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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 7 to 31 of 31. Go back in thread:
Posted by SLS on January 28, 2011, at 7:06:28
In reply to Re: I think im stopping my meds, posted by Christ_empowered on January 27, 2011, at 23:53:35
> hey. Thanks for your response. I could try switching, I suppose, but it kind of seems like so many of the meds pretty much the same thing. Neuroleptics induce varying degrees of Parkinson's, making the patient more docile and "tranquil". The antidepressant (at least from my experience with the SRI drugs) reduce anxiety and tension, but again--treatment results in a degree of emotional detachment and apathy.
>
> I'm wondering if I can do PRN antipsychotics. What do you think?Make a list of the drugs that were helpful. Let's see where we can go from there.
- Scott
Posted by Christ_empowered on January 28, 2011, at 7:10:54
In reply to Re: I think im stopping my meds, posted by linkadge on January 28, 2011, at 6:39:04
I looked up the half-life of abilify and celexa. Both are fairly long; it almost seems as if they self-taper when you discontinue them.
I'm still torn, though. I don't want to be tranquilized into docility, but I don't want to end up in a mental institution, either. What's creepy is that I've got the DSM burned into my mind; I do little self-checks to see if I'm: psychotic, (hypo)manic, anxious, depressed, etc. I kind of feel as if I *need* to go off meds so I can reclaim my emotions. Even if I fail--and by fail, I mean go psychotic and have to go back on medication, at least the Abilify--I kind of feel like I might get a bit of my humanity back.
This is so frustrating. I don't want to hog the board, but I would like some tips on how I should handle this.
Posted by Christ_empowered on January 28, 2011, at 7:23:30
In reply to Re: I think im stopping my meds » Christ_empowered, posted by SLS on January 28, 2011, at 7:06:28
Thanks for the suggestion, SLS. Here's my list of helpful meds.
Good--Abilify (particularly lower doses); Zyprexa (until it caused akathisia...); Risperdal was OK, after a few days I found it too dulling.
Bad--most antidepressants. Tofranil-PM+Adderall was helpful, but flattened my emotions and made me irritable. Most SSRIs didn't help much. Celexa has helped, but I feel docile.
Also bad--Depakote. Trileptal. Haldol.
Good, but can't take--controlled substances. I go to a very conservative public health doctor, so I'm not going to be getting any Klonopin or stimulant prescriptions.
Pointless- BuSpar. hydroxyzine. Propranolol. Neurontin.
Posted by linkadge on January 28, 2011, at 7:24:56
In reply to drop the pills, or stick with 'em?, posted by Christ_empowered on January 28, 2011, at 7:10:54
I have had some pretty bad bouts with various issues over the years - depression, some hypomania (I suppose), some bouts of psychosis (mainly manifestations of lack of quality sleep).
I've been on the gammot of meds - most meds from every class of antipsychotics, antidepressants, anticonvulsants, stimulants, benzos, z-drugs, you name it.
Mind you, I've never actually *heard* voices (as you said you have). Sometimes my thoughts become very loud and "external" - as if they are attacking me and are not "exactly my own" - but I've never had an auditory hallucination (i.e. actually "hearing" something that wasn't there).
Sometimes antidepressants help, sometimes some lithium or a tranquilizer, but most of the time I am off meds. I did try to take escitalopram last summer, but I felt that I could replicate 75% of the effect with some ginger root, omega-3, green tea, SJW....with fewer side effects.
I've started to hate the SSRI feeling. Theres no depth to thought or emotion on the drugs. All I want to do is sit around and watch the Golden Girls.
Nevertheless, whatever changes you make, make them slowly. How much citalopram are you actually taking on a daily basis?
Linkadge
Posted by Christ_empowered on January 28, 2011, at 7:30:08
In reply to Re: drop the pills, or stick with 'em?, posted by linkadge on January 28, 2011, at 7:24:56
I take 20mgs/day citalopram.
Posted by SLS on January 28, 2011, at 9:47:58
In reply to drop the pills, or stick with 'em?, posted by Christ_empowered on January 28, 2011, at 7:10:54
Haven't you tried this drug-free thing before?
Remember Einstein.
- Scott
Posted by SLS on January 28, 2011, at 10:00:29
In reply to Good pills, bad pills, posted by Christ_empowered on January 28, 2011, at 7:23:30
> Thanks for the suggestion, SLS. Here's my list of helpful meds...
Lurazidone (Lutada) should reach store shelves very soon. The drug was developed as an antipsychotic, but has shown activity as an antidepressant as well. I will most likely try this drug next. It is a potent antagonist of 5-HT7 receptors along with being a partial agonist of 5-HT1a receptors. Lurasidone is also an antagonist at D2 and 5-HT2a receptors similar to the other atypical antipsychotics.
