Keystone 95: Seeking advice/support for lamictal withdrawal

[Keystone95]

Hello there, I'm new. I'll just give a quick run down of the situation I'm in. Starting with my basic history.

 

I'm 19 right now, male. When I was about 5 years old I was put on zoloft for anxiety which manifested itself really bad in crowds or at night. I was put on risperdal as well for my temper tantrums I used to throw. I was putting a few holes in the wall at that young age. 

 

After that, honestly, I was superb for 9 years. When I was in 8th grade, my psychiatrist suggested I could try and come off the meds since I was going through puberty. So, came off both of them, and then I had a rough couple years. For my second half of 8th grade, freshmen year, and then 1st half of sophomore year, I was off the meds. I was a straight A student before this, and during that 2-year time my grades dropped horribly because I didn't even care enough to do my homework. I'm not very good at recognizing my feelings, but looking back on it I was severely depressed. I slept all the time, every day after I got back from school. I was reclusive, I was horribly mean to my parents, and broke numerous things in my household. Finally, after two years, I went back on the meds, along with trazodone to help with insomnia I had developed in early high school. 

 

My 1st half of junior year, late 2012, I switched from zoloft to cymbalta due to some health issues that were causing me stress in school. Docs just wanted to try a new med. So, that was all fine for a long time, too. I felt pretty great.

 

Here's where all the recent problems have started, though. In March of this year, 5 months ago from yesterday, I was sitting at my computer at around 10:30 at night. All of a sudden it felt like something exploded in my head, and my ears were ringing. I rushed into my mom's room and told her something was wrong with my head. I lied down on her bed and was shaking terribly. I was seeing flashes of lights. We called 911. Paramedics came, and those sensations had died down, though I was still seeing the flashes of light. My pupils were dilated so the paramedics said I needed to be taken in. 

 

Later that night I was diagnosed with serotonin syndrome and hospitalized for two days. We deducted my case was caused by tryptophan in a new protein shake I was taking. Interacted with my meds and caused this. I was taken off 30mg cymbalta and 50mg trazodone cold turkey. Still on the risperdal, .5mg 2x a day. Honestly, it was uncomfortable for a week or two, but that wasn't even the hard part.

 

The hard part was realizing I developed horrible anxiety. I had my first ever panic attack in April and I went to the ER and called 911 because I thought I was having a heart attack. As of right now, the panic attacks are mostly under control, largely thanks to a psychologist I've been working with for a few months. I still have anxiety, even though I've been improving vastly with natural methods.

 

Anyways, I'll get to my meds. A new psychiatrist I saw after March put me on lamictal and lorazepam for anxiety. Also seroquel for sleep. I was on 1.5 and even 2 mg of lorazepam a day for a while, but I went down to 1mg at the beginning of August. Not too many issues with that I don't think. I went from 25mg of lamictal all the way up to 150mg over the course of a month and a half or so.  A new psychiatrist and I met. I said the lamictal was doing nothing for me, and I don't want to be on a psych med that's not doing anything positively. So, in late June, I came down from 150 to 75. After a week or so, I started not feeling like myself. Just felt odd, and felt very lonely and sad. That went away for a bit, UNTIL I went down again to 50 3 weeks later, and then same thing. Then 25 3 weeks later, and then same thing. Now after 3 weeks of 25, I was instructed to take 25 every other day. That's where I'm at right now, about to take my last dosage tomorrow, and really struggling.

 

Right now, I don't feel like myself. I am lonely and sad for the most part. I have cried a lot. Am I going down too fast? Tomorrow is supposed to be the last day I take lamictal. Then I am off. I know this is the meds, but I am just really struggling with my sadness. I don't feel depressed. I want to proactively do things, I'm not being reclusive, and I just want to feel better.

 

I'm just miffed that that Dr. prescribed me this for anxiety and now I have to deal with the horrible withdrawals.

 

Do you have any advice? Should I come off more slowly? All the psychiatrists have different opinions, and they've done nothing but worsen my situation. I decided a while ago that I am in control now. It's my body, and I'm going to listen to it and fix it naturally.

 

Thank you everyone.

 

edit: I also want to ask a question about the 25mg of seroquel I'm on for sleep. Last night I got in bed after taking it and could not fall alseep. Muscles all over my body were twitching really bad. Is it safe for me to continue taking this? 

[brassmonkey]

Hi Keystone-- welcome to the group.  It's no wonder you feel so bad after having been through all of that.  I'm so sorry you had to experience it at such a young age.  Right now you have a good case of the withdrawals, and what the doctor is doing is making it worse.  These drugs don't replace or cover each other so you are getting the effects of your CT back in march plus the start up of all the new drugs and the switching doses all piled on top of each other.  Alternating doses is one of the worst things to do, it causes you to go in and out of WD and really screws with the brain.

