Bandboy: Introduction

[Bandboy]

Moderator note: link to benzo forum thread - Bandboy: Tapering benzos and latuda

 

Hi all. Began taking antidepressants around 2000. Tried them all, Wellbutrin, Effexor, Prestiq, and more I can't remember. A few years ago I was put on Abilify, but it caused too much weight gain. I was then placed on Latuda, which was effective. I believe I have developed a tolerance to Latuda, and I suspect it has caused higher glucose levels and at rare times difficulty swallowing. I tried a fast taper, 50, 25, 0 percent and about 3 days later started withdrawals--sniffling, claminess, irritatabilty. Went back up to 50% and the symptoms quickly subsided. Have initiated the 10 percent tapering and while I feel uncomfortable with the first drop, I can tolerate it so far. When I feel comfortable or in 4 weeks, whichever is first, I'll try another 10%. I intend to treat the depression with ketamine, which I have found to be effective for me.

Edited August 9, 2018 by Shep
added link to benzo thread and tags

[Gridley]

Hello, Bandboy, and welcome to SA.  I'm glad your reinstatement worked.

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.

• Any drugs prior to 24 months ago can just be listed with start and stop years. 
• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago) 
• Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016. 
• Please leave out symptoms and diagnoses. 
• A list is easier to understand than one or multiple paragraphs. 
• Link to Account Settings – Create or Edit a signature.

Please include the dates of your taper, the rate at which you tapered, and whether you did every-other-day dosing.  Please keep your signature as simple and easy to read as possible.

 

At Surviving Antidepressants, it is recommended that a person taper by no more than 10% of their current dose with at least a four week hold in-between decreases.  The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs.  Some people may have to taper at a more conservative rate as they are sensitive to even the smallest drops.  I would suggest that you wait the full four weeks before tapering again.
  

Before you begin tapering what you need to know

Why taper by 10% of my dosage?

 

Brain Remodelling

 

Tips for tapering off lurasidone (Latuda) 

 

Here is some helpful information on withdrawal.

 

What is withdrawal syndrome.

 

Glenmullen’s withdrawal symptom list.

 

When we take medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.  

 

Youtube video, 4 minutes: Healing from antidepressants

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Please research all supplements first and only add in one at a time and at a low dose in case you do experience problems.

 

This is your introduction topic -- the place for you to ask questions, record symptoms, share your progress, and connect with other members of the SA community.  I hope you’ll find the information in the SA forums helpful for your situation.  I'm sorry that you are in the position that you need the information, but I am glad that you found us.

 

 

 

 

 

 

[Bandboy]

Thank you, Gridley, especially for the suggestions.  I hope to intermittently log my progress here. 

[Bandboy]

Tuesday May 15.  Rough day. Had little sleep the previous night. To compound matters I am in the beginning of an out of town week visit with my elderly parents. Just before I left I had about 3 days of estazalom (a benzo) and Lunesta, my sleeping aids.  Before I left I emailed my psychiatrist for refills and received an auto reply that he is on vacation till the 26th.  So I will be off my benzo and Z drugs for a few days as I doubt my Pcp will prescribe these. 

 

Major WD symptoms and sleep deprivation pretty much wrecked Tuesday. More insomnia Tuesday night. 

[Shep]

20 hours ago, Bandboy said:

Just before I left I had about 3 days of estazalom (a benzo) and Lunesta, my sleeping aids.  Before I left I emailed my psychiatrist for refills and received an auto reply that he is on vacation till the 26th.  So I will be off my benzo and Z drugs for a few days as I doubt my Pcp will prescribe these. 

 

Hi, Bandboy.

 

Please try to find scripts for estazalom and Lunesta. These are NOT drugs that you should ever stop taking like that. I don't know your history with these - please add them to your signature. 

 

Depending on your dose and / or the length of time on them, you could suffer a seizure by stopping them cold turkey. There's also the problem of kindling - starting and stopping benzos is very hard on your nervous system and could cause problems when you re-start them. 

 

Call your PCP and let him/her know. If the PCP won't prescribe it, stop into one of those walk-in clinics or an emergency room or talk to your pharmacist to see if you can get a few days supply until your doctor comes in. Or see who is on call at your doctor's office. Doctors almost always have someone to fill in for them. You only need an emergency supply for a few days, so you'll likely find someone who will work with you. Also speak calmly and collected, though, as some doctors are wary of prescribing benzos and z-drugs due to their status as controlled substances. 

 

Please let us know what you find out. 

[Bandboy]

Wed. May 16. Felt much better, especially after the morning with all withdrawal symptoms greatly reduced.  Today I am working on getting my sleep meds refilled.  It will be a project navigating my Pcp, local doctors in San Antonio, and my BCBS hmo insurance provider.  Found a sleep specialist here but my Pcp has to refer me and I am waiting on that.  Quite a system. 

