dadtobe: Klonopin, escitalopram, alcohol, Novocaine - need advice

[dadtobe]

Looking for some advice on what I should do with my Escitalopram (technically taking Escitalopram but Lexapro is easier to remember so I'm using that a lot here) dosage.. Made a lot of mistakes last week.

 

Basically I'm a short-term Klonopin user (3 months total) who had a very rough time getting off of it. I had very extreme anxiety and burning sensations where I was basically limited to a couch. I was taking it as needed, and didn't realize I was putting myself through inter-dose withdrawals every few days. Doctor said it was my anxiety returning, and then I ended up on Lexapro because of that which made me take more Klonopin. Thankfully I found this forum else I would be in an even worse place with no hope. I tapered off the Klonopin roughly 1 month ago and I felt great for 3 weeks after. However, I'm pretty sure I've screwed up my withdrawal from Klonopin or my Lexapro taper or both. I'm hoping for a second opinion to guide me in what I should do next. Long story short I knew much better but I drank alcohol only 3 weeks after jumping off Klonopin and while fast-tapering Lexapro. I tried alcohol 1 night, thought I got away with it. And got excited to feel normal again and then drank a few more times over the week 1 or 2 drinks a night. Never felt bad the next day. Roll around to last Monday. I had a dentist visit for a cavity and received novocaine (or something like it, I don't know what they gave). A few hours after the novocaine I started getting some returning anxiety. I thought nothing of it, until the next morning I woke up feeling like I was going back into acute benzo withdrawal with extreme anxiety again. I've now been in this state for 5 days.  At first I blamed myself for drinking and the novocaine, but now I've realized I've tried to taper my Lexapro too fast as well. I dropped from 9mg to basically 3mg in about a month. I know the 10% rule, I guess I just felt invisible since I was dropping fast and was a short-termer (1 month or so on 10mg when I started tapering) and seeing no withdrawal effects. 

 

My questions:

 

1) Is Lexapro withdrawal as anxiety intense as benzo withdrawal? Or do they feel the same? I have severe burning in my back / neck /arms and basically either sit in a ball, lay down, or have to pace the house.

 

2) Given that I definitely tapered Lexapro too fast, what amount of Lexapro should I updose to, to start over @ the 10% every month? If I should be updosing at all. Right now I have a pretty bad headache from going up today. I feel like I'm making all sorts of mistakes trying to fix this problem since the anxiety is pretty unbearable and unlike my previous withdrawal a few weeks ago it lasts all day with basically no windows.

 

Any help is appreciated. I left my complete notes below. But if they need to be improved let me know. 

 

5/24 - Started .5mg - 1 Klonopin as needed

7/20 - Started Lexapro 5mg (still on Klonopin)

7/27 - Lexapro 10mg

8/5 - Started tapering Klonopin stabilizing on a daily dose of .25mg

8/17 - Jumped at .065 (fast taper... but it seemed to work)

8/17 - Lexapro to 9mg (time to get rid of the next drug..)

8/29 - Lexapro to 6.5mg from 9mg (probably too fast but I had only been on Lexapro for a month so I felt like I could get away with it)

9/8-9/13 - Had alcohol all week sporadically (1 to 2 drinks) because I was feeling so much better. I tested with 1 drink, got away with it, and just kind of got excited.. ugh 

9/13 - Lexapro was down to 2.78mg (so 8/29-9/13 6.5 to 2.78mg) way too fast I know. 

9/14 - Had a dentist appointment, received probably Novocaine

9/14 - Had mild anxiety in the afternoon after Novocaine wore off

9/15 - Feels like I'm starting back into acute benzo withdrawal 

9/16 - Definitely very back into acute something, feels like Benzo withdrawal with extreme feeling of anxiety and burning sensation on skin, doing laps around the house. 

9/17 - Updosed Lexapro to 3.9mg 

9/19 - Updosed Lexapro more to 4.46mg

 

 

 

 

[Gridley]

Welcome to SA, dadtobe.

 

What you're likely experiencing in withdrawal from a too-fast taper of the Lexapro.  You could also be experiencing benzo withdrawal from your fast taper of the Klonopin.  The symptoms can be similar.  You symptoms could also be attributable to a too-high reinstatement of Lexapro, as I'll explain in my answer to your question #2.

.

3 hours ago, dadtobe said:

My questions:

 

1) Is Lexapro withdrawal as anxiety intense as benzo withdrawal? Or do they feel the same? I have severe burning in my back / neck /arms and basically either sit in a ball, lay down, or have to pace the house.

 

2) Given that I definitely tapered Lexapro too fast, what amount of Lexapro should I updose to, to start over @ the 10% every month? If I should be updosing at all. Right now I have a pretty bad headache from going up today. I feel like I'm making all sorts of mistakes trying to fix this problem since the anxiety is pretty unbearable and unlike my previous withdrawal a few weeks ago it lasts all day with basically no windows.

