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88keys: 14 months off Klonopin, need a plan to come off gabapentin and lithium


88keys

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Posted

Hello, new family.

 

I’m a 39 year old man, 14 months off benzos.  I am not doing well; withdrawal continues.  But I want to start coming off of this other crap that I’m sure is worsening my situation too.  I trust what I’ve been told about you much more than I trust my psych alone about how to do this.

 

 

BENZO/WITHDRAWAL HISTORY: 

 

I was on Klonopin about four years.  In an voluntary inpatient setting I was taken from 3mg to .5mg in one week.  This gave me a manic episode that I was then blamed for.  (“You must not have been taking your bipolar meds.”)  I was reinstated on equivalent Ativan and then tapered more reasonably although still too fast; ultimately found the Ashton Manual and tapered according to that for my final 1mg.

 

14 months out I’m still in hell; in fact, while I could work even in my first month, I haven’t been able to since Thanksgiving.  I had a gravely serious setback last summer when I moved and overexerted myself physically and I think my system is still recovering.  I had another bad setback in January when I was put on an antibiotic (for nothing.)

 

Current physical symptoms include involuntary jaw movement / facial contortions that are incredibly distressing.  Tinnitus.  Tremor.  GI distress.  Involuntary eye movement.  Bizarre hard to describe sensations in head and body.  Heart palpitations.  Hives. I’ve been sick with multiple bugs basically the entire fall and winter.  This is the short list.

 

Psych symptoms: intense depersonalization.  Strange vision issue; I don’t think it’s quite derealization but a hyper-awareness of depth perception.  It feels like I’m inside a Facebook 3D Photo, or that things are HD instead of SD.  Racist thoughts.  Frequent suicidal ideation.  The worst anxiety of my life, far worse than anything the Klonopin was meant to medicate.

 

 

CURRENT GOALS / REQUEST FOR HELP: 

 

I want off of everything now.  I no longer believe in any of these drugs and believe psychiatry has done far more harm to me than help.  I need to be careful as my system is so messed up.  But I have come to suspect some significant part of what I’ve been calling benzo withdrawal 14 months after jumping must be due to gabapentin and lithium.

 

Lithium - I had a manic episode in 2015; no history of mania or bipolar prior.  I was told I was bipolar and had to take lithium the rest of my life.  (I was also on Seroquel for a while but have been off for a couple of years.) This diagnosis is in question, given that bipolar emerges in the teens, I don’t have alternating periods of mania and extreme depression, etc. Whatever the case, my psych has given me clearance to taper down and I’m just trying to come up with the best plan of attack. He had said we could go down by 150 monthly and see. 

 

Gabapentin - I had been on 1200mg/daily since fall 2018 to help while I was tapering the benzo.  I tapered very successfully (100mg/week) down to 900 in January but then held when things got bad with my antibiotic setback.  My psych also said I should stay on the gabapentin, actually, as it could help with the lithium taper (is that true?) 

 

I dream of being off all psych meds by my 40th birthday in six months, but I of course don’t want to rush.

 

Those are what I’m most concerned about, but I’m also on primidone 50mg for tremor that I’d like to drop (not sure if that drug comes up here or if it even needs to be tapered.)  I do take 150-200mg trazodone for sleep which seems pretty non-negotiable right now though I also want to drop that eventually.  (I also take allopurinol but that’s another story.)

 

I’d appreciate any thoughts as to the wisest plan of action for ridding myself of gabapentin and lithium against a backdrop of ongoing benzo withdrawal.

 

Thank you so, so much. 

As of 7/18/21:

 

Lithium 105mg down from 900mg, have held for a while, have been focusing on this one, taken at bedtime

Gabapentin 400mg down from 1200mg, held for well over a year, 200mg morning 200mg night 

Trazodone 87.5mg down from 150-200mg prn, held for well over a year, bedtime 

Posted

I forgot to mention the lithium dosage is 900. 
 

The gabapentin 900 is currently 300 in the morning 600 at night. 

