PortugueseSea: metoclopramide, akathisia and mirtazapine

[PortugueseSea]

4 hours ago, Altostrata said:

You are not in an acute setting. However, if you take Klonopin every day (and sometimes every other day), you may become physiologically dependent and experience interdose withdrawal symptoms.

 

Thank you, that is my understanding. I have been very careful with the Klonopin and am hoping to not use it more than twice a week. In fact, ideally, I won't use it at all.

[PortugueseSea]

Monday:

 

Slept well

 

07:00 Woke up in a trance-like state, catatonic almost; severe head pressure that quickly led to suicidality.

07:00 - 12:00 Ate milk and cereals, restlessness grew on top of it, tried to remain calm and reminded myself of the transiency and temporary nature of not only the symptoms but also this whole mess. Suicidality diminishes.

12:00 Head pressure started to become self-limited to the right side of my head.

12:00 - 15:00 had a healthy lunch with friends and their children; was able to enjoy conversation despite the head pressure.

15:00 - 18:00 Head pressure morphed into pain (for which I'm very grateful) and restlessness almost completely disappeared for a couple hours! Amazing to feel almost normal for a little bit.

18:00 Restlessness comes back but it is limited, headache becomes muted.

20:00 Eat a burger for dinner

21:00 Take Mirtazapine 3.75mg (forgot it at home so couldn't take it another hour earlier lol

22:00 Take Mirtazapine 11.25 mg

22:00 - 23:00  Played video-games and then went to bed.

[PortugueseSea]

Tuesday:

 

Slept well

 

07:00 Woke up okayish

07:30 Ate healthy breakfast

10:00 Head pressure and limited restlessness

11:00 Symptoms start to ease; worked for one hour.

12:00 Ate a burger for lunch and went to my psych appointment and autogenic training

13:00 - 22:00 Relatively free of symptoms; activation/akathisia limited. Can hardly believe it. Had a slight headache, that is it.
23:00 Mirtazapine 15mg, Magnesium and go to bed.

This was my best day in over a month...
I've decided to only split the dose when back in Portugal, will move the 15mg to a later time to adjust to the time difference. Will keep you posted! My flight is the day after tomorrow.

[EttaLouWho]

So happy that you had a good day.  Praying for many more for you.

[PortugueseSea]

Wednesday:

07:00 Woke up okayish and took child to nursery school.

08:00 Ate a sugary breakfast.

09:00 Diffuse restlessness and discomfort starts building.

10:00 Packing to move back to Portugal.

12:40 Meet wife for lunch; healthy; symptoms remain the same. No anxiety and sadness though; I actually feel defiant and confident I will beat this. Talk about our future plans.

15:00 Go directly to work, zoned out at work. Discomfort becomes more focused in the neck area.
16:00 - 22:30 Work goes fairly well, restlessness bearable.
23:30 Mirtazapine 15mg and magnesium; go to bed.
00:30 Wake up with heart palpitations; subsided in 30m.

Well, that's new.

 

[EttaLouWho]

6 minutes ago, PortugueseSea said:

12:40 Meet wife for lunch; healthy; symptoms remain the same. No anxiety and sadness though; I actually feel defiant and confident I will beat this. Talk about our future plans.

 

This made me smile. Im glad you were able to have this positive time with your wife. Praying for you guys. 

[PortugueseSea]

Just now, EttaLouWho said:

This made me smile. Im glad you were able to have this positive time with your wife. Praying for you guys. 

And I for you; we will beat this together.

[EttaLouWho]

Yes, together my friend. 

[PortugueseSea]

Thursday:

07:00 wake up okayish
08: 00 eat healthy breakfast

10:00 - 17:00 fluctuating head pressure and diffuse restlessness/agitation; at times very teary. Walked around town and listened to music and audiobooks, I feel it helped  little, working on acceptance.

17:00 - 20:00 work; teary but okay mood.

20:00 eat a burger

20:00 - 23:00 symptoms calm down; played video-games
23:30 Mirtazapine 15mg and magnesium, go to bed.

I feel that agitation/akathisia and terror alternate in a way, one or the other is preeminent. Also, sometimes I do not know if I'm akathesic, at the border of a panic attack or agitated, or all three. It's hard to tell. Today I am obviously not calm and feel uncomfortable, but I am not fidgety. Am I just distressed because of the head pressure and labored breathing? I wish I could tell the difference, if someone has any idea let me know.

