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The End of my Addiction

DefinitelyMedicated
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I'm on a lot of medication for my alcohol use disorder and major depression disorder /w concomitant anxiety. 

ALCOHOLISM:

Acamprosate [Campral] 333mg TT (666mg) TID CF
Baclofen [Lioresal] 20mg TID 
Topiramate [Topamax] 50mg BID 

DEPRESSION:

Sertraline [Zoloft] 100mg TT (200mg) QD
Aplenzin 348mg (bupropion [Wellbutrin] hbr) QAM
Aripiprazole [Abilify] 20mg QD

ANXIOLYSIS:

Propranolol [Inderal] 60mg TID
Amitriptyline [Elavil] 50mg QHS

---

I stumbled upon a 750ml (fifth) of vodka I hid from myself three days ago; I am now thinking that drinking is gross! (after I ended up drinking it all at once, after a month clean.) I was not drunk at all. No euphoria whatsoever. I began to question what I ever found to be so elusive about drinking— I've been having cravings on the medication, tbh, but this slip up has actually made the cravings a lot better since I now know I won't enjoy the drink unless I stop taking the meds.

I woke up the next morning with a mild hangover feeling too, and that is unusual for me. I'm becoming... indifferent to alcohol, but I still think about other drugs from time to time, but ETOH almost killed me. My anxiety is still high, and my depression is still there, but I think that symptomology will improve if I can stay sober.

Is there a particular medicine I take that makes me adverse to the alcohol or maybe it's the combo of everything? Placebo? 

Thanks! 

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Welcome to the forum Def! 

So glad to hear that your medications are working. To be honest I've never heard of a medical provider who prescribes those three alcoholism medications at the same time! That said, it sounds like they are doing the trick nicely. 

I have never tried Campral or Topamax so I can't speak about those meds with any authority, but I do take high dose baclofen. The dose you are taking (60 mgs if I read correctly) can lead to complete indifference on its own for some people. It's hard to pin down a "culprit" for your experience when you're taking three drugs, but I know that baclofen definitely helped even when I was at lower doses. How long have you been on that combination of meds?

Please stick around and share your experiences! I'm glad you found us.

 

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19 minutes ago, Felina said:

Welcome to the forum Def! 

So glad to hear that your medications are working. To be honest I've never heard of a medical provider who prescribes three different alcoholism medications at the same time! That said, it sounds like they are doing the trick nicely. 

I have never tried Campral or Topamax so I can't speak about those meds with any authority, but I do take high dose baclofen. The dose you are taking (60 mgs if I read correctly) can lead to complete indifference on its own for some people. It's hard to pin down a "culprit" for your experience when you're taking three drugs, but I know that baclofen definitely helped even when I was at lower doses. How long have you been on that combination of meds?

Please stick around and share your experiences! I'm glad you found us.

 

Thanks, Felina! 

I've been on the combo since April, started with Campral then added Topamax up to 300mg, but it caused brain fog at that dose— 100mg/day does not and still has an anti-craving effect. I slipped up in July and was put on baclofen and started taking all three in August and have 1 drinking day in the past two months, and it was not enjoyable. My doctor is thinking about giving me gabapentin or pregabalin to help my incessant anxiety, but wants to see if I can get by on increases on my Zoloft and Inderal first. 

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15 hours ago, neophyte said:

wow thats quite a cocktail you are on 

how long idd it take to find the right mix for you

Been prescribed everything slowly since April '16

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20 hours ago, DefinitelyMedicated said:

I slipped up in July and was put on baclofen and started taking all three in August and have 1 drinking day in the past two months, and it was not enjoyable. My doctor is thinking about giving me gabapentin or pregabalin to help my incessant anxiety, but wants to see if I can get by on increases on my Zoloft and Inderal first. 

What is you current dose of Baclofen and how often (a day) do you take it?

Regards

 

Bacman

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13 minutes ago, Baclofenman said:

What is you current dose of Baclofen and how often (a day) do you take it?

