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F*ck Rxs, or: My Psychiatric Diary

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Sometime in early Spring (March?), I began seeing a psychiatrist. A lot of people think my P is evil, a mad scientist, a quirky intellectual with a bloated god complex, or a miracle worker who lacks basic social skills. He’s extremely infamous in my work community, hence the cocktail of strong opinions. I went to see him because the only doctor people recommended in a 30 mile radius was always booked solid, and this guy is the only recommendation that doctor had.

I don’t think he’s evil. He definitely has a mad scientist thing going for him. He definitely gave me the very distinct impression that I was a very shiny new guinea pig. But I like him, because he’s not condescending and he was pretty cool about me being entirely transparent about my affinity for recreational drugs, especially powerful hallucinogenics. And he totally understands how I get away with trying out drugs a la carte, because he’s very familiar with my community and how people around me pretty much offer anyone with cash a buffet of narcotics. All this, and he was still open to giving me controlled substances, and how can a girl like me hate a doctor who says, “Well what drugs do you want?” after I tell him about the litany of drugs I refuse to take?

So for better or for worse, this is who I’m working with. Do I like him? Moderately. Do I trust him? Not really. Do I think he’s going to do stupid things with my brain? Well, I don’t know. He’s not dumb, and his ego is huge, and I feel like he’s not going to totally f*ck me up mostly because he’s too proud to fail after telling me at great length how he’s the end all be all of being able to regulate abnormal brains.

We had a deal. His way first, then my way.

My way:
-Find a drug I can take daily to knock the edge off my anxiety, something I can start and stop anytime that’s very gentle
-Give me Ambien
-Give me PRN klonopin

His way:
-I started propranolol for anxiety: success. This is my gentle daily drug that I can start and stop without consequence. I can skip it entirely or basically eat it all day like skittles and it doesn’t hurt me either way.
-Trazedone: success, then failure. Trazedone was great until it gave me horrific nightmares. The problem is I had/have trouble coming off of it, but the withdrawal only lasts like 4-7 days. The bigger problem is that I love it, and sometimes the nightmares feel worth the mood regulation. I tapered off of it—just took my last 50mg dose about 5 days ago—because my boyfriend begged me to stop taking it. He couldn’t handle me waking up multiple times a night screaming or crying. That really isn’t great, I agree, so no more trazedone.
-Buspar: didn’t help with anxiety unless replacing anxiety with an uncomfortably raging libido counts. I kept taking it until it started making me throw up all the time. Also, I realized it was causing weight gain, because when I stopped taking it, the weight I’d gained back melted off almost immediately.

I tried Seroquel. It was like magic. That was my decision, which he endorsed. I can’t blame anyone for this one. I had terrible side effects, and some of them were esoteric (paraesthesia in my leg, which is still partially numb and sometimes burns/stings/tingles/itches). High blood sugar. Weight gain.

Stopped taking Seroquel three weeks ago. About 7-10 days after I stopped I fell apart hard. I started taking half doses again (50mg) Sunday night. I feel way better now. Last night I bumped down to a third of a dose (~30mg). I feel fine today.

So after Seroquel tanked, I got the combo I wanted: propranolol, Ambien, klonopin. Unfortunately I blew through my klonopin supply trying to control my withdrawal symptoms. I’ve been tapering for nearly a week, taking .25-.5 doses daily. I withdrew from Xanax by myself early this year, and it really sucked, but I don’t think this will be nearly as bad. I was taking like 1mg Xanax a night for 10 days and then stopped cold turkey (because my supplier ran out). It was maybe 4 days of anxiety/insomnia hell. I think I’ll be okay coming off klonopin. I have some backup substances for controlling withdrawal symptoms that I won’t get into here, but let’s just say I’ve been preparing for this fallout.

I wanted to keep a log somewhere of what’s going on with me chemically, because it’s been pretty rough on me and focusing on the pharmacology behind my massive mood swings and symptoms will probably help me keep everything in perspective.

I’m doing well so far this week except for Wednesday, which was a f*cking disaster, but there were extra stressors involved.

