annatino: I need help because I messed myself up

[Shep]

1 minute ago, annatino said:

Do you think that 11mg Ativan is too low dose? What could cause me to feel like this? I understand that I sped up taper the Ativan? 
 

 

Yes, I do think it was the Ativan decreases. I'm very glad to read you're getting liquid. That will help a lot.

 

I'm not sure if .11 mg is too low a dose, but it may be. It's safe to updose a benzo to where you were 2 - 4 weeks ago. It looks like you were at .15 mg 4 weeks ago, so you may want to updose partway back to that dose, perhaps .13 mg and see how you do. And then go into a very long hold at that same dose. 

 

Please do not change your dose when you transition to liquid. If you wish to updose, I would do that first while you're still on the pill form. Then hold for awhile before transitioning over to liquid. Only one change at a time so if you have problems, you'll know what caused it. 

[annatino]

Thank you Shep. 
 

At night I feel better but I believe I get morning inter dose withdrawals especially from tapering so low.

I will try to get the liquid. Will let you know how it goes.

Oh, I know that is a huge mistake to transition from pill to liquid while tapering. Definitely I will move into liquid after at least 3-4 weeks on a 0.13 mg pill form.

[annatino]

I meant 0.11mg* Ativan. God forbid 11mg. 

[annatino]

On 1/31/2023 at 6:49 PM, Shep said:

I'm very glad to read you're getting liquid. That will help a lo

Hi Shep, 

 

I spoke with a compounding pharmacy and unfortunately I don’t think this would be convenient. 
 

This is what the pharmacist answered back:

 

“Thank you for answering all my questions.

However, after checking the formulation we use, I realized that the liquid form of Lorazepam expires 14 days after it is made and the product needs to be refrigerated. Therefore, unless you are in GTA to pick it up or get the medication sent by same-day courier (which would increase the cost), I would suggest to try the capsule form or find a local compounding pharmacy for your convenience.”

[annatino]

Never mind, I got a way to get it. 
After consulting a different reference, they have found a formulation that lasts 35 days, either kept refrigerated or at room temperature. Therefore, they could compound a 30-day supply each time.
 

[annatino]

Hi Shep, 

 

I am having few days of intense withdrawals. 
I am on my second week from tapering Mirtazepine to 8mg. Also I fell and fractured my left hand pinky and have a split to wear for the next 6 weeks.

I am wondering if an physical injury could make things worst to the CNS and make my withdrawals more intense. 

I am better now but suffering with guilt emotions because the intrusive thoughts that bothered me for past 17 years. These thoughts are not mine, and the worst is because they associate with my child which makes me feel very sad of having them. 
 

I still did not get the liquid Ativan. My doctor wrote the prescription wrong and the pharmacy said it needs to be written their way, which upset my doctor. Now I have a different prescription written 0.11mg/1ml and will take it to the compounding pharmacy soon. 

 

In two weeks I will reduce the Mirtazepine to 7.5mg which will make it easier for me to break the tablet at the score line in two pieces, and take it two nights in a row, without cutting and weighting the pill anymore. I am planing to stay on this dose until I am off Sertraline, like the next two and half years.

 

How long should I wait till I move to the Sertraline tapper. Is there a wash out period? Or I could just move into Sertraline taper after being on 7.5mg Mirtazepine for one month at least?

 

 

 

Thank you. 

[Shep]

2 hours ago, annatino said:

Also I fell and fractured my left hand pinky and have a split to wear for the next 6 weeks.

I am wondering if an physical injury could make things worst to the CNS and make my withdrawals more intense. 

 

I'm sorry to read this, Annatino. Yes, a physical injury can definitely make things worse, especially if you're in pain and can't sleep.

 

Are you taking any medication for pain? If so, please list what you're taking - the name of the drug and the dose, including over the counter meds. 

 

2 hours ago, annatino said:

How long should I wait till I move to the Sertraline tapper. Is there a wash out period? Or I could just move into Sertraline taper after being on 7.5mg Mirtazepine for one month at least?