 

What is withdrawal syndrome? 

 

First thing to do is start taking your dose at the same time every day.  That should help to get you stabilized.  It isn't going to happen over night, it could take several weeks.  It is excellent that you have made the decision to take control, now let's get you in control.

 

About reinstating and stabilizing to reduce withdrawal symptoms 

 

Taking multiple psych drugs? Which drug to taper first?

 

Why taper by 10% of my dosage?

 

 

These will give you a lot of information about what is ahead.

 

Thank you for filling in a signature block, it really makes is a lot easier for us to see what is going on.

[Keystone95]

I think I'm just going to go back on the 25mg every day until I feel fine again. Then, I''ll decrease. 

 

Question though: How do I decrease a 25mg pill by 10 percent? I could cut it in half and take 12.5, or thirds and take 18.75.

 

Thanks.

[Altostrata]

Welcome, Keystone.
 
It sounds to me like you have a long history of unnecessary psychiatric drugs. I find it incredible that you were put on Zoloft at 5 years old because you were anxious in crowds. A lot of adults, me included, feel uncomfortable in crowds. I could certainly understand the fear of a young child with all those strangers looming over him.
 
When you were in 8th grade, after 8 years on the drugs, it's possible you came off them too fast and your subsequent problems were due to withdrawal syndrome. From there on, it's the drug merry-go-round. Many of us have gotten on that, too.
 
Let's assume that all these drug adventures, particularly serotonin syndrome, have left your nervous system hypersensitive to drug changes and psychoactive substances. See The rule of 3KIS: Keep it simple. Keep it slow. Keep it stable.

 

Never, ever skip doses of a psychoactive drug to taper. There is no need to do that with lamotrigine; your psychiatrist is a lazy fool. Lamotrigine has a very short half-life and comes in 5mg tablets. He should at least have known that.

 

See more here Tips for tapering off Lamictal (lamotrigine)

 

Given your long drug history, if I were you, I'd plan on staying on 25mg for several months, at least. Be sure to take it at the same time each day. Give your nervous system a good long time to stabilize.

[Keystone95]

Thanks for the advice. Right now I'll just stay on the lamictal at 25 mg for a while and get to the point where I'm feeling better before going down again. I'll have to stay on the lorazepam too for now. Was planning to get off that right after the lamictal.

[Keystone95]

I'm just so sad and keep crying because of it. It all correlates with the times I've tapered lamictal, but feeling so bad in this moment is the worst. 

 

I do want to ask, though: I take 25mg of seroquel for sleep. Not enough to actually work on my brain, but enough to be like an anti-histamine. I have heard good reviews of people who take this drug for sleep. But, all the clinical articals say long-term use is not recommended. I've been on it for about 4-5 months. 

[Altostrata]

It's not a terribly destructive drug. People stay on it for years to control seizures.

 

Don't worry, you'll be able to go off it.

[Keystone95]

It's not a terribly destructive drug. People stay on it for years to control seizures.

 

Don't worry, you'll be able to go off it.

You're talking about the lamictal, right?

[Altostrata]

Yes, the Lamictal.

 

Has the Seroquel ever helped for sleep? What time of day do you take each of your drugs?

 

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.

[Keystone95]

Yes, the seroquel has made me sleep great every night. Just slows my mind really bad and sometimes makes me hallucinate right before I fall asleep. I only take 12.5mg or 25 mg. Literally the lowest doses used. I have looked into it more and plenty of people have no problem with it. It knocks you out until the morning, and really gives people a much-needed rest. Eventually, I'll get off it and look for a more natural sleep-aid if need be. 

 

Here are the results from that checker. I've already looked at interactions for all my meds and everything seems to check out fine. Most of it is low blood-pressure stuff, and don't really have a problem with that. I'm on low dosages of everything except my metoprolol, which is an intermediate dose.

 

metoprolol ↔ risperidone

Applies to: Metoprolol Succinate ER (metoprolol), risperidone

RisperiDONE and metoprolol may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. 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

lorazepam ↔ risperidone

Applies to: lorazepam, risperidone

Using LORazepam together with risperiDONE 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.

Switch to professional interaction data

lorazepam ↔ lamotrigine

Applies to: lorazepam, lamotrigine

Using LORazepam together with lamoTRIgine 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.

