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DMV64

DMV64: Reinstate Saphris?

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DMV64

Hello. I am glad to have found this place. I am currently in a horrible withdrawal from Saphris. Really it is like debilitating terror, beyond panic even. I saw a post from 2014 mentioning Dr. Rob Purssey but the link was broken. A bit about me: I am I guess atypical. I have major depressive disorder and anxiety and ADHD. I respond in unexpected ways to many drugs. Although I do not "fit" the criteria for bi-polar, I cannot take seratonin, it makes me sick and manic. I have been on a lot of (cocktails) things so I won't list a history, but am currently on: Lithium 300mg, about 5mg vyvanse (I open capsule), 1mg Klonopin and now 40mg Geoden to help with the Saphris withdrawal. Mornings are THE WORST. I feel afraid to get out of the bed. My psychiatrist seems to not even know about this kind of Saphris withdrawal. Really I just want to take it again to feel better but it kind of turned on me causing depression and dips to suicidal thinking. This is not the first time with the Saphris. In 2011 I was on it for about the same amount of time (2 months) and had a dystonic reaction and went off cold turkey. Very bad. this last time they had me on Cogentin along with Saphris. So I am suffering and I need help. I need to function. When will this end? I need to know what to expect. The Geoden is helping but it's still there. 

-D

 

 

Edited by baroquep

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DMV64

I was hoping to see if there were any responses...I just don't know at this point if I should reinstate some level of Saphris or stay the course. I did titrate but quite rapidly. Now full of symptoms. I could reinstate and try to go slower, just hard since it is sublingual. Really need help.

Edited by Altostrata
added screen name to title

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DMV64

Hello everyone,

I just searched Saphris and found this thread. I am hoping for help and am desperate. I titrated (as best one can sublingual) probably too fast. And now I am suffering terribly.

I don't know whether to reinstate and try to go slower or stay the course. Its been about a week. Doc started me on Geoden (restarted as I have been here before) to try to help the EXTREME panic. The mornings are the worst. I am trying to function. 

Help. Reinstate? Stay where I am?

-D

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Altostrata

Welcome, DMV.

 

How much Saphris were you taking, in what form?

 

What is your current symptom pattern? What drugs are you taking now, at what time of day, and what dosages?

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DMV64

Thank you for responding.

I am taking everything on my tagline...

After reading these boards I have done a low dose reinstate of 1/4 of 5mg tab of Saphris. Just now.

My symptoms are very severe panic, terror, anxiety. Trouble thinking, doing much of anything. Nausea.

Really it is the extreme panic that is debilitating. I don't know if the reinstate will help or how long I should wait to see if it does.

Or even exactly how to titrate down off it if it does. Is there a table? This is just too much, I need to work.

Since Saphris is sublingual I am not sure even how to do it exactly.

The mornings are the worst-I read something about black out shades? Will this help? I mean I do still have to get up.

-D

 

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1 hour ago, Altostrata said:

Welcome, DMV.

 

How much Saphris were you taking, in what form?

 

What is your current symptom pattern? What drugs are you taking now, at what time of day, and what dosages?

Please answer these questions to the best of your ability.

 

Try to give the times when you take each drug and what kind of symptoms you have before and after taking them.

 

We don't believe in psychiatric diagnoses here, self-imposed or other. The ones you mention in particular describe the states very frequently caused by long history of poly drugging - being on and coming off myltiple psychotropic medication in an attempt to be functional.

 

A short drug history with information when you first started taking drugs and which you had changed would be helpful also. It doesn't have to be all since you wrote there were a lot but just something brief to give us an idea.

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DMV64

Hi...

As of just a few hours ago I reinstated a small dose of Saphris, 1/4 of sublingual tab. From my readings here I am hoping this helps stablize me. Once stable I hope to titrate slowly off although I am not sure how exactly to do this with sublingual.

 

My current symptoms are very severe panic terror anxiety, especially in the morning. It started after I quickly titrated (cut doses in half) off 5 mg Saphris. I was taking at night. Sublingual.