 

1.  This depends on the individual.  Some say SSRI withdrawal is worse, others say benzo.  Anxiety is certainly a symptom of benzo WD, but it's also typical of SSRI WD.  I've experienced anxiety at various dosages along the way down from 20mg Lexapro.

 

2. With reinstatement, we generally recommend reinstating a very small amount, much less than you reinstated Lexapro.  Reinstatement is one of those situations where more is not better, and some of your symptoms may be due to too high a reinstatement, which can be destabilizing to your system.  

What your system needs now is stability.  I would hold where you are 4.46mg Lexapro and wait to stabilize.  This can take anywhere from weeks to months.  Time is going to be the cure here.

 

Once you've stabilized, and not before, you can begin a 10% taper down to zero.

 

Why taper by 10% of my dosage?

 

Reinstatement of a very small dose of Klonopin may be a possibility.  Is this something you might want to consider? You're at the outside of the window when benzo reinstatement is best, 2 to 4 weeks after last dose.  I'm going to bring your situation  to the attention of our benzo specialist and see if she thinks this is a good idea and, if so, what dosage to reinstate.  Please don't reinstate without letting us suggest a dosage.

 

So that you'll have a better idea of what you're experiencing, whether it be benzo WD or Lexapro WD, here is some information on withdrawal and the healing process.

 

 

What is withdrawal syndrome.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

When we take psychiatric medications, the 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 the healing process really well:

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

Brain Remodelling 

 

We recommend avoiding sugar, caffeine and alcohol during withdrawal.  Regarding the novocaine, I recently had some dental work done with novocaine and noticed a definite ramping of of anxiety symptoms afterward.  It faded after a couple of days.

 

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) 

 

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

 

I sympathize about the anxiety but as time passes it should begin to fade.  Here are some links to help cope with anxiety.  I've found the restorative yoga posture to be very helpful with anxiety.

 

Audio:  How to Recover from Anxiety - Dr Claire Weekes
 

VIDEO:  Peace from Nervous Suffering - Claire Weekes (1 hour) (http://sendvid.com/vgquc1dg)
 

Anxiety Stuff - all kinds of stuff about anxiety attacks and things that help …

 

10 minute Restorative Yoga for Relaxation | Up the wall

 

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

 

 

 

 

 

Edited September 19, 2020 by Gridley

[Shep]

5 hours ago, dadtobe said:

I tapered off the Klonopin roughly 1 month ago and I felt great for 3 weeks after. However, I'm pretty sure I've screwed up my withdrawal from Klonopin or my Lexapro taper or both. I'm hoping for a second opinion to guide me in what I should do next. Long story short I knew much better but I drank alcohol only 3 weeks after jumping off Klonopin and while fast-tapering Lexapro. I tried alcohol 1 night, thought I got away with it. And got excited to feel normal again and then drank a few more times over the week 1 or 2 drinks a night. Never felt bad the next day. Roll around to last Monday. I had a dentist visit for a cavity and received novocaine (or something like it, I don't know what they gave). A few hours after the novocaine I started getting some returning anxiety. I thought nothing of it, until the next morning I woke up feeling like I was going back into acute benzo withdrawal with extreme anxiety again. I've now been in this state for 5 days.  

 

5 hours ago, dadtobe said:

8/17 - Jumped at .065 (fast taper... but it seemed to work)

8/17 - Lexapro to 9mg (time to get rid of the next drug..)

8/29 - Lexapro to 6.5mg from 9mg (probably too fast but I had only been on Lexapro for a month so I felt like I could get away with it)

9/8-9/13 - Had alcohol all week sporadically (1 to 2 drinks) because I was feeling so much better. I tested with 1 drink, got away with it, and just kind of got excited.. ugh 

 

Welcome to SA, dadtobe. 

 

I've highlighted a few sentences in purple that I'd like to discuss. It looks like the fast taper off Klonopin destabilized your nervous system. The rapid tapering of Lexapro right after the Klonopin jump exasperated this destabilization. So by the time you added in alcohol at that 3 week mark, your nervous system let you know it was too much, too soon. 

 

I'm a bit confused about this part:  "I woke up feeling like I was going back into acute benzo withdrawal."  Please let us know more about your benzo taper experience. From what you've written, it sounded like you didn't have a lot of symptoms from when you came off Klonopin until you had some alcohol three weeks later. Please let us know more about your symptoms during your benzo taper and in the following three weeks before the alcohol - this is important information that will help determine whether or not to reinstate a small amount of benzo. 

[dadtobe]

@Shep

 

Thanks for the fast responses. What you guys do is amazing.

 

As far as my Klonopin history.

 

I had a panic attack back in May and on May 24th my PCP provided me 60 1mg tablets of Klonopin and told me to take 1mg in the morning and 1mg at night. Basically my first ever panic attack as an adult and I'm in my late 30s. After taking just 1mg a couple times it literally knocked me out for 15 hours. Which is probably what I needed at the time, but I knew the dose was too strong. I asked my PCP if I could just take it as needed which ended up being .5mg roughly every 3 days.

