blazesboylan: Why should I taper?

[blazesboylan]

Hi All,

 

I hope that you are doing well. I haven't been here in a while. I am still alive obviously. My signature has been updated to reflect the taper for this year to date. As you will see I did something very foolish on the 21st of February. I discontinued the Lyrica altogether and at the same time made a 25% cut to my Effexor. It went ok for a while but then I started to get major discontinuation. So I went back up to 112.5mg Effexor and 1.6mg risperidone. As you will see I have cut back the risperidone a bit since. So, that is where I am at.

 

I have found a new doctor. I have told her about my plan to get off the meds and she is working with me. My sleep isn't amazing. She prescribed mirtazapine for that. When I got it home and saw that it was yet another anti-depressant I decided that I wasn't going to take it. I haven't. I have some zopiclone tabs and sometimes I take those. I have been taking the occasional ativan tab as well although I am almost out of those and I see that as a good thing.

 

My mood has not been great for a few months now. I have been reflecting very deeply on life and have come around to an almost nihilistic point of view. I am isolating a lot. People I have known have families now and so on and they don't really have that much time for me. I'm not sure if they care very much anyway. I am suspicious and questioning of their actions all the time. I suppose that I am a bit paranoid.

 

I am more or less alone now . I am generally most at peace when I am alone at home listening to music and reading. Going to work is a challenge and I isolate a lot there also.

 

So folks, that is where I am at. I have discovered a mental health support group in the city and I am going to go along next week. I am looking forward to meeting like-minded people. People who may understand and empathise. I am beginning to explore Buddhism as well. I already meditate most days.

 

But, my future looks a little bleak now. I don't think that the marriage and family thing is going to happen for me at this stage. However, I am pretty much decided that I don't want kids. So, I will continue to taper and hope for the best. I think that I am going through a bit of a rough patch now but I am not ill in a debilitating sense. I do meet some people and I do continue to go to work of course. I have no choice there.

 

All the best,

Blazes.

[Altostrata]

Good to hear from you, blazes.

 

Sorry to hear of your setbacks.

 

You may be an introvert. There's nothing wrong with that. Just be sure to cultivate relationships that nourish you rather than drain you.

[blazesboylan]

Thanks Altostrata. It's not all bad. I feel a bit better today. I slept well last night without any meds. Yes, I suppose that I am an introvert. I just need to find like minded people and I am working on that. I don't mind my own company and probably prefer it a lot of the time.

[blazesboylan]

Greetings All,

 

I am looking for some advice. From where I am right now I am wondering what is the best way forward. I see 3 potential strategies.

 

1. Taper off effexor completely. Then taper off risperidone.

2. Taper off risperidone. Then taper off Effexor.

3. Interleave the taper reducing each drug every other month.

 

So, which might be best? Also, as regards tapering the effexor is bridging with prozac advisable?

 

All the best,

Blazes.

 

P.S. My signature is up to date.

[Altostrata]

What are your current symptoms?

 

I would not do the interleaving strategy. It brings too much upset into the picture.

[blazesboylan]

Well to be honest there haven't been any major symptoms since I went back up to 1.5mg risperidone. Before that I had trouble sleeping and felt quite depressed at times. Quite anxious also. I think that I will stay at the level (of risperidone) for a while and maybe focus on the Effexor for the time being.

 

As regards the Effexor, I am almost 2 weeks since the last cut and there has been nothing major to report either so this is good. I would have been expecting some withdrawal by now.

[Altostrata]

That is good news! Yes, I would work on the Effexor only.

[blazesboylan]

Hi All,

 

I hope that everyone is doing well. I'd like to share a website with you that I think is really great. It may be of use to someone although a lot of you will have heard of it already maybe.

 

https://www.patientslikeme.com/ 

 

I just use it to keep track of my symptoms daily (things like antidepressant withdrawal syndrome, anxious mood, sleep problems etc. etc.) You can also keep a diary of your treatments which could include meds, supplements, psychotherapy, meditation, exercise, whatever. Anyway, I think that it's really cool. Maybe read up on the terms and conditions and all that before signing up though.

 

I have a question by the way. I am experiencing a lot of pressure in my forehead these days. It's not pain exactly, just a tense feeling in my forehead. Is this a common withdrawal symptom? According to the following headaches are indeed a possibility.

 

http://mentalhealthdaily.com/2014/06/23/risperdal-risperidone-withdrawal-symptoms-how-long-do-they-last/

 

Anyway, I am just wondering if anyone else is experiencing this? It has been going on for a while and it's particularly bad today.

