Mario77: Multiple medication mishaps

[Mario77]

@Altostrata @Frogie

Jan 16th

 

0700AM Woke up anxious, propranolol 40mg

0800-1000AM In bed, depressed, with SI-

0800 Clonazepam 0.75mg

1000 Escitalopram 12.5mg

1100 Amlodipine 5mg (it was 5 from beginning, sorry)-some TV

1200 laying on couch, terror, agitation

01PM all of the above plus horrendous back pain

0140PM clonazepam 0.5 mg

0200PM Same as 1 PM

0300PM  Back pain better, but nauseated  

0400 PM back pain gone, (stiffness now) plus dread

0500 PM A bit better, still nausea

0700PM no appetite

0800PM Little better

08:30PM clonazepam 0.75mg

TV, reading, eating a bit

10:30 Mirtazapine liquid 18.75 mg

[Mario77]

Not so good, I guess, @AltostrataI caved in and took my 0.5mg clonazepam at 11:45 today. I could not take it anymore. My agitation was EXTREME. It's bit better now. Will post daily notes later.

[Mario77]

@Altostrata @Frogie

Jan 17

640 AM woke up, anxious, tossing and turning 

715AM propranolol 40, back to bed

800AM clonazepam 0.75, back pain, agitation, muscle fasciculations

0915AM escitalopram 12.5,  shivers 

1000AM amlodipine 5, jaw clenching, cold, went to WalMart

1100 AM extreme agitation 

1145 AM Clonazepam 0.5mg

1230 PM a bit better

0100 PM no appetite

130 PM Omega 3 (1640mg) and Mg 100mg

2:30 PM eat a croissant

400PM band headache, stiff upper back and neck muscles

630 PM a bit of dinner

800PM clonazepam 0.75

900PM Finished book to read, TV

1030PM mirt liquid 18.75

 

 

 

[Frogie]

@Mario77

 

Thank you for the notes.

 

It looks a little better. You were able to go to Walmart, you finished a book you were reading and you watched tv. Big improvement.

 

You can take Tylenol for your headaches, and aches and pains.

 

I know this is rough, but just as I pointed out, look at all the strides you made, not the negative.

Edited January 18, 2022 by Frogie

[Mario77]

And Target!😄

Thanks, @Frogie , but you know how the  mind is; I am fixated on the fact that I took my midday clonazepam around noon, instead of 2pm. But I was in such pain...I just switched to liquid mirt and cutting my benzo that I took for months...I am trying to see the positives. Trying...

[Frogie]

@Mario77

 

Positive will overpower negative. It's hard to learn and I'm still working in it myself🙂

[Mario77]

@Altostrata @Frogie

Just got back from my Doc. She was supportive of my plan to stop increasing meds and even tapering some. Her pace for doing that was obviously not 10% per months, but she was adamant that she will keep prescribing me the meds I need. I guess this is good news! Now , if I can increase my coping mechanisms to compensate for the benzo reduction...that would be great. Seeing the therapist in few hours...Wish me luck!!!

[Chlo]

Good luck, my friend!

[Frogie]

@Mario77

 

I'm glad the dr is supportive and hope the therapist will be as well!

[Mario77]

@Altostrata @FrogieBest day in months!

0640 AM Woke up, bit of agitation

0700 AM Propranolol 40mg

0800 AM Clonazepam 0.75mg

0900 AM Escitalopram 12.5

1000 AM Amlodipine 5

1100 Dr. appt

1200 lunch

All morning a bit of brain fog, stiff back, headache, tinnitus, slight muscle fasciculations

145PM clonazepam 0.5 

1500 Headache

1600 Therapist appt

2000 Still the best day ! NO back pain, chills, shakes, akathisia, shivers, jaw clenching

2100 clonazepam 0.75

Reading !!!

2230 18.75mg liquid mirtazapine

[Frogie]

@Mario77

 

It sounds so like you were very positive and it was a super day! I’m sure this will continue with a good attitude and getting off the afternoon dose.

[Mario77]

I can't believe the difference between today and yesterday.  I know, waves and windows....I am re-reading my previous post and I just can't believe it! Today I am back to all the symptoms. Will post the daily log in the evening.

