Nick-Intro

[Nick]

Hello everyone,

 

I've been on an SSRI in one form or another for the last 12 years and dabbled (with a doctor of course) with them even before that in high school. I've primarily been on Prozac during that time (averaging a respectable 40mg), but have tried many others--Wellbutrin, Effexor, Paxil, Celexa, Cymbalta and maybe some more that I've forgotten about. Over the last ten years or so I've primarily been on Prozac, with varying results--generally content, but never super happy (but then again, I'd feel weird being super happy). Also, the Prozac I've since discovered was putting me to sleep. I would regularly sleep 10 to 12 hours a day and still feel tired. I believe I had what doctors call "Prozac poopout."

 

In May of 2012 my new psychiatrist put me on a new SSRI, Viibryd, and also added Lamotrigine (aka Lamictal). With the Viibryd (40mg) came vivid nightmares, diarrhea, and weight gain, which in and of themselves were depressing. So, with the SSRI side effects seemingly outweighing the positives, and with my life generally 'okay' I decided to try going off meds. Boy, has it been a rough journey...

 

Over the last three months I've tapered down from 40mg of Viibryd to 5mg. I noticed within a week when my doc cut my Viibryd from 40mg to 20mg that I was having side effects: brain fog, lack of concentration, disoriented, clumsy, and some dysphoria. Now down to 5mg (and completely off the Lamotrigine), I am not doing great. I have okay days where life is manageable but the bad days are really bad--depressed, irritable, angry, and hopeless. I have even started to have suicidal ideation, which I have not had in years. I most often feel like I'm trapped in my own head, and things are happening around me. I'm using cognitive behavioral techniques and see a therapist regularly. At this point I feel like my options are to go back on meds and be somewhat better but have depressing side effects, or to hope things get better. Neither option seems very promising at the moment.

 

The only upside to titrating off meds is that physically I am doing better. I read a very enlightening book "The Chemistry of Joy" and have been taking oodles of supplements--Sam-e, 5-HTP, St. Johns Wort, multivitamin, B vitamins, and Fish Oil. I have also radically changed my diet to include way less sugar, whole grains, complex carbs, many more fruits and vegetables, and organic items when I can afford them. I've also been exercising a lot more, and have lost about 15 pounds. With the reduced SSRI's I have definitely noticed a reduction in carb and sweet cravings.

 

I'm feeling rather hopeless that I can make this med-free thing work, and the prospect of going back on more meds feels just as bleak. Any advice, tips, words of wisdom, words of hope, or even a totally unrelated funny anecdote would be appreciated.

 

Sincerely,

Nick

[Altostrata]

Welcome, Nick. Thanks for joining us.

 

You said:

Over the last three months I've tapered down from 40mg of Viibryd to 5mg. I noticed within a week when my doc cut my Viibryd from 40mg to 20mg that I was having side effects: brain fog, lack of concentration, disoriented, clumsy, and some dysphoria. Now down to 5mg (and completely off the Lamotrigine), I am not doing great. I have okay days where life is manageable but the bad days are really bad--depressed, irritable, angry, and hopeless. I have even started to have suicidal ideation, which I have not had in years.

These symptoms sound like withdrawal syndrome. You may be tapering Viibryd too fast.

 

How did your doctor switch you from Prozac to Viibryd? It does indeed sound like you and Viibryd did not get along, you're right to go off it.

 

How long did you take lamotrigine, at what dosage, and how did you go off that? Lamotrigine also needs to be tapered.

 

I read a very enlightening book "The Chemistry of Joy" and have been taking oodles of supplements--Sam-e, 5-HTP, St. Johns Wort, multivitamin, B vitamins, and Fish Oil. I have also radically changed my diet to include way less sugar, whole grains, complex carbs, many more fruits and vegetables, and organic items when I can afford them. I've also been exercising a lot more, and have lost about 15 pounds. With the reduced SSRI's I have definitely noticed a reduction in carb and sweet cravings.

 

I'm not familiar with "The Chemistry of Joy," but if it says wellbeing depends on serotonin, I'd take it with a grain of salt. Psychiatry's "serotonin imbalance" theory has been debunked; it's also invalid in alternative medicine.

 

However, your diet changes are excellent and will help you recover.

 

It sounds like the antidepressants deranged your sugar metabolism. Long-term antidepressants increase the risk of diabetes and have other adverse health consequences. It is highly possible you never needed them and have been kept on them for far too long.

