Angryhydrangea: amitriptyline withdrawal

[Angryhydrangea]

Hi folks, 

After reading all of the good advice on here about how to properly taper off a medication I'm a bit embarrassed to confess how rashly I approached the process, but in my defense, in none of my discussions with my doctor did they ever suggest that I was moving too quickly. I dropped from 75mg to 32mg amitriptyline some time last year, then to 25mg about four months ago, and then last week I ran out of my prescription, couldn't get in touch with my doctor to get it refilled, and decided to just quit it altogether. I was also taking 25mg atenolol, and stopped taking it at the same time and for the same reason. I do understand that you are not supposed to simply stop taking a beta-blocker abruptly but, well, I did.

I didn't think dropping from 75mg to 32mg amitriptyline had caused me any problems, but in retrospect the overwhelming anxiety I attributed to being overworked in my doctoral studies was probably greatly exacerbated by it.

I was prescribed both medications for chronic migraines, depression, and anxiety. They worked very well for me for a long time, eliminating my morning depression, stopping my migraines almost entirely, and doing a lot for my anxiety. My migraines had reached a point prior to medication that I was experiencing suicidal ideation, and I believe the meds saved my life.

Over the years I started to notice some concerning sides: difficulty urinating, constipation, Reynaud's disease (from the atenolol), weight gain (40-ish pounds) and persistent increased appetite and sugar cravings. I also got pretty severe heartburn from the amitriptyline and worried about doing long-term damage there. I don't think I experienced any of the severe cognitive side effects that I have heard other people complain of, but to be honest it's hard to say. I am diagnosed C-PTSD and combined-type ADHD, and already have extremely poor short-term memory, difficulty focusing, frequent dissociation, emotional dysregulation, etc.  It can be very hard to pinpoint new problems when I already have so much going on.

As far as I could tell, these medications made an unliveable life liveable again. But I put enough distance between myself and the migraines and depression and felt brave enough to start lowering my dose, so I decided to give it a shot. Cut to today, and I've been on no medications for just over a week.

I can only describe the first week off as the worst physical anxiety I have ever experienced in my life. I had no thoughts associated with it, just a constant, full-body, wracking anxiety. I felt like my skin was electrified, I couldn't handle anything, and basically locked myself in the basement to be alone as much as possible. I was not remotely functional and more than once could not really move or speak. I had to run a couple errands with my partner and being in the grocery store/wal-mart was basically tottering back and forth between being dissociated and having a panic attack. I'm fortunate to live with people who understand mental health struggles, and thankfully I can safely take a break from my work. I cannot imagine what this would be like with children or a 9-5.

Today was much better, honestly I think because I found this forum last night and realized that I am going through withdrawal and that I'm not just stuck like this forever. I hope tomorrow will improve again, but it is what it is at this point. I had considered just going back on a lower dose of my medication but after a week it may be too late to make a difference? I'm not sure how the timeline works. Anyways, thanks for reading, here's hoping the anxiety does not return in full force tomorrow. It's worst in the morning. 

[Angryhydrangea]

Well, another very bad day today and more reading the content on this site about what withdrawal looks like and how to respond to it. My symptoms seem to follow a general timeline throughout the day. It's the worst in the first half of the day, with extreme anxiety beginning shortly after waking. This develops into intense physical symptoms very much in line with what others have described as their experience: my body feels "electrified", I feel extremely restless and agitated, sensitive to everything around me, it feels like my skin or my muscles are burning from the inside, I am nauseous (a symptom I have NEVER experienced from anxiety before, only ever with the most intense migraines), everything in my body aches, I am exhausted from pain and anxiety, and I have brain fog worse than anything I have ever experienced. I thought I knew what brain fog was. I know what it feels like to be "here but not here", for things to feel far away, to lack focus, to drift away... this is so much worse. It's truly as if there is a cloud around my head. 

 

I had a "warning" migraine yesterday (I don't know how else to describe it, it's like a headache that I can sense is the seed of a migraine but has not yet become debilitating. Increased light and noise sensitivity, a sense of dread as it often precedes a full-blown attack) for about 15 hours+. I fell asleep with it and woke up with it, which is generally a bad sign. I had some more warning senses again today but thankfully no full-blown migraine. 

