Terry Posted September 1, 2017 Share Posted September 1, 2017 On 1/25/2015 at 1:37 PM, Altostrata said: Hi, sunflower. From what I've seen, most people stabilize within a few days after a reduction. Some do not feel it at all. I changed the title of this topic because I think that there's a lot of variation and the experience of others will be very informative. After 2 weeks on escitalopram and then 4 weeks on sertrilene, I can't say I've ever stabilized. I decreased the sertrilene 10 days ago and symptoms seem overall slightly better. I'm trying to decide whether to stay at my current dose or continue to taper. 2007 - 2008 Paxil and Klonopin 2008 - 2012 Mirtazapine following CT from Klonopin and Paxil. 2012 Unsuccessful taper of mirtazapine; reinstated. 7/2013 - 1/2014 Successfully tapered mirtazapine from 7.5 mg to 0.00. Sertraline (Zoloft) 25 mg. - Tapered from Aug 4, 2017 to July 18, 2021 - Current dose 0.00 Alprazolam (Xanax) 0.25 mg. July 19, 2017 - Nov 15, 2021 Began 10% taper Nov 16, 2021 - 0.25 Jan 11, 2022 - 0.203; Jan 13, 2023 - 0.0499; Jan 21, 2024 - 0.0137; July 20, 2024 - 0.00608; Taper is 97% complete. Link to comment
Administrator Altostrata Posted September 5, 2017 Administrator Share Posted September 5, 2017 ADMIN NOTE Terry's original Introductions topic was accidentally deleted yesterday. I recovered as much as I could today from Google cache. Apologies to Terry and everyone else who contributed to this topic. ___________________________________________________________________________________ TERRY I had TKR surgery in early May this year. I was given oxycodone for pain and used it for 5-6 weeks, cutting back as I no longer needed it. A few weeks later I was having anxiety symptoms and my doctor put me on Lexapro and Xanax. He said side effects should stop after 2-3 weeks, but they didn't. So he then switched me to Zoloft and kept me on the Xanax. Now, after 2 1/2 weeks my symptoms are the same and I don't know which way to turn. I have sleep problems, shaking, burning skin, anxiety. I would appreciate any suggestions that anyone can offer. I don't know how to keep going in this miserable state. This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner. "It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein All postings © copyrighted. Link to comment
Administrator Altostrata Posted September 5, 2017 Administrator Share Posted September 5, 2017 MAMMAP Hi Terry, welcome to SA. Oxycodone is very addictive quite quickly and you would have been in withdrawal. It is an opiate so lexapro wouldn't have touched it and xanax is placing one drug with another that is even harder to withdraw from. As ypu have only been taking lexapro/zoloft for about weeks you may be able to taper quickly. Take half dose for a few days then stop. If you take it any longer your brain will have adapted and you will need to do a slow taper. Can you give us a symptom pattern? eg. worse before taking the drugs, or worse after. Bad in the morning or evening. When do you take the tablets? From this we might get a picture of what is causing your symptoms. Are you still taking xanax? If so how are you taking it? If you click quote you will be able to answer the questions right underneath them in the quote box that will be in the reply part. It would be good if you can fill in your signature with your drugs, doses, start and stop dates. The link will take you to the signature box , just fill it in and click save. :). I am so glad that you came found us, hopefully we will be able to help you find the way through this. http://survivingantidepressants.org/settings/signature/ This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner. "It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein All postings © copyrighted. Link to comment
Administrator Altostrata Posted September 5, 2017 Administrator Share Posted September 5, 2017 TERRY Symptoms are burning skin (mostly during the night), shaking, anxiety, weakness, shortness of breath, fatigue. My symptoms are worse now than before I began taking these drugs. I take the sertrilene (zoloft) in the morning along with half dose of alprazolam (xanax). Then use the rest of the alprazolam dose as needed. This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner. "It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein All postings © copyrighted. Link to comment
Administrator Altostrata Posted September 5, 2017 Administrator Share Posted September 5, 2017 ALTOSTRATA Welcome, Terry. Did these symptoms start when you started taking Lexapro and Xanax? Do you take any other drugs? What times of day do you take your drugs, at what dosages? Please keep daily notes on paper about your symptoms, when you take your drugs, and dosages. This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner. "It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein All postings © copyrighted. Link to comment
Administrator Altostrata Posted September 5, 2017 Administrator Share Posted September 5, 2017 CHESSIECAT Hi Terry, This is an example of the way to keep notes: Keep notes on paper about your drug dosages and daily symptom pattern This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner. "It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein All postings © copyrighted. Link to comment
Administrator Altostrata Posted September 5, 2017 Administrator Share Posted September 5, 2017 SHEP Hi, Terry. Welcome to SA from me, too. When you say "then use the rest of the alprazolam dose as needed", are you taking the same amount of alprazolam every day? Or does your daily total alprazolam dose vary each day? This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner. "It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein All postings © copyrighted. Link to comment
