Shelton: withdrawal from short term amitriptyline and nortriptyline use, Celexa previously

[Shelton]

9 hours ago, manymoretodays said:

Are you able to get a .125 mg dose accurately?

Have you tried it twice a day?  Consistently?

I know, I know.......more questions than answers.

I was doing it twice a day constituently and she told me my shivers/anxiety/flu like symptoms/nausea sounds like benzo withdrawal and it’s not withdrawal from Celexa. So she wanted me to change ativan to .125mg 3 times a day. Is adding a dose in there really the solution? I hate how ativan makes me feel. 

corrected Celexa doses- per members post-

Here are notes:

Thursday 09/10

8:00pm - 6:30am - SEVERE nausea...lasted all night. Felt like I was going to throw up at any moment. Diarrhea twice. Slept 3 hours total - no cortisol anxiety or shakes throughout the night

6:30am-11:00am - severe nausea with flu like symptoms - “heavy brain” weakness

11:00am - appt with doc. Told me to switch to Celexa liquid starting tomorrow. Did not take Lexapro this morning. 

11:15am - .25 ativan - calmed down nausea some - still feeling flu like symptoms, weakness, hard to get out of bed

2:00pm - was able to eat a little toast and enjoyed it

3:00-6:00 - on and off nausea but not severe, weakness, flu like symptoms, brain fog

Throughout the day, PGAD sensations increased. Hoping starting Celexa tomorrow will tame those sensations

6:30pm - weakness, feeling fatigued/tired which haven’t felt in a while due to severe “cortisol anxiety” - body aches that are mild but noticeable - PGAD 5-6/10. 

7:00pm - anxiety/nervousness/body aches/fatigue - waves of nausea but not severe 

7:30pm - .125mg ativan

8:00pm - ate - body aches

9:30pm - no nausea - body aches (mostly in legs, weakness, little dizzy - PGAD 5-6/10)

11:30pm-12:15ish? woke up with anxiety/shivers

 

Friday 09/11

 

2:30am-3:15am - awake, no anxiety/shivers just body aches

5:30am - 6:00am - awake, slight anxiety/nervousness

6:45am - awake for the day with anxiety/nervousness, pit in stomach/slight nausea

8:45am - still anxious/nervousness, slight nausea but drove 20 minutes to get medicine from CVS

9:00am - ate breakfast

9:30am - took .5ml Celexa   0.5 mg Celexa

10:20am - still feel nervous and slight nausea 

10:45am - anxiety/nervousness got worse, slight nausea still - tough talk with sister in law could’ve made it worse

11:30am - .25mg ativan - anxiety/nervousness a little better - nausea subsided

12:30 - ate grilled chicken and green beans 

12-4pm- PGAD 2/10 - body aches, still nervousness/anxiety but improved, tired but too “wired” to nap, nausea comes off and on

Felt so much anxiety/nervousness & symptoms above but forced myself to go to in laws house. “Faked it until I made it” today 

5-8pm - PGAD 4/10 - internal uneasiness, anxiety/nervousness getting worse, nauseous/no appetite (not as bad as yesterday), brain fog

8:20 - took .25mg ativan

8:30pm - ate chicken sandwich - forced it down 

9:30pm - body aches, slight anxiety, nausea & shivering waves - PGAD 2/10

10-11:30pm - sleep

11:30pm - woke up severe panicky and anxious - shivers from anxiety/panic

1:45am - still awake - bad anxiety/panic shivers

Took 25mg magnesium and it calmed panic a lot - back to sleep

 

Saturday 9/12

3:30am - woke up with PGAD sensations 6-7/10

5:00am - fell back asleep

6:30am - woke up severe anxiety and shaking

7:30am - took 25mg magnesium to see if it would help me sleep again - did not work

9:15am - took .5ml Celexa  0.5 mg Celexa - severe anxiety/shaky/nervousness

9:45am - ativan .125

Anxiety/shakiness/nervousness calmed down a tad but came back quickly. 

PGAD 6/10

2:20pm - shivers/anxiety/heart racing calmed down - nauseous and feeling sick like I have the flu

PGAD 7/10 - vaginal Valium calmed it down to 3/10

7:30pm - slight shivers

8:00pm - ate grilled chicken sandwich 

8:30pm - slight nausea (comes and goes), shivering comes and goes, PGAD 5/10, fatigue/body aches 

9:00 - PGAD 8/10 - took .125mg ativan

11:00 - sleep

 

Sunday 9/13

1:40am-3:30am - no shivers, PGAD 8-9/10

Ice added

3:45am-7:15am - sleep

7:15am - woke up feeling groggy/drugged and hungover feeling - hate this feeling - anxiety, no shivers - PGAD 3/10

 

9 hours ago, manymoretodays said:

Any non-drug coping that you have found to be helpful?  Cuddling the baby is one, for sure!  Baths, walks, breathing, listening to music.......oh so many things.  These are tough times for you I know.

Edited September 13, 2020 by manymoretodays
removed some spacing, reduced font size notes to 14

[Shelton]

6 hours ago, manymoretodays said:

So we don't really know what's what yet.    

Any non-drug coping that you have found to be helpful?  Cuddling the baby is one, for sure!  Baths, walks, breathing, listening to music.......oh so many things.  These are tough times for you I know.

Yes, taking care of him for sure helps and the magnesium helped once. She told me to stop the magnesium so we can see what’s going on with the meds and what is causing what. She does not believe any of my symptoms are Celexa withdrawal so I’m scared she’s assuming it’s ativan withdrawal which may not be the case?

[Shelton]

@manymoretodays I can’t figure out how to edit. I put .5ml of Celexa - it’s not. It’s .25ml (.5mg)

 

also updated my signature. 

[manymoretodays]

I fixed it. Members only have up to 1 hour to edit.

Shelton,

I've got to be honest with you here.  I was aghast that your doctor added vaginal Valium!   What's the dose?  I didn't even know it came in a vaginal insert.  It didn't seem to help and so, I would, if I were you ditch that one.   This after cutting your Ativan down abruptly!

 

Use some common sense here please and going forward.  Here's what I'm seeing.

