SurreyGuy: amitriptyline is my poison ...

[modelarz71]

W dniu 17.04.2023 o 05:40 SurreyGuy powiedział:

W tej chwili cierpiącej na paraliżującą bezsenność i stany lękowe. 😢  Nie wiem co z tym rolnikiem. Jestem u kresu wytrzymałości. Wydaje mi się, że nie mam żadnych dodatkowych okien od czasu ostatniego stożka. Mam 1 lub 2 „przyzwoite” noce/dni w czasie i na wszystko… Boję się, że jestem zepsuty nie do naprawy i miną lata, zanim będę mógł ukończyć leczenie… Tak nienawidzę tego mojego mózgu… Nienawidzę lekarza, który przepisał dziesięć beznadziejnych leków. .. Do tego dochodzi stres z pracą, który nie pomaga, ale jako główna osoba zarabiająca na chleb nie mam innego wyjścia, jak tylko cierpieć i żyć dalej..

 

Przepraszam za język...

I have been having IBS problems since May (WD from esci...) Sad that you reinstate drug and the stomach continues to be bad.
I don't like the doctor who prescribed either, but every doctor I've been to has wanted to prescribe,
so I shouldn't like them all (They dine with friends digest well and sleep and we suffer) so something is wrong with the system. It was better to live in the bush and get treatment from a shaman

[SurreyGuy]

@modelarz71, so sorry to hear you're having IBS issues. That particular type of symptom can be particularly debilitating as it impacts on your ability to have a social life and to enjoy food. My IBS symptoms were very bad back in July, but they have since disappeared and my guts are working much better than they have ever worked for the past 20 years I have been on amitriptyline. I don't know if they will come back as I taper further... Anyway, I hope you get better.

[SurreyGuy]

***New symptom alert!***

 

Over the past few weeks, I have been experiencing a weird new symptom, which may or may not be related to withdrawal. I have some kind of metallic taste in the mouth, mostly on the part of the tongue at the back, a bit like when you burn your tongue from drinking very hot tea or coffee, except that I do not remember burning my tongue at all so I wonder where it's coming from. I am now wondering if this could be related to withdrawal.

 

Is there any function/part of the body this poison of amitriptyline does not affect?!?

[SurreyGuy]

I reduced to 2.9mg 3 days ago... 

 

Interesting development to report: over the past 5 days, I have experienced 2 days where may tinnitus is very much reduced/faint, almost to the point that I cannot perceive it anymore during the day in a normally noisy environment. I have been living with debilitating tinnitus since my ill fated cold turkey about 4 years ago. It's a small improvement, but an improvement nevertheless.

 

Insomnia is still bad though. I do not suffer from sleep onset insomnia as much as before so there has been a good improvement. However, sleep maintenance insomnia and early morning awakening insomnia are still very much prevalent in my case. 

[SurreyGuy]

I have been feeling high / activated for the past 2 days or so. The pattern of symptoms following each of my amitriptyline reductions recently is weird but quite consistent too.

 

Upon decreasing my dosage, I tend to experience 1 to 3 days of wave, typically poor sleep and a variety of other symptoms. Then things gradually improves until my sleep gets disrupted again, but this time in a different way: I wake up at night (2am or even 1am) and cannot go back to sleep. But when I get up in the morning, I am activated and tired at the same time, a rather weird feeling. I then feel high for 2 to 4 days and my sleep much improves (I can sleep 8 to 9 hours). It's an exilarting period of time when I feel I want to take on the entire world. 

 

Then, after 2 to 4 days this 'high' feeling goes away, sleep deteriorates again and I simply crash down, back to where I started on the day of taper. 

 

I feel like I'm being bipolar or at least I suspect this is how people who are diagnosed as bipolar feel, which leads me to (wrongly?) believe that what we call bipolar may just be an adverse effect of psychotropic substance rather than an actual condition.

 

I have posted on the above pattern several times on my activity stream. I find it so weird...

