54fiftyfour: trazodone WD

[54fiftyfour]

I mean to remain at 0,08 in the morning and 0,45 in the night.

[Shep]

3 minutes ago, 54fiftyfour said:

I mean to remain at 0,08 in the morning and 0,45 in the night.

 

Thanks, 54. This sounds like a good plan - holding until you are more stable. 

 

I know this is difficult because it's hard to measure your progress while going through symptoms that are waves without windows, but holding will at least keep you from getting worse. 

 

I have a feeling that some of what you're dealing with is what could be called "battle fatigue," meaning being sick for so long is making you exhausted. And also what is called being "caught between a rock and a hard place," which means a difficult situation where any option you take still means having to suffer - there's no easy way out. 

 

But holding can give your nervous system a chance to rest. 

 

Maybe hold for a month and see how you're feeling. That will get you past the holiday season, when a lot of people feel more stressed. It may be easier in January when the holidays are over. 

[54fiftyfour]

I'm holding since three weeks (0,08 morning and 0,45 night), but the symptoms are more and more unbearable. My anguish and anxiety are going to the stars, my heart beats wildly and all my body is trembling. If I go out of home, I look at the "normality" of other people as a psychotic. I can't go on like this, it's not human and I really risk to kill me.

 

Not only I don't see any sign of spontaneous remission or stabilization, but I'm living a constant worsening. Maybe it's a problem of interdose symptoms, could it be'? Also the effects of night dose are shorter and, in the early morning, heart and anxiety starts to give worning signs. At this conditions, tapering of clonazepam will be simply unpossible.

 

I'm likely to be admitted in a psychiatric clinic in the second half of january. I talked with them about the necessity to help me without the normal therapies of antidepressants, trying to treat the devastating effects of trazodone WD and clonazepam taper in other ways (NAC? Very little dose of fluoxetine or other SSRI?). They seem to understand the problem of abstinence, withdrawal and neurological dysregulation, but I can't imagine what they can invent. Probably nothing. What do you think?

 

At worst, I will give rest and relief to my parents, who are hosting me and are elderly and very tried and exhausted to see me like this.

 

 

[Shep]

@54fiftyfour Please do what you need to do to keep yourself safe. 

[MontanaMan]

@54fiftyfour is the Anhedonia from the original pssd or the trazadone? 

[54fiftyfour]

Pecora,

 

cosa intendi per "tieniti al sicuro"? Non sono autosufficiente e, dal punto di vista materiale e psicologico, dipendo dai miei genitori, ma loro stanno soffrendo molto per la mia situazione. Di volta in volta sento la necessità di alleviare il loro sacrificio mentale nell'assistermi, uscendo dal mio letto in direzione di altri luoghi. Hanno bisogno di speranza, altrimenti rischiano di morire di dolore e agonia.

 

Non voglio prendere nessun altro farmaco, ma cosa posso fare ora? Dimmelo, ti prego. Sento un grado di acatisia più alto e sono costretto a prendere un benzo che è molto tossico per la mia salute e produce sempre più effetti collaterali nel tempo, costringendomi a stare a letto. Quali sono le strategie da ricercare? Continuando questa agonia?

[54fiftyfour]

Sorry for the above Italian post.

 

11 hours ago, Shep said:

Please do what you need to do to keep yourself safe

 

What do you mean for "keep yourself safe"? Do not take any other medicine? Consider I am not self-sufficient and, materially and psychologically, I depend from my parents now, but they are suffering a lot for my situation. Time and again I feel the duty to relieve their mental sacrifice in assisting me, getting out of my bed in the direction of other places. They need hope or they risk to die for this great grief and agony. I feel guilty for this.

