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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by Djenane on September 2, 2006, at 19:24:22
I'm very scared. Here's why: I'm currently taking 3 different antidepressants: Trazodone at 50 mgs, Lexapro at 30 mgs and Desipramine at 25mgs. I want to get off of them all, but I'm terrified.
I've seen several different psychiatrists, hoping to find one who would help me come off. The reaction has pretty much been the same every time... they say they don't recommend coming off (even if they'd only met me a few minutes before), as if I'm destined to stay on these drugs for the rest of my life.
I've tried a fairly slow taper before and had bad withdrawal effects. And that was with only one drug and now I have three!
I wish I could prevent these symptoms. Does anyone know how?
Posted by Racer on September 2, 2006, at 20:16:48
In reply to Terrified to stop taking my antidepressants, posted by Djenane on September 2, 2006, at 19:24:22
OK, I've got a few questions for you, but I promise I won't tell you what to do:
1. Why do you want to come off these drugs? I'm absolutely not going to suggest staying on them -- only asking because sometimes identifying the reason you want to come off might help with suggestions about how, etc. Also, if you think about why you want to come off, you may figure out that you don't want to come off all of them, or even maybe any of them.
2. Why have you seen so many psychiatrists about coming off these drugs? Do you not have one pdoc, to handle your treatment? That really is the best way to go. Even if you're wanting to get off these drugs, it's still a good idea to see only the one doctor. That's the best way to get good advice about how to meet your needs, including your need to get off these drugs.
3. Who's been prescribing these drugs, and can that doctor help you taper off? If not, why not?
As for tapering, I guess I'd suggest tapering off one at a time, starting with the Trazadone, then moving through the desipramine to the Lexapro. That's the order I'd go, but that's just me. Plan on a couple of weeks for each medication, with a slowing of the taper for the Lexapro as you get to the lowest doses. I'd also suggest getting one or two Prozac for the end of the taper. I've also heard Benadryl is good for some of the discontinuation effects of SSRIs.
There's a whole board here, about Withdrawal, by the wya. They can tell you a lot about it over there.
Posted by willyee on September 2, 2006, at 21:49:03
In reply to Terrified to stop taking my antidepressants, posted by Djenane on September 2, 2006, at 19:24:22
> I'm very scared. Here's why: I'm currently taking 3 different antidepressants: Trazodone at 50 mgs, Lexapro at 30 mgs and Desipramine at 25mgs. I want to get off of them all, but I'm terrified.
>
> I've seen several different psychiatrists, hoping to find one who would help me come off. The reaction has pretty much been the same every time... they say they don't recommend coming off (even if they'd only met me a few minutes before), as if I'm destined to stay on these drugs for the rest of my life.
>
> I've tried a fairly slow taper before and had bad withdrawal effects. And that was with only one drug and now I have three!
>
> I wish I could prevent these symptoms. Does anyone know how?I agree a lot with the second poster,in no way recomending you stay on these drugs,i would ask myself the same question i pose to people wanting to get off benzos.....this question is...
On a scale of 1-10,how bad off was i before i touched any of these drugs,not to scare you but it most likly makes sense that you could expect to at the LEAST be prepared to return to this state even if you succesfully taper.This is hard because this can for some confuse people between a withdrawal of the drugs the original symptoms,sometimes and im speaking in general,benzos many times,people seem to forget that they went on the drug for a reason.
A personal suggestion,as i face the same fears you do,the very same ones,is to try to place a plan in tact,perhaps comming off a single set of two drugs to instead a single drug that might at least provide the same reliaf.
You are right,it would be best two have two on board,you who already seems to be,keeping track of what meds you can elimnate,and slowly doing so,and your doc providing you with any help you will need doing this.
But the lentgh of time you have taken these drugs,the fact it is more than a single one,adding the last factor you went on them for a reason,creates a hurdle i think you might not choose best to try and jump at once.Lastly if you do,there are definatly many support groups online,and probuably general ones in your area for support.
Good luck,im looking down the barrel of the same gun and with so much lack of knowledge in the REAL WORLD around me,i feel very much alone that i have to turn to the internet to get anywhere.
Id love to bring this PC down,lock the room,and turn to real life resources,id be a happy camper and would not look back,but i dont,i have 5 min with a docter who always turns up being one im not happy with,a pharmacy who is not concerned in doing any more than dispensing medication,and friends family who in there attempt to help only make me feel more isolated and messed up.