[Bandboy]

Still working on meds. Waiting on Pcp to either prescribe the meds or refer me to a sleep specialist.  If things are not resolved soon I will see the specialist sans insurance, which would make the refills $300. 

 

Meanwhile, changed my signature to include all meds. 

[Bandboy]

I guess posting has its benefits. As soon as I made my last post my Pcp doctor called to let me know they were calling in a 15 day supply.  Shep, thx for the warning.  

[Bandboy]

Picked up the meds this afternoon.  So far a pretty decent day. 

[Shep]

Wonderful, Bandboy. Thanks for letting us know. 

[Bandboy]

You were right.  Feel better this morning with estazalom back in my system after a day or two absence. Another med problem to deal with later. 

 

Yesterday was a bit of a scramble but after a morning of calls my internist refilled my sleep meds without any hassles or trouble.   Physically feeling better.  Very few sniffles, claminess but still not mentally 100%.  Today is going to be active so it will be a good test.  Still have most of my Latuda side effects, mostly lack of emotion, apathy, and lack of motivation. 

 

I'm planning my next couple of tapers.  I started at 30mg and am on my first drop to 27.5 (not 27).  Right now I have a collection of 60, 40,  and 20mg tablets.  While the pills are easy to cut, my cutter will barely manage quarters. So next drop will be to 25 comprised of 1/2 a 40 (I have a lot of 40s so am saving the 20s for lower doses) plus 1/4 a 20.   I think below 10 I will have to do something different, but that is a ways away.  

[Shep]

Hi, Bandboy. 

 

Before going farther with your taper, please have a read of this thread:

 

Taking multiple psych drugs? Which drug to taper first?

 

Please note the difference between "accelerators" and "brakes". Preserving sleep is key during withdrawal, so if the Latuda is helping with sleep, you may want to come off the Adderall first. 

 

Let us know what you think after you have time to read. 

[Bandboy]

Hi Shep,

Thank you for the link. I have three immediate problems: Latuda, sleep medication, and Adderall.  The Latuda was prescribed for depression after Wellbutrin and then several SRIs proved ineffective in dealing with depression.  I was first prescribed Abilify, which was effective but caused rapid weight gain.  As I have a heart condition (heart attack 9 years ago treated with stents and angioplasty) I did not want to carry the extra weight. 

 

I was then prescribed Latuda, which was initially effective, but with time the effectiveness declined.  I became apathetic, felt irrelevant, devoid of emotion or pleasure, and simply seemed to lose my personality. 

 

I was prescribed Adderall to increase motivation and counter the Latuda fatigue.   I am to take one 30mg dose in the morning, and another around lunch or early afternoon. Often I find the afternoon dose to be unnecessary and skip it.  Throughout my Adderall use I have monitored my blood pressure, which is fine with the help of blood pressure medication.  My annual cardiology tests have been fine. 

 

All my life, since I was a very young child, I have had trouble sleeping, both falling asleep and staying asleep.  My psychiatrist early on, well before the Adderall, put me on 2mg Lunesta.  It was at first initially very effective in getting me to fall asleep, but I would often awake about four hours later.  In time I developed a tolerance and the dosage was raised to 3mg.  As it became less effective, 4mg of estazalom (2mg x 2) was added (estazalom at bedtime, Lunesta when I would awake 3-4 hrs later).It was not as effective as the Lunesta but I continued using it.  Because of this lack of efficacy I often skipped the estazalom without incurring any noticeable effect. 

 

Over the past two years my blood sugar levels, both fasting glucose and A1C, have creeped up to near diabetic levels.  In examining the package warnings of my meds I learned that Latuda and Lipitor can both increase sugar levels.

 

I deceased my carbohydrate intake and limited my carbs to complex carbohydrates, especially beans.  My sugar levels decreased a little but they should be lower still.

 

My impetus to taper off of Latuda, as opposed to the Adderall or sleep meds, occurred when I had a few instances of having difficulty swallowing. This, combined with the previously described side effects, convinced me to tackle the Latuda first.  I am on a tight budget and the Latuda is not covered effectively by my Blue Cross insurance.  It is cheaper to buy out of Canada but still costs about $300 per 30 day supply. This also swayed my decision. 

 

The swallowing episodes are strange and frightening.  My mother and sister have blood sugar issues, so I am at risk anyway.  I attribute my sugar levels to the Latuda because first, I was on statins prior to my Latuda use and did not have sugar increases, and second, my diet (little to no sugar, only complex carbs) and weight (5'9"", 140lbs) are atypical of prediabetes. My strongest motivator is Latuda's adverse effect on my personality.  I can't remember the last time I took pleasure in activities or laughed at something funny, or had a meaningful relationship. 

