draggin49: Help! I’m really struggling

[manymoretodays]

Hi draggin49,

Was the tooth extraction before you spiraled?

And okay on the Amoxicillin and the Lorazepam......I copy your responses above.

Any idea what the trigger was for the spiral of symptoms?

 

Keep note of when you doubled the Lorazepam then. (I'm assuming you've gone from 1 mg total each day to now 2 mg, correct me if wrong)

What dose do you take and when?

Why don't you lay out your current drug regimen for us again, just in a reply.......that will help.

Times.  Current drugs by name and dose.

 

So am I reading correctly then, that you have improved......at least the level of severity of symptoms, and that you attribute that to the increased Lorazepam?

 

Non-drug coping?  Are you familiar with any yet?  Practices that help when you feel overwhelming emotions?

Support system at home?  People you can call on when in distress?

 

And good job on the signature, doing it while feeling so distressed.  I just want a bit more clarity there.  For when you said "currently" you could just put a year and then month.  That might make it easier to do.  Honest, it is so helpful to be able to see recent drug history at a glance, when we come around and try to support and make suggestions.

 

Okay.  Keep us updated.  And good.  I see the drug interactions above, and yes Celexa is a good place to start tapering I agree. 

What do your days look like now?  You didn't really say much, as far as your improvement on more Lorazepam goes.

 

Lifting you up draggin49.

 

 

 

 

[draggin49]

45 minutes ago, manymoretodays said:

Hi draggin49,

Was the tooth extraction before you spiraled?

no , tooth extraction was at least 5 days after I spiraled . Both teeth were in bad shape . 

45 minutes ago, manymoretodays said:

And okay on the Amoxicillin and the Lorazepam......I copy your responses above.

Any idea what the trigger was for the spiral of symptoms?

I can’t for the life of me figure out the trigger for the spiral ,that is what has me so scared . It’s like if I can’t identify it how can I fix it and make this debilitating situation stop. 

 

Keep note of when you doubled the Lorazepam then. (I'm assuming you've gone from 1 mg total each day to now 2 mg, correct me if wrong)

been on 4 lorazepam of 0.5mg since January 15th ( under a week) 

What dose do you take and when?

Why don't you lay out your current drug regimen for us again, just in a reply.......that will help.

Times.  Current drugs by name and dose.

current drugs by name and dose 

6-7am lorazepam 0.5mg

9am amoxicillin for tooth infection 500mg
11:30 am celexa 60 mg , guanfacine 1mg, lorazepam 0.5mg

3pm amoxicillin for tooth infection 500mg

6pm lorazepam 0.5mg

11:30pm amitriptyline 25mg, guanfacine 1mg , 0.5mg lorazepam 

 

 

45 minutes ago, manymoretodays said:

 

So am I reading correctly then, that you have improved......at least the level of severity of symptoms, and that you attribute that to the increased Lorazepam?

Yes, I have seen improvement at the level of severity of the symptoms with the 2 lorazepam mixed in the middle of day instead of when they were morning /night . Prior to taking the extra lorazepam I was having 5-7 panic attacks daily and in a constant state of anxiety just about as high as a panic attack from moment I woke up till moment I could fall asleep. It was so extreme I couldn’t get more than 1-3 hours of sleep . This was not like a normal panic attack . I’ve had lots , this was more than that . the level of fear panic sadness and emotional meltdown was unbearable 

Non-drug coping?  Are you familiar with any yet?  Practices that help when you feel overwhelming emotions? I can handle overwhelming emotions if they come and go but this is NOT that , this was going non stop every waking moment for 4-5 days. 

Support system at home?  People you can call on when in distress?

im staying with my mother . Thankfully she has been staying with me . I’ve been staying around her all day /night . Do not feel comfortable being alone . 

 

And good job on the signature, doing it while feeling so distressed.  I just want a bit more clarity there.  For when you said "currently" you could just put a year and then month.  That might make it easier to do.  Honest, it is so helpful to be able to see recent drug history at a glance, when we come around and try to support and make suggestions.

 

Okay.  Keep us updated.  And good.  I see the drug interactions above, and yes Celexa is a good place to start tapering I agree. 

What do your days look like now?  You didn't really say much, as far as your improvement on more Lorazepam goes.

My days currently are me barely able to sit in my own home without being overwhelmed for NO reason. Which obviously isn’t good but it’s WAY better than how bad I was the first four days. I’m not currently driving, I’ve been going with my mom places . I don’t feel comfortable doing much of anything. Prior to this I drove and would be doing c errands going to appointments , or going places I wanted to. 

 

Lifting you up draggin49.

Thank you for your support. This has been a very scary /traumatic time for me . 

 

 

 

 

[getofflex]

Your signature says "Most recent psych raised me from 10 mg to 20 mg to 40mg then to 60 mg over course of maybe 2-3 years "

 

About what month/year did you increase your celexa from 10 to 20, then to 40, then to 60?  Please give us approximate dates for each of these increases.  Why was your dose increased?  

