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ironmanDD: Situational or meds?


ironmanDD

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Hello everyone,

My name is David, I'm 37 years old and suffering from severe anxiety for the last 2 months.

To make a long story short, in January, I discovered my wife (together for 9 years, married for 1) had a bit of an affair.  I was completely blindsided, and devastated to say the least.  For the first few months I had bad anxiety and depression.  Near the end of January, my GP prescribed me Ativan as needed for the anxiety, and then was prescribed Citalopram sometime in March.  I was hesitant in taking the anti-depressants, just because I was scared, googled so many negative things, and quite honestly didn't feel I needed them just yet.  Eventually after another month or two of being down in the dumps I decided to give it a try.  I took 10mg for 6 days, then upped my dose to 20mg, and just after 4 days at 20mg the side effects were absolutely unbearable.  Severe brain zap, anxiety, memory loss, confusion, suicidal thoughts.  That was enough for me, I freaked out and asked my GP to take me off.  She wanted me to continue on saying it would get better soon, but I couldn't take it anymore.  She told me to ween off, so I went back to 10mg for 4 days before stopping altogether.  For the next 4 weeks after stopping I had very scary withdrawal effects similar to the effects when I started.  The brain zaps eventually stopped, the anxiety calmed a bit.  But all of a sudden out of nowhere about 1 month ago, I've been having severe anxiety almost daily, palpitations, my entire body goes tingly and a bit numb, and I have these fearful thoughts that affect my daily life (Thoughts about aging, dying, living alone), and I just don't feel like myself at all.

 

My question is.. I was only on Citalopram for a total of 21 days... is it possible I'm still withdrawing even after stopping 8 weeks ago?  Will these effects ever go away, did it do some permanent damage that I will have these effects for the rest of my life?  Or is this all build up of the anxiety that has been there since the beginning even before I started the meds?  I have been under tremendous stress and anxiety since I discovered the affair, and I can't decide either way if I could ever forgive my wife, or if I should leave and start a new life.  I can't live with what she did, but leaving her and starting over scares me so much.  I'm a emotional and sedimental guy and have a hard time letting go, and cherish our memories.  Thank god, we didn't have any kids involved, but I freak out at the thought of starting over at my age of 37 (I know I'm not old, but this anxiety makes me feel theres no hope)  I literally don't know what to do, and the constant deciding back and forth everyday I'm sure isn't helping any, as it's now been 6 months living in limbo.  I'm pretty sure I have a mild case of OCD, and even a very mild case of social anxiety (both undiagnosed) but nothing that has ever affected my life.  I just don't know if its the on going anxiety or the meds did something to me.  Thanks so much in advance, any reassurance is appreciated.

January 2017 - Prescribed Ativan 1mg as needed

May 5 - Started Citalopram 10mg, continued for 6 days

May 11 - Upped dose to 20mg

May 15 - Severe side effects (Major brain zap, increased anxiety, confusion, memory loss, fearful about future, suicidal thoughts)

May 24 - Side effects unbearable, asked GP to take me off

May 25 - Weened down to 10mg for 4 days

May 29 - Completely stopped Citalopram

May 30 - June 26 (Severe withdrawal symptoms similar to side effects when starting) Also took Ativan 1mg as needed since stopping Citalopram (Usually 1mg every other day)

June 26 - Stopped taking Ativan (Had insomnia, panic, screaming noises in head for 3 days)

Oct 3 - No Citalopram for 16 weeks. No Ativan for 12 weeks.  Still feel panicky, fearful thoughts, and a sense of detachment? (I just don't feel like myself)  Every day, all day long.

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  • ChessieCat changed the title to ironmanDD: Situational or meds?
  • Moderator Emeritus

Hi David, welcome to SA. Sadly you had adverse reactions to citalopram which can take some time to settle down but will get better. 

Also the ativan can be a culprit here, they cause rebound anxiety and interdose withdrawal. You have been taking them for 6-7  months and will likely need to adjust the doses and then taper off them later. They could help you through this as long as your doctor is happy to prescribe them for you.  Don't worry about it, you can taper off the ativan when you are stable from the citalopram withdrawal. If you would like to start a topic for yourself in the benzo forum the mods there will help you with the right way forward with ativan.  Can you tell us how often you take them, and how they help. Do you have a pattern of symptoms?

http://survivingantidepressants.org/index.php?/forum/29-members-only-benzo-forum/

 

You will notice windows and waves as you go through withdrawal, this is the normal pattern of recovery, feeling a little better, then waves where things go back again but the waves always pass. 

 

http://survivingantidepressants.org/index.php?/topic/82-the-windows-and-waves-pattern-of-stabilization/

 

Lots of us here find that fish oil and magnesium are very helpful in withdrawal, I wouldn't be without either.

http://survivingantidepressants.org/index.php?/topic/1300-magnesium-natures-calcium-channel-blocker/

http://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/?view=findpost&p=100596&hl=magnesium

 

 

**I am not a medical professional, if in doubt please consult a doctor with withdrawal knowledge.

 

 

Different drugs occasionally (mostly benzos) 1976 - 1981 (no problem)

1993 - 2002 in and out of hospital. every type of drug + ECT. Staring with seroxat

2002  effexor. 

Tapered  March 2012 to March 2013, ending with 5 beads.

Withdrawal April 2013 . Reinstated 5 beads reduced to 4 beads May 2013

Restarted taper  Nov 2013  

OFF EFFEXOR Feb 2015    :D 

Tapered atenolol and omeprazole Dec 2013 - May 2014

 

Tapering tramadol, Feb 2015 100mg , March 2015 50mg  

 July 2017 30mg.  May 15 2018 25mg

Taking fish oil, magnesium, B12, folic acid, bilberry eyebright for eye pressure. 

 

My story http://survivingantidepressants.org/index.php?/topic/4199-hello-mammap-checking-in/page-33

 

Lesson learned, slow down taper at lower doses. Taper no more than 10% of CURRENT dose if possible

 

 

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Thank you for the reply.  I have been taking only Ativan when absolutely needed, sometimes .5mg, sometimes 1mg every 2 or 3 days, nothing routinely.  For the most part I've been suffering through the severe anxiety.  I've been to the ER twice because of the anxiety, but mostly because of other symptoms of anxiety like fearful thoughts and a sense of detachment.  There have been times I felt I was losing my mind, and it's really starting to scare me.  The nurses reassured me I'm not crazy, and say I do have severe anxiety, but they seem to think it's situational and has nothing to do with Citalopram.  They also said taking Ativan as needed is ok.

 

I notice severe anxiety in the mornings as soon as I wake up.  Sometimes lessens after a few hours, but the fearful thoughts and sense of detachment, and the tingly legs is there constantly.  I just don't feel like me, and I can't describe it to anybody because they just don't get it, or they say it's all in my head.  I was never this bad before taking Citalopram, and my GP says I'm looking for a reason to blame the medication which is very frustrating.

 

I only took them for 21 days, is it even possible to suffer withdrawals even 8 weeks later?  I'm starting to worry this has done permanent damage.  I've read other experiences with people having withdrawals for years, and that scares me!  This is ridiculous and is certainly no way to live.

 

Everyone I talk to about this, including the nurses, seem to think this is all because I can't make up my mind about whether I should leave my wife or not, and it's causing too much stress and anxiety.  It's been 6 months of living in limbo not knowing where my life is headed.  I'm hoping that is the culprit and not the medication, and once a decision is made these symptoms will go away.

January 2017 - Prescribed Ativan 1mg as needed

May 5 - Started Citalopram 10mg, continued for 6 days

May 11 - Upped dose to 20mg

May 15 - Severe side effects (Major brain zap, increased anxiety, confusion, memory loss, fearful about future, suicidal thoughts)

May 24 - Side effects unbearable, asked GP to take me off

May 25 - Weened down to 10mg for 4 days

May 29 - Completely stopped Citalopram

May 30 - June 26 (Severe withdrawal symptoms similar to side effects when starting) Also took Ativan 1mg as needed since stopping Citalopram (Usually 1mg every other day)

June 26 - Stopped taking Ativan (Had insomnia, panic, screaming noises in head for 3 days)

Oct 3 - No Citalopram for 16 weeks. No Ativan for 12 weeks.  Still feel panicky, fearful thoughts, and a sense of detachment? (I just don't feel like myself)  Every day, all day long.

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  • Moderator Emeritus
48 minutes ago, ironmanDD said:

I have been taking only Ativan when absolutely needed, sometimes .5mg, sometimes 1mg every 2 or 3 days, nothing routinely.  For the most part I've been suffering through the severe anxiety.  I've been to the ER twice because of the anxiety, but mostly because of other symptoms of anxiety like fearful thoughts and a sense of detachment.

 

Hi, Ironmann. 

 

Welcome to Surviving Antidepressants from me, too.