 

I am keeping an open mind but presently believe the Latuda is more detrimental to my health and happiness than the Adderall or the sleep meds.  If you question my reasoning please feel free to weigh in.  At my reduced dosage I am feeling better, though I did have another swallowing episode this week, and am open to reevaluating my tapering priorities.  

 

Thank you and the other moderators for your help, advice and concern.  Without SA I would be on a typically prescribed very fast taper schedule with attendant withdrawals worse than the adverse effects of the Latuda. 

[Shep]

6 hours ago, Bandboy said:

I was prescribed Adderall to increase motivation and counter the Latuda fatigue.   I am to take one 30mg dose in the morning, and another around lunch or early afternoon. Often I find the afternoon dose to be unnecessary and skip it.  Throughout my Adderall use I have monitored my blood pressure, which is fine with the help of blood pressure medication.  My annual cardiology tests have been fine. 

 

Hi, Bandboy. Thanks for your thorough analysis. 

 

Please keep careful watch over your heart condition issues as you come off these drugs. I'm so glad you researched your drugs and found this site, as you are on a lot of drugs that someone with a heart condition would do best to avoid. I hope as you come off the stimulant and other psych drugs, you find that your other medical conditions improve. 

 

6 hours ago, Bandboy said:

All my life, since I was a very young child, I have had trouble sleeping, both falling asleep and staying asleep.

 

Many of us (myself included) suffered from insomnia prior to going on these drugs. Because insomnia is one of the most common withdrawal symptoms, we have a ton of information about sleep on this site. These links may be helpful:

 

Tips to help sleep - so many of us have that awful withdrawal insomnia

 

What is the sleep cycle?

 

Some practical ideas such as wearing a sleep mask and / or using room darkening shades may be helpful. There are many non-drug coping techniques that can help with sleep such as guided meditations, mindfulness, gentle yoga, etc. You can read about these and more ideas here:

 

Non-drug techniques to cope with emotional symptoms

 

6 hours ago, Bandboy said:

In time I developed a tolerance and the dosage was raised to 3mg.  As it became less effective, 4mg of estazalom (2mg x 2) was added (estazalom at bedtime, Lunesta when I would awake 3-4 hrs later).It was not as effective as the Lunesta but I continued using it.  Because of this lack of efficacy I often skipped the estazalom without incurring any noticeable effect. 

 

 

Drugs such as Lunesta are called z-drugs. These are very similar to benzodizepines (benzos). Benzos and z-drugs only work for about 2 - 4 weeks. After that, the reason most people stay on them is to stave off withdrawal symptoms. 

 

We have a members-only benzo forum and I invite you to read the green "pinned" topics that are stickied to the top of this forum. You'll find a lot of information about these drugs. You may want to start with this thread:

 

Ashton and Beyond in Benzo Tapering

 

Once you are ready to taper the Lunesta and estazalom, please start a new topic for yourself in the Members-only benzo forum. 

 

You mention that you have "often skipped estazalom without incurring any noticeable effect".  Please note that it's best to take your drugs every day (and preferably at the same times each day). Skipping doses leads to fluctuating levels of the drugs in your bloodstream and makes it harder to taper. Please see this post for more information. 

 

6 hours ago, Bandboy said:

My impetus to taper off of Latuda, as opposed to the Adderall or sleep meds, occurred when I had a few instances of having difficulty swallowing.

 

This could be dysphagia. Dysphagia is a something that is seen not just in Latuda, but also in antidepressants and benzos. Please see:

 

Swallowing and throat problems

 

6 hours ago, Bandboy said:

I am keeping an open mind but presently believe the Latuda is more detrimental to my health and happiness than the Adderall or the sleep meds.  If you question my reasoning please feel free to weigh in.  At my reduced dosage I am feeling better, though I did have another swallowing episode this week, and am open to reevaluating my tapering priorities.  

 

Let's let your symptoms chart your course. Please keep a symptoms and drugs journal either here on your thread or on paper. This is a great format to use:

 

 

Keep notes on paper about your drug dosages and daily symptom pattern

 

Please also include your supplements and the number of hours you sleep at night. 

 

The risk of diabetes and the high cost of Latuda are certainly reasons to want to come off that drug first, but your symptoms are also key to helping you set up a game plan. If you are sleeping well and have a good appetite and are able to function, than please continue to taper the Latuda. 

 

As you keep your drug and symptoms journal, please take note if you feel you are having interdose withdrawal, especially from the Lunesta. This is a very short-acting drug and can cause withdrawal. The z-drugs and benzos are notorious for causing rebound anxiety, so that's also something to watch out for. Your drug and symptoms journal will be very helpful in determining if this is happening. 

 

Please keep posting updates and asking questions. 

[Shep]

In addition, I just added all of your drugs into the drug interaction checker and you have a number of major and moderate interactions. The report is here:

 

Drug interaction checker - Interactions between your drugs

 

 

[Bandboy]

Thx again, Shep.  I was unaware of the dysphasia associated with the benzo and z-drugs. At the moment I am feeling better.   I had a nice and comfortable dinner last night with my sister and brother-in-law. 