 

And as many more todays requested, please give us more information about the amitriptyline tapering too - dates, dosages, etc.  

Edited January 22, 2023 by getofflex

[draggin49]

1 hour ago, getofflex said:

Your signature says "Most recent psych raised me from 10 mg to 20 mg to 40mg then to 60 mg over course of maybe 2-3 years "

 

About what month/year did you increase your celexa from 10 to 20, then to 40, then to 60?  Please give us approximate dates for each of these increases.  Why was your dose increased?  

 

And as many more todays requested, please give us more information about the amitriptyline tapering too - dates, dosages, etc.  

I updated the amitriptyline in my signature with more accurate dates of how he had me taper off. 
I will try and find either old pill bottles or I guess I could email my psychiatrist and ask for the dates we adjusted the celexa. It’s hard because my psych is VERY defensive , if i question anything med related or his choices of what he put me on he gets really mad and makes me feel as if I’m wrong for asking or that whatever it is going on with me is all me not caused by any meds he prescribed .just isn’t a true empathetic person. I’m a pretty tough guy . I wouldn’t bother him with my problems unless what I’m dealing with is SEVERE to the point where I physically and mentally can’t handle it . I’ve been trying to find a new psych but it has been tough . But that is my goal for 2023 . 

[getofflex]

1 hour ago, draggin49 said:

I’ve been trying to find a new psych but it has been tough . But that is my goal for 2023

I'm glad, because it definitely sounds like your current one is pretty bad.  

 

Personally, if it were me, I would start by reducing the Celexa.  You are on a very high dose of that, and combined with amitriptyline,  which as you saw has a major interaction, may be causing your problems.  The formula for figuring out a 10% reduction is current dose x 0.9 = new dose.  So, 60 x .9 = 54.  You may want to wait until you are done with your course of antibiotics, and the tooth extractions and infection are fully resolved first.  This link will explain about tapering, and measuring the nonstandard doses.  

 

Tips for Tapering Celexa

 

If it were me, I would switch to the liquid, which makes it very easy to taper and measure nonstandard doses.  But, you want to switch over from the tablet form to liquid gradually.  Don't start the taper until you have fully switched to liquid, and have not been destabilized from this, meaning it gave you symptoms.  

 

Cross Over - Changing Form of the Drug

 

 

Edited January 22, 2023 by getofflex

[getofflex]

1 hour ago, draggin49 said:

I updated the amitriptyline in my signature with more accurate dates of how he had me taper off. 

Did you forget to hit save after you did this?  I don't see the information. 

[draggin49]

25 minutes ago, getofflex said:

Did you forget to hit save after you did this?  I don't see the information. 

I just went and checked and it shows it saved in there when I go to edit profile . Hmmmmmm, seems like it is just cutting down the off for some reason even though it says it’s saved in there .

[draggin49]

33 minutes ago, getofflex said:

I'm glad, because it definitely sounds like your current one is pretty bad.  

 

Personally, if it were me, I would start by reducing the Celexa.  You are on a very high dose of that, and combined with amitriptyline,  which as you saw has a major interaction, may be causing your problems.  The formula for figuring out a 10% reduction is current dose x 0.9 = new dose.  So, 60 x .9 = 54.  You may want to wait until you are done with your course of antibiotics, and the tooth extractions and infection are fully resolved first.  This link will explain about tapering, and measuring the nonstandard doses.  
Do you think the celexa being lowered might help even though I will still be taking amitriptyline? Obviously I’d like to get off amitriptyline down the road . But maybe if the celexa goes down to a low amount I will stop getting this reaction. 

 

Tips for Tapering Celexa

 

If it were me, I would switch to the liquid, which makes it very easy to taper and measure nonstandard doses.  But, you want to switch over from the tablet form to liquid gradually.  Don't start the taper until you have fully switched to liquid, and have not been destabilized from this, meaning it gave you symptoms.  
 

if I end up switching to liquid how much time do you think I should do 60mg of liquid before I ever start the taper ? 
Is there normally a major reaction from changing from pill form to liquid on the body ?Im gonna try and follow up and see if maybe a doctor can do a test on my after my amoxicillin is done to make sure I’m infection free . 

 

Cross Over - Changing Form of the Drug

 

 

 

[manymoretodays]

21 hours ago, draggin49 said:

current drugs by name and dose 

6-7am lorazepam 0.5mg

9am amoxicillin for tooth infection 500mg
11:30 am celexa 60 mg , guanfacine 1mg, lorazepam 0.5mg

3pm amoxicillin for tooth infection 500mg

6pm lorazepam 0.5mg

11:30pm amitriptyline 25mg, guanfacine 1mg , 0.5mg lorazepam 

 

 

Hey there.  And good, good.  You got this done ^

draggin49, if you can, please get to a PC.....desktop/laptop so you can do some further sorting and dating with your signature.  I'm copying your present signature here, below, and I'll add in purple what would be helpful, for us to see.  And then if you scroll up, you'll find the multiple references and links to help you with signature editing and updates.

