Victoria94: polydrugged and desperate - don't know what to do

[Altostrata]

Please restate your daily drug schedule. Thanks.

[Victoria94]

04/09/22 5mg Valium, 3.25mg Mirt

- 07.30am. 2.5mg valium
- 10:00am. Get up. Really depressed, suicidal, spaced out, confused, unable to accept the situation or understand what’s going on. Want to cry but unable to
- 13.00pm. No change in mood
- 14.30pm. No change in mood but getting sleepy, cannot sleep though 
- 15.40pm. Burning sensation in legs
- 17.00pm. Constant ruminating as always. Head feels as though it will explode. Unable to focus on what others say to me.
- 17.30pm. Weeping spell then heart Palpitations 
- 18.30pm very shallow breathing and heart palpitations
- 20.00pm. Shallow breathing, feeling warm 
- 20.30pm. Valium 2.5mg
- 22.30pm. Mirtazapine 3.25mg
- 11pm. No physical symptoms but feeling very low
- 12:00 bed. Takes a while to drift off
- 01.20am. Wake up from horrific nightmare 
- 02.30am. Still awake. Ruminating. Burning sensation in legs
- 7:30am. Have been awake ruminating but no physical symptoms. Valium 2.5mg

[Altostrata]

Why did you increase from 3mg diazepam per day to 8mg on August 26?

[Victoria94]

Because I thought it would calm me down - It was the closest ive felt to killing myself from the thought loops. 

[Victoria94]

4 hours ago, Altostrata said:

Please restate your daily drug schedule. Thanks.

 

What do you mean? Times oclock and dosages? Where?

 

I know not to increase doses now due to paradoxical effects and extension of tapering btw

[ChessieCat]

Alto just wants your to post a list here in your Introduction.  She wants to know what you are taking and when, ie the time and the drug and the dose, like the following example:

 

Using the information from your above post as a example

 

07.30am. 2.5mg valium
20.30pm. Valium 2.5mg
22.30pm. Mirtazapine 3.25mg
 

 

[Victoria94]

 

 

 

8 hours ago, ChessieCat said:

Alto just wants your to post a list here in your Introduction.  She wants to know what you are taking and when, ie the time and the drug and the dose, like the following example:

 

Using the information from your above post as a example

 

07.30am. 2.5mg valium
20.30pm. Valium 2.5mg
22.30pm. Mirtazapine 3.25mg
 

 

SOrry I'm still not 100% with it. Daily? Or go over the old history so the big picture is easier to see? Or seperately from symptoms?
 

 

 

[Altostrata]

Because I'm confused and this saves me time. Please help me out, I have a lot to do.

[Victoria94]

Hi. Her partner - she's not asking why but how you want it formatted? From the beginning of when she took her dose to now WITHOUT symptoms (a history or daily)? Or just doses with symptoms (a history or daily from now on)? 

I know you're really busy. Sorry for the inconvenience!

 

I'll compile the history of times oclock and doses/drug. If you need symptoms let me know. Thanks

 

9 hours ago, ChessieCat said:

Alto just wants your to post a list here in your Introduction.  She wants to know what you are taking and when, ie the time and the drug and the dose, like the following example:

 

Using the information from your above post as a example

 

07.30am. 2.5mg valium
20.30pm. Valium 2.5mg
22.30pm. Mirtazapine 3.25mg
 

 

 

 

 

[Altostrata]

Just a simple list:

 

9 hours ago, ChessieCat said:

07.30am. 2.5mg valium
20.30pm. Valium 2.5mg
22.30pm. Mirtazapine 3.25mg

 

[Victoria94]

31/08/22
8.30am - 2mg valium (mixed up 2mg and 10mg tablets) sorry I’m suffering from confusion 

 

11pm - 3.25mg mirtazapine. 