 If you were sketchily taking the Ativan .25 mg twice a day, that's .5 mg total. 

.125 mg 3X/day is an abrupt decrease of 25% of your dose. 

.125 mg 2X/day is a 50% decrease. 

Yet wait, now there's more......there you are using vaginal Valium now!

AND being told not to use something simple, non toxic like magnesium.

 

Plain old benzo WD, interdose WD..........who knows right now.  Flucuating dosing and types of benzos!   Again, who knows. 

One thing is sure- Continuation of the neuro dysregulation, that appears to have been medically induced, with abrupt medication changes made in May, while yes......you were also going through some hormonal shifts after giving birth.  So, I don't know.

 

I do know that it feels like you are playing us a bit, going back and forth with your doctor.........not really paying attention to our suggestions........and that makes it difficult as well.

And no, Celexa is not a data driven or even scientific remedy for benzo WD, if that's the case now.

 

You can look around the benzo forum here, unfortunately we're not having members start new topics there right now.  You'll see it from our home page, once you are signed in.

You can go to PGAD member support sites, to the Benzo Information Coalition site, here in the U.S., even to Benzo Buddies if you'd like, for further education and beginning to empower yourself, to take charge of your now medically induced condition.  benzo.org.uk is good too, and the only site I have a link handy for right now.

 

Just stay steady with something now please, for an entire weeks time, this gets really frustrating for us to follow.

 

Hey, I also decreased the font size on your notes, and took out some of that spacing for ease of readability.  And do keep them coming.  I'd love to see just no changes for an entire weeks time.  Decide what YOU want to do with your benzo intake and then stick with it.  And breathe, walk, eat, Love, pray.......use music and ear buds, do some meditations.......note that stuff too in your notes and what is helping.

I apologize for my frustration at the moment too.  Just being honest.

 

Have a great Sunday......truly.

 

L, P, H, and G,

mmt

 

Edited September 13, 2020 by manymoretodays
removed excess white space

[Shelton]

8 minutes ago, manymoretodays said:

I've got to be honest with you here.  I was aghast that your doctor added vaginal Valium!   What's the dose?  I didn't even know it came in a vaginal insert.  It didn't seem to help and so, I would, if I were you ditch that one.   This after cutting your Ativan down abruptly

This was when I first cold turkey’d and got PGAD - before I found you guys! It helped for a bit but came back strong overnight. I was told it’s not addictive and “topical” to calm the pelvic floor muscles. I will avoid! I promise I’m not stupid LOL - I just grew up thinking ALL doctors were so smart and knew exactly what to do. I’m learning and my mind is opened! 
 

18 minutes ago, manymoretodays said:

Use some common sense here please and going forward.  Here's what I'm seeing.

 If you were sketchily taking the Ativan .25 mg twice a day, that's .5 mg total. 

.125 mg 3X/day is an abrupt decrease of 25% of your dose. 

.125 mg 2X/day is a 50% decrease. 

Yet wait, now there's more......there you are using vaginal Valium now!

AND being told not to use something simple, non toxic like magnesium.

What are your recommendations on the Ativan dose? I thought you were on board with this .125mg/ 3 x’s a day? Should I do .167 3 x’s a day? I would honestly rather do .125 2x’s a day because it makes me feel so yuck after I take it but I want to be smart. Let me know what you think. 
 

23 minutes ago, manymoretodays said:

do know that it feels like you are playing us a bit, going back and forth with your doctor.........not really paying attention to our suggestions........and that makes it difficult as well.

And no, Celexa is not a data driven or even scientific remedy for benzo WD, if that's the case now

No! Please don’t think that. I have to have her for prescriptions and I’m just communicating what she says to make sure it’s either correct or wrong. Once I know a steady dose of the Ativan, I’ll be consistent. I have been consistent with the Celexa!

 

 

i will keep up with my notes and journaling! Sorry about the font - I’m copying and pasting. I’ll try to be more aware. 
 

Please don’t get frustrated, I’m learning and unlearning from years of wrong doing from doctors. 
 

Much love and gratefulness!!!! 

[manymoretodays]

Me, I'd do the 1.25 .125 mg 3 times per day, evenly spaced 8 hours apart for the next week,  and use some magnesium.

Meanwhile, I'd get reading and learning.......start in the benzo forum here , read the pinned topics, look at some of Shep's great coping skills layed out for others there too.......and then expand to some of those other sites, including finding some PGAD specific sites.  In small doses though, don't do more than you can handle right now.

 

And I know......I know.  They mean well, most of them.  The docs.  It's how they've been taught.  I still struggle with all that........my own shifted paradigm and all that goes with that, living in a mainstream society of believers of something I know longer believe in.  Be careful Shelton, with folks like your sister in law, and talking to much about what you are learning and all........get strong in yourself.  Some.......like my own dear Mum, of 92 years now.........just cannot change........Love them anyway.

 

Find a few buddies here or elsewhere online to help carry you through.

 

You ARE more aware and are shining bright.  I'm so sorry........just going through my own stuff.  I am going to the music for awhile......maybe I'll do some kitchen ecstatic dancing or something.  I'm actually feeling quite a bit better and more real than I have in awhile.  Grounded in reality.  Not always fun.

 

Best.  Healing and all that!

 

 

Edited September 13, 2020 by manymoretodays
urg on me, corrected dose

[ShiningLight]

Shelton,

 

The PGAD sounds absolutely miserable. I am so sorry you have to go through that!

 

As I was reading your symptom log, I had a flashback to how all-encompassing these symptoms can be at their worst. Know that it won't always be like this. You are getting good advice to limit how much you change at a time. Also, when I am in a wave, it helps me to remember that just as quickly as the wave came, it can go.

 

I heard somewhere (maybe here, I don't know?) when you wake up, immediately try to notice three things in the environment. Maybe that will help with the cortisol spikes. The spikes may keep happening until your body settles a little more, but you can divert your attention once it does. I think that may help to prevent it from becoming a self-perpetuating cycle, ie help your brain from associating the act of waking up=time to panic. 