year, even if you can approximate a year, put that here klonopin don’t recall dose was short term after an ER visit for panic attack 

what year, when? Paxil for maybe 1 year stopped taking it and switched to celexa 
count backwards, and put a year for when it was started here 10mg of celexa for maybe 15 years (you could leave the 15 years out then, as it will be evident)

year, month- Most recent psych raised me from 10 mg to 20 mg to 40mg then to 60 mg over course of maybe 2-3 years and then keep all your celexa information together too, this can go with the above celexa information

 

currently taking

Celexa 60 mg at least 2 years  again, just keep all your celexa information together and dated, with at least a year

start date, dates of changes, approximate if needed amitriptyline 25 mg over a year ( at one point as high as 100 mg . Doctor tapered me off but it was too fast so I ended up back on at 25(when?, date, year, month) because the withdrawl symptoms were debilitating.

guanfancine 1 mg 2x a day ( 3 years ) start date and then could just note to present

Lorazepam 0.5 mg 2x a day ( 2years ) start date, year, month, approximate if needed,  and do get your most recent change, increase of total daily dose here and dated

 

Thanks.  I'll show you the example from:

-how-to-summarize-your-drug-history-in-your-signature

Example:

2001–2002 paroxetine 
2003  citalopram 
2004  paroxetine
2008  paroxetine slow taper down to 2016 Aug off paroxetine
2016  citalopram May 20mg  Oct slow taper down
2018  citalopram 13 Feb 4.6mg 15 Mar 4.4mg 29 Apr 4.2mg

 

And then use that underlined link to access your signature to edit it, when you can get to a PC.  Get the years on the left and then drug information on the right.

 

So......that's all pertaining to signature clarity, and........I'm hoping if you work it on paper first, before you edit, and then get to a PC you'll be able to get that in good shape.

 

Next up.  Did we ask you to do NOTES/daily drug and symptom logs yet?  What I quoted above, is great draggin49.  You got all your drugs accounted for, and got the times on the left and the drugs by name and dose on the right.

Now.  I want you to add a date at the top, then note times on the left again, and on the right note drugs again, the same way you did, and also on the right try and note your symptoms as they occur throughout the day. 

Try and get 24 hours done, then post, then another 24 hours, and post, and then even another 24 hours, and post.  So we'd have a couple of days to view and can see objectively what is happening before and after your current drugs are taken.

This can help so much.

I'll give you links, explaining this more......the Notes/daily drug and symptom logs.  And then you post them here, in a reply, once done. 

They ARE different from your signature, but oh so helpful so please try.

 

 

Recording drug schedule and symptoms to track patterns and progress

and then here is what is in the quote in the first post ^

Keep notes......

with a sample note even

 

You're getting good at giving us good information now draggin, and that will surely help us with suggests, so keep going......do some NOTES to post here.  Get that signature fixed up when you can get to a PC too.......maybe trying to do everything from your phone device has been making it tough.  I don't know.

 

So many concerns.  Drug interactions and now more Lorazepam, which may just add to further depressed feelings soon enough.......a tough trade off from what you relate to as panic and out of this world anxiety. 

 

Edited January 22, 2023 by getofflex
I kept this hidden for now, as I don't know if it would be more confusing or less, I'll comment in reports

[Onmyway]

Dear @draggin49, 

I see you are very well supported here by a few moderators but I wanted to emphasize how important it is to provide the daily notes and fix the signature so we can help you better and faster. We need the information from you. 

 

I also wanted to say that you are at a very dangerous dose of citalopram. There is an FDA black box warning on it from 2012 to not prescribed citalopram at doses larger than 40mg. 

https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-revised-recommendations-celexa-citalopram-hydrobromide-related#:~:text=Citalopram causes dose-dependent QT,ventricular tachycardia%2C and sudden death.

 

If I were you, I would start tapering citalopram at the earliest. We recommend no more than a 10% taper every 4 weeks but as an exception here if I were at that dose myself, I'd drop to 50mg first and then to 45 and 40 after that. And then continue the 10% reductions. I am not a fan of exceptions to the 10% rule and I go even slower at the low dose but at the higher dose you might be able to handle it. 

 

I understand that you are suffering quite a lot currently. I suspect that it is a wave and that it will soon pass. But in the meantime I highly recommend that you try to use some non-drug techniques to manage extreme emotions. Many members find Claire Weekes' methods here change their lives and allow them to manage their emotions much better. It works for emotions other than anxiety as well. 

 

Do you have any of your own tools to manage emotions? Do you have access to a therapist who might be able to support you in learning techniques to manage emotions. Emotions can be sometimes scary but drugs just numb them. Therapy, especially CBT or some others (I do IFS personally) may be helpful in creating life long skills that can be useful even after withdrawal. 

Have a look at the links below. 

 

 

http://www.claireweekespublications.com/the-4-steps.html

 

Also, remember that this period, while difficult, will also pass. 