 

01/09/22
7.20am - 2.5mg valium
9.30am - 2.5mg valium & 3.25mg mirtazapine

 

02/09/22
7.20am - 2.5mg valium
9.30pm - 2.5mg valium & 3.25mg mirtazapine

 

03/09/22
7.20am - 2.5mg valium
8.15pm - 2.5mg valium
10.30pm - 3.25mg mirtazapine

 

04/09/22
7.30am - 2.5mg valium
8.30pm - 2.5mg valium
10.30pm - 3.25mg mirtazapine

 

05/09/22
7.30am - 2.5mg valium
7.30pm - 2.5mg valium
10.30pm - 3.25mg mirtazapine

 

Let me know if I can do anything else to make this easier

[Altostrata]

You've settled on taking 2.5mg diazepam at 7:30 a.m. and 7:30 p.m.? How do you feel before and after the morning dose?

 

How do you feel taking 5mg diazepam per day compared to the 6mg/day you were taking on August 29?

[Victoria94]

 

On 9/5/2022 at 11:16 PM, Altostrata said:

You've settled on taking 2.5mg diazepam at 7:30 a.m. and 7:30 p.m.? How do you feel before and after the morning dose?

 

How do you feel taking 5mg diazepam per day compared to the 6mg/day you were taking on August 29?

Hi, to save you time I stopped posting constantly.

I don't see any difference. I just feel constantly wired either way. 

My doses are all still the same. My tremors have lessened. I'm now feeling more depressed alongside the other symptoms.

[Victoria94]

I'm eager to know any theories you have. Should I use the benzodiazapine taper strategy here? Or should I taper mirtazapine first due to the serotonin interaction. 

 

[Altostrata]

On 9/12/2022 at 3:28 PM, TylerPez said:

I don't see any difference. I just feel constantly wired either way. 

 

Is this better or worse at any particular times of day?

 

My theory is you're taking TOO MUCH diazepam, you are getting paradoxical reactions (wired) to it as well as common symptoms such a depression and shallow breathing. It's very possible that if you get the diazepam dose right, you can go off mirtazapine and then taper diazepam.

 

To verify this, 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. Thank you.

[Victoria94]

10 hours ago, Altostrata said:

 

Is this better or worse at any particular times of day?

 

Worse in the early morning to the early evening. From early morning its accompanied with suicidal thoughts. 

13/09/2022

3.00 a.m. Woke with anxiety, rumination, feel depressed, suicidal thoughts, wired
7:30 a.m. Took 2.5mg valium

9:00am. Forced out of bed
10 a.m. Struggle to eat breakfast
12.00pm. Still have have anxiety, rumination, feel depressed, suicidal thoughts, wired

2.00pm: burning in legs, akathisia
4:10 p.m. Panic attack, suicidal thoughts, go to kitchen and pick up a knife, grab partner tell him what I did. I didn't want to actually do it
6:00 p.m. Rumination "speed" slowing down, burning in legs
7:30 p.m. Take 2.5mg valium
8:00 p.m. Small spike in appetite, eat and finish dinner

9:00pm. Mental symptoms calming down, wired feeling dissipating
10:00 p.m. Take 3.25mg mirtazapine
10:30 p.m. Huge spike in appetite, eat as much as I can in this window
12:00 pm. Fell asleep
04.00 a.m. Woke up, sweating profusely



 

 

[Altostrata]

Did mirtazapine always make you want to eat?

[Victoria94]

13 hours ago, Altostrata said:

Did mirtazapine always make you want to eat?

Yes but the eating window has reduced to just the evenings now.

14/09/2022

4.00 a.m. Woke up sweating profusely
5.00am. Fell back asleep
7:30 a.m.  Took 2.5mg valium as per alarm, covered in sweat

8:00am. Depressed in bed suicidal rumination
10 a.m. Get out of bed
12.00pm. Suicidal thought loop/rumination, burning in legs

2.15pm: burning in legs, bout of akathisia
3:00 p.m Go for a walk, tired very quickly
7:30 p.m. Take 2.5mg valium

9:00pm. Mental symptoms calming down, wired feeling dissipating
10:00 p.m. Take 3.25mg mirtazapine
10:30 p.m. Spike in appetite
02:00 pm. Fell asleep
04.00 a.m. Woke up, burning all over body, thought loops

[Victoria94]

My partner just had her worst bout of akathisia yet. Is there any reason why its getting worse?

[Altostrata]

What time o'clock did this bout of akathisia occur?

