Christian: Reinstatement Question

[Christian]

I haven't drank alcohol in two months. the thought of it in my condition makes me ill. 

 

12 MG Ambien, 5 MG Lexapro, 5 MG Melatonin before bed. 1-2 times a week I might add a .25 MG Xanax. Either before bed or when I wake up at 3 AM. I wake up like clockwork after 3 hours for one month straight. If I get 1-2 more hours after that Ill be lucky. 5 hours a night split into two with maybe an hour gap in between trying to get back to sleep.    

 

  

Drug List: My+Drug+List Email | Print | Saved Save | New list Ambien CR (zolpidem) Lexapro (escitalopram) Melatonin Time Release (melatonin) Xanax (alprazolam)

 

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Interactions between your selected drugs

Moderate alprazolam zolpidem

Applies to: Xanax (alprazolam), Ambien CR (zolpidem)

Using ALPRAZolam together with zolpidem may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as 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

Moderate alprazolam escitalopram

Applies to: Xanax (alprazolam), Lexapro (escitalopram)

Using ALPRAZolam together with escitalopram may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as 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

Moderate zolpidem escitalopram

Applies to: Ambien CR (zolpidem), Lexapro (escitalopram)

Using zolpidem together with escitalopram may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as 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

Minor alprazolam melatonin

Applies to: Xanax (alprazolam), Melatonin Time Release (melatonin)

Consumer information for this minor interaction is not currently available. Some minor drug interactions may not be clinically relevant in all patients. Minor drug interactions do not usually cause harm or require a change in therapy. However, your healthcare provider can determine if adjustments to your medications are needed.

For clinical details see professional interaction data.

Minor zolpidem melatonin

Applies to: Ambien CR (zolpidem), Melatonin Time Release (melatonin)

Consumer information for this minor interaction is not currently available. Some minor drug interactions may not be clinically relevant in all patients. Minor drug interactions do not usually cause harm or require a change in therapy. However, your healthcare provider can determine if adjustments to your medications are needed.

For clinical details see professional interaction data.

[Altostrata]

What drugs are you taking for hyponatremia? That's a serious condition.

 

As you can see, the combination of Ambien and Xanax may contribute to your difficulty concentrating, How often do you take them, what time of day, and for how long?

[Christian]

I only take Ambien at night and Xanax with it 1-2 times a week. The low sodium I was taking Lasix but stopped that last week cause I was urinating too much. The lack on concentration, anxiety and insomnia set it 12/24. 3 weeks after I stopped the 8 day Lexapro trial which. In those 3 weeks I was blood tested for everything and the most alarming issue was highl cortisol and high ACTH. Yes, Cushings was suspected but the follow up tests show it's not that but I have a doctor an Endo appointment to discuss further. Based on what I've read here that this is a typical direction doctors go with withdrawal symptoms. I highly doubt I have Cushings. I just am exhausted with stress. I'm sure the tests would be worse now!

[Altostrata]

What is your daily symptom pattern? Please keep notes on paper.

[Christian]

Sorry.

6:30 am wake up (if I'm able to sleep that late). anxiety yet tired. Dizzy and light headed. Breakfast then work.

 

11 AM become even more exhausted.

 

Noon-5 PM: anxiety and exhaustion

 

6-10 pm- 2nd wind. But Go to bed at 10 pm regardless. Nightly Rituals of chamomile tea and Epsom salt baths prior from 9-10 pm roughly.

[Altostrata]

At what times do you take your drugs? Is your anxiety in waves? What do you mean by second wind?

[Christian]

I take them before bed at 10 pm. My anxiety is constant but peaks in AM and evening I would say. Bedtime scares me cause I know what's in store. AM I wake up and pray when I get up I'll be normal again. It comes crashing down Everytime. I am sure restarting Lexapro causes a lot of it. Headaches and some dizziness as this rebuilds into my system.

[Christian]

Sorry 2nd wind means I'm more awake.

[Christian]

Marmite,

Thanks for your reply. No way I haven't had any alcohol for two months. It's really not anything my body can even tolerate right now. When I drank it was a couple times a week but several drinks. But only at night. It wasn't a problem to quit. I didn't feel withdrawals from it. I did it more out of boredom This protracted Lexapro WD has also made it impossible to even consider drinking again. Eating food is a challenge to digest let alone booze.