Linkadge will most likely be able to characterize the 5-HT7 receptor and its functions. It might be a good time for us to explore the 5-HT7 receptor.
- Scott
Posted by phillipa on January 28, 2011, at 11:19:24
In reply to Re: drop the pills, or stick with 'em?, posted by Christ_empowered on January 28, 2011, at 7:30:08
Please don't go off your meds. Don't you have some plans for the future you spoke of on here and how much better you felt when you visited home over Christmas? Phillipa
Posted by Christ_empowered on January 28, 2011, at 14:34:14
In reply to Re: drop the pills, or stick with 'em? » Christ_empowered, posted by phillipa on January 28, 2011, at 11:19:24
I thought about it, and I should probably keep myself medicated for a while. I have the potential to actually DO things--go back to school, get a job, build a life--and I don't think untreated mental illness (especially mental illness that involves hallucinations and paranoia) is conducive to a productive life.
So, here's what I'm doing: I'm not going to take Abilify for 3 days...today is day #2. This should reduce my blood levels considerably. Then, I'm going to start taking 1/2 of my 30mgs tablets (15mgs/day) as my new dose. I'm also going to drop the Celexa; it was helpful, but I'm not pleased with my drug-induced apathy and docility.
15mgs used to be the recommended starting and maintenance dose for Abilify; part of my problem, I think, is that I'm taking a full 30mgs, which would be appropriate if I had just had severe mania or something, but is overkill for maintenance. Abilify seems to work fairly quickly, so I figure that if I have breakthrough problems, like paranoia or agitation, I can always go right back up to 30mgs.
Sound good? Thanks for all the posts,everyone.
Posted by mrtook on January 28, 2011, at 14:42:34
In reply to I think im stopping my meds, posted by Christ_empowered on January 27, 2011, at 22:02:00
but wasn't it just a month ago that you were having problems and added the celexa?
I really wish you would give it another month or so.
Posted by linkadge on January 28, 2011, at 16:40:13
In reply to Re: drop the pills, or stick with 'em? » Christ_empowered, posted by SLS on January 28, 2011, at 9:47:58
With many medications you're damned if you do and damned if you don't. I wouldn't blame anybody for wanted to get off a psychiatric medication.
One thing I would say though is that, if you're taking 20mg of citalopram consistently, I would *not* go off cold turkey. Reduce it to 10mg then maybe 5. I have had some bad psychotic breaks from abrupt SSRI discontinuation. You may find 10mg is more tollerable too.
Linkadge
Posted by morgan miller on January 28, 2011, at 21:47:29
In reply to Re: I think im stopping my meds, posted by linkadge on January 28, 2011, at 6:39:04
> I could have told you 2 months ago when you started the celexa, that you'd probably be interested in stopping your meds.
>
> The SSRIs seem great at first, then you just turn into a zombie.
>
> LinkadgeI believe that to be a blanket statement that simply is not true. Sure this happens to people on SSRIs, but there are tons of people doing just fine and feeling very much alive on them. You're obviously a very bright person, I'm not sure why you continue to apply what you and other people experience to everyone. It just does not make any sense at all.
Posted by morgan miller on January 28, 2011, at 22:04:56
In reply to Do what you think is right..., posted by mrtook on January 28, 2011, at 14:42:34
CE, how long have you been on Celexa?
Weening off Celexa is probably a good idea if you've been on it for a few months and simply feel too numb and unmotivated. I understand Mrtook's take sentiments though. If you have only been on an SSRI for a month or two, it is possible that given some time and dosage tweaking, the apathetic/unmotivated feeling may begin to lift.
As I mentioned before, I believe Zoloft to be a more stimulating and emoting SSRI for many people. It's always there if you feel you need some extra anxiety and depression relief. Beware though that responses to Zoloft can be highly dose dependent. 50 mg for some may come with certain of side effects and lack of efficacy, while 100 mg ends up being the sweet spot for many where side effects seem to disappear, stability comes, and depression/anxiety are greatly alleviated.