 

I would hold for at least a month after you get your mirtazapine at the 7.5 mg dose. You may want to hold even longer, since you're recovering from an injury. There's no rush. 

 

You'll want to be at what's called withdrawal normal:

 

WDNormal

[annatino]

32 minutes ago, Shep said:

 

Are you taking any medication for pain?

I had only took 400mg clear gel Advil once and second time I bought lower dose 200mg Advil and it was a blue die in it and had bad reaction. 
 

I am still sleeping good like eight hours and healing naturally. I don’t want to take OC meds. The swelling is going away after five days already, but the pain in the finger when I move it is still bad. So I know that it will take at least one more month. I am seeing the occupational therapist Friday again. And in three weeks I will see the doctor again too. Luckily didn’t need surgery. 

[Shep]

Sounds like you're hanging in there as best as possible, @annatino. I'm very glad to read you're sleeping so well. That will bring healing in time. 

[annatino]

@Shep, 

 

Dear Shep,

 

I didn’t post in a while. I was busy working and going fine for most of the 2023 year. 
 

Unfortunately, I am not in a good place right now. It’s been very hard for me the last month. 
I was under huge stress for a personal matter and for some reason I couldn’t cope and getting very ill day by day. 

In august I had an UTI and thought I will be ok without treatment because I had no symptoms.

Last month I went to my doctor and asked to do a blood test again and randomly did another UTI test and found out I had Klebsiella pneumonae, a bacteria that is resistant to many antibiotics. I was put on strong one for twelve days and cleared it out. 
I am having the worst time of my life with symptoms that make me feel very sick. I was bed ridden for few weeks and was afraid to leave the house. 
Now, I developed the worst withdrawals and feeling constantly nauseous, and terror from panic attacks or constant anxiety.

I probably moved to fast into my Zoloft taper, not sure. 
My doctor wanted to put me back on Prozac, the one that I took for 10 years. 
I don’t think bringing from Zoloft to Prozac is a good idea.

I took today 10mg Prozac and I decided not to touch it again.

 

I asked her for 0.5mg Ativan because I was not able to sleep even on 7.5mg Mirtazepine one night because the constant panic in my soul. 
 

I split 0.5mg into two parts and took 0.25mg and I felt like myself again, and it’s so much joy to feel normal.

 

In the morning I took 0.25mg but didn’t feel the effects so I am on anxiety again. 

I am afraid to restart Ativan, because last time I took it, it was 0.11mg in March 2023 and jumped. Was two weeks rough but I’ve made it fine after that, but cannot suffer so much like this. 

I am also 47 years old in couple days and I know that I’m perimenopausal. 
I had progesterone cream compounded for me, because I tried last year the pill and went into bad depression for few days. Soon after six days of applying the progesterone cream twice a day, I crushed so bad that this terror is out of this world. I realized that I’m the unlucky one that cannot tolerate progesterone, even my own progesterone makes me feel bad the two weeks prior my period.

I believe I have PMDD because I’ve suffer since 21. 

I need your help I’m my situation. Should I restart Ativan small dose until I’m off Zoloft? I am another 10 months to finish the taper if I will go 5% every two weeks, and still have Mirtazepine to taper which is another monster. 
Is this bad wave what I’m experiencing? I have nausea, anxiety and, headache and can’t function. My doctor and I had to apply for disability program for myself, and when I get better I am allowed to work part time while on it. Should only be temporary for few years until meds are out of my system. 
Thank you so much dear, and God bless. 

[LotusRising]

Hi @annatino,

 

I'm sorry to hear you're not doing well right now. It sounds like you've had additional stress and it's not uncommon for it to stir up withdrawal symptoms. 

 

17 hours ago, annatino said:

I am having the worst time of my life with symptoms that make me feel very sick. I was bed ridden for few weeks and was afraid to leave the house. 
Now, I developed the worst withdrawals and feeling constantly nauseous, and terror from panic attacks or constant anxiety.