 

It sounds like you may be dependent on the Ativan and are getting symptoms of severe rebound anxiety and depersonalization (what you describe as a "sense of detachment"), which is very common with benzodiazepines. Ativan has a very short half life (10 - 20 hours) and can cause upticks in anxiety that can be very severe and many people have found themselves in the emergency room, sometimes fearing a heart attack, due to the severity of symptoms. 

 

You can become dependent on a benzo in as little as 2 - 4 weeks, even with periodic use. It's unfortunate that most doctors don't understand this and will prescribe benzos for longer than this period. 

 

As MammaP mentioned, we do have a separate forum for benzo withdrawal questions. Please go ahead and start a new topic for yourself here:

 

Members-only benzo forum

 

I'm sorry for all you're going through with your marriage and that certainly is making things much worse, but it's quite possible that you are also suffering from rebound anxiety from the Ativan in addition to antidepressant withdrawal. It would be good to set up a gameplan for coming off the Ativan with a slow and safe taper.  Once you set up a thread in the members-only benzo forum, we can discuss your options. 

 

 

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  • Moderator Emeritus

Thank you Shep, this is what I suspected.

David, doctors don't have a clue hopw the drugs affect people and most don't even believe withdrawal exists. You are not losing your mind and it is not the relationship but the stress does make it harder. This is not because you can't make your mind up, it is physical and very real. 

It will not be permanent and will get better. Take good care of yourself, eat good fresh food where possible, avoid alcohol and caffeine (not forever!) . 

Sort out the ativan with Shep over in benzos and hopefully things will get easier. There are thousands of members here and most of us have experienced the doctors and nurses who deny that we have withdrawal and deny the drugs can be problem. They don't know what to do about it except offer more drugs and tell us to pull ourselves together like we are a pair of curtains :angry:.   Read this about brain remodelling that was written by Rhi, it explains what happens to our brain. Yours started with normal anxiety that was medicated with a benzo then citalopram was added which you reacted to. It is easier to cope with something when you understand what is happening. 

 

 

 

**I am not a medical professional, if in doubt please consult a doctor with withdrawal knowledge.

 

 

Different drugs occasionally (mostly benzos) 1976 - 1981 (no problem)

1993 - 2002 in and out of hospital. every type of drug + ECT. Staring with seroxat

2002  effexor. 

Tapered  March 2012 to March 2013, ending with 5 beads.

Withdrawal April 2013 . Reinstated 5 beads reduced to 4 beads May 2013

Restarted taper  Nov 2013  

OFF EFFEXOR Feb 2015    :D 

Tapered atenolol and omeprazole Dec 2013 - May 2014

 

Tapering tramadol, Feb 2015 100mg , March 2015 50mg  

 July 2017 30mg.  May 15 2018 25mg

Taking fish oil, magnesium, B12, folic acid, bilberry eyebright for eye pressure. 

 

My story http://survivingantidepressants.org/index.php?/topic/4199-hello-mammap-checking-in/page-33

 

Lesson learned, slow down taper at lower doses. Taper no more than 10% of CURRENT dose if possible

 

 

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Again, thank you so much for the reassurance.  Before posting in the benzo forum, I have a quick question.  If I just stop taking the Ativan altogether, and try to fight through the symptoms... how long before it completely subsides and I'm normal, and feel like myself again?

January 2017 - Prescribed Ativan 1mg as needed

May 5 - Started Citalopram 10mg, continued for 6 days

May 11 - Upped dose to 20mg

May 15 - Severe side effects (Major brain zap, increased anxiety, confusion, memory loss, fearful about future, suicidal thoughts)

May 24 - Side effects unbearable, asked GP to take me off

May 25 - Weened down to 10mg for 4 days

May 29 - Completely stopped Citalopram

May 30 - June 26 (Severe withdrawal symptoms similar to side effects when starting) Also took Ativan 1mg as needed since stopping Citalopram (Usually 1mg every other day)

June 26 - Stopped taking Ativan (Had insomnia, panic, screaming noises in head for 3 days)

Oct 3 - No Citalopram for 16 weeks. No Ativan for 12 weeks.  Still feel panicky, fearful thoughts, and a sense of detachment? (I just don't feel like myself)  Every day, all day long.

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  • Moderator Emeritus

You have been taking ativan for too long, benzo withdrawal can be brutal, and added to citalopram reactions and withdrawal it could be a very long and rough ride. Some people can quit but you are already in withdrawal so there is very little chance of it being a short period. It is not like heroin or cocain, which is hard but can be stopped and the withdrawals stop when the drug has left the system. These drugs make changes in the brain which have to be reversed. The best way to reverse them is to withdraw very very slowly so that the brain can adjust as the dose lowers. Yanking them away leaves the nervous system in chaos and takes a long time to correct itself.  

I would love to tell you that it will be short lived if you just tough it out but the reality is that some people can be sick for years with benzo withdrawal. You can be functioning while tapering, which is much better than suffering unnecessarily. We see so much suffering here and don't want anyone to go through more than is necessary. 

Edited by mammaP

**I am not a medical professional, if in doubt please consult a doctor with withdrawal knowledge.

 

 

Different drugs occasionally (mostly benzos) 1976 - 1981 (no problem)

1993 - 2002 in and out of hospital. every type of drug + ECT. Staring with seroxat

2002  effexor. 

Tapered  March 2012 to March 2013, ending with 5 beads.

Withdrawal April 2013 . Reinstated 5 beads reduced to 4 beads May 2013

Restarted taper  Nov 2013  

OFF EFFEXOR Feb 2015    :D 

Tapered atenolol and omeprazole Dec 2013 - May 2014

 

Tapering tramadol, Feb 2015 100mg , March 2015 50mg  

 July 2017 30mg.  May 15 2018 25mg

Taking fish oil, magnesium, B12, folic acid, bilberry eyebright for eye pressure. 

 

My story http://survivingantidepressants.org/index.php?/topic/4199-hello-mammap-checking-in/page-33

 

Lesson learned, slow down taper at lower doses. Taper no more than 10% of CURRENT dose if possible

 

 

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  • Moderator Emeritus

Ironman, what MammaP wrote is so true. Benzo withdrawal is not something to be taken lightly, especially for someone who is already having symptoms so severe, it required trips to the ER.

 

This is a list of symptoms from the Ashton Manual on benzo withdrawal:

 

Ashton Manual - benzo withdrawal symptoms

 

Please note that the Ashton Manual was created in the 1980's and lists antidepressants as drugs used to come off benzos. We at Surviving Antidepressants, of course, do not advocate the use of antidepressants - or any other drug - to help with benzo withdrawal. This section of the manual listing symptoms is still a valuable resource in helping people understand benzo withdrawal and is worth a read. 

 

If you are having a lot of those symptoms listed in the manual and they are keeping you from functioning, I would recommend stabilizing on a daily dose of Ativan and then doing a very slow and careful taper off. Once dependent on a benzo, going cold turkey (even from periodic use) is like jumping off a roof. Doing a taper is like using the stairs. It still may be uncomfortable, but the landing is a lot softer. 

 

 

 

 

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Thank you,

I will post in the benzo forum to discuss something to help ease the symptoms.  As far as the Citalopram goes, can I be done with that?  My last dose was 8 weeks ago, and as mentioned earlier, was only on them a total of 21 days.

January 2017 - Prescribed Ativan 1mg as needed

May 5 - Started Citalopram 10mg, continued for 6 days

May 11 - Upped dose to 20mg

May 15 - Severe side effects (Major brain zap, increased anxiety, confusion, memory loss, fearful about future, suicidal thoughts)

May 24 - Side effects unbearable, asked GP to take me off

May 25 - Weened down to 10mg for 4 days

May 29 - Completely stopped Citalopram

May 30 - June 26 (Severe withdrawal symptoms similar to side effects when starting) Also took Ativan 1mg as needed since stopping Citalopram (Usually 1mg every other day)

June 26 - Stopped taking Ativan (Had insomnia, panic, screaming noises in head for 3 days)

Oct 3 - No Citalopram for 16 weeks. No Ativan for 12 weeks.  Still feel panicky, fearful thoughts, and a sense of detachment? (I just don't feel like myself)  Every day, all day long.

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  • Moderator Emeritus

Since you were dealing with an adverse reaction to Citalopram and you were only on it for three weeks, it may be best left in the past, as opposed to a small reinstatement. 

 

Do you feel that the adverse reactions you were having from the Citalopram (brain zaps, increased anxiety, confusion, memory loss, fearful about future, suicidal thoughts) are any better since you came off it? 

 

Also, you mentioned going to the ER. Did that happen while you were dealing with adverse effects of the Citalopram or more recently while only on the Ativan? 

 

 

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All of those adverse reactions started on the 3rd day of 20mg Citalopram.  I continued on for another week of hell, and those reactions slowly subsided, but not completely.  My GP was happy saying it was starting to work, but I decided I did not want to be on these any longer, so we started tapering back to 10mg.  Once completely off, the same adverse reactions started again for about 2 more hellish weeks.

