54fiftyfour: trazodone WD

[54fiftyfour]

Hi all,

 

unfortunately, my story begins long ago.

In 2008, To cure the anxiety symptoms caused by the finasteride withdrawal  I was prescribed paroxetine and, already on the first day of intake, I developed PSSD with anesthesia and narrowing of the genitals (which still lasts). After a month of completing a forty-day course of taking paroxetine without a long tapering, the anxiety symptoms returned much stronger than before and included panic attacks, muscle twitching, motor agitation and restlessness, mental confusion, insomnia and so on. I developed, in other words, a withdrawal syndrome.

An indescribable ordeal began in 2009, with continuous prescriptions of antidepressants and benzodiazepines (citalopram, cymbalta, mirtazapine and Xanax) to contain the continuation of anxious-depressive symptoms. The more antidepressant drugs I took, the worse I was. Extreme anxiety, panic attacks, twitching, confusion and insomnia were joined by tremors in the hands and limbs, shivering, motor restlessness, numbness and mental confusion, photosensitivity to sunlight, tingling along the neck .

I solved this vicious circle after a year and a half of suffering by administering high doses of testosterone for six weeks. The extreme anxiety, panic attacks and all other related symptoms disappeared, while the effects on libido and genital sensitivity remained there and continue to this day.

For thirteen years, however, I have lived without drugs of any kind. From February 26 to March 19, on the advice of my doctor and believing that it was not dangerous at dosages below 150 mg., I made the colossal mistake, only  for a period of three weeks, of taking trazodone with muscle relaxant and sedative targets (3 days 25mg., then a week 50 mg., then another week 75 mg., and then three days drop to 50 mg. and then stop). I specify, in this regard, that before taking trazodone I had no particular problems of anxiety or depression, but only a difficulty in falling asleep due to work thoughts and so on. Nothing to justify taking an antidepressant. I was really very stupid.

Within a few days (March 22) I began to experience unusual levels of night and morning anxiety, with restless awakenings around 4.00 o'clock. I had to take again Xanax as needed, but on April 23, more than a month after the suspension of trazodone, the symptomatic crisis worsened and, to extreme anxiety, I got panic attacks with fainting, muscle twitching, tingling, shocks along the head, neck and arms, strong agitation, motor restlessness, dullness and mental confusion, insomnia, photosensitivity to sunlight, difficulty in relieving, intestinal cramps, exhaustion and so on and so forth. I recognize, in short, the same symptoms as in 2009 and a new persistent withdrawal syndrome.

To manage the withdrawal crises, a doctor prescribed me clonazepam. Now I'm taking 0.5 mg. in the night to combat insomnia and, during the day, 1 or 2 drops as needed, but not regularly. Clonazepam  accentuates my depression symptoms and, sometimes, I have the impression that, as soon as it is taken, it provokes paradoxical reactions before reducing anxiety and agitation levels.

I don't know if you can kindly answere and help me with some advice, but I am writing because I am really desperate and would like to know if, in these cases, something can be done to alleviate the symptoms, for example restore a small dosage of trazodone (in addition to clonazepam?). Doctors, obviously, don't believe in withdrawal symptoms, but they are really too strong now and I risck to lose job and the rest of my life.

 

Thanking you in advance for the attention you will be able to dedicate to my message, I cordially greet you.

 

Edited July 3, 2022 by ChessieCat
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[getofflex]

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.  I'm very sorry that the trazodone has caused such problems after only being on it for 3 weeks. It may be that your system became extra sensitive to psych meds from your drug history from 13 years prior.  What exact symptoms do you wish to alleviate by reinstating the trazodone?  

 

Can you please give us specific information in your signature about your drug history for all drugs you are on and have been on, especially for the past 18-24 months?  It would be especially helpful to have the details of your drugs in a concise vertical list (no symptoms), only drug names, specific dates (as best you can say for example early March if you don't recall the day) and dosages of each medication decrease or increase.  Use this format:

 

Drug name: date, dose, date, dose, date, dose…

Drug name: date, dose, date, dose, date, dose…

Etcetera

 

Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

How to List Drug History in Signature

 

Here is some important information about how these drugs actually work.  This explains why we get symptoms from going off of these medications. 

 

How Psychiatric Drugs Remodel Your Brain

 

 

This helps you understand what withdrawal syndrome is: 

 

Video on Recovery from Psych Drugs

 

Windows and Waves Pattern of Stabilization

 

 

Here is a link with checklists of common WD symptoms: 

 

Dr Joseph Glenmullen Withdrawal Symptom Checklists

 

 

Here are some techniques to cope with symptoms: 

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

Stability is really important when we are tapering off psych meds.  Please read the link about stability:

 

Keep It Simple, Slow, and Stable

 

 

We don't suggest many supplements, but 2 that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you. 

