KLA324 - Need guidance to get off this cocktail please

[KLA324]

Hello everyone and thank you for providing this safe haven. 

 

My nightmare began in 1999 when, after a re-marriage, moving with my kids across country and a health scare, I spiraled downward into a state of anxiety and depression. I had never been on an AD before but after a month of being a recluse, I gave in and started on Wellbutrin. My anxiety and depression improved and I thought this is a miracle drug!

 

From 2000 to 2009 I believe (hard to recall) that I did take an AD a few times but nothing for an extended time. 

 

In 2009 I went thru a divorce and temporarily went on an AD for about 9 months. 

 

In 2010, I decided to move on my own  to a new state and start a new career. Along with the stress of the move and a new job, I had my daughter and newborn twins move in with me after the collapse of her marriage from 2012 to 2013). During this time I only took Ambien to sleep.

 

In Jan 2013, I came down with bronchitis and lost my job which threw me into another deep depression. My doc put me on 25mg and then 50mg Sertraline along with the Ambien. I started a new job in March 2013 and my daughter/granddaughters moved out on their own. I stayed on this until April 2014 when my dose of Sertraline was increased to 100mg and my sleep meds were changed to Amitriptylene as I said Ambien was no longer helping. 

 

Looking back over my refills, I got them steadily from April 2014 to April 2015. I still had 20 pills of Sertraline remaining which tells me that sometime in June/July I stopped taking the Sertraline. I honestly don't recall because, until I found this site, I was NEVER told by any doctor that these drugs need to be taken consistently. I was also never told that Amitriptylene is also an AD - I was told it was for sleep.

 

In August 2015 I had kidney stones and the doc gave me Tramodol for the pain (took 20 of the 30 pills). During that visit I told her I had weaned off the Sertraline and that the Amitriptylene didn't seem to be working anymore. She then gave me 50mg of Trazadone - which I now know is yet ANOTHER AD! When I complained of how much weight I had gained, she also gave me Phentermine. 

 

So off I go---the pain from the kidney stones passed and I stopped the Tramodol. I then start taking the Phentermine in the morning and the Trazadone at night. Almost immediately I just wasn't feeling quote "right". Way too anxious, wasn't sleeping and wasn't losing weight either. 

 

So, on Oct 2 I stopped both the Phentermine and the Trazadone CT. 2 days later I literally hit a wall. Unbelievable anxiety, depression, insomnia, crying non-stop, racing thoughts, dilated pupils, sensitive to sounds and light, racing heart - pure hell. Because I needed to work, I started taking Sertraline again at 50mg until I could get into the doc. Honestly, it didn't help very much and I was literally in agony every second of the day...afraid to be alone in my own house, afraid to go to sleep, afraid of everything. 

 

I finally saw the doc on Oct 15 and I was still a mess and sobbed through the entire appt. When she listened to my symptoms she said it sounded like I "may" have gone thru withdrawal but that I needed to be on an AD and something (temporarily) for anxiety---possibly for life. I had already come to this site and expected that to be her response, which I didn't argue with. I did tell her that I do not want to be on an AD for the rest of my life to which she replied that "the AD I am putting you on has been tested/used in Europe for 25 years". 

 

So here I am with a bottle of Aprazolam 0.5mg and Citalopram 20mg. Being as desperate as I was/am, yes---I am taking the meds at a reduced dosage until I can figure out how to get all this poison out of my body forever. 

 

10/15 - Citalopram 20mg and Aprazolam 0.5mg

10/16 - Citalopram 10mg and Aprazolam 0.25mg

10/17 - Citalopram 10mg and Aprazolam 0.25mg

 

So there's my story (sorry so long) and where I am confused. 

 

First---when I came off the Sertraline, were any withdrawal symptoms being covered up by my taking the Trazadone?

 

Then, when I quit everything CT (Phentermine and Trazadone) and 2 days later crashed, was that caused by withdrawal?

 

So now what do I do? How do I start weaning off this stuff? I am OK with not taking the anxiety drug and suffering through but how should I wean off the Citalopram? Or do I need to?

 

I so much appreciate your help and guidance as I know most of you have been thru this nightmare and have learned a lot. I am willing to take this day-by-day in order to minimize my symptoms but I need help. I am doing this alone (unless you count my 2 dogs) and I have little to no support. My daughter doesn't understand what I'm going through and is involved in her own life. I am ashamed and embarrased to be around my grandkids since all I do is cry. Therefore I am alone in my house which is making my anxiety soar. I feel like such a failure at life and am mad at myself for not being a more informed consumer and checking out this *rap I was putting in my body. 