PS: Flying to Europe so my weekend updates will only be available on Sunday. Thanks for everything.

 

 

 

[EttaLouWho]

Hi @PortugueseSea  terror is a main component of akathisia but I understand what you mean here. I often have panic attacks and can feel them build and that feels different from the terror of akathisia. However they all feel so intertwined that it is difficult to say. Praying for your peace and safe trip to Portugal today. 
 

Also the below website has helped me tremendously. You may already be aware of it but it’s what I’ve been sending to family and friends and has helped me vocalize what I am feeling and going through the best. 
 

https://akathisiaalliance.org/for-family-and-friends/

[Elaine5]

Hi there, saw you followed my thread and wanted to say hi. Restlessness/terror is very upsetting symptom. I sometimes have that too. Cheers to you and hope you have a sunny day. 

[PortugueseSea]

Hello everyone, thank you so much for all the support. I am back in Portugal and all set up so will be posting daily from now on.

Here is the first missing daily update:

Friday:

07:00 - 15:00 woke up restless and stayed restless. Head discomfort came and went. Spent morning with my child.

15:00 Some reprieve from restlessness, anhedonia and anxiety. Teary most of the day, unsettled. 

18:00 Took bus to the airport, said goodbye to family

21:00 Restless focused on the back of my head, eventually settled on the right side.

23:00 Symtoms settle.

23:30 Boarded first flight

00:00 Took Mirtazapine 15mg, no magnesium.

 

Unfortunately, I need to leave right now. Will post the other two later today.

 

[PortugueseSea]

Saturday:

 

Broken sleep; seat was uncomfortable

Dubai time

03:30  Woke up restless before arriving in Dubai; localized discomfort in my head, eventually "moved" to chest. Feel restless.

04:45 Land in Dubai; diffuse restlessness, discomfort.

07:30 Before boarding onto the Lisbon flight restlessness lessens, I get a "veil of terror" in exchange, and DR.
08:30 In flight I get burning neck, slight chest pressure, bearable restlessness, diffuse.

 

Lisbon Time

12:30 Arrival in Lisbon; symptoms wax and wane throughout the flight.

13:30 Lunch with parents, feel discomfort but restlessness is diminished.

13:30 - 18:30 Chest pressure while breathing was the most noticeable symptom; restlessness and discomfort were barely noticeable. Enjoyed conversation with parents!

18:30 Take Mirtazapine (about a 3 hour difference from Japan dosing, maybe a bit much), magnesium and went to bed.

Sunday:

 

Slept well

 

05:30 Woke up okayish, feeling jetlagged.

06:00 Ate a cottage cheese sandwich

07:00 - 10:00 watched stuff on Amazon

10:00 Started work, went well

11:00 - 14:00 Restlessness biting, uncomfortable breathing, could not enjoy lunch that much.

12:00 Ate steak and salad for lunch.

14:00 Went for a walk with parents, helped.

14:00 - 19:30 Restless and fidgety, bearable; 

19:00 Light dinner, salad and turkey steak.

19:30 Take Mirtazapine, magnesium and went to bed.
 

[PortugueseSea]

Monday:

 

Slept well

 

06:00 Woke up with head pressure, slightly restless feel drowsy from jetlag. 

06:30 Cottage cheese sandwich.

07:00 - 12:00 Work

12:00 - 15:00 Lunch with borther and mom; eat beef skewer with salad. Was able to distract myself.

15:00 Went to a cafe with mother, feeling more restless, jetlagged.

16:00 - 18:00 Back home, nap, head pressure and restless still going

18:30 - 20:30 Eat dinner with dad. Meat and salad plus cheese.

20:30 Take the mirtazapine 15mg and magnesium, go to bed.

 

[PortugueseSea]

Tuesday:

06:00 Woke up restless and drowsy.

07:00 Used drowsiness to take a nap, felt better after.

08:00 Ate cottage cheese sandwich for breakfast.

09:00 - 11:00 Played videogames.

11:00 -14:00 Went for lunch with mom, ate pork risotto with wild mushrooms, feel dysphoric.

15:00 - 16:30 Intense akathisia attack; pacing, fidgeting, despair; probably reacted to the food.