Administrator Altostrata Posted September 5, 2017 Administrator Share Posted September 5, 2017 TERRY I was experiencing anxiety before the drugs. My short term memory isn't very good, so I can't remember anything else. I'm now on Zoloft and Xanax generics. I was taking 50 mg Zoloft (Sertrilene) abt. 7AM until two days ago when I cut it to 25 mg. I take 0.25 mg Xanax (alprazolam) daily, dividing the pills in half and sometimes in quarters. I usually take a half pill abt. 7AM and then take the other half (or quarters) as needed, times varying. My doc now wants me to switch to Mirtazipine instead of sertrilene, but all this switching seems like it could make things worse. I also take Amlodipine 10 mg and Losartan 50 mg for high blood pressure. No other prescriptions. I wish I knew how to control my anxiety without meds, On this site, mammaP suggested that post-oxycodone might be responsible for my anxiety, but from what I've read and been told by my providers, I don't think so. This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner. "It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein All postings © copyrighted. Link to comment
Administrator Altostrata Posted September 5, 2017 Administrator Share Posted September 5, 2017 TERRY Quote On 8/25/2017 at 5:31 AM, Shep said: Hi, Terry. Welcome to SA from me, too. When you say "then use the rest of the alprazolam dose as needed", are you taking the same amount of alprazolam every day? Or does your daily total alprazolam dose vary each day? I take 0.25 mg /day. I divide it to try to control symptoms thru the day, though I'm not sure if this is the right thing to do. This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner. "It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein All postings © copyrighted. Link to comment
Administrator Altostrata Posted September 5, 2017 Administrator Share Posted September 5, 2017 SHEP Hi, Terry. This is actually very good because you're spreading your doses throughout the day, which reduces symptoms in between doses, also known as "interdose withdrawal". You may want to be more consistent, though, and take it at regularly scheduled times. Due to the short half-life of alprazolam (6-12 hours), you may want to take it every 6 hours throughout the day consistently. Some people even take it as much as 6 times a day. But the more you can dose at the same, consistent times every day, the easier it is on your nervous system. Quote On 8/25/2017 at 6:55 AM, Terry said: I wish I knew how to control my anxiety without meds, This is a great section to check out. Non-drug coping techniques to cope with emotional symptoms Quote On 8/25/2017 at 6:55 AM, Terry said: I also take Amlodipine 10 mg and Losartan 50 mg for high blood pressure. No other prescriptions. Please add these to your signature. Here is the direct link: Account Settings - signature Please check out the link to the non-drug coping section. There are links to mindfulness and acceptance, journaling and art therapy, and many other ways of coping during withdrawal. This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner. "It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein All postings © copyrighted. Link to comment
Administrator Altostrata Posted September 5, 2017 Administrator Share Posted September 5, 2017 ALTOSTRATA Terry, we need to know your symptom pattern in the morning. Also, exactly when you take any of your drugs, their dosages, and your symptoms throughout the day. This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner. "It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein All postings © copyrighted. Link to comment
Administrator Altostrata Posted September 5, 2017 Administrator Share Posted September 5, 2017 TERRY Thanks for the suggestions, Shep. I split my Xanax dose into quarters one day, and even though they weren't really timed as well as you suggest, I found that the next day was pretty decent. Cause and effect? I'm going to try this again, but with more regular timing. This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner. "It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein All postings © copyrighted. Link to comment
Administrator Altostrata Posted September 5, 2017 Administrator Share Posted September 5, 2017 TERRY Quote On 8/25/2017 at 1:25 PM, Altostrata said: Terry, we need to know your symptom pattern in the morning. Also, exactly when you take any of your drugs, their dosages, and your symptoms throughout the day. Currently I am taking 25 mg sertrilene at 6 to 7 AM. I usually take 0.125 mg alprazolam at the same time, then 0.125 or 0.0625 mg as needed, no set time. The losartan 50 mg and amlodipine 10 mg I take between 7 and 8 AM. My morning symptoms are shaking, anxiety, sometimes burning skin, and no desire to do anything, except maybe read or work a puzzle, something to focus my mind on. Usually by afternoon symptoms ease a bit and evenings are often quite tolerable. This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner. "It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein All postings © copyrighted. Link to comment
Quote On 8/25/2017 at 1:25 PM, Altostrata said: Terry, we need to know your symptom pattern in the morning. Also, exactly when you take any of your drugs, their dosages, and your symptoms throughout the day. Currently I am taking 25 mg sertrilene at 6 to 7 AM. I usually take 0.125 mg alprazolam at the same time, then 0.125 or 0.0625 mg as needed, no set time. The losartan 50 mg and amlodipine 10 mg I take between 7 and 8 AM. My morning symptoms are shaking, anxiety, sometimes burning skin, and no desire to do anything, except maybe read or work a puzzle, something to focus my mind on. Usually by afternoon symptoms ease a bit and evenings are often quite tolerable.