 

The brain zaps, confusion, memory loss, suicidal thoughts, extreme difficulty ejaculating, slowly went away after a few weeks of stopping.  But the increased anxiety here and there remained.  To be clear, the anxiety has been there since January, long before I started the Citalopram.  But 4 weeks after stopping, the fearful thoughts and body tingles got worse out of nowhere, and have been for the past several weeks

 

My first trip to the ER was during the adverse side effects of Citalopram.  They said all was normal reactions to anti-depressants.

The 2nd time to the ER, maybe 6 weeks later, was because of the fearful thoughts in my head, tingling all over, and feeling like I'm losing my mind.  This time they said its because I'm under severe stress and anxiety with my marriage, and is all situational.

 

I have literally been dwelling on my marriage every day for 6 months not knowing what to do.  Nothing I do helps distract my mind.  Some say its ruminating, and the anxiety thats causing me to feel this way.

 

And the entire time I've been taking Ativan as needed.

Jan 26 - 1mg (20 Tablets)

May 21 - .5mg (15 Tablets)

May 28 - 1mg (20 Tablets)

That's the only refills I've had.  I still have 6 tablets left of my latest refill.

 

Could the on going anxiety, living in limbo from my situation cause these symptoms?

January 2017 - Prescribed Ativan 1mg as needed

May 5 - Started Citalopram 10mg, continued for 6 days

May 11 - Upped dose to 20mg

May 15 - Severe side effects (Major brain zap, increased anxiety, confusion, memory loss, fearful about future, suicidal thoughts)

May 24 - Side effects unbearable, asked GP to take me off

May 25 - Weened down to 10mg for 4 days

May 29 - Completely stopped Citalopram

May 30 - June 26 (Severe withdrawal symptoms similar to side effects when starting) Also took Ativan 1mg as needed since stopping Citalopram (Usually 1mg every other day)

June 26 - Stopped taking Ativan (Had insomnia, panic, screaming noises in head for 3 days)

Oct 3 - No Citalopram for 16 weeks. No Ativan for 12 weeks.  Still feel panicky, fearful thoughts, and a sense of detachment? (I just don't feel like myself)  Every day, all day long.

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49 minutes ago, ironmanDD said:

Could the on going anxiety, living in limbo from my situation cause these symptoms?

 

Situational anxiety can definitely cause a lot of problems, exacerbated by doctors giving you drugs and increasing the dose as you clearly tell them the AD is making you sicker and sicker. Thanks for the additional information and timeline for your ER visits. Unfortunately, it is difficult to piece together the Ativan issues from the Citalopram. 

 

When deciding if you have developed a dependency, please let us know:

 

1. How many hours a night are you sleeping, with and without the Ativan? Are you able to sit down and eat? Can you take care of your day-to-day activities? 

2. Knowing that what you know now (that you are experiencing "chemical anxiety" in additional to your situational anxiety), can you use calming techniques such as mindful breathing to handle your symptoms using non-drug methods?

 

Here are a few techniques to help aid in self-calming:

 

4-7-8 Breath Health Benefits Demonstration - article and video

 

The Breathing Space by Jon Kabat Zinn Sam DC  Sam DC - video 4 minutes

 

Jon Kabat-Zinn: Body Scan - video 29 minutes

 

Guided Meditation for Detachment From Over-Thinking (Anxiety / OCD / Depression) - video 42 minutes

 

For a more complete list:

 

Non-drug techniques to cope with emotional symptoms

 

If you aren't sleeping and you are having difficulty eating and having other symptoms, such as depersonalization (feeling detached) and having cognitive problems, you will likely benefit from going on a stable daily dose of Ativan and slowly tapering off. 

 

You may want to take a day or two to see if these kinds of non-drug coping techniques help and also read up on articles in the forum, especially the "green stickied" items at the top of the benzo forum, and then make your decision.

 

Please continue to ask questions here and if you decide to do a taper, make yourself at home with a new topic in the benzo area. Either online here or in an offline journal, please keep careful notes of your symptoms. This format is excellent for helping you track patterns that can let you know if you've developed a dependency and are experiencing interdose withdrawal (i.e. going into withdrawal in between doses):

 

Keep notes on paper about your drug dosages and daily symptom pattern

 

Whether you decide to taper or not, please give the non-drug coping techniques a try, as they also work great for situational anxiety and have an overall calming influence on your injured nervous system. 

 

 

Edited by Shep
added additional meditation link

 

 

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4 hours ago, ironmanDD said:

That's the only refills I've had.  I still have 6 tablets left of my latest refill.

 

Sorry, Ironman, I should have caught this when I made my last post. Do you only have 6 tablets left? Please make sure you have another refill of your benzos and a doctor who is willing to prescribe for at least a few more months.  If you are dependent, going cold turkey off Ativan can mean a recovery period of a year to several years and the symptoms for many of us have been severe enough to cost us our jobs, families, homes, etc. I don't want to see that happen to you or anyone else. 

 

Please prepare for a taper even if you want to try the non-drug coping skills for a few days first. 

 

 

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It's very frustrating not knowing what's causing these symptoms.  Situational, Anti-Depressant or Ativan withdrawal.  Maybe all three?  I just want to be myself again... this is absolute torture.

 

I've been keeping a log ever since starting the AD, and I can give a rough idea how much Ativan I took before the AD.

 

January 20:  When I discovered affair.  Had severe anxiety, couldn't sleep for a week.  No appetite.  Lost 25 pounds in 6 weeks.

February-April:  Ativan 1mg (20 tablets) as needed:  Just had situational anxiety here and there, and felt depressed

May 5-10:  Started Citalopram 10mg

May 11-24:  Citalopram 20mg - Adverse side effects started here

May 25-28:  Citalopram 10mg - Severe brain zap, anxiety, tingling and trouble sleeping for the entire week.  First time having fearful thoughts and sense of detachment

May 29:  Completely off Citalopram

June 1:  Severe brain zap, anxiety and tingling again.  Went to ER

June 4:  1mg Ativan

June 10:  .5mg Atican

June 17:  1mg Ativan

June 14: Brain zaps gone, tingling mostly gone.  Still anxious and fearful thoughts

June 20:  .5mg Ativan

June 21:  1mg Ativan

June 28:  Tingling started again

June 29:  .5mg Ativan

July 2:  .5mg Ativan 

July 4:  1mg Ativan

July 6:  1mg Ativan

July 13:  .5mg Ativan

July 16:  1mg Ativan

July 19:  1mg Ativan

July 21:  Sense of detachment, fearful thoughts.  Went to ER again

July 24:  .5mg Ativan

July 26:  .5mg Ativan

July 27:  1mg Ativan

July 29 (Today):  Severe anxiety in morning.  Went away around noon.  Severe again from 3-6pm.  Calmer in later evening

 

Basically ever since the adverse side effects of AD started, I've had the fearful thoughts, bouts of severe anxiety, and tingling, on and off.  Some days just ok, some bad.  I notice mornings are worse.  Whenever the severe anxiety hits, I have trouble sleeping, and not much appetite.  Taking Ativan does help if I can't sleep, usually when I come off of night shift,  but lately I've had no issues sleeping. Only during the adverse side effects I hardly slept.

 

Before the AD, I had bouts of anxiety only, none of the other stuff.  Also, the entire time I've been dwelling on my situation undecided about what to do, certainly not helping the anxiety.

 

Yes I do have 6 tablets left from the latest refill.

 

How can I know if I've become dependant on Ativan, and I'm not just withdrawing from the Citalopram still..  Or if this is all just the original situational anxiety gradually getting worse.  In all honesty, I really haven't taken that much Ativan over 6 months

January 2017 - Prescribed Ativan 1mg as needed

May 5 - Started Citalopram 10mg, continued for 6 days

May 11 - Upped dose to 20mg

May 15 - Severe side effects (Major brain zap, increased anxiety, confusion, memory loss, fearful about future, suicidal thoughts)

May 24 - Side effects unbearable, asked GP to take me off

May 25 - Weened down to 10mg for 4 days

May 29 - Completely stopped Citalopram

May 30 - June 26 (Severe withdrawal symptoms similar to side effects when starting) Also took Ativan 1mg as needed since stopping Citalopram (Usually 1mg every other day)

June 26 - Stopped taking Ativan (Had insomnia, panic, screaming noises in head for 3 days)

Oct 3 - No Citalopram for 16 weeks. No Ativan for 12 weeks.  Still feel panicky, fearful thoughts, and a sense of detachment? (I just don't feel like myself)  Every day, all day long.

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Just as I say i've been sleeping better lately.  Last night I went to bed around 3am... woke up at 6:30am with severe heart palpitations and can't get back to sleep...  I did have a slice of cake and a can of coke around midnight which may or may not be a factor... 

