Psycho-Babble Medication Thread 835521

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Re: I'm slowing going off my meds

Posted by bleauberry on June 20, 2008, at 17:17:23

In reply to I'm slowing going off my meds, posted by Deneb on June 19, 2008, at 18:01:40

Millions of people have health conditions that are completely improved with medications and require lifetime consumption to stay well. Heart disease, blood pressure, diabetes, cancer, organ transplants, on and on. I wonder why we tend to think the central nervous system or the brain are different?

Just wanted to followup and say I agree with the wisdom of SLS. If it must be done, do it one drug at a time. I would add, do it very slowly in very tiny increments. If at any time you notice worsening that is instinctively different than withdrawals, get back to your regular dose immediately.

The phenomenon has been noted here hundreds of times in the last decade, and is well documented at other places such askapatient.com or revolution health. The mysterious phenomenon. A drug that previously worked very well without notable side effects becomes a poison with strong side effects that either doesn't work, works only a fraction of how it used to, or actually makes you feel worse than ever. Almost like your immune system recognizes it and says no no no. And there is a certain aspect of treatment resistance that was not there previously, which makes the whole process harder and more complex in followup efforts.

There are indeed people who take a drug, get well, stop the drug and stay well. There are indeed people who take a drug, get well, stop the drug, relapse, start the drug again and it works just as good as ever. No scientific evidence to back it up, but my guess is the bad outcomes outnumber the the good ones. Any way you look at it, one is taking a situation of very low risk and purposely voluntarily entering a realm of high risk.

Personally I think the time to think about changing meds is when they are obviously not working like they used to, for whatever reason. Poopout, aggravation of underlying biology, whatever. That's a time to maybe change. But when perfectly well? Hmmm.

I guess what I am saying is, you've heard it before, "if it aint broke, don't fix it". It's too easy to accidentally mess it up even with perfectly honorable good intentions and skill.

So you decide to stay on the meds. You have to put a pill or two in your mouth everyday, someone else is paying for most of it, you feel pretty good. I dunno, I would trade you a million dollars for that.

 

Re: I'm slowing going off my meds Deneb

Posted by seldomseen on June 20, 2008, at 18:09:08

In reply to I'm slowing going off my meds, posted by Deneb on June 19, 2008, at 18:01:40

oooooooo - everytime I do that I get into trouble.

And I am the queen of doing that.

I'm lucky because thus far everytime I restarted Prozac it has worked for me. It's just I forget what the start up is like (it sucks) and I'm always like "Why did I quit this med again?"

I would approach this decision with much much caution. If I can vow to stay on my meds, then anyone can.

Seldom

 

Re: I'm slowing going off my meds

Posted by Deneb on June 20, 2008, at 18:14:36

In reply to Re: I'm slowing going off my meds, posted by Justherself54 on June 20, 2008, at 10:08:39

Thanks dbc, Midnightblue, bleauberry, Phillipa, gg, SLS, Justherself,

I really feel you all care about me. Thanks for caring. It seems like the majority vote is to not fix something that isn't broken. i.e. don't mess around with what works.

In the past, I have expressed an interest in becoming med free and perhaps my pdoc is just trying to make that happen for me.

The thing is, my pdoc mostly gives me psychotherapy. Perhaps I feel good because of psychotherapy?

No, that is too simple. Why would she increase my meds sometimes if she didn't think it was doing something?

I think my pdoc doesn't like the Risperdal. She never did anything to its dose, it was always increasing the SSRI. I think she likes SSRIs a whole lot. I'm on two of them.

She also doesn't like benzos. She's only given me 3 0.5mg instant dissolve tablets and that was for a very specific circumstance.

I think what I'll do is follow her instructions and see if I get worse.

 

Re: I'm slowing going off my meds

Posted by Justherself54 on June 20, 2008, at 18:52:41

In reply to Re: I'm slowing going off my meds, posted by Deneb on June 20, 2008, at 18:14:36

I'm glad to hear that you are going to follow your doctor's directions Deneb. As I said before she knows your history. The decision to go off your meds should be made between you and your doctor.

Just go slow to try to counter the effects of coming off them and keep in touch with your doctor during the titration. Keep us posted on your progress!

