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ratherbedigging: Sam-E started it all...I think. Yrs later, to taper Depakote, or Lamictal 1st?


ratherbedigging

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Hi Yall. Nice to see this board.

My main dilemma is trying to decide whether to taper Lamictal or Depakote first. I had one manic episode 4 1/2 yrs ago after taking SAM-E and none since. Got tired of being dull and stupid, dropping dosage of Depakote by 1/3 helped a lot. Am gaining weight. And I am worried about these drugs' effect on my brain if I continue taking them. Forever is a long time. Currently 200mg Depakote ER and 150mg Lamictal

 

My backstory:

I'm 47 this month. I have always been a somewhat thoughtful, idealistic, melancholy yet goofy person with periods of depressed, helpless and hopeless feelings. But smart, motivated, curious and willing to go outside my comfort zone as well (i.e. lived in 3rd world countries etc.) Most of my life I was in an extremely religious environment which also made me feel trapped and helpless. (Can't defy "authority", shouldn't borrow money or divorce, should always put God and others first). Even as a kid much of it was normal existential depression as well as conflict and normal questioning of growing up. I just wasn't allowed to question. Parents also had depression issues, after parents' divorce over the woman who became my step-mom, mom off and on agitated and angry and depressed. Back in the day, you had your nervous breakdown, got out of the hospital and went back to work. Post shock treatment in my dad's case. Of course he was ready to come back to the Lord after all the guilt. At least I never had a drug or drinking problem being so sheltered.

 

Spotted SAM-E at Costco! About 4 1/2 yrs ago I recognized that I was depressed/angry/mentally in a rut, but being self-emmployed I never wanted to get in "the system" as having mental health issues. I figured would become uninsurable, never took meds. Tried SAM-E as directed for a few days. Around the same time got a severe gum infection that didn't respond to antibiotic, couldn't sleep. Finally had a decent night of sleep and woke up peaceful. Returned a call to an old friend who had tried to reach me a couple months prior. I had a major emotional reaction after I hung up the phone (there were strong feelings on my side years ago). Then it was like a switchover happened in my mind and day by day I got happier and happier, like coming out of prision. I didn't know exactly what mania was but eventually wasn't sleeping and getting erratic and finally taken to hospital by a friend who is a counselor on Thanksgiving day. It was a horrible scenario for my husband but I had an enjoyable time. I won't go into it all but it was a classic manic episode.

 

I was put on Zyprexa, Ativan and Depakote after a week in the hospital. Shortly thereafter I had a car accident (overmedicated ya think?). Then just Depakote ER and Ativan if needed for sleep. So dodged the Zyprexa and Ativan bullets.

 

After awhile I was still depressed so added Lamictal 150mg. Been on that several years. I'm not depressed right now anyway. About six months ago I told my doctor how frustrated I was that I felt so stupid still, I used to be smart and function well. If I missed my dosage accidentally I felt pleasantly alert the next day. We decided to cut down the Depakote from 1500 to 1250, and I did have some messed up sleep and overreacting for a week or so. But I had done my homework and knew it could be withdrawal. Checking in after 3 months, I wanted to keep cutting down (she wanted to know why), but this time went slower, a week at 1125, then 1000 mg. No problems.

 

When I first received the dx I was so relieved. You mean it's not my fault I have these awful hopeless feelings sometimes? I have some sort of genetic brain disorder and I can't help it? Oh good, it's treatable. Sort of. But it'll only be in remission, ready to rear its ugly head and make me do awful crazy and embarassing things, and I might give this disease to my kid who the establishment will happily throw drugs at as well. You'd do anything to keep the boundaries intact though because it's a lifelong filter through which anyone you tell will hear all your utterances till the day you die (did you take your pills?). My husband always said "It's just an excuse. Everyone is bipolar. Everyone is depressed. Those drugs are bad stuff. Those doctors just want to make the bucks off you for the rest of your life." and I was FURIOUS of course. Till you do some digging and learn the whole field is compromised, none of it is that simple.

 

About a year ago a friend pointed me to the brain-gut connection ideas. This led to dietary Paleo people like Emily Deans. I did lose about 15lbs last year before falling off the wagon into a pile of baked goods. Then somehow stumbled over 1boringoldman. Then altostrata, beyondmeds and many others far out on the fringe. Wow. what an eye-opener. Doesn't anyone get well? It would seem that some do in spite of the meds.

 

I have learned a lot. Like how crucial sleep is. Like caffeine is just not worth it. Like exercise and being outdoors is necessary. Time with friends is necessary, if I see a counselor to be a listening "paid friend". That I can't just eat whatever I want and not expect it to affect me. My mood has a lot to do with the health of my relationships and the moods in my family and I have to give substantial attention to that. Nicely. Work is satisfying, even housework. These are not things a pill can fix. Maybe help, but not necessarily forever.

 

Given all the reports out there of SAM-E causing mania and severe anxiety and having withdrawal effects also the things that converged at the time of my manic episode, I may have been misdiagnosed. I mentioned the SAM-E at the time of my 1st psych appt and the warning on the box not to take if you have bipolar disorder, and she dismissed it, I think she might have been unfamiliar. I may have just been responding disproportionately to that substance that, come to find out, is used by prescription in Europe. And some writers in USA state the dosages it comes in is way too high. I won't know if I can do without the psych drugs unless I come off them.

 

Given the Lamictal's half-life is extended nearly double by using in conjunction with Depakote, would you try to taper off that first? The initial effects from cutting depakote may have been from the less Lamictal in my system, not the depakote itself. Does anyone have ideas? Does depakote cause probs typically?

Young adult daughter Feb 2020 discharge w 1500mg Depakote, 1350 mg Lithium, 20 mg Zyprexa, 3mg clonazepam. A boatload. 