January 2017 - Prescribed Ativan 1mg as needed

May 5 - Started Citalopram 10mg, continued for 6 days

May 11 - Upped dose to 20mg

May 15 - Severe side effects (Major brain zap, increased anxiety, confusion, memory loss, fearful about future, suicidal thoughts)

May 24 - Side effects unbearable, asked GP to take me off

May 25 - Weened down to 10mg for 4 days

May 29 - Completely stopped Citalopram

May 30 - June 26 (Severe withdrawal symptoms similar to side effects when starting) Also took Ativan 1mg as needed since stopping Citalopram (Usually 1mg every other day)

June 26 - Stopped taking Ativan (Had insomnia, panic, screaming noises in head for 3 days)

Oct 3 - No Citalopram for 16 weeks. No Ativan for 12 weeks.  Still feel panicky, fearful thoughts, and a sense of detachment? (I just don't feel like myself)  Every day, all day long.

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  • Moderator Emeritus

Hi, Ironman.

 

Thanks for taking the time to write out all of this. It's good you've kept track of your doses. It's helpful to look for an escalation in the dose being taken, as well as the number of consecutive days. I'm honestly not sure if you're dependent or not. In the past 2 weeks (since July 13) you haven't been able to go more than 3 days without taking it. And more concerning, in the past week, you haven't been able to go more than 2 days. 

 

But the fact that you're sleeping well most nights is a great sign that even if you are dependent, it's at a low level. The problem is sorting out if you will stay that way if you simply stop taking the Ativan or if you'd do better by stabilizing on a daily dose and then tapering. 

 

Two options:

 

1.  Go on a daily dose of Ativan at the lowest rate that gives you relief. Stabilize on that dose and then do a slow taper.

         OR

2.  Since benzo reinstatements are most effective 2 - 4 weeks out, you could try not taking Ativan over the next week and see how you do. If you start having problems, then you can go to option number 1. This will keep you well within the reinstatement window while giving you a chance to test your dependency level. 

 

I would cut out caffeine and try to eat as little sugar as possible, especially since you mention it ramping up symptoms. Also, please try the non-drug coping techniques posted here. 

 

If you have some vacation or sick time from your job, you may wish to use that during this week. If you find yourself having a bad night of sleep, instead of resorting to an Ativan, can you call in sick? Or if you find yourself feeling panicky at work, could you leave early as opposed to taking an Ativan? Really work on the non-drug coping techniques to see you through the anxiety. Whether it's rebound anxiety or withdrawal, the "chemical anxiety" that shoots through the body can show up in our thoughts. If you can stop that from happening using mindfulness or breathing techniques, you may be able to stop the spiral. 

 

In fact, there are a lot of spirals that can happen, whether you're dealing with withdrawal or simply dealing with life in general. This is a great thread on it:

 

Dealing with emotional spirals

 

One of the techniques that can help break the spiral that can escalate into a full blow panic attack is:

 

"Change the channel" -- dealing with cognitive symptoms

 

I wish there was an easier way to gage dependency. It's good you found this forum so early in your psych drug experience, and in the future, I hope you're able to find a counselor to talk to (one who cannot prescribe drugs) and get some support that way. I'm sorry you're having psych drug dependency thrown in on top of an already difficult situation. 

 

Please let us know what you think about options 1 and 2 above. 

 

Edited by Shep

 

 

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Update for today (July 30): Had 4-5 hours of broken sleep, with severe palpitations and tingling throughout the night.  Moderate anxiety, jitters, tingling and panicky feeling all day long.  Normally in the last few months, if I had a bad day like today, I would take .5 or 1mg Ativan.  Not knowing why I felt this way, the last time I felt like this I went to the ER.  But I'm determined to feel normal again, and might decide to see how I feel without Ativan for a few weeks.

 

I spoke to a pharmacist today, she said it's very unlikely to have these withdrawal symptoms from Ativan if only used as needed.  She said it would make more sense if I was taking scheduled doses every single day for several months.  She also said the Citalopram should be well out of my system by now, and she didn't really know why I'm feeling this way.  Said most likely to the situational anxiety slowly elevating over time.  That's not the first time I've heard this, but since adding the meds I can't tell the difference!

 

I have cut out all caffeine for several months now.  I have gone to work on very little sleep, and gone to work feeling like today,  and thankfully they have been good with allowing me to leave early, but it can't go on forever.  I went to work like this last week, I freaked to medical, and they sent me to the ER just to be told I'm not crazy and what I'm feeling is normal signs of anxiety and not because of the meds, and keep taking Ativan lol.

 

Quote

The problem is sorting out if you will stay that way if you simply stop taking the Ativan or if you'd do better by stabilizing on a daily dose and then tapering. 

 

So if I stop taking the Ativan as of now, what is the typical timeline to continue feeling like this vs a slow taper?  Will everyday progressively get better?

 

Also, apologies for my ignorance, but what do you mean by reinstating? What is the reinstatement window?  And why would I want to start taking Ativan again after discontinued use for a few weeks.  Couldn't I soldier through it until things get better?

 

The chemical anxiety you mention definitely shows up in my thoughts, as mentioned I have fearful thoughts and feelings that I've never felt before.   I'm concerned about the spirals you mentioned, with withdrawals and life itself since my marriage issues are not resolved elevating my anxiety.  I started seeing a counsellor before I started any meds, but didn't find it very helpful.  Now, I just started seeing a psychologist, and have my 2nd appointment this week.  Also looking into CBT therapy.

 

Again, thank you for the wealth of knowledge.  For the most part this is all new to me, very scary as well.  I just want to feel like myself again, without any meds, that's all I ask for lol

January 2017 - Prescribed Ativan 1mg as needed

May 5 - Started Citalopram 10mg, continued for 6 days

May 11 - Upped dose to 20mg

May 15 - Severe side effects (Major brain zap, increased anxiety, confusion, memory loss, fearful about future, suicidal thoughts)

May 24 - Side effects unbearable, asked GP to take me off

May 25 - Weened down to 10mg for 4 days

May 29 - Completely stopped Citalopram

May 30 - June 26 (Severe withdrawal symptoms similar to side effects when starting) Also took Ativan 1mg as needed since stopping Citalopram (Usually 1mg every other day)

June 26 - Stopped taking Ativan (Had insomnia, panic, screaming noises in head for 3 days)

Oct 3 - No Citalopram for 16 weeks. No Ativan for 12 weeks.  Still feel panicky, fearful thoughts, and a sense of detachment? (I just don't feel like myself)  Every day, all day long.

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11 hours ago, ironmanDD said:

I spoke to a pharmacist today, she said it's very unlikely to have these withdrawal symptoms from Ativan if only used as needed.  She said it would make more sense if I was taking scheduled doses every single day for several months.  She also said the Citalopram should be well out of my system by now, and she didn't really know why I'm feeling this way.  Said most likely to the situational anxiety slowly elevating over time.  That's not the first time I've heard this, but since adding the meds I can't tell the difference!

 

Hi, Ironman.

 

Having situational anxiety certainly does make it worse, but when you've been severely stressed in the past, such as having an argument with your wife or suffering the loss of a close friend or a family member, did you experience stress in this way, so severe that you sought out an emergency room?

 

Unfortunately, most pharmacists don't understand these drugs any more than the doctors who prescribe them - they all go to the same schools. 

 

Even though Citalopram is out of your system, it has fundamentally changed the way your brain works. See these articles:

 

How psychiatric drugs remodel your brain

 

Now Antidepressant-Induced Chronic Depression Has a Name: Tardive Dysphoria

 

Withdrawal from benzodiazepines

 

Even though you're taking the Ativan "as needed", the drug has a half-life of 10 - 20 hours. So even two days later, there is still Ativan in your bloodstream, depending on how fast you are metabolizing it. 

 

This is a brochure on safe prescribing guidelines and it states that benzos should only be used for severe cases and only for one month. It's well-known that you can become dependent in only a month's time. And as I mentioned, the half-life of the drug should be considered. It's quite possible you've been going into withdrawal off and on for months. 

 

Benzo Good Practice Guide

 

Benzos only work for 2 - 4 weeks and then the only reason we keep taking them is to stave off withdrawal. Please see this thread for more information:

 

Ashton and beyond in benzo tapering

 

11 hours ago, ironmanDD said:

So if I stop taking the Ativan as of now, what is the typical timeline to continue feeling like this vs a slow taper?  Will everyday progressively get better?

 

 

Benzo withdrawal is very similar to antidepressant withdrawal - it comes in windows (good days) and waves (bad days). This explains more:

 

The Windows and Waves Pattern of Stabilization

 

This video is on antidepressant withdrawal, but it's very similar to benzo withdrawal, especially with the windows and waves pattern:

 

Healing from antidepressants. Patterns of recovery - video 4 minutes

 

11 hours ago, ironmanDD said:

Also, apologies for my ignorance, but what do you mean by reinstating? What is the reinstatement window?  And why would I want to start taking Ativan again after discontinued use for a few weeks.  Couldn't I soldier through it until things get better?

