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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 72 to 96 of 96. Go back in thread:
Posted by BGB on July 19, 2008, at 13:41:51
In reply to Want to stop meds ... should I?, posted by Maxime on July 16, 2008, at 20:48:26
First of all Maxie, congratulations to you on feeling better! Second of all, sorry to hijack your thread there...but that article was just too funny not to comment on. Getting back on topic, I think that it might be wise to get a second opinion before discontinuing anything. If you get the okay from two docs, why not try tapering down off of your meds, one at a time? You can always go back on them.
I once hit a horrible depressive episode and convinced myself that I'm not bipolar at all and just depressed. Thinking that it was making me worse, I tapered myself down off of Depakote (without my doctor's consent or knowledge) and had some really, really horrible consequences from it. It turns out that I am very, very bipolar and will probably have to stay on mood stabilizers for the rest of my life.
That's not to say I regret the decision; I did walk away with some knowledge...I promise you I'll never just decide to stop any drug all by myself again. However, if you have the support of a doctor, or even better, two doctors, I don't see the harm.
A suicide attempt (and being in a coma, for that matter) are very intense psychological events...who knows what that could have done to your brain??? We know so little. While it's very possible that this event caused true physiological changes in your brain chemistry, it's also possible that the changes are psychological in nature. That does not diminish their significance. This experience could have completely changed the way that you think. That might be exactly what you needed.
Whatever you decide, I just hope that you continue to feel well. It's great to hear a positive story here on PB!!!
Take care, Maxie!!!!
B =)
Posted by SLS on July 19, 2008, at 13:56:39
In reply to Re: Want to stop meds ... should I?, posted by BGB on July 19, 2008, at 13:41:51
> First of all Maxie, congratulations to you on feeling better! Second of all, sorry to hijack your thread there...but that article was just too funny not to comment on. Getting back on topic, I think that it might be wise to get a second opinion before discontinuing anything. If you get the okay from two docs, why not try tapering down off of your meds, one at a time? You can always go back on them.
The thing that concerns me, though, is that it very often takes 4 months to relapse after the discontinuation of treatment. By that time, one may become less responsive to what got them well in the first place. Having said that, I have done exactly what you suggest, and have been better off for knowing what drugs I need and at what dosages. However, it is still early in my response to treatment. I have not been in remission for more than a year. I think you can get a more immediate gage of how much you need a particular drug by doing this experimentation earlier rather than later. I would not suggest this course of action for anyone except myself. The risks I took were mine and my doctor's.
This stuff is highly speculative, but it is how I have experienced the illness and its treatment.
- Scott
Posted by BGB on July 19, 2008, at 14:08:03
In reply to Re: Want to stop meds ... should I? » BGB, posted by SLS on July 19, 2008, at 13:56:39
> The thing that concerns me, though, is that it very often takes 4 months to relapse after the discontinuation of treatment.
Excellent point. My mania returned full-force after a 50% reduction in my Depakote dose. However, I do know that depression is a whole lot different from mania, and often takes much longer to return after the discontinuation of medication. It's also much harder to treat than depression (for me, anyway). That is definitely something that should be considered.
Posted by Maxime on July 19, 2008, at 17:10:12
In reply to Re: Thank you, everyone » SLS, posted by SLS on July 19, 2008, at 5:55:26
> Maxime,
>
> After reading this thread, how have your feelings surrounding the discontinuation of treatment changed, if at all?
>
>
> - ScottThis thread has made me realise that changing or stopping my meds right could really mess me up. I need to wait until I have been out of my depression for longer. It's possible that I may never get off meds, and I can live with that as long as I am doing well. It was so frustrating to try every single med and combo and get little or no relief. I'm 39 years and I have been depressed since I was a child.
Maybe my suicide attempt did change something in my brain that has allowed meds to work. I don't know. I will never know.
For now, I am staying on my cocktail of meds. :)
Maxime
Posted by Maxime on July 19, 2008, at 17:14:54
In reply to Re: Want to stop meds ... should I?, posted by BGB on July 19, 2008, at 13:41:51
> A suicide attempt (and being in a coma, for that matter) are very intense psychological events...who knows what that could have done to your brain??? We know so little. While it's very possible that this event caused true physiological changes in your brain chemistry, it's also possible that the changes are psychological in nature. That does not diminish their significance. This experience could have completely changed the way that you think. That might be exactly what you needed.
>
> Whatever you decide, I just hope that you continue to feel well. It's great to hear a positive story here on PB!!!
>
> Take care, Maxie!!!!
