I thought this time, I would write a post about my medical journey throughout last year while I was in Korea, especially in terms of the medication I took that were revolved around my health problems; fibromyalgia, depression and anxiety.
Before going to Korea in November, I was on an antidepressant called Venlafaxine that is a type of SNRI (serotonin-noradrenaline reuptake inhibitors), and two nerve-painkillers; Nortriptylene (primarily a type of tricyclic antidepressant but can also be used as a nerve-painkiller) and Gabapentin (primarily an anti-epileptic drug but can also be used as a nerve-painkiller).
Then I had my first medical session with my psychiatrist at Seoul National Uni Hospital in December 2018. From there, listening to my loooooong story about my health situation, my doctor decided to combine my nortriptylene and gabapentin into just a higher gabapentin dosage (as nortriptylene was to not be compatible with the meds he would co-prescribe me with), and so introduced new meds into my life.
He explained that he will get me to try mood stabiliser meds to (literally) try and stabilise my mood. I said okay, so he prescribed me with Olanzapine.
I tried this combination of meds for six or so weeks; venlafaxine, gabapentin, and olanzapine.
In the next session, my psychiatrist asked me about how I went with the meds. And he also asked how my mood was affected, how I was emotionally for the past weeks, etc.
I said it was good, but I still had a bit of depressive thoughts. And so he decided to let me try another mood-stabiliser, called Aripiprazole.
He then asked about my sleep. I said that I don’t get good quality sleep because I tend to be a light sleeper, or sometimes because of my fibromyalgia pains. And because of these, I feel groggy and lethargic throughout the day along with the drowsiness from the meds I take.
He said that it is important to have good quality sleep during the night, so that the quality of my life during the daytime may be good, too. And so he said he would prescribe me with sleeping pills to help me have good sleep. And not knowing what I was getting into, I just followed his guidance and said okay. So without telling me much more than that, he prescribed me with a benzodiazepine called Lorazepam.
But this is where the catch is.
I like to be aware of what kinds of meds I am consuming, and be aware of the side effects and such. So when I went home, I googled lorazepam to find out more information about it.
And then I found out that lorazepam has both dependence AND withdrawal effects.
A dependence effect is literally what it implies- once I start taking the lorazepam, I will eventually develop dependence/addiction to the meds. I would either seek for the meds at a sooner rate, or would seek for a higher dosage because my body will become accustomed to the dosage I am taking.
A withdrawal effect is what I would get when I am withdrawn from the meds; when I don’t take the meds anymore. This is because of the dependency my body formed during the time I have been taking the meds. It includes both physical and mental effects. Some generic withdrawal effects from meds or substances can include things like irritability, muscle pain, restlessness, insomnia or fatigue, tremors and more.
So it was shocking to find out that my psychiatrist so EASILY prescribed me with such meds. I was speechless. I wasn’t sure that I felt safe to consume these meds. Buuuuut… I still took them since I felt obliged to trust my doctor to make the right decisions for me.
And so another month or so passed and the next session came up. I must admit though, I had GREAT sleep during that month. And because I had great sleep during the night, I woke up feeling so refreshed and went through the day with less fatigue problems than before. Lethargy was still present, but not at a constant frequency.
But in the next consultation session when I brought up what I found out about the addictive and withdrawal effects of lorazepam, he reassured me that I was on a level of dosage where I wouldn’t significantly develop these effects. So he said to not worry.
And so I decided to put my faith in him further and carried on taking those meds.
Then a year passed by.
Once I was back in NZ and went to my Auckland psychiatrist, I told him the current list of meds I was on.
And the immediate thing he told me was that I shouldn’t have been taking lorazepam for such a long period of time (of a year); most people are only prescribed this med at MOST a month. And he also told me that in NZ, doctors don’t tend to prescribe lorazepam to patients because of the strong addictive and withdrawal effects.
Like, WHAT? What did I just hear?
Once again, I was shocked.
I was in disbelief; how could I have let this happen to me? How did I let myself blindly take such a med for such a long time?
And most importantly, WHY did the psychiatrist in Korea prescribe lorazepam to me so easily without any concerns?
I felt incredibly frustrated at the situation. (Emphasis on the SITUATION, not the PEOPLE, that I’m frustrated at.)
But, I also got to remember that, the way of prescribing meds may be different in Korea and in NZ.
And so I wasn’t mad at my Korean psychiatrist.
I just wish he was more conscious of the consequences before making the decision to prescribe me with lorazepam.
Anyway. It’s already in the past and I can’t do much about what happened.
My psychiatrist in NZ decided to get me off lorazepam and onto another type of sleeping pills called Zopiclone because it has less dependence and withdrawal effects, although they still exist at a low level. He said ideally, I shouldn’t be on these meds for more than 4 weeks too. But I couldn’t bear the idea of giving up my good quality sleep, and so he partially unwillingly let me take zopiclone.