 

Karen

 

[KLA324]

If anyone can help me, I would appreciate it. Or just talk. I am very alone and scared - severe anxiety and racing thoughts. Does this get any better? 

[dalsaan]

Hi Kla324,

 

Welcome to surviving antidepressants. You have had a lot of drug changes over a short period of time. I'm not surprised that these things have kicked in. I tend to agree that it's Zoloft withdrawal. What to do from here I'm not so sure. I'm going to ask Alto's opinion.

 

Things will get better but you need a strategy from here. I think this should include developing non drug ways of dealing with your emotions. As I read your story, every time you have a stressful life event you have reached for medication. This is not a great strategy as you are now finding out. We have resources on this site in the symptoms forum which I recommend you go to but it might also be useful to access some good face to face therapy.

 

Dalsaan

[Altostrata]

Welcome, KLA.

 

In the last year, it seems you went off 100mg sertraline in June/July, but were still taking amitriptyline when you were prescribed Tramadol (another psychoactive drug).

 

Did you switch directly from Tramadol and amitriptyline (cold turkey?) to trazodone and phentermine (another psychoactive drug)?

 

At this point, you were "way too anxious, wasn't sleeping and wasn't losing weight either."

 

After a month or so on trazodone and phentermine, you quit both cold turkey and developed intense withdrawal symptoms. Your doctor then prescribed citalopram (aka Celexa) and alprazolam (an addictive benzodiazepine).

 

What is your symptom pattern like now?

 

How did you go off Ambien? Did you have any odd symptoms after that?

 

When you said amitriptyline wasn't working any more, what did you mean?

 

My guess is you might have gotten away with going off Zoloft, however you did it, but going off Ambien and then bouncing around from amitriptyline, Tramadol, trazodone, and phentermine pushed your nervous system too far. Now it is sensitized, and it's going to be very difficult to unravel the cause. It could have been going on and off any of the drugs you've taken in the last year. (Did you also take an antibiotic?)

 

Please put ALL the drugs you take in the Drug Interactions Checker http://www.drugs.com/drug_interactions.html and copy and paste the results in this topic.

 

If I may observe, your doctor is very promiscuous when it comes to prescribing neuroactive drugs. I would not trust her to do this any more. Also, from now on, you should look up any prescription on drugs.com before taking a drug.

[KarenB]

Hello Karen,

 

I'm so so sorry for all you're going through right now - that doctor has a lot to answer for.  I'm glad you've found s/a - the more you read and learn on here the stronger you'll feel about getting yourself through this.  There are many things you can do to nurture yourself as you go, as Dalsaan said.  Have a look at http://survivingantidepressants.org/index.php?/topic/1112-non-drug-techniques-to-cope-with-emotional-symptoms/ for a start.  As strange as it sounds you can definately count your dogs as 'help'.  Cuddling pets is known to be very soothing to our nervous-system, and increases the 'feeling good' hormones.   

 

And no wonder you are feeling anxious and scared - you are in a really hard place, plus you will be experiencing 'neuro-emotions' which are actually caused by the drugs.  You can learn to recognise these, to help keep things in perspective.  For anxiety, try a hot bath with epsom salts in it.  Or sipping ice-water with magnesium-citrate.  Even a very simple yoga pose like putting your legs up the wall can help re-set your emotions and ground you a bit.  

 

Things will get better Karen.  Alto and the other staff will help you make a good plan once they have all your med info.  And everyone of us here took the drugs - don't let yourself feel guilty because you got swept up in a powerful multi-national deception.  You are only human . 

 

Hugs,

from another Karen

[marie123]

Hi there Karen,

 

So sorry you are going through all this. I am taking a cocktail too - trazadone and remeron. I have all of the same emotions as you, withdrawing from meds can cause these things. Cold turkeying and tapering too fast can make these symptoms worse. Try to remember that this soon too will pass. You need to stabilize your meds for a while before you think of tapering and then go real slow.  I'm slowly tapering one med at a time to try and minimize those troublesome symptoms. Epsom salt baths were mentioned above, along with magnesium citrate. I have a glass full of magnesium citrate at night before bedtime. It relaxes me so I have a better sleep. The Epsom salts relieve the achy tense muscles and is very soothing.

 

Get plenty of exercise if you can even if it's just a walking your precious pooches around the neighborhood.

[JanCarol]

Hey KLA - welcome to SA!