Regards

 

Bacman

21 hours ago, DefinitelyMedicated said:

ALCOHOLISM:

Baclofen [Lioresal] 20mg TID 

 

Ignore this, I see you are on 20mg three times a day - Have you titrated to this? - Do you have a schedule to follow?

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Just now, Baclofenman said:

Ignore this, I see you are on 20mg three times a day - Have you titrated to this? - Do you have a schedule to follow?

I started at 10mg 3X/day for a week then bumped up; my doctor is only willing to go up to 20mg 4X/ day then will begin adding gabapentin up to 3,600mg as an augmentation to the baclofen. He said he'd rather me order my own baclofen than use phenibut and be honest about dosing, but he really wants me on the 80mg. He also said Lyrica could be an option, but I would be required to take urinalysis in his office as it's CIV, and that is his policy.

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I can understand his hesitation re: the Lyrica, especially if you have a history of addictions to other drugs (as you alluded to above). I have a good friend who is addicted to that stuff. It's hard to watch. You mentioned Phenibut. A poster here, @Jetsman32, recently recovered from both Phenibut addiction and alcohol addiction using primarily baclofen.

It sounds like your doctor is a "throw everything at the problem and see what sticks" type. And it seems to be working! He sure isn't shy about trying new drugs, and that's so refreshing.  I've told to go to AA by way too many doctors in the past. And it's nice to hear he is open to you supplementing your own baclofen regimen. A lot of people on these boards supplement their baclofen with gabapentin, so that's a combination that many people will be able to advise you on.

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im interested in what the lyrica addiction symptoms are like, benzo like? i heard this stuff can be worse than benzos to get off. ive read many people having the same issues with gabapentin online, though a lot of doctors say it isnt addictive. but they said the same thing about oxycodone when it first came out... big pharama trying to make $$$ is probably the reason for these lies

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My understanding about Lyrica is that it is more like opiate addiction. My friend was addicted to opiates before the Lyrica. He also has chronic pain, which really complicates matters.

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The same doctor treats my parents as well. He's a general practitioner with an addictionology creditional and keen interest in psychiatry. Family doctor. Better than all the real PDOCs I've been too. My dad was an opiate addict, my mom should be emailing his list of meds from Dr. Z as well. 

 

This is is what my mom takes, if anyone has any questions for her.

 

COCAINE ADDICTION:

 

Nuvigil (armodafinil) 250mg QAM

Naltrexone 1/2 50mg tab (25mg) QD

 

DEPRESSION:

 

Effexor (venlafaxine) IR 75mg TT QAM then 75mg noon/QHS (300mg/daily)

Rexulti (brexpiprazole) 2mg QD

Nortriptyline 25mg TID

Buspirone (Buspar) 15mg TID

Deplin (l-methylfolate) 15mg QD 

 

MISC:

Trimipramine (Surmontil) 25mg QHS (sleep)

Metoprolol 25mg BID (hypertension)

Metformin 500mg TT (1,000mg) BID (Type 2 diabetes)

Benztropine 0.5mg BID (Rexulti side effects) 

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dad's meds:

Subutex (buprenorphine) 2mg BID (opiate addiction)

Byvalson (nebivolol/valsartan) 5mg/80mg (hypertension) QD

Emsam patch (selegiline) 12mg/24hr QD (depression)

Nuvigil (armodafinil) 50mg QAM (dopaminergic)

Namenda XR (memantine) 21mg QD (atypical AD)

Abilify (aripiprazole) 5mg QD (AD augmentation)

Klonopin (clonazepam) 1mg BID (anxiety/mood)

Nortriptyline 50mg QHS (sleep/etc) 

---

Dr. Z likes tricyclics and phenylpiperazines like Abilify and Rexulti. He screens my dad, but my dad doesn't mind— I still like to smoke occasionally, however. I could quit and join the benzo/Lyrica/modafinil train, and that is tempting...

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17 hours ago, DefinitelyMedicated said:

I could quit and join the benzo/Lyrica/modafinil train,

That sounds incredibly dangerous for someone with your history!

