Getting off meds cold turkey

In My Humble Opinion
1

I take a lot of medications prescribed by my internist and my psychiatrist. My step-daughter, a very loving and self-sufficient young woman, and now my sweet granddaughter have both expressed concern about the amount of medication that I take. Recently my granddaughter asked me what would happen if I just stopped taking everything.

Will you help all of us to understand the consequences? (Since I will, in the end, be following the advice of my own physicians, I welcome all informed opinions, comments and explanations.)

Both physicians consult when necessary and are aware of all of the medications. These are the medications and supplements that I take:

  1. cozaar and norvasc (to control hypertension) My father died of heart disease, my mother has had mini-strokes, and my sister had a heart attack at age 58.

  2. premarin (hormone replacement therapy) I began taking this afer a hysterectomy for two ovarian cysts – one was the size of a soccer ball. I had previously had surgery for ovarian polycystic syndrome (formerly known as Stein-Leventhal Syndrome).

  3. prozac (for depression) I have chronic (diagnosed in over forty years ago) low grade depression that responds extremely well to prozac. Every few years I have bouts of extreme depression which require an adjustment in medication, hospitalization and close supervision. The last time was 7 or 8 years ago.

  4. xanax (for anxiety) I take l.5 mg a day which is .5 ( one pill) less than I am allowed.

  5. trazodone (to regulate sleep disturbances associated with depression) I take half of what is allowed.

  6. provigil (to help me stay awake during the daytime)

  7. topamax (to control compulsive behaviors such as overeating and compulsive shopping)

Supplements:

  1. Calcium plus Vitamin D (to help with my bone density problems which have shown up in tests and to stave off the osteoporosis and osteoarthritis that my mother and sister have)

  2. Tums (for additional calcium and for digestive concerns resulting from a gastric bypass)

  3. Multivitamin plus Iron (my intestines were shortened during the bypass procedure and therefore do not absorb nutrients as well)

  4. zinc (to keep my hair from thinning)

I am 60 and a half. :wink:

2

I am not a doctor, nor do I have any medical training. However, I read a lot, and I’ve had some experiences with similar medications.

I had my uterus and both ovaries removed about 3 years ago, and I started on HRT. When I read the studies that HRT didn’t provide heart health benefits, I quit taking it after consulting with my doctor. I started having symptoms of menopause very quickly. It was somewhat unpleasant, but nothing that I couldn’t handle.

I take Paxil, which is an antidepressant/antianxiety medication. If I abruptly quit taking the medicine for some reason, I have hellacious withdrawal symptoms. I get an extreme headache, I feel nauseated constantly, my nerves are on edge, I get damn near homicidal. I don’t recommend it at all. I had to taper down quickly one time, as the Paxil interfered in some way with an antibiotic that I HAD to take (no other antibiotic was working), and I still had very bad withdrawal symptoms. I don’t know how similar Prozac and Paxil are, but I really, REALLY urge you to taper off under a doctor’s care, if you must stop taking these sorts of medications.

I take Cozaar as well. I’ve never run out of it since I started taking it, so I can’t tell you what reactions I’ve had.

I also take other medications, relating to diabetes, heart, and kidney problems. Oh, and a couple of allergy remedies, one prescribed, and a couple of over the counter meds that my doctor has recommended.

I’m 46 and a half.

3

No truer words have been spoken. I stopped taking Paxil cold turkey and it was not a pretty picture.

Since no one on a message board even remotely knows about you or your general medical conditions, I would strongly recommend following your doctor’s orders and not pay attention to strangers opinions. If you truly want to learn about the medications and their contraindications, start studying about them from a factual position and not anectdotes here.

Best of luck to you!

4

Yes, Zoe, you are taking a lot of meds.

On the other hand, sometimes a person needs a lot of meds.

If I read the OP right, you basically have three medical conditions for which you take medication/supplements: high blood pressure, gastric bypass surgery, and a psychiatric diagnosis.

