Mario77: Multiple medication mishaps

[Mario77]

Thanks a lot , Alto. I will keep the notes coming.

[Mario77]

Able to read a chapter last evening!!!!

Sleep 10:30PM to 6AM

6AM woke up tense and dreading the day

7 AM propranolol 40mg, bit of agitation

8 AM clonazepam 0.75-brain fog, sleepy

9AM escitalopram 12.5mg, tinnitus, mild agitation, yawning

10 AM amlodipine 10mg, less brain fog

1130AM bit of agitation, cold, stiff back

1150 AM  chest pain, not bad

12 PM lunch

1:50PM bit of chest pain, stiff back (meeting at work?)

2:00 PM clonazepam 0.75 mg

2:50 PM sleepy

4:30 PM home, trying to nap

6 PM shopping!

7 PM dinner

9PM  clonazepam 0.75mg

Read 2 chapters!

10:30 PM  18.75 liquid mirtazapine

@Altostrata @Frogie

 

[Frogie]

@Mario77

 

It looks like your anxiety is getting a little better each day.

 

Just keep on the schedule and you will stabilize!

 

Good job.

[Mario77]

Not this morning...I'm VERY shaky...

[Frogie]

@Mario77

 

You are going to have good and bad days. Just try to make the best of it and put one foot in front of the other.

[Mario77]

@FrogieI'm scared. How to make the best of ...THIS? Yesterday I was so more stabile...What's going on?

[Frogie]

@Mario77

 

You are going to have good days and bad days, just like you did when you weren't on the meds.

 

I don't want to be harsh, but my therapist, who I dearly loved, and wished I still had, but I moved, told me to get over it and put one foot in front of the other. Take it hour by hour, minute by minute and second by second. And don't dwell on it. Just keep going, that's all you can do.

 

I know it's hard, but be thankful for everything you have. Go for a walk and look at nature, smell the fresh air, listen to the bird sing,  just be in the moment and not think about it all the time.

 

You'll get through it. I know it's scary, but you will. Read success stories on here, they are worth a million!

[Frogie]

@Mario77

 

What is Happening in Your Brain

 

Windows and Waves Pattern of Stabilization

[Mario77]

23 minutes ago, Frogie said:

Go for a walk and look at nature, smell the fresh air, listen to the bird sing,  just be in the moment and not think about it all the time.

Trying...But...

[Frogie]

@Mario77

 

It doesn't happen overnight. Your body takes time to heal.

[Mario77]

It's the worst day of my life. I am super-agitated. 

[Mario77]

@Altostrata @Frogie I am super agitated, jittery, can't stand still, have brain fog, back pain, I'm cold, can't concentrate, shaking, desperate...ANYTHING I can do? I just need some reassurance, I'm ready to give up

[Frogie]

@Mario77

 

I can't give you much reassurance other than you will be ok. You've changed doses and went up and down on doses so much that your body needs to just stabilize and I can't tell you how long it will take.

 

Like I told you before take a walk, get some fresh air.

 

"Change the channel" -- dealing with cognitive symptoms

 

Cognitive Behavior Therapy (CBT) for anxiety, depression

[Altostrata]

@Mario77, in discussing your symptom patterns, you may have noticed we always ask when a symptom happens. Please supply this information so we don't have to ask for it every time you post about an isolated symptom.

 

As explained previously, it's very possible you're just now feeling drug changes you made 2 weeks ago.

[Mario77]

It happens now, after I was relatively OK yesterday. Is it possible to be from my changes 2 weeks ago?!

[Altostrata]

I mean: We need to know how you feel before and after taking each drug, and your symptoms in between. Post 24 hours of notes at a time in this topic, in a simple list format with time o’clock on the left and notation (symptom or drug and dosage) on the right. This can show if your symptoms are adverse effects from one of your drugs.

