Willowman: moclobemide MAO and a long history of psychiatric drugs

[Willowman]

 Switched to the cough medicine ambroxol because acetylcysteine is apparently not working enough and there may be psychotrophic effects. Bothered by a stiff painful neck for 10 days now.

 

5:00 gave up got up

5:30 estrogen gel

6:00 breakfast

supplements: beer yeast, vitamin d3/k2 1000 i.U., vitamin b12 1000 i.U.

225 mg moclobemide 

10ml Ambroxol

 

Relatively ok day, very tired and brain foggy, bad cough

 

16:15 Bisoprolol 1,25mg, Ambroxol 5ml

 

18:30 Ambroxol 5ml

 

19:30 magnesium glycinate 300mg, Passion flower 260mg, progesterone 

 

fell asleep around 21:30

 

1:15 awake, little bit anxious, fell asleep after around 30mins, levithyroxine 

3:05 awake, more anxious. Calmed down with internet.

Fell into very light sleep around 4.00

5:15 woke up. Tired. Neck hurts.

6:00 breakfast

6:15 beer yeast, vitamin d3/k2 1000 iE, vitamin b12 1000 iE, 225mg moclobemide, 10 ml ambroxol

 

Relatively good day

15:45 1,25mg bisoprolol

 

20:00 magnesium glycinate 300mg, progesterone, 260mg passion flower

20:30 fell asleep

1:00 awake, not too anxious

1:30 about fell asleep

3:50 awake, rather anxious, levithyroxine 

uneasy napping and breathing exercise 

5:20 got up, groggy foggy feeling, anxiety 

 

Is this a correct 24 hour notes sheet? If not, please tell me how to improve it,

 

Best and thank you so much

 

Willow

 

[Altostrata]

Hello, @Willowman

 

Which drugs do you take consistently every day? Which drugs do you take occasionally?

 

Did you recently have covid?

 

Which of your symptoms do you attribute to moclobemide withdrawal?

 

 

[manymoretodays]

Thank you Alto.

And Willowman, yes, those NOTES look good.

Extraneous factors now, unfortunate, but it is what it is.........is your current illness and cough.

Have I pointed you towards using an interaction checker whenever you add any new medication?

I think I have, unfortunate that Drugs.com doesn't recognize moclobemide, as it's not used in the U.S.

There is also Medscape- https://reference.medscape.com/drug-interactionchecker

That one may be a little more international friendly.  It's also a good source for single medication information.  Always check the addition of anything to your moclobemide please.  If no luck at Medscape, use a pharmacist.  Just a good rule of thumb for anyone, and especially you with the moclobemide.

(I did see the the new cough remedy addition, and the take away of the NAC)

 

So.....more NOTES.  Answer Alto's questions.  And I am hoping your current illness is fading.

And we'll get back to work on next steps, suggests, advice.

 

Best, L, P, H, and G,

mmt

 

 

Edited November 5, 2022 by manymoretodays

[Willowman]

Thankyou so much for your help. I really want to sleep again and I want this anxiety to go away and be psychotrophic drug free. Here is about your questions:
 

 

My illness is a bit better but not much

I did not have covid, or I am at least not aware of having caught covid

 

I had mononucleosis and lyme disease a couple of years ago (seperately)
 

Which meds do I take regularly:

 

supplements: Beer yeast tablets, magnesium glycinate 300mg, potassium tblet homeopathic, silicea tablet homoeopathic, vit d3/k2 1000 i.u., vitamin b12 1000 i.u.

 

Meds: Levithyroxine 75, moclobemide (currently 225mg), passion flower extract 260mg, bisoprolol 1,25mg, corticoid asthma spray once daily

 

cyclical HRT; estradiol gel daily, 2 weeks on and off 200mg progesterone 

Which meds occasionally: 

 

whatever prescribed for a current illness

Currently Ambroxol 10ml for cough

Iboprofen for pain as needed (400/600/800mg depending)

 

supplements: Occasionally a colon activating culture of lactobacillus, especially in times of sickness, occasionally zinc and selenium 

Which symptoms do I link to withdrawal 

 

I am so unsure. This anxiety, is it hormonal, psychological or withdrawal? Same with insomnia? I do experience a waves and windows pattern. 
 

Anxiety and insomnia are ruining my life, but otherwise I have balance issues I never had, blurry vision, brain fog occasionally, high nervous energy, „need to talk“, neck pain, headaches, dizzy spells. I don’t know if this is caused by withdrawal as I don’t know much about it.

 

I always put my meds and supplements through an interaction checker. Occasionally I ask a pharmacist as well. Moclobemide and betablockers have an interaction warning but the doctors said obviously all is going well so I am to continue with them. Levithyroxine has multiple interactions so I always take it atleast 30mins away from everything else, more if I wake up early.

 

 

Continued notes

 

Day was relatively ok after the fog passed around 11

 

16.00 1,25mg bisoprolol

20:00 progesterone, 260mg passion flower, 300mg magnesium he evening

21:00 went to bed, anxious

around 22:30 fell asleep

3:00 woke up very tense, feeling dread

4:00 trying to go back to sleep

uneasy sleep/waking naps

6:40 got up 

7:00 breakfast

beer yeast, vitamin d3/k2 1000iu, b12 1000iu, potassium/Kalium minuscule amount

225mg moclobemide 

 

day ok, rising anxiety in the evening. Rather bad anxiety all evening.

 

20:00 25 mg quetiapine, magnesium 300mg, progesterone 

Yes I did give in this once and take quetiapine. My doctor kept going on how I will never recover without sleep and this weekend I am alone which gives me anxiety in good times. I am aware this may throw off things a bit but I didn’t want to lie.

