Posted by yxibow on September 15, 2009, at 0:10:30
In reply to Discontinuation: How do you know?, posted by zana on September 14, 2009, at 15:52:04
> I have a major depressive disorder which is being treated with a slew of meds. I have listed them before; here goes again:
> Pristiq 100mgs- good response at first; less good now.
> Wellbutrin 300mgs- helps with sexual side effects and energy but probably increases anxiety.
> Remeron 45mgs- I sleep like a log but noticed no AD effect though it is thought to be a good combo with Pristiq.
> Seroquel 150mgs- got me out of bed when I was at my worst but never made me feel good.
> Rispedal 1mg- when I try to decrease it my thoughts darken.
> Klonopin 3mgs- started when I was in an agitated depression.
> Provigil 200mgs- improves my mood, gets me going.
> Gabapentin 600mgs- takes the edge off the provigil.
> I keep trying to decrease the doses of the seroquel and the rispedal. When I lower the seroquel 25mgs, I become weepy after about 5 days. When I lower the dose or respedal, my thoughts darken after about 5 days.
> MY QUESTION IS: How do I know what is a withdrawal symptom and what is a re-emergence of my depression? Do I just tough it out and see if the weeping lessens over time? How long do I give it?
> I really want to decrease the meds I am on but I'm stuck at this point.
> Any help?
> Thanks for reading the too long post.
> Zana
I know how it feels to want to decrease medications in polypharmacy. I wish I could decrease some of the 5 or 6 + medications on board.It sounds like a careful dance... because the Pristiq, the Remeron, the Seroquel, and the Risperdal all have to be monitored for serotonin syndrome interaction.
Having two stimulants on board (Wellbutrin and Provigil) sounds redundant but maybe there's a reason for it, I can't second guess.
But if you have to "take the edge" off of Provigil with gabapentin, what is the use of the dose of Provigil you're on? There's one that could be cut down since the Wellbutrin should already be stimulating.
I don't want to be crass or mean to say "tough it out"... nobody wants that situation. Sometimes side effects though are admittedly hard to tell from a complicated set of medications.It sounds more like anxiety-driven withdrawal from the Seroquel. The Risperdal I can't say -- it is more potent, if you do have any psychotic spectrum parts to your depression, it could be emergent symptoms, but I can't say at that dose.
I'm not sure why the combination of two antipsychotics on top of all the rest though.
Are you "playing" with the medications yourself or has your doctor given you instructions to try?
Maybe you should have a real strong discussion with your doctor about the load of medications, how they make you feel, make sure that both of you are on board about the amounts and what they're for and then try to reduce them.
-- best wishesJay
poster:yxibow
thread:917067
URL: http://www.dr-bob.org/babble/20090912/msgs/917139.html