 

Re: I'm slowing going off my meds

Posted by Phillipa on June 20, 2008, at 20:43:10

In reply to Re: I'm slowing going off my meds, posted by Justherself54 on June 20, 2008, at 18:52:41

Deneb definitely agree with above posts and not all are treatment resistant. Your doc decided with you that you no longer needed that dose and that is great. And I know you are very responsisble now. Good Luck!!! Love Phillipa

 

I have a very different view bleauberry

Posted by Racer on June 21, 2008, at 1:34:26

In reply to Re: I'm slowing going off my meds, posted by bleauberry on June 20, 2008, at 17:17:23

>
>> The phenomenon has been noted here hundreds of times in the last decade, and is well documented at other places such askapatient.com or revolution health. The mysterious phenomenon. A drug that previously worked very well without notable side effects becomes a poison with strong side effects that either doesn't work, works only a fraction of how it used to, or actually makes you feel worse than ever.
>
> There are indeed people who take a drug, get well, stop the drug and stay well. There are indeed people who take a drug, get well, stop the drug, relapse, start the drug again and it works just as good as ever. No scientific evidence to back it up, but my guess is the bad outcomes outnumber the the good ones. Any way you look at it, one is taking a situation of very low risk and purposely voluntarily entering a realm of high risk.
>

I respectfully disagree, and would suggest that the specific population posting on sites such as this one and others where that phenomenon is reported may be a causal factor of this belief.

Last year, I tried EMSAM, with lousy results, and went back onto my trusty Wellbutrin/Concerta cocktail. And felt miserable, because it didn't seem to be working very well. I started to think, "Oh, it's because I went off it and now it won't work as well anymore..." Only one problem with that theory -- if it had been working well in the first place, we'd never have tried something else. My combination is working about as well as it ever has -- but I remembered it working better than in fact it had been. I don't think my experience is all that unusual, and I think that skewed view of how well a medication worked is behind that belief that drugs don't work as well on subsequent trials.

Furthermore, as SeldomSeen pointed out, often times start up effects are a problem when restarting a medication. Also, restarting at too high a dose can cause problems.

Personally, I believe that for many people -- in fact, the vast majority of people who do not experience treatment resistance of any sort and simply improve on the first medication they take -- stopping a medication and later restarting it probably poses no significant challenges. I think it's worth remembering that the people who post here are a distinct, though heterogeneous, population.

I also think it's wonderful that Deneb has worked so hard and improved so much that her doctor thinks she will do well off medications. I hope that it turns out well, and that this thread does not cause too much anxiety for her.

 

Re: I have a very different view

Posted by SLS on June 21, 2008, at 5:15:10

In reply to I have a very different view bleauberry, posted by Racer on June 21, 2008, at 1:34:26

To Deneb:

It sounds to me like your doctor is doing the right thing for you. Don't let the rest of this post influence your decisions. You are smart enough to be cautious, as is your doctor.

*************************************************************

The phenomenon of antidepressant-induced-treatment refractoriness has not been formally studied. All we have is compelling anecdotes with no statistics.

If this is indeed a "special" population where this phenomenon occurs at a rate greater than that seen in the majority of people treated pharmacologically, then, the chances of any one person experiencing post-treatment TRD is greater.

Of course, this might not true of Deneb. It just sounds like it is a warranted precaution to treat her as such.

The decision to attempt the discontuation of treatment might be exactly what is right and justified. Much of this decision is dependant on Deneb's history of depression. Is it recurrent? Is it chronic? Is it biological or psychological or both? Has she had a previous episode of depression for which treatment was discontinued successfully? How long would such a remission last for? Family history? Etc. These are the type of things a good doctor will use to make treatment decisions by.

Obviously, I cannot, and would not, assess someone's absolute risk of any sequale to discontinuing treatment.

And.

The doctor might be happy to remove the Risperdal only, and assess the consequences, only to make small adjustments in the rest of her treatment regime. I don't know.

Yes, a huge number of people can discontinue their treatment for depression once psychosocial issues are resolved. Even if the depression be totally biological, maintaining a stable remission for even 6 months can allow for discontinuation. It really depends on case history and clinical assessment.

For Deneb, I have no idea of her case history to be able to submit anything more as a suggestion.