 

I don't want to take any other medicine, but I see that, in the forum, there are people who proceed with some drug reinstatement or dose adjustments to get better. What can I do now? Please tell me. I feel a ever higher degree of akathisia (inner terror and agitation, trembling, mental confusion, etc.) and I am forced to take a poisonous benzo which is very toxic to my health and produces more and more side effects over time, forcing me to stay all the day in bed. What are the strategies to look for? Continuing this agony? I understand nobody has a magic wand, but please, tell me something to help me.

[54fiftyfour]

8 hours ago, MontanaMan said:

is the Anhedonia from the original pssd or the trazadone

 

Untill before taking trazodone I did not suffer from anhedonia. I had it in 2009 after a first crisis, but taking testosterone restored all my good mood and the ability to connect with emotions and interest for life. After testosterone assumption, PSSD gave me "only" sexual side effects, but not mental. I'm in a catatonic state now and I think it's aggravated by taking clonazepam.

[Shep]

8 hours ago, 54fiftyfour said:

I don't want to take any other medicine, but I see that, in the forum, there are people who proceed with some drug reinstatement or dose adjustments to get better. What can I do now? Please tell me.

 

You may want to re-read your thread. It may help to go over the options that were presented earlier, along with discussions. 

 

[MontanaMan]

@54fiftyfour interesting. And the trt didn’t aggravate WD? Why haven’t you considered trying it agian? I have pretty bad but not total Anhedonia and my Test is literally the levels of an 80 year old man at 22 but definitely nervous about adverse effects of trying it. 

[MontanaMan]

@54fiftyfour also, just my 2 cents about reinstatement, I did reinstate with a different SSRI than I discontinued.  It did stabilize me but left me with Anhedonia. Still preferable than the extreme anxiety I had. HOWEVER, it’s risky and could make you worse, and I had withdrawal after being on ssris for a longer period than you so It’s a different. Our situations are different so this is not a recommendation just my experience...

[54fiftyfour]

TRT had a very good effect first time (2009), probably becouse the degree of CNS hypersensitivity was not still so high. I tried again after trazodone WD with three injections, but after a short good effect on anxiety during one day, it increased my motor and psychical agitation. Maybe I reached an highest level of hypersensitivity and any substance can be dangerous.

[54fiftyfour]

The tapering process of clonazepam seems to be more and more difficult for me. After 21 days of stabilization at the same dose (0,45 night and 0,08 morning), I start reducing again 0,01 mg. last week. This night I had continuous awakening, palpitations and sweating. During days, anxiety and depression are devastating.

 

I'm using a graduated cilinder for liquid form, but at this point I'm asking if it would be better to do a slower daily microtapering with pills and little scale. Could it be better for my hypersensitive CNS?

[Shep]

On 12/31/2022 at 9:12 AM, 54fiftyfour said:

The tapering process of clonazepam seems to be more and more difficult for me. After 21 days of stabilization at the same dose (0,45 night and 0,08 morning), I start reducing again 0,01 mg. last week. This night I had continuous awakening, palpitations and sweating. During days, anxiety and depression are devastating.

 

I'm using a graduated cilinder for liquid form, but at this point I'm asking if it would be better to do a slower daily microtapering with pills and little scale. Could it be better for my hypersensitive CNS?

 

I'm not sure switching from liquid to pill is going to solve your problems. A 21 day hold is not long and if you're getting more symptoms after reducing 0.01 mg, it sounds like you may need to hold a bit longer. 

 

When your symptoms ramp up like that right after a reduction, it's a sign your nervous system isn't ready for any more reductions. Switching from liquid to pill is another change that may also upset your nervous system. 

[54fiftyfour]

Depression from clonazepam is  unbearable. I can not manage it anymore. I can't stay on this drug for life. It's like to be walking dead.

[54fiftyfour]

Shep,

 

I' sure that an important part of my symptoms derive from the continuation of clonazepam. It doesn't work anymore for anxiety and sleep and is furtherly destroying my body and nervous system (muscle pain and weakness, poor motor coordination, catatonia, tinnitus, more rigidity, etc.). I'm forced to continue to take it, but how many permanent damages will it produce over time? I feel very bad symptoms anyway, remaining in a stable dose or not. It seems there is no solution at the vicious circle of my disastrous health. You also took two mg/day of clonazepam, if I don't remember wrong. How long? Didn't you have strong side effects from it?

