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Reduced Dose

antidepressants

A week ago I wrote about how I was forced to think about quitting my medication which is used to treat my depressive disorder and anxiety disease. At that time I only had 5 pills left but couldn’t get new ones due to a serious supply bottleneck. So, I was forced to reduce my regular dose of 20mg down to 10mg, to have a few more days and to not discontinue too fast as this can have side-effects. Now I will write about what happened next.

I went to my doctor to discuss the issue. He wanted to give me a package of Citalopram and I said “Nope!” as I am not planning to go from one type of antidepressant to another one. So, he said “Wait, a minute” and looked into his cabinet and then gave me a package of Doxepin, the medication I’ve used. It wasn’t a package like I usually had, it was a package with 50 instead of 100 pills. But as I halved my dose already, that’s now effectively the same length of days until I run out again. I told him that I am now already at 10mg and said that I want to continue on that dose because it would be a way to find out if I still have any problems with a smaller dose. He said that would be a nice idea and that he supports the try. And eventually, I can discontinue at a later point, that could be the next try. But I am not in a hurry. Now I have enough medication on a reduced dose and until I run out again, the Doxepin bottleneck might be gone.

So, what did I notice during the week? First of all, there haven’t been any real side-effects after I halved the dose. That’s at least what I think. That surprised me a little bit but on the other side, the previous dose was already pretty tiny anyway. But the real surprise is that my sleep is much better. Honestly? I haven’t had such great sleep during the last ten years. I am not sure if this is coincidence or correlated with the reduced dose. But one thing is sure, my sleep was fantastic and it led to feeling much more energized during the day, which means I wasn’t tired all day long and didn’t need to sleep at the wrong times. I mean, it’s no secret, some antidepressants are also sleeping pills but that doesn’t mean that they increase your sleep quality. It’s well-known that they might help you to fall asleep but in return, they can worsen your overall sleep quality. It would be ironic if my sleep problems would have had more to do with the pills than with my medical conditions. I will continue to monitor this.

Apart from being slightly more strung up, I feel ok so far. I expected it to be worse. I actually feared I could get severe panic attacks again but that was so far not the case. I’m just a bit more tensed up with the reduced dose but I think I can manage that. My stomach didn’t appear to be stressed so far, that is a good sign too, actually the best sign because there is nothing worse than having stress-related stomach issues. The only issue I spotted so far is that this week was an emotional rollercoaster. I was alternating between extremely sad feelings and extremely happy feelings without any reason. Today I felt like I need to cry and there was no reason for it, I just felt extremely sad and didn’t know why but forced myself not to drop any tears. An hour later until now, I’m the luckiest guy on earth, I feel fantastic and there is no reason for it either. That’s pretty manic, huh? I don’t want to argue if that is a side-effect of reducing the dose or depression at work again. But honestly, I experienced far worse things in the past than alternating between unexpected happiness and unexpected sadness. I will monitor that too. But it was kinda strange anyways.

My conclusion is that it works well so far. I only had one day so far where I felt completely burned out. And apart from being slightly more nervous, I had no panic attacks or any of the worst symptoms I experienced in the past. I will stay on that smaller dose for a while now and see how it works long-term and then I can maybe go a step further, getting rid of it completely. Time will tell.

6 Comments »

  1. I’m glad to hear that you were able to obtain another supply of tablets so that you can slowly wind down rather than having to do “cold turkey” as they say. It sounds like you are coping well so far, naturally, you are probably a bit anxious about the situation but getting a better nights sleep must be fantastic. By the time you need a new prescription again, you should know whether you can cut the dose still further or would prefer to maintain the current one or even go back to the previous dose. With any luck by that time, the shortages will have ceased and you will be free to choose what you want based on how you feel not a necessity.

    • I do agree with you. A much better way than going “cold turkey”. Like we said in the comments of the other post… it’s a shame that people have to go through this. That shouldn’t happen. Now it seems I can manage the reduced dose well but a couple of years ago it could have sabotaged my treatment completely and could have thrown me back. I fear this might have happened to some people now who still have bigger difficulties than me.

      Sleep is also related to stress, well, it’s about our brain taking a time out and deleting unneeded information’s. I wouldn’t be surprised if long-term good sleep would further reduce any negative symptoms. There are a lot of coherences between sleep, stress, anxiety and so on. I really enjoyed how I could sleep through the nights this week…improved my days a lot. I hope it stays this way.

  2. Medical treatments are somewhat experimental because each patient has physical differences that can contribute to the efficacy of any standard level of treatment. You are fortunate your doctor is open to the idea of letting you try the lower dose! Congratulations, too, on the better quality of sleep. That can make a significant difference in mental and physical health. You seem to be discovering that through personal experience!

    • Exactly. Yes, I always thought my bad sleep would hurt me in the long run because I’ve read much about sleep and seen many documentaries and know how important good sleep is for us. I still think the pills have been a nice trade-off even if they might have caused bad sleep as my anxiety symptoms have been far worse than that and would have hurt me too in the long run (stress). But now it’s the right time to experiment with a lower dose because I feel good. And now with better sleep, I am amazed and feel so much better during the day 🙂 It really shows how important sleep is. Thank you 🙂

  3. Sounds positive to me. Guess you can expect some adjustment, the brain is a bio-chemical system after all. The swings should stabilise eh and better sleep is a tremendously healthy trade off. Keep fighting the good fight Dennis

    • Right, it’s probably related to the adjustment. The swings felt strange but I am not too concerned about that either. When I felt sad for no reason, I went outside running and was okay afterward. Had another good night with very good sleep… very surprising but I am amazed about that. Yes, sleep is super important and I hope my sleep stays that good… really amazing. Thanks, Jeremy, I keep fighting 🙂

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