As of 7/18/21:

 

Lithium 105mg down from 900mg, have held for a while, have been focusing on this one, taken at bedtime

Gabapentin 400mg down from 1200mg, held for well over a year, 200mg morning 200mg night 

Trazodone 87.5mg down from 150-200mg prn, held for well over a year, bedtime 

  • Moderator Emeritus
Posted (edited)

Welcome to SA, 88keys.    

 

You're very likely still suffering from withdrawal from the fast benzo taper.  Fourteen months is really not that long for withdrawal to last, though I know it seems like eternity to be living it.  The following two links are written in the context of antidepressants but are applicable to benzo withdrawal.

 

What is withdrawal syndrome.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 
 

I know you want to get off these drugs, but it's important (as you learned from the benzo taper) to do it slowly.  We recommend tapering only one drug at a time.  Otherwise, if problems develop you won't know which drug taper is the cause.  

 

Since there is a major drug interaction between lithium and trazodone (and only a moderate one between trazodone and gabapentin) I'd recommend you taper the lithium first.

Interactions between your drugs

Major

Talk to your doctor before using lithium together with traZODone. Combining these medications can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should contact your doctor immediately if you experience these symptoms while taking the medications. 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.

------------------------------------------------------------------------------------------------------------------------------------------------------------------

This link is specifically about tapering lithium.

 

Tips for tapering off lithium

 

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 one supplements that we do recommend is omega 3 (fish oil). Many people find it to be calming to the nervous system. (Usually we also recommend magnesium, but there's a reaction between magnesium and gabapentin, so we wouldn't suggest it in your case.)

 

Omega-3 fatty acids (fish oil) 

 

Add in at a low dose in case you do experience problems.

 

I'm not familiar with primodone but my guess would be it would need to be tapered like other anticonvulsants.

 

This is your Introduction topic, where you can ask questions and connect with other members.  We're glad you found your way here.

 

Edited by manymoretodays
white space removal

Gridley Introduction

 

Lexapro 20 mg since 2004.  Begin Brassmonkey Slide Taper Jan. 2017.   

End 2017 year 1 of taper at 9.25mg 

End 2018 year 2 of taper at 4.1mg

End 2019 year 3 of taper at 1.0mg  

Oct. 30, 2020  Jump to zero from 0.025mg.  Current dose: 0.000mg

3 year, 10 month taper is 100% complete.

 

Ativan 1 mg to 1.875mg 1986-2020, two CT's and reinstatements

Nov. 2020, 7-week Ativan-Valium crossover to 18.75mg Valium

Feb. 2021, begin 10%/4 week taper of 18.75mg Valium 

End 2021  year 1 of Valium taper at 6mg

End 2022 year 2 of Valium taper at 2.75mg 

End 2023 year 3 of Valium taper at 1mg

Jan. 24, 2024: Hold at 1mg and shift to Imipramine taper.

Taper is 95% complete.

 

Imipramine 75 mg daily since 1986.  Jan.-Sept. 2016 tapered to 14.4mg  

March 22, 2022: Begin 10%/4 week taper

Aug. 5, 2022: hold at 9.5mg and shift to Valium taper

Jan. 24, 2024: Resume Imipramine taper.  Current dose as of Oct 15: 3.2mg

Taper is 96% complete.  

  

Supplements: multiple, quercetin, omega-3, vitamins C, E and D3, magnesium glycinate, probiotic, zinc, melatonin .3mg, iron, serrapeptase, nattokinase, L-Glutamine, milk thistle, choline


I am not a medical professional and this is not medical advice. It is information based on my own experience as well as that of other members who have survived these drugs.

  • 2 months later...
Posted (edited)

How soon did you start feeling better once you started a lithium taper?

 

I begin tonight, with guidance I received here. Wish me luck! 

 

Edited by ChessieCat
added topic title

As of 7/18/21:

 

Lithium 105mg down from 900mg, have held for a while, have been focusing on this one, taken at bedtime

Gabapentin 400mg down from 1200mg, held for well over a year, 200mg morning 200mg night 

Trazodone 87.5mg down from 150-200mg prn, held for well over a year, bedtime 

  • 4 months later...
Posted

Belated thanks to Gridley for all the info.  I did go forward with lithium first.  With a compounding pharmacy I'm down to 500mg (down from 900) and will reduce to 450 on Monday.  I'm pretty upset that my tremor hasn't improved; I've been sure that lithium worsened it and I hoped to see more positives here at halfway down.

