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answered 06:40 AM EST, Wed August 28, 2013
oh me again my medication was increased first venlafaxine from 180 to 225mg and sulpiride 200 to 600 but i went back down to 400 because i just didnt have any energy.not sure if this is making me feel scared in the morning

Jill Edwards Says...

I have spoken in the previous answer about letting your doctor know about the change in medication and the need for some talking therapy around the intrusive thoughts.

This might however be useful to think about: It is from one of the UK NHS Trusts

Handy Guide – coming off medicines

Very few people actually want to have to have to take medicines every day, but many people do e.g. for

diabetes, high blood pressure, low thyroid, epilepsy, arthritis, Parkinson’s Disease and heart problems.

They take them to help control symptoms or problems that then help them get on with their life. You need

to decide what are the pros and cons of taking a medicine and the risks of becoming unwell again.

This is not a definitive guide and it's not even really very scientific. These are ideas gathered together over

many years, but should help you have a meaningful discussion with your health professional.

Why might you want or need to stop taking a medicine?

 Side effects

 Concern about long-term side effects

 Fear of addiction or dependence

 Not then being able to take something else that interacts with it e.g. pain killers

 The medicine is no longer needed – your life may have changed

 Other illness affecting the medicine

 Doesn’t help or work

 You’re too unwell to remember to take a medicine regularly or reliably

 The medicine might be making things worse

 You need to prioritise another medicine

 You’re taking too many medicines already

 You’re pregnant or breast-feeding

 Cost (e.g. the prescription tax in England)

 The medicine has been withdrawn, not available in UK or no one will prescribe it for you

 Don’t like the pain of an injection or having to go somewhere for a regular injection.

What are the advantages of stopping a medicine?

 No side effects (short-term or long-term)

 No need to collect medicines

 No stress of trying to remember to take medicines every day

 Being able to drive (e.g. if the medicine is making you feel sleepy)

 Relationships might improve

 Less stigma

 Feeling better in yourself because you’re managing without medicines

 You can find out whether it was working or not – if you get ill again at least you’ll know it was working

 Saves the cost of the prescriptions.

What are the disadvantages of stopping a medicine?

 Risk of becoming ill again and what might then happen e.g.:

o Effects on your relationships – family and friends

o Effects on your work (either getting or keeping a job)

o Effects on you e.g. the distress of getting unwell again, the need to start treatment again. This

might actually end up with you needing more medicines than you would have had if you’d carried


 Possibility of going into hospital or see the crisis team again

 Annoying your GP if you get ill again

 Getting some withdrawal or discontinuation effects

www.nsft.nhs.uk and click "Learn more about medication". Medicine

helplines 01603-421212(Nfk), 01473-329141(Sfk)

How can you work out how to make a decision?

Have a look at this table and tick the boxes for the nearest answer for you:

Stability (how stable you have been recently)

I have been: □

Stable for many

years with no


Stable for a couple

of years or just had

a few wobbles

Stable for about a


□ Unwell in the last year

How often I

have been


I’ve only been ill

once before

I’ve been ill a few

times before □

I’ve been ill quite

a few times

and/or had quite a

few wobbles

I’ve been ill lots before

and/or they may be

getting closer together

Severity (how badly ill you have been)

In the past

when I’ve been


I’ve been managed

and supported by

my GP

I’ve been managed

as an out-patient □

I’ve been an inpatient or seen

the crisis team

I’ve nearly been

sectioned or have

been sectioned

Support (from family, friends, carers)

I have: □

Good family/carer

support □


family/carer support □

Some family/carer

support □

Very little or no

family/carer support

Relapses (getting unwell again)

If I start to get

unwell again a

relapse seems

to come on:

slowly over several

months □

gradually over

several weeks □

quickly over a

week or so □

quickly over a few


If I start to get

unwell again: □ I notice early on □

I notice but often

not how badly □

I don’t really

notice until it’s got

quite bad

I don’t notice until too


If I start to get

unwell again: □

Other people notice

early on and say so □

Other people notice

and don’t say but

would if I asked

Other people don’t

really notice or

wouldn’t say

Other people don’t

notice at all

If I start to get

unwell again: □

I listen to and

believe other

people and will

seek help early on

I hear other people

and might be willing

seek help early on

I don’t listen to

what other people


I don’t listen to what

other people think and

wouldn’t want any

help anyway

Medicines (the one(s) you are taking for the mental health problem)

Long-term side

effects: □

I get side effects

and find them hard

to cope with

I get some side

effects which I can

just about cope with

I get some side

effects but I can

cope with them

I don’t seem to get

any side effects at all

Do medicines

help? □

Very sure

medicines don’t

help me

Not sure if

medicines help me □

I’m fairly sure I

started to get

better within a

month or so of the

medicines starting

I started to get better

within a month or so

of when the medicines


If I restart

medicines: □

I get better in a

few weeks □

I get better in a few

months □

it takes many

months to start to

feel better

it might take many

months or longer to

start to get better

Consequences (what would happen if you became unwell again)

If I get ill

again: □

my GP should be

able to help me □

I’ll probably end up

as an out-patient □

I’ll probably end

up with the crisis


I’ll probably end up as

an in-patient

If I get ill again

it would: □

really only affect

me □

affect me and my

family □

affect me, my

family and lots of


Be a disaster for me

and my family, friends

and/or work

Risk factors (see the list on the C website for the symptoms you are taking medicines for)

I’ve looked at

the list and: □

I haven’t got any

extra risk factors □

I have a few minor

risk factors □

I have a few risk

factors □

I’ve got lots of extra

risk factors

Number of ticks

Multiply by 1 2 3 4

Scores a b c d

Your relapse risk score is: a + b + c + d =

www.nsft.nhs.uk and click "Learn more about medication". Medicine

helplines 01603-421212(Nfk), 01473-329141(Sfk)

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Page last updated Sep 02, 2013

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