gn11: WD symptoms appearing at 5mg due to cortisol dysfunction after eye surgery

[gn11]

4:30 at a sandwich and potato salad

5:30 Dr's appointment

7:30-8:00  Lysine 1000 mg

Vitamin C 500 mg

[KarenB]

That was really helpful info you gathered there GN - thanks for taking the time to do that.  I agree with you that your anxiety and most of the dizziness is due to the early morning cortisol spike - this is common in w/d.  It also looks like being out and interacting with others tires you out quickly, causing further light-headedness.  In my more intense times of w/d I've had the same problem.  Even talking of the phone was too much for me, and I'd need to go lie down. 

 

I'm glad you mentioned that cup of tea, because caffeine can cause worsening symptoms - and you did seem to have a blip after that cup.  I've had to cut out caffeine completely.  Well, I can manage a little cocoa. 

 

It also looks like your symptoms have been a little improved each day.  It's seeming less like you are having adverse drug reactions, and more like your CNS has been taking it's time to settle.  What do you think? 

 

Keep taking notes though - it's incredibly helpful. 

 

Karen

[gn11]

Thanks for the support KarenB.

 

Yesterday my interactions were a killer. I had a hard time going to sleep an kept waking up. I finally was able to get more relaxed. Woke ups a little dizzy. I gave up coffee by cutting from 3 to 1 cup a day in a period of two to  three weeks.  I cut it altogether but started having black tea occasionally. I will cut that as well and stick to herbals. I got up a little dizzy today but no cortisol spike so far. I do have mild muscle spasms these days...wondering whether is the magnesium since I read something about that.

[Altostrata]

No, I'm not on cortisone drops, I stopped sometime in March. It was during this time that I started having all of the severe symptoms affecting my overall system, I do drops for glaucoma and one of them are beta blockers. I started closely tracking my symptoms after meds. I wiil do the drug interaction checker.

 

Here is today:

 

8:00 am woke up dizzy/nausea drank water

8:30 ate oatmeal, 1/2 banana and candied ginger for nausea, more water with about 100 mg of magnesium

9:00 took Lysine 1000 mg and Vitamin D 2000 mg

9:45 nausea began to subside

10:00 took 7.5 mg of Celexa (3.75 ml) ate half a banana. 1/2 cup of milk and some almond butter

10;30 much milder symptoms than yesterday mild palpitations and some increase in eye and mouth dryness. Dizziness much better at this point

11 am had black tea with cream and a glass of water at coffeehouse. Some mild discomfort (sinus pressure, light headness when talking)

1;30-2:30 light lunch and more talking

3:00 low energy;light headed; left friend's house

 

Seemed okay after I've been home for a while

 

rest of the day: I was okay for the most part in the afternoon!

 

5-6 Vitamin C and 1000 Lysine

6:30 dinnner

6:45 Dorzalamide

7:30 Meditation group

 

no reaction but slight dryness after eating...mild stomach upset

 

....Monday 27 am Morning Tracking

 

Slept well with darkened room

 

7;30 Woke up and drank water; no dizziness; normal cortisol; no anxiety

7:30 and 9:00 try to read in rooom but ket dozing off

9:00 ate oatmeal, milk, lysine; vitamin C, vitamin D

(9:00-9:30 cortisol spike while sitting in the computer in a room with more light

9:30 went to darkened room and meditated some; started to doze off; ate 1/3 banana with almond butter

10:00 took Celexa 7.5 (3.75 ml)

10 to 11: stay in darkened room; anxiety increased a little within an hour but not much more than cortisol spike earlier

12:00 cortisol decrease a little; some anxiety; getting ready to eat lunch.

 

Three days of observing more closely and the agitation seems to be related to cortisol in the morning; yesterday I was in a low and din't feel any agitation after meds.

Thank you for doing such a good job on your daily symptom notes. But when do you take dorzalamide (about 10 a.m.?) and latanoprost? Please include that dosing in your notes.

