How did you know it was time

[bravesurvivor411]

For those of you who have came off all meds especially anti depressants how did you know it was time? I had pp last April and was put on the antipsychotic invega. A month later I was hospitalized for depression and put on Prozac. I had to be taken off of the invega after six months due to hormonal issues. My old psych doc wanted to put me on a new antipsychotic but I knew I didn't need it anymore. After I came off invega my life dramatically improved. My depression symptoms that were there even with the Prozac improved. I was also put on a mood stabilizer with the Prozac in case I'm bi polar...I had no previous mental health issues. Now I'm on the lowest dose of Prozac and half of the therapeutic dose of lamictal. My new psych doc doesn't approve of the dosage but it works for me and I've been on that combination since January. She was unsure about taking me off during the summer like I wanted and would considerate in the winter. I want to come off of Prozac in sept and lamictal in dec. I feel like I don't need it anymore. And I have been doing so much work with my extended care team to make sure I don't get sick again. Any stories or thoughts about coming off medicine would be appreciated! Thanks

[Lilybeth Volunteer]

Hello bravesurvivor

Thanks for your post. I'm sure if you have read some of my replies on the forum you will know that my PP episodes were many years ago and medication has changed in that time. I would like to help though and searched 'coming off meds' on this site and there are a number of replies which might help until other mums here can offer their advice.

Well done for doing so much work with your extended care team so that you don't get sick again. PP mums are amazing ........

Take good care of yourself.

[bravesurvivor411]

Oh whoops I guess I forgot there was a post about this a few days ago ...and I even made a comment!!😀

[Ellie_at_APP Partner]

Hi bravesurvivor

I think I commented on the other thread as well, but I just wanted to say re how to know when to come off anti depressants. Basically mine were being reduced, and when I was on a small dose, I realised I kept forgetting to take them. That's when I thought, I am better and don't need them, because when I was feeling depressed I would never have forgotten to take them because I was trying to take anything / do anything to help with the depression. Does that make sense? What I would say though is not to do it on your own obviously, I spoke to my CPN after I realised I kept forgetting to take them and she said it was fine to just stop. Basically it just felt right, I really didn't feel I needed them anymore.

Gradually reducing is definitely the way to go though. If I was you I would be clear what you want with professionals. My psychiatrist/CPN etc did listen to me, and what I wanted, and reduced when I asked to.

Great to hear you're feeling well.

[DEb12W]

When I adjust my meds I also take a lot from those around me. My main support crew eg husband, Mum, close friends. I ask them what they think, and then also let them know when changes have been agreed upon by my psychiatrist. So they can be lovingly looking out for me, and let me know if they have any concerns.

Usually it's just their job to reassure me that yes I'm getting better, and reducing the meds has helped me slowly enjoy being myself again

[Ceew]

I also felt a lot more like myself once discontinuing antipsychotics - a really noticeable improvement. And like you I agreed to carry on with a Lamictal as a mood stabilizer due to bipolar concerns from my doctor, even though my PPP mania was my only symptom that would fit that diagnosis. I also took about half of the usual dose of Lamictal while I was on it. However, in my case I was already taking a long term antidepressant before pregnancy, so I requested to be placed back on that and plan to continue taking it long term.

I only saw a perinatal psychiatrist once, and her advice was to stay cautious during the first year, and then start to adjust based on how things were going. I planned to stay on Lamictal until my 1 year anniversary of getting sick, but I ended up getting a rash while traveling, and discontinued taking it just in case. It more than likely wasn't the Lamictal/liver issue that is very dangerous, but it seemed safest to stop just in case. I had a tough few weeks after stopping quickly, but then had the same experience as with stopping Seroquel (anti-psych) -- I felt a lot if relief from my last bits of fatigue and low energy that I had been associating with my depression.

If your doctor doesn't seem to be on the same page with you about medication, can you get a second opinion? Have you ever seen a perinatal psychiatrist during your recovery?

My opinion is that if you and your care team and family are all on the same page about taking any possible symptoms very seriously, it is reasonable to try life without medication and see how things go. Maybe if you agree to keep medication on hand to use if something comes up suddenly, to use to manage what's going on until you can see your doc, that would be an acceptable compromise? I have done with my doctor during the period after stopping Lamictal.

