karenp: my story so far ... and thanks for reading

[karenp]

Hi Rhi,

 

Thanks so much for your thoughts and observations. Regarding the benzo, I was mostly on Ativan until I switched to Clonopin over the summer to complete the taper. I don't remember how much I was on when I began tapering the Ativan -- something like 3 mg a day....maybe less. I don't know where I was at when I made the switch. I was doing this all on my own by cutting the pills into smaller and smaller sizes and spacing the dosing throughout the day. Wish I had known then what I know now .

 

So now I'm at 75 of the lamictal, 30 of the mirtazipine, 60 of the prozac, and .375 of the clonopin. My head is not right although better than a few days ago. The severe despair is less and the panic is less but i have a terrible gnawing anxiety and fear that seems located in the middle of my forehead--third eye area.

[Rhiannon]

3 mg of lorazepam is equivalent to 1.5 mg of clonazepam and to 30 mg of Valium. Do you remember how much clonazepam you were taking? Did you take them both at the same time or did you switch over fully and take just clonazepam?

 

I think you're mostly in the throes of benzo withdrawal right now, exacerbated by the Lamictal mess. You may find it beneficial to visit the forum Benzo Buddies, although the information given there is not quite as carefully sorted through as the information you will get here. But you might find it helpful and supportive to share with others going through the same things.

 

I think the reinstatement of the clonazepam was a good idea. You could probably go higher, in small increments, if you need to, up to 0.5 mg or so. Then hold for three months at the very least and see if your symptoms improve. Don't change anything else during that time. Once you've stabilized, you can begin a cautious and reasonable taper off the clonazepam. Given your history, I think you need to plan at least eight months to taper off. A year would be safer and more realistic. You'll need to do liquid titration, which is not difficult.

 

I wish I could give you better news about how long this will take. But I think you've had a glimpse of what happens when you try to do it too fast. Recovery from a too-rapid benzo withdrawal can take up to two or three years and people are often disabled during much of that time. You have kids, which is not a job that allows for taking a couple of years off. So please take care and be very conservative. You CAN do this and remain functional, but the trade-off is that you have to be very careful and patient.

 

Polydrug withdrawal after many years on psych drugs is a tricky business. You have to grow a new nervous system and endocrine system. That's not something that happens quickly.

 

I know you're suffering, and I'm so sorry...I've been there. It's awful.

[Altostrata]

karen, it looks like you increased Lamictal 25mg, to 75mg? Are you headed for 100mg?

 

I agree with Rhi, going up and down, especially with multiple drugs in large increments at the same time, is a recipe for destabilization.

 

The nervous system likes stability.

 

Since you changed the Lamictal dosage and the Klonopin dosage at the same time, we don't know which is causing your current symptom pattern (on top of benzo withdrawal).

 

But it is a good thing you're feeling a bit better.

 

Perhaps, given Rhi's very welcome advice, you can make a plan? And change only one drug at a time? Maybe stay at 75mg Lamictal and work on the benzo?

 

PS I was just contacted by a well-respected and very experienced psychiatrist who tries to untangle the polydrugging of his mostly bipolar patients. He said it was unexpectedly difficult to get them off Lamictal; I replied with my experience and suggestions.

[karenp]

I am staying at 75 of the lamictal and going up to .5 of the benzo. Just did that tonight and the extreme fear and anxiety has let up a bit. I so don't want to get caught in the dreaded cycle of having to keep increasing the benzo again.

 

Has anyone done one of these intensive orthomolecular programs that have a all sorts of therapies including chelation (for heavy metal reduction) and other alternative modalities that help calm the nervous system?

 

-karen

[Altostrata]

Errrr...okay, here's my take: Those programs are far too strenuous and experimental for nervous systems sensitized by withdrawal.

 

You should be aware that every "alternative" treatment for depression or mood or whatever presumes you have a normal, intact nervous system. None of them account for the hypersensitivities of withdrawal syndrome. Whatever claims they make for dramatic results are based on people who have relatively normal tolerances.

 

Chelation is irrelevant in treating withdrawal syndrome. It was developed to treat heavy metal poisoning. You do not have that.

[Rhiannon]

Absolutely agree with Alto. Many people find that even just taking normal vitamin supplements exacerbates their withdrawal symptoms. You need to be very gentle with your nervous system. Anything that says "detox" in it, steer clear, IMO! Later, once you're through with the withdrawal process and fully stable, you can look at trying things like this.

 

At this point I think you need to just HOLD ON for a while and give your nervous and endocrine systems the time they need to balance and stabilize. Find your dosage and just stick with it. It may take a while. Three months is optimistic; six may be more realistic. Work on supporting yourself with gentle exercise, minimal stress, healthy diet, and consistent daily routines. And you can also use this time to do some reading and self-education.

