Nikki74: Lexapro mirtazapine diazepam akathisia

[Altostrata]

On 1/8/2018 at 4:34 AM, Nikki74 said:

....

The answer is yes, I do feel I’m getting more stable but it’s literally only been since the second half of December that I’ve been noticing almost leaps in my improvement, kind of sandwiched between some pretty awful days where it’s as severe as ever but like I say, overall I’m seeing those leaps.

 

....

 

 

This is good, Nikki. Stabilizing can be very frustrating, two steps forward and one back and so forth. Perhaps you can put up with being benzo'd for a bit, let your nervous system calm down more, and taper very gradually later, maybe in a month or two.

[Nikki74]

On 10/01/2018 at 11:20 PM, Altostrata said:

 

This is good, Nikki. Stabilizing can be very frustrating, two steps forward and one back and so forth. Perhaps you can put up with being benzo'd for a bit, let your nervous system calm down more, and taper very gradually later, maybe in a month or two.

Thank you for commenting Alto.

 

Unfortunately have hit a really bad spot again with akathisia right up. At these times I don’t have the drugged benzo feeling just constantly revved and don’t feel the diazepam.

 

I get so very concerned and confused about all this. Well it feels unbearable. I don’t know if the lexapro or any of the other drugs are causing the akathisia to remain as it’s the one symptoms that has never left. I realise I have had it before but thought it was extreme anxiety. I know I experienced now when I was on the lexapro with pregabalin. I know that I’ve rubbed my feet together and squeezed my hands for years (my physical manifestations of the akathisia now when it’s revved up) but without the distressing feeling I have now to accompany those things.

 

Do I taper the lexapro first? Do I taper some of that then some of the diazepam?

 

I feel truly trapped by the akathisia as it’s such a volatile symptom both caused by wd and as a side effect.

 

I am truly scared by it and cannot function much with it like this. 

[kesh]

45 minutes ago, Nikki74 said:

Do I taper the lexapro first? Do I taper some of that then some of the diazepam?

 

I feel truly trapped by the akathisia as it’s such a volatile symptom both caused by wd and as a side effect.

These are exactly my two dilemmas.

 

I think the consensus here is taper the SSRI first as it is activating. But as you say wd from the SSRI could also induce (well, increase in our case) the activation of akathisia. But withdrawal of diazepam I think will be more likely to make things worse.

 

My history is that I have never got akathisia from withdrawal of SSRIs, only from starting them (I have withdrawn quickly from SSRIs multiple times without any side effects) but I know everything can change with continued use. So my plan is hold the diazepam and cut the SSRI at 10% a month.

 

We shall see what happens. 

[Nikki74]

3 hours ago, kesh said:

These are exactly my two dilemmas.

 

I think the consensus here is taper the SSRI first as it is activating. But as you say wd from the SSRI could also induce (well, increase in our case) the activation of akathisia. But withdrawal of diazepam I think will be more likely to make things worse.

 

My history is that I have never got akathisia from withdrawal of SSRIs, only from starting them (I have withdrawn quickly from SSRIs multiple times without any side effects) but I know everything can change with continued use. So my plan is hold the diazepam and cut the SSRI at 10% a month.

 

We shall see what happens. 

Thanks for commenting Kesh. It’s good you have a plan.

 

Unfortunately the akathisia hit me as soon as I’d ct’d the lexapro so I know mine is from too rapidly stopping (I tapered for three weeks which I now know was a ct) and continues despite reinstatement. But had a whole load of other drastic changes happen too to meds. I also know I’ve had aka before now I know what it is but why I don’t know. One drug? Too many? Dose changes? A generally damaged system? 

 

Does my nut in.

[pinkfairy]

Nikki....

 

just remember my lovely friend when all those feelings lessoned for you ❣️I promise you they will again & again...I remembered a quote from baylisa...accept the symptoms because each & every one is your healing take place..& to fight it wouldn’t make sense,as your just fighting your your own CNS..The healing is in the aching ❣️.

 

Every second of every day you are healing.Even when you wash your pots,are laid in bed,drawing for 5 minutes your still healing...it’s so so hard to see when your in the thick of the storm.But one day this will pass....While the storm is raging,we have to learn to calm our selfs & let it rage...for every dark night there’s always a new day break....

 

your doing amazing & your a  very strong lady ♥️♥️♥️♥️!

 

This whole site is full of the bravest & kindered spirits on the planet...