Magnesium

Omega 3 Fish Oil

 

Finally, going back on a small dose of your drug, or increasing your dose, which we call reinstatement, is best done very carefully.  This is temporary, and after stabilizing you would then taper gradually off of this.  There is some risk involved, and we need more specifics about your drug history before we can suggest a good dose at which to reinstate.  Here is some information about reinstatement.  

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

 

I will confer with the other staff, and one of us will come up with a suggestion for you. In the meantime, please read through the information about withdrawal syndrome. 

[Shep]

On 7/3/2022 at 6:54 AM, 54fiftyfour said:

To manage the withdrawal crises, a doctor prescribed me clonazepam. Now I'm taking 0.5 mg. in the night to combat insomnia and, during the day, 1 or 2 drops as needed, but not regularly. Clonazepam  accentuates my depression symptoms and, sometimes, I have the impression that, as soon as it is taken, it provokes paradoxical reactions before reducing anxiety and agitation levels.

 

Yes, clonazepam can indeed cause depression, as it's a central nervous system depressant, and it can cause paradoxical reactions. 

 

Also if you're taking it irregularly, that can cause problems, as well.

 

Once you set up a signature (getofflex left you a link), and we know the timeline for all of your recent drugs, we can help you sort out the best solution going forward. 

 

 

[54fiftyfour]

 

Getoffless

I don't know exactly what to expect from a reintroduction of trazodone. Maybe to alleviate some symptoms, but I'm not sure if it will work, also because, at the same time, I am taking a benzodiazepine.

 

Shep

I am planning to gradually switch from clonazepam to diazepam as I hope the latter will be easier to reduce as soon as it will be possible. Clonazepam also has controversial effects on my body. Sometimes it works, sometimes it doesn't. I've been taking it for almost two months. I think I'm already addicted. What kinds of problems can reliever intake cause? Inconsistent signals at GABA receptors?

[Altostrata]

Welcome, @54fiftyfour

 

What effect did trazodone have on you? It appears that going on and off destablized your system because of your history, which clearly sensitized and made your system vulnerable. Under these circumstances, we often advise people hold on until the adverse reaction settles down. Some people take benzos for this.

 

How has your symptom pattern changed in the last month?

 

As @Shep said, your benzos may be causing you problems. 

[54fiftyfour]

Trazodone withdrawal destroyed me from a phisical and emotional point of view. Please, see the list of symptoms in my first post.

 

Since now, symptoms have increased day by day and there are only waves with some little and fare hour of non complete windows. I fear this will non end anymore and everybody wants me to go in a psichiatric clinic to cure, in particolar with low dose of olanzapine.

 

I'm not able to cook alone and doing normal activities (i.e. shopping), except than working with a lot of sacrifice. The rest of the time I want to stay on bed at home of my parents, who are desperate.

 

Anxyety is ever present and this is the reason of benzos use. Which kind of problems can they give?

[Shep]

17 hours ago, 54fiftyfour said:

Shep

I am planning to gradually switch from clonazepam to diazepam as I hope the latter will be easier to reduce as soon as it will be possible. Clonazepam also has controversial effects on my body. Sometimes it works, sometimes it doesn't. I've been taking it for almost two months. I think I'm already addicted. What kinds of problems can reliever intake cause? Inconsistent signals at GABA receptors?

 

The reason most people switch to diazepam is for the longer half life. But clonazepam also has a long half life. Clonazepam's half life is 18 - 50 hours, so you can take it one to two times a day and not have to deal with interdose withdrawal (going into withdrawal in between doses). We don't recommend switching to diazepam because you'll go into withdrawal from your current benzo and the diazepam may or may not cover that withdrawal. And continuing to make abrupt changes by switching benzos can cause nervous system kindling, which is damage to the nervous system from repeated withdrawals. You've already switched from Xanax to clonazepam. 

 

We recommend taking all drugs at the same time and dose each day. This keeps the drug level in your bloodstream. 

 

When you take a drug irregularly, it causes you to go into withdrawal in between doses. Instead of switching to diazepam, I would set up a daily schedule for taking clonazepam in the morning and in the evening and try to stabilize. 

 

Please add the clonazepam dose in milligrams to your signature (right now, you have the dose in drops). 

[54fiftyfour]

Shep

The problem is that clonazepam enhances my depression symptoms (expecially in the morning), prevents me from working. If I stabilize it also in the morning and afternoon every day, I can't do any activitiy and increase my suicidal symptoms. Besides, I'm also wondering how difficult it is to taper, being much concentrated than diazepam. Isn't diazepam easier to taper?

 

Do you think I risk to fall into a withdrawal from clonazepam, even if I do a very gradual substitution, as recommended by Ashton manual? In this case, what should I do with inconsistent morning or afternoon clonazepam dosages? I'm so worried.

[Altostrata]

What are your current most prominent symptoms and how has your symptom pattern changed in the last month?

 

[54fiftyfour]

In the last month panic attacks and electric shocks from the head to the arms and back are decreased and almost disappeared.

