Csilover: What to do? Effexor

[Altostrata]

Hang in there. Takes more than one blip to make a trend.

[Altostrata]

@Csilover I need to see those daily notes! What times of day does your heart rate go up?

[Csilover]

July 11, 2020

4 am woke up. High anxiety

Tossed and turned 

6 heart rate is 100

7:30 get breakfast. Heart rate calms down. 

9:00 am high anxiety. Headaches. Take .5 Ativan. 

12 pm calm

3 crying all day For no reason
6 crying physical anxiety in stomach. Feel I need to move. 
9 take 50 seroquel and .5 Ativan. Anxiety. 
10 fall asleep

3:40 wake up can’t go back to sleep. Crying 

cant go back to sleep 

6 heart rate high. Crying spells. Suicidal thoughts.

7:30 eat breakfast

 

@Altostrata sorry about that. Here you go. The heart rate is high in the mornings. Luckily the palpitations and chest pains have calmed down. Also the eye twitching. I hadn’t been taking magnesium baths but once I started doing that again I felt better as far as palpitations.

[Csilover]

June 21,2020 dropped 12.5 seroquel. Slept fine throughout the week. Dropped to 50 June 29, no problem the first night. Every night since then anxiety poor sleep. Sleep declining still 

[Csilover]

I’m angry and anxious. Crawling out of my skin. I want to isolate and be away from everyone. I wasn’t like this the first drop. I felt really good

[Altostrata]

Do not assume your sleep is declining because of one night of poor sleep.

 

How about the eating? Are you eating 3 good meals a day? Low blood sugar releases adrenaline.

[Csilover]

my sleep has been bad for two weeks now. I wake up with intense anxiety after 5 hours max. The last two nights it’s been worse. Yeah I eat three pretty healthy meals a day. Anxiety has felt very high. @Altostrata

[Altostrata]

Hmmmmm. Benzos tend to make you sad, we know that.

 

I've always been concerned about your taking Ativan and Seroquel together at night.

 

Interaction between Seroquel and Ativan:

 

https://www.drugs.com/interactions-check.php?drug_list=1488-899,1979-0&types[]=major&types[]=minor&types[]=moderate&types[]=food&types[]=therapeutic_duplication&professional=1

 

Quote

The oral clearance of a single dose of lorazepam has been reported to be decreased by 20% when taken concomitantly with quetiapine. The mechanism of the interaction is unknown. Additionally, quetiapine may enhance the CNS effects of lorazepam.

 

It's possible the reduction in Seroquel has caused you to process the Ativan faster, which is a functional decrease in Ativan.

 

Has this clinic talked about switching you to Valium to bridge off Ativan? It does not appear that Seroquel and Valium interact in the same way.

[Csilover]

@Altostrata she said she was willing to bridge me but I’d probably have to request it to be a specific way. I’m assuming they’d just cold switch me over instead of gradually going over. How would I ask them to go about it?

 

That makes sense. 

[Csilover]

I talked with my doc today. She really thinks my taper was too quick and that I can’t make 25 cuts that quick. She’s gonna call and tell my parents that j in can’t go that fast. She’s encouraging me to go up 12.5 and stabilize on that dose. She said I may be a 12.5 person who has to cut and hold a couple of weeks. She wants me to get the most out of therapy here and coping and doesn’t want to rush me off of it. I’m not sure if I will go up as I got 7 hours of sleep last night. Unfortunately my mental state is not good and I’m extremely suicidal and anxiety is revved up high. I can’t sit still and constantly crying. I don’t know if going back up would be beneficial or make it worse at this point. 

[Csilover]

I should be seeing my doc again Wednesday 

[Csilover]

July 12

3 am wake with anxiety

9 am take .5 ativan. crying
11 headaches crying 

12-6 anger crying suicidal ideation

7 calmer

9 take 50 seroquel and .5 Ativan 

9:45 fall asleep

5 wake up high anxiety. suicidal thoughts 

[Altostrata]

2 hours ago, Csilover said:

I’m not sure if I will go up as I got 7 hours of sleep last night.

 

Okay, this is good. It's taken you a little time to stabilize.

 

2 hours ago, Csilover said:

Unfortunately my mental state is not good and I’m extremely suicidal and anxiety is revved up high. I can’t sit still and constantly crying.

 

This may be from the Ativan. Please hang in there. Keep reminding yourself that you'll get through the bad effects of the drugs. It may take a few months. Stay as calm as possible. There is no need to think of suicide.

 

I am thinking the reduction in Seroquel made you less groggy and now you're feeling the adverse effects of too much Ativan again.

 

17 hours ago, Csilover said:

@Altostrata she said she was willing to bridge me but I’d probably have to request it to be a specific way. I’m assuming they’d just cold switch me over instead of gradually going over. How would I ask them to go about it?