[Mario77]

@Altostrata@Frogie I realize you are helping multiple people at the same time. I really appreciate your advice

 

630 AM woke up, agitated

700 AM  propranolol 40mg, agitation, stiff back

800 AM clonazepam 0.75 agitation, abdominal muscle contraction

900 AM escitalopram 12.5  Increasing agitation, abdominal  contraction. stiff back, back pain,

10:30 AM Shivering

10:35 AM Amlodipine 10mg

1100 AM Agitation, shivers

12 PM lunch, shivers,agitation

1230 PM Burning sensation along the spine, pacing

130 PM Extreme agitation, akathisia?

2PM clonazepam 0.75

3 PM Super agitation, stiff back,  jittery, can't stand still, have brain fog, back pain, I'm cold, can't concentrate, shaking, desperate

4PM Home-trying to  nap, woke up by terror moments, intrusive toughts, SI

6PM A bit better

7PM dinner,

8PM reading, TV

9:30 PM clonazepam 0.75mg

10.30PM 18.75 Mirtazapine

[Altostrata]

Clonazepam reaches steady-state in 5-20 days. The unnecessary additional 0.75mg clonazepam you added 12 days ago has backfired, with paradoxical reactions. The unnecessary additional Lexapro may be contributing as well. 

 

Suggest you start reducing the 2 p.m. 0.75mg clonazepam dose by 0.25mg. This is 11% of your total daily dose. The reduction will take about 12 days to take full effect, as it appears you metabolize clonazepam in about 12 days.

 

However, suggest you make the next 0.25mg decrease in the 2 p.m. dose, to 0.25mg in a week, the goal being to eliminate this dose after the next week, hoping you haven't become fully dependent on it.

 

You should feel progressively better over the next week. Please let us know how you're doing. 

[Mario77]

@AltostrataI used 0.75 clonazepam at lunch sparingly in November and December. December more regularly.  So, you suggest reducing 2pm clonazepam to 0.5 for a week and to 0.25 following week, and 0 the third week?

 

I feel bad and I am being asked why not increase the Lex? I don't want to, but I don't have an answer...Some people feel good at 15-20 or 30, at least for a while...How come?

I just need an answer to counter the people pushing me to increase my Lex.

 

I will start reducing the midday clonazepam to see what it will happen.

Thanks a lot!

[Altostrata]

We've been around this barn before, Mario. It appears your problem is TOO MUCH CLONAZEPAM. Increasing Lexapro is not going to help, it's probably going to make you worse.

 

You seem to be adverse to reducing your drugs. This is a site for going off drugs, not to provide free advice about self-medicating with benzos and other psychiatric drugs. If you want to increase the dosage of any of your drugs, please talk to your doctor -- and take your problems to your doctor.

[Mario77]

Please understand me , @AltostrataI appreciate your help. I do NOT want to increase my meds. I am ready to cut the clonazepam starting tomorrow. I want off of all my meds.

But right now I feel pretty bad and not functional.

I would appreciate an explanation for your suggestion. I know you helped thousand of people...Please do not give up on me, I know I am difficult. I apologize.

But I am being pressed for a reason not to raise my escitalopram, mostly by family. "It is an AD, not A-anxiety" is not good enough. 

Everything is at play: my career, relationship, life...

Yes, I followed my doctor's advice and here I am, in a bad place. I am ready to follow yours; however, some details regarding our plan would put my mind at ease.

Thank you.

[Mario77]

@Frogie @Altostrata

630M AM Woke up, dread

700 AM Propranolol 40, back to bed, no sleep, ruminating

800 AM  Clonazepam 0.75, back to bed, no sleep, ruminating

830 AM Got out of bed

900 AM escitalopram 12.5-agitation, tried to nap

1000AM Amlodipine 10

10:30 Am Running errands, brain fog

1100AM shivers, cold

12 PM lunch

1 PM agitation, stiff back

2PM clonazepam 0.75, tried to nap, jolted by terror

3PM reading on line, a bit better

630PM, looking forward to bed time, a bit better, 

800PM reading, TV

9:30 PM Clonazepam 0.75mg

11:30 PM mirtazapine 18.75 mg

[Altostrata]

The details of the plan have been explained to you repeatedly. You're taking TOO MUCH clonazepam and getting paradoxical reactions from it.