Posted by Phillipa on September 2, 2006, at 22:15:00
In reply to Re: Terrified to stop taking my antidepressants, posted by willyee on September 2, 2006, at 21:49:03
Willyee real story. When I had my third child 30years ago I wanted to breast feed her and knew I couldn't as I was on benzos seconal my OB-GYN prescribed, good red wine my pdoc prescribed. I thought since she had had surgery and was in the hospital hernia. I decided now's the time to stop the meds. I quit them all at once. The hospital said I might have a seizure but I did it anyway for two weeks amount of time she was in the hospital. I slept most of the time. Felt like I was walking on a boat when I got up. But I did it and when done was only on 5mg of valium. See the docs didn't know what they do today. So a slow withdrawal would probably work. And meds are messing with our brains as you said about Parker and the effexor. Love Phillipa
Posted by willyee on September 3, 2006, at 0:13:30
In reply to Re: Terrified to stop taking my antidepressants » willyee, posted by Phillipa on September 2, 2006, at 22:15:00
> Willyee real story. When I had my third child 30years ago I wanted to breast feed her and knew I couldn't as I was on benzos seconal my OB-GYN prescribed, good red wine my pdoc prescribed. I thought since she had had surgery and was in the hospital hernia. I decided now's the time to stop the meds. I quit them all at once. The hospital said I might have a seizure but I did it anyway for two weeks amount of time she was in the hospital. I slept most of the time. Felt like I was walking on a boat when I got up. But I did it and when done was only on 5mg of valium. See the docs didn't know what they do today. So a slow withdrawal would probably work. And meds are messing with our brains as you said about Parker and the effexor. Love Phillipa
I wouldent be surprised if i woke up tommorrow to hear in the news that these drugs were found to be extremly toxic to the brain.
With that said,when i wasnt so absorbed into such deep doses and highly druged like i am now,and i was on a much smaller single dose of parnate,i stopped,i remember having a bottle of parnate,a huge one in my closet for a long time.
I promised i was going natural,i had severance from a high end job who outsourced,i was in school for a few hours a day which i enjoyed,and i had a steady girlfriend who came over all the time.
I was determined to go natural,i began a cardio program,along with my normal weight training,i bought some natural nutrients i had read about,i tried to come in prepared.
Thinking back it was one of the worst years i ever had,i remember every morning was a tremdonous struggle,i became so self invovled with my own struggle that after 6 years right under my nose i was ignoring my girlfriend and she left.
I also for the first,and only time since,got into a major car accident on the NJ turnpike,in a geo tracker doing 90 mph which isnt a lot if you ride that highway,the trucks on it will ride over you if your not doing at least 70,they own it.
Finaly one day i felt so bad,i just said im going back on meds,i thought maybe if i were more strict i could have a better response.Funny thing is i re-started parnate on a single 10 mg dose,and on day 4 woke up with that adrenaline rush,i remeber the drug stayed active the entire day,i even drove out to meet a girl i had been talking too,on my way home i almost balled thinking this was gonna be permanent and i was gonna be ok.
Well obviously it wasnt,and thats just it,for me no drug,no combo,ever stays,its like working out,the theory applies for me i have to keep tricking my brain by lowering a dose,highing it,etc,to keep it working,and in all honesty im exhausted,i cant play this game anymore,its beaten me up pretty bad.
My father once said to me its good i do workout because he cant believe the stuff hes seen me go through and come out looking ok.Luckly for me the outside hasent shown the beating yet,but if it does its gonna be a sad time for me.
Posted by Racer on September 3, 2006, at 2:03:34
In reply to Re: Terrified to stop taking my antidepressants » willyee, posted by Phillipa on September 2, 2006, at 22:15:00
> I thought since she had had surgery and was in the hospital hernia.
Sorry to ask a personal question, but what sort of hernia? CDH?
Sorry to be nosy. There is a reason I'm asking...
Posted by Jay on September 3, 2006, at 15:35:21
In reply to Terrified to stop taking my antidepressants, posted by Djenane on September 2, 2006, at 19:24:22
> I'm very scared. Here's why: I'm currently taking 3 different antidepressants: Trazodone at 50 mgs, Lexapro at 30 mgs and Desipramine at 25mgs. I want to get off of them all, but I'm terrified.
>
> I've seen several different psychiatrists, hoping to find one who would help me come off. The reaction has pretty much been the same every time... they say they don't recommend coming off (even if they'd only met me a few minutes before), as if I'm destined to stay on these drugs for the rest of my life.
>
> I've tried a fairly slow taper before and had bad withdrawal effects. And that was with only one drug and now I have three!