 

After about a month of this, I was basically fighting not to take Klonopin and would have to give in every 2-3 days and take another .5mg. I was basically confined to the couch at this point, unable to work. Sometimes I would take 1mg if on day 2-3 the anxiety was really intense. By intense I mean intense burning all over my body, I was waking up in the morning with extreme anxiety / burning and if I laid in bed too long it'd only get more intense. I kept trying to not have to take Klonopin because I knew it could cause dependency. 

 

I asked my PCP about a month in if he thought it was dependency / withdrawal since by that time I was no longer in panic and he said no, it's the anxiety returning (I'm sure you've heard this story a 1000x) and to keep taking it. I was able to quit cold turkey for about a week at around the 1 month mark after about a week of suffering. During this time I ended up contacting a psychiatrist because I didn't believe my PCP anymore, and unfortunately he backed up the PCP and said it's my anxiety returning as well and convinced me to go on Lexapro. This also convinced me I could still take the Klonopin so when the anxiety returned again I reinstated. 

 

When I started Lexapro the side-effects of nausea, headaches, and more anxiety got really intense and I started taking more Klonopin and having breakdowns way easier over things I'd normally never be triggered by. I tried to go cold turkey again on Klonopin on August 2nd, and could only last 2 days before I was in so much pain and anxiety (severe burning all over my body) I had to re-instate.

 

I read something that said I should stabilize on a daily dose instead of doing as needed, so I stabilized at .25mg which at the time I was averaging about .324mg a day (I took a total of 24mgs over a 74 day period roughly?). This made me practically normal again and was a huge game changer. From here I quickly tapered after I got stable. Once I jumped, I actually had really no symptoms at all other than some slight anxiety a week in and I felt almost back to normal for 3 weeks until obviously drinking.

 

Hope that all makes sense now. I had tons and tons of symptoms on Klonopin, I think mostly caused by putting myself into inter-dose withdrawal all the time. If I had to guess how I got so sensitive I think the high doses of Klonopin on top of taking it as needed really just messed me up. And then throwing Lexapro at me which caused those symptoms to be more severe for a month while going on it. 

 

For symptoms now... I have the burning back, chest and the intense anxiety most of the day for the past 7 days (including today). My arms feel weak. My mind is clear though so I know it's not related to an actual stressor. As of the past 2 days I'm getting the stomach rumbling again when I wake up in the morning which I was getting when on Klonopin, which basically makes me have to get out of the bed and eat. I'm getting almost a full nights sleep although I woke up at 1AM last night and had to take a Unisom to go back to sleep.

 

During the day I'm basically bed ridden / couch ridden until about 4-5pm when things let up slightly. I'm on day 7 of this. The main difference this time from when I was on Klonopin is that usually I'd get windows, and that by day 3-4 off it would be most intense and then subside. This time it doesn't feel like it's subsiding at all. It feels to me like maybe the alcohol gave my brain a taste of what it wanted, and now it won't reset until I give it what it wants and taper off again. I'd really hate to re-instate after being so proud of being off for over a month.

 

 

 

 

Edited September 20, 2020 by Shep
added paragraph breaks for readability

[dadtobe]

12 hours ago, Shep said:

 

 

I've highlighted a few sentences in purple that I'd like to discuss. It looks like the fast taper off Klonopin destabilized your nervous system. The rapid tapering of Lexapro right after the Klonopin jump exasperated this destabilization. So by the time you added in alcohol at that 3 week mark, your nervous system let you know it was too much, too soon. 

 

I'm a bit confused about this part:  "I woke up feeling like I was going back into acute benzo withdrawal."  Please let us know more about your benzo taper experience. From what you've written, it sounded like you didn't have a lot of symptoms from when you came off Klonopin until you had some alcohol three weeks later. Please let us know more about your symptoms during your benzo taper and in the following three weeks before the alcohol - this is important information that will help determine whether or not to reinstate a small amount of benzo.  So I tried to quit Klonopin several times and had serious withdrawals going cold turkey (mainly intense anxiety / burning sensations). After I tapered and jumped I had still had mild anxiety but it was very tolerable, I was basically normal for 3 weeks after my jump. I didn't keep a good record of this time as far as symptoms, however I wrote I had afternoon anxiety on 9/1 and anxiety on 9/2 which was about 2 weeks after my jump. But that ended on 9/3. I wouldn't have wrote that unless it was very noticeable. But ya, I mean it wasn't much... After stabilizing on daily Klonopin it made a big difference. 

 

[dadtobe]

I wanted to add, my taper schedule when I went off Klonopin was

 

.25mg for 5 days,

.18-.2 for 5 days,

.125 for 1 day

.065 for 1 day

Jumped...

 

 

[Shep]

6 hours ago, dadtobe said:

 I asked my PCP if I could just take it as needed which ended up being .5mg roughly every 3 days. After about a month of this, I was basically fighting not to take Klonopin and would have to give in every 2-3 days and take another .5mg. I was basically confined to the couch at this point, unable to work.

 

 

6 hours ago, dadtobe said:

Hope that all makes sense now. I had tons and tons of symptoms on Klonopin, I think mostly caused by putting myself into inter-dose withdrawal all the time.

