lyanne: medication / anxiety relationship

[lyanne]

My story..

I  have had a year from hell and scared and traumatised.

Typically a high functioning professional person working full time until May last  year  when psychiatrist changed my medication from citalopram 40mg to fluoxeteine.

This was because of episodes I experienced following drinking alcohol usually when tired and run down,  I may drink 3-4 glasses of wine wake up with a hangover and crash.

A crash involved feelings of severe anxiety and I would take 1-2 mg Diazepam and hanker down in bed for one sometimes two weeks and would gradually come right and life would go on as normal for years. The occurrence of theses crashes were becoming more frequent potentially because of work and family stressors so the decision was made to switch from citalopram to fluoxteine.  From here I had 3 major mental health crisis which involved outpatient treatment at local psych hospital my medication regime was changed (see signature)and  I completed a 11 week programme at anxiety disorders clinic  based on CBD ending in December last year.   While useful I continued until now to have a couple of good weeks followed by weeks where I felt terrible mainly with with physical symptoms anxiety, bowel and bladder hypersensitivity,  unable to wind down, fatigued, breathless, weight gain +++ very speedy and fast in processing then crashing when i stop. Since January 2019  I have been trying to cut back the diazepam unsuccessfully an have currently given up on this idea. Have just been back to my GP as am struggling big time with the current combinations of medications (in signature) and do not feel they are helping me. She wrote to the psychiatrist who a recommended 

Psychiatrist recommending not commenced as yet 

• Continuing with diazepam 3 mg daily not reducing while making changes to medication
• Reduction of Mirtazapin at 15mg increments 
• prior to this decreasing mirtazapine increasing fluoxteine to 60 mg 

In the mean time I have had another crash needing to take a week off work. I should mention I resigned from my  initial job after taking 3 months sick leave and started a new Job in February this year which is only 4 days a week. One day I go to yoga and have a quite day. 

Would be grateful for any advice support, I feel like i have lost my life and wonder how much of this is related to medication or combination of .? 

 

[Gridley]

Hello, Lyanne, and welcome to SA.  Thank you for completing your signature.

 

Your psychiatrist's proposed taper of 45mg Mirtazapine in 15mg increments (a 33 1/3% decrees the first drop, a 50% decrease the second) is far faster than what we recommend, which is no more than 10% of current dose every four weeks.

 

Why taper by 10% of my dosage?

 

Tips for tapering off Remeron (mirtazapine)

 

Psychiatrists almost invariably taper their patients too quickly off psychiatric medications, which puts the patient at risk of protracted withdrawal symptoms (which psychiatrists don't believe exist).  While some people may be able to taper quickly, many others can't, which is why we recommend a harm-reduction rate of taper of 10% to minimize the possibility of withdrawal syndrome.

 

What is withdrawal syndrome.

 

Glenmullen’s withdrawal symptom list.

 

When we take medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.  

 

These explain it really well:

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

   On 8/30/2011 at 2:28 PM,  Rhiannon said: 

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay. When the drug is removed, the remodeling process has to take place in reverse. SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. It's a matter of, as I describe it, having to grow a new brain. I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long.

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Please research all supplements first and only add in one at a time and at a low dose in case you do experience problems.

 

This is your Introduction topic, where you can post updates, ask questions and connect with other members.  I'm glad you found your way here.

 

 

 

[lyanne]

Thank-you for the reply I have found the links and videos very inciteful. And am questioning how much of what I have been through over the past year is related to transferring from Citlapram to Fluxoteine and reducing dosage of diazepam. I will add to my signature but have been taking Usana Core minerals and Vita Antioxidants  2 tablets daily I note theses have some maganium citrate 408.33mg and magnanesim abcorbate per tablet but have not explored Omega 3.  Is it best to stick with this or explore a more pure form . I also have had Epsom salt baths.  Do you have any comments on increasing fluxoteine before I taper  mirtazapine? I ind this whole process very scarey and its so good to connect with people who have similar experiences.  

[Altostrata]

Hello, lyanne.

 

As I understand it, when you switched form citalopram to fluoxetine, you felt awful for some months and were hospitalized several times. You felt a little better after December, 2018.

 

I wonder if you're experiencing adverse drug effects. Do your symptoms follow any daily pattern?  Please keep daily notes of times of day you take your drugs, their dosages, and your symptoms. You can post them in this topic with a simple list format with time of day on the left and notation (symptom, drug and dosage) on the right.

 

Since last September, have you accidentally skipped any doses? Drunk alcohol?

 

I would not change any dosages until we can establish your baseline symptom pattern.

 

[ChessieCat]

9 minutes ago, Altostrata said:

Please keep daily notes of times of day you take your drugs, their dosages, and your symptoms. You can post them in this topic with a simple list format with time of day on the left and notation (symptom, drug and dosage) on the right.