16:30 - 21:00 Food poisoning symptoms; nausea, vomiting, malaise.

21:00 Took mirtazapine 15mg and went to bed.

 

My akathisia had never reacted to food before, now I know how that works.

 

 

[PortugueseSea]

Wednesday:

 

07:00 Woke up well; neck tension, discomfort focused on the back of the neck. Anhedonia is actually okay.

07:30 Ate healthy breakfast, cottage cheese sandwich, orange juice and a bit of chocolate.

08:00 Throat paresthesia

10:00 Agitation starts building, a bit of pacing and fidgeting; not a lot of despair though. Neck discomfort turns into pressure.

12:30 Neck pressure gets better.

14:40 Pressure on the right side of the head.

16:00 Window time! Barely any restlessness. Was able to sit and read a book for around 1 hour!!

18:00 Light dinner; salad, cheese and beef steak.

20:00 Able to sit down through a whole soccer match!

 

This was one of the best days I've had in a long while. For some time life wasn't torture, and that is saying a lot looking back at the last 9 months.

 

[PortugueseSea]

Thursday:

 

07:00 Woke up slightly restless, anhedonia.

07:30 Cottage cheese breakfast; played video games until 10 am.

10:00 Went shopping with dad, restlessness started building, paced a bit in the supermarket.

12:00 Ate a beef, lamb and pork sausage with salad for lunch with parents

12:30 Binge played video games, lost track of time, which is unusual and in a way good. Learning to cope with symptoms. Restlessness did not ease, stayed agitated until nighttime.

19:30 Salmon, raw cheese and salad dinner.

20:00 - 22:00 Watched a whole soccer match despite feeling restless.

21:00 Mirtazapine 15mg and Magnesium.

22:00 bedtime.

[PortugueseSea]

On 9/24/2022 at 5:44 AM, Altostrata said:

Move the 3.75mg by an hour earlier each day until you are taking it 12 hours before the evening dose. If it makes you too sleepy during the day, you'll have to make it a smaller morning dose.

Altostrata, I feel like I am stable enough after moving back to start moving the 3.75mg up by one hour until I hit the desired time. What do you think? 

Thank you for everything.

[Altostrata]

Sure, you could try that, see what happens.

[PortugueseSea]

Got it!

Will start soon and then deliver daily updates again. I find myself with a bad cold so I will delay this a bit more. 

Thank you.

[manymoretodays]

Oh no.  A cold, darn it!!

How are you adjusting to the time change PS?  Are you used to it yet?

Your sounding good and I am hoping you are settling in okay.

 

[PortugueseSea]

Time change adjustment is pretty well done.

 

Akathisia has been mild and things seem to be settling down. The oh so very bad cold did not seem to worsen my symptoms. I am waiting for it to heal before starting to move the 3,75mg.
I know maybe I am being overly conservative but I have come a long way and do not want to jeopardize my progress...

[manymoretodays]

Yay.

It's okay to go slow.

If akathisia is mild that is great.  Rename it or just further describe as "mild restlessness, or less agitation, or less anxiety, or less panic"  .......whatever it is that you previously called akathisia.  That can help your brain too in processing it more mildly.  Hopefully??!  I think I just made that up, but........maybe it will work in keeping you calmer overall.

Akathisia can be fierce, and one of the worst symptoms, so rename it if it has resolved in severity.

And praise the lucky stars above!

Edited October 13, 2022 by manymoretodays

[PortugueseSea]

19 hours ago, manymoretodays said:

Rename it or just further describe as "mild restlessness, or less agitation, or less anxiety, or less panic"

That is a great idea! To be honest, given that I only rarely feel the urge to move, it is better classified as agitation or even activation at this point. I have just changed it in my symptom notes to "agitation" today, talk about coincidence.
 

My very bad cold has gotten better, my parents were put on antibiotics for it so I was scared I'd have to go down that route. Thankfully, I didn't. One more thing to be thankful for!

 

19 hours ago, manymoretodays said:

And praise the lucky stars above!

 

Thank you so so much for your support. This is a very lonely experience and leaving my wife and son behind in Japan was not an easy choice, despite having her blessing to do so.
Also, in Portugal liquid mirtazapine is not available so I will likely have to do my own homemade "brew". Geez!