OMW

 

 

 

Edited January 23, 2023 by Onmyway

[draggin49]

1 hour ago, Onmyway said:

Dear @draggin49, 

I see you are very well supported here by a few moderators but I wanted to emphasize how important it is to provide the daily notes and fix the signature so we can help you better and faster. We need the information from you. 

 

I also wanted to say that you are at a very dangerous dose of citalopram. There is an FDA black box warning on it from 2012 to not prescribed citalopram at doses larger than 40mg. 

https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-revised-recommendations-celexa-citalopram-hydrobromide-related#:~:text=Citalopram causes dose-dependent QT,ventricular tachycardia%2C and sudden death.

Thank you for telling me this. I am gonna try not to freak out over it . I was already scared before finding this out. 
 

 

If I were you, I would start tapering citalopram at the earliest. We recommend no more than a 10% taper every 4 weeks but as an exception here if I were at that dose myself, I'd drop to 50mg first and then to 45 and 40 after that. And then continue the 10% reductions. I am not a fan of exceptions to the 10% rule and I go even slower at the low dose but at the higher dose you might be able to handle it. 

so do you mean switch from my current 60mg to 50mg for 4 weeks ,2 week hold

then 45 mg for 4 weeks, 2 week hold then 40 mg for 4 weeks 2 week hold ? 
I’m just so fragile and scared . I want my taper to go ok this time compared to last time .but maybe more of what I dealt with was from when I had a few weeks of no amitriptyline after I took my last dose. 

do you think I will have gnarly withdrawl symptoms as I taper the celexa  ? Or any chance I feel better as the dosage lowers . If I recall with the amitriptyline taper I felt ok through the first phases of the taper , it wasn’t till I was full off that I really started feeling severely debilitating anxiety /depression/mood swings etc . I guess it’s sort of just a fear thing because I’m hit with this debilitating anxiety /depression right now that could tapering make things worse ? Or am I pretty much already at the anxiety level /emotional level/depression level . 
 

 

I understand that you are suffering quite a lot currently. I suspect that it is a wave and that it will soon pass. But in the meantime I highly recommend that you try to use some non-drug techniques to manage extreme emotions. Many members find Claire Weekes' methods here change their lives and allow them to manage their emotions much better. It works for emotions other than anxiety as well. I will try and listen to Claire weekend and learn. 

 

Do you have any of your own tools to manage emotions?
I try and manage my breathing when anxiety is bad , sometimes I will try to listen soothing music or sounds .

 

Do you have access to a therapist who might be able to support you in learning techniques to manage emotions.

Yes, I am currently seeing a psychologist .  I will telll her I want to work on cbt/ifs to try and help 
 

Emotions can be sometimes scary but drugs just numb them. Therapy, especially CBT or some others (I do IFS personally) may be helpful in creating life long skills that can be useful even after withdrawal. 

Have a look at the links below. 

 

 

http://www.claireweekespublications.com/the-4-steps.html

 

Also, remember that this period, while difficult, will also pass. 

Thank you for your reply . I appreciate the support. This has been beyond hard 
OMW

 

 

 

 

[Onmyway]

Hi @draggin49, 

I understand your worries. And it is entirely up to you what to do, I am just telling you what decision I would make. You carry out your own risk/benefit analysis. I understand that these decisions may not be easy for you. 

 

Anxiety and panic attacks are tough but they are just emotions that you needn't fear - they come and go like waves like Claire Weekes above says even the ones created by withdrawal. A panic attack doesn't actually harm you even if it makes you feel like you are dying. If you remember that in the midst of it, it will likely subside faster. 

 

We can't predict how your withdrawal will go - nobody can and we don't like to idly speculate. If you post the daily notes like you have been asked to we may be able to guess whether you are having an adverse reaction to the drugs. *Usually* with adverse reactions as you lower your dosage you may find relief. However, until you post these we can't really answer your questions. 

 

OMW

[draggin49]

Is there ANY way to get access for ALL my medical records over my last 25 years ?? I get that some people are great note takers and detailed every step of their meds taken /stopped but I unfortunately have never been super organized and to be honest I never saw this becoming such a mess  . Do I email my old doctors maybe ? 

[Onmyway]

Hi @draggin49

Pls look in earlier posts - the daily notes are about your daily symptoms now - you have been given examples above by at least two people. Follow that template. We need at least a few days worth.

 

we don't need detailed drug notes from 25 years ago. Focus on the last few years for them but we need details on the up and down on the amitriptyline for example and the current doses of benzos (they're incorrect in your signature).  We need to understand how sensitizEd your system is - going on/off drugs, changing drugs, stopping cold turkey all add up and need time to be 'processed' by your brain so that you can get back to stability.

 

Please know these are not idle requests - we are not making it to make your your life harder or annoy you. It is genuinely to help you better. We are volunteers with own jobs/struggles/families and don't have time to make empty requests. 

 

OMW

[draggin49]

32 minutes ago, Onmyway said:

Hi @draggin49

Pls look in earlier posts - the daily notes are about your daily symptoms now - you have been given examples above by at least two people. Follow that template. We need at least a few days worth.