 

””when your going through hell””

KEEP GOING

xxxxx

 

 

[Altostrata]

9 hours ago, Nikki74 said:

Thank you for commenting Alto.

 

Unfortunately have hit a really bad spot again with akathisia right up. At these times I don’t have the drugged benzo feeling just constantly revved and don’t feel the diazepam.

 

I get so very concerned and confused about all this. Well it feels unbearable. I don’t know if the lexapro or any of the other drugs are causing the akathisia to remain as it’s the one symptoms that has never left. I realise I have had it before but thought it was extreme anxiety. I know I experienced now when I was on the lexapro with pregabalin. I know that I’ve rubbed my feet together and squeezed my hands for years (my physical manifestations of the akathisia now when it’s revved up) but without the distressing feeling I have now to accompany those things.

 

Do I taper the lexapro first? Do I taper some of that then some of the diazepam?

 

I feel truly trapped by the akathisia as it’s such a volatile symptom both caused by wd and as a side effect.

 

I am truly scared by it and cannot function much with it like this. 

 

Nikki, I think we've been through this before. We need to know exactly what your symptom pattern is relative to when you take your drugs. What time of day did this akathisia feeling start? What exactly is the feeling?

 

How is your sleep?

 

Have you tried weighted blankets Weighted blankets & Bed Tents for restlessness, akathisia, insomnia and anxiety

[Nikki74]

18 hours ago, Altostrata said:

 

Nikki, I think we've been through this before. We need to know exactly what your symptom pattern is relative to when you take your drugs. What time of day did this akathisia feeling start? What exactly is the feeling?

 

How is your sleep?

 

Have you tried weighted blankets Weighted blankets & Bed Tents for restlessness, akathisia, insomnia and anxiety

Yes I bought a weighted blanket when I first joined and read about them. Invested £180 and it’s a good purchase.

 

Ok. I’m never without akathisia is some form. I always have the urge to move but can sit just not for long without shifting around or going to do something then back to sitting etc. I can never just focus on one thing. Head needs something else. 

 

But when it’s worse as it has been since I woke Tuesday morning it’s like this:

 

I sleep midnight-6 or 7am but wake one or two times. 

 

7.45am lexapro 5mg feel drowsy, back to bed, head has claustrophobic feeling like I want to escape, looping thoughts begin, have to move legs and rub them together repeatedly due to feeling of internal discomfort and need to move. Pent up feeling I’m chest and head. Toss and turn. But also dozy.

 

9am take 2mg diazepam, might doze a little but head continually looping. 

10am pent up feeling, buzzy bugs under skin all over, head looping so get up.

 

Feeling like I’m screaming in my head as it won’t stop looping, panic but not panic attack just panicky in my chest and feeling like I want to run away. Claustrophobic in my head.

 

Tears and despairing feeling. 

 

This continues all morning but abates a bit late morning.

 

1pm 2mg diazepam

 

Do a little sewing but hard to feel comfortable. Incredibly tense and pent up with agitation.

 

All afternoon, massively restless and agitated. All as before, need to rub legs together. Restless mental aka. Can’t focus, go from tv to phone to cigarette to food to tv and round and round.

 

5pm 2mg diazepam 

 

Everything continues like during the morning and can intensify in the evening.

 

Depression comes along often mid/late evening. 

11pm bed, tears, take Mirtazipine, instantly hungry, eat, eventually sleep. 

 

 

[AliG]

Nikki: How are you doing ? I'm sorry we really need to know your symptom pattern ~`

[Nikki74]

1 hour ago, AliG said:

Nikki: How are you doing ? I'm sorry we really need to know your symptom pattern ~`

Hi Ali, ok, is the above not done right? 

 

I’m getting by. Fed up of this constant tension and agitation and no peace. But I’m trying to focus best I can on nature documentaries which I find easy to tolerate!

 

Got a bit of paranoia going on this evening too. Get it sometimes, did you ever get that? 

 

Let me know what I need to change about symptoms I’ve written about above.

 

Good to see you and hope you’re doing ok? X

Edited January 13, 2018 by Nikki74

[Altostrata]

You have a spurt of akathisia after taking 5mg Lexapro?

 

If so, I would reduce the Lexapro to 4.5mg. Please tell us how that affects you.

