Posted by Janmar on August 16, 2003, at 2:30:13
In reply to I'm scared-am I going insane?, posted by Peter on August 15, 2003, at 21:05:42
> After years of one med cocktail after the next, my pdoc had me taper off of a lot of the latest meds I've been taking - lamictal, prozac, adderall, strattera.
> For months afterwards-well, months after stopping the 1st 2 - only weeks now since stopping the last 2- I've been experiencing some very acute symtpoms. And supposedly I was taking a fairly 'small' dose of everything (50mg lamictal, 5mg prozac, 25mg strattera, and 35mg adderall). BTW, I forgot - I also tapered off of trazadone 50mg and will soon cut mt temazepam 15mg down to the new 7.5mg strength restoril for 2 weeks and then stop it. The adderall was the latest, quickest taper, taking a bit over a week and ending almost3 weeks ago.
> Not a day goes by when there isn't constant, obsessive, chatter in my head about all these morbid, shocking things; the inevitable death of my parents, since they're growing old; questions of my own sanity, sudden flashes of haunting memories - constant worry, self-criticizing; can't talk to people, 'cause the self-deprecating voice just keeps questioning me and making me always feel like a 'loser' who can't survive in this world, and will never be able to, no matter what new meds I continue to try.
> My pdoc said the best thing for me to do, (now that I am overseas and we can't meet in person (and he's going on vacation) is to double my daily intake of klonopin, the only med I still take and that I've been on at varying doses for 5 years (for anxiety, panick, social anxiety, and insomnia)-even though i find it no longer does anything but prevent panick attacks.
> He said that the most important thing now is to just get my anxiety levels way down, so he has me increasing to 4mg daily.
> He's also aware that adderall, in the past, had some benefits for me, including 'calming' me and at least 'narrowing down' the constant, random chatter. While it stimulates, it also calms me, albeit in a different way than how klonopin does. I suppose this is where my ADHD-related symptomology comes in, though different doctors have told me different things regarding if I have ADHD or not.
> I find, especially now with the increased klonopin, that I am more emotionally numb - this is good in the sense that the constant overall anxiety has lessened.
> But it also makes me very tired and inactive throughout the day, and causes me to crave some stimulation. He told me that if, within 4 days of higher klonopin, I don't feel at least 80% better, I should start in again on the adderall 10mg bid. But he also said if I do feel 80% better but I am also tired, that that is another reason for me to resume the stimulant. On the other hand, he seemed to be quite happy when I finally got off of the stimulant, and he even said to me to be careful in assessing my need ofr adderall after 4 days, because I've already come so far in getting off of it.
> Bare with me, please. I'm quite confused, and he's already away. He's telling me, I think, that the only reason to NOT start up adderall in 4 days is if I feel at least 80% better and NOT tired (it seems quite unlikely that I won't be tired after the first 4 days of DOUBLING my klonopin intake-wouldn't you say)?
> But, in the same sentence, he also gave me the ides to only take the stim if absolutely necessary, as if taking it would negate my former 'accomplishment' of succesfully coming off of it. Can anyone see clarity here where I don't?
> As I said above, while the higher klonopin takes away some anxiety, it also makes me more withdrawn and numb. I always remember that with klonopin - it helped my social anxiety in that it helped me get out there around people, but it left me bereft of any drive, motivation, interest, confidence, or 'pep' in being able to step out and talk to anyone or be social in any way.
> The stimulant, though it caused problems in synergy with the many other meds with which i took it, seemed to compensate for this withdrawn, sluggish quality and lent me some social interest (unless i took higher doses - like I think the 35mg might have been too high a dose, since it caused me to hyperfocua on singular tasks and made me isolate, callous to the outide world).
> Anyway, sorry - I'm almost done. Agh! i could never just write a straightforward, succinct ,short post!
> Because of the 'withdrawn numbness the higher klonopin has been giving me, I've been resorting to 1 or 2 beers each night (no more) AND a few puffs of pot, in a search for stimulation.
> Tonight, as I smoked pot with a group of people, I felt like I was having a psychotic episode; everyone else seemed 'together' but I was losing it. I was convinced it was sprayed with angel dust or some hallucinogen. My mind was all convoluted, racing, random, negative, morbid thoughts. I was super-self-conscious. Funny, since a few nights before, the pot seemed to rid me of anxiety and help me relax. But I became a basketcase - at least on the inside - I somehow didn't show it on the outside.
> So I guess it would seem that the current higher klonopin dose + the addition in 4 days of 20mg adderall makes most practical sense - they both in their own way narrow my thoughts and calm me down.
> But this negative episode that the pot triggered (which was, in essence, an exxagerated, though similar, version of what I go thru day by day), makes me consider that I might actually be undergoing a type of psychotic episode in my life, in which case, it would seem that any dopamine/NE increasing or reuptake-blocking meds like stims (adderall included) should be avoided at all costs.
> How do I know if this is psychosis? I've even experienced suicidal ideations and the mood-states are non-reactive to my environment; I'm in a beautiful place on vacation, but none of it phases me in a positive way. I just seem to be getting more insane and hopeless (anxious and depressed). I feel like I'm at the end of my rope, and I have no friends to confide in. Please help me, if not with the technical psychopharmacology opinions, than even with a word of encouragement or advice? I'd really appreciate it, and thank you if you even got to the end of this monstrously long, self-obsessed post.
> Peter
Hi Peter. I just read your post while looking for some kind of hope on here myself. It does suck when there seems to be no one to confide in. Well, I'm off to a positive start here...It sounds like you just have a need to explain so someone can truly understand you and maybe help.
There are so many things I could comment on in your post, but it's way late, and my brain is getting dopier, so just take this as a "word of encouragement". Even though you think you're not being succinct, this really explained things very well. I think psychotic is a break from reality, and the crap of it is, you're totally in reality. You are tired of feeling the way you do, but you're right there in it. And you're making it through each day even though you feel this way. You're posting in here for help.
You ARE going to make it out of this pit!
poster:Janmar
thread:251194
URL: http://www.dr-bob.org/babble/20030812/msgs/251260.html