Siga: introduction

[Siga]

2012-2023: 10 mg and 20 mg Citalopram. Had tried to get off, but felt weird below 10 mg every time. 

Then saw a YouTube video about hyperbolic taper and decided to do that.

June 2023 - January 2024:

20 - 10 - 7,5 - 5 - 2,5 - 1,25 mg at random intervals. That's not good. Because I am an idiot who can't do math. 🤦

At first it was fine,  finally I got below 10 mg. I didn't realise that I became more and more depressed and anxious. 

January 16th: Severe symptoms, almost incapable of eating, breakthrough anxiety. I had never dealt with anxiety (although in hindsight I can see that it has been increasing since the start of the pandemic, and) and didn't recognise it as such. 

Several visits to the doctor to figure out the stomach issue. 

 

From January 18th: Total insomnia due to nerve twitches/pangs and muscle jerks.

January 22nd: Stilnoct 10 mg, then 31st: Zolpiclone 7,5 mg.

Took and still tale every night, getting 4-5 hours of KO/"sleep". Because the constant nerve pangs otherwise kept me completely awake, no sleep. 

January 27th: Finally(!) realised Citalopram symptoms might be the cause. Reinstated 2,5 - 5 - 10 - 20 mg over the course of the next three weeks.

 

Got Quetiapine/Seroquel, and tried for a few days. But it didn't work for the nerve pangs at all, so still awake. And very doozy for most of the day too. So stopped them after 3 days

 

Update March 2nd: Brain zaps gone, full body chills gone. Speedily learned to accept and defuse some of the anxiety symptoms, which made them go away. But having bad sleep anxiety. 

The 4-5 hours of "chemical sleep" on Zolpiclone keeps me - minimally - functional. Can't work, bare mimimum home chores. 

This late night/morning I actually didn't have nerve pangs, but in stead was extremely restless in bed. I can't decide if it is better or worse. I decide that it is better. The nerve pangs are worse.

 

Doctors have absolutely no suggestions for what I could get for the nerve pangs instead of Zolpiclone other than this or that sedating meds.

I don't need sleeping pills, I can fall asleep just fine.  It is the nerve pangs that keep me awake, like being pricked with a needle randomly all over the body.

 

Oh, and bought a precise weight for weighing meds.

[Siga]

Oh, I forgot something potentially important: From about 14th of January to about 18th of January I took prescribed for ADHD Elvanse/Vyvanse 20 mg.

Had taken a break since... I honestly can't remember if I took them in autumn, or if I stopped before summer.

 

Stopped taking them because as things went sideways I thought that they might contribute somehow.

[Siga]

I am so tired. Having microsleeps. Wrapped in layers of wool but so cold.

So extremely tired, lack of initiative, joy. The Zolpiclone knocks me out for a couple of hours, but it doesn't really feel like sleep. And when I "wake up" from it I can't sleep anymore. 

 

But without the pills nerve stings keeps me all awake. It feels like a deal with the devil: Bad sleep with side effects or no sleep due to stings.

I also have the stings during the day, but I don't  care too much about them during daytime, until it is a particularly nasty one.

 

And no one understand the stings. They are small electric shocks which hurt as if if you prick someone with a amall sewong needle just hard enough to pierce the skin.

Have medical professionals reall never  come onto contact with nerve stings? Other than as MS and Parkinson.

[Siga]

I have been tapering the Zolpiclone down to 3/4 and 5/8 of a tablet. I still "sleep"/am sedated for the same amount of time, 4-5 ish hours. Some kind of rest, but never actually rested or feeling like I have slept.

 

I don't know if my reinstatement of Citalopram really makes any difference. Some small symptoms, like brain zaps and full body chills, are gone.

But mentally I am still in a very depressed and anxious place. Of course exacerbated by the lack of sleep.

And so so difficult to eat. Never hungry, very nauseated until midafternoon. Close to 10 kg lost.

 

So difficult to sort between cause and effect now. 

And I get fungus everywhere if I eat just a little sugar, which would otherwise be good for me because it is easy calories. Mouth, toes, privates.

 

 

[Onmyway]

Hi Siga,welcome to SA thanks for filling in your signature. I'm really sorry you have to deal with all this. I also had terrible insomnia coming off of citalopram. In glad that reinstatement caused the reversal of some of the symptoms. Can you let us know if some symptoms are worse since reinstatement?  We advise keeping track of symptoms every day. 

 

Would you be able to post your symptoms for us here during the day at different times. We want to see how your symptoms are before and after you take your drugs. It can look sth like this:

 

9 am wake up, eat breakfast, and very anxious

10 am take medicine, stings increase etc 

.... 

.... 