 

For the the moment I am going to continue with the Latuda taper.  I am a couple of weeks or so before I'm tentatively scheduled to reduce the Latuda from 27.5 to 25mg, so I will wait to make any further decisions until I see how that reduction feels. 

 

From the information you have given me it appears the Adderall should be tapered next (better for my heart) but that will be a long way off and I am not looking forward to splitting the Lunesta; they have a hard coating that looks like it may impede my pill cutter. 

 

The withdrawal insomnia has decreased--getting to sleep 2:00-2:30am instead of 4:30.  Not great but better. 

 

I was was surprised at the overlap of interactions among my drugs, especially those involving heart medication, all of which are quite common. Neither my internist nor psychiatrist addressed these issues, though my p dr was also concerned with my weight gain (145-165 in a short time).  

 

One symptom I neglected to mention is my memory.  I play in a band as a hobby and over the last 2-3 years I have found it too difficult to remember many songs, especially those with several chord changes.  I chalked it up to age (62) but I wonder if these meds are exacerbating this. 

 

Thank you for all of your time and help. I hope to have the chance to return the favor to you or others.  I will keep posting my progress or lack thereof. 

 

Bandboy

 

 

 

 

[Altostrata]

Hello, Bandboy.

 

What times of day do you take each drug, and at what dosage? What is your current daily symptom pattern? Please keep daily notes on paper about your symptoms, when you take your drugs, and their dosages.

 

Thank you for putting your drugs into two piles, in your signature. I was going to suggest you do that. Ten prescription drugs is too many. As you can see, you have a number of drug interactions that might degrade your health. Minimizing the psychiatric drugs so you have room for drugs that are truly essential to your health will benefit you in the long run (though I strongly recommend you research every one of those drugs in the "heart" basket to see if they're absolutely necessary; there's a lot of doubling up).

 

Both benzodiazepines and statins can affect memory, but drug-drug interactions can be involved, too.

 

Sounds like the Latuda taper is proceeding. Going off that first seems like a good idea. Please note that if the Adderall is countering the stupefying effect of the Latuda, you might find the Adderall to be more stimulating as the Latuda dosage goes down. You may end up interleaving Adderall and Latuda tapering.

[Bandboy]

Hi Altostrata,

Thanks for your thoughts.  I have to agree that ten meds are a lot to handle.  

 

I take all of the heart medications at one time in the morning.  The Latuda must be taken with at least 350 calories of food, so I take it immediately after dinner when I eat at home.  When I dine out I take the Latuda as soon as I return home.  I have heard that it may be sedating but it has never had that effect on me, at least that I have been able to recognize.  

 

I take the estazalom when I am about to go to sleep.  At the beginning of my taper I had a lot of restlessness and insomnia, leaving me awake till about 4:30am.  Lately, about two weeks in, I am able to sleep at about 2:30.  My regular bedtime is usually 12:00-1:00am

 

I take the Lunesta when I awake after about 3-4 hrs of sleep.  I choose this order for the sleep meds because the Lunesta still seems to work a little (nowhere as effective as when I first began it; it was miraculous back then) and activates faster than the estazalom. 

 

The Adderall is taken every morning and most, but not all, early afternoons (12:00-3:00).  My Adderall bottle shows I filled my 60 pill monthly prescription on April 12.  Today is May 20 and I have 16 pills left, leading me to believe that over 38 days I have taken only 44 doses, rather than the 76 I could have taken. 

 

I am still getting a handle on the withdrawal symptoms, which I find hard to anticipate.  May 18 and 19 (Friday and Saturday) I felt very good, almost normal.  Today (May 20) I felt ok in the morning and early afternoon but around 5:00pm I began feeling anxious (not one of my typical depression feelings), clammy, and having reduced concentration.  At 6:30 I had dinner and immediately took my 27.5mg Latuda dose.  By 9:30 nearly all these ill feelings had nearly completely dissipated.  This disappearance and subsequent reappearance of symptoms is unlike anything I have experienced before. 

 

My family is concerned but I am trying to minimize their worries by vaguely describing my condition as a minor discomfort that I must endure in order to get off of the Latuda.  They are very supportive and without prompting told me earlier this week that I have looked and acted better than I have for quite some time.  

 

This week will will be strenuous.  I fly home tomorrow--short 1 hr flight, have band practice Tues and Thur afternoon, fly back to my parents' Friday for my mother's 90th birthday party (my entire immediate family and their respective families will be there), fly back to Dallas Saturday morning, then drive 45 minutes for an hour and half band performance that begins at 5::00, and then return to Dallas early that night.  It will be quite a test.  

