annatino: I need help because I messed myself up

[annatino]

3 hours ago, Shep said:

More signs that you're taking good care of yourself. Very glad to read this. This is a STRONG sign of resiliency. Please continue to hold. This isn't about how fast you can get off these drugs. This is about how functional you can be as you get off the drugs. 

Last last night I think I forgot to take the Mirtazepine. I remember around 9 pm I looked at the bottle to check how many left are, so I could call for refill. 
At 10 pm what I was about to take the pill, for some reason I had a brain fog and I wasn’t sure if I took the pill at 9 pm and I was scared to take it twice.

I could not fall asleep all night. Around 3 am I took one progesterone Promentium 200mg to (help me fall asleep)that my Obgyn prescribed me 2 months ago, but had a very bad experience on this and on Estrogel for perimenopause so I decided to not take it. 
After I took it last night, big mistake. 
Fell asleep, yes but woke up in anxiety and sweating all night. 
I have been urinating like five times and had anxiety all morning.

 

I really don’t know what to do anymore because I know that I am in perimenopause for few years and it’s getting worst. 
Because I had hormonal deficiency, all the symptoms, I ended up in emergencies and hospitals and was put on psychiatric meds.

 

 

[annatino]

@Shep I just opened my notebook where I write what meds I take, mg etc

and I found the Mirtazepine inside.

Unbelievable how bad my memory is.

So I took it with me from the pill container to wait for 10pm to drink it, and closed the notebook with the pill inside.

When 10pm alarm started, I knew that I had the pill with me but I would not drink it at 9 pm so I thought what if I really did an hour earlier, so I was scared to take another one.
This sent me into a long hours until 3 am not able to fall asleep. 
I was so desperate to fall asleep and tried the Promentium to get me drowsy.

Only to wake up many times in panic and sweating.

I had a rough night and morning and now it’s 2pm and still feel low.

Not sure what caused this.

Is it the Mirtazepine missing dose or the Promentium (many scary reviews about this “natural” progesterone), or could be both. 
Now, I have to resettle my CNS again.

[Shep]

@annatino Accidentally skipping or doubling a dose is common during withdrawal and your nervous system will settle down in time. You may find it helpful to read how other members have coped with perimenopause: 

 

Older female issues: perimenopause, menopause, WD or something else

 

You may want to read Altostrata's posts in that thread. She is the owner of this site and went through menopause while going through Paxil withdrawal. 

 

 

[annatino]

@ShepHi Shep,

 

I just want to let you guys know that I am doing fine.

 

Thank God, knock on wood. 
 

Soon I will start taper the Sertraline by 2.5% a week. I don’t want to jump right into 10% a month cut yet. 
 

With Lorazepam I will shave, dry cut 1 gram every two days instead doing water titration.

 

The 0.5mg pill it’s so tiny, it weighs  0.049g, so I will do like 0.005g p.w. a day basically.

 

It will take me till end of November to come to 0.004g ( because the scale won’t go further) which is ok, so I will take small steps. 
 

I will keep you posted every couple weeks to let you know how everything goes. 
 

Thank you again for helping be. I believe that God sent me to this website to get the proper help. I would not know what is going with the hysteria that I went through the past year and half. 
 

Much love.

 

[Shep]

17 hours ago, annatino said:

Soon I will start taper the Sertraline by 2.5% a week. I don’t want to jump right into 10% a month cut yet. 
 

With Lorazepam I will shave, dry cut 1 gram every two days instead doing water titration.

 

Please note we recommend tapering only one drug at a time. If you're seeing any benefit from the nighttime Ativan, you'll want to stay on that while you taper the sertraline. Even if you don't feel the Ativan is making you drowsy, removing a benzo while still on an SSRI such as sertraline can cause problems including anxiety and insomnia. 

 

Even if the benzo is not doing much to help, removing it too soon could cause you to stop sleeping. I'm going to post a pic that I like to use to demonstrate this. 

 

Think of this as a Jenga game: 

 

 

If you pull out the benzo, it could collapse your already destabilized nervous system. 

 

So from this perspective, keeping the benzo in place is helping, even if it's not doing much as far as working. But then again, it depends on your definition of "working". By holding it steady, you're letting these drugs do their job holding up your nervous system, so in that respect, they are working. 

 

How are you feeling? Is the hold helping? 

[annatino]

2 hours ago, Shep said:

nighttime Ativan, you'll want to stay on that while you taper the sertraline. Even if you don't feel the Ativan is making you drowsy, removing a benzo while still on an SSRI such as sertraline can cause problems including anxiety and insomnia. 

I don’t take Ativan in night time. 
I take half of 0.5mg at 9am and the other half at 2pm.