- Scott

 

Re: I have a very different view SLS

Posted by Racer on June 21, 2008, at 9:04:41

In reply to Re: I have a very different view, posted by SLS on June 21, 2008, at 5:15:10

>
> The phenomenon of antidepressant-induced-treatment refractoriness has not been formally studied. All we have is compelling anecdotes with no statistics.
>
> If this is indeed a "special" population where this phenomenon occurs at a rate greater than that seen in the majority of people treated pharmacologically, then, the chances of any one person experiencing post-treatment TRD is greater.
>
>

Actually, I had a slightly different point I was hoping I'd made -- not so much that people here are more prone to develop TRD if we stopped a medication and then restarted it, but that since so many of us already are experiencing TRD, that scenario may lead us to over-estimate how much a medication benefited us in the first place. Like my view that Wellbutrin/Concerta wasn't working as well when I restarted it, when it fact it hadn't been working all that well in the first place, which is WHY we'd stopped it. Does that make more sense? That I inaccurately attributed to it much greater efficacy than it, in fact, had, and that lead me to believe it was less effective after the hiatus?

And it could be that you're right and I'm -- not right. I think, though, that in the absence of formal studies, it's worth considering that we might be a special population, and that the phenomenon may be illusory.

By the way, I really hope you'll let me know what I've done.

 

Re: I'm slowing going off my meds

Posted by bleauberry on June 21, 2008, at 13:35:47

In reply to I'm slowing going off my meds, posted by Deneb on June 19, 2008, at 18:01:40

Bottom line, Deneb will benefit by knowing every angle of this decision. So I'm glad the thread was started and I am glad everyone who contributed an opinion did so. It arms Deneb with a great deal of wisdom that would not have been found any other way except at psychobabble.

 

Re: I'm slowing going off my meds

Posted by Phillipa on June 21, 2008, at 19:00:04

In reply to Re: I'm slowing going off my meds, posted by bleauberry on June 21, 2008, at 13:35:47

I feel Deneb will do very well going down or off the resperidol as she has worked very hard in theraphy and now is making rational decisions. And remember she has now become an adult and is working. And has attende what three babble conventions on her own and had a great time. Congrats again to you Deneb. Love Phillipa

 

Re: I have a very different view

Posted by SLS on June 21, 2008, at 22:32:13

In reply to Re: I have a very different view SLS, posted by Racer on June 21, 2008, at 9:04:41

Hi Racer.

> By the way, I really hope you'll let me know what I've done.

That's easy. You've done good!

;-)


- Scott

 

Re: Can anyone find a pattern? lol

Posted by Deneb on June 22, 2008, at 0:56:42

In reply to Re: I have a very different view, posted by SLS on June 21, 2008, at 5:15:10

Sorry, this post is really disorganized and unfocused, but I just want to know if anyone can find any pattern in this? Maybe this will help me make my meds decision.


I've never actually tried going off medications slowly.

The only other SSRI I've been on was Zoloft. I was on that for a few years and still had bad times on and off, I think... My memory is fuzzy, my pdoc probably has a better idea of how I was. Then my pdoc went on maternity leave.

Oh wait, no. Before my pdoc went on maternity leave, I didn't see her for a while, like 6 months. I just kind of lost contact with her.

I was well I think...yeah. I remember I got 3 As and 2 Bs that semester. I was doing really well and I wasn't on any meds or had any therapy.

Then, next semester something went wrong.

Man, my memory is bad. LOL

Anyways, a few days before I seriously OD'd, I'd gone to a family doc and she gave me Celexa, so I must not have been on any meds then. I remember this b/c she gave me samples of Celexa and I remember I almost forgot to take them back after the psych ward people took them when I stayed there.

The thing is, I didn't OD because I wanted to die. I think I did it to escape.

Then the hospital made me see my pdoc again. I saw her intensely for a bit, then she went on maternity leave.

Then I was without a pdoc for a while. Then I got bad again and saw another time and he agreed to try Risperdal. That was my idea, cuz I'd read about it for BPD. Then I thought I had apathy so he added Wellbutrin.

I saw non therapist pdoc for a few months. Then pdoc came back.

I got bulimia for a while so pdoc took me off Wellbutrin. She was very afraid of seizures for me. She put me on Prozac.

I also started seeing my pdoc everyweek instead of every 2 or 3 weeks.

And I've been doing really well.

My pdoc should know all this.

Well my pdoc thinks I'm ready to reduce my meds so lets hope she's right.

I'm not sure what makes me do well and what doesn't. It all seems so random.

So...

