daveycrocket -- Newbie here for support (& friendship?) :)

[daveycrocket]

Hello!

 

Long time reader on here, and other anxiety forums, and thought I would take "the plunge" and post a quick introduction. Instead of staring at the wall and suffering in silence, I figured this is a healthier coping approach...

 

Background: 29 year old gay man, healthy/active and generally outgoing by nature. Started suffering anxiety attacks, blushing/social anxiety, and insomnia in my early 20s in NYC which landed me in a physiatrist's office with an RX for Zoloft and Xanax. I then proceeded to go on the Med Merry Go round (paxil, lexapro, effexor, ambien, luvox, among others) and eventually - to cope with a new "important" corporate job - convinced a physician to prescribe me the MAOI Nardil, allegedly the gold standard for social anxiety. It all came crashing down last year when I woke up in the ER several mornings (after nights of uncharacteristic impulsive decision making, drinking and mixing), receiving a DUI, and eventually (under some duress) resigning from my job last May.

 

At the time, I was living in San Francisco, and decided "f*ck it," I'm going to restart my life in Hawaii and pursue a career in Real Estate. I lasted a week in HI and was miserably homesick, lost, and anxious. I came home to Boston where I've since been doing consulting work remotely. 

 

I tried - again - to move to Hawaii in March of this year, and lasted 3 weeks, woke up one morning with a panic attack, and was on a plane that evening. 

 

Kelly Brogan's book "A Mind of Your Own" (MUST READ) has recently opened my eyes to the painful and bottomless pit that are antipsychotic meds and antidepressants. I pretty much ripped the bandaid off and stopped cold turkey from Nardil earlier this year, and then Clonapin & Risperdal a few weeks ago. Without a doubt, I am absolutely miserable; I can't focus, have horrible mood swings, irritable, hopeless, indecisive, and depressed. I really do not want to reinstate on meds. I'm taking St. John's Wort herb and considering adding Gaba to try and cope. I do have bright spots in the day, but then quickly revert back to feeling miserable and lost. I workout regularly and eat healthy, which definitely helps. 

 

Oh - also - because I like to make the same mistake OVER AND OVER again (sarcasm intended), I committed to an apt in Honolulu on June 1st when I was feeling good a few weeks ago. Today, I was suppose to fly back to SF and stay with a friend and I was too anxious to make the flight. Right now I'm totally lost, oscillating between "Stay safe at home in MA" AND "Go back to HI and 'push through' the anxiety."

 

I am worried about myself and feel unrecognizable to my (normally) ambitious, outgoing, entrepreneurial and adventurous self; my anxiety and depression is undercutting my confidence. I am exhausted and frustrated. I want to create a new life for myself and move on in HI, but at the same time, want to keep myself safe and sane. I can absolutely make a life for myself here @ home, but struggling to commit to anything at this point. 

 

Appreciate any kind words, thoughts or feedback. And thanks very much for reading. 

[Petunia]

Welcome daveycrocket,

I'm glad you decided to post an introduction. I recently downloaded the free first chapter of Kelly Brogan's book, but have only read the first few pages. I'm surprised she doesn't mention anything about how to taper properly, that its not a good idea to go CT. I'm sorry you've had to learn about withdrawal the hard way, from what you've written, that's what it sounds like.

 

I know you don't want to reinstate, no one does, but reinstatement of a small amount of the drug can often work well to alleviate withdrawal symptoms. According to medical knowledge, reinstatement is the only way to alleviate withdrawal. Reinstatement is best done immediately upon appearance of symptoms. The more time that passes, the less likely it is to work. Once you have stabilized on a low dose of the drug, then a slower, safer taper can be started. Here is some information about reinstatement to help you decide if its something you would like to try:  About reinstating and stabilizing to stop withdrawal symptoms

 

If you decide to try, we can help you decide which drug to reinstate and at what dose. Withdrawal symptoms can last a long time for some people and get worse before they get better. I found this site and learned about safe tapering when it was too late for me to reinstate. So I've been in protracted withdrawal for over 3 years now, longer if I count the years after I tapered too fast off an antidepressant. I'm not saying you will be sick for as long as me, but it can take a long time for some people to recover from stopping these drugs too fast.

 

Here's a link which explains more about withdrawal syndrome:  What is withdrawal syndrome?

 

...and more that explain the importance of slow tapering:

 

Why taper by 10% of my dosage?

Why taper? Paper demonstrates importance of gradual change in plasma concentration

Brain Remodelling (Rhi's Description of Brain Healing)

 

How long were you taking Nardil, Clonopin and Risperdal for? What doses were you on?

