DMV64: reinstate Saphris?

[bubble]

I put a link to this very important information about how these drugs work and why we can't just stop taking them.

 

I don't know if you had a chance to read it because I know you struggle with your eyesight so I'm copying it here.

 

(It doesn't matter that the example is with SSRIs - the same type of changes happens with all types of psychotropic drugs).

 

A lot of people, including healthcare practitioners; in fact, I guess, most people-- are operating from entirely the wrong paradigm, or way of thinking, about these meds. They're thinking of them like aspirin--as something that has an effect when it's in your system, and then when it gets out of your system the effect goes away.

 

That's not what happens with medications that alter neurotransmitter function, we are learning. What happens when you change the chemistry of the brain is, the brain adjusts its chemistry and structure to try to return to homeostasis, or biochemical and functional balance. It tries to restabilize the chemistry. For example: SSRI antidepressants work as "serotonin reuptake inhibitors." That is, they cause serotonin to remain in the space between neurons, rather than being taken back up into the cells to be re-used, like it would be in a normal healthy nondrugged brain. So the brain, which wants to re-establish normal signaling and function, adapts to the higher level of serotonin between neurons (in the "synapse", the space between neurons where signals get passed along).

 

It does this by removing serotonin receptors, so that the signal is reduced and changed to something closer to normal. It also decreases the amount of serotonin it produces overall. To do that, genes have to be turned on and off; new proteins have to be made; whole cascades of chemical reactions have to be changed, which means turning on and off OTHER genes; cells are destroyed, new cells are made; in other words, a complex physiologic remodeling takes place. This takes place over time. The brain does not grow and change rapidly. This is a vast oversimplification of the amount of adaptation that takes place in the brain when we change its normal chemistry, but that's the principle.

 

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay. When the drug is removed, the remodeling process has to take place in reverse. SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. It's a matter of, as I describe it, having to grow a new brain. I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long.

 

With multiple drugs and a history of drug changes and cold turkeys, all of this becomes even more complicated. And if a person is started on these kinds of drugs at an early age before the brain has ever completely established normal mature functioning--well, it can't be good. (All of which is why I recommend an extremely slow taper particularly to anyone with a multiple drug history, a history of many years on meds, a history of past cold turkeys or frequent med changes, and a history of being put on drugs at a young age.)

 

This isn't intended to scare people, but hopefully to give you some idea of what's happening, and to help you respect and understand the process so you can work with it; ALSO, because you are likely to encounter many, many people who still believe these drugs work kind of like aspirin, or a glass of wine, and all you need to do is stop and get it out of your system. Now you can explain to them that no, getting it out of your system is not the issue; the issue is, you need to regrow or at least remodel your brain. This is a long, slow, very poorly understood process, and it needs to be respected

 

 

 

Edited September 17, 2017 by bubble

[DMV64]

3 minutes ago, bubble said:

I put a link to this very important information about how these drugs work and why we can't just stop taking them.

 

I don't know if you had a chance to read it because I know you struggle with your eyesight so I'm copying it here.

 

(It doesn't matter that the example is with SSRIs - the same type of changes happens with all types of psychotropic drugs).

 

 

Thank you. I will have my husband help me with it later today!

[DMV64]

9 minutes ago, bubble said:

One change at a time, close monitoring of the symptoms for a week, detailed log of the symptoms and then we reassess.

 

How many days were you off vyvanse? 2 days but I did reinstate this morning as you suggested in your last post

 

I suspect worsening of your symptoms was due to cold turkeying it. Now once you have reinstated, it might take even a few weeks before things come to the pre-cold turkey state. Maybe less but maybe more.

 

Not to mention that now we can't tell how reinstating Saphris is working. And there is no way to tell how CT lithium and reducing Geodon is affecting you either. It's all contributing and causing your symptoms. Not making any further changes and riding tge symptoms out is a way out. I know I messed up. And now it is impossible to tell. I am doing the best I can here, learning curve and my MIND.

 

The first thing that needs to be done is to wait for the consequences of vyvanse cold turkey to abate and keep still with no further changes. 

 

There will be symptoms. The brain got badly traumatised. But you know what they say the best thing when attacked by a bear is: not do anything, keep still, don't panic and don't run (or in your case don't change drugs).

 

[bubble]

Just now, DMV64 said:

I know I messed up. And now it is impossible to tell. I am doing the best I can here, learning curve and my MIND.

 

We all have to make our share of mistakes  Don't worry. We are moving on.

 

Mistakes are an important part of the learning process and they are never in vain as long as we learn something from them.

 

I would leave Geoden as it is right now so that we can see what happens to your symptoms after you have reinstated vyvanse. One change at a time is a very important principle. 

 

6 minutes ago, DMV64 said:

Thank you. I will have my husband help me with it later today!

 

That explanation helped mo so very much. It's very simple and it makes so much sense and it is so very important because everybody tends to assume these drugs are just like aspirin (psychiatrists in particular  So may things started making sense after I read it the first time. I'm glad your husband will help you read it because it is very useful for people around us to understand what is happening to us.

 

You are a fighter and you are very strong and you are trying hard. You will beat this. Just slowly and mindfully.

[DMV64]

12 minutes ago, bubble said:

 

We all have to make our share of mistakes  Don't worry. We are moving on. Yes thank you. I am beating myself up a little.

 

Mistakes are an important part of the learning process and they are never in vain as long as we learn something from them.

 

I would leave Geoden as it is right now so that we can see what happens to your symptoms after you have reinstated vyvanse. One change at a time is a very important principle.  Ok. lets see what happens, right now I feel ok. Have to go teach in a moment. Have meditation planned for afternoon. Also FYI my phone won't let me respond. So that kind of stinks. Have to wait to be on computer.

 

 

That explanation helped mo so very much. It's very simple and it makes so much sense and it is so very important because everybody tends to assume these drugs are just like aspirin (psychiatrists in particular  So may things started making sense after I read it the first time. I'm glad your husband will help you read it because it is very useful for people around us to understand what is happening to us. Yes, well I think the more I can understand and not feel like I am stuck on a bad acid trip forever, the better off I will be.