 

This is an example of what Alto requires:

 

6 a.m. Woke with anxiety
8 a.m. Took 2.5mg Lexapro
10 a.m. Stomach is upset
10:30 a.m. Ate breakfast
11:35 a.m. Got a headache, lasted one hour
12:35 p.m. Ate lunch
4 p.m. Feel a bit better
5 p.m. Took 2.5mg Lexapro
6 p.m. Ate dinner
9:20 p.m. Headache
10:00 p.m. Took 50mg Seroquel
10:20 p.m. Feeling dizzy
10:30 p.m. Fell asleep
2:30 a.m. Woke, took 3mg Ambien (NOT "took 1/2 tablet Ambien")
2:45 a.m. Fell asleep
4:30 a.m. Woke but got back to sleep

[lyanne]

Thanks will do. I have not drunken a y alcohol for a year 

 

[lyanne]

Hi I haven't really had a stable period over the past year. i might have a couple pf weeks where I feel Ok and manage to go to work without an effort and feel well through the day more frequently i  feel exhausted , have bowel problems,  am breathless etc. I had to take a week off work  from 6-13th June  as crashed big time very high anxiety, couldn't leave house, needed to have someone with me, tearful, etc but am starting to on the up. 

 

My pattern the last two days 

Sunday Cold horrible weather here

Woke at 9 am  feeling ok 

Have breakfast and medication 3mg diazepam , 40mg fluoxoteine, about 9.30

Spent morning feeling anxious, stayed in bed as really cold

Had lunch and shower and got dressed 

Pushed myself to go out at 1.30, about 3 anxiety not as intense but very tearful

Dinner at 6 

Bed 9.30 with Meds 45mg mirtazepam and supplements 

Listen to hypnotic sleep app to get to sleep got up a 11 and had snack then slept til 7 

 

Monday (Work day) had a really good day 

Up at 7am Breakfast and meds as yesterday

Work at 8 am

Feeling anxious 4/10 all morning but pushed through and functioned well. 

Pre lunch anxiety levels increase but improve when I  have eaten 

Good afternoon No anxiety 

Home and Dinner 6pm 

Blobbing at home listening to music watching TV 

 Bed 9.30 with Meds 45mg mirtazepam and supplements 

 

 

Thanks Lyanne

[lyanne]

I have collected some data over the past few days overall I've been well enough to function and push through the anxiety but each day is a struggle I'm really tired by about 5ish and once i sit down that it. I need to snack frequently or my anxiety increases. I enjoyed being away with friends and having extra company and ws more physically active than normal.

 

Tuesday 18/6 Work day Up at 7am Meds Diazepam 3mg Fluoxeteine 40mg Breakfast the work at 8am Very busy day Lunch break 30 minutes snacks intermittently in am as feeling very hungry and faint. Home 4.30 Very tied cook dinner and watch TV in evening bed 9.30 Meds mirtazepam 40mg and supplements

Wed 19/6 Same routine ate lots of sweet cake in pm.

Thursday 20/6 Long weekend flew to another city 90min flight to stay with friends Same routine with meds, anxiety 3/5 stomach cramps loose bowels motions and frequent urination morning.  More settled in pm and anxiety level drops. Bed 10ish with meds

Friday 21/6 Up about 9  and meds and breakfast.  Loose bowel motions again in morning and frequent urination Anxiety in morning 2/5, very breathless on exertion. Went for a 40 walk up some hillsin pm.  Enjoyed but breathless +++. Need to snack regularly  throughout day, feel like blood sugar levels drop, increase in anxiety  until I’ve eaten then settles.  Quiet evening  Bed 10.30 with meds. Flare up of staph aureus infection not responding to topical cream

Saturday 22/6 Similar routine as yesterday anxiety 3/5 morning but pushed through. Felt quite shaky and breathless. Good in pm went for walk and out for late lunch, then friends over for dinner which I prepared with friend. Bed 11ish with meds.

Sunday 23/6 Same routine,  Had a good day went for  walk Flew home mid afternoon  Started antibiotics for staph infection.

Monday 24/6 Work Day Meds 7am Meds Diazepam 3mg Fluoxeteine 40mg. Anxiety 4/5 loose bowels motions and frequent urination morning  breathless on exertion. ? Body sensitive to Antibiotics  feeling ok around 2.30. Fatique +++ Bed 9 ish with Meds

Tuesday 25/6/2019 Work Day as above Anxiety 3/5 in morning settled pm. Stomach settled but frequent urination and breathless on exertion.

Wed 26/6/ AS above

Thursday 27/6 Day off Up 9am Morning Meds 8am Yoga 10-11.30. Easeful yoga so lots of breathing and stretching, not to physically demanding. Home lunchtime feeling shaky and exhausted, anxiety 2/5 improves slightly after eating quiet afternoon eating and preparing dinner Anxiety decrease. 

[ChessieCat]

When providing symptom notes please use the format provided previously.  We need to be able to see things easily.  Thank you.

 

[Altostrata]

Hello, Lyanne. Why do you take 3mg diazepam in the morning? Fatigue is a side effect of benzos. 

 

Please note the times of day you have anxiety, or feel faint, breathless, or fatigued.

 

How long have you been taking antibiotics?

[lyanne]

Only been taking antibiotics since Monday this week.   No specific reason take diazepam in morning just routine was wondering about switching till evening?  In terms of fatigue  I feel tired more often than not    by the end of a work day am exhausted often have.naps in the weekend in the afternoon to catch up my energy levels. Typically yawn a lot first thing in morning and feel tired better after breakfast, usually about 3 in afternoon I start feeling really tired.  If I don't eat or snack regularly will feel faint and sometimes. Shaky so about 10am 12 and 2.30  I will have fruit and nuts.  Anxiety is always in the morning from about 3pm I start feeling normal unless I am really tired then after evening meal I always feel OK.