Switch to professional interaction data

risperidone ↔ lamotrigine

Applies to: risperidone, lamotrigine

Using risperiDONE together with lamoTRIgine can increase your blood levels of risperiDONE. This can cause side effects such as excessive drowsiness, dizziness, increase in heart rate, seizures, and tremors. Talk with your doctor before using these medications together, and report any side effects promptly. You may need a dose adjustment or special tests to safely take both medications. Avoid driving until you know how these medications will 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.

Switch to professional interaction data

metoprolol ↔ quetiapine

Applies to: Metoprolol Succinate ER (metoprolol), quetiapine

QUEtiapine and metoprolol may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. 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

lorazepam ↔ quetiapine

Applies to: lorazepam, quetiapine

Before using LORazepam, tell your doctor if you also use QUEtiapine. This combination may cause excessive sedation, confusion, dizziness, or lack of coordination. If you take both medications together, tell your doctor if you have any of these symptoms. You may need a dose adjustment 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.

Switch to professional interaction data

risperidone ↔ quetiapine

Applies to: risperidone, quetiapine

Using QUEtiapine together with risperiDONE can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a rare side effect. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether together or alone. 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.

Switch to professional interaction data

metoprolol ↔ lorazepam

Applies to: Metoprolol Succinate ER (metoprolol), lorazepam

Consumer information for this minor interaction is not currently available. Some minor drug interactions may not be clinically relevant in all patients. Minor drug interactions do not usually cause harm or require a change in therapy. However, your healthcare provider can determine if adjustments to your medications are needed. 

For clinical details see professional interaction data.

[Altostrata]

If I were you, I'd make going off Seroquel the priority once you stabilize from the lamotrigine reduction.

 

Why was metoprolol added and when?

[Keystone95]

If I were you, I'd make going off Seroquel the priority once you stabilize from the lamotrigine reduction.

 

Why was metoprolol added and when?

The seroquel just works as a powerful antihistamine at that at that low dose. Plenty of people have done great with it and the doc says it's fine. I'll eventually get off it and switch to like melatonin, but I need sleep when I'm stressed and it does the job. I'm not gonna worry about it until in off the lamictal and lorazepam.

 

The metoprolol was added a few months ago for shortness of breath and tachycardia I was getting. That has gone away. It was more than likely due to so much constant adrenaline and after effects of my reactions to the SSRIs.

[Keystone95]

Well, it's now Monday and I've broke down crying at someone else's house already. I don't know what to do. Suffering so much.

[Altostrata]

If I were you, I'd take those drug interactions seriously.

 

You may be able to get by with lower doses of Seroquel. Just because the tablets are packaged in certain dosages doesn't mean they're appropriate for your nervous system.

 

Tachycardia from a drug cocktail is not a benign reaction. Adding a drug to cover up adverse effects to other drugs is standard operating procedure among the lesser lights in psychiatry.

 

Take a good look at your history and be aware that you are taking TWO antipsychotics (!!!!), an anti-anxiety drug, lamotrigine, and a blood pressure drug at 19 years old.

 

Long-term, the antipsychotics (Seroquel and Risperdal) are known to cause blood sugar dysregulation and other hormonal problems. Neither is an antihistamine at any dosage. That you get hallucinations (probably at 25mg Seroquel) also is not a benign symptom.

[Keystone95]

I am coming off the lamictal right now. I'll come off the seroquel once I feel better.

 

I got the tachycardia after I tried zoloft. I wasn't on any of these drugs except risperdal at the time. I've been checked out by numerous heart doctors and I have no serious issues.

 

As for the risperdal, I will eventually get off it. Right now my blood sugar is great, but I did develop gynecomastia a while ago and that may be due to hormones.

 

What do you recommend I do right now? Really only dealing with an odd feeling and sadness from the lamictal withdrawal.

[Altostrata]

Gynecomastia is a side effect of Risperdal and Seroquel, see http://www.pharmacologyweekly.com/articles/what-are-the-most-common-medications-that-can-cause-gynecomastia-breast-enlargement-and-tenderness-in-males

 

While your doctor may be waving this away, it's not an indication that your hormones are being affected in a bad way.

 

I don't want to scare you -- I just want you to consider that you are taking a lot of powerful drugs at a very young age and that over time, this will erode your health.

 

You're hearing rationalizations from doctors -- "it's only an antihistamine," "it's a low dose," "it's just for sleep" -- yet you are having adverse effects that indicate this drug cocktail is having pervasive effects on your body.

 

If I were you, I'd take the bare minimum of drugs.

 

Of course, you're going to have to taper one drug at a time. This is just something to consider. Of all the drugs you're taking, Lamictal is probably the least destructive.

[Keystone95]

Haha yeah you were scaring me a bit. Pretty fragile right now.