 

You are a fighter and you are very strong and you are trying hard. You will beat this. Just slowly and mindfully. Yes. It is hard and humbling. Thank you for saying this. I feel like I will be stuck forever.

 

[DMV64]

I read the quote today-it was very helpful. I pasted it into a doc on my computer to remind me!

Good news is today I felt better than yesterday. Hopefully the Vyvanse reinstate after 2 days off is good.

Todays symptoms

6AM: Wake with panic. Deep breathing. Remembering there is no threat. Read boards.

7AM: 5mg Vyvanse

7:45: Feeling better. Have breakfast

8AM: 1mg Klonopin

Go to work and feel functional. YAY

1PM: 100mg gabapentin and lunch

3PM: Usual mid afternoon anxiety starts (this is pretty consistently not a good time. I forgot to mention I moved the Geoden dose to this time to try to help the anxiety but wondering if I need to move it even earlier, before symptoms?) 10mg Geoden

3-5PM: I think DR? I have seen this mentioned-is this the outside of myself unreality feeling? 

5PM: 100mg gabapentin. Feeling a little better, more in body, less afraid.

6PM: Go to a meeting and connect with people and feel ok. FEEL OK!

7PM: eat dinner. Still feel ok and very grateful.

Plan to take 2.5mg Saphris with .5 Cogentin at 9:30 before bed along with last daily dose 100mg gabapentin. Will report any other symptoms after the time of this post tomorrow.

 

[JanCarol]

Hey DMV - thanks for your PM.  I'm reading your thread now, but have other demands on my time, so I will comment as I can:

 

Quote

Cannot take SSRI, they make me manic and sick. This lead Psych to think maybe Bi-polar, except that I don't fit the rest of the criteria. 

 

This is what led the docs to believe I was "bipolar."  The SSRI made me hallucinate and jazzed me up.  To the psychs, this was an "unmasking" of my "native bipolar."  It was all a load of bunk, it was a drug reaction and that is that.

 

I'm fully undiagnosed now, but I leave it in the charts as it gives me the right to refuse drugs.  "Can't take that - bipolar!" is something they can buy, rather than the truth of my journey from drugged to drug free.

 

Reading your story, it is a classic drug cascade.  The klonopin eased your anxiety, but caused depression.  The other drugs were added to "help" with the muscular problems with Saphris.  Withdrawal from Saphris has thrown you into the polypharmacy where you now reside.  It's classic prescribing practices.

 

Quickly (as I need to go) I do not think that you are ready to taper.   You need for your symptoms to settle and be more stable before you taper.

Brassmonkey writes about a condition we've learned to call "Withdrawal Normal:"
 

Quote

I see WDnormal as the overall baseline of where you are in general. The place you are when you're not feeling good, but you're not feeling bad. Sorta a rolling average of the past couple of months between the windows and waves.  Watching the level of WDnormal is a good indicator that things are improving.  Over time you should be seeing a raising of the standard for WDnormal.  So how you're feeling now is better than say six months ago. It changes very slowly but is a really good indicator.

 

 Many people have the idea that stability is feeling good again, when in fact it's feeling the same level of blah day after day with no big swings to the better or bad. When a person does a drop in dose there will be a corresponding increase in WD symptoms over the next few days.  These symptoms will resolve themselves over the following several weeks and return the person to a slightly raised baseline of discomfort. The time frame and severity are dependent on a huge number of factors and end up being unique to each individual.  But the pattern remains.  This is why paying attention to your WDnormal is very important.  It is also referred to as listening to your body.  After a drop in dose and the symptoms have resolved to WDnormal the person then should wait a couple of more weeks to let things really settle out (there are a lot of little unfelt changer still going on) before considering doing their next drop.

 

Hope you find it helpful.

 

During that waiting time people may think that they're not doing anything and want to get on with it.  When in fact doing nothing is very proactive.  It's those little unfelt things that need to be finished up before the next step can be taken.  It's letting the glue harden, the paint dry, the cement cure.  The things that need to be complete before the path is safe to walk on again.  If these details are ignored then they start to pile up and compound each other, then somewhere down the line the foundation slips out from under us and the whole thing collapses.

 

Also - your bladder and back pain makes me concerned about the lithium.  Now is not the time to taper, but lithium can be toxic. 

 

How long have you taken lithium overall?  When did it start / stop / start again?  Has your dose always been 300 mg?

Have you ever received blood tests to check for kidney and liver toxicity?

 

Please hydrate and take electrolyes (I like himalayan or celtic salts).  One event of dehydration when on lithium can cause damage, so this is probably the first thing you need to address to heal.

I'll be back when I can get to a computer again.

 

I hope you see the sun today!

[DMV64]

12 minutes ago, JanCarol said:

Hey DMV - thanks for your PM.  I'm reading your thread now, but have other demands on my time, so I will comment as I can:

 

 

This is what led the docs to believe I was "bipolar."  The SSRI made me hallucinate and jazzed me up.  To the psychs, this was an "unmasking" of my "native bipolar."  It was all a load of bunk, it was a drug reaction and that is that. Yes! Thank you!

 

I'm fully undiagnosed now, but I leave it in the charts as it gives me the right to refuse drugs.  "Can't take that - bipolar!" is something they can buy, rather than the truth of my journey from drugged to drug free.

 

Reading your story, it is a classic drug cascade.  The klonopin eased your anxiety, but caused depression.  The other drugs were added to "help" with the muscular problems with Saphris.  Withdrawal from Saphris has thrown you into the polypharmacy where you now reside.  It's classic prescribing practices. This makes me sad. I know it is true. And now I am here and seems like it will be awhile before I am out. But I really want out.

 

Quickly (as I need to go) I do not think that you are ready to taper.   You need for your symptoms to settle and be more stable before you taper. I agree.

Brassmonkey writes about a condition we've learned to call "Withdrawal Normal:" This was very helpful! I know I tend to jump ahead.
 

 

Also - your bladder and back pain makes me concerned about the lithium.  Now is not the time to taper, but lithium can be toxic. I am off the Lithium actually. It did burn my bladder.