 

Yep, I completely agree - sounds a lot like interdose withdrawal and possibly some rebound symptoms. 

 

6 hours ago, dadtobe said:

When I started Lexapro the side-effects of nausea, headaches, and more anxiety got really intense and I started taking more Klonopin and having breakdowns way easier over things I'd normally never be triggered by. I tried to go cold turkey again on Klonopin on August 2nd, and could only last 2 days before I was in so much pain and anxiety (severe burning all over my body) I had to re-instate.

 

I read something that said I should stabilize on a daily dose instead of doing as needed, so I stabilized at .25mg which at the time I was averaging about .324mg a day (I took a total of 24mgs over a 74 day period roughly?). This made me practically normal again and was a huge game changer. From here I quickly tapered after I got stable. Once I jumped, I actually had really no symptoms at all other than some slight anxiety a week in and I felt almost back to normal for 3 weeks until obviously drinking.

 

6 hours ago, dadtobe said:

I'm getting almost a full nights sleep although I woke up at 1AM last night and had to take a Unisom to go back to sleep.

 

Dadtobe, the fact that you're sleeping is great. I know you're struggling during the day, but I would not reinstate the Klonopin at this point. If you weren't sleeping, it might be worth it, but it really sounds like being on Klonopin was the problem (at least the periodic use). 

 

Please note that alcohol hits the same GABA receptors as benzos, so I would abstain from alcohol for a very long time. 

 

Please be careful of using OTC drugs like Unisom. They tend to turn paradoxical and can also cause dependency problems. 

 

6 hours ago, dadtobe said:

During the day I'm basically bed ridden / couch ridden until about 4-5pm when things let up slightly. I'm on day 7 of this.

 

7 days ago, you were down to 2.78 mg Lexapro before updosing. Did you feel better on the lower dose of Lexapro? 

 

What time of day do you take Lexapro? Are you taking any other drugs or supplements? 

[dadtobe]

7 days ago, you were down to 2.78 mg Lexapro before updosing. Did you feel better on the lower dose of Lexapro? 

 

I did not, I put a chart together of my Lexapro taper with symptoms. I should have done this originally that's why I decided to updose Lexapro thinking maybe I got a little excited to get off the Lexapro now that I was feeling better and cut too fast (I'm a short-termer so I just didn't think I could possibly be that dependent yet). I think right now my days are gradually getting slightly worse. I'm keeping an all day symptom chart now. As in I'm in a lot of anxiety and pain right now, no appetite today, and starting to get the GI issues coming back. Also my sleep I woke up at 1AM last night. Hopefully I sleep through the night tonight. But it definitely feels like the times I tried to quit cold turkey from Klonopin but the burning isn't quite as intense so while extremely uncomfortable it's tolerable to hold for now, but if it's like this for months I don't know if I could handle it. I'm just so confused, when I finally got off Klonopin I was completely fine. To be suffering these symptoms for this long after having alcohol. 

 

 

 

What time of day do you take Lexapro? Are you taking any other drugs or supplements?

 

 In the morning usually an hour or so after I wake up.  I did have a marijuana gummy mid last week and melatonin but I can't remember which days. I was kind of switching between unisom, melatonin and marijuana as needed for sleep for the exact reason you mentioned that they can be addictive and frankly I'm anti-everything now. I'm cutting them all out now until this feeling subsides for sure! 

Edited September 21, 2020 by ChessieCat
reversed bolding

[dadtobe]

@Shep

Just slept for about 1 and a half hours. Woke up to intense burning / anxiety already. I took a cold shower and now my body is shaking uncontrollably. What are the potential consequences of reinstating at this point? And what would I reinstate to? I have a feeling tomorrow if I'm able to sleep again is going to be a lot worse than today. Not sure I'm even going to have a choice whether I reinstate this is getting pretty crushingly bad. Also, is there anything I can take for sleep? Marijuana puts me to sleep the best, unisom 2, melotonin 3. I also have access to a Doctor.

[dadtobe]

I should also add, what would the strategy be if I do reinstate?

[dadtobe]

16 hours ago, Shep said:

7 days ago, you were down to 2.78 mg Lexapro before updosing. Did you feel better on the lower dose of Lexapro? 

 

What time of day do you take Lexapro? Are you taking any other drugs or supplements? 

 

Just realized I misread your ?, I felt better, but it was also the beginning stages of the anxiety returning, so not sure if I would feel better back at the lower dose now. I probably should have held. 

[Shep]

16 hours ago, dadtobe said:

I did have a marijuana gummy mid last week and melatonin but I can't remember which days. I was kind of switching between unisom, melatonin and marijuana as needed for sleep for the exact reason you mentioned that they can be addictive and frankly I'm anti-everything now. I'm cutting them all out now until this feeling subsides for sure! 

 

How often were you taking these sleep aids? Were you taking something every night and alternating them around? 

 

7 hours ago, dadtobe said:

I should also add, what would the strategy be if I do reinstate?