 

In the second half of the day, around 5pm, the anxiety dramatically abates and the feeling that my body is electrified disappears entirely. I almost feel normal, except for the nausea, exhaustion, and other comparatively "minor complaints" like histamine response.

 

I am able to sleep. I feel very grateful for this given what I have read about others with insomnia.

 

I have an appointment with my doctor on Monday, I am going to try to reinstate at a reduced dose. I read on the site that cold turkey can make things much worse in the long run and I don't want that. 

 

I guess I am prepared for another hard day tomorrow.

 

One possible help is juniper tea. A friend of mine forages (we live in a place with a lot of untouched forest) and I had a cup of her juniper tea on a whim yesterday and was surprised to find that it seemed to alleviate some of my anxiety. I looked it up and there is thujone in juniper, a compound that affects GABA somehow. I don't really understand it, and it's quite a small amount, but it seemed to help. 

[Altostrata]

Welcome, @Angryhydrangea

 

How are you feeling now?

 

Yes, you are experiencing acute withdrawal. You might try reinstating 5mg, even as low a dose as this may stop the withdrawal symptoms, and you'll have less to taper off later. Did you use liquid to taper before?

 

Please let us know how you're doing.

[Angryhydrangea]

On 1/31/2021 at 3:08 AM, Altostrata said:

Welcome, @Angryhydrangea

 

How are you feeling now?

 

Yes, you are experiencing acute withdrawal. You might try reinstating 5mg, even as low a dose as this may stop the withdrawal symptoms, and you'll have less to taper off later. Did you use liquid to taper before?

 

Please let us know how you're doing.

 

Thanks for the welcome.

I didn't do a liquid, I split the pills and weighed them. 

I am doing much better today. I think my body is adjusting, and it seems if I can catch the cortisol spike in the morning and calm it down before it gets out of hand, I can prevent the whole day from spiralling out of control. It hits pretty much as soon as I move, so the first thing I do in the morning now is a guided meditation to calm me down and help push the anxiety out while I'm still lying in bed. I've also been researching techniques to control the pain response, which has been helping to with the headaches, muscle burning, itching, random aches and pains, etc. It doesn't go away, it just helps to stop me from panicking and becoming totally immobilized. 

It's still a struggle. I no longer feel like I'm dying, but the anxiety and pain is by no means gone. I'm still perpetually anxious and I get bouts of nausea, it's just less than what it was. I'm doing a lot of calming internal self-talk during the day to try to circumvent cortisol spikes, deep breathing when I feel a headache coming on (which is about every five to ten minutes...), and visualizing expelling anxiety when I start to feel it building up. I have a continuous twitch in my left eye, I get waves of anxiety through my body, I feel dehydrated a lot, and I'm totally wiped out by about 4pm. Right now the back of my neck and shoulders feel hot and prickly, my forearms are a bit tight (this is where I seem to hold most of my anxiety, in the morning I have to visualize pushing it out through my hands), and I have no focus. 

I saw my GP today and she acknowledged that I could still be feeling the effects of coming off the amitriptyline but she was not really affirming of my experience and didn't seem to want to hear anything about what I've been through in the past week or so, just asked me how I am feeling today, took a list of my symptoms, and then suggested that I try wellbutrin. I have been through a lot with medications in the past few months (prior to dropping the amitriptyline and atenolol I tried two different ADHD medications that both failed to help my concentration and seriously aggravated my anxiety) and I told her that I'm not ready to try introducing anything new to my body right now. She said it's fair enough to want to take a break but that if I continue to have anxiety and it is affecting my life we have to treat it. Thankfully I'm an adult and I can make my own decisions, so I will be taking my time before agreeing to try anything again. 

For now I am just going to focus on managing the symptoms and keeping my expectations for myself low. I wish I could focus, but I don't feel like my entire body is on fire, so that will have to be enough for now.

 

 

[Angryhydrangea]

Also, a funny coincidence, I was talking with my roommate about some of my symptoms last night (she has bipolar II and has also been through the wringer), and I mentioned this site. She said she used it to finally get off of effexor, she learned how to open the pills and count out the beads to taper.

[Mia1]

@Angryhydrangeahow are you doing?