[Mario77]

@Altostrata @Frogie

I was wondering, since my symptoms are worse in the morning and early afternoon, if I can move my clonazepam from 2PM to 1 PM or noon...

[Mario77]

@Frogie I forgot my morning 0.75 Clonazepam somehow...but took 0.5 at 1:20PM. What now? Take my evening 0.75 a bit earlier?

[Frogie]

@Mario77

 

I would keep on your schedule. Sometimes that happens, I forgot a lot to take my doses and I felt off for a while but by evening after taking my evening dose, I was ok.

 

Then just make sure you take it tomorrow.

[Mario77]

Thanks a lot! @Frogie

[Mario77]

@Frogie Maybe take the evening one a bit earlier, like 7PM, instead of 9PM?

[Frogie]

@Mario77

 

I wouldn't take it any earlier unless you don't think you can handle the extra couple of hours. You've already thrown yourself off not taking the morning dose and then to take the evening dose earlier will throw you off even more.

[Mario77]

5 hours ago, Mario77 said:

@Altostrata @Frogie

I was wondering, since my symptoms are worse in the morning and early afternoon, if I can move my clonazepam from 2PM to 1 PM or noon...

 

@FrogieThen, Should I stick with 2PM for midday dosing, too, regardless of my symptoms being worse in the AM ?

 

[Altostrata]

For the last time, @Mario77, we need to see a trend in your daily notes before recommending a drug change. Stop playing with your drugs.

[Mario77]

I followed your advice, staying at 12.5mg escitalopram and lowering my midday dose of clonazepam to 0.5mg, @AltostrataUnfortunately, I am not sure if today I took my morning clonazepam

[Altostrata]

Can't tell a damn thing without your symptom pattern as shown in those notes, Mario. Have you had an usual symptom pattern today?

[Mario77]

@AltostrataYes, I have had the usual pattern. A bit disappointed after the good day yesterday...and I freaked out a bit when I realize that MAYBE I missed my morning clonazepam.

[Mario77]

@Altostrata @Frogie

Jan 19

 

0640 Woke up

0700 Propranolol 40

0800 Breakfast Clonazepam? 0.75 (NOT SURE IF TAKEN OR NOT), 

0900 Escitalopram 12.5

1000 Amlodipine 5 : chills, shivers,  (mild)

1050 Back pain

1120 chills, jaw clenching

1pm Agitation, realized I might have missed my morning clonazepam

0120pm Clonazepam 0.5mg

300pm a bit better, stiff back muscles

430pm home, in bed, a bit better

600pm improving a bit, watching TV

700pm dinner

730pm bit of TV....

900pm will take 0.75 clonazepam

10pm will take 18.75 liquid mirtazapine

 

[Altostrata]

Unlikely you missed the dose. Your symptoms do not support this.

 

Please do not upset the applecart again by messing with your drugs.

[Frogie]

@Mario77

 

I agree with @Altostrata. You would have had a lot more symptoms missing that dose.

 

Just make sure you stay on a schedule. You could set alarms on your phone so you don't miss doses if that would help. I did that when tapering.

[Mario77]

Thank you for explaining the reason for why I might have not missed that dose, @Frogie.  I'll pay more attention in the future and stick with the plan. 

It's always easier to follow advice if the rationale is explained to me. 

[Mario77]

@Altostrata@Frogie

 

1/20 , all doses in mg

 

500 AM Woke up, but fell back asleep, I supposed

6:30 AM Woke up

7:00 AM Propranolol 40

8:00 AM  Clonazepam 0.75

Call work for sick day

9:00 AM Escitalopram 12.5

10:00 AM Amlodipine 5

11:00 AM Out of bed, after hours of tossing and turning, deep despair, suicidal ideation, headache, hyperventilation

11:15 AM Sandwich, feeling a bit better

0100PM Stiff back

0200 PM Clonazepam 0.5 

0400-0500 PM Nap with jolts of terror

0600 PM Walked the pets

0700 PM Dinner, feeling better

0800 PM TV

0900 PM will take 0.75 clonazepam, read a book

1000 PM will take liquid mirtazapine 18.75 mg

 

 

[Mario77]

@Frogie @Altostrata

 

1/21 ; all doses in mg

 

Something I have for a while but I never mentioned before: problems initiating urination, and completely emptying my bladder (it feels like I am done, but 5-10 seconds later...). I know it might be some sphincter dysregulation issue... 