 

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/

 

If you decide reinstatement is not for you, here is the link to our symptoms and self care section, you may find some useful ideas to help manage symptoms as you recover.  Especially read the topics pinned at the top.

 

Many people find  fish oil and magnesium helpful, see King of Supplements: Omega 3 Fatty Acids (Fish Oil) and Magnesium, Nature's Calcium Channel Blocker

 

...and some videos about recovery:

 

 

 

Please feel free to write whenever you want, you will find a lot of friendly help and support here, do let us know what you decide... about reinstatement and moving to Hawaii, I spent a lovely week there in the late 80's.

 

Petunia.

[daveycrocket]

Hi Petunia, thanks for the welcome and thoughtful response.

 

I've been on clonapin for a few years, around 2-5MG total per week as needed, phenalzine/Nardil @ 75 MG for 2+ years, and Risperdal just for the past few months @ .5MG. I read the links you shared (thx!) and think starting to reinstate with 15MG of Nardil/daily and perhaps a low .25MG of clonapin would be a prudent way to start. I think the biggest thing I need to work on is showing some consistency to my nervous system -- and just *sticking with*, and documenting a plan of action.

 

I'm destroying my life by making impulsive decisions across all aspects. I feel like I get motivated and work to create plans, and then everything unravels so quickly once my anxiety takes the wheel. I am now learning, thanks to this site, that much of this may be do to W/d.

 

In terms of moving to HI, I have no idea anymore. I get extremely discouraged that I tried this before and failed. I do feel more tuned in to what's going on inside me, but unless I medicate myself out the wazoo, idk if I can handle *another* huge shift right now. I have bright moments where I think "I *can* do this, it's all going to be okay," followed by a return to dread and despair. Regardless, I do have to make a decision soon, whether to move forward or abort. Sigh.

[daveycrocket]

Hey, 

 

Not sure anyone is reading this, but nonetheless. I feel incredibly lost and hopeless. I tried twice this week to get on a plane to SF and move on with my life, but couldn't bring myself to get on the plane both times. I feel like i'm disappointing everyone and feel beyond upset and lost. The frustration around decision making and follow through is paralyzing me; i can't follow through with anything. It's like my life is getting smaller and smaller as the anxiety and panic edge away at my level of functioning. I think "I should get back on meds, this is no way to live" but then i think "i had anxiety attacks *on* meds" and maybe i should "tough it out" and move toward the goal of being med-free. 

 

I'm taking St. John's Wort, fish oil, b complex, b-12 at the moment. 

 

Thanks for reading. 

[dowdaller]

Hey davey.

I know the fear you are talking about, but my advice to you would be to face it down. If you keep runing it will keep coming after you. You are taking kolopin i was on that before after a while in my experience it doesnt work.

You have made it this far so thats something, and as jon kabat zinn says" you are breathing and that means there is more right than wrong with you".

And when you are going through hell, keep going..

[daveycrocket]

Thanks dowdaller. I'm definitely trying to move forward, it's exhausting tho. I'm going to call my primary care doctor tomorrow, but I'm nervous he's going to just try and put me back on meds. On paper, everything in my life is fine, but in my mind, it's a total mess. Thx for listening.

[dowdaller]

Hang in there, do what your gut tells you, dont be pushed into something you dont want to do, good luck

[daveycrocket]

Hi all. So in all, I made 5 attempts to get on the damn airplane across a week's time and couldn't do it. I do not have a fear of flying but everytime I had a downward mood swing (likely a result of the withdrawal), it produced an unbelievable urge to cancel and abort. So definitely down in the dumbs at the moment. I spoke to my primary doc yesterday who suggested I try lexapro again. From what I've read on here, substituting a new antidepressant isn't necessary going to take away the withdrawal effects from the Nardil. And could just prolong issues down the road.

 

But I *need* to do something. I am not functioning: can't think, can't focus, mostly just want to lay in bed all day, severely depressed; it's exhausting. I do force myself to the gym and eat healthy, so that is one positive thing.

 

Given I went CT from Nardil in February of 2016 (was on 60MG), my thought was to try and reinstate on 30 or 45MG. I could also try 1 tablet at 15MG and see how that goes from there. I have a lot left over so this is possible.

 

Given I was only on Risperdal for a few months and have since stopped CT 3 weeks ago (I know, big mistake), I was thinking I don't need to reinstate on that med.

 

So maybe the approach is to try Nardil 1 tablet (15mg) and see how I feel in a week.

 

I also need to abstain from alcohol as I think it's potentially complicating the withdrawal, and making myself *even more* miserable.

