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DexterWhite

DexterWhite: Journey to hell

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DexterWhite

Hello,

I am in quite the conundrum currently. My CNS is completely destabilized due to several factors.

Firstly, I have been on lorazepam for nearly 8 years. I was initially prescribed 1 mg three times a day along with 10 mg zolpidem after my mom died in August 2008 and I had a panic attack. I took the lorazepam basically at this full dose up until June 2013 when I was ripped off of the lorazepam after my previous doctor left his practice and ended up with a ruthless doctor. He prescribed me 30 mg for a month and that was it. I was able to obtain some diazepam which helped with this abrupt withdrawal.

I was off of all gaba drugs and functioning in society with manageable symptoms until April 2014 when the stress of noisy neighbors pushed me over the edge. At this time, I didn't know how dangerous benzodiazepines really were, so I sought out an old psychiatrist who prescribed me 2 mg lorazepam daily plus 10 mg zaleplon at night for the ongoing insomnia.

Fast forward to October 2014, when I had a life changing incident. I suffered a mild traumatic brain injury, which to this day has affected me greatly. I was going to school to be a chemical engineer  but this injury caused me to have major issues with light, sound sensitivity, brain fog, fatigue. I managed to finish the semester barely.

In February 2015, while attempting to start the next semester with a lighter course load, I bumped my head again. This is when all hell broke loose. The symptoms got so bad that I couldn't be in classrooms and I had to withdraw from university due to the light/sound sensitivity.

In May 2015, I was prescribed gabapentin by my neurologist. I know this isn't a benzodiazepine but it does seem to have some gaba/glutamate action. Anyway, it seemed to help me at first for my anxiety. At this point I was forced to stay inside and wear sunglasses and earplugs a lot of the time. I could no longer read as I once did.

Over the course of the summer I started to improve slightly, and I began tapering of the gabapentin. All the while I was still taking the 2 mg/ lorazepam daily. I didn't use the z-drugs often but I still had a supply that I used occasionally.

It was clear that I wasn't going back to school any time soon.

It was then that a tragedy occurred. My brother lost his life to a drug overdose. He was my only brother and I loved him dearly. This event took a lot out of me, emotionally and physically. I started to decline. I went to my psychiatrist and he upped me back to 3mg lorazepam/day and renewed a zolpidem prescription. My neurologist upped my gabapentin to 1800 mg/day. (It had been at 900mg over the course of the summer).

Shortly after my brother died, my girlfriend and I moved to a quiet town in the hopes that I would heal with less noise bothering me. She became distant and left me in January 2016.

This is when I hit rock bottom. I was suffering strange symptoms that seemed to be withdrawal even though I had increased dosages of both medications. I somehow managed to realize that the medications were not helping and I needed to get off of them.

I spent 2016 reducing my gabapentin dosage from 1800 mg (600 mg three times a day) down to 300 mg (100 mg three times a day). This was not easy given that I have not been able to work, or go to school due to intense symptoms of sensory overstimulation. I can barely go for walks due to light sensitivity and driving in cars is just as bad due to sound/motion sensitivity.

Over the course of 2016, I tried to convert over to a longer acting benzo twice. I tried using clonazepam for a few weeks using the Ashton conversion table. This didn't work well as I felt much worse on the clonazepam. In July I tried to convert to diazepam. I only took two 10 mg doses to replace one of my 1 mg doses of lorazepam on consecutive days. This caused a significant increase in visual symptoms I have been experiencing since 2015 and a failed SSRI effort. This visual phenomenon is known as visual snow and I have all the trademark symptoms now - palinospia, starburts, the static field over my vision, etc. along with tinnitus.

So, anyway as it stands now, I have a pretty poor quality of life and I am basically on my own emotionally - no family support.

My present dose is 1 mg lorazepam three times a day, and 100 mg gabapentin three times a day. I have not taken any other medications since the diazepam in July. My last zolpidem dose was in March, nearly a year ago. The last cut I made with the gabapentin was 5/31/2016. Prior to that I was making 100 mg cuts weekly as directed by my doctor. Looking back, I'm sure this was much too fast.

One of my doctors has been quite sympathetic to my situation and he prescribed me the lorazepam solution to begin a taper. He seems to be willing to work at a slow pace that I'm comfortable with.

I actually started writing out a plan for tapering with the liquid. I plan on cutting 5% over the course of the next month using a 0.1mg/mL solution.

Thanks for reading, and take care to all.

Edited by scallywag
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DexterWhite

I will add that I'm quite overwhelmed and I'm not sure if I'm ready to start tapering or not due to my symptoms. It's hard to tell if the benzos themselves are causing problems on their own.

 

Please help.