 

20:45 (about) fell asleep

4:20  woke up with an awful feeling of dread and doom. Bit foggy. I don’t like the way my brain feels. Even though I did not wake up during the night I don’t think I will take the quetiapine regularly. I really hate feeling drugged and anxious at the same time.

levithyroxine 

5:30 anxious and tired, got up

 

 

 

[Willowman]

More notes: 

 

Breakfast 6.30

Moclobemide 225mg, the usual supplements

anxiety still there

slowly subsiding around 8.30

Better around 10:00

 

normal day

 

16.00 Bisoprolol 1,25mg

19:45 progesterone, passion flower 260mg, magnesium glycinate 300mg

21:00 went to bed, anxiety ok

21:45 fell asleep

2:20 woke up with very bad anxiety and dread

3:00 fell asleep

3:50 woke up, moderate anxiety

4:10 napped

4:40 gave up and got up

6:00 breakfast, supplements and moclobemide 225mg

16:00 1,25mg bisoprolol

rising depression

19:40  260mg passion flower, 300mg magnesium glycinate 

 

 

[Willowman]

Continued:

 

Horrible night with multiple awakenings and dread. This insomnia is driving me nuts. 
 

Melatonin spray at 1:15
 

I could sleep a little better with seroquel but I will try upping the dose of passion flower first.

 

Or do you have any advice?

[manymoretodays]

Your seroquel experiment didn't really look that great:

On 11/5/2022 at 10:59 PM, Willowman said:

20:00 25 mg quetiapine, magnesium 300mg, progesterone 

Yes I did give in this once and take quetiapine. My doctor kept going on how I will never recover without sleep and this weekend I am alone which gives me anxiety in good times. I am aware this may throw off things a bit but I didn’t want to lie.

 

20:45 (about) fell asleep

4:20  woke up with an awful feeling of dread and doom. Bit foggy. I don’t like the way my brain feels. Even though I did not wake up during the night I don’t think I will take the quetiapine regularly. I really hate feeling drugged and anxious at the same time.

 

Nor has the passion flower been any real help.  I'd rather see you go down a bit on that......as I think you know.

I do see some sleep, with consistent night awakenings regardless of quetiapine or passionflower.

 

Did I give you this one?

Early morning waking- managing the morning cortisol spike

try something non-drug, non-supplement if you can

don't let your doctor make you believe it's worse and feed the "I need more drugs" persona....it's up to you I suppose, but do you see how this IS WD yourself now?  Sometimes just acceptance can relieve a lot of angst and frustration.  This takes time to get some resolution and homeostasis balance back. 

 

 

Keep a going with the NOTES.  They are a bit unclear, as to dates, and then try for a nice delineated appearance when you post them.  The more you do, the easier.  And then when Alto gets a free moment to make rounds.......we want it clear as can be for when she views them.  Keep getting all the supplements in there, each day.......don't get sloppy or slap happy now with them.

 

Thank you for the good effort.  And soldiering on.  Sending restorative sleep......Zzzzzz.

 

Best.  L, P, H, and G,

mmt

[Willowman]

Thank you manymoredays! 
 

Well I don’t like how my brain feels the day after quetiapine but I did sleep 6 hours plus in a row for the first time in ages. I am on the fence if that’s worth it. I feel I am at a breaking point with these nighttime awakenings. I just cannot go on with these fear filled, broken nights and tired, tired days.

 

I didn’t want to reduce the passion flower before I am safely off moclobemide. I did try increasing it yesterday and the night was a disaster, though, so I am not sure it helps at all. I may try melatonin again.

 

I did read the link about morning cortisol, I have to admit it made me feel worse that this may last for years! I just cannot bear the thought.

 

This anxiety and insomnia was bad before the antidepressants - and after them, it’s much worse. Also, I am so so down I will never get rid of the specific fear that has now accompanied me daily and nightly for nearly a year. How how how can I forget it again! I don’t want my brain to go there all the time.

 

I have the habit of using my Ipad at night because I have a hard time calming down. I believe just turning on a meditation, music or sleep story is ok (takes a minute and I use blue light blocking glasses) but surfing the net is not good. I have to find a different distraction.

 

Melatonin; I read it is good for falling asleep. Can I take it again early in the night like 0am, 1am, 2am to fall back asleep?
 

More notes:

 

8.11. 

very tired all day, had trouble not falling asleep even sitting in a chair

Ambroxol 10ml for cough

16:00 1,25mg bisoprolol

18:00 Ambroxol 10ml

20:00 2 capsules of 260mg passion flower (so 520mg), 300mg magnesium glycinate 

 

lying in bed from 21:00 on dead tired but cannot sleep! Sweaty, palpitations, miserable. Anxious.

 

fell asleep around 23:30

 

9.11

1:15 woke up, anxious, heart beating fast, sweaty

3:00 woke up again. Dread and doom feeling. Fighting despair.

4:00 relaxed a bit after some tapping and walking around

4:05 remembered my existential fear (which is my main issue), doesn’t help I got the notification of a death of an acquaintance today

anxiety attack, have to start calming down again

4:30 gave up, got up and called a helpline 

6:00 breakfast, 225mg moclobemide, 10ml ambroxol, vitamin d3/k2/b12 1000i.u.

 

 

 

 

[Altostrata]

When did you start taking progesterone? Please read up on the adverse effects of progesterone.

[Willowman]

I started in June with cyclic hormone replacement therapy because my gynecologist thought it would help me. And I notice a small effect but not much. Also I feel worse in the two weeks without progesterone.

 

You cannot only take estrogen as a woman. That would mean almost certain cancer.

 

I did read up a lot before I decided on HRT. The research is woefully inadequate and many studies outdated or flawed. But all in all it seemed the better option for brain and bone health with minimally elevated cardiovascular risks.