[SurreyGuy]

The last 3 reductions have been easier than what I have endured over the past 4 years and it got me wondering if that poison of amitriptyline could finally be losing its grip over my body and soul. By no means am I out of the woods yet, but I can see how psychological withdrawal symptoms have been gradually vanishing over the past 12 months and the physical symptoms (insomnia, muscle issues, GI issues, etc.) are not as intense as they once were. Could it be light at the end of the tunnel?

[SurreyGuy]

Last night, I splept better (well, longer to be exact), but today the mood is definitely lower. Not suicidal, not teary, just lower. On a slightly different note, over the past month or so, I have spent as many nights without melatonin than with. I feel less and less a need for it. It may not be long before I can reduce my list of supplements to fish oil only. 

[SurreyGuy]

Dropped to 2.5mg a few days. Not feeling too bad at the moment...

[Gertie]

Just wanted to let you know how much I appreciate your updates.  We have weaned my daughter down from 25mg to 10mg amitriptyline over the past few years.  She’s also tapering Zoloft at the same time, so once we got to 10mg of amitriptyline she decided to hold there (since it’s a whole pill) until she finishes her Zoloft taper (which will be another 1-2 years).

There aren’t too many people on here talking about their amitriptyline taper, so I’m incredibly grateful to have you forging the road ahead of us and sharing your experience on your way down!

[SurreyGuy]

@Gertie, glad my posting is of use to someone! And, yes, you're right, there aren't too many of us talking about amitriptyline. Amitriptyline is from an older generations of antidepressants, the so-called tricyclic antidepressants (TCA) class of drugs from the 60s. Unlike modern SSRI, TCA target multiple types of neurotransmitter receptors and tend to cause a wider range of adverse effects (nevermind withdrawal effects). More likely than not, when a consultant asks me if I am on any medications and I mention amitriptyline, I get an answer like "Amitriptyline? Really? That's an old dirty drug... Why are you taking that?"

Anyway, I hope your daughter manages to free herself from all those poisons. Holding at 10mg is a smart thing to do as tapering multiple drugs at the same time is not recommended (I know what I'm talking about, I was polydrugged). The good news is that your daughter is still young and even if it takes her a few more years to rid herself from those innefective dependence-inducing drugs, she will still have most of her life in front of her, drug free and happy.

From my own experience, I can feel that I am improving as I gradually decrease amitriptyline. Unfortunately, the improvement is not linear and now and then, I do get symptom flares. For example, last night, I woke up at 4am unable to go back to sleep. 2 years ago, I would have been anxious and depressed throughout the following day but, today, I just feel physically tired and that's it. I didn't sleep enough, I'm tired, no big deal. That, in itself, is an improvement.  

[SurreyGuy]

The past 3 months have been quite good in terms of anxiety. I was feeling increasingly relaxed, almost to the point where my symptoms were purely physical with no mental dimension to them. In truth, I was feeling close to content, with things going well at home and at work. Then I came across some professional opportunities, which, because I was feeling so well and was getting some of my old ambitions back, I decided to apply for. In hindsight, I was perhaps thinking I was out of the wood...

 

Big mistake! 😢

 

With an interview already scheduled for the new year, I am now stuck in a world of dreadful anticipation and the sheer thought of getting a new role, having different responsibilities, working with different people, etc., basically, the very idea of uncertainty, has triggered in me a return of anxiety.

 

Back are those unpleasant sensations near the heart and in the tummy, back are the dodgy guts and core muscles playing up, the appetite vanishing and cortisol spiking in the middle of the night (or whatever that is that makes me wake up alert and anxious in the middle of the night). 😖

 

I don't know what to do. I guess there is no choice, I have to be patient and wait for the anxiety to eventually subside. I have been there before and I know anxiety will subside given I have experienced a 3-month long window before. Perhaps I should stick to my existing job until I have finished my taper and my body has stabilised on a new drug-free homeostatic equilibrium. Or perhaps I should plough ahead and go for the new job, which I'm not guaranteed to get anyway. Somehow, I need to anchor myself in the now and ignore the future, which is easier said than done...