 

we don't need detailed drug notes from 25 years ago. Focus on the last few years for them but we need details on the up and down on the amitriptyline for example and the current doses of benzos (they're incorrect in your signature).  We need to understand how sensitizEd your system is - going on/off drugs, changing drugs, stopping cold turkey all add up and need time to be 'processed' by your brain so that you can get back to stability.

 

Please know these are not idle requests - we are not making it to make your your life harder or annoy you. It is genuinely to help you better. We are volunteers with own jobs/struggles/families and don't have time to make empty requests. 

I’m sorry if it came across like I was mad or felt like you were making idle requests. I do NOT feel that way so I want to clarify that 100%. I’m thankful for every second of time you give  and every reply you post in my thread. I apologize I don’t know if it’s because I’m such a train wreck right now that I’m struggling to get this signature and other elements of items wrong on here . Do you think my pharmacy would be able to get me records for the more recent stuff ? Tomorrow I will start the daily log of what I took /how I felt over the day . I will try again on the signature , I attempted to borrow a laptop and Edit it earlier today . 

OMW

 

[getofflex]

I agree with On My Way.  We need this information in order to help you.  We don't need detailed information on the last 25 years of your drugs.  If you can at least give us the approximate dates for the drug changes you've made in the past 18-24 months, that would help a lot.  

 

As OnMyWay said, we have our own lives too, and there are very many people on this site who need a lot of help.  We have asked you repeatedly to supply daily notes, and update your signature.  You need to take responsibility to do your part, and cooperate with us.  We cannot wave a magic wand, and fix your troubles.  

Edited January 24, 2023 by getofflex

[draggin49]

*Testing to see if signature is fixed now *

[draggin49]

I tried to get my records online from target for my meds over last 3 years but wasn’t successful, I’m gonna ask my psych if he can email his records he has kept over our time together charting meds/med dosage amounts /dates started /dates changed etc . If I get my hands on those . I will repost them here to try and give the most accurate info I have on my last 4-5 years . Thanks again for everyone helping me. I apologize for being a wreck. I think of myself as a pretty tough guy in general , physical pain I have a high threshold but this is so much worse /harder to deal with . 
will also start my daily journal in here tomorrow . 

[Onmyway]

Dear @draggin49, 

we understand you are suffering, we are just a bit frustrated. I didn't realize you didn't have access to a laptop so I have gone and made changes to your signature using the info you provided to make it readable. I have put in brackets the questions that still remain.

 

Please answer them in the post text and I will add them to the signature. Please answer where I have put the A: - so that I can find them easily. You can write text to explain more later - try to make these answers as succinct as possible. 

 

- When did you start citalopram (year, if possible month)

A: 

 

- When did you change your doses of citalopram (year, month if possible for the various changes) - pls do your best, if changes are older than 2 years

A: 

 

- When did you start lorazepam (ativan) (year, month if possible) 

A: 

 

- When did you increase your lorazepam (ativan) (year, month if possible for every change - the more accurate the better for recent changes)

A: 

 

Was amitriptyline before 2000 (which would mean as a kid)? Or after stopping paxil in 2001?

A: 

 

When did you start guanfacine?

A: 

 

Was guanfacine prescribed for diabetes or for mental health issues? 

A: 

 

Are you taking any other medicines or supplements? This includes everything in pill form or herbal tea or smoking etc. 

A: 

 

In the meantime, please follow Claire Weekes' videos (there are more on YouTube) to help you manage your moods. They really help. Nothing we suggest will be a quick fix so there will be suffering in this process unfortunately. There simply aren't quick fixes in this process.  There are some ideas here: 

 

https://www.survivingantidepressants.org/topic/1112-non-drug-techniques-to-cope-with-emotional-symptoms/

 

Distraction really helps. Play your favorite video game/watch your favorite show, anything you can do. Deep breathing engages the parasympathetic nervous system and stimulates the vagus nerve - try any of these. 

https://sass.uottawa.ca/sites/sass.uottawa.ca/files/how_to_stimulate_your_vagus_nerve_for_better_mental_health_1.pdf

 

OMW

[manymoretodays]

21 hours ago, draggin49 said:

Is there ANY way to get access for ALL my medical records over my last 25 years ?? I get that some people are great note takers and detailed every step of their meds taken /stopped but I unfortunately have never been super organized and to be honest I never saw this becoming such a mess  . Do I email my old doctors maybe ? 

 

Your signature is getting there.  Good job.

Hey, no I don't think you need to focus on getting all your medical records over the last 25 years right now.  Or exact days down.

We just needed some more dates, is all, and likely you can approximate, and then correct later if you find you were off a bit.

 

Here's a copy of your present signature.  You can certainly remove some of the questions that you left in there, and parenthesis items.  When you can draggin49.  Sounds like you are operating under some cognitive fog and confusion right now.