[Altostrata]

Christian, I need the times of day with your drug and symptom pattern.

 

You seem prone to catastrophizing. You must learn to manage this tendency to deal with withdrawal, not to mention your medical condition.

[Christian]

Understood but hard not to.

 

I have non stop anxiety. I can look at my laptop and do some work. Some times with headaches sometimes without. Concentration is always an issue. I've been mostly preoccupied with my condition.

 

I am up out of bed by 6:30 AM. No drugs

 

11 AM I usually get very tired but can't nap.

 

Noon- anxiety a little better but still tired.

 

After 5 pm. I feel more energized. This lasts all night.

 

9pm- ritual of salt bath, Ashwaganda dose, chamomile tea to unwind

 

10:30 pm- lights out. I take a Melstonin, Ambien and maybe Tylenol for headache.

 

2:30 AM- wake up. Usually to wired to go back to sleep. Usually take a .25 Xanax or Librium to get back to sleep. However last two nights I had to take an Ambien 12.5 mg in addition.

 

Wake up at 6 am usually. No drugs until bedtime

[Christian]

I must add that Ambien puts me to sleep within 30 minutes. But never more than 2 1-2 hours. With usually a 1-2 hour gap inbetween going to sleep again. Then 2 1-2 hours sleep. Total 5 hours of sleep a night split up but need meds to fall asleep both times. I don't take any drugs until bedtime.

[Christian]

I will add that social interaction is challenging. Going to a store causes more anxiety.

[Christian]

Hello again,

I wanted to first say that I appreciate all of your comments and suggestions. I do have one question I've been kicking around. If you recall, I was on Lexapro 10 MG for 15 years quitting CT in June/July 2015. I had WD symptoms now that I think back. Dizziness, etc. not a lot of anxiety at all. Some maybe. I reinstated 5 MG end of November only because I Wanted to be in the right mind set stress wise for a new job I was supposed to start. The side effects (foggy, dizzy, headaches, slightly increased anxiety) made me nervous but pressed on. I increased the dose to 10 MGS after one week per my Dr. The symptoms intensified. I quit taking them. Three weeks of dizziness and headaches then the 12/24 episode with the beginning of high anxiety and insomnia which still persists. I reinstated 1/1 and can't tell it it's improving. More than likely the same. Is there a possibility this is an "adverse effect" vs protracted WD? When do I make the determination that the reinstatement is just delaying the the healing process? I know most will say two weeks isn't enough time. I know the quickest way to repairing my condition is reinstatement. But there is a chance it also won't work.

[Altostrata]

No one can predict the future. We don't know if it will "work." You will need to manage your anxiety until you get more data from your experience.

 

If you don't have obvious adverse effects from 5mg, why is it a problem to give it more time?

 

Keeping notes on paper about your drugs, dosages, and daily symptom pattern helps identify whether symptoms are from a drug. When do you get headaches? Are they at the same time each day?

 

When is it you take 5mg Lexapro? How often do you take Xanax, Librium, and Ambien? At what dosages? How much melatonin? Do you take anything else? All of these details are important.

[Christian]

Thanks. I know you have a lot of posts to get through but I answered these last night on this post if you need more detail.

 

I have non stop anxiety (little less at night for some reason but still wired). A headache is pretty non stop. I'm used to it. Little dizzy when I get stressed. Leaving my house or taking to people stress me out big time. Concentration is hard as TV is hard to follow. I feel obsessive feelings as I'm googling my situation frequently looking for answers. I've lost 10 lbs in a month. No appetite. Below are the meds.

 

Lexapro 5 MGS at bedtime

 

Ambien 12.5 MGS at bedtime (1-2 a week another tablet to get back to sleep when I wake up at 230 am).

 

Xanax every other night to help me get to sleep after waking up at 2:30 am

 

Melatonin 5 mgs every night at bed

 

No meds all day until bed time. Maybe Tylenol for headaches

 

Does this help?

[Altostrata]

Great. Now what I would like to see is more like a diary, instead of a schedule, with the drug times and doses interleaved with whatever symptoms you experience throughout the day.

 

This is why I keep saying "keep notes on paper." There may be variations in your symptoms that are not revealed by the high-level schedule you've given us.

