9 replies to this topic

[pmacdona51]

I will keep this short, but I am in desperate need for some advice on how to get off all of my medication and return to the normal functioning, happy person I was for 28 or the 32 years of my life.  Here is what I currently take and the length of time I have been on them.  I am hoping someone can help:

 

Percocet - 18-22 daily (4-5 months starting at 10 per day)

Dexadrine XR - 30-45mg per day (have come down from being at 90mg adderall, started about 1 year ago)

Cipralex - 5mg per day (about 6 weeks on)

 

Current symptoms:

 

- serious insomnia

- lethargy throughout the day

- brain fog

- mild depression

- general feeling of unwell

- zero will power (which was once as a pro athlete very easy)

 

I have a 90 hour a week job, a family, and am so sick of waking up every morning needing all this crap to even make me function, which it is not even doing anymore.  I am willing to do whatever it takes at this point........please help guys.

[Flex]

I have unfortunaetly no experiences with Dexadrine or Percocet even not with SSRI.

Only SNRI and Tricylic´s.

I guess it would be hard to stay productive during the 90hours/week and doing the cessation.

Stupid Question, but havent You asked a Doc to help ?

 

 

[Tom_]

A 90 hour work week is simply to much for a lot of people - there is half the problem. Burn out

 

I assume the Oxycodone and paracetamol were prescribed for some sort of pain? Has the pain gone now? That is the drug I would focus on reducing first. As you come off them all of your symptoms will worsen. The Percocet if reduced by 2-5mg every 2 weeks might help you avoid withdrawal. A short term course of Clonazepam or equally long acting Benzo's will help with the withdrawal.

 

Once you are off the Percocet a swap to modafinil may help get you of the dexamfetamine. Its been shown useful for methamfetamine addiction. Although its quite possible a simple taper will ensure no withdrawal.

 

The citalopram can be stopped straight away. Its a sub-clinical dosage and you haven't been on it for very long at all. The chances of withdrawal are minimal.

 

I would seriously take a look at your lifestyle. Burn out is commonly associated with increasing amounts of drug use, depression and anxiety. An antidepressant may actually be very useful. Trazadone may be useful in that it improves mood and will help you get a decent night of sleep.

 

Sulbutiamine, Caffeine and CDP-Coline/Citiocholine may all be used as stimulants to combat fatigue and cognitive defecits caused by the depression. CDP-Choline may also have some effiacy in helping you get off the dexamfetamine.

[Flex]

Tom_ is right.

- SSRI supposedly shouldnt be a problem to quit.

 

- You cant, epecially when You have a family, not work 90 hours.

Sooner or later You´ll get a heart attack, Stroke, Burnout or something.

 

I dont know You circumstances e.g. Finances, but You cant decide to wear such boulders,for e.g. maintaining a certain life standard.

No offence, just an example. Many people take their health sometimes too easy for different reasons,

but there could be some some justified ones. You never know.

So ask Your self if there could be another solution for this.

 

If I had a family, I would be more carefull to my self, to have a long and healthy life.

Its like beeing a Sportsman.

You have to maintain a endurance exercise, not a high output. Since You want to maintain this performance for a long time.

Or did You have ever seen a Marathon jogger, running 40 Miles

 

 

Edited by Flex, 20 June 2014 - 03:50 PM.

[nootsz]

You could try something like bacopa monnieri, it could possibly alleviate some stress and anxiety. I personally find it makes smoking a horrible experience (cigarettes taste like a nightmare), I also find that it makes my back pain less - not completely gone but less. I'm on a very low dosage and it works for me. The nice thing about it is that it's available without perscription. I would check out how it could possibly affect your current medication first though and read up on other side effects, just to be safe. Also consult a doctor about your current medication and possible safer alternatives, doctors are supposed to help so don't be afraid. Other than that, try to reduce your work hours, even if you're just cutting an hour a day off, it's still an hour you can use to relax or just sleep. You could also start taking short walks, you don't have to go far, just take a walk down the street and back, so long as you're actually doing something physical. It'll help release some feel good hormones. Good luck! Wish I had better advice.

[scarredforlife]

As already said, if you want to come off the medications, you need to make some serious changes in your lifestyle. Work-life balance is essential. I don't think you can kick such a habit as long as you need to function in your high-stress job. You need to take some time off and if you can't reduce your working hours by 40-50%, I'd really consider to not go back to that position at all. Your brain needs time to readjust itself and you have to learn to function without that chemical crook. I don't know where you are from, but at least here in europe any medical professional would advice you to go to a clinic which is specialised for psychosomatic problems for a few month. 

 

 

[Tom_]

bacopa monnieri is an unevidence based treatment and is a 'drug' solution, which is unlikely to be helpful either in quiting the drugs or in developing a drug free positive enviroment (for you to feel better). The only drugs you should consider are those used to to help in quiting the other drugs (and only for as long as that takes + reducing withdrawl) and an antidepressant if your depression is of moderate severity (unlikely since you are maintaining a 90 hour work week). If you must (for what ever reason) continue to work 90ish hours a week its not unreasonable to intermittently use non-addictive stimulant like supplements which don't appear to have any major negative effects like Sulbutiamine.