[Altostrata]

Please review your current symptoms and consider whether they may be related to hormone therapy.

 

Why are you taking Ambroxol 10ml for cough?

 

On 10/14/2022 at 9:31 PM, Willowman said:

I have not come out of the severe anxiety episode that started this spring. It is a tiny bit better, but especially the anxiety induced insomnia is really dragging me down.

 

It appears you went off sertraline at the end of April. When did this severe anxiety episode start?

[Willowman]

1 hour ago, Altostrata said:

Please review your current symptoms and consider whether they may be related to hormone therapy.

 

They may be in part but I don’t think it’s the real cause. On the contrary I believe a stabilization of hormones hopefully will relieve the symptoms. If this continues however I may have to try going off hormone replacement

 

1 hour ago, Altostrata said:

Why are you taking Ambroxol 10ml for cough?

 

Because I need and expectorant

 

1 hour ago, Altostrata said:

 

It appears you went off sertraline at the end of April. When did this severe anxiety episode start?

I was tense and a bit of „couldn’t relax“ anxiety. Then I made the mistake of taking sertraline and I had intense agitation, anxiety, panic attacks - it was hell and the psychiatrist made me stay on it five weeks. 12,5 and then 25mg. Not a high dose but after that it never went away

[manymoretodays]

Hey Willowman,

Don't forget yesterdays NOTES.  You're doing them and yay......and keep them coming.

L, P, H, and G,

mmt

[Willowman]

9.11.

 Very very tired day with lots of downs

16:00 1,25 mg bisoprolol

20:00 New sleep meditation try, 40 prothipendyl hydrochloridemonohydrate

fell asleep quickly

23:30 short awakening

 

10.11.

3:40 woke up, palpitations and anxiety 

got up and walked around

6:00 breakfast with usual supplements and 225mg moclobemide 

Anxious and depressed day, but also some life events causing that

 

16:00 1,25 mg bisoprolol

20:40 prothipendyl 40mg 

fell asleep quickly

 

11.11.

1:16 woke up with bad palpitations but not too anxious 

2:00 tired again tried to sleep, took a while

4:00 woke up again

anxiety just a bit, tired

4:50 gave up and got up

 

I consider this experiment failed. 120/95 blood pressure and 100 pulse at 1am seems a bad reaction plus I still couldn’t sleep. Less anxiety was nice though.

 

[manymoretodays]

On 11/9/2022 at 1:32 AM, Willowman said:

I was tense and a bit of „couldn’t relax“ anxiety. Then I made the mistake of taking sertraline and I had intense agitation, anxiety, panic attacks - it was hell and the psychiatrist made me stay on it five weeks. 12,5 and then 25mg. Not a high dose but after that it never went away

 

Willowman, I do hope that you know that your psychiatrist cannot "make you" take or stay on something that you are reacting adversely to, or simply do not wish to take.  We have rights.  Do you have some kind of advocate for yourself at home......who will speak up for you when it is hard to do so yourself?  I've been in those shoes of not being not only heard but grossly mis-understood by psychiatrists and others in the system.

Or.....some will try a new doctor completely.

Any doctor can prescribe what you need now in terms of medication(s).

See -how-to-talk-to-a-doctor-about-tapering-and-withdrawal-what-to-expect/

and this one may be helpful too:

-feelings-towards-my-doctor/

 

  

12 hours ago, Willowman said:

I consider this experiment failed. 120/95 blood pressure and 100 pulse at 1am seems a bad reaction plus I still couldn’t sleep. Less anxiety was nice though.

 

This experiment? 

  

12 hours ago, Willowman said:

New sleep meditation try, 40 prothipendyl hydrochloridemonohydrate

 

Ouch, oh, oh, oh, and why?  I don't know about you, but I learned quite awhile ago to limit myself as to psychiatrist suggests to treat what IS WD and also........refused to take anything else that was so difficult to spell that it was hard to look up.

 

Do you think it might have interacted a bit with the moclobemide in your system?   Seriously.  I. am. stunned.

I am glad you are okay, and were able to post NOTES today.........I feel like you are playing with fire now......and am concerned.....

 

Here is PubMed: https://pubchem.ncbi.nlm.nih.gov/compound/Prothipendyl-hydrochloride

 

And Drugs.com brought me to this: https://www.drugs.com/search.php?searchterm=prothipendyl+hydrochloride&sources[]=

the first topic, shows the ph as an ingredient in Dominal, and that's a drug we've seen..... more trouble with around here.

 

I don't know Willowman.  If you do wish to keep following all unlimited drug trials, with your doctor ........what you are doing here now?

I mean I know it is extremely difficult for you now, but perhaps you could return later if and when, you really wish to taper off moclobemide. 

 

You obviously should be talking to whom ever is prescribing all these drug trials to you now, about them, and the new drugs.  Again, I do feel you have a real choice here.  If you however are not being heard by your doctor......you do or I sure hope you have a choice there too.  As I said above.......

 

I don't mean to sound harsh......I'm sure I do however.  I don't how else to say it.

 

No way can we get a clear picture, of just how to help you with the moclobemide taper, and even help get you to some stabilization of WD symptoms, while you are off taking everything under the sun.

 

The rule of 3 KIs

 

And best, sincerely,

L, P, H, and G,

mmt

 

 

Edited November 11, 2022 by manymoretodays
formatting difficulties, re-formatting, and more!

[Altostrata]

You have a long history of trying out an antidepressant for a short amount of time, then quitting it. It appears your last drug experiment started in June, with moclobemide.