>
> I wish I could prevent these symptoms. Does >anyone know how?Hello....I would say, No. 1, don't be afraid of the medication. I go on really weird "cocktails" of pills, and have learned what takes away the bad symptoms...the terrifying anxiety, the nightmares, sleepless nights, sleeping all day, the bottomless pit of despair, etc. Some docs like to think you just take say drug A and MAYBE a bit of drug B, and say that is "all you need". I've experimented, over 15 years, with doses, micro-doses, using two-three antidepressants, anti-anxiety drugs of all sorts at a time. My pills looked like a rainbow of colours in my hands, but every single pill was accounted for in some way. Our brains and bodies use many, many chemical "messengers"...but in the 1990's, sadly, the drug industry tried to make it like serotonin was the only neurochemical that needed to be affected to treat symptoms of depression. Mucking around with a few other of these neurochemicals, though, seems to work much better, for different people, at diminishing the symptoms of depression and anxiety. And, the thing is, *focus* on the symptoms. The anxiety..the tension...the sleeplessness or sleepiness. I was told this by one of the leading psychiatric clinicians at McMaster University, that if you target your symptoms like say you target a headache, you can "check off" each symptom as you go along.
So if it takes this "weird" combo of pills (and I don't just mean taking pills for their own sake), then so be it. I have found that through trial and error, over the years, which meds help me and which don't, so I go back to say taking a few of the same kind of antidepressants that worked "a bit", combine them with some anti-anxiety meds that seemed to work (but didn't do much for depression), use of some of the atypical antipsychotics and/or anticonvulsants, (which helped with keeping a "stable" mood), and they together have worked the best. I get back to enjoying life everyday way better then I did before meds.
So, anyhow, there are a few things maybe to think about. You may have to change a med here or there, but you *really* get to know your body, your moods, and life will be just as enjoyable as ever. Of course you will still have bad days...that is only being *human*. But, as part of your learning, it's almost like self-taught CBT talk therapy, things become much smoother over time.
Best wishes..
Jay
Posted by flmm on September 3, 2006, at 16:44:46
In reply to Re: Terrified..Please read.. » Djenane, posted by Jay on September 3, 2006, at 15:35:21
Great points Jay! I have experimented over time as well and right now I take 5mg lexapro and 30 mg cymbalta. A little xanax to sleep at night! It,s very strange, with lexapro alone I am calm but bored and a little depressed. With Cymbalta alone I am too nervous. Now, when I combine 30 mmg Cymbalta with 10 mg Lexapro, the lexapro seems to cancel out the good effects of Cymbalta. When I lower Lex to 5 mg I feel good! This make any sense?
Posted by Djenane on September 3, 2006, at 18:47:01
In reply to Re: Terrified to stop taking my antidepressants » Djenane, posted by Racer on September 2, 2006, at 20:16:48
I’d like to say first that I appreciate so much your comments and help. I didn’t expect to get such caring and helpful responses, so just want to say thanks.
To give some further background, I’ve been taking antidepressants for about ten years, but different ones than these. I tried a number of different medicines because I couldn’t seem to find one that worked well for very long. I started taking them in the first place because after I graduated from college, I had a number of very difficult life situations fall upon me all at once and I wasn’t functioning well at the time. I moved around a lot, so I haven’t had a steady psychiatrist for more than perhaps two years at a time. None of these doctors ever suggested that I try going off…so I just kept trying different antidepressants.
The reason that I need to stop at this point in my life (even though I’m terrified) is that my husband and I very much want to have a baby. I’ve talked with my OBGYN, he says that it’s possible for me to stay on one medication and still have a healthy pregnancy, but I just don’t want to risk it. I want to be totally medication free at least while I’m pregnant and possibly longer if I nurse the baby.
So being on medication for good isn’t really something I can do because it’s not in line with one of my main life goals (which is to have several children).
I’m hesitant to fully trust any of the psychiatrists I’ve seen because they don’t ever even try to explore the possibility of going off meds. I don’t know whether it’s that they want me to continue being their patient, or if they really think that I need to be medicated on a life-long basis. I really don’t think I need to be on them forever. Although I have found psychiatrists who are willing to prescribe smaller doses, I haven’t found one who would really address my concerns, discuss ways to come off successfully, etc.. I do have a doctor now who is very kind, but he doesn’t think coming off will be difficult at all. His plan is just to prescribe say 10 milligrams less ever week or two. I wish it were that easy, but I know from experience that it isn’t.
Sigh.