[PortugueseSea]

To be honest, and 6 months removed from the causative agent, 3 months removed from the follow up prescription cascade, I wonder how much of this is it "just" me reinforcing it by literally "worrying myself sick".

I know it's real, I know it started after the causative med but I might have compounded it. Neuroemotions are serious business and I am working hard on "normalizing" my fears and moving forward.

Maybe in Spring it was 80% the med and 20% me and now it is 50% the med and 50% me, who knows.

 

Regardless, the way forward must be one of optimism and affirmation!

[PortugueseSea]

I guess why I kept calling it akathisia despite my movements ceasing is because I never feel relaxed or content, always feel on edge. That said, that is something many feel during PAWS and other iatrogenic syndromes. 

Anyhow, I will change the nomenclature. It makes a whole lot of sense.

[manymoretodays]

Well that sounds good.  That maybe the change in terminology might help you some.

Sorry to hear you had to leave your family behind.  You must be missing them a lot right now.

 

Don't ever be so hard on yourself though again........doing that thing where you are feeling like it is all in your head, and your fault.  WD is real, when it occurs and can be tough.  You don't have to become a superhuman.

 

Any meditation or mindfulness stuff you do that helps.....that staying in the moment, looking for the roses, etc., etc.?

 

I'll look for some to link you to now.  Often the internet is our friend, when used right, for guided meditations, or music, or learning new non-drug coping.  Someone recommended this app to me recently called "Waking Up" and I've enjoyed it, and am still somewhat novice on regular, real regular meditation practice twice daily but.......it's helping.  I'm beyond WD I think now.  Just still healing from the whole experience and iatrogenic stuff I guess.

Anyway.....Waking Up will do a free trial and then if you cannot pay, you can do a scholarship......so you might try that.

 

Here's what I'm finding here, as far as links to different ideas and practices to help you feel less on edge all the time.  That is no fun.

I'll just go with the indexed list at the end of the first post of:

Non-drug techniques to cope

Scroll through the lists.  I like EFT, and journaling, and music making, listening, gratitude lists, journaling, and more.......

 

Sometimes.....it's just feeling alone, or lonliness.  Go kibbitz and support some of the other members if that's the case for you?

 

And know it's not your fault.  It isn't.  It's hard.  It's a lot of work.

You'll heal.

 

L, P, H, and G,

mmt

[PortugueseSea]

9 hours ago, manymoretodays said:

Don't ever be so hard on yourself though again........doing that thing where you are feeling like it is all in your head, and your fault.  WD is real, when it occurs and can be tough. 

Thank you, I guess I needed to hear that. The doctors make you feel it's all in your head. You know, the "It's out of your system" bull.

I had both an adverse reaction, withdrawal on top of that later, and everything was stupendously mishandled by the doctors, if they had figured it out sooner I wouldn't be in this mess, and I saw many.

 

9 hours ago, manymoretodays said:

 

Any meditation or mindfulness stuff you do that helps.....that staying in the moment, looking for the roses, etc., etc.?

 

I'll look for some to link you to now. 

Very grateful for all these resources, I've been exploring those and will keep doing it. I really want to set up a daily routine that works for me after this cold is over.

 

9 hours ago, manymoretodays said:

Sometimes.....it's just feeling alone, or lonliness.  Go kibbitz and support some of the other members if that's the case for you?

I want to get more into that, I think it makes me feel less alone and it gives some meaning to my suffering. 

It means the world to me you guys are keeping an eye on me.

 

[manymoretodays]

Yes.  And thank you for what you do to support others.

 

And I know, on the docs sometimes, and even other professionals sometimes,........... and then we have to rework our whole self while healing, to get out of that "we are so ill" mentality.  Trauma, if experienced outside of the system does tend to resurface too.  So good to be prepared, and cope the best we can during and after WD.

 

I've personally been blessed with some good pros for counseling.  It took me awhile too, to find the right ones, and be able to share candidly with them.  One knows me better than I know myself.......and still a keeper.  I do look forward to the day I let them go, and graduate into complete selfhood.  The right dependence isn't so bad, in the meantime.  Anyway.....just chatting......blah, blah, blah.  Back to work in a moment.

 

I'd give  it 7 to 14 days with the cold, for that to peak, and then get better again. 

 

Did you rule out the darn Covid with a test?