 

I was on Saphris for about 2 months, went on it to help depression. I cannot tolerate SSRI's. It started to cause agitation and I went off.

I had been taking Geoden 40 mg, but went off while on Saphris and now am back on in hopes of reducing symptoms. I take it in evening. It makes me very heavy and dopey. I think it is helping the Saphris withdrawal though.

 

I take Lithium 300 mg in evening. 

I take vyvanse 5 mg in morning. I feel a little better as morning goes on.

I take Klonopin 1mg in morning. I feel a little better as morning goes on.

I take 20 mg omezerpole at night.

 

I hope this is clear enough....

Edited by baroquep
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DMV64

Hello,

Is there an excel taper spreadsheet? I am unsure how to taper down from 1/4 tab sublingual saphris in the manner discussed, making the cuts incrementally smaller.

Wondering if there is some kind of sheet?

-D

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DMV64

Today I feel a little better with the low dose re-instate. But I would really like to talk to one of you. The isolation is very hard. Feeling like I am permanently damaged makes me feel like life is hopeless. I know I need to stablize and start the very slow process of titration the right way. But meantime I still am almost paralyzed by fear. Today I have terrible nausea as well. I amtrying to be hopeful but it is hard not to feel like it will never end. I honestly don't know how some people here have made it through. Please tell me it is going to get better.

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It is going to get better :)

 

One way to get to 'talk to' people here is to visit their threads and offer them support and encouragement. While you are doing that you will see that most people here are going through very similar states. You will feel like they are all describing what you are going through. And you will also benefit from advice and suggestion they got. With us who have been here longer you will notice how we were in a very bad way but gradually got better.

 

Some people take longer to recover but I am lucky in that I can always get something positive for myself from different stories. Or I just stick with people who are dealing with this constructively and I can learn something from them.

 

In that way you will build your own support network.

 

Recovery happens in windows and waves so don't worry if things continue to be rough for a while. Especially don't react to change in symptoms by changing drugs. 

 

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DMV64

Thank you so much for your reply! It means so much to me to connect! I will take your suggestion and read and follow threads and "meet" people!!

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ChessieCat

Here is the link:  Tapering Calculator - Online

There are different tabs at the bottom.

 

You can download this by:  Select File (in the spreadsheet not in your browser) 

Feel free to download this spreadsheet
Select File from menu above, then download

 

Here is another one.  It is different to the Online one:  The Work

Edited by ChessieCat

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bubble

Thank you for reaching out to other people.

 

I hope you found it helpful.

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DMV64

Oh my gosh yes. It is a little hard to think and function now. But I am just starting with a few people. 

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DMV64

Well today's update is it has been a hard day.  I only went back on Geoden and Lithium (both of which never worked great for me) to "manage" my too fast Saphris taper withdrawal, and so I am taking them out. I have only been on the Geoden for 5days. Lithium for almost 10 days. I came off Lithium previously with not much problem. I came off Geoden when I started Saphris. So with the re-instate I want these recent extra meds out. I only started them when I was off the Saphris/ The Lithium I am stopping. The Geoden I am halving over a few days. I figure the sooner I get off since it has been a short time,  the less my body will have gotten used to them. I hope I am right. I am open to your experiences and opinions I hope this is a "good" change. I re-instated at 1/4 of the 5mg tab of Saphris as of 9/9. I hope this is enough. I would rather not go up to 1/2 tab. But I am willing to do it if it means starting a taper from a better place. I also got in touch with a Doc who seems to be knowledgeable about withdrawal syndrome and treatment resistant people like me. I have hope that I will get to work with him and he can help guide me. So that's my update. I hope you are all having a good day. Oh! I also got blackout curtains-they really seem to help!

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Altostrata

How's the nausea?

 

You're taking quite the (fluctuating) cocktail. You need to be aware of drug interactions, it seems your doctor is just throwing ingredients into the blender.

Please put ALL your CURRENT drugs in the Drug Interactions Checker https://www.drugs.com/drug_interactions.php
and copy and paste the results in this topic.

