![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by tonyz on July 4, 2009, at 10:23:21
I've been on Nortriptyline, and Valium for a while, and have recently added Lamictal and Zoloft. Seroquel has been on and off since last November.
I'm not comfortable taking all of these meds. My depression is characterized by very bad insomnia. Recently this seems to be improving.
I've been on Zoloft (50mg) and Lamictal (25mg) for about a week. I started splitting the pills 2 days ago. I figure I can do that for about 3 days and then maybe take 1/4 of each of these for a these for 2 days and then stop.
Seroquel I have been on and off for the past year.
The adjustment has been modified a lot and during the period of May 13 through July 3 - I have averaged 88mg. This is a weird number because I am just taking the average over that time period. I want off the Seroquel, recently since May 27 through July 3, the dosage has been between 125-150mg most of the time. I figure if I drop it by 25mg every 2 days that would be a safe reduction schedule - any opinions? One of my pdocs
had mentioned I could just stop it whenever - but I think this is bad advice. This drug from a psychological standpoint gives me the most anxiety.What do you guys think of this schedule?
I didn't have any problems ditching the valium last year; this year has been harder for some reason.
I think for me Lithium and Zoloft might be a good prophylactic treatment, but I am not there yet. I've never experienced mania and they say lamictal is better for recurrent depression whereas lithium is better for bipolar. I think I like lithium because it has been around a lot longer and all the effects are known and I'm hoping that a lower dosage of lithium in combination with an an anti-depressant may work for me, but I will discuss with a new pdoc. I am unfortunately a cynic when it comes to the pharmaceutical industry. While I recognize that these drugs can be very helpful sometimes I wonder. There was a study done by Glaxo Smith Kline concerning paxil which indicated that it was no more effective than a placebo. I heard this on a news program recently - so I don't know the details of the study, who was involved, how it was conducted, etc. The last pdoc I saw indicated that my anxiety over the drugs gets in the way of my recovery - perhaps he is correct. But as others have said it is important that we lobby for our own rights and suggest our own alternatives if we have some trepidation over certain drugs whether justified or not.
Nortriptyline has been the mainstay for me in numerous depressions. So I figure once I get off the other stuff I will start tapering that one slowly and get back on the Zoloft and add lithium. I will discuss this part with a pdoc before doing this. But for now my main concern is getting off the Seroquel, Zoloft, Lamictal and Valium. I've been reducing the valium by about 1mg every 3-4 days. So far seems to be working ok. I started with 20mg and bounced around a bit before settling on this. When I get down to 5mg I may have to taper slowly. That is where I was having problems before. I got down to 2.5mg got very little sleep and then crashed.
Under doctor's supervision last year had a similar bout of depression and was on the benzos for a long period of time (4-6months). He recommended droping by 2.5mg per week. I was also on Seroquel and I believe I was droping that by 25mg per week. I was probably on the Seroquel for a longer period of time, but I would have to check.
For others that may be withdrawing from meds, please do not use anything that I've said as a guideline. I am a person that knows very little about these drugs and is just trying to navigate through a tough period of depression. I don't like taking these drugs but have had so many relapses that I believe I don't have an alternative. But I do have a choice in deciding what I think will be best for me.
Others have mentioned the Ashton guide as a method for withdrawing from the benzos and this is from an experienced doctor and is probably a good place to start.
Best of luck to those that are withdrawing, hang in there.
Posted by morganpmiller on July 9, 2009, at 1:07:31
In reply to Withdrawing from Zoloft, Lamictal, and Seroquel, posted by tonyz on July 4, 2009, at 10:23:21
Hey Tony,
Why not stay on Zoloft and Nortriptyline and withdrawal from the rest?
Man, If you can find a way to feel even 75 percent better on Zoloft, Nortriptyline and a small dose of lithium, that would be a great success as far as I am concerned. Then, you will have the strength to do all of those other things that may make you feel 100 percent better, at least for short periods of time.