 

See these side effects for dorzalamide https://www.drugs.com/sfx/dorzolamide-ophthalmic-side-effects.html

 

Commonly reported side effects of dorzolamide ophthalmic include: eye pruritus, swelling of eye, eye discomfort, stinging of eyes, local ocular hypersensitivity reaction, superficial punctate keratitis, burning sensation of eyes, eye redness, eye irritation, and bitter taste. Other side effects include: lacrimation, xerophthalmia, blurred vision, and photophobia. See below for a comprehensive list of adverse effects.

Xerophthalmia is dryness of the eyes.

 

Side effects for latanoprost https://www.drugs.com/sfx/latanoprost-ophthalmic-side-effects.html

 

Please read the side effects -- also refer to the "Professional" tab on those pages -- and see if they apply to you.

 

It could be that light sensitivity brought on by the dorzolamide (and possibly exacerbated by withdrawal syndrome) is making you dizzy.

 

You might also be sensitized to the normal morning cortisol peak. See

 

Waking with panic or anxiety -- managing cortisol spikes

 

Light-sensitive? Try blocking out blue light: Your computer may be your problem

 

Also, you may find more magnesium is helpful. Many people do better with fish oil and magnesium supplements, see

http://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

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

 

Good to hear your doctor is concerned and open-minded.

 

[gn11]

6;30-7;30 woke up bu kept dozing off

 

7:30-8;45 felt somehow intense cortisol spike, practice deep breathing which helped some. Finally got out of bed

9:00  ate small amount of oatmeal w milk and 1 tbs of almond butter

9:00-9:30 took vitamin D 2000; Lysine 1000;  

9;30 to 1 sipping drinking magnesium with water  300

10:00  Med at same levl as yesterday

11:00 am moderately stressful conversation over the phone

12;15 lunch

 

Note: I used dark amber glasses with computer this morning and see if it helps. I didn't notice much of a difference.

 

My obsrvation again that anxiety and lows seed to be related to cortisol spikes or lows. Yesterday, I had no spike and ended ti up cycling somehow in the low range of intensity.  Lunch didn't sit well and I was spacey and low energy after that. Picked up energy later in the afernoon after meeting. Seemed to be balanced overnight. Medium cortisol this morning. mild to medium anxiety. Celexa seems to act accordingly how my cortisol level is in the morning. Slightly activating today but did't eat as much. Today is my 7 day on my exact liquid dose.

[Altostrata]

Good to hear you're finding ways to manage your light sensitivity. Perhaps you need to talk to your ophthalmologist about the glaucoma drug side effects.

 

Please include your drug dosing in your symptom report. Do you take one of your glaucoma drugs at the same time you take Celexa?

[gn11]

I have been inconsistent using the dorzalamide due to being anxious  about its effect .Sometimes  do it in the am sometimes the evening. I am supposed to do twice a day. I am going to try to be consistent starrting tomorrow so I can track the effect better. I know that I have dry eyes and mouth partially because of the eye drops. I will start tracking them better.

 

I have a had a pretty activated day today. Not sure why...

 

4 changes:

 

Not eating enough

oversleeping this morning

sleep apnea events

More magnesium

 

or maybe the long meetings yesterday

[gn11]

June 30th 

Cortisol was high most of the day yesterday. Slept poorly due to anxiety

6:30-7:00 woke up slightly dizzy

mild to moderate cortisol spike used dark glasse for a couple of hours. helped with spike

7:45-8:00 took lysine, vitamin D; cup of water with 100 magnesium ( experiemented with more yesterday and felt queasy)

8:30-9:00 breakfast oatmeal and almond butter

8:30 dorzolomide/timolol drop on righ eye; became slightly activated; increase of heart rate; dryness of mouth/sinus pressure

10:00 am Celexa  heart beat went up a little more

Had anxiety and grief most of the morning

12:00 Acupuncture

1;30 lunch

2:00 pm started feeling better and went back to work

6:30 Vitamin C; Lysine; snack

6:45 second drop of dorzolomide/timolol; slight reaction: increase heart beatand some sinus pressure

7:30 dinner

[gn11]

Update: I did the dorzolomide/timolol drop at 8: 30 this morning and noticed increase in heartbeat. It seems like one or tow of the components raises my heartbeat which  makes my coritsol symptoms. I will research the ingredients and try to get a hold of a doctor. I suspect that my dizziness could have been caused by my skipping the morning dose of the drop. There is probably some kind of withdrawal effect with this stuff as well.