High blood pressure should be treated. That usually require a pill or two. If you’ve lost weight post-surgery you might be able to reduce the dose, but since it’s quite possible to be thin as a rail and hypertensive (although maybe not real common) you may still need this. If you require medication to control high blood pressure do not stop taking the medication. If, however, you’ve lost weight since the gastric surgery and if you can exercise a little more it might be possible to bring down your blood pressure to the point you don’t need pills anymore. Might. Definitely not something to try on your own, ask your doctors, etc., etc.

Gastric bypass surgery involving shortening or re-routing of the intestines requires supplements to prevent malnutrition. Don’t stop taking those, either. If you did, you might not have immediate symptoms but you could over the long term.

Hormone replacement therapy is not the cure-all previously thought. You might be able to reduce or eliminate this entirely, but as **Lynn Bodoni ** points out, that does have side effects. Since one of the possible symptoms of menopause is sleep disturbances, and you already seem to have some issues with sleep, you might want to consult with both your doctors prior to discontinuing HRT. If you have concerns with bone-thinning and discontinue HRT you might need something like Fosamax to help preserve your bones. Of course, this isn’t giving up a pill, it’s switching to a different one. Sometimes that’s a good thing, if the new pill is more effective for the condition and has fewer side effects. You might want to ask about this.

Seems like it’s the psych condition that requires the most number of pills (5 out of 8). Now, some folks are anti-psych medication, and since mental illness does not result in physically visible disease there is a tendency to poo-poo the whole matter. However, if these medications allow you to function better, you’re under the eye of a watchful doctor, and your condition is periodically reviewd, they may all be appropriate and needed.

Some people can breeze through life without having to take pills. Other people have medical conditions where pills are necessary in order to live at their best. For those people, having helpful medications is a good thing. I think it’s a fine thing your step-daughter and granddaughter are concerned about your health, and you should thank them for their concern. But then perhaps you could politely point out that you have several different medical conditions, each of which requires it’s own variety of pill. It is unfortunate that you have so many prescriptions, but it would be more unfortunate if these medicines were not available to you. In particular, if your doctors do periodically review these medications and dosages with you, keep an eye on side effects, and so forth all of this may be entirely appropriate in your paritcular case

5

Zoe, I don’t know anything about most of the medications you’re taking, and I’m not any kind of medical professional, but I can second what Lynn said about anti-depressants:

I too took Paxil for some time. After too long on the drug, I decided to stop. Although I was ultimately successful, it was not a pleasant experience. If Prozac (or any of your other medications) is anything like Paxil, you should stop gradually, under a physician’s supervision.

6

Zoe - The only aspect of your condition I fell confident about commenting on would be the psychological aspect. And even then, my best advice would be that you have a meeting with both of your physicians, the internist and the psychiatrist. I’d start the meeting with letting both of them know you want to titrate off some of your non-essential meds. Consulting with a nutritionist would be a valuable, and close contact with a therapist essential. Have you ever considered behaviour therapy for your obsessive, and depressive behaviours? They are key in staying on the non-medicinal side of controlling your behaviours.
I agree that getting off meds would be a wonderful thing, however, sometimes it is simply not in ones best interest. And one of the most difficult things to break is the habit of association with waking up and popping a pill, or going to sleep and doing the same…And a behaviour therapist you may find very beneficial.

Fair thee well getting through this - my sense is you will do just fine, you appear to be a strong woman.

7

Do you think that if you just quit it all cold turkey tomorrow that your arms and legs would fly off and your head would explode?

Kidding, I’m kidding. Please don’t.

8

I would also urge that you speak to your physicians and ask if there are any medications you’re taking that perhaps you might not need any longer, or at least might not need as much of.

As other posters have said, some people see a mess of prescription bottles and automatically assume that overmedication is going on. Others think that medications aren’t useful or are more harmful than good. Your step-daughter and granddaughter surely have the best of intentions for you, but they are not trained medical professionals, and you have what appear to be serious medical conditions. Ask your doctors. Get a second opinion if you are unsure if they are right.

