Mental Health Tapering off my meds

[beekr]

After experiencing some escalating bipolar and panic episodes all my life, including an unending stream of ER and doctor visits for psychosomatic illnesses, I finally went to a psychiatrist.

That was 14 years ago, and after some slight tweaking of the variety and dosages medications I have been taking these, unchanged for about 12 years:

* 10 mg Lexapro (in the evening)
* 200 mg Lamotrigine (twice a day)
* 200 mg Buproprion ER (in the morning)

The trouble is that after all this time... I'm still miserable. I still have crippling anxiety, I have no friends, any relationship I get into quickly implodes as I get anxious and needy and just a mess. It's exhausting. My career is in shambles and I haven't been able to hold a job longer than a few months. I experienced a bout of alcoholism a few years ago, been sober since, but it culminated in ulcers and delirium tremens. I've also abused the ambien the pysch gave me, used it for fun, has no effect on me anymore. No other drugs. Tried xanax and it didn't do anything for me.

So now I'm thinking it's time to stop the meds. Why continue them?

So my question is: what do you all recommend as a means of doing this, and what do you think will happen to me once I'm off? Will I see my libido & sexual function improve then at least?

Thank you.

 

[a dream]

It would be best to have a psychiatrist help you with this. If you don't have one who will endorse this, find another. If you have someone who suggests that lamotrigine or escitalopram can be stopped quickly, find another. It's not unheard of for doctors to deny that SSRI withdrawal symptoms are as bad as they are.

bupropion - Probably not causing decreased sexual function. doesn't have much withdrawal symptoms in my experience. Stopping 150 mg XL resulted in somewhat decreased energy and enjoyment for a few days to a week.

lamotrigine - Probably not causing decreased sexual function either. for me skipping a dose results in feeling weird less than 6 hours after the normal dose (once daily for me) and that feeling is enough for me to want to take it again ASAP. as it is an anticonvulsant, stopping abruptly is a bad idea and according to official literature has resulted in seizures in non-epileptic patients; even if that's not the case, side effects will occur. I believe the official literature recommends how to discontinue the drug and I think I've read about people stepping down slowly, lowering the dose in small increments every week or two. I've only gone from 100 mg to 0 and IIRC did it over the course of 3 weeks or so, and I don't think I noticed any adverse effects. Now I'm back up to 300 mg and haven't dropped from that dose at any point.

escitalopram - Likely cause of sexual dysfunction. May make you feel absolutely miserable if discontinued abruptly, although people's experiences vary. Tapering down is a good idea, staying on each lower dose for a week or two, although since I believe pills are available in 5 mg and 10 mg it's hard to go down as slowly as is possible with lamotrigine. Switching to fluoxetine with its longer half life for a while can avoid withdrawal symptoms.

As for sequence... stopping escitalopram before bupropion may help make withdrawal easier; I had less severe Zoloft withdrawal when taking Wellbutrin. Bupropion decreases the seizure threshold so it seems to make sense to stop that before stopping lamotrigine.

 

[neurotic]

have you tried cognitive behavioral therapy?

 

[beekr]

Thanks for the counsel about the meds, dream. I'm already tapering down from the escitalopram, don't feel any difference so far.

CBT? Yes I've read books by David Burns and even though I felt silly doing it I did try the exercises and all, just couldn't stick with it. I'm just programmed to feel worthless I guess. Deep inside I'm still that fragile little child that savagely had his innocence taken away. Therapists have never helped me at all. I guess I'll just ride it out and hope to do as little damage as I can the rest of the way. It'd be nice to be able to get ahold of something that could help me pass the time though, I just don't want to go to jail trying to get it.

 

[AlphaMethylPhenyl]

Sounds to me like you're under-medicated. I'd ask your doc about switching meds or upping doses. You're on a low dose of Wellbutrin considering your current state. I don't have much experience with the others. But it definitely doesn't appear (to me) that you should just stop your meds; I would only reserve that judgement for extreme cases of happiness and when the patient has demonstrated the use of a variety of coping mechanisms by which to pull themselves out of inevitable bad (at least) couple of weeks. I don't think I'd ever think someone should stop three meds at once.

If you don't min me asking could you elucidate more on what is bothering you? Is it more on the side of apathy/anhedonia for instance? Do you have crying spells? Any thing else you could include would be great. Most of us aren't doctors (including myself) and we don't offer medical advice but more information might be enable us to help you more. But please don't just go off your meds without first consulting your doctor.

 

[beekr]

Under-medicated, hrm. I'm thinking my problems are nurture not nature and really the drugs haven't helped so I'm just thinking it'd be best to just go back to my natal state of cleanliness. But I hear you and will talk to my psych about it. I see every three months to check in.

My current crisis is because of a girl. Ah same old story. Met her online, went on a few dates, totally smitten and crazy about her, but I got anxious and needy and scared her away. Happens every time when I like them.

It'll pass. Thanks for asking and for the counsel though.

 

[weekend addiction]

OP: I went off the following over the course of 4 days or so.

900 mg LIthium
600mg Seroquel
1800mg Neurontin
15mg Remeron

I felt fine until I had an episode about two weeks later. It was short-lived but a reminder that the mentally ill can't change their body chemistry to abruptly.

 

[PriestTheyCalledHim]

I'm not on these meds and not biopolar but I know people who do take meds like this and you should do this under the supervision of a doctor or medical professional. Talk to the doctor or person who prescribed them to you.