 

You jumped off at .065 mg a little over a month ago, so you could try .03125 mg and see how you feel. .03125 mg is 1/8 of a .25 mg pill. 

 

24 minutes ago, dadtobe said:

Just realized I misread your ?, I felt better, but it was also the beginning stages of the anxiety returning, so not sure if I would feel better back at the lower dose now. I probably should have held. 

 

I'm not sure whether to advise reinstating a small amount of the Klonopin or whether to advise reducing the Lexapro a bit. 

 

Did going on Lexapro cause upticks in anxiety? I know it may be hard to parse through because you were also dealing with the Klonopin issues. What is your gut feeling about this?

[dadtobe]

@Shep

 

Yea going on Lexapro was miserable, increased anxiety for sure but I was also trying to quit Klonopin at the same time, but I was definitely taking more Klonopin while going onto Lexapro. I literally just took my Lexapro dose for today at the same amount as yesterday so kind of stuck now. My gut is telling me I probably screwed this up with the booze and then should have held the Lexapro when I noticed symptoms.  Now I might be dealing with going back up on Lexapro enhancing the negative effects of basically kindling Klonopin with alcohol. I'm going to really try to resist taking Klonopin. I'm just in a massive amount of pain and anxiety. Last night I only got 2 hours of sleep and had a lot of nausea. When it really hits it's certainly hard not to want to feel some relief. In general, how long do people stay in these states for? Any idea? I guess I just wonder if I'm towards the end of this hell, or if it's the beginning. But I'm assuming no one knows. 

 

How much would you suggest I lower my Lexapro dose if I decide to go down now? I'll try lowering it tomorrow if I resist the urge to re-instate Klonopin today.

[dadtobe]

1 hour ago, Shep said:

How often were you taking these sleep aids? Were you taking something every night and alternating them around? 

 

I'm alternating them around as needed. I don't take something to sleep every night and haven't really been taking them that often the past 3-4 weeks. Unisom past 2 nights, but if you tell me don't even do that I won't.  

[dadtobe]

@Shep

 

Let me know what you think of this plan. Last time I came off Klonopin 4ish weeks ago, the first 3 weeks I was fine after jumping but I did a rapid taper. I drank coffee, booze, and went to dentist.  4th week I was hit hard by withdrawal. Not sure if it was triggered by my actions or if there could have been delayed withdrawal? If delayed withdrawal exist that might bust a hole in my plan. However, I'm fairly confident it's benzo withdrawal I'm in. I shouldn't have bumped up the Lexapro when I had withdrawal symptoms as I might have tolerable symptoms right now if I hadn't done that. So... I think I need to stabilize on Lexapro, but that's going to be very challenging going through Benzo withdrawal at the same time as holding this higher dose of Lexapro. I basically won't feel good until the Lexapro is no longer giving me side-effects. I'm a little over 30 days off Klonopin. So I'm above where you'd recommend to reinstate so I might be rolling the dice here? But my thoughts are to reinstate at the 1/8th of .25mg and hold Klonopin a bit until withdrawal symptoms subside and then maybe taper again, while I hold Lexapro for a couple months at same dose. Then I'll do a proper taper of Lexapro at 10% of a month. Do you think this is a good plan? 

 

I think the main things are, if I can be thrown into this acute withdrawal again because it's delayed onset then that doesn't sound ideal to reinstate. I know reinstate comes with a risk that the next withdrawal may be even worse. I can't imagine what worse than this is.

 

[dadtobe]

Couldn't handle it, reinstated the Klonopin @ .03125 mg. 

 

To be clear, I took .065 mg for only 1 day, as well as .125 mg for only 1 day. before that it was 5 days of .18-.20 (I was eyeballing it before my scale arrived) and 5 days of .25. I kind of went very fast at the end. Is this re-instatement amount flexible if I don't feel anything? 

[dadtobe]

Shockingly that small of a dose has probably eliminated 70% of the burning sensation for the last 4 hours and was able to get a couple hours of sleep. I feel the best I have in 8 days. I had to get up to eat because my appetite is back. I guess I need to know how I should taper now from both Lexapro and Klonopin. Thanks for all the help again. Sorry for all the spam of forum posts. Hopefully this works out! 

[dadtobe]

Ugh, can't win. Spoke too soon. Everything is back now at 3AM. Felt good from 9PM to 1AM. Just threw up Cheerios and milk and an Ensure I had at 1AM. Maybe the Ensure has too many vitamins or something? All the symptoms are back full force. Got a good 3ish hour window after taking the reinstatement. Can I go up to .065mg?

[dadtobe]

Feeling a little better. I'm light-headed and still a little bit nauseaous. Took Pepto Bismol. Burning sensation right now is definitely a lot less intense than yesterday. Which will make today much more tolerable. I think either when I dose again tonight or if I can go up to .065mg I'll feel pretty back to normal other than the nausea which might be caused by going up on the Lexipro too quickly or drinking the Ensure. Seems like that might have revved me up for a bit. 