 

All the best,

Blazes.

[cymbaltawithdrawal5600]

None other than our own esteemed Altostrata has a thread on patientslikeme. I found it long ago while searching the net for anything about her (that is just how I am). It was in my bookmarks when I looked it up yesterday and I see that late last year she added something to it.

 

About the head thing: as with any symptom in wd, don't rely on the anecdotal reports of users here in determining if what is wrong with you is due to wd or something that is actually medically actionable. In my experience, I had something odd happen:

 

I needed to find a different computer game for distraction and loaded a copy of Jumbline2 onto my tablet. It is a word game and to me, very addicting. The first day I could not stop playing it and it gave my brain something different to do in spite of the fact I got this tremendous burning sensation on the inside of my forehead. Would have been totally fabulous if I had been able to get an MRI at the time to see what was going on. As with any 'weirdity' that has occurred in my experience while I am still recovering, I waited for a bit so I could see if it was something for which I needed medical attention, but it went away rather quickly, within a couple of days.

 

When in doubt, see your doctor.

[blazesboylan]

When in doubt, see your doctor.

 

I think that that is very good advice. I have made an appointment. I am really concious of it when I am meditating. It was pretty intense earlier today actually. and it has been doing on now for 12 months intermittently so it's time to get it seen to. It seems to be getting worse though.

 

Thanks.

[Altostrata]

Hi, blazes. Are you still taking fish oil and magnesium?

[blazesboylan]

Hi Alsostrata. Yes, I take those every day. I am going to see the doctor tomorrow anyhow. Thanks.

[Altostrata]

A lot of people get funny feelings in their heads as a result of being on these drugs or going off them.

[blazesboylan]

Hello Again,

 

So I went to the GP. He thought that it might be a sinus infection so he gave me a prescription for an antibiotic (doxycycline). I am pretty certain that is not the problem. So, if it doesn't resolve by the end of the course (which I am almost certain that it won't) I will be sent for a brain scan. I think that it's just related to tension/anxiety myself. Or withdrawal.

 

By the way, I have been taking ativan (lorezapam) relatively frequently for a while now. 1 or 2mg a day. Some days I take none though. So, I am starting to worry that I may get hooked on that. However, they are not large amounts I don't think?

 

I am using 7.5mg zopiclone to sleep some nights also. But not every night.

 

Any thoughts on that anyone?

 

All the best,

Blazes.

[Altostrata]

If you are using a benzo often, you may be experiencing rebound anxiety or tension when it wears off. Discuss this in http://survivingantidepressants.org/index.php?/forum/29-members-only-benzo-tapering-discussion/
 

[blazesboylan]

I had a look at that thread. Thanks. Interesting and scary.

 

So, I have decided to minimize use of the ativan . I had a look through my diary and I have taken some most days going on a month now. I haven't had any in 48 hours now though. I might take 0.5mg if I really need it. So far so good though, apart from the anxiety

 

And, as predicted, the antibiotics did nothing for the pressure in my skull. So, I will go back to the GP and he will presumably send me for a brain scan which will hopefully turn up nothing!!!

 

I would say that it's withdrawal related/iatrogenic myself.

 

All the best,

Blazes.

[Petunia]

Hi Blazes,

Please would you add your recent Ativan use to your signature. If you find your symptoms get worse as you minimize the dose, it may be a good idea to post a topic in the  Members-only benzo forum  as Alto suggested, then you can get some help with that. Its possible to become dependent on a benzo, if taken regularly, in as little as 2 weeks.

 

Hopefully you will fine though, try not to take it at all or no more than once or twice a week at the most.

 

It might be a good idea to hold on your Effexor and Risperidone tapering while you are stopping/cutting down the Ativan, that way, if you start to get increased symptoms, you will know what's causing it.

[blazesboylan]

Hi Petunia,

 

I have updated my signature as requested. I will try my hardest to cut out the benzo use entirely and maybe hold steady on the risperidone and the effexor for a while until I have detoxed from the ativan. I can manage 24 hours without taking a benzo no problem. Overall I am doing ok I suppose although I am a little sensitive to things at the moment. My mood seems to fluctuate rapidly and there is always some anxiety in the background. I am meditating an awful lot at the moment and it helps deal with that.

 

I hope that you are having a good weekend.

 

All the best,

Blazes.

