Withdrawal...

I have spent the past three to four weeks experiencing the worst prescription drug withdrawal.  About three years ago I was started on lamotragine -  a mood stabilizer commonly marketed under the brand name Lamictal.  At the time I was in a bad place emotionally and participating in a five hour a day outpatient psychiatric treatment program.  The doctor with the program was trying me on a variety of new medications and I didn't know which was  helping and which was hurting, but I knew that the class of drugs known as "mood stabilizers" was causing within me some major side effects.  Instead of stabilizing my mood, I began having racing thoughts and many other symptoms characteristic of manic episodes.  I was having a great deal of trouble sleeping.  My menstrual cycle was greatly affected, and my overall sense of well-being was impacted, although I couldn't explain exactly why.  When I consulted my doctor about what I was experiencing, she reacted as if I were making these concerns up out of the blue.  I grew very frustrated with her and was deeply affected by her lack of understanding and compassion.  Though she treated me as if my complaints were out of the ordinary, further research on my own discovered similar symptoms in other patients who were new to mood stabilizers.  Not only had Lamictal affected me this way, but Depakote as well.

Fast forward three years.  My current doctor puts me on lamotragine, and I did not recognize it was Lamictal under that name.  I also was not made aware that it was a mood stabilizer.  I was on it about a week when I noticed how FAST I was suddenly thinking.  Ideas would bombard me so fast I would have notes everywhere of the thoughts that came to mind, but I could not organize the information into any useful combination. I finally had to make myself use one place for notes so I could keep track. I couldn't sleep, my mind was revved up but my motivation was so low.  I began sleepwalking, something I haven't done since I was a small child.  I felt entirely out of sorts and unlike myself.  I turned to my best friend Google and began to research lamotragine - something I usually do immediately upon receiving a new medication.  As soon as I saw that lamotragine was in fact Lamictal, it all started to click.  I saw my doctor soon after and reported my symptoms.  Although apparently very rare, she believed me and immediately started tapering me off, much to my relief. 

It was short lived. 

Little did I know I would feel even worse as I tapered off the medication.  I had only reached 100 mg before reducing.  The minimum effective dose is around 200mg I believe but one must gradually increase dosage over a prolonged period of time to avoid a serious rash reaction known as Steven Johnson's syndrome.  One must also taper back off slowly to reduce the chance of suicidal thoughts, suicide and seizures.  So about a week after I start tapering off I notice I cannot make it through the first three hours of the day without the intense need to sleep again.  I feel like I am moving through mud.  I develop a rash and call the doctor, who is pretty certain it is not from the medication reduction, although there is no other explanation.  It goes away a bit, but again Saturday when the amount reduces once more another rash appears - one I am certain is a symptom of the lamictal withdrawal.  I have not been this tired in my entire life.  Even the infection that my body fought for 4 months after gastric bypass surgery was not as exhausting as I've felt these past few weeks.  

I have to sleep several hours every day. I have to force myself to do the most basic activities.  If it's not essential it just doesn't happen right now. I am incredibly anxious most of the time and I feel completely different from "normal" tiredness that comes with depression and insomnia.  It's a fatigue I cannot adequately explain, but it makes me feel lazy and unproductive and only contributes to the anxiety I feel.  

I have no idea how long this withdrawal will last.  I am supposed to see my doctor next week and I am hoping she will have some insight.  In the meantime I am trying to listen to my body and do as it requests, even though it's not what I want to do.  I am watching the rash and noting symptoms so I can determine what is getting better and what isn't. 

It's a frustrating and frightening process.  A tiny white pill can make my life significantly better in a matter of six weeks, which another one just like it can change everything.  I feel fortunate on the one hand, and annoyed on the other.  It's such a mixed bag.  I'm sure I've said this before, but the most frustrating part of mental illness, for me, is that there is no exact science to it's treatment.  It's a constant mixing and matching of medications, amounts and waiting for a reaction - either a reduction of symptoms or an increase.  It can also mean deciding which side effects you are willing to live with to have the better mood.  At least when you have high cholesterol, you know which med will work the best (most likely) and how much you need.  You can then do bloodwork to see if it's working.  It's not that way for depression and bipolar.  The other aspect of it is that you must usually taper off one med before starting the next, meaning you can be looking at at least a ten week wait to see what the next one is going to do for you.  

I try to remain grateful for the pharmaceutical interventions that make my life manageable, but I can't always ignore the negative.  It's part of my life, and even though I don't like it, it's the way it is.  Addressing it with honesty is the only way I can deal with all the feelings it brings up.