Posted by Phillipa on September 3, 2006, at 19:03:23
In reply to Re: Terrified to stop taking my antidepressants » Phillipa, posted by Racer on September 3, 2006, at 2:03:34
Racer that's fine I'm an open book. It was an inguinal one on the right side. She cried 24hours a days and I held her the whole time. In the pediatricians office he let her cry and it popped out. I hope this helps you. Love Phillipa
Posted by Phillipa on September 3, 2006, at 19:09:42
In reply to Re: Terrified to stop taking my antidepressants » Phillipa, posted by Racer on September 3, 2006, at 2:03:34
Racer does CDH heal on it's own? As she projectile vomited for her first l8 months. I always had to refeed her and we went from breast milk to goats milk all the formulas inbetween. But she's fine today no problems at all. Except she's a b*tch. Love Phillipa
Posted by Racer on September 3, 2006, at 19:58:21
In reply to Re: Terrified to stop taking my antidepressants » Racer, posted by Phillipa on September 3, 2006, at 19:09:42
> Racer does CDH heal on it's own?
No, mostly CDH kills if untreated. Not a lot of variation on that, as far as I know. The good news being that it's usually caught and treated -- before birth now, too.
Posted by Racer on September 3, 2006, at 20:10:38
In reply to Re: Terrified to stop taking my antidepressants, posted by Djenane on September 3, 2006, at 18:47:01
> >
>
> The reason that I need to stop at this point in my life (even though I’m terrified) is that my husband and I very much want to have a baby. I’ve talked with my OBGYN, he says that it’s possible for me to stay on one medication and still have a healthy pregnancy, but I just don’t want to risk it. I want to be totally medication free at least while I’m pregnant and possibly longer if I nurse the baby.Good reason. As it happens, my husband and I are trying, too, and as a result I'm only willing to take Wellbutrin, which was happily ensconsed in Category B until it was changed a few months ago, with no new studies. In my case, I know I need something, so it's not much of a question. (Unfortunately, I need something more than Wellbutrin, but that's another story...)
>
> I’m hesitant to fully trust any of the psychiatrists I’ve seen because they don’t ever even try to explore the possibility of going off meds. I don’t know whether it’s that they want me to continue being their patient, or if they really think that I need to be medicated on a life-long basis.As for this, I suspect that they're going by the Received Wisdom of psychiatry these days: For a first episode of depression, stay on antidepressants for a minimum of two years after remission. For subsequent episodes, plan on staying on medication indefinitely. That's the basic guideline for antidepressants. Do I agree? Not necessarily... And I think that, even if it were spot on true, it wouldn't mean that you *had* to stay on meds.
The last time I went off meds, I told my erstwhile pdoc that I needed to stop them -- in my case, side effects and they weren't working -- and that I knew I'd have another episode, and could go back on them then. A sort of "we'll burn that bridge when we come to it" thing...
Anyway, I strongly suggest you give the Withdrawal board a try, see what others have to say. And I think I offered up my suggestion about the order I'd go off them if it were me.
Good luck -- on both counts!
Posted by Phillipa on September 3, 2006, at 20:37:08
In reply to Re: Terrified to stop taking my antidepressants » Phillipa, posted by Racer on September 3, 2006, at 19:58:21
Oh good. And I think we all need to rethink these ad's. Reason I say this is what happened to people in the olden days if they felt probably didn't even have the term depressed? I guess they just dealed with it and life when on. I think I've let too many docs influence me and confuse me to death. So I'm going to try weaning off them . Boy am I dizzy today. And hopefully that baby will come soon. I routing for you. Love Phillipa
Posted by Djenane on September 4, 2006, at 7:56:09
In reply to Re: Terrified to stop taking my antidepressants » Djenane, posted by Racer on September 2, 2006, at 20:16:48
> As for tapering, I guess I'd suggest tapering off one at a time, starting with the Trazadone, then moving through the desipramine to the Lexapro. That's the order I'd go, but that's just me.Dear Racer,
Would you mind explaining why you'd tackle Trazodone first, ending with Lexapro? I thought I'd end with Trazodone because it helps me sleep at night, so I guess it's my favorite :) What do you think?
Thanks,
Djenane
Posted by joslynn on September 5, 2006, at 14:44:01
In reply to Re: Terrified to stop taking my antidepressants, posted by Djenane on September 3, 2006, at 18:47:01
Well that is a certainly a good reason to want to go off of them, at least temporarily.