 

 

Reinstating means taking the drug again after you've been off it. The reinstatement window is the length of time you see the best results. For antidepressants, many people are successful two or three months (or even longer) after they've been completely off the drug. However, benzo reinstatement is best done within 2 - 4 weeks. Please see:

 

Notes on reinstatment

 

No one can tell you if you can "soldier through" this or not and it would be irresponsible for us to do so. The best advice I can give you is to try the non-drug coping skills over the next week and see how you do. If you are in bad shape, I would reinstate the Ativan at the lowest rate that gives you relief and we can discuss tapering off after you stabilize. 

 

12 hours ago, ironmanDD said:

The chemical anxiety you mention definitely shows up in my thoughts, as mentioned I have fearful thoughts and feelings that I've never felt before.   I'm concerned about the spirals you mentioned, with withdrawals and life itself since my marriage issues are not resolved elevating my anxiety.  I started seeing a counsellor before I started any meds, but didn't find it very helpful.  Now, I just started seeing a psychologist, and have my 2nd appointment this week.  Also looking into CBT therapy.

 

Counseling sounds good. You may also consider a mindfulness therapist. Mindfulness Based Stress Reduction can be great for any kind of anxiety and many members going through withdrawal report great results with it. You can find more here:

 

Non-drug techniques to cope with emotional symptoms

 

This is a free online course:

 

Online Mindfulness-Based Stress Reduction (MBSR) - free online 8-week course

 

You may also want to read over this thread on neuro-emotions,  as it can help with those thoughts coming from withdrawal:

 

Neuro-emotions

 

12 hours ago, ironmanDD said:

Again, thank you for the wealth of knowledge.  For the most part this is all new to me, very scary as well.  I just want to feel like myself again, without any meds, that's all I ask for lol

 

You are definitely in the right place and I hope you find a lot of information and support here. Many of us only find these forums when we're acutely ill and have to learn as we go. 

 

Please keep updating and let us know if you want to stay off the Ativan or to do a taper. And definitely let us know if the non-drug coping techniques are helping to keep the chemical anxiety from spiraling into panic attacks and other symptoms. 

 

 

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Hi IronmanDD -

 

I am so sorry for what you are going through. I want to smack your GP for giving you meds when what you are going through with your wife requires counseling, not psych-active drugs.

 

The mods here will give you great advice about the medicines themselves. I just wanted to weigh in and reassure you that you will recover from this. Yes, it does suck that being on these drugs even for a short time can cause the symptoms you are dealing with now. But there are things you can do to mitigate the symptoms and help you heal.

 

I want to ask you, if I may, where are things at now with you and your wife? Have you gone for counseling? Has she ended the affair? Have you been able to work towards forgiving her? I know these are very personal questions, but I do believe that forgiveness and rebuilding trust will be key to helping you heal not only in the specific circumstances of your marriage, but in your body, mind, and spirit as well.

 

I'm here as a sounding board if you need one.

 

SJ

Main thread: http://survivingantidepressants.org/index.php?/topic/14472-shakeyjerr-say-hello/

History: Prozac & Lithium from 1999 to 2003. Ended up back on after 4 months because taking a beta-blocker caused immediate depression (just 2 doses - turned out I didn't even need it; I had no other withdrawal symptoms - I might have ended up med and withdrawal-free otherwise :(). - Switched to Effexor (75mg 3/day) and Seroquel (50mg 3/day) in 2010. - Did a self-taper during 2016. - Developed Discontinuation Syndrome 02/17.

Supplements: Magnesium-Glycinate 400mg split into 4 100mg doses throughout the day. Vitamin C 500mg - once per day. Fish Oil 1360 mg (950 mg Active Omega-3) - twice per day.

I'm not a doctor. I use the internet, experience, and trial & error. Seek medical advice if necessary.

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Ironman, I did a little math to show what the level may be in your bloodstream 2 days after taking Ativan. While having a drug in your bloodstream doesn't automatically mean you develop a dependency, there is that possibility. This is why "as needed" use is so tricky. 

 

As you can see from the sentences in blue, depending how quickly you metabolize the drug, you may still have a sizable amount of it in your bloodstream even two days later. 

 

Once the nervous system is dysregulated, the nervous system can become hypervigilant in registering even small amounts of a drug. This is why people who are tapering become so sensitive to even 1% decreases. 

 

Please don't use this to say it proves you do or don't have a dependency, but just to provide some background on how dependency on "as needed" drugs can develop. 

_____________________________________________________________________________________

 

Ativan has a half-life of 10-20 hours. I'd like to figure this out for the 20 hour half-life timeframe and for the 10 hour half-life timeframe. 

 

So for 2 days:

 

2 x 24 = 48 hours

 

48 / 20 hours = 2.4 

 

So 2.4 is the power which can be used to multiply the number of hours by and .5 is for the half-life. 

 

0.52.4 = .1895 or 18.95%

 

So if you're metabolizing the Ativan at the 20 hour half-life rate, you  would still have 18.95% in your bloodstream.

 

If you were metabolizing it at the 10 hour range, it would be:

 

2 x 24 = 48 hours

 

48/10 hours = 4.8

 

0.54.8 = .0359 or 3.59%

 

So if you're metabolizing the Ativan at the 10 hour half-life rate, you would still have 3.59% in your bloodstream. 

 

And if you're somewhere in between, it's going to be (3.59% + 18.95%) / 2 = 11.27%

 

 

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Update for today (July 31):  Day 4 without Ativan, 8 weeks without Citalopram:  Went to bed around midnight, woke up around 3am with pretty bad palpitations, jitters and tingling.  Went back to sleep in and out until 5:30am, when my alarm went off for work.  Had some tingling all day at work, palpitations on and off, and fearful thoughts as usual.

 

Quote

Having situational anxiety certainly does make it worse, but when you've been severely stressed in the past, such as having an argument with your wife or suffering the loss of a close friend or a family member, did you experience stress in this way, so severe that you sought out an emergency room?

 

To be perfectly honest, I don't think I have been under such severe stress.  I have lost loved ones, but grieved like any other average person and got on with life.  I did lose my first house due to a 10 month layoff at work, it sucked and I worried what I would do, but I was only 28, figured I had all the time in the world to figure it out, and my wife (girlfriend at the time), was very supportive and I just took things day by day.

The stress I'm under now feels so much worse.  I'm 37, just got married 2 years ago, we had a new house and I was ready for a family.  This affair blew up my world, and I'm panicking about where my life goes from here, and I have it in my head it's too late to start over.  I'm an emotional and sedamental guy, and will have a hard time letting go of all the memories, but at the same time I can't let go of what happened either!  I'll be the first to admit I am stuck.

 

 

Quote from "Benzo good practice guide"

"once dependence has become established, it is often extremely difficult to treat and may become a long-term or even permanent state."

 

Ok this is freaking me out!!  Does this mean if I am dependent, it's possible I would feel like this forever?  I was taking such small doses and spread out so much, it's so hard to believe this is possible.  Especially when compared to people who take higher doses on a daily basis.  These adverse side effects all started when I took Citalopram.  And again, was only on those for 3 weeks! What the heck!  It scares me because I've read other threads where people are still suffering several months, even years after being drug free, and I'm not about to start experimenting with this drug, that drug, to compensate this feeling for that feeling!  I've never been on any medication in my life before all this, and I'm not about to start now!  Man, this is frustrating

 

It may be in my head, but I swear this all started when trying Citalopram.  Things have gone downhill ever since!

 

 

ShakeyJerr:

Thank you for the words of encouragement brother.  I pray you're right, and do recover from this hell.. like soon!

 

Quote

I want to ask you, if I may, where are things at now with you and your wife? Have you gone for counseling? Has she ended the affair? Have you been able to work towards forgiving her? I know these are very personal questions, but I do believe that forgiveness and rebuilding trust will be key to helping you heal not only in the specific circumstances of your marriage, but in your body, mind, and spirit as well.

 

As of now, things are literally still in limbo for the past 6 months.  I have seen a counsellor, which I did not find very effective.  She just let me vent away, while she told me everything was going to be ok.  No offence to her, but I could have used my mom for that lol.  I am now seeing a psychotherapist, and have my 2nd appointment this week, and looking into CBT as well.  I'm a stubborn guy, have never had/needed therapy or counselling, and I'm trying not to have a bad attitude towards it, but I'm not really sure how they can help me.  But I'm definitely willing to go.