Administrator Altostrata Posted September 5, 2017 Administrator Share Posted September 5, 2017 SHEP Quote On 8/25/2017 at 2:55 PM, Terry said: I split my Xanax dose into quarters one day, and even though they weren't really timed as well as you suggest, I found that the next day was pretty decent. Cause and effect? I'm going to try this again, but with more regular timing. That sounds like a good idea, Terry. Spreading out the doses is good for handling interdose withdrawal. Please let us know how you do over the next few days as you're dosing more consistently. Quote On 8/25/2017 at 3:08 PM, Terry said: My morning symptoms are shaking, anxiety, sometimes burning skin, and no desire to do anything, except maybe read or work a puzzle, something to focus my mind on. Usually by afternoon symptoms ease a bit and evenings are often quite tolerable. Having more symptoms in the morning is very common during withdrawal. Reading and working puzzles sound like great distractions. You may find some more helpful hints about dealing with this here: Waking with panic or anxiety -- managing cortisol spikes This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner. "It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein All postings © copyrighted. Link to comment
Quote On 8/25/2017 at 2:55 PM, Terry said: I split my Xanax dose into quarters one day, and even though they weren't really timed as well as you suggest, I found that the next day was pretty decent. Cause and effect? I'm going to try this again, but with more regular timing. That sounds like a good idea, Terry. Spreading out the doses is good for handling interdose withdrawal. Please let us know how you do over the next few days as you're dosing more consistently. Quote On 8/25/2017 at 3:08 PM, Terry said: My morning symptoms are shaking, anxiety, sometimes burning skin, and no desire to do anything, except maybe read or work a puzzle, something to focus my mind on. Usually by afternoon symptoms ease a bit and evenings are often quite tolerable. Having more symptoms in the morning is very common during withdrawal. Reading and working puzzles sound like great distractions. You may find some more helpful hints about dealing with this here: Waking with panic or anxiety -- managing cortisol spikes
Terry Posted September 5, 2017 Author Share Posted September 5, 2017 7 hours ago, Altostrata said: ALTOSTRATA Terry, we need to know your symptom pattern in the morning. Also, exactly when you take any of your drugs, their dosages, and your symptoms throughout the day. I usually awaken with feelings of anxiety and shakiness. I take 0.125 mg alprazolam and 25 mg sertraline at 7AM, and 0.125 mg alprazolam at 7PM. I take my BP meds, losartan and amlodipine, about 8 AM. 8/29/17: 1:30AM burning skin 4:30AM burning skin 7AM 0.125 mg alprazolam, 25 mg sertraline 8AM breakfast and BP meds, feeling groggy 10AM anxious, short of breath Noon weak, groggy 1PM walked 2 blocks, tired, short of breath 3PM groggy 5:30 dinner 7PM 0.125 mg alprazolam 8/30/17: 3:30AM mild skin burning, disturbed sleep 7AM got up, had abt. 6 hours interrupted sleep, 0.125 mg alprazolam, 25 mg sertraline 7:30AM breakfast, feeling weak 8AM BP meds 8:30AM walked 1 mile 11AM physical therapy Noon bought a few groceries, feeling shaky 12:40PM lunch 4:30PM less shaky 5:30PM dinner 6:30PM feeling nervous 7PM 0.125 mg alprazolam, followed by better evening 8/31/17: abt. 6 hours sleep, slightly burning skin 6:30AM slightly anxious 7AM 0.125 mg alprazolam, 25 mg sertraline 7:30AM breakfast, BP meds, feeling better 10:30AM shaky, anxious 11AM walked 1 mile, still shaky, slight shortness of breath 11:30 lunch 12-4PM shaky 4-5PM less shaky, feeling tired 7PM 0.125 mg alprazolam 9PM went to bed early 9/1/17: abt. 5-6 hours sleep 5AM woke with burning skin and anxiety 7AM 0.125 mg alprazolam, 25 mg sertraline 8AM groggy 9:30AM sl. anxious 10AM shaky Noon lunch 12-4PM sl. shaky 4-7PM more calm 7PM 0.125 mg alprazolam 7-10PM fair evening 9/2/17: slept 6+ hours, awoke sl. shaky, no burning skin 7AM 0.125 mg alprazolam, 25 mg sertraline 8AM breakfast, BP low, feeling lightheaded. Doc explained that BP would get lower when anxiety is better, and BP meds may have to be adjusted. 8:30AM groggy 9:50AM walked 0.9 mile Noon lunch, feeling weak 1PM tired, low energy 7PM 0.125 mg alprazolam 9PM sleepy, went to bed early 9/3/17: abt. 6.5 hours sleep, woke with sl. burning of skin 7AM 0.125 mg alprazolam, 25 mg sertraline 8AM breakfast, BP meds shaky all morning and afternoon forgot to make notes abt. evening 9/4/17: slept 4-5 hours, interrupted sleep 7AM 0.125 mg alprazolam, 25 mg sertraline 7PM 0.125 mg alprazolam GOOD DAY WITH VIRTUALLY NO SIDE EFFECTS! 9/5/17: slept most of the night, woke with slight burning, sl. shaking, sl. anxiety 7AM 0.125 mg alprazolam, 25 mg sertraline . 2007 - 2008 Paxil and Klonopin 2008 - 2012 Mirtazapine following CT from Klonopin and Paxil. 2012 Unsuccessful taper of mirtazapine; reinstated. 7/2013 - 1/2014 Successfully tapered mirtazapine from 7.5 mg to 0.00. Sertraline (Zoloft) 25 mg. - Tapered from Aug 4, 2017 to July 18, 2021 - Current dose 0.00 Alprazolam (Xanax) 0.25 mg. July 19, 2017 - Nov 15, 2021 Began 10% taper Nov 16, 2021 - 0.25 Jan 11, 2022 - 0.203; Jan 13, 2023 - 0.0499; Jan 21, 2024 - 0.0137; July 20, 2024 - 0.00608; Taper is 97% complete. Link to comment