I remember,

No meds no therapy no loving Dr. Bob in high school = very very bad state

Zoloft no therapy, no loving Dr. Bob = very very bad state

Zoloft and little therapy, no Dr. Bob = bad state

Zoloft and little therapy, no Bob = ok, good?

No meds (stopped on own) no therapy (stopped on own), no Bob = very good

No meds no therapy, no Bob = very very bad

Celexa little therapy (Bob? don't remember) = OK

Celexa, Risperdal, no therapy (Bob? don't remember) = OK

(May 2006) Celexa, Risperdal, Wellbutrin therapy Love Dr. Bob ( I know I loved Dr. Bob then b/c I wrote in in the Babbleometer thing LOL) = CES-D score of 1!! i.e. very very good

(July 2006)50 mg Celexa, 0.75 mg Risperdal, 150 mg Wellbutrin, therapy, breast cancer scare = CES-D score 31 (bad??)

(Sept 2006) Meds: 50 mg Celexa, 0.75 mg Risperdal, 150 mg Wellbutrin, therapy, health anxieties = CES-D score 5

(Mar 2007)20 mg Celexa 40 mg Prozac 0.75 mg Risperdal, therapy, love bob = CES-D 21 (bad?)

(Mar, 2008) 40 Prozac 0.75 Risperdal 40 Celexa, therapy, love bob = CES 7 good

(Today) 40mg Celexa 40mg Prozac 0.75mg Risperdal, therapy, love bob, new job = CES 8 (today's score)

Is there a pattern?

It's hard to tell because my moods are very volatile and each snapshot may not be representative of my overall state.

I fill out the scale more frequently and do averages over time.


 

Re: Can anyone find a pattern? lol Deneb

Posted by SLS on June 22, 2008, at 5:03:36

In reply to Re: Can anyone find a pattern? lol, posted by Deneb on June 22, 2008, at 0:56:42

Dear Deneb,

I'm sorry if I am repeating a question found elsewhere on this thread, but...

Do you have borderline personality disorder or anything like it?


- Scott

 

Re: Can anyone find a pattern? lol

Posted by Deneb on June 22, 2008, at 21:03:12

In reply to Re: Can anyone find a pattern? lol Deneb, posted by SLS on June 22, 2008, at 5:03:36

My pdoc said I no longer meet the criteria for borderline personality. :-)

But yeah, I had it.


> Dear Deneb,
>
> I'm sorry if I am repeating a question found elsewhere on this thread, but...
>
> Do you have borderline personality disorder or anything like it?
>
>
> - Scott

 

Re: Can anyone find a pattern? lol Deneb

Posted by SLS on June 23, 2008, at 5:36:05

In reply to Re: Can anyone find a pattern? lol, posted by Deneb on June 22, 2008, at 21:03:12

Hi Deneb.

> > I'm sorry if I am repeating a question found elsewhere on this thread, but...
> >
> > Do you have borderline personality disorder or anything like it?


> My pdoc said I no longer meet the criteria for borderline personality. :-)

> But yeah, I had it.

If you really were borderline, and successfully worked through it, you should earn the Nobel Prize. I know it is extremely hard to change one's thoughts, feelings, and behavior when dealing with this disorder.

Good job!


- Scott

 

Re: Thanks SLS

Posted by Deneb on June 24, 2008, at 2:16:42

In reply to Re: Can anyone find a pattern? lol Deneb, posted by SLS on June 23, 2008, at 5:36:05

I'm not sure what really helped me.

I started seeing my pdoc once a week instead of once every 2 weeks. That might have helped.

It seems like I had bad and good times both on and off meds, so meds are probably not the main reason why I feel better.

Working has helped me a lot as well. I feel good knowing I earn my money. I'm also good at what I do.

Yeah, work and seeing pdoc every week...those are probably the main things that helped me.

 

Re: I saw my pdoc/T today

Posted by Deneb on June 24, 2008, at 23:47:51

In reply to Re: Thanks SLS, posted by Deneb on June 24, 2008, at 2:16:42

She decided not to reduce the Risperdal just yet.

My sleep habits are a bit wonky and she wants me to cut out all caffeine and sleep 8 hours/night with no problems before reducing my med.

I'm only drinking decaf now.

 

Re: I saw my pdoc/T today Deneb

Posted by SLS on June 25, 2008, at 3:50:37

In reply to Re: I saw my pdoc/T today, posted by Deneb on June 24, 2008, at 23:47:51

> She decided not to reduce the Risperdal just yet.
>
> My sleep habits are a bit wonky and she wants me to cut out all caffeine and sleep 8 hours/night with no problems before reducing my med.
>
> I'm only drinking decaf now.