 

[dadtobe]

Alright last post, hopefully you have time to respond today. Unfortunately I can't edit my old posts else this would be one post. Any suggestions on holding Lexapro now that I've reinstated Klonopin? You suggested maybe going down a little bit and see if that helps?  I know we just restarted Klonopin. 

[Shep]

22 hours ago, dadtobe said:

 

I'm alternating them around as needed. I don't take something to sleep every night and haven't really been taking them that often the past 3-4 weeks. Unisom past 2 nights, but if you tell me don't even do that I won't.  

 

Yes, I would stop these. They tend to turn paradoxical. Also, since you're reinstating the benzo, you'll want to limit other drugs, even OTC drugs. Please see:

 

The rule of 3KIS: Keep it simple. Keep it slow. Keep it stable.

 

Your nervous system is fighting for stability right now and throwing random chemicals into the mix can confuse your system. Slow, gentle, and one change at a time works best.

 

12 hours ago, dadtobe said:

Couldn't handle it, reinstated the Klonopin @ .03125 mg. 

 

7 hours ago, dadtobe said:

Shockingly that small of a dose has probably eliminated 70% of the burning sensation for the last 4 hours and was able to get a couple hours of sleep. I feel the best I have in 8 days. I had to get up to eat because my appetite is back.

 

6 hours ago, dadtobe said:

Ugh, can't win. Spoke too soon. Everything is back now at 3AM. Felt good from 9PM to 1AM. Just threw up Cheerios and milk and an Ensure I had at 1AM. Maybe the Ensure has too many vitamins or something? All the symptoms are back full force. Got a good 3ish hour window after taking the reinstatement. Can I go up to .065mg?

 

3 hours ago, dadtobe said:

Feeling a little better. I'm light-headed and still a little bit nauseaous. Took Pepto Bismol. Burning sensation right now is definitely a lot less intense than yesterday. Which will make today much more tolerable. I think either when I dose again tonight or if I can go up to .065mg I'll feel pretty back to normal other than the nausea which might be caused by going up on the Lexipro too quickly or drinking the Ensure. Seems like that might have revved me up for a bit. 

 

I quoted the posts where you listed your Klonopin reinstatement experience. 

 

A suggestion - stay with the .03125 mg for another day and see how you do. Also, please don't make any changes to the Lexapro.

 

You're right about the Ensure. It has a ton of stuff in it that may have caused problems. It's good you're catching these kinds of things. Try to stay away from processed foods, alcohol, large amounts of caffeine (if you already have a coffee habit, please don't make any abrupt reductions that could create another withdrawal), etc. The cleaner your diet, the better. Also make sure you're drinking plenty of water every day and staying hydrated. 

 

For tips on sleeping:

 

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

 

Perhaps wind down in the evening with a guided meditation. There are a ton of these on YouTube. Here's one to get you started:

 

Guided Meditation Deep sleep | anxiety and insomnia relief | relaxation before bedtime video (21 minutes)

 

It's going to take time to stabilize, so please work with the non-drug coping skills to get you through. 

 

Non-drug techniques to cope with emotional symptoms

 

Mindfulness, yoga or gentle stretching, listening to soft music, working a jigsaw puzzle, etc. can all be helpful to settle the mind and body before trying to sleep. 

 

Again, please stay with the .03125 mg Klonopin for another day and let us know how you're doing tomorrow morning.

[dadtobe]

OK will do, thanks again. Taking Lexapro now. 

[dadtobe]

?, if you don't mind me asking, what's the issue with going on a higher dose of Klonopin right now? I guess how do we come up with the amount you want me to take.

 

Took Tylenol for back pain. All the walking around the house has started to cause it to hurt. 

[dadtobe]

Solving my own questions I think. Kindling is the reason why we want such a low dose?

 

 

[dadtobe]

First 2 and a half hours after  taking .03125 mg. It has made me light headed and hasn't really alleviated any symptoms this time around. It actually made me feel a bit more revved up the first hour or so. Haven't been able to sleep at all. Still have some burning in my arms, chest, back. 

[dadtobe]

Fell asleep for half a second, woke up sweaty and now even more euphoric feeling. It's very uncomfortable. Same way how I felt yesterday when I thought it was the Ensure.

[dadtobe]

Burning pain is somewhat tolerable now. Trying to stay awake and burn the euphoric feeling off. I feel like if I do this I won't get nauseous like last night.

[dadtobe]

11:34PM - Feeling better, not as amped up

12:42AM - Slept for a sec, maybe an hour maybe less.. Woke up feeling amped up and dizzy again. Mild headache, some trembling

1:55AM - No change

2:38AM - Got a tiny bit more sleep

3:28AM - Feels like electricity is running through me full-time. 

[dadtobe]

6:05AM still very amped up. 
I had a strawberry banana smoothie for dinner with lowish sugar last night and mac and cheese midday yesterday. Don't think those could have triggered this.
This literally all started within 1 hour after I took the Klonopin
 

[dadtobe]

Starting to get anxiety returning, burning on my back and arms. Still revved up as well. Sigh. Does this mean the re-instatement probably isn't working? What do you advise as next steps? Anything I can take for sleep or is everything pretty much off limits? I have access to a Doctor.