9

As others have pointed out, you’ve got different things going on, and the consequences of stopping the medication for each condition is going to vary.

If you stop taking your blood pressure meds, your blood pressure will probably go up, increasing your risk for stroke and other vascular issues. Depending on how bad your hypertension is, you could potentially have problems very quickly. I’d stop taking those when either my doctor told me to or they pried the bottles from my cold, dead hand, if it were me.

If you stop the premarin, you’ll have menopause-type effects pretty quickly. This will be unpleasant, but I’ve never heard of anyone dying of menopause. The switch can affect sexual response, though, so that might be a consideration.

If you stop the prozac cold-turkey, you could have some pretty nasty withdrawal symptoms, and you’ll return to your pre-medication level of depression. It seems like you’d be likely to have the really bad episodes more often, but I could be wrong. Since these bouts require hospitalization, I’d guess that they’re afraid you might be a danger to yourself at those times. I’d keep the prozac.

I really don’t know much about the anxiety and sleep-regulation drugs, but it seems reasonable to assume that you’re going to be anxious and your sleep patterns disturbed if you quit taking them. This may or may not be worthwhile to you.

If you stop the topomax, you’ll return to compulsive, destructive habits like overeating and overspending, and I’m sure you’re all too aware of the effects of those habits. Again with the line about the cold, dead hand.

If you stop taking the vitamins and minerals, your hair will fall out, your bones will get brittle, and you’ll eventually get malnutrition diseases like rickets or scurvy or pellegra. Personally, I’d rather take the pills.

10

IANADoctor, but I also give my vote for not quitting meds cold turkey. Doctors can dose you down properly (if it’s possible to do so given the nature of your medical conditions) and recommend (if applicable) herbal or OTC remedies as substitutes (if you’d prefer them over prescription meds).

**I learned something though…I never knew there was a drug for compulsive behavior such as over-eating! :eek: I’d never heard of Topamax! Why is it that this drug is not prescribed more frequently (or is it?) for people with weight issues? And a pill can help you not shop compusively? Wait 'til I tell my certifiable compulsive shopper friends!!

Yogini :smiley:

11

Thank you all for the kindness and consideration of your replies.

For a while after the bypass, I was able to stop taking all blood pressure medicine. I think that if I lose some of the thirty pounds I regained, I will again be able to leave it off.

I asked my internist about leaving off the premarin. He left the decision to me, but he didn’t think that this medication at this dosage was particularly a threat. If I do leave it off, I may return to having a lot of superflous hair. There are worse things, I suppose. I wouldn’t want to become irritable though.

I have also been told by my doctor and pharmacist that I must not stop taking prozac suddenly. I think it can do some strange things to the heart, but I’m not certain about that.

If by behavior therapy you mean counselling, I have had counselling on an off since first diagnosed in the early 1960’s. For the last fourteen years I have met with my psychiatrist for 20-30 minutes once a month. The focus has been totally on how I handle things in the present rather than on traumas from childhood and earlier years. That has been incredibly helpful.

That’s nice of you to say and I think that I am strong too in terms of emotional intelligence. But before I began taking prozac, when my brain chemistry was apparently screwed up, I had no sense of self, no confidence, no knowledge of my own strength.

I think that use of it to treat compulsive behaviors is fairly new. Topamax, if I understand correctly, is actually a anti-convulsive medication. But one of the side effects is that it affects compulsiveness in some people. After a weight loss of 155 pounds after the bypass surgery, I began to regain some weight slowly. Since I have also had a problem with too much shopping, my shrink suggested that we try topamax. I stopped gaining weight several months ago and often I just forget to eat. (I’m serious.) I just returned from a two week trip to Paris where I bought a book and an inexpensive compact. I just didn’t feel the “need” to indulge myself. A few other items were small gifts for family.