> B =)Aw, thank you! I don't mind that the thread was highjacked. I like to see discussion and some valid points for both side of the argument have been made.
Very early on, when I started to experience relief (beginning of March) my psychiatrist that indeed the coma and all the seizures I had may have had a psychological effect on me. He said that when people escape death, that their mood can change. I don't really know if that is the case because I remember being very unhappy that I was still alive.
Anyhow, I am doing well now and trying to live my life as much as possible!
Maxime
Posted by linkadge on July 19, 2008, at 17:44:57
In reply to Re: Thank you, everyone » linkadge, posted by SLS on July 19, 2008, at 13:23:20
>In my opinion, you are supporting a dangerous >course of action. I'm sure you would expect at >least one person to feel that way.
Well thats your opinion.
>> Unless you're just asking the question to get >>the response you want to hear.>Is that an accusation, my dear Linkadge? You >don't have a clue as to what I'm all about. This >is tragic.
I wasn't refering to you.
>This thread is what it is.
I know thats why I'm not going to respond to such anymore.Linkadge
Posted by linkadge on July 19, 2008, at 17:59:41
In reply to Re: Thank you, everyone, posted by 49er on July 19, 2008, at 13:28:37
Thats for your reply and this is what I am refering to. People are so loaded up with the "standard" opinion pushed by doctors and drug companies they rarely dare to think for themselves. This is one issue I'm sure people know that I have with SLS. He believes that the only way people with depression can feel better is if they take their meds as prescribed by their doctor and continue to take them as prescribed by their doctor. SLS still has issues dispite following this plan to the T.
Anyhow, like 49er mentioned there are many times when people actually feel better getting off meds. In these cases its not a matter of not being sick or not having been sick, its a matter of the drugs are simply not providing sufficiant relief and for whatever reason they are making the patient feel worse. Psychatry doesn't have all the answers and if you start with the assumption that they do, it may be a long and hard lesson for you.
If people are constantly questioning the efficacy of their meds, if they are constantly unsure as to whether they are really feeling better or not then it might be for good reason. People have a brain and the only person who can tell whether the risk benifit profile for them is really in their favor is the patient. Don't say the Emperor is wearing cloths if you don't think he is. Don't let any babbler convince you to take a med that you don't want to take or try to tell you that they are working when they may not be working. There are many times that I have trusted my intuition and got off meds and have felt better in the long run.
Contrary to popular belief meds are not the only answer and it doesn't undermine the validity of your illness or your suffering to not be on medication. I think sometimes people feel that if "I'm not on meds than nobody will belive there is anything wrong with me".
Linkadge
Posted by linkadge on July 19, 2008, at 18:13:55
In reply to Re: Want to stop meds ... should I?, posted by BGB on July 19, 2008, at 14:08:03
Theres also something called rebound mania. If you take a mood stabilizer for long enough you can experience mania from the rapid discontinuation of the medication.
Some people take that as evidence that they do infact have bipolar disorder, but its important to note that rebound mania is *not* restricted to bipolar patients.
For instance, there are many case reports of lithium discontinuation causing rebound mania in patients who were not bipolar! (I.e. the patients were using lithium for depression agumentation!)
The point is that when you are on drugs, you are on drugs. If you discontinue any medication too quickly you can experience the homeostatic forces of your brain acting unrestrained. If you were on an anxiety drug, you can have rebound anxiety, if you were on a mood stabilizer you can experience instability etc. etc.
Heres another good example. Doctors know that if you come off anticonvulsants too quickly you can have a seizure - even if you're not using the drug for epilepsy. So, if you have a seizure coming off an anticonvulsant that you were using for migrane would you take that as evidence that you really do have epilepsy ?? Of course not.
Its really important to compare and contrast the episodes of drug induced behavior to previous behaviors. If the episode you had coming off depakote was very similar to past epsisodes you had while drug free, then this would be an indication that you are bipolar. If the episode you had coming off depakote was very much unlike any epsiode you have had previously, then you may want to rethink the notion that it is proof of bipolar.
Linkadge
Posted by linkadge on July 19, 2008, at 18:15:47
In reply to Re: Want to stop meds ... should I? » BGB, posted by Maxime on July 19, 2008, at 17:14:54
if you don't mind me asking?