 

I will post heart med dosages tomorrow on my signature.  I am out of town and don't have access to my pill bottles.  Most are maximum doses.  All heart meds were prescribed by my cardiologist 9 years ago, except for metoprolol, which was prescribed last July by my internist.  My internist and cardiologist are both aware of all drugs and dosages.  I am not sure of ever discussing my heart meds in detail with my psychiatrist.  

 

Please let me know if I am going into too many mundane details and if you want drug ingestion times or other info in my signature. 

 

Again, thank you and your team for the help, advice, and support. It means a lot to me. 

[Shep]

4 hours ago, Bandboy said:

Please let me know if I am going into too many mundane details and if you want drug ingestion times or other info in my signature. 

 

 

What you posted is quite helpful, Bandboy. Thank you. Yes, please add the times you take your drugs into your signature. You could simply add that in parentheses next to the dose.  

 

5 hours ago, Bandboy said:

This disappearance and subsequent reappearance of symptoms is unlike anything I have experienced before. 

 

Withdrawal comes in what we call "windows and waves" so it's a very unpredictable experience. Please see:

 

The Windows and Waves Pattern of Stabilization

 

4 hours ago, Bandboy said:

The Adderall is taken every morning and most, but not all, early afternoons (12:00-3:00).  My Adderall bottle shows I filled my 60 pill monthly prescription on April 12.  Today is May 20 and I have 16 pills left, leading me to believe that over 38 days I have taken only 44 doses, rather than the 76 I could have taken. 

 

 

Please go ahead and start your daily drug and symptoms journal either here or on paper. It's important that you take your drugs consistently and the journal will help keep you on track. If you think you could do well with only one dose of Adderall a day, that could already minimize your drug burden, but it is important to be consistent. Adderall has a  half-life of around 10 hours, so it may be affecting your sleep. I would take it at noon as opposed to 3 pm. But since about half the time you've only been taking 1 dose a day, do you think you could do well to stop the afternoon Adderall dose and only take it once a day, preferably in the morning? 

[Bandboy]

Hi, Shep, and thanks again thank you for your time in reviewing my post. 

 

I will I'll update my signature with ingestion times later this afternoon.  

 

I was surprised to learn from my Adderall count that I am not taking afternoon doses as frequently as I had previously thought.  I will try using a morning dosage and doubt it will affect my afternoons. 

 

I didn't realize the half life was so long and this could very well be contributing to my insomnia.  For some reason I thought it was effective for only about 4 hrs. 

 

My only other experience with withdrawing from meds is over 20 years old and involved opiates. It was a relatively steep bell curve.  The symptoms were mostly physical and much harsher, but once they began to subside they never increased.  When they were completely over in about 2 weeks the symptoms never returned. 

 

I read the windows and waves link and it is an apt description of my situation, though I also experience neutral feelings--neither ebullient or distraught, just even keel.

 

i also read the dysphasia link and one of the variants seemed to accurately describe my symptoms. Mine seem to first occur mostly with liquids, often water.  The water does not go down and pools in my throat and my mouth seems to salivate.  I have to leave the table and harshly cough and/or regurgitate the liquid in my throat.  It leaves me flushed and bloodshot, and certainly disturbs my companions and their dining experience.  It is completely random.  It does occur at times with solid food.  Even a small sip of water can trigger it. I usually have to wait a half hour before I can resume swallowing.  Often I continue salivating and have to expel the trapped liquid a second time.  I have not had trouble breathing though it can be labored for a while. 

 

Again, thanks for the attention and help. 

[Altostrata]

On 5/19/2018 at 9:14 PM, Bandboy said:

I was prescribed Adderall to increase motivation and counter the Latuda fatigue.

 

Please explain more about this. What makes you decide to take the additional dose of Adderall in the afternoon?

 

If I were you, I'd have your doctor review your statin drugs. Three at maximum dosage seems a bit of overkill, and the statin guidelines have changed.

[Bandboy]

Hi Altostrata,

Thank you for checking in on me.  Even while on Latuda I had trouble motivating myself to get out of bed, shower, straighten things, etc.  The morning dose of Adderall got me out of bed and helped me get going.  I don't drink coffee or other stimulants. 

 

I take an afternoon dose of Adderall if I have activities or obligations in the afternoon.  These could range from my Tues afternoon yoga lesson, an afternoon band rehearsal, conference call, work meeting etc.  I do not like interacting with people looking/acting zombified.  

 

Many days my afternoons are free and I won't take the afternoon dose.

 

I am home now and have access to my heart meds, so I will list them below and note my understanding as to why I am taking them.  If you are aware of a problem with any of them, or know of a better replacement, I would appreciate your advice.  I have not had my 2018 physical so I will soon have an opportunity to review my regimen with both my cardiologist and internist.  I also have a psychiatrist appointment coming up.  After I post this I will add the dosages and ingestion times to my signature. So you don't have to scroll through my thread I will summarize these times:

 

Adderall: morning, usually before 10:00, sometimes another dose between 12:00-3:00pm, though after Shep's and your comments I am considering dropping the afternoon dose.

