Nikki74: Lexapro mirtazapine diazepam akathisia

[Nikki74]

4 minutes ago, jonnypeters1234567 said:

I find that propanalol and Vitamin B6 helps akathisia

Thank you Johnnyp

have had it constant 14 months

Scared to add more drugs to the mix, I know about beta blockers, but am on benzos and remeron both sedating though benzos are largely paradoxical. What’s your akathisia situation? 

 

Ps did take propranolol once for a week or two when I think the akathisia was around but nothing like now, I had to stop as got freezing cold extremities. 

[manymoretodays]

Hi Nikki,

Here's a bit more on the AAF, (Acknowledge, Accept, Float) technique that I mentioned in my previous post.  As well as some additional coping you might find helpful.

 

  (Thanks Ccat)

 

Love, peace, healing, and growth,

mmt

I think a color highlight on the mirtazapine, might help it stand out a bit in your signature.  Perhaps a color highlight on each of your present drugs.  Thanks.

Edited August 29, 2018 by manymoretodays
signature comment

[Nikki74]

On 8/29/2018 at 2:57 PM, manymoretodays said:

Hi Nikki,

Here's a bit more on the AAF, (Acknowledge, Accept, Float) technique that I mentioned in my previous post.  As well as some additional coping you might find helpful.

 

  (Thanks Ccat)

 

Love, peace, healing, and growth,

mmt

I think a color highlight on the mirtazapine, might help it stand out a bit in your signature.  Perhaps a color highlight on each of your present drugs.  Thanks.

Thank you mmt

 

Im losing all hope.

 

Akathisia has been overall much worse the past two months since cutting the lexapro. My cns feels raw.

 

Ive made the changes to benzo dosing but slightly different as I feel I need the dose badly by 10am.

 

so current dosing is:

 

8am 4.5mg lex

10am .22 clonazepam 

1pm .21 clonazepam 

5pm .375 clonazepam 

11pm 15mg Mirtazipine 

 

Journal as follows:

 

Sleep 8 hours

wake with akathisia intensifying, can’t be still

8am 4.5mg lexapro akathisia continues to increase, 

10am .21 clonazepam, shaking, pacing

1pm .22 clonazepam, shaking and teeth chattering then some sedation and able to sit

5pm .375 clonazepam, shaking, then fades and sedated for evening but very depressed and restless still but akathisia lowered to restlessness 

extreme depression, despair and tears

10.30 bed

11pm 15mg Mirtazipine 

[Nikki74]

Today

Slept 8 hours

woke with akathisia and needing to pace

8am 4.5mg lex 

akathisia continues the same then increases

10am .21 clonazepam, shaking

zero sedation, in fact needing to pace more, highly agitated

1pm .22 clonazepam, adrenaline surge, akathisia intensifies

1.30 able to stop pacing

2.30pm massive surge in akathisia, head squeezing like a vice, total mental agitation unable to think, terror, want to scream. Pacing

continues until present, 3.50pm head feels on fire, crying with agitation

4.10pm head squeezing agitation and terror lifted and replaced with head bobbing/ shaking

[Nikki74]

Pacing continued until 5pm benzo 

5pm .375 clonazepam

severe depression all evening, restless but not pacing.

11pm 15mg Mirtazipine 

 

 

slept 6 hours, woke with akathisia intensifying 

 

8am 4.5mg lexapro, akathisia the same as when I woke, can’t be still

10am .21 clonazepam, shivering and shaking, then some sedation

12 noon extreme fatigue, can hardly think, need to lie down, feel I could drop off but can’t due to internal akathisia and can’t stay in bed long

1pm .22 clonazepam, surge in adrenaline 

1.45pm drowsy but restless and depressed 

[manymoretodays]

Hi Nikki,

 

Good job with getting your dosages split!!!!!  And daily drug/symptom logs!!!

Very helpful.

 

.......it appears that you are still working on getting the new schedule going.

And I really do thing that this might account for SOME of the changing intensities in symptoms. 

What do you think? 

 

Are you able to set up the morning dose the night before?   

 

I did see you noted that it was very difficult right now to wait until 10am for the first 0.21 mg of clonazepam. 

This may improve as you start to adjust to the new schedule.  So hold on. 

 

I don't have much experience myself with benzo's but do know it's really hard right now for you Nikki.

I know that there is lot's of good stuff collected on your benzo thread that Shep put together for you.........so I will refer you back there...... to take a look and see if there's anything that might help now.  I'll go and review some of it later as well, as I like to "steal somewhat" some of the best of the best, that I find from other mods here when I get a chance.

 

How did the visit with the neurologist go? 

