Further change in meds with goal of being drug-free

[BluMac81]

So while I was away on vacation, my psychiatrist called and said that he (finally) was able to get the approval for lunesta, the sleep aid I was on for two years that...well...cured all my insomnia issues. Up until now he had to put me through temazapam, ambien, hydroxizine, and the like since they are cheaper, and bleh... they are just no good.

So with this lunesta, I'll no longer need hydroxizine or ambien, not sure if I have to taper off those but I'll do it anyway to be safe (will call the pharmacist tomorrow). The lunesta I was given though was 2mg as opposed to the 3mg I was on before, but I think that'll be okay...

But that's all sleeping meds... anxiety and depression is a whole different issue. After talking with some close friends, family, and my psychologist I've decided NOT to take the path of taking Xanax whenever I feel anxious, and instead opt to use CBT/mindfulness techniques for my anxiety. So currently I'm at 5mg a day, 2mg to be taken at night but I won't be doing that anymore since I have lunesta. But I know very well the withdrawl effects of xanax so I'll probably do a two day 4.5mg dose, then two day 4mg dose, etc., but again i'll consult my pharmacist to be sure.

Furthermore, I did give antidepressants 'one last chance' with that desiparimine tricyclic, but had already experienced nasty side effects with that, so again... I'm going to focus on CBT/DBT techniques, because I'm sick of messing with my brain chemicals.... it makes me feel so uneasy.

So the only drug remaining after all the weening off is going to be lunesta...because well...I have had chronic insomnia for decades, made worse by working lots of night shifts and shifting sleep schedules back and forth, as well as the fact that I tend to get all hyperactive around 9-11pm...

BUT lunesta is certainly not as bad a drug to be on in the long-term compared to a benzo like xanax.

The one thing good about xanax was that it made it so I never felt like I needed to drink when I was on it. I usually only drank alchohol when I was nervous at some social event, but xanax pretty much took the place of booze... not too sure if thats a good thing or a bad thing actually lol.

Of course I'm going to be running this by my psychiatrist and pharmacist all in the future, but I can definitely forsee dark roads ahead if I stick to taking xanax whenever I'm anxious... addiction, withdrawl, and the like. Even an 'emergency' set of xanax pills in my cabinet would be too much temptation, since really in the end I have found that xanax = short-term fast positive relief with long-term ill effects, while cbt = short-term slow positive relief with longterm positive effects. They key difference here is fast and slow, and when in an anxiety or panic attack, I'd reach for the bottle long before I reach for my CBT worksheets if it were available.

Just posting this to see what you guys think Thanks

 

[Halo]

Re: Further change in meds; goal of being drug-free

Blu,

I am glad that you got approved for the Lunesta as I am sure that it will work well for you. As for tapering/discontinuing some of your other medications, I would really, really stress that you talk to your psychiatrist about this to make sure that it is all done properly. You don't want to suffer needless withdrawal effects that could have been avoided.

Goodluck :goodluck:

 

[BluMac81]

Re: Further change in meds; goal of being drug-free

Thanks Halo, and of course I'll be talking with my psychiatrist soon hopefully (if I can get a hold of that guy!)

I can already tell this is going to be difficult... Last night for my sleeping meds I took 2mg lunesta and 1 pill hydroxizine 50mg (tapering off)... and going to that from 1 ambien 2 hydroxizine and 2 xanax at night plus being home after the long trip plus not getting much exercise that day caused me to have that anxiety build up upon trying to sleep. And once it starts, it tends to cascade into panic... so I took another 2mg lunesta tab and 3mg xanax and was able to sleep. *sigh* I need to get myself off of these! What a crutch....

 

[BittersweetMisery]

Re: Further change in meds; goal of being drug-free

I agree with you and am currently trying to do the same thing. I hope you get your sleep worked out, I know how frustrating insomnia can really be.

 

[ladylore]

Re: Further change in meds; goal of being drug-free

It isn't a crutch Blu. I do have a question however. Does your doctor know you are tapering off?

 

[Retired]

Re: Further change in meds; goal of being drug-free

Furthermore, I did give antidepressants 'one last chance' with that desiparimine tricyclic

I may have mussed details in another posting on your situation, but why was your last chance antidepressant a tricyclic, rather than an SSRI or even and SNRI which are usually much better tolerated?

Most of us strive to be medication free, and I would count myself among those.

However, the disorders for which many on Psychlinks are being treated are thouight to be due to neurotransmitter chemical imbalances which can often be corrected using the right medication.