[AliG]

Sorry Nikki. On re -reading, I see that you have tried to include everything ~ I guess, I was hoping for a little more detail but what you have provided is actually enough and with Alto's questions, and your answers, gives us even more information.

3 hours ago, Nikki74 said:

Got a bit of paranoia going on this evening too. Get it sometimes, did you ever get that?

 

I often got neuro- emotional at night which was then exacerbated by not sleeping ~ it was extremely challenging. It's all gone, now, though.

 

If you reduce the Lexapro, which I would do : let's know how you go. 

 

[Nikki74]

3 hours ago, Altostrata said:

You have a spurt of akathisia after taking 5mg Lexapro?

 

If so, I would reduce the Lexapro to 4.5mg. Please tell us how that affects you.

Thank you for responding again Alto.

 

When my akathisia isn’t so intense, I go to sleep after taking the lexapro, then set my alarm and take the diazepam and go to sleep again until 11am. So it’s extremely hard to tell what’s going on. The lexapro does make me dozy at the moment but I’ve got the symptoms I described above that you responded about.

 

I’m sorry if this is confusing but it is! 

 

I don’t know if this is a wave of wds still or side effects.

 

I’m either revved up or less so and having the drunken drugged stuff. Seems to interchange days or weeks at a time.

 

I appreciate your time and input. 

 

I’ve got some scales so I guess if I want to try the cut I just file off 10% of the weight? 

 

Thanks again, Nikki 

[Altostrata]

Nikki, only you can decide if your akathisia or anxiety increases after the Lexapro. We've urged you many times to keep notes on paper so you can see if there's a pattern.

 

If you believe the Lexapro is causing uncomfortable symptoms, yes, you would reduce 10% by weight, using your scale.

[Nikki74]

9 hours ago, Altostrata said:

 

 

Sorry I replied then decided I’d hold off until I’ve monitored the lexapro even more closely. I couldn’t delete the quote box. 

 

 

Edited January 14, 2018 by Nikki74

[UnfoldingSky]

Nikki, if you do decide to cut the lex soon I hope it goes well!  Maybe it will give you a better idea of what's going on too. 

 

[Nikki74]

12 hours ago, Altostrata said:

Nikki, only you can decide if your akathisia or anxiety increases after the Lexapro. We've urged you many times to keep notes on paper so you can see if there's a pattern.

 

If you believe the Lexapro is causing uncomfortable symptoms, yes, you would reduce 10% by weight, using your scale.

Thanks Alto for your input. 

 

The thing is, I do keep a journal of my symptoms and drew up my own symptoms list that I record on too. Things are so variable, just as I’ve explained. I appreciate the years of experience you’ve got dealing with polydrugged folks like me, trying to figure things out. 

Will come up with a plan. 

 

[Altostrata]

How frequently do anxiety or other symptoms in the hours after taking Lexapro compared to the hours prior to taking Lexapro? Your journal should be able to answer that question.

 

It might help if you put this on graph paper, with black boxes for the times of bad symptoms.

[Nikki74]

On 14/01/2018 at 11:39 PM, Altostrata said:

How frequently do anxiety or other symptoms in the hours after taking Lexapro compared to the hours prior to taking Lexapro? Your journal should be able to answer that question.

 

It might help if you put this on graph paper, with black boxes for the times of bad symptoms.

Ok so I realise I’ve been in a wave for a week that has intensified the past two days to severe levels of panic and agitation and mental symptoms.

 

To answer your question Alto:

 

In the hours preceding taking lexapro I generally sleep midnight to 7am.

 

Wake up with panic.

 

7.45 lexapro

Agitated but drowsy and want to go back to bed.

Drowsy and doze 8.30-9 when I come round I’m shaking (sort of shuddering feeling) and panicky

 

Take 9am diazepam 2mg

Head is looping, intrusive memories, paranoia, dr, agitation, trying to rest. Panic attack.

 

The above continues waxing and waning with a peak in akathisia under skin around 11-1pm

1pm diazepam. Drowsy by 2pm and some stillness and rest. 

 

3pm shaky and panic again, akathisia under skin, continues until 5pm, take diazepam.

 

5.30-7.15 window of more calm, normal thinking.

 

7.15 panicky feelings increase again and peaks at bedtime with depression too but mornings are generally the worst times.

 

11pm take Mirtazipine and eventually sleep 12/12.30.

[Nikki74]

Would like to add 8.30pm nausea and increasing sense I might vomit  but don’t. 