 

Symptoms that remain unchanged are: high level of acatisia and psycho-motor agitation, especially at sunrise (not able to stay in bed);  insomnia; strong derealization; fear and extreme anxiety; total anhedonia; mental confusion; flu-like malaise throughout the body.

 

Depression, PSSD and loss weight have increased.

 

I live as I am another person than before and I feel very depress when thinking to the past. 

[Shep]

17 hours ago, 54fiftyfour said:

Shep

The problem is that clonazepam enhances my depression symptoms (expecially in the morning), prevents me from working. If I stabilize it also in the morning and afternoon every day, I can't do any activitiy and increase my suicidal symptoms. Besides, I'm also wondering how difficult it is to taper, being much concentrated than diazepam. Isn't diazepam easier to taper?

 

Do you think I risk to fall into a withdrawal from clonazepam, even if I do a very gradual substitution, as recommended by Ashton manual? In this case, what should I do with inconsistent morning or afternoon clonazepam dosages? I'm so worried.

 

No, diazepam isn't necessarily easier to taper. Crossovers aren't recommended for people who are already destabilized. Once the nervous system is destabilized, crossovers are very risky. 

 

Also, diazepam is sedating for a lot of people, so it can cause a lot of fatigue during the day. Is that currently a problem when you take clonazepam during the day? 

 

I would get on a regular dosing schedule of the clonazepam. If it's too sedating during the day, you could only take it at night to get some much-needed sleep and then work with non-drug coping skills to get through the day.

 

Non-drug techniques to cope with emotional symptoms

 

Please post your thoughts. 

[54fiftyfour]

Shep,

 

I will seriously take into account your suggestions, even if I would have altready scheduled the switch with the psychiatrist. I'll try to convince her otherwise.

 

The problem is that, often, in the morning the levels of anxyety and agitation are too strong to manage them with non-drug methods. So far I have done this: I do not take anything if symptoms are bearable, otherwise I need to take two drops when need. Do you think I should be regular, also when symptoms are not too strong?

 

Second thing: reading the forum, I'm going to convince myself that there are very little hope to recovery and, in any case, it will probably need a lot of years, not months. My past experience of drug assumption addeed to a recent cold turkey suspension of trazodone, the worst thing to do. How can I realistically believe that this nightmare will over?  

 

  

[getofflex]

4 hours ago, 54fiftyfour said:

Second thing: reading the forum, I'm going to convince myself that there are very little hope to recovery and, in any case, it will probably need a lot of years, not months.

If you read the success stories of this forum it should convince you have plenty of hope for recovery.  It can take months, or years.  However, the acute phase does not last for years.  As time goes on, this will become milder, and easier to live with it.  It has for me.  

 

Here are some success stories of people who recovered from trazodone. 

 

Kronicles900 Success Story

 

Armstrong Success Story

 

Undiagnosed Success Story

 

Also, I recovered from trazodone, haven't taken it in 2 years 7 months.  

 

 

[getofflex]

4 hours ago, 54fiftyfour said:

The problem is that, often, in the morning the levels of anxyety and agitation are too strong to manage them with non-drug methods. So far I have done this: I do not take anything if symptoms are bearable, otherwise I need to take two drops when need. Do you think I should be regular, also when symptoms are not too strong?

You've just joined the forum 5 days ago.  Have you really given the non-drug methods a fair shot?  These are habits of mind that can take weeks or months to learn to use, and they do take some work and self discipline.  I find that going for a walk outside really help me to calm agitation.  Try the Claire Weekes link (third link) for a quick audio tutorial on anxiety. 

 

Audio:  First Aid for Panic (4 minutes)
 

CBT Course:  An Introductory Self-Help Course in Cognitive Behaviour Therapy
 

Audio:  How to Recover from Anxiety - Dr Claire Weekes
 

Anxiety Stuff - all kinds of stuff about anxiety attacks and things that help ...

 

Dealing With Emotional Spirals

 

"Change the channel" -- dealing with cognitive symptoms

 

 

Acknowledge Accept Float

 

Music to Calm Anxiety

 

Breathing Technique for Anxiety

 

Meditation

 

Audio:  First Aid for Panic (4 minutes) Female voice - getselfhelp.co.uk

 

Audio:  First Aid for Panic (4 minutes) Male voice - getselfhelp.co.uk

Edited July 7, 2022 by getofflex

[54fiftyfour]

Getoffless,

thank you for your advice, but believe me, in this moment I can't manage so strong and frequent symptoms without benzos, even if I hate them. What do you mean for acute phase? I believed to be already in PAWS after three months of withdrawal. 

 

Altostrada,

you asked me how my symptoms have changed in the last month. Why? I answer, what do you think? 

 

Shep,

Can you tell me which kind of problems can benzos cause? Same of the antidepressants when you try to taper? Or they don't help the nervous system to recover alone?