These disorders are truly medical disorders in the same way as diabetes, and coronary artery disease are medical disorders that can be treated with appropriate medications.

Sometimes these meds need to be taken for prolonged periods, even a lifetime to maintain the required chemical balance.

It all has to do with benefits vs risks and maintaining an acceptable quality of life.

 

[BluMac81]

Re: Further change in meds; goal of being drug-free

It isn't a crutch Blu. I do have a question however. Does your doctor know you are tapering off?

My doctor does know, I just talked to him a few hours ago about it. I also called the pharmacist (working at the same VA hospital) who was surprised to find that I am perscribed daily doses of xanax as opposed to the reccomended 'use as needed' dose. This really leads me to distrust my current psychiatrist... even my pharmacist there said that 'they don't track medications here as well as they should.'

Well I meant popping 3mg of xanax every time I get extremely nervous (which is several times a day) for the rest of my life would be a crutch. My tolerance to that drug is already such that I feel nothing from 1 or 2mg, do feel the effects at 3mg and above, and I'm sure if I stuck with that drug my tolerance would continue to build, and I'd just be another addict needing drug rehab to get off of it. So the 'crutch' aspect for psych meds I was describing is only referring to benzo barbituates (like xanax)... antidepressants however, I do NOT believe to be a crutch as they are intended for long term use, and the benefits tend to increase if you stick with the drug.

I may have mussed details in another posting on your situation, but why was your last chance antidepressant a tricyclic, rather than an SSRI or even and SNRI which are usually much better tolerated?

Because I have tried about 8 different SSRI's (and stuck with them) with no positive effects. I have also tried a few anti-psychotics like Lamictal when my last psychiatrist said I had 'probable bipolar II'. I have also tried stuff like Buspar, which I don't really know what class of drugs that falls under. I have only tried one SNRI and that was Cymbalta. My whole point of trying a tri-cyclic is because it really was the last remaining antidepressant type I had not yet tried.

My major issue, I have realized, is anxiety. I don't think I have depression or bipolar disorder as it is the anxiety which spurs depression in me and the varying levels of anxiety that cause my mood swings

Most of us strive to be medication free, and I would count myself among those.

However, the disorders for which many on Psychlinks are being treated are thouight to be due to neurotransmitter chemical imbalances which can often be corrected using the right medication.

These disorders are truly medical disorders in the same way as diabetes, and coronary artery disease are medical disorders that can be treated with appropriate medications.

Sometimes these meds need to be taken for prolonged periods, even a lifetime to maintain the required chemical balance.

It all has to do with benefits vs risks and maintaining an acceptable quality of life.

Ahh good point. And the thing of it is, I seriously DONT KNOW if my anxiety issues are caused by a chemical imbalance or if it is purely cognitive. If only they had tests to determine such imbalances.... ahh psychiatry

I do know this, both of my sisters have (albiet milder) anxiety issues, my older sister takes Lexapro and says it has made a world of difference for her (yes I have tried that one...no difference). My mother had major depression, my father was an alchoholic (who knows what he was self-medicating for), and my aunt has anxiety/panic issues.

All three of us siblings were born with an extremely sensitive nature. Possibly myself with the most sensitive nature (hence the overreaction to nearly everything, like not being able to sleep, etc.) So with this evidence I can nearly say in assurance that my issues are of the genetic nature.

But is that to say that I genetically inherited a neuro-chemical imbalance or that I inherited an over-sensitive personality?

So that leads me to the flip side of things and how cognition (thoughts) relate to neurochemical actions/reactions. Since in the end it is our thoughts which determine our feelings... and it is those feelings that are the symptoms being treated by either medicine or psychotherapy.

I guess the question is:
*Distorted Thoughts CAUSES Distorted Feelings (treat disorted thoughts with CBT)
or...

*Neurochemical Imbalance CAUSES Distorted Thoughts CAUSES Distorted Feelings (treat distorted feelings with cbt and medications)

or... (possibly less probable)
*Neurochemical Imbalance CAUSES Distorted Feelings (treat distorted feelings with medications)


So I leave you with this, how do you, myself, and the others on this forum absolutely KNOW that it is a neurotransmitter chemical imbalance that they have, and not just cognition developed through possible psychological trauma, oversensitive personality, and/or socio-psychological factors?