 

Remember to be kind to yourself. Having a baby is a huge life change. The pandemic is a huge life change. Withdrawal is a huge life change. You are coping with all three simultaneously, which is amazing.

 

💜💜💜

 

 

[manymoretodays]

Oh wowser. 

Shelton, please see the corrected dose, that I would try, if in your shoes now.

And it's me, not you.......that I get flustered at.  Really.  Been struggling with my own self discipline lately......alot.

1.  Rule of thumb for me, scanning here first thing in the morning.......is Not any kind of substitute for morning meditation.  I don't know why I keep doing what I do sometimes, as far as my own bad habits.

p.s. music helped, an unexpected actual phone call from a friend really helped too.

Again so sorry Shelton.  I am not always very cool.............in fact frequently I am a real dorky, timid, nerd. ❤️

[Shelton]

4 hours ago, manymoretodays said:

Been struggling with my own self discipline lately......alot.

1.  Rule of thumb for me, scanning here first thing in the morning.......is Not any kind of substitute for morning meditation.  I don't know why I keep doing what I do sometimes, as far as my own bad habits.

p.s. music helped, an unexpected actual phone call from a friend really helped too.

Oh my goodness, I completely relate to struggling with self discipline. I have been obsessing over how bad I feel and it’s so hard. This is all just so hard - I’m trying to be strong for my son and family but it’s hurting badly.

 

I have a couple questions - please take your time answering! I know you’re busy - just thankful for you!

 

1. My worst symptoms are PGAD, body aches, restless legs, no appetite, insomnia, sleepy through the day but can’t nap, diarrhea and nausea waves. Are these all symptoms of withdrawal? I get scared that it’s either Celexa, ativan or something else wrong. 
 

2. Can the restless legs/akathisia feeling in my legs be caused by ativan? I hate taking that medicine. Can’t believe I ever started.

 

3. How will I know when I’m stable or if the reinstatement of Celexa is working? I guess I’m having a hard time knowing what “stable” means and how will I know if I may need to increase? Does “stable” mean feeling like I did prior to Celexa crash?

 

4. I know we have a ways to go but how do you taper ativan? My doc mentioned something about switching to Valium to taper but I’m just curious on that process.

Thank you so much! I hope you’re staying happy and well!

 

[ChessieCat]

These might be helpful for a couple of your questions.

 

Dr Joseph Glenmullen's Withdrawal Symptoms

 

Stability

 

WDnormal

[Shelton]

6 hours ago, ShiningLight said:

As I was reading your symptom log, I had a flashback to how all-encompassing these symptoms can be at their worst. Know that it won't always be like this. You are getting good advice to limit how much you change at a time. Also, when I am in a wave, it helps me to remember that just as quickly as the wave came, it can go.

Hey ShiningLight! Thank you so much for coming here to say this. I am really struggling and just hearing that it gets better makes me feel so much better. How are you doing? I’m still trying to understand the waves and windows pattern, it’s so hard. 
 

6 hours ago, ShiningLight said:

heard somewhere (maybe here, I don't know?) when you wake up, immediately try to notice three things in the environment. Maybe that will help with the cortisol spikes. The spikes may keep happening until your body settles a little more, but you can divert your attention once it does. I think that may help to prevent it from becoming a self-perpetuating cycle, ie help your brain from associating the act of waking up=time to panic

This is genius! I will try this. Thank you so much!

 

6 hours ago, ShiningLight said:

Remember to be kind to yourself. Having a baby is a huge life change. The pandemic is a huge life change. Withdrawal is a huge life change. You are coping with all three simultaneously, which is amazing.

Thank you so much! I am really struggling. I am out of work right now but don’t have much longer to be off and I’m so scared. Dealing with this + a new baby + work, I’m having a really hard time. Is it possible to go back to work/your life during this? Does it get easier? Really having a hard time. 
 

I hope you’re doing well!!!!

[Shelton]

41 minutes ago, ChessieCat said:

These might be helpful for a couple of your questions.

 

Dr Joseph Glenmullen's Withdrawal Symptoms

 

Stability

 

WDnormal

This helps so much! I do have a question - I was on 30mg of Celexa for 3 weeks (gradual increase from transition from Lexapro to Celexa). For those 3 weeks, I was fine and then one night it hit me - severe insomnia, weakness, “electricity through my body” type anxiety. Literally came out of nowhere. I stayed on for 2 weeks because my doc said it could be hormonal. At the end of the 2 weeks, I was having akathisia and had to get up and pace the floors at night. She said it could be serotonin syndrome and stopped cold turkey. I felt better within 2 days until withdrawals hit, of course.

 

Now I’m having a hard time deciphering if what I’m feeling (restless legs, achey legs) are because I reinstated Celexa and I’m reacting badly or if it’s just withdrawals and hopefully the reinstatement will calm it down?

 

Any suggestions/thoughts?

 

Also, how do I know if it’s akathisia or just restless legs?

 

Thank you so much!

[Shelton]

On 9/10/2020 at 3:50 PM, Hanna72 said:

Hey @Shelton

I am sorry to see that you are struggling. I have been in your shoes before and I just want you to know that you don’t have to be scared. I know it’s frightening when you get overwhelming withdrawals and are hit with these symptoms. But you don’t have to be scared. We are right here to support you and the moderators will give you their advice as they have on doses. Try to stay as calm as you can, it truly helps your nervous system. Can you put on a soothing music and focus on your breathing. 
You will be ok, know that.

Sending you strength and calming vibes 🙏

 

Awww Hanna72, thank you so so much! Please tell me it gets better! I’m desperate. 

[Hanna72]

hi @Shelton

10 hours ago, Shelton said:

Please tell me it gets better!

Yes I am telling you, it gets better. It might be a slow process and we crave for more improvements every day. You need to have faith and allow your body to heal. 

If you over analyze every symptom and follow every negative thought that appears in your mind, it only makes you suffer more. Finding something positive and reaching within for some own motivation, can play a huge role in getting better faster. You have a beautiful baby, congratulation 😃 Find strength in that, and a motivation to want to make a better life for yourself and become the person you want to be. Make your baby proud of its mum, and he will be able to look up to you in the future and say, wow you are my inspiration

One day at a time my friend, and please dont be hard on yourself.