[Altostrata]

It sounds to me like that dosage of Lexapro is too high. If I were you, I would reduce it to 4.5mg and see how what it does. Be sure to keep careful notes of the hours after you take Lexapro.

[Nikki74]

On 16/01/2018 at 11:59 PM, Altostrata said:

It sounds to me like that dosage of Lexapro is too high. If I were you, I would reduce it to 4.5mg and see how what it does. Be sure to keep careful notes of the hours after you take Lexapro.

Thank you Alto.

 

I’ve been getting feelings of rage building in me in this wave. I think it’s part of the akathisia. 

 

I will update when I make a cut.

[Nikki74]

On 16/01/2018 at 11:59 PM, Altostrata said:

It sounds to me like that dosage of Lexapro is too high. If I were you, I would reduce it to 4.5mg and see how what it does. Be sure to keep careful notes of the hours after you take Lexapro.

Also, Alto, would you conclude based my severe symptoms, that the Lexapro reinstatement didn’t work for me? That stability will remain elusive no matter how long I hold? 

[Littlegrandma]

Hi Nikki

sorry you are suffering so. 

My experience is I reinstated at too high of a dose. I had aka nonstop for 2 months. Once I tapered, the aka got so much better. Still suffer it periodically, but nothing like initially. Those days were hell I didn’t think I’d get through. 

So much better now. Hold on. You’ll get there.   xx Lg

[Nikki74]

33 minutes ago, Littlegrandma said:

Hi Nikki

sorry you are suffering so. 

My experience is I reinstated at too high of a dose. I had aka nonstop for 2 months. Once I tapered, the aka got so much better. Still suffer it periodically, but nothing like initially. Those days were hell I didn’t think I’d get through. 

So much better now. Hold on. You’ll get there.   xx Lg

Thank you for stopping by dear Lg. Been so out of touch with you and Frogie.

 

Thing is mine hit when I’d ct’d my full dose. So it came with that rather than when I reinstated. But I’m pretty sure I experienced aka on the drug though I was on others too.

 

It’s never left since June. Despite reinstating. 

 

Guess I can only try a cut and see...xxx

[Littlegrandma]

🤞🏻Hoping for the best, Nikki. 

After a cut from 5 to 4.8 of lex 3 weeks ago, I feel much better now. That is after the 2 weeks of symptoms. I now have gone down to 4.6. Waiting for side effects to hit, but right now I feel overall better than I have in almost 8 mo. 

 

I think lex is toxic to me, maybe you, and at least one other person I talk to on this forum. Hopefully the cut will give you some relief. 

Hugs

[Nikki74]

3 minutes ago, Littlegrandma said:

🤞🏻Hoping for the best, Nikki. 

After a cut from 5 to 4.8 of lex 3 weeks ago, I feel much better now. That is after the 2 weeks of symptoms. I now have gone down to 4.6. Waiting for side effects to hit, but right now I feel overall better than I have in almost 8 mo. 

 

I think lex is toxic to me, maybe you, and at least one other person I talk to on this forum. Hopefully the cut will give you some relief. 

Hugs

That’s great news Lg!

 

I think after 5 years on it in 2016 it turned on me. Polydrugging started when I started to get bizarre symptom like muscle twitching and that was the only drug I was on at the time. 

 

Hoping your latest cut goes well for you xxx

[AliG]

2 hours ago, Nikki74 said:

Also, Alto, would you conclude based my severe symptoms, that the Lexapro reinstatement didn’t work for me? That stability will remain elusive no matter how long I hold? 

 

I'm not Alto ~  but I don't believe that's true, Nikki. Holding has helped and even if you are not where you want to be ~ you are more stable and that will help as a base to go on from here. 

[Nikki74]

1 hour ago, AliG said:

 

I'm not Alto ~  but I don't believe that's true, Nikki. Holding has helped and even if you are not where you want to be ~ you are more stable and that will help as a base to go on from here. 

Thanks Ali.

 

This wave has been pretty scary. More intense ocd, paranoia, panic than I’ve had all together before, and this awful rage that I feel in my chest and through my body, building up. Like I’m going to lose it! Then it ebbs away after an hour or two. And then back again! It has freaked me out. I don’t like feeling I could flip out! 

 

I cant tell you how many times I’ve repeated ‘it’s withdrawal, it’s witjdrawal’ And ‘this too shall pass’ and ‘you are safe’ this past week or so!