 

You can't really accurately judge the effect of a change of dosage in just 24 hours, because symptoms would be waxing and waning anyway.

 

Also, just FYI, mornings are worst for people in benzo withdrawal. I think it's probably because cortisol levels are highest then and drop as the day goes along. This is really common.

 

Once you're stable you can look at what kind of safe, conservative taper makes sense for you in your life situation.

 

Good luck! We're rooting for you.

[karenp]

Hi. I've been away from the forum for a while. I finished a Clonopin taper at the end of February and just 2 weeks ago tried to reduce Lamictal--went from 50 mg. to 37.5. At the end of last week I decided to try and reduce the remaining Prozac from 35 to 25. My ns went totally haywire a few days ago and I went back up on the Lamictal and this morning I reinstated 5 mg. of the Prozac. It seems that maybe I should not touch anything else for a while until my system more fully recovers from the Benzo taper?

 

Thanks

Karenk

[Altostrata]

That's a good idea, karenp. Let your system stabilize from the recent changes.

 

If I were you, I'd taper the Prozac before the Lamictal. Lamictal is a regulatory (sedative-like) drug.

[karenp]

Thank you Alto. The panic, confusion, depression, and cog fog are just awful this last week. I hope that with a smaller reduction I will do better. How long do you think I should wait until trying again with the Prozac? This process is so brutal!

 

Karen

[Altostrata]

Hard to tell, my guess is to stabilize over at least a few weeks. With the prior benzo withdrawal and destabilization from too big a drop in Lamictal, perhaps you should think in terms of very, very small decreases in the Prozac.

 

Let's continue this discussion in your karenp topic http://survivingantidepressants.org/index.php?/topic/1410-karenp-my-story-so-farand-thanks-for-reading/page__p__13101__hl__karenp__fromsearch__1#entry13101

[karenp]

Hi.  I am currently on 50mg. Seroquel, 50mg. Lamictal, 25 mg. Prozac, and 3 mg. of Melatonin.  I was on Klonopin and Ativan for 4+ years.  I have been totally off the benzos for 14 months now.  As of last summer (when I had 2 hospitalizations for benzo w/d) I was on 100 mg. of Seroquel, 40 of Prozac, 50 of Lamictal, 150 of Gabapentin, and 6 mg. of Melatonin.  So I have tapered quite a bit.  Am holding now after cutting the Melatonin again and feeling pretty rotten.

 

I haven't touched the others in over a month after a distressing life event that turned things upside-down.  Hopefully I will stabilize soon from the Melatonin cut and then I'd like to get back to tapering the others.  It seems like I should work on the Prozac first?  And should I go all the way off of it before moving to another drug?  I am very sensitive and have definitely tapered too fast in the past.  I want to be very cautious and not try more than 10% at a time.  I am also afraid to start to decrease again after what I've gone through these last two months and have seen how sensitized my nervous system remains.

 

Any guidance around this would be much appreciated.

 

Thanks!

Karen

[Jemima]

If I were in your place, I'd taper off the Mirtazapine first.  It seems to be an exceptionally difficult drug to get off of, so I'm thinking that it might be easier while you still have support from the other two drugs.  I was on Mirtazapine for about five months and tapered off while still on another antidepressant and I didn't have any withdrawal symptoms.  The fact that you've been on it longer may be a factor, but I'm still guessing that would be your best bet.  Mirtazapine also has a way of backfiring and giving people sleep problems, so if you aren't at that point yet, it might be a good idea to eliminate it before it gives you trouble.

[Rhiannon]

Hi Karen!

 

It looks like you've realized that trying to taper too fast just takes way more time in the long run plus causes a lot more misery. Given your history I think even 10% cuts may be large for you. I'd recommend starting smaller, maybe 3-5% cuts, with 3-4 week holds at first.  

 

Again, I'm saying this specifically because of your history.  

 

As Alto says, our nervous systems are not made of rubber. They are not infinitely flexible. It appears to me that once people have had a certain amount of history of difficult withdrawals, and gone up and down on meds a lot and changed meds a lot, they become much more sensitive to changes in meds and need to be extremely conservative with tapers.

 

Since it looks to me like you generally in the past have pushed things too far too fast and ended up paying harshly for it, I'd like to encourage you to try a different approach now: try to do too little, too slowly. Sort of. I mean, start very small, very slow, with long holds. A tiny cut followed by a long enough hold to let the symptoms fully resolve before making another cut. Then do that again, and again, and again, until you have a feel for how your withdrawal symptoms play out, and you have a feel for what it feels like to actually taper and be stable.  

 

You may find you can speed up after a while. I have found that it's far better to start too slow and speed up a bit, to learn your body's tolerance to cuts slowly and gradually, than to start too fast and crash and hit the wall and go through that whole horrible process and probably end up on more meds before being able to start tapering again.