 

I wonder: are there any threads on this forum discussin about psychiatric drug withdrawal and work in an office environment?

 

 

[SurreyGuy]

The anxiety has come down a fair bit since yesterday, which is a relief. 👍

There are other symptoms but, hopefully, they will subside too.

[SurreyGuy]

One thing I don't believe I mentioned and that could be useful to other members of this forum is that, about 4 months ago, I got an agreement from my pharmacist that they would always try give me the same brand of generic amitriptyline moving forward. This has helped a fair bit and is something I regret not doing earlier in my taper. 

[Faure]

On 12/17/2023 at 2:17 PM, SurreyGuy said:

I don't know what to do. I guess there is no choice, I have to be patient and wait for the anxiety to eventually subside. I have been there before and I know anxiety will subside given I have experienced a 3-month long window before. Perhaps I should stick to my existing job until I have finished my taper and my body has stabilised on a new drug-free homeostatic equilibrium. Or perhaps I should plough ahead and go for the new job, which I'm not guaranteed to get anyway. Somehow, I need to anchor myself in the now and ignore the future, which is easier said than done...

I’d recommend sticking with the job you know and can do and can handle in good times and particularly in bad ones until you’re in a much better place, with no waves, no WD symptoms and no drugs in your system for a year….there is no point taking risks you don’t need to.  I prioritise staying well over everything else and am very careful not to over do anything. I am focusing on getting fitter as my goal ☺️
 

I’m fairly sure you could withdraw your application due to whatever reason you make up!

Edited December 19, 2023 by Faure

[SurreyGuy]

@Faure, that's pretty much what my relatives are saying. 😀

I think I will do some thinking over the Christmas period.

[SurreyGuy]

Time for an end-of-year plot to visualise progress...

 

 

12 months ago, I was at 5mg. As I post this graph, I am now at 2.5mg and may soon taper again. On average, in 2023, I tapered at a pace of 5% of previous dose every month.

 

What a journey the past 4 years have been. I never thought it would take so long. And there is still so much ground to cover... 😔 At the present pace, I could be at 1.2mg in 12 months' time and 0.6mg in 2 years' time. 

 

Lately, I have been thinking about jumping. At what dose will I stop this madness? I have been reading the excellent article Managing the Endgame Taper - Tapering - Surviving Antidepressants by BrassMonkey. Some very useful hints and guidance, but no hard instruction as you would expect given that tapering is very much an individual experience. I may jump at 0.5mg (i.e. a 40th of 25mg, which is the dose I've been on for the longest before going on 50mg for 1 month or so). I don't know, I will see how it goes... 

 

In the meantime, Merry Christmas and Happy New Year to all AD survivors. Sending you all healing.

 

 

[SurreyGuy]

Well... in the end, I decided to sit the interview.

 

Deep down, more than getting a new role, I wanted to prove to myself that I could still go after a different job, that I still had, somehow, some control over my life...

 

As you can expect, it was painful, with a wave triggered by the anticipation of the interview and many symptoms, including insomnia and anxiety, but I went through it anyway. I'm not sure I presented very well on the day but it's irrelevant, because what matters is that I did it in spite of the withdrawal, and that, in itself, is a huge victory for me, more important than getting the role... 

[Mia1]

@SurreyGuy you have no idea how happy I am that you went on the interview, that's amazing and took tremendous courage so congratulations!! And you're right, getting the job is so besides the point, the point is you are changing that anxiety response and that's the most important thing, to live a fearless life. 

 

Good job on your taper, it seems like you're going at a good pace and listening to your intuition so keep it up!! 

[SurreyGuy]

@Mia1, so good to hear from you! I hope your drug-free journey is going from strength to strength.

 

I am curious: I believe you were taking 2 drugs, right? Klonopin and amitriptyline. Did you taper amitriptyline last? If so, at what dose did you jump and what was your initial amitriptyline dosage before you started your taper? 

