thisismylife
Greenlighter
- Joined
- Jul 18, 2018
- Messages
- 29
Had a nine-night stay in the hospital earlier this month after developing suicidal ideation 4-5 days after starting Effexor. I was also on 50mg. of Pamelor and 30 mg. of Remeron. I think the plan with my outpatient psychiatrist was to eventually eliminate the Pamelor, increase the Remeron, and go up on the Effexor. When I ended up in the hospital, I was pretty set on having ECT; I had it before 5 1/2 years ago, and it was a true miracle. But we live in another state now, 2000 miles away from our previous home, and this was a new hospital for me. It is a large teaching facility and their psych ward is considered one of the best in the country. I was only there nine nights because our insurance would not authorize any more time there, despite appeals by the psychiatrist on my end (they would not authorize inpatient ECT, either). Then I got a rude awakening when I found out this facility would not offer ECT if you are taking any anti-seizure medication. As long as I was on Xanax (I was taking regularly scheduled .5mg. ER Xanax in the AM and PM, with .25mg PRN; some days I just took the scheduled, and some days I had to take an additional .25mg-.75mg.), and Pamelor, they could not do ECT. I wasn't willing at this time to go off Xanax (we are in the middle of a major relocation and I'm also experiencing PTSD from other events over the last 18 months), so they recommended I give gabapentin a try to use instead of Xanax. In the hospital they switched me from Xanax to gabapentin in one day. I had a rough first week, but they also added 2.5mg Zyprexa (with plans to increase it to 5mg, which we eventually did) and 25mg.Trazadone at night to sleep (one time I took another 25mg. three hours later and my BP dropped to 83/52, so no more 50mg of Trazadone for me). We started the gabapentin at 200mg. three times a day, and I worked up to 300mg. four times a day. They also upped my Remeron to 45mg. In the hospital I was allowed .25mg. Xanax PRN, but only after I'd take a gabapentin as the first line, so the .25mg. was maybe once every day or two. I think they felt if I wasn't going to do ECT immediately, it was OK to take a.25 mg. of Xanax a day if I needed it.
It wasn't a fun time - my anxiety was still relatively high, and I probably won't know what caused the new physical anxiety (shaking, cognitive dysfunction - slurred some of my words, repeated words twice, fogginess, slow cognition... couldn't get some words from my brain to my mouth), but the suicidal ideation did slightly improve. Now I am under the care of my new psychiatrist (that I like a lot), and he and my therapist believe it's best if I sort of continue what I'm doing because I have so many things coming up in the next month - we have to go back to our home in our previous location, meet the movers, and have all of our stuff moved to where we are, as we will be closing on a new house this Tuesday. There's some cosmetic work we want to have done, which is stressful, and then there's the holidays (which will be minimal for us this year).
Since getting home, I have three times gone 48 hours without any Xanax. But when I hit that 48 hour mark (as I did this morning), the shaking starts again (for instance, typing on the laptop is sort of challenging due to my hands shaking), the anxiety really ramps up, despite taking my 300mg. gapapentin this morning. I'm pretty sure if I took .25mg. of Xanax at this point, the shaking and anxiety would go away, and it would keep me mostly anxiety-free the rest of the day and evening. I wouldn't feel a need for it, for another 48 hours. From my understanding, Xanax is a short-acting drug, so I guess my question is, why is it taking 48 hours for me to feel effects of not having any? The doctor told me I would have to go at least 72 hours without it, before the acute side effects would start to abate. So really, if I can go 48 hours, I'd really only have a bad 24 hours of feeling like this before it would peak, if I'm understanding it right. I guess the experiment I'm trying is, what is it going to be like to get off this so ECT can become an option if other medications don't work for anxiety and depression (ECT also did help with my anxiety, as well as depression). And yes, I'd have to get off the gabapentin, too, to do ECT. The p-doc at the hospital said to prepare people for ECT, they will often use Zyprexa and Trazadone (low dose during the day) to help with the anxiety while people are doing ECT and can't take any anti-seizure medication. So basically I would walk around like a zombie, knocked out on those meds to get me through the ECT. Now, she said you have to not have taken any Xanax for 24 hours prior to an ECT treatment. Since they do them, pretty much M, W, Fri., I could take one the afternoon after ECT, and be OK until the next treatment, if I'm taking one now about every 48 hours. The other option is, there are probably ECT centers in our large metropolitan area that will do ECT while you're on Xanax. How it was explained to me was, if you're on any anti-seizure medications, they will have to use a higher voltage to induce the seizure. And when you use higher voltages, you increase side effects. When I did ECT 5 1/2 years ago, they did allow me to be on Xanax, but I did have some short-term memory loss (most of it came back in the months following treatment), cognitive slowing, and am wondering if I did ECT without being on Xanax, would my memory loss and slow cognition be less. So that's why I'm really hoping to eliminate the Xanax eventually.
Any thoughts on my plan here?
It wasn't a fun time - my anxiety was still relatively high, and I probably won't know what caused the new physical anxiety (shaking, cognitive dysfunction - slurred some of my words, repeated words twice, fogginess, slow cognition... couldn't get some words from my brain to my mouth), but the suicidal ideation did slightly improve. Now I am under the care of my new psychiatrist (that I like a lot), and he and my therapist believe it's best if I sort of continue what I'm doing because I have so many things coming up in the next month - we have to go back to our home in our previous location, meet the movers, and have all of our stuff moved to where we are, as we will be closing on a new house this Tuesday. There's some cosmetic work we want to have done, which is stressful, and then there's the holidays (which will be minimal for us this year).
Since getting home, I have three times gone 48 hours without any Xanax. But when I hit that 48 hour mark (as I did this morning), the shaking starts again (for instance, typing on the laptop is sort of challenging due to my hands shaking), the anxiety really ramps up, despite taking my 300mg. gapapentin this morning. I'm pretty sure if I took .25mg. of Xanax at this point, the shaking and anxiety would go away, and it would keep me mostly anxiety-free the rest of the day and evening. I wouldn't feel a need for it, for another 48 hours. From my understanding, Xanax is a short-acting drug, so I guess my question is, why is it taking 48 hours for me to feel effects of not having any? The doctor told me I would have to go at least 72 hours without it, before the acute side effects would start to abate. So really, if I can go 48 hours, I'd really only have a bad 24 hours of feeling like this before it would peak, if I'm understanding it right. I guess the experiment I'm trying is, what is it going to be like to get off this so ECT can become an option if other medications don't work for anxiety and depression (ECT also did help with my anxiety, as well as depression). And yes, I'd have to get off the gabapentin, too, to do ECT. The p-doc at the hospital said to prepare people for ECT, they will often use Zyprexa and Trazadone (low dose during the day) to help with the anxiety while people are doing ECT and can't take any anti-seizure medication. So basically I would walk around like a zombie, knocked out on those meds to get me through the ECT. Now, she said you have to not have taken any Xanax for 24 hours prior to an ECT treatment. Since they do them, pretty much M, W, Fri., I could take one the afternoon after ECT, and be OK until the next treatment, if I'm taking one now about every 48 hours. The other option is, there are probably ECT centers in our large metropolitan area that will do ECT while you're on Xanax. How it was explained to me was, if you're on any anti-seizure medications, they will have to use a higher voltage to induce the seizure. And when you use higher voltages, you increase side effects. When I did ECT 5 1/2 years ago, they did allow me to be on Xanax, but I did have some short-term memory loss (most of it came back in the months following treatment), cognitive slowing, and am wondering if I did ECT without being on Xanax, would my memory loss and slow cognition be less. So that's why I'm really hoping to eliminate the Xanax eventually.
Any thoughts on my plan here?