[54fiftyfour]

Shep,

 

you wrote this step in your post "Hypersensiivity and kindling".

 

"A benzo works by increasing GABA. Long-term exposure to benzos causes GABA receptor down-regulation and glutamate receptor up-regulation. A slow and careful taper makes it easier for the receptors to return to their pre-benzo state. But when there's a history of prior withdrawal, hypersensitivity may result in increased neuro-excitability, creating worsening withdrawal symptoms upon dosage reduction.

 

If someone is dealing with antidepressant withdrawal in addition to benzo withdrawal, neurological hyper-reactivity may be even more intense. And with serotonin needed to release GABA and glutamate (see Serotonin as a Modulator of Glutamate- and GABA-Mediated Neurotransmission), the interplay of all of this neurotransmitter dysregulation can make hypersensitivity more likely".

 

In my opinion, your post exactly captures my problems in clonazepam taper. Unfortunately I have a history of prior cold turkey interruptions of psycho-active substances (finasteride, paroxetine, trazodone and other antidepressants) and now I'm dealing both with AD and benzo's WD. Therefore it's pratically prohibitive to get out of this vicious circle, also becouse the serotonergic system (e.g. receptors) is completely dysregulated (as I said, I have had PSSD for may years). The functioning of my neurotransmitters and endocrine system is too compromised to allow a recovery. Neuro-excitability has been too high for a long time and now it's even higher.

[Shep]

3 hours ago, 54fiftyfour said:

The functioning of my neurotransmitters and endocrine system is too compromised to allow a recovery. Neuro-excitability has been too high for a long time and now it's even higher.

 

Lots of people who've been polydrugged for years go onto heal. Your symptoms are so severe now because of your prior withdrawals, but also due to side effects. I wouldn't say your system is "too compromised to allow a recovery." The brain is incredibly neuro-plastic. See:

 

Neuroplasticity video (2 minutes)

 

Healing from antidepressants. How to speed up the recovery process video (5 minutes)

 

And just like there are positives to neuroplasticity, be careful of going into spirals of catastrophic thinking, as that can also re-wire the brain. 

 

Norman Doidge - The Dark Side of Neuroplasticity video (2 minutes)

 

Some ways of not going down the dark side of neuroplasticity:

 

Dealing With Emotional Spirals

 

"Change the channel" -- dealing with cognitive symptoms

 

I think some of these links may already be on your thread, but they're some of the best links out there. If you haven't checked them out, please do. Continuing to tell yourself you're not going to recover is not a good to do to yourself. 

 

This is also a great post on benzos:

 

What is happening in your brain?

 

 

[54fiftyfour]

Today I was out of home all the time from 11.00 to 21.00 o'clock. I went to eat in two restaurants and, in the afternoon, I met several friends at an outdoor sport event full of people. Anxiety was always present, but I can say that, for the first time after many months, I was talkative and able to joke and laugh spontaneusly. Only yesterday, on the countrary, I was completely suicidal and in a state of total derealization, while trembling in my bed and not able to get up. 

[54fiftyfour]

This morning the anxiety and tremors are paralizing again. I don't know what to do, but I'm nomore able to manage this condition for long. I know that a very small dose of antidepressant could be too risky, but also the current situation is for my life and my family as well.

 

If I should evaluate the possibility to introduce a very little dose of antidepressant, which kind? I read some post that mention fluoxetine for its long half-life. Am I saying a non-sense?

[54fiftyfour]

Sorry for the continuous post, but I would kindly need an explanation. Is it possible, or not, that the loss of clonazepam's effectiveness (e.g. insomnia) is due to a tolerance WD? I read that Altostrata doesn't believe in this possibility, or am I understanding wrong? If so, how can we explain the fact that the more I take Rivotril, the more the negative side effects and the less benefits?