 

Cognitive behavioural therapy either in the form of a book or face to face may be helpful for the depression (where as antidepressants are unlikely to be effective in mild depression).

 

I do hope scarredforlife is not suggesting a few months of inpatient admission, which is clearly not even remotely indicated and would in fact be both ineffective and downright negative for your health and life in general. None but the most incomptent doctors would recommend such a course of action. You also don't have a psychosomatic problem and so I am not sure why he is recommending a referal to the typically rare psychosomatic clinics.(unless you forgot to mention non-medically diagnosed pain/physical ailments or psychogenic sezuires - the later I highly doubt, the former...well I have no clue as to why you are on the opioids but I also doubt). You should of course be talking to a family doctor/G.P (depending on where you live they may make a referal to another service) about coming off the meds and only if you fail after a few attempts is referal to more specialised OUTPATIENT clinics indicated.

 

I would also like to point out (I forgot to) that your decreased cognitive function, fatigue and general malaise are caused by excessive work and NOT the medication. Anyone working 90 hours should expect to feel like that, although depending on personal characteristics and biology those feelings can appear instantainously or even a 1-2 years down the line.

[pmacdona51]

thanks guys.  I work in the hedge fund world and its been a really tough slug recently and our financial situation is not anywhere near acceptable, but what was once keeping me going 90hours a week (the medications) now is doing nothing but just slowing me down, especially the opiods.  You are right on the opiods related to pain, I am an ex-NFL player and have a pile of injuries I am deal with, but I will take physical pain the rest of my life over the way I feel every day.  The combination of agitation, exhaustion, depression and general ahedonia is so frustrating.  I have a decent GP to help me out, but she is doing what she can, the damage was done when I was a player as it was basically throw pills at any problem and that mentality kept on going after I retired (due to a knee injury)

 

I think that I could get a few weeks off, perhaps 3 at max, and those 3 weeks would be without my wife and daughter as well as starting next week they are gone for most of July.  I want to take advantage of that freedom to do whatever it takes to get on the road to recovery.  Weaning off the opiods is simply not acheivable, I tried that multiple times and failed, in fact, a year ago around this time I went cold turkey on around the same dose, and the biggest regret I have is that I stayed on my 20mg of dexadrine IR during that period.  A few weeks after successfully getting off the opiods the doc switched me to adderral, thinking that my addictions were limited to just opiods I quickly got up to over 120mg of that crap a day.  I tried to cold turkey off that a few times, but that withdrawl was the worst depression I have ever felt and couldn't do it.  I figured I would use opiods to get off the amps but after a back injury I quickly had both back in my life.  Then a few months ago I added cipralex thinking it would help, and of course it hasn't.  the whole situation just sucks, I have been in this cycle of trying to use one medication to help get off the other.  and while I realize this is stupid now, at the time it was simply because I could not afford any time where I could not function.  family needed money, and I couldn't get any time off work.  so when you are faced with that pressure, it's hard to just be selfish like you need to be.

 

i guess i will just have to try using the 3 weeks to cold turkey off both the amps and opiods.  hopefully things don't get too dark.......

[Tom_]

No No and No.

 

First off, taking time off work shouldn't be done unless it becomes nessary. Doing stuff will help to keep your mind off withdrawal symptoms, it will give you a sense of effiacy and usefulness and research shows if you can stay in work your chances of recovery are much improved. You must reduce your work hours though, even if its only until you are off the drugs.

 

There is one other option. A week detox program as an inpatient. I am not suggesting it as a good idea but it is a possibility.

 

Using drugs of abuse to ween off other drugs of abuse is never going to work.

 

It might be time to consider a Naltrexone taper off the Oxycodone and alternative pain management. Other option is to taper with a benzo. I still think its best to do one at a time.

 

Drugs for the taper off of the amfetamine could be bupropion, modafinil or a swap to methylphenidate.

 

Your G.P may not be willing to prescribe the Naltrexone and that might nessitate a referal to specialist drug services. I don't recommend using other opioids for a detox.

 

Another option is trying a Benzo detox. Although I would recommend adding in a benzo on top of the other options on a PRN basis.

 

Stop the antidepressant cold turkey, there won't be any withdrawal from such a small dose after such a little time and start on the opioid detox. Once you stop them, never use them again unless its for acute severe pain (like you break a leg), even then, try to manage on something else if possible.

 

Mindfulness practice daily (meditation in particular), will help with pain, depression and general withdrawal. Alternative pain management can come in the form of Nortriptyline, Amitriptyline, Aspirin, Iboprofen, Pregabalin, Naproxen and Nefopam are all options depending on type, cause and severity of pain (more than likely two to three will be needed to control the pain as well as an opioid but in relatively low dosage).

 

 

[nootsz]

Maybe a 3 week break is just what you need to get yourself and your mindset/mental well-being right. I'd rather taper it off, steadily decreasing dosage. It'll give your body less of a shock. Consult a doctor first before going cold turkey, rather safe than sorry. Best of luck to you!

Edit:

I agree with Tom_ that keeping yourself busy will help keep your mind off the withdrawal symptoms.

Edited by nootsz, 23 June 2014 - 09:10 AM.