 

Also, sleeping too much and having needles in my head in acupuncture seem to h activate me.

 

Gloria

[gn11]

I updated and made my signature more accurate and I am paying attention to my glaucoma drops. Something to share: Keeping my eys moist and my mouth also I seem to do better . I do a neti pot rinse most nights and use woodyknows nose contraption to help me breathe better.

[Altostrata]

Yes, I think you need to discuss side effects of the glaucoma drugs with a good ophthalmologist. Dorzolomide has a very long half-life; a dose during the day may very well be affecting your sleep and the next day, too.

 

It seems taking the Celexa might add to this effect.

 

If you find acupuncture activating, your practitioner is doing the wrong thing. (Acupuncture treatments for "depression" are often activating.) You need to discuss this with the acupuncturist and see if they have other ideas. If not, you'll need a different acupuncturist.

[gn11]

Thanks! I have discussed it with one of the two acupuncturist I  I see at the community clinic. Most of the time is fine. Yesterday I had a good session. I went today again with the other one and it was okay...not so good. I'll stick with the one that seems to be better for me.

[gn11]

BTW, I sleep pretty well. I wonder oif I take the Dorzolomide in the evening at all. Do you know if it has withdrawal symptoms. I'll talk to an ophthalmologist next week.

[Altostrata]

I doubt dorzolomide has withdrawal symptoms, but you might need to take it or another drug to control your glaucoma.

[gn11]

I will try to change to another drug ...meanwhile i'll take it once a day. I've been on different drops and surgery in my left eye to control pressure. That drug has timolol too which I think it's a pretty intense drug. Thanks for all of your time and good info!

[gn11]

On another topic: If I am having an increase in anxiety as I upped the celexa...would it be advisable  to cut down a bit...hesitant to do something like this and make it worse. 

[gn11]

My anxiety was bad yesterday into the night, This has been rare for me as I have felt better later in the day. Like I said before I'm afraid the dose is too high, Should I cut down slightly...really struggling today!

[AliG]

I think you have to " listen" , and if you feel it's too high cut back by a fraction and see if it helps. Only a small change , though .  You will possibly know fairly swiftly and then can start to " feel " your way through. Keep notes on your symptoms. Sometimes , you have to follow your intuition.

Ali

[gn11]

What with a fraction be? Less than 5 %

[AliG]

Yes. Sometimes it doesn't take much to make a difference. See how it goes.

[gn11]

Thanks! I think I'll do 4% and increase a little if i feel bad. Will this be too high for a microdose? If I have to increase do I wait a few days or I can do within a day?

[gn11]

I cut 4 % 7.50 mg to 7.20 ..having some heart palpitation after 40 minutess which I 've been having for a few days. I cut my am Dorzalamide to see if it helps. I had noticed that it was giving me palpitations This is the longest period of anxiety that I've had for a while

[Altostrata]

Why did you increase the Celexa?

[gn11]

I was stable at 5 mg. I had tried to withdraw December of 2014 after being in it for a year. I had a real hard time for the reasons I know now..too fast of a taper etc (lack of knowledge from my Dr's part).  My job is stressful and I stayed on it for a couple of other years and then I was told I needed eye surgery in my left eye because I was losing vision. I stayed on 5 mg through the surgery.

 

In March I started to have all kinds of problems: allergic reactions to all kinds of stuff, serious sinus problems, anxiety reactions, elevated cortisol. I did a lot of research as well as I had allergy testing with negative results. Meanwhile, I was doing my own research since none of the doctor's seemed to have a clue.  I was on a cortisone drop on my left eye longer that I should have been so I thought that this was the culprit. I  read about cortisol dysfunction and  realized I was experiencing that. This took me to research the relationship between  celexa and  cortisol thinking it could be a drug interaction.  I found a posting on this forum and I realized I had been in withdrawal...basically I had all of the symptoms. I joined and started getting some ideas.