Moderator Emeritus baroquep Posted September 9, 2017 Moderator Emeritus Share Posted September 9, 2017 Hi Terry, as I mentioned, I am pasting your personal message in your intro thread so that all of the moderators are able to weigh in a respond to your questions and have copied your PM below. I would encourage you to post in your intro thread (I promise I won't delete it again ) so that we have all of your information in one spot and can respond to your questions and concerns as a team. Your Email I believe you mentioned that my problem may have started with delayed withdrawal from oxycodone that I had taken for my total knee replacement. If that were the case, how would I go about getting over that when I'm now on alprazolam and sertraline? I just don't know where to begin. After 5 weeks on alprazolam and sertraline I'm still having side effects every day, although not as bad as when I first started on them. My sleep is better, usually about 6 hours or slightly more. I always wake up with some anxiety, then after taking my meds at 7AM I feel foggy headed and somewhat shaky most of the day. I'm uncertain whether I should taper the sertraline or stay on it a while longer to see if things get better. I realize my situation is not as bad as some on this forum, but I still would like to feel normal again. Judging by your email, it would appear that you are beginning to stabilize on the sertraline and alprazolam. It is very unfortunate that your doctor wasn't very well informed and subsequently prescribed you additional drugs to alleviate the withdrawal symptoms from the oxycodone. It is something I see here all the time and it really upsets me. Unfortunately because you have been taking both of these drugs for over a month (as well as a history of anti-depressant use in the past), and are already experiencing difficulties, you will need to be very careful to not upset your central nervous system any further and wouldn't advise that you not make any other changes at this time. Personally, knowing what I know now about these drugs, at the very least, as a doctor, I would have first suggested trying to ride out the symptoms rather than mask them with any new drugs or at the most prescribed a very small dose of alazopram until the symptoms settled and then slowly withdraw by 10% off of that. I wouldn't have added the sertraline at all and have a feeling that this has just made things 10 x worse for you. I have asked the more experienced moderators to have a look at your situation to see if, once you've stabilized, if it might be possible to discontinue the sertraline a little faster as it does seem like a shame to have to continue this drug when it likely isn't providing any real benefit. But as I said, now that your central nervous system has been destabilized, it is a lot more complicated. Please do not make anymore 50% reductions, if I remember correctly, you did a very large drop of the sertraline very recently and that has made things harder for you to stabilize. Please do keep track of your symptoms on a day to day basis so that you can record your progress. Another moderator will be by shortly to have a look and see if there is anything that they can add or have any further recommendations. Unfortunately right now, all you can do is try and make yourself as comfortable as you can until we can put a plan in place to help you taper off of these drugs safely. Best, BaroqueP Current Prescription Drugs for Hypothyroidism: Synthroid 100mcg / Cytomel 5mcg (15 years Pristiq/Effexor)Tapering Schedule September 15, 2016 - switched from Pristiq 50mg to Effexor XR 75mg; November 10, 2016 - reduced to 67.5 Effexor XR December 9, 2016 - reduced 60.75 January 5, 2017 - reduced 54.67 January 30, 2017 - reduced to 49.0 February 20, 2017 - reduced to 44.0 May 20, 2017 - reduced to 40.25 (holding for additional month due to late onset of withdrawal symptoms after this taper) July 17, 2017 - reduced to 38.24 August 15, 2017 - reduced to 37.5 (50% of my original dose) October 15, 2017 - reduced to 35.6 November 12, 2017 - reduced to 33.8 December 15, 2017 - up-dose to 35.6 December 28, 2017 - up-dose to 37.5 Link to comment
Terry Posted September 9, 2017 Author Share Posted September 9, 2017 On 9/5/2017 at 1:09 AM, Altostrata said: ADMIN NOTE Terry's original Introductions topic was accidentally deleted yesterday. I recovered as much as I could today from Google cache. Apologies to Terry and everyone else who contributed to this topic. ___________________________________________________________________________________ TERRY I had TKR surgery in early May this year. I was given oxycodone for pain and used it for 5-6 weeks, cutting back as I no longer needed it. A few weeks later I was having anxiety symptoms and my doctor put me on Lexapro and Xanax. He said side effects should stop after 2-3 weeks, but they didn't. So he then switched me to Zoloft and kept me on the Xanax. Now, after 2 1/2 weeks my symptoms are the same and I don't know which way to turn. I have sleep problems, shaking, burning skin, anxiety. I would appreciate any suggestions that anyone can offer. I don't know how to keep going in this miserable state. After 5 weeks on alprazolam and sertraline I have improved a bit, but do still have some side effects, mostly shakiness. 2007 - 2008 Paxil and Klonopin 2008 - 2012 Mirtazapine following CT from Klonopin and Paxil. 2012 Unsuccessful taper of mirtazapine; reinstated. 7/2013 - 1/2014 Successfully tapered mirtazapine from 7.5 mg to 0.00. Sertraline (Zoloft) 25 mg. - Tapered from Aug 4, 2017 to July 18, 2021 - Current dose 0.00 Alprazolam (Xanax) 0.25 mg. July 19, 2017 - Nov 15, 2021 Began 10% taper Nov 16, 2021 - 0.25 Jan 11, 2022 - 0.203; Jan 13, 2023 - 0.0499; Jan 21, 2024 - 0.0137; July 20, 2024 - 0.00608; Taper is 97% complete. Link to comment