 

I'm struggling terribly.  I think about killing myself every day (I won't take action.)  I'm in month 21 of Klonopin withdrawal, doing lithium taper now, while gabapentin and trazodone (I reduced that too but psych said stop) wait in the wings (and I worry about their current effects on me.) I have dozens of bizarre and terrible symptoms and am functioning at maybe 25% of my normal capacity.  

 

Is there anything I can be doing differently?  Should I reconsider the plan and remove one of the other drugs?  Is there anything else I can do beside omega-3 fish oil?  Do I just suffer for the next 1.5 years until I'm off of everything?  I don't think I can do it. I've been fighting so long but my life doesn't feel living, that's how terrible withdrawal has been.  I haven't been myself for 2.5 years. Please help?

As of 7/18/21:

 

Lithium 105mg down from 900mg, have held for a while, have been focusing on this one, taken at bedtime

Gabapentin 400mg down from 1200mg, held for well over a year, 200mg morning 200mg night 

Trazodone 87.5mg down from 150-200mg prn, held for well over a year, bedtime 

  • Moderator Emeritus
Posted
23 minutes ago, 88keys said:

With a compounding pharmacy I'm down to 500mg (down from 900) and will reduce to 450 on Monday.  

That's a 10% cut, which is what we recommend.

 

Why taper by 10% of my dosage?

 

I know you're in Klonopin WD, but ave your symptoms worsened since you started the Lithium taper?  If so you may need to hold for a while at 500 until things settle down, then taper more slowly, perhaps 5% every 4 weeks.  I know you want to get off these drugs, but doing it slowly is what works best.  

 

29 minutes ago, 88keys said:

 Should I reconsider the plan and remove one of the other drugs?

I'd stick with the lithium taper.  You don't want to be in withdrawal from 3 drugs.

 

32 minutes ago, 88keys said:

Is there anything else I can do beside omega-3 fish oil?

Magnesium is the only other supplement we recommend.  Many members find it calming.  Start at a low dose and work up.

 

Magnesium, nature's calcium channel blocker 

 

We strongly recommend non-drug techniques to cope with withdrawal.

 

Non-drug techniques to cope

 

33 minutes ago, 88keys said:

Do I just suffer for the next 1.5 years until I'm off of everything?

 

It's better to assume that it won't be all suffering.  There will be windows among the waves.  

 

The Windows and Waves Pattern of Stabilization

 

At some point the pain from the Klonopin withdrawal will fade and that will be a big relief.

 

 

 

 

 

 

 

 

Gridley Introduction

 

Lexapro 20 mg since 2004.  Begin Brassmonkey Slide Taper Jan. 2017.   

End 2017 year 1 of taper at 9.25mg 

End 2018 year 2 of taper at 4.1mg

End 2019 year 3 of taper at 1.0mg  

Oct. 30, 2020  Jump to zero from 0.025mg.  Current dose: 0.000mg

3 year, 10 month taper is 100% complete.

 

Ativan 1 mg to 1.875mg 1986-2020, two CT's and reinstatements

Nov. 2020, 7-week Ativan-Valium crossover to 18.75mg Valium

Feb. 2021, begin 10%/4 week taper of 18.75mg Valium 

End 2021  year 1 of Valium taper at 6mg

End 2022 year 2 of Valium taper at 2.75mg 

End 2023 year 3 of Valium taper at 1mg

Jan. 24, 2024: Hold at 1mg and shift to Imipramine taper.

Taper is 95% complete.

 

Imipramine 75 mg daily since 1986.  Jan.-Sept. 2016 tapered to 14.4mg  

March 22, 2022: Begin 10%/4 week taper

Aug. 5, 2022: hold at 9.5mg and shift to Valium taper

Jan. 24, 2024: Resume Imipramine taper.  Current dose as of Oct 15: 3.2mg

Taper is 96% complete.  

  

Supplements: multiple, quercetin, omega-3, vitamins C, E and D3, magnesium glycinate, probiotic, zinc, melatonin .3mg, iron, serrapeptase, nattokinase, L-Glutamine, milk thistle, choline


I am not a medical professional and this is not medical advice. It is information based on my own experience as well as that of other members who have survived these drugs.