12

Another IANAD but I have long term experience with this drug opinion…

I strongly recommend not stopping Xanax cold turkey. Even at that low a dose (I’m on 1 mg a day, have been for going on 3 yrs now), withdrawal will most likely occur. It’s a benzo drug, and they are both physically and psychologically addictive. The withdrawal symptoms mimic anxiety/panic attacks and are not fun. Your doctor can recommend a tapering schedule, gradually cutting the dosage over time, slowly, to reduce or eliminate such withdrawals.

My own personal experience with trying to stop Xanax was bad enough for me to not wish it on anyone. YMMV of course and you may not have the same problems. But I definitely recommend not going cold turkey on Xanax.

Best of luck to you.

13

I’m one of the board’s more outspoken critics of psychiatric meds, and even I think stopping cold turkey is a really poor idea.

The anti-psychiatric movement, aka the psychiatric inmates’ liberation movement, has a fairly rich literature on how to cope with detox from psych meds, but the short and sweet of it is, with rare exceptions, pare down, don’t just hop off. The rebound effects of a great many psych meds is pretty awful.

The ideal situation is to find a supportive shrink who will gradually decrease what you’re on while monitoring you to see how you’re doing with it. This should be a doctor who is not an ideologue holding an attitude of either “you should stay on your meds, we’ll try this but at any hint of problems you go back on the full dose and I get to say ‘I told you so’” or “you should be off psych meds, so I’m going to keep reducing your dosage and you just clench your teeth and scream into your pillow”.

As for the other (non-psych) meds, some of them will affect the psych meds and vice versa, so you may have to re-titrate the dose on the ones you decide to stay on, if any. Likewise they may affect each other, i.e., the premarin might accentuate or mute the effects of the norvasc. And some of these non-psych meds do tend to have emotional or behavioral side effects, which will of course add a bit of additional muddle to your picture of self as you evaluate how you’re doing with coming off the psych meds.

I tend to think you’re best off not trying to wean off the whole bundle simultaneously (although weaning is better than going off everything cold-turkey); instead, solicit your physician’s advice and try a few at a time.

Get labs! Get a baseline before you mess with anything, a complete battery of relevant tests. Keep a diary of how you feel at changing doses and protocols.

Finally, make sure you have a supportive family / network of friends, as opposed to well-meaning folks in those positions who think you should not be doing this. They aren’t going to be a good support system if they aren’t in favor of what you’re trying to accomplish.

14

Yes, and no. What I mean about behavior therapy is seeing an actual behavior therapist. The folks specialize in working with psychiatrists to help people change behaviors. Most start off taking the medication the psychiatrist (medical doctor) prescribed, in conjunction with working with the BT. The BT will work with you to identify triggers for every behavior you consider adverse and want to change. Anything from obesity, to depression to cleptomania, to bi-polar disorder. Eventually this person will help you to identify triggers that have produced the behaviors you want to get rid of. They are usually extremely compassionate people who will advise on all aspects of your past history, and will identify historical triggers that may be affecting your current state of affairs. Many times they are LCSW’s (licensed clinical social workers) or LCP’s (licensed clinical Psychologists).
If going to the Psychiatrist once a month is helping, then I would stay with what works for now, until you can explore other avenues. It’s my experience that psychiatrists tend to be over worked, and in some cases tied to hospitals, given them limited time for longer sessions with clients. This is not the rule of course, but it does happen.
I am not a clinical Psychologist, just a teacher of it. Good Luck with your endeavor.

15

Phlosphr, I guess I am lagging behind in terminology. A quick search brought me to “cognitive behavior therapy” which I am familiar with. I think that CBT is helpful to many people in breaking old patterns of reactions. My counselling sessions with my psychiatrists have done just that for many of my problems.

Other problems seem to have physical origins and that is why they have responded to a change in chemistry. Then the successses from both sources of help tend to reenforce each other.