 

I've been busy with family visiting just recently, and sending them off again today.........so will be a bit more regular again here soon. 

 

All for now.......I'll be back to check as soon as I can.

Love, peace, healing, and growth,

mmt

[Nikki74]

2pm onwards pacing/ jiggling my legs

4pm movements stopped, still on edge with akathisia but no movements 

5pm .375 clonazepam 

Restless as always.

[Nikki74]

 

5.30 some muscle twitching

5.45pm dark intrusive thoughts and feelings of panic. Mental confusion, hard to make a meal.

 

I don’t like these benzos one bit

 

7pm depression, everything seems heavy and dark.

8pm onwards, pacing 

 

Am I in tolerance on the benzo? 

 

Mmt, unfortunately I’ve always had this changing in intensity of symptoms and mixed reactions to the benzo so I don’t think it’s the change in schedule 😕 

 

Sorry, I don’t know why it’s posting in larger text.

[Nikki74]

I’m realising that any form of stability will continue to elude me. I react to the benzo in such crazy, differing ways. The lexapro has lost its sudden severe reaction now but is undoubtedly activating. Though since cutting it, the akathisia and my waking akathisia has been much more intense. 

 

I am miserably agitated every hour I’m awake, with varying and random intensities. No two days are the same. But always defined by akathisia every moment. Lord help me when it gets too intense again for the Mirtazipine as it did in January.

 

I just think I need off the drugs. 

 

Or I hold for a year and see what happens, but I can’t see me ever being stable or ok on this cocktail and because of the crazy cts and messing last summer that brought me here.

 

I do reach crisis point most days where I feel I cannot handle this existence any longer. But I don’t want to quit. I want my life back from these poisons and the akathisia that has basically deprived me of any quality of life for 14 months now.

 

I often feel about ready to cut these drugs drastically. But I somehow need to do multiple tapers one after the other. 

 

Am I just so massively destabilised by last year that I can’t handle any drugs but can’t handle tapering them either?

 

I am sick and tired. So, so, so tired. 

 

 

[Altostrata]

Nikki, how much Lexapro are you taking now? When did you last reduce it?

 

 

[Altostrata]

4 hours ago, Nikki74 said:

2pm onwards pacing/ jiggling my legs

4pm movements stopped, still on edge with akathisia but no movements 

5pm .375 clonazepam 

Restless as always.

 

1 hour ago, Nikki74 said:

 

5.30 some muscle twitching

5.45pm dark intrusive thoughts and feelings of panic. Mental confusion, hard to make a meal.

 

I don’t like these benzos one bit

 

7pm depression, everything seems heavy and dark.

8pm onwards, pacing 

 

Am I in tolerance on the benzo? 

 

Mmt, unfortunately I’ve always had this changing in intensity of symptoms and mixed reactions to the benzo so I don’t think it’s the change in schedule 😕 

 

Sorry, I don’t know why it’s posting in larger text.

 

When did you take clonazepam in the above day, and at what dosages? When did you take Lexapro?

 

Please include ALL your drug intake in your symptom notes.

[Nikki74]

10 hours ago, Altostrata said:

 

 

When did you take clonazepam in the above day, and at what dosages? When did you take Lexapro?

 

Please include ALL your drug intake in your symptom notes.

The times and dosages are above, before mmt’s post. 

 

8 am 4.5mg lexapro 

10am .21 clonazepam

1pm .22 clonazepam 

 

I’m on 4.5mg lexapro, I made the .5mg cut on 2nd July. I attempted a .25mg cut 9th August for 4 days and reinstated 13th August after the cut hit within 24 hours with severe panic, shaking and terror. 

 

The first .5mg cut took about two weeks to hit and wasn’t as severe as the .25 cut I tried.

 

The first month of the .5mg cut things weren’t so severe with the akathisia, it went pretty bad every other day. But a month in, everything changed and the pacing started and things were more intense. So I tried a cut 5 and a half weeks in thinking it might help. Things have been severe most days since.

 

 

[Nikki74]

Wednesday 

slept 7 hours, broken by waking twice

Akathisia rising on waking

Full body shaking started

8am 4.5mg lexapro 

full body shaking intensified, back of head squeezing, and continues til 10am, legs aching with the shaking, pacing in between lying on bed shaking v badly

10am .21 clonazepam 

10.20 shaking stops

10.40 some muscle twitching and need to rock and pace, no relief

[Nikki74]

12.15 still pacing, hot flushes, panic attack 

1pm .22 clonazepam 

1.15pm head burning, panic attacks, adrenaline surges, feeling of going insane, hard to breathe due to all this, can’t keep still, all this ongoing currently coming up to 2pm, head squeezing badly, feel nauseous. 