 

Like you, I was absolutely obsessed with my sleep in the beginning. And what helped was exactly the opposite. At some point my GP said - nothing still happen to you if you don't sleep well for a bit. I was initially angry but  in the end just went with it and slowly my sleep got better. Not back to normal but now when not in waves I can manage 6-7 hrs. Even though it sounds counterintuitive accepting that sleep was going to be bad for a while made it much  better. Surrender. If you can't sleep, then do something else, go for a walk if you can, play board games, listen to music. Don't strive to change things. Don't think you have the power to change it. It will be very difficult but it will slowly get better. 

 

Please keep posting your symptoms here daily as shown above for the next few days and we can go from there. 

 

You will survive this. It will be one of the hardest things you'll have to do in your life. But you will get through this. 

 

Hugs 

Omw

[Siga]

 

 

1 hour ago, Onmyway said:

Hi Siga,welcome to SA thanks for filling in your signature. I'm really sorry you have to deal with all this. I also had terrible insomnia coming off of citalopram. In glad that reinstatement caused the reversal of some of the symptoms. Can you let us know if some symptoms are worse since reinstatement?  We advise keeping track of symptoms every day. 

 

Would you be able to post your symptoms for us here during the day at different times. We want to see how your symptoms are before and after you take your drugs. It can look sth like this:

 

9 am wake up, eat breakfast, and very anxious

10 am take medicine, stings increase etc 

.... 

 

Like you, I was absolutely obsessed with my sleep in the beginning. And what helped was exactly the opposite. At some point my GP said - nothing still happen to you if you don't sleep well for a bit. I was initially angry but  in the end just went with it and slowly my sleep got better. Not back to normal but now when not in waves I can manage 6-7 hrs. Even though it sounds counterintuitive accepting that sleep was going to be bad for a while made it much  better. Surrender. If you can't sleep, then do something else, go for a walk if you can, play board games, listen to music. Don't strive to change things. Don't think you have the power to change it. It will be very difficult but it will slowly get better. 

 

Please keep posting your symptoms here daily as shown above for the next few days and we can go from there. 

 

You will survive this. It will be one of the hardest things you'll have to do in your life. But you will get through this. 

 

Hugs 

Omw

Thank you Omw.

I don't think any symptoms are worse since reinstatement. The bad symptoms I had (e.g. sound and visual hypersensitivity, nerve stings, anxiety/panic attacks, depression, botched appetite and ability to eat), all came before I reinstated (either withdrawal or... messed up mind)

The hypersensitivity lowered, I have had some tiny enjoyment of eating here and there, and I have even been able to knit a little, which had been overwhelming but is otherwise my main hobby. 

So for now reinstating was absolutely the right choice. Those small improvements feels life saving. 

 

Thank you for your kind advice. I think that by now I am an expert on good sleep habits, and acceptance of insomnia. And I did manage to accept palpitations, breathing patterns, stomach pain ass insignificant.

 

Unfortunately the nerve stings absolutely don't care about any of that. And it is very difficult to sleep when you constantly get "stung by needles" or get small electric shocks.

Which is why I got the Z-drug after several days of zero sleep, because they woke me hundreds of times until my body just gave up on sleeping.

Even if I try to take a nap during the day (I try not to, in order to not mess with night sleep), the nerve stings get worse (I have them during the day too).

 

I'll try to record symptoms during the day, but I almost always feel better in the evening (it is quite pronounced, and was also in the week before reinstatement and Zol).

And so each day it basically:

- 21:00: Citalopram. Feel calm and chilled.

- 23:00. Zolpiclone.

- Wake up during the night as the effect wears off. 

- Twist and turn. Sometimes nerve stings (although it has become less at this time of night). Maybe some sleep during this?

- Get up when can make myself move my body to upright. 7:00-ish

- Couple of hours of attempting to become human and functional. Weak, pain, esp. whole lower body, zombie, brain mush, upper body warm and lower body very cold.

- Late morning/midday: Feel kind of awake. Spend hours on social media, distracting myself. Or going to the community centre for mentally vulnerable people, spending hours there.

- Dinner for me and teen. I used to cook. Now it is mostly premade.

- Feeling better as evening progresses.

 

I forgot to take the Citalopram yesterday! I think, I am not 100% sure. But the blister pack confirmed, I think.

I noticed because my sound sensitivity was higher. That is one main thing that I had noticed went away as I went up in dose.

 

So I took half dosage app. 11:30. And got out my pill dispenser box and put tonight's dose in it, so I remember to do it right.

 

I took 1/2 (3.75 mg) Zolpiclone last night. I was out from 23:30 to 2:30. Rapid heartbeat and stomach pain.