 

Good to hear about the blackout curtains.

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DMV64

Hello <3

The nausea today is bad. Honestly I would rather just reinstate (I don't think I have reinstated quite right, not sure) and not be on any of the other stuff and then just titrate off.

Switching docs is going to help but I don't think they can see me til October. Thank you I will look into the interactions. Thank you for responding <3

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jkun41

Hi DMV. I'm happy you found my post helpful in the other thread about separating fear/anxiety. 

 

We are on completely different journeys, so I can't offer much in the way of advice for your medication. I just wanted to mention something that's in line with my other post. 

 

After having a very rough week (I'm hoping I'm on the mend now) I was trying to do some research and reassurance seeking (which isn't necessarily a good thing) about panic and why my head felt so strange. 

 

I came across something that seems ridiculously obvious after the fact, but obviously in the throughs of panic wasn't on my mind. 

 

I often get more scared, more fearful, and in a worse state of panic because I feel like my mind and brain are about to explode. Like I can't think. Along with all of the other physical sensations I almost convince myself that "this is it."

 

This is something you have likely heard a thousand times. 

 

Racing Thoughts.

 

With racing thoughts our mind is trying to rush through a million thoughts, yet can't focus on a single one. It makes things worse because, if you're like me, it makes you more worried there is something physically or psychologically wrong with your brain. This makes the panic worse, or turns a state of worry and fear into a full blown panic. 

 

This is still very much a work in progress for me, but as I said in my other post, try and separate the feeling(s) of fear from your thoughts of anxiety. Tell your body, even if you don't believe it, that there is no threat. That the threat has passed. It's okay for your body to calm down. It's okay for your mind to slow down and get calm. Once the fear has passed a little, affirm with yourself that the anxiety and worry is unfounded. 

 

Unfounded does not mean impossible, so don't let your thoughts trick you into once again rationalizing that they "could" be true and that you "should" be fearful. We must learn to cope with uncertainty, and this is probably my biggest struggle currently. 

 

We get so used to our bodies being in a state of fear that we think we need it to be safe. "Sure my thought might be ridiculous for 99.9% of people, but for me, I should be thinking about it! I'm not doing myself justice by not focussing on it." Wrong. We don't need to be fearful to be safe. We don't need to worry and be anxious to fight uncertainty. 

 

What we need is to regain the confidence in ourselves. We are strong, or else we wouldn't be where we are right now. 

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1 hour ago, jkun41 said:

This is still very much a work in progress for me, but as I said in my other post, try and separate the feeling(s) of fear from your thoughts of anxiety.

Jkun, you are onto something very important here.

 

Maybe you would want to meet Shep and through her Mooji who, among other things, speaks a lot about what he calls beautiful detachment.

 

 

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On 11/09/2017 at 9:17 PM, DMV64 said:

I have only been on the Geoden for 5days. Lithium for almost 10 days. I came off Lithium previously with not much problem. I came off Geoden when I started Saphris. So with the re-instate I want these recent extra meds out. I only started them when I was off the Saphris/ The Lithium I am stopping. The Geoden I am halving over a few days.

You might be able to pull that off but monitor your symptoms closely.

 

Unfortunately we see people getting stuck on drugs they took for a very short period of time in situations like yours with a history of poly drugging.

 

If you are able to pull it off, do yourself a huge favour and stop mixing coctails (according to your own inclinations or that of a doctor).

 

If we ever want to get off this drug merry go round we have to at one point just ride the symptoms out. 

 

The moment you experience that your symptoms abated WITHOUT adding, increasing, decreasing, stopping drug is the moment when your journey to a drug free life starts. Not before.

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DMV64

Hi Bubble.

Yes, I do realize the last part of what you said. Right now I am trying to stablize so I can begin a titrate the 10% way. I don't want to be on all these drugs. I want to be free. I am willing to go slow. The re-instate has helped me stablize. I am wondering how long I should hold on this dose before I can begin a taper?