 

Latuda: after dinner

 

Estazolam: at bed time

 

Lunesta: when I awake at night

 

All heart meds listed below are taken in the morning before 10:00:

 

Lisinopril-HCTZ 10/12mg: I understand this is a combination of two drugs designed to lower my blood pressure.  I believe one component is a diuretic. 

 

Metoprolol ER Succinate 25mg:  I understand this drug moderates how fast my heart beats and is intended to reduce blood pressure. 

 

Plavix (clopidogrel) 75mg:  This is a blood thinner intended to reduce/prevent plaque from building up in my arteries. 

 

Lipitor (atorvastatin) 80mg:  This is a statin intended to reduce my cholesterol, especially the LDL.  As with all of my heart meds except for the metoprolol, it was first prescribed to me by the doctor who performed my angiogram, stent, and angioplasty procedures following my heart attack 9 years ago. He originally prescribed a lower dose but raised it to 80mg when at my one month followup visit my cholesterol remained too high (around 200 as I recall). My current cardiologist has maintained these and the rest of the drugs listed here. 

 

Trilipix (fenofibric acid delayed release capsules) 135mg:  I believe this medication is intended to reduce the production of triglycerides by my liver. 

 

Low Dose Coated Aspirin 81mg:  Intended to thin my blood and prevent clotting in conjunction with the Plavix. 

 

Vitamin D3 (NatureMade Cholecalciferol) 2000 IU/50 mcg: (is this really only 50 micrograms? Seems low). I take this on my own as I don't get in the sun often, in fact hardly ever). Last year's blood panel showed sufficient vitamin D.  

 

My blood pressure is well under control.  While the meds certainly help, I have been better at exercising.  I use the treadmill for 20 minutes and weight work for 1 hour twice a week and yoga for one hour once a week.

 

When I was on Abilify for a short while my weight went from about 150 to 175 (my height is 5'9"). I was switched to Latuda and did not suffer any adverse symptoms even though there was no tapering.  Apparently they act in a very similar fashion. 

 

With better execise and diet diet my weight fluctuates between 138-141lbs.  My cholesterol is always under 150, often as low as 135, and I have a high ratio of HDL and a low ratio of LDL. 

 

I have been tolerating the statins well; I do not get muscle cramps.  The previous comments from SA stating that the statins may be causing or contributing to my prediabetes and memory issues does concern me.  If you are able to suggest actions I should be taking or good books or links to read on this subject I would appreciate the suggestions.  Meanwhile I will see what comes up with a google search. 

 

I must say say I am very impressed with the knowledge dispensed here and your ability to handle prodigious volume.  Truly good deeds for which I thank you. 

 

Bandboy

 

 

[Bandboy]

Hi Altostrata,

Thank you for checking in on me.  Even while on Latuda I had trouble motivating myself to get out of bed, shower, straighten things, etc.  The morning dose of Adderall got me out of bed and helped me get going.  I don't drink coffee or other stimulants. 

 

I take an afternoon dose of Adderall if I have activities or obligations in the afternoon.  These could range from my Tues afternoon yoga lesson, an afternoon band rehearsal, conference call, work meeting etc.  I do not like interacting with people looking/acting zombified.  

 

Many days my afternoons are free and I won't take the afternoon dose.

 

I am home now and have access to my heart meds, so I will list them below and note my understanding as to why I am taking them.  If you are aware of a problem with any of them, or know of a better replacement, I would appreciate your advice.  I have not had my 2018 physical so I will soon have an opportunity to review my regimen with both my cardiologist and internist.  I also have a psychiatrist appointment coming up.  After I post this I will add the dosages and ingestion times to my signature. So you don't have to scroll through my thread I will summarize these times:

 

Adderall: morning, usually before 10:00, sometimes another dose between 12:00-3:00pm, though after Shep's and your comments I am considering dropping the afternoon dose.

 

Latuda: after dinner

 

Estazolam: at bed time

 

Lunesta: when I awake at night

 

All heart meds listed below are taken in the morning before 10:00:

 

Lisinopril-HCTZ 10/12mg: I understand this is a combination of two drugs designed to lower my blood pressure.  I believe one component is a diuretic. 

 

Metoprolol ER Succinate 25mg:  I understand this drug moderates how fast my heart beats and is intended to reduce blood pressure. 

 

Plavix (clopidogrel) 75mg:  This is a blood thinner intended to reduce/prevent plaque from building up in my arteries. 

 

Lipitor (atorvastatin) 80mg:  This is a statin intended to reduce my cholesterol, especially the LDL.  As with all of my heart meds except for the metoprolol, it was first prescribed to me by the doctor who performed my angiogram, stent, and angioplasty procedures following my heart attack 9 years ago. He originally prescribed a lower dose but raised it to 80mg when at my one month followup visit my cholesterol remained too high (around 200 as I recall). My current cardiologist has maintained these and the rest of the drugs listed here. 