[Iamfine]

In your first post you said "I am feeling fine". Later you started having problems when you started a serious taper. I am defiantly not pro med but if I would have ever taken anything that allowed me to say "I feel fine" I think I would have happily stayed on my meds. Psychosis is not to be messed around with. Good luck to you whatever your path may be. I wish I were able to say I felt fine while on drugs.

[blazesboylan]

Hi there Iamfine.

 

What you wrote really made me reflect and I am wondering how best to answer you. I do take your point although there have been times when I definitely was not fine regardless of what meds/doses I was taking. I will write more as soon as I get a chance. It is getting late here and I need to go to bed. I have had a very busy day. If will be back with more asap.

 

Thanks.

[Petunia]

In your first post you said "I am feeling fine". Later you started having problems when you started a serious taper. I am defiantly not pro med but if I would have ever taken anything that allowed me to say "I feel fine" I think I would have happily stayed on my meds. Psychosis is not to be messed around with.

 

This is a support site to help people safely taper off medications which they feel are not right for them. We all have a right to information to help us decide what is best for our own health and to be able to make that decision for ourselves.

 

Just because someone may feel ok initially, while taking psychiatric drugs, it doesn't mean they are benign. These are toxic substances, they cause damage over time and the longer you take them, the potential for a difficult withdrawal is increased.

 

Studies have shown that long term, people do worse when they stay on psychiatric medication as opposed to people who don't use it at all or only take it short term. There are much healthier ways for people to manage their problems, difficult emotions and moods. Even psychotic episodes can be overcome without drugs, or with the use of them at a low dose short term, in a supportive, understanding environment.

 

Iamfine, please don't discourage people from trying to improve their health and quality of life long term. As I suggested to you in your own thread, please get hold of a copy of Anatomy of an Epidemic by Robert Whitaker.

[blazesboylan]

Hi there everybody,

 

@Petunia - thanks for your reply.

 

Before I ever discovered this forum I had questioned whether I needed to meds for the rest of my life. Reading Anatomy of an Epidemic really made me question it however. In fact it scared me a bit and I started to worry about long term consequences. Consider my progress to date though.

 

18 months ago

300mg Effexor, 200mg Lyrica, 3mg risperidone

 

Today

75mg Effexor, 1.3mg risperidone

 

I have had some rough spells in all that time but overall I have pulled through. I haven't had to take any time off work sick. I am still living my life.

 

What I have learned though is that I need to slow down a bit at times maybe. I think that what happens is that I can cut a dose then feel some withdrawal for a while. However, as soon as I feel relatively well again I could make another cut. 

 

So, I think that I will stay where I am at now for a little while. I am taking a vacation next week and while I am off work I might see if I can manage without the zopiclone at night. I won't have to worry about not getting enough sleep for work etc. As regards the ativan, I am managing to cut it back. Hopefully I will be able to discontinue it soon.

 

Apart from that, I have been doing a lot of other stuff. I am connecting with a lot of people with mental health difficulties/issues. Mainly through meetup.com which I thoroughly recommend. I have got back into AA also. And I am meditating a lot and taking care of myself generally.

 

But that's just me. Everyone else's experience will be different.

 

All the best,

Blazes.

[Altostrata]

Those are words of wisdom, Blazes. Please let us know how you're doing.

[LoveandLight]

Sounds like your doing well pleased for you

[blazesboylan]

Hi All,

 

I thought that I would check in as I haven't been here in a while. First of all, my signature has been updated to reflect my current cocktail.

 

So, as I was saying, I went on vacation. I have to admit that I felt quite well for the week that I was away (around the start of July). However, as soon as I got back to Ireland I started to feel quite unwell again. So, I increased the risperidone back up to 1.5mg. It didn't seem to be having and effect though.

 

I went to my doctor eventually and she added 15mg mirtazapine. I have been taking it a week now and I have to say that I think that I am feeling some positive effects. Having said that, I felt pretty awful yesterday evening. But, I am optimistic and it's early days. I am feeling better than usual today.

 

As regards the venlafaxine, my doctor wanted to increase it to 150mg (up from 75mg) also. However, I have decided to hold off on doing that and maybe giving the mirtazapine a chance. It's only been a week as I say.

 

So,

 

Positive

• Less ativan - I can manage 72 hours without having to take any.
  
• Less zopiclone - I only take half a tablet at night now (3.75mg). I may be able to discontinue this altogether as mirtazapine is supposed to help with sleep. However, I sometimes wake in the early hours and I need another half tab to get back to sleep again.
  