[Shep]

On 1/8/2023 at 4:02 PM, 54fiftyfour said:

Today I was out of home all the time from 11.00 to 21.00 o'clock. I went to eat in two restaurants and, in the afternoon, I met several friends at an outdoor sport event full of people. Anxiety was always present, but I can say that, for the first time after many months, I was talkative and able to joke and laugh spontaneusly. Only yesterday, on the countrary, I was completely suicidal and in a state of total derealization, while trembling in my bed and not able to get up. 

 

This is awesome, 54! This is definitely a window.

 

Perhaps you did too much or ate something that triggered some symptoms that caused the set back. Or it may have been a wave that would have happened regardless of how you spent your window time. 

 

10 hours ago, 54fiftyfour said:

I know that a very small dose of antidepressant could be too risky, but also the current situation is for my life and my family as well.

 

If I should evaluate the possibility to introduce a very little dose of antidepressant, which kind? I read some post that mention fluoxetine for its long half-life. Am I saying a non-sense?

 

You just had a window, 54. And now you want to take another drug? 

 

Please re-read the first post in this thread. It's important that you understand how withdrawal works. It comes in unpredictable windows and waves.

 

The Windows and Waves Pattern of Stabilization

 

7 hours ago, 54fiftyfour said:

Sorry for the continuous post, but I would kindly need an explanation. Is it possible, or not, that the loss of clonazepam's effectiveness (e.g. insomnia) is due to a tolerance WD? I read that Altostrata doesn't believe in this possibility, or am I understanding wrong? If so, how can we explain the fact that the more I take Rivotril, the more the negative side effects and the less benefits?

 

Is this the post by Alto you're referring to when you say that Alto doesn't believe in this?

 

On 3/30/2012 at 7:01 PM, Altostrata said:

This seems a hazy concept in tapering to me -- how can you distinguish feeling crummy from "tolerance withdrawal" vs feeling crummy from withdrawal symptoms?

 

No one can tell you exactly what is going on, especially since you have prior withdrawals in your history. But if you feel worse the more you taper, it's likely withdrawal and it's best to slow down.  Many people who are destabilized as much as you are struggle throughout the taper, making it very hard to parse what is causing what. If you re-read your thread, it looks like you never were stable on this drug - it was brought into help with your prior drug withdrawals. That doesn't mean you're in tolerance withdrawal from the benzo - it may mean you still have a lot of withdrawal symptoms from other drugs and the benzo isn't covering for those withdrawals. However, you are dependent on the benzo, so that means it's best to taper slowly and to hold often so you're not adding more damage to your nervous system. 

 

The good news is you recently had a nice window. Since you did have a nice window, you may want to go into a long hold and see if you can experience any more window activity. That window was a sign of resilience. I would hold and give your nervous system time to rest and get a better baseline. 

 

 

[Altostrata]

What makes you think you have developed tolerance to clonazepam?

 

What times o'clock do you take each of your drugs, with their dosages? What changes have you made in clonazepam and Rivotril since the beginning of December?

[54fiftyfour]

Hi Alto,

 

sorry for my delay in answering you.

 

On 1/11/2023 at 2:07 AM, Altostrata said:

What makes you think you have developed tolerance to clonazepam?

 

Less effectiveness in promoting and keeping sleep, paradoxical effects (e.g. more anxiety or pressure surges), daily increase of muscle tenderness/weakness/pain, backache, chronic fatigue, total loss of libido, tinnitus, nerve sensitization, skin burning, etc. As I wrote several times, this drug is destroying me. There are many side effects I have to deal with, without corresponding benefits.

 

On 1/11/2023 at 2:07 AM, Altostrata said:

What times o'clock do you take each of your drugs, with their dosages? What changes have you made in clonazepam and Rivotril since the beginning of December?