 

[Into The Light]

Re: Further change in meds; goal of being drug-free

So I leave you with this, how do you, myself, and the others on this forum absolutely KNOW that it is a neurotransmitter chemical imbalance that they have, and not just cognition developed through possible psychological trauma, oversensitive personality, and/or socio-psychological factors?

i'm not sure i understand your point.

these conditions (anxiety/depression/etc) are probably a combination of all of the above. that's as close as science has been able to come (so far).

 

[Daniel E.]

Re: Further change in meds; goal of being drug-free

Yeah, I see it this way: The only way for there to be a beneficial change in one's current symptoms is to have a change in the brain. That change can occur from medication, therapy, socialization, habituation, exercise, music, learning new things, bibliotherapy, the passage of time, etc. Similarly:

Perhaps one reason that an SSRI or psychotherapy may help children with an anxiety disorder is that both are associated with an increase in the size of the left amygdala.

http://pn.psychiatryonline.org/cgi/content/full/40/9/37

 

[David Baxter PhD]

Re: Further change in meds; goal of being drug-free

I seriously DONT KNOW if my anxiety issues are caused by a chemical imbalance or if it is purely cognitive. If only they had tests to determine such imbalances.... ahh psychiatry

I do know this, both of my sisters have (albiet milder) anxiety issues, my older sister takes Lexapro and says it has made a world of difference for her (yes I have tried that one...no difference). My mother had major depression, my father was an alchoholic (who knows what he was self-medicating for), and my aunt has anxiety/panic issues.

All three of us siblings were born with an extremely sensitive nature. Possibly myself with the most sensitive nature (hence the overreaction to nearly everything, like not being able to sleep, etc.) So with this evidence I can nearly say in assurance that my issues are of the genetic nature.

But is that to say that I genetically inherited a neuro-chemical imbalance or that I inherited an over-sensitive personality?

They are pretty much one and the same.

So that leads me to the flip side of things and how cognition (thoughts) relate to neurochemical actions/reactions. Since in the end it is our thoughts which determine our feelings... and it is those feelings that are the symptoms being treated by either medicine or psychotherapy.

I guess the question is:
*Distorted Thoughts CAUSES Distorted Feelings (treat disorted thoughts with CBT)
or...

*Neurochemical Imbalance CAUSES Distorted Thoughts CAUSES Distorted Feelings (treat distorted feelings with cbt and medications)

or... (possibly less probable)
*Neurochemical Imbalance CAUSES Distorted Feelings (treat distorted feelings with medications)

None of the above.

*Neurochemical Imbalance UNDERLIES anxiety disorders, depression, and other mental disorders which CAUSES Distorted Thoughts CAUSES Distorted Feelings (treat with a combination of psychotherapy and medications)

So I leave you with this, how do you, myself, and the others on this forum absolutely KNOW that it is a neurotransmitter chemical imbalance that they have, and not just cognition developed through possible psychological trauma, oversensitive personality, and/or socio-psychological factors?

We do not know for sure whether the neurochemical imbalance causes the anxiety or depression or is an effect of the mental disorder, but we do know that if you have an anxiety disorder or depression you also have a neurochemical imbalance which is usually corrected with the appropriate medication.

 

[BluMac81]

*Neurochemical Imbalance UNDERLIES anxiety disorders, depression, and other mental disorders which CAUSES Distorted Thoughts CAUSES Distorted Feelings (treat with a combination of psychotherapy and medications)

What definition do you apply to 'uderlies' in this context? Do necurochemical imbalances always 'underlie' mental disorders or 'most of the time'?

We do not know for sure whether the neurochemical imbalance causes the anxiety or depression or is an effect of the mental disorder, but we do know that if you have an anxiety disorder or depression you also have a neurochemical imbalance which is usually corrected with the appropriate medication.

Ahh thank you for that insight Dr. Baxter. One quick question for you, do you believe that every thought/cognition we posess as humans has an associated neurochemical action or reaction? What about feelings? This really intrigues me.

 

[David Baxter PhD]

What definition do you apply to 'uderlies' in this context?

Is associated with, possibly in a causative way.

Do necurochemical imbalances always 'underlie' mental disorders or 'most of the time'?

Not fully known at this time but my guess is yes, always.

Ahh thank you for that insight Dr. Baxter. One quick question for you, do you believe that every thought/cognition we posess as humans has an associated neurochemical action or reaction? What about feelings? This really intrigues me.

I don't think there is any way to answer that question. It's a question more for philosophy than science at this point.