Sancho: When to get off my medications

[Sancho]

I'm new to this world, so I apologize for my naiveté.  I was diagnosed with clinical depression 5 months ago and have been taking Pristiq and Wellbutrin for approximately 4 months (see medical history below) with "partial results", as my psychiatrist said.  I'm already experiencing side effects that worry and scare me—frequent urination, ringing in my ears, increased sweating, tremors, and others.  My question is very simple—when is the right time to get off medications?  Should I do it now in spite of my psychiatrist's warnings that I will get worse?  When did you decide to get off your medications?  Thank you for your advice.        

[Fresh]

Hello Sancho , welcome to the site.   You'll find lots of information here about how to stop your medications safely , but you'll

need to take a little time to understand the process first.

 

Could you have another go at doing your signature please , including dosages.

 

I suspect that the side effects you're having now indicate that you may get worse if you STAY on the meds.  You'll get lots of advice

and support here to taper off them in an effective way.

 

If you click FOLLOW at the top right , you'll receive an email each time someone posts here.

 

Best wishes ,  Fresh 

[Petunia]

Welcome Sancho,

Thank you for doing your signature.

 

Tell me if I'm understanding this right.  In October 2014 you started taking Clonazepam. Two months later you were diagnosed with depression, then a month later you started taking Pristiq and Wellbutrin?

 

Is it possible that Clonazepam caused you to feel depressed? How were you feeling before you started taking Clonazepam?

 

If the drugs aren't helping and you are getting side effects, then coming off them would be a good idea. It was antidepressants which gave me depression. I went on Zoloft, another antidepressant, for anxiety and became depressed 2 weeks later. Stupidly, I stayed on these awful drugs for 13 years and have had a very hard time getting off them.

 

I'd highly recommend reading Anatomy of an Epidemic by Robert Whitaker. Psych meds can cause harmful side effects and long term, they can worsen health, increasing the risk of other illnesses.

 

There are potential major interactions between the 3 drugs you are now currently on.

 

http://www.drugs.com/interactions-check.php?drug_list=703-0,2796-12488,440-203

Interactions between your selected drugs

bupropion ↔ desvenlafaxine

Applies to: Wellbutrin (bupropion), Pristiq (desvenlafaxine)

BuPROPion may cause seizures, especially at higher dosages, and combining it with other medications that can also cause seizures such as desvenlafaxine may increase that risk. The interaction may be more likely if you are elderly, undergoing alcohol or drug withdrawal, have a history of seizures, or have a condition affecting the central nervous system such as a brain tumor or head trauma. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. 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.

Switch to professional interaction data

bupropion ↔ clonazepam

Applies to: Wellbutrin (bupropion), clonazepam

Excessive use of clonazePAM, or abrupt discontinuation following long-term use, may occasionally trigger seizures in patients taking buPROPion. Talk to your doctor before using these medications together if you have any questions or concerns. 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.

Switch to professional interaction data

clonazepam ↔ desvenlafaxine

Applies to: clonazepam, Pristiq (desvenlafaxine)

Using clonazePAM together with desvenlafaxine may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. 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.

 

My advice is if you want to find healthier ways to manage life, then safely tapering off your medication now would be a good choice.

 

BUT.... it looks like you are already tapering the Clonazepam. We recommend only tapering one drug at a time, please read through this topic:

Taking multiple psych drugs? Which drug to taper first?

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?

 

Please stay in touch and let us know what you decide. You can ask any questions here in your thread.

 

Petunia.

 

 

[Sancho]

Petunia, thank you very much for your detailed information.  I'll certainly consult my psychiatrist about the interaction between the drugs I'm taking.

 

In answer to your questions, I started feeling "low" around June 2014 and got increasingly worse throughout the summer and fall 2014, before I started taking citalopram.  In that sense, I'm pretty sure citalopram did not cause my depression.  The depression was triggered by a concatenation of personal events.  I began taking clonazepam around September or October 2014 because of severe insomnia, along with 10-15mg of citalopram, which I forgot to mention in my medication history.  It did'n help much.  As symptoms got worse, they switched me to pristiq XR and wellbutrin XR.  I'm feeling a little bit better than before, but just a little.  

 

You are right about the clonazepam.  I'm trying to taper it very slowly, although from what I've read on this site, I should go even slower.  I will.

 

My most immediate concern now is the ringing in my ears, which seems to be a side effect of wellbutrin.  It started five days ago and it hasn't gone away.  It's not very loud, but I feel it anyway.  I asked my psychiatrist yesterday, and he suggested cutting down wellbutrin from 300mg to 150mg.  I thought it was too much and said "no". Then he suggested to take 200mg of wellbutrin SR, which you can taper more moderately than the XR form.  Still, I find going from 300mg to 200mg too abrupt.  I'm right?    