 

Sorry for my questions, I'm a new user and very worried this nightmare will non end anymore. I don't know if I will be able to resist for a too long time. 

[Shep]

21 hours ago, 54fiftyfour said:

The problem is that, often, in the morning the levels of anxyety and agitation are too strong to manage them with non-drug methods. So far I have done this: I do not take anything if symptoms are bearable, otherwise I need to take two drops when need. Do you think I should be regular, also when symptoms are not too strong?

 

How long after you wake up do you eat breakfast and have some juice or water to drink? The reason I ask is because early morning low blood sugar and even mild dehydration can cause anxiety. 

 

It's important to eat a healthy breakfast with protein and to avoid sugar and caffeine (many of us have to give up coffee during withdrawal). 

 

 

16 hours ago, 54fiftyfour said:

Shep,

Can you tell me which kind of problems can benzos cause? Same of the antidepressants when you try to taper? Or they don't help the nervous system to recover alone?

 

Yes, benzo withdrawal is very similar to antidepressant withdrawal. There are a few differences - benzo withdrawal symptoms usually start much sooner after stopped them. Some people don't even have withdrawal symptoms after stopping antidepressants for several months. It's a delayed withdrawal phenomenon. This is especially true for the class of antidepressants called SSRIs. 

 

But the withdrawal symptoms from benzos and antidepressants are very similar. They both cause nervous system dysregulation. 

[54fiftyfour]

2 hours ago, Shep said:

How long after you wake up do you eat breakfast and have some juice or water to drink?

When I’m lucky, I wake up between four and five o'clock because the motor agitation starts and won't let me sleep. I have breakfast around 7.30-8.00 in the morning and eat a piece of egg omelette (without cheese) with vegetables and a herbal tea. No sugar, coffee or tea. Then, during the morning, I drink water.

 

3 hours ago, Shep said:

Yes, benzo withdrawal is very similar to antidepressant withdrawal

Ok, but how can I understand when symptoms (e.g. anxiety, tremors, agitation, ecc.) result from my current withdrawal cold turkey from trazodone or, possibly, from withdrawal in between doses of clonazepam? If I had to, how would you advise me to taper clonazepam? How should I split a single drop? In my situation, removing one drop at a time would be too risky. Is there some method?

 

3 hours ago, Shep said:

Some people don't even have withdrawal symptoms after stopping antidepressants for several months.

 

I know what you're talking about. Both in 2008 (paroxetine) and in April 2022 (trazodone), my symptoms exploded violently one month after withdrawal.

[Shep]

On 7/8/2022 at 10:12 AM, 54fiftyfour said:

When I’m lucky, I wake up between four and five o'clock because the motor agitation starts and won't let me sleep. I have breakfast around 7.30-8.00 in the morning and eat a piece of egg omelette (without cheese) with vegetables and a herbal tea. No sugar, coffee or tea. Then, during the morning, I drink water.

 

You may want to try having something to eat and drink when you first wake up. Even if it's just a glass of milk and a handful of almonds, you'll be giving your body protein, which can help tide you over until you're ready for a full breakfast. Sounds like you're already eating healthy, which is great. 

 

On 7/8/2022 at 10:12 AM, 54fiftyfour said:

Ok, but how can I understand when symptoms (e.g. anxiety, tremors, agitation, ecc.) result from my current withdrawal cold turkey from trazodone or, possibly, from withdrawal in between doses of clonazepam? If I had to, how would you advise me to taper clonazepam? How should I split a single drop? In my situation, removing one drop at a time would be too risky. Is there some method?

 

Please list the brand of clonazepam you're using and the ratio. The ratio will be on the container and will show the amount of milligram to milliliter - mg / mL. 

 

You'll want to add your drop to water measuring with a graduated cylinder marked with mLs or a syringe.  By adding the drop to water, you can taper as slowly as you need. 

 

Once we know the ratio of milligram to milliliter of your drops, we can help you set up the correct amounts of liquid medication and water and can answer any questions you have. 

 

You may want to read over this thread:

 

Questions and answers about liquid medications, use by date, expiry

 

It can seem daunting to set up a liquid taper, but we can answer your questions about math and equipment needed, such as a cylinder and / or a syringe. 

 

Once you have the clonazepam set up with regular dosing, some of your symptoms may resolve or at least may not be as troublesome. If so, you may know whether you're dealing with Trazodone withdrawal or if it's problems with irregular benzo dosing. 

[54fiftyfour]

14 hours ago, Shep said:

Please list the brand of clonazepam you're using and the ratio. The ratio will be on the container and will show the amount of milligram to milliliter - mg / mL. 

The brand of clonazepam is RIVOTRIL and the ratio is 2,5 mg/ml. I think that one drop is equivalent to 0,1 mg.

 

14 hours ago, Shep said:

a graduated cylinder marked with mLs or a syringe

I don't understand well what you mean.