 

Wow, that's a lot of switching!  I'm going to echo behind Alto - we'd like to see your drug interactions (and this might include other medicines, like statins, stomach drugs, NSAIDs, etc.) from http://www.drugs.com/drug_interactions.html

 

It sounds like, some of your changes were very recent, that the best thing you can do right now is hold.  Don't make any changes, wait until you are stabilized with what you are on before considering any tapers or changes at all.

 

And by all means, let those doggies take care of you while you take care of them!

[KLA324]

Dalsaan- thank you so much for taking the time to respond. I agree - I suffered on my own that first time in 1999 and after a month was convinced by my GP at the time to go on an AD. Her exact quote was "over 50% of my patients are on an AD" and being in such a fragile state at the time I thought that meant it was OK. Big mistake on my part. I am now trying to correct that bad decision. Thank you again and I hope you are doing well. 

Karen

[KLA324]

Alto - thank you so much for your help and guidance and let me try and clarify some points:

 

In the last year, it seems you went off 100mg sertraline in June/July, but were still taking amitriptyline when you were prescribed Tramadol (another psychoactive drug).

 

Did you switch directly from Tramadol and amitriptyline (cold turkey?) to trazodone and phentermine (another psychoactive drug)?

 

I was on Sertraline and Amitriptylene (took maybe 2-3 times a week) and quite both of those and "thought" I had no issues. Them maybe 2 months later, during a kidney stone attack, I was given Tramadol for pain (took 20 of 30 pills prescribed) and after that recovery I started taking Trazodone for sleep and Phentermine for weight loss (gained 40 lbs while on Zoloft).  I only took the Phentermine and Trazodone for a short time - approximately 2 weeks. 

 

At this point, you were "way too anxious, wasn't sleeping and wasn't losing weight either."

 

That's correct...the Trazodone wasn't giving me a restful sleep and the Phentermine was just making me anxious and short tempered but very little weight loss. 

 

After a month or so on trazodone and phentermine, you quit both cold turkey and developed intense withdrawal symptoms. Your doctor then prescribed citalopram (aka Celexa) and alprazolam (an addictive benzodiazepine).

 

What is your symptom pattern like now?

 

I am anxious, crying a lot, pessimistic about the future. Very depressed, little to no desire to do anything, have missed multiple days of work. I have now lost 25 lbs in 3 weeks.  Today I have taken 10mg of the Celexa and no Xanax. I am trying to NOT take the Xanax and to only start on 10mg of the 20mg prescribed of the Celexa - or is that a wise approach?

 

How did you go off Ambien? Did you have any odd symptoms after that?

 

Nothing bad that I can recall from going off Ambien. It's strange because, prior to going off the Zoloft and then going to the Tramadol/Trazodone/Phentermine combo and coming off all CT, I don't recall ever having any WD symptoms after stopping a drug. 

 

When you said amitriptyline wasn't working any more, what did you mean?

 

It just didn't seem to be as effective as it was at the beginning. I wasn't falling asleep and staying asleep. Of course I do have a very stressful career and that may have attributed to that. 

 

My guess is you might have gotten away with going off Zoloft, however you did it, but going off Ambien and then bouncing around from amitriptyline, Tramadol, trazodone, and phentermine pushed your nervous system too far. Now it is sensitized, and it's going to be very difficult to unravel the cause. It could have been going on and off any of the drugs you've taken in the last year. (Did you also take an antibiotic?)

 

Yes, I did take an antibitoic (can't recall the name) in Jan 2013 when I had the bronchitis. 

 

Please put ALL the drugs you take in the Drug Interactions Checker http://www.drugs.com/drug_interactions.html and copy and paste the results in this topic.

 

I will do that next and post below. 

 

If I may observe, your doctor is very promiscuous when it comes to prescribing neuroactive drugs. I would not trust her to do this any more. Also, from now on, you should look up any prescription on drugs.com before taking a drug.

 

Yes, I agree. I only went back to her this week out of desperation. I am going to find a new doctor who will listen and not just send me on my way with the newest AD without considering what is best for ME. Unfortunately when I have gone to her I was desperate and just wanted a fix for the pain I was in. Thanks to the site I now know that some doctors are not looking out for the best interests of their patients. 

 

Thank you for taking time out of your day to respond to me - I am so grateful. 