 

Did these symptoms start after taking the antibiotic? Anything else happening that may have stirred things up - virus, alcohol, supplements, increase in exercise?

 

17 hours ago, annatino said:

I probably moved to fast into my Zoloft taper, not sure. 
My doctor wanted to put me back on Prozac, the one that I took for 10 years. 

When was your last zoloft reduction? Have you been following the recommended tapering strategy from SA, no more than 10% per month?

 

Personally, I would not restart ativan, as you would risk kindling. Just because you had a prior good experience with coming off ativan, unfortunately does not mean that you will again. Please see Hypersensitivity and Kindling

 

18 hours ago, annatino said:

I am also 47 years old in couple days and I know that I’m perimenopausal. 
I had progesterone cream compounded for me, because I tried last year the pill and went into bad depression for few days. Soon after six days of applying the progesterone cream twice a day, I crushed so bad that this terror is out of this world. I realized that I’m the unlucky one that cannot tolerate progesterone, even my own progesterone makes me feel bad the two weeks prior my period.

I believe I have PMDD because I’ve suffer since 21. 

 

I'm 47 and perimenopausal as well, so I can relate a little to the ups and downs of what this transition brings to the table. Have you ever tried working with a naturopath, or considered diet/lifestyle changes to help with PMDD? What coping skills are you currently using?

 

18 hours ago, annatino said:

Is this bad wave what I’m experiencing? I have nausea, anxiety and, headache and can’t function.

 

It's very possible this is the case due to the additional stress and the disturbance to your gut from the antibiotic. Unfortunately, these waves are an uncomfortable part of moving forward. I don't know that adding another medication will help, rather, it has the potential to make things worse. 

 

 

[annatino]

On 11/30/2023 at 3:20 PM, LotusRising said:

Hi @annatino,

 

I'm sorry to hear you're not doing well right now. It sounds like you've had additional stress and it's not uncommon for it to stir up withdrawal symptoms. 

 

 

Did these symptoms start after taking the antibiotic? Anything else happening that may have stirred things up - virus, alcohol, supplements, increase in exercise?

 

When was your last zoloft reduction? Have you been following the recommended tapering strategy from SA, no more than 10% per month?

 

Personally, I would not restart ativan, as you would risk kindling. Just because you had a prior good experience with coming off ativan, unfortunately does not mean that you will again. Please see Hypersensitivity and Kindling

 

 

I'm 47 and perimenopausal as well, so I can relate a little to the ups and downs of what this transition brings to the table. Have you ever tried working with a naturopath, or considered diet/lifestyle changes to help with PMDD? What coping skills are you currently using?

 

 

It's very possible this is the case due to the additional stress and the disturbance to your gut from the antibiotic. Unfortunately, these waves are an uncomfortable part of moving forward. I don't know that adding another medication will help, rather, it has the potential to make things worse. 

 

 

Hi Lotus,

Unfortunately I’m still in bad place. 
I am feeling very sick. I’ve tried 20mg Fluoxetine in hospital for fours days and I’ve decided to stop. 

Now I’m taking 0.5mg Ativan when needed, mostly daily, sometimes I’m splitting it in two pieces but it’s not really helping always. I had a two day window and did not take it.

Then today I took it split into two at 10:30 am and at 12:30pm and still have symptoms like nausea, tinnitus and extreme fatigue with some anxiety. 
I’m 47 and still have my period which is due in five days. I believe I’m in a bad perimenopause. Antidepressant worked fine for past year and ever since I was down to a small dose at 7mg when I was battling UTI and added the antibiotic, my CNS is wrecked. My bottom lip which I had surgery three years ago feels so tingling like I had a punch on my mouth. My ears are hissing off and on, my eyes are dry. 
Heart palpitations, anxiety sometimes severe with a heat on my chest and feeling like I’m losing my mind.

 

What can I do to make it better? 
 