 

On 10/14/2022 at 9:31 PM, Willowman said:

I have not come out of the severe anxiety episode that started this spring. It is a tiny bit better, but especially the anxiety induced insomnia is really dragging me down.

 

My psychiatrist put me on moclobemide after a second try with an SSRI went south and had the same result as the first try, severe anxiety, unbearable agitation and even worse insomnia. 

 

You were on sertraline for 5 weeks prior to moclobemide. Did "severe anxiety, unbearable agitation and even worse insomnia" happen while you were taking sertraline? If not, when did it occur?

 

You went off sertraline April 30. When did the "severe anxiety episode" start?

 

You are under the active care of a psychiatrist who has been changing your dosage, and adding new drugs, the latest being prothipendyl. How did it happen that you increased moclobemide to 225mg only 3 weeks ago?

[Willowman]

11.11.

16:30  1,25 mg bisoprolol

20:00 magnesium glycinate 300mg

anxiety spike

21:00 passion flower 260mg

fwll aslwwp around 22:00

23:30 wokw up, anxiety. Melatonin spray.

fell asleep some point

 

12.11.

2:20 woke up, bad anxiety 

Hello,

 

I am not sure if I should go on posting but I feel so terrible and lost I am going to try go on. 

 

Answers to your questions:

3 hours ago, Altostrata said:

You have a long history of trying out an antidepressant for a short amount of time, then quitting it.

 

Yes. I am scared. Scared of what these drugs do to me. So I always quit asap. And then I start something again because I feel so terrible, cannot sleep, am lying in bed shaking with fear or wandering around tired and restless and afraid. And then it starts again

3 hours ago, Altostrata said:

 

You were on sertraline for 5 weeks prior to moclobemide. Did "severe anxiety, unbearable agitation and even worse insomnia" happen while you were taking sertraline? If not, when did it occur?

 

Before I took the sertraline I was “just” scared of the war starting, had some insomnia but not as severe and I had some inner tension and ocd. I have had ocd all my life. Because I was so afraid that “it”, meaning the sickness I had 12 years ago, could come back, I went to my psychiatrist. The one I knew and trusted, however, had just quit his job for age related reasons and a new one had taken his place. I didn’t get along with the new one too well but it is impossible to get a new one where I live at the moment, it’s crazy how booked they are.

 

I don’t know if the illness started up badly or if it was the sertraline. I will try and write down the history of this coherently because maybe then it will be clearer why I don’t know if this is withdrawal, my illness or (as I am starting to believe) a mix of both.
 

I had a -much shorter- episode of the same thing, intense fear and existential anxiety and insomnia, before, 12 years ago, and that started and was bad before I tried antidepressants. I held out for almost two months then and after that I was in such a bad state I walked to the hospital in the middle of the night and told them they had to do something . They put me on escitalopram along with lorazepam. While I was on lorazepam, everything was ok (well the anxiety was almost gone but only while lorazepam was working (it always came back shortly before the next dose) but then I was taken off lorazepam. I don’t remember if it was two or three weeks lorazepam but they took me from 3x 1mg or 0,5mg (they never told me the dose in the clinic) to zero cold turkey. I had a dreadful time after that until they also agreed this doesn’t work and took me off escitalopram and put me on mirtazapine which at least helped a little with sleep. I was still very depressed and anxious though and then was put on wellbutrin. This seemed to help a bit but it took a long time, about two months, until the anxiety went away and I was more or less back to normal. I was on 4x 260ng passion flower from then on ans on a betablocker at night though, so I don’t know if I was ever truly healed. I didn’t take the passion flower too seriously because my doctor didn’t either.
 

The last episode took about 6 months altogether. I am in a bad state now since February, so 9 months. I think it’s because it has chronified and sleep is so bad. Without sleep there can be no healing.

 

Now, 12 years later.  As I said I had some anxiety and insomnia before the sertraline. How I wish I had never taken it! But I trialed with 12,5 mg for a week and felt much calmer if a little spaced out. So I thought it was a good thing. And went on 25mg which according to my doctor was not an effective dose.

 

For a week or a bit more, the anxiety rose slowly. I should have gotten off the sertraline then and there! But the description on the medication sounded like it could help exactly what I have (anxiety, ocd) and my doctor told me “it always gets worse before it gets better” so I stayed on.
 

And during that time, “it” came back full force. My existential anxiety was reawakened and I was in a state of constant horrible dread for weeks. I called doctors, I got on everyone’s nerves by constant cries for help. Horrible dread hung over me and I was anxious all day and night and couldn’t sit still for five minutes. Insomnia went through the roof. Soon I was in such a bad state I couldn’t make good decisions anymore and I certainly couldn’t advocate for myself.

 

I went off sertraline after five weeks of that and was without medication for about six weeks. During that time, I got better but not well at first and at the end of six weeks, I suddenly had a bad crash again. Which is why I went on moclobemide.

 

Thinking back, though, I was exactly the same way before any drugs or hormone therapy. So I want to get off the moclobemide. Why take a drug if it isn’t even helping. I had waves of this illness before it and I have waves of this illness on it. But sadly I have shaken my system and scrambled everything so badly with trying this and that in the desperate hope to find relief I don’t know anything anymore and it is very hard to judge what is doing hat - for me and others.

 

3 hours ago, Altostrata said:

You went off sertraline April 30. When did the "severe anxiety episode" start?

 

I hioe the above answers that question.

3 hours ago, Altostrata said:

You are under the active care of a psychiatrist who has been changing your dosage, and adding new drugs, the latest being prothipendyl. How did it happen that you increased moclobemide to 225mg only 3 weeks ago?

 

I am scared of drugs and then I feel so badly I feel I can’t go on and don’t have medication free support. So I go on and off…and up and down. It is not good and I even know it. I can’t help myself.