 

Has the symptom pattern varied at all since you reinstated Lexapro? Do you have different symptoms the days after you take Xanax? After you take Librium?

 

You see, I need much more detail from notes you keep each day, rather than what you recall happened.

 

How long have you been taking 5mg melatonin, how did you arrive at 5mg as your dosage?

[Christian]

Ok. I'll try the diary method. I read somewhere that most people take too much melatonin. I think you said that it can over stimulate and cause sleeping problems. I used to take 10 MGS. But now only 5 since what I've read. In October and November all I used was Melstonin w/o sleeping pills best Sleep I had in years. Sometimes only 5 MGS or sometimes 10. Now just 5 MGS.

[Altostrata]

Why do you take Lexapro at night, does it make you sleepy?

[Christian]

It used to make me sleepy when I first started taking it. Now I think it's over stimulating like I did when I tried it last month. But I read it does that the first few weeks upon starting. I tried it in the AM the first week and switched to bed time last week. I only did it to see if daytime anxiety improved and or remained the same. Come to think of it. It seems that around the time I switched it to night time I no longer can get back to sleep on my own when I wake up at 2:30 am. I need another sleeping pill as I'm wired. Any suggestions to this ? Split the pill up and take 1/2 at night and 1/2 in the am? The entire pill in the AM? I see a psych next week. Any prediction on when I tell him my symptoms what he will suggest? Another SSRI ? remeron? Increase in Lexapro dose ? I need to be strong and manage the anxiety I know.

[KarenB]

Just wanted to send you some encouragement Christian - it's a hard phase you're in right now, but luckily you have Alto on the job .  Just keep going, make the notes, see what conclusions you can make from them.  A plan will start to emerge.  The important thing is not to panic at this stage. 

 

One day at a time...

Karen

[Christian]

Thank you Karen. I know you have had a tough stretch. I hope things are better with you. This situation can make someone so self absorbed with their own pain that they forget that the audience they are complaining to are struggling as well. My apologies to all.

[Altostrata]

It is very unlikely the psychiatrist will know anything about tapering, withdrawal, or reinstatement.

 

He will most likely offer another drug or drugs.

 

Yes, it sounds like Lexapro at night might be affecting your sleep. To test this, gradually move it an hour or so earlier each day until you get to, say, noon, and make notes of your reaction.

[KarenB]

No need to apologise!  You're doing great - read anybody's thread from the start and you'll see how we've all been in the same boat of needing reassurance.  

[Christian]

Hi Alto,

I understand you want a diary. I will do that. In the meantime here is a snapshot of everything including symptoms and what that is going into my system on one post vs going through multiple posts. My apologies for lack of clarity in prior posts.

 

Symptoms

 

Anxiety-constant

Social interaction fear-constant

Headache-constant

Internal restlessness-constant- not physical but I do feel better when I get up and do something

Obsession with my health-constant

Dizziness- some of the time

Constipation- most of the time

Insomnia- constant

Poor Concentration- constant- can read but conversations and TV are challenging and uncomfortable

Fatigue- insomnia related I'm sure.

No appetite- lost 12 lbs in 40 days. Force meals.

 

Sleep pattern- bedtime 10-10:30. Fall asleep at 11-1130 pm. Wake up at 2-230 am. Take a 2nd Ambien (only last 2 nights) and fall asleep at 3:30am. Wake back up at 5-6 am.

 

Meds

Lexapro-5 MGS/ bedtime dose

Ambien-12 MGS/bedtime dose

Xanax-.25 dose 1-2 times a week bedtime

Librium- 25 MGS-1 time per week at bedtime instead of Xanax

Melatonin- 5 MGS bedtime dose

 

Supplements-

Multi vitamin-morning

Magnesium- night

Ashwaganda-night

Fish oil- after meals

Seriphos- after dinner and bed time

Itosinol-15 g daily

[Christian]