[Nikki74]

12.15 still pacing, hot flushes, panic attack 

1pm .22 clonazepam 

1.15pm head burning, panic attacks, adrenaline surges, feeling of going insane, hard to breathe due to all this, can’t keep still, all this ongoing currently coming up to 2pm, head squeezing badly, feel nauseous. 

Pacing, racing head, major agitation, terror, confusion all continued til 4.30pm when able to sit and stare but still v uncomfortable.

 

[Nikki74]

12.15 still pacing, hot flushes, panic attack 

1pm .22 clonazepam 

1.15pm head burning, panic attacks, adrenaline surges, feeling of going insane, hard to breathe due to all this, can’t keep still, all this ongoing currently coming up to 2pm, head squeezing badly, feel nauseous. 

Pacing, racing head, major agitation, terror, confusion all continued til 4.30pm when able to sit and stare but still v uncomfortable.

5pm .375 clonazepam 

5.30 tears, agitation

6.30 panic attacks, pacing, nausea, extreme discomfort with akathisia all over my body, jumpy, dizzy, depressed, blurry vision, confusion 

 

This is hell. 

[SkyBlue]

Nikki, 

 

You are certainly experiencing extreme symptoms and I can understand your feeling sick and tired of it.

 

I can tell from your posts that you are strong. You are surviving this, and you will live to heal, and to tell about it.

 

Thanks for providing the information above.

One question: Have things been worse, slightly better or about the same since updosing to 4.5 Lexapro on Aug 9?

 

[Altostrata]

Please stop changing Lexapro. We need to look at clonazepam.

 

What is your drug schedule for an entire day?

[Nikki74]

14 minutes ago, Altostrata said:

Please stop changing Lexapro. We need to look at clonazepam.

 

What is your drug schedule for an entire day?

8am 4.5mg lexapro 

10am .21 clonazepam 

1pm .22 clonazepam 

5pm .375 clonazepam 

11pm 15mg Mirtazipine 

[Nikki74]

21 minutes ago, SkyBlue said:

Nikki, 

 

You are certainly experiencing extreme symptoms and I can understand your feeling sick and tired of it.

 

I can tell from your posts that you are strong. You are surviving this, and you will live to heal, and to tell about it.

 

Thanks for providing the information above.

One question: Have things been worse, slightly better or about the same since updosing to 4.5 Lexapro on Aug 9?

 

I’m hanging on for dear life. I do not want to lose this fight! But I am really struggling.

 

I think it’s been slightly worse since the .25mg cut that I reinstated. 

 

But it was getting v bad before that which is why I tried that cut. I reinstated it and exactly a week later, things went off the charts. 

 

The whole of August was pretty bad though.

 

Alto has said to hold on the lexapro.

[Altostrata]

So you're in the process of moving the clonazepam doses to align with @Shep's suggested schedule?

 

8 am - 4.5mg Lexapro 

11 am - .21 clonazepam 

2 pm - .22 clonazepam 

5pm - .375 clonazepam 

11pm -15mg mirtazapine 

 

As you've moved your clonazepam doses, have your symptoms gotten better or worse?

[Nikki74]

13 minutes ago, Altostrata said:

So you're in the process of moving the clonazepam doses to align with @Shep's suggested schedule?

 

8 am - 4.5mg Lexapro 

11 am - .21 clonazepam 

2 pm - .22 clonazepam 

5pm - .375 clonazepam 

11pm -15mg mirtazapine 

 

As you've moved your clonazepam doses, have your symptoms gotten better or worse?

Yes I’m in the process but got stuck at the 10am and 1pm position because I feel desperate for the benzo by 10am even though it’s horrible!

 

I feel like my symptoms are just as bad. 

[Altostrata]

Nikki, that's very important information. I'll bring @Shep into the discussion.

[Nikki74]

2 hours ago, SkyBlue said:

Nikki, 

 

You are certainly experiencing extreme symptoms and I can understand your feeling sick and tired of it.

 

I can tell from your posts that you are strong. You are surviving this, and you will live to heal, and to tell about it.

 

Thanks for providing the information above.

One question: Have things been worse, slightly better or about the same since updosing to 4.5 Lexapro on Aug 9?

 

Ps thank you Sky Blue x

[SkyBlue]

You're so welcome, Nikki. < 3 You're in extremely capable hands with Alto and Shep. This will get sorted out; hang in there. 

[Nikki74]

52 minutes ago, SkyBlue said:

You're so welcome, Nikki. < 3 You're in extremely capable hands with Alto and Shep. This will get sorted out; hang in there. 