Posted by phillipa on January 28, 2011, at 22:10:31
In reply to I think I found a solution, posted by Christ_empowered on January 28, 2011, at 14:34:14
Yes you have great plans and the opportunity just give it a bit more time of being stable okay:) Phillipa
Posted by morgan miller on January 28, 2011, at 23:08:11
In reply to Re: I think im stopping my meds, posted by linkadge on January 28, 2011, at 6:39:04
Sorry if that sounded like a criticism of you Linkage, and I'm not just saying this out of fear of a warning or blockage. I actually know exactly what you mean. I have experienced some apathy and lack of motivation on SSRIs. I have though experienced plenty of energy and motivation to do the things I enjoyed in life. I may have lacked some depth of thought in the beginning, but this wore off after 2 or 3 months and I was back to my old sensitive, analytical, deep thinking, and empathetic self. Did I at times feel a bit too numb to the world and a little too stimulated in an artificial way? Yep, sure did. But it beat the hell out of the way I felt without my SSRI, which was much much worse. In the end, for me, and a lot of other people out there, the positives of being on SSRIs way out weigh the negatives.
I have to admit I'm feeling pretty numb and apathetic on Lexapro after 3 weeks. But, I have worked out 5 times in the last week and I have much less anxiety. I see progress taking place and I only hope that with time, dosage tweaking, pleasurable social interaction and working out again I will be close to feeling more like my old self again.
Morgan
Posted by morgan miller on January 29, 2011, at 0:53:34
In reply to Re: I think im stopping my meds » linkadge, posted by morgan miller on January 28, 2011, at 23:08:11
Forgot to mention I am on 1000 mg of Depoakote, this may be a factor in my feeling even more numb than I normally would on Lexapro.
Posted by linkadge on January 29, 2011, at 8:07:05
In reply to Re: I think im stopping my meds, posted by morgan miller on January 28, 2011, at 21:47:29
> The SSRIs seem great at first, then you just turn into a zombie.
>
> Linkadge>I believe that to be a blanket statement that >simply is not true. Sure this happens to people >on SSRIs, but there are tons of people doing >just fine and feeling very much alive on them.
Well, its all relative. Coming out of a deep depression some people might not notice the ways in which their medication might be restricting their emotional function. Its the same with sexual dysfunction. Sure, there are some people that can take 60mg of paxil and still have decent sexual function, but they are few and far between IMHO. Of course I am speaking in conjecture, but I do believe that a very high percentage of people taking full dose SSRI monotherapy will eventually experience emotional numbing, in some way shape or form.
Of course, without a large scale study, nobody will know for sure, what percentage exactly.
Linkadge
Posted by 49er on January 29, 2011, at 9:38:25
In reply to I think im stopping my meds, posted by Christ_empowered on January 27, 2011, at 22:02:00
Hi,
I am not sure what you have decided to do since I didn't read the whole thread.
But if you do decide to go off of any med, do not cold turkey it. Most people have the best success tapering very slowly at 10% of current dose every 4 to 6 weeks. Antipsychotics might have to be tapered more slowly.
I know I sound like a broken record but I will keep preaching this method:)
49er
Posted by morgan miller on January 29, 2011, at 11:31:31
In reply to Re: I think im stopping my meds, posted by linkadge on January 29, 2011, at 8:07:05
>Of course I am speaking in conjecture, but I do believe that a very high percentage of people taking full dose SSRI monotherapy will eventually experience emotional numbing, in some way shape or form.
I agree. I do think the emotional numbing can be minimal enough to make SSRIs a pleasurable enough experience for many people to want to stay on them. I also think the emotional numbing can come and go so that it is not there all the time. And, with some extra efforts to do improve well being on the part of the patient, the emotional numbing may be able to be reduced some. Some emotional numbing might be necessary anyway in therapy as emotional instability was a symptom that was problematic to begin with. Enough of my little SSRI advocate rant.
Posted by SLS on January 29, 2011, at 12:16:00
In reply to Re: I think im stopping my meds » Christ_empowered, posted by 49er on January 29, 2011, at 9:38:25
> I know I sound like a broken record but I will keep preaching this method:)
Actually, you sound like a fixed record. You are very helpful.
If you need something to do because of boredom, perhaps you can add to your personal knowledge base by investigating other opinions regarding alternative methods of discontinuing drugs. You could be our first "expert" in drug discontinuation protocols and withdrawal syndromes. If after your investigations you decide that your current recommendations are best, you could speak to the weaknesses of other methods.
If you already do this, then never mind. :-)
- Scott
Posted by floatingbridge on January 30, 2011, at 5:24:10
In reply to Re: I think im stopping my meds, posted by morgan miller on January 29, 2011, at 11:31:31
C_E,
Was lithium on your list? Lower dose, maybe?
Abilify at 30 might be causing numbing. I felt that at lower doses. Sometimes with Abilify, less is more or radically differently affecting.
And see if zoloft is as bad as celexa.
Please reduce a little, only a little, and see how you feel.