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mammaP

Hi Dexter, welcome to SA. I am sorry to read of everything you have been through, that is a lot for one person to have to deal with.After reading through your post it is obvious that there have been a few changes with the drugs that have been prescribed for you, and have led to destabilisation of your nervous system. The gabapentin taper has been much faster than we would recommend, leading to withdrawal and attempting to switch benzo's have complicated things further. This is not your fault, you were trying to do what seemed to be best at the time. I am not a benzo expert and will flag up your post so our benzo mods can take a look but my feeling is that holding everything for a while will help your CNS to recover before starting to taper again.  This will take time and you will need to take good care of yourself while you wait it out. This will get better and you will get your life back. Baby steps will get you there in the end. 

 

It will help if you can fill out your signature for us, you can find instructions how to do that here..Please include any supplements, prescription and over the counter drugs you have tried over the last year or so, also any recreational drugs, there is no judgement here and it is important to have the full picture.

 

http://survivingantidepressants.org/index.php?/topic/12364-please-put-your-withdrawal-history-in-your-signature/

 

When you are ready to taper the gabapentin again, here is our topic on tapering.

 

http://survivingantidepressants.org/index.php?/topic/2309-tips-for-tapering-neurontin-gabapentin/?p=26292

 

Many of us have found that fish oil and magnesium help 

 

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

 

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

 

Take a look round the self care forum where you will find lots of experiences of what helps people. 

 

http://survivingantidepressants.org/index.php?/forum/8-symptoms-and-self-care/

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scallywag

DexterWhite -- Welcome to Surviving Antidepressants (SA)

[post composed while mammaP was writing and posting hers!]

I'm sorry you've been forced to deal with several tragic difficult events in the last few years. Without going into details publicly, I went through a similar set of losses over a few years and understand how disorienting and isolating it can feel. Thanks for coming out of lurking and reading to post an introduction. I hope that connecting with other people online will provide a least a little relief.

I'm glad you've got a supportive doctor on your side as you work your way through tapering these medications. Because you're taking multiple medications, please read
Taking multiple drugs? Which to taper first.

Also, When a someone is taking multiple medications, we ask that that you post an interactions report. Follow the link below to get your report. Just select the text, copy it and paste it in a post here.
Drugs-dot-com Drugs Interactions Checker.

A request: Would you summarize your history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly?

  • Any drugs prior to 24 months ago can just be listed with start and stop years.
  • Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago)
  • Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016.
  • Please leave out symptoms and diagnoses.
  • A list is easier to understand than one or multiple paragraphs.
  • You can find instructions in this topic: Please put your withdrawal history in signature
  • If you are using a phone or mobile device, you need to switch to the "full" or desktop version of the site. Instructions are in Post 9 and Post 10

You may wish to start a topic in the Members-only benzo forum

About gabapentin: Tips for tapering off Neurontin (gabapentin)

You're wise to think carefully about whether you're ready to start tapering.
Before you begin tapering -- what you need to know.
Preparing to taper

 

edited to add another link: Preparing to taper psych meds on beyondmeds [dot] com.

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.

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Shep

Hi, Dexter.

 

Welcome to the forum from me, too. I certainly can understand your struggles with benzo withdrawal. 

 

When you're ready to taper the lorazepam, please start a new thread for yourself here:

 

Members-only benzo forum

 

We can help you set up a safe and careful taper, as well as provide non-drug coping skills to make yourself a bit more comfortable.

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DexterWhite

Thank you so much for the welcome.

 

At this point, I'm thinking that I should hold for a while but the problem is it can be hard to get a never ending prescription of benzos from doctors.

 

Either way my main concern is my next course of action. I have changed my mind about tapering any time soon, but maybe I've reached a tolerance and should updose? Lorazepam only, I don't plan on changing the gabapentin dose for a long time. I know benzos can be unique with tolerance.

 

I'm overwhelmed with the situation and not sure what my next course of action should be.

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Shep

Thank you so much for the welcome.

 

At this point, I'm thinking that I should hold for a while but the problem is it can be hard to get a never ending prescription of benzos from doctors.

 

Either way my main concern is my next course of action. I have changed my mind about tapering any time soon, but maybe I've reached a tolerance and should updose? Lorazepam only, I don't plan on changing the gabapentin dose for a long time. I know benzos can be unique with tolerance.

 

I'm overwhelmed with the situation and not sure what my next course of action should be.

 

 

Hi, Dexter.

 

It sounds like you're already familiar with Ashton, so you may find the discussions listed here to be of help:

 

Ashton and Beyond in Benzo Tapering

 

 

Benzo "tolerance withdrawal" during tapering -- does it exist?

 

Considering the number of drug changes you've had, it's possible that your symptoms are from those changes as opposed to tolerance, so holding may be the best course for now. 

 

An updose may help, however, if you're only taking the lorazepam 3 times a day, I would see if taking the same daily amount spread over 5 or 6 doses throughout the day may help, as you may be experiencing interdose withdrawal due to lorazepam's short half-life (10 - 20 hours with the peak concentration hitting about 2 hours after you take it). 

 

If spreading out the doses doesn't help, than a slight updose may be in order:

 

Notes on Updosing Benzodiazepines

 

But again, I would try spreading out the doses first and giving yourself time to adjust. 

