Psycho-Babble Medication Thread 930924

Shown: posts 1 to 13 of 13. This is the beginning of the thread.

 

too scared to drop meds-- what would you change?

Posted by inanimate peanut on December 26, 2009, at 0:53:27

OK, so it has been suggested that I'm on too many meds for too many bad reasons. This is probably right. But, I'm scared to death to drop any of them. This has bitten me in the *ss twice. Flashback to a happy me 1.5 years ago (good job, good relationship, enjoys exercise, and smiles enough to be annoying) who decided that Lithium wasn't actually the drug that was working but was making her sick- I went off it and destabilized and am now in the pursuant hell 1.5 years later(job by a hair,, single and lonely, has forgotten how to smile). I tried to go back on it several months later to no avail. If I could change any decision in my life, that would be it. Literally, any decision in my entire life.

1 year ago- we thought I was on too many meds so we took me off several in progression. It turns out the Lexapro and Lamictal were working so we put me back on them almost immediately (within 1 month). They never had the same effect.

I am scared to death to do this again. What med do I go off of and screw up a perfectly good med working this time? Even if something is only helping marginally, it is still helping some. Even though I don't think the Lamictal is helping like it used to, what if I go off it and it turns out it was helping but then I try to go back on it and it won't help any more?

I really only have 3 meds that actually are for mood effects-- Lamictal, Geodon, and Parnate. The rest may be branded psych meds but used for other reasons. I can try going off the propranolol, I'm not worried about that. I can do that starting tomorrow. It will probably just help resolve the hypotension from the Parnate anyway. I won't go off the Topamax because it's the only thing stopping me from being obese with now, and I'll especially need it if I'm going on the Remeron. I'm scared to go off the Lamictal again and ruin any residual usefulness that it may be having. The Geodon controls the mixed states and may help some with the depression. Seroquel and Ambien for sleep. I still worry about taking something as strong as Seroquel just for sleep. Don't both Remeron and Nortriptyline put you to sleep? Maybe I wouldn't need the Seroquel then? I just don't know what to change other than trying to drop the propranolol. I'm open to suggestions but I'm just so deathly afraid of getting rid of something that I think isn't working only to find out that it's doing something useful that won't start again after I stop it. I've never regretted keeping a med-- stopping them have been the biggest regrets of my life.

Geodon-- controls mixed states (and some anti-dep?)
Parnate- anti-dep
Lamictal- not sure- used to be anti-dep effect
Seroquel- sleep- no mood effect
Ambien- sleep
Topamax- appetite control- no mood effects
Propranolol- stopping tonight
D3
Fish Oil

 

Re: too scared to drop meds-- what would you chang inanimate peanut

Posted by floatingbridge on December 26, 2009, at 3:22:01

In reply to too scared to drop meds-- what would you change?, posted by inanimate peanut on December 26, 2009, at 0:53:27

Peanut,

Yes, med changes can truly induce fear--I'm so sorry. I'm saddened to hear your regrets, too, and I appreciate you sharing some of your story here. What are your reasons for eliminating some? I know some docs stack meds, but what is your doc's take? Do you need both meds to sleep because of parmate insomnia? How is your anxiety level?

My first thought is that maybe the seroquel might go--but I take your concerns about destabilization seriuosly. Get lots of input. What are you wanting by making a change?

hang in there!
fb


 

Re: too scared to drop meds-- what would you change?

Posted by linkadge on December 26, 2009, at 7:43:43

In reply to too scared to drop meds-- what would you change?, posted by inanimate peanut on December 26, 2009, at 0:53:27

Any medication you stop will give you a rebound effect. For instance, stopping lithium often gives people exaggerated mood swings. I had rebound psychosis from stopping an AP too qucik - the funny part is that I never had psychosis to begin with.

You are on too many meds, but you need to determine which meds are not helping much and then stop them *slowly*. I don't mean cut in half for a week then stop. I mean stop over the course of 3 months, 6 months perhaps.

Linkadge

 

Re: too scared to drop meds-- what would you change?