 

How long have you taken lithium overall?  When did it start / stop / start again?  Has your dose always been 300 mg? I took it from December to April and then again in June for a short bit. It has always been 300. I took a weeks worth right after the last Saphris crash but stopped it.

Have you ever received blood tests to check for kidney and liver toxicity? Yes. Were normal.

 

Please hydrate and take electrolyes (I like himalayan or celtic salts).  One event of dehydration when on lithium can cause damage, so this is probably the first thing you need to address to heal. Ok yes.

I'll be back when I can get to a computer again. Thank you!!

 

I hope you see the sun today!

 

[JanCarol]

On 17/09/2017 at 9:24 AM, DMV64 said:

I do take magnesium thank you though! 

 

Hey D - 

 

What kind of magnesium do you take?  It is unconscionable but the most common magnesium is Magnesium Oxide, which is as effective as chewing rocks to get your magnesium.  It is not well absorbed, and frequently bundled with calcium which makes it even less effective.

 

Please read the magnesium thread to learn about magnesium citrate and glycinate, if you are taking magnesium oxide.

 

The next thing to consider is Omega-3 fish oil .  I find that the magnesium helps facilitate healing, while the fish oil keeps things (like your myelin nerve sheaths) lubricated and smooth running.

[DMV64]

4 hours ago, JanCarol said:

 

Hey D - 

 

What kind of magnesium do you take?  It is unconscionable but the most common magnesium is Magnesium Oxide, which is as effective as chewing rocks to get your magnesium.  It is not well absorbed, and frequently bundled with calcium which makes it even less effective.

 

Please read the magnesium thread to learn about magnesium citrate and glycinate, if you are taking magnesium oxide.

 

The next thing to consider is Omega-3 fish oil .  I find that the magnesium helps facilitate healing, while the fish oil keeps things (like your myelin nerve sheaths) lubricated and smooth running.

Hi! I am not even sure- I have to check my magnesium. I take cod liver oil. Is that the same?

[DMV64]

I would also like to add to my symptoms that I feel so much better at night. So much better.

[DMV64]

Oh my gosh! My magnesium is Oxide!

[JanCarol]

Hey D - 

 

Quote

 I take cod liver oil. Is that the same?

 

No, cod liver oil is a compound which also contains Vitamin D and A.   The D and A may be overstimulating, especially if you have paradoxical reactions to things.  Some people can take it, but most people do better on plain Omega-3 fish oil.  It doesn't even need to be expensive.

 

Don't be alarmed about the mag oxide - it's common as dirt.  For my first year  of tapering I was on Mag Oxide and wondered why I wasn't getting the same effects as others. 

 

Overall, you have been getting wise advice and support from Bubble.  I'm going to quote her here:

Quote

I also firmly believe it's this stability that heals and not a particular dose. 

 

and from your own thread:

 

Quote

The moment you experience that your symptoms abated WITHOUT adding, increasing, decreasing, stopping drug is the moment when your journey to a drug free life starts. Not before.

 

I hope that you can stay on your same doses for awhile longer until things settle down.  It's hard, I know - here is what I said to you in PM:

 

Quote

In my experience the difference between SSRI's and antipsychotics is often impulse control.  It is easier to control the slow taper on antidepressant than it is on the antipsychotic, because rarely do the antipsychotics "feel good," while the antidepressants can be associated with "feeling better."  

 

People on antipsychotics want to come off too fast.  As hard as it is, this is the most important thing:  to taper more slowly than your symptoms.  Taper so slowly that you have few or no symptoms.

 

The impulse is to "come off your drugs," and that rarely goes well.  It seems that the people who quit cold turkey (CT) have the most trouble for the longest time.

 

I haven't read your story - so much depends on how long you have been on them, how much you have been on, how many different drugs you have been on.

 

But I believe that anyone can come off of them.

 

Upon reading your story, I have to emphasise how important it is for you to stabilize before making any other changes.

 

What do we mean by that?  

 

One suggestion I've heard is when you have been stable for a month, wait another month before tapering anything.  There is a  Delayed Onset of Withdrawal Symptoms .  This is why Bubble is so concerned about you - you have made several changes since the beginning of the month.  It might take 3 or even 6 months until those changes are felt!  It's the cruel truth of these drugs.

 

Carl Sagan judged the quality of a drug by the length of time it took to have effect.  He hated the concept that you could take a thing now, and then 3 hours from now regret it.  These drugs have long lasting, lingering effects, as they make changes in your brain that may take weeks or months to happen.  The time scale on these drugs is so long, and this is how we end up with "diag-nonsense."  3 months after a change, a new "effect" is diagnosed as something else.

 

Your signature is still not really clear to me - You say in the signature that you went back on the lithium Aug 31, but you also said 

18 hours ago, DMV64 said:

I took it from December to April and then again in June for a short bit. It has always been 300. I took a weeks worth right after the last Saphris crash but stopped it.

 

So I'm not sure what has happened here.  But let's just use the lithium for an example.  A change you made in April could be felt in July.  A change you made in August might be felt into November.  You made a ton of changes this month.  Expect to feel the results of those changes into December.  You might get lucky and settle in less time - or - you might be experiencing symptoms for longer, as you adjusted not one, but several drugs within a single month.

 

In order for moderators to help you, we need to know exactly what you have taken and when and any changes you made.

 

Let me suggest this for a format (your actual dates and numbers may vary):

 

2007 - Xanax (0.xx mg)

2010 - depressed, tried several SSRI's, settled in 2011 on Saphris (xx mg)

2013 - side effects from saphris, added cogentin xxx mg

2015 - vyvanse xx mg added, gabapentin xxx mg added.

2017 - lithium 300 mg tried Jan - June, then Aug 31 - Sept 7

DATE you quit the Saphris (xx mg), DATE you reinstated the Saphris (xx mg),   Date you updosed the Saphris.

DATE you started the Geodon, Dates you CHANGED DOSAGE on Geodon.

 

I know this is complicated - but can you see how not having this information is making it hard for us to help?  If there is a 3-6 month delay in effects from the drugs, we need those dates  and changes to understand what is happening to you going forward.

 

You may also want to  Keep notes on paper .  In fact, read that whole page about Before you begin tapering.