So I want to report back to everyone. I saw a psych today. As Alto predicted she wants to change me to Paxil. My symptoms of severe anxiety, insomnia, headaches, social nervousness, weak concentration are better suited for a less stimulating drug like Paxil. Does not think Lexapro and I work well together based on my lack of improvement in the 3 weeks plus the "adverse effects" of them every time I take them now. SSRIs should not give such significant headaches and dizziness whenever I take it she said. She said I emotionally crashed 3 weeks after quitting lex in December because of extreme fear of my health. Going on line she said contributed to my anxiety. Please know I'm only reporting back to you not aggreeing with her. She suggested that I have Lexapro poopout. She had hundreds of patients including herself that has been in the same boat and crawled out by switching. She also said that a swap vs tapering Lex is all that is needed. Folks, I've been in bed now for 4 weeks now including the last 3 weeks reinstating. My head pressure is intense, I'm useless in the AM. I'm going on 3 hours sleep a night. Plus this anxiety. I can manage leaving the house a couple times a week but I'm mostly in bed in a daze. I know many of you may be worse and I'm sorry. I'm trying to now find the quickest path out of this as I need to hop on airplanes for my job. The thought of that makes me sick in my current state. Please provide any feedback. I know what it might be. Please know I think this is a great group and cause and appreciate all of you.

Lastly, I am going to see a Psychologist to work on some none med ways to fix my anxiety and constant worry.

[Christian]

I have searched everywhere online and I have yet to see a succesful reinstatement after 6 months. 4 yes. But now I think about it Lexapro was pooping out in me when I quit it CT in June. I was getting headaches and dizziness prior to June and after when I quit. They all went away in the fall. When I was off it for months.

[Christian]

I'll hold off until I get some feedback.

[Altostrata]

It used to make me sleepy when I first started taking it. Now I think it's over stimulating like I did when I tried it last month. But I read it does that the first few weeks upon starting. I tried it in the AM the first week and switched to bed time last week. I only did it to see if daytime anxiety improved and or remained the same. Come to think of it. It seems that around the time I switched it to night time I no longer can get back to sleep on my own when I wake up at 2:30 am. I need another sleeping pill as I'm wired. Any suggestions to this ? Split the pill up and take 1/2 at night and 1/2 in the am? The entire pill in the AM? I see a psych next week. Any prediction on when I tell him my symptoms what he will suggest? Another SSRI ? remeron? Increase in Lexapro dose ? I need to be strong and manage the anxiety I know.

 

It is very unlikely the psychiatrist will know anything about tapering, withdrawal, or reinstatement.

 

He will most likely offer another drug or drugs.

 

Yes, it sounds like Lexapro at night might be affecting your sleep. To test this, gradually move it an hour or so earlier each day until you get to, say, noon, and make notes of your reaction.

 

Have you considered the above?

 

What do you mean when you say you get a headache every time you take Lexapro? Your notes above say your headache is constant. Which is it?

 

That doctor knows nothing about withdrawal syndrome. She also failed to observe that rebound from the benzos you take at night may be causing you anxiety during the day.

 

She is right about your health anxiety. This is interfering with your ability to understand and manage your situation. If you do not feel you can manage it -- this means staying calm and doing things systematically -- perhaps you should let a doctor make the decisions for you. We cannot do that for you here.

[Christian]

I know I can be annoying. My apologies it's not intentional. I have had a headache since the first day I took Lexapro for that one week 5 MG reinstatement in late November. It never went away and got worse when I stopped than I went through all the dizziness that still persist. It may have happened when I jumped to to 10 MGS the last two days of that trial that drove me to stop. I have been doing As you suggest with the lex dose and I got less sleep last night. I took it at 8 pm. Not sure if that played into it. No benzo's for two days but two Ambien at 12.5 mg now trying to sleep. Could that be giving me extra anxiety and headaches ? All I know is it's been 3 weeks and I'm still the same. Maybe worse. I have read where folks snap out of it in about 3 weeks or improve somewhat. I haven't seen it.

[Altostrata]

There is no pattern for "snap out of it."

 

5mg Lexapro might be too much for you. You may wish to try 4mg and see if things change any. Don't move the time around when you change dosage -- change only one thing at a time.

 

Your sleeplessness last night might be because you did not take a benzo. How often have you been taking a benzo in the last week, which benzo, and at what dosage? For accuracy, please refer to the notes you've been keeping.

 

My intuition is that your use of benzos and Ambien is contributing to your symptoms.

[downtongirl]

Hi Alto,

I understand you want a diary. I will do that. In the meantime here is a snapshot of everything including symptoms and what that is going into my system on one post vs going through multiple posts. My apologies for lack of clarity in prior posts.