Posted by Phillipa on December 26, 2009, at 9:58:41

In reply to Re: too scared to drop meds-- what would you change?, posted by linkadge on December 26, 2009, at 7:43:43

Peanut if your're not afraid to stop the propanolol just stop that and wait. Funny as my fear is of taking meds maybe cause never except one time did they work. So I stick to low dose benzos and low dose luvox as terrified to go them. And do they help I don't know. So I truly feel your dilemma. I offer support. Phillipa

 

Re: too scared to drop meds-- what would you chang floatingbridge

Posted by inanimate peanut on December 26, 2009, at 14:54:45

In reply to Re: too scared to drop meds-- what would you chang inanimate peanut, posted by floatingbridge on December 26, 2009, at 3:22:01

Sorry, this started off from my Remeron thread where ace and bleauberry were suggesting that I go off a med before I take on Remeron or another one. I agree that I'm on a ton of meds, but it's stange that only 3 of them are actually for mood control (and I'm not sure how much the Lamictal is doing anymore, so I may really only be being helped by the Parnate and Geodon). I haven't talked with my doc about eliminating any of them. I do need both ambien and Seroquel to sleep with Parnate-- I was just on Ambien and wasn't able to sleep with just it. I think my anxiety level is ok when I'm not letting myself obsess about this whole meds thing. I'm wanting to add some meds to get out of this depression, but, as I said, I think ace and bleauberry have a point when they say don't add anything without eliminating something else. I'm just kind of at a loss for what to do.

 

Re: too scared to drop meds-- what would you change?

Posted by bleauberry on December 26, 2009, at 17:44:05

In reply to too scared to drop meds-- what would you change?, posted by inanimate peanut on December 26, 2009, at 0:53:27

I agree with Linkadge. You have to wean down over a long period of time in very tiny steps. Get good at slicing pieces off pills, crushing pills into powder to make your own capsules, dividing powder in capsules to make your own new capsules, and such.

For example, I weaned off Zyprexa after 8 years by dropping the dose from 5mg at about .2mg at a time, sometimes going back up to a previous dose if it felt like I went too far too fast.

I couldn't possibly suggest which meds to stop. I'm not even sure you should. I just cannot agree with taking so many meds and not being real close to remission. Makes no sense.

I understand the previous med stoppages went bad. The weaning process probably went too fast and the steps down in dosage were probably too large. Some people, ya know, can handle that. Some can't. We have to find our own comfortable pace and go with it.

Ultimately you have to do what you and your doctor think is best. Sometimes your gut instinct is your best guide. Try not to let fear cloud judgement one way or the other.

 

Re: too scared to drop meds-- what would you change? inanimate peanut

Posted by Maxime on December 26, 2009, at 17:55:50

In reply to too scared to drop meds-- what would you change?, posted by inanimate peanut on December 26, 2009, at 0:53:27

I think that you should talk to your doctor about it. Maybe drop the propanol and see what happens. But for the rest I wouldn't change anything. You are on a lot of meds, but maybe that's the cocktail you need. It's very easy for outsiders to say "oh, you are taking too much" but only you know your body.

Take care.

 

Re: too scared to drop meds-- what would you change? inanimate peanut

Posted by SLS on December 26, 2009, at 18:13:08

In reply to too scared to drop meds-- what would you change?, posted by inanimate peanut on December 26, 2009, at 0:53:27

> I think that you should talk to your doctor about it. Maybe drop the propanol and see what happens.

Be sure to taper the propranolol as per your doctor's suggestions. You don't want to trigger a rebound hypertensive reaction or tachycardia.

> It's very easy for outsiders to say "oh, you are taking too much" but only you know your body.

I agree with this sentiment. There is no arbitrary upper limit to the number of drugs that one may need to take.

Have you established that you definitely need both the Ambien and Seroquel for sleep?

What dosage of Lamictal are you taking?

I think Topamax is a good choice for mixed states, but I don't know if I would use it primarily for weight control. It is done all the time, I know. Just make sure you drink plenty of liquids to avoid developing kidney stones.

What do you need from treatment that you are not currently getting?


- Scott

 

Re: too scared to drop meds-- what would you change?

Posted by bleauberry on December 26, 2009, at 20:04:15

In reply to Re: too scared to drop meds-- what would you change? inanimate peanut, posted by SLS on December 26, 2009, at 18:13:08

> > It's very easy for outsiders to say "oh, you are taking too much" but only you know your body.
>
> I agree with this sentiment. There is no arbitrary upper limit to the number of drugs that one may need to take.
>
>

If 5 psychiatric meds have a patient close to remission, then 5 is not too much.

If 5 psych meds have the patient closer to "quite ill", then 5 is too much.

Well, actually not so much that they are too many, but that they are not the right ones to be many, if that makes any sense.

If you're gonna have a lot of meds, they better be performing. That's all.

With systematic strategies, such as employed by STAR*D or by SLS, underperformers are traded for newcomers, rather than adding more and more and more with no end in sight.

I think the reason some posters thought there were too many meds is based on the predicament that the patient is not doing well on them. It would be a totally different story if the patient was doing very well and merely seeking to do some fine-tuning.