Terry Posted September 9, 2017 Author Share Posted September 9, 2017 8/29/17: 1:30AM burning skin 4:30AM burning skin 7AM 0.125 mg alprazolam, 25 mg sertraline 8AM breakfast and BP meds, feeling groggy 10AM anxious, short of breath Noon weak, groggy 1PM walked 2 blocks, tired, short of breath 3PM groggy 5:30 dinner 7PM 0.125 mg alprazolam 8/30/17: 3:30AM mild skin burning, disturbed sleep 7AM got up, had abt. 6 hours interrupted sleep, 0.125 mg alprazolam, 25 mg sertraline 7:30AM breakfast, feeling weak 8AM BP meds 8:30AM walked 1 mile 11AM physical therapy Noon bought a few groceries, feeling shaky 12:40PM lunch 4:30PM less shaky 5:30PM dinner 6:30PM feeling nervous 7PM 0.125 mg alprazolam, followed by better evening 8/31/17: abt. 6 hours sleep, slightly burning skin 6:30AM slightly anxious 7AM 0.125 mg alprazolam, 25 mg sertraline 7:30AM breakfast, BP meds, feeling better 10:30AM shaky, anxious 11AM walked 1 mile, still shaky, slight shortness of breath 11:30 lunch 12-4PM shaky 4-5PM less shaky, feeling tired 7PM 0.125 mg alprazolam 9PM went to bed early 9/1/17: abt. 5-6 hours sleep 5AM woke with burning skin and anxiety 7AM 0.125 mg alprazolam, 25 mg sertraline 8AM groggy 9:30AM sl. anxious 10AM shaky Noon lunch 12-4PM sl. shaky 4-7PM more calm 7PM 0.125 mg alprazolam 7-10PM fair evening 9/2/17: slept 6+ hours, awoke sl. shaky, no burning skin 7AM 0.125 mg alprazolam, 25 mg sertraline 8AM breakfast, BP low, feeling lightheaded. Doc explained that BP would get lower when anxiety is better, and BP meds may have to be adjusted. 8:30AM groggy 9:50AM walked 0.9 mile Noon lunch, feeling weak 1PM tired, low energy 7PM 0.125 mg alprazolam 9PM sleepy, went to bed early 9/3/17: abt. 6.5 hours sleep, woke with sl. burning of skin 7AM 0.125 mg alprazolam, 25 mg sertraline 8AM breakfast, BP meds shaky all morning and afternoon forgot to make notes abt. evening 9/4/17: slept 4-5 hours, interrupted sleep 7AM 0.125 mg alprazolam, 25 mg sertraline 7PM 0.125 mg alprazolam GOOD DAY WITH VIRTUALLY NO SIDE EFFECTS! 9/5/17: slept most of the night, woke with slight burning, sl. shaking, sl. anxiety, decreasing through the rest of the day. 7AM 0.125 mg alprazolam, 25 mg sertraline 7PM 0.125 mg alprazolam 9/6/17: 5AM woke with skin burning sensation 7AM 0.125 mg alprazolam, 25 mg sertraline 7:30AM breakfast 8AM feeling OK, walked 1.3 miles slightly shaky AM, good afternoon and evening 7PM 0.125 mg alprazolam 9/7/17: slept abt. 6 hours woke with shakiness and mild anxiety 7AM 0.125 mg alprazolam, 25 mg sertraline shakiness throughout the day 7PM 0.125 mg alprazolam evening was better 2007 - 2008 Paxil and Klonopin 2008 - 2012 Mirtazapine following CT from Klonopin and Paxil. 2012 Unsuccessful taper of mirtazapine; reinstated. 7/2013 - 1/2014 Successfully tapered mirtazapine from 7.5 mg to 0.00. Sertraline (Zoloft) 25 mg. - Tapered from Aug 4, 2017 to July 18, 2021 - Current dose 0.00 Alprazolam (Xanax) 0.25 mg. July 19, 2017 - Nov 15, 2021 Began 10% taper Nov 16, 2021 - 0.25 Jan 11, 2022 - 0.203; Jan 13, 2023 - 0.0499; Jan 21, 2024 - 0.0137; July 20, 2024 - 0.00608; Taper is 97% complete. Link to comment
Administrator Altostrata Posted September 9, 2017 Administrator Share Posted September 9, 2017 It's looking to me like you are getting interdose withdrawal from alprazolam during the night and into the morning. The daytime grogginess is probably the morning dose of alprazolam being too high. This is repeated every day. I wonder what happened the evening of 9/3; it may have affected 9/4. Did you perhaps take the alprazolam later than 7 p.m. the evening of 9/3? This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner. "It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein All postings © copyrighted. Link to comment
Terry Posted September 13, 2017 Author Share Posted September 13, 2017 On 9/5/2017 at 1:16 AM, Altostrata said: ALTOSTRATA Terry, we need to know your symptom pattern in the morning. Also, exactly when you take any of your drugs, their dosages, and your symptoms throughout the day. On 9/9/2017 at 1:59 PM, Altostrata said: It's looking to me like you are getting interdose withdrawal from alprazolam during the night and into the morning. The daytime grogginess is probably the morning dose of alprazolam being too high. This is repeated every day. I wonder what happened the evening of 9/3; it may have affected 9/4. Did you perhaps take the alprazolam later than 7 p.m. the evening of 9/3? Looks like I didn't finish my post for 9/3. I'm careful to take the alprazolam each evening at 7:00, give or take less than half an hour. I take 0.125 mg alprazolam at 7AM and 7PM and sertraline about 7AM. Currently my symptoms are mild anxiety upon awakening. Once I'm up I feel shaky, jittery. It eases somewhat through the morning and early afternoon. Often by mid- to late afternoon I'll feel groggy. Evenings have been mostly good. 2007 - 2008 Paxil and Klonopin 2008 - 2012 Mirtazapine following CT from Klonopin and Paxil. 2012 Unsuccessful taper of mirtazapine; reinstated. 7/2013 - 1/2014 Successfully tapered mirtazapine from 7.5 mg to 0.00. Sertraline (Zoloft) 25 mg. - Tapered from Aug 4, 2017 to July 18, 2021 - Current dose 0.00 Alprazolam (Xanax) 0.25 mg. July 19, 2017 - Nov 15, 2021 Began 10% taper Nov 16, 2021 - 0.25 Jan 11, 2022 - 0.203; Jan 13, 2023 - 0.0499; Jan 21, 2024 - 0.0137; July 20, 2024 - 0.00608; Taper is 97% complete. Link to comment
Administrator Altostrata Posted September 15, 2017 Administrator Share Posted September 15, 2017 Yes, as the alprazolam wears off overnight, you get rebound anxiety. This goes away after you take your morning dose of alprazolam, which makes you dopey. How do you feel prior to your evening dose? This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner. "It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein All postings © copyrighted. Link to comment
