CRPS, or Complex Regional Pain Syndrome (Type 1), is a change in the nervous system that's usually triggered by a very painful episode. The bad kinds affect the brain, nerves, muscles, skin, metabolism, circulation, and fight-or-flight response. Lucky me; that's what I've got. ... But life is still inherently good (or I don't know when to quit; either way) and, good or not, life still goes on.

Monday, March 28, 2011

Out of the foggy night: Overmedication and abandonment issues

I was overmedicated on mixed psychoactives (in plain English, my doctors had me on too many pills for CRPS) and, at the beginning of February, I ditched most of them. The following weeks were pretty hideous in an interesting way, as my brain's natural chemistry struggled with the messy extrication and departure of the pharmaceuticals.

It feels like washing my dirty laundry to say this, but I suspect I'm being too finicky: LOTS of people get overmedicated by well-meaning medicos who don't talk to each other.

The pills I stopped were SSRIs and SNRIs. (I can't remember which was which.) The upside to this class of medication is that it specifically relieves nerve pain, in addition to helping lift depression. (I wrote an article, buried in my archives, about the tiny handful of neurotransmitters, and how each one has many jobs. Serotonin, for instance, helps digest protein in the gut; dopamine mediates decisions. I'll dig it out and post it on the Biowizardry blog.)

When you have CRPS and you're overmedicated on neurotransmitter Reuptake Inhibitors (of whatever flavor), your brain is in the toilet and there's no way to tell which mental blurch is due to drugs and which one is CRPS. I couldn't always tell how well I was thinking, though I kept trying anyway. Perceiving how I felt underneath it all was like trying to determine the shape of a bomb while it's still in the box. I was usually clear about what I remembered and what I wasn't sure about... but just try getting anyone to believe you when they already know that your brain is not firing on all four cylinders.

There's a lot of grey area in the grey matter, when you're overmedicated and have CRPS.

I'm not sure how much more crap there is to clear out, but I know I'm a lot clearer about what's going on right now. I look back on the past two years with some dismay, as I try to rebuild the relationships I dented, and (most painfully) try to understand why those who should have known better had simply abandoned me to that foggy night.

[photo credit]

But anyway.

I am remarkably clear, now, about what I remember and what is nothing but a sudden hole in my mind. I'm clear about whether I can think right now or not. I'm able to feel the brain crank up and crank down, so I can communicate to others, "I can do this!" or "Gotta stop now!" And, for the first time in years, I can get something done on some sort of schedule. Not a consistent or reliable schedule, not to any sort of clock, but just to know that I CAN do something is quite a step. I'll take it and be thankful!

I still have CRPS. My medication is still problematic. I still have sudden, random, Swiss-cheese-like holes in my memory and cognition. BUT -- and it's a big but! -- there is no grey area in my grey matter any more. I know if I know, and I know if I don't know.

And that's information I intend to use.


  1. How did you figure out that you were overmedicated?

  2. It was a suspicion that had been growing on me for some time. I had a couple of big hints: I was on sky-high doses of both those meds, and my psychiatrist at the time had promised me that we'd revisit the medication issue after the holidays and try to come up with a better solution than we had.

    Getting prescriptions out of him was a logistical nightmare but he never wrote for more than one month's supply at a time. I wound up dropping the meds in a relatively uncontrolled fashion because I suddenly had no more patience for the drama associated with getting my meds renewed every damn month. I eked out my last few days of meds over a week, and that was that. (I could stagger the two come-downs a week apart.)

    I didn't realize how much I was overmedicated until I was well into the withdrawal period, and had flashes of startling cognizance.

  3. So how is the pain now? Can you manage it without those meds?

  4. At times.

    The bigger problem is the autonomic system disruption caused by chronic CRPS. An underlying element in CRPS is mitochondrial destruction, meaning your body's cells find it harder and harder to make energy.

    So the pain is certainly unfortunate, but I have an amazing toolkit of mental and attention tricks I can play to get past that. The harder things to deal with are the profound exhaustion after activity, circulatory issues, dizzy spells, lack of awareness of my body in space (kinesthetic nerves get taken over), intermittent cognitive disruption, and intermittent but quite crippling swelling in my hands.

    When I was overmedicated, I found that disturbing, but now that I'm more awake, it's a big damn pain.

    As it were.


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