 

I'm sorry this is so challenging, from what I can tell you are in pretty good shape and should come around fairly quickly, especially with your yoga practice.  But not even Iyengar understood the effects of these drugs!

 

Please, get us some good information on your signature, and hunker down and prepare to hold!  

 

I'll leave you with a quote from our Scallywag:

Quote

Changing dose, up OR down, can be destabilizing. Most often the lowest risk action is no action -- staying at the same dose.

 

 

And I hope you see the sun today!

[DMV64]

4 minutes ago, JanCarol said:

Hey D - 

 

 

No, cod liver oil is a compound which also contains Vitamin D and A.   The D and A may be overstimulating, especially if you have paradoxical reactions to things.  Some people can take it, but most people do better on plain Omega-3 fish oil.  It doesn't even need to be expensive. Ah ok! I just ordered some!

 

Don't be alarmed about the mag oxide - it's common as dirt.  For my first year  of tapering I was on Mag Oxide and wondered why I wasn't getting the same effects as others. 

 

Overall, you have been getting wise advice and support from Bubble.  I'm going to quote her here:

 

and from your own thread:

 

 

I hope that you can stay on your same doses for awhile longer until things settle down.  It's hard, I know - here is what I said to you in PM: I am HOLDING

 

 

Upon reading your story, I have to emphasise how important it is for you to stabilize before making any other changes.

 

What do we mean by that?  

 

One suggestion I've heard is when you have been stable for a month, wait another month before tapering anything.  There is a  Delayed Onset of Withdrawal Symptoms .  This is why Bubble is so concerned about you - you have made several changes since the beginning of the month.  It might take 3 or even 6 months until those changes are felt!  It's the cruel truth of these drugs.

 

Carl Sagan judged the quality of a drug by the length of time it took to have effect.  He hated the concept that you could take a thing now, and then 3 hours from now regret it.  These drugs have long lasting, lingering effects, as they make changes in your brain that may take weeks or months to happen.  The time scale on these drugs is so long, and this is how we end up with "diag-nonsense."  3 months after a change, a new "effect" is diagnosed as something else.

 

Your signature is still not really clear to me - You say in the signature that you went back on the lithium Aug 31, but you also said I am going to try to make a better signature with the brain I have

 

So I'm not sure what has happened here.  But let's just use the lithium for an example.  A change you made in April could be felt in July.  A change you made in August might be felt into November.  You made a ton of changes this month.  Expect to feel the results of those changes into December.  You might get lucky and settle in less time - or - you might be experiencing symptoms for longer, as you adjusted not one, but several drugs within a single month.

 

In order for moderators to help you, we need to know exactly what you have taken and when and any changes you made. I have to do my best to remember

 

Let me suggest this for a format (your actual dates and numbers may vary):

 

2007 - Xanax (0.xx mg)

2010 - depressed, tried several SSRI's, settled in 2011 on Saphris (xx mg)

2013 - side effects from saphris, added cogentin xxx mg

2015 - vyvanse xx mg added, gabapentin xxx mg added.

2017 - lithium 300 mg tried Jan - June, then Aug 31 - Sept 7

DATE you quit the Saphris (xx mg), DATE you reinstated the Saphris (xx mg),   Date you updosed the Saphris.

DATE you started the Geodon, Dates you CHANGED DOSAGE on Geodon.

 

I know this is complicated - but can you see how not having this information is making it hard for us to help?  If there is a 3-6 month delay in effects from the drugs, we need those dates  and changes to understand what is happening to you going forward.

 

You may also want to  Keep notes on paper .  In fact, read that whole page about Before you begin tapering.

 

I'm sorry this is so challenging, from what I can tell you are in pretty good shape and should come around fairly quickly, especially with your yoga practice.  But not even Iyengar understood the effects of these drugs!

 

Please, get us some good information on your signature, and hunker down and prepare to hold!  

 

I'll leave you with a quote from our Scallywag:

 

 

And I hope you see the sun today!

 

[JanCarol]

Thanks D!

[DMV64]

22 minutes ago, DMV64 said:

 

I did it I made a new signature I hope it makes senseI did it I made a new signature I hope it makes sense

[DMV64]

Todays symptoms

7AM: Wake with less panic.

7:30AM: 5mg Vyvanse Go for a run

7:45: Feeling better. Have breakfast

8AM: 1mg Klonopin

Go to yoga, meeting, another meeting. Feel ok!

11AM: 100mg gabapentin and lunch

12:30: 100mg Geoden

2:30PM: Usual mid afternoon anxiety starts 

3:30PM Anxiety subsides

5PM: 100mg gabapentin. Go teach.

8:30PM: Dinner

9PM: 100mg gabapentin

Plan to take 2.5mg Saphris with .5 Cogentin at 10PM before bed. Will report any other symptoms after the time of this post tomorrow.

[Altostrata]

Do you take Klonopin only once a day, at 8 a.m.? Why do you do this?

 

It looks like you are getting "anxiety" every afternoon when your 11 a.m. gabapentin dose reaches peak plasma. It may be having an additive effect to the Klonopin, causing a paradoxical reaction. The two "brakes" press your nervous system down, your nervous system fights back with hyperactivation.

 

Why are you taking gabapentin? What do you mean by ADHD? When did you develop that? When did you start taking Cogentin, and why? What side effects is it supposed to help you with?

 

Please don't move any of your doses more than an hour or two in any direction, and be sure to make a note of that. The fewer changes right now, the better.

 

By the way, a common side effect of Klonopin and other benzos is "depression." (I put this in quotes because it is iatrogenic: drug-caused.)

 

On 9/15/2017 at 10:03 AM, DMV64 said:

Afternoons are hard. Anxiety.  Fear. Been thinking should I split my klonopin dose? Half in am. Half in pm. Maybe not right now but soonish. 

 

Please stop trying to treat your drug reactions with other drugs.

 

On 9/17/2017 at 5:01 PM, DMV64 said:

I read the quote today-it was very helpful. I pasted it into a doc on my computer to remind me!

Good news is today I felt better than yesterday. Hopefully the Vyvanse reinstate after 2 days off is good.