 

0630 Woke up, hyperventilation

0700 Propranolol 40

0730 Breakfast, took care of pets

0815 Clonazepam, 0.75-bit of brain fog

0930 Escitalopram 12.5-brain fog, stiff back, thirsty

10:30 Amlodipine 5

11:00 Lunch, muscle fasciculations through the morning

12 noon stiff back, brain fog

1:30PM burning sensation along the spine

02 PM Clonazepam 0.5 mg

03 PM Still burning spine

04 PM Laying in bed

05 PM burning almost gone

07 pm watching some TV, no burning spine

09 pm clonazepam 0.75

10PM some TV or book

11 pm will take liquid mirtazapine 18.75

 

 

[Altostrata]

Pets? Pics, please.

 

Please look up adverse effects of amlodipine and propranolol. Knowing about your drugs is your job. Did you ever discuss your urination difficulty with the doctor who prescribed these drugs? Please do, and discuss alternatives, perhaps lower doses, that do not cause those adverse effects.

 

You've got 4 drugs clustered between 7 and 10:30 a.m. Why are you taking propranolol at all? Is it immediate-release? When was it added to your cocktail?

[Mario77]

@Altostrata

The amlodipine and propranolol were added years ago for my hypertension. They are immediate release. My urination issue was worse at 45 mirtazapine, when I talked to the doc . Since then I lower the dose and switched docs (but add escitalopram, unfortunately). 

My main issue is the burning spine, but I imagine that's common in benzo withdrawal.

All my pics are over 500kB, not sure how to attached them. I have a calico cat (Jewel) and a Havanese (Snoopy). I'll keep trying to post pics...

So, for now, no moves, try and stay at 0.5 clonazepam at 1400? 

Thank you!

 

 

[Altostrata]

Did you review adverse effects of amlodipine and propranolol? Did you discuss your urination issues with your doctor, and alternatives to the combination of these 2 drugs for your blood pressure? This is also your job, @Mario.

 

Not all of your problems are due to psychiatric drugs, though mirtazapine is also known to cause urination difficulties. That would be 3 drugs you're taking that can cause this, out of 5 drugs. In my opinion, you're taking too many drugs altogether. The combination can affect your mood as well. Fewer drugs is better.

[Mario77]

@AltostrataYes, I agree, fewer is better. I know about the side effects, but now I am stuck with them. Should I keep trying to get rid of my midday clonazepam? I take 0.5mg now, and I had horrendous backpain along the spine prior to dosing.

Fortunately, I am still sleeping, today even 1 hr longer. I will post 24 hr notes later. The urination problem is not such a  big deal as the back pain and sometimes agitation.

[Altostrata]

Yes, you're probably still taking too much benzodiazepine, as you have been doing for many years.

 

I have no idea whether the back pain might be related to your urinary problems. As I have explained numerous times, the drugs you're taking interact and these interactions may be causing some of your symptoms.

 

You should not be taking drugs you don't need or excessive dosages or drugs that are causing additional health problems, but that's your responsibility, not mine.

 

You have been extraordinarily passive in taking charge of your own health, despite our many requests. I am tired of looking at your symptom pattern and reviewing potential adverse effects of the amlodipine and propranolol combination with excessive benzodiazepine and possibly unnecessary escitalopram and mirtazapine. 

 

If you're fine with your symptom pattern, I have no more interest in it.

 

As you know, I have been dubious about your intention to go off your psychiatric drugs from the very start. Seems like you just want to get comfortable on the benzo. @Frogie, do you still want to see Mario's daily notes? I'm not going to look at them any more.

[Frogie]

@Mario77

 

Do you go to therapy? Not a psychiatrist for your meds, but a therapist once a week?

 

I think it would really help if you could learn some CBT to acknowledge and accept your feelings instead of just taking all these medications.

 

Cognitive Behavior Therapy (CBT) for anxiety, depression

 

You can't rely on these to make you feel better. You have to be able to take control of your life and not allow the medications to control you, which is happening right now. You are on a slew of medications, that you really need to work on going off, not "caving" and taking it to feel better.  That's when you know they are controlling you.

 

I want to see you get off of them, but it takes work. It's hard and not a walk in the park unfortunately. But it can be done.

