Bill341: Polydrugged, looking for a strategy to get off

[Bill341]

My a/d story started back in June.  Right now I'm currently taking 10mg of lexapro, 150mg of trazodone and a little less than .225 of klonopin.  Since June the lexapro is what I consistently took.  In the time span between June and now I got the whole cocktail, buspar, doxepin, remeron and probably another one or two.  I took the klonopin intermittently during this time too.  In September I realized  I was in interdose withdrawal from the klonopin.  I cold turkeyed.  I was still taking the trazodone and the lexapro.  I had withdrawal for sure.  I blamed a lot of my symptoms on the trazodone.  My doc was like "you can just stop trazodone c/t".  I did that one night.  Big mistake.  I  shocked my system for sure.  I reinstated .25 of klonopin.  I since started to taper the klonopin.  I'm concerned though.  I know lexapro is activating.  When I c/t'd the klonopin a few weeks ago, it seemed  like the pattern I felt during the day was more sedated in the morning, probably because of the trazodone, I would then get ramped up in the afternoon, then settle down a little by the evening.  I don't want to be on a benzo any longer than I have to be.  I have addiction issues already.  My plan is to taper off the klonopin, then the lexapro and finally the trazodone.  I'm getting mixed suggestions if this is the correct method.   I read the article about accelerators and brakes.  Is the trazodone enough of a brake?  Somebody from benzobuddies told me to come to this site to try to get some answers.  Again, I've this has all happened since mid June.  Hopefully time is somewhat on my side in this.  Does anyone on here have any good advice?  MIght I add, there was some temazapam in there at the beginning for 5 days.  After I stopped it I got really bad panic attacks with air hunger.  The air hunger is still my most debilitating symptom.

[Meimeiquest]

I am a big believer in tapering accelerators before brakes. Or doing a round robin to keep the proportions basically the same as you wind your way down

[Meimeiquest]

Also, anything you can do to resolve the issues that led you to drugs in the first place is very important.

[Bill341]

Doing a round robin?  Doing a little of one then doing a little of another?  Back and forth?

[Meimeiquest]

Yes

[Bill341]

Doing a round robin sounds dicey to the CNS.

[Meimeiquest]

All your options are dicey. Removing all the brakes or all the accelerators is really dicey.

[Bill341]

I'm not sure what to do.  Ughh...  which do first..

 

Anybody else have experience with benzos and ssri's?

[Petunia]

Welcome Bill,

We need a little more information about your drug history before we can really offer any suggestions. It sounds like you have been on and off a lot of different drugs in a very short amount of time, your nervous system is probably in an uproar and needs time to settle back down before any more tapering.

 

How long have you been taking Klonopin, Lexapro and Trazodone?

 

It would be great if you would put your drug and withdrawal history in your signature. Doing this helps people understand your context, it appears below each of your posts. Here are instructions for how to do it:

 

http://survivinganti...your-signature/

 

What symptoms are you having now? Is there a pattern in relation to when you take your drugs?

 

You are taking more than one medication, there may be interactions between them, which your doctor is unaware of, these may be adding to your symptoms. Please put ALL the drugs you take in the drugs.com Drug Interactions Checker at:

 

Drug Interactions Checker

 

You may post the results here in your thread.

 

My advice would be to hold off on tapering anything until your symptoms settle down. Keep notes of your symptoms in relation to when you take your drugs, you may be having interdose withdrawal if you are just taking the klonopin once a day, it may need to be split.

 

My advice would also be to taper off the Lexapro and Trazodone first and then the Klonopin, but only after you have stabilized. Once your nervous system has become unbalanced, any further tapering is just going to make symptoms worse. So my advice is to hold for a while.

 

I’m glad you found us, we’re here to support you.

 

You can use this thread as your ongoing journal to track progress, write about symptoms, ask questions and communicate with the community, add to it whenever you want.

 

Petunia.

[Bill341]

I was feeling stable.  I started doing a 10% taper of the klonopin.  I've been fine with it all week.  I was actually feeling quite tired.  Last night I didn't prepare my trazodone until right before I went to bed.  I don't think I took the right amount.  Today I'm unstable.  I need to get stabilized again.  My main symptom through all this is air hunger.  I have addiction issues.  I don't want to have to go through interdose w/d with the klonopin and have to raise it.  It scares me to be on it long.  I would rather get off the klonopin first but I don't want the lexapro activation to effect me.

[Bill341]

Any thoughts?

[Bill341]

Why would you suggest going off lexapro and Trazodone first? I'm on a high dose of trazodone. I would hate to stay on klonopin for a long time while tapering off Traz.

[Altostrata]

Welcome, Bill.

 

Please read Taking multiple psych drugs? Which drug to taper first?

 

If you're taking trazodone because Lexapro disturbs your sleep and Klonopin because Lexapro makes you anxious, you would want to reduce the Lexapro first. If you reduce the others first, you'd be experiencing the adverse effects of Lexapro.