Then I took 1/8 (0.9375 mg) and was out again for...?.. I didn't look at the clock. But I gained consciousness again at some point and laid/sat upright in bed for maybe an hour because of the stomach pain. The stomach pain was there in the week before I started on Zolpiclone, but I am pretty sure it adds to it.

 

Then zombie on the couch for another few hours. Didn't even bother to look at my phone. Just an empty husk and stomach pain.

Then at around 10:00 I started to feel existing. It is when the med concentration is low enough, after roughly 12 hours.

 

[Onmyway]

Hi Siga

Yes reinstatement is absolutely the best choice when done soon enough and it seems to be working well with you. The only thing we worry about with that is that sometimes full dose reinstatement can make people too activated/hypersensitive so we recommend a small dose reinstatement. But it doesn't seem to be your case. 

 

Why are you trying to lower zopiclone at this point? On the one hand you have the worry of dependence and on the other hand it may make things harder changing more things. I don't know what the right thing to do is. 

 

I find the post below quite useful Personally and return to it often. 

 

 

 

[Siga]

5 hours ago, Onmyway said:

Hi Siga

Yes reinstatement is absolutely the best choice when done soon enough and it seems to be working well with you. The only thing we worry about with that is that sometimes full dose reinstatement can make people too activated/hypersensitive so we recommend a small dose reinstatement. But it doesn't seem to be your case. 

 

Why are you trying to lower zopiclone at this point? On the one hand you have the worry of dependence and on the other hand it may make things harder changing more things. I don't know what the right thing to do is. 

 

I find the post below quite useful Personally and return to it often. 

 

 

 

I did reinstate across three weeks, doing it quickly-slowly  to be able to sense if things felt way off. Since the brain zaps and then sound sensitivity went away I felt comfortable increasing.

 

Having likely had depression since childhood, I think that I am probably a person who needs to be on SSRI permanently, I know that now.

 

As for the Zolpiclone I hate how it feels. I get knocked out cold, but it doesn't feel like sleep, it just feels like being sedated, and I never really feel rested. 

I gain conscience again after 4-5 hours every day - I don't transfer to sleep once it stops working. My body hurts (I believe I lie completely immobile), my stomach/aesophagus hurts, I have fast heartbeat and sometimes anxiety attacks. And then I feel very uncomfortable for several hours.

So quite quickly after starting I went down to 3/4 from a whole tablet, and it was better, while still working.

So I want to test how low I can go and still get the muscle relaxing effect, which is what I really use it for, not falling asleep.

[Siga]

Oh, took magnesium glycinate at about 14:00 and had a wired and tingly feeling in my legs a couple of hours later and for a while. 

It might be a coincidence, and it might not be a bad thing (I have poor circulation and temperature regulation), I would definitely take them in the morning. I am going to try that before I write them off.

 

Sorry, that I am a bit all over the place. ADHD and then the cognitive issues from lack of sleep, plus whatever the Citalopram does or the lack of it, has me even more all over the place than I usually am.

[Onmyway]

13 hours ago, Siga said:

Having likely had depression since childhood, I think that I am probably a person who needs to be on SSRI permanently, I know that now.

Hi @Siga

there is no evidence that anyone needs ADs permanently and they are not usually tested for more than 6 months. The chemical imbalance theory is a myth. https://www.psychiatrictimes.com/view/debunking-two-chemical-imbalance-myths-again and the evidence for the effectiveness of ADs is very weak. Here is a good review and explanation by Harvard professor Irving Kirsch

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172306/

 

Withdrawal does create a disruption in your brain and as such should not be used to conclude that you need these drugs forever. I'd wait to see how you feel until you are off for at least 2-3 years to decide if you need these drugs. 

 

Please do check out the links on this page to understand how to taper when you decide to taper. 

It is possible that your ADHD med was the straw that broke the camel's back and started the severe WD effects but no matter what it was, this will slowly improve. 

 

OMW

 

[Siga]

Thank you for the info and links.

 

Last night I again only took 1/2 a Zolpiclon (4,8 mg), and put the 1/8 by the bed so I could take it if needed.

I regained conscienceness, some time during the night, went back to sleep(!) and slept to about 5:00!

And I remember that I dreamed, which I haven't/can't remember to have done since things went sideways. Which also mean that I did sleep.

 

I am still tired and I have bad GERD as I do almost every morning. But I am pleased.

[mstimc]

Hi Siga

 

First, I'd like to reinforce what Onmyway said--your brain is nor permanently damaged and the idea of a chemical imbalance causing depression or anxiety is a myth.  At best, SSRI's mask symptoms for a while.  

