Friday, January 31, 2014

Antidepressant reduction

Did I mention that I've been tapering off my antidepressants? I've been taking Cipralex (also known as Lexapro) ever since I was diagnosed with the mets and I ended up on a fairly high dose of 30mg/day. I'd been wanting to try to decrease the dose for a few years now, mainly because I sensed that my brain was a bit fuzzy: I felt like I wasn't getting to enjoy things quite as much as I wanted to and that my thinking was duller than it used to be. I also felt like my body and brain were missing a connection and I didn't feel quite right.

However, my family doctor didn't support the idea when I first talked to him about it a couple of years ago. I could sort of see his point as at that time I was still undergoing some pretty intense therapy to deal with my childhood and my traumatic past and my new tools for dealing with life's events weren't as well-used.

However, about six months ago, after having spent two years with my psychologist, I felt ready to try to slooooowly taper off the Cirpalex. I knew I didn't want to do this too quickly because I'd heard about some unpleasant side effects (SSRI discontinuation syndrome) that could happen if the dosage was reduced too quickly. I also wanted to be sure that I really could handle life without the antidepressant (or at least this level of it) and I was confident that I could. My psychologist was also careful to make sure that I knew that it might not be possible for me to go off of the Cipralex entirely; it may be that my brain requires the chemical to function.

My psychologist helped me set up a self-monitoring plan to chart things that were early signs of worsening depression and/or poor coping skills. Each day I track the amount of sleep I get at night and from naps, how cranky I am, and how many commitments I'm dropping (the more I drop, the worse I'm doing). I also track more general signs of depression each week. She agreed to help monitor me as I do this as well, and somehow all of that convinced my doctor that I was doing this taper in a responsible way and he said I could do it.

I've been dropping 5mg/day every six or eight weeks or so and this week I just got down to 10mg/day (remember I started at 30!). The only side effect I've noticed is that I'm more tired and easily fatigued when I first drop down a level. It's as though my brain has to work a little harder when the dosage is reduced and gets tired more easily. Aside from that, I haven't noticed any other issues.

I saw my psychologist today and she agrees that I'm doing well. I'm feeling creative and my brain feels alive in a way that it didn't before. Apparently this 10mg/day is the level beyond which I might not be able to go and if that turns out to be true I'm ok with that. I'm still going to try to get down to zero and if I make it, that's great but if I don't, things are pretty good right now. Even if I do go to zero, I won't rule out taking an antidepressant (or increasing the dosage) in the future if I need it. It's a tool in my coping toolbox and it has its place. In the meantime, I'm looking forward to life without quite so many chemicals in it.


Greg said...

That's awesome. Glad things are looking up.

manchester fat acceptance said...

when i weaned off antidepressants, i would sometimes have to go back on them for a few weeks at a low dose when side effects cropped up. then i would try again to get off them completely. it probably took a year or more to get all the way off them.