 

14 hours ago, Shep said:

Once you have the clonazepam set up with regular dosing, some of your symptoms may resolve or at least may not be as troublesome. If so, you may know whether you're dealing with Trazodone withdrawal or if it's problems with irregular benzo dosing. 

For the past twenty days I have been using a not regular dosage ranging from 0,5 to 0,9 mg. of clonazepam per day. In the last two days I have been trying to stabilize on only 0,5 mg. at night. I don't know if I can have success in the short term, or it can cause problems. Should it be too risky? Altogether I have been taking it exactly since two months.

 

[ChessieCat]

7 minutes ago, 54fiftyfour said:

I don't understand well what you mean

 

They can be purchased online, eg from eBay or Amazon.  There are different sizes available.

 

This is only example.  I am not telling you to buy from this seller.  I am just showing you what they are.

 

https://www.ebay.com/itm/284583129691?hash=item424279f25b:g:nC4AAOSwGrhhyCLE

 

Edited July 11, 2022 by ChessieCat

[ChessieCat]

And plastic graduated cylinders are okay.  That is what I used.  You do not need to buy glass ones.

[Shep]

2 hours ago, 54fiftyfour said:

The brand of clonazepam is RIVOTRIL and the ratio is 2,5 mg/ml. I think that one drop is equivalent to 0,1 mg.

 

Thanks, 54. Yes, one drop of Rivotril at 2.5mg/mL  is 0.1 mg. I've added this information to your signature. 

 

2 hours ago, 54fiftyfour said:

For the past twenty days I have been using a not regular dosage ranging from 0,5 to 0,9 mg. of clonazepam per day. In the last two days I have been trying to stabilize on only 0,5 mg. at night. I don't know if I can have success in the short term, or it can cause problems. Should it be too risky? Altogether I have been taking it exactly since two months.

 

Please let us know how you're doing with 0.5 mg at night. Do you remember how many times you were taking as much as .9 mg a day? You may be dependent on this higher dose, so if you have start having a lot of symptoms, please go ahead and updose. The timeframe for a safe benzo updose is within 4 weeks of last being on that higher dose. So you'll want to updose sooner rather than later. 

 

How many hours are you sleeping? How do you feel throughout the day? Do you feel like you're getting interdose withdrawal (withdrawal between doses) during the day? If so, when do the symptoms start? 

 

These are the questions to ask as you settle in on a dose. 

 

Once you settle in on a regular dosing schedule, please hold. During that hold time, we can discuss how to use a cylinder and set up a proper taper, as you feel able to. There's no rush. 

 

[54fiftyfour]

5 hours ago, Shep said:

Please let us know how you're doing with 0.5 mg at night. Do you remember how many times you were taking as much as .9 mg a day?

I try to be more precise that I can. I started clonazepam on may, 12 and, in the first week, I toke 0,5 mg. three times per day, but it was too strong for me (depression and drowsiness). I told it to the psychiatrist and we agree on 0,25 mg. in the morning and 0,5 mg. at night. This regularly lasted another week or a bit more.

 

Then I tried to take as little clonazepam as possible becouse it is a drug that, during the day, increase depression and prevents to work. There have been several days when I was able to take it only at night.

 

In the last twenty days, however, I had to add again 0,2 mg. in the morning or afternoon becouse the psyco-motor agitation from trazodone withdrawal was unbearable.

 

In these last three days I toke again clonazepam only at night (0,6, 0,5 and 0,5 mg.). I must say that, yesterday and today, I started to feel some light cardiac palpitation that I never had before and, today, I experimented a particular level on derealization and mental confusion, but there have been other times in which this happened cause trazodone, even when I was taking clonazepam two times per day at a regular dosage.

 

I toke 0,9 mg. on june, 26 and 29. The rest of this last twenty days I toke from 0,6 to 0,8 mg. depending on the contexts and needs. The medium of the last 20 days, except these last three ones, is around 0,75 mg.

 

6 hours ago, Shep said:

How many hours are you sleeping?

 

As I already said, I wake up between four and five o'clock because the motor agitation starts and won't let me sleep. I can sleep from 3 to 4,5 hours, even if, strangely, yesterday night was the first time that I did non experimented motor agitation at dawn and I could sleep six hours. I'm convinced it was only a very little windows, but better than nothing.

 

I hate clonazepam, expecially during the day, becouse sometime it gives me paradoxical reactions and, in general, it enhance my depression and death thoughts. Today I have also read that it is the worst drug to taper and can give derealization symptoms even if you can have success in stopping it. Is it true? At the same time, I still have to manage the strong trazodone WD symptoms and am very scared to fall in abstinence from Rivotril too. It would be letal. 

[Altostrata]

On 7/7/2022 at 6:01 AM, 54fiftyfour said:

....

