Meds, redux

[jeshyr]

I got some feedback from my lovely friends worrying about me messing with psych meds, or being concerned. Thank you for caring :)

My goal is not especially to be off the Effexor - if I actually need to be on some dose to be OK then that's fine! So why mess with it? Two reasons:

1. I've been on the same 300mg dose for over ten years, so there's absolutely no way to tell if it's doing anything. I'm a huge amount more stable and with lower anxiety/depression than I had for the first several years when I was on the same 300mg dose, so it might be that I just got more naturally stable in my old age, etc. The only way to know is to be off it ... but even so I'd probably stay put except for ...

2. This is the biggie: I'm on way way way too many strong meds for comfort - the guidelines say start getting worried about polypharmacy if you're on more than 3-4 prescription meds. I'm on twelve.

Well, technically I'm on sixteen but if I'm only counting ones with systemic action it's twelve - the others are eye drops and nose sprays for eyes/nose symptoms only so they're much less likely to interact. Of those twelve, we have 6 for the mast cell crap which is ongoing and causing active trouble, and 4 for the POTS/NMH which is ongoing and causing active trouble. I'm under the regular care of experts for both of those, so those meds are being closely overseen and reviewed for necessity every 1-3 months. The only other two meds are Effexor and Neurontin, both of which I've been on for 10+ years with very little review and no dose changes until recently.

Until a few years ago there was also Klonopin/Clonazepam in that third category, but I successfully slowly slowly weaned off that with my last (teeny!) dose on 3/3/2011. The Neurontin dose is now 1/3 of the stable-for-a-decade dose. The Effexor will be down to 1/4 of that top dose after next week's reduction.

The Neurontin and Effexor dose changes started about a year ago I think? They've been VERY slow and VERY gradual and with TONS of time in between dose changes and I have been monitoring VERY carefully for any effects. Also because there are psych things involved I have worded up my flatmate and close friends (and selected family) with instructions about watching for anxiety/depression if I don't realise it, and authorised them to tell me to raise the dose again if they think I need it.

And although it'd be nice to manage it, I have no particular investment in getting the doses down to zero - if I find any dose level that makes me sicker for longer than a week or so's withdrawal effects I'll bump the dose back up and stay there.

Basically I'm doing it SO slowly that the doctors who are involved think I'm being nuts, which is fine with me - I'd way rather be over-cautious than end up mired unexpectedly in psych issues or anything else awful!! I have plenty of unavoidable problems in my life, I won't add any avoidable ones :)

There is another plus to the very slow steps down too - it lets me feel like there's something that I can do for myself, and something that I have some control over. Having some actual agency is pretty hard when your body's being this shitty, so even if it's mostly-illusory I'll take it!!!

Love you all,
r

Comments

[kaberett]

Hurrah, all round, for self-determination of healthcare where possible. ♥

[pauamma]

in my old age

Ahem. :-)

[dadi]

The high dosages are good when situations are particularly depressing/anguishing. I never exclude to go back on a higher dosage when needed.. but definitely agree with you on trying to keep it as low as possible, when possible. I am on a lot of meds too with my autoimmune issues and already refused to go on additional psych meds for the bipolar reasons because at a certain point one simply feels like under a constant chemical onslaught. I know what you mean with the alerting family and friends.. they were my warning light last year too, when I was slipping more and more into the Crazy after having been off the meds for 5 months. On my own, it would probably have taken a serious meltdown to realize I simply couldn´t do without. As it is, 3 different people independently from each other gave me the "maybe you should see your psych doc for a reassessment" talk.. and so I did. Thank the universe for people who are honest with us!