 

That makes sense. 

 

First you have to let you sleep come back after the Seroquel reduction.

 

What I would do is substitute diazepam first for the evening Ativan dose first so it stops conflicting with Seroquel. Diazepam is milder, too, so you might not get the same adverse effects.

 

After you stabilize, change the morning dose to diazepam.

 

The clinic should be familiar with the Ashton manual regarding benzo dosage equivalencies.

[Csilover]

@Altostrata I’ve become very agoraphobic. My startle response is high and my depression is much worse. I was feeling more connected to people and my emotions. Now I feel very distant and mood swings like crazy. Can’t sit still. Is two weeks too late to reinstate? Even a small amount? Like half a 12.5? I was doing really good the first week after the drop and then when I dropped the second dose and feel horrible. I know I need off seroquel eventually but my reaction to the drop has not been good and it’s been two weeks and my emotions seem to have only gotten worse as times gone one. 
I don’t know if it makes a difference with half life being shorter and what not.

[Altostrata]

2 hours ago, Csilover said:

Can’t sit still. Is two weeks too late to reinstate?

 

Are you talking about Seroquel? Yes, you might try increasing by maybe 2mg. That could be enough. They'll have to use a liquid.

[Csilover]

@Altostrata they won’t do liquid I doubt. Would 6.25 of seroquel be too high? Slept 7 hours last night and woke at 5 with extreme anxiety agitation. But I slept 7 hours which was good. 

@Shep

[ChessieCat]

1 hour ago, Csilover said:

they won’t do liquid I doubt.

 

It sounds like you are assuming that they won't.  You won't know unless you ask. If they can't prescribe a liquid then you could ask if they can write a prescription for compounding.  You would only need it for the additional amount to add to the tablet.

 

 

EDITED TO ADD:

 

It is possible to make your own liquid from immediate release according to Post #1 of this topic.  This post also mentions getting the drug compounded into a liquid:

 

 

Edited July 14, 2020 by ChessieCat

[Csilover]

9 am took .5 ativan

11 extremely anxious. Can’t be around anyone. Crying.

1 very anxious. Crying.

4 crying anxious Muscle twitches.

5 some relief. Calm

6 crying

8 anhedonic. Calm. Don’t feel much at all

9 take 50 seroquel and .5 Ativan 

10 fall asleep

5 wake up anxiety. More anhedonic.

[Csilover]

@ChessieCat I asked and they won’t. There’s not a compounding pharmacy around. It’s a very small town.

[Csilover]

Do you think I’d have a bad reaction to a higher dose?

[Csilover]

The sleep and mood was good after dropping 12.5. A week later dropped another 12.5. Sleep not as good. 5 hours. Mental symptoms not prominent. Actually felt better.  A week after that mental symptoms kicked in pretty badly. Extreme mood swings. It’s been a week since my mental symptoms have started. Inner restlessness, antisocial, revved up feeling, anxiety high. Hard to relax or sit still. Can’t pay attention. More emotionally disconnected. Last week was able to watch a movie now can’t sit still.   Sleep has improved the last two days. Getting 7 hours straight through which is good. Not sure if I should wait it out. 

[Altostrata]

Right, you're feeling the effects of the Seroquel decrease. 5 hours sleep is not too bad in withdrawal, and you're getting better sleep now and then, which indicates you're stabilizing. Can you hang in? In a few days, you might be back to baseline.

 

Please tell yourself, "I can get through this."

[Csilover]

My doc said she can’t do even 6.25 and wants me to do 12.5.

 

I will try to tough it out. 

[Csilover]

 

July 14, 2020

5 am wake up. 7 hours sleep. Anxiety

9 .5 Ativan anxiety high

10 high anxiety

12 high anxiety 

1 calm

2 anxiety

5 calner

8 anxiety. take bath muscles pounding twitching 

9 50 seroquel .5 ativan 

10 fall asleep

4:30 am wake up with low anxiety 

[Erell]

Dear you, 

 

I just realized you were only 17 : I'm so sorry you're going through this, and wish I could help you.

You're so young, you have a life ahead for which you can plan and dream.

One day, stronger than ever, you'll dance and thank your old self.

Hang on dear, it will get better ❤️

 

[Csilover]

July 15, 2020

 

5 am woke with anxiety 

9 took .5 ativan 

12 calm

1 anxious.

5 really anxious

8 felt myself and calm

9 take 50 seroquel and atuvan

10 fall asleep

5 wake up not anxious 

5:30 fall back asleep.

7 get up. Anxious.