[Shep]

21 hours ago, dadtobe said:

?, if you don't mind me asking, what's the issue with going on a higher dose of Klonopin right now?

 

Your history of problems with Klonopin in the past may indicate this drug doesn't agree with you, so it's best to start small and increase if needed. Also, you were off Klonopin long enough for the drug to be well out of your system and you reported not having an withdrawal symptoms. You can check out the half-life of Klonopin using this half-life calculator:

 

Drug Half-Life Calculator

 

Klonopin's half-life is 18 - 50 hours, depending on how quickly you metabolize it. Even at the 50 hour rate, the drug is out of your system completely in 14 days. So if you weren't having any symptoms for a couple of weeks after that, I'm wondering if it's really the Klonopin causing the problems. 

 

Your symptoms started after drinking alcohol and then the dental work. So your nervous system is definitely compromised, but I'm wondering if you may be having more problems from a too-high Lexapro updose. Please see this thread on reinstatement which also gives a good explanation of why too high a reinstatement (and in your case, an updose) can cause problems:

 

About reinstating and stabilizing to reduce withdrawal symptoms

 

You mentioned kindling and yes, you are correct to be concerned. According to the reinstating thread:

 

On 10/8/2012 at 7:17 PM, Altostrata said:

• Often a very low dose will relieve withdrawal symptoms. If, for example, you were taking 20mg Paxil and quit rapidly or cold-turkeyed only a few days ago, 5mg may be enough. After trying the lower dose for a week, you can always increase if you feel you need more. If you've been off the drug longer, your nervous system may be sensitized and it may be wiser to try a sample dose, such as 0.5mg-1mg, to see how you react.
• Avoid kindling, start low to see what you need. You can always increase if necessary. If you've been off the drug for a month or more, many people can find some relief from withdrawal symptoms by reinstating as little as 0.5mg-1mg for 20mg citalopram, for example. Do not start at a high dose, your nervous system may be sensitized by withdrawal and you may your symptoms much worse, which is called kindling

 

 

This is from the Tips for tapering off escitalopram (Lexapro) thread: 

 

On 5/26/2011 at 10:16 PM, Altostrata said:

A significant characteristic of Lexapro is that milligram for milligram, it is much stronger than other SSRIs. Chemically, Lexapro is a variation of Celexa; the molecule was re-engineered to be patentable as Celexa's patent was about to expire. The streamlined molecule is a more potent SSRI, 2 to 4 times stronger than others. (Wikipedia has a good explanation of this at https://secure.wikimedia.org/wikipedia/en/wiki/Escitalopram.)

 

As you can read, it's a VERY potent drug. 

 

1 hour ago, dadtobe said:

6:05AM still very amped up. 
I had a strawberry banana smoothie for dinner with lowish sugar last night and mac and cheese midday yesterday. Don't think those could have triggered this.
This literally all started within 1 hour after I took the Klonopin
 

 

This sounds like a paradoxical reaction to the Klonopin. How do you feel after you take Lexapro? 

 

Please go ahead and start a daily drug and symptoms journal so we can take a look at your symptoms within the context of when you take your drugs. Please see the below quote for how to do this. Include any supplements, OTC meds, and the name, dose, and time(s) you take each of your drugs. 

 

The goal is to see if you might benefit from reducing the Lexapro as opposed to continuing on with the Klonopin reinstatement. Please note that it takes 4 days for your nervous system to register and change and a week or longer for your nervous system to adjust to the change, so reinstatements can take awhile to work. 

 

On 9/27/2016 at 2:49 PM, Altostrata said:

In the course of discussion in your Introductions forum topic, you may be asked to keep notes on paper of your daily symptom pattern, including when you take your drugs, their dosages, and any symptoms. We ask this because there may be something we can do to reduce the symptoms.

 

What we need to see for every single day over several days is what symptoms you get before and after you take your drugs. If you're not taking any drugs and have withdrawal symptoms, we still need to see your symptom pattern throughout the day:

 

The time of day, dosage, and severity of symptoms are essential information. Include

 

- Time and dosage for all drugs taken throughout the day, psychiatric and non-psychiatric.

- Following each dose, note any symptoms. If you are having a reaction to the drug, it may take hours for a symptom to show up -- that's why we ask you to keep notes all day long.

- If you're not taking any drugs, your symptoms throughout the day.

- Your sleep pattern. Since so many drugs disturb sleep, if you find you're waking in the middle of the night, it could be from a drug you took earlier in the evening. If you're not taking any drugs, there may be ways you can improve your sleep.

And so forth. A diary, in chronological order, looking something like this:
 

Example:

DATE:

 

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

 

[dadtobe]

Hi @Shep

 

Hopefully catching you before you go.

