Monthly Archives: August 2014

How do you know when to come off anti-depressants?

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Medication can play a vital role in managing mental health issues. I’ve been on an anti-depressant called Dosulepin since December 2009 and at the end of last year, felt stable enough to try to come off it.

However, my GP told me that Dosulepin is one of the hardest anti-depressants to come off. It’s an older, tricyclic version and there aren’t many people still on it. Which begs the question, ‘Why was I put on it in the first place?’ I don’t suppose I’ll ever know; I was at a different practice in 2009 and was in no fit state to question the doctor at the time.

At Christmas I was taking 150mg a day and my GP advised a very slow and gradual reduction by 25mg to start with. Imagine my surprise when I felt like a complete mental raving lunatic within a week. It was so unbearable that I immediately went back up to 150mg.

A few months passed and I decided to have another go at reducing the dose. I dropped by 25mg again and the exact same thing happened. I decided to try and withstand the withdrawal effects and mustered up all my strength and determination. I had two weeks of intense mood swings, feeling unsettled and bad nightmares, but sweated it out as I can be very stubborn and didn’t want to be beaten by a tablet. It was hard to separate the feelings from my sense of ‘myself’ but tried to see it as a purely biochemical response; a change in brain chemistry that was bound to make me unsettled. It didn’t mean I had lost control or slipped back into depression. Things stabilised at the end of the second week and it seemed like my body had become used to the change so I dropped my dose by another 25mg. This immediately made me feel I had been thrown into turmoil again and I noticed that my anxiety, which had never been far away, had now reared its head again with a vengeance.

It’s been two months since the last reduction and although my GP is keen for me to keep dropping the dose, I now don’t feel confident enough to attempt this.
I realised there were a lot of psychological issues coming up that I was confused about. For one, I can’t remember what I was really like before the anti-depressants. I don’t know what I will be getting back to and I don’t know what my ‘normal’ was. I’m not sure if I’m permanently changed now from life experiences and simply being older and I don’t know how I will know when I am ok enough not to need the tablets.

I do remember that I always felt things intensely, always felt anxious  and always struggled with low moods, even without the bereavement that pushed me over the edge and onto anti-depressants.

During the last two months of being on 100mg, I’ve definitely felt different and not in a good way. I’ve settled into feeling generally low and noticing that I’m struggling a lot with my Neutropenia and M.E. My health problems have always been difficult to cope with, but I have a new sense that I’m at the end of my tether with them and can’t take it any more. They are lifelong conditions though, so I need to find a way around this! But do I need to have come off the tablets completely and had a ‘settling in’ to the new brain chemistry period to really know how I am going to deal with things?

The way I’m feeling right now is that I’m having to constantly draw on everything I’ve learned from counselling and CBT in the last five years to keep a grip on my mood. My anxiety can be all-consuming and whether it’s a biochemical withdrawal reaction or not, it is difficult to cope with. It’s knocking my confidence and it’s demoralising that this is how I am without a third of my tablets. After two months, I’m obviously through the turbulent upheaval of the last reduction and this is what I’ve been left with. I’m thinking maybe I’m just one of those people who needs medication and I should not try to reduce the dose further. I don’t have a problem with that, but Dosulepin has some pretty nasty side-effects if you take it long term and if I’m going to be on tablets, I don’t think these are the best choice.

I’m intrigued to know what’s on the other side though and to see if I could cope without them. I’ll never know if I don’t try. I don’t want lack of confidence to stop me trying, but I also don’t want to take risks with my mental health, as its taken most of the last five years to rebuild it.

Ultimately, I want to feel as ok as possible and as though I am coping and I don’t mind taking tablets to achieve this. I don’t want to come of the tablets for the sake of it, or stay on them for the sake of it, but this period is a useful experiment in seeing where the boundaries are between the tablets and my own mind. I’m surprised it’s so hard to reduce the dose and also surprised that a lot of my old ways of feeling have resurfaced so for now, I’ll tread carefully and think long and hard about whether to drop the dose any further.

Has anyone else experienced similar difficulties? How do you know whether you should come of anti-depressants or not?

 

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