 

So I was on moclobemide 150mg for about eight weeks. During that time, I tried going off it for a week, but had a bad crash again and my doctor was angry and then I went back. I don’t remember when I upped to 300mg, somewhen in August. The;it was upped to 450mg, then to 600 as I stated in my signature. Since the 600 didn’t help, we went back to 450 and then back to 300 because I have tremors in my hands. My doctor now says 300mg is the lowest effective dose. It wasn’t effective for me, the anxiety never went away, the insomnia is as bad as ever if not worse, so I decided I want to come off it. I went down to 150mg but had a bad crash  - this illness comes in waves so I never know if the crash is from going off medication or the original illness or withdrawal - and upped again to 225mg because I read here that you have to taper down much slower.

 

I hope this answers your questions Alto. 
 

Now on to manymoredays.

 

10 hours ago, manymoretodays said:

 

Willowman, I do hope that you know that your psychiatrist cannot "make you" take or stay on something that you are reacting adversely to, or simply do not wish to take.  We have rights.  Do you have some kind of advocate for yourself at home......who will speak up for you when it is hard to do so yourself?  I've been in those shoes of not being not only heard but grossly mis-understood by psychiatrists and others in the system.

Or.....some will try a new doctor completely.

 I would if any doctor took new patients but they don’t.

 

I don’t have an advocate. Everyone including my family inly tells me to take my meds and not to stop with them all the time. And with this insomnia I am less and less able to make good decisions for myself.

10 hours ago, manymoretodays said:

 

Ouch, oh, oh, oh, and why? 
 

 

Becaus this insomnia HAS to stop. I can’t heal or do anything while not being able to sleep. I tried without sleep aids for six months! However I was on moclobemide for much of that time so I don’t know if that caused it or if it has simply chronified, but I have to sleep.  I just cannot bear these nights of tiredness and dread and the days of nonfunctional somehow existing anymore. Dominal isn’t right for me, though, so I think I have to go to quetiapine. I will have issues withdrawing from, I know, but I hope I will get help and if it helps with sleep and this vicious cycke breaks…that is my hope. I am really in despair here and with no support and my thinking affected by illness and sleep deprivation. 

10 hours ago, manymoretodays said:

Do you think it might have interacted a bit with the moclobemide in your system?   Seriously.  I. am. stunned.

I am glad you are okay, and were able to post NOTES today.........I feel like you are playing with fire now......and am concerned.....

 

As I said I will go on quetiapine instead. Severe prolonged sleep deprivation is not healthy either. I tried for a long time now to sleep again without drugs.

 

 

10 hours ago, manymoretodays said:

I don't know Willowman.  If you do wish to keep following all unlimited drug trials, with your doctor ........what you are doing here now?

I hear you and understand the frustration. I am feeling the same. I WANT to be drug free and I will go on tapering off moclobemide. Because it hurt more than it helped I feel. It even has agitation and insomnia as warnings! I don’t know why my doctors want to keep me on it, really don’t.

 

So I am going to go off it and take something at the same time to help me sleep and calm me down a tiny bit. 25 mg quetiapine is not a big dose, neither would 50 be if I have to go there for sleep. I am very sensitive to the “drugged” feeling it gives me the whole day after, though, so I thought Dominal, but that doesn’t help me sleep and gives me these palpitations on top so I am not taking it anymore.

 

10 hours ago, manymoretodays said:

 

You obviously should be talking to whom ever is prescribing all these drug trials to you now, about them, and the new drugs.  Again, I do feel you have a real choice here.  If you however are not being heard by your doctor......you do or I sure hope you have a choice there too.  As I said above.......

 

I am not being heard, no, not at all, and very sick. The only two things I want are sleep again and be less anxious and be drug free. I don’t know what to do anymore.

 

10 hours ago, manymoretodays said:

 

I don't mean to sound harsh......I'm sure I do however.  I don't how else to say it.

 

I understand.

 

 

10 hours ago, manymoretodays said:

No way can we get a clear picture, of just how to help you with the moclobemide taper, and even help get you to some stabilization of WD symptoms, while you are off taking everything under the sun

 

Ok I understand. 
 

After I explained all about how I came to be as I am now, do you have any idea how to stabilize? A time frame I can cling to? 
 

I am grateful for your help and I understand the frustration. It is the middle of the night again and instead of sleeping, I am typing here, dreading the moment I “have to” try and sleep again.

 

My brain feels overtired and on fire at the same time. It is so so horrible.

 

If you say  “well we cannot help you” it’s ok then that is that and I have to try in my own.

 

thank you for your patience and time, I really appreciate it

 

Willow

[manymoretodays]

Oh Willowman,

I certainly did not mean to add to your distress.  And can sure understand how the ongoing poor sleep may have sent you to more extremes of symptoms now.

Anything non-drug that does help?  Can you tune in to something with ear buds or ear phones that is calming.  I do see several YouTube meditations or music for sleep.

Also see:

Relaxation exercises, guided meditations, calming videos, sleep hypnosis

 

Tips to help sleep: so many of us have that awful withdrawal insomnia

And taken from the first post ^:

 

  

On 3/16/2011 at 9:38 AM, Altostrata said:

Also see
What is the sleep cycle?

Waking with panic or anxiety - managing cortisol spikes

 

Sleep and withdrawal

Melatonin for sleep: Many people find it helpful

 

Music for self-care: Calms hyperalertness, anxiety, aids relaxation and sleep

TV or computer use in evening can disrupt sleep: Bright light signals the brain that it's daytime

White noise devices for sleep

Light boxes / light therapy

Update on milk peptides for sleep: Our friend Lactium again

 

Path to Better Sleep FREE online for everyone from the US Veterans Administration

 

Yes.  Please keep posting.  And appreciate your detail, in answering all questions and in doing NOTES as well.

