weaning off an antidepressant?

[HerMajesty]

Thank you Bathsheba I was suspicious of this information myself.
I am still a little confused though, maybe due to your research you could clarify: Yes, it makes sense that gabapentin would in no way cure an underlying condition. This is a little different though for those of us who have experienced long term nerve compression, and have now had the underlying condition removed. Of course gabapentin will not remove compression. But now I am in this position, and I know others are too, where the compression has been removed and I have to wait to see how much healthy nerve function will return and how much of the damage to the nerve is permanent.
I have heard from a couple of sources that surgeons are happier when they remove a compressing force from a nerve and find that the nerve is still round and pink; but are less hopeful when the nerve appears white and flat...that happens with longer term or greater force of compression and is more likely to be associated with a poor long term outcome. Personally, I don't know how my nerve roots looked when the compressing cysts were drained. I asked the Doc and got the evasive, "I like to look at the patient's response not the appearance of the nerve". The bad news is my 1st symptoms started over 7 years before I finally got proper diagnosis and surgery. After this Tarlov cyst surgery, return of normal function is typically slow: They follow the patient for two years but the nurse told me she has had patients report improvement even 3 years post op. So I am a little superstitious about stopping gabapentin while waiting to see how much nerve function returns.
In other words, gabapentin will not remove underlying cause, but can it assist in the regeneration process when underlying cause has been removed? Do you have a definite yes or no for this? If there is an article you could link to, that would be great.
If I were wholly convinced that I would have the same final outcome with or without gabapentin, I would certainly consider getting rid of the stuff sooner. After the nortriptyline, it is my 2nd most hated med.

[HerMajesty]

BTW I noticed something about cutting the antidepressant dose, maybe this is obvious to everyone else but me, but for me it was kind of an epiphany: Getting a pain flare when you cut a med dose DOES NOT necessarily mean the med was keeping you more pain-free and you can't live without it. I got a flare with the nortriptyline withdrawl that lasted about a week beyond other withdrawl symptoms. I was very frustrated because I thought I was doing well enough to get off the stuff, and that flare temporarily had me convinced I really needed it after all. Now I am doing quite well and planning to cut the dose another 10mg next week (have to time this for when I haven't made too many plans, ugh).
What this made me realize is, in theory, people on long term pain control will probably flare when almost any med is first withdrawn, whether or not they really need medication anymore. After all, most of our meds, and definitely antidepressants, act on neurotransmitters. The withdrawl syndrome is because your body has to re-learn to make the neurotransmitter that the med was supplying. Meanwhile, your body is going to be functioning with a lower level of something in the brain, and that contributes to pain. I think when my brain started making enough of whatever chemical(s) to bring me out of acute withdrawl, it still had borderline low levels hence the flare.
Now my brain is doing what it should again - time to step down the dose, but this time I will expect a few days of acute withdrawl followed by a few more days of flare. I hope this makes logical sense - I am posting it for the benefit of anyone who has improved with treatment but gets worse when they try to get off meds. Logically, I think that's to be expected and is a temporary response. It doesn't necessarily mean the med is still necessary - hope this makes sense (?)

[Julia]

Thank you HerMajesty, I think you are right about that. After weaning off of Lyrica, I had a terrible 2 week flare and was convinced that I had to go back on it, so I did!! A few months later, I tried again to wean off, had a 2 week flare but this time stuck it out, and my pain evened out and I was able to get off it permanently. Now I am on amitritpyline only and would like to try getting off it because it is causing me to have a fast heart rate. If I do get up the courage to taper down the dose, I will keep in mind that an increase in pain may only be temporary.

[janetm2]

HM,
Thanks again for the insight. Although I would not know for certain what you said is correct it does seem to make sense especially with Julia's experience following along. I guess we cannot be scared off by the flare and push through to see if the brain takes over. A great leeson learned and passed along. Thanks Julia for providing the extra proof.
Janet

[HerMajesty]

Well I am 100% off the nortriptyline now for 5 days. I removed another 10mg and had a shorter sleeping jag and another mild flare, and realized I didn't want to play this game 3 more times to get off the last 30mg. last dose i took was Monday night and it is Saturday night now. No sleeping jag this time, HORRIBLE flare Wednesday night,now my symptoms are improving quite a bit and I am starting to get my pre-nortriptyline energy back, no more lying around like a neutered dog and I require a LOT less sleep than when I was on it. I had to be on nortriptyline for a year and a half if I remember right, and my brain really was able to bounce back very quickly and start manufacturing its own neurotransmitters again. Wednesday was very tough - I kept second-guessing my ability to feel OK without the med and i was thinking maybe it's not withdrawl, maybe I really need to still be on this stuff. I lived through it by telling myself "I'll give it 2 weeks", and instead I needed more like 2 days. 1 med gone, 3 to go!

[janetm2]

HM,
wonderful news and your are an inspiration to us. Glad to hear it was not another week and a half! Many thanks for sharing your struggle and advice for those to follow. Take care,
Janet

[helenlegs 11]

Excellent HM, well done.Think the world had better watch out for HM on top form
Take care,
Helen

[Julia]

Good for you HM, you give us all hope! Very best of luck!