 

The problem I face is forgiveness.  When I discovered the affair, I found out they secretly met up.  She lied and denied over and over to my face to the point I felt I was overthinking and assuming something that wasn't there. Then she swore on our marriage there was nothing going on.  Then after a month of lying, and both of us literally deteriorating, she finally turned to me one night and admitted to "something" that happened.  She downplayed the truth, then revealed it was 1 kiss, then lied and denied anymore happened... then she revealed it was 2 kisses.  Then a few weeks later, she admitted to intense kissing with groping.  This all took place over roughly 2 months, and to this day she has never admitted to anything else happening.  So what's the truth at this point?  I don't even know, or if it even matters.  The affair was with her much older boss (47).  She has since quit her job in hopes I will stay with her.  She has begged for forgiveness, and apologized over and over.  I've tried to stay and make things work, but things just are not the same. We've cried a million tears, have had many fights about it in the last 6 months, to the point where she is frustrated and fed up as well.  I'm still heartbroken, and just can't get over it.

 

Sorry for that little rant lol.  I just want to be free of these symptoms!!!

 

Thank you all again for the words of encouragement, wisdom, and genouristy.. truly thank you!

 

 

January 2017 - Prescribed Ativan 1mg as needed

May 5 - Started Citalopram 10mg, continued for 6 days

May 11 - Upped dose to 20mg

May 15 - Severe side effects (Major brain zap, increased anxiety, confusion, memory loss, fearful about future, suicidal thoughts)

May 24 - Side effects unbearable, asked GP to take me off

May 25 - Weened down to 10mg for 4 days

May 29 - Completely stopped Citalopram

May 30 - June 26 (Severe withdrawal symptoms similar to side effects when starting) Also took Ativan 1mg as needed since stopping Citalopram (Usually 1mg every other day)

June 26 - Stopped taking Ativan (Had insomnia, panic, screaming noises in head for 3 days)

Oct 3 - No Citalopram for 16 weeks. No Ativan for 12 weeks.  Still feel panicky, fearful thoughts, and a sense of detachment? (I just don't feel like myself)  Every day, all day long.

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Hi ironmanDD ,I'm privileged to read such honesty poured  from your heart ,the one thing is for certain ,you are under tremendous stress and  please act sooner rather than later ,I reacted too late last year to stress and I avoided the hospital by a whisker [withdrawl stress].

only you can make decisions on your marriage ,its very tricky for you,i personally thought therapy was cathartic and good for me but it was a long road for me .

 

from what i know about therapy and relationships ,would you and your wife think of doing couples counselling ,they could help navigate all the emotions .

withdrawl will eat your brain up with ruminating thoughts and rehashing these actions you describe is very toxic for you .

the fact your aware your panicking is something positive if there can be one .

have you ever watched Eckhart tolles videos about the male ego ,i found this to be brilliant and it explains a lot to me about the sickness of the world .be open to new things ,its helped me massive .

peace to you in recovery

PB

Alcohol free since February 2015 

1MG diazepam

4.5MG PROZAC.

 

 

 

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26 minutes ago, ironmanDD said:

Update for today (July 31):  Day 4 without Ativan, 8 weeks without Citalopram:  Went to bed around midnight, woke up around 3am with pretty bad palpitations, jitters and tingling.  Went back to sleep in and out until 5:30am, when my alarm went off for work.  Had some tingling all day at work, palpitations on and off, and fearful thoughts as usual.

 

Hi, Ironman.

 

If you were experiencing bad palpitations while awake and thinking about your situational anxiety, you might be able to chalk this up to situational anxiety.

 

But being jolted awake in the middle of the night sounds like you do have a dependency to the Ativan. 

 

Here is the thread on palpitations, which may have some helpful tips:

 

Irregular heartbeats, palpitations, tachycardia, bradycardia

 

 

28 minutes ago, ironmanDD said:

Quote from "Benzo good practice guide"

"once dependence has become established, it is often extremely difficult to treat and may become a long-term or even permanent state."

 

Ok this is freaking me out!!  Does this mean if I am dependent, it's possible I would feel like this forever?

 

There are people who do have really bad protracted withdrawal experiences, but you are young and your dosage wasn't high or used for decades, so please put that worry behind you. 

 

Are any of the non-drug coping skills helping with your symptoms? If they aren't, please consider going on a steady dose of Ativan and doing a slow taper. 

 

We don't recommend a lot of supplements on SA, as many people find they ramp up symptoms. But the two we do recommend are magnesium and fish oil, as they are calming to the nervous system. Please only add in one at a time and at a low dose. 

 

Magnesium, nature's calcium channel blocker

 

King of supplements: Omega-3 fatty acids (fish oil)

 

You are going to survive this, Ironman. Many people on this forum have used these drugs for decades and come off and healed. Your youth and short term exposure are to your advantage. 

 

 

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Aug 1:  5 days without Ativan.  Went to bed at 11:30, was awaken at 2am with severe body tingling and numbing, palpitations, and unwanted loud noises in my head...

 

I found a website with a timeline on Ativan withdrawal.

Days 1-3: Rebound symptoms, severe anxiety, palpitations, and insomnia

Days 4-7:  Symptoms peak during this time.  Severity varies with each person but may include tremors and irritibility.

Days 8-14: Symptoms start to lessen, and should mostly be subsided

Days 15+: The worst part is over.  Acute withdrawal symptoms should all be gone. Lingering symptoms should be mild.

 

I'm no doctor, but my reactions so far follow this guideline pretty accurately.

 

Trying to function at work with 2-3 hours of sleep for the 2nd day isn't fun, but as long as I know there's light at the end of the tunnel, I'm stubborn and will fight through it.

 

I have not tried the non-drug coping methods yet but will be.

 

What doesn't make sense to me is these symptoms (tingling, fearful thoughts, concussion/light buzz feeling in the head and sense of detachment) didn't start for the very first time until the adverse side effects of Citalopram.  Throughout the entire month of May I never had any Ativan at all, only Citalopram.

Once I stopped Citalopram, these effects slowly subsided over the next month, but not completely.

 

Then the tingling, and fearful thoughts started out of nowhere, and only then did I start taking Ativan more often (Still only small doses every 2-3 days)

 

Is it possible I became dependent on Ativan even before taking Citalopram?

Then things got worse once starting Citalopram?  I wasn't keeping a log of when I took Ativan prior to Citalopram, but I know it was also as needed over a 2 month period.

 

For the first 4 months of discovering the affair I did have days of bad anxiety, some days worse than others, and I remember constantly worrying "What am I gonna do, what am I gonna do".  But never felt these extra unbearable symptoms at al. 

 

Not once did my GP, or the nurses at ER ever mention I could be going through withdrawal.  Only encouraged me to continue taking more Ativan as needed!

 

For arguments sake, if I didn't take any drugs at all, would it be possible to be feeling these unbearable symptoms due to natural stress and anxiety?

January 2017 - Prescribed Ativan 1mg as needed

May 5 - Started Citalopram 10mg, continued for 6 days

May 11 - Upped dose to 20mg

May 15 - Severe side effects (Major brain zap, increased anxiety, confusion, memory loss, fearful about future, suicidal thoughts)

May 24 - Side effects unbearable, asked GP to take me off

May 25 - Weened down to 10mg for 4 days

May 29 - Completely stopped Citalopram

May 30 - June 26 (Severe withdrawal symptoms similar to side effects when starting) Also took Ativan 1mg as needed since stopping Citalopram (Usually 1mg every other day)

June 26 - Stopped taking Ativan (Had insomnia, panic, screaming noises in head for 3 days)

Oct 3 - No Citalopram for 16 weeks. No Ativan for 12 weeks.  Still feel panicky, fearful thoughts, and a sense of detachment? (I just don't feel like myself)  Every day, all day long.

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50 minutes ago, ironmanDD said:

I found a website with a timeline on Ativan withdrawal.

Days 1-3: Rebound symptoms, severe anxiety, palpitations, and insomnia

Days 4-7:  Symptoms peak during this time.  Severity varies with each person but may include tremors and irritibility.

Days 8-14: Symptoms start to lessen, and should mostly be subsided

Days 15+: The worst part is over.  Acute withdrawal symptoms should all be gone. Lingering symptoms should be mild.

 

 

Please note that's from this website:

 

Addiction Center - What is Ativan Withdrawal

 

That's a website for a detox center. Please note that SA does NOT advocate this type of withdrawal. If you read over that site, you'll see it's geared toward benzo addiction, not dependency, and the timeline is a marketing point to get customers / patients. It doesn't give the whole picture. Many (if not most) people who go through detox end up in a very difficult position because it's similar to a cold turkey withdrawal, and many end up reinstating, setting themselves up for kindling and a worse withdrawal the next time around. Also, most of these detox facilities use what they call "helper meds" to get you off the benzo, so many people come out of these places highly drugged on antipsychotics and antidepressants. 

 

Also, when someone goes through a detox program, they are able to "market" this timeline because any subsequent problems with anxiety, insomnia, pain, etc are categorized as the patient's underlying anxiety or depression disorder. 

 

While some people do experience mild withdrawal, you won't know if you are in that category ahead of time. 