Posted by 49er on July 11, 2009, at 7:17:09
In reply to Withdrawing from Zoloft, Lamictal, and Seroquel, posted by tonyz on July 4, 2009, at 10:23:21
Hi Tony,
Due to insomnia, I didn't read your whole post so forgive me if I am missing something.
I know people on this board are tired of me saying this but it bears repeating.
Any psych med needs to be tapered slowly. On the Paxil Progress Boards, run by an RN, the recommendation is to taper 10% of current dose every 3 to 6 weeks.
For more powerful drugs, you might to need to taper more slowly.
If you're scoffing at this, you're right, you may be one of the lucky ones who can taper more quickly. The problem is you won't know it for a while as even if you feel fine initially, wd symptoms can catch up to you. Then it might be too late to change course.
So many post on the Paxil Progress boards wishing they hadn't tapered too quickly or CT'd their meds.
Anyway, I will step off my soapbox.
49er
PS - Tony, this is a general rant and not specifically directed at you.
Posted by tonyz on July 11, 2009, at 18:58:49
In reply to Re: Withdrawing from Zoloft, Lamictal, and Seroquel, posted by morganpmiller on July 9, 2009, at 1:07:31
Well thanks guys and gals for responding. Things have slid for me and I checked myself into a hospital as an outpatient. I figured, I needed more attention and adjustment then could be provided just seeing a pdoc once a week.
So the pdoc in the hospital recommended stopping the Zoloft I had already stopped the lamictal. He upped the seroquel to 150mg, left the NTP at 150mg and started me on lithium at 300mg.
I would rather take lithium than lamictal. I posted a link to an excellent article (IMHO) that talks about all the physiological changes that can occur with lithium usage.
I am getting some involuntary twitches, my balance sucks, and when my muscles are tensed from exercising there is a fair amount of shaking. I don't like this. I think the shakiness and the twitches are from the Nortriptyline and Seroquel, and the balance may be from the valium.
I think I am slightly improved, but not at all in good shape.Normally I would get better taper my beds sometimes on my own sometimes in concert with a doctor and when all was gone I would be stable with no apparent side effects or relapse until sometime later. Unfortunately, as expected the incidents are becoming more frequent and harder to treat and there is always the loss of something that I feel.
So honestly at this point I don't feel human, but maybe just a wee bit better.
Sleep is always a big issue along with anxiety that is why I need the seroquel and valium now. I asked about restoril (which I have taken before) but the response I got which I know is that it is just another benzo.
The tricyclics have some rough side effects to deal with. My hope is that I will be able to switch to an SSRI and maybe take a small dosage of lithium in concert. I think I could possibly accept that as a solution.
A lot of people seem to respect this pdoc in the hospital that he gets people well. It worked last year when I was in the hospital and on Nortriptyline, valium, seroquel, and abilify. I didn't want to go in the hospital but the doctor I had been seeing had supported my usage of sam-e which had kept me stable for almost 2 years. I am also thinking that for me that may have been a better antidepressant than Nortriptyline. The problem is the dosage had been adjusted pretty high and was not working. He was trying all different combos but my anxiety was growing, my lack of sleep exacerbating and I was in very bad shape. He was recommending shock therapy. That is when I found another doctor, but unfortunately he couldn't do enough for me so it was the hospital.
So the short answer to your question is I don't like the meds because of the side effects. My medical knowledge is very limited but I look at the depression as pathway that has been programmed into my brain in response to certain stimuli. Just as learning anything else the more it occurs the easier it is to remember or in the case of depression relapse.
So is it possible to rewire your brain so you don't need pharmaceuticals -- I don't know and given where I am now and the frequency of relapse, quality of life, etc. I can't afford the risk to try.
I'm also thinking about TMS (transcranial magnetic stimulation). I don't know much about it but there is some promising work done in Canada and also at MIT here in the US. I think ECT actually destroys brain cells, I don't know about TMS. I will make another posting about this and find out if anyone has tried it and had good experiences.