Some people say that I need antidepressants to go through the peri/menopause symptoms or estrogen patches. I cannot tolerate any progesterone. I’m intolerant even on my own progesterone, example right now on the luteal phase before period arrives.

I am curious if symptoms will be more tolerable after the menses starts in five days. 
 

I am so desperate because I don’t know what is happening to me. I cannot work for past two months, my poor son is working and my mom had do come from Europe to help me. 
 

Please anyone can advise me hat to do? 

A year and half ago, @Shep was helping me so good to get stabilized, I wonder if she can help me again! God bless you all! 
 

[LotusRising]

@annatino

 

To confirm, it looks like you jumped from 7mg zoloft to zero in one month. Is that correct?

 

Are you still taking mirtazapine 7.5mg?

 

Can you please add the ativan to your signature - I need to know when you started it and how long you've been taking it daily?

 

1 hour ago, annatino said:

Then today I took it split into two at 10:30 am and at 12:30pm

 

Why did you split it into two, 2 1/2 hrs apart?

 

When did you take the antibiotic?

 

1 hour ago, annatino said:

Some people say that I need antidepressants to go through the peri/menopause symptoms or estrogen patches.

 

You do not need antidepressants to go through perimenopause, though doctors will certainly offer them to you for this. It's possible you had a poor response to progesterone because of an imbalance in estrogen/progesterone. I suggest speaking to a naturopath or nurse practitioner that specializes in hormones.

 

1 hour ago, annatino said:

What can I do to make it better?

 

I would stop making changes. Adding more drugs will only destabilize your CNS further.

 

If you answer the above questions and update your signature, we can try to help you out.

 

[annatino]

1 hour ago, LotusRising said:

To confirm, it looks like you jumped from 7mg zoloft to zero in one month. Is that correct?

Yes. Took 25 mg for couple days and then 12.5mg for couple days and I wasn’t feeling good then quit it all. After I was taking Prozac 20mg for few days. It’s been three weeks without any SSRI’s.

[annatino]

1 hour ago, LotusRising said:

Are you still taking mirtazapine 7.5mg?

I do take it. It is switched to oral dispersed because they gave me this in hospital those two days I was there.

The previous ones I took literally tasted like roach poison spray so I believe it damaged my gut as I was inflamed. Now I’ve lost 8 lbs during the withdrawals and take different form and my tummy is not inflamed anymore. 

[annatino]

1 hour ago, LotusRising said:

Can you please add the ativan to your signature - I need to know when you started it and how long you've been taking it daily?

I added it previously. I started it a month ago. Took it in the smallest possible dose and almost daily. 
Last time I took it it was in March this year and had it tapered down 10% cad very two weeks from 0.5mg since August 2022.

I had to reinstate the Ativan because I would have not survived. I was in constant terror and shaking after the 12 days of Ceffixime 400mg for Klebsiella pneumonae UTI. I read about this type of antibiotics that had affinity with GABA receptors. And I’m sure I floxed myself from it. Ever since the antibiotic treatment the insanity started. 
It was one after another one. Stoped the Zoloft after the antibiotic treatment. 

[annatino]

2 hours ago, LotusRising said:

I suggest speaking to a naturopath or nurse practitioner that specializes in hormones.

I have a lady that is trained by Dr. Lewis Newson from England and she is very knowledgeable to these therapies, but heard that Estrogen including progesterone is not good to take if I’m Benzo withdrawals, for at least two years. 

https://www.benzoinfo.com/medications-and-supplements/

Medications And Supplements Of Concern On Benzodiazepines, During Cessation And After Withdraw

 

[annatino]

2 hours ago, LotusRising said:

Why did you split it into two, 2 1/2 hrs apart

I split it into two to avoid inter dose withdrawals. This is how I used to do it last year, and how Shep guided me through because Ativan half life is around 18 hrs. 
But today the pills didn’t work, I still have waves and windows all day. 

[annatino]

2 hours ago, LotusRising said:

When did you take the antibiotic?