Easy does it from me, on the new additions of drugs now.

I think you have got yourself into a place of being really sensitive now to most everything AND the WD has set in.  I mean unknowingly, of course, as far as getting to this point.

I did also see your description of your original symptoms prior to using any of these types of drugs:

12 hours ago, Willowman said:

I had a -much shorter- episode of the same thing, intense fear and existential anxiety and insomnia, before, 12 years ago, and that started and was bad before I tried antidepressants. I held out for almost two months then and after that I was in such a bad state I walked to the hospital in the middle of the night and told them they had to do something . They put me on escitalopram along with lorazepam.

And of course, you are going to be fearful now and sometimes it all feels enhanced with neuroemotions at play.

And......now.......you have found that the drugs don't really help with these states of mind, or "normal" feelings.  That you did have a brief early response to the drugs is nice I suppose, but unfortunately you may not get that again.  This has happened to many of us Willow.  Me included.

I concluded I had situational overwhelm and that brought on my initial discomfort.  And so wish someone had just taken me aside, way back when, and told me how to cope without drugs, or assured me that I could, and had offered me comfort and understanding.  That would have made a difference.  We are not big on the existence of "mental illness" around here, especially not some biological, chemical imbalance type thing.  It's been dis-proven at this point in time.  I should/could cite you articles.  For now, when you feel up to it, do explore the site, and go to our Current Events forum.

 

And best Willoman.

L, P, H, and G,

mmt

[Altostrata]

On 11/11/2022 at 6:29 PM, Willowman said:

I am in a bad state now since February, so 9 months. I think it’s because it has chronified and sleep is so bad.

 

What was the period when you took lorazepam? When did you stop it? Please add it to your signature and put the events in chronological order. Thank you.

 

On 11/11/2022 at 6:29 PM, Willowman said:

Now, 12 years later.  As I said I had some anxiety and insomnia before the sertraline. How I wish I had never taken it! But I trialed with 12,5 mg for a week and felt much calmer if a little spaced out. So I thought it was a good thing. And went on 25mg which according to my doctor was not an effective dose.

 

For a week or a bit more, the anxiety rose slowly. I should have gotten off the sertraline then and there! But the description on the medication sounded like it could help exactly what I have (anxiety, ocd) and my doctor told me “it always gets worse before it gets better” so I stayed on.
 

And during that time, “it” came back full force. My existential anxiety was reawakened and I was in a state of constant horrible dread for weeks.

 

This sounds like an adverse effect of too-high a dose of sertaline. It's very possible that since 2010, you have had numerous adverse reactions to or withdrawal symptoms from the psychiatric drugs you kept on trying.

 

Going on and off psychiatric drugs probably caused your nervous system to become hypersensitive to even lower-than-normal doses of drugs.

 

Insomnia is a very common symptom of psychiatric drug withdrawal, excessive drug dosage, or the instability caused by drug switches. My guess is that you are currently experiencing insomnia from one of these drug-related causes.

 

On 11/11/2022 at 6:29 PM, Willowman said:

I went off sertraline after five weeks of that and was without medication for about six weeks. During that time, I got better but not well at first and at the end of six weeks, I suddenly had a bad crash again. Which is why I went on moclobemide.

 

How did you get better when you went off sertraline?

 

On 11/11/2022 at 6:29 PM, Willowman said:

As I said I will go on quetiapine instead

 

Please do what you think is best, and let us know when you want to decrease your drugs. You do seem rather convinced that you need drug treatment, despite one disaster after another. We do not provide peer support for drug switches for therapeutic reasons.

We cannot help you while you are increasing your drugs. We require at least a month of stable dosing and symptom pattern before we can provide peer support for tapering.

[Willowman]

12.11. 
Could not sleep again after 2.20

 

intense morning dread about 2.20am to 7am

 

5:30 Breakfast: beer yeast, 1000i.u. Vitamin b12 and D3:k2, 150mh moclobemide, estrogen gel

 

Anxiety slowly got better but very tired and foggy brain all day

 

16:00 1,25mg bisoprolol

 

20:00 magnesium 300mg, quetiapine  25mg

 

Bearable anxiety level, very tired, fell asleep quickly 

 

13.11

3:00 woke up with anxiety plus druggy feeling

on and off napping until 

5:00 woke up and got up with really intense anxiety and inner dread

6:30 breakfast, 150 mg moclobemide 

7:15 estrogen gel

 

Anxiety lessening after 8am but still noticeable 

[Altostrata]

Please answer my questions above.

[Willowman]

16 minutes ago, Altostrata said:

 

What was the period when you took lorazepam? When did you stop it? Please add it to your signature and put the events in chronological order. Thank you.

 

It was 2 or 3 weeks in March 2010. I stopped it after that and took maybe 3 during the 12 years since.

16 minutes ago, Altostrata said:

 

Going on and off psychiatric drugs probably caused your nervous system to become hypersensitive to even lower-than-normal doses of drugs.

I wish I had never touched any of them. 2010 is was in such a bad state without the drugs something had to be done, but this time, with the sertraline, I feel that made it so much worse it’s now a constant pain.

16 minutes ago, Altostrata said:

 

How did you get better when you went off sertraline?

 

The anxiety got to a more manageable level and I also could sleep a little better. Existential dread and insomnia had solidified in these five weeks of sertraline, though, so I had to fight that and withdrawal from that time on.

 

16 minutes ago, Altostrata said:

 

Please do what you think is best, and let us know when you want to decrease your drugs. You do seem rather convinced that you need drug treatment, despite one disaster after another. We do not provide peer support for drug switches for therapeutic reasons.
We cannot help you while you are increasing your drugs. We require at least a month of stable dosing and symptom pattern before we can provide peer support for tapering.