Posted by tonyz on July 11, 2009, at 19:06:01
In reply to Re: Withdrawing from Zoloft, Lamictal, and Seroquel, posted by tonyz on July 11, 2009, at 18:58:49
Forget something. I was at 125 NTP, 20mg of valium and 400mg of seroquel and abilify small dosage every other day. The abilify was stopped first under doctor's guidelines. The seroquel I'm not absolutely sure where I was when I left the hospital I think it was lower than 400mg. Anyway the plan was to taper the valium 2.5mg / week and the seroquel 25mg / week. I had no problems. This year the valium has been harder to come off - I'm going a little faster than the Ashton schedule, but other things are getting adjusted at the same time as well.
Posted by morganpmiller on July 23, 2009, at 0:05:12
In reply to Re: Withdrawing from Zoloft, Lamictal, and Seroquel, posted by tonyz on July 11, 2009, at 19:06:01
Lyrica! Lyrica! Lyrica! For Sleep!
http://www.mindandmuscle.net/forum/index.php?showtopic=38670
Have you ever considered the prozac/zyprexa combo for depression/irritability?
So the doc said no to zoloft but had no problem with NTP? Doesn't he understand you are feeling miserable and need as much a positive lift as possible?
Posted by morganpmiller on July 23, 2009, at 0:16:29
In reply to Re: Withdrawing from Zoloft, Lamictal, and Seroquel, posted by tonyz on July 11, 2009, at 18:58:49
>I'm also thinking about TMS (transcranial magnetic stimulation). I don't know much about it but there is some promising work done in Canada and also at MIT here in the US. I think ECT actually destroys brain cells, I don't know about TMS. I will make another posting about this and find out if anyone has tried it and had good experiences.
I think TMS is definitely worth the shot. ECT can cause brain damage and promote neurogenesis at the same type; not worth the risk.
>So the pdoc in the hospital recommended stopping the Zoloft I had already stopped the lamictal. He upped the seroquel to 150mg, left the NTP at 150mg and started me on lithium at 300mg.
Yeah it's not a bad idea to just stick with 150 to 300 mgs of lithobid a day no matter what else you take, unless of course it is stongly contraindicated. I suggest lithobid because it is the extended release version and many feel better on it; you may not be one of those.
>So honestly at this point I don't feel human, but maybe just a wee bit better.
God I can totally relate. I actually just got back from a nice little inpatient stay at the hospital. I just couldn't handle feeling that bad and not being able to find a psychiatrist that knew what he/she was doing.
Posted by morganpmiller on July 23, 2009, at 0:41:41
In reply to Re: Withdrawing from Zoloft, Lamictal, and Seroquel, posted by tonyz on July 11, 2009, at 18:58:49
I'm going to play armchair psychiatrist. Here is a possible cocktail that may work for you:
20mgs Prozac-Morning Dose
2.5mgs Zyprexa - Morning Dose
300mgs Lithobid or Lithium QD - Morning Dose
250mgs Divalproex ER or this http://www.medicalnewstoday.com/articles/86674.php - Bedtime Dose
100 mgs Lyrica - Bedtime DoseI know it sounds like a lot of medications. Hey, if it works and you feel better and sleep better than you have in a long time, why not try something like this?
Posted by morganpmiller on July 23, 2009, at 0:45:33
In reply to Re: Withdrawing from Zoloft, Lamictal, and Seroquel, posted by morganpmiller on July 23, 2009, at 0:41:41
Come to think of it, that regimen sounds like what I want my regimen to be in a few months. Maybe that's why I wrote it out. You and I do have some similar symptoms, so I think something like this may work for you.
Posted by tonyz on August 1, 2009, at 21:27:50
In reply to Re: Withdrawing from Zoloft, Lamictal, and Seroquel, posted by morganpmiller on July 23, 2009, at 0:16:29
Hi Morgan,
Sorry to hear of your hospital stay - in patient is not fun at all, but you do what you have to.Lithobid has been working very well for me. I've been off the seroquel for about 2weeks now and have the valium down to 4mg a night. I've been tapering at 1mg every three days - so far so good.