Linkadge
Posted by Jeroen on July 19, 2008, at 18:22:50
In reply to Want to stop meds ... should I?, posted by Maxime on July 16, 2008, at 20:48:26
you had lot of luck , well that you survived. . .
im not getting in to this, but thanks to you i have a little hope of getting rid of my psychosis 800 mg of seroquel you said
Posted by BGB on July 19, 2008, at 18:34:30
In reply to Re: Want to stop meds ... should I?, posted by linkadge on July 19, 2008, at 18:13:55
> Its really important to compare and contrast the episodes of drug induced behavior to previous behaviors. If the episode you had coming off depakote was very similar to past epsisodes you had while drug free, then this would be an indication that you are bipolar. If the episode you had coming off depakote was very much unlike any epsiode you have had previously, then you may want to rethink the notion that it is proof of bipolar.
That's a great point that I had not thought of. My experience going off of Depakote was IDENTICAL to my previous manic episodes, so I'm pretty sure I'm bipolar and really really really need my mood stabilizers. Of course, with psychiatric meds you never really can know for SURE, but my experience was so very terrifying that I don't think I'll ever try to go off of MS's ever again, unless I'm locked up somewhere where I cannot hurt (or kill) anyone else. I was waaaay too close to committing murder to ever want to try that again. A nice little gay boy like me wouldn't bode well in the clink. ;)
Posted by SLS on July 19, 2008, at 18:55:27
In reply to Re: Thank you, everyone » 49er, posted by linkadge on July 19, 2008, at 17:59:41
You don't know the first thing about me or how my mind works. I am quite certain that you don't know how my brain works.
If you can't afford to be wrong, please don't post to me or anyone else about me.
- Scott
Posted by Maxime on July 19, 2008, at 20:44:59
In reply to Re: What meds R U on? » Maxime, posted by linkadge on July 19, 2008, at 18:15:47
> if you don't mind me asking?
>
> Linkadge60 mg Cymbalta
300 mg Wellbutrin SR
200 mg Seroquel
Posted by gardenergirl on July 19, 2008, at 22:48:24
In reply to Re: Want to stop meds ... should I?, posted by linkadge on July 19, 2008, at 18:13:55
> For instance, there are many case reports of lithium discontinuation causing rebound mania in patients who were not bipolar! (I.e. the patients were using lithium for depression agumentation!)Well what do you know? I just stopped Lithium, and I've been feeling more "revved up", though not manic and not sure if even reaching hypomanic levels. But I wake up and I'm wide awake and talking, which has not been my usual for the last several years. My husband and I were just talking about this last night to try to determine if this was my baseline or if I was exerperiencing some euphoria or what. Interesting.
I was taking 600 mg. I lowered it to 450 mg by taking alternating between two 300 mg capsules and one capsule every other day to average 450 mg. I did this for about 2 weeks, then 300 mg for two weeks, then off. Perhaps that was too fast? Though if I had to come off it because I was pregnant, I'd have to do it even faster.
Anyway, I was worried I'd feel a rebound depression, not any kind of up feeling.
gg
Posted by linkadge on July 20, 2008, at 11:40:58
In reply to Re: Thank you, everyone » linkadge, posted by SLS on July 19, 2008, at 18:55:27
>You don't know the first thing about me or how >my mind works. I am quite certain that you don't >know how my brain works.
No, I don't know how your brain works and I never said I did.
I should rephrase. From what I have observed on this board, it seems that you are very much a proponent of the notion that the only way to treat "true" mental illness is with medications and that people are somehow destined to a particular course of illness as outlined by their psychiatrist.
If I am wrong about these observations, then I appoligise.
Linkadge
Posted by linkadge on July 20, 2008, at 11:46:22
In reply to Re: Want to stop meds ... should I? » linkadge, posted by gardenergirl on July 19, 2008, at 22:48:24
Yes, if you feel you came off of it too quickly, you could go back on say 150mg. At least you did taper. Some people drop a theraputic dose cold turkey and can have serious rebound symptoms.
Linkadge
Posted by linkadge on July 20, 2008, at 11:48:55
In reply to Re: Want to stop meds ... should I?, posted by BGB on July 19, 2008, at 18:34:30
Thanks for sharing. I wasn't trying to negate your experience, I was only suggesting that some people can get trapped on meds beliving that withdrawl symptoms are their underlying disorder.
Linkadge
Posted by 49er on July 20, 2008, at 15:05:59
In reply to Re: Thank you, everyone » 49er, posted by SLS on July 19, 2008, at 13:40:32
> > Obviously, everyone has to make their own decision regarding meds. But it is totally incorrect to assume that anyone with a serious depression needs to be on meds for life.
>
> Do you think your position on this issue speaks to the majority of people with a history of recurrent or chronic depression?