The problem is that, often, in the morning the levels of anxyety and agitation are too strong to manage them with non-drug methods. So far I have done this: I do not take anything if symptoms are bearable, otherwise I need to take two drops when need. Do you think I should be regular, also when symptoms are not too strong?

....  

 

I agree with @Shep, it's likely your irregular clonazepam dosing is causing problems and your morning symptoms are interdose withdrawal as the prior night's clonazepam dose wears off overnight.

 

On 7/7/2022 at 1:56 AM, 54fiftyfour said:

In the last month panic attacks and electric shocks from the head to the arms and back are decreased and almost disappeared.

 

This indicates the typical withdrawal symptoms from abruptly going off trazodone are going away. If I were you, I would not reintroduce trazodone. It's more likely your symptoms are due to clonazepam.

 

 

[54fiftyfour]

6 hours ago, Altostrata said:

I agree with @Shep, it's likely your irregular clonazepam dosing is causing problems and your morning symptoms are interdose withdrawal as the prior night's clonazepam dose wears off overnight.

Please, consider that I had strong motor-agitation symptoms even before taking clonazepam and also when I was taking a regulare dosage of it (morning and night). In my opinion, they result from trazodone withdrawal cold turkey. The question is whether new or stronger symptoms may arise due to irregular dosage of clonazepam.

 

6 hours ago, Altostrata said:

This indicates the typical withdrawal symptoms from abruptly going off trazodone are going away. If I were you, I would not reintroduce trazodone. It's more likely your symptoms are due to clonazepam.

There are other symptoms from trazodone WD which still last from the beginning and can not depend from clonazepam: acatisia and psycho-motor agitation; insomnia; strong derealization; fear and extreme anxiety; total anhedonia; mental confusion; flu-like malaise throughout the body, tingling in the arms and legs, depression and sexual numbness. They are not disappearing and I don't know if and when they will go completely away. May be never.

[Shep]

 

 

On 7/7/2022 at 4:56 AM, 54fiftyfour said:

In the last month panic attacks and electric shocks from the head to the arms and back are decreased and almost disappeared.

 

 

12 hours ago, Altostrata said:

This indicates the typical withdrawal symptoms from abruptly going off trazodone are going away.

 

I agree with Alto here. There is an acute phase of withdrawal, which may be related to the panic attacks and electric shocks. 

 

So even though you have these symptoms:

 

On 7/7/2022 at 4:56 AM, 54fiftyfour said:

Symptoms that remain unchanged are: high level of acatisia and psycho-motor agitation, especially at sunrise (not able to stay in bed);  insomnia; strong derealization; fear and extreme anxiety; total anhedonia; mental confusion; flu-like malaise throughout the body.

 

Depression, PSSD and loss weight have increased.

 

These symptoms may be from the phase that happens after acute. Once you've been on a steady dose of clonazepam, it will be easier to parse out what is causing what and if a reinstatement of trazodone will help. 

 

This is from Alto's thread One theory of antidepressant withdrawal syndrome

 

On 5/24/2011 at 10:59 PM, Altostrata said:

My guess is: The first phase of withdrawal, the acute phase, is the initial shock of withdrawal at the target receptors, with the most defined symptoms, such as brain zaps and nausea and possibly waves of unusually intense "depression" and "anxiety" -- actually, emotions generated by the neurological upset. Later, hyper-reactivity and autonomic instability take over. Often the autonomic instability causes wide hypersensitivity to drugs, supplements, and even foods.

Out of control, unrelated to environmental or psychological triggers, the alerting system sends intense, spontaneous signals to the adrenals, which produce the stress hormones cortisol and adrenaline.

This is not strictly brain damage. Brain damage means some physical part has been permanently removed and can never be recovered. Rather, this is iatrogenic neuropsychiatric dysregulation. The feedback mechanisms that keep your body in homeostasis are not functioning as they should.

 

[54fiftyfour]

2 hours ago, Shep said:

Once you've been on a steady dose of clonazepam

Today I restored 0,2 mg. in the morning and tonight I will take 0,5 mg. Reading my previous post about not irregular intake, do you think it is enaugh? How can I understand? To be honest, today I had highest level of anxiety. Clonazepam, however, makes me sick. It increase a lot depression and suicidal toughts. I curse the psychiatrist who prescribed it for me.

 

2 hours ago, Shep said:

it will be easier to parse out what is causing what and if a reinstatement of trazodone will help

Altostrada advice me not to reintroduce trazodone and to resist, even if, form me, it is extremely difficult to do. 

[Shep]

20 hours ago, 54fiftyfour said:

Today I restored 0,2 mg. in the morning and tonight I will take 0,5 mg. Reading my previous post about not irregular intake, do you think it is enaugh? How can I understand? To be honest, today I had highest level of anxiety. Clonazepam, however, makes me sick. It increase a lot depression and suicidal toughts. I curse the psychiatrist who prescribed it for me.

 

Have you always felt depressed and suicidal when taking clonazepam? Or is this new? 