• Venlafaxine unchanged - In my doctors opinion, at 75mg I am not actually be getting any clinical benefit from it. AFAIK that's the minimum effective dose. Maybe I will be able to taper this off further without too much difficulty.
  

 

Negative

• Mirtazapine - I am not happy to have to take a new med. However, it's probably necessary for the time being.
  

 

That's all folks

 

Blazes.

[Altostrata]

Your doctor is of the "more is better" school of drugs. He is not correct about the lack of "clinical benefit." The standard is how you feel.

 

It's good you can minimize the Ativan and zopiclone. It sounds like sleep is a major problem for you.

[blazesboylan]

Hello,

 

Just a quick update. Overall I feel that the mirtazapine is having a positive affect on the sleep front. I am not waking in the middle of the night any longer and I generally get a good night's sleep.

 

I am tapering off the zopiclone now. I have been taking less that half a tablet a tablet for the last week. I will keep going on that.

 

As regards the ativan, I am taking 0.5mg a day now. I will taper that off further also. Slowly. I thought that it was best to take a little rather than abstain for 2 or 3 days and then maybe take a tab or two. Anyway, I will hopefully be able to discontinue it altogether over time.

 

If I manage to get off these two medications I will start to look at the venflaxafine or the risperidone. I will just see how it goes.

 

That's all really.

 

All the best,

Blazes.

[Altostrata]

Sounds good. Go carefully off the zopiclone before the benzo.

[blazesboylan]

Hi All,

 

I haven't posted in a while so I just thought that I would check in. I'm not doing too badly really. A couple of weeks back I hadn't taken any ativan in maybe 3 days. I started feeling what I recognise now as major withdrawal. I had to take a day off work. So, I am taking 0.2mg of ativan twice a day now. I complained about having pressure in my head a lot a while back and it's still a problem so not as bad as it used to be. My doctor even sent me for an MRI brain scan but nothing showed up thankfully.

 

Otherwise, my sleep is pretty good these days. So overall things are ok. I hope that everyone is doing well.

 

All the best,

Blazes.

[blazesboylan]

Hello,

 

It's me again. I have (as per my doctor's advice on the last visit) doubled my Effexor. I have been looking back over the diary of symptoms which I record diligently on patientslikeme.com, and I have been experiencing a lot of depression/anxiety. I must have made the last post on one of my better days. As well as adding mirtazapine on my last visit the doc suggested that I go back up to 150mg Effexor, which I have. I see it as a defeat in some ways maybe. So, to summarise.

 

The Good

• I am taking half the dose of Effexor that I was on 18 months ago (300mgs)
• I am taking half the dose of risperidone that I was taking 18 months ago (3mg)
• I am now managing to taper off the ativan. I am on a very low daily dose now.
• I no longer take Lyrica. I used to when I started posting here.
• I am now on a very low dose of zopiclone. I presume that the mirtazapine is helping with the sleep and I am sleeping well.

The Bad

• I now take mirtazapine, albeit at the lowest dose (15mg)
• I have had to increase the Effexor.
• I have developed a dependency on ativan over the last 6 months. I should soon be off it however.
• I am also dependent on zopiclone now although at a very low and ever decreasing dose.

To be honest, I feel that I started to become dependent on ativan as a means of dealing with withdrawal from the other meds. The same might be said for the zopiclone which I never needed at one point. Today I am feeling reasonably well though. So, for now, I think that I will slowly taper off the ativan and the zopiclone and then review the situation in a while.

 

My signature is up to date anyway. I hope that everyone is keeping well.

 

All the best,

Blazes.

[blazesboylan]

I was back with the doctor last week. More changes and my signature has been updated accordingly. Two weeks after doubling of the Effexor and the depression isn't really lifting though. Anxiety/paranoia are a bit of a problem as well. 

 

However, I am sleeping very well. I am going to try and go without the zopiclone (2.5mgs) tonight for the first time in months. I take 5mg zyprexa at night along with 15mgs mirtazapine so I should fall asleep ok.

 

Over and out,

Blazes.

[Petunia]

Hi Blazes,

Thanks for updating and changing your signature. I was wondering, did you ever get around to reading this:

 

I recommend:

...

Anatomy of an Epidemic by Robert Whitaker, for sure.

 

[blazesboylan]

Hello Petunia,

 

I have read Anatomy of an Epidemic twice. The second reading convinced me to try and taper off all meds. However, I don't think that it is really working out.

 

Why do you ask?