[KLA324]

INTERACTION WHILE TAKING ZOLOFT AND AMITRIPTYLINE - JAN 2013 TO JUNE/JULY 2015

 

 

Interactions between your selected drugs

Major amitriptyline  sertraline

Applies to: amitriptyline, Zoloft (sertraline)

Before taking amitriptyline, tell your doctor if you also use sertraline. You may need dose adjustments or special tests in order to safely take both medications together. This combination may increase the effects of amitriptyline in your body. You should notify your doctor if you have symptoms of sedation, dry mouth, blurred vision, constipation, or urinary retention. You might also have altered consciousness, confusion, poor muscle coordination, abdominal cramping, shivering, pupillary dilation, sweating, high blood pressure, and high heart rate. It is important that you tell your healthcare provider about all other medications that you are using including vitamins and herbs. Do not stop using your medications without first talking to your doctor first.

Switch to professional interaction data

Other drugs that your selected drugs interact with

• amitriptyline interacts with more than 500 other drugs.
• Zoloft (sertraline) interacts with more than 500 other drugs.

Interactions between your selected drugs and food

Moderate sertraline  food

Applies to: Zoloft (sertraline)

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of sertraline. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills. In addition, limited clinical data suggest that consumption of grapefruit juice during treatment with sertraline may result in increased plasma concentrations of sertraline. The proposed mechanism is inhibition of CYP450 3A4-mediated metabolism by certain compounds present in grapefruit. An in-vitro study demonstrated that grapefruit juice dose-dependently inhibits the conversion of sertraline to its metabolite, desmethylsertraline. In a study with eight Japanese subjects, mean plasma levels of sertraline increased by approximately 100% and maximum plasma concentrations increased by 66% after the ingestion of three 250 mL glasses of grapefruit juice per day for 5 days and administration of a single dose of sertraline 75 mg on the sixth day. In another small study with 5 patients, mean sertraline trough levels increased by 47% after taking sertraline for at least 6 weeks, then taking sertraline with 240 mL grapefruit juice daily for 1 week. The clinical significance is unknown; however, pharmacokinetic alterations associated with interactions involving grapefruit juice are often subject to a high degree of interpatient variability. The possibility of significant interaction in some patients should be considered.

MANAGEMENT: Patients receiving sertraline should be advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how sertraline affects them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities. Some authorities recommend that consumption of grapefruit juice should be avoided during sertraline therapy.

Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication Antidepressants

Therapeutic duplication

The recommended maximum number of medicines in the 'antidepressants' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'antidepressants' category:

• amitriptyline
• sertraline (active ingredient in Zoloft)

Note: The benefits of taking this combination of medicines may outweigh any risks associated with therapeutic duplication. This information does not take the place of talking to your doctor. Always check with your healthcare provider to determine if any adjustments to your medications are needed.

[KLA324]

INTERACTION WHILE TAKING TRAZODONE, TRAMAODOL AND PHENTERMINE - AUG/SEPT 2015

 

 

Interactions between your selected drugs

Major trazodone  tramadol

Applies to: trazodone, tramadol

Talk to your doctor before using traMADol together with traZODone. Combining these medications can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, blurred vision, muscle spasm or stiffness, tremor, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should contact your doctor immediately if you experience these symptoms while taking the medications. Using traMADol with traZODone may also increase the risk of seizures not related to the serotonin syndrome. The interaction may be more likely if you are elderly, undergoing alcohol or drug withdrawal, have a history of seizures, or have a condition affecting the central nervous system such as a brain tumor or head trauma. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Major phentermine  tramadol

Applies to: phentermine, tramadol

TraMADol may cause seizures, and combining it with other medications that can also cause seizures such as phentermine may increase that risk. The interaction may be more likely if you are elderly, undergoing alcohol or drug withdrawal, have a history of seizures, or have a condition affecting the central nervous system such as a brain tumor or head trauma. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

No other interactions were found between your selected drugs.
Note: this does not necessarily mean no interactions exist. ALWAYS consult with your doctor or pharmacist.

Other drugs that your selected drugs interact with

• phentermine interacts with more than 100 other drugs.
• tramadol interacts with more than 300 other drugs.
• trazodone interacts with more than 500 other drugs.

Interactions between your selected drugs and food

Moderate trazodone  food

Applies to: trazodone

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

Moderate phentermine  food

Applies to: phentermine

Using phentermine with alcohol can increase the risk of cardiovascular side effects such as increased heart rate, chest pain, or blood pressure changes. In addition, you may also be more likely to experience nervous system side effects such as dizziness, drowsiness, depression, and difficulty concentrating. You should avoid or limit the use of alcohol while being treated with phentermine. Do not use more than the recommended dose of phentermine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medication without first talking to your doctor.

