Bachicara: Intro and need help coming up with a plan

[Bachicara]

On antidepressants since 2005. Spent 2 years tapering off of sertraline and finished while early in my last pregnancy in January 2016. Went slow because I had tried coming off in the past and failed due to brain zaps, depression, and anxiety. Bad depression, anxiety, and insomnia problems the last 2 months of pregnancy, starting early June 2016. Tried to nap in the day and usually couldn’t. Had difficulty keeping up with my toddler. Tried herbal supplements, melatonin, and sedating antihistamines, a couple of doses of Ambien. Had my baby in July 2016 so was relieved to be able to more aggressively treat the insomnia.

 

Tried rotating different sedating medications, but was especially wary about becoming dependant on Ambien or a benzodiazepine so tried hard to limit those medications to occasional use. Tolerance developed quickly to each medication (25 mg trazodone, doxylamine, diphenhydramine 25-50 mg, a couple doses of clonazepam 0.5, herbal supplements such as lemon balm and chamomile, a few doses of Ambien). Was depressed, anxious, mood swings, totally exhausted, and sedated during the day from medication even if I didn’t sleep much at night. Unable to sleep at all when I tried napping in the day, which I had ample opportunity to do.

 

Beginning of September 2016 was placed back on sertraline starting at 25 mg with 50 mg of trazodone on medical advice that depression and anxiety were the cause of the insomnia and that the trazodone could be discontinued once the activating effects of the sertraline began diminishing and I started sleeping. Did not sleep at all that night or the next day. I stopped it for a 2 or 3 days, but by this time I was at the point where the insomnia had gotten scarier, and I felt that would be awake for days without medication. I was alarmed at how ineffective the insomnia medications were and  so concerned about being on benzodiazepine type drugs for long and developing tolerance, so in desperation, I prayed things would improve over time on the sertraline and that I could get by with minimal use of Ambien or clonazepam until then.

 

On top of sertraline I tried various medications to see if I could at least get a little sleep including 5-10 mg Ambien, Seroquel 25 mg, diphenhydramine, melatonin, and herbal supplements as add ons to sleep. Everything failed but Ambien or clonazepam, but I tried to minimize use of those and opted to do all-nighters instead. I was very, very concerned about continuing nightly with higher doses of clonazepam or nightly use of Ambien so I tried to use those as sparingly. I was reassured by the midwife who was taking care of me that I could take clonazepam up to 2 mg for a month or so and come off of it later. People did it all the time no problem. I tried clonazepam nightly for 4 nights, going up to 1.5 mg, but was so alarmed by the rapid development of tolerance that I stopped it and was scared to try it again.

 

In mid-September 2016, I was referred to a psych nurse who discontinued the sertraline I had been on for two weeks and placed me on a higher dose of trazodone. Someone else took over the care of my infant at night and I was titrated up to 150, for a week, as the only med. Buzzing in head and feet developed on trazodone, and has not gone away. Each dose increase of trazodone over the week helped me sleep some initially, but I rapidly developed tolerance to the sedation and felt like death during the day. After 2 nights maxed out on the insomnia dose of trazodone (150 mg) I was not sleeping at all night or day, so Ambien 10 mg was added in and I went off the trazodone over 4 days. Was scared of being on benzos or Ambien for more than a few days in succession, but felt out of options so gave into nightly use of Ambien.

 

In the process of switching from trazodone to Ambien beginning in late September 2016, I began to be jolted awake repeatedly either with brain zaps or a feeling of activation in my brain right before actually falling asleep. Have not fallen asleep once without Ambien since then. I would spend hours during the day or before the bedtime dose of Ambien trying to rest with my eyes closed because I was too exhausted to go on, dazed and void of thought, but remaining conscious. I would jolt alert repeatedly if I came too close to sleep. I got maybe 4 hours of sleep on Ambien, but I was very depressed, anxious, and exhausted. Ambien seemed to amplified the buzzing in head and I also began to have constant tinnitis and musical sounds playing in my ears, which also continues. I drank one evening (the only time) and sleep deteriorated some after that, with brain zapping and buzzing in head increased for a while. I did not dare touch other meds until I reached an emotional breaking point three weeks ago.

 

After about 2.5 months solid only only Ambien 7.5 mg, three weeks ago (November 2016) I switched to Lunesta 2 mg one night and 3 mg the next. Then two nights of clonazepam 1 mg. Then switched back to Ambien 7.5 mg. Added diphenhydramine 12.5 mg two nights for vertigo/dizziness in night. Since returning to only Ambien 7.5 mg 2 weeks ago, I have become increasingly dysfunctional. I have feelings of being connected to an electric current running through my brain that are much more pronounced, along with more pronounced episodes of electric anxiety in my chest accompanied by feeling disoriented and like I am losing touch with reality. Increasing brain fog, cognitive impairment, distress, inability to focus, inability to engage in physical activity or any activity causing stress without worsening symptoms. Last three nights reduced Ambien to 6.875. Two nights ago after taking Ambien and before falling asleep had muscle jerking, increased electrical buzzing in head, and feeling overall horrible.

 

I have lost the ability to even be around my kids, let alone care for them. I no longer have them with me. The psych nurse I see seems to think I'm a drug abuser or something and am having a hard time finding someone to help me. I am hoping people might have some ideas about what to do about the Ambien, whether I should slowly taper or if there is a chance I'll become more stable if I stay at the current dose. Tolerance withdrawal from Ambien? Without it, no matter how long I've been awake, I'm jolted back alert before I sleep, though right now I’m so wired I don’t know if I would even get close to sleep. Deteriorating. Don't know if I need to recover more from what I did a couple of weeks ago with trying new meds before I come off the Ambien,what to do if I completely stop sleeping while decreasing the Ambien, etc.

 

I feel like I need a short-term and long-term plan and I was hoping people could help me come up with one. Any advice or ideas about anything would be appreciated. Thanks everybody.

Edited December 20, 2016 by ChessieCat
Added paragraphs

[scallywag]

Bachicara -- Welcome to Surviving Antidepressants (SA)

 

I hope you'll find the information in the SA forums helpful for your situation. I'm sorry that you are in the position that you need the information, but am glad that you found us.

 

Insomnia is a very common withdrawal symptom. Some people experience symptoms arising well after the acute period of 4-6 weeks, the period to which medical professionals (even psychiatrists and psychiatric nurses) believe symptoms are limited.

 

What is withdrawal syndrome

Delayed onset of withdrawal symptoms.

 

Here's tapering information relevant to your situation:

Tips for tapering off Z drugs for sleep (Ambien, Imovane, Sonata, Lunesta, Intermezzo, etc.)

 

It may be that the best thing to do is to stabilize, if possible. Your CNS (central nervous system) seems to be very sensitive to medications and medication changes. You may not experience 100% relief from symptoms; some people find that they achieve a everday tolerable level of discomfort as they taper medication.

3KIS: Keep it slow. Keep it simple. Keep it stable.

 

Have a look at the topics I've linked. Please come back here to ask questions about your situation and/or next steps.

[Bachicara]

Thanks. I read the links. The z drugs link recommends tapering of Ambien at a rate of 12.5 percent per week? That seems fast.

 

Any thoughts on whether I'll be able to "heal" much while still on the Ambien, since it has such a short half-life and I withdraw from it every day?

[scallywag]

If you'd rather taper <12.5% per week, go for it!

 

The point of gradual tapering is to allow the CNS (central nervous system) to do the restoration/transformation work while the dose decreases. You'll find out how your CNS deals with the situation as you go through it. Symptoms may or may not arise -- it's nearly impossible to predict.