 

For sleep I am taking 15mg Mirtazepine. 

[annatino]

2 hours ago, Shep said:

How are you feeling? Is the hold helping?

I feel unmotivated on these meds. 
 

For some reason I felt a bit scared today when waking up.

 

I will start with the benzo first. 

I cannot see myself stuck with it until I am off Sertraline, which will take me some years.

 

[Shep]

20 hours ago, annatino said:

I will start with the benzo first. 

I cannot see myself stuck with it until I am off Sertraline, which will take me some years.

 

If you start to feel upticks in anxiety as you reduce the benzo, you may want to stop tapering it, stabilize, and then reduce the sertraline. Increases in anxiety when reducing a benzo may be a sign that the benzo was helping with the stimulating side effects of the antidepressant. 

 

Although we don't recommend reducing two drugs at once, there are times when it's best to reduce a sedating drug for awhile and then switch over to tapering a stimulating drug. 

[annatino]

@ShepI never was on daily Ativan for more then a month. 
I used it sparkly and what concerns me is to stay too long on it while I am tapping Sertraline. 
It does help with the anxiety but also I don’t want to build tolerance after taking it many months on the row.

 

Not sure how I will resolve this. 
 

I will try Sertraline every 3 weeks tapper, then if there are no withdrawals, every two weeks and so while taking the benzodiazepine and I will see how it goes. 

Thank you again Shep. 
 

Will keep you posted.

 

[Shep]

@annatinoYou may find this thread helpful for benzos:

 

"Benzo Tolerance withdrawal" during tapering - does it exist?

 

And for antidepressants:

 

Tachyphylaxis, Reaching Tolerance or as It's Lovingly Known “Poop-Out”

[annatino]

@Shep I am a bit scared to read more info. 
What is your opinion? 
Should I stay longer on benzo? How long would be in my case if I will start tapper Zoloft. 
Will I be able to tapper every three weeks Zoloft? 
I feel very unmitigated since on these drugs. I don’t feel like looking for work or even get of the bed unless it’s after 11 am. Sleeping like 11 hours and still feeling tired.

[annatino]

I meant unmotivated*

[Shep]

20 hours ago, annatino said:

@Shep I am a bit scared to read more info. 
What is your opinion? 
Should I stay longer on benzo? How long would be in my case if I will start tapper Zoloft. 
Will I be able to tapper every three weeks Zoloft? 
I feel very unmitigated since on these drugs. I don’t feel like looking for work or even get of the bed unless it’s after 11 am. Sleeping like 11 hours and still feeling tired.

 

20 hours ago, annatino said:

I meant unmotivated*

 

If you feel more unmotivated, tired, and sluggish within 30 minutes or so of taking the Ativan, you may want to make a decrease in the morning Ativan dose. You could try a 5% decrease to see how it goes. Daytime benzo use often causes people to feel sedated. 

 

Another option is to continue to hold and see if you can reach a stronger baseline. 

[annatino]

I don’t think it’s Ativan because both doses are taking in day time. 
I never feel sedated from the 2pm dose. 
I believe it’s the Zoloft.

 

[annatino]

@Shep

Hi Shep, 

 

I thought I will come by and say hi.

 

I am doing very good. I am stabilized for past months or more.

 

I started work part time and feeling great.

 

Couple days ago, I started to reduce 1g every day or two out of the 48g pill weight of Ativan.

 

I will take my time slowly and get off it.

 

Having tinnitus and body aches like muscle and joints. Not sure why. Maybe from starting running around with work or withdrawals. Other then that, thank God, I am not having anxiety.

 

I will come by every few weeks and let you know how I do. 
 

Thank you so much for helping me get back to normal to be able to function again.

 

[Shep]

23 hours ago, annatino said:

Couple days ago, I started to reduce 1g every day or two out of the 48g pill weight of Ativan.

 

I'm glad you're feeling better and are able to work. Very good news.  I just want to clarify how fast you wish to reduce. Are you doing a daily micro taper? What will be your monthly reduction rate? 

[annatino]

@ShepI want to stop the Ativan within 90 days. So in three months.

Why should I stay on it longer? Ok 

[annatino]

1 hour ago, Shep said:

I just want to clarify how fast you wish to reduce. Are you doing a daily micro taper? What will be your monthly reduction rate? 

This morning I had a very strange wake up.

I felt very low and anxious at the same time.

I cut from 0.049g to 0.044 in four days.

I will go slowly. 

[Shep]

10 hours ago, annatino said:

@ShepI want to stop the Ativan within 90 days. So in three months.

Why should I stay on it longer? Ok 

 

If you're dependent on Ativan, the slower you taper, the fewer withdrawal symptoms you'll have, which is why we recommend a 10% (or less) monthly reduction, based on the prior month's dose (not the original dose).