Switch to professional interaction data

Moderate tramadol  food

Applies to: tramadol

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication Stimulants

Therapeutic duplication

The recommended maximum number of medicines in the 'stimulants' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'stimulants' category:

• phentermine

Note: The benefits of taking this combination of medicines may outweigh any risks associated with therapeutic duplication. This information does not take the place of talking to your doctor. Always check with your healthcare provider to determine if any adjustments to your medications are needed.

    

[KLA324]

KarenB - what a nice and thoughtful post! Thank you...your kindness and advice warms my heart. I do love my Cocker Spaniels, Tucker and Ella. They have been very worried about me and do not leave my side. I don't know what I would do without them right now. 

 

I will definitely try the magnesium and will post if it is helpful. 

 

Thank God for this forum and people (like you) who care. 

 

Karen 

[KLA324]

Marie - I am touched that you took time out of your day to post. So many strangers willing to help me thru this---that is more than my own family is willing to do for me at this point. 

 

I am trying to be gentle to myself and accept that this may be a long road. Tonight I made myself go to dinner with a neighbor who I just met (I haven't lived in my house long). It was a welcome distraction although I had a difficult time making conversation and staying on topic. My once sharp mind kept wandering and losing focus. I can only pray this is temporary.

 

Now I am back on my couch, cuddling my puppies, and hoping that I am able to sleep for longer than a few hours. 

[KLA324]

JanCarol - I am definitely taking your advice. I disposed of all prior drugs and now only have the Xanax and Celexa on hand. Today I stood strong (despite an anxiety attack mid-afternoon) and did not take Xanax. I did takem10mg of the 20mg prescribed of the Celexa. That is all I have taken today. To help me sleep I am going to take 2 "Simply Sleep" tablets and pray that they relax me enough to get at least a few hours sleep. 

 

One question I do have---can anyone tell me why I awake each day with a sense of dread and anxiety? I don't have a memory of a bad dream but I awake in almost a panic and am almost fearful to get up. I really have to FIGHT to make myself get out of bed. 

 

Hugs to you,

Karen

[Altostrata]

You've been on citalopram only since Oct 15. It takes at least 4 days for a drug change to register in your system. Then, it's likely it will take some time, maybe months, for your nervous system to settle down (if the citalopram is effective in compensating for whatever withdrawal syndrome you might have).

 

I haven't the faintest idea what to suggest to you, other than DO NOT skip doses of citalopram, take it at the same time each day, and take Xanax at the lowest possible dose (maybe cut up a tablet) as infrequently as possible.

 

Please consider that adding or switching to additional neuroactive drugs may exacerbate your nervous system instability.

 

Once your nervous system is stabilized, you might consider tapering off citalopram.

 

See What is withdrawal syndrome?
 
The Windows and Waves Pattern of Stabilization

 

Early-morning waking with panic or anxiety

 

and other topics in the Symptoms and Self-care forum  http://survivingantidepressants.org/index.php?/forum/8-symptoms-and-self-care/

 

Please let us know how you're doing.

[KLA324]

Alto -

 

Thank you for writing me. Today has been very hard for me. I woke up with very jittery insides which is a new symptom for me. I drank some Chamomille Tea and ate some almonds and it calmed me a bit. Since then I have been crying for no reason and the negative thoughts and depression have incapacitated me all day. 

 

I wanted to ask (anyone who has time to reply)...the doctor gave me 20mg of Citalopram but I am only taking 10mg. Today is Day 5. Is that wise or do I take the entire dose and stabilize? I am just so afraid of taking too much and then taking longer to wean off.

 

I did have to take a small sliver of Xanax awhile ago (less than 1/4 of a 0.5mg tab) but I am trying to stay off the Xanax as much as possible. 

 

I am thinking of all of you and praying for recovery,

Karen

[marie123]

If it were me I would stay with the 10 mg Citalopram and stay there for some time. If I read correctly you just started this dose of Citalopram Oct. 15, correct? You have gone through a lot of med changes lately and your central nervous system needs to calm down. Also, any time you start a new med it takes time to get used to it (possibly a month or more) and you'll feel it's side effects until then.

 

So do not make more med changes unless you must. See how you feel a month from now, I think you'll see improvement.

[KLA324]

Thank you, Marie.

 

Update - today is my 1st day back to work. I am very shaky and am afraid people can see there is something wrong. I won't be able to talk or even tell them (or should I?) without crying. It is obvious something is not right as I have lost 30 lbs in that past 2 weeks or so.

 

I still have not taken any Xanax since Wed, 10/15 (same day I got the scrip). I was able to sleep 6 hours last night but not a restful sleep.

 

I am sorry I have not been to more of your pages to post and I promise to do so as I believe in paying it forward.