-D

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DMV64

Jkun!

I am going to copy and paste what you said so I can have it handy for reading later and again!

<3

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On 11/09/2017 at 10:03 PM, Altostrata said:

 

Please put ALL your CURRENT drugs in the Drug Interactions Checker https://www.drugs.com/drug_interactions.php
and copy and paste the results in this topic.

 

Can you please do what Alto asked here so that she and other mods could be in a better position to offer suggestions?

 

Are you keeping a log of your symptoms? That's very important to try to understand what is causing what and what to do.

 

Have you reduced any drugs as you planned? The trouble might be you are not reducing only 10 or 5 days use of drug but the whole of your drug history comes into play so it's not the same as if you only ever took this drugs for that period of time.

 

Only your symptoms will tell you that: if you decrease and your symptoms increase especially to a high level it will mean you will have to choose some other course of action.

 

Good luck and keep us posted.

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DMV64

Not sure if this posted. Will post again. I am tracking my symptoms. And I am reducing The Geoden (almost off) and jumped off the Lithium. I did reinstate as small as I could to stablize.

I have a taper plan (in my mind) and will be working with a new more informed doc. I feel good about this. 

I am hopng to taper one at a time starting with Saphris, then Klonopin, Vyvanse and Gabapentin. 

Hi! Here's my report. Sorry the adverts are in it. I did it from my phone. I am almost off the Geoden.

Drug Interaction Report

Drug interactions for the following 5 drug(s):

My Interactions List (Unsaved)Email | Print  | Save  | Create new list
gabapentin
Geodon (ziprasidone)
Klonopin (clonazepam)
Saphris (asenapine)
Vyvanse (lisdexamfetamine)
 

Interactions between your selected drugs

Major

ziprasidone  asenapine

Applies to: Geodon (ziprasidone), Saphris (asenapine)

Using ziprasidone together with asenapine is not recommended. Combining these medications can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively 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 be able to prescribe alternatives that do not interact. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with either of these 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

Moderate

clonazepam  ziprasidone

Applies to: Klonopin (clonazepam), Geodon (ziprasidone)

Using clonazePAM together with ziprasidone may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. 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

Moderate

clonazepam  asenapine

Applies to: Klonopin (clonazepam), Saphris (asenapine)

Using clonazePAM together with asenapine may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. 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

Moderate

gabapentin  ziprasidone

Applies to: gabapentin, Geodon (ziprasidone)

Using gabapentin together with ziprasidone may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. 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

Moderate

gabapentin  asenapine

Applies to: gabapentin, Saphris (asenapine)

Using gabapentin together with asenapine may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. 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

No other interactions were found between your selected drugs.
Note: this does not necessarily mean no interactions exist. Always consult with your doctor or pharmacist.

Other drugs and diseases that your selected drugs interact with

Interactions between your selected drugs and food

Moderate

gabapentin  food

Applies to: gabapentin

Alcohol can increase the nervous system side effects of gabapentin such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with gabapentin. Do not use more than the recommended dose of gabapentin, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

Switch to professional interaction data

Moderate

ziprasidone  food

Applies to: Geodon (ziprasidone)

Alcohol can increase the nervous system side effects of ziprasidone such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with ziprasidone. Do not use more than the recommended dose of ziprasidone, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

Switch to professional interaction data

Moderate

lisdexamfetamine  food

Applies to: Vyvanse (lisdexamfetamine)

Using lisdexamfetamine together with alcohol can increase the risk of cardiovascular side effects such as increased heart rate, chest pain, or blood pressure changes. You should avoid or limit the use of alcohol while being treated with lisdexamfetamine. Let your doctor know if you experience severe or frequent headaches, chest pain, and/or a fast or pounding heartbeat. 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

Moderate

asenapine  food

Applies to: Saphris (asenapine)

Alcohol can increase the nervous system side effects of asenapine such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with asenapine. Do not use more than the recommended dose of asenapine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