 

I'm taking only clonazepam and Omega 3 fish oil. Since the beginning of December, I gradually reduced from 0,53 mg. to 0,495 mg. per day. This morning I started with 0,75 mg. at 10.00 and 0,42 mg. at 22.00 o'clock and will go on like this for twelve days. I reduced -3,8% in December and -4,8% in January.

 

 

 

[Altostrata]

9 hours ago, 54fiftyfour said:

I'm taking only clonazepam and Omega 3 fish oil. Since the beginning of December, I gradually reduced from 0,53 mg. to 0,495 mg. per day. This morning I started with 0,75 mg. at 10.00 and 0,42 mg. at 22.00 o'clock and will go on like this for twelve days. I reduced -3,8% in December and -4,8% in January.

 

Sorry, I cannot follow this. What happened to the Rivotril?

 

In a simple list format, what changes have you made in clonazepam and Rivotril since the beginning of December?

[54fiftyfour]

Sorry, but I don't understand what you mean. Rivotril is the brand name of clonazepam. The changes in dosage since the beginning of December are described in my previous post. Is there something I'm not able to understand?

[Altostrata]

19 hours ago, 54fiftyfour said:

Since the beginning of December, I gradually reduced from 0,53 mg. to 0,495 mg. per day. This morning I started with 0,75 mg. at 10.00 and 0,42 mg. at 22.00 o'clock and will go on like this for twelve days. I reduced -3,8% in December and -4,8% in January.

 

If you reduced to 0.495mg per day, how is it that you're taking 0.75mg in the morning? Are you talking about clonazepam or another drug?

 

In a simple list format, what changes have you made in your drugsl since the beginning of December? What times o'clock do you take each dose, at what dosage?

[54fiftyfour]

3 hours ago, Altostrata said:

If you reduced to 0.495mg per day, how is it that you're taking 0.75mg in the morning? Are you talking about clonazepam or another drug?

 

Sorry Alto, I wrote a mistake: 0,075 mg. at 10.00 and 0,42 mg. at 22.00 (total daily dose: 0,495 mg.). I'm only talking about clonazepam. I take it in two divided doses twelve hours apart (10am and 10pm). The morning dose is much less than the night dose, due to the goal of avoiding the effects of daytime depression and sedation. When I started to take clonazepam on may 12, 2022, I was taking 0,2 mg. in the morning and 0,5 mg. at night.

 

3 hours ago, Altostrata said:

In a simple list format, what changes have you made in your drugs since the beginning of December? What times o'clock do you take each dose, at what dosage?

 

November, 28 - December, 4 (7 days): 0,09 at 10.00 + 0,45 at 22.00 (total 0,54 mg. per day)

December, 5 - December 25 (21 days): 0,08 at 10.00 + 0,45 at 22.00 (total 0,53 mg. per day)

December, 26 - January, 5 (12 days): 0,08 at 10.00 + 0,44 at 22.00 (total 0,52 mg. per day)

January, 7 - January, 12 (6 days): 0,08 at 10.00 + 0,43 at 22.00 (total 0,51 mg. per day)

January, 13 - January, 17 (5 days): 0,075 at 10.00 + 0,43 at 22.00 (total 0,505 mg. per day)

January, 18 - January, 29 (12 days): 0,075 at 10.00 + 0,42 at 22.00 (total 0,495 mg. per day)

 

[Altostrata]

How do you feel on this dosing schedule? When did the problem with insomnia start?

[54fiftyfour]

I feel ill and hopeless. Clonazepam, to tell the truth, has never been very effective for me. It increased a lot my depression, suicidal thoughts, derealization, anhedonia and sexual problems. Anxiety is still present and sometime, in the morning, it increase after taking Rivotril. My muscles are very weak and painful and I'm strongly damaged from a physical point of view: I've lost 17 kg. Lsince I've been taking it. My skin seems older and I and can not have any weight gain, even if I eat as before. In my opinion, clonazepam is significantly responsible of these side effect and I have add a benzo  WD condition to the AD one (trazodone). Or not?