Yes I can relate to bad doctors, I have a new one I'll be seeing at the end of the month. Last two guys were losers. Hospital doc was ok, we didn't always agree on things but we did have agreement on some important points which is probably the most that can be expected.
Hope you are doing better.
Posted by morganpmiller on August 1, 2009, at 22:36:36
In reply to Re: Withdrawing from Zoloft, Lamictal, and Seroquel » morganpmiller, posted by tonyz on August 1, 2009, at 21:27:50
That's great you are having success with Lithobid. Do you mind me asking if you are on anything else? Did you withdrawal from everything else? I'm doing better now. Still haven't found the right doc though. I hope to do that soon.
Down to 4mgs valium, huh, that is awesome. It really sounds like your doing better. I'm glad for you man.
Posted by tonyz on August 2, 2009, at 21:57:15
In reply to Re: Withdrawing from Zoloft, Lamictal, and Seroquel, posted by morganpmiller on August 1, 2009, at 22:36:36
I was on Nortriptyline up to 150mg when I went in the hospital as an outpatient, 20mg valium, zoloft and some seroquel. Stopped the zoloft and the doc put me on lithobid starting at 300mg for about 3-4 days then went up to 600mg. Within a few days I started feeling better dropped the Nortriptyline down to 125mg, and started droping the seroquel by about 25mg every 3-4 days. My blood levels for Lithium were taken twice first time was 0.4 and second time 0.5 which is just inside the therapeutic range. I have been seroquel free for several weeks now, valium is down to 4mg a night and continuing the taper. I also started tapering the Nortriptyline and am at 50mg now. It is likely the Notriptyline is not doing anything at this level, but I feel great.
From my perspective, I believe SAM-e to be a far more effective AD than Notriptyline w/o any of the anticholinergic stuff. The problem is for major depression it requires a pretty high dosage and in my case since the anxiety and insomnia are a component it will exacerbate sleep problems, but this is something I will explore with the new pdoc.
So to summarize right now I'm on 50mg of Notrriptyline, 4mg of valium and 600mg of Lithobid. All the mood stabilizers suck, lithium appears to have the lowest side effect profile and has been around the longest, however it can cause thyroid and kidney problems. The belief was that as long as the creatine tests were normal the kidneys were ok; however, there was a study in which autopsied people that had been on lithium for 15 years (don't know the dosage) and although they did not knowingly experience kidney problems while they were alive the autopsies indicated all had undergone some level of changes that were thought to be very rare. But I think with lithium the thyroid problems can be more of an issue. I think I read the incidence of goiter is quite high on the neighborhood of 25% and it can show up as rather small nodular additions to the thyroid that might only be detectable via MRI.
So I feel great now, but I'm in a quandary over what to do for the long term.
It's interesting in Italy Sam-e is the most prescribed AD, in Germany it is St John's Wort. The studies in the US for ST Johhn's Wort were not very compelling; however, the German's argument is that the US studies only used a brand that was standardized to hypericin whereas the Europeans believe that is the synergistic action between hypericin and hypeferon that gives ST John's Wort it's powerful AD effect (I'm sure I'm misspelling the last term)
As I am lowering the valium, I find it takes me a bit longer to fall asleep, but I have a lot of flexibility with my hours so that is not much of an issue. I know probably in a month or so I should completely stabilize and be benzo free.
If the new pdoc thinks I need to be on an AD then I would prefer either SAM-e, ST John's Wort or an SSRI. The side effects of the tricyclics are just too annoying. And I will certainly explore options with the Lithium - for now I'm sticking with it.
As you can probably surmise by now, I believe that less is better, but I don't want a relapse. It is a very delicate balance.