 

Second, once you feel a bit more stabilized, I strongly recommend you look into coping strategies to help you manage your negative thoughts and emotions. The feeling that you'll need medication for life is an example of a negative belied taking over your thought processes.  The negative mind's power is based on continual production of anxiety-provoking thoughts.   There are a lot of tools you can use to manage your negative and depressive thoughts: CBT, mindfulness, meditation and slow exercise, thoughtful tapping, etc.  CBT has been shown to be more effective and far more longer-lasting than medication.  It takes time and practice, but the payoff in the end is well worth the effort!

[Siga]

4 hours ago, mstimc said:

Hi Siga

 

First, I'd like to reinforce what Onmyway said--your brain is nor permanently damaged and the idea of a chemical imbalance causing depression or anxiety is a myth.  At best, SSRI's mask symptoms for a while.  

 

Second, once you feel a bit more stabilized, I strongly recommend you look into coping strategies to help you manage your negative thoughts and emotions. The feeling that you'll need medication for life is an example of a negative belied taking over your thought processes.  The negative mind's power is based on continual production of anxiety-provoking thoughts.   There are a lot of tools you can use to manage your negative and depressive thoughts: CBT, mindfulness, meditation and slow exercise, thoughtful tapping, etc.  CBT has been shown to be more effective and far more longer-lasting than medication.  It takes time and practice, but the payoff in the end is well worth the effort!

Thank you, Tim, I appreciate the support.

I have been watching videos about a lot of the topics that you mention, and I would say that I am improving. Unfortunately I can't access therapy, but I feel lucky that good therapists post about the topics.

I am also going to a community centre for mentally vulnerable people, and it gives me positive interaction and gets me out of the house, and some exercise too.

At the moment my focus is sleep and nerve stings. I read that it is best to taper benzos first, so once the sleep is better, and I am able to come off the Zs, I will revisit tapering Citalopram. Right now it is all and stabilising for me. 

 

[Siga]

Down to 1/2 a Zolpiclone, 3,75 mg.

I am still out for the same amount of time, some 5-ish hours.

And for the last few days I have been able to fall asleep into a real sleep (I know because I have been dreaming!) for some amount of time afterwards.

Rather than the uncomfortable, restless dozing off, that I had had for a while. 

 

I am not as to-the-bones cold anymore. My feet have been disturbingly cold, not responding to any heating attempts, as well as my whole legs and arms. I couldn't quite tell if the weather had gotten warmer or my home warmer, but I think that by now I am certain that my temperature regulation has improved to normal level (which is being slightly cold most of the time, but in an ok way).

 

Oh, and my kid gave me their cold. Yay..... But it feels ok. My system seems so ramped up that it offs the cold very effectively. So at least there's that.  

[Siga]

I'll take that back.  I have a really bad cold. 🤧

 

I wake up at night because my mouth is so dry, because I have to have my mouth open, because my nose is clogged. As if I didn't sleeo bad enough already.

But at least colds have an expiration date and I am looking very much forward to that 7 day-ish mark.

 

Still 3,75 mg Zolpiclone. I think I sleep/am out for a while on that dose, but it is in a strange way where I am not sure if I have actually been out, or if I am sort of lucid. Nevertheless I seem to get enough sleep/rest to be at least minimally functional.

[Onmyway]

nasal spray is a miracle for clogged noses - xylomethazoline, oxymethazoline... 

 

[OffPills]

35 minutes ago, Onmyway said:

nasal spray is a miracle for clogged noses - xylomethazoline, oxymethazoline... 

 

I think you mean well, but nasal spray can have a lot of side effects and is addictive. Best to not use.

[Onmyway]

The above recommended nasal spray is not addictive. You can get rebound congestion from it if you use long term but that is not a risk with the common cold as you use it 3 days max. And even that rebound effect has been disputed as most studies do not observe it though some have done in the past. Some people do have side effects with it but it allows people to sleep which helps recovery. 

 

I personally take it every time and it has been a Godsend. 

Edited March 11 by Onmyway

[Siga]

I appreciate the advice on nasal spray. But they always make my nose hurt so bad, so I never use it now.

 

I also don't want to add even the slightest med, if not absolutely necessary right now, because my system is hypersensitive.

 

But I value you wanting to help. 😊

[Siga]

Decreasing Zolpiclone dose and still seem to get the same effect. Which still is probably because what I actually use is the muscle relaxant/anti convulsive effect, not the sedative-hypnotic effect.

 

Same type of sleep as before: The sleeping pill one, and then on/off sleep/waking. Which means it is not worse.

Notably didn't have anxiety symptoms during the wakeups, as I have been having a lot, and only a little when actually waking up to get up. 

My stomach pain has eased, except for in one spot below my right rib. But now I have gotten severe pain and high tension in my upper right shoulder/thorasic/neck area. It must hurt somewhere?