 

Have you ever had anything like this Ali? The rage feeling? 

[Staz]

3 minutes ago, Nikki74 said:

This wave has been pretty scary. More intense ocd, paranoia, panic than I’ve had all together before, and this awful rage that I feel in my chest and through my body, building up. Like I’m going to lose it! Then it ebbs away after an hour or two. And then back again! It has freaked me out. I don’t like feeling I could flip out! 

 

I cant tell you how many times I’ve repeated ‘it’s withdrawal, it’s witjdrawal’ And ‘this too shall pass’ and ‘you are safe’ this past week or so!

Sorry you are still feeling unwell Nikki,

It is withdrawal but from what? I feel the only thing you can do is eliminate one drug at a time. I'm in the same position as you know and I've 3 choices for my next taper and it's immpossible to second guess which med is causing your problem.

Having been on and come off of Pregabalin you could be having the residual effects from that combined with your other c/t's and drug changes. Pregabalin has a nasty reputation for w/d's and I know of people who have taken a year to recover from a c/t and describe symptoms similar to the ones you have. I c/t'd Lexapro 5mg and didn't notice it. Same with prozac but we are all different.

Stability cannot be guaranteed as I've found out. If I were you I'd start slowly reducing one of your drugs and stick with it until it's done. That's the way I'm doing it and using the harm reduction principle to choose which next to taper from. In my case that was Seroquel first then it will be Diazepam. Just please do not look for the answer in additional medications.

Steve

xx

[AliG]

Of course! I've had it all. LOl. I've had  lots of rage ~ it's just another part of this. It's yet another symptom ~ I know there are so very many , and it's just not fair that we have to go through all this but I'm almost through it Nikki - it does get better.

 

I used to walk and still do. I know you can't do that but any physical activity can help. Can you "punch a pillow" ?   Sounds weird doesn't it ? Try it .

 

20 minutes ago, Nikki74 said:

 

I cant tell you how many times I’ve repeated ‘it’s withdrawal, it’s witjdrawal’ And ‘this too shall pass’ and ‘you are safe’ this past week or so!

 

This is good ~ that's what I did. You are safe and this is withdrawal. 

[Nikki74]

Thank you both Ali and Steve!

 

Been hit with flu symptoms (another regular visitor in my wd symptom repertoire) and will respond properly tomorrow xxx

[Jony]

It seems that we have the same problem...wich drug taper first...

 

 

[Altostrata]

14 hours ago, Nikki74 said:

Also, Alto, would you conclude based my severe symptoms, that the Lexapro reinstatement didn’t work for me? That stability will remain elusive no matter how long I hold? 

 

No, my conclusion is that you might be taking too much Lexapro.

 

However, I must be frank, Nikki -- it's been difficult getting a clear report of symptom pattern from you. I always need to know when symptoms come on, if they're better or worse at any particular time of day, when you took your drugs, and their dosages. Always. No exceptions.

 

Given your symptom pattern is reported in such a confusing way, I hope my guess is correct and you feel a bit better when taking less Lexapro.

 

If you are not keeping daily notes on paper, you are doing a disservice to both of us.

[Staz]

14 hours ago, Altostrata said:

No, my conclusion is that you might be taking too much Lexapro.

Given Nikki's drug history what leads you to this conclusion Alto?

She's been on higher doseages of lex in the past but sound like they pooped out on her. There's also benzo and Z drugs instability at play here, a C/T off of lyrica and quite rapid increases and decreases in Mirtazapine all within a very short space of time. Any one of these could be the problem or part of it could they not?

Staz

[Altostrata]

Because

 

On 1/16/2018 at 11:22 AM, Nikki74 said:

Wake up with panic.

 

7.45 lexapro

Agitated but drowsy and want to go back to bed.

Drowsy and doze 8.30-9 when I come round I’m shaking (sort of shuddering feeling) and panicky

1

 

This appears to be an adverse reaction to Lexapro, Nikki hadn't taken anything else yet.

 

However, as I said up above, I would appreciate Nikki reporting her symptom pattern more clearly, as I can only guess Lexapro is too high. I suggested a test reduction of 0.5mg to see what happens.

 

The usefulness of this test of this test will depend on Nikki accurately reporting her symptom pattern, when she takes her drugs, and their dosages after making this reduction.

[UnfoldingSky]

Nik, I hope your day went okay today. xxx