 I'm just speechless at the above drug combos, both you & your parents.  I find it difficult to believe that that sort of drug regime is sustainable or compatible with a healthy life.  I guess it's preferable to opiate or alcohol addiction, but long term benzos?  Does your doc have any plans to reduce down your treatment or is this going to be lifelong?

Sorry, I'm not sounding very supportive here, but I even have reservations about taking baclofen for the rest of my life, & that's a pussy cat in  pharmaceutical terms compared to some of the stuff you & your parents are taking.

Anyway, you said "any questions" - so can I ask what side effects you have from your current regime?

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I agree with Molly,

id be wary of a dr who throws the kitchen sink of drugs at you and other people in your family, were these introduced slowly one after the other or all at once?

at least get a second opinion from a psychiatrist, one or two.

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23 hours ago, DefinitelyMedicated said:

I could quit and join the benzo/Lyrica/modafinil train, and that is tempting...

I missed this post. I agree with the others: given what you have said about your history, that is a very scary sounding train to ride on. 

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Hi @DefinitelyMedicated nice to meet you. I agree with the above posters- it sounds like you are on a whole lot of drugs!

@Felina is right. Before I started Baclofen I was addicted to both alcohol and phenibut. Being a phenibut user allowed me to titrate up very quickly on Baclofen. I am now at 310mgs per day and am totally indifferent. Today is day (14) I believe at this dose- once I hit 90 I'll start titrating down to my maintenance dose.

I am also like you in that my anxiety is almost crippling at times. I am prescribed Klonopin but also use a number of herbal supplements.

Please let know what you think of gabapentin or lyrica when you start. I have a weird situation with gabapentin in that it gets me high. I take 300mgs 4-6 times throughout the day and it gives me a feeling of mild euphoria, clear headedness and a buzz that is hard to describe. If you have used Phenibut it can best be compared to that. I've done some research and it turns out only like 30% of people that take gabapentin have this reaction. I'd be curious to know what it does for you.

Also- welcome to the forum- should have led with that! Great info and people on here.

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Here are all the changes he made.

ALCOHOLISM

Acamprosate [Campral] 333mg TT (666mg) TID CF **DISCONTINUED**
Baclofen [Lioresal] 20mg TID --> 20mg QID (4X/day: 8AM, 1PM, 5PM, BEDTIME)
Topiramate [Topamax] 50mg BID

AUGMENTED: Gabapentin [Neurontin] 300mg TID --> QID after 1 week at same time as baclofen

DEPRESSION:

Sertraline [Zoloft] 100mg TT (200mg) QD **REDUCED TO ONE 100mg TABLET**
Aplenzin 348mg (bupropion [Wellbutrin] hbr) QAM
Aripiprazole [Abilify] 20mg QD

AUGMENTED: l-methylfolate [Deplin] 15mg. QD


ANXIOLYSIS:

Propranolol [Inderal] 60mg TID --> QID same time as baclofen, gabapentin
Amitriptyline [Elavil] 50mg QHS

 

He is discussing the possibility of using Subutex as a anti-craving medication/antidepressant. Thoughts?

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On October 3, 2016 at 7:33 PM, DefinitelyMedicated said:

I'm on a lot of medication for my alcohol use disorder and major depression disorder /w concomitant anxiety. 

ALCOHOLISM:

Acamprosate [Campral] 333mg TT (666mg) TID CF
Baclofen [Lioresal] 20mg TID 
Topiramate [Topamax] 50mg BID 

DEPRESSION:

Sertraline [Zoloft] 100mg TT (200mg) QD
Aplenzin 348mg (bupropion [Wellbutrin] hbr) QAM
Aripiprazole [Abilify] 20mg QD

ANXIOLYSIS:

Propranolol [Inderal] 60mg TID
Amitriptyline [Elavil] 50mg QHS

---

I stumbled upon a 750ml (fifth) of vodka I hid from myself three days ago; I am now thinking that drinking is gross! (after I ended up drinking it all at once, after a month clean.) I was not drunk at all. No euphoria whatsoever. I began to question what I ever found to be so elusive about drinking— I've been having cravings on the medication, tbh, but this slip up has actually made the cravings a lot better since I now know I won't enjoy the drink unless I stop taking the meds.