Todays symptoms

6AM: Wake with panic. Deep breathing. Remembering there is no threat. Read boards.

7AM: 5mg Vyvanse

7:45: Feeling better. Have breakfast

8AM: 1mg Klonopin

Go to work and feel functional. YAY

1PM: 100mg gabapentin and lunch

3PM: Usual mid afternoon anxiety starts (this is pretty consistently not a good time. I forgot to mention I moved the Geoden dose to this time to try to help the anxiety but wondering if I need to move it even earlier, before symptoms?) 10mg Geoden

3-5PM: I think DR? I have seen this mentioned-is this the outside of myself unreality feeling? 

5PM: 100mg gabapentin. Feeling a little better, more in body, less afraid.

6PM: Go to a meeting and connect with people and feel ok. FEEL OK!

7PM: eat dinner. Still feel ok and very grateful.

Plan to take 2.5mg Saphris with .5 Cogentin at 9:30 before bed along with last daily dose 100mg gabapentin. Will report any other symptoms after the time of this post tomorrow.

 

 

Of course you had an "unreal" feeling by late afternoon, you were drugged to the gills with gabapentin, Geodon, and the remains of the Klonopin.

 

It's possible you are a fast metabolizer and pass these drugs through before they can make you comatose. The problem with fast metabolizers is that they can appear to handle an unholy quantity of drugs -- but your liver and kidneys pay the price, nevertheless. The next time you see your primary care physician, if I were you, I'd have kidney and liver tests.

 

My guess is your morning panic is rebound anxiety from the prior day's Klonopin wearing off.

[DMV64]

6 hours ago, Altostrata said:

Do you take Klonopin only once a day, at 8 a.m.? Why do you do this? This is the time I take it. For anxiety. Also-I was not having any of these symptoms before I stopped Saphris so fast. I have been advised not to move anything or switch anything.

 

It looks like you are getting "anxiety" every afternoon when your 11 a.m. gabapentin dose reaches peak plasma. It may be having an additive effect to the Klonopin, causing a paradoxical reaction. The two "brakes" press your nervous system down, your nervous system fights back with hyperactivation. Ok, so should I do something?

 

Why are you taking gabapentin? Interstitial Cystitis/Bladder pain. What do you mean by ADHD? Trouble paying attention. Memory issues (I realize could be caused by Klonopin) When did you develop that? Worsened with age, but had it since teens in one form or another. When did you start taking Cogentin, and why? What side effects is it supposed to help you with? It stops the dystonic or kinesia reaction I once had with Saphris.

 

Please don't move any of your doses more than an hour or two in any direction, and be sure to make a note of that. The fewer changes right now, the better. Ok

 

By the way, a common side effect of Klonopin and other benzos is "depression." (I put this in quotes because it is iatrogenic: drug-caused.) Yes I know.

 

 

Please stop trying to treat your drug reactions with other drugs. I am not doing this. I am trying to listen to what everyone here is saying and just holding.

 

 

Of course you had an "unreal" feeling by late afternoon, you were drugged to the gills with gabapentin, Geodon, and the remains of the Klonopin. Ok, I am here like everyone else to eventually, hopefully, taper. So I am not trying to "drug myself to the gills" I am just trying to stablize after some bad decisions. Also I did not have this unreal feeling before I tried to stop Saphris. 

 

It's possible you are a fast metabolizer and pass these drugs through before they can make you comatose. The problem with fast metabolizers is that they can appear to handle an unholy quantity of drugs -- but your liver and kidneys pay the price, nevertheless. The next time you see your primary care physician, if I were you, I'd have kidney and liver tests.

I have recently had a complete battery of tests including liver. All is well. Generally I am a slow metabolizer. 

My guess is your morning panic is rebound anxiety from the prior day's Klonopin wearing off. Maybe? But I did not have this symptom before pulling off Saphris.

 

[DMV64]

 I am just wondering how relevant some other life circumstances are in my story. As I think about it there's different trauma and things that might be relevant but I'm not sure if they are appropriate to include here. 

 

Edited September 19, 2017 by ChessieCat
removed quote

[ChessieCat]

Are they current or historical?

 

If they are current you need to take care of yourself and try and stay as calm as possible to allow your CNS to stabilise.

 

If they are historical, now is not the time to be rehashing and trying to deal with them.  If you need to deal with them, it would be better to leave it until your CNS is stable.

 

Neuro Emotions

 

Focus on looking after yourself and allowing your brain to heal.

Non-drug techniques

[Altostrata]

10 hours ago, DMV64 said:

My guess is your morning panic is rebound anxiety from the prior day's Klonopin wearing off. Maybe? But I did not have this symptom before pulling off Saphris.

 

Over time, your reaction to Klonopin changes. Your body can get accustomed to it or reject it. A reaction like this indicates you are at least physiologically dependent on Klonopin. If you didn't take it, you would experience terrible withdrawal symptoms. As it is now, when it wears off, you are getting interdose withdrawal. When you take it with gabapentin, looks like a paradoxical reaction.

 

Do you take 300mg gabapentin a day or 200mg, when do you take it, and at what dosages? Has it been effective for interstitial cystitis? (Have you tried the limited diet for this?) When do you take omeprazole, and what dosage?

 

 

[DMV64]

5 minutes ago, Altostrata said:

 

Over time, your reaction to Klonopin changes. Your body can get accustomed to it or reject it. A reaction like this indicates you are at least physiologically dependent on Klonopin. If you didn't take it, you would experience terrible withdrawal symptoms. As it is now, when it wears off, you are getting interdose withdrawal. When you take it with gabapentin, looks like a paradoxical reaction. Oh I totally know I would have a terrible withdrawal from this benzo. I can only hope at some point I can taper.

 

Do you take 300mg gabapentin a day or 200mg, when do you take it, and at what dosages? Has it been effective for interstitial cystitis? (Have you tried the limited diet for this?) When do you take omeprazole, and what dosage? I take three 100mg capsules a day of gabapentin, spaced out 11am, 4pm, 9am. It has been very effective. My IC (since 36) was managed by diet until menopause when it became unmanageable and I was in constant pain. I take omeprazole 20mg at bedtime.