Sounds like a good plan. Sounds like a good doctor.

Cutting out caffeine abruptly might give you some monstrous headaches. Maybe try weaning off caffeine if they occur? It should only take a few days to a week.


- Scott

 

Re: I saw my pdoc/T today

Posted by Deneb on June 25, 2008, at 11:39:45

In reply to Re: I saw my pdoc/T today Deneb, posted by SLS on June 25, 2008, at 3:50:37

Yeah, she told me I might get headaches. She said I can wean myself off it or take Advil for the headaches, if I get any.

So far I'm good. I don't have any problems.

>> Sounds like a good plan. Sounds like a good doctor.
>
> Cutting out caffeine abruptly might give you some monstrous headaches. Maybe try weaning off caffeine if they occur? It should only take a few days to a week.
>
>
> - Scott

 

Re: I haven't done anything and yet...

Posted by Deneb on June 30, 2008, at 19:11:54

In reply to Re: I saw my pdoc/T today, posted by Deneb on June 25, 2008, at 11:39:45

I haven't changed my meds yet but I feel depressed now.

Yesterday I froze at work. I just couldn't work. I left in tears. I asked to go home early.

I wandered for a while not knowing what to do because I didn't want my family finding out. I felt too tired to walk. I just wanted to drop down to the ground.

Today I called in sick.

I can't face work. This is really bad because I just got my job.

I haven't changed a thing with my meds yet. I didn't take them for one day the other day, but I've done that in the past and I don't remember anything bad happening.

I was doing so well, now all of a sudden I can barely function.

What's wrong with me?!

 

Re: I haven't done anything and yet...

Posted by Justherself54 on June 30, 2008, at 20:42:55

In reply to Re: I haven't done anything and yet..., posted by Deneb on June 30, 2008, at 19:11:54

Are you finding your new job overwhelming? That could have caused you to feel awfully stressed. Also, are you worried about going off your meds while starting a new job? If you are maybe you could talk to your pdoc about staying on your meds until you adjust to your new environment at work.

I hope you're feeling better and this was just a "bump" in the road..

Justy

 

Re: I haven't done anything and yet...

Posted by Deneb on June 30, 2008, at 22:21:17

In reply to Re: I haven't done anything and yet..., posted by Justherself54 on June 30, 2008, at 20:42:55

OK, I need to deal with work.

I cannot take the easy way out.

I need to deal with this!

Problems have solutions. Problems have solutions. Problems have solutions. Problems have solutions. Problems have solutions. Problems have solutions.

OK, I see I'm on the meds board...gotta talk about meds.

Hmmm...is there a med that can help me deal with this anxiety I get from work?

If there is, how can I get it?

My pdoc always increases my SSRIs for anxiety. I also take the propranolol. I stopped taking the propranolol. I should take it again. I think the stress is catching up with me.


 

Re: I haven't done anything and yet...

Posted by Justherself54 on June 30, 2008, at 22:31:11

In reply to Re: I haven't done anything and yet..., posted by Deneb on June 30, 2008, at 22:21:17

Good plan. If it helps your anxiety, it'll be easier to adjust at your new job. If you absolutely hate your new job..time to look for another...hope you feel better when you go back to work...keep us posted

 

Re: What are some ways to reduce anxiety?

Posted by Deneb on June 30, 2008, at 23:31:20

In reply to Re: I haven't done anything and yet..., posted by Justherself54 on June 30, 2008, at 22:31:11

I think my main problem is anxiety.

I get anxious about work.

How should I reduce it?

OK...I'm going to take propranolol twice a day (pdoc said it was OK).

I think I should practice some relaxation techniques.

Exericse? My pdoc told me not to take propranolol before exercising. Maybe I should get up early to exercise?

 

Re: I haven't done anything and yet...

Posted by elanor roosevelt on July 1, 2008, at 21:56:46

In reply to Re: I haven't done anything and yet..., posted by Deneb on June 30, 2008, at 19:11:54

look,
you just started a new job,
you are concerned about making it work
and worrying about changing your meds

take a deep breath
take a warm bath

don't mess with your meds until you have comfortably settled in to your new job

good luck to you


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