[Mia1]

On 1/14/2024 at 11:31 AM, SurreyGuy said:

I am curious: I believe you were taking 2 drugs, right? Klonopin and amitriptyline. Did you taper amitriptyline last? If so, at what dose did you jump and what was your initial amitriptyline dosage before you started your taper? 

Yes, I actually started tapering amitriptyline before I found SA and went from 20mg to 8mg in two months. Needless to say I was in a lot of pain and ended up going back to 10mg and held there for about a year. When I started tapering again I went from 10 mg to 5mg doing 10% monthly cuts and had no issues. When I got to 5mg I got impatient and did a fast taper to 2mg in a few months and jumped off. It was not a smart move as I was very symptomatic but I had Klonopin still to taper so pushed through. It took me about a year to heal though and I wasn’t able to taper Klonopin until then so in the long run it really didn’t help.

 

When I tapered the Klonopin I did micro cuts weekly and jumped off at .05mg, which is recommended a lot on this site. Even though I didn’t rush this taper I was very symptomatic, maybe from the previous tapers or from the fact that I was on it for 23 years. 
 

It seems like you’re going nice and slow and are overall functional so probably the .05mg will work for you, so much of this is intuitive and individual though.  I know that was a long answer but I hope it helps!!

[SurreyGuy]

Thanks @Mia1. I really appreciate those details and your honesty. I have had a few exchanges regarding end of game taper and I am keen to gather as much feedback as possible before I get there.

It's true that, in my case, I manage to remain functional but it was quite hard at the beginning, shortly after my failed cold turkey. I had times when I wanted to 'give up' whatever that meant at the time...

In my case, I was suffering (and still am) many adverse effects from the drugs, nothing to do with withdrawal per se. Those adverse effects are very slowly disappearing and this is what gives me hope...

[SurreyGuy]

Help!

 

This is the message I have been dreading to write all along: I have received news that my cancer is back. 😨 I think I still have an opportunity for more treatment with the possibility to put it in remission for some time, but, nevertheless, the news has triggered the mother of all waves (MOAW?). My limbic brain has already written myself off and I feel like I am back to square one, 4 years ago, after my attempted cold turkey. The anxiety is relentless and the insomnia is sheer torture. All this hard work and progress for nothing. I was doing so well and now.... 

 

Workwise, I am able to go on sick leave for a decent period of time and/or work from home (though working from home is not ideal given some of my people management and client facing responsibilities). 

 

I truly am at a loss. I need to be able to sleep some decent time and I need the anxiety to come down but the past 7 days have been relentless (bar 1 evening/1 night when I slept 7h). Are there other SA members who have been going through a similar ordeal? How long did the wave last once you receive the bad news? How did you cope? What coping techniques did you use? Should I updose? If so, by how much? Ideally, I would like to stay at my present dosage but...

 

I could really do with your collective wisdom/knowledge right now.

 

[Gertie]

Oh man SurreyGuy I’m so sorry for this news.  As a fellow cancer survivor, I relate to the anxiety of a returned diagnosis. 
I know it sounds corney, but have you looked into hypnosis for the anxiety?  My daughter is the one withdrawing from antidepressants, and she’s been battling anxiety surges and a lot of GI issues currently.  I started looking into hypnosis for both of these issues, and there’s some pretty good evidence to support it.  She has a consultation set up for later this week, so I can’t attest yet to whether it works for her or not, but it’s a non-drug approach which I always appreciate.  I struggle with anxiety over HER health - when she struggles, I don’t sleep and literally stay up all night doing research trying to find answers.  No wonder us “Type A” wind up with cancer and other health problems!  Turning down the noise in our heads is such a battle.