If you need the exact details of the meds and the taper, I can post that, but everyone is different. We also change within ourselves from year to year. Several years ago it was a piece of cake to stop the benzos, this year has been tougher. That is certainly something I hope I never will revisit again.
I think for me the combination of the Lithobid, Nortriptyline and Seroquel was the key. I don't ever want to take an anti psychotic again, so it will require some deep thinking and evaluating for an ultimate solution.
Hope you are doing ok.
Posted by morganpmiller on August 3, 2009, at 1:39:34
In reply to Re: Withdrawing from Zoloft, Lamictal, and Seroquel, posted by tonyz on August 2, 2009, at 21:57:15
Yeah if you can get off seroquel eventually that would be great.
Can you describe what the low dose of lithobid felt like when you first started?
Again, I'm glad you are feeling better.
Morgan
Posted by tonyz on August 3, 2009, at 13:48:50
In reply to Re: Withdrawing from Zoloft, Lamictal, and Seroquel, posted by morganpmiller on August 3, 2009, at 1:39:34
I have been seroquel free for about 2 weeks now - no problems.
As for the Lithobid I was on 300mg for only 3 days and then bumped up to 600mg. I honestly can't remember when I started feeling better, but I'm going to assume it was around day 4 when the dosage was bumped up to 600mg. It was on day 5 that I started reducing the Nortriptyline from 150mg down to 125mg. If I hadn't been feeling something going on it is doubtful that I would have done this.
You have to decide if you need a mood stabilizer. Some doctors are stubborn and insist that if you haven't experienced mania than lamictal is a better choice. If you happen to have psoriasis which I do, lithium is generally not considered to be a good choice; however, the effects in this department have been very minor. I'm more concerned about the thyroid and kidney issues that I alluded to in my previous posting.
So you mentioned you were in patient for a time. I'm assuming that you are out now and doing better? Are you still trying to tweak your meds to find the optimal solution?
Posted by morganpmiller on August 3, 2009, at 17:16:57
In reply to Re: Withdrawing from Zoloft, Lamictal, and Seroquel, posted by tonyz on August 3, 2009, at 13:48:50
>If you happen to have psoriasis which I do, lithium is generally not considered to be a good choice; however, the effects in this department have been very minor.
>So you mentioned you were in patient for a time. I'm assuming that you are out now and doing better? Are you still trying to tweak your meds to find the optimal solution?
I am better..Yes, I am trying to tweak medications
still. I went into my medicine cabinet and popped 25mgs of Zoloft that I had sitting around. I could not wait for my new psychiatrist to make a decision. I swear, 4 days into it(actually today I took 50) I am feeling better. So if he does not suggest that I get back on zoloft in combination with depakote and zyprexa, I'm going to have to tell him what I'm doing. I have also been taking a low dose of lithium, which I believe is helping as well.>I'm more concerned about the thyroid and kidney issues that I alluded to in my previous posting.
I think if you are in good health and take good care of your body, you should not have to worry about those issues. And, maybe at some point you will find that you can lower the dose of lithium some and still find it to be effective. You are already at a reasonably low dose. I'm sure you're aware of this already.
How do you like Nortriptyline? Any noticeable side effects?
So I guess you dose the Lithobid one time a day. Do you do it in the morning or evening?
That's great that you were able to discontinue seroquel successfully. I think p docs nowadays are a little atypical happy.
Posted by morganpmiller on August 3, 2009, at 17:22:33
In reply to Re: Withdrawing from Zoloft, Lamictal, and Seroquel, posted by morganpmiller on August 3, 2009, at 17:16:57
For some reason that second link is not taking you straight to the article. It does when I click on it on the google page. Oh well, all you have to do is google inositol for psoriasis. I googled it because I remembered reading something about supplementing with inositol to avoid having hair and skin issues, back when I started taking lithium.