I woke up the next morning with a mild hangover feeling too, and that is unusual for me. I'm becoming... indifferent to alcohol, but I still think about other drugs from time to time, but ETOH almost killed me. My anxiety is still high, and my depression is still there, but I think that symptomology will improve if I can stay sober.

Is there a particular medicine I take that makes me adverse to the alcohol or maybe it's the combo of everything? Placebo? 

Thanks! 

I'm going to come out and say right now that the cocktail you are on is a disaster waiting to happen. If you lost access to those meds for 2 or three days you would almost certainly have a disastrous psychotic episode. It's also a matter of time before your body habituates  and burns out on them, leading your doctor to either switch them up or increase dosages even further. 

 

 Your medication reputation precedes you, and anyone else in a position to help you will see that list of medications and assume you're a severe case who has been written off for any chance of getting better- and that prejudice will determine your future  treatment. They are going to be more concerned about you not shooting someone or killing yourself under their watch than questioning why those meds were prescribed to begin with. 

 

I'm preaching this from experience- I was on 5-10 mg of Abilify for 5 years and it nearly destroyed my health, career and entire life. By the time I realized that the drug itself was the problem and not some underlying disorder, the doctors I saw were not helpful or supportive at all in getting me off of them and I essentially had to go through the hellish withdrawal process myself. The bottom line is someone with a white coat and a professional title is not going to act in your best interest- there is one of them and hundreds of you. Trusting them to make profound alterations to your brain chemistry on the basis of their authority and the sense of security they give is a crapshoot on their part to get to the next patient because they are overloaded.  It is not going to turn out in your favor. 

While I'm on the soapbox, there is a mentality on mental health/addiction boards with people being proud of how many medications they are on, as if it signifies complexity and sophistication, and it has to end because it is destroying people. It's no different than any other materialistic impulse to craft an identity by hoarding things that are easily defined and recognizable to others, but considering that brain functioning is being permanently altered it's an unacceptably destructive fashion trend. I say this because I've been guilty of this myself: I thought I had a chemical imbalance from my intense approach to life, and to be tweaked and optimized to perfection by a cutting edge scientific intervention proved that I was all the more exceptional and above the fold...

In reality, the professionals I had sought treatment from medicated me because they had totally written me off as ever having a productive life and it made me easier to deal with, my parents regretted how I ended up and threw money at me out of pity, and my friends got completely exhausted at what a drag I constantly was and faded out of the picture. The chemical imbalance never existed except as a theory in the prescribing guide, and at the time that theory seemed like less work than actually having respect for myself and adding value to my life. I paid dearly in a multitude of ways and regret it in some manner every single day. 

 

 

If this sounds harsh, so be it. I can't conscionably let someone do what you are doing to their minds after seeing how it plays out.  This board is a very good place to get help from the collective experiences we have here, but a I wrote above,  a lot of them are bad ones that we never want to see others have. 

 

 

 

 

 

 

 

 

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@fredson Your reply is the most profound I've read in this thread and in a long time; it has given me a lot of food for thought!! Wow. I guess I am creating an identity behind these medications, messing with my brain, appear hopeless, going down the wrong path, etc. Thank you for your input.

Now, with the Subutex, he was talking about using 2mg, half of that in the morning and the other half in the evening and decreasing some of my other medications. He prescribes it to opiate addicts, and he thinks it could work with alcoholics and those with MDD. 

Oh yeah, he prescribed me trimipramine 25mg. QHS as well for sleep, and it seems to be working. 

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You asked for thoughts on using Subutex.  My thoughts are......DON'T.  It's addictive.

Best not allow your doc to add anything new at all to your regime.  Ask him to very gradually reduce everything so that your brain returns to normal.  And please do think about Fredson's comments.

The only exception to that would be baclofen - I just re read your posts & I can't believe that a doc who would prescribe such a dangerous mish mash of meds isn't prepared to go above 80 mg daily of a safe drug like baclofen.