 

 

 

[Altostrata]

When did "reflux" start and when did you start taking omeprazole? Have you tried controlling "reflux" with diet?

[DMV64]

3 minutes ago, Altostrata said:

When did "reflux" start and when did you start taking omeprazole? Have you tried controlling "reflux" with diet?

Reflux started after baby number two smashed my guts up into my throat. True. So 1999 in and about. Reflux began causing reoccurring sinus infections and antibiotics. Finally went on nexium. Then off and on omeprazole. I have had an endoscopy confirming weak valve (forgot the name) to stomach from esophagus. When it is time to make changes, I am hoping to come off this drug too

[Altostrata]

You've been taking omeprazole since 1999? Do you have gastrointestinal esophageal reflux as diagnosed by endoscopy?

 

Have you ever taking vitamin B12 to compensate for this?

[DMV64]

1 minute ago, Altostrata said:

You've been taking omeprazole since 1999? Do you have gastrointestinal esophageal reflux as diagnosed by endoscopy?  first Nexium. Yes diagnosed by endoscopy. Switched to Omeprazole in 2013. I do take B12. How much though?

 

Have you ever taking vitamin B12 to compensate for this?

 

[Altostrata]

You would need to take sublingual B12 because absorption is blocked in your gut by the omeprazole. Methylcobalamin is the most reliable type. Low B12 can cause a lot of neurological symptoms, including "depression."

 

My take is your first priority is your Klonopin problem, you probably need to space out the doses to avoid the rebound symptoms in the early morning. Spacing out the doses will require careful adjustment over some weeks or months, probably.

 

Reducing the morning symptoms should reduce your need for the other drugs in the morning.

 

You are over-drugged. You need to reduce your drug burden, your doctor has not been responsible in this regard. You need a new doctor. The gabapentin might be justified (or might not) for interstitial cystitis. Real gastrointestinal esophageal reflux is one of the few reasons for a stomach acid blocker. Two drugs, that's it.

 

Most likely, the Saphris, Vyvanse, and Cogentin are unnecessary; at least two of those drugs are intended to treat adverse effects of the third; It looks like antidepressants, Saphris, etc. were initially prescribed to treat "depression" from 10 years of Klonopin. So all of this started with Klonopin.

 

The lithium was absurd and the Vyvanse is to mask other drug side effects (dopiness, brain fog, etc.), probably from the benzo. People do tend to like the amphetamine analogs, though -- every speed freak knows why.

 

The Saphris withdrawal dystonia for which you're taking Cogentin was 6 years ago. After you get the Klonopin in order, I might try a very gradual reduction of Saphris, then Cogentin, then Vyvanse, and finally Klonopin. This will be a multi-year project, but it's likely you will feel better and better as your drugs are reduced to the minimum.

 

[DMV64]

7 minutes ago, Altostrata said:

You would need to take sublingual B12 because absorption is blocked in your gut by the omeprazole. Methylcobalamin is the most reliable type. Low B12 can cause a lot of neurological symptoms, including "depression." I am going to look this up right now!

 

My take is your first priority is your Klonopin problem, you probably need to space out the doses to avoid the rebound symptoms in the early morning. Spacing out the doses will require careful adjustment over some weeks or months, probably. I am very excited about this plan. I really want to be as drug free as possible. I should not do any spacing yet right? I don't even really know how, or how much.

 

Reducing the morning symptoms should reduce your need for the other drugs in the morning. Yes.

 

You are over-drugged. You need to reduce your drug burden, your doctor has not been responsible in this regard. You need a new doctor. The gabapentin might be justified (or might not) for interstitial cystitis. Real gastrointestinal esophageal reflux is one of the few reasons for a stomach acid blocker. Two drugs, that's it. I totally know I am overdrugged. I hate that I am here. I don't know if you saw, but I have an appointment with a new, hopefully better doctor in a month. It was the first one I could get.

 

Most likely, the Saphris, Vyvanse, and Cogentin are unnecessary; at least two of those drugs are intended to treat adverse effects of the third; It looks like antidepressants, Saphris, etc. were initially prescribed to treat "depression" from 10 years of Klonopin. So all of this started with Klonopin. Yes, it definitely started with Klonopin.

 

The lithium was absurd and the Vyvanse is to mask other drug side effects (dopiness, brain fog, etc.), probably from the benzo. People do tend to like the amphetamine analogs, though -- every speed freak knows why. 

 

The Saphris withdrawal dystonia for which you're taking Cogentin was 6 years ago. After you get the Klonopin in order, I might try a very gradual reduction of Saphris, then Cogentin, then Vyvanse, and finally Klonopin. This will be a multi-year project, but it's likely you will feel better and better as your drugs are reduced to the minimum. This is really hopeful. I am so willing to do it a day at a time. How long to stablize now then begin spacing doses? A month? More?

 

 

[DMV64]

Symptom Log 9/19

7AM: Wake with slight panic. Talk with husband

7:15AM: 5mg Vyvanse

7:45: Feeling better. Have breakfast

8AM: 1mg Klonopin

Work from home. 

11AM: 100mg gabapentin

12: Yoga class.

1PM: lunch. 10 mg Geoden

2PM: Some anxiety but very brief!

4PM: 100mg Gabapentin

3-7PM: Work from home.

7PM: eat dinner. Feeling good after dark

Plan to take 2.5mg Saphris with .5 Cogentin at 9:30 before bed along with last daily dose 100mg gabapentin. 

Wondering if I should add my magnesium and fish oil to this list?

[JanCarol]

Hey D - thanks for the signature - that helps immensely, thank you!  Well done!

 

How long are your runs?  In withdrawal, if you can tolerate it, anything up to 30 minutes a day is good - after that, you might run into fatigue cascades.  There may come a time when you cannot tolerate it, and since yoga is your bread-and-butter, you may have to limit your runs  But for now, getting that morning sun and a run outdoors (remember to look at the horizon whenever possible!) will be excellent for mood stabilization!