 

Re: too scared to drop meds-- what would you chang

Posted by floatingbridge on December 27, 2009, at 1:00:12

In reply to Re: too scared to drop meds-- what would you chang inanimate peanut, posted by floatingbridge on December 26, 2009, at 3:22:01

Sometime after I posted, I came across your earlier thread--I'm sorry to have you repeat yourself.

So you want more complete remission from depression, and your sense is to increase parmate--if I'm recalling correctly from another thread.

Is there a way to test your hunch under another doc's guidance. (Personally I have not
done well by self-medicating,
hence my
caution.)

Where would you rate your
current level of response? At about 35% like Scott?

What are your thoughts on getting another consult--maybe
'shopping' a bit by phone to find a more parnate-friendly
doc.

Please don't feel the need to answer all these questions--I
want you to know you have my support, even if I lack advice.

fb

 

Re: too scared to drop meds-- what would you chang

Posted by bleauberry on December 27, 2009, at 6:36:34

In reply to Re: too scared to drop meds-- what would you chang, posted by floatingbridge on December 27, 2009, at 1:00:12

floatingbridge has some heavy hitting simple logic here that I totally agree with. If the desire is more parnate, then that should be done. Makes a lot more sense than messing with the whole works. There is nothing wrong with having a second opinion or a second doctor. It is kind of scarey, sometimes successful and sometimes not, to order your own meds from overseas mailorder, but the option does exist. Finding a second doctor sounds like the wisest thing to do, though a mailorder supply would probably arrive sooner than that could be arranged.

Look, we need our doctors to work with us. I don't see what the concern is in increasing the dose, unless he is paranoid about insurance regulations you don't know about, potential law suits, or potential State Boards coming down on him.

You want a higher dose of Parnate, you should get it. Makes the most sense. And thankyou floatingbridge for that wisdom. I kick myself in the butt sometimes for not seeing the obvious. I'm glad someone else did. :-)


> So you want more complete remission from depression, and your sense is to increase parmate--if I'm recalling correctly from another thread.
>
> Is there a way to test your hunch under another doc's guidance. (Personally I have not
> done well by self-medicating,
> hence my
> caution.)
>
> Where would you rate your
> current level of response? At about 35% like Scott?
>
> What are your thoughts on getting another consult--maybe
> 'shopping' a bit by phone to find a more parnate-friendly
> doc.
>
> Please don't feel the need to answer all these questions--I
> want you to know you have my support, even if I lack advice.
>
> fb
>
>

 

Re: too scared to drop meds-- what would you chang

Posted by inanimate peanut on December 27, 2009, at 11:06:05

In reply to Re: too scared to drop meds-- what would you chang, posted by floatingbridge on December 27, 2009, at 1:00:12

My doc doesn't want me to increase my Parnate or add Nortriptyline. I'm really torn about whether to keep her posted on what I'm doing anyway or to keep her out of it. I would rather her be in the loop but I'm worried she might refuse to treat me if I'm self-medicating.

I'm probably at closer to 40-50%. 25% is hell on my scale. I'm probably functional at about 65-75%, which is my goal to get to right now so I can go back to work (although wouldn't all of us like to feel normal at 100% at the end of the day). It's hard to interpret those numbers, though, as everyone has a different scale for themselves.

I've thought of trying to find a new doc but this one is very good with me- returning calls within the same day, being very flexible with my treatment based on what I want, etc. She's just not being flexible on the Parnate issue. I know self-medication is not the ideal, but I know it's safe to increase the parnate-- I've read the articles where they've had it up to 170mg. I'm a little more nervous about adding the nortriptyline on my own, so we'll cross that bridge when the time comes.

Thanks for the support-- that's the most important thing.

 

Re: too scared to drop meds-- what would you chang

Posted by floatingbridge on December 27, 2009, at 13:00:47

In reply to Re: too scared to drop meds-- what would you chang, posted by inanimate peanut on December 27, 2009, at 11:06:05


>
> I've thought of trying to find a new doc but this one is very good with me- returning calls within the same day, being very flexible with my treatment based on what I want, etc. She's just not being flexible on the Parnate issue. I know self-medication is not the ideal, but I know it's safe to increase the
parnate-- I've read the articles where
they've had it up to 170mg. I'm a little more nervous about adding the nortriptyline on my own, so we'll cross
that bridge when the time comes.

Please keep us on the loop; I hope you make rapid progress toward your goal.

fb
>
> Thanks for the support-- that's the most important thing.


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