 

I'm currently on Lithium 900 mg for 5ish yrs after 2nd manic hospitalization. 

Sam-E in 2007 for a short period, then manic episode, dx bipolar 1

Zyprexa (brief then discontinued)

Ativan (brief then discontinued)

Depakote ER 1500mg plus Lamictal 150mg Dec 2007 to Jan 2012

Started tapering Depakote early 2012

Depakote ER at 750mg, plus Lamictal 150mg as of July 2012--about 3 months between steps down

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So sorry to hear that your experience in the hospital and with the pdoc was first to drug and not to consider that the sam-e could be and probably was the cause of your manic episode.

 

Amazing isn't it, that people used to be able to survive without all of these drugs and now they are quick to shove them at you???

 

Others will chime in with good advice. Welcome!

Years:150mg Wellbutrin (to concentrate) 20-30 mg Celexa (rumination).

CT 8/2011 during a pregnancy attempt under MD orders. (Idiot!!!) Pregnancy hormones allowed it.

Felt great with 6 mg of melatonin per night to sleep plus preggo hormones-didn't last:(

Best time of my life. Botched IVF in Dec 2011.Stress.

Bone chilling exhaustion and told to go back on celexa and wellbutrin.

4/9/2012 Back on celexa wb for some relief, wb gave me heart palps so dropped and only need 6.6 mg celexa and 1/4 melatonin pill...IMPROVEMENT because my doses are much lower!

REMEMBER to get your thyroid and hormones checked/out of whack ones can appear LIKE MOOD DISORDERS!!

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  • Administrator

Welcome, ratherbedigging.

 

That is a bizarre combination of meds you were on -- Zyprexa, Ativan and Depakote. It's a wonder you managed to stay upright. Are you still seeing the same doctor?

 

You are the second person here who's had an adverse reaction to SAM-e. It's much more powerful, at least for some people, than anyone would expect from a little ol' supplement.

 

Given that you were having an adverse reaction to a serotonergic, your diagnosis of bipolar disorder is questionable.

 

I agree with your husband. He sounds like a level-headed person.

 

See Taking multiple psych drugs? Taper the antidepressant first!

 

Because Lamictal may dampen some of the withdrawal effects from Depakote, and Depakote has worse effects on general health, I might taper Depakote before Lamictal.

 

Depakote comes in 125mg "sprinkle" capsules you can open up; you might be able to use this to taper by weighing with an electronic digital scale. I don't believe this is the ER form; you may need to dose more than once a day, at least at first, to keep your nervous system stable.

 

Phone Abbott to see what the equivalency is between Depakote ER and sprinkles (800) 633-9110 8:15 a.m. - 4:55 p.m. CST. Make them talk to you. They should put a nurse or pharmacist on the line.

 

For information about Depakote, see http://www.drugs.com/ppa/valproic-acid-and-derivatives-divalproex-sodium-sodium-valproate.html

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Nobody was aware of the SAM-e initially. I don't even remember how long I took it--hadn't taken it very long. A week? Two? supposedly builds up in your system. My husband wasn't even aware of it till I told him my theory the other day. Hospital didn't know as I was practically incoherent when I went in. Dr. not familiar with it. In fact I had almost forgotten about it until recently. I started reading up on it. It is powerful stuff, not an innocuous "supplement". This supplement pusher has some cautions about SAM-e http://www.raysahelian.com/sam-e.html Mayo's site says http://www.mayoclinic.com/health/same/NS_patient-same/DSECTION=safety Anxiety, insomnia, hypomania, hostility, insomnia, elevated mood, psychoactivation, headache, suicidal ideation, hyperactivity, a reduced need for sleep, and bursts of energy have also been reported. hmmm. Other writings are more than sanguine, glowing reviews, "no side effects."

Young adult daughter Feb 2020 discharge w 1500mg Depakote, 1350 mg Lithium, 20 mg Zyprexa, 3mg clonazepam. A boatload. 

 

I'm currently on Lithium 900 mg for 5ish yrs after 2nd manic hospitalization. 

Sam-E in 2007 for a short period, then manic episode, dx bipolar 1

Zyprexa (brief then discontinued)

Ativan (brief then discontinued)

Depakote ER 1500mg plus Lamictal 150mg Dec 2007 to Jan 2012

Started tapering Depakote early 2012

Depakote ER at 750mg, plus Lamictal 150mg as of July 2012--about 3 months between steps down

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  • Administrator

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Hi...

 

Do to memory loss from taking ssri's I can't remember who recently posted on SAM-e and is having huge issues with an adverse reaction. Browse this sight. It was fairly recent.

 

You went through alot with medications. It seems that alot of people do not actually have the problems they were diagnosed with. It was their reaction to AD's.

 

Best Regards

Intro: http://survivingantidepressants.org/index.php?/topic/1902-nikki-hi-my-rundown-with-ads/

 

Paxil 1997-2004

Crossed over to Lexapro Paxil not available

at Pharmacies GSK halted deliveries

Lexapro 40mgs

Lexapro taper (2years)

Imipramine

Imipramine and Celexa

Now Nefazadone/Imipramine 50mgs. each

45mgs. Serzone  50mgs. Imipramine

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Hi rather!

I just read your story... Amazing! My guess is that Sam-e DID give you a manic response and that you probably could have just tapered it down or cold turkeyed it without introducing other drugs. However you might have taken the hell walk I am on now way back then. I hope your journey off your current meds doesn't give you trouble.

 

I did write dr sahelian and he wrote me back. Brief, but he said my issues should resolve in time. After I told him of my story, he put the Q/A on his site about Sam-e that withdrawal is potential in sensitive individuals or something like that. <_<

 

Thanks for saying hi! Nice to finally "see" someone else who probably hates Sam-e as much as I do for what it did to their life! I hope you get yours back soon.

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