 

How long have you been taking the supplements?

[Nick]

Thanks for the response Altostrata!

 

My doc kept me on my regular dose of Prozac (40mg) while I titrated up on the Viibryd to 40mg, which took about a month. I then tapered off the Prozac over the course of a month until I was completely off. While I was going on the Viibryd I was concurrently titrating up on lamotrigine for about two months until I peaked at 200mg. I tapered off the lamotrigine slowly as it's possible to suffer Stevens-Johnson syndrome if done too fast (as you're most likely aware).

 

The Chemistry of Joy does indeed basically espouse the notion that serotonin can equal happiness. It does offer that other neurotransmitters are involved (e.g. dopamine, norepinephrine), as well as specific regions of the brain. What I appreciated about the book was that it was written by a psychiatrist who believed that meds aren't necessarily a panacea and that people can do so many other things to improve their well-being. One study the author pointed out showed that among three groups (those on meds alone, those on meds who exercised, and those who only exercised) the group who only exercised actually fared best. The book also talks at length about Ayurvedic medicine, though I honestly didn't read that part.

 

I have been taking the supplements for about three months now. It's difficult to pinpoint how much they help they provide but my energy level is good, as is my sleep--though these two markers have been improved since I stopped the Prozac a few months ago. I wouldn't say the supplements have necessarily improved my post-Prozac energy or sleep. But they don't seem to hurt and I know they're good for my body. One thing the Chemistry of Joy recommends is a high dose of B6 and B12 vitamins--right now about 1000% of normal. I don't know if you have any thoughts on high vitamin intake? Over the long run I would think it's probably not good to ingest super high doses of any vitamin/mineral.

 

So, if you think I might be tapering Viibryd too fast would you recommend I increase my dose for the time being? As well as I'm doing physically, I really am in a pit of despair mentally. The prospect of feeling like I do now is supremely daunting, to the point that I've considered going back on meds. One notion I've had that does give me hope is the idea that if I was truly becoming depressed again (and not 'just' going through withdrawal), I would not have so much energy and my sleep would not be so 'normal.' In a weird way I hope I'm going through withdrawal, and not relapsing into a major depressive episode again.

 

Thank you!

[Altostrata]

Nick, were you tapering off Lamictal at the same time you were decreasing Viibryd?

 

Lamictal has its own withdrawal syndrome. How did you taper it?

 

(Stevens-Johnson syndrome occurs when increasing Lamictal, not decreasing it.)

 

No matter who wrote The Chemistry of Joy, the theory that well-being depends on a balance of 3 (or 4) neurotransmitters is incorrect.

 

Yes, I would be very cautious about megadoses of anything. These supplements may have added to your symptoms. Try reducing them gradually one by one and see if that makes any difference.

 

I would avoid a high dose of B6. This vitamin in particular can cause anxiety.

 

As for B12, anything in excess of what the body can absorb is excreted. 25mcg-100mcg daily is plenty. Taking megadoses is useless, unless you have a B12 deficiency; in that case, B12 is stored in the liver after a short period of supplementation.

[Nick]

Yes, tapered off lamictal and viibryd at the same time. Is that bad? I decreased lamictal by 50mg (from initial 200mg) every week for a month. I've been off the lamictal entirely for a month.

 

I cut out the B vitamin supplement as I think it was just passing through me.

 

No matter who wrote The Chemistry of Joy, the theory that well-being depends on a balance of 3 (or 4) neurotransmitters is incorrect.

What role do you think they have? I DID feel happier on the psych meds so I'm wondering through what mechanism you think they might help.

 

Thanks,

Nick

[Altostrata]

Antidepressants tend to be stimulating, and they tend to anesthetize feelings. Either of these effects might have diminished your emotional pain.

 

SAM-e is also stimulating. Coincidentally, we have a couple of people here who've had adverse reactions to it identical to antidepressant adverse reactions.

 

Yes, tapering two meds at once can be very hard on your system. Lamotrigine works differently from antidepressants, so you could be having withdrawal from both of them.

 

Do you have any lamotrigine left? How much Viibryd are you taking now?

[Nick]

I have a bottle full of 10mg lamotrigines just sitting on my med shelf. I'm down to 5mg viibryd every night which I'm planning on staying on until (hopefully) I stabilize.

