Tapering All By Myself! (Remeron, Epival)
As much as for you, fellow psych patients, for myself, let’s summarize the medication I was on before I went into hospital – for a serious case of mania that plummeted towards a very serious depression, largely circumstantial, when I learned the man who offered me a rental situation that sounded too good to be true, was, indeed, too good to be true, and he had not only taken me for about $1000 cash, but stole the majority of my clothing and my cat – factors my hospital psychiatrist couldn’t care less about (“we can deal with that later…first things first, medication“ – with that I am now on, post-hospitalization (Obviously, all of the possessions taken are now permanently AWOL, to none of their concern). Looking back, the cab driver, posing as a good samaritan (look out, ladies!), was probably more of a pimp-samaritan (why else the interest in women’s clothing?). Although my dream of tapering down significantly on my massive dosage of Effexor (450 mg) was met, I was put on a litany of new pills, and now, out of hospital, I am starting to feel their own nasty side effects “big time” – namely, words stick to my tongue like never before – my fairly large vocabulary no longer seems accessible as fast as “dictionary.com”, but its annals have been catalogued back into the heavy, written Oxford dictionary, and I’ve never been good with searching any alphebetized catalogue – anyone who has ever seen me try to a phone book knows this! (Thank Goddess this is the last year Vancouver will be publishing a written phone book! …unless you have no Internet connection… ); and a major slowing of my metabolism, meaning lethargy and the consumption of far too many cupcakes (I am temporarily staying way too close to “The Original Cupcake” location at Davie and Denman for my health’s sake, before I move back to East Van in April…and there, ha, there is only more food!!).
Thus, as I know my body, and that this is in no way close to my natural metabolism, and I am becoming unhealthy – smoking more cigarettes to supress my appetite, that usually only turn into cigarettes between dips into the freezer for ice cream, I have decided another taper is in order. Back to that list, so we can see what I’m doing.
- 450 mg Effexor/venlafaxine (taken in am)
- 250 mg Lamictal/lamotrigine (taken 100 mg am, 150 mg pm)
- 8 – 12 mg Klonopin/clonazepam (throughout day, “as needed”…I know, immense)
- 300 mg Effexor/venlafaxine (taken in am)
- 1000 mg Epival/valproic acid (taken 500 mg am, 500 mg pm)
- 30 mg Remeron/mitrazapine (taken at pm – i.e. bedtime)
- 2 mg Klonopin/clonzaepam (throughout day “as needed”
- PRN 25 mg Seroquel/quetiapine (IF needed to aid sleep – right…I’m comatose as it is!)
So, I left the hospital on less Effexor, but on more medications in general. Thanks, but no thanks.
My plan: Immediately eliminate the 500 mg Epival at bedtime, and cut the bedtime dose of Remeron in half (these two are both metabolism-slowing, especially the Remeron). Then, eliminate the am dosage of Epival in a week or two, depending on how I am feeling. Perhaps do the opposite and eliminate the Remeron, we’ll see.
Here in Vancouver, British Columbia, Canada, you see, psych patients are not given the luxury of a regular psychiatrist, but are divided, by neighbourhood, to see members of a “mental health team” (Northeast, Northwest, Southeast, Southwest). That’s right – not by diagnosis, history (abuse, suicide, eating disorders, etc.), or any other psychiatrically relevant factor, but by where one lives.
Then, depending on where one lives, “support groups” for certain issues are pushed on the patient, even if almost completely irrelevant. For example, “Crystal Meth Support Groups” are hot right now with the Northwest team. Way to give someone without a previous problem with meth a new problem – send them to a group where dealers hang out to pounce on newbies…
I’ll be seeing the Northeast team, myself, in a few weeks. Goddess knows what they’re touting. I’m sure it has something to do with addictions (addictions, ADDICTIONS, you’re an addict, GO BE A GOOD ADDICT SO WE CAN TREAT YOU ALONG WITH OUR CHOSEN LOWEST COMMON DENOMINATOR, crack, meth, addictions, group, addictions, SUPPORT!). If this weren’t bad enough, the psychiatrist we end up seeing depends on the day of the week the clinic is available to slot us in given our/their ability, and so, real treatment is left in our own hands.
Thankfully, I know my mind and body well, and have a good GP (almost unheard of for a migrant to Vancouver), so I’ll do alright. However, the ol’ revolving door is the most striking part of the architecture as one walks past the office of the four mental health teams in the city.
It’s an incredibly depressing situation that certainly cannot be medicated away, and one that those who are lucky enough to have been taken on by a private psychiatrst rarely never think about, even if involved in “antipsychiatry petitioning” of sorts. Why won’t a private psychiatrist take me on?
Because my case history is too extensive. My GP told me this, flat out. Private psychiatrists are much more interested in young, attractive women with body-image issues, than one with multiple suicide attempts and sexual assaults under her stockings, to boot. That’s just too much of a workload.
And so, I will let you know how my self-taper is going along with all else as we move into March!