Switch to professional interaction data

Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication

Central Nervous System (CNS) Drugs

Therapeutic duplication

The recommended maximum number of medicines in the 'Central Nervous System (CNS) Drugs' category to be taken concurrently is usually three. Your list includes five medicines belonging to the 'Central Nervous System (CNS) Drugs' category:

  • gabapentin
  • ziprasidone (active ingredient in Geodon (ziprasidone))
  • clonazepam (active ingredient in Klonopin (clonazepam))
  • asenapine (active ingredient in Saphris (asenapine))
  • lisdexamfetamine (active ingredient in Vyvanse (lisdexamfetamine))

Note: The benefits of taking this combination of medicines may outweigh any risks associated with therapeutic duplication. This information does not take the place of talking to your doctor. Always check with your healthcare provider to determine if any adjustments to your medications are needed.

Duplication

Antipsychotics

Therapeutic duplication

The recommended maximum number of medicines in the 'antipsychotics' category to be taken concurrently is usually one. Your list includes twomedicines belonging to the 'antipsychotics' category:

  • ziprasidone (active ingredient in Geodon (ziprasidone))
  • asenapine (active ingredient in Saphris (asenapine))

Note: The benefits of taking this combination of medicines may outweigh any risks associated with therapeutic duplication. This information does not take the place of talking to your doctor. Always check with your healthcare provider to determine if any adjustments to your medications are needed.

 

Drug Interaction Classification

The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

Edited by ChessieCat
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DMV64

Here's my hopeful plan:

 

I do want to be off all of these drugs. I'm willing to call one drug at a time. I have already started beginning with geoden. I will be working with a new better informed doc too. Next I would like to titrate klonopin. Then stop vyvanse. And gabapentin is last but I am not sure what I will do about bladder pain after that. I am not sure where to titrate the Saphris? before the Klonopin? After?

I would welcome any feedback about this plan. I am most concerned about the Saphris right now. I have titrated off klonopin very slowly before.  Saphris never but only abruptly with many symptoms. 

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On ‎09‎/‎09‎/‎2017 at 1:28 PM, DMV64 said:

I am I guess atypical

 

Ok, let me have a look. There are a lot of things that jump at me... First of all why do you say (what makes you think :) you are atypical?

 

You did a very good job with your signature highlighting the most recent changes. But I would also very much appreciate a (very) brief history of psychotropic medication (when you first started taking them, what drugs were you taking, how many times you stopped, etc.). This all determines how you react to drugs now.

 

Maybe this history will shed some light on why you have so many diagnoses (if you stick with us for longer you will see that we don't think much of them). What I'm trying to say is that people who start and stop psychotropic drugs end up with withdrawal symptoms which are then diagnosed as a 'mental illness: bipolar 2 is very popular for that purpose. Also ADHD is another diagnosis that is attached to people suffering from withdrawal or experiencing side effects or in case of cocktails, drug interactions.

 

In the light of this you will maybe need to 'rewrite' your whole history of your 'mental illness". I'm  not saying that we didn't experience some mental distress that led us to taking these drugs in the first place but starting and stopping, adding more, etc. would have complicate that situation a lot.

 

On ‎09‎/‎09‎/‎2017 at 1:28 PM, DMV64 said:

I need to function.

As understandable as this is, for somebody in your situation it is actually not a useful goal.  I would venture to say that the need to function led you to throw more and more drugs into the mix. To get off this drug merry go round you will have to accept that for some time you maybe won't be able to function. In that way you will prioritize your well being. Chasing functioning can be dangerous and actually doesn't go together with the goal of coming off drugs. 

 

You may have a differently defined goal: instead of coming off (which you seem to have been doing over the years with the end result being only ending up on even more drugs or just a different mixture), you can this time set your goal as being on the least doses of the least number of drugs which will allow me to function (and then gradually taper them). Gradual taper depending on various factors takes years (I've been tapering for 4 years now and haven't even got half way. Or if you want to look at it from another angle: I've reduced my drug load in half while keeping my job and other aspects of my life manageable).