Is there an option in the US of getting a second opinion?  I guess for you poor guys it's all tied up in insurance.  In the UK we just ask our GP to refer us to someone else.

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you might think the dr is amazing but you dont know much about medicine, you should go see a psychiatrist or two to see what they think about this medication regime, try finding one that specialises in addiction

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Sertraline [Zoloft] 100mg QD

Aplenzin 348mg (bupropion [Wellbutrin] hbr) QAM

L-methylfolate [Deplin] 15mg QD

Propranolol [Inderal] 60mg QID

Baclofen [Lioresal] 20mg QID

TOPAMAX DISCONTINUED

Amitriptyline DISCONTINUED

Trimipramine was not available due to shortage; Quetiapine 50mg QHS RX'd instead. 

Abilify 20mg changed to Rexulti [brexpiprazole] 3mg QD

Gabapentin 300mg QID changed to Gralise [gabapentin] #3 600mg tab (1,800) QD CF

AUGMENTED: Valium [diazepam] 5mg QID -- says he's comfortable enough with my sobriety and this would help my anxiety and mood regulation and cravings, take it at same time as other QID meds

AUGMENTED: Desipramine [Norpramin] 150mg QHS -- AD for energy/mood; he thinks the amitriptyline helps my depression but causes somnolence during the day so he's trying out a more activating TCA

------------------------------------------------

Updated List:

Sertraline [Zoloft] 100mg QD

Aplenzin 348mg (bupropion [Wellbutrin] hbr) QAM

L-methylfolate [Deplin] 15mg QD

Propranolol [Inderal] 60mg QID

Baclofen [Lioresal] 20mg QID

Seroquel IR [quetiapine] 50mg QHS

Rexulti [brexpiprazole] 3mg QD

Gralise [gabapentin] #3 600mg tab (1,800) QD CF

Valium [diazepam] 5mg QID

Desipramine [Norpramin] 150mg QHS

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Hi, Definitely, and welcome to the forum. Sorry for the delayed welcome!

Man, that is one liberal doctor, and those are a WHOLE LOT of meds. Definitely not something I'd recommend anyone trying on their own. Ha!

That said, a lot of those meds are ones I've tried or are in my arsenal, too. I'm in the process (near the end of it) of giving everything the heave-ho and trying to keep it simple. Not that I'm suggesting that, if  you're sober and not depressed! Dear God, don't change a thing if things are going well!!! I just couldn't stay sober and I don't think I ever got full results from the ADs I tried. 

I stopped the bupropion (Wellbutrin) recently, because I didn't think it added anything and might have actually been increasing my anxiety. I haven't noticed a difference since stopping it. 

I switched from Effexor->Rexulti, then dropped that one altogether, too, when I found evidence that it may increase craving and withdrawal symptoms in rats with alcoholism. 

I gained 25lbs on Abilify, and was just taking it for sleep, at a very low dose. Ditched that one, too. Wish I'd done it much sooner! (Also, wish I'd stuck with a low-ish dose of seroquel.) 

Now I'm only taking amitryptilline for depression. A low dose, and I'm not sure I'll keep taking it. Interesting that your doctor changed it to desipramine. I am fairly certain I need an antidepressant, and may look into that one. 

The propanolol and valium are things I've taken PRN, too. 

I've also taken gabapentin (and will again in the future, probably) for alcohol cravings, but just started titrating up on baclofen to reach indifference again. (I'm only taking 80mg at the moment.) 

There are conflicting results in the research for Zoloft. In some studies, it shows a pretty good improvement in cessation of cravings and in others it increases cravings. Apparently, they think, a genetic thing. Who knows? Haven't taken that one in years. And I'm not familiar with Deplin.

Interesting that your doc only has you on 20mg of baclofen. That's...unusual. 

Hope you're well and continue to be sober and contented. (And able to keep all those meds straight! That was hard when I was doing it!!) 

 

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Ne, I'm pleased to hear you're giving everything the heave-ho (in your words!) apart from bac.

Sounds as though you're feeling a lot better for it, according to your comments on the other thread?

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