 

Again, given your history, I think it is crucial now that you bite the bullet and taper extremely cautiously. So it's going to take a few years, so what. As you can see, going too fast ends up taking a lot of years too, and one is miserable and dysfunctional most of the time. A slow taper that allows you to feel well enough to enjoy life is, in my opinion, a better way to go, and probably easier on your brain and body as well.

 

Good luck! Hope to see you around and doing well.

 

Edit: PS: Don't start tapering until you're feeling well. You have tapered a lot, as you say, plus you're still recovering from those benzo tapers. I highly recommend you keep a daily journal of symptoms, rating your symptoms and how you're feeling on a scale of, say, 1 to 5.  Once you see the numbers have plateaued out and are consistently below something like 2, you can consider starting another taper.  Once you start to taper, keep track of your daily dosages and cuts in the journal, and continue to rate your symptoms daily. This will help you detect your own withdrawal patterns.

 

And again: SLOW. This is definitely a case where the more you hurry, the further behind you fall, as I think you have found out the hard way.

[karenp]

Thank you so much Rhi for your comments.  You are spot on with everything you said.  Yes I do need to bite the bullet and be very conservative.  I guess I will have to liquid titrate?  Should I start with the Prozac first?  

 

Thanks again,

Karen

[Rhiannon]

Jemima thinks starting with the mirtazapine is a good idea and I'm going to defer to her on that. She knows more than I do about the ADs.

 

I think it's too soon for you to start tapering again. This is a good time to hold and practice patience. And start your journal, and read up about liquid tapering and microtapering. Again--it's not time to start tapering yet.

[karenp]

Thanks Rhi and Jemima.  I have updated my signature -- I am no longer taking mirtazipine.  I tapered from that early last year.  I am now on Seroquel, Prozac, and Lamictal.

 

What is your advice based on these drugs?

 

Thanks so much,

Karen

[Altostrata]

Why are you taking Seroquel? What effect has it had on you?

[karenp]

I started taking Seroquel in the hospital last summer when I was desperate and barely sleeping.  I regret getting on it but it did knock me out at night.  Not sure if it still has a sedating effect or not.  I am down to 50 mg. from 150 at one point last summer.  It did whacky things to my appetite at a higher dose and I gained a few pounds which is common.  Not feeling that particular effect so much anymore at 50.

[Altostrata]

In that case, I'd start tapering the mirtazapine first, figuring Seroquel will help any rebound insomnia.

 

Then, I'd go off the Prozac, then the Seroquel.

[karenp]

Hi Alto,

 

Thanks for replying.  I am no longer taking Mirtazipine.  I updated my signature a few days ago so you may not have seen it.  I am currently on 50 Lamictal, 25 Prozac, 50 Seroquel, and 3 mg of Melatonin.

 

Should I start with the Prozac?

 

Thanks!

[Altostrata]

How's your sleep?

 

Prozac comes in a liquid, see the Tapering forum for tips on tapering it.

 

I might decrease the Prozac part way, then work on the Seroquel. I wouldn't want to be taking Seroquel any longer than needed for sleep.

[karenp]

My sleep is generally good, thankfully.  I am starting to wonder if the Prozac is contributing to this "revved" up feeling I have almost all the time.  I want off these poisons but know that I can't do anything dramatic.  I will look at the tapering guidelines for Prozac.

 

Thank you

Karen

[karenp]

Hi Everyone,

 

So I have started tapering the Prozac again--haven't touched it since last fall.  I have gone down 1 mg. from 25 to 24 and am on day 9.  The depression has been pretty awful with a little lessening today.  Hard to know if it's connected at all to the taper.  

 

I have been through the wringer these last 3 months with a nasty court issue that arose with my ex-husband.  I was in a sort of window just before that but it's been brutal ever since.  

 

I am also 16 months off Klonopin after 2 rapid tapers.  And since last summer I have aggressively tapered Neurontin and Seroquel.  I have definitely hit a wall and have to be much more careful.  When the legal stuff began I stopped any tapering for 2 plus months.  Then I decided to try going down a bit on the Melatonin I've been taking.  Just a little decrease sent me into a really bad place (this is before the 1 mg decrease of Prozac).  Again it was hard to know what was causing the problems but it seemed connected.  I waited a few weeks to start the Prozac taper, waiting for certain symptoms to subside, including the massive dizziness which I had never had before.

 

I am just really struggling and trying to keep a bit of perspective that what I'm feeling is the drugs and not me.  Hard to keep going day after day feeling like this.

 

Wishing everyone the best as we heal from this nightmare,

Karen

[Rhiannon]

Hang in there, Karen.  Remember that when it comes to withdrawal, often the hurrieder we go the behinder we get. You may need to slow down or hold completely for a while.