 

What you really need is to read a lot here so that you begin to understand how these drugs really work. I mean, you don't have to but that would be the first step.

 

Before any tapering you need to stabilize. If you pull of stopping Lithium and reducing Geoden sit there for as long as it takes for symptoms to reduce as much as possible. 

 

Are you keeping the log of your symptoms? This is very important. How have your symptoms changed since you stopped Lithium and reduced Geoden?

 

1 hour ago, DMV64 said:

I am most concerned about the Saphris right now.

 

I'm on the other hand most concerned that you reinstated Saphris (we don't know how long you were taking it) and then before we could see how that affected you, you went ahead with two other major changes... 

 

I see we didn't post the customary reading we advise all our new members to do. Baroquep did a great job for other new members so I will just post what applies to you:

 

This will be the third piece of rather bulky homework for you. Reading in particular will take some time but it is well worth the effort. 

 

 

What is Withdrawal Syndrome?

Before you begin tapering what you need to know
Why taper by 10% of my dosage?

 

 

I am also including a couple of links that discusses how you can talk to you doctor so that you can be prepared for your appointment with your psychiatrist.  In general they don't think WD exists past two weeks or so, think drugs can be stopped and started as if they were candy (I don't think any other drugs are stopped and started so randomly) and if you develop symptoms, there comes another label. They don't know how to take smaller doses of drugs so they only idea of a 'slow and gradual' reduction is the horrible every other day.

 

How do you talk to a doctor about tapering and withdrawal?
What should I expect from my doctor about withdrawal symptoms?

 

This is an absolute must: 

 

To sum up: 1) a more complete drug history

 

2) stop tapering, keep log of symptoms and post it

 

3) read the links and ask questions. In particular read the post on brain remodeling to understand what is happening with your brain right now

 

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DMV64

Hello!!

Thank you thank you!

 

I LOVE your definition of "function" - this best describes my "goal". Be on smallest doses to not lose job and completely shut down. I have already read some of the links you provided but will reread now-I have the afternoon. Yes, I am keeping a log of my symptoms, so far the lithium and Geoden are going well. Manageable. Honestly, Lithium did not do much for me really. Not sure if that matters. The reinstate of the Saphris kind of takes the "need" for those away, so to speak.

 

How do I post my symptoms log? In a tagline, in the body of a post?

 

A thing you should know about me and reading: I have eyesight damage which makes sustained reading impossible. I have to do small chunks.

So about atypical: I am the kind of person who most of the time responds in an unpredictable way to drugs. Including antibiotics, Opiods (allergic "phenomena" reaction) and SSRI. Cannot take SSRI, they make me manic and sick. This lead Psych to think maybe Bi-polar, except that I don't fit the rest of the criteria. So a brief, deeper history:

 