 

By the way, as I said previously, I was suffering from major pressure in my forehead (I even went for a brain MRI) and a tingling in my left ear which seemed to be spreading to the left hand side of my face. Since I have increased the Effexor again this is no longer a problem. However, my mood isn't really improving I don't think. Maybe I have re-instated too rapidly or something. 

 

Also, I have managed to fall asleep the last two nights without zopiclone.

 

Over and out,

Blazes.

[JanCarol]

Hey Blazes - 

 

Are the increased drugs helping you?  It seems so hard, when you worked so carefully to come down off the Effexor to just double it so quickly!  And then add the Mirtazapine!  (did you know that the less Mirtazapine you take, the more sedating it is?  i.e., 7.5 mg is more sedating than 15.)  I agree with Alto, your doctor seems to prescribe to the "more is better" school of script-writing.

 

What are your plans now?  You have decreased your dosages, which will help you in the long term.  Do you want to just stay there for awhile as you get off the benzo?  (I don't see the zopiclone in your sig, are you off it totally now?)

 

What is your medical system like - do you always go to the same doctor?  Are you happy with that doctor, or do you ever think about changing?  Or is that an option for you at your location?

 

My concern for you with doctors is, if you taper with the wrong doctor, s/he might call it "non-compliant" and section you?  I've heard of this being a problem in Ireland, even when you are not a threat to yourself or others.  If I were in your shoes, I would dance very carefully around doctors.

 

I think about you - going through all of your tapers while working - OMG - a "productive member of society!"  I haven't been able to do that, due to iatrogenic damage, for nearly 15 years now!  So if you're working - how dangerous are your symptoms?  Do they really need so much medication?

 

Or is it that you need the medication in order to continue working?

 

Just some thoughts to mull around with you, I look forward to your poetic/prose response!

[blazesboylan]

Hello Jancarol,

 

Thank you for your reply. A lot of questions. I will do my best to answer them all.

 

Firstly, as to whether the new cocktail is actually helpful or not, I would tend to say that it is not at the moment. I have taken a look at my symptoms (which I track daily on Patients Like Me). In the month since the Effexor was doubled I have been feeling more anxious and depressed than before. Significantly so. The pressure in my forehead continues along with the tingling/numbness in my left ear. This seems to be spreading to the left hand side of my face now.

 

For the past month I have been taking up to 0.5mg of Ativan daily. I am hoping to eliminate this before I consider making any other changes. There have been an awful lot of changes in recent weeks. In general I haven't been using zopiclone but I had to take half a tablet last night and the night before.

 

At the moment I can't say that the olanzapine is helping either. But I have read that it can take up to 6 weeks before it is effective. However, I have read also that the life expectancy of people treated with anti-psychotics can be reduced by up to 25 years (!!!) because of the health complications that they can cause. And in many cases (perhaps the majority) they may not actually be effective.

 

The plan for the time being is just to get off the benzo. As regards the zopiclone, I hadn't been using it really but I have had to take half a tablet the last two nights.

 

It's a right bloody mess to be honest. I will be back with my doctor again at start of next month but I can't imagine that it will be a worthwhile visit. Perhaps things will have stabilised a little in the meantime. I do see the same doctor all the time now by the way. Sectioning is a British thing. As far as I know, it refers to a certain section in the Mental Health Act. You did make me consider the question however. All the relevant information is here.

 

http://www.citizensinformation.ie/en/health/mental_health/rights_of_psychiatric_patients.html

 

In particular this part

 

"Under the Act, your consent to treatment is required except where the consultant psychiatrist considers that the treatment is necessary to safeguard your life, to restore your health, to alleviate your condition or to relieve your suffering, and you are incapable of giving such consent because of your mental disorder."

 

Yes, I go to work every day. Lately I would really prefer to stay at home though. I am finding it tough going.

 

All the best,

Blazes.

[JanCarol]

Wait - what?  Olanzapine?  Please update your signature!  Somehow I missed that one!

 

It sounds like you would've been better served by a micro-reinstatement instead of a medical one (we reinstate to last taper, or 10% of dose, the smallest amount possible, and then see if that helps the symptoms).  I'm sorry that your symptoms are still a struggle!

 

I used the word "section" because that's the one I know here in Australia.  In the US it's called "Involuntary," and I know they have it in Ireland, under whatever name it is.

 

The one question I don't think I got answered was this:  do you need this level of medication to continue working?  Even though, at this stage it is making it difficult?  

And I guess that adds another question:  is it helping with that?

 

Keep up the brave battle, Blazes.  You are a survivor!