 

Its action in promoting my sleep has never been constant, but it is worsening, as tinnitus, the more I taper. Should I expect an increase of insomnia and painful muscles for the future? I think it's not rare in benzo withdrawal, isn't it?

 

Probably I will not be able to be clonazepam free, due to the unbearable side effects of its taper/suspension. I would like to know how many people are imprisoned in this perverse mechanism. My sensation is that I'm hopelessly poisoning my mind and body every day, but the dependance from this drug and my neurological dysregulation are too strong for having a good success in reducing and stopping it. Any feedback or clarification is welcome.

[54fiftyfour]

Any feedback or advice?

[Altostrata]

My guess is you've been tapering too fast, and you have withdrawal symptoms, which you mistake for adverse drug effects.

 

Please keep daily notes of times o’clock you take your drugs, their dosages, and your symptoms throughout the day. We need to know how you feel before and after taking each drug, and your symptoms in between. Post 24 hours of notes at a time in this topic, in a simple list format with time o’clock on the left and notation (symptom or drug and dosage) on the right. This can help identify symptoms that are adverse drug effects.

[54fiftyfour]

January, 23 2023

 

5.00 - Wake up anxiously, then stayed in bed without sleeping

8.00 - Breakfast with fruit, egg end herbal tea

10.00 - Taking 0,075 mg. of clonazepam

10.30 - Increased anxiety and agitation, feeling of impending panic attack, chills, depression, heart palpitations, muscle weakness

12.30 - Lunch

15.00 - Increased derealization

16.30 - Started autoimmune pains, muscle pain in the legs, strong exhaustion untill evening

19.30 - Dinner

22.00 - Taking 0,42 mg. of clonazepam

22.30 - Falling asleep

5.00 - Wake up with intrusive thoughts

 

Maybe I'm tapering too fast, but it's also true that the more I take clonazepam, the more are the side effects it produces on my body (not only depression, but muscle weakness, fatigue, respiratory depression, etc.). I'm sure about this.

[Shep]

@54fiftyfour How many hours are you sleeping at night? Please add the number of hours in your daily journal. 

[54fiftyfour]

5.00 - Wake up with internal agitation and heart palpitations, then stayed in bed without sleeping

8.00 - Breakfast with fruit, egg end herbal tea

10.00 - Taking 0,075 mg. of clonazepam and go to work

10.30 - Less anxiety than yesterday, but anhedonia and depression

12.30 - Lunch

16.30 - Started again autoimmune pains, muscle pain in the legs and exhaustion

18.30 - Come back from work

19.20 - Dinner

21.00 - Go to walk with depression and derealization

22.00 - Taking 0,42 mg. of clonazepam

22.30 - Falling asleep

3.30 - Wake up with intrusive thoughts, then continued half and disturbed sleep untill 7.00 (I slept 5 hours with continuity)

7.00 - Getting out of bed completely powerless, with sagging face skin, strong depression, derealization and unable to stand

 

Why did I get out of bed so badly? It's not the first time, but it's been happening since I've been taking clonazepam. Today I'm destroyed. Please, help.

[Shep]

2 hours ago, 54fiftyfour said:

(I slept 5 hours with continuity)

 

I know you're struggling, but 5 hours of continuous sleep is actually quite good for someone going through benzo withdrawal. I went for several years functioning on far less. Don't lose hope, 54. 

 

2 hours ago, 54fiftyfour said:

8.00 - Breakfast with fruit, egg end herbal tea

 

What type of herbal tea are you having with breakfast? The reason I ask is that some herbal teas are contraindicated with benzos. 

 

Are you able to take a few days off from work? Does your job offer paid vacation or sick days? If so, you may want to schedule some time off so you can rest.