It has a horrible metal-flavour to it when I take it; a side effect of zopiclone. HORRIBLE. But it still did its job, so I was grateful.
And then in the beginning of April during our lockdown Zoom consulting session, my psychiatrist gave me the task to try get off zopiclone. For obvious reasons.
And it was the perfect timing to try do so. THE best ever timing to attempt getting off zopiclone.
Because, withdrawal symptoms vary and may include rebound insomnia, reverse insomnia, muscle pain, anxiety, tremor, sweating, agitation, confusion, headache, palpitations, tachycardia, delirium, nightmares, hallucinations, panic attacks, muscle aches/cramps, gastrointestinal disturbances and irritability.
The most significant one is rebound insomnia.
Rebound insomnia is defined as “difficulty initiating or maintaining sleep that is worsened in the context of the abrupt discontinuation of sleeping pills. Insomnia may be worse than ever, leading some to experience a complete loss of sleep that lasts for hours or sleep that may be worsened over days.”
Scary, no…?
And so since we were in the Covid lockdown where I had my bed readily available to rest whenever I struggled with the aftereffects of zopiclone withdrawal, I attempted to get off zopiclone.
At first, I reduced my intake from one whole pill to a half each night. For two weeks. Already, the rebound insomnia was horrible. I couldn’t fall asleep until like 6am; 2-3 hours before I had to get up to work again. And so I struggled to function during the day with my engineering work with the lack of sleep. I had to spend my lunch breaks taking naps to catch up on sleep. And then in the afternoon I would crash again and need another nap. And then the cycle continued the next evening.
I was so tempted and soooo close to giving in and going back to my normal dosage of zopiclone so that I could get good sleep again. BUT I just had to keep going, for the better for myself. Sigh.
I was halfway there already. I could do this.
And so after the two weeks I cut down the dosage from half a pill to zero pills each night.
Again, I had terribly bad rebound insomnia. TERRIBLY bad. It was so bad that I couldn’t sit at my desk for 8 hours per day to do work because I struggled with the daytime fatigue from the meds and insomnia. And so I spread out my hours over seven days a week so that I could do just less than 5 hours per day. The downside to this was that I was constantly working every day of the week, so I hardly felt like I had time to myself. But, I gotta do what I gotta do. And therefore, I somehow (barely) pushed through lockdown like this.
Honestly, I’ve heard from people around me about how great lock down was for them. But it was the total opposite for me, because of the journey of getting off my sleeping pills and not getting to do ANYTHING else during lock down other than constantly sleeping and working. Lock down was a horrible memory for me.
However, now that I was now off my sleeping meds, I could hugely praise myself for succeeding in my attempt.
But from my health conditions and other medications I was taking, I started getting back the drowsiness side effect again.
It was difficult because, once lockdown ended, I started my one-day weekend work at Barkers again. And Sunday was kept for socialising with friends, so I had to cut down the days I spread out my 32 hours from seven to four/five. And so to ensure I kept up my productivity I volunteered to go into my engineering office to work four days a week. But going back from working five hours a day to eight hours a day was challenging because of my fatigue I had to also deal with.
There was no hope to keep me awake- long sleeps don’t help, caffeine doesn’t work on me, going for fresh air or a short walk doesn’t help; I don’t know what I could have done to keep me at a good condition during the day.
I was pretty worried and stressed out about this, you could probably imagine.
But then something miraculous happened a couple of weeks later.
I leisurely drink coffee- I love the taste of coffee, I love to sit at a cafe and read/write, so my hobby is to cafe-hop. Therefore, I sometimes drink more than one cup of coffee a day, even though I mentioned earlier that caffeine doesn’t work on me to wake me up.
But one night I noticed that I couldn’t fall asleep, even though I was so exhausted. I just thought I had a lot on my mind so didn’t think much about it, but then the next day I had the same situation where I couldn’t fall asleep for ages.
And so I had a think about why that could be. The only reason I could think of why was that I drank two cups of coffee on both days.
COULD it possibly be……..? COULD coffee work on me now??
And then I tested it out. One weekday, I drank one cup of coffee and saw how my body reacted.
Miraculously, I didn’t feel drowsy that day at work. I didn’t have the strong urges to sleep, I could actually be productive!
This was considered to be a huge saviour for me, I didn’t have to feel sleepy during the day now!
I was so relieved that this was the solution to my fatigue problems; increeeeedibly relieved.
And so, a few months down from my horrible lock down experience, I am at a much better, much more functional and happy place. Honestly.
Receiving the congratulations and thoughtful responses from my friends and my psychiatrist was also really meaningful, too. They were genuinely happy for me.
It felt good. It feeeeeels good.
I am good.
I am well.
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