 

Thank you all,

Karen

[Petunia]

Hi Karen,

Well done for being able to get back to work. I don't think you need to tell your co-workers details of what you are going through, unless you feel comfortable doing so, I think most people understand that illness can be a personal issue and not everyone wants to talk about it.

 

Hopefully, you will start to feel better soon. I agree with sticking with the 10mg, don't make any more changes for now. I just want to emphasize a few points that Alto made:

 

 

You've been on citalopram only since Oct 15. It takes at least 4 days for a drug change to register in your system. Then, it's likely it will take some time, maybe months, for your nervous system to settle down (if the citalopram is effective in compensating for whatever withdrawal syndrome you might have).

 

DO NOT skip doses of citalopram, take it at the same time each day, and take Xanax at the lowest possible dose (maybe cut up a tablet) as infrequently as possible.

 

 

Read through the links she posted a few times, it will help you understand what to expect and may answer any questions you have.

 

No need to apologize for not supporting others at the moment, when you start to feel better, I'm sure you will, we have to take care of ourselves first before we can help others.

 

Petunia.

[KarenB]

II've found it really helpful to have a short reply ready for people I don't know well, something like  'yeah I've had some stuff going on, but it's starting to work out now.'  Most people are satisfied with that, and don't feel compelled to share their wisdoms because you've indicated it's getting sorted out.   

[KLA324]

Thanks, Petunia. I did read thru all that Alto sent to me and it all makes sense. I'm still waiting for an improvement. By the end of yesterday (once I went home and ate) I was experiencing what I thought was an improvement. I had difficulties falling asleep and then at 12:12AM the gas company called and woke me up! I struggled to fall back asleep and today I am feeling even more foggy. 

 

So today is Day 7 of starting the Celexa (still resisting taking any Xanax). I don't know how to explain what I am feeling---it's like a spacey, almost out-of-body existence. Like I can hear myself talking and I know it's me but almost like I am an observer? Has anyone else had that reaction after reinstating a new med?

 

Thank you for the advice on how to deal at work, Karen. For the most part I am staying at my desk and trying to concentrate (difficult) and not interact with too many people. I've lost SO much weight that I know people are "talking". 

 

But one good thing...I actually ate last night and when I got up and weighed today I had gained a lb! 

 

Hope all is well with each of your recovery.

 

Karen

[KLA324]

Not a good day. I am taking the Celexa in the morning and I wonder if that's the right way? I am so sleepy during the day that I am almost dozing off at my desk. Can anyone advise me? I am home today instead of going to my office. I just want to curl up in a ball and do nothing. It doesn't help that it is cold and rainy here - the weather reflects my mood.

[Martina23]

Hello Karen, thank you for your writing on my thread. It reassured me a bit, even if I dont know how my withdrawal will continue, hopefully it doesnt go worse. I read that your daughter also got twins. I have also twins. Now almost 3 years old. I am sorry that you feel alone. But at least you have two dogs. It is also a company. I always wanted a dog but now with two children it would be too much for me. There is some nice film in the TV with Liza Minelli, and luckily enough the alien thoughts are away. Hope you are feeling ok, Martina

[Martina23]

Actually I like very much the name Karen, this woman in film Out of Africa had also name Karen, I liked the film very much.

[KLA324]

Thank you for your nice notes, Martina. Yes, my daughter has twin girls who are 4. They lived with me for over 2 years and are the loves of my life. Sadly my daughter is not speaking to me as she doesn't understand what I am dealing with but she did allow the twins to call me last night. They only live 10 mins. from me so it is hard for me not to go see them but I don't want to cry and upset them so I won't go to see them.

 

You sound like a wonderful mother and, if I can say, I am very proud of how you are taking care of them alone. With all that you are going through with the WD - not many people would be that strong.

 

Thank you for the comment on my name.

 

Warm hugs to you,

Karen

[Altostrata]

Some people prefer to take Celexa at night because it makes them sleepy. You might gradually move it to the nighttime by taking it an hour or so later every day.

[KLA324]

Thank you, Alto. I will try doing as you suggest.

 

Another question...the only reason I have felt comfortable to take Simply Sleep at night is because I am not taking anything else at that time (drinking Chamomile Tea).

 

When I am able to move my Celexa intake to bedtime, is it safe to also take Simply Sleep/another OTC sleep aid?

 

Thank you,

 

Karen

[Altostrata]

You may not wish to take another sleep aid.

 

I'm not familiar with Simply Sleep, link please.