 

I'm in the process of coming off everything right now. My goal is to not be taking any of these meds in a year and a half. And I think that's reasonable. I have had no new side effects just from this med mix. I had side effects right after serotonin syndrome and then side effects from withdrawing too fast and improperly from lamictal. Nothing else.

 

Am I good right now with this plan? There's no immediate emergency and I'm not asking my doctors for more meds. Want to get off every thing. Just need reassurance because I feel so alone right now.

[Keystone95]

The last day I didn't take it was last Thursday. I still don't feel like myself. Just getting discouraged.

[Keystone95]

My anxiety was steadily improving and has only gotten worse each time I reduce the lamictal. So, I'm proving I can manage my anxiety with my psychologist and the other things I'm doing with a functional doctor. 

 

My plan is to stabilize on the lamictal for about a month. Then, slowly come off it, and once I'm feeling fine, slowly come off the benzo which is now klonopine .5mg at night. I've stopped taking the seroquel since it is too overpowering. Slept OK without it last night.

 

Risperdal will be last since I have no side effects from this drug, been on it a long time, and know it doesn't cause me any new symptoms. 

 

Do you think taking the klonopin, without upping the dose, until I get done with lamictal, will be a problem? I could possibly be on the klonopin til the end of the year, or just however long it takes me to get off the lamictal.

[Altostrata]

Please stay on 25mg lamotrigine for a good while. Take it at the same time each day. It may take some time for your nervous system to settle down from the recent changes.

 

Did you just quit the Seroquel? How long have you been taking it? Have you been taking it every day? If so, you are risking withdrawal syndrome from that.

 

Please stop making drug changes until your system gets used to the lamotrigine again.

 

I would not worry about putting a deadline on going off drugs. As you lower the dosage, the adverse effects will lessen.

 

Risperdal plus Seroquel is causing gynecomastia. You may not notice the effect of Risperdal, but it is affecting you.

 

If I were you, I would taper Seroquel first, lowering it to a level that does not cause hallucinations. Then I might go off Risperdal, then Ativan, saving lamotrigine for last.

 

All of these drugs require careful tapering to avoid withdrawal symptoms.

[Keystone95]

I've been taking the seroquel for about 4 months. I stopped taking it last night. I was told there will be no withdrawal effects besides the obvious not sleeping as well. Despite what you told me, I have also been told numerous times by people and doctors that at 25-75 and even 100 mg, seroquel only hits the histamijne receptors. It is used as an off-label sleep aid. I don't know what to believe, but I did fine last night and until I notice actual withdrawals from it, I'm not too worried about it. If I notice new things that pop up from quitting it, I will certainly stabilize and lower the dose. But, I have been advised that I am okay.

 

I know you really want me to go off risperdal quick, but I need you to listen to me in that I can't do that. It is going to be way down the road when I am off of everything except that. It has caused me no issues. I've taken it for 12 years of my life. It has to be the last medicine I go off of, especially because it is the one that stabilizes my mood.

 

I've been taking lamictal for about 4 months, prescribed around the same time as seroquel. It did nothing for me, and I've already come down from 150 to 25mg. I'm definitely going to stabilize for a while, but there's no need to have that drug in my system at such a low dose. I need to finish going off it. 

 

Then, I will go off the benzo. At my Dr.'s recommendation, I switched today from ativan to klonopin. Ativan wasn't really doing anything for me, and I figured if I'm going to be on a benzo for at least a few more months, I might as well receive the benefit from it. I'm taking .5mg which is equivalent to the 1mg of ativan I was taking. Klonopin is more potent and longer lasting, though.

 

I know it seems I'm debating some of your advice, but I do love having people give me advice, especially when I'm struggling more than I ever have in my life.

 

Question: Do you think being on a benzo for already 4 months and then another few months will hinder me? I know these meds aren't supposed to be used long-term, but I didn't know that when I started and now I have to wait to withdraw because of the lamictal.

[Altostrata]

I definitely do NOT want you to go off any drugs quickly.

 

The reason this site exists is because people find the advice they get from their doctors is wrong. If any doctor told you that 100mg Seroquel only hits the histamijne receptors, that doctor is talking through an orifice from which once seldom hears wisdom.

 

Just about everyone on this site is here because they followed a doctor's advice in tapering and it went very wrong.

 

All the benzos are technically addictive as well as indubitably causing physiological dependency. I don't know what you mean by "hinder." All benzos require tapering. Some people find them very difficult to go off.

 

Given the wide variation in nervous systems, it may be that yours is, at this time in your life, fairly impervious to drug changes. Or it could be they haven't caught up with you yet. You've already had a sample of how bad that can be.

 

You came here asking "Should I come off more slowly?" and we gave you our best advice. Good luck to you.