 

prior to 2000 - amitriptyline - tapered off 2-3 week (? OMW)

Jan 2000  - Jul 2000 clonazepam

July 2000 - Feb 2001 paxil 

????? OMW

100 mg amitriptyline

7/14/20 - 8/5/20 - 75mg of amitriptyline 

8/6/20 - 8/27/20-  50mg of amitriptyline 

8/28/20- 9/18/20 - 25mg of amitriptyline

9/19/20 - 10/10/20 - 12.5 mg amitriptyline

10/11/20 - 10/31/20  - 6.25 mg , stopped 10/31/20

11/21/20 - 11/19/20  12.5 

11/19/20 - now 25 mg amitriptyline 

 

Currently on: celexa 60mg once a day (year started? years changes in dose), guanfacine 2mg (year started? year of changes in dose if any?)  lorazepam 2mg (split 4x a day) (months/year started/changed?) 

 

17 hours ago, draggin49 said:

tried to get my records online from target for my meds over last 3 years but wasn’t successful, I’m gonna ask my psych if he can email his records he has kept over our time together charting meds/med dosage amounts /dates started /dates changed etc . If I get my hands on those . I will repost them here to try and give the most accurate info I have on my last 4-5 years . Thanks again for everyone helping me. I apologize for being a wreck. I think of myself as a pretty tough guy in general , physical pain I have a high threshold but this is so much worse /harder to deal with . 
will also start my daily journal in here tomorrow . 

 

I think you might be making it more difficult than it needs to be.  Look at the sample signature again too. You're getting there with the signature.

 

Go through what you have posted above draggin49.  You'll be able to figure out the date that you doubled up your Lorazepam from your own replies here. 

 

Has your cognition or thinking been this foggy?  Or is it more recent?  Confusion?  Present before the increased Lorazepam? 

 

Good.  I look forward to seeing your Notes/dailies.  And focus on those please.  Simple.  Times.  On the left.  And then basically everything else to the right.  Scroll up to find the instructions to doing those, and a sample note.  Just post your first 24 hours of Notes separate from any narratives.  And it will help you focus a bit.......I think it will.  Look at it like a occupational therapy exercise for now.

 

Hoping today is half decent for your draggin49.

 

L, P, H, and G,

mmt

Edited January 24, 2023 by manymoretodays

[Altostrata]

On 1/13/2023 at 11:48 AM, draggin49 said:

Sorry I’ve been away . I stayed on the 25mg dose of amitriptyline I got back on.the last failed fast taper was so traumatizing I’ve been scared to try again . Im so disappointed in myself for EVER allowing myself to trust my psychiatrist who put me on all these meds. Im so much worse than when I was only on 10mg of celexa . I should’ve never let him add new meds or raise my dose. 
lately my anxiety has suddenly spiked and I don’t know why . But ever since the dr put me on all the meds above the 10mg of celexa . I have gotten to a point where all I feel is the negative emotions sadness , fear , disparity , feeling alone . At least when I was on only 10 mg of celexa I could still feel some positive emotions occasionally and had my own company/was working  , enjoyed activities I liked doing , enjoyed hanging out with friends . I feel like I must attempt a slow taper to get me off these meds that have made me so much worse . 

 

Hello, @draggin49 You're taking a huge dosage of citalopram, which is dangerous in combination with amitriptyline (and maybe your other drugs as well.

 

It's possible that this recent spike in symptom pattern was caused by interaction among your serotonergics or perhaps the way you've been using lorazepam for so long. You may have had interdose withdrawal from the benzo.

 

It's a concern that you increased lorazepam by adding 2 daily doses. Eventually, you will become adapted to the higher daily dose and it will be harder to come off. Rather than further increases in lorazepam, you might consider gradually reducing citalopram.

[draggin49]

3 hours ago, Altostrata said:

 

Hello, @draggin49 You're taking a huge dosage of citalopram, which is dangerous in combination with amitriptyline (and maybe your other drugs as well.

 

It's possible that this recent spike in symptom pattern was caused by interaction among your serotonergics or perhaps the way you've been using lorazepam for so long. You may have had interdose withdrawal from the benzo.

 

It's a concern that you increased lorazepam by adding 2 daily doses. Eventually, you will become adapted to the higher daily dose and it will be harder to come off. Rather than further increases in lorazepam, you might consider gradually reducing citalopram.

I wish someone like you could explain this to my psychiatrist.Unless it was from someone intelligent with experience it seems like he wouldn’t accept it hearing it from me. I feel so helpless , I get made to feel like by him that there isn’t anything wrong with what I’m currently on. 
What manner could I lower the citalopram ? How much per week, and would I be doing the 2 week hold periods after 4 weeks of tapering ? 
I think you mentioned I’d need to switch to liquid to do this ? But do I need to take liquid for a set time before starting to taper ? 
 

[getofflex]

8 hours ago, draggin49 said:

What manner could I lower the citalopram ? How much per week, and would I be doing the 2 week hold periods after 4 weeks of tapering ? 
I think you mentioned I’d need to switch to liquid to do this ? But do I need to take liquid for a set time before starting to taper ? 
 

I posted on Sunday, explaining how to do this.  Please go back and reread this post.  