 

I'm sorry for the loss of your brother and the breakup with your girlfriend. Dealing with grief and loss can also cause cause symptoms in both the mind and the body. Please take care of yourself. You may find some of the ideas listed here to be of help. Many of us find we are at a loss for even the most basic form of self soothing and self care during this very isolating illness, but things such as meditation, gentle yoga, music, art, etc can all be pathways into feeling a bit better.

 

 

Non-drug Techniques to cope with emotional symptoms

 

Please keep updating. Once you're ready to start tapering the benzo, please start a new thread here:

 

Members-only benzo forum

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DexterWhite

I appreciate your kind words.

 

I will try and attempt to space out the doses to 6 times a day before considering an updose.

 

What are the thoughts on updosing the gabapentin? I haven't gone above 100 mg three times a day since May 31 2016, when I dropped from 100 mg four times a day to three. 400 mg daily to 300 mg daily.

 

I wouldn't updose both medications at once I was just rethinking my situation and that was the last med that I tapered. Like I stated in my first post I tapered down from 1800 mg daily to 300 last year. Within about 4 months. Does it not make sense to adjust that dosage?

 

I really am not doing well and my mind is spinning searching for the right choice. I do understand that patience is key but I also know there must be a plan that I can set in motion that I can be confident about.

 

Thanks

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DexterWhite

What is the verdict on supplements? I've been taking all kinds of different things over the course of my ordeal. Maybe it's better to discontinue all of them?

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ChessieCat

The only supplements that SA recommends are Magnesium and Omega-3 Fish Oil

 

To search the site for existing topics/discussions I use google and type in survivingantidepressants.org + topic. In this instance I typed in supplements and the following were the results.  If you want to search for other things, type in the subject you are looking for, for example st johns wort.

  1. supplements-what-helps-what-doesnt
  2. dont-waste-your-money-on-these-supplements
  3. orthomolecular-supplements-for-tapering
  4. mushroom-supplements-lions-mane-reishi-shiitake-ahcc
  5. important-topics-about-tests-supplements-treatments-diet
  6. memory-boosting-supplements
  7. supplements-that-interfere-with-antidepressants

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Shep

Hi, Dexter.

 

Can you list your supplements? Some are actually dangerous when combined with prescription drugs. 

 

And some supplements may need to be tapered, so please don't suddenly stop taking them. 

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DexterWhite

I haven't been taking anything on a daily basis in the past week.

Within the past month I've taken somewhat regularly but again not consistently:

vitamin d-3 2,000 iu
2 grams fish oil
600 mg NAC
800 mg curcumin
B-complex
1,0000 mg mcg B-12
1,000 mg vitamin C

Edited by scallywag
corrected units for B12

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Shep

Hi, Dexter.

 

Thanks for the update.  Some vitamins, especially B vitamins, can ramp up symptoms like anxiety and insomnia. 

 

Hypersensitive to B vitamin or B vitamin complex?

 

You may find information on other supplements by using the search feature or googling "surviving antidepressants" + "supplement name".

 

Please read the links that ChessieCat left, as those are great resources. 

 

Also, please add a signature:

 

 Please put your withdrawal history in signature

 

 

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DexterWhite

I'm not doing well. I'm really wondering if adjusting the gabapentin dose would help.

 

I feel very isolated as no one I am in contact with in person understands what has happened to me including my doctors. I don't have any family support and for the most part am on my own.

 

I'm feeling hopelesss. It seems like I've done too much damage to recover. I've dug a hole too deep to come out of.

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KarenB

I've seen people dig their way of some fairly deep holes Dexter - right here on SA.  Instead of jumping and trying to grab onto the ledge way up above you, start with building a little foot-hold right where you are now.  

 

Did you try spacing the lorazepam, as Shep suggested?  How did that go?  This could be a foot-hold for you.  Holding would be another very stabilising foot-hold.  

 

Once you're stable and feeling some strength, then you could look at where to make the next step.

 

(And a signature would make it lots easier for us to help you...cheers).

Karen 

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DexterWhite

Hello all. I have added a signature in hopes of more advice and support. I am really not doing well. I haven't been able to make it on here for a while.

 

I know the main source of my symptoms is drug related but I am very much alone with all of this. I am terrified of my future.

 

I haven't as of yet attempted to space out the lorazepam doses, because I was attempting to stabilize on the current dose schedule I had but now I'm considering spacing out the lorazepam doses.

 

To be honest ,though I have an inclination that it is the gabapentin causing me more problems and unfortunately the lowest they make is 100 mg capsules - impossible to split those in half. 

 

This is so overwhelming and seemingly hopeless...

 

Please help

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DexterWhite

Yes, I have. I've basically scoured the internet for similar information for the past two years so I feel I'm well educated but need help with my very unique and terrifying situation. I'm also looking for support from people who understand what I'm going through. I attempted to use the solution to taper in September of last year. It did not go well at all.