Terry Posted September 18, 2017 Author Share Posted September 18, 2017 (edited) On 2017-09-15 at 0:48 AM, Altostrata said: Yes, as the alprazolam wears off overnight, you get rebound anxiety. This goes away after you take your morning dose of alprazolam, which makes you dopey. How do you feel prior to your evening dose? I'm usually feeling tired, weak, sometimes slightly shaky. If I have never stabilized on these drugs, how will I know when I've stabilized during tapering? On 2017-09-05 at 2:16 AM, Altostrata said: ALTOSTRATA Terry, we need to know your symptom pattern in the morning. Also, exactly when you take any of your drugs, their dosages, and your symptoms throughout the day. I'm careful to take the alprazolam each evening at 7:00, give or take less than half an hour. I take 0.125 mg alprazolam at 7AM and 7PM and sertraline about 7AM. Edited September 18, 2017 by baroquep put his answer to Alto's question in his reply 2007 - 2008 Paxil and Klonopin 2008 - 2012 Mirtazapine following CT from Klonopin and Paxil. 2012 Unsuccessful taper of mirtazapine; reinstated. 7/2013 - 1/2014 Successfully tapered mirtazapine from 7.5 mg to 0.00. Sertraline (Zoloft) 25 mg. - Tapered from Aug 4, 2017 to July 18, 2021 - Current dose 0.00 Alprazolam (Xanax) 0.25 mg. July 19, 2017 - Nov 15, 2021 Began 10% taper Nov 16, 2021 - 0.25 Jan 11, 2022 - 0.203; Jan 13, 2023 - 0.0499; Jan 21, 2024 - 0.0137; July 20, 2024 - 0.00608; Taper is 97% complete. Link to comment
Administrator Altostrata Posted September 19, 2017 Administrator Share Posted September 19, 2017 Have you thought about spacing out your benzo dosing? Rebound anxiety and symptoms ahead of your evening dose indicate two dose of alprazolam are not enough. This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner. "It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein All postings © copyrighted. Link to comment
Moderator Emeritus Shep Posted September 19, 2017 Moderator Emeritus Share Posted September 19, 2017 Hi, Terry. In addition to what Alto is saying about rebound anxiety, I also want to add that there's a "Moderate" adverse reaction with alprazolam and one of your blood pressure meds, Losartan. I copied and pasted it below. Please consider spacing out the benzo, as that may also help with this adverse reaction because you won't be taking as much alprazolam at a time and it will be dosed farther apart from when you take your blood pressure meds. Also, combining blood pressure pills with benzos can cause paradoxical reactions. Benzos are already notorious for causing paradoxical reactions, but taking them with blood pressure meds can make it more likely, along with possible adverse reactions. You may want to split out your two doses of 0.125 mg alprazolam into four doses of .0625 mg each. You reported feeling "shakiness throughout the day" and "weakness" after your morning benzo and blood pressure meds, so perhaps working with the timing and spacing will help. Quote Interactions between your selected drugs Moderate alprazolam losartan Applies to: Xanax (alprazolam), losartan Losartan and ALPRAZolam may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. 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. Link to comment
Moderator Emeritus Shep Posted September 19, 2017 Moderator Emeritus Share Posted September 19, 2017 Sorry, Terry. I meant to add if you do decide to space out your alprazolam doses, please only move each dose 1 hour per day. This is the gentlest on your nervous system. If you need help setting up a specific schedule, please let us know. Link to comment
Terry Posted September 19, 2017 Author Share Posted September 19, 2017 8 hours ago, Altostrata said: Have you thought about spacing out your benzo dosing? Rebound anxiety and symptoms ahead of your evening dose indicate two dose of alprazolam are not enough. I had tried one day of quartering my dose,but that wasn't to even out doses throughout the day. I took quarter doses at 2 AM, 4 AM, 7 AM, and 11 AM just because I was having such bad symptoms. 2007 - 2008 Paxil and Klonopin 2008 - 2012 Mirtazapine following CT from Klonopin and Paxil. 2012 Unsuccessful taper of mirtazapine; reinstated. 7/2013 - 1/2014 Successfully tapered mirtazapine from 7.5 mg to 0.00. Sertraline (Zoloft) 25 mg. - Tapered from Aug 4, 2017 to July 18, 2021 - Current dose 0.00 Alprazolam (Xanax) 0.25 mg. July 19, 2017 - Nov 15, 2021 Began 10% taper Nov 16, 2021 - 0.25 Jan 11, 2022 - 0.203; Jan 13, 2023 - 0.0499; Jan 21, 2024 - 0.0137; July 20, 2024 - 0.00608; Taper is 97% complete. Link to comment
Terry Posted September 19, 2017 Author Share Posted September 19, 2017 1 hour ago, Shep said: Hi, Terry. In addition to what Alto is saying about rebound anxiety, I also want to add that there's a "Moderate" adverse reaction with alprazolam and one of your blood pressure meds, Losartan. I copied and pasted it below. Please consider spacing out the benzo, as that may also help with this adverse reaction because you won't be taking as much alprazolam at a time and it will be dosed farther apart from when you take your blood pressure meds. Also, combining blood pressure pills with benzos can cause paradoxical reactions. Benzos are already notorious for causing paradoxical reactions, but taking them with blood pressure meds can make it more likely, along with possible adverse reactions. You may want to split out your two doses of 0.125 mg alprazolam into four doses of .0625 mg each. You reported feeling "shakiness throughout the day" and "weakness" after your morning benzo and blood pressure meds, so perhaps working with the timing and spacing will help. My doctor had told me that as my anxiety got better I may be able to eliminate one BP med, specifically because of the reactions listed above. The benzo can be calming and cause a drop in BP which would cause the interaction symptoms listed. I check my BPs at home, and thus far they've been very normal except for one day. So I don't think the alprazolam/ losartan combo is the problem. I could split the benzo dose into four, but in order to space the timing evenly, for one of the doses I would have to wake up at the same time every night. I can't set an alarm as it would wake my husband too, which would not be good. How else might I do it? 2007 - 2008 Paxil and Klonopin 2008 - 2012 Mirtazapine following CT from Klonopin and Paxil. 2012 Unsuccessful taper of mirtazapine; reinstated. 7/2013 - 1/2014 Successfully tapered mirtazapine from 7.5 mg to 0.00. Sertraline (Zoloft) 25 mg. - Tapered from Aug 4, 2017 to July 18, 2021 - Current dose 0.00 Alprazolam (Xanax) 0.25 mg. July 19, 2017 - Nov 15, 2021 Began 10% taper Nov 16, 2021 - 0.25 Jan 11, 2022 - 0.203; Jan 13, 2023 - 0.0499; Jan 21, 2024 - 0.0137; July 20, 2024 - 0.00608; Taper is 97% complete. Link to comment