 

The 2 week hold periods are if you do microtapering.  This link explains about that.  

 

Brass Monkey Slide Method of Microtapering

 

We've also asked you repeatedly for daily drug and symptom notes, but haven't seen those yet.  Also On My Way asked you questions about your drug history on Monday, which you haven't answered. 

On 1/23/2023 at 9:26 PM, Onmyway said:

Please answer them in the post text and I will add them to the signature. Please answer where I have put the A: - so that I can find them easily. You can write text to explain more later - try to make these answers as succinct as possible. 

 

- When did you start citalopram (year, if possible month)

A: 

 

- When did you change your doses of citalopram (year, month if possible for the various changes) - pls do your best, if changes are older than 2 years

A: 

 

- When did you start lorazepam (ativan) (year, month if possible) 

A: 

 

- When did you increase your lorazepam (ativan) (year, month if possible for every change - the more accurate the better for recent changes)

A: 

 

Was amitriptyline before 2000 (which would mean as a kid)? Or after stopping paxil in 2001?

A: 

 

When did you start guanfacine?

A: 

 

Was guanfacine prescribed for diabetes or for mental health issues? 

A: 

 

Are you taking any other medicines or supplements? This includes everything in pill form or herbal tea or smoking etc. 

A: 

 

 

I believe that if you can try to get a grasp on what we are saying, and start to reduce your drug load, that you can get out from under this.  There is a lot of hope for you, but it takes time, diligence, and patience.  

Edited January 26, 2023 by getofflex

[Onmyway]

10 hours ago, draggin49 said:

I wish someone like you could explain this to my psychiatrist.Unless it was from someone intelligent with experience it seems like he wouldn’t accept it hearing it from me. I feel so helpless , I get made to feel like by him that there isn’t anything wrong with what I’m currently on. 
What manner could I lower the citalopram ? How much per week, and would I be doing the 2 week hold periods after 4 weeks of tapering ? 
I think you mentioned I’d need to switch to liquid to do this ? But do I need to take liquid for a set time before starting to taper ? 
 

@draggin49

is your goal to fix your psychiatrist's thinking or is it to get better. If it is the former, we are not involved in that business. If it is the latter, then you have been given all the advice above including on how to lower your citalopram. 

 

We have requested information from you which you are not providing. If you don't want to help yourself, I am not about to spend more time with you. 

 

Your daily citalopram dose is so high that you can actually drop dead from it due to sudden cardiac arrest. (Pls see FDA warning above). Your serotonergic drugs are at such high doses that it is a miracle you haven't had serotonin syndrome yet. Or you may be having it at a low level. What you choose to do is up to you. We have given you the resources. 

 

Good luck. 

[draggin49]

11 minutes ago, Onmyway said:

@draggin49

is your goal to fix your psychiatrist's thinking or is it to get better. If it is the former, we are not involved in that business. If it is the latter, then you have been given all the advice above including on how to lower your citalopram. 

 

We have requested information from you which you are not providing. If you don't want to help yourself, I am not about to spend more time with you. 

 

Your daily citalopram dose is so high that you can actually drop dead from it due to sudden cardiac arrest. (Pls see FDA warning above). Your serotonergic drugs are at such high doses that it is a miracle you haven't had serotonin syndrome yet. Or you may be having it at a low level. What you choose to do is up to you. We have given you the resources. 

 

Good luck. 

I am emailing my psych this morning requesting everything you asked for from start of when I saw him ( what meds , dose started at , time spent at each dose as it was as increased If he refuses to give me the info you requested I will go  and find a new psychiatrist today . 

[draggin49]

yesterdays daily log 

 ( I had woke up at 3am feeling major anxiety , manged to fall back asleep on scale of 1-10 anxiety was an 8

7am took 1st 0.5 lorazepam . Still feeling alot of anxiety faded a bit an hour later anxiety went down to maybe a 7 on scale of 1-10

9am took amoxicillin for my tooth extraction. Didn’t notice any symptom change 

1130am took 60mgcelexa /guanfacine 1mg

1230pm took 0.5 lorazepam 

3pm amoxicillin 

630pm 3rd lorazepam 0.5 mg

9pm Amoxicillin 

1130pm 25 mg Amitriptyline/1 mg guanfacine 4th lorazepam 0.5 mg. Was having a difficult night , feeling of anxiety / hopelessness . Anxiety was back up to more like an 8 . No panic attack but definitely overwhelming . 
never felt  physically sick throughout the day, or any standout physical symptoms 

[draggin49]

In regards to dropping the celexa dose

you said “

 were you, I would start tapering citalopram at the earliest. We recommend no more than a 10% taper every 4 weeks but as an exception here if I were at that dose myself, I'd drop to 50mg first and then to 45 and 40 after that. And then continue the 10% reductions. I am not a fan of exceptions to the 10% rule and I go even slower at the low dose but at the higher dose you might be able to handle it. 
 