 

My doctor had wanted me to increase my dose for anxiety  (she wanted to give me benzos and I said no). I had lots of symptoms!! tried to up to 10 mg and it was too intense and I went down to 5 again. I didn't realize this up and down was making things worse. I read about updosing but didn't know enough or had the tools to up-dose  to 6  mg ( didn't even know it was possible). I went to 7.5 and have been trying to stabilize there ...I have been having a hard time but people in the forum said to give it a try. I think is too much as I am sensitive to the drug and to a bunch of other things. I just made a micro-cut and stopped the daytime dorzalamide/timolol. I started to feel better around 2 pm...had a strong anxiety reaction for 24 hours.  I had been on the exact liquid dose of 7.5 for 10 days. I just went down to 7.20 as it was suggested a very small cut could help the activation I am experiencing.

 

(BTW, I also changed from pill to liquid)

 

I feel better now as my cortisol level is down. A little  dizzy. 

[gn11]

A question: I have been monitoring how I feel after I take the celexa dose.  Yesterday and today, I felt very anxious within 2 to 3 hours. There were some confounding factors today such as being in front of the computer for a long time without my dark glasses and a couple of minor stresses. I could feel my heart beat increasing within a half hour, I also increased the magnesium back to 300 but I haven't had anxiety from the magnesium before increasing. I am alos not taking my glaucoma drop in the morning which was adding to this problem.  I now have taken 7.2 mg rather than 7,5 for two days to see if this would help. Is it possible to do a quick taper if one is being activated by the medicine to a lower dose?

[gn11]

I have very few symptoms other than anxiety after i take the med. I sleep well and I don't have headaches. Occasionally, I have some nausea related to a low sugar when my cortisol is low. I also have some muscle twitches and have to be careful with my hydration but this one  has been going on since I started glaucoma drops. If my cortisol rise is high or normal the meds make my heart beat faster and if low I don't feel it.I have alos noticed if i fal sleep or doze off after I wake up  I feel worse

 

I've had palpitations from other OTC such histamines when I thought I had allergies and of course any kind of emotional stress or talking too much in stressful or intense situations. 

[gn11]

I increased my hydration by drinking electrolyte water plus a couple of other suggested maneuvers and my palpitations are finally down. It seems hat the med affects my hydration and with other drops do also. This increases my heart palpitations. I didn't have heart palpitations with Celexa until I increased the dose The palpitations are very much the effect of Celexa but now I am wondering about the hydration factor. I do try to sip water most  of the day and I've been doing some electrolyte water...not very clear how to make my own. 

[Altostrata]

It sounds to me that 7.5mg Celexa is too much for you. There is a prevalent belief that increasing antidepressant dosage reduces anxiety, but that is false, especially if the anxiety is caused by an adverse reaction to another drug or withdrawal syndrome.

 

So the answer is: More is not necessarily better.

 

If I were you, I'd go back down to 5mg by reducing .5mg every few days. Keep notes of your dosages and symptoms.

 

Does the electrolyte water contain potassium and taurine? Many drugs leach potassium from the body. Low potassium can cause palpitations. Taurine is also good for stabilizing heart activity; start with a low dose and increase slowly.

[gn11]

Thanks.  Yes, some potassium. I feel much better after drinking more of it.

 

I am at 7.2 which I reduced yesterday.   How many days should I wait until I reduce again? I was on  an exact 7.5 dose for about 10 days. I'm thinking I could do 7 tomorrow and then wait 4 to 7 days each time  to go down .5 until I get back to 5.

 

I will look for a reference but I read that low hydration increases histamine reactions which I have been plagued by since March.

 

 

I'll buy Potassium and Taurine tomorrow and will continue with electrolyte water. I think I may be getting somewhere. thanks! 

[gn11]

5:00 went to whole foods and got coconut water, other eelctrolyte water and some food

 6:00-7:00 I ate food that didn't sit right: grass fed beef.( I usually don't eat much beef) and a potato salad. I also put my dorzalamide  drop

I reacted, I think to the food...had a hystemine reaction plus some dizziness. I also had coconut water that had 300 mg Potasium. My gut tells me it was the heavy meal

 

7:30-9:00 meditation.