Posted by morganpmiller on August 3, 2009, at 17:39:18
In reply to Re: Withdrawing from Zoloft, Lamictal, and Seroquel, posted by morganpmiller on August 3, 2009, at 17:16:57
I really don't know why my posted links are that big. They were not like that before.
Posted by tonyz on August 3, 2009, at 22:52:17
In reply to Re: Withdrawing from Zoloft, Lamictal, and Seroquel, posted by morganpmiller on August 3, 2009, at 17:16:57
The tricyclics are a pain, when you start them it kind of feels like your body is turning into a prune. Constipation issues, dry mouth, dry nasal membranes. Miralax works really well for constipation but in trials I believe it has not been evaluated for more than a year of use. Amitriptyline is probably the worse in terms of side effects, but one benefit is that it is very sedating for some people. Increase in ocular pressure is another side effect.
Thanks for the tip on inositol, I'm not sure how I missed that. I'm always doing searches on these topics.
Yep 600mg of Lithium is a low dose. I take everything at bedtime.
That's a lot of meds you are on. Do you think you need the depakote and the Lithium. How was your hospital doctor? I'm thinking that you were doing better but not really well as you seem to be adding instead of subtracting stuff.
I am not a big fan of the anti psychotics unless they are absolutely necessary. However, I can't argue with the fact that they do seem to potentiate the effect of ADs and that combination helped me over the hump.
I always let the doc I'm seeing know what I am doing even if he/she strongly disagrees. I hope you tell your doc about the Zoloft. I would just be cautious adding things unless you are really confident and have done your homework.
Anyway good luck, let me know how your appointment goes. I see my new doc at the end of the month.
Posted by morganpmiller on August 4, 2009, at 2:19:16
In reply to Re: Withdrawing from Zoloft, Lamictal, and Seroquel, posted by tonyz on August 3, 2009, at 22:52:17
Depakote and Zyprexa is the combo they gave me in the hospital. Depakote is better for the kind of mixed agitated states that I was experiencing. The combo of Depakote and Zyprexa is the most commonly used treatment for acute manic episodes in the hospital setting.
I added a mere 150mgs of lithium and 25mgs Zoloft.
I'm going to tell the doc what I am on Thursday. I have done enough research to know that what I am currently on is perfectly safe.
I will tell you how the appt. goes. I am very curious to see what this guy thinks I should do, or try doing.
Keep feeling better!
Posted by trainspotter on August 20, 2009, at 10:46:14
In reply to Withdrawing from Zoloft, Lamictal, and Seroquel, posted by tonyz on July 4, 2009, at 10:23:21
Hi, wish you luck and support
Is there any need to withdraw the Lamictal? It's a really good drug.POSSIBLY THE ONLY MOOD STABILISER FOR BIPOLAR DEPRESSION AND NOT MANIA. I've seen that I must keep a touch of Zoloft 25 else I get vertigo- possibly zoloft's dopaminergic effect. It can cause insomnia. Instead of nortriptyline you can take amitriptyline, it's more sedating and you have it's metabolite. Lithium can be lowered off to just for taking's sake. The only stuff I dislike is seroquel, though it combines well with lithium I've read. It makes me feel worse as do other atypicals except olanzapine and ziprasidone.
80 okay 90 percent of my life I'm taking antideps. For sleep low doses of melatonin 150-300 MICROGRAMS can be tried. DO NOT TAPER OFF ALL ANTIDEPS, PROPHYLAXIS IS NEEDED, if you take this how will it be? 1>Zoloft 25mg 2>Lamitor 25 3>Amitriptyline 10 - 25mg bedtime 4>Valium tapering slow slow slow to 5-10mg For sleep another sedative is Doxepin 10mg(read wikipedia) and some like it great on Remeron 7.5-15mg (Mirtazapine- IT'S A GOOD ANTIDEP SPECIALLY IF YOU TAKE IT >3- 4 weeks ) or Trazodone 25mg, I don't feel quetiapine will ever make you feel better, reduce it by 25mg to 0 (you can take 1 or 2.5mg extra valium during 1 week of quitting Seroquel,
(ASK YOURSELF IS THIS MED MAKING ME FEEL BETTER?) HOPE YOU FIND A GOOD DOC >just a little more- FLUPENTHIXOL LOW DOSE IS A GREAT ANXIOLYTIC AND ANTIDEP (It's also a neuroleptic taken in the morning). I think a good doc gives insomnia it's gravity.-------------------------------------------------
> I've been on Nortriptyline, and Valium for a while, and have recently added Lamictal and Zoloft. Seroquel has been on and off since last November.