 

Ok, clear words and I understand. I am going to leave off new drugs and stay on what I am on for a month. I did decrease the moclobemide yesterday to 150mg since it was a month on 225mg. I thought that was the correct pattern?

 

I am willing to work with you, I am just very badly off and sometimes not able to think and decide clearly. When the insomnia and anxiety grip me so badly I am not myself. Later in the day, I can think more coherently.

 

Please let me know what I am to take or not to work with you. Do I go on reducing moclobemide? Do I continue with passion flower? 
 

What do you think the time frame is for feeling this badly?

[Willowman]

Sidenote: I just now remembered another drug I took many years ago. I had to take mefloquine/lariam for a trip. It’s a treatment for malaria. I had intense psychiatric side effects and insomnia. I feel this never went away 100%. I added it to my signature.

 

Oh I hope I am not permanently brain damaged. I feel so horrible. Sorry for putting this all on you and being difficult. I am really at the end of my rope and would probably dance in the moonlight if someone convinced me that helps.

[Altostrata]

27 minutes ago, Willowman said:

12.11. 
Could not sleep again after 2.20

horrible day

Breakfast: regular supplements, 150mg moclobemide, estrogen gel

16:00 1,25mg bisoprolol

20:00 magnesium 300mg, quetiapine  25mg

 

13.11

3:00 woke up with anxiety plus druggy feeling

on and off napping until 

5:00 woke up and got up with really intense anxiety and inner dread

6:30 breakfast, 150 mg moclobemide 

7:15 estrogen gel

 

Please include the time o'clock for each drug dose, the dosage, and your symptoms before and after each drug dose.

 

18 minutes ago, Willowman said:

I did decrease the moclobemide yesterday to 150mg since it was a month on 225mg.

 

This is the advice we gave you on tapering:

On 10/19/2022 at 12:56 PM, manymoretodays said:

Here at Surviving Antidepressants, it is recommended that a person taper by no more than 10% of their current dose with at least a four week hold in-between decreases.  The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs.

Why taper by 10% of my dosage?

 

First, you should not make a reduction if you still have instability from the last dosage change.

 

Since you got withdrawal symptoms from reducing to 150mg from 225mg before, we would conclude a reduction of 33% would be too much for you.

 

I hope you do not get withdrawal symptoms from this reduction.

[Willowman]

Oh ok - I didn‘t realize the part about not changing while still unstable. I thought it was once per month. I will note this from now on.

 

I did read your advice on tapering and also that moclobemide is not water soluble. So I will have to resort to cutting. The tablets I have are rather resistant to cutting and the best way is to cut off 75mg. Which is a large decrease. Maybe it will be possible to reduce by half of that (35 mg) without destroying the tablet for the next reducing- I will ask at a pharmacy for a better pill cutter.

 

I will attempt to better the notes as per your wish

[Altostrata]

How are you taking 225mg moclobemide? You must be cutting up tablets.

 

You can also cut up 150mg tablets into fourths for 4 smaller doses of 37.5mg. There is no necessity to reduce from 225mg by 75mg, you can reduce by 37.5mg (still too large a reduction from 225mg).

 

Further, a drug does not need to be soluble to make up a suspension. Moclobemide is probably soluble enough.

 

 https://go.drugbank.com/drugs/DB01171

[Willowman]

Yes I cut up the tablets, but there is only one place to cut where it doesnt break and that’s half. I will try cut a quarter next time I reduce.

 

I also hope the new reduction will be ok.

 

I will continue with the passion flower until I am off and stable without moclobemide. From what I read here, parralel withdrawing of two things is not a bright idea. Is that correct?

 

Manymoredays, if I may ask, is your nick because you told yourself during the bad times that you have many more days to be happy and healthy when this is over? Because that’s how I try to keep going.

 

Notes continued

 

13.11. Anxiety and tension on off all day, not able to relax but not unbearable after 11.00

16.40 bisoprolol 1,25 mg

still tense, urge to walk around, tired and a bit foggy

20:40 passion flower  520 mg, magnesium 300mg

20,45 Fell asleep

 

14.11.

0:45 woke up, anxious but not too badly. Melatonin spray (approx. 1mg)

1:15 about fell asleep

1:55 woke up

on and off dozing until 2:30

3:00 gave up and got up

medium anxious night, there have been a lot worse, but ofc very tired because even medium anxiety means = no going back to sleep

6:00 estrogen gel

6:30 breakfast, moclobemide 150mg

ok day, occasional anxiety, depressed

17:30 1,25mg bisoprolol (came home late)

20;00 magnesium 300mg

21:00 woke up, melatonin spray

21:30 fell asleep

22:30 short awakening 

 

15.11.

1:10 awake, anxiety, melatonin spray

nearly fell asleep, anxiety jolt

repeat several times, always nearly falling asleep and then waking up with a jolt

2:40 gave up and got up

 

 

 

 

 

 

 

[Willowman]

Question: Am I doing it correctly to reduce the moclobemide first an leave the passion flower for later?

 

Manymoredays, did you name yurself manymoredays because in bad times you remind yourself that you have many more days left to live and eventually those will be good again? Because that’s what I try to hold on to.

[manymoretodays]

Hey there.  You know, I don't know why I chose my somewhat lengthy user name anymore........but yes, I figured I had many more days to recover and heal.  And I sure wasn't one to give up.  I am pretty good now.  Go read my success story.  I wrote one.

There is always more......in a good way I think.

 

You could do one 150 mg tablet, and then make a suspension with another one.....a liquid.  This for your moclobemide.  And then rather than do abrupt, greater than 10% tapers, do it the harm reduction way.