>
>
> - Scott
>
>Scott,
Hmm, I am not sure what you're asking. Are you saying I am incorrect about a fast taper being confused with withdrawal symptoms?
Sorry, due to insomnia from staying up too late, I am not understanding your question.
I just don't want to write a long response and find I totally missed the boat.
49er
Posted by 49er on July 20, 2008, at 15:19:22
In reply to Re: Thank you, everyone » 49er, posted by linkadge on July 19, 2008, at 17:59:41
> Thats for your reply and this is what I am refering to.
Linkadge,
Thank you for what you said.
That is great, you trusted your intuition. Doing that saved me big time even when I was still on meds.
I had a severe reaction to Celexa several years ago. I am totally convinced that if I had heeded my p-doc's advice to stay on the med, I might not be writing this post.
I wasn't sure what SLS was asking in his response to me. In reading your answer, I think I now understand (smile).
49er
Posted by 49er on July 20, 2008, at 15:26:44
In reply to Re: Want to stop meds ... should I? » linkadge, posted by gardenergirl on July 19, 2008, at 22:48:24
Hi GG,
> I was taking 600 mg. I lowered it to 450 mg by taking alternating between two 300 mg capsules and one capsule every other day to average 450 mg. I did this for about 2 weeks, then 300 mg for two weeks, then off. Perhaps that was too fast? Though if I had to come off it because I was pregnant, I'd have to do it even faster.
>
Hi GG,Not to hijack this thread or to sound critical but yeah, you definitely tapered too fast.
Also, alternating doses is one the worst things you can do as it puts your body into withdrawal.
Hopefully, you're not suffering too badly but many people would suffer greatly from this type of tapering.
Unfortunately, tapering slowly is easier said than done and I won't lie about that. But it is doable.
Sorry if it sounds like I am beating a dead horse. I am obviously very passionate about this issue.
49er
Posted by 49er on July 20, 2008, at 15:31:13
In reply to Re: Thank you, everyone » SLS, posted by linkadge on July 20, 2008, at 11:40:58
> I should rephrase. From what I have observed on this board, it seems that you are very much a proponent of the notion that the only way to treat "true" mental illness is with medications and that people are somehow destined to a particular course of illness as outlined by their psychiatrist.
>
> If I am wrong about these observations, then I appoligise.
>
> LinkadgeSLS,
I wanted to echo what Linkadge said. I sensed in your response to me which it took me awhile to get (due to my brain being slow today) that you feel that meds are the only treatment for depression which I obviously disagree with.
I have no clue as to how many people can be successful without meds but I think it is safe to say that it is alot more than what you think it is.
My apologies for any misstatements.
49er.
Posted by Deputy Racer on July 20, 2008, at 15:46:54
In reply to Re: Thank you, everyone » linkadge, posted by SLS on July 19, 2008, at 18:55:27
> please don't post to me or anyone else about me.
>I'm sorry, Scott, but I'm going to have to ask you to follow site guidelines regarding requests to others not to post to you. Since you received a PBC less than a week ago, I'm also going to have to block you from posting for 1 week. This certainly isn't personal, since you are someone I like and respect a great deal.
If you have any questions regarding the posting policies on this site, please read the FAQ, located at http://www.dr-bob.org/babble/faq.html#civil Follow ups to this action should be directed to the Administration board and should themselves be civil.
Dr Bob has ultimate authority over all administrative issues on this site, and may choose at any time to revise or reverse any action taken by a deputy.
Deputy Racer
Posted by gardenergirl on July 20, 2008, at 17:59:09
In reply to Re: Want to stop meds ... should I? » gardenergirl, posted by 49er on July 20, 2008, at 15:26:44
The thing is, I'm not suffering at all. I feel good. Almost too good, which is why I'm left wondering about it.
gg
Posted by linkadge on July 20, 2008, at 20:09:45
In reply to Re: Want to stop meds ... should I? » 49er, posted by gardenergirl on July 20, 2008, at 17:59:09
Thats the thing, somtimes meds work well initially, but then either stop working or somehow work to cause more imballance.
The acute effects of the drug can be very different from the chronic effects of the drug.
Sometimes coming off a drug can actually result in clinical improvement.
Linkadge
Posted by Deputy 10derHeart on July 21, 2008, at 22:43:31
In reply to , posted by on December 31, 1969, at 18:00:00
I've moved the Admin related posts in this thread to Psycho-Babble Administration. Here's a link:
http://www.dr-bob.org/babble/admin/20080719/msgs/841346.html
-- 10derHeart, acting as deputy for Dr. Bob
This is the end of the thread.
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