[KLA324]

Alto -

 

Here is the link:

 

https://www.tylenol.com/products/simply-sleep-caplet

 

Thank you,

Karen

[brassmonkey]

It's an overpriced form of benadryl.  The house brand of antihistamine containing Diphenhydramine HCl 25 mg in each caplet is just as effective and costs a whole lot less.

[KLA324]

Thanks, BrassMonkey. I hope to not take it too long.

 

Alto - I saw some posts on here about a Dr Mark Foster. Do you know whatever became of his work with trying to help with AD WD? I ask because it turns out his office is 5 mins from me.

[KLA324]

Since hitting a wall 3 days after going CT from Trazodone and Phentermine (and about 3 months off Zoloft) I have had constant anxiety, depression and tears out of nowhere.

 

Today, Day #8 of my reinstatement to 20mg of Citalopram, I think I had a small window. I was able to eat, my anxiety was manageable, and my head actually felt like it belonged to me and was on my body - instead of me being in some sort of dreamlike state. It's made working very difficult and so many people keep commenting that I'm not myself, that I almost want to scream. I know they are trying to be nice but honestly, it takes so much energy just to engage with them and I just don't have it in me.

 

What I would like to know is, how long should I wait to start a 10% drop?

 

I return to my GP on Monday. The only reason I am returning is to get the results of all the bloodwork I had done - thyroid, hormones, CBC, Vit D---they did a bunch. Honestly I would love to find out this all has to do with my thyroid or hormones being out of whack but I don't think I will be that lucky. Therefore I plan to get all my results and to then find a new doc who will not just hand out drugs like candy. It may take awhile but I am sure they're out there.

 

I pray you can all find a bit of peace and relaxation wherever you are,

Karen

[Martina23]

Dear Karen, you are also so much brave that you were able to stop taking three meds. I really hope that you will have more luck with symptoms like me. I had it always much more difficult with dependancies, I was not able to stop smoking until I was pregnant. I was thinking about to check my iron values, I was always "bloodarm" (I dont know if it is the right English word) and too less iron can cause also mental problems. Maybe you could check your iron values too. My son is too hyperactive and together with obsessive violent thoughts I feel sometimes that it is too much. How are your two dogs? Which race do you have? I like newfoundland dog and labrador and deutscher schaeferhund (I know only German word of that dog). And I like also Dalmatines. We have at home a lot of stories about 100 Dalmatines and Cruella. The children like it very much.

[KLA324]

Thank you for your kind words, Martina. Today has started bad and I am trying to be kind to myself by staying home to work. When I woke up at 6am my stomach was upset and I was very shaky and my head started spinning when I stood up. I went back to bed and it seems to have passed.

 

My dogs are Cocker Spaniels. That is one of them in my profile pic - Tucker. He is 8 yrs old and a real sweetie. My other Cocker, Ella, is 2 yrs old. They are both rather small at about 20 lbs each.

 

I am having a tough time rationalizing what these drugs have done to me. Until my current dr. started me on this drug cocktail, I rarely took anything. Even when I started on my 1st round of AD's in 1999, once I felt better I just quit them and had no WD. Even when this dr. started me on AD in 2013 and added a sleep aid, I never had a reaction when starting or stopping. It wasn't until I had stopped taking the Trazodone for sleep and the Phentermine (which I was only on for a 2 week period) that I had this severe WD - which I now know was a delayed WD from stopping Zoloft months prior.

 

I feel like a failure that, to correct what I've done to myself, I've had to start taking Citalopram. Yes, it has stabilized my mood. I haven't cried in 3 days and I have not taken the Xanax I was given (except one day) so I feel my anxiety is under control. But now I will have to wean off this drug! My head feels strange on this drug - I hate it.

 

Karen

[apace41]

 

I am having a tough time rationalizing what these drugs have done to me. Until my current dr. started me on this drug cocktail, I rarely took anything. Even when I started on my 1st round of AD's in 1999, once I felt better I just quit them and had no WD. Even when this dr. started me on AD in 2013 and added a sleep aid, I never had a reaction when starting or stopping. It wasn't until I had stopped taking the Trazodone for sleep and the Phentermine (which I was only on for a 2 week period) that I had this severe WD - which I now know was a delayed WD from stopping Zoloft months prior.

 

I feel like a failure that, to correct what I've done to myself, I've had to start taking Citalopram. Yes, it has stabilized my mood. I haven't cried in 3 days and I have not taken the Xanax I was given (except one day) so I feel my anxiety is under control. But now I will have to wean off this drug! My head feels strange on this drug - I hate it.