 

And if you are in the category of someone who is dependent, once the nervous system is destabilized, all bets are off. Recovery could take a year or more before the nervous system settles down and your sleep goes back to normal and other symptoms fade out. 

 

The fact that you are able to go to sleep but then you are being jolted awake speaks to benzo withdrawal more than situational anxiety. 

 

If these symptoms continue, I would recommend going on the Ativan and doing a taper. Please keep posting how you're doing. You're doing a great job of noting your symptoms and are very aware of the impact of your situational anxiety, but please don't try to soldier through this. Once the nervous system is destabilized, it can be very hard to fix. This is why we recommend tapering. It's not a sign of weakness. It's simply a way of protecting your already damaged nervous system. 

 

 

 

 

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As the day has gone on, I feel a constant headache/hangover type feeling with a bit of pressure.  Tingly feelings in my legs are still there.  Palpitations are minor.

 

I went to my work medical, they have decided to send me to the ER again, and have put me off work on short term disability.

I just left the ER, and again they insist it's the situational anxiety causing this.  Not really considering the symptoms I describe to them, they say what I'm feeling is rare.  Also they're, believing it has anything at all to do with the Ativan.

 

I will try to fight through the next week, and pray this feeling subsides.  Hopefully get sleep tonight and take it from there.  The funny thing with the Ativan, even when I do take it, it doesn't fully eliminate all my symptoms.  I still get the fearful thoughts, tingling, and light pressure in my head.  It does calm the heart a bit, and it helps me stay asleep though.

 

The ER has referred me to an anxiety clinic, and I have my therapist appointment tomorrow.  This is absolute torture

January 2017 - Prescribed Ativan 1mg as needed

May 5 - Started Citalopram 10mg, continued for 6 days

May 11 - Upped dose to 20mg

May 15 - Severe side effects (Major brain zap, increased anxiety, confusion, memory loss, fearful about future, suicidal thoughts)

May 24 - Side effects unbearable, asked GP to take me off

May 25 - Weened down to 10mg for 4 days

May 29 - Completely stopped Citalopram

May 30 - June 26 (Severe withdrawal symptoms similar to side effects when starting) Also took Ativan 1mg as needed since stopping Citalopram (Usually 1mg every other day)

June 26 - Stopped taking Ativan (Had insomnia, panic, screaming noises in head for 3 days)

Oct 3 - No Citalopram for 16 weeks. No Ativan for 12 weeks.  Still feel panicky, fearful thoughts, and a sense of detachment? (I just don't feel like myself)  Every day, all day long.

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Ironman, even if the doctors don't believe you're experiencing symptoms from benzo withdrawal, will they prescribe it for you? 

 

I'm really concerned you may need to go back on it and taper. Like I've already posted, if you crash your nervous system, it could take a year or more to fix it and get back to normal. 

 

 

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David you are suffering from a reaction and withdrawal from citalopram, that is going to take some time to stabilise. I also agree with Shep that the ativan use is causing interdose withdrawal. Pushing through is not working, you are suffering and doctors haven't a clue. They say your symptoms are 'rare' because they don't accept that the drugs cause this, they are all taught by the drug companies who deny any problems with their drugs. Here in the England they are only allowed to prescribe benzos for one week, my daughter had them prescribed last year and the doctor told her that she can have one prescription for one week supply and she is not allowed to prescribe any more because of the risk of addiction. Dependence is different to addiction. Anyone who takes a drug for any condition regularly is dependent on that driug for something. The body adapts to a drug and changes the way it works, often they are life saving but many many of them cause an imbalance. When the drug is taken away the body has to try and get back to normal functioning.

 

 This is why psychiatric drugs need careful tapering, it is the brain that is trying to regain homeostasis and that takes time. During that time  there are lots of symptoms that come and go, some severe and some mild but together they can be disabling. You are now off work and doctors are telling you it is all in your imagination, which is devastating and insulting. Eventually you could be diagnosed with fibromyalgia or CFS, you have to have symptoms for 6 months to 'qualify' for that diagnosis here, and is often because of drugs side effects or withdrawal. 

All you need to do is make the ativan doses regular to keep a steady level in your blood that will help you to keep stable. It will help with the citalopram withdrawal too. It will take a few days to level out, and could make a huge difference for you. It will not be a miraculous cure but could leave you funtioning and not getting those awakenings with terrible symptoms. When you are stable you can then begin to cut the doses by small amounts until you are free of it, and function along the way. 

**I am not a medical professional, if in doubt please consult a doctor with withdrawal knowledge.

 

 

Different drugs occasionally (mostly benzos) 1976 - 1981 (no problem)

1993 - 2002 in and out of hospital. every type of drug + ECT. Staring with seroxat

2002  effexor. 

Tapered  March 2012 to March 2013, ending with 5 beads.

Withdrawal April 2013 . Reinstated 5 beads reduced to 4 beads May 2013

Restarted taper  Nov 2013  

OFF EFFEXOR Feb 2015    :D 

Tapered atenolol and omeprazole Dec 2013 - May 2014

 

Tapering tramadol, Feb 2015 100mg , March 2015 50mg  

 July 2017 30mg.  May 15 2018 25mg

Taking fish oil, magnesium, B12, folic acid, bilberry eyebright for eye pressure. 

 

My story http://survivingantidepressants.org/index.php?/topic/4199-hello-mammap-checking-in/page-33

 

Lesson learned, slow down taper at lower doses. Taper no more than 10% of CURRENT dose if possible

 

 

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About how many more days should I give it to see if things get better before I consider a regular dose?  I could probably do another week now that I'm off work.  It's the sleeping through the night that's troubling right now. (2 days in a row).  My dad says take a Tylenol 3 with codeine, he said that will knock me out lol.

 

Also, once I have a plan to taper off Ativan fully, however long that may take, won't the withdrawals from Citalopram still be persistent?  Even if I wasn't on Citalopram very long, did I taper too quickly?  I've been told Citalopram withdrawals can take up to 6 weeks and 3 months.  It's going on 8 weeks if those withdrawals are even part of the problem.

 

Also, mammaP, I took Ativan for about 6 weeks before Citalopram, and now has been 2 months post Citalopram.  Both periodic.  Just wanted to clarify you mentioned I was on them for 6-7 months in your first post :)

 

I'll update tomorrow with how I can sleep tonight. Thanks again

January 2017 - Prescribed Ativan 1mg as needed

May 5 - Started Citalopram 10mg, continued for 6 days

May 11 - Upped dose to 20mg

May 15 - Severe side effects (Major brain zap, increased anxiety, confusion, memory loss, fearful about future, suicidal thoughts)

May 24 - Side effects unbearable, asked GP to take me off

May 25 - Weened down to 10mg for 4 days

May 29 - Completely stopped Citalopram

May 30 - June 26 (Severe withdrawal symptoms similar to side effects when starting) Also took Ativan 1mg as needed since stopping Citalopram (Usually 1mg every other day)

June 26 - Stopped taking Ativan (Had insomnia, panic, screaming noises in head for 3 days)

Oct 3 - No Citalopram for 16 weeks. No Ativan for 12 weeks.  Still feel panicky, fearful thoughts, and a sense of detachment? (I just don't feel like myself)  Every day, all day long.

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I wouldn't wait any longer to be honest, there is no point in suffering. Citaopram withdrawal can go on for several months or more., everyone is different. You were onlu=y on it 3 weeks but reacted to it. The benzo can dampen the withdrawal from ADs and if people are taking both ADs and benzos we recommend tapering the AD first because the benzo can help with any withdrawal symptoms that might pop up. 

Personally I would avoid the codeine, it can make things worse.  You only took citalopram for 3 weeks and had a reaction to it but we suspect your problem is with benzo withdrawal as well as citalopram.  You could take the lowest dose that has helped you and take that dose every day at the same time, the time which is best for you.  

Edited by mammaP

**I am not a medical professional, if in doubt please consult a doctor with withdrawal knowledge.

 

 

Different drugs occasionally (mostly benzos) 1976 - 1981 (no problem)

1993 - 2002 in and out of hospital. every type of drug + ECT. Staring with seroxat

2002  effexor. 

Tapered  March 2012 to March 2013, ending with 5 beads.

Withdrawal April 2013 . Reinstated 5 beads reduced to 4 beads May 2013

Restarted taper  Nov 2013  

OFF EFFEXOR Feb 2015    :D 

Tapered atenolol and omeprazole Dec 2013 - May 2014

 

Tapering tramadol, Feb 2015 100mg , March 2015 50mg  

 July 2017 30mg.  May 15 2018 25mg

Taking fish oil, magnesium, B12, folic acid, bilberry eyebright for eye pressure. 

 

My story http://survivingantidepressants.org/index.php?/topic/4199-hello-mammap-checking-in/page-33

 

Lesson learned, slow down taper at lower doses. Taper no more than 10% of CURRENT dose if possible

 

 

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MammaP makes some excellent points. 