 

Thanks for reading.

[apace41]

Davey,

 

Welcome to SA.  Sorry you have not received as much attention as you should have.  Too many people -- too little time.  Sad state of affairs these days.

 

I've been on clonapin for a few years, around 2-5MG total per week as needed, phenalzine/Nardil @ 75 MG for 2+ years, and Risperdal just for the past few months @ .5MG. I read the links you shared (thx!) and think starting to reinstate with 15MG of Nardil/daily and perhaps a low .25MG of clonapin would be a prudent way to start. I think the biggest thing I need to work on is showing some consistency to my nervous system -- and just *sticking with*, and documenting a plan of action.

 

You are right to be considering a reinstatement of some kind as the only way to address the symptoms you are dealing with.  These are all strong medications with a lot of potential impact on the brain chemistry.  There is no right or wrong answer about how much to do and which drugs to do it with.  I understand your desire to not go back on the Risperidal and while there is a risk associated with that approach, if it works have one less medication to taper.  It's really hard when you go off 3 meds at once to know what symptoms are coming from where.

 

We are far more well schooled in the SSRI and SNRI arena and I know that I don't know much about the MAOI world.  I think that a low level like 15mg is a good place to start to see how you respond.  Give it a good solid 4-5 days before you make any judgments as it takes time to get to a steady state in the blood stream.  Hopefully, you will respond favorably. 

 

Klonopin is a very difficult benzodiazepine to taper and being on it can help while you taper off the Nardil so I would leave it in place while you do the Nardil taper.  Try the .25 daily and see how that works for you.  The key here, as you suggest, is consistency.  Trying to keep things slow and steady for a while to see if you can stabilize the CNS would be the best thing you can do.

 

In that regard, each person responds differently to getting off the meds.  Some have an easy time and others struggle mightily.  We at SA advise on the basis that until proven otherwise we assume a struggle.  Easier to adjust to an easier time than vice versa.  Thus, I would strongly advise that you put a major life move like heading to Hawaii on hold until you get yourself stable.  Putting that kind of stress on your CNS is not going to bode you well as you try to figure out where you are.

 

As Petunia requested, please fill in your signature so others can provide further input:

 

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

 

Also, she has provided other excellent links that you should read through to understand where you are and where you may be headed.

 

Best,

 

Andy

[daveycrocket]

Davey,

 

Welcome to SA.  Sorry you have not received as much attention as you should have.  Too many people -- too little time.  Sad state of affairs these days.

 

I've been on clonapin for a few years, around 2-5MG total per week as needed, phenalzine/Nardil @ 75 MG for 2+ years, and Risperdal just for the past few months @ .5MG. I read the links you shared (thx!) and think starting to reinstate with 15MG of Nardil/daily and perhaps a low .25MG of clonapin would be a prudent way to start. I think the biggest thing I need to work on is showing some consistency to my nervous system -- and just *sticking with*, and documenting a plan of action.

 

You are right to be considering a reinstatement of some kind as the only way to address the symptoms you are dealing with.  These are all strong medications with a lot of potential impact on the brain chemistry.  There is no right or wrong answer about how much to do and which drugs to do it with.  I understand your desire to not go back on the Risperidal and while there is a risk associated with that approach, if it works have one less medication to taper.  It's really hard when you go off 3 meds at once to know what symptoms are coming from where.

 

We are far more well schooled in the SSRI and SNRI arena and I know that I don't know much about the MAOI world.  I think that a low level like 15mg is a good place to start to see how you respond.  Give it a good solid 4-5 days before you make any judgments as it takes time to get to a steady state in the blood stream.  Hopefully, you will respond favorably. 

 

Klonopin is a very difficult benzodiazepine to taper and being on it can help while you taper off the Nardil so I would leave it in place while you do the Nardil taper.  Try the .25 daily and see how that works for you.  The key here, as you suggest, is consistency.  Trying to keep things slow and steady for a while to see if you can stabilize the CNS would be the best thing you can do.

 

In that regard, each person responds differently to getting off the meds.  Some have an easy time and others struggle mightily.  We at SA advise on the basis that until proven otherwise we assume a struggle.  Easier to adjust to an easier time than vice versa.  Thus, I would strongly advise that you put a major life move like heading to Hawaii on hold until you get yourself stable.  Putting that kind of stress on your CNS is not going to bode you well as you try to figure out where you are.

 

As Petunia requested, please fill in your signature so others can provide further input:

 

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

 

Also, she has provided other excellent links that you should read through to understand where you are and where you may be headed.