Terry Posted September 19, 2017 Author Share Posted September 19, 2017 30 minutes ago, Shep said: Sorry, Terry. I meant to add if you do decide to space out your alprazolam doses, please only move each dose 1 hour per day. This is the gentlest on your nervous system. If you need help setting up a specific schedule, please let us know. "please only move each dose 1 hour per day" Could you please explain this, and perhaps you could suggest a workable schedule. Thanks! 2007 - 2008 Paxil and Klonopin 2008 - 2012 Mirtazapine following CT from Klonopin and Paxil. 2012 Unsuccessful taper of mirtazapine; reinstated. 7/2013 - 1/2014 Successfully tapered mirtazapine from 7.5 mg to 0.00. Sertraline (Zoloft) 25 mg. - Tapered from Aug 4, 2017 to July 18, 2021 - Current dose 0.00 Alprazolam (Xanax) 0.25 mg. July 19, 2017 - Nov 15, 2021 Began 10% taper Nov 16, 2021 - 0.25 Jan 11, 2022 - 0.203; Jan 13, 2023 - 0.0499; Jan 21, 2024 - 0.0137; July 20, 2024 - 0.00608; Taper is 97% complete. Link to comment
Moderator Emeritus Shep Posted September 19, 2017 Moderator Emeritus Share Posted September 19, 2017 (edited) Sure, Terry. Let's get you a benzo schedule. You're currently taking 0.125 mg alprazolam at 7 am and 7 pm. The goal is to get to 4 doses of .0625 mg taken at 7 am, 12 pm, 5 pm, and 10 pm. This will space out your doses evenly 5 hours apart. If 10 pm is too late, you may want to take that dose a bit earlier, but as long as you're consistently taking it earlier (say 8 or 9 pm every night), you'll be fine. Step One - moving the morning dose Day One: 7 am - .0625 mg alprazolam 8 am - .0625 mg 7 pm - .125 mg Day Two: 7 am - .0625 mg alprazolam 9 am - .0625 mg 7 pm - .125 mg Day Three: 7 am - .0625 mg alprazolam 10 am - .0625 mg 7 pm - .125 mg Day Four: 7 am - .0625 mg alprazolam 11 am - .0625 mg 7 pm - .125 mg Day Five: 7 am - .0625 mg alprazolam noon - .0625 mg 7 pm - .125 mg Step Two - moving the evening dose Day Six: 7 am - .0625 mg alprazolam noon - .0625 mg 7 pm - .0625 mg 8 pm - .0625 mg Day Seven: 7 am - .0625 mg alprazolam noon - .0625 mg 7 pm - .0625 mg 9 pm - .0625 mg Day Eight: 7 am - .0625 mg alprazolam noon - .0625 mg 7 pm - .0625 mg 10 pm - .0625 mg Day Nine: 7 am - .0625 mg alprazolam noon - .0625 mg 6 pm - .0625 mg 10 pm - .0625 mg Day Ten: 7 am - .0625 mg alprazolam noon - .0625 mg 5 pm - .0625 mg 10 pm - .0625 mg This will get your doses spread gently out over a 10 day period one hour at a time, so hopefully it will go smoothly. Please let me know if this is a schedule you can work with. Edited September 19, 2017 by Shep added bold highlighting Link to comment
Terry Posted September 19, 2017 Author Share Posted September 19, 2017 19 minutes ago, Shep said: Sure, Terry. Let's get you a benzo schedule. You're currently taking 0.125 mg alprazolam at 7 am and 7 pm. The goal is to get to 4 doses of .0625 mg taken at 7 am, 12 pm, 5 pm, and 10 pm. This will space out your doses evenly 5 hours apart. If 10 pm is too late, you may want to take that dose a bit earlier, but as long as you're consistently taking it earlier (say 8 or 9 pm every night), you'll be fine. Step One - moving the morning dose Day One: 7 am - .0625 mg alprazolam 8 am - .0625 mg 7 pm - .125 mg Day Two: 7 am - .0625 mg alprazolam 9 am - .0625 mg 7 pm - .125 mg Day Three: 7 am - .0625 mg alprazolam 10 am - .0625 mg 7 pm - .125 mg Day Four: 7 am - .0625 mg alprazolam 11 am - .0625 mg 7 pm - .125 mg Day Five: 7 am - .0625 mg alprazolam noon - .0625 mg 7 pm - .125 mg Step Two - moving the evening dose Day Six: 7 am - .0625 mg alprazolam noon - .0625 mg 7 pm - .0625 mg 8 pm - .0625 mg Day Seven: 7 am - .0625 mg alprazolam noon - .0625 mg 7 pm - .0625 mg 9 pm - .0625 mg Day Eight: 7 am - .0625 mg alprazolam noon - .0625 mg 7 pm - .0625 mg 10 pm - .0625 mg Day Nine: 7 am - .0625 mg alprazolam noon - .0625 mg 6 pm - .0625 mg 10 pm - .0625 mg Day Ten: 7 am - .0625 mg alprazolam noon - .0625 mg 5 pm - .0625 mg 10 pm - .0625 mg This will get your doses spread gently out over a 10 day period one hour at a time, so hopefully it will go smoothly. Please let me know if this is a schedule you can work with. Thanks, Shep. I never would have figured this out on my own. I'll give it a try. 2007 - 2008 Paxil and Klonopin 2008 - 2012 Mirtazapine following CT from Klonopin and Paxil. 2012 Unsuccessful taper of mirtazapine; reinstated. 7/2013 - 1/2014 Successfully tapered mirtazapine from 7.5 mg to 0.00. Sertraline (Zoloft) 25 mg. - Tapered from Aug 4, 2017 to July 18, 2021 - Current dose 0.00 Alprazolam (Xanax) 0.25 mg. July 19, 2017 - Nov 15, 2021 Began 10% taper Nov 16, 2021 - 0.25 Jan 11, 2022 - 0.203; Jan 13, 2023 - 0.0499; Jan 21, 2024 - 0.0137; July 20, 2024 - 0.00608; Taper is 97% complete. Link to comment
Moderator Emeritus Shep Posted September 20, 2017 Moderator Emeritus Share Posted September 20, 2017 You're welcome, Terry. Please let us know how you do over the coming days. Link to comment
Moderator Emeritus Shep Posted September 26, 2017 Moderator Emeritus Share Posted September 26, 2017 Hi, Terry. Please give an update when you feel able and let us know how you're doing spacing out the alprazolam doses. Link to comment