 

 

[Mario77]

@Altostrata @Frogie

With all due respect, there might be some misunderstanding here. I hope not because English is not my first language. I would like to clarify some things.

15 hours ago, Altostrata said:

Yes, you're probably still taking too much benzodiazepine, as you have been doing for many years.

I started Diazepam in April 2021, 10 months ago. My doctor switched me to lorazepam in August and then to clonazepam in September last year. In the last 17 years , maybe I used benzo 2 or 3 years total but not more than 1 year in a cycle. Yes, I am taking too much but I have already cut 11% of my previous dose (as you suggested) and I am willing to continue the tapering.

 

15 hours ago, Altostrata said:

You should not be taking drugs you don't need or excessive dosages or drugs that are causing additional health problems

My drugs were prescribed by a cardiologist (propranolol and amlodipine) and a psychiatrist (the rest of them). I think I need hypertensive medication. Not sure about the rest, that's why I am here, for advise. I am trying to taper them down.

15 hours ago, Altostrata said:

You have been extraordinarily passive in taking charge of your own health, despite our many requests. I am tired of looking at your symptom pattern and reviewing potential adverse effects of the amlodipine and propranolol combination with excessive benzodiazepine and possibly unnecessary escitalopram and mirtazapine. 

I am not sure what  this means. Was I "extraordinarily passive"? I refused the doctor escitalopram increase, and the addition of clonidine and/or pregabalin. I was advised on SA to space the medication 1 hr. apart, to switch to liquid mirtazapine, hold at 12.5 escitalopram and cut my midday clonazepam to 0.5 from 0.75mg. I did all that. If you have any suggestions of how to manage the meds better, I am more than happy to listen. But you realize that I cannot suddenly drop all my medication at once (maybe amlodipine?).

 

I was on the propranolol/amlodipine combo for years.  I agree, the benzo is excessive, that's why I am trying to taper it. The escitalopram and mirtazapine might be unnecessary, but I am stuck with them for now. I am looking for ways to get rid of them; that's why I am on this site every day. I am not coming here  for fun, or to convert people to psychotropic drugs. I am suffering tremendously and need advise and support.  

15 hours ago, Altostrata said:

As you know, I have been dubious about your intention to go off your psychiatric drugs from the very start. Seems like you just want to get comfortable on the benzo.

This is really hurtful and not necessarily encouraging for someone who is suffering and looking for support.  Unfortunately, I know you had reservations about my commitment. Even now, I don't know why. I don't want to get comfortable on the benzo. I am trying to taper my medication. You suggested I cut 0.25 mg of my midday clonazepam. That's what I am doing for the last 8 days. And posting 24 hrs. notes to figure out the next step.

 

14 hours ago, Frogie said:

You are on a slew of medications, that you really need to work on going off, not "caving" and taking it to feel better. 

I know, and that is what I am trying to do. I thought I was supposed to go slowly and stabilize in between changes.  Believe me, If I would be able to get rid of all my meds tonight, I would do it.

 

14 hours ago, Frogie said:

You can't rely on these to make you feel better. You have to be able to take control of your life and not allow the medications to control you, which is happening right now. 

I am not relying on them; I am stuck with them. I cannot discard all my meds tonight and use only CBT or other psychotherapy (Yes, I do see a therapist weekly at the local university).

I am not taking meds to feel better; I am tapering them and I am looking for guidance.

 

I hope I am not offending anybody. But I am disappointed that after so much work and suffering, I am being accused of trying to be comfortable with my meds. Should that be the case, why am I spending hours here, looking for a glimmer of hope, assurance, advice, guidance, encouragement and maybe empathy?

If you have suggestions or advice, I am more than happy to try them and I will be forever grateful. Telling me I take too much of this, that you see interactions or that "I should be able to take control of my life" are not helpful because I know all this.  I need concrete advise on how to taper my drugs, that is my main goal while also trying to understand what is going on in my body.  It would be very helpful for me to know what should be the next step (i.e. lowering amlodipine or take it in the evening or something else I could do).  

Please let me know if this clarifies things and if we can continue to work constructively together.  I realize all of you are volunteers and provide this unvaluable service to the community. I would very much appreciate any support. 

Thank you very much.