Frotob: Lexapro/Clonazepam advice needed

[Frotob]

My signature should have pertinent info. 

 

Essentially, I am not in a great place right now. I've been on 1.5mg (.5 3xday) Clonazepam for the past 3 years. . . and for the past week I've had bad anxiety in the morning. I have teased wanting to get off of it many times. I DO need to get off of it. My main concern is that I ran into severe akathisia/dysphoria earlier in life while tapering a much lower dose. I believe that Lexapro had SOME role in this and perhaps the benzos were/still are just masking this side effect til I got down to a dose where it wasn't. 

 

I'm lost as to what my first move should be. I've been given an increased script for 2mg Clonazepam a day, have an appointment with a psychiatrist(I've seen previously) on Monday. . . It SEEMS like I might want to taper off of the Lexapro first, but I am not sure a long taper would suit me. I have yet to take more than 1.5mg Clonazepam a day despite mounting anxiety (particularly bad in the morning) but if I taper off of Lexapro for a year or longer, as so many of you suggest. . . I'll become further dependent on the Clonazepam and may indeed require a higher dose.  I desperately want to be off of these drugs, I can handle anxiety. . . I can somewhat handle depression. I cannot handle the dysphoria and severe akathisia I ran into during my last foray into tapering off benzos. 

[Songbird]

Hi Frotob, welcome to SA.  Thanks for adding a signature.  Here are some topics with information you may find helpful:

 

before you begin tapering - what you need to know

 

why taper by 10% of my dosage?

 

the rule of 3KIS - keep it simple keep it slow keep it stable

 

taking multiple psych drugs - which drug to taper first

 

There are mods here experienced with benzos who will be able to give more specific suggestions for your situation.

[Shep]

19 hours ago, Frotob said:

I've been given an increased script for 2mg Clonazepam a day,

 

Hi, Frotob. Welcome to SA from me, too.

 

Please do not increase your clonazepam from 1.5 mg to 2 mg. Let's get some more information before you make such a drastic increase.

 

Please give more details on your Ativan to Valium crossover.  The crossover from 1 mg Ativan to 10 mg Valium was correct according to the equivalency chart, so I'm wondering if the "severe akathisia and dysphoria" may have been from tapering too quickly, perhaps? 

 

When did you do the Ativan to Valium crossover? Please add the month and year to your signature. 

 

Also, when did you go onto clonazepam? It's confusing - in your signature it looks like you went from Ativan to Valium and then you state "after toying with CTing me off of Ativan I was started on 1.5 mg clonazepam". A timeline for this will really help. 

 

[Frotob]

Unfortunately I already took the extra .5 last night as the anxiety had been too much. 

 

I can’t honestly remember the exact dates. But it was no less than 3 years ago, more likely closer to 4. I had crossed to Valium, tapered down using dry cuts and a scale from 10mg to 6mg. Over a period of 5-7 months. When I was hospitalized I was put back on Ativan. At 1mg which had little effect. The night of hospitalization I took 20mg of Valium which also had no effect on the akathisia. It was only several days later when I was in the hospital and increased to 1.5mg clonazepam that I actually got relief. 

[Shep]

Thanks for the additional information in your post and in your signature, Frotob.

 

I also received your PM but will respond here in your thread.

 

You mentioned in your PM that you would like to stabilize before tapering, so if you do stay at the higher dose, I would hold for several months and then start a micro-taper off the Lexapro. More information on this:

 

Tips for tapering off Lexapro (escitalopram)

 

Micro-taper instead of 10% or 5% decreases

 

The Brassmonkey Slide Method of Micro-tapering

 

One thing that stands out in your history, taken from your signature: "Bad reaction to first dose of 10mg Lexapro" and "Unsure if Lexapro caused akathisia and benzos were masking it or from benzo withdrawal(I was going pretty slow)".

 

It's likely you were (and probably still are) having adverse affects from the Lexapro, so that would be the drug to taper first. It's possible that reducing the Lexapro may give you enough relief that you won't need the increase of benzo. 

 

According to your PM and also listed in your signature, you are now at 2 mg of clonazepam. There are two paths to choose from:

 

• Consider the increased clonazepam dose to 2 mg a "rescue dose" and go back down to 1.5 mg. Then start reducing the Lexapro to reduce the side effects of anxiety/akathisa.

         OR

• Stay with the 2 mg clonazepam dose and hold for several months, giving yourself time to stabilize. 

It may help to keep a log of your symptoms throughout the day. This is a great format to use:

 

 

Keep notes on paper about your drug dosages and daily symptom pattern

 

Some more information on keeping track of symptoms:

 

Rate symptoms daily to track patterns and progress

 

Dr. Joseph Glenmullen's withdrawal symptom checklist

 

It's important to bring in non-drug coping skills to aid you on your journey off these drugs. This list will give you some ideas and get you started:

 

Non-drug techniques to cope with emotional symptoms

 

Tips to help sleep - so many of us have that awful withdrawal insomnia

 

A request: Please make it clearer in your signature what drugs you are currently taking. The last part of your signature starting with June 2018 doesn't include your Lexapro. Please add that with your current Lexapro dose. 

 

Please let us know what you decide to do and how you are feeling over the coming days.