to medicate (again) or not to medicate?

August 31, 2008 11:10 PM

Should I go back on the antidepressants before even my cat starts to hate me?

So, I went off of my antidepressants (300 mg. daily of the generic form of Wellbutrin XL, 37.5 mg. daily of non-generic Effexor, both of which I'd been on for over three years) about two weeks ago. I hadn't planned to do so, but between being super-busy and not being able to see my doctor, who was away for a month, it just happened. First, I started taking them less often (e.g., every two or three days) to maximize what was left; then I realized that I was about to run out altogether; then I did run out and thought (perhaps stupidly) that I'd just see what happened.

Since running out of the meds, though, I've become a bitch on wheels. I'm not the world's most patient person in the best of circumstances, but my levels of impatience and irritability have now gone through the roof. I've also been a little more weepy than usual, which could, of course, just be regular ol' hormones. So far, I'm not feeling depressed, but I'm also not feeling quite as calm and optimistic as I was when I was still on the meds. To be fair, some of these effects may result from my newly-hectic schedule (being back in school while working full time). Still, I'm a little concerned. Should I tough it out for the next month or so, then reassess? Or should I call my doctor, confess the error of my ways, and beg his forgiveness/prescription pad? I know that he (the doctor) is ultimately the best person to answer this question, but a) given my work/school schedule, it's hard for me to get in to see him right now and b) I've never felt that he was especially invested in my situation, perhaps because he has so many patients.

posted by chicainthecity to health & fitness (11 comments total)

Get back on them now. If your schedule has just become more stressful, now is not the time to "experiment" with not taking your meds. You should never stop taking medication for mental illness without talking to your doctor first.

Many people who "go off" their meds without a doctor's supervision often say "Well, I'm moody and weepy and bitchy now, but that could be due to A, B, or C, and not the lack of meds." That's extremely common, and almost always wrong.

Talk to your doctor ASAP.
posted by tzikeh at 11:27 PM on August 31, 2008

Yes. Go back on the antidepressants. Your hectic schedule isn't anywhere near as important as your health, and any pharmacist with any professional ethics would have given you a top up for a couple of weeks if you'd asked.

Get back on the pills. Then you can have a cookie.
posted by Hildegarde at 11:32 PM on August 31, 2008

Also, this is not how you come off your antidepressants anyway - you can't just stop taking them on your own hastily drawn up schedule. It's a slow process that can often be done over months.

And I can't imagine it's the first time your doctor has known someone do this... they really have seen all things under the sun.
posted by Augenblick at 12:31 AM on September 1, 2008

For the good of the planet, go back on them. I'm currently living with a man who ran out of Celexa 6 days ago. It ain't pretty. And while I now have made him an appt. w/ his doc for next week to get his prescriptions renewed, even after he's back on, another week will be shot before he's his affable self again. Until then, all bets are off for the survival of our lengthy (to date) marriage.

That said, it IS hard to be excited to see a doc who seems not to be personally invested in your wellbeing. But YOU need to be, whether he/she is or not. Given your hectic work/school, it's even more important to be well-regulated on your medication.

Good for you for having the insight into your situation even in this time of emotions gone awry.
And ditto on what tzika, and Hildegarde said, btw.
posted by mumstheword at 12:35 AM on September 1, 2008

Tapering off antidepressants can be dicey even under ideal circumstances. Even if you ultimately want to get off them, it's very unwise to do so without a doctor's supervision. Get back on them at least for now, and then, if there is a valid reason to go off them, talk that over with your doctor. Even he's just an overworked GP, he'll still be able to give you the industry standard advice for tapering, which will be better than you just suddenly going off them like this.

I was in a similar situation a couple years ago when I ran out of my Paxil and was dragging my feet on scheduling an appointment. In retrospect, I was definitely moodier, and I was also having this weird symptom where I'd get a pulsating sensation when I'd make large eye movements. I tried to convince myself at the time that these symptoms couldn't possibly be related, and that my increased sadness was merely a result of changing life circumstances. I eventually wrote to the NP who had been handling my case that I was "embarrassed" about letting things slip like this. She wrote back to say that she was sorry that I was embarrassed, and that helped me realize that there was no reason to feel like I would need to "beg forgiveness" over a situation like this.
posted by epugachev at 12:37 AM on September 1, 2008

Some people can go off antidepressants.

Some can't and shouldn't.

Get back on. Take the time to do it now. Your schedule won't get any better if you don't.

From personal experience going cold turkey on Effexor is a bad trip.
posted by Ookseer at 12:56 AM on September 1, 2008

Please call your doctor now and be honest. Everyone who has said this is not the way to go off meds is absolutely right. Effexor, in particular, is a nasty withdrawal process if not done properly. Maybe you want to reevaluate your meds, and that is perfectly reasonable, but this isn't the way to do it. Also, people go off their meds without their doctor's consent often, so I wouldn't worry about begging for forgiveness. I'm sure s/he has heard it all before. Be honest, matter of fact, and it will all fall into place. Good luck!
posted by katemcd at 3:15 AM on September 1, 2008

Actually, there's no smaller dose of Effexor than 37.5 mg, so there's no way you can "taper off" that dose--if one were intentionally going off a 37.5 mg dose, one would do it the way chicainthecity's been doing it, by going from every day to every other day to every few days to never.

But for heaven's sake, if you go off the meds and experience a return of symptoms, why would you want to "tough it out"? The point of the meds is to keep you from having the symptoms you don't want.

Call your doctor. Get a renewal of the Wellbutrin prescription right away. If you want to change meds or taper off, the time to do it is not in the midst of "a newly hectic schedule."
posted by Sidhedevil at 9:04 AM on September 1, 2008

Usually a doctor will call in at least a short-term prescription to cover you until your next appointment.
posted by ClaudiaCenter at 9:13 AM on September 1, 2008

Also -- Walgreens will call and bug your doctor for a renewal, and often that will work without another appointment. Also again -- Walgreens has given me several days of an anti-depressant as an "advance" on a not-yet-confirmed renewal so as to avoid withdrawal. (I've had the same SSRI script at Walgreens for many years, but it didn't seem as though it was based on that.)
posted by ClaudiaCenter at 9:16 AM on September 1, 2008

I've had CVS give me a few days of Effexor to "get me through" until my Dr. called in a refill prescription.

Go back on the meds. If you *want* to go off, talk to your doctor about that in your appointment. But the way to do that is to taper off under medical supervision. Going cold turkey, especially with a hectic schedule, is setting yourself up for a bad, bad scene.
posted by grapefruitmoon at 9:30 AM on September 1, 2008