 

Best,

 

Andy

 

Hi Andy, 

 

Thanks for very much for your thoughtful response. I agree with all of your feedback. The biggest thing i've learned from this site is the importance of making gradual and consistent changes to the CNS, and something I've completed neglected to do over the past 10 years. Even as I struggle now, my first reaction was "let me try effexor, or try a new med! i need to make a change now!" -- which is not where I want to be. 

 

I'm not sure if I should try 15MG or 30MG of Nardil to start. I know that the site would probably advise start low and go higher as needed, but i'm nervous it's not going to work. I *should* put those fears aside and just commit to 15MG of Nardil daily for the next week. In terms of the Clonapin and Risperdal, I think I should hold off for a moment and see how my body adjusts to the Nardil. The Clonapin has been a variable as I've just taken it as needed, particularly (and to be honest) after a night of drinking to deal with a hangover -- and right now, i'm not drinking (also read thats' a big no no during withdrawal)....It probably makes good sense to start a daily journal of meds/supplements and how i'm feeling that day. 

 

I agree with Hawaii. CA and HI will always be there and I need to get on solid footing before introducing *another* huge change. I get extremely nervous that i'm wasting my life or not living up to my potential, but I need to realize that getting my mind healthy *is* the main project right now. 

 

I'm extremely grateful for this site as it gives me a sense of hope. I also intend to welcome and respond to others in an attempt to "pass it on." 

 

Thanks again. 

 

Dave

 

PS I will update my signature now. 

[apace41]

I'm not sure if I should try 15MG or 30MG of Nardil to start. I know that the site would probably advise start low and go higher as needed, but i'm nervous it's not going to work. I *should* put those fears aside and just commit to 15MG of Nardil daily for the next week.

 

You should commit to Nardil at 15mg daily for the next week.  You can always go up if that doesn't do the trick (although I'd probably recommend going to 20mg rather than 30mg but hopefully we won't need to discuss that).

 

In terms of the Clonapin and Risperdal, I think I should hold off for a moment and see how my body adjusts to the Nardil.

 

Certainly a valid approach.  The challenge is being able to isolate what symptoms are the result of what medicines so you know whether you are feeling the withdrawal from one versus another.  There is, of course, a lot of overlap.  Let's see how things go over the next week after you reinstate Nardil and we can revisit as you go along.

 

Good news is that you're young so that should give you a leg up and you are learning valuable self-care lessons at a very early stage.  Lots of us got a lot further along our journeys before that occurred.

 

Best,

 

Andy

[Altostrata]

Welcome, davy.

 

When you went off Klonopin, how often were you taking it?

 

How often are you taking it now?

 

Psychiatric drug withdrawal syndrome very commonly includes waves of what feels like anxiety or panic AND a greater susceptibility to anxiety in stressful situations. You have repeatedly put yourself in high-stress situations. You need to stop doing that for a while and help your nervous system settle down. Take some deep breaths. In fact, get serious about learning meditative breathing because you're going to need it.

 

In addition, once the nervous system becomes sensitized in this way from withdrawal, drugs such as Klonopin and other benzos often cause paradoxical reactions -- the opposition of what they're supposed to do for you. Also, it could be that when the Klonopin wears off, you are getting rebound anxiety. (This makes you reach for another Klonopin.)

 

My guess is that you are suffering a combination of withdrawal syndrome from Nardil, Risperdal, and Klonopin, with paradoxical or rebound reactions from any Klonopin you're taking now.

 

Do your symptoms follow any daily pattern? Please keep notes on paper of your symptoms, when you take your drugs, and their dosages. This will help us sort this out.

[mammaP]

Hi Daveycrocket, I agree with the others that getting yourself stable is the most important thing right now.  75mg of Nardil is a high maintainence dose, and I am not surprised that you have done some impulsive things while taking it. I took it for a while many years ago and thought it was amazing, I didn't realise it then of course but I was manic! Eventually it made me very very ill and doctors had me come off it in hospital. Withdrawal was a nightmare but nardil was just one of a long list that I tried so my nervous system was in bits, rather like yours must be right now. 

 

Personally I would reinstate at half a tablet, and see how you are for a week. It may be enough to help the withdrawal. If you tolerate it but still feel withdrawal you could increase the dose.  Nardil should not be taken for 2 weeks after stopping an SSRI, and St Johns wort has the same mode of action so it could be dangerous to take them close together.  Copied from drugs.com.......