 

Please start a daily drug and symptoms journal. We need the times of day you take your drugs and supplements and the dose. Write down any symptoms that show up throughout the day. Also, please write down how many hours you sleep each night. This allows us to see your symptoms within the context of when you take your drugs and supplements. Please post these daily notes for several days so we can see if there are any patterns and ways of spacing out what you're taking to mitigate any paradoxical reactions and to see when the worst of your symptoms start. 

 

Here are the instructions:

 

On 9/27/2016 at 2:49 PM, Altostrata said:

In the course of discussion in your Introductions forum topic, you may be asked to keep notes on paper of your daily symptom pattern, including when you take your drugs, their dosages, and any symptoms. We ask this because there may be something we can do to reduce the symptoms.

 

What we need to see for every single day over several days is what symptoms you get before and after you take your drugs. If you're not taking any drugs and have withdrawal symptoms, we still need to see your symptom pattern throughout the day:

 

The time of day, dosage, and severity of symptoms are essential information. Include

 

- Time and dosage for all drugs taken throughout the day, psychiatric and non-psychiatric.

- Following each dose, note any symptoms. If you are having a reaction to the drug, it may take hours for a symptom to show up -- that's why we ask you to keep notes all day long.

- If you're not taking any drugs, your symptoms throughout the day.

- Your sleep pattern. Since so many drugs disturb sleep, if you find you're waking in the middle of the night, it could be from a drug you took earlier in the evening. If you're not taking any drugs, there may be ways you can improve your sleep.

And so forth. A diary, in chronological order, looking something like this:
 

Example:

DATE:

 

6 a.m. Woke with anxiety
8 a.m. Took 2.5mg Lexapro
10 a.m. Stomach is upset
10:30 a.m. Ate breakfast
11:35 a.m. Got a headache, lasted one hour
12:35 p.m. Ate lunch
4 p.m. Feel a bit better
5 p.m. Took 2.5mg Lexapro
6 p.m. Ate dinner
9:20 p.m. Headache
10:00 p.m. Took 50mg Seroquel
10:20 p.m. Feeling dizzy
10:30 p.m. Fell asleep
2:30 a.m. Woke, took 3mg Ambien (NOT "took 1/2 tablet Ambien")
2:45 a.m. Fell asleep
4:30 a.m. Woke but got back to sleep

 

 

[54fiftyfour]

5 hours ago, Shep said:

Have you always felt depressed and suicidal when taking clonazepam? Or is this new? 

Absolutely yes. In the beginning (0,5 mg. three times per day) I felt extreme drowsiness, then, only with 0,2 mg. in the morning or afternoon, I start to feel strong depression and suicidal thoughts. This is the reason for which I tried to take it only at night or as needed. I read an Italian forum in which it is recommended to always take it three times per day in equal dosages, otherwise dependence develops. Is it correct?

 

5 hours ago, Shep said:

We need the times of day you take your drugs and supplements and the dose.

Currently I am not taking any supplement, except probiotics. I'm on 0,5 mg. at night (23.00) and 0,2 mg. in the morning (10.00), nothing in the afternoon. I don't know if it is correct, but this drug is not comfortable for me and I think I couldn't tolerate higher dosages during all day. Do you think it's necessary to take the drug also in the afternoon?

 

 

[54fiftyfour]

Date: july, 13 2022

 

5.00 - Woke up with slight depression and got back to bed (no agitation)

7.30 - Ate breakfast (omelette with vegetables)

10.00 - Took 0,2 mg. clonazepam

11.00 - Got depression all the day

13:00 - Ate lunch (zucchini with rice)

17.00 - Obsessive thoughts about PSSD and mental agitation

20.00 - Ate dinner (raw fennel, vegetable soup, fish with cooked vegetables)

21.00 - Feeling cardiac palpitations, distress and slight head and neck tremors

23.00 - Feeling sleepy and took 0,5 mg. clonazepam for helping sleep

23.30 - Clonazepam developed a paradoxical effect (keeping awake, insomnia, agitation, etc.)

From 23.30 onwards - Very light/disturbed sleep and constant awakenings

5.00 - Woke up with anxiety, muscle twitching and tingling in the limbs

[Shep]

18 hours ago, 54fiftyfour said:

Absolutely yes. In the beginning (0,5 mg. three times per day) I felt extreme drowsiness, then, only with 0,2 mg. in the morning or afternoon, I start to feel strong depression and suicidal thoughts. This is the reason for which I tried to take it only at night or as needed. I read an Italian forum in which it is recommended to always take it three times per day in equal dosages, otherwise dependence develops. Is it correct?

 

No, that's not correct. I'm glad you're questioning this advice. Taking the drug three times a day helps prevent interdose withdrawal but you can still become dependent on the drug. 

 

18 hours ago, 54fiftyfour said:

Do you think it's necessary to take the drug also in the afternoon?