 

Are you saying I should continue with the same dose of Klonopin or just stop now? If taking the same dose, can I take it a couple hours earlier?  The goal being that the intense energy it has been giving me will hopefully be when I'm awake and not when I want to sleep. If you're saying it takes 4 days for a re-instatement to start working then maybe I'm best going for it? The paradoxical reaction is pretty horrible for me. This is really challenging to decide whether to push forward or not. 

 

When I was on Klonopin I was taking as needed and quit once for a week. I had the same sensations and issues I'm getting right now. But if SSRI's are the same it could be that. I took Lexapro consistently though and started tapering after only being on it for 1 month. I really feel my dosing w/ the Klonopin is to blame for my sensitivity. But it's impossible to be 100% sure.

 

After I take Lexapro I'm usually a bit sweaty. But it hasn't been too bad recently. When I updosed, I went back to where I was 2 weeks ago.

 

Is there anything you'd recommend for sleep? Seems Marijuana, Unisom and Melatonin are all out of the ?

[Shep]

20 minutes ago, dadtobe said:

Are you saying I should continue with the same dose of Klonopin or just stop now? If taking the same dose, can I take it a couple hours earlier?  The goal being that the intense energy it has been giving me will hopefully be when I'm awake and not when I want to sleep. If you're saying it takes 4 days for a re-instatement to start working then maybe I'm best going for it? The paradoxical reaction is pretty horrible for me. This is really challenging to decide whether to push forward or not. 

 

 

Yes, you could take it earlier. 

 

25 minutes ago, dadtobe said:

When I was on Klonopin I was taking as needed and quit once for a week. I had the same sensations and issues I'm getting right now. But if SSRI's are the same it could be that. I took Lexapro consistently though and started tapering after only being on it for 1 month. I really feel my dosing w/ the Klonopin is to blame for my sensitivity. But it's impossible to be 100% sure.

 

That's a huge part of the problem - SSRI and benzo withdrawal are extremely similar in their symptoms. SSRIs can have a delayed withdrawal of several months, which isn't seen a lot with benzos, but the actual symptoms are almost identical. See my post here:

 

Which is more difficult to withdraw - ssri vs. benzo?

 

However, since you're making some connections between the benzo and your symptoms, you could continue on for a day or two more and see if it gets better. Usually with benzos, people get some form of relief sooner rather than later. If it doesn't get any better over the next few days, I would stop the reinstatement, especially if the paradoxical reactions continue and make your sleep worse. 

 

29 minutes ago, dadtobe said:

After I take Lexapro I'm usually a bit sweaty. But it hasn't been too bad recently. When I updosed, I went back to where I was 2 weeks ago.

 

Is the sweaty feeling a new symptom or was this a side effect you've always had with this drug? 

 

29 minutes ago, dadtobe said:

Is there anything you'd recommend for sleep? Seems Marijuana, Unisom and Melatonin are all out of the ?

 

Please don't add anything right now. It's important to know how the Klonopin reinstatement is working. You don't want to mask the symptoms of a reinstatement. Also, the more you dampen down your nervous system with sedating supplements, the more likely you'll have a paradoxical reaction.

 

Later on, you may want to add in some magnesium and fish oil (although do this one at a time). But for now, let's do one change at a time and see how the Klonopin affects you.

 

As you post your daily drug and symptoms journal, it will provide guidance on how to proceed. 

[dadtobe]

23 minutes ago, Shep said:

Is the sweaty feeling a new symptom or was this a side effect you've always had with this drug? 

 

It was like that when I went on the drug. But also I think I'm just sweating because of Benzo w/d. 

 

25 minutes ago, Shep said:

As you post your daily drug and symptoms journal, it will provide guidance on how to proceed. 

 

I've started my journal

 

[dadtobe]

Daily log

 

9/23

8:31AM - Took 500mg of Tylenol for mild headache

8:41AM - Ate bowl of plain cheerios and milk

9:16am - Took Lexapro 4.46mg

9:24am - No major burning on body. Still a bit amped up though.

11:23am - Burning neck, back. Still tiny bit amped up.

1:29pm - Had Mac & Cheese, and glass of milk. I think my first case of Brain Fog, Symptoms rating: 5. No longer amped up

4:50pm - Symptoms are manageable… for the first time in a few days it feels like. 

5:06pm - Took 500mg of Tylenol for back pain

5:15pm - Homemade Strawberry banana smoothie

5:25pm - Bean cheese burrito

6:15pm - 8:30pm - symptoms mild took a nap on the couch (more sleep than past couple nights)

12isham - 6:30am - was able to sleep again after laying in bed for 3 hours

6:37am - very mild burning in chest and back + bad headache. Best I’ve felt since Sept 14th. Trying not to celebrate too quickly

 

Note: I did not take Klonopin yesterday

 

Should we go down on the Lexapro now that I feel almost ok today? Or maybe best to hold now?

 

[Shep]

59 minutes ago, dadtobe said:

Note: I did not take Klonopin yesterday

 

Should we go down on the Lexapro now that I feel almost ok today? Or maybe best to hold now?

 

I've asked moderators more familiar with Lexapro to take a look at your thread, but just to clarify, are you stopping the Klonopin reinstatement?