 

There have been reports of serious reactions (including hyperthermia, rigidity, myoclonic movements and death) when serotoninergic drugs (e.g., dexfenfluramine, fluoxetine, fluvoxamine, paroxetine, sertraline, citalopram, venlafaxine) have been combined with an MAO inhibitor. Therefore, the concomitant use of Nardil with serotoninergic agents is contraindicated (see PRECAUTIONS-Drug Interactions). At least 14 days should elapse between the discontinuation of an MAO inhibitor and the start of a serotonin re-uptake inhibitor or vice-versa, with the exception of fluoxetine. Allow at least five weeks between discontinuation of fluoxetine and initiation of Nardil and at least 14 days between discontinuation of Nardil and initiation of fluoxetine, or other serotoninergic agents. Before initiating Nardil after using other serotoninergic agents, a sufficient amount of time must be allowed for clearance of the serotoninergic agent and its active metabolites.

 

You need to take care of yourself and you will recover. Imagine the person you love most in all the world and what you would do for them if they were in the same position as you are now, you would do everything you can to help them get better. Look after yourself that way, then you will recover  and get on that plane. Check out the symptoms and self care forum and you will find some excellent topics on diet, sleep, supplements etc. 

[dowdaller]

Hi davey, giving alchol a miss would probably be a wise move. I came off xanax before and its tough. Dont try to do too much to soon, baby steps are best. The other posters would have more knowledge about these meds than me. All I can tell you is from my own experience.High grade fish oils helped me get through some rough days.

[daveycrocket]

You should commit to Nardil at 15mg daily for the next week.  You can always go up if that doesn't do the trick (although I'd probably recommend going to 20mg rather than 30mg but hopefully we won't need to discuss that).

 

 

Thanks Andy. I agree with the 1 tablet (15MG) commitment of Nardil and seeing how I do over the next week. I plan to divide the tablet in half and take one dose in the AM, and one in the PM. I'm nervous (what else is new), but optimistic.

 

Welcome, davy.

 

When you went off Klonopin, how often were you taking it?

 

How often are you taking it now?

 

Psychiatric drug withdrawal syndrome very commonly includes waves of what feels like anxiety or panic AND a greater susceptibility to anxiety in stressful situations. You have repeatedly put yourself in high-stress situations. You need to stop doing that for a while and help your nervous system settle down. Take some deep breaths. In fact, get serious about learning meditative breathing because you're going to need it.

 

In addition, once the nervous system becomes sensitized in this way from withdrawal, drugs such as Klonopin and other benzos often cause paradoxical reactions -- the opposition of what they're supposed to do for you. Also, it could be that when the Klonopin wears off, you are getting rebound anxiety. (This makes you reach for another Klonopin.)

 

My guess is that you are suffering a combination of withdrawal syndrome from Nardil, Risperdal, and Klonopin, with paradoxical or rebound reactions from any Klonopin you're taking now.

 

Do your symptoms follow any daily pattern? Please keep notes on paper of your symptoms, when you take your drugs, and their dosages. This will help us sort this out.

 

Thanks Alto for the help and thoughtful advice. I've read a lot of your posts on this forum -- very informative stuff. I really like your self-care tip of trying not to purposefully put myself in high-stress situations; i have absolutely been my own worst enemy here. 

 

The Nardil caused bad insomnia so I would venture to guess I would take anywhere from 8-10MG+ per week, and lately in 2016, post-nardil, much closer to 2-5MG per week. Most recently, I take it maybe 1 or 2x a week @ .5 or 1MG. Perhaps i've been experiencing Clonapin withdrawal for a while, and just now realizing it. I have not done a great job of keeping a daily log, but will commit to doing this moving forward.

 

At the moment my primary symptoms are extremely low mood (i have a few bright spots in the day, but generally feel a high sense of dread and sadness), low energy/lethargy, and apathy. I'm able to sleep which is nice. That said, I dread waking up -- the mornings are *most* miserable and it's difficult to get out of bed, but I force myself with self-talking techniques like "if you go eat a healthy breakfast, you can go back to bed" or "go to the gym, then you can go to bed again" lol. As a generally active and outgoing guy, I would never imagine myself using "going back to bed" as a reward to function. Sigh. 

 

Hi Daveycrocket, I agree with the others that getting yourself stable is the most important thing right now.  75mg of Nardil is a high maintainence dose, and I am not surprised that you have done some impulsive things while taking it. I took it for a while many years ago and thought it was amazing, I didn't realise it then of course but I was manic! Eventually it made me very very ill and doctors had me come off it in hospital. Withdrawal was a nightmare but nardil was just one of a long list that I tried so my nervous system was in bits, rather like yours must be right now. 