My tears seem to be on less of a hairline trigger this week, and I’m not waking up sobbing for hours. Suicidality seems lower. No compulsive self-harm. Fewer bouts of random rage. Less irritability. I still feel a pervasive sense of hopelessness, but I think part of that is simply feeling like this whole medication thing has been a bust for me.

I’m tired of trying new drugs. I’m done with it. I feel like my first instincts were good ones. I never wanted to be on a daily mood stabilizer or antidepressant etc. that I would have trouble coming off of. I loved the mood effects of trazedone and then Seroquel but they aren’t worth the shit that comes with them or the trouble getting off of them. I’m turning 28 this month and I’ve been unmedicated AMA since I was 15. I do hate how sometimes my symptoms flare up and disrupt my life, but I can deal with my PTSD. I can’t deal with my symptoms being completely off the wall intense out of nowhere because of withdrawal. I don’t want to f*ck with my libido or weight with meds. I don’t want to feel dependent on a medication to manage my symptoms. I have a rather expansive toolbox for coping with PTSD, and medication is just more trouble than it’s worth. The meds I asked for originally and now have are enough to help me without stressing me out re: dependence. The PRN klonopin is a non-issue; I’m either going to buy it off the street or pick it up from a pharmacy. Ambien doesn’t give me any side effects and I’ve quit it cold turkey after months and months of daily usage with zero fallout. The propranolol is a nice addition to my life; it helps calm me down for a few hours so I can go to work, go to school, go to a meeting, or fall asleep without racing thoughts.

Now I just need to stick out coming off of Seroquel. I’m hoping I tapered off of trazedone and klonopin effectively. I think I did. I’m anxious about running out of klonopin, but although I know someone who would give me more, I’d rather take a wait and see approach so I don’t refill my script while still taking it daily. That would be a vicious cycle. I need it to clear my system so I can go back to what it’s intended for: PRN to put out big fires that crop up in my life due to big stressors. I’ve never wanted to take benzos daily. I know all the risks. I’m not down.

So day one. Last night I took around 30mg Seroquel, 10mg Ambien, .25mg klonopin, and 80mg propranolol. I woke up feeling fine. Weird dreams but not nightmares. I need to pick up my new propranolol script today. I’m thinking about holding off on my last .25 dose of klonopin for a day or two. That way I can kinda pilot not having it and still have a smidge if things start going sideways.

Tonight I’ll take 30mg Seroquel and 10mg Ambien. I’m thinking about asking for 25mg tablets of Seroquel if they make them. That way I can step down another little bit without trying to cut up these stupid 100mg tablets that are NOT easy to cut. Getting them into thirds is hard enough.
To me it sounds like you started with a heavy hitter (seroquel) which is very well known for weight gain, sugar issues, and heavy sedation, and you’re using this experience as a reason to stay away from most other drugs. I’m not sure how sound this reasoning is, given that there are other classses of drugs out there, including true mood stabilizers (not antipsychotics which have mood stabilizing capabilities but work in totally different ways), which don’t have serious side effects, and for many of us, cause minimal/no side effects. I know there’s the belief that everyone can just handle PTSD with a lot of hard work, but for some of us, with very damaged systems, this simply isn’t true. My advice? Get past this med craziness and then start a true mood stabilizer. You may be pleasantly surprised.
Thanks for reading @EveHarrington. I was on Lamictal for a little while when I was finishing school as an undergrad, but it was problematic for two reasons. One was that I had to take it consistently or I felt like hell and I had to start again from a low dose and progress slowly back to my normal dose (which I thought would still be a problem now, seven years later, but actually I seem to usually remember my meds now or at least I don’t forget for days in a row). The other problem was that it would work for 3-5 weeks, and then I would need a higher dose. But to be fair, I was under an ungodly amount of stress at the time. I’m not sure if that would happen again.

But I told my P all this, and he wasn’t big on the idea of a drug like Lamictal. I’m not sure if he’d change his mind now that he sees my sensitivity to drugs. From the start, he was enthusiastic about atypical antipsychotics. I’ve thought about trying a real mood stabilizer again, but I’m sick of drugs that cause whiplash when you don’t take them, and it’s not just Seroquel but also trazedone that have made me feel trapped taking something that really isn’t great for me lest I suffer the fallout.
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