 

Regarding going back on Ativan for a taper, many people find that they experience interdose withdrawal (symptoms in between doses) if they only take it once or twice a day due to the short half-life. In fact, many people find it works best to spread out the doses 5 or more times a day.

 

So if you do go back on Ativan - and as you can read, we are hoping you do - please consider spreading out the doses. So with a daily dose of 1 mg Ativan, that would be 5 doses at .20 mg each. 

 

This can be accomplished using a scale or with a liquid taper. Here is information on this:

 

Using a digital scale to measure doses

 

How to make a liquid from tablets or capsules

 

I know this is a lot of information to take in, but we can walk you through it step by step. Continuing to deteriorate to the point of needing the ER is a clear sign that your nervous system is dependent and would benefit from a taper. 

 

 

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Aug 2:  Day 6 without Ativan

I slept from 11pm-5am.. then in and out till around 10am, and I did not take the Tylenol 3 with codein.

Woke up feeling a little tingly, and a bad headache.  I took some advil, and have felt better as the day goes on.  Minor palpitations, less intense tingling, and slightly better feeling in the head. Definitely not 100%, but better than the last 2 days I think

 

Had my 2nd appointment with psychotherapist dude.  All in all, went alright.  Trying to tackle some of the underlying issues causing the anxiety.

January 2017 - Prescribed Ativan 1mg as needed

May 5 - Started Citalopram 10mg, continued for 6 days

May 11 - Upped dose to 20mg

May 15 - Severe side effects (Major brain zap, increased anxiety, confusion, memory loss, fearful about future, suicidal thoughts)

May 24 - Side effects unbearable, asked GP to take me off

May 25 - Weened down to 10mg for 4 days

May 29 - Completely stopped Citalopram

May 30 - June 26 (Severe withdrawal symptoms similar to side effects when starting) Also took Ativan 1mg as needed since stopping Citalopram (Usually 1mg every other day)

June 26 - Stopped taking Ativan (Had insomnia, panic, screaming noises in head for 3 days)

Oct 3 - No Citalopram for 16 weeks. No Ativan for 12 weeks.  Still feel panicky, fearful thoughts, and a sense of detachment? (I just don't feel like myself)  Every day, all day long.

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Sounds like you're doing better, Ironman. Good to read. 

 

Please let us know how you continue to do. 

 

 

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Aug 3: Day 6 without Ativan, into 9th week without Citalopram.

Slept a solid 9 hours last night, which was nice.  Anxiety is minor, and palpitations are minor.  But, the body tingling is still there non-stop, which is starting to scare me.  It's been a steady 4 weeks of tingling, and I even feel it slightly in my face.

 

It's so frustrating that nobody believes me when I say this all started when I tried the Citalopram.  My GP thinks I'm looking for excuses to blame the meds. The psych nurses at ER say its situational.  My friends and family say its all in my head.  I have a friend who's been on Lorazepam for almost 10 years, and anti-depressants for 17 years, and is encouraging me to get back on anti-depressants AND Lorazepam.  No thanks!  She says no way that the Lorazepam is causing this lol.

 

Maybe it is just a coincidence these symptoms showed up at the same time I started meds.  We all know the anxiety is the underlining cause to this mess with my marriage at stake, but I'm wondering if the fearful thoughts, and fears of the future are all natural reactions to divorce anyway.  I've read lots about divorce causing panic, anxiety, fearful thoughts etc.  All of which I'm feeling.  Maybe the meds amplified those fears.

January 2017 - Prescribed Ativan 1mg as needed

May 5 - Started Citalopram 10mg, continued for 6 days

May 11 - Upped dose to 20mg

May 15 - Severe side effects (Major brain zap, increased anxiety, confusion, memory loss, fearful about future, suicidal thoughts)

May 24 - Side effects unbearable, asked GP to take me off

May 25 - Weened down to 10mg for 4 days

May 29 - Completely stopped Citalopram

May 30 - June 26 (Severe withdrawal symptoms similar to side effects when starting) Also took Ativan 1mg as needed since stopping Citalopram (Usually 1mg every other day)

June 26 - Stopped taking Ativan (Had insomnia, panic, screaming noises in head for 3 days)

Oct 3 - No Citalopram for 16 weeks. No Ativan for 12 weeks.  Still feel panicky, fearful thoughts, and a sense of detachment? (I just don't feel like myself)  Every day, all day long.

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On 8/3/2017 at 2:42 PM, ironmanDD said:

But, the body tingling is still there non-stop, which is starting to scare me.  It's been a steady 4 weeks of tingling, and I even feel it slightly in my face.

 

This is a common withdrawal symptom, Ironmann. If you haven't already seen this thread, please have a read, as knowing that others are dealing with it may make it less scary. 

 

Paresthesia: Pins & Needles, Numbness, Tingling, Burning Sensations

 

It's a sign of nervous system dysregulation. 

 

On 8/3/2017 at 2:42 PM, ironmanDD said:

It's so frustrating that nobody believes me when I say this all started when I tried the Citalopram.  My GP thinks I'm looking for excuses to blame the meds.

 

I hear your frustration. This is something that is so tragic in our medical system. There's a great book by medical journalist Robert Whitaker called Anatomy of an Epidemic that explores how psychiatric drugs have increased the disability rate for mental illness, hardly an indication that these drugs work and more likely that they cause great harm.

 

Here's a short video where he talks about his book:

 

Robert Whitaker, author Anatomy of an Epidemic - video 11 minutes

 

 

On 8/3/2017 at 2:42 PM, ironmanDD said:

I have a friend who's been on Lorazepam for almost 10 years, and anti-depressants for 17 years, and is encouraging me to get back on anti-depressants AND Lorazepam.  No thanks!  She says no way that the Lorazepam is causing this lol.

 

I'm glad you said, "No thanks!". I used to belong to a benzodiazpine forum when I was dealing with benzo withdrawal and this article was one that brought in a LOT of new members:

 

Benzodiazepine use may raise the risk of Alzheimers disease

 

My own memory problems were quite severe, especially for the first two years off the drug, but now I'm seeing remarkable improvements. Sadly, your friend may travel down some dangerous roads in her future, especially as she gets older, but at least you have given her a seed of doubt. These drugs may also cause medication spell-binding, so that's one reason it's so hard to convince other people that "your drug may be your problem", as Dr. Breggin likes to say.

 

What is Medication Spellbinding? Simple Truths in Psychiatry Video  video 13 minutes

 

On 8/3/2017 at 2:42 PM, ironmanDD said:

Slept a solid 9 hours last night, which was nice.  Anxiety is minor, and palpitations are minor.  But, the body tingling is still there non-stop, which is starting to scare me.  It's been a steady 4 weeks of tingling, and I even feel it slightly in my face.

 

 

 

With this kind of progress, you were right not to reinstate. I'm glad going without any drugs for a week has led to such progress.

 

Please take another week and keep giving us these updates and let us know how you do. If you continue to sleep well, your anxiety and palps are minor, and the only symptom you have is body tingling (which I don't think is a coincidence that it started with the AD), you most likely will be better off not reinstating and using the non-drug coping skills and continuing on with talk therapy. 

 

 

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Aug 6:  Day 9 off Ativan

Been sleeping decent (6+ hours before waking up, and nightmares here and there).  Anxiety was moderate yesterday, tingling is still there, same with the light pressure feeling in my head.  It almost feels like a constant hangover.  Also brain feels burning sensation every so often, but goes away.  I often times feel "out of it".  Like I'm not 100% in the moment.  One thing I never mentioned before, and I'm noticing more and more, is I'm having slight problems reading.  I'll read a few words, then feel I need to stop and let my brain catch up before I continue reading.  I feel a bit slow to react to things like I'm not 100% focused.

 

I've yet to find anyone whose given a time frame before they started to get better.  I wish I had a timeline when I can expect to start feeling normal again, this is ridiculous to feel this way. 

January 2017 - Prescribed Ativan 1mg as needed

May 5 - Started Citalopram 10mg, continued for 6 days

May 11 - Upped dose to 20mg

May 15 - Severe side effects (Major brain zap, increased anxiety, confusion, memory loss, fearful about future, suicidal thoughts)

May 24 - Side effects unbearable, asked GP to take me off

May 25 - Weened down to 10mg for 4 days

May 29 - Completely stopped Citalopram

May 30 - June 26 (Severe withdrawal symptoms similar to side effects when starting) Also took Ativan 1mg as needed since stopping Citalopram (Usually 1mg every other day)

June 26 - Stopped taking Ativan (Had insomnia, panic, screaming noises in head for 3 days)

Oct 3 - No Citalopram for 16 weeks. No Ativan for 12 weeks.  Still feel panicky, fearful thoughts, and a sense of detachment? (I just don't feel like myself)  Every day, all day long.

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