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ChessieCat

I'm letting the other mods know that you need some further assistance.

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ChessieCat

What are your current symptoms?

 

Are you keeping daily notes?  Here is a suggested way:  Keep Notes on Paper

 

Were you taking prescription gabapentin solution?  What issues did you have?

 

I'm also wondering are you drinking alcohol at all?

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mammaP

What happened when you tried the gabapentin solution Dexter? Gabapentin is freely soluble in water so you could make a solution yourself from the powder in the capsules. I don't know what happened with the solution but sometimes people can have a reaction to the change but using the same capsules that you already have will minimse the risk of a reaction. It is quite easy to do once you get used to it.  However it does seem that spacing the lorazepam might be of more benefit, and keeping the gabapentin stable for now.  It's always hard to know what to do when you are suffering, especially when it is complicated by a physical brain injury. 

 

One of the benzo mods will be along to take a look for you. 

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DexterWhite

First of all, Thank you for your responses. I’m having a difficult time holding on at this point.

 

I wanted to mention each morning I wake up and feel even worse than my baseline throughout the day prior to taking my first doses. After they kick in I feel better and am able to fall back asleep for an hour or so. This happens every day and I steadily feel better as the day goes on. Nights are the best for me and then the vicious cycle starts over again.

 

I also wanted to say that the concussion I suffered was mild. I didn't lose consciousness, or have to be hospitalized. I went to classes the next day. My memory of the event is completely intact.  Although it hurt like hell (door slammed into my head) and caused significant symptoms they didn't get out of control until medication changes were introduced.

 

ChessieCat –

 

 

What are your current symptoms?

 

I have quite the list of symptoms. I will list the most debilitating ones –

 

Severe sensitivity to light, sound, touch, temperature, motion : I cannot tolerate being in the sun for long, or out in public, or in the car even with earplugs and sunglasses. Even within my home the sounds from outside are unbearable. It’s like a physical form of agoraphobia – the light, the noise, the motion are all too much for my brain to process. I cannot go out to socialize and I'm completely disabled from work or schooling. Easily Overstimulated

Anxiety/Panic Attacks/OCD like symptoms

Stress Intolerance – I get awful sensations in my gut from very basic stress like phonecalls

DP/DR

Depression/Feelings of hopelessness which lead to suicidal thoughts

Crying Spells/Mood Swings

Brain fog – slowed cognitive processing, word retrieval, confusion

Inability to concentrate/lack of patience, enjoyment

Visual Snow – Static like distortions across my field of vision, after images, cannot read for long stretches

Tinnitus

Difficulty focusing eyes

Feel tired all the time need to lay down, cannot exercise

Cannot maintain conversations without feeling generally awful and overstimulated/overwhelmed, phones are the worst 

Headaches/Eyeaches/dizziness

Muscle twitches

Severe Gastrointestinal issues

Nightmares/Poor sleep quality/Difficulty falling asleep

When I'm tired or have been active all symptoms seem to increase

 

Are you keeping daily notes?

I’ve been keeping a log of my symptoms, medication dosages, activities, supplements, etc. for over two years now.

I will look over the link you provided.

 

Were you taking prescription gabapentin solution?  What issues did you have?

 

In September I was using prescription gabapentin solution to taper. I had an increase in basically all of my symptoms. I felt very ill, could not concentrate, extra sensitive to noise and light, anxiety, etc.

The final straw was when I woke up in sweats and couldn’t get back to sleep for two straight nights. I also became extremely itchy, tinnitus increased, visual snow worsened. This is when I had cut from 270 mg/day to 240 mg/day.

 

I'm also wondering are you drinking alcohol at all?

 

No, I haven’t had any alcohol since September of 2014 prior to the concussion.

 

 

MammaP – I sort of explained above some of the symptoms I had when I tried the gabapentin solution above. Here’s what happened – Mid-September I wanted to continue tapering the gabapentin because I didn’t know what else to do so I started calling my neurologist and psychiatrist to ask for the solution. Neither of them would comply so I decided to start splitting the capsules myself and was using a scale to subtract 30mg from one of the three 100 mg capsules to make a 10 percent reduction. I made this reduction on September 15, 2016. I believe this was fairly accurate but not as accurate as the solution. Either way I started experiencing the horrid exacerbation of all my symptoms the same day I cut the middle dose from 100mg to 70mg. I guess that’s how sensitive I am. I didn’t realize exactly what a bad sign that was until I read more on this site.

About a week later I was able to obtain the solution from my primary doctor and there was little difference in my overall symptom level although it’s always hard to tell when things are that bad. I don't think the formulation switch made that much of a difference but it's truly impossible to tell looking back. The next bad decision I made was to cut further from 270 mg/ day to 240 mg/day on October 2, 2016. This caused a complete withdrawal type reaction where I could no longer sleep at night and would wake up in sweats. I reinstated to the full 100 mg capsules three times a day on October 6, 2016 which seemed to alleviate those acute symptoms and over the course of October I returned close to where I was prior to the cuts, thankfully. This is what I'm currently taking.