[Victoria94]

3 hours ago, Altostrata said:

What time o'clock did this bout of akathisia occur?

3.50pm 

 

Slight delayed from days before. Right after eating 

 

 

[Altostrata]

This does not appear in daily notes. Please explain more about this symptom: What did it feel like? How long did it last? 

 

Is there any typical mid-day meal?

 

Does Victoria94 take any other drugs or drink alcohol?

[Victoria94]

26 minutes ago, Altostrata said:

This does not appear in daily notes. Please explain more about this symptom: What did it feel like? How long did it last? 

It did, the day before. There is usually a meal at midday.

 

14/09/2022 was 10 minutes at 2:15pm. Started with restless legs. Followed by what I can only describe as squirming in pain, a look of terror with crying. She explains there is no physical pain.

The one I'm referring to happened on the 15/09/2022 at 3.50pm and went on for 20 minutes.  Started again with restless legs, eventually consuming her whole body except this time she was begging for me to end her life from it. There are no other drugs. She mistakenly had a green mango tea thinking it was fruit tea at 11am. Maybe this caused it to be more extreme. 

 

I will stick to the daily notes to avoid confusion. Just never seen anything like this. I'll post the daily notes for the 15th tomorrow and we can pick up from there.

 

[Altostrata]

Why is she squirming? Are you posting all her notes?

[Victoria94]

 

9 hours ago, Altostrata said:

Why is she squirming? Are you posting all her notes?

 

The squirming is involuntary. Yes. Every day has been posted since the 13th. The time difference and me posting impulsively is throwing you off. I won't do it again, just was really concerned after that episode yesterday.

Please note I have posted about what I think is akathisia before. But I didn't know what this was at the time. Described it as jitteryness and tremors, feeling suicidal. She would wake up throughout the night doing this when on the 3mg.

In hindsight she had an extreme bout of this on August 28th when we mistakenly increased the valium to 8mg. Do you think this is akathisia?


15/09/2022

4.00 a.m. Woke up burning on skin all over, depressed, ruminating
8.00am. Feeling very suicidal, memory is foggy
7:30 a.m.  Took 2.5mg valium 

8:00am. Depressed in bed suicidal rumination
10.30 a.m. Forced to get out of bed
11.00pm. Accidentally drink a caffeinated green mango tea

13.00pm Suicidal rumination, depressed, anxiety
3:00 p.m Eat mushroom tagliatelle pasta

3.40pm Restless legs, jittery

3.50pm Jitteryness turns more extreme. Squirming on the chair as body feels super agitated, head feels like its going to explode from anguish, crying and shouting begging partner to end my life from how this feels.

4.20pm. Episode passes, feel very confused about what just happened. Feel hopeless.

6.00pm. Suicidal rumination calming down.
7:30 p.m. Take 2.5mg valium

9:00pm. Feeling calmer, wired feeling dissipating. Eat a small meal.
10:00 p.m. Take 3.25mg mirtazapine
10:30 p.m. Wired feeling still lowered. Noticing I have "windows" in the evenings. Spike in appetite, eat a large meal.

01.30am. Went to bed
02:00 am. Fell asleep
04.00 a.m. Woke up, burning all over body, thought loops rumination

[Altostrata]

It's not the timing that's throwing me off, it's the way symptoms are described.

 

As I indicated before, my guess is @Victoria94 is taking TOO MUCH Valium, and she's getting paradoxical effects from it (activation rather than calming) along with the typical adverse effects of depression, demotivation, foggy brain, etc. 

 

Did she reduce to 2.5mg Valium twice a day on September 1? How has her overall symptom pattern changed in the last week? Better. worse, the same?

[Victoria94]

On 9/16/2022 at 4:19 PM, Altostrata said:

It's not the timing that's throwing me off, it's the way symptoms are described.

 

As I indicated before, my guess is @Victoria94 is taking TOO MUCH Valium, and she's getting paradoxical effects from it (activation rather than calming) along with the typical adverse effects of depression, demotivation, foggy brain, etc. 

 

Did she reduce to 2.5mg Valium twice a day on September 1? How has her overall symptom pattern changed in the last week? Better. worse, the same?

 In what way is the way I've described things throwing you off so I can make this easier for you?

I agree with your theory. Let me know anything else.

The akathisia has calmed down since September 1st. They've become shorter in duration and less intense, with the exception of on the 15th. I think this was due to caffeine.

I thought it worth mentioning. Victoria94 vapes. 20mg nicotine. She has been since she started going through this.

 

Thanks Altostrata

16/09/22

6.00am. Wake up, anxiety, depressed, suicidal rumination, burning all over
7:00am burning stops
7:30 am took 2.5mg valium, anxiety, depressed, suicidal rumination
10:00am finally muster strength to get out of bed, feel scared
12:00pm  Have a fruit tea, heavily ruminating, thought loops speeding up

12:30pm Akathisia bout (mental anguish, despair, terror, suicidal thoughts, agitation, squirming)
12:45: Akathisia passes
13:00pm Feel calmer
14:00pm speak to sister, she finally listens and believes me, feel calmer as  external situation might be more manageable 
15:00 eat a sandwich and some chocolate

16:00 calmness continues 
19:30 took 2.5 mg valium
20:00 wired, but feeling slightly more mental clarity

00:00 fall asleep

03.00am wake up, panicked, anxious, suicidal thoughts

04:00am fall back sleep

06:00am Wake up, panicked, anxious, suicidal thoughts, depressed

 

[Altostrata]

On 9/17/2022 at 12:52 PM, Victoria94 said:

12:30pm Akathisia bout (mental anguish, despair, terror, suicidal thoughts, agitation, squirming)
12:45: Akathisia passes

 

This is not true akathisia, it's the paradoxical reaction from TOO MUCH benzo. I suggest @Victoria94 reduce the 12:30 p.m. dose to 2mg Valium.

 

The Valium doses should be taken at the same times each day, 12 hours apart.

 

Did @Victoria94 skip mirtazapine on 9/16? 

Edited September 23, 2022 by Karma
Name update

[Victoria94]

"Did @Victoria94 skip mirtazapine on 9/16? "

No she didn't. 

What taper would you recommend? Is a 10% reduction necessary since Tyler's only been on diazepam 14 weeks? Could the Ashton manual be viable? I just want to get her off everything ASAP. But am cautious because of potential protracted withdrawal. But atm the most important thing is that she is alive.

I want to make it clear. I agree there is TOO MUCH DIAZEPAM.

What is true akathisia? Are high doses of benzos and akathisia mutually exclusive? The dose of valium is at 7:30am/pm. Not 12:30pm when that particular bout of "x" occured. There is no correlation between when she has the episodes and when she takes the medications. or when she eats. 

She had these episode on 3mg diazepam. She has done this since starting the SSRI and SNRI with varying degrees of intensity throughout. They continued after the SSRI and SNRI were dropped.

She is EXTREMELY SUICIDAL when these episodes peak.  She shakes her legs and arms uncontrollably. Hits her face. Picks at skin around her finger nails frantically. Squirms. Begs for me to kill her. Tells me I'm selfish for letting her live. I have to pin her down or else there is a possibility she will do it. When she doesn't have the MENTAL symptoms of anguish and despair she just has physical restlessness. 

I have removed all the knives from the flat. I've only just convinced her parents who she is going to see tomorrow that more drugs IS A BAD IDEA. The external situation is extremely sensitive. Any advice for taper would be greatly appreciated. The situation is becoming untenable and I do not want the psychiatrists or doctors to get hold of her because then it's game over. 

What about the nicotine I mentioned? Please

 

 

 

Edited September 23, 2022 by Karma
Name update

[Altostrata]

On 9/18/2022 at 6:13 PM, Altostrata said:

I suggest @Victoria94 reduce the 12:30 p.m. dose to 2mg Valium.

 

As before, it will take about 2 weeks for a diazepam reduction to take full effect. I would expect the activation from her overlarge daily diazepam dose to gradually reduce over that time.

 

Is @Victoria94capable of understanding that her symptoms are drug-induced?

[Victoria94]

On 9/19/2022 at 12:27 PM, Altostrata said:

 

As before, it will take about 2 weeks for a diazepam reduction to take full effect. I would expect the activation from her overlarge daily diazepam dose to gradually reduce over that time.

