taper, taper, taper...

Today is the first day on my path to just taking mood stabilizers for Bipolar disorder. I've been taking a four drug cocktail (not including supplements and vitamins!) since 2006 that included an SSRI, an antipsychotic and two mood stabilizers(anticonvulsants). So this is a big step!

During yesterday's visit with the doc we came to the conclusion that I was ready to start pulling back on my SSRI, a drug called Celexa (citalopram) as well as the antipsychotic Risperdal (risperidone). I'll be cutting both medicines in half. From 20mg to 10mg of Celexa and from 2mg to 1mg of Risperdal. The doc didn't seem to think this was too aggressive of a taper. I was a little concerned, but he reassured me that I was strong enough to do this. He said the goal would be to get to a point where I was only taking mood stabilizers and that with this smaller combination of drugs we might see more of my "native" state. I've heard horror stories about getting off these drugs, but the doc seems to think I may just feel a little more reactive and moody for the next ten days or so until my brain chemistry settles into the new dosages. Right now the Celexa is letting the synaptic gaps in my brain stay very full or serotonin to treat depression while the Risperdal comes in behind it and kind of keeps a lid on the serotonin and dopamine especially to keep me from going into mania. By lowering both meds at the same time there will be less feel good chemical in the gaps but also less of a lid on things. The doc thinks it will balance out anyhow. Inevitably getting rid of Celexa lowers my risk for mania. This is the main goal assuming depression doesn't creep back in

I think this is a great thing. I don't think I've ever been more ready to do this. I don't have anything major coming up. I have a very low stress job situation right now and I have a lot of family support. I also think it will be beneficial to do this during the summer with the longer days and warmer weather. I guess if you've never taken drugs for depression or bipolar this probably sounds very strange. Just take a smaller pill, right??? Lets hope! I watched a Wayne Dyer lecture recently where he talked about stress. He was teaching about how we expect certain life events to be stressful like when our parents die, we change jobs, buy a new house or end a relationship. His point was that most of the time its the expectation that these things will be terrible and hard to get through that make them so terrible. What makes these things innately stressful or bad?

I'm going to stick with the attitude that all I have to do is take some smaller pills. The expectation that withdrawal will be terrible is what will screw me in the end if I get flustered. My doctor alluded to this as he walked me out of his office yesterday. He said "You know things could just go fine, it's not that big of a change, don't psych yourself out!"

There's the rub, roll with the changes...