Growing up I took many drugs and drink. I got sober in 2001. At age 35 I began taking klonopin for anxiety. I had .5 tabs and I took a quarter at night. That was my only med. I think I tried Ambien for sleep a few times. Somewhere around 46 depression hit. I tried a few things (before I knew I could not take SSRI) Zoloft, Lexapro, Celexa, all for a very brief run of a few days. They decided to try another route: Lamictal (short lived, digestive upset-I also have reflux-diagnosed post baby #2 in 1999 and irritable bowel syndrome-diagnosed at 19). Then we hit upon Saphris, which worked great. Started it Summer 2011 Worked Like no other. However after 2 or 3 months on I had a dystonic (at least they called it that) reaction. I had no idea what was happening and would up in the ER at a hospital which gave me no information on withdrawal or using Cogentin or benedryl to stop these reactions, they just told me to stop. And so I did and promptly went into the most hideous withdrawal. This is where major Poly drugging started because I was single mothering two kids in NYC working FT as a teacher and I had to keep going. My original prescriber was a psychpharmacologist and was "in over her head" as she said. So I got a shrink. Many things were tried for AGAIN short stints. Seroquel. Lamictal again. Celexa one more time. We finally came to rest on Wellbutrin (I forgot I was on this!) and Geoden with xanax for panic in the classroom. It was at this time also that the Klonopin gradually climbed up to 1mg. Basically, I never really came through that withdrawal. And so I was on these when I remarried and moved here. Somewhere in here gabapentin was added for my irritable bladder pain. Doing ok until...December 2016 when I became suicidally depressed. The wellbutrin was giving me a rash (common for me) Psych tried Lithium. Which also gave me a rash. It helped with the suicidal but I can't say I felt good on it. It irritated the heck out of my irritable bladder. We looked at other options but many had things that would affect my IBS or cause too much weight gain (I am a yoga teacher now with my own studio). So we decided to try Saphris again, this time with cogentin. And it worked, again. That was June. I cannot even tell you why I wanted to go off it. My husband says it was causing me to feel irritable. So I cut my dose up over two weeks and thought I was off. Wrong. Again debilitating fear, social anxiety, inability to function and work. Just terror. Psych says take the geoden and Lithium to calm it. It worked to take the edge off, but not really, you know? I took them for a short time a week for lithum, 4 days for geoden. You know the rest, I reinstated the Saphris at half dose 2.5mg, took out the lithium and am almost off the geoden. Then I will hold. I know I have to move very very slowly off the Saphris now. Or whenever now is. I will post this for now, more in a bit. I should also mention that I have a lot of allergies.

 

Edited by ChessieCat
added spacing

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DMV64

I believe some of the dips I have experienced are hormonal. My only diagnosis has been major depressive disorder

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ChessieCat
6 minutes ago, DMV64 said:

How do I post my symptoms log? In a tagline, in the body of a post?

 

Just post as a regular post.

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DMV64

Ok Posting symptoms today so far and drugs and also after reading the things Bubble suggested I remembered that I was put on Abilify for about 6 months after the 2011 Saphris crash. 

6:30AM: Panic. Told self there is no threat, it is just fear. Really did help!

7AM: took 5mg vyvanse, 1 mg klonopin

11Am: Took 100mg gabapentin

Noon: Taught a class and felt pretty good.

1PM: Back pain, kidney? On one side.

4PM: Nausea.Burning bladder, took 100mg gabapentin

5PM: Anxiety.

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DMV64

Strange new symptom. Right side under ribs back pain. Kidney stone? Coincidence? Infection? I do not have a fever.

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DMV64

Hello!

I am soon to begin a Saphris taper. Is it true I cannot dissolve the sublingual tablet in water and just drink a portion? Won't the tablet still dissolve in water? Any suggestions welcome! I am not sure how to do the taper if dissolving it won't work. I assumed since it melts in my mouth I could just melt it in water, shake it up, and drink a portion.

-D

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DMV64

Can anyone tell me how to taper off a sublingual? I am baffled. It doesn't seem I can crush it, or if I could I could use digital scale, but I think it will just disintegrate.

-D

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ChessieCat

Here is a short discussion: how-to-taper-sublingual-tablets

 

If you go to the main page, click on the logo top left, and type saphris in the search at the top right you will find others taking this drug and may find some information on how they are tapering.

 

Another idea would be to contact a compounding pharmacy and ask if it is possible to have them make up your doses.

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DMV64

Thank you very much!!  I called compounding pharmacy's today but they said they couldn't do it because of it being sublingual.   But it looks like from the link that there might be an option using a jeweler scale   

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Altostrata

Hi, DMV. Why are you taking each of these drugs? When do you take gabapentin? Was it successful for bladder pain, or are you taking so many drugs you can't tell?

 

When did you add each drug?

 

On 9/9/2017 at 0:30 PM, DMV64 said:

I take Lithium 300 mg in evening. 

I take vyvanse 5 mg in morning. I feel a little better as morning goes on.

I take Klonopin 1mg in morning. I feel a little better as morning goes on.

I take 20 mg omezerpole at night.

 

Please also update your signature with explicit information about Saphris. In the first line, we don't know which drug you're talking about.

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