 

Is @Victoria94capable of understanding that her symptoms are drug-induced?

 

Yes I would say most of the time when she is with me. She wavers alot, almost arguing that she was always like this for reassurance.

Her family are not helping with this. They think it is a relapse.

As before, it will take about 2 weeks for a diazepam reduction to take full effect. I would expect the activation from her overlarge daily diazepam dose to gradually reduce over that time.

So you're saying to taper every 2 weeks?

[Victoria94]

17/09/22

6:00am Wake up, anxious, depressed, suicidal rumination
7:30am Take 2.5mg valium
8:00am depressed, anxious, suicidal rumination
10:00am get out of bed
11:00am go to pick up a parcel from store, have a conversation for first time in weeks 
11:30am wave of panic in the next store, head straight home
12:00pm symptoms of "x" ((mental anguish, despair, terror, suicidal thoughts/urges, agitation, squirming)
13:00pm Symptoms calm down, depressed, suicidal, no feelings
15:00pm eat a sandwich
16:00pm "x" occurs again (mental anguish, despair, terror, suicidal thoughts/urges, agitation, squirming)
17:00pm calms down, emotions comeback, crying and weeping, suicidal thoughts, depressed
19:30 take 2.5mg valium
20:00 panicking 
21:00 eat a meal
22:30 take 3.25mg mirtazapine
23:00 eat some more food as appetite increased
00.00 sleep
02:00am wake up, usual thought loops, suicidal rumination

03:30am sleep

05:00am wake up usual thought loops, suicidal rumination
 

18/09/22

6.00am. Wake up, anxiety, depressed, suicidal rumination, burning all over
7:30 am took 2.5mg valium
10:00 am in bed, depressed, suicidal thought loops
11:30am: "x" (mental anguish, despair, terror, suicidal thoughts, agitation, squirming) partner tries to calm me by pinning me down as im begging him to kill me and can't control my body
12:15pm "x"symptoms stop
13:00pm Feel calmer, thought loops slow down 
15:00pm eat a sandwich
16:00pm negative thought loops, depressed, anxious
18:00pm continues
19:30pm took 2.5mg valium
20:00pm Still depressed
20:30pm eat a meal
22:30pm Take 3.25mg mirtazapine
00:00 fall asleep
03.20am wake up, panicked, anxious, suicidal thought loop
04:00am fall back sleep
06:00am Wake up, panicked, anxious, suicidal thoughts, depressed
 

19/09/22

06:00am Wake up, anxiety, depressed, suicidal rumination
07:30am take 2mg valium
10:30am get out of bed
11:00am try to watch tv, can't focus on anything but negative things, mentally or directing attention outward
12:00pm "x" occurs (mental anguish, despair, terror, suicidal thoughts, agitation, squirming) partner is with me trying to hold me
13:30 "stops", headache
15:00pm eat a sandwich and some chocolate
16:00pm "x" occurs, less intense physically
16:30pm "x" stops
19:30pm take 2mg valium
21:00pm eat a meal 
22:30pm take 3.25mg mirazapine
23:20 eat some candy, burning sensation in chest
00:00am sleep
03:00am wake up, terrified, usual mental state of anxiety, depressed, suicidal rumination
04:30am shaking
06:00am still shaking (external circumstance is troubling me, not sure this is dose related)
 

 

It's the 20th here, notes to follow tomorrow

 

 Would we be able to see less activation that quickly from a reduction in dose? Some of my partner's emotions came back today (other than fear etc). She felt love for the first time in weeks.

Also, how would you proceed with taper? Are you basing it off the logs? Please just an extra 1 min to explain this. The mirtazapine is bothering me as well. Could 3.25 be a problem if it is not taken out before the benzo taper is completed?