Thank you. Unfortunately I’ve had the constant akathisia for 14 months now with only worsening and no sign of let up. Am in a real mess.

 

But hopefully a way forward can be found. I appreciate the help of Alto, Shep and all here x

[Nikki74]

3 hours ago, Altostrata said:

Nikki, that's very important information. I'll bring @Shep into the discussion.

Ok thank you Alto

[Oceanrat]

Sending lots of love from California! I’m in a similar state as you, but with less sleep. I’m glad you’re fighting, it makes me fight as well!

[Shep]

15 hours ago, Nikki74 said:

Yes I’m in the process but got stuck at the 10am and 1pm position because I feel desperate for the benzo by 10am even though it’s horrible!

 

 

What does "I feel desperate for the benzo" mean? And what does "even though it's horrible" mean? Can you tell if you're dealing with a psychological issue or a physical (dependency) issue? 

 

When you take the benzo that you "feel desperate for", do any of your symptoms decrease? 

 

[Nikki74]

11 minutes ago, Shep said:

 

What does "I feel desperate for the benzo" mean?

I think it’s because of the akathisia and I’m desperate for something to calm it. But there is also a craving for it.

11 minutes ago, Shep said:

 

And what does "even though it's horrible" mean?

Because when I take it, it more often than not gives me a myriad of unpleasant symptoms, increases the pacing etc

11 minutes ago, Shep said:

 

Can you tell if you're dealing with a psychological issue or a physical (dependency) issue? 

Hmm. Definitely a physical dependency and probably a psychological one too.

11 minutes ago, Shep said:

When you take the benzo that you "feel desperate for", do any of your symptoms decrease? 

 

It varies Shep, on the whole it doesn’t seem to decrease things now but causes extra issues. 

 

Today for example, it’s an hour after taking it. It gave me an adrenaline surge after taking it, panic and mental confusion increased and I’ve paced the whole time. Now I’m sitting down but will shortly need to pace again.

 

Last night I took my evening dose at 5 and it was 8pm before I was able to sit but still restless.

 

I have had times recently where I almost feel like I’m hallucinating, things seem off and my visual perceptions are distorted. 

 

I hope this helps? 😕 

[Shep]

9 minutes ago, Nikki74 said:

I think it’s because of the akathisia and I’m desperate for something to calm it. But there is also a craving for it.

 

9 minutes ago, Nikki74 said:

Hmm. Definitely a physical dependency and probably a psychological one too.

 

The way to help with physical dependency is through a slow taper, but the psychological - the "craving" form - of addiction is something that you'll need to address. It's very important that you find ways of self-soothing to replace the benzo (and prior to that, alcohol). You will need to explore ways of being drug and alcohol free and knowing you'll be okay. 

 

For me, and many other people on this forum, finding ways to self-sooth are extremely difficult, especially when you're in crisis states, but it's important. 

 

I have a "toolkit" linked in my signature that I spent a couple of years coming up with as I was going through withdrawal. Please start one of your own. I can't emphasize how much having those resources helped me deal with the psychological and the physical aspects of coming off these drugs. 

 

When you are posting your drug and symptoms journal, please list any videos, exercises (including breathing exercises), or other ways of coping that you are doing. Please don't say that "nothing works". This is about exploring and trying to see what may lessen your symptoms in the long run. Starting out, very few things work, but over time, learning to breathe works, learning to become The Observer to your thoughts work because it keeps you from going into emotional spirals. This is VERY important to learn when you're dealing with akathisia. 

 

Simply letting the uncomfortable feelings wash over you without attaching your thoughts can help, but it does take time. Bringing in short meditations and breathing exercises every couple of hours will help over the long term. 

 

19 minutes ago, Nikki74 said:

Today for example, it’s an hour after taking it. It gave me an adrenaline surge after taking it, panic and mental confusion increased and I’ve paced the whole time. Now I’m sitting down but will shortly need to pace again.

 

This is why we were trying to get you to space the benzo out - to reduce the surges. By spacing out the benzo doses, you have a lower blood concentration level in your blood stream. The closer you take the doses together, the higher the blood concentration level. 

 

20 minutes ago, Nikki74 said:

I have had times recently where I almost feel like I’m hallucinating, things seem off and my visual perceptions are distorted. 

 

Visual distortions are very common with benzo withdrawal. I often referred to it as Psychiatry's Acid Trip. I used to put on Pink Floyd and kick back and watch the distortions play out as a form of entertainment.

 

The less power you give your symptoms, the less they will have power over you. 

 

 

[Nikