xPAP and discontinuing antidepressants (long)

kteague2 · Post by **kteague2** » Fri Aug 10, 2007 9:20 pm

Amandalee,

Just a couple thoughts on getting off the meds... Too many changes at one time may make it hard to determine the cause of any problematic symptoms. I would consider first getting your xpap therapy stabilized, getting to the point where you feel your sleep debt is repaid, and you are getting adequate restful sleep.

I've not taken the medicines you are on. I did stop taking Mirapex abruptly about a year ago, and experienced some neurological problems that have yet to resolve. Just do your homework.

Kathy

svh · Post by **svh** » Sat Aug 11, 2007 6:47 am

Everyone is different, and I'm not a doctor, yada, yada, yada....I am 40, and was on prozac for tiredness and extreme irritability for several years before I realized I probably had sleep apnea, got a sleep study to confirm it, went on CPAP. I've been on CPAP, completely compliant since the first night, since last fall. I waited a month before I began to taper off on the prozac. I figured I needed a period of adjustment to get to the point where the CPAP could really do its job. I then tapered off by splitting the dose in half each week until it was pretty small, then alternating days, then quitting completely. The process took about three weeks. I *never* felt any withdrawal or increase in depressive symptoms.

The adderall is a different story, imo. My son (ADHD) has taken adderall, and had to quit due to mood altering side effects (negative ones, needless to say). Over the years he's taken several different stimulants, some for a long time. When we've taken him completely off them, we have gone through about a two week period of *extreme* hyperactivity and sometimes reactive moods. Then it's over.

Good luck!

j.a.taylor · Post by **j.a.taylor** » Sat Aug 11, 2007 6:07 pm

garycub wrote:Trust your friends and family. Tell them that you want to stop taking your antidepressants because you feel you don't need them anymore. Also tell them to let you know if you need to go back on them. They will help you if you let them.

Hunter1 wrote:you need to TAKE YOUR HEALTH CARE INTO YOUR OWN HANDS.

Amanda,

There's a lot of wisdom evident in everyone's statements.

Using garycub's and Hunter1's statements as an example, I'd suggest that you try a three-pronged approach.

Ask your family and friends to serve as monitors, then talk to your doctor, and let this person know, that you want to work with them on your health care treatment, and you believe that what you've experienced is related more to your sleep apnea, than clinical depression.

Tell your doctor that you've created a support network of family and friends, who are willing to speak to you truthfully, if you seem to be falling into a state of depression, then ask your doctor for guidelines to taper off the medicine appropriately.

At least you've given the Dr. an opportunity to listen--if the Dr. doesn't listen, and won't let you participate in your own health care, then this is probably not the right person to assist you, and it would lend the appearance that they're prescribing meds rather indiscriminately.

SanDigital · Post by **SanDigital** » Sun Aug 12, 2007 12:24 am

Honestly, if your psychiatrist isn't open to stopping all mood altering drugs while you are starting cpap therapy, ask to see another one. Psychiatrists have gone through medical school, so they know there is more going on in the brain than can be fixed with chemical tweaks.

From my own history...I have been taking Wellbutrin and Effexor for about 5 years. While relentless exhaustion was one symptom I sited, I also had more classical ones...hopelessness, suicidal thoughts, self-destructive behavior, etc.

After being on the cpap for a month, I decided not to get my Effexor refilled. Partly because I wanted to see how the cpap was affecting me and partly because I didn't like the side effect it had "downstairs", if you know what I mean.

After stopping, I felt dizzy like I had the flu and I was in the worst mood, but that went away after a week or so, then I went back to normal. I don't feel like I still want to take it either. I don't know if it was never doing much or if the extra rest alone helped.

In the end, it comes down to this...mood altering drugs are purely subjective. Your doctor will almost always follow how you "feel" and give you a slew of pills until you have one you think works.

Unless you are really, really bad depression-wise, a doctor has no business telling you you must continue what is essentially an optional medication (as opposed to something that is "essential" like high blood pressure meds, diabetes meds, etc.)

So, I say go off all your mood meds following guidelines posted by medical sites. Once you have those out of your system, you can see once and for all if the apnea is at the root of your problems.

fredpb · Post by **fredpb** » Sun Aug 12, 2007 9:28 pm

I take meds for depression, bipolar, and schizophrenia. I am sure CPAP therapy will not help me!

Psychologically anyway.

A lot of people on antidepressants really don't need them or there is a fixable cause for their "depression". It all depends on you brain and your psychiatrist. They love giving out their candy.

Some people have disease of the liver, pancreas, bowels, etc. The brain is also an organ subject to disease.

If you are on antidepressants, and think CPAP will fix this, it may, but taper off, and have yourself monitored for depression. It can be very sneaky. If the depression does not go away, you must face the fact that you need meds.

Not all antidepressants are goodness. Some are very nasty. I have tried a few. The worst were Effexor and Wellbutin. I am on Zoloft now and am doing ok.

I am a CPAP newbie. I guess I gave the doc fits when he saw my sleep study! Between the mental disease, obesity, and med effects I don't sleep very well.

But CPAP machine works great!!!!!! Less than a week and I feel better. I don't mind the mask as I used to scuba dive and wore masks in the military.

Just be careful going off psych meds!

John_M · Post by **John_M** » Mon Aug 13, 2007 8:01 am

fredpb wrote:I take meds for depression, bipolar, and schizophrenia. I am sure CPAP therapy will not help me!