I hope hearing some of my story was helpful, and I wish you the best in finding a doctor that wants to work with you. I think it's totally reasonable to be ready to stop medication and try to return to "normal" life.

[Ellie_at_APP Partner]

Hi

Re Ceew's post mentioning getting a second opinion from a psychiatrist, I don't know if you know (or if it's been mentioned on here before) but APP do offer a free second opinion psychiatrist service. Info about it is here on their website app-network.org/what-is-pp/...

Take care

[Sarah2015]

I would always remain on the side of caution and listen to the professionals. After I had PP I ignored my local CMHT and didn't see a psychiatric nurse or continue with medication. I considered the PP a blip. Ten months later I had a relapse which knocked me sideways. After that I started to listen -I have to say I did argue about the level of medication I was taking, continually trying to push it down but six years later I still take a background level amount of anti-psychotic. It's such a small amount I wonder if it's just a placebo sometimes and I have considered coming off it but I'm not sure it matters at this dose and it's a level of protection for my family.

[jen5678]

Hi, this is my first post on here.

I didn't take any anti depressants, but I took the anti psychotic olanzapine for several months, after having pp when my son was born 3 years ago.

I was on 20mg, which I think is the max dose, for about three months. Initially it did its job, in dulling the hyperactivity I was feeling after the pp episode, but then it started dulling everything else too.

I knew it was time to stop / reduce it, because I just had no ability to feel happy or sad or anything, except for really not wanting to do whatever I was doing at the time, and wanting it to be over, even though I knew I would hate whatever I had to do next just as much. I really struggled to engage with anyone about anything. I just wanted to go to bed so I could be away from everyone and not have to do anything.

My oh and I were sure it was the olanzapine making me feel like this, after all its designed to dull your feelings and that is what it was doing. But it was hard work convincing the heath professionals, as they were understandably concerned it could be the depressive phase of the illness.

They reduced my dose to 15mg which helped a little, but were very reluctant to reduce it again to 10. When we did manage to get it reduced to 10 I started to feel noticably better, and still hadn't had any worrying symptoms. The next time they surprised me by saying I could stop it completely, when I'd been expecting a fight to get it down to 5mg.

I think if you feel ready to come off then let your health professionals know and argue your point. It is their job to be cautious and they are right in taking it slowly. While it's hard at the time, it's better to spend a few extra months on a dose which may be too high, than to risk going onto a dose which is too low and relapsing, which could set your recovery back a year or more. If you reduce a little at a time, you can see if it's helping and also keep an eye out for any early warning symptoms.

[Sarah2015 in reply to jen5678]

I just had no ability to feel happy or sad or anything, except for really not wanting to do whatever I was doing at the time, and wanting it to be over, even though I knew I would hate whatever I had to do next just as much. I really struggled to engage with anyone about anything. I just wanted to go to bed so I could be away from everyone and not have to do anything.

That is exactly how I felt! Exactly! It was awful!

[Lilybeth Volunteer]

Hello jen5678

Welcome to the forum and thank you for posting about your experience of the effects of medication.

I can also remember the overwhelming feeling of wanting to retreat to my bed and stay there during my psychoses. I wasn't as self aware as you were at the time to discuss medication with the professionals, so I'm glad they made all the right decisions and I eventually fully recovered.

I think your post will be very helpful. If you would like to check the forum from time to time I'm sure you will be able to help other mums with your good advice.

Best wishes.

[Hannah_at_APP Administrator]

Hi jen5678

Some great info in your reply, thanks for posting. I too took olanzapine and recall all too well the dulling effects. I was like a zombie at times, would be caught staring into space (which was really embarrassing) and had zero motivation or decision making skills.

Bravesurvivor411, As others have said, listening to the professionals is important when reducing meds. But if you have strong preferences, they should all listen to you and especially a partner or other person close to you advocating for you can be invaluable.

My olanzapine was stopped after a year or so, with controlled reductions. I desperately wanted to be off meds but had to take lithium for 3yrs altogether. It's hard, and I personally felt really frustrated at times that I had to take it, like a constant reminder, but in hindsight it was what helped me get better so it was worth it in the end.

All the best with coming off the meds if that's what you and your care team decide. I didn't take anti depressants so can't share experiences of this. Interestingly the psychiatrist wanted to reduce meds over summer in my case as winter can be harder with dark nights apparently. Everyone is different though, I hope you find the right solution for you and your family. Xx