Whitelily: trying to withdraw from an antipsychotic (amisulpride)

[whitelily]

Hi, Just a very quick update - stopped the sertraline without any side-effects, so now just on 100mg amisulpride and 10mg aripripazole..  

 

I don't seem to have come across many people who have managed to get off amisulpride.  If anyone reading this knows anything about taking valium whilst switching to a lower dose of antipsychotic, would be very interested to hear as I used to find valium very helpful and didn't find it addictive in the past.  Thanks. 

[scallywag]

Whitelily - thanks for coming by to update and congratulations on your success tapering off sertraline!  <<<applause>>>

 

Someone who joined and posted recently was looking to taper amisulpride. I've added some tags to your intro thread. One of them is "amisulpride" If you click on the tag, you'll find other members who are tapering it.  The recent member is "Samanta."

[whitelily]

Thanks scallywag ...... I'm glad to be off it, I just would love to be able to have the same success with the antipsychotics.  Thanks for the tip for how to see others who are tapering off amisulpride.  

[whitelily]

The following is just recording information for reference:

 

I had not been careful enough about documenting everything (partly due to memory issues), but lately my memory seems to be working a bit better again.  I hadn't explained that after I crashed in Feb 2015 I had been put on 200mg amisulpride plus 10mg aripripazole and 50mg sertraline.  

 

So, after this what I forgot to mention was that I weaned myself down from 200mg amisulpride to 100mg amisulpride as well as cutting out the sertraline.  I didn't notice the any side-effects with the sertraline going, but with the amisulpride I now realise with hindsight that I had had about two/three weeks of an emotional meltdown with psychosis which came on without me realising it was beginning until i was in the middle of it.   As it hadn't happened straight away, I didn't register that it could well have been withdrawal and I hadn't been working so I had just missed some things and rested at home and had put it down to a relapse of illness.    

 

But because I had figured that 100mg amisulpride plus 10mg aripripazle (Abilify) was the dose I wanted to aim for (since I used to be on just 200mg amisulpride) i decided i wouldn't increase my antipsychotic medication but waited the couple of weeks out and took valium to get through and thankfully although I was very fragile and unstable for a while, thing seemed to settle - can't remember how long exactly it took to recover but at least a month and I haven't relapsed since, and overall have been functioning better (I do notice my emotions a bit more).  

 

Anyway, now apart from my menstrual cycle starting again with the lower dose of amisulpride .... I have also developed a problem swallowing tablets and can’t take metformin.

 

So just to confirm current dose is still 100mg amisulpride and 10mg aripripazole (abilify) which is a long way off from being drug free, if that miracle ever happens.  

 

I also made a discovery that taking meds for diabetes (metformin) together with the psych meds, meant that I had interrupted sleep and could only manage about 3 1/2 to 4 hours without waking thirsty.  Not sure of a way round this since psych meds have caused diabetes, but when I stopped the metformin for a week or two, my sleep returned to normal and I wasn't so thirsty.  I am now taking linoglyptin  with the psych meds, and the interrupted sleep has returned. 

 

I have just started the gentle version of the low blood sugar diet by Dr Michael Mosley to try and hold off the diabetes.  Within several days, cravings lessened and I try and drink more between meals. 

 

Finally, just to mention – the reason I was prescribed sertraline back after ‘crashing’ last year was because I had developed OCD – but this disappeared again on reinstatement of the antipsychotic, and thankfully I was easily able to withdraw from the sertraline but wonder if I would need to take an antdepressant if I got to a lower dose of antipsychotic again?  

[whitelily]

..... is it best to taper the antipsychotic first?

 

I am now wondering if this is what I should have done instead of the other way round.  

 

I ask because when I tapered the antipsychotic amisulpride and got into severe problems with psychosis and OCD - the only thing that helped with the OCD was Sertraline until the overall dose of antipsychotics I was taking increased again.  At least that's the way it seemed to me - I can't think what else it was.  

 

I came across another person here too who successfully tapered from Abilify by maintaining her dose of antedepressant.

 

  

[ChessieCat]

Hi Whitelily,

 

I moved your new topic to your Intro because it is about your own situation and will keep your history together.

 

Here is SA's discussion:

 

Taking multiple psych drugs? Which drug to taper first?
"If you're not having an adverse reaction from the other medications, taper the most activating drug first. This is usually an antidepressant or stimulant (ADHD drug)."