This would mean move from current 60mg and  do 50mg for 4 weeks correct ? 
45mg 4 weeks , 40 mg 4 weeks . Is this ONLY possible via liquid form or can I do the taper using pills adding up to the dose we are tapering down to?like a 40mg celexa plus a 10mg celexa which would equal the 50mg dose we want to move down to ? In the past I’ve only ever tapered using pills so my knowledge with tapering is limited . I apologize. I think there might be a pharmacy in next city over that does compounding meds into liquid form I don’t believe my current pharmacy does 
 

[manymoretodays]

3 hours ago, draggin49 said:

This would mean move from current 60mg and  do 50mg for 4 weeks correct ? 
45mg 4 weeks , 40 mg 4 weeks . Is this ONLY possible via liquid form or can I do the taper using pills adding up to the dose we are tapering down to?like a 40mg celexa plus a 10mg celexa which would equal the 50mg dose we want to move down to ? In the past I’ve only ever tapered using pills so my knowledge with tapering is limited . I apologize. I think there might be a pharmacy in next city over that does compounding meds into liquid form I don’t believe my current pharmacy does 

 

Yes, I would HOLD at 50 mg for 4 weeks, and then 45 mg for 4 weeks, and then 40 mg.

Have you studied the below topic?:

Tips for tapering off Celexa(citalopram)

If not, do so now

Also:  How to make a liquid from tablet or capsules

^ should be helpful

 

Good time I think for you to review......the first post here:

Why taper by 10% of my dosage?

and then, again the first post here as well:

Why taper? SERT transporter occupancy studies show importance of gradual change in plasma concentration

 

We are hoping that going from 60 mg of citalopram to 40 mg will not be a huge change in receptor occupancy, and so due to the danger of the high dose........are suggesting you might tolerate greater than 10% tapers to get you started and in a safer situation.  And tolerate it without too much in the way of WD symptoms.

Of course......we don't know for sure.  You are as unique as a snowflake.  And that is why record keeping, doing NOTES, will be really helpful when or if you do report back to us.

3 hours ago, draggin49 said:

yesterdays daily log 

 ( I had woke up at 3am feeling major anxiety , manged to fall back asleep on scale of 1-10 anxiety was an 8

7am took 1st 0.5 lorazepam . Still feeling alot of anxiety faded a bit an hour later anxiety went down to maybe a 7 on scale of 1-10

9am took amoxicillin for my tooth extraction. Didn’t notice any symptom change 

1130am took 60mgcelexa /guanfacine 1mg

1230pm took 0.5 lorazepam 

3pm amoxicillin 

630pm 3rd lorazepam 0.5 mg

9pm Amoxicillin 

1130pm 25 mg Amitriptyline/1 mg guanfacine 4th lorazepam 0.5 mg. Was having a difficult night , feeling of anxiety / hopelessness . Anxiety was back up to more like an 8 . No panic attack but definitely overwhelming . 
never felt  physically sick throughout the day, or any standout physical symptoms 

 

With the next set put a date at the top.  This one ^ is January 25th.  So no symptoms from 9 am to 11:30 pm to report at all?  Then note if you are up and around, what you are doing, if you are eating, taking a walk, doing hygiene......whatever put it there.

 

 

Many will take the DIY route, you don't neccessarily need a compounder but would need to understand what you are doing, and also might need a mixing container, and measuring syringes, for dosing accurracy.

 

Also, it is best to do some form of cross-over when changing formulations of your drug:

Cross Over: Changing form(eg tablet to liquid) of drug OR changing brand of same drug

 

Might you consider dropping back a bit with your Ativan/lorazepam too sometime soon?  Did you come up with a start date for doubling that dose?

 

And then again draggin49, if you don't really care about medication dependencies, and don't mind staying mired in psychiatry and pharmacology........then just stick with your doctors now.  Come back when you are motivated and determined and really WANT to taper and possibly get drug free some day.  Okay?  All I ask is you think about it, and make a decision as to what you would commit to.

 

Meantime.....oh my gosh......thank you.  You did an honorable good try at first day of NOTES/daily drug and symptom logs.  I would love to see today's tomorrow, and tomorrows the next day with you teasing them out a bit more as I suggested above.

 

Okay, enough said.  Have a super well enough healing day.

 

L, P, H, and G,

mmt

 

 

Edited January 26, 2023 by manymoretodays
spelling, grammar

[Altostrata]

On 1/25/2023 at 10:50 PM, draggin49 said:

I wish someone like you could explain this to my psychiatrist.

 

Take a good look at your own drug history, your current cocktail, and how you feel now. Why can you not explain that you feel overdrugged to your psychiatrist? Do you feel you can trust your psychiatrist? Can you say your psychiatrist is doing you any good?

 

Your psychiatrist is supposed to be working for you. Why do you have this doctor on your payroll? Do you think you really need a psychiatrist?

 

Any doctor, such as your GP, can prescribe these drugs. If you wanted to minimize your dosage, you can ask your GP to help. See How do you talk to a doctor about tapering and withdrawal?
 

If you feel you really need a psychiatrist, suggest you find one who will help you minimize your drugs.