 

Symptoms

 

Anxiety-constant

Social interaction fear-constant

Headache-constant

Internal restlessness-constant- not physical but I do feel better when I get up and do something

Obsession with my health-constant

Dizziness- some of the time

Constipation- most of the time

Insomnia- constant

Poor Concentration- constant- can read but conversations and TV are challenging and uncomfortable

Fatigue- insomnia related I'm sure.

No appetite- lost 12 lbs in 40 days. Force meals.

 

Sleep pattern- bedtime 10-10:30. Fall asleep at 11-1130 pm. Wake up at 2-230 am. Take a 2nd Ambien (only last 2 nights) and fall asleep at 3:30am. Wake back up at 5-6 am.

 

Meds

Lexapro-5 MGS/ bedtime dose

Ambien-12 MGS/bedtime dose

Xanax-.25 dose 1-2 times a week bedtime

Librium- 25 MGS-1 time per week at bedtime instead of Xanax

Melatonin- 5 MGS bedtime dose

 

Supplements-

Multi vitamin-morning

Magnesium- night

Ashwaganda-night

Fish oil- after meals

Seriphos- after dinner and bed time

Itosinol-15 g daily

 

Hello Christian!  I am so sorry you are having to go through this.  You and I seem to be in the same boat.  I am trying to reinstate prozac.  I too get more anxiety and restless energy beginning around suppertime.  I have not slept more than 2 hours since Sunday night.  I have been taking hydroxyzine to help sleep but it is not working.  I wish you the best!

[Christian]

Thank you. I hope your are right. I know it's a lot of info you are receiving but I only take a benzo 1-2 times a week. .25 of Xanax or a small dose of Librium and it's before bed with the 12.5 Ambien. The 2nd Ambien comes in now at 230 am when I get up. Each dose works only for 2 hours. Yes, that's bad as that's not a lot of sleep with a lot of a drug hangover to contend with the next day. So its contribution probably with possible headaches and concentration. I want you to know I rarely took any of these prior to my side effects of the early December Lexapro start up. I was booze and drug free. Only using Melstonin. What a mistake to go back to Lex was!

[Altostrata]

Christian, I need to know exactly what you have taken each day (drug, dosage, time) with the symptom pattern for each day (symptom, time) so I can see if there's any relationship between what you're taking and your symptoms. The way you're answering my questions, I have no idea what's causing what.

 

This is why I've asked several times for you to keep notes on paper. If you don't care to do this, I'm in the dark. You might as well let the doctor take her best guess.

[Christian]

ok

[Christian]

 

Hi Alto,

I understand you want a diary. I will do that. In the meantime here is a snapshot of everything including symptoms and what that is going into my system on one post vs going through multiple posts. My apologies for lack of clarity in prior posts.

 

Symptoms

 

Anxiety-constant

Social interaction fear-constant

Headache-constant

Internal restlessness-constant- not physical but I do feel better when I get up and do something

Obsession with my health-constant

Dizziness- some of the time

Constipation- most of the time

Insomnia- constant

Poor Concentration- constant- can read but conversations and TV are challenging and uncomfortable

Fatigue- insomnia related I'm sure.

No appetite- lost 12 lbs in 40 days. Force meals.

 

Sleep pattern- bedtime 10-10:30. Fall asleep at 11-1130 pm. Wake up at 2-230 am. Take a 2nd Ambien (only last 2 nights) and fall asleep at 3:30am. Wake back up at 5-6 am.

 

Meds

Lexapro-5 MGS/ bedtime dose

Ambien-12 MGS/bedtime dose

Xanax-.25 dose 1-2 times a week bedtime

Librium- 25 MGS-1 time per week at bedtime instead of Xanax

Melatonin- 5 MGS bedtime dose

 

Supplements-

Multi vitamin-morning

Magnesium- night

Ashwaganda-night

Fish oil- after meals

Seriphos- after dinner and bed time

Itosinol-15 g daily

Hello Christian! I am so sorry you are having to go through this. You and I seem to be in the same boat. I am trying to reinstate prozac. I too get more anxiety and restless energy beginning around suppertime. I have not slept more than 2 hours since Sunday night. I have been taking hydroxyzine to help sleep but it is not working. I wish you the best!