I am not married yet, but if I do marry my boyfriend, and IF I decide I want kids enough to do it in my 40s (I am getting close to that age), and IF I can even GET pregnant in my 40s, I will definitely go off meds for the pregnancy. If I relapse bad, I would go right back on them after the birth and not nurse. I know nursing is better, but myself and plenty of my other friends weren't nursed when we were born in the late 60s/early 70s, and no major health problems.
So, let us know how things go. I am curious.
When it just comes to affecting my own personal health and body, I can handle taking meds for now, especially considering I am in the 3-or-more-episodes group. But when it comes to what I take affecting a little, growing baby, then that's different. However, this is a really personal decision.
FWIW, I think that most pdocs have too many patients as it is, and wouldn't recommend we stay on meds just to get more business. New depressed people will always come through their door, whether we stay on meds or not. I think it's more that they think a relapse could occur.
Posted by joslynn on September 5, 2006, at 14:48:31
In reply to Re: Terrified to stop taking my antidepressants, posted by Djenane on September 3, 2006, at 18:47:01
P.S. At my age, I should probably try to adopt, and not deal with going off meds/relapse/post-natal depression stuff. But with a mental health hospitalization in my background, would I even be able to do that? Would I qualify? Having children, from a mental health perspective, gets more complex. However, there are so many kids out there who need love in one form or another...nephews, kids in other countries who need financial support, the kids at church, foster kids, etc. So I am thinking of creative ways to still touch a child's life, even if it's not a biological or adopted child.
Posted by yxibow on September 7, 2006, at 3:22:31
In reply to Re: Terrified to stop taking my antidepressants, posted by Djenane on September 3, 2006, at 18:47:01
> So being on medication for good isn’t really something I can do because it’s not in line with one of my main life goals (which is to have several children).
>
> I’m hesitant to fully trust any of the psychiatrists I’ve seen because they don’t ever even try to explore the possibility of going off meds. I don’t know whether it’s that they want me to continue being their patient, or if they really think that I need to be medicated on a life-long basis. I really don’t think I need to be on them forever. Although I have found psychiatrists who are willing to prescribe smaller doses, I haven’t found one who would really address my concerns, discuss ways to come off successfully, etc.. I do have a doctor now who is very kind, but he doesn’t think coming off will be difficult at all. His plan is just to prescribe say 10 milligrams less ever week or two. I wish it were that easy, but I know from experience that it isn’t.
>
> Sigh.
Withdrawing from any compound is not easy, especially if you've been on it for so long. One has to outweigh the risks of depression and postpartum depression and any harm to the baby.
The only antidepressant that has been anectodally listed in category B due to limited studies and the amount of time they have been out (regardless of the manufacturers statements to protect themselves and place in Category C) is Wellbutrin due to small monitoring studies as it has also been a smoking cessation medicaiton.Prozac is probably category C although there have been some monitoring studies that hedge the other direction.
But I assume you have talked with your doctor and weighed the risks of any birth defects (which can occur of course regardless and amniocentesis is done far more regularly today to predict outcomes.) There are alternatives as well, as noted at http://www.ehealthmd.com/library/amniocentesis/AMO_alt.html
for example.
At any rate, going without medication, I would say just as a layman commment that if depression returns during pregnancy, that non-drug methods such as psychotherapy be considered, just as a suggestion.
- tidings and best wishes
Posted by ace on September 9, 2006, at 0:44:14
In reply to Terrified to stop taking my antidepressants, posted by Djenane on September 2, 2006, at 19:24:22
> I'm very scared. Here's why: I'm currently taking 3 different antidepressants: Trazodone at 50 mgs, Lexapro at 30 mgs and Desipramine at 25mgs. I want to get off of them all, but I'm terrified.
Why do you want to get off them? Are they working?
> I've seen several different psychiatrists, hoping to find one who would help me come off. The reaction has pretty much been the same every time... they say they don't recommend coming off (even if they'd only met me a few minutes before), as if I'm destined to stay on these drugs for the rest of my life.Some people DO have to take psychiatric drugs for a lifetime...I know I will. If they are working stay on them indefinately in my opinion. Take care of your overall health, get regular blood counts. But, their is no long term s/effects. None. Only drug I'd worry about is the Lexapro. Also, you aren't on high doses.
> I've tried a fairly slow taper before and had bad withdrawal effects. And that was with only one drug and now I have three!
>
> I wish I could prevent these symptoms. Does anyone know how?
I'd just leave things as they are, or taper very very very very slowly of the lexapro. Why you want to get off them so much?Ace
This is the end of the thread.
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