225 mg  X 0.90 = 203 mg rounded up, and this is represents a full 10% reduction from 225 mg.

 

I think I went over this a bit in previous posts.  So you could do 150 mg in tablet, and then 53 mg in liquid suspension, to get a dose of 203 mg.

And then you don't have to do big jumps, big tapers......and set yourself up for potentially more WD symptoms.

 

I can check over what is up above in my own and others posts tomorrow, and leave you links, topics, instructions. 

I don't if you'll do them though.  But I'll do that.

 

I don't know what to do about all your other drugs and supplements, to be honest.  Taper the passion flower, yes.......we discovered you should do that when the time comes.  And yes, just do one thing, substance, at a time.

 

Anyway.....late for me to me modding now, head hitting desk.......sending sleep, restorative sleep.  And looks like you ARE getting some.  Yay!

After tomorrow, I'm out for a week, or a bit more.......with just limited access to internet and devices.  Just so you know.

 

Okay, be well.  Review what has been given thus far.  And stay calm.......use and learn non-drug coping.......this is your time for that.  You'll get there.  Wherever there.  You will.  Am I reading and observing improvement Willowman????  I think I am. Goody.

 

Best, L, P, H, and G,

mmt

 

 

Edited November 15, 2022 by manymoretodays

[manymoretodays]

Oh yeah, and yay!  The information is there Willowman, on making a suspension.  Both Ccat and brassmonkey have contributed to it.  So scroll back and look at it.

Don't go to full liquid though.  Or I would not, if I were you.  Look at this:

-cross-over-changing-form-eg-tablet-to-liquid-of-drug-or-changing-brand-of-same-drug/

I'd go with using a liquid portion for part of your dose only now, and don't cross over while you are doing any tapers at the same time.  Please.

 

The turtle wins the race here.  Go slow, simple, and get as stable as you can.

3 KI's

 

Important topics in the Tapering forum and FAQ's(the first post there, links to several topics of interest for you now)

 

 

 

Edited November 15, 2022 by manymoretodays

[Willowman]

Thank you for the support! So my next reduction will be less. 
 

I assume that you want me to continue the notes (I feel a bit egocentric here^^)

 

I am seeing an improvement in daytime anxiety but sleep and anxious nights are a real problem.
 

15.11.

6:00 breakfast, estrogen gel, 150mg moclobemide 

ok day, a few smaller anxiety attacks, depressed

17.30 1,25 mg bisoprolol

20:00 melatonin spray, magnesium 300mg

short nap unintentionally, startled up 20:45

more intense anxiety, got up

21:00 260mg passion flower

calmed down a bit

drifted off

21:50 woke up with bad anxiety. Doubts that I will get through this without drugs. Trying to stay strong.

23:00 another anxiety arrack. Very high tension. 

0.00 still no sleep

 

16.11.

1:00 no sleep

Every time I drift off I am jolted awake by intense fear for a moment

 

[Altostrata]

7 hours ago, Willowman said:

6:00 breakfast, estrogen gel, 150mg moclobemide 

 

 

You're taking only one tablet per day? Is your moclobemide extended-release? Half-life is only a few hours.

 

What instructions did you get about foods you should avoid while taking moclobemide?

[Willowman]

Continued notes

 

16.11.

napped a bit at some point

4:00 woke up panicky and crazy tired

Very very anxious and overtired and overwhelmed 

6:20 gave up got up (holiday over here)

7:00 estrogen gel

7:15 breakfast, 150mg moclobemide 

 

Anxiety and tension still strong, bit of a sick stomach feeling, palpitations 

18 minutes ago, Altostrata said:

 

You're taking only one tablet per day? Is your moclobemide extended-release? Half-life is only a few hours.

 

What instructions did you get about foods you should avoid while taking moclobemide?

Yes, 1 per day as per doctors instructions. It is not extended release. And I have been thinking: Am I going through withdrawal every night since taking it?? My doctor really doesn’t listen to me. He says „just take the drugs“ and otherwise when I try to make myself heard with the fact this isn’t working „you have to learn to stop leaning on other people for help“. Hello?? I hope someone tells him that if he breaks a leg.

 

I did not get any instructions about food except to avoid „excessive“ amounts of aged cheese
 

 

[Willowman]

16.11.

Anxiety subsided somewhat around 11.30

17.00 1,25 mg bisoprolol 

19:40 magnesium 300mg, melatonin spray (0,5 mg melatonin, small amount of passion flower)

20:30 went to sleep, fell asleep quickly 

22:00 awake

fell asleep again ok

 

17.11.

2:00 awake. Bit of tension and anxiety. Headache.Melatonin spray (0,5mg melatonin, small amount of passion flower)

Fell asleep againafter a while

4:20 woke up. Very anxious and shaky. Got up

5:15 estrogen gel

6:00 breakfast, 150mg moclobemide 

 

[Altostrata]

Please post 24 hours of notes at a time.

 

You must look up the recommended diet for moclobemide.

 

Are you able to cut the moclobemide tablet in half? If you can, I would cut it in half and take 75mg at your usual 6 a.m. in the morning, move the other 75mg an hour later each day until you are taking it at 6 p.m.

[Willowman]

6 minutes ago, Altostrata said:

Please post 24 hours of notes at a time

 

ok sorry

 

6 minutes ago, Altostrata said:

 

Are you able to cut the moclobemide tablet in half? If you can, I would cut it in half and take 75mg at your usual 6 a.m. in the morning, move the other 75mg an hour later each day until you are taking it at 6 p.m.

 

ok but will that not make the nervous system which is used to a bigger dose in the morning irritated?