You will get there.

[Altostrata]

Vaginal Valium, a new one on me.

 

16 hours ago, Shelton said:

Now I’m having a hard time deciphering if what I’m feeling (restless legs, achey legs) are because I reinstated Celexa and I’m reacting badly or if it’s just withdrawals and hopefully the reinstatement will calm it down?

 

Any suggestions/thoughts?

 

Also, how do I know if it’s akathisia or just restless legs?

 

At 30mg Celexa, you were taking too much SSRI. You had serotonin toxicity. It can take quite a while for your nervous system to settle down from this, even if you don't follow up with more SSRI. But you had subsequent drug experiments that may have added to the confusion.

 

With all the benzo shenanigans, it will be impossible to see if changing to 0.5mg Celexa has any beneficial effect at all. Any effects you feel might be from Ativan, or even the occasional Valium application, its effects last for weeks.

 

How long have you been on the schedule of lorazepam .125mg 3 times a day or twice a day or whatever? What exactly is your drug schedule? You will need to keep daily notes to see the effect of drug changes.

 

Please stop jumping around on drugs. Every time you make a change , it can take a week or so for your system to settle down from it.

 

You might find fish oil and magnesium supplements helpful, see
https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/
https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

You might try a little bit of one at a time to see how it affects you.

 

Magnesium in particular is good for "restless legs". Also, be sure to stretch your legs frequently.

 

[Shelton]

21 minutes ago, Altostrata said:

How long have you been on the schedule of lorazepam .125mg 3 times a day or twice a day or whatever? What exactly is your drug schedule? You will need to keep daily notes to see the effect of drug changes.

I was told by my doctor to take it as needed so during all of this when my anxiety was high, I took it. I had no idea it could cause a domino effect. I have been taking .125mg 3 x’s a day since Saturday. I don’t feel like I “need it” this often - is it still recommended to stay on this schedule?

 

My doctor thinks all of my symptoms are Ativan withdrawal symptoms. She has discussed switching to a different, longer lasting benzo or tapering off Ativan. I have no idea what to do - I’m very unfamiliar with benzos and dependency on them so need your opinion. Do you suggest staying on .125mg 3 x’s a day? If so, how long? Would rather get off benzo before Celexa as it makes me so fatigued with not much help at all and almost makes me feel more anxious sometimes. Is it possible to do a fast taper on benzo if I haven’t been on it consistently for a long time?

 

26 minutes ago, Altostrata said:

Please stop jumping around on drugs. Every time you make a change , it can take a week or so for your system to settle down from it.

I’m not! I am steady at .5mg of Celexa and .125mg Ativan 3 times a day. Unsure of what to do with the Ativan. 

 

28 minutes ago, Altostrata said:

With all the benzo shenanigans, it will be impossible to see if changing to 0.5mg Celexa has any beneficial effect at all. Any effects you feel might be from Ativan, or even the occasional Valium application, its effects last for weeks.

I only used the vaginal Valium once. I was told it was topical and just relaxed the pelvic floor muscles. Had no idea it could interfere with Ativan or put me backwards. 

 

29 minutes ago, Altostrata said:

At 30mg Celexa, you were taking too much SSRI. You had serotonin toxicity. It can take quite a while for your nervous system to settle down from this, even if you don't follow up with more SSRI. But you had subsequent drug experiments that may have added to the confusion.

Yes, my plan (before I found SA) was to stay off all AD’s and just deal with the withdrawal symptoms. PGAD hit me and threw me for a scary loop. Doctor prescribed several things to “calm it down” quickly and now I’m here. I wish I would’ve known then that reinstating Celexa could calm PGAD down and pause withdrawal symptoms but I didn’t know what I know now. 

 

 

[Shelton]

@Altostrata @manymoretodays @ChessieCat @Shep -

 

Hey guys, really needing some help/encouragement. The insomnia I am struggling with is severe. I am averaging 1-2 hours a night. The PGAD is also almost unbearable since stopping Nortriptyline and reinstating Celexa which does not help with insomnia.

 

I tried magnesium and it calmed me but made the PGAD worse. Could L-Theanine be beneficial?

 

I have read finding ways to cope and dealing with insomnia but at times, I feel so bad that I just want to go to the Emergency Room because I feel like I’m dying and get no relief! Sometimes I feel like I’ll end up there because I’m so ill. This is terrifying!

 

Is there something I can change about my medication times to help or what should I do? I updated my signature. Diary post next. 

 

I’m so desperate - please help me. 

[Shelton]

SUNDAY 09/13

1:40am-3:30am - no shivers, PGAD 8-9/10

Ice added

3:45am-7:15am - sleep

7:15am - woke up feeling groggy/drugged and hungover feeling - hate this feeling - anxiety, no shivers - PGAD 3/10

9:30am - took Celexa .5mg

10:30am - still feel the same. Sleepy/brain fog. Body aches mostly in legs - slight anxiety (rebound anxiety?) PGAD 5-6/10

10:30am - took .125mg Ativan 

11:10am - shortness of breath kind of like heavy chest? Body aches/restlessness in legs

12pm-2pm - fatigue/sleepy, some anxiety - went to store and felt anxious inside - restless legs - had diarrhea - still no appetite

2pm-3:30pm - really sleepy but anxious, brain fog, hard to focus, achey/restless legs, weak

3:45pm - .125mg ativan

4:15pm - diarrhea, sleepy - had to lay down

5:30pm - 7:15pm - achey/restless akathisia legs worse - can’t concentrate - depersonalization - PGAD 1-2/10

7:45pm - severe irritability /agitated

8:00pm - ate chicken sandwich 

8:30pm-9:30pm - body aches, restless legs (is it akathisia?), agitation, depersonalization, sleepy but can’t sleep

PGAD 0-1/10

9:30pm - .125mg Ativan

 

MONDAY 09/14

10:15pm - 1:30am - sleep

1:30am - woke up with slight anxiety, feeling dread, pit in stomach. Fell back asleep. 