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ChessieCat

Hi Dexter,

 

Thank you for providing so an indepth answer to the questions.  The mods will be now be able to discuss what your options are.

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Shep

Hi, Dexter.

 

Thanks, that was a very thorough account. 

 

Quick question - has your Lorazepam use stayed the same at 1 mg three times a day? I just want to verify that the only tapering you have done so far is to the gabapentin. 

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DexterWhite

Hello,

Yes my lorazepam use has stayed the same at 1 mg three times day besides some slight alterations I mentioned with other medications but for the past year or so it's been steady. I have not attempted a lorazepam taper of any sort.

 

There were some significant dosage alterations before October 2015, but I also was only prescribed 2mg/day at this point. During 2015, I will say I tried to be steady with the doses at 1 mg/ twice a day spread out 12 hours but it didn't always happen. I would some days take more than 2mg. Plus I was mixing in the z-drugs.

 

Since early 2016 I have pretty much been taking the lorazepam at the same dosage (1mg/three times a day) at the same time intervals every day.

I have spread out the doses as much as possible to allow for sleep.

 

The gabapentin dosages were much more inconsistent and downright stupid looking back, but I thought increasing the dose would help with some symptoms. And then I figured I should get off the stuff so I started that taper from 1800 mg/day to 300mg/day from Jan. 2016- May 2016.

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DexterWhite

Hello

It's been a couple days since my last post. I'm curious what sort of advice you can give me. I'm truly suffering and losing hope.

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DexterWhite

Hey ChessieCat,

 

I have been using mindfulness meditation for over a year now and I see a therapist weekly who helps me with dealing with past psychological traumas and using CBT.

 

I appreciate the link you posted, there is a lot of good information there.

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JanCarol

Hey Dexter - 

 

When you say that you are taking lorazepam 3x a day - when is that?  Every 8 hours?  Or more during daylight, and you try to sleep through?

 

IF this is the case, is it worse in the morning before you take your morning lorazepam?

 

This could be a clear sign of interdose withdrawal.  We're looking for clues as to what might help you.

 

I looked at your supplements - Fish oil is awesome, 

 

B Complex, as Shep pointed out, is problematic.  I'm a big fan of B-vitamins, just not the "One size fits all here try all of these" variety.  At some point, you might be helped by niacin.

 

Have you had a D3 profile done?  Do you have to avoid sunlight to keep from triggering your nervous system?  D3 can be stimulating - but - it's also often depleted by lifestyle as well as the drugs.  B12 is like that too - so essential, but so hard to take in withdrawal.

 

As I see it, you were traumatized when you were withdrawing, and had further traumatic events to shake your system up.  Symptoms are often guidelines to healing - if you require a dark, quiet room, then that is what you need to heal.  I know it's hard to think of yourself in a dark quiet room for years, but that seems to be what your body is asking for.  Have you read GiaK's story at Beyond Meds?   I think Gabapentin (or Pregabalin, a cousin) was on her list of drugs - and she had to keep a very low profile for awhile.  She's better now, and back to being an activist.

 

NAC - is an excellent glutathione precursor.  It is the main way to stimulate glutathione, but can also be energizing.  Another way to get a similar effect might be MSM.  But let's get the supplements down before adding any others.

 

Think of yourself as a science experiment of N=1.  I'm sorry that you have to do it this way, but we get so little guidance about these drugs, and you are already in an extremely sensitive place.

 

Take away the B vitamins.  Is it better, or worse?  (there's your notes on paper).  Wait a week.  If it's good enough, stop the experiment and prepare to hold.  If it's not good enough, take away the NAC, rinse and repeat.  

 

The supplements which could be overstimulating in your case are (in order of possible offense)

B-Complex

B-12 (10,000 mcg is HIGH, before you eliminate this, try reducing it to 2500 mcg, most people only take 1000 mcg.  Are you vegetarian?)

NAC

and maybe (just maybe) the Curamin.  Curamin is best taken with food for absorption.

 

Also - I do not see any Magnesium here.  This is a muscle relaxant, and a vital co-factor for 300 cascades in the body.  It may be the key to eventually getting you off the gabapentin.

 

Let's start by:

1.  Determining whether you are having interdose withdrawal from the lorazepam.  IF SO, adjust dosing times.  

2.  Eliminating supplements to see if any of those are overstimulating.

3.  Considering Magnesium, whether dissolved in water and sipped to ease distress, or Epsom Salts baths, or supplement.

 

This is about 3-6 weeks of work, but gives you something to focus on while you are suffering.

 

You've done amazing work at eliminating the things which set you off.  I'm wondering, because you were drugged, if you've had a chance to grieve properly, or if the numbing of the benzos and the gabapentin has delayed your feelings of grieving.  That would be good personal work to do in a Journal or with a therapist.  

