by HL Teabury
I started on Prozac for depression in 1990. For me, it proved the miracle drug my doctor had promised. I rejoined the world, finished my graduate degree, and reshaped the life of my young family by moving from Detroit to Colorado.
Prozac, the world's first selective serotonin re-uptake inhibitor (SSRI)--lost much of its heartening punch for me over the course of years, and my initial daily dosage of 20 mg gradually was increased until it had swelled to 80 mg/day--the maximum recommended. By 1998 even the efficacy of that dose had flagged to the point that my family physician switched me over to Paxil (another SSRI) at 60 mg per day. I would never again enjoy the shinyness of life that I first experienced on Prozac, but Paxil got me through the days.
Also in 1998, my family's situation changed again, when I took a full-time professorship in Iowa. The move proved most beneficial for my kids, who thrived in the safety and reasonable values of the state. Good pay and great benefits contributed much to our improved existence, but the complicated weave of a responsible adult's life (mine) demanded over the Iowa years that more medications be piled onto my regime.
In 2002, my employer sent me for evaluation--to see if psychiatry could help me behave with fewer quirks in front of my classes, and more to their point, become more tractable in administrative affairs. Doctors diagnosed me with adult attention deficit disorder, and gave me a stimulant medication, Adderal--the dosage of which also was increased over a decade, from an initial 30 mg daily to its present 90.
In 2007, a knock-out major tranquilizer was added to my heady mix by well-intending doctors at a rehab clinic in Mississippi, where I had gone for treatment of a compulsive gambling problem. They added Seroquel to my other prescriptions, but in a relatively small dose of 25 mg twice daily. The drug lost its efficacy with lightning rapidity. By 2011 that dosage had shot up 400%. I was taking 200 mg of Seroquel each night before bed. I can't say that it helped me fall asleep; it simply knocked me out cold for the night.
I began to feel seriously overmedicated, and even a bit suspicious about my reliance on pharmaceutical culture for my sanity. I mean, would I be taking all this legal dope for the rest of my life?
In March of 2013, I tried to give up my nightly knock-out pills--60 mg of Paxil and 200 mg of Seroquel, taken before bed. I gave them up cold turkey and spent a couple of intensely sleep-disturbed weeks. My entire nights were spent in the preconscious, pre-sleep state characterized by theta waves. Rest was replaced by long nights in the theater behind my closed eyes--an ever-flashing montage of a thousand human faces, self-materializing and then dissolving into different faces.
And when I did sleep, my dreams crowded in immediately, vivid and long--I dreamt a dozen original episodes of "Curb Your Enthusiasm," all starring me, and permeated with the discomfiture of Larry David--the ironies of unexpected graces or windfalls, and the surreal failures that seem to follow such apprehension. I woke up exhausted. The result of that 2012 withdrawal: I have stayed off Seroquel--over five years now, although I did go back on a new antidepressant.
During several weeks in 2014, I ran out of antidepressant and challenged myself to stay off for a while. My dreams--exhausting dreams--have returned, although not so vibrant as they were. And as far as I can see, devoid of ironies. For example, last night I spent my sleeping hours trying to direct some sort of theatrical event, coaching a procession of kids how to enter the stage. This was a dream, of course.
My waking hours have taken on a similar preconscious twilight. And my judgement has been impaired. For example:
I was happy to be a volunteer shuttle driver between a large RV campground facility and a nearby town having their summer celebration day, "Happy Families Funday." The vehicle I drove was a stretch golfcart--with three rows facing forward and a fourth facing back. It could accommodate up to 10 adults, and as many as 18 kids. No railing or seatbelts, and it moved at a good clip. Every trip was loaded with kids, for word of my impromptu thrillride had circulated fast. Parents were happy to let their kids ride--out of their hair for a while with a responsible adult--me.
In order to get from RV campground to town quickly, I could cut through a small woods--a route full of twists, turns, bumps, low-hanging branches, etc. I had taken to making the trip at full throttle, with kids hanging on like a rollercoaster with no safety bar. Some kids brought their toddler brothers and sisters, and every rider thought it marvellous, death-defying fun--which it was. I shudder to think back at doing such an irresponsible thing now. I thank God none of those kids fell off or got hurt. But this is one of the problems of trying to get off psychotropic medications; you can go a bit nutty.
At the present time, I am taking 300 mg Venlafaxine, 90 mg of Adderal, 3 mg of clonazepam--and doing okay. But it was a terrible transition. Don't let the bumpy ride kill your patients.