4:15am - woke up with slight anxiety, feeling dread, pit in stomach.

5:15am-6:16am - up with anxiety/panicky feeling throughout body

8:00am - anxiety not letting up at all.

9:15am - ate biscuit - PGAD 1-2/10

9:30am - .5mg Celexa 

9:45 - .125mg ativan

11am-12pm - anxiety eased - very sleepy

2:00pm - ate lean cuisine 

2:05pm - a little anxious/sleepy/derealization/brain fog

2:44pm - bad heightened anxiety

4:00-4:45pm - anxiety calmed down for a bit 

5:30pm - PGAD starting to come back 5/10 - Anxiety heightened.

6:45pm - at grilled chicken pita - Took .125mg Ativan 
7:00pm-9:00pm - PGAD worsened

10:00pm-11:00pm - Sleep

11:00pm - PGAD unbearable

11:30-now - been awake with terrible PGAD and anxiety

 

Did I make a mistake stopping the low dose of Nortriptyline for PGAD?

 

Edited September 15, 2020 by ChessieCat
reformatted for ease of reading

[manymoretodays]

Shelton,

It's still really hard to tell much about anything.  Since arrival here on September 3rd, you been on and off the nortryptiline, with varying doses.  On and off Lexapro, varying doses.  And then disclosed the Ativan usage as well, using it for 3 and 1/2 months prior to arrival here, 3 times, then 5 times per week, and then daily.

You've asked about Buspar as well.  Meantime have taken your second dose of Vaginal Valium(I'm assuming it's 10 mg) while tinkering with your Ativan.  Or attempting to try and get some regularity of that, both timing and dosage.  Not a bad idea at this point.

 

From your narrative on the 12th, Saturday:

On 9/13/2020 at 5:51 AM, Shelton said:

I was doing it twice a day constituently and she told me my shivers/anxiety/flu like symptoms/nausea sounds like benzo withdrawal and it’s not withdrawal from Celexa. So she wanted me to change ativan to .125mg 3 times a day. Is adding a dose in there really the solution? I hate how ativan makes me feel. 

 I then tried to explain to you that you weren't really adding a dose, but decreasing the total daily amount from .5 mg to .375 mg.

.375 mg/day is better than the .5 mg/day, you stated you had only been doing for a couple of days anyway. 

 

 

I'm not seeing any reports of nauseau in your notes, but I am seeing a fairly irregular schedule with the Ativan .125 mg.

Last Saturday, September 12 you took it about 12 hours apart, but then that was the same day you decided to go with the Vaginal Valium(?10 mg) at or after 2:20 in the afternoon.

 

That Valium will be hanging around now for quite awhile, it's long acting, even when given orally, and pretty experimental.  No telling when that additional benzo burst will be out of your system.......I'd say at least a weeks time, and then maybe more.  https://pubmed.ncbi.nlm.nih.gov/31010782/

 

And so......we don't know.  We can't tell much of anything, until you manage to stay real consistent with dosing AND timing of your 2 medications now.  Without any new additions.  If you want to play more with additional medications now, that will be between you and your doctor Shelton.  We don't endorse any supplements either beyond the Omega 3's and Magnesium.  And again, other than magnesium........NOW, not a good idea to further experiment on your own with supplements. 

 

You seem to have consistency now for exactly 4 days.......today being the 5th, with the Celexa only, at 9:30 am.  BUT, in those 4 days, you've made other changes with the Ativan and the addition of Valium.

 

It looks like Saturday you tried to cut your Ativan dose down, and took it at a 12 hour interval........this was also the day you added in Valium.

 

Sunday......Ativan .125 at 10:30 am, 3:45 pm, and 9:30 pm.  (so a 5 hour interval, and then almost a 6 hour interval.......but then almost a 12 hour interval until Mondays dose at 9:45 am)

Monday you took your second dose 9 hours later at 9:45 pm  8 hours later at 6:45pm.    So Monday, just the 2 doses? 

Tuesday, maybe you took a another in the early morning hours and are going to try for every 8 hours now.

 

And so, so far exactly maybe 1 day of consistency with Ativan both total daily dose and timing.  Which isn't really showing consistency yet.

 

10 hours ago, Shelton said:

Did I make a mistake stopping the low dose of Nortriptyline for PGAD?

 

I think you'd be making a mistake, making yet another switch right now.  If you can do a whole week without any changes that would be great.  With notes.

Looks like sleep of about 3-4 hours most nights.  And some real panic and desperation frequently when you do post. 

We don't have quick solutions.......man, I wish we did for this kind of stuff. 

 

Hoping someone can pop in with some more guidance on coping right now.  Sleep tips, panic and desperation tips, etc.

I know it's hard. Sifting through the past days and making some sense out of your notes took me awhile.

Keep the Notes coming.  Things may start feeling better about a week from today for you.  Maybe even sooner I hope.

 

L, P, H, and G,

mmt

 

I had also asked how you were doing with getting the .125 doses of Ativan, from what I'm assuming is a 5 sided pill/tablet of .5 mg.  Might be best to work with your pharmacist, on getting even splits of your pill, now that you are quartering them.

Edited September 15, 2020 by manymoretodays
in purple, and clarity on some statements in black

[Altostrata]

14 hours ago, Shelton said:

Did I make a mistake stopping the low dose of Nortriptyline for PGAD?

 

Why was it you went off nortriptyline again?

 

You've been taking 0.5mg Celexa for 4 days. In what ways are your symptoms different before you started taking 0.5mg Celexa?

[Shelton]

1 hour ago, Altostrata said:

Why was it you went off nortriptyline again?

 

You've been taking 0.5mg Celexa for 4 days. In what ways are your symptoms different before you started taking 0.5mg Celexa?

@Altostrata

For PGAD  it stopped the PGAD flares. Now that I’m on Celexa, PGAD is almost unbearable. I’m assuming because it’s a low dose? I’m not sure. I wouldn’t wish PGAD on anyone...it is truly awful. 
 

I am having severe insomnia now - where as before, I wasn’t. And restless legs. But who knows if that’s withdrawal or Celexa?