 

Trilipix (fenofibric acid delayed release capsules) 135mg:  I believe this medication is intended to reduce the production of triglycerides by my liver. 

 

Low Dose Coated Aspirin 81mg:  Intended to thin my blood and prevent clotting in conjunction with the Plavix. 

 

Vitamin D3 (NatureMade Cholecalciferol) 2000 IU/50 mcg: (is this really only 50 micrograms? Seems low). I take this on my own as I don't get in the sun often, in fact hardly ever). Last year's blood panel showed sufficient vitamin D.  

 

My blood pressure is well under control.  While the meds certainly help, I have been better at exercising.  I use the treadmill for 20 minutes and weight work for 1 hour twice a week and yoga for one hour once a week.

 

When I was on Abilify for a short while my weight went from about 150 to 175 (my height is 5'9"). I was switched to Latuda and did not suffer any adverse symptoms even though there was no tapering.  Apparently they act in a very similar fashion. 

 

With better execise and diet diet my weight fluctuates between 138-141lbs.  My cholesterol is always under 150, often as low as 135, and I have a high ratio of HDL and a low ratio of LDL. 

 

I have been tolerating the statins well; I do not get muscle cramps.  The previous comments from SA stating that the statins may be causing or contributing to my prediabetes and memory issues does concern me.  If you are able to suggest actions I should be taking or good books or links to read on this subject I would appreciate the suggestions.  Meanwhile I will see what comes up with a google search. 

 

I must say say I am very impressed with the knowledge dispensed here and your ability to handle prodigious volume.  Truly good deeds for which I thank you. 

 

Bandboy

 

 

[Bandboy]

@Altostrata  Please don't bother finding me links etc. re statins and diabetes/memory loss. I have already found enough legitimate articles to confirm your warnings.  Now my question is why 3 cardiologists, 2 internists, and a psychiatrist have never raised these issues in the last 9 years.  

 

This is a lot to think about and it looks like there are no good solutions. 

 

Thank you. 

[Altostrata]

Bandboy, quite often physicians would rather leave well enough alone. If you're not complaining about too many drugs, they'll keep adding them.

 

The solution is to be somewhat more assertive in one's health care. This is best accomplished in calmly, consistently repeated requests, such as: Let's minimize these statins.

[Bandboy]

Monday, May 21. Still on 27.5mg of Latuda.  After experiencing a couple of reoccurrences of withdrawal symptoms the previous week I feel like continuing this dose and not making any changes for at least a week. Spent much of the day traveling though it was a short 1 hr flight. 

 

I would call call it a good day.  Easily chatted with airport personnel and Uber drivers.  Happy to see my two cats.  I have much better attitude on this lower dose.  Still not nearly out of the woods: was up till 3:00am and awoke today (Tues May 22) at about a little before 6:00am but did not feel as bad as I normally would with that amount of sleep. 

 

Spent much of Monday night researching the drugs I am taking and their effect on blood sugar levels (I am just below prediabetic levels) and memory loss.  My findings do not leave me very optimistic but I will work it out the best I can. 

 

I am going to try eliminating my afternoon Adderall dose (30mg) Sunday. This week is busy and requires a lot of activity and social contacts. 

 

Today (Tues May 22) is starting out very well and upbeat.  Will provide details tomorrow.  

 

My best to you all. 

 

Edited May 22, 2018 by Bandboy
Repeated words

[Altostrata]

Please also note the benzo-type drugs you're taking for sleep can also affect memory and energy level throughout the day. These also need to be tapered.

[Bandboy]

Hi Altostrata,

I agree the estazalom and Lunesta need to go; they are at best marginally effective. I'm still reading and learning from the SA site, but I thought the standard advice is to taper one drug at a time.  If I'm wrong then I have no problem developing a program to taper these drugs in conjunction with the Latuda.  If this is advisable it would greatly decrease the time needed to get off these drugs.  I have no evidence to back this up, and I know benzos are highly addictive, but  I feel tapering the estazalom and Lunesta will be easier than tapering the Latuda. I think I feel this way because they seem to have little effect and on the odd nights when I miss a dose I don't get any adverse effects. 

[Altostrata]

That is correct, we advise tapering one drug at a time. I would not change your sleep drugs. I was pointing out that symptoms for which you're taking Adderall might also be drug-caused. (And Adderall might be breaking up your sleep.)

 

You may find that as you reduce Latuda, you need less Adderall.

[Bandboy]

Thank you, Altostrata,

I agree with you completely.  It makes sense that at my lower Latuda doses I should require less Adderall, certainly in the afternoon when any benzo or z-drug after effects should be lessened.  Oddly I never felt any noticeable stimulant effects from Adderall so I doubt I will miss an afternoon dose.  So far missing afternoon doses has not had any noticeable effect. 