 

Reducing the clonazepam should reduce the paradoxical reactions. You should feel better. 

 

Suggest you tell your family to mind their own business. Also suggest you stop complaining to them, they don't know how to fix your drug situation.

[Mario77]

Thank you. I'll try 0.5 for a week, 0.25 the second and none the third. Is that OK, even if I used midday 0.75 since or before Thanksgiving?

Thanks, @Altostrata

[Altostrata]

Please review:

 

23 hours ago, Altostrata said:

Clonazepam reaches steady-state in 5-20 days. The unnecessary additional 0.75mg clonazepam you added 12 days ago has backfired, with paradoxical reactions. The unnecessary additional Lexapro may be contributing as well. 

 

Suggest you start reducing the 2 p.m. 0.75mg clonazepam dose by 0.25mg. This is 11% of your total daily dose. The reduction will take about 12 days to take full effect, as it appears you metabolize clonazepam in about 12 days.

 

However, suggest you make the next 0.25mg decrease in the 2 p.m. dose, to 0.25mg in a week, the goal being to eliminate this dose after the next week, hoping you haven't become fully dependent on it.

 

You should feel progressively better over the next week. Please let us know how you're doing. 

 

[Mario77]

@Altostrata

I am taking the midday dose for more than 12 days...that's my concern. Since I have paradoxical reaction, I shouldn't worry about tapering a "brake" first, correct?

Thanks,

[Altostrata]

We've been around this for 6 pages, Mario. Please stop waffling and get on it.

[Mario77]

Got it. Thank you, @Altostrata

I'll keep you posted. 

 

[Mario77]

@Frogie @Altostrata

7AM woke up anxious, took propranolol 40 mg

8AM clonazepam 0.75 mg, back to bed , rumination, muscle fasciculations

9AM escitalopram 12.5 mg muscle fasciculations, agitation, chills, shakiness

10AM amlodipine 10 mg agitation

1130AM brunch

1230 chills, increased agitation

1:30 slight headache

2PM 0.5mg clonazepam

3PM nap with terror jolts

4PM back pain with burning sensation along the spine, mild chest pain

5PM Dinner out, VERY TENSE

730PM back from dinner, tense, agitation

830PM clonazepam 0.75mg

10 PM nap

11 PM mirtazapine 18.75mg

 

 

[Mario77]

@Frogie @AltostrataExtreme agitation, restlessness and frozen painful back prior to my 2 pm Clonazepam and now, one hr after 0.5 mg. Not sure I can get through this...How long is gonna be like this? This morning deep depression and black thoughts...What can I do, just suffer? Again, I am ready to go to the ER, but I am sure they won't know what to do. The back pain is horrendous (10/10) with a bit of headache (3/10).

[Frogie]

@Mario77

 

You could try an Epson salt bath, a heating pad, even some tylenol.

 

It is your choice to go to the ER, but they are just going to pump you with all kinds of unneeded medications and send you home. Or admit you where the dr will change your medications and put you in a whirl wind all over again.

 

Your body need time to heal. I know this is the pits, but you will get through it. I feel for you, I really do. I've been there. I just used to go for walks, even in 20 degree weather, fresh air, Epson salt baths, hot showers, heating pad, watching tv and just trying not to dwell on it helped me the most.

 

 

[Mario77]

So, is this normal? The second day after cutting 0.25 clonazepam and I am floored. 

Can I take Tylenol then?

[Frogie]

Yes you can take tylenol.

 

Yes this is perfectly normal, especially in your medication history/changes.

 

You will be fine. You can't dwell on it like I said. It will just make it worse.

 

Have a light snack, peanut butter and crackers, yogurt, things like that. Drink some peppermint tea. But just breathe.

[Altostrata]

After the reduction in dosage, it's going to take a few days for your average clonazepam blood level to go down.

[Mario77]

Thanks, @Altostrata. Should I still decrease next week another 0.25, as per plan?

[Altostrata]

We need to see how you're doing before deciding next steps !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!