[manymoretodays]

18 hours ago, Altostrata said:

Why was it you went off nortriptyline again?

 

You've been taking 0.5mg Celexa for 4 days. In what ways are your symptoms different before you started taking 0.5mg Celexa?

 

17 hours ago, Shelton said:

For PGAD  it stopped the PGAD flares.

 

Hi Shelton,

Let me try and help you out here.  The question was why did you go off of it?

Both the Amytriptiline 10 mg for 10 days seemed to help the PGAD, as did the Nortryptiline first 3 days of 4 mg, and then possibly a day of 2 mg, but you were having all the bolded below adverse effects: 

(note: I  noted the mg(s) of your Nortryptiline doses, based on a 10 mg/5mL concentrate)

  

On 9/1/2020 at 6:51 AM, Shelton said:

I was on 30mg of Celexa for 3 months for generalized anxiety. After coming off of Celexa, I developed PGAD which I’m learning is unfortunately happening to people a lot. My doctor put me on 10mg Amitriptyline for 9 days and I had terrible side effects - brain fog, heightened anxiety, no appetite. Day 10 they switched me to Nortriptyline at a low dose of 2mL (liquid it’s such a small dose). on the 4th night, I was going toTook it for 3 days and felt angry/mood swings, emotional, extremely depressed, agitated (couldn’t handle any mental stimulation or it made me so anxious - none of this is like me!) stop Nortriptyline altogether. I fell asleep for an hour and woke up with the worst withdrawals - nausea, flu symptoms, agitation, insomnia, heart racing. I then got out of bed and lowered the Nortriptyline dose to 1mL. My withdrawals calmed down a tad and I was able to sleep for a couple hours. Woke up with anxiety, nausea, flu-like symptoms, fatigue. 

 

And here is when your doctor tried tried the 2.5 mg of Lexapro, you tried doing 1.25 mg too and then settled on the 0.5 mg Celexa reinstatement. So you stopped the Nortryptiline to try something else with your doctors assist(some of this is in your notes too, and may be more than Alto needs right now, but just putting it here):

  

On 9/4/2020 at 10:14 AM, Shelton said:

My doctor lowered my Nortriptyline to .5ml 2 nights ago and tried me on 2.5mg of Lexapro yesterday morning and I had the serotonin syndrome like symptoms again - an adverse reaction. 
 

I just fixed my signature because before I was put on Amitriptyline, I was on Buspar 5mg twice a day. It calmed my anxiety/withdrawal symptoms but didn’t touch PGAD so that’s when they prescribed Amitriptyline.

 

My next question -

Should I do the low dose of Buspar and the low dose of Nortriptyline - calming my nervous system then gradually taper both?

 

  Looks like you did fine with the second question. 

You answered that since the 0.5 mg Celexa you've felt unbearable PGAD, as well as insomnia and restless legs.

 

I hope that helps.  Keep up with the Notes too, Shelton.

 

  

 

 

 

[Altostrata]

If I were you, I'd stop taking Celexa. Serotonergics are not for you.

 

Do you still have the nortripyline liquid? You might take 0.25mg of it. I believe you and your doctor misinterpreted your reaction to 4mg nortriptyline. Your nervous system is sensitized, 4mg was too much, a little can go a long way.

[Shelton]

7 minutes ago, manymoretodays said:

Let me try and help you out here.  The question was why did you go off of it?

Both the Amytriptiline 10 mg for 10 days seemed to help the PGAD, as did the Nortryptiline first 3 days of 4 mg, and then possibly a day of 2 mg, but you were having all the bolded below adverse effects: 

(note: I  noted the mg(s) of your Nortryptiline doses, based on a 10 mg/5mL concentrate)

@manymoretodays @Altostrata-

 

5 minutes ago, Altostrata said:

If I were you, I'd stop taking Celexa. Serotonergics are not for you.

 

Do you still have the nortripyline liquid? You might take 0.25mg of it. I believe you and your doctor misinterpreted your reaction to 4mg nortriptyline. Your nervous system is sensitized, 4mg was too much, a little can go a long way.

 I went off of Nortriptyline because I thought I was having bad reactions to it. Now, looking back. I’m not sure if it was adverse reactions to Amitriptyline/Nortriptyline or if it was withdrawals from Celexa. I have no idea! 
 

Symptoms now - fatigue, anxiety like crazy (especially in the middle of the night and early morning), insomnia, PGAD is unbearable, some feelings of restlessness/akathisia feelings/restless legs, fog/derealization/depersonalization, can’t handle a lot of stimulation at one time or loud noises or I get anxious/agitated, no appetite whatsoever (forcing myself to eat), intrusive OCD thoughts (so hard to focus on anything other than how I’m feeling and the “what if’s” no matter how hard I try to cope (in therapy twice a day) and I feel like my brain is burning in the back lower part? 

 

Couple questions-

1. Do these symptoms sound like withdrawal or something else?

 

2. My hope was that Celexa would keep PGAD away and calm down withdrawal symptoms. At this point, not sure it’s working or how long I stick it out?

 

3. If I stop Celexa and get back on Nortriptyline, can L-theanine be added for anxiety/derealization/depersonalization in my situation? I know it’s different for everyone but my mom had great results from it when she unknowingly tapered an antidepressant way too fast. 

 

I really want to “stabilize” so I can taper the Ativan because I hate it. It doesn’t help whatsoever and I had no idea it was dangerous too.

 

Please also note, I started these meds when I was 14 years old so this is why I have such a hard time understanding what is “stable” or how I’m supposed to feel 😭

 

@Altostrata @manymoretodays I know you guys are busy but I just want to say thank you for taking time with me. When I recover from this, I am already planning on blogging or writing a book about my experiences and bringing awareness to this nightmare. I am young, I have a sweet little baby, husband, career and life that I’m being robbed of right now. 
 

I don’t want one more person to suffer. Not one more!

[Altostrata]

10 minutes ago, Shelton said:

1. Do these symptoms sound like withdrawal or something else?

 

2. My hope was that Celexa would keep PGAD away and calm down withdrawal symptoms. At this point, not sure it’s working or how long I stick it out?