 

I've read about people having anxiety from Sam-e but I have not noticed that myself. Really, what I notice now is that I have energy but my mind feels very unstimulated.

 

I'm feeling like I tapered too fast now and am wondering if I should up my viibryd does to 10mg. Oy vey. I can't stand feeling so blunted and irritable.

[alexjuice]

Nick,

 

Hey, just read your intro.

 

Seeing as you started on ADs as a minor and have taken multiple meds and now have reduced pretty rapidly bringing on symptoms... I am not surprised you are worried and uncertain.

 

I've got a piece of advice, but it's hard to activate, still here goes: Be patient. You started on medications very young and have not been an adult without them. As you remove them from your system, the system will compensate in response to their absence. This will provoke emotions.

 

No matter what, it seems to me, you are going to learn a tremendous amount about yourself. I know I did. I was not able, and I don't think most people who started young are, to fully understand the ways the medications impacted me.

 

Adding lots of supplements is probably unwise. Some supplemntation can be beneficial in alleviating specific w/d complaints, in most cases. However, a shotgun approach is not recommended. Try a more scientific approach by adding one supp at a time, at a low dose and giving it a few days before adding any others. You'd be surprised how potent supplements can be to the brain when it's adapting to the withdrawal of medication.

 

There is a lot of experience on this site about, believeitornot, survivingantidepressants. The way you feel today won't last forever.

 

Welcome to the forum,

Alex

[Altostrata]

It's hard to tell what's responsible for your symptoms. If I were you, I'd try adding 2.5mg lamotrigine. If it gives you some relief, stabilize and taper the Viibryd slower.

 

Then you can get off the lamotrigine, also very gradually.

 

You can test whether the supplements are doing you good or bad by reducing them, one by one, maybe one per week. If there's no change when you reduce, add it back and go on to the next one.

 

We have people here who've found some of their symptoms disappear when they go off the supplements.

[Nick]

Alex,

Thank you for your kind and supportive reply--it's really appreciated. I hear what you're saying about patience, and I wish I had more of it. I've just felt so irritable, so depressed, and so hopeless lately that I've been very impatient for change. I feel like I can't keep feeling so bad much longer. It seems like the options are to go back on some med or continue holding out for a bright spot that doesn't seem to be coming. Both prospects feel dim.

 

I've cut down on the supplements and am taking a multivitamin, fish oil, st johns wort and sam-e. I might try cutting out the sam-e and see what happens there.

 

This site is great and I'm glad I found it. I continue to draw inspiration and hope from others and hope to one day (soon?) be among the success stories.

 

Nick

[Nick]

Altostrata,

I might try adding the lamicatal, thanks. And I'm gonna experiment with the ole supplements.

Thanks,

Nick

[Altostrata]

Nick, also watch out for the St. John's Wort -- it's a noradrenergic, which can be stimulating and increase the sense of stress.

[Nick]

Nick, also watch out for the St. John's Wort -- it's a noradrenergic, which can be stimulating and increase the sense of stress.

 

Argh, this is all so complicated haha

 

So, I made the decision tonight that I've tapered too fast and I'm thinking of trying again. My tentative plan is to go back on prozac (perhaps liquid), and try tapering down really slowly from that (~10% increments). I've been reading this excellent blog Prozac Withdrawal I found linked from this site and it seems to offer a framework I think might work for me.

 

I definitely don't want to up my level of any SSRI as it feels like a step backwards but the way I'm feeling now is just not tenable. If I knew that if I held out a few more weeks or even a month that things would get better, then I would do that. But there seems to be no end in sight and I feel as if I'm getting worse. Any thoughts are always appreciated. I definitely feel like I've 'failed' in this attempt but I guess as long as I learn from my mistakes that is what matters. Ugh.

[Nikki]

Hi Nick and welcome...

 

Nick I have not taken the two meds you are using. I have taken ssri's and have gone thru WD.

 

Alto knows alot about this so her advise is spot on.

 

The advise Alex provided is also very true.

 

I no longer take any supplements and believe that for me they didn't really help, and some like B complex made my anxiety worse. You shift in diet is a good thing. I feel better when removing sugar.

 

There are threads about you medication from people who are where you are. There is a trhead by Strawberry about slow tapers. Check it out.

 

Glad you found this site, very helpful at all times.

 

Best Regards

Nikki

[Altostrata]

That's our strawberry17's excellent blog!