 

Sleeplessness and anxiety are very, very common symptoms of withdrawal from benzos and antidepressants.

[Bill341]

Ughhh...  so confusing.  So this means I might be on the klonopin for a considerable amount of more time?  I've only been taking it intermittently for 4 months.  It's only now I've been on it consistently.  My body may have gotten use to the lexapro.  I'm not sure.  When I c/t'd off the klonopin the first time, I definitely had a lot of anxiety.  Not sure if it was from the lexapro or just withdrawal.  I hate the idea of being on klonopin any longer.  

[Petunia]

 In September I realized  I was in interdose withdrawal from the klonopin. 

 

If you were experiencing interdose withdrawal, then you have developed a physiological dependence, it doesn't matter how long you have been taking it, you will need to taper if you want to avoid withdrawal symptoms.

 

We recommend only tapering one drug at a time. We recommend tapering your benzo last because it can help protect sleep and cushion some of the anxiety which can be experienced while tapering other drugs.

 

Another reason to taper lexapro and trazodone first is because there is a major interaction between them, this is why we ask you to check for interactions using drugs.com:

 

http://www.drugs.com/interactions-check.php?drug_list=2228-0,703-357,1013-565

 

Major

trazodone escitalopram

Applies to: trazodone, Lexapro (escitalopram)

Using escitalopram together with traZODone can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should contact your doctor immediately if you experience these symptoms during treatment. In addition, combining these medications can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether together or alone. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

 

Moderate

clonazepam trazodone

Applies to: Klonopin (clonazepam), trazodone

Using clonazePAM together with traZODone may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate

clonazepam escitalopram

Applies to: Klonopin (clonazepam), Lexapro (escitalopram)

Using clonazePAM together with escitalopram may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

 

Duplication

Antidepressants

Therapeutic duplication

The recommended maximum number of medicines in the 'antidepressants' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'antidepressants' category:

• trazodone

• escitalopram (active ingredient in Lexapro)

 

I'm sorry you have ended up on this cocktail of drugs, its shocking how often this happens as more drugs are added to 'treat' the side effects of current drugs. But if you remain patient and calm, its possible to get off them without withdrawal symptoms from disrupting your life too much, it can take some time though.

[Bill341]

I'm tapering off klonopin.   I started at .25mg.  I'm also on 8.5mg of lexapro.  I am getting that same ramped up feeling I had from the lexapro prior to going on klonopin.  I would rather go with the klonopin, but I literally feel like I'm going out of my mind every day.

 

I would like to do an experiment, is this advisable?  I normally take my lexapro first thing in the morning.  I get that real ramped up feeling right around 11:30.  Would it be ok to take it a little later to see if the same effect happens to me?

[brassmonkey]

Hi Bill--  there is a lot of controversy about which to taper first the AD or the benzo.  The prime concern being the addictiveness of the benzo.  That said, if the Lex is causing problems then it should be the first to go and keep the benzo to help with the WD symptoms.  Then once your Lex free and stable go after the others.

[Bill341]

If I hold my Klonopin at .160mg, will I remain stabile?  Or will I develop more issues staying at this level?  

[Altostrata]

Bill, I moved your posts here, to your Intro topic.

Keeping your history together in one topic allows us to see the context of your question.

Please read this topic from the beginning. For example:
 

Welcome, Bill.
 
Please read Taking multiple psych drugs? Which drug to taper first?
 
If you're taking trazodone because Lexapro disturbs your sleep and Klonopin because Lexapro makes you anxious, you would want to reduce the Lexapro first. If you reduce the others first, you'd be experiencing the adverse effects of Lexapro.
 
Sleeplessness and anxiety are very, very common symptoms of withdrawal from benzos and antidepressants.

In your case, it's fairly clear that you find Lexapro very activating and that you would need to taper that first, or experience the anxiety and sleeplessness that it causes you.

 

In addition, tapering any psychiatric drug tends to cause sleep disturbance, so you want to leave the sleepers for last.

 

We do not recommend tapering two drugs at once, this confuses things, even more so when there's a benzo in the mix, because one can develop rebound symptoms from the benzo which might look like withdrawal symptoms.

 

It seems you decided to taper Lexapro and Klonopin at the same time?

 

What time of day do you take each of your drugs, how much, and what is your daily symptom pattern? Please keep notes on paper to determine this.

[Bill341]

Hello Altostrata-

 

I take the lexapro around 6am every morning and I take the klonopin at 7am.  The anxiety really seems to fire up around 11:30 or so.  I literally feel like I'm going out of my mind.   Then there's the trazodone factor too, I know that has mcpp in it.   The anxiety could be caused by that.  .  I guess I just need to pick one and go with it.

 

Bill 

[Altostrata]

If I were you, I'd stop tapering everything.

 

You can see where the anxiety is coming from by moving the Lexapro later in the day, by an hour at a time. Can you take it at 10 a.m.?