 

I hope we can help you find some answers and a path through this forest.

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DexterWhite

Hello Jan Carol,

 

Thank you for your thoughtful response. It is much appreciated. This forum has provided me with some hope in very dark times.

I wanted to respond to your questions.

 

When you say that you are taking lorazepam 3x a day - when is that?  Every 8 hours?  Or more during daylight, and you try to sleep through?

 IF this is the case, is it worse in the morning before you take your morning lorazepam?

 

I had been taking it spaced out about 6 hours apart during the day and then sleeping through. I always feel worse in the morning before taking my morning lorazepam and gabapentin.

 

Here is a quote from an earlier post of mine: “I wanted to mention each morning I wake up and feel even worse than my baseline throughout the day prior to taking my first doses. After they kick in I feel better and am able to fall back asleep for an hour or so. This happens every day and I steadily feel better as the day goes on. Nights are the best for me and then the vicious cycle starts over again”

 

It seems I am suffering from interdose withdrawals from both medications.

 

Shep has recommended that I spread the lorazepam doses out over the course of the day so I have been taking the lorazepam at 0.5mg/ six times a day. I haven’t noticed much of a difference so far but it’s only been about a week.

 

Unfortunately there is no way to accurately split the 100 mg gabapentin capsules.

 

As far as supplements go, that list I made was an old one that isn’t current. I had been taking those supplements but not on a daily basis.

I have discontinued the B-complex and B-12 based on recommendations here. I had been taking a lot of supplements over these past couple of years and I am now learning that was a big mistake, so now I will be very cautious about supplements.

 

Have you had a D3 profile done?  Do you have to avoid sunlight to keep from triggering your nervous system?

 

I’ve had a few blood tests of my vitamin d levels over the past 2 years and mostly I range in the 30-35 range, but that’s with supplementation.

Unfortunately, I have to avoid sunlight at all costs to avoid symptoms. It is probably the worst aspect of this condition. This is why I felt it necessary to take vitamin d-3 supplements.

 

Have you read GiaK's story at Beyond Meds? 

 

Actually, yes. As I was becoming familiar with this website I stumbled upon her story. It is quite a journey she went through and I certainly can relate. I can only hope to come out of the other side OK. Thank you for sharing that link.

 

A big issue I have is living in a relatively noisy neighborhood. I can block out the light, but it is nearly impossible to settle down my mind and body to rest during the day. Even with earplugs and white noise, my body is still too stimulated by any noise to get rest. I have been traumatized repeatedly by my experiences and it has been impossible to give my body the dark and quiet room it has been so desperately asking for with any consistency. I have been trying my best to listen to my body. This has been a huge barrier for me for a long time and I really don't know how to approach it. It's even worse now with the summer coming in the northeast US and all the noise of lawnmowers, motorcycles, and children screaming. I purchased some noise-cancelling headphones but even they are only so helpful at times.

 

Also - I do not see any Magnesium here.  This is a muscle relaxant, and a vital co-factor for 300 cascades in the body.  It may be the key to eventually getting you off the gabapentin.

 

I’ve been taking a magnesium supplement before bed each night consistently for the past couple of months and been taking magnesium for two years now. It definitely helps my symptoms but I can’t take it more often because it interacts with the absorption of gabapentin.

 

Let's start by:

 

1.  Determining whether you are having interdose withdrawal from the lorazepam.  IF SO, adjust dosing times.  

2.  Eliminating supplements to see if any of those are overstimulating.

3.  Considering Magnesium, whether dissolved in water and sipped to ease distress, or Epsom Salts baths, or supplement.

 

So in response to your list here,

 

1.      I think I am having interdose withdrawal and (possibly tolerance withdrawal) from both medications but I am not sure what your recommendation would be.

2.      The only supplements I am taking are Omega-3 fish oil, 1,000 mg vitamin c, vitamin e, and magnesium before bed.

3.      I have been taking magnesium before bed, 500 mg, not sure if I should try to figure out a way to increase this dose.

 

I appreciate your positivity during this very difficult time. I still am struggling mightily but this website has been very crucial in making me feel less alone and providing me with some sense of sanity and ideas on how to get better.

 

I am terrified of permanently being stuck with these symptoms. I will keep trying to get better.

 

I look forward to hearing back.

 

Thanks again,

 

Dexter

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JanCarol

Hey Dexter - I don't think you will be permanently stuck here.

 

That's why I sent you to GiaK's thread - it gets better.  It takes some time - but it does get better.

 

I'll start with #3 - magnesium.  I know you're good at the research, but I just want to check - most mag supplements are mag oxide, which is not very helpful.  Be sure and read our Magnesium thread to pick a form that will work best for you.