>
> I'm not comfortable taking all of these meds. My depression is characterized by very bad insomnia. Recently this seems to be improving.
>
> I've been on Zoloft (50mg) and Lamictal (25mg) for about a week. I started splitting the pills 2 days ago. I figure I can do that for about 3 days and then maybe take 1/4 of each of these for a these for 2 days and then stop.
>
> Seroquel I have been on and off for the past year.
> The adjustment has been modified a lot and during the period of May 13 through July 3 - I have averaged 88mg. This is a weird number because I am just taking the average over that time period. I want off the Seroquel, recently since May 27 through July 3, the dosage has been between 125-150mg most of the time. I figure if I drop it by 25mg every 2 days that would be a safe reduction schedule - any opinions? One of my pdocs
> had mentioned I could just stop it whenever - but I think this is bad advice. This drug from a psychological standpoint gives me the most anxiety.
>
> What do you guys think of this schedule?
>
> I didn't have any problems ditching the valium last year; this year has been harder for some reason.
>
> I think for me Lithium and Zoloft might be a good prophylactic treatment, but I am not there yet. I've never experienced mania and they say lamictal is better for recurrent depression whereas lithium is better for bipolar. I think I like lithium because it has been around a lot longer and all the effects are known and I'm hoping that a lower dosage of lithium in combination with an an anti-depressant may work for me, but I will discuss with a new pdoc. I am unfortunately a cynic when it comes to the pharmaceutical industry. While I recognize that these drugs can be very helpful sometimes I wonder. There was a study done by Glaxo Smith Kline concerning paxil which indicated that it was no more effective than a placebo. I heard this on a news program recently - so I don't know the details of the study, who was involved, how it was conducted, etc. The last pdoc I saw indicated that my anxiety over the drugs gets in the way of my recovery - perhaps he is correct. But as others have said it is important that we lobby for our own rights and suggest our own alternatives if we have some trepidation over certain drugs whether justified or not.
>
> Nortriptyline has been the mainstay for me in numerous depressions. So I figure once I get off the other stuff I will start tapering that one slowly and get back on the Zoloft and add lithium. I will discuss this part with a pdoc before doing this. But for now my main concern is getting off the Seroquel, Zoloft, Lamictal and Valium. I've been reducing the valium by about 1mg every 3-4 days. So far seems to be working ok. I started with 20mg and bounced around a bit before settling on this. When I get down to 5mg I may have to taper slowly. That is where I was having problems before. I got down to 2.5mg got very little sleep and then crashed.
>
> Under doctor's supervision last year had a similar bout of depression and was on the benzos for a long period of time (4-6months). He recommended droping by 2.5mg per week. I was also on Seroquel and I believe I was droping that by 25mg per week. I was probably on the Seroquel for a longer period of time, but I would have to check.
>
> For others that may be withdrawing from meds, please do not use anything that I've said as a guideline. I am a person that knows very little about these drugs and is just trying to navigate through a tough period of depression. I don't like taking these drugs but have had so many relapses that I believe I don't have an alternative. But I do have a choice in deciding what I think will be best for me.
>
> Others have mentioned the Ashton guide as a method for withdrawing from the benzos and this is from an experienced doctor and is probably a good place to start.
>
> Best of luck to those that are withdrawing, hang in there.
This is the end of the thread.
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Dr. Bob is Robert Hsiung, MD,
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