Agreed, for a while I thought Nardil was amazing (and social anxiety forums do praise it as the "gold standard" for SA), but it almost cost me my life; after mixing with a street drug and alcohol, one morning last summer I woke up in the ER covered in blood and bruises and sweat, presumably from passing out, falling, and developing severe serotonin syndrome. 

 

I feel like crap now, but feel fortunate for this forum and do see a light at the end of the tunnel. I no longer feel so alone and lost. 

[JanCarol]

Hey DC - all good advice here, I just want to emphasize what Mamma said:

 

Please discontinue St. John's Wort 2 weeks before reinstating, to avoid serotonin toxicity.  People think of it as an herb, but it's just a natural version of the pharma, and can have quite significant effect, especially in drug interactions.

 

Please consider making your reinstatement 1/2 tablet of Nardil - 7.5 mg.  How much you reinstate is ultimately up to you, but if 7.5 works, then why go higher?  You can always slide it up to find the "least miserable place" from which to taper.

 

and - what Andy and Alto said = withdrawal is not the time to make major decisions. Instead, it is a time for nesting, taking care of yourself, learning to love yourself and be patient with yourself.  The Big Stuff will always be there, and if you do this well and carefully, it may be less than a year before you feel ready to make a new move (and you will have a much clearer head for it then).

 

In fact, I will attest that Big Stuff - the Stuff Dreams Are Made Of - is much easier to see when you are free of the drugs.  And much more real, too!

[daveycrocket]

Thanks all for the feedback. The most frustrating withdrawal symptom at the moment is the sacked motivation and level of despair and hopelessness; it's a weird feeling -- a mix of wanting to crawl out my skin, but at the same time, having 0 motivation to do anything. I am hoping reinstating on the small dose of Nardil will help, but nervous and scared if it doesn't. The idea of having to suffer for a year or more until I feel better is an exhausting idea to grasp.

 

I realize I need to practice self-care at the moment and stabilize my CNS, but also feel panicky that i'm not accomplishing the things I *should* be professionally and personally. I regret leaving HI and not being able to get on the plane to CA. I feel that i'm currently a bystander watching my own life pass me by, and that is a horrible feeling. 

 

Thanks for reading. 

[daveycrocket]

I feel like a complete mess. I started back on Nardil yesterday at 7.5mg twice daily; I woke up in the middle of the night covered in sweat, panic, and my body screaming for a clonapin. I took .5MG of Clonapin and fell asleep. It's possible this was serotonin syndrome as earlier this week I tried one tablet of lexapro at 20MG and also took St. John's Wort last week. I realize I need to *stop* making impulsive decisions with meds and promote CNS stabilization, but I am so mentally exhausted and feeling miserable, which leads to desperation. I don't care anymore if I'm *off* meds, I just want some sort of a life back. I realize I need to let the Lexapro and SJW washout before moving forward, but I'm extremely confused about what to do now: (1) continue with reinstatement plan, (2) give SJW an adequate chance to work, (3) go back to lexapro, (4) try something new. I also definitely need to figure out how to reinstate clonapin at a low daily dose as I know realize I'm withdrawling from that, too. I think about going to the hospital often, but I know that's not the right answer.

[bubble]

Hello Davey,

 

sorry that you didn't get the answer. How have things changed over the last 2 days since you wrote this?

 

Klonopin is most likely contributing to your symptoms so it's hard to tell whether the middle of the night experience that you describe was a reaction to reinstating Nardil or withdrawal from Klonopin (probably both).

 

I would suggest you start a thread in our benzo subsection regarding your Klonopin situation.

http://survivingantidepressants.org/index.php?/forum/29-members-only-benzo-forum/.

[daveycrocket]

Things are okay. I remain confused about what the next step should be. Yesterday I had several hours where I felt really good and upbeat, today is miserable. I realize I should try to give reinstatement on Nardil a realistic chance to work, but the anxiety is preventing me from making and committing to a course of action. My family and friends want me to see a dr. and get help, but I worry they'll just throw more meds at me. That said, I just want to feel some relief at this point.

[AmyK]

Hi! Reinstatement can take a while, don't rush things now.

 

"I get extremely nervous that i'm wasting my life or not living up to my potential, but I need to realize that getting my mind healthy *is* the main project right now."

I recognize this too, Davey. (Thanks for writing on my thread). But don't hurry. You have time. You are young.

 

Your main goal now is, precisely, to feel stable and relax. Do everything to calm your CNS down. And then little by little, when you feel better, you can take steps towards the kind of life you want.