Took it around mid November for two weeks. 

[LotusRising]

1 hour ago, annatino said:

Took 25 mg for couple days and then 12.5mg for couple days and I wasn’t feeling good then quit it all. After I was taking Prozac 20mg for few days. It’s been three weeks without any SSRI’s.

 

It sounds like you may have disrupted your CNS here by going up and down on the zoloft and then stopping it completely.

 

1 hour ago, annatino said:

Ceffixime 400mg for Klebsiella pneumonae UTI. I read about this type of antibiotics that had affinity with GABA receptors. And I’m sure I floxed myself from it.

 

Cefixime is not a fluoroquinolone, so please don't worry that you've "floxxed" yourself, but it could certainly be contributing.

 

1 hour ago, annatino said:

Ever since the antibiotic treatment the insanity started.

 

Please explain here what happened. What symptoms are you getting? It's possible that they're related to stopping the sertraline, as well as starting the antibiotic.

 

4 hours ago, annatino said:

today I took it split into two at 10:30 am and at 12:30pm

 

Is this a typo? If you dose two times a day, it should be 12 hours apart. Is this what you did last time, with Shep? And why do you not feel like it's working?

[annatino]

5 minutes ago, LotusRising said:

If you dose two times a day, it should be 12 hours apart. Is this what you did last time, with Shep? And why do you not feel like it's working?

I try to take it after 4-6 hours from the first dose to get the half life 18-20 hours. 
I supposed to do 9 am and 1 pm but in rushed it today. 
When I did that last time with Shep, it worked. 
Do you have any idea that’s would benefit me better? 
Thank you so much for your prompt response. 

[LotusRising]

Just now, annatino said:

I supposed to do 9 am and 1 pm but in rushed it today. 
When I did that last time with Shep, it worked. 

If this worked for you before, then you could continue this. However, if it were me, I would dose 12 hrs apart to keep the drug level even in my system.

[annatino]

8 minutes ago, LotusRising said:

It's possible that they're related to stopping the sertraline, as well as starting the antibiotic.

These symptoms started to get worst while on the antibiotic. That’s when I started shaking and I stoped the Sertraline after going up and down 25mg, 12.5mg to zero within few days. 
It started when I had the extreme stress in begging of November but it was more like crying spells feeling depressed. 
After the progesterone and antibiotic, it started getting into panic attacks and physical anxiety. Horrible nausea, feeling like dying. 
I also found out my ferritin is 18 which makes me iron deficiency without anemia because my hemoglobin is within range. I’m taking heme iron Profferin three times a day for past two weeks, and I can see the red vessels coming back on my bottom eyelids. These were very pale and I was very weak. 
 

[annatino]

5 minutes ago, LotusRising said:

If this worked for you before, then you could continue this. However, if it were me, I would dose 12 hrs apart to keep the drug level even in my sy

It seems like it’s now working much. 
I really don’t want to increase the dosage. I still have symptoms but not unbearable like I used to. 

[LotusRising]

I think you should decide on a schedule for the ativan and stick to it. Then, I would give yourself a hold until symptoms start to subside. 

[annatino]

13 minutes ago, LotusRising said:

I think you should decide on a schedule for the ativan and stick to it. Then, I would give yourself a hold until symptoms start to subside. 

That’s what I’m trying to do. 
Will I have to start another tapper all over again after my symptoms subside?

[LotusRising]

Just now, annatino said:

Will I have to start another tapper all over again after my symptoms subside?

Yes, it would be safest to taper it since you've been taking it regularly for over 4 weeks. It's likely that you've already developed a dependency and since you're quite unstable from stopping the sertraline and taking the antibiotic, I'm not sure a fast taper would be suitable for you at this point. 

[annatino]

14 minutes ago, LotusRising said:

23 minutes ago, annatino said:

after my symptoms subside?

Yes, it would be safest to taper it since you've been taking

Thank you Lotus. I will try stabilize and will keep you posted.