Posted

Thanks very much Gridley; I'll try magnesium again after researching that I shouldn't take it within a few hours of the gabapentin.

 

I guess I was asking about the order of my tapering.  I know tapering another drug concurrently could be bad.  Facing lithium, gabapentin, and trazodone, does it make sense to be doing lithium first?  I want to go in whatever order is going to mean less suffering. 

 

Also, I'm still a newbie to this site... should I be posting all my questions in this thread or can I post about my issues in other forums? What's the personal thread for, vs. posting about a specific issue?  Only you have ever replied to me. 

 

Thanks again. 

As of 7/18/21:

 

Lithium 105mg down from 900mg, have held for a while, have been focusing on this one, taken at bedtime

Gabapentin 400mg down from 1200mg, held for well over a year, 200mg morning 200mg night 

Trazodone 87.5mg down from 150-200mg prn, held for well over a year, bedtime 

Posted (edited)

In what order to taper Lithium, Gabapentin, and Trazodone:

 

Please see my intro post for background, but I'm 21 months off Klonopin, feeling like hell all the time, and halfway through a lithium taper that may or may not be contributing to feeling awful.  I still have 400mg gabapentin and 87.5mg trazodone to taper.

 

There's an interaction between lithium and trazodone, and lithium has a huge side effect profile, so I've been focusing on reducing lithium (with some trazodone cuts along the way too.)

 

However I'm wondering if this is the best plan, and if I should be going about this in a different order, or maybe even trying to reduce everything very slowly at the same time.

 

Greatly appreciate any input.  It feels like I'll never be free of all of this. 

 

Rich

Edited by manymoretodays
moved from tapering, added title

As of 7/18/21:

 

Lithium 105mg down from 900mg, have held for a while, have been focusing on this one, taken at bedtime

Gabapentin 400mg down from 1200mg, held for well over a year, 200mg morning 200mg night 

Trazodone 87.5mg down from 150-200mg prn, held for well over a year, bedtime 

  • Moderator Emeritus
Posted (edited)
On 10/11/2020 at 11:00 AM, 88keys said:

Also, I'm still a newbie to this site... should I be posting all my questions in this thread or can I post about my issues in other forums? What's the personal thread for, vs. posting about a specific issue?  Only you have ever replied to me. 

 

Hi 88keys and welcome, @88keys

Yes, your introduction, is where you should post questions around your specific case.  I moved your most recent post from tapering to back here.  This is also where you can communicate with other members, moderators, and mentors. 

 

Also:  Please summarize your withdrawal history to help us out. 

Take a look at the link, it will explain what we like to see there, it's the section you'll see below other members post

Dates, names of drugs, previous tapers, etc.

 

And then could you also note here, in a reply,   when you take your medications now?  Note the time on the left, and then each medication by name, and dose, that you take throughout the day.

 

We do like to get to know you first, before making many suggests or recommends.  Here's our topic, in regards to your recent post and questions, that I think you'll find helpful.

Taking multiple psych drugs? Which drug to taper first?

 

Okay, all for now.

L, P, H, and G,

mmt

 

 

 

Edited by manymoretodays
added an @ notification for member

Late 2023- gone to emeritus status, inactive, don't @ me, I can check who I've posted on, and I'm not really here like I used to be......thanks.

Started with psycho meds/psychiatric care circa 1988.  In retrospect, and on contemplation, situational overwhelm.

Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time).

5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014)

12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs.  My last psycho med ever!  Tapered @ 10% every 4 weeks, sometimes 2 weeks to

2016 Dec 16 medication free!!

Longer signature post here, with current supplements.

Herb and alcohol free since 5/15/2016.  And.....I quit smoking 11/2021. Lapsed.  Redo of quit smoking 9/28/2022, and again finally 5/25/24.  Can you say Hallelujah?(took me long enough)💜

None of my posts are intended as medical advice.  Please discuss any decisions about your medical care with a knowledgeable medical provider.  My success story:  Blue skies ahead, clear sailing

 

  • 4 months later...
Posted (edited)

I’ve been doing compounded capsules but would like to slow down and do it myself. Would love to connect with anyone who’s done this. I’m thinking jeweler’s scale and empty gelatin capsules so I can make smaller cuts at my own pace and not be reliant on my doctor as a gatekeeper but I want to be informed first. Thanks! 