[karenp]

Thanks Rhi.  I am having trouble letting go of the thought that I my healing will be stalled as long as I'm on this crap:(.

[karenp]

Hi.  I am taking about 17 mgs. of Prozac.  I was taking a 10mg. capsule and the rest in liquid.  But my pharmacy stopped carrying the manufacturer of the capsule I was taking so I decided to switch to all liquid.  I don't think I noticed anything besides some stomach cramping the first day or two.  Has anyone had any major reactions from switching to liquid?

 

Thanks

[ChessieCat]

I've simplified your drug signature.  We only need drugs, dates and doses.  I've bolded what seem to be the current drugs your are taking and put question marks where years are needed (Klonopin and Gabapentin).

 

I suggest that you copy and paste your current drug signature into a post before updating to the new drug signature.

 

Please check the following, add any additions necessary.  Click on this link to go straight to the drug signature.  Account Settings – Create or Edit a signature

 

Zoloft:  1997-2010

Effexor:  2010-2011 cross taper to Prozac

Prozac:  2011, 60mg, current 17mg

Ativan:  2005-2006 PRN, 2007 daily, tapered off June-Sept 2011

Mirtazapine:  2010-2012

Lamictal:  2011, 100mg, current 50mg

Klonopin:  ?-2012

Seroquel:  2013, 150mg, current 50mg

Melatonin:  2013, 9mg, current 3mg

Gabapentin:  ?-?

[ChessieCat]

7 hours ago, karenp said:

Has anyone had any major reactions from switching to liquid?

 

Other members have reported noticing a difference when they change the form of a drug.  Because you had already been taking part of your dose in tablet and the other part in liquid the change over probably was a lot less of an issue than if you had gone straight from tablet to liquid.  When a member needs to change we generally suggest doing a few days to a week of the combos 3/4 + 1/4, 1/2 + 1/2, 1/4 + 3/4 which is gentler on their system.

 

On 8/12/2011 at 4:31 AM, Altostrata said:

 

People have trouble switching from tablets to liquid, or brand-name to generics, because of very small differences in formulation and absorbability. A liquid may be absorbed faster.

 

But many people do not have difficulty with these switches.

 

[ChessieCat]

BTW, welcome back after such a long, long time away.

 

You might find this topic helpful:  are-we-there-yet-how-long-is-withdrawal-going-to-take

 

And how are you?

 

 

[karenp]

Hi thanks.  I’m not doing so well.  The Klonopin ct messed me up bad making tapering the other stuff very difficult.  It’s been a long road I’m still traveling.

[karenp]

Hi.  I had been microtapering the Prozac but just recently tried to do a slightly different reduction.  So basically I cut by a half a mg. All at once.  That was 16 days ago and I feel just awful.  I am so sensitive it’s incredible.  It could be partly a benzo wave but I sense that it’s connected to the cut.  Have others been impacted badly by such a small cut?  The racing thoughts and the terror are just horrific.  Should I just wait it out?  No sense in going back up right?  Thanks 

[ChessieCat]

25 minutes ago, karenp said:

had been microtapering the Prozac but just recently tried to do a slightly different reduction.  So basically I cut by a half a mg. All at once.  That was 16 days ago and I feel just awful.

 

16 days ago was the middle of December.  Right before Christmas.  Many members have posted about their symptoms increasing over the Christmas/New Year season.  Any stress, even pleasant/good stress can cause withdrawal symptoms to ramp up.

 

Q:  Did you have any alcohol over Christmas/New Year, or eat different things, or more irregularly, or more than usual, or have late nights?

 

Q:  Are you taking any benzos PRN?

 

Q:  Are you taking supplements?  B vitamins, especially B6 can be activating.

 

Q:  Has anything different happened, like suffering sickness, eg cold/flu, stress at work, relationship issues?

 

If you can bear to wait it out, that's what I would be doing.  If it was caused by the seasonal stress then things will hopefully ease up in the next week or so.

[karenp]

Thanks Chessie,

 

No I haven't had any alcohol.  I don't take any supplements or prn benzos (been off benzos for 6 years after a cold turkey).  Christmas was stressful for sure and I haven't been sleeping well.

 

I will just be waiting it out I think.  Today seems ever so slightly better.

 

Thanks again,

Karen

[ChessieCat]

11 hours ago, karenp said:

Christmas was stressful for sure and I haven't been sleeping well.

 

That may be the reason.

 

11 hours ago, karenp said:

I will just be waiting it out I think.

 

Good idea.

 

11 hours ago, karenp said:

Today seems ever so slightly better.

 

That's heading in the right direction.

 

 

When we feel worse it's a good idea to try and see the big picture and think about the previous month or two and about what else may have caused it.  Not everything can be blamed wholly and solely on withdrawal.

[Carmie]

Hi Karen, 

 

How have you been doing?💚