At last all the weeks and misery of withdrawing from a carload of psychotropic meds was over. On September 6th I went to my psychiatrist's office hungry (fasting for more lab tests) but excited. Eric took me through many pages of questionnaires, charted my weight - 180 pounds (I am just STUCK there!) - and waistline (which figure I have mercifully forgotten). I was taken aback when he measured my height at just 5'7" - it means I have lost another inch in the last year or so (I used to be 5'10"!). The questionnaires were pretty similar to the ones from the previous week. Finally he handed me my medication packet, with strict instructions to bring it back on my next appointment, 8 days later.
You can see from the picture of the meds packet that the number and size of the pills increases on days 2 through 5, then stays the same until the 8th day, when the last change is made. Across the top of the panel are these legends:
*On the left: "IR Seroquel 25mg, 100mg and 200mg or Placebo"
*On the left: "Paroxetine 20mg or Placebo"
Thus, a patient receiving Paxil (Paroxetine) would be taking 20mg steadily from day one, and all the pills would be Placebo. A person strictly on Placebo would wind up taking five medication-free pills every night. A patient receiving Seroquel would be titrated upward gradually to either the 300mg or the 600mg final dose (plus a Placebo capsule in place of Paxil) as follows:
- First day - 50mg (two 25mg tablets)
- Second day - 100 mg (one 100mg tablet)
- Third day - 200 mg (one 200mg tablet)
- Fourth day - 300 mg (one 200mg and one 100mg tablet)
- Fifth through seventh days - 300 or 400mg (one 200mg tablet and either two 200mg tablets or one plus one Placebo)
- Eighth day - 300 or 600 mg (either one 200mg and one 100mg plus one Placebo of each size, or two 200mg and two 100mg tablets)
Over the next few days a pattern began to emerge: I'd have difficulty getting comfortable, then sleep very soundly and be very groggy in the morning. In the early evening I'd have a few hours of pleasant mental focus, and then after taking the night's pills the pattern began again. On the night of September 13th, after taking five pills for the first time, I had severe dry mouth.
By the end of the first eight days, my experiences included:
- Sounder sleep, though with significant trouble getting to sleep
- Pronounced difficulty getting up and getting my head clear in the morning
- Bad taste for the first few days, then dry mouth at the end
- Stopped remembering dreams
- Reduced appetite toward the end of the period
- Reduced level of muscle and joint pain
- Episodes of increased mental focus and productivity
I might sleep harder, have mouth/taste side effects, and even feel more clear-headed in the evenings due to Placebo effect. But the one thing I never would have anticipated was that my chronic back pain would improve because of a psychotropic drug. The decrease in pain has been so significant that for the first time in years I am not taking painkillers every single day.
If I were to grade the study medications for the first 8 days, they'd get a strong B.