 

3. If I stop Celexa and get back on Nortriptyline, can L-theanine be added for anxiety/derealization/depersonalization in my situation? I know it’s different for everyone but my mom had great results from it when she unknowingly tapered an antidepressant way too fast. 

 

They sound exactly like withdrawal. You don't get PGAD from anything else.

 

If PGAD got worse after you started Celexa, the Celexa is probably making it worse. You must keep those daily notes to track drug reactions.

 

Have you found L-theanine to be helpful?

 

You can add theanine after you make sure 0.5mg nortriptyline agrees with you. Change only one thing at a time.

 

Please note that if you stop Celexa today and start nortriptyline tomorrow, a tiny bit of Celexa will still be in you, along with the nortriptyline, for about a week. You may have no reaction to the combination or you may get odd symptoms. Please keep those daily notes throughout this period, post at least 24 hours of notes at a time.

[Shelton]

2 minutes ago, Altostrata said:

They sound exactly like withdrawal. You don't get PGAD from anything else.

What a nightmare! I’m not sure if Celexa is making it worse or if it’s just not helping and Nortriptyline did. 
 

3 minutes ago, Altostrata said:

Have you found L-theanine to be helpful?

 

You can add theanine after you make sure 0.5mg nortriptyline agrees with you. Change only one thing at a time.

I haven’t tried L-theanine yet. I was scared to add it because you guys told me to stop jumping meds LOL. Magnesium calmed me down but I thought it may have made my PGAD worse. I will test again later once PGAD calms down. 
 

6 minutes ago, Altostrata said:

Please note that if you stop Celexa today and start nortriptyline tomorrow, a tiny bit of Celexa will still be in you, along with the nortriptyline, for about a week. You may have no reaction to the combination or you may get odd symptoms. Please keep those daily notes throughout this period, post at least 24 hours of notes at a time.

I am posting notes now. Please let me know if you think I should stop Celexa and get back on Nortriptyline! I have to call my doc to get more. 

[Altostrata]

If Celexa doesn't help or makes your symptoms worse, and nortriptyline helped at the beginning, before the dosage ramped up, common sense would suggest you take a lower dose of nortriptyline.

 

If you think Celexa is helping, stay on Celexa. Your symptom pattern is the only way you can figure out what to do. You're the expert on what symptoms you feel.

 

Yes, stop jumping around. Be methodical.

[Shelton]

8 minutes ago, Altostrata said:

If Celexa doesn't help or makes your symptoms worse, and nortriptyline helped at the beginning, before the dosage ramped up, common sense would suggest you take a lower dose of nortriptyline.

 

If you think Celexa is helping, stay on Celexa. Your symptom pattern is the only way you can figure out what to do. You're the expert on what symptoms you feel.

 

Yes, stop jumping around. Be methodical.

 

TUESDAY 09/15

 

11:30pm-6:30am - did not sleep - PGAD/anxiety and insomnia bad

 

6:00am - took .125mg Ativan - made my heart race and made me anxious (not sure if it’s because it was on an empty stomach)

 

6:30am-8:30am - slept

 

8:30am - woke up feeling hungover, little nauseous, tired, anxious

 

9:00am-12:15pm - exhausted/fatigued/cant concentrate, PGAD 6/10

 

9:30am - took Celexa 

(anxiety during this time - PGAD 8/10)

 

12:30pm - ate lean cuisine

 

1:30pm - took .125mg Ativan & took a shower - PGAD 6/10

 

3:00pm - therapy appt - PGAD 6/10

 

4:00-7:00 - PGAD 6/10 - sleepy, having a hard time forming sentences? Remembering conversations?

 

7:30pm - ate grilled chicken pita - sleepy

 

8:30pm - PGAD 7/10

 

9:30pm-2:15am - slept with some intermittent waking up 

 

WEDNESDAY 09/16

 

2:30am-5:30am - cortisol anxiety? Very tight chest, heart racing, anxiety like crazy - PGAD 4/10

 

5:30am - took .125mg Ativan - felt more anxious but fell then fell asleep

 

7:30am - woke up with anxiety, tight chest, heart racing, anxiety - PGAD 2/10

 

9:00am - ate egg white muffins

 

9:30am - took Celexa - still super anxious

(sleepy but super anxious - having a hard time concentrating on anything other than withdrawal and OCD intrusive thoughts)

 

12:00 - super shakey/anxious - PGAD 3/10 - ate a sandwich 

 

12:30 - showered, anxiety calmed down - sleepy

 

1:30pm - took .125mg Ativan 

(sleepy but anxious during this time. Achey/mild akathisia? legs)

 

overall feeling of unwell like I’m dying. 
 

 

2:30pm - PGAD 5/10

 

 

[Shelton]

34 minutes ago, Altostrata said:

If Celexa doesn't help or makes your symptoms worse, and nortriptyline helped at the beginning, before the dosage ramped up, common sense would suggest you take a lower dose of nortriptyline.

 

If you think Celexa is helping, stay on Celexa. Your symptom pattern is the only way you can figure out what to do. You're the expert on what symptoms you feel.

 

Yes, stop jumping around. Be methodical.

I have been on Celexa for a week. Looking back at my journal, when I was on Nortriptyline, I could show emotions and had windows during the afternoon where I felt like my nervous system was calm but would get waves of anxiety. I had some funky side effects like sweating, crazy dreams and heart racing. I also noted that I had flu like symptoms, belly aches/no appetite, body aches, sleepy but looking back, may have been withdrawal symptoms?

 

With Celexa, not many flu like symptoms just the restless legs and PGAD bad again.

 

On higher doses of Amitriptyline/Nortriptyline, I was able to nap, PGAD calmed a lot but had increased heart rate that was scary. 

 

On lower doses, PGAD was calmed (not gone) but still dealt with withdrawal symptoms.

 

Do you think I have given Celexa enough time to work & I should just consider it a failed reinstatement?
 

The best I have felt so far is when I took 2.5mg Lexapro (prior to SA) - for 4 hours, I felt like myself again. Then once it built up in my system, I was very sick! Vomiting, etc. So maybe L-theanine would be successful in that sense?