[Victoria94]

20/09/2022

06:00 wake up, usual thought loops
07:30 take 2mg valium
09:00 restless legs, depressed, usual thought loops
12:00 eat
13:00 outburst of "x", highly agitated, can't sit still, hitting myself in the face, suicidal thoughts
15:00 noticeably less agitated than earlier, more depressed, crying, neuro emotions, can't tell if this is drug induced
17:00 some emotions come back, can feel love
17:30 emotions gone again, thought loop resumes
19:30 take 2mg valium
20:00 big headache 
21:30 eat a meal
22:30 take 3.25mg mirtazapine
23:00 stabbing headache, sweet food cravings, eat chocolate
00:00 bed, fall asleep straight away
02:00 restless legs as I sleep, not aware of it
06:00 wake up, depressed, suicidal, anxious
 

[PortugueseSea]

Hello Tyler,

I have been reading through this mess and I am very sorry you are going through this. It is invaluable your partner is by your side through this.

I wanted to chime in on the tapers and the mirtazapine. I understand you guys want her off the meds as soon as possible. I would love to be off myself. That said, with her this unstable as of now it is not the time to think of the taper. You guys need to settle on a Valium dose, as per what Alto mentioned. I would not be too concerned about the mirtazapine, 3.75mg is a very low dose. I have noticed that sleep, while broken, is not non existent. At that dosage it is probably just helping her sleep and stimulating her appetite, which are good things, all things concerned.

Let us see what Alto thinks about the Valium dose.

Praying for you guys.
 

[Victoria94]

21/09/2022

6:00am wake up, deep depressed feeling, suicidal thoughts slowing down
7.30am 2mg Valium
11:45am restless legs, suicidal rumination
12:30pm eat
13:30pm partner asks me to go for a walk - filled with terror. 
13:45pm highly agitated from noise in the street, restless
14:22pm bout of "x" less intense than before, seems more drawn out
15:00pm highly agitated, angry
16:30pm still highly agitated, neuro emotions in overdrive, can't tell the difference between neuro emotions and real emotions
18:00pm still suffering anger frustration and intense thought of suicide
19:00 full breakdown, can't tell if this is a relapse or drug induced, my sister convinces me maybe I was like this before, confused as I was moderately anxious and depressed before, "is this where I was headed anyway?"
19:30 2mg Valium
20:00 go for a walk, feel alot calmer outside
21:00 return home, eat
22:30 3.25 mg Mirtazapine
23:00 calmer
01:00 sleep
04:00 jolt awake, panicking, my brain is telling me my only way out is suicide or I'm going to end up in a psychiatric ward
05:00 can't stay still, suicidal thought loops
06:00 feel emotionless, suicidal, fear of psychiatric ward, still not convinced this is drug induced

 

[Victoria94]

5 hours ago, PortugueseSea said:

Hello Tyler,

I have been reading through this mess and I am very sorry you are going through this. It is invaluable your partner is by your side through this.

I wanted to chime in on the tapers and the mirtazapine. I understand you guys want her off the meds as soon as possible. I would love to be off myself. That said, with her this unstable as of now it is not the time to think of the taper. You guys need to settle on a Valium dose, as per what Alto mentioned. I would not be too concerned about the mirtazapine, 3.75mg is a very low dose. I have noticed that sleep, while broken, is not non existent. At that dosage it is probably just helping her sleep and stimulating her appetite, which are good things, all things concerned.

Let us see what Alto thinks about the Valium dose.

Praying for you guys.
 

Thankyou @PortugueseSea
 

I have been thinking the same about the Mirtazapine. My instinct about taper is Ashton method is viable due to the duration my partner has been on valium vis a vis a 10% reduction duration. It seems a longer amount of time on this could be more damaging than a 1/2 week reduction. I remain cautious.

 

I'm struggling because my partner cannot always see that this is drug induced so any support is greatly appreciated. She knows it sometimes. But when she speaks to a family member, she is not convinced as they say she was anxious before, and saw her in a bad way during serotonin syndrome. They have blind faith in "professionals", have no understanding of pharmacology or medicine and I think they see me as dangerous for doing my own research and utilising resources like this. I have outlined there is a gap in the literature and gave them Framer's article back in August but it was called "an article from a laymen". I'm trying to remain calm, as not the inflame the situation and seek their support. But they really have no idea what is going on or what they are talking about. It is highly infuriating as much as it is disheartening. I am battling her neuro-emotional side and trying to negotiate with her family at the same time.

Thankyou so much for your kind words. Honestly this feels like the most defining moment of both our lives.