Why taper by 10% of my dosage?

 

10 hours ago, annatino said:

This morning I had a very strange wake up.

I felt very low and anxious at the same time.

I cut from 0.049g to 0.044 in four days.

I will go slowly. 

 

You may want to updose back to 0.049g since it's only been 4 days. Going slowly sounds like a good plan. 

[annatino]

@Shep Hi Shep,

 

The second day I woke up it was fine.

I am thinking maybe I had a reaction of mixing benzo and one drink the other night?

 

I have heard that mixing these two while withdrawing, it causes bad symptoms because alcohol affects GABA receptors the same way Ativan does. 
 

I will stay at 0.044g for couple weeks then go 10% reduction and I should be done in 6-7 months instead 2-3 the way I planned.
 

Thank you for everything, for being here for me when I was at my worst and didn’t know what is happening with me. 

 

I will come back every few weeks and post my progress. 
 

 

[ChessieCat]

4 hours ago, annatino said:

I am thinking maybe I had a reaction of mixing benzo and one drink the other night?

 

Yes that does sound very likely and not surprising.

 

alcohol-wine-and-beer

 

See this:

 

What is Happening in Your Brain

 

The following is from the Are We There Yet topic:

  

On 7/6/2020 at 5:50 AM, brassmonkey said:

Drinking alcohol is a major factor in excellent recoveries getting derailed.  We just had a case of a member who has been drug free for several years with an excellent recovery underway.  They had a couple of drinks over the weekend and tripped off their symptoms all over again.  Luckily, it cleared in a few days, but that is not always the case.

 

And from https://pubmed.ncbi.nlm.nih.gov/26466222/

 

Quote

Results: the studies reviewed describe the direct effect of alcohol on several neurotransmitter receptors (gamma-aminobutyric acid [GABA], glutamate, endocannabinoids AEA and 2-AG, among others), the indirect effect of alcohol on the limbic and opioid systems, and the effect on calcium and potassium channels and on proteins regulated by GABA in the hippocampus.

 

[annatino]

@ChessieCat I knew it. 
I only had one shot of vodka mixed with Red Bull.

Thanks for confirming it. 

 

 

[ChessieCat]

19 minutes ago, annatino said:

Red Bull.

 

And a large amount of caffeine.

 

My suggestion would be to hold on your dose and wait at least 4 weeks before considering a reduction.  And only reduce if you are stable.  You might consider only make a tiny reduction to start with.

 

caffeine-in-coffee-tea-soft-drinks-energy-drinks-tolerance-issues

 

 

By the way, please do not tag me.  I have it stated in my signature.  Thank you.

[annatino]

@Shep

Hi Shep. 
 

I want to ask you if I am going to major stress could I still tapper?

 

I’ve been crying until my eyes swelled and are raw now because my dad is in critical condition in ICU for past 20 days. 
He is being smoking and his lungs were bad since 15 years ago when he was in hospital and still smoked till the day collapsed at home in Romania. 
 

Ambulance came in 15 minutes. My mom told me after two weeks because on the 14 th was his 75 years old Bday and he didn’t answer me. 
 

My mom lied to me because she knew my condition and because I just stabilized she was scared that I would relapse again. 
 

He was intubated then released and intubated again and released in ventilator and I finally spoke to him and he was doing fine.

 

Yesterday I asked my mom and she said he is sedated and intubated again. 
 

I knew in my heart that this is possible a slow kill because I’ve read before that in UK and other countries they do this type o Liverpool protocol where they give morphine until they die but my mom assured me that the doctor there is trying her best to save his life but his lungs are pierced and cannot pump again so we have to expect the worst only if God wants him to live few more years. 
 

I am in Canada and haven’t seen him since March and I just wanted to say goodbye to him on the phone but he cannot hear or speak because the sedation 😭

 

I am the only child and my son which he loves him so much and he is there and I cannot go because I don’t have money for the plane tickets.

 

My heart is broken.

 

I am not sure if it’s a good idea to cut my Sertraline.

 

Did cut for past three weeks and was doing fine. 
 

 

[ChessieCat]

Generally SA recommends holding during times of stress.  And what you are going through at this time is MAJOR stress.  If I was me, the only reason I would reduce when going through a major stressor was if I knew for certain that I was having an adverse reaction to a drug and needed to reduce/get off the drug as quickly as possible.

[annatino]

Hi Chesiecat,

 

Thank you so much for your prompt response.

I will hold it. 

[annatino]

@Shep

Hi all!

 

Just wanted to come by and let you know that I am doing fine.

 

I still have sad days because my dad passed away on 29th of September, but it’s normal, it’s part of grieving.