 

9 hours ago, DMV64 said:

 I am just wondering how relevant some other life circumstances are in my story. As I think about it there's different trauma and things that might be relevant but I'm not sure if they are appropriate to include here. 

 

 

These are very relevant, but may be personal.  This is why we recommend Journalling - Therapeutic Writing , expressions through art and music - and, if you have a good practitioner, therapy.

 

We're not quite equipped to help you with your situational and life circumstances, but you are free to talk about them here if it helps your journey.  It all depends on how public you want to be with your personal stuff.

 

But in my experience, people who do not look at their life circumstances are less successful in their tapers.  Withdrawal can be a great volcano or cyclone that clears your life and pares you down to the bare necessities.  From that perspective, it becomes clear what is important and helpful, and what is harmful or toxic.  

 

It sounds like you are close to WD normal - every day is the same?  At that point it is safe to consider Mag, Fish Oil, and B12.  But B12 can do strange things, especially if you are deficient (the more deficient you are, the more of a shock it is to take it).  So much depends on your symptoms.

 

If every day is the same, I would start with fish oil.  I take 6000 IU a day, it seems the benefits start at around 3000 IU.  But start slow, with just one, 500 IU if you can get it.  Build up by 500 IU per week, and keep note of any changes in your symptoms.  If you get up to 300-4000 IU, you can take a similar approach with the magnesium.  When you get the magnesium up to what you can tolerate (take as much as you can tolerate), then start carefully with the B12.    One SA member was advised that when adding a supplement, your first 4 days should be no more than what you can fit on the tine of a fork.  This is rarely practical, but it is a good way to test to see if you are going to have a reaction to a supplement.

 

 Take a break from the supplementation  - hold - if you are going to be moving your klonopin.

 

Only one change at a time.  At least a week between changes in supplements. 

 

When you are feeling fairly stable (every day is about the same for 2 weeks to a month) - then it's time to start moving the klonopin.  Start by moving it 1 hour per day.  Take half at your regular 8 am time, and half at 9 am.  Do that for 4 days, then move the second dose to 10 am.  4 days later, move the second dose to 11 am.   Continue with that - tracking your symptoms the whole time - until you are taking half at 8 am and half at 8 pm.  If you are suffering interdose withdrawal, you should notice changes in your times of anxiety.  This will be valuable information.

 

When you get your klonopin split between 8am and 8 pm, plan to hold there for awhile.

 

Does that sound like an appealing plan?

 

Recap:  Start by adding a little fish oil, every week.  When you start to stabilize (a month about the same), stop at whatever supplementation you've achieved, and start moving the klonopin.  It will take about a month and a half to move the second dose to 12 hours apart.  Then plan on waiting a month and going back to working on fish oil, and eventually magnesium and B12.  After about 3 months (or whatever your body says)  holding there, you should be feeling better, and can consider a taper.

 

If, of course, anything produces symptoms, write here, and we'll try and figure out what is happening.

 

There is a real chance that even the reflux and bladder pain is caused by these drugs (even with the experiences you had with birthing), and when these drugs go away - you may not need the omeprazole or gabapentin at all.  We can talk about tapering them down the track.

 

As you can see, it's going to be a slow, careful process - but by making only one change at a time, we will be able to clearly see what is happening with you, like a laboratory experiment with n=1 (that's you).  We go carefully here because it's the internet and we can't catch you if you fall.

 

This is also an excellent time to build up your toolkit.  Please, talk about your yoga & meditation - how does it help your emotional well being?  What helps the most?  What kind of yoga do you do?  See Non Drug Techniques for Coping with Emotional Symptoms for some other ideas about how to self-soothe and survive through difficult times.

 

I hope you see the sun today!

 

[DMV64]

9 hours ago, JanCarol said:

Hey D - thanks for the signature - that helps immensely, thank you!  Well done! Thank you!!

 

How long are your runs?  In withdrawal, if you can tolerate it, anything up to 30 minutes a day is good - after that, you might run into fatigue cascades.  There may come a time when you cannot tolerate it, and since yoga is your bread-and-butter, you may have to limit your runs  But for now, getting that morning sun and a run outdoors (remember to look at the horizon whenever possible!) will be excellent for mood stabilization! My runs are more like trots. Ha! About 30 minutes every other day.

 

 

These are very relevant, but may be personal.  This is why we recommend Journalling - Therapeutic Writing , expressions through art and music - and, if you have a good practitioner, therapy. Yes, have therapy...

 

We're not quite equipped to help you with your situational and life circumstances, but you are free to talk about them here if it helps your journey.  It all depends on how public you want to be with your personal stuff. Ok, will think about this...

 

But in my experience, people who do not look at their life circumstances are less successful in their tapers.  Withdrawal can be a great volcano or cyclone that clears your life and pares you down to the bare necessities.  From that perspective, it becomes clear what is important and helpful, and what is harmful or toxic.  

 

It sounds like you are close to WD normal - every day is the same?  At that point it is safe to consider Mag, Fish Oil, and B12.  But B12 can do strange things, especially if you are deficient (the more deficient you are, the more of a shock it is to take it).  So much depends on your symptoms. I think I am ALMOST WD normal. Things are leveling out but not quite the same everyday. I already take that other magnesium (oxide) and cod liver oil. But I ordered the magnesium citrate and the omega 3 fish oil and sublingual B12.

 

If every day is the same, I would start with fish oil.  I take 6000 IU a day, it seems the benefits start at around 3000 IU.  But start slow, with just one, 500 IU if you can get it.  Build up by 500 IU per week, and keep note of any changes in your symptoms.  If you get up to 300-4000 IU, you can take a similar approach with the magnesium.  When you get the magnesium up to what you can tolerate (take as much as you can tolerate), then start carefully with the B12.    One SA member was advised that when adding a supplement, your first 4 days should be no more than what you can fit on the tine of a fork.  This is rarely practical, but it is a good way to test to see if you are going to have a reaction to a supplement. This sounds good! What do they do exactly?

 

 Take a break from the supplementation  - hold - if you are going to be moving your klonopin. Ok

 

Only one change at a time.  At least a week between changes in supplements. 