 

9: 45  I'm still reactive but not as much: sinus inflamed which affects my ,, A little jerky in my left leg

[gn11]

Lots of problems today:

 

My digestion is affected I think from last night so everything I eat or ingest seems to be activating.  Taurine really helped with palpitations and Cortisol spike today

 

7:00 woke up noticed my urine was dark yellow a sign of dehydration

7:30 to 8:30 I drank 16 Ozs fo coconut water-hydration improved by midmorning

8;15-8:30  took Vitamin D, Vitaminn C ( achneg that I think it was a bad idea since I changed the dose, the time and the consistency) will get back to my old 500 gel caps tomorrow early evening

8:30 ate tablespoon of grassfed yogurt/Tbls of almond butter (butter probably too heavy for today)

9:30 ate breakfast (some oatmeal) maybe I need to eat all at once right before med??

10:00 am med still at 7.2 some  activation 250 taurine half hour later but I think taking it out of the capsule affected my stomach ...same for magnesium out of the capsule--capsule helps digestion?

12:00-12:30Continue to sip water and drinking tea now. Had some crystallized ginger to see if it helps digestion

 

Probably need to simplify and be more consistent with food and supplements in terms of time and what I take?

[Altostrata]

Be sure to stay hydrated.

 

If you think you have food sensitivities, tracking your foods is probably in order along with your symptom notes.

[gn11]

It sounds to me that 7.5mg Celexa is too much for you. There is a prevalent belief that increasing antidepressant dosage reduces anxiety, but that is false, especially if the anxiety is caused by an adverse reaction to another drug or withdrawal syndrome.

 

So the answer is: More is not necessarily better.

 

If I were you, I'd go back down to 5mg by reducing .5mg every few days. Keep notes of your dosages and symptoms.

 

Does the electrolyte water contain potassium and taurine? Many drugs leach potassium from the body. Low potassium can cause palpitations. Taurine is also good for stabilizing heart activity; start with a low dose and increase slowly.

I know that more is not better.  I have used this same words with many of my doctors.  I actually up the dose because of what I read in your forum about w/d symptoms improving by up dosing ...I had been having extreme reactions for 3 months on 5 mg (thinking there were allergies or med interactions) ...It just took me a while to catch up with what I needed to do. I still wondered whether I should stay at 7.2 for a while longer and then cut .5?

[gn11]

Be sure to stay hydrated.

 

If you think you have food sensitivities, tracking your foods is probably in order along with your symptom notes.

I have been tracking some of it...not sure yesterday... maybe the potatoes. I got very sick back in March eating Thai food that probably had MSG. I ma trying to up my water intake to 2 lts...I have an additional burden with the glaucoma meds dehydrating me as well. I believe this dehydration problem is a the root of my histamine reactions as well. 

[JanCarol]

Hey GN:

 

 

 Is it possible to do a quick taper if one is being activated by the medicine to a lower dose?

 

I think Alto gave you a clear schedule for this one.  How is it going?  Please feel free to hold, if the symptoms seem to "stack up." with frequent microdoses.

 

 

 

 I do try to sip water most  of the day and I've been doing some electrolyte water...not very clear how to make my own. 

 

My acupuncturist turned me on to Barley water.  Apparently it's a great English tradition, as well as Chinese and East Indian.

 

Here's my fave recipe:

http://survivingantidepressants.org/index.php?/topic/5973-urination-and-bladder-issues-male-and-female/page-3?p=220311#entry220311

 

I hope you see the sun today.

[gn11]

Thanks  JanCarol!

 

I am doing fine with my stomach and hydration today. My main problem is the cortisol spikes in the morning. When I have them, it takes over my morning. I moved my med one hour to 11 am as I have noticed that it makes my anxiety worse when I'm in the middle of a spike. I think I'll move it an hour for a couple of days until I get to early afternoon where usually I am calmer. After 3 days at 7.2 I did a .2 cut to 7. I'll hold here for a few days 3-4??) and then begin the .5 until I get to 5 or close to it. Besides the cortisone spike which I' 've been having for a while, I am fine today...no stomach problems and I am back been hydrated.

 

Thanks for the water recipe...I will experiment with it at some point.