 

As best as you can, stay in today; “future tripping” only creates scenarios to worry about that may never happen.  Today you are here.  Today you have choices. Today you are safe.  
Make a daily gratitude list, meditate, do deep breathing exercises, take a warm shower, go for a walk, read inspiring books.  Maybe look into the hypnosis.  I’ll report back if she proceeds with it and we see any results…

[SurreyGuy]

@Gertie, thank you so much for taking the time to read my last post and reply. 

 

The past week has been really challenging (and that's an understatement). I developped some kind of constant panic attack (or maybe it was akithasia?) coupled with severe insomnia. The anxiety/terror were such I could not stay in place. That seems to have subsided after a week. I am calmer now and I slept for 7h yesterday, which is a relief. I even went out today for a decent 1h walk. 

 

The cancer return is a real blow. It's hard to battle on 2 fronts, withdrawal and cancer...  But there is still another potentially curative treatment I can get so I try to remain hopeful things will work out cancer-wise and I can resume my taper.

 

You make a very good point of staying in the "now". Unfortunately, I seem to excel at "future tripping"! 😓

 

 

[Mia1]

@SurreyGuyI'm so sorry, I can't imagine how difficult this must be for you. You're not back to square one though, I think probably the shock of it and other strong emotions has activated your nervous system. To the best of your ability try to rest and relax and immerse yourself in nature and give yourself a chance to process and heal.

 

The thing is we never know how much time we have, I know it sounds cliché but it's true. I have a family member who has had cancer since they were a teenager, a lot of radiation and chemotherapy, and always being told time is limited and they have X amount of time. Well, that person is in their fifties now and they continue to work and travel and live life to the fullest. No one knows what the future holds so what you do day to day and the decisions you make are not pointless. You've done such a good job so don't forget that.

 

As for sleep, as someone who has not slept through the night in almost four years now, I say do not worry about it at all. It's the anxiety you create around the not sleeping that's a problem and not the not sleeping itself. If you can't sleep but are able to at least rest and relax then that will be restorative to your body and mind. But if you panic and stress over not sleeping that will most likely ensure you will not sleep and then the added stress will be detrimental to you. So try your best to allow yourself to feel what you are feeling without getting too caught up in the outcome. I know it's hard but it's also a way out of the pain and suffering you are experiencing. 

 

As for coping skills I personally have found acceptance to be the easiest  but it does take practice, as do all of them. Unfortunately there's no quick fix, I wish there were. As @Gertie mentioned I saw a hypnotist for my sleep anxiety/OCD and it helped somewhat but what really helped me was learning to sit through feeling and emotions in meditation. I have really used this experience as a way to get to know myself and accept myself unconditionally and as a result I no longer have an anxiety problem, sleep problem, etc.  So I would recommend a daily meditation practice to help you create some space around what you are going through. I also recommend daily nature walks, listening to soothing music (which is really just meditation) and daily contemplation about life and your purpose, etc. 

 

I know none of this is easy, believe me I know. But it's going to get better. I wish there was something I could do to take some of this pain away but remember these three things: you are strong, you are loved and everything is going to be okay. 

[Gertie]

I love @Mia1’s advice on acceptance.  So incredibly hard to do, but so worthy of our efforts.

There is a book I read when going through my cancer treatments that I found helpful.  It’s called “Radical Acceptance” by Tara Brach.  I’ve unfortunately been lazy in my practice - talking to you has inspired me to dust off the book and give it a refresher.  Might be a good place to start if you’re interested.
 

This blogger did a good job summarizing  how it may help. https://www.mummingaftercancer.com/radical-acceptance-and-breast-cancer/

[SurreyGuy]

Oh @Mia1, thank you so much for your message. I have never met you, I don't know you, but your words have touched me so much. You have no idea. I will read on radical acceptance. And I will certainly walk in nature.

 

@Gertie, thank you so much for posting the link. I will look into it.

[SurreyGuy]

Well, I managed to sleep over 8h last night and I feel better today, more like my usual self, though still mentally fragile given the circumstances. I need to gather my energy to battle this thing.

[SurreyGuy]

Lovely window today... feeling very calm, almost content.