 

The half-life of clonazepam is 18 - 50 hours, so twice-a-day dosing is fine. 

 

Thank you for doing your drug and symptoms journal. This is very helpful. It looks like you may be getting adverse, paradoxical reactions, and / or side effects.  Please continue with the journal for a couple more days to see if that's a consistent pattern. And then we can discuss your next steps.

[54fiftyfour]

1 hour ago, Shep said:

 

No, that's not correct. I'm glad you're questioning this advice. Taking the drug three times a day helps prevent interdose withdrawal but you can still become dependent on the drug. 

 

 

The half-life of clonazepam is 18 - 50 hours, so twice-a-day dosing is fine. 

 

Thank you for doing your drug and symptoms journal. This is very helpful. It looks like you may be getting adverse, paradoxical reactions, and / or side effects.  Please continue with the journal for a couple more days to see if that's a consistent pattern. And then we can discuss your next steps.

 

[54fiftyfour]

Is it true that Clonazepam is the worst drug to taper with suxcess? And is it true that, even if a guy is able to do it, he will continue to be exposed at anxiety and panic symptoms for the rest of his life?

[54fiftyfour]

I'm realizing that, the longer I take clonazepam, the more I'm strongly depressed and risk to be suicidal. It is destroying me. Please, help me to understand how to reduce this awful drug as soon as possible. Is it too risky if I start to reduce 0,1 mg. this night before going to sleep? 

[54fiftyfour]

5.00 - Woke up with anxiety, muscle twitching and tingling in the limbs

8.00 - Ate breakfast (fruit, omelette with vegetables)

10.00 - Took 0,2 mg. clonazepam

11.00 - Feeling very worried, but no agitation or anxiety

13.30 - Ate lunch (raw vegetables and tuna)

14.00 - Started depression and suicidal thoughts symptoms

17.00 - Started severe pressure in the nape with sensory disturbance in the neck's ribs and cognitive impairment. Abandoned my job office.

20.00 - Ate dinner (raw fennel and omelette with vegetables)

21.00 - Feeling headhache, cardiac palpitations and slight head and neck tremors

22.45 - Took 0,4 mg. clonazepam for helping sleep (reduced 0,1 mg.)

23.00 - Feeling some tremors in the body while trying to fall asleep

From 23.00 onwards - Very light sleep

3.30 - Woke up with headhache and got to bed again

5.00 - Woke up with cardiac palpitation, headhache and motor agitation

 

My impression is that I'm developing some withdrawal symptoms from clonazepam, but, at the same time, when I take it, it make me feel very sick and suicidal, slows my breathing and movements and doesn't help well for sleeping. I don't know what to do.

[Shep]

22 hours ago, 54fiftyfour said:

Is it true that Clonazepam is the worst drug to taper with suxcess? And is it true that, even if a guy is able to do it, he will continue to be exposed at anxiety and panic symptoms for the rest of his life?

 

Clonazepam is a very potent drug, but I wouldn't say it's the worst drug to taper. Many people struggle to come off of diazepam, which is a lot less potent and has a long half life. It really depends. It's less about the drug and more about how sensitized a person's nervous system is, especially if the taper has been too fast. 

 

On 7/14/2022 at 1:58 AM, 54fiftyfour said:

5.00 - Woke up with slight depression and got back to bed (no agitation)

 

6 hours ago, 54fiftyfour said:

5.00 - Woke up with anxiety, muscle twitching and tingling in the limbs

 

These two mornings are completely different experiences. 

 

On 7/14/2022 at 1:58 AM, 54fiftyfour said:

10.00 - Took 0,2 mg. clonazepam

11.00 - Got depression all the day

 

6 hours ago, 54fiftyfour said:

10.00 - Took 0,2 mg. clonazepam

11.00 - Feeling very worried, but no agitation or anxiety

 

 

You report feeling depressed not long after taking clonazepam on 7/14/22, but in the next day's journal, you report not feeling any anxiety. Did you feel any depression? 

 

On 7/14/2022 at 1:58 AM, 54fiftyfour said:

23.30 - Clonazepam developed a paradoxical effect (keeping awake, insomnia, agitation, etc.)

 

6 hours ago, 54fiftyfour said:

22.45 - Took 0,4 mg. clonazepam for helping sleep (reduced 0,1 mg.)

23.00 - Feeling some tremors in the body while trying to fall asleep

 

You were taking .5 mg + .2 mg and now you're taking .4 mg + .2 mg. Going from .7 mg to .6 mg is a 14.29% reduction, which is too fast.

 

54fiftyhour, please give your nervous system some time to recover. You've been periodically dosing, meaning your nervous system has been dealing with unpredictable amounts of the drug in your system.  And now you're making a large reduction. Some of your symptoms may be side effects and paradoxical effects, but making abrupt changes like this can make the problem worse by traumatizing your nervous system further.