 

Gabapentin and magnesium - ut oh.  Here's what I found on the interwebs.  This is just in a forum discussion, so warrants further research, but it is promising:

 between magnesium and neurontin (gabapentin) applies to magnesium carbonate, magnesium hydroxide and magnesium oxide as these are alkaline and will have an effect on stomach aciditiy and will reduce the absorption and effectiveness of gabapentin.<BR>

<BR>
However more modern preparations of magnesium which are not alkaline are OK, eg. magnesium chelates, magnesium glycinate, magnesium taurinate, magnesium threonate. However magnesium citrate, while not as bad as the above can interfere slightly.<BR>
<BR>
This interaction is more important for epilepitics and others who have epileptiform seizures and who take neurontin because thay cannot tolerate other anti-seizure medications. If you are taking neurontin for neuropathic pain the decrease in effectiveness is minor.

 

 

So - I did a check on drugs.com (they don't have all of the different chelates of magnesium) and they gave a "minor" interaction between Mag Oxide and gabapentin.

 

Everything I did find, was about digestion of magnesium inhibiting metabolism of gabapentin.  This would mean that epsom salts baths are a safe and soothing way to get your magnesium.

 

500 mg of a chelate is a good sized dose and should help your neurotransmitters start to heal.

 

2.  How do you feel after removal of B vitamins and D3?  Are you any better, or still struggling?  If it makes no difference, you can start adding back D3, and if that goes well, perhaps niacin.  But if you felt a difference, an improvement, then let's keep your system still and stable. 

 

I do know people who have extremely low D3 and it can cause health challenges (headaches, insomnia) - but it can be survived, as well, for awhile.  Yours, at 30, with supplementation, is low, but not at a crisis level. The choice is yours.

 

And oh yeah:  leafy green vegetables, organ meats, bone broth, are healthy ways to make sure you get enough B vitamins.

 

1.  Interdose withdrawal, tachyphylaxis.  This is the crux of the biscuit.

 

I am not a benzo expert, so trust Shep's guidance on the benzo forum.  Whatever she says, is probably the best suggestion that any of us would have.

 

And you've done that.  And you say it makes little or no difference.

 

Here's the key piece, I think.  Gabapentin has an even shorter half life than the lorazepam.  Lorazepam is about 12 hours - so it will be less sensitive to changes (and you may even be able to take it just 2x a day).  Gabapentin has a 5-7 hour half life.

 

I think that's your problem.

 

So - how to get under 100 mg in capsule?

 

You can split them with a scale and gel-caps:  http://survivingantidepressants.org/index.php?/topic/1596-using-a-digital-scale-to-measure-doses/

Or you can make a liquid:

How to Make a Liquid from Tablets or Capsule

 

After I did all of my tapers with powder and scale - I believe that the liquid is simpler and more accurate.  The advantage of the gel-caps is they are portable, you can easily pack your doses for the day when you go out.

 

Even if you take 75 mg 4x a day, you may still get drop outs.  I had no idea that it was so horribly short acting!  At 5-7 hours, every 6 hours should be enough.

 

But that's the next step, the next direction to head.

 

I'm sorry this is a science experiment of n=1, which is why we make small changes, and only one at a time - so that we can figure out "what is better, what is worse."

 

So I suggest you bone up on splitting capsules (whether liquid or scale) and try to make a move to 4x75mg gabapentin daily.  

 

I gotta go for now, I'd like to address your noise / sleep / sensitivity.  I'll try and get back later tonight.

 

I hope you see dark, quiet, shade today!  (not what I usually tell folks!)

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JanCarol

Hey Dexter - 

 

That extra sensitivity to sound and light and difficulty getting restful, is so common to those of us in withdrawal.

 

In fact, I might venture so far as to say that it is part of the reason we got drugged to begin with.

 

Anxiety and Highly Sensitive People

and

Highly Sensitive People - Low Tolerance / NO tolerance list

 

If you google "HSP" you will find a lot of articles about other people who cannot stand the crunch of a cracker, or the smacking of lips.  My bug-a-bear is the barking of neighbor dogs.  It sets off alarms in me and I HAVE to DO something about it, only I cannot.  So I have to learn to shift my focus away from those things (and I work on conditioning the dogs to give me some breaks - two dogs trainable, the others are unreachable/unteachable - and - I can't get up when I'm sleeping and "go talk to the dog.")

 

A yogi (maybe it was Nisargardatta) was asked by his student: "Master I'm having trouble meditating.  My flat is above a mechanic shop, and the noise goes on every day.  At night, the neighbors are loud and drunk, and I cannot sleep or meditate.  What should I do?"  The student expected that Nisargardatta had a supreme answer about shifting focus and attention, but the Master only said one word, "Move."

 

That may not be possible for you now; I understand these kinds of challenges - after all, I cannot move from my barking dogs, and I cannot move the dogs, either.

 

So the first step is to accept your sensitivity, and honor it.