 

I'm 56 now, and have never been depressed before.  I've always lead a healthy lifestyle, including organic food and regular exercise.  Even now, in the midst of my depression, I go to he gym regularly, and I'm practicing yoga, meditation, and acupuncture.  I mean, I'd rather do anything than taking these pills.  

[Altostrata]

Welcome, Sancho.

 

You are taking an absurdly high amount of Pristiq with a high amount of Wellbutrin.

 

There is no reason to take these drugs in combination, with a benzo added for good measure. Your psychiatrist is drug-happy (and did not check for drug-drug interactions). See Recommended doctors, therapists, or clinics

 

Situational stress is not Major Depressive Disorder. You might consider ways to manage your symptoms without drugs.

 

If I were you, I'd hold on tapering clonazepam, a "brake," and taper one of the "accelerators," Pristiq and Wellbutrin, which could very well be responsible for your tinnitus.

 

Wellbutrin would be most amenable to tapering, see Tips for tapering off Wellbutrin, IR, SR, XR, XL (bupropion)

 

Pristiq is more difficult, see Tips for tapering off Pristiq (desvenlafaxine)

[Sancho]

Thank you, Alostrata.  I always had the feeling that 100mg of Pristiq was excesive.  I'll follow your advice and hold on tapering clonazepam and start tapering wellbutrin following the 10 percent method.

 

By the way, I suggested my psychiatrist to check this site.  He had never heard of it.  I'll print some of the information and bring it to him. 

 

Best,

 

Sancho

[Altostrata]

That would be nice, if your doctor were so interested he would educate himself about tapering.

[Sancho]

Altostrata, you mentioned in one of your previous posts that I did not have a major depression, but rather a situational depression.  I wish it was true, but unfortunately it’s not.  I’ve experienced intense grief before and what I’ve been going through during the past 10 months is very different from grief—fatigue, crying spells, feelings of worthlessness, loss of weight, hopelessness, rumination, suicidal thoughts, insomnia, lack of motivation...  It sounds like severe depression to mee.  At any rate, it sucks and it has nothing to do with my character, which always tended to be enthusiastic, passionate, and witty.

 

My questions are:

 

1.  Are antidepressants useful in some cases and if so, when? 

2.  If they are at all useful, how long should one use them without creating irreparable damage in your system?

3.  Can you navigate a major depression without antidepressants?

 

In perusing this site, I get the impression that the antidepressant industry is nothing but a major sham.  Is that so?  Believe me, I’m not questioning your authority or the value of this site, which I find enormously rigorous and helpful.  Neither do I mean to diminish the immense suffering that many of the site members are going through.  I myself am beginning to experience some of that suffering.  I only want to get the facts right, because if antidepressants really don’t help, then I don’t know what I’m doing taking them!

 

Can you shed some light on this?  I’ve been taking ADs for four months only.  They have helped some, but I’m also beginning to experience a bunch of side effects I don’t like.  In your honest opinion and I know it’s only your opinion, should I quit them before things get out of hand?  I feel very uneasy taking medications that can have devastating effects without even knowing if they work at all.

 

Thank you.  

[clearday]

Great use of the word concatenation. 

 

Beware ringing of the ears. I have been off SSRIs for quite some time yet the ear ringing caused by Lexapro persists and is very difficult to deal with.

 

This person told her doctor that her ears were starting to ring, and her doctor recognized the danger and urged her to get off the medication that was causing it - in this case, Zoloft:

 

http://survivingantidepressants.org/index.php?/topic/1275-dani-zoloft-withdrawals/?hl=dani

 

Most doctors have no idea how damaging these medications are. 

[mammaP]

Hi Sancho, welcome from me too. Alto has given you some excellent advice, she is the most knowledgeable person when it comes to psychotropic drugs after studying them for many years.  In the days before antidepressants people recovered from major depression without drugs. Since drugs were invented depression has become an epidemic, you said..... I started feeling "low" around June 2014 and got increasingly worse throughout the summer and fall 2014............The depression was triggered by a concatenation of personal events.   Which is why it looked like situational depression. I was diagnosed with major depression and started 22 years of psych drugs, after extreme stress led to very similar symptoms to yours. I went on to get the bi-polar label, then after 19 years decided it was time to get off the drugs and did some research which taught me  about the  the psychiatric fraud!   It would be good if you can get a copy of 'Anatomy of an epidemic' by Robert Whitaker. It is an excellent book and a real eye opener! 