Psychologically anyway.

A lot of people on antidepressants really don't need them or there is a fixable cause for their "depression".

There is scientifc evidence that people with Sleep Aonea have had their depression reduced when they were treated with CPAP.

So my dr is reducing my meds right now and I think I may be "cured" of depression and bipolar by using my CPAP.

John M

Guest · Post by **Guest** » Mon Aug 13, 2007 10:39 am

amanda

i was another lucky patient who was prescribed effexor by a pill pushing gp who doesn't know anything but prescribing

i totally get you on the situational depression thing...when i first went to my current dr. i had prepared a list of my symptoms, which included fatigue, muscle weakness, global pain, mood swings, weepiness, weight gain, irritability etc. etc. (the list goes on & on, but i won't) and the first thing she told me was that we should get my mood improved then we could get to work on the other stuff...i was so relieved to have someone appear to be listening, i filled the rx for effexor and started taking it, even though i was pretty sure that anyone experiencing what i had for so many years would have a hard time not crying...of course, once she had me on the meds, suddenly there was no more effort put into "working on the other stuff"

i took it for around 6 months, all the while knowing it wasn't the answer for me; this was, of course, a short time to be taking it, but i still experienced some withdrawal (if you search withdrawal syndrome many pharmaceutical proponents will try to tell you there is no such thing, btw) which included dizziness and a weird shifting sensation in my eyes--very disconcerting...but it lasted 2 weeks and then i was back to normal--well, as normal as one can be contending with untreated severe OSA! later, when i told my gp i was off the effexor she was none too pleased, but i reminded her that without her help i had figured out that the symptoms i had previously discussed with her were clearly OSA related and that since someone else was taking care of me on that front she need not concern herself with any of that anymore

anyway, my point is that i agree with you about the OSA causing symptoms that could certainly mimic clinical depression, or they could actually cause a situational depression, which can be addressed without pharmaceuticals (ie xpap!); i also think the advice others have given you about how to taper off the meds is excellent...there's no need to make it harder than it has to be...you have enough to contend with as it is

best of luck to you...hope you'll be on the mend soon
sharon1965

Babette · Post by **Babette** » Mon Aug 13, 2007 10:54 am

Hey Amanda, I just wanted to say that I'm tapering off Lexapro starting today. I've been thinking about it for a long time, but your post, and doing some internet research has decided I'm going to TRY. I don't know if I can do it I'm a big baby, which is why I run to the doc and beg for pills.

So, for anyone else out there doing Lexapro, I recommend doing some googling on Lexapro withdrawal. I was surprised at how many people stated they had severe withdrawal symptoms. I don't think my doc knows anything about this, and from what I'm reading, many docs DON'T. Anyway, I've been on them for 3 years, and I'm just really ready to cut out all the many many meds I'm on. We shall see if I can survive a week of this.

I'm taking 10mg a day, and I cut my pills down to 5 mg. I have enough to taper off very slowly for a month or two. I figure I'll try 2-3 weeks of 5 mg, then try to half these teensy pills again for 2-3 weeks, then try skipping days.

I'm also, unintentionally, going off Provigil cold turkey. I discovered last night I was completely out. Hopefully I can survive that. I've only been taking them since May. Again, if I wig out, trust me, I'm calling the doc for more!

Cheers,
B.

amandalee · Post by **amandalee** » Mon Aug 13, 2007 4:13 pm

Thanks for all the advice. I appreciate the wide range of opinions. I'm going to get an appointment with the doctor who finally sent me for a sleep study and talk to her about tapering off the drugs.

Basically, I need access to smaller doses of the meds, because all I have are 60mg capsules of Cymbalta and 20 mg capsules of Adderall.
Hopefully I can talk her into giving me some samples so I don't have to waste any more money on this stuff that has never helped me.
Nope, I'm not bitter at all...

Again, I'm not completely anti-medication. There are probably many people who are helped by various psychiatric drugs. But all they've done for me is delay my OSA diagnosis, and take a huge bite out of my paycheck.

Babette- Good luck with the Lexapro. I took it for awhile, but switched straight to Cymbalta as soon as I came off it, so I don't know about withdrawal symptoms.

There's some information on this site about slowly tapering off psychiatric meds:
http://www.theroadback.org/

Another interesting link on the site is about how many antidepressants can cause weight gain (as well as nasty sugar cravings):
http://www.psychdrugtruth.com/weight.htm#what

Interesting. YVMV, of course.

Babette · Post by **Babette** » Mon Aug 13, 2007 5:56 pm

Man, if tapering off drugs helps me lose weight I'M ALL FOR IT!

Thanks for the links!

Huggers,
B.

GARYHRX · Post by **GARYHRX** » Mon Aug 13, 2007 6:24 pm

HUnter is right..It may be a challenge but even if you don't have the money up front for sleep studies and equipment etc. talk to the people providing those services. YOu can always bargain if you really want to do it. I have been on Prozac, Zoloft, Welbutrin and Lexapro. I have stoped all of them by tapering for a week then discontinuing. THe first few weeks are easy but then the symptoms start to return, I get moody and irritable. My partner and friends are quite relieved when I go back on my medication. I really do have depression and a significant history in my family. Unfortunately not all folks that are prescribed antidepressents are depressed.

Take things into your own hands.

xPAP and discontinuing antidepressants (long)

Weaning off meds

There is hope

Way to go Hunter.

Mask