 

 

Anhedonia worse it’s been in a while and nausea. My anxiety and depression is the worst it’s been since May. My theory is I was finally stabilizing before the drop because I was socializing and playing games and actually wanting to be around people. Feeling connected. Crying and laughing with people.   I could eat dessert and still sleep and play volleyball and sleep. I was also getting my appetite back and wasn’t crying as much. Looking back I was improving. Silly me should have waited because now I’m having trouble enjoying this experience. It took me almost two months to get to that point  and I was sleeping well most of that time so I know that even if I sleep well, it doesn’t mean I’m gonna get better emotionally. My nurse said she’d cut my 6.25s but I haven’t reinstated. I could technically take the 6.25 back to my room and try to cut it in half, making it I scooped one last night intending on taking it and then threw it away. I didn’t end up taking it. I slept the best I’ve slept in 2 weeks. So that’s the one positive. I went to the bathroom like three times today and feel sick. It’s definitley the seroquel because this happened last time I withdrew. Extreme stomach pains. Diahrea. I called and yelled at my mom today. That’s not me. I don’t do that. I was getting better. I was getting more rational. More me. I’m so dumb for not holding.

@Altostrata will reinstating help with my emotions? It’s been 3 1/2 weeks since the drop to 62.5 and 2 1/2 weeks since the drop to 50.

[Csilover]

Thank you @Erell it means a lot. I’m trying to hang on but struggling. It seems whenever I start to get better I make it way worse. It feels like I can’t get a break at this point

[Csilover]

My memory has gotten bad again. I can’t remember something someone told me only moments ago 

 

I was feeling load of empathy. Really crying and feeling people’s stories. Now back to zombie. People were telling me how sweet and smart they thought I was and I felt so connected to them. Now, I can’t even look people in the eyes a lot and rubbing my head again like I used to. Compulsions like pulling my hair back constantly. This happened after my reaction  guess you don’t realize you’re getting better until you do something to mess it up AGAIN. I truly think I was stabilizing from the drops and the adverse reaction in April and May and it was all just starting to settle down.

 

 

I did EEG and the lady said my frontal lobe was “quiet” and that it’s not communicating with the rest of my brain. I did this 1 week ago I imagine it’s even more quiet now. Makes sense because when I took Paxil it felt like my forehead exploded.

[ChessieCat]

57 minutes ago, Csilover said:

It seems whenever I start to get better I make it way worse. It feels like I can’t get a break at this point

 

We all make mistakes.  The thing to do is to learn from them and try not to make the same mistake again.  And sometimes what we learn from a particular mistake can be used for a different thing.

 

The important thing is to not beat yourself up over it.  It helps if you can accept that it has happened and if the thought keeps coming back remind yourself that you know not to do it again.  Continuing to be angry and upset about it just adds stress and stress isn't good for us.  The more you can stay calm and relaxed the easier it is for the brain to do what it needs to do for things to settle down again.

[Altostrata]

1 hour ago, Csilover said:

I did EEG and the lady said my frontal lobe was “quiet” and that it’s not communicating with the rest of my brain. I did this 1 week ago I imagine it’s even more quiet now.

 

These tests don't show anything useful. Don't worry about this test. Sometimes people will do sciencey stuff to make you feel you're getting your money's worth.

 

You will be okay. You are stabilizing from the Seroquel decrease. Going without sleep can throw you off quite a bit.

 

You are also under the influence all day long of the drugs you're taking. Their effect is to make you dull. Just stay calm and hang in there, you'll reduce the drugs and come out the other side.

 

None of this is a sign that you're a bad person or that you're deteriorating.

[Csilover]

I can’t do the anhedonia again. I just cant

[Csilover]

@Altostrata I know now that the anhedonia was not from the seroquel and that I was stabilizing after my adverse reaction and drug changes in April and May. It all makes sense because the drug couldn’t be causing it if I was improving on it. I’m sorry but I think I’ll go up 12.5  Or 6.25tonight  I can’t deal with this. I think my anhedonia is worse than it was before even april. I feel like I can’t even cry now if I wanted to 

[Csilover]

I also find that I’m smiling when people tell me sad things. I wasn’t doing that before. I did that in old withdrawal

[Csilover]

I feel a bit better now. Not as out of it. Was able to cry this morning and connect a bit with people. I just panicked

[Hanna72]

Dear @Csilover

You are a brave young lady. It takes a lot of courage and strength to go through withdrawals. 
You are strong and you will survive all this I have no doubt.

Sending you good vibes and hugs your way💖

[Csilover]

8 am crying

9 took .5 ativan

12 crying 

1 calm 

2 some anxiety

3 calm

6 calm

9 took meds

9;45 fell asleep

5 am woke up without much anxiety

dozed in and out of sleep until 7 am