 

I tend to catastrophize about how my life look from "the outside", what people will think about my "career". I quit my job last year and struggling to get back. But, I feel best when I focus on what I FEEL, what I know is best for me right now. If I feel the best thing for me today is to just stay in bed for a few hours, then I'll do that. I use exercise as a way to calm my body and get more focused. (Yoga and also swimming to me.)

 

What I want yo say is, try to work with yourself instead of pushing thru and work against yourself. Be your best friend and try to be more mindful about where you are right now. Everything changes. So will you. And everything will be fine.

 

Have you heard of Eckhart Tolle? I have a clip in my thread that I can watch over and over again. It's about anxiety and fear of the future. (On youtube: "Get rid of fear and anxiety".)

Take care, hugs!

[Altostrata]

Thanks all for the feedback. The most frustrating withdrawal symptom at the moment is the sacked motivation and level of despair and hopelessness; it's a weird feeling -- a mix of wanting to crawl out my skin, but at the same time, having 0 motivation to do anything. I am hoping reinstating on the small dose of Nardil will help, but nervous and scared if it doesn't. The idea of having to suffer for a year or more until I feel better is an exhausting idea to grasp.

 

I realize I need to practice self-care at the moment and stabilize my CNS, but also feel panicky that i'm not accomplishing the things I *should* be professionally and personally. I regret leaving HI and not being able to get on the plane to CA. I feel that i'm currently a bystander watching my own life pass me by, and that is a horrible feeling. 

 

Thanks for reading. 

 

^This sounds like fairly typical post-withdrawal syndrome. You will have to deal with the lack of focus and motivation for a while, probably months. It will very gradually get better.

 

 

I feel like a complete mess. I started back on Nardil yesterday at 7.5mg twice daily; I woke up in the middle of the night covered in sweat, panic, and my body screaming for a clonapin. I took .5MG of Clonapin and fell asleep. It's possible this was serotonin syndrome as earlier this week I tried one tablet of lexapro at 20MG and also took St. John's Wort last week. I realize I need to *stop* making impulsive decisions with meds and promote CNS stabilization, but I am so mentally exhausted and feeling miserable, which leads to desperation. I don't care anymore if I'm *off* meds, I just want some sort of a life back. I realize I need to let the Lexapro and SJW washout before moving forward, but I'm extremely confused about what to do now: (1) continue with reinstatement plan, (2) give SJW an adequate chance to work, (3) go back to lexapro, (4) try something new. I also definitely need to figure out how to reinstate clonapin at a low daily dose as I know realize I'm withdrawling from that, too. I think about going to the hospital often, but I know that's not the right answer.

 

^Sounds like 7.5mg Nardil twice daily is too much for you. Suggest you try 3.75mg Nardil once daily, in the morning, as it disturbs your sleep.

 

To make any sense of your situation, you absolutely must do things in a controlled, consistent way. If you decide to try 3.75mg Nardil, you must take it at the same time each day for at least a week, barring clear signs of an adverse reaction.

 

Stop taking random drugs of any kind and any alcohol. Forget St. John's Wort, it's only muddying the waters.

 

You have to get this straightened out before making any decisions about taking Klonopin again, as you may be getting paradoxical reactions from taking it.

 

When you first took Nardil, were you advised of its many interactions with drugs and food? If not, Google it immediately and educate yourself.

[JanCarol]

Hey DaveyCrockett - how you feeling?

 

Have you tried the smaller dose of Nardil that Alto suggested?

 

Here is what Alto was talking about the food (just a small sample) listed as a MAJOR interaction:

phenelzine  food

Applies to: Nardil (phenelzine)

During and within two weeks after treatment with phenelzine, you must not consume any foods or beverages that are high in tyramine content. Doing so can raise your blood pressure to dangerous levels, a condition known as hypertensive crisis. The condition is potentially fatal and may cause symptoms such as severe headache, confusion, blurred vision, problems with speech or balance, nausea, vomiting, chest pain, convulsions, and sudden numbness or weakness (especially on one side of the body). You should seek immediate medical attention if you have any of these symptoms. Foods that are high in tyramine include, but are not limited to, air dried meats; aged or fermented meats; sausage or salami; pickled herring; anchovies; liver; red wine; beer; aged cheeses, including blue, brick, brie, cheddar, parmesan, romano, and swiss; sour cream; sauerkraut; canned figs; raisins; bananas or avocados (particularly if overripe); soy beans; soy sauce; tofu; miso soup; bean curd; fava beans; or yeast extracts (such as Marmite). You should avoid the use of alcohol while being treated with phenelzine, as alcohol may increase some of the nervous system side effects such as dizziness, drowsiness, and difficulty concentrating. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

 

Please let us know how you are going?