Terry Posted September 26, 2017 Author Share Posted September 26, 2017 3 hours ago, Shep said: Hi, Terry. Please give an update when you feel able and let us know how you're doing spacing out the alprazolam doses. I seem to be doing OK with the changes. I only have 4 steps to go before I'm totally on the schedule you proposed. I'm wondering if the increased muscle and joint pain I'm having is due to these meds or something else. When I see that your method of reduction was CT and rapid taper, I wonder how you ever survived all your meds. How are you doing now? Unwittingly at the time (2008), I did a rapid taper from klonopin and it was HORRID! 2007 - 2008 Paxil and Klonopin 2008 - 2012 Mirtazapine following CT from Klonopin and Paxil. 2012 Unsuccessful taper of mirtazapine; reinstated. 7/2013 - 1/2014 Successfully tapered mirtazapine from 7.5 mg to 0.00. Sertraline (Zoloft) 25 mg. - Tapered from Aug 4, 2017 to July 18, 2021 - Current dose 0.00 Alprazolam (Xanax) 0.25 mg. July 19, 2017 - Nov 15, 2021 Began 10% taper Nov 16, 2021 - 0.25 Jan 11, 2022 - 0.203; Jan 13, 2023 - 0.0499; Jan 21, 2024 - 0.0137; July 20, 2024 - 0.00608; Taper is 97% complete. Link to comment
Moderator Emeritus Shep Posted September 27, 2017 Moderator Emeritus Share Posted September 27, 2017 23 hours ago, Terry said: I seem to be doing OK with the changes. I only have 4 steps to go before I'm totally on the schedule you proposed. I'm wondering if the increased muscle and joint pain I'm having is due to these meds or something else. Hi, Terry. Thank you for the update. I'm glad to read you're doing okay. Having an uptick in symptoms like muscle and joint pain could be your nervous system letting you know it's dealing with this change in timing. Or it could simply be the non-linear nature of withdrawal. Are you able to find relief in Epsom salt baths and / or gentle yoga stretches to ease the muscle tension? 23 hours ago, Terry said: When I see that your method of reduction was CT and rapid taper, I wonder how you ever survived all your meds. How are you doing now? Unwittingly at the time (2008), I did a rapid taper from klonopin and it was HORRID! Yes, I agree with the HORRID part. I do not recommend coming off the way I did. I am just very grateful I found SA and learned the valuable non-drug coping skills. And also, that what I was dealing with is withdrawal and not a mental illness. So from a psychological standpoint, that made all the difference in the world. Thanks for asking. All I can tell you is there will be very difficult waves along the way, but the windows make it worth it. It does get better. Link to comment
Terry Posted September 30, 2017 Author Share Posted September 30, 2017 On 9/26/2017 at 9:54 AM, Terry said: I seem to be doing OK with the changes. I only have 4 steps to go before I'm totally on the schedule you proposed. I'm wondering if the increased muscle and joint pain I'm having is due to these meds or something else. When I see that your method of reduction was CT and rapid taper, I wonder how you ever survived all your meds. How are you doing now? Unwittingly at the time (2008), I did a rapid taper from klonopin and it was HORRID! On 9/26/2017 at 9:54 AM, Terry said: Hi, Terry. Please give an update when you feel able and let us know how you're doing spacing out the alprazolam doses. On 9/27/2017 at 9:51 AM, Shep said: Hi, Terry. Thank you for the update. I'm glad to read you're doing okay. Having an uptick in symptoms like muscle and joint pain could be your nervous system letting you know it's dealing with this change in timing. Or it could simply be the non-linear nature of withdrawal. Are you able to find relief in Epsom salt baths and / or gentle yoga stretches to ease the muscle tension? Yes, I agree with the HORRID part. I do not recommend coming off the way I did. I am just very grateful I found SA and learned the valuable non-drug coping skills. And also, that what I was dealing with is withdrawal and not a mental illness. So from a psychological standpoint, that made all the difference in the world. Thanks for asking. All I can tell you is there will be very difficult waves along the way, but the windows make it worth it. It does get better. I completed all the schedule changes and have had 4 good days in a row. (Windows??) This is looking further down the road, but I'm wondering how difficult it might be to taper the benzo on my current schedule. I don't suppose it would be a good idea to taper the benzo alongside the AD. 2007 - 2008 Paxil and Klonopin 2008 - 2012 Mirtazapine following CT from Klonopin and Paxil. 2012 Unsuccessful taper of mirtazapine; reinstated. 7/2013 - 1/2014 Successfully tapered mirtazapine from 7.5 mg to 0.00. Sertraline (Zoloft) 25 mg. - Tapered from Aug 4, 2017 to July 18, 2021 - Current dose 0.00 Alprazolam (Xanax) 0.25 mg. July 19, 2017 - Nov 15, 2021 Began 10% taper Nov 16, 2021 - 0.25 Jan 11, 2022 - 0.203; Jan 13, 2023 - 0.0499; Jan 21, 2024 - 0.0137; July 20, 2024 - 0.00608; Taper is 97% complete. Link to comment
Moderator Emeritus Shep Posted September 30, 2017 Moderator Emeritus Share Posted September 30, 2017 37 minutes ago, Terry said: I completed all the schedule changes and have had 4 good days in a row. (Windows??) This is looking further down the road, but I'm wondering how difficult it might be to taper the benzo on my current schedule. I don't suppose it would be a good idea to taper the benzo alongside the AD. This is such great news, Terry! I'm so glad to read about your 4-day window. Please hold. That is the best advice I can give. You are right to say that it's not a good idea to taper the benzo alongside the AD. How many hours a night are you sleeping now? Link to comment
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