 

 

Edited by getofflex
merged topic Lithium Micro Taper from Tapering forum

As of 7/18/21:

 

Lithium 105mg down from 900mg, have held for a while, have been focusing on this one, taken at bedtime

Gabapentin 400mg down from 1200mg, held for well over a year, 200mg morning 200mg night 

Trazodone 87.5mg down from 150-200mg prn, held for well over a year, bedtime 

  • 3 months later...
Posted

How are you doing now?

Completely drug free 11/26/22 🎉

 

Supplements: Magnesium citrate: 250 mg; Fish oil: 1200 mg

 

“When we are no longer able to change a situation, we are challenged to change ourselves.” - Victor Frankl

Posted

Hi and thanks for asking. I’m in hell. Down to 105mg from original 900 but my health baseline is so terrible here in month 30 of protracted benzo withdrawal that I held the lithium taper for 5-6 weeks and only recently restarted with smaller cuts. I still don’t know what to do and am sick of feeling that no one can tell me because we just don’t know! Staying on lithium is bad, coming off is bad. Same with the other drugs that await me. Feels like I’ll never be free. I appreciate any thoughts. 

As of 7/18/21:

 

Lithium 105mg down from 900mg, have held for a while, have been focusing on this one, taken at bedtime

Gabapentin 400mg down from 1200mg, held for well over a year, 200mg morning 200mg night 

Trazodone 87.5mg down from 150-200mg prn, held for well over a year, bedtime 

Posted

I really am so sorry to hear you’re not doing well. What drug are you currently tapering? I’m not a moderator but I do know they say taper only one drug at a time and not more than 10%. Do you think you need to go slower or maybe hold longer?

 I know this is hard and can seem like a never ending process. As counter intuitive as it may seem I found true acceptance helped alleviate some of my symptoms. Or at least they didn’t bother me as much. I want to live my life medication free and fully feel so that gives me a great drive to learn those skills I didn’t have before taking medication. So maybe find your motivation and build on that.

Definitely practice self care. I recommend a daily walk in nature, gentle stretching, being involved in a project you enjoy. I also recommend you be kind to yourself and patient with the process. It’s amazing how far you have come, I think you need to acknowledge your own strength!! I honestly believe we all come out of this stronger. You just have to put in the work.

What are your biggest symptoms? What are you currently doing to help yourself? 

Sending you healing vibes 💓

Completely drug free 11/26/22 🎉

 

Supplements: Magnesium citrate: 250 mg; Fish oil: 1200 mg

 

“When we are no longer able to change a situation, we are challenged to change ourselves.” - Victor Frankl

  • 1 month later...
  • Administrator
Posted

Hello,@88keys What drugs are you taking now, at what times of day and dosages?

 

To help us out, follow these instructions Please put your drug and withdrawal history in your signature You may need to use a computer to do this.

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.

Posted

Is this sufficient? 

As of 7/18/21:

 

Lithium 105mg down from 900mg, have held for a while, have been focusing on this one, taken at bedtime

Gabapentin 400mg down from 1200mg, held for well over a year, 200mg morning 200mg night 

Trazodone 87.5mg down from 150-200mg prn, held for well over a year, bedtime 

  • Administrator
Posted

Do you feel better or worse since you've reduced lithium? When was your last reduction? How has your symptom pattern changed in the last month?

 

What times of day (o'clock) do you take your drugs? How do you feel before and after taking each one?

 

Please keep daily notes of times of day you take your drugs, their dosages, and your symptoms throughout the day. We need to know how you feel before and after taking each drug, and your symptoms in between. Post 24 hours of notes at a time in this topic, in a simple list format with time of day on the left and notation (symptom or drug and dosage) on the right. This can show if your symptoms are adverse effects from one of your drugs.

 

Please put ALL your drugs in this Interactions Checker and post the report or a link to it in this topic.

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.

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