Treatment Need opinions on getting off multiple meds

[petey03]

I've had anxiety/panic disorder for over 20 years. I've tried multiple benzos and SSRIs/SNRIs. They seemed to have worked on occasion, but i can't say for certain.

I'm currently prescribed daily:
1mg of clonazepam
600mg lyrica (for pain)
60mg duloxetine
40mg vyvanse for supposed adhd

I've been abusing the lyrica pretty badly over the last 2 to 3 years and taking clonazepam more than prescribed at occasion.
The vyvanse sometimes works really well, i can focus and do stuff, other times i get a bit jittery and anxious.

I feel i can't continue this way, i feel dumber and forgetful.

I will go and discuss with my psychiatrist soon, but i really would like to feel more stable, sober and productive.

What do you think i should be doing besides taking everything as prescribed? Can i taper multiple meds at the same time? What should i drop or keep.

Than you for helping out

 

[n3ophy7e]

If anxiety and panic attacks are a problem for you I would strongly consider discussing with your psychiatrist to stop the vyvanse and to increase the duloxetine. See what your psych thinks.

 

[Isavela]

I propably would taper duloxetine first. Nice and slow.

 

[RC-Lover123]

You can easily drop the Vyvanse, no tapering needed as it is not physically addictive. You will be tired/fatigued/depressed for a while, though. Dropping the lyrica and the clonazepam together may be dangerous, that is probably best tapered. I'd taper the lyrica first and maintain the clonazepam to avoid seizures. I don't know anything about the duloxetine, cannot advise on that. You could probably stop taking that as the withdrawal from the stronger shit will be so bad that it may just cancel out the antidepressant withdrawal.

Personally, I would just drop everything all at once (maybe not the clonazepam for the first week or so), accept the horrible withdrawal that will probably last a a few weeks and be done with the shit. But that is not for everyone, you have to be willing to endure a lot of discomfort, bad insomnia, pain, anxiety, panic attacks and possibly seizures. I had a massive amphetamine/benzo/alcohol habit that lasted for a year or a bit more. I ate at least 10 Valium and another 5 Xanax tablets per day, washed down with Smirnoff Ice or beer and I plugged (nose was fucked up too badly) several grams of street amphetamine daily. Similar to your habit, actually, besides the duloxetine. I threw everything away, got into my bed and rode that shit out. Took a few weeks of near complete insomnia, bad anxiety/panic, shaking/shivering, paranoia until it was over.

Why don't you give it a try? Just stop everything all at once and see how bad it really gets? It is not like it will hit you like an accident, you will slowly sink into your withdrawal hell. If I were you, I'd be curious about how dependent you really are. If it gets too bad, you can always take the clonazepam to avoid the most dangerous part of your withdrawal.

 

[deficiT]

^^ i would absolutely not "just drop everything at once" if you've had an anxiety problem and been on these or some other meds for ~20 years. If you've been heavy on the Lyrica, that needs to be tapered. If you've been on the Clonazepam for longer than a few weeks or months that ought to be tapered. Duloxetine is an SNRI, and so has similar withdrawal to an SSRI but worse due to the norepinephrine effect. Vyvanse you'd be safe to just stop, but again might have a relapse in Adhd or whatever and have some fatigue.

I honestly would just consider tinkering with/lowering your doses on the lyrica and Clonazepam. Hopefully that will lift you from the fog, but you should definitely talk to your doctor. You can lower your doses without having to stop any one med and it might help. Go from there.

 

[deficiT]

Also I'm not super familiar with the duloxetine dosage range, but you might consider dropping that one a bit too. I know personally I got a fair amount of side effects from those types of meds that made be feel kinda out of it, that could be a factor.

 

[n3ophy7e]

I've been on 120mg duloxetine for 12 years.
I started on 60mg then my psych just put me straight up to 120mg, which is the highest recommended dose.

The withdrawals are HECTIC. So, do not just stop taking the duloxetine. 60mg will not be difficult to get off of, and obviously everyone's experience is different, but you cannot just stop taking it cold turkey.

 

[AlphaMethylPhenyl]

I just think it's strange to gve someone with significant anxiety an amphetamine. That's kind of what pops out for me. They are known for making it worse over time. How long have you been taking it? Duloxetine should be somewhat stimulating. But yeah I can say that you need to gradually reduce doses of the other ones if you want to get off, particularly klonopin.

 

[n3ophy7e]

I just think it's strange to gve someone with significant anxiety an amphetamine. That's kind of what pops out for me. They are known for making it worse over time. How long have you been taking it? Duloxetine should be somewhat stimulating. But yeah I can say that you need to gradually reduce doses of the other ones if you want to get off, particularly klonopin.

I completely agree re: the vyvanse. Seems very odd to me.

 

[petey03]

I completely agree re: the vyvanse. Seems very odd to me.

Unfortunately it's quite common for adhd adults to have anxiety, and although it seems paradoxical, on adhd people, amphetamines can have a calming effect. For me sometimes i get sleepy a couple of hours after the vyvanse.

 

[plumbus-nine]

I just think it's strange to gve someone with significant anxiety an amphetamine. That's kind of what pops out for me. They are known for making it worse over time. How long have you been taking it? Duloxetine should be somewhat stimulating. But yeah I can say that you need to gradually reduce doses of the other ones if you want to get off, particularly klonopin.

I have general and social anxiety diagnosed and also myself think to having them. But stims are sometimes actually anxiolytic for me, very different from e.g. a benzo, pregabalin or (my favorite) a dissociative but stims don't need to be contraindicated when one has AD(H)D. The increase in focus and attention can decrease the focus from anxiety, possibly. Problem is that as he says, they don't work all the times, and depending on mood, food and whatnot are stims sometimes edgy and sometimes smooth.

In my experience is unfortunately pregabalin the one of all your meds which dumbs one down the most, this increases with dose and thus is worse when abusing it instead of sticking to the medical dosages. I remember sitting in the cinema and literally forgetting the past scene, leaving me in a weird, scatter-brained now. So my suggestion would be to firstly stick with the prescribed dosages of pregabalin, and check how much of the benzo you really need. For me it was effortless to quit pregabalin, it didn't do anything for me at normal dosages anymore anyways, but I know that for some it is difficult to quit. I had the theory that high (900+mg) dosages might be easier to quit because of an additional mechanism which arises as dose increases but this is plain theorism.

 

[Sonnystoner61]

I've had anxiety/panic disorder for over 20 years. I've tried multiple benzos and SSRIs/SNRIs. They seemed to have worked on occasion, but i can't say for certain.

I'm currently prescribed daily:
1mg of clonazepam
600mg lyrica (for pain)
60mg duloxetine
40mg vyvanse for supposed adhd

I've been abusing the lyrica pretty badly over the last 2 to 3 years and taking clonazepam more than prescribed at occasion.
The vyvanse sometimes works really well, i can focus and do stuff, other times i get a bit jittery and anxious.

I feel i can't continue this way, i feel dumber and forgetful.

I will go and discuss with my psychiatrist soon, but i really would like to feel more stable, sober and productive.

What do you think i should be doing besides taking everything as prescribed? Can i taper multiple meds at the same time? What should i drop or keep.

Than you for helping out

When I am prescribed a medication whether for mental or physical issues I research what else I can do to help control my condition.
When I was on 840 MED pain meds I did nothing but take meds to help myself.
After I chose to switch to buperenorphine, I added exercise (excellent treatment for most ailments), Yoga, diet changes, music therapy, meditation, blah, blah.
With my ADHD I eliminated certain dyes in food and added to both my Yoga, exercise and meditation. All these non pharmacological treatments help me immensely.
I hope it is some help to you too.