 

I am reducing my meds as follow:

 

2.5% a week for Zoloft (currently at 28 mg)

5% biweekly for Mirtazepine (currently at 135 mg)

10% month for Ativan ( currently at 0.30 mg) 

All at the same time, but doing it in baby steps. 
 

I am trying to update 

my signature but it won’t let me add any more words. Not shire what I am doing wrong.
 

 

 

[Shep]

@annatinoI'm sorry to hear about the loss of your father. 

 

You're not doing anything wrong with your signature. It's limited to 12 lines. You may want to remove some of the narrative and simply list the month and year, drug name and dose. This post may help:

 

How to Summarize Your Drug History in Your Signature

 

2 hours ago, annatino said:

2.5% a week for Zoloft (currently at 28 mg)

5% biweekly for Mirtazepine (currently at 135 mg)

10% month for Ativan ( currently at 0.30 mg) 

All at the same time, but doing it in baby steps. 

 

I'm glad you're doing well, but this is not baby steps. If you feel your sleep getting worse, you may want to stop tapering the brakes (Ativan and mirtazapine). 

 

Taking multiple psych drugs? Which drug to taper first?

 

Please also see:

 

Taper more than one drug at a time?

 

Note this part written by Alto:

 

On 8/10/2011 at 2:34 PM, Altostrata said:

I also believe that simultaneously quitting benzos and antidepressants is perhaps the worst withdrawal strategy possible. Antidepressant withdrawal will knock out the regulatory effect of the serotonin system and benzo withdrawal will knock out the regulatory effect of the GABA system. Then you are trying to recover without two very important mechanisms for recovery. Ouch!

 

Please read that entire thread. I think you'll find the information helpful. 

 

[annatino]

56 minutes ago, Shep said:

 

I'm glad you're doing well, but this is not baby steps. If you feel your sleep getting worse, you may want to stop tapering the brakes (Ativan and mirtazapine

My sleep is more then enough.

I sleep 10 hours a night.

 

[annatino]

57 minutes ago, Shep said:

 

Please read that entire thread. I think you'll find the information helpful. 

So I will reduce Zoloft and Mirtazepine and will remain on 0.30mg Ativan

[annatino]

58 minutes ago, Shep said:

I'm sorry to hear about the loss of your father. 

Thank you. 
I was very sad and cried all day for a month.

[Shep]

1 minute ago, annatino said:

My sleep is more then enough.

I sleep 10 hours a night.

 

 

Do you feel overly sedated during the day? 

 

1 minute ago, annatino said:

So I will reduce Zoloft and Mirtazepine and will remain on 0.30mg Ativan

 

If the Ativan is the most helpful for sleep, this is a good plan. 

 

Just now, annatino said:

Thank you. 
I was very sad and cried all day for a month.

 

Make sure you're doing as much self care as you can. If you need to pause your taper, remember there's no rush. 

[annatino]

2 hours ago, Shep said:

Do you feel

 

2 hours ago, Shep said:

Do you feel overly sedated during the day? 

Not at all.

I just like to sleep long  

[annatino]

2 hours ago, Shep said:

If the Ativan is the most helpful for sleep, this is a good plan. 

Actually is the Mirtazepine that helps me sleep. 

[Shep]

9 hours ago, annatino said:

Actually is the Mirtazepine that helps me sleep. 

 

Then Mirtazapine is the LAST drug you'll want to taper. The goal is to preserve sleep. Since you reported that you're not overly sedated during the day, there's no reason to come off the sedating drugs first. 

 

I would taper the sertraline first, then Ativan, then mirtazapine. This will allow you to sleep well throughout your taper.

 

Please post your thoughts. 

 

 

[annatino]

5 hours ago, Shep said:

 

Then Mirtazapine is the LAST drug you'll want to taper. The goal is to preserve sleep. Since you reported that you're not overly sedated during the day, there's no reason to come off the sedating drugs first. 

 

I would taper the sertraline first, then Ativan, then mirtazapine. This will allow you to sleep well throughout your taper.

 

Please post your thoughts. 

 

 

I am trying to decrease Mirtazepine as well from 15mg.

I am having brain fog a lot and believe that since I am in Mirtazepine I am over sleeping as well. 
 

I am already at 13.5mg from 15mg and will decrease slowly, because this will take me 5 years to get to zero, and I cannot afford to stay this long on these meds. 
I was given this for sleep because I was in withdrawals a year ago, and the doctor thought I suffer of insomnia, which I never had this problem, I was just stressed and had some noisy neighbors that kept waking me up all night. 
 

I will see how I am doing with the taper, and if I can handle it, I will continue it.

 

I will keep you in touch.