 

When you are feeling fairly stable (every day is about the same for 2 weeks to a month) - then it's time to start moving the klonopin.  Start by moving it 1 hour per day.  Take half at your regular 8 am time, and half at 9 am.  Do that for 4 days, then move the second dose to 10 am.  4 days later, move the second dose to 11 am.   Continue with that - tracking your symptoms the whole time - until you are taking half at 8 am and half at 8 pm.  If you are suffering interdose withdrawal, you should notice changes in your times of anxiety.  This will be valuable information. This is great information. I kind of can't wait to start but I know I need wait a bit more. 

 

When you get your klonopin split between 8am and 8 pm, plan to hold there for awhile. ok

 

Does that sound like an appealing plan? YES!

 

Recap:  Start by adding a little fish oil, every week.  When you start to stabilize (a month about the same), stop at whatever supplementation you've achieved, and start moving the klonopin.  It will take about a month and a half to move the second dose to 12 hours apart.  Then plan on waiting a month and going back to working on fish oil, and eventually magnesium and B12.  After about 3 months (or whatever your body says)  holding there, you should be feeling better, and can consider a taper. OK. 

 

If, of course, anything produces symptoms, write here, and we'll try and figure out what is happening. Thank you

 

There is a real chance that even the reflux and bladder pain is caused by these drugs (even with the experiences you had with birthing), and when these drugs go away - you may not need the omeprazole or gabapentin at all.  We can talk about tapering them down the track. Good

 

As you can see, it's going to be a slow, careful process - but by making only one change at a time, we will be able to clearly see what is happening with you, like a laboratory experiment with n=1 (that's you).  We go carefully here because it's the internet and we can't catch you if you fall. Right I understand. I am excited about becoming undrugged.

 

This is also an excellent time to build up your toolkit.  Please, talk about your yoga & meditation - how does it help your emotional well being?  What helps the most?  What kind of yoga do you do?  See Non Drug Techniques for Coping with Emotional Symptoms for some other ideas about how to self-soothe and survive through difficult times.

 

I hope you see the sun today! I just did!!!

 

 

[Shep]

13 hours ago, DMV64 said:

Do you take 300mg gabapentin a day or 200mg, when do you take it, and at what dosages? Has it been effective for interstitial cystitis? (Have you tried the limited diet for this?) When do you take omeprazole, and what dosage? I take three 100mg capsules a day of gabapentin, spaced out 11am, 4pm, 9am. It has been very effective. My IC (since 36) was managed by diet until menopause when it became unmanageable and I was in constant pain. I take omeprazole 20mg at bedtime.

 

 

DMV, sorry if you've already discussed this in your thread, but I saw the above timing of your gapabentin and wanted to ask what time you are taking your magnesium.

 

Please note the below adverse reaction warning from the magnesium thread.

 

Are you spacing your magnesium out from your gabapentin doses by at least 2 hours? 

 

 

 

 

On 5/24/2015 at 7:15 PM, Altostrata said:

Quote

Neurontin Interactions Gabapentin/Aluminum; Magnesium-Containing Compounds

Medical warning:
Moderate.

These medicines may cause some risk when taken together....

How the interaction occurs:
Aluminum or magnesium containing products may decrease the amount of gabapentin your body absorbs.

 

What might happen:
The amount of gabapentin in your blood may decrease....

 

What you should do about this interaction:
Avoid taking aluminum or magnesium containing products (such as antacids) for 2 hours before your gabapentin.....

[Shep]

12 hours ago, DMV64 said:

Symptom Log 9/19

7AM: Wake with slight panic. Talk with husband

7:15AM: 5mg Vyvanse

7:45: Feeling better. Have breakfast

8AM: 1mg Klonopin

Work from home. 

11AM: 100mg gabapentin

12: Yoga class.

1PM: lunch. 10 mg Geoden

2PM: Some anxiety but very brief!

4PM: 100mg Gabapentin

3-7PM: Work from home.

7PM: eat dinner. Feeling good after dark

Plan to take 2.5mg Saphris with .5 Cogentin at 9:30 before bed along with last daily dose 100mg gabapentin. 

Wondering if I should add my magnesium and fish oil to this list?

 

 

Yes, please do add your magnesium and fish oil to the list. Are these the only supplements you are on? 

 

You're doing great with your symptom and drug journal.  Thank you for doing this. 

[DMV64]

41 minutes ago, Shep said:

 

 

Yes, please do add your magnesium and fish oil to the list. Are these the only supplements you are on? No I also take Metagenics Ultrainflammex protien drink mix for my IBS gut stuff in the morning. And a probiotic mixed with Supergreens powder. Oh and a calcium pill.

 

You're doing great with your symptom and drug journal.  Thank you for doing this.  Thank you! I am really trying! Also I take my magnesium about two hours AFTER gabapentin, except at night I take it before. Should I take it always before or is just two hours space enough.

 

[JanCarol]

Hey D - 

9 hours ago, DMV64 said:

This sounds good! What do they do exactly?

 

Briefly, fish oil coats your neurons and smooths firing of nerves.  Magnesium supports over 200 cascades in the body, including neurotransmitters.  It smooths muscle tissue, relaxing it.   It's also excellent for bones, heart.

 

Read here for what others have said about it:  Magnesium and Omega-3 fish oil

 

As you work with your body - you might enjoy  Epsom Salts - Another Way to Relax with Magnesium

 

Do not take your calcium with your magnesium, as they bind to each other.  Separate them by at least 2 hours.  (I don't know why they sell them bundled!)  I would think that the same rule applies to magnesium and gabapentin, as well.  The 2 hours thing is to separate the digestion of them, and it pretty standard for separating drugs.

 

I wrote:

Quote

This is also an excellent time to build up your toolkit.  Please, talk about your yoga & meditation - how does it help your emotional well being?  What helps the most?  What kind of yoga do you do?  See Non Drug Techniques for Coping with Emotional Symptoms for some other ideas about how to self-soothe and survive through difficult times.

 

 

 

I'm eager to hear about your yoga!  I've been a yogini since 1976, and while I can no longer bend into a pretzel, find it a really important part of my journey, grounding, and transformation.

 

It's another day, another sun!  I hope you see it!