[Altostrata]

Sancho, "depression" can be a side effect of clonazepam. You also are at risk for other adverse effects from the combination of drugs you take.

 

You need to look at your life to see what may be causing your despair. If there has been a "concatenation of events," your condition is situational.

 

Even people who have metabolically based Major Depressive Disorder can manage it with non-drug means. I cannot answer your questions about whether antidepressants are useful. They are vastly overprescribed, diagnosis is sloppy, and the drugs have been misrepresented as to effectiveness and dangers.

 

One cannot determine whether it's worth taking a drug without a good idea of the risks. That is absent when it comes to antidepressants.

 

You are having adverse effects from the combination of drugs your psychiatrist has selected for you. If your doctor is not concerned about this, that's a sign you need a new doctor.

 

In fact, the symptom you describe, "frequent urination, ringing in my ears, increased sweating, tremors," suggests excessive stimulation, possibly serotonin overdose, from the Pristiq and Wellbutrin. You can see the red warning sign on this combination above.

[Sancho]

Thank you all for the information.  I have a pretty good idea of what's causing my despair, Altostrata, and I'm seeing a therapist to deal with the issue.  I just thought that all depressions were triggered by some traumatic event—essentially loss—without being considered "situational" for that reason.   What is a non-situational depression, then?  A depression without an apparent reason?        

 

 I'll bring up the issue of the combination of drugs with my psychiatrist next time I see him, in a couple of days.

 

In the meantime, I'd like to ask a practical question about the use of weight scales to taper.  I recently bought a AWS Gemini-20.  Problem is...  I don't know how to use it.  That is to say, I'm so silly I didn't know that clonazepam 1mg, for example, only refers to the dosage contained in the pill, not to its actual weight, since clonazepam 2mg weights more or less the same—0.171g.  

 

If that is the case, how do you actually taper?  Here is my concrete example:

One pill of Wellbutrin SR 100mg weights, if I'm reading well the scale, 0.310g.  Thus, half a pill should weight about 0.155g.  But if I need to taper the dosage to 40mg, how do I do it?  It might be a simple mathematical formula, but since I flunked math, I have no idea.

 

I'd like to taper wellbutrin 300mg 20% every two weeks.  Thus 300mg > 240mg > 192mg, etc.  How do I use the scale to determine what the weight of 40mg  or 92mg is?  

 

Best,

 

S

[Altostrata]

That is explained in the digital scale topic.

[Sancho]

I guess today I just need moral support.  Driving to and back from work my eyes were filled with tears just thinking how different I am from the person I was only a year ago.  Please tell me there is a cure for this, that I will not always need these pills, that I will be able to laugh again.   

[Fresh]

Hey Sancho ,  you WILL get past this , and there will be a time when you look back this phase and give yourself credit for

the way you handled yourself.

 

Did you work out the scales?     I can work out the schedule for you if you want - do you realize that 20% may be too big?

The idea of 10% decreases is that you don't get bad symptoms , so can continue your life as you taper.  You might want

try a 10% decrease the first time and see how it affects you.  It's only been a couple of days so you could go back up 10%.

[Sancho]

Thank you Silver Star.  Yes, I did work out the scales, although I made a couple of mistakes along the way.   

 

I know there is a thread about tapering Pristiq, but if you don't mind my asking—how are you doing it?  I see you went from 50mg down to 45.  Are cutting the pills?  

[Fresh]

Yes , I am.   Each tablet weighs 380mg (50mg of active ingredient).  

My first decrease was 10% , which was 342.5mg of tablet (45mg of active ingredient).

 

You need a pill-cutter and tweezers , and weigh out the amount that correlates per mg.

It's easy once you get the hang of it  .

[Sancho]

Are you taking it once or twice a day?  I ask because of the "dumping" effect.  

 

You started tapering in February and we are in May.  Are you still doing 45mg?

 

My psychiatrist said that Pristiq now comes in 25mg.  Do you know anything about this?

[Fresh]

In Australia it's not available in 25mg tablets . . . not sure why.

 

I stayed on 45mg for 8 weeks before my second drop.  I had 4 weeks of symptoms , and was settled for 4 weeks.

 

I've been taking one dose , but may have to look at dividing it as it decreases.  I recall reading that the the added ingredients that made it slow release are bound to the molecules , not contained in the coating (Tips for Tapering

off Pristiq , post 1)  

But as what I'm ingesting becomes less of a solid piece and more of crushed up dust , it makes sense that it would

be absorbed quicker.

 

Fresh