 

And.....if you ever need a release.  There is the swearing area in Off Topic(so you have to sign in) and many faith based threads, some religious specific, some open to all or Universal, in the Finding Meaning forum.  Both helpful depending on what you might need.

Finding Meaning forum

Lalochezia! The cursing thread

and you don't have to actually swear, just type it and it gets Xed out......makes me laugh when I swear sometimes, switches my gears is all

 

 

Best.  L, P, H, and G,

mmt

 

 

[PortugueseSea]

13 hours ago, manymoretodays said:

and then we have to rework our whole self while healing, to get out of that "we are so ill" mentality.

This is so true. I am working hard to change things right now. One the one hand I know it is "just withdrawal" and that worrying just makes things worse. On the other hand, I have little quality of life with this relentless agitation and that itself makes taking my mind off it difficult. Be that what it may, I am fully aware changing my mentality is key. My symptoms might be serious but the underlying condition is not (?).

To think myself moving towards health is a key part of healing.

 

13 hours ago, manymoretodays said:

I've personally been blessed with some good pros for counseling.  It took me awhile too, to find the right ones, and be able to share candidly with them.  One knows me better than I know myself.......and still a keeper.  I do look forward to the day I let them go, and graduate into complete selfhood.  The right dependence isn't so bad, in the meantime.  Anyway.....just chatting......blah, blah, blah.  Back to work in a moment.

I had good counseling but without full time work it has become untenable to pay for. I fully intend to go back to it once I feel well enough to return to the workplace.

For now my counseling happens... here? Or by talking with friends and family. Not ideal, I know... but...

 

 

13 hours ago, manymoretodays said:

 

I'd give  it 7 to 14 days with the cold, for that to peak, and then get better again. 

 

Did you rule out the darn Covid with a test?

Not COVID at all, it is a bacteria, my dad (or my mom) gave this to me lol, they both had the COVID test and were negative. So I decided there was no need to get one.

[manymoretodays]

Good. No Covid.

 

And oh yes.  Peers are the best or have been in my healing.

 

I just have to do co-pays, so not a ton to pay, and no charge for phone visits for me(that's an odd one, but so be it.....I'm thankful).......but.......kind of tired of being over analyzed and following dumbish rules......with some of the professionals.  I'm like, get real, be real, be human, and I am not an infant!

 

And yeah, well with WD......no one believes it, or very few.  I go with iatrogenic injury now, as most all WD has subsided.  Even that though......I mean it's like no short story to tell.  I've slowly....got more.....allies.  AND....trust myself and my truth about it all......which is now priceless.  I'm a stronger person, with what I do know about myself and my story.

 

Okay PS.  You heal.  Chicken soup, lot's of fluids.  Permission to lay about.  All granted.

 

L, P, H, and G,

mmt

[PortugueseSea]

On 10/16/2022 at 7:26 PM, manymoretodays said:

I go with iatrogenic injury now, as most all WD has subsided.

You still do not feel like 90% healed? Man, that is rough... It is a long road...

 

*added mod note:  I responded to this over on my Success Story

Edited November 1, 2022 by manymoretodays
mod note

[ChessieCat]

There are many existing topics on SA.  SA likes to keep similar information information in the same topic.  Before creating a new topic please do a search to see if one already exists.  You topic has been moved:

 

migraine-headache-neck-ache-pain-and-head-pressure

 

[PortugueseSea]

5 hours ago, ChessieCat said:

Before creating a new topic please do a search to see if one already exists.

Thank you, sorry. I thought my concern was specific enough to warrant a new one.

[PortugueseSea]

On 9/24/2022 at 5:44 AM, Altostrata said:

I suppose you could try this. Move the 3.75mg by an hour earlier each day until you are taking it 12 hours before the evening dose. If it makes you too sleepy during the day, you'll have to make it a smaller morning dose.

 

It appears you metabolize mirtazapine on the faster side of the range.

I am healed from both the jetlag and my bad cold. I will start moving the dose up today and will post daily symptom logs for as long as you think it is necessary. Thank you so much. 

I think I am slowly healing as you said I would with the mirtazapine but the agitation, specially around late morning and lunch time, I still hard to bear.

[PortugueseSea]

7 hours ago, PortugueseSea said:

I think I am slowly healing as you said I would with the mirtazapine but the agitation, specially around late morning and lunch time, I still hard to bear.

*is still hard to bear.