Mad in America is stirring reading. It has it's critics, too, and not all were big pharmacy, only please don't ask me who--I can't remember :)
We all (I think, as human beings) want to live this life fully, each in our own unique way. All of us suffer limitations and roadblocks. I'd dislike very much if you had to start from scratch again. Give yourself some time. You got some good advice on this thread; there's alot of folks
pulling for you.Peace,
fb, who tonight will dream of a med free and happy Babble.
Oh, and silly! How can you hog the board C_E?
Posted by 49er on January 30, 2011, at 5:50:25
In reply to Re: I think im stopping my meds » 49er, posted by SLS on January 29, 2011, at 12:16:00
> > I know I sound like a broken record but I will keep preaching this method:)
>
> Actually, you sound like a fixed record. You are very helpful.
>
> If you need something to do because of boredom, perhaps you can add to your personal knowledge base by investigating other opinions regarding alternative methods of discontinuing drugs. You could be our first "expert" in drug discontinuation protocols and withdrawal syndromes. If after your investigations you decide that your current recommendations are best, you could speak to the weaknesses of other methods.
>
> If you already do this, then never mind. :-)
>
>
> - ScottThanks Scott, you're very kind.
Regarding drug discontinuation protocols, there really is little research. Even the folks like Peter Breggin, who are strident about their anti meds views, really don't have good advice about this.
Regarding discontinuing antidepressants, there is some thought that transitioning to Prozac can be helpful. David Healey, who has spoken about against ADS but who interestingly is a big fan of ECT, advocates this.
On a similar note, the benzo boards are big advocates of everyone transitioning to valium because the theory is as with Prozac, that the longer half life would make it easier to get off the med.
I obviously don't have an evidence to back up what I say but in reality, this doesn't seem to work so well. It seems to me that you're better off sticking with the drug you are on to withdraw from. The side effects of withdrawal and transitioning to another drugs can be quite negative. Of course, as I say, there are no absolutes.
As far as tapering faster, that might work for some people. But the problem is that many times, a person will experience delayed withdrawal symptoms. You may think everything is fine and then 3 months later, you get hit big time with mysterious symptoms.
That is why I feel to be on the safe side, you should taper slowly. While I am not completely recovered from tapering off of psych meds (I still have weird sleep issues), I am convinced if I had tapered too quickly, I would be alot worse. And I am definitely not depressed except for the usual unemployment issues that anyone would be concerned about.
Again, I am making these claims on anecdotal experience and nothing more.
I am not sure I really addressed the issues you raised:) I think doing the type of research you suggest is just not possible since little is out there for various reasons which are too long to get into and would get me extremely sidetracked.
49er
Posted by floatingbridge on January 30, 2011, at 9:39:10
In reply to Re: I think im stopping my meds, posted by morgan miller on January 29, 2011, at 11:31:31
C_E,
Was lithium on your list? Lower dose, maybe?
Abilify at 30 might be causing numbing. I felt that at lower doses. Sometimes with Abilify, less is more or radically differently affecting.
And see if zoloft is as bad as celexa.
Please reduce a little, only a little, and see how you feel.
Mad in America is stirring reading. It has it's critics, too, and not all were big pharmacy, only please don't ask me who--I can't remember :)
We all (I think, as human beings) want to live this life fully, each in our own unique way. All of us suffer limitations and roadblocks. I'd dislike very much if you had to start from scratch again. Give yourself some time. You got some good advice on this thread; there's alot of folks
pulling for you.Peace,
fb, who tonight will dream of a med free and happy Babble.
Oh, and silly! How can you hog the board C_E?
Posted by floatingbridge on January 30, 2011, at 10:27:15
In reply to Re: I think im stopping my meds, posted by floatingbridge on January 30, 2011, at 5:24:10
Posted by ed_uk2010 on January 30, 2011, at 13:35:08
In reply to I think im stopping my meds, posted by Christ_empowered on January 27, 2011, at 22:02:00
In my opinion, it's too early to be thinking about coming off Abilify. It's only recently that you were experiencing 'break through' symptoms and had an increase in your medication.
It's clear that you are not too happy with being on a high dose of Abilify. The effective maintenance dose for schizophrenia appears to be 10-15mg per day. It is not clear whether higher doses offer any advantages, but they may do for some patients.
I appreciate that you are not diagnosed with schizophrenia, but I would consider aiming for 10mg or 15mg as a maintenance dose, increasing temporarily to 30mg if needed.
I think you could gradually reduce to 20mg, then 15mg, then (if appropriate) 10mg over a period of a few months. I don't see any advantage in making abrupt reductions, the most likely outcome of which is making you ill.
This is the end of the thread.
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