 

Trying to lay out all options before I changed again. 

[Shelton]

@manymoretodays @Altostrata

 

I had the worst night I’ve had thus far. Extreme doom and despair throughout my entire body. Feel overall extremely unwell. Almost like inner akathisia with doom and despair. Brain continues to burn in the back lower part? Intrusive thoughts and OCD that were unbearable. 
 

Do you think this is Ativan or Celexa? I am at my wits end. Something feels very wrong. 

[manymoretodays]

Shelton,

Were you posting above before or after your 5:30- 6 am dose of Ativan 0.5?

And why did you decide to go with that 6 hour interval with your 2 doses of Ativan .125 mg, instead of .125 mg spaced at 8 hour intervals?  

You do see how you leave a huge gap period from 1:30 pm until the next morning?  I'm seeing 2 or 3 days of your doing this now.

 

Do you think you did the .25 mg doses twice a day for more than a week?

 

I know you are at your wits end sweetie, and I'm hoping you got a bit of rest since posting.

Meticulous notes going forward.

 

No reason you couldn't try an Epsom Salt bath, that might do dual action on relaxation and PGAD discomfort.  It's one of the options for Magnesium.  And it's cheap, you can find it at most any grocers.  Just try a couple palm fulls first, in warm water.  Don't be taking the oral form, or by mouth form too.......unless it's just a small amount throughout the day.

 

Windows and Waves Patterns of Stabilization

More non-drug techniques to cope

Neuroemotions-  hair triggered, amplified everything.......and no fun at all

 

I'm hoping you have a found a bit of relief.

And I'd like if you could look around the benzo site today, a bit, especially at some of the top-pinned topics. 

Answer my questions.

And do meticulous notes, and then post a day at a time. 

 

You are in some pretty severe neuro dysregulation now.  I'm holding you tight sweetie.  None of us are quite prepared for this kind of surfing when we get here.  Just do what you can today.

 

L, P, H, and G,

mmt

 

 

I'm leaning towards Ativan as the culprit, WD including interdose WD. 

[Shelton]

14 minutes ago, manymoretodays said:

Were you posting above before or after your 5:30- 6 am dose of Ativan 0.5?

And why did you decide to go with that 6 hour interval with your 2 doses of Ativan .125 mg, instead of .125 mg spaced at 8 hour intervals?  

You do see how you leave a huge gap period from 1:30 pm until the next morning?  I'm seeing 2 or 3 days of your doing this now.

I am not doing this! I’m taking it 3x’s a day at .125mg. I try for 5:30am, 1:30pm and 9:30pm. So sorry I missed that note! 

 

15 minutes ago, manymoretodays said:

Do you think you did the .25 mg doses twice a day for more than a week?

No. It was very inconsistent so some days I wouldn’t take it at all, other days it would be .25mg twice a day! I didn’t know any better 😭

 

19 minutes ago, manymoretodays said:

You are in some pretty severe neuro dysregulation now.  I'm holding you tight sweetie.  None of us are quite prepared for this kind of surfing when we get here.  Just do what you can today.

Thank you so much 😭 is it best to just stay the course of my medications and try to stay calm? There have been times it’s so bad I just wanted to go to the hospital. I’ve never been so sick in my life. 

[Shelton]

22 minutes ago, manymoretodays said:

Were you posting above before or after your 5:30- 6 am dose of Ativan 0.5?

 After!

[manymoretodays]

Okay!  I did not see the 9:30 pm dose in any of your notes.  I'm glad you are on the 3.75 mg daily too, I was really worried about that.......that you could have potentially cut your dose down by 50% AND were doing some weird spacing.  On the upside, I got a good study period of benzo tapering, and Ativan properties and all that in).

 

I'll fix your signature too, you might have noticed what I put there, in purple.

 

Popping back for a second too. 

I think it was me, I'd go with ditching the trial of Celexa now too........working on getting what you need to go low, low, with another trial of the nortryptiline.

We're recommending you start really low this time.  Lower than where you left off.  I'm just checking for what Alto had suggested.

 

And okay. 

1.  it comes in 10 mg per 5 mL

On 9/16/2020 at 12:42 PM, Altostrata said:

You can add theanine after you make sure 0.5mg nortriptyline agrees with you. Change only one thing at a time.

 

2. So then .5 mg is going to be just .25 mL when you draw it up in your syringe.

 

And phew......I'm happy to hear that,  on the benzo,  but quite easy to see how I was mistaken, as I wasn't seeing it in your notes.

Rooting for you!!!!

 

We do have a topic on L-theanine too, some mixed results with it......but here that is, if you haven't found it yet:  L-theanine for anxiety, insomnia

 

 

 

 

Edited September 17, 2020 by manymoretodays

[manymoretodays]

28 minutes ago, Shelton said:

Thank you so much 😭 is it best to just stay the course of my medications and try to stay calm? There have been times it’s so bad I just wanted to go to the hospital. I’ve never been so sick in my life. 

 

I know. 

 

I remember. 

 

I'd go with the nortryptiline.  It isn't going to be instantly magical, but I did well just trusting Alto's wisdom, when I got here and it served me well.

 

And then ......stay steady.    Meticulous observations.  Sheesh, you are not different from most, shortly after arrival.  I tinkered and monkeyed around for a couple of weeks......could barely put words together, etc.   And then it all kind of fell together, and it took awhile, but the cognition and organization all improved.   AND......the worst of the waves too.  I was pacing and clutching pillows some nights and even days. 

 

I thought it was going to all clear up in a couple of weeks.  Frankly, I was glad to hear that may not be the case, for me, and cut myself some slack in expectations of myself.

The hospital is going to be the hospital....... you can do this!!!!

 

[Altostrata]

Do you feel better or worse after you take Ativan? How often do you feel this increased heart rate? Please include this in your daily notes.

 

Your recent drug history has so many changes, we can't tell what's going on. You're going to have to ride out one-off weird symptoms, like the doom you felt last night. You've still got some Valium in you, you've been taking Ativan inconsistently, and it's unclear what Celexa is doing, if anything.

 

Still need to see those daily notes.