change anything, because everything interacts. (I am pretty sure that my lamictal and thyroid meds and benzos all affect me in ways that work together and a change in any one affects the effects of all of them.)

 

tl;dr: I think it might be best to stay where you are or make only a small change. Keep track of everything.