[whitelily]

hi ChessieCat,

 

Thanks but I posted in the other section because I was curious to hear whether other people on antipsychotics had found it better to taper off them first and the antidepressant next - perhaps i didn't word it well.  I appreciate that you have certain guidelines or rules to follow, but I don't know that many others in that situation would necessarily comment on this thread - partly because amisulpride doesn't seem to be available in some countries. 

 

I've found myself rather stuck with the antipsychotics now, and my health has been worsening so I am keen to learn from others experience.  

[whitelily]

Please can someone advise how I can post more on my signature to give update on reductions made?  I seem to have run out of available space.  Thanks very much.

[PluckyPony]

Please can someone advise how I can post more on my signature to give update on reductions made?  I seem to have run out of available space.  Thanks very much.

 

Hi whitelily, 

 

To create more space, you can combine the paragraphs ( you only get 12 lines for the signature).

 

I discontinued my antidepressant (Wellbutrin) prior to starting the Abilify taper. I'm a voicehearer, but I've learned to discern my triggers and what prevents me from staying grounded.  Once in a while though, things can get rough, but I lean on my faith and patience to see me through. I found that it usually (the scary, gossipy voices) dies down to manageable levels or goes away entirely, especially when I practice good self care (eating less sugar, drinking lots of water, and oddly enough, discovering how others deal with their voices).  Have you been taught any non-drug methods to de-escalate a crisis since your last hospitalization?

[whitelily]

Hi PluckyPony,

 

Thanks for your reply and I was also interested to hear that you are a fellow voice-hearer and are also tapering antipsychotic medication.  That’s great that you managed to discontinue the Wellbutrin. 

 

I haven’t actually been taught any non-drug methods to de-escalate a crisis by anyone, but I’m also going the low sugar route (I’ve just started the blood sugar maintenance diet by Dr Michael Mosley which is really easy to follow).  Also, just resting plenty (even if I can’t sleep) seems to be helpful.  Interesting to read that you’ve written about ‘staying grounded’.  I did find lavender oil helpful when I couldn’t relax, and I wonder if other essential oils would be helpful. 

 

For ref on thread:

 

I omitted to take the psych meds for several days due to being disorganized and busy (I know.. not the best)– had no symptoms and reinstated at 75mg amisulpride and abilify stayed the same at 10mg.  Now taking in the impact of doing too big a cut, but the tablets are tiny and my scales had been stored away.  Had insomnia for one night so far – just rested and took a diazepam, caught up the next day with sleep which I felt was positive. 

 

Wondering if I really should search for scales and still reinstate at higher dose – no other symptoms other than insomnia. 

[PluckyPony]

Hi Whitelily,

 

You're welcome. Very happy to meet another voice-hearer as well. *hugs* 

 

I have a bottle of lavender that I love, but rarely use.  Essential oils can really be helpful for some people. Whenever I feel really wired or stressed, I drink chamomile tea. It helps me a great deal, especially when I am going through my episodes (happens less and less as the years go by). Most of my de-escalation techniques I learned from experience and research.  I try to remind myself that I am the captain of my ship, that I am responsible for my choices, not the voices.  And those choices include what to believe and what not to believe.  But being human, when I do become especially frightened or confused, I discuss my experience with others and/or pray. 

 

I'm happy that you have implemented lifestyle changes that will impact you in a positive way. That first step can sometimes be the hardest one to take, but totally worthwhile.

 

In terms of your drug questions, I will defer to the SA team.  It can be very tough when dealing with insomnia, but they give solid advice that has worked during my taper.  I especially like the sleep hygiene thread; incredibly useful and easy to implement in one's life.

[whitelily]

Thanks for your reply PluckyPony - *hugs* back too.  

 

I am really keen to find out more about de-escalation techniques - would it be okay to pm you to ask about this?  and also for me to share anything too that might be helpful  - but atm I do not feel able to on open forum.  Do you know if the pm feature works here?

 

Last night, I was awake until about 3am, then woke approximately every hour until morning when I had a longer couple of hours.  I'm thankful to have slept.  

 

Thanks for mentioning the sleep hygiene thread - will check that out.  

[PluckyPony]

Hi Whitelily,

 

I am always happy to discuss non-drug and non-supplement based methods for dealing with episodes in PMs.  I do not have specific methods for dealing with antagonistic/demanding voices, but what I mentioned continues to work for me. 

 

PluckyPony

[jmncrr]

hi whitelily,

 

I too am tapering an anti-psychotic (risperidone). No problems for me so far, as ive almost cut my original dosage in half. It seems like you have done a great job with tapering your anti-psychotic.