[daveycrocket]

This sucks. Plain and simple.

I've reinstated on Nardil 15MG for a week and feel just as dysfunctional and hopeless. I am trying to stay the course and stay calm, but I'm getting desperate. I have some bright spots during the day where I think "I can do this!" but days are typically just a blur of sadness, hopelessness, and zero motivation. I have to force myself to do the bare minimum life requires; I feel that I'm losing myself. My Dad really wanted to drive me to the ER today, but I refused.

A part of me wants to take Lexapro (I currently have that) and see if I can use that to stabilize and then taper slowly from there. I realize Prozac would be the ideal bridge med. I have limited options given my insurance is based in CA, and i'm in MA currently, so working with what i have. I can also try increasing the Nardil, but really feel like the MAOI is just no longer working, or I would have to increase significantly. Most of all, *I'm* not working or functioning right now.

 

I'm aware of all the MAOI interactions (not sure what I was thinking when myself OR the PA who prescribed it was thinking! ugh). I appreciate everyone's feedback and kind thoughts. Thanks for reading. 

[Altostrata]

Are these "bright spots" a new development? Does this happen at a particular time of day?

 

Even if the Nardil reinstatement is "working," it may take some time for you to stabilize. Symptoms will come in waves, see The Windows and Waves Pattern of Stabilization

 

Over time -- weeks, not days -- the waves should get less intense and less frequent, while windows get longer and more frequent.
 
Please be aware that your symptoms are not due to lack of serotonin, to be remedied by Prozac, but the changes your body made to accommodate itself to Nardil and withdrawal from Nardil.
 
I have no idea what Prozac might do for you. If I were you, I wouldn't throw that into the mix.

 

Are you still taking a benzo occasionally?
 
 

[daveycrocket]

Just wanted to post an update: 

 

I wasn't able to reinstate Nardil with much luck. I added fish oil (4 capsules) w/ Vitamin E, which does seem to be helping some, going on 2 weeks. My stomach couldn't seem to tolerate Magnesium, but I may again try at a later point. I also added Sam-E @ 400MG and going on 1 week of that. I realize Sam-E isn't generally recommended on here, but I am encouraged by the studies that support it's efficacy. I am trying to experiment carefully, balancing my despair to *feel better now* and the need to treat my central nervous system gently.  

 

My main side effects at this point are cortisol mornings, anhedonia, depersonalization, lack of motivation, and occasional panic attacks. I would say that I feel slightly better than a few weeks back in that I'm now able to convince myself to get out of bed. I've come to accept that this is going to be a process, and isn't going to be easy -- acceptance is a big accomplishment in itself. I realize I essentially went cold turkey off 3 strong psychiatric medications, which has absolutely created mayhem in my system. My family and friends are supportive, but for obvious reasons, protracted withdrawal is extremely difficult for others to relate to.

 

Thanks for listening.

[daveycrocket]

I'm so tired of this. I'm able to get out of bed but still not myself or even 50% myself. I am trying to be patient, experimenting with supplements prudently, but this is a nightmare. I'm considering just fully reinstating back on Nardil. I didn't even given reinstatement a chance to work. It's extremely hard to go "slow, steady, and stable" when your mood is a damn roller coaster and everything feels so awful. Not to mention this has been going on for MONTHS. I can't do this anymore. My family is losing patience with me and i'm losing patience with myself. My life has been on standby for so long. I'm sorry for the rant. 

[scallywag]

davey -- Withdrawal off antidepressants is a rough ride; after a cold-turkey cessation it can be a wild, bucking-bronco ride. You are unfortunately getting the wild ride.

 

In the last 5 months your CNS (central nervous system) has been adjusting to the absence of Nardil. As your CNS rewires -- upregulating the monoamine oxidase production that was inhibited -- new neural connections are made. These new connections and shifting chemical amoutns are the source of symptoms during tapering and after stopping an MAOI such as Nardil.

 

The cold turkey stop has destabilized your CNS and there is no guarantee that reinstating any amount of Nardil will alleviate your symptoms -- they could reduce, stay the same or get worse. No one can predict how your CNS will react.

 

Reinstating the full 75 mg will almost certainly destabilize your CNS more. If you are thinking of reinstating, please start with a very small amount to test your CNS response. A small amount is 1 mg.  I'll research whether or not Nardil is soluble in a liquid and update you.

 

Update: it is soluble in water. Read this to learn about Making a liquid from a tablet or capsules

Edited July 5, 2016 by scallywag
solubility information