 

I never imagined being on a constant use of ten pharmaceuticals, most of which cause more harm than benefit. This is quite an experience.  

[Bandboy]

I've missed posting the last three days. Generally feeling well but I am still dealing with insomnia, getting to sleep late (2:30-4:00am) and getting up maybe 4 hours later. Motivation is still an issue. On the good side, despite the sleep deprivation I am comfortable relating to people (check out clerks, yoga instructor, band mates). Today is Thursday May 24.  Today and yesterday I had band practice and did well both days.  Still need to rely on notes but doing well with some songs without help. 

 

I had had a hard time getting out of bed today. Very little motivation or interests--didn't even watch tv.  Felt better as practice came around (4:00pm) and feel better, but still tired. 

 

Aside from the insomnia i am not having serious side effects besides getting out of bed.  None of the clamminess, sweating, nervousness or anxiety. 

 

Unless something changes drastically I plan on reducing my Latuda from 27.5 to 25mg this Sunday night.  I also intend to drop my afternoon 30mg afternoon dose of Adderall.  I'm hoping the Adderall reduction helps with the insomnia. 

[Altostrata]

Please do not change two drugs at once or we won't know where symptoms are coming from. You might drop the Adderall and at least 4 days later, reduce the Latuda.

 

Do you get to bed at 2:30 a.m. because you are a nightowl or because you can't sleep? Do you use the computer late at night?

[Bandboy]

Hi Altostrata,

Thank you for the heads up on discontinuing two drugs at once.  I will delay discontinuing the Adderall for at least a week after dropping the Latuda dose.  I won't discontinue it until I have run through any Latuda side affects. 

 

I am a a night owl but I usually try to go to bed by 1:00am. I have always stayed up late as long as I can remember. As a child I would sneak a flashlight to bed to read. That is why when I was first prescribed Lunesta I was astonished; I fell asleep fast though it only lasted about 4 hrs. 

 

 Over the last week I think I have gone to bed before 2:00am maybe twice. I have tried to improve my sleep with the usual methods. I have a new mattress, installed black out curtains, and a noise machine. My apartment has an antiquated air conditioning system; it rarely gets below 74 degrees F.  I would prefer to sleep at about 68 degrees. 

 

I do use my smart phone at night, which I know is ill advised, but I get bored lying awake in the dark. I used to to get out of bed when I would awake in the middle of the night and do business related research on the computer. I don't do this anymore.

 

Pre ADs I used to be a prolific reader.  Now I have very little interest in reading something lengthy.  The exception is when I travel; I will read my Kindle in the airport and on the plane. 

[Altostrata]

Here's a suggestion: Rather than looking at your smartphone while waiting to sleep, listen to some very soothing music, even meditation music. Follow the music with your mind.

 

This is a form of meditation. You might be able to train yourself to sleep.

[Bandboy]

Thank you, Altostrata,

Excellent suggestion.  I like the meditation analog.  I've tried meditation but could not keep my mind from wandering. Listening to music may be more natural (I play and enjoy music) and where I live hosts a 24hr classical station; words and voices in music tend to distract me so classical should work fine. 

[Bandboy]

The last few days have been hectic. Friday I went to my mother's birthday party.  It was just immediate family and there were 14 people there.  Everything went well and it was nice to see all my brother, sisters, and their kids all at one time. 

 

I felt well and did not notice any WD symptoms, though I still have insomnia. I slept ok, maybe even 5 hrs, and then went back to dallas in the morning (Saturday).

 

I met up with one of my band mates in the afternoon and drove an hour out of town to play a short happy hour show at a very cool bar.  After the show we had dinner and then drove back to dallas, arriving about eleven.  The show went well. I played ok and the crowd seemed to like us.  I enjoyed it.  No stress and a lot of fun.  

 

Saturday night I went to bed about 2:30. Woke up early but dozed in and out of sleep for a couple of hours.  Felt fine Sunday and reduced my Latuda dosage to 25mg from 27.5mg.  Actually slept ok even though I didn't fall asleep till 3:00. 

 

Today, Monday, things feel fine.  Did a lot of errands and settled in to watch a baseball game, which is actually a little interesting. 

 

My Adderall is up for renewal.  I'm thinking about either limiting the afternoon dosage to 12/1:00pm or omitting it entirely. 

 

In preparing my 25mg dosage I am learning that some of these pills are not easily cut into quarters. I'm ok for the next few weeks at 25mg, but I'm going to have to get creative for the next drop to 22.5 or break the 10% rule and go to 20. I do have a scale and the math involved in computing weights of pill dosages doesn't phase me.  What does surprise me is that a $20 scale claims to accurate to a mg. A hundredth of a gram accuracy would surprise me.