 

Did you have a problem with anxiety, and that is why you took the valium, or was it for sleep?

[whitelily]

hi jmncrr, thanks for your encouragement - still got a long way to go I think, especially given it can get more difficult with lower doses.  But atm feeling much better with lower dose of amisulpride - I'd been on it so long I hadn't realised how much it had stopped me feeling emotionally.  Yes, I take valium occasionally for anxiety.  All the best with your withdrawal too. 

[whitelily]

Update:  had reduced to 75mg amisulpride on about 16th October with 10mg abilify ....... only had a little insomnia and then felt very well, however, over the past four days have had momentary episodes of psychosis (voices) and have been easily stressed - which is about 24 days after I made the reduction.  Unsure if this is a withdrawal reaction?  

[jmncrr]

hi Whitelily,

I have a simple question, for i am also tapering from an antipsychotic.

 

Have you had any anxiety with your taper, and was it psychological anxiety or physical?

 

Thank you

[whitelily]

hi jmncrr, I don't really know how I am to tell the difference between psychological and physical anxiety, but yes I have had anxiety with tapering, but I also had anxiety before I tapered.

[whitelily]

Just updating:  after having some psychosis lately (which I noticed coincided with pms), it's almost stopped now and I'm feeling pretty stable on current dose of 75mg amisulpride 10mg aripripazole.  Hoping to reduce again in December.  Just so frustrated about memory loss in particular atm.  My appetite has increased lately and I don't know why, unless its the colder weather.  Unable to hold down a job still and it seems unlikely I would ever make it back, except for possibly a part-time position with low stress.  

 

I have seen a therapist with experience of helping war veterans with ptsd who confirmed, as I have suspected for a long while, that I have  symptoms of ptsd with my brain stuck in a 'fight or flight' loop.  I believe I had this from before I was prescribed psych meds, but it only worsened with 'treatment' from the mental health service. She has recommended deep breathing exercises several times a day to begin with and a simple grounding exercise, and I am due to see her again next week.  She also has experience of seeing people recover from psychosis.     

 

I just wondered again if anyone knew if it was at all helpful to switch to a different type of drug to aid withdrawal from an antipsychotic??

[jmncrr]

 

I just wondered again if anyone knew if it was at all helpful to switch to a different type of drug to aid withdrawal from an antipsychotic??

 

 

Increasing your sertraline might work.

 

 

You stated that you had anxiety while tapering, but you had anxiety before you tapered. Has it gotten worse since you started tapering, or stayed about the same?

 

Thanks

[whitelily]

 

 

I just wondered again if anyone knew if it was at all helpful to switch to a different type of drug to aid withdrawal from an antipsychotic??

 

 

Increasing your sertraline might work.

 

 

You stated that you had anxiety while tapering, but you had anxiety before you tapered. Has it gotten worse since you started tapering, or stayed about the same?

 

Thanks

 

I actually stopped taking the sertraline, but yes, I wondered whether it might be possible to switch from an antipsychotic to an AD - I feel that it might be the lesser of two evils.  

 

Regarding the anxiety - it was at its absolute worse when I crashed after tapering too quickly or have tried to come off cold-turkey.  

[jmncrr]

I am glad you were able to get down to 75mg of amisulpride. I don't handle anxiety very well at all, thats why i have questions pertaining to that.

 

Since you have been tapering more slowly, do you not notice any increase in your anxiety, or has it leveled off and stayed about the same?

[whitelily]

hi jmncrr, at the moment the anxiety has levelled off - but I am not working and can't imagine doing so currently.   Sorry I can't be more specific - unless I write things down I tend to forget, a major side-effect which I am very concerned over.  

[whitelily]

Is it too late to get off these drugs?  I'm seriously concerned about my memory and I know that it must be med-related because there's no history of early memory loss in my family.  I'm focussing on breathing exercises, walks, healthy eating and now brain training exercises. 

 

I was going to make a 10% reduction, but think I will wait till the end of the month when I have more of the above under my belt so to speak incase I get hit with insomnia.  I wish I could go faster. 

[scallywag]

It's not too late to taper off the medications. The coping tactics you've developed and are using will make a big difference to your experience from here to reaching 0 mg.

[whitelily]

Thanks scallywag for your encouraging reply - I could give you a hug! 

 

Will check in with update when I've made next reduction.....

[scallywag]

Here you go: 

[whitelily]

thanks scallywag.... i don't know how you did that cos it doesn't show up on my screen, but (hugs) back .....