Mindfulness and Acceptance

 

Here's what others have said about sound, light, and the like:  There are others about light sensitivity, too 

 

http://survivingantidepressants.org/index.php?/topic/6122-guided-meditations-calming-videos-sleep-hypnosis/

 

Head Noise

 

Misophonia

 

http://survivingantidepressants.org/index.php?/topic/13597-sensitization/

 

http://survivingantidepressants.org/index.php?/topic/9912-overstimulation-and-increased-sensitivity-to-light-sound-etc/

 

You are not alone, and it does get better.

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DexterWhite

Hello JanCarol, Thank you for the thoughtful response. I appreciate it and hope you are doing well.

 

I will continue with our numbering system to keep things in order:

 

1.       Interdose withdrawals – I tend to believe that the gabapentin is causing the most problems with this and overall. I have looked into the idea of splitting the capsules and am considering doing a solution. Is gabapentin soluble in water?

 

Also, instead of dosing 75mg, four times a day, why not proceed with 60 mg/ five times a day. This would make the peaks and valleys even smaller.

 

2.       Supplements – I haven’t really noticed much of a difference since swapping out the supplements but I do think the b complex was probably a little stimulating.

 

I had blood work done this past week with the following results:

 

Vitamin D, 25-OH = 29 ng/mL

 

This is starting to get into a low range and I would appreciate some feedback. Vitamin D is vital for good health and I think I should start taking the 2,000 i.u. d-3 supplement. I’m not sure how stimulating it has been for other people that’s why I refer to you to understand it in reference to my withdrawal syndrome.

 

Vitamin B-12 = 449 pg/mL

 

Again this is in the low range of normal. I know b vitamins are more stimulating than others. I feel it might be a good idea to take the 1,000 mcg supplement but I if I do this it would be after the D-3. I will make sure to make adjustments slowly. I know that B-12 is another vital nutrient, especially for nerve function.

 

 I also had a CBC, Metabolic Panel, Cortisol, and TSH checked which all came back in the normal ranges.

 

3.       Magnesium – The magnesium is gonna be tough to get into my system other than espom baths . I’m currently thinking the supplement I'm taking is messing up absorption of my evening dose of gabapentin. If I stretch out the 300 mg to 4 or 5 doses of gabapentin it will be virtually impossible to take magnesium supplements.

 

So I guess my main questions are

 

Is gabapentin water soluble?

 

Should I do 60 mg/ 5 times a day?

 

What are your thoughts on resuming vitamin d supplementation?

 

I am trying to hold on to some hope, but I am not doing well. My symptoms are unbearable honestly. I have been trying to listen to my body and rest more but I think that stretching out the gabapentin is the next logical step.

 

Thanks again for everything,

 

Dexter

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JanCarol

Hey Dex - 

 

I'm going to do what you could do - go to the thread about:  Tips for tapering off Gabapentin

 

Where I will learn:   Gabapentin is water soluble, the best possible solution (pun intended).

 

It is available in a liquid (wow!) but it seems, only in Canada.

 

Read the thread, and learn all you can!

 

As for the Vitamin D - you can get liquid vitamin D, start back up at 500 or 1000 IU - spring is coming, build up to 2000 iu.

 

See how it goes!  It may go fine, at which point you can take it up to 5000 IU.  (1000 really only maintains you at the level you are at, prevents decrease in blood levels, 2000 Iu is where it starts to increase.)  Resist any doctor who wants to "up your D" with a shot, they are usually xx,xxx IU or even xxx,xxx IU, and too strong for withdrawal.  (same with Vitamin B)

 

We have had people surviving on much lower D levels than that - because they reacted in withdrawal.  If you do not react, if you reinstate the D smoothly, then - go for it!

 

It's more about your reaction than your levels.  We want to smooth you out.  While it's important for health, you can correct it later.

 

Magnesium - learn about ways to take it in a bath, here:  Epsom Salts - Another Way to Relax with Magnesium

 

It is important, too, to develop a practice in Non Drug Techniques for Coping with Emotional Symptoms.

 

Doing one thing daily, whether that is 5 minutes of stretching (one of my 5 minute practices was circling my joints.  Ankles, knees, hips, waist, shoulders, elbows, wrists, neck, clockwise, counter clockwise.  This circulates lymph and helps with inflammation), 5 minutes of meditation, 5 minutes of walking - start small, and build your practice up (whatever your practice is).

 

Once you have established a practice for 3 weeks, you begin to build a "bank account" of relaxation response, or trained awareness, that will help you when the symptoms are greater. 

 

Still, when a wave is on you, you are convinced that it's the worst, and it will never get better.

Then, when the window comes, you are convinced that it's wonderful, and you'll never be sick again.

 

Both are not exactly true.  Life comes in waves and windows, so when in a window, build your bank account for the next wave.  When in a wave, be sure and fall back on your practice to help get through it.

 

Start simple, 5 minutes.  An ideal practice is at least 10 minutes per day.

 

It does get better, and it does take time.

 

How are you going with working through the concept of making a liquid - splitting capsules, dissolving, measuring, etc?

 

I hope you have a better day!

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