I am still confused about how you can have your doctorate in clinical psychology and not be a clinical psychologist. I understand that you are not a practicing cp or even a licensed cp. Oh well. Thanks for the good support!

AHunter3, as always, you cover all bases! Wise words, I think.

Rasa, a friend of mind ended up in the hospital when he decided to go cold turkey on xanax. You are absolutely right that it has to be reduced slowly. When I went for 2.0 mg to 1.5 a day, I had to do it a half a pill at a time over a four week period before I stopped having signs of withdrawal. That is one of the medications that I would like to be able to eliminate if possible.

I just can’t imagine the consequences for my poor husband if I eliminate both xanax and hormones! :eek:

16

One of my husband’s primary goals is to make sure that I do not run out of Paxil. Every week or so, he asks if I need to refill my Paxil. He DOES NOT want me to run out of that stuff ever again. Not if he has to be in the same city, let alone the same house. :smiley:

I’d love to quit taking Paxil, but I know that my old bad behaviors will start again, or start increasing again. Realistically, I think that I’ll probably have to take it for the rest of my life, just as I’ll probably have to take insulin for the rest of my life.

17

Zoe, ask yourself this question:

Do YOU feel like you are taking too many pills a day?

Because this really is all about you - do YOU want to reduce the number of pills? Do YOU want to take less medication?

If you feel every pill is doing you some good and right now you’re stable, do you really want to mess with that? I’m sure you weren’t thrilled to be handed Topomax, but if it really has cut down on your overeating and compulsive shopping isn’t that a good thing? If you had had Topomax, oh, I don’t know 25 years ago and not gained a lot of weight in the first place maybe you could have avoided gastric bypass surgery. We didn’t have the drug 25 years ago, of course, but if we had and you had taken it your overall health might be better now. Certainly, a return to weight gain and compulsive shopping will not be good for you. If that pill can help you stay healthy mentally, physically, and financially (and assuming no debilitating side effects) why on earth would you want to stop taking it? Likewise, if your hypertension medication lowers your blood pressure and risk of stroke and heart attack why on earth would you want to stop taking it? My mother has had six heart attacks and a stroke and can tell you that’s no fun - if she could have prevented all that by taking a pill or three a day she certainly would have.

As I said before, reviewing what you’re taking, why, and if something can be reduced or eliminated every so often is alway a good idea. If the Topomax allows you to control your weight, the blood pressure comes down, and you can go off the blood pressure meds… well, you would have (slowly) traded two pills for one. If you can reduce the Xanax under controlled conditions by all means do so.

However, do not mess up the gains you have made in pursuit of jettisoning all the pills if it’s not in your best interests - especially if it’s at the urging of someone else. It’s YOUR health, not theirs. It sounds like you’ve made some progress with your health by using these tools called drugs That’s what pharmaceuticals are, you know - they’re tools. Good tools get good results. There should be no more shame in a person with legitimate medical needs taking a dozen pills a day if that’s what they need than, say, someone missing a leg using a prosthesis to walk. Until there’s a one-shot cure all we have is on-going treatment.

18

I was on the lowest dosage of premarin when I had my annual checkup in 2003 - right after my 49th birthday. My ovaries and uterus have been gone since '89, but as I was just 35 then, my Dr at the time didn’t want to dump me into hot-flash land.

However, my current Dr decided I needed to be weaned off the hormones. We stepped down gradually, first every other day for a few weeks, then every third day, and so on, till I was off them in about 6 months. A few months after that, the hot flashes started, and they continue to this day. Not fun, but not debilitating.

I also take ziac for my BP, but I’ve shed some weight, so that dosage was reduced. I’m hoping to lose more so I can get off it completely. But since there’s a history of stroke and heart disease in my family, whatever I do will be under Dr’s orders.

Good luck to you - and I’ll just opine that you shouldn’t do anything without professional guidance, but you know that.