 

guess maybe my feelings are coming back somewhat because I'm feeling so angry about this now.  It's absolutely criminal that pdoc's are coercing people into taking these meds when they cause physical dependency and brain damage and they justify any issues by saying that its better than having a mental illness.  

 

I have just tried a brain training app and was shocked at how low my scores were - when prior to taking meds my IQ was in the 130's.  I'm so angry that there's a culture of denial over what these meds are doing to people and how information about it is being suppressed.  

 

I'm sick of seeing my local pdoc, who changes every six months or so anyway.  I feel sick over them having the power to lock you up and block your treatment from other professionals if they think you're irrational or not complying with treatment.   

 

I then saw one person for counselling who, when I confessed that I was attempting gradual withdrawal, tried to push me into still taking the meds and to go back to my doctor - but what good will that do- they just wear you down to persuade you to take the drugs again, or else they insist you are better and ought not therefore to be claiming any kind of welfare and going back into full-time employment, which after 20 years of psychosis and being caught up in the mental health system where you lose your coping skills, is a big ask.

 

arrrrggggghhh........

 

on a more positive note, I am back to using scales to weigh my tablets.  

 

also, what do you do when you feel so depressed over what's happened??  the irony is that I think I have got clinical depression now but its been iatragenically caused and the last thing I want to do is take another med, but  I feel like I'm struggling to think positively.

[scallywag]

We are rightfully angry when we realize that we blindly and mistakenly trusted in a doctor, in the medical profession with respect to these medications.  After being angry about anything, a period of sadness and low energy often follows. Put your energy and attention toward those things that help you feel better -- careful tapering and non-drug coping techniques.
 
Non-drug techniques to cope with emotional symptoms

Sometimes anger, depression, and other emotions are chemical "neuro-emotions", not real emotional responses:
Neuro-emotions
 
There is a new topic in the relationships forum, Being on or tapering neuroleptics ("anti-psychotics"), for members who want to connect with others rowing the same boat.

[whitelily]

Thanks very much for your reply scallywag.  It seems to take a while for things to go in, so I'm rereading links today.  

 

Yesterday, I cut my dose of amisulpride by 10% to 67.5mg amisulpride with 10mg aripripazole, using the scales to weigh the tablet.  Last night I had felt quite tense and alert when trying to go to sleep so I am wondering if I have done it too soon? However, I am thinking a little better.

[scallywag]

Some people experience symptoms after a decrease. For some the symptoms arise within a day; for others the symptoms show up after 4-5 days; others don't see them until 2 weeks after. 

 

Be patient. Keep a log so that you learn your symptom pattern. Then you'll be able to say/think, "Oh yeah, this usually shows up on the day I decrease and goes away by day 4 (or whatever is true for you)."

 

Please keep notes on paper of your symptoms and the times of your dose(s). This post has a useful format for a daily log:

Take notes of doses and symptoms

[whitelily]

Thanks for your reply scallywag and the helpful links.

 

Just to update - woke up with what I think was a bad panic attack on morning of 28th (cut dose on evening of 25th) - couldn't breathe properly for about an hour with racing heart.  Went to doctor later that morning and bp slightly high but otherwise all okay by then.  I wasn't conscious of worrying more than usual - wondered if this was to do with withdrawal.  Waking in night with diabetes, but otherwise am ok.  However, appetite has been through the roof lately and I don't know why that is. 

[whitelily]

Update: since being on 67.5mg amisulpride just realised that my sleep has been lighter and I keep waking in the middle of the night and feeling tense and finding it harder to get back to sleep.  Guess that means I will have to wait for longer until I'm really settled before cutting the dose again.  

[scallywag]

Reactions to a dose decrease aren't fun but they do provide good information about the next step. You can hold for longer now and/or decrease by a smaller amount next time.

[whitelily]

Been awake from 3.30am - awoke dehydrated.  Drank lots, then have eaten as felt really hungry.  Realise I need to go back to the doctor to ask about getting dehydrated at night so much (diabetes), but not sure why all this hunger has started - and at night. 

 

I was feeling that I had got somewhere with lowering amisulpride dose, but I've just been trying to find out what 10mg of abilify is equivalent to in terms of amisulpride again without success, and think that I may not have made much progress at all because of now being put on abilify last time I was admitted. 

 

Have ordered some liquid fish oil (as opposed to capsules due to difficulty swallowing) and need to order more Mg oil.   

[whitelily]

Could vitamins and minerals be problematic for some people because of where they are sourced from - from chemical sources?  Would plant-based vitamins and minerals be safer and better used by the body?