 

 

Karen,

 

Hi, and welcome to SA.  First and foremost, it is essential that you not beat yourself up over how you got to where you are.  The beauty of this site is that you are among a group of people who all understand and are in substantially similar places to the one you find yourself in.  Withdrawing from psychoactive drugs is hard work and there will be plenty of ups and downs.  If you are good to yourself, have self-compassion and take the time to truly care for yourself, you can come out on the other side a stronger, healthier person.  We have all, to some degree or another, been failed by the medical establishment and it is probably emotionally healthier to cast your blame in that direction than at yourself. 

 

Morning spikes in cortisol and heightened levels of anxiety are a very common complaint.  Many speak of "waking with terror" but over time it will ease and you will feel better.  How much time?  It is very individual and hard to predict.

 

You ask about how long to wait until you start your taper.  One of the things we tend to suffer with as part of this process is the desire to "get the drugs out of our systems."  In this regard, understanding the process is critical.  Perhaps the single best explanation of all of this is from our mod/friend/inspiration Rhi, who wrote:

 

Rhi on how drugs change our brains/regowing a new brain through tapering

 

A lot of people, including healthcare practitioners; in fact, I guess, most people-- are operating from entirely the wrong paradigm, or way of thinking, about these meds. They're thinking of them like aspirin--as something that has an effect when it's in your system, and then when it gets out of your system the effect goes away.

That's not what happens with medications that alter neurotransmitter function, we are learning.

 

What happens when you change the chemistry of the brain is, the brain adjusts its chemistry and structure to try to return to homeostasis, or biochemical and functional balance. It tries to restabilize the chemistry. 

 

For example: SSRI antidepressants work as "serotonin reuptake inhibitors." That is, they cause serotonin to remain in the space between neurons, rather than being taken back up into the cells to be re-used, like it would be in a normal healthy nondrugged brain.

 

So the brain, which wants to re-establish normal signaling and function, adapts to the higher level of serotonin between neurons (in the "synapse", the space between neurons where signals get passed along). It does this by removing serotonin receptors, so that the signal is reduced and changed to something closer to normal. It also decreases the amount of serotonin it produces overall. 

 

To do that, genes have to be turned on and off; new proteins have to be made; whole cascades of chemical reactions have to be changed, which means turning on and off OTHER genes; cells are destroyed, new cells are made; in other words, a complex physiologic remodeling takes place. This takes place over time. The brain does not grow and change rapidly. 

 

This is a vast oversimplification of the amount of adaptation that takes place in the brain when we change its normal chemistry, but that's the principle.

 

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay.

 

When the drug is removed, the remodeling process has to take place in reverse.

 

SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. 

 

It's a matter of, as I describe it, having to grow a new brain. 

 

I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long. 

 

With multiple drugs and a history of drug changes and cold turkeys, all of this becomes even more complicated. And if a person is started on these kinds of drugs at an early age before the brain has ever completely established normal mature functioning--well, it can't be good. (All of which is why I recommend an extremely slow taper particularly to anyone with a multiple drug history, a history of many years on meds, a history of past cold turkeys or frequent med changes, and a history of being put on drugs at a young age.)

 

This isn't intended to scare people, but hopefully to give you some idea of what's happening, and to help you respect and understand the process so you can work with it; ALSO, because you are likely to encounter many, many people who still believe these drugs work kind of like aspirin, or a glass of wine, and all you need to do is stop and get it out of your system. 

 

Now you can explain to them that no, getting it out of your system is not the issue; the issue is, you need to regrow or at least remodel your brain. This is a long, slow, very poorly understood process, and it needs to be respected. 

 

So the key is to allow for the healing and not rush to try to "get off the meds."  To do this you need to be able to live within your own skin as all this is happening.  Time with your dogs, time for walks, exercise, music, whatever resonates for you will allow you to do this.

 

Once you are feeling more stable and less like you don't know what each day will bring, you will be ready to start a taper and there are plenty of people here who will be happy to help.  Slow and steady is the key.  Get as stable as you can so you can stay ahead of the curve as you work your way down.

 

We are all here for you, Karen.

 

Hang in there and congratulate yourself for starting this journey.

 

Andy

​

[KLA324]

Thank you, Andy. I know this will take time and I try to remind myself of that daily. However, in times of stress, I lose that focus.

 

Every little new twinge or slight pain that comes up I am over-analyzing. I feel very fortunate that I have not suffered a lot of the symptoms that many on here have...no brain zaps, migraines, etc. - but I worry about that daily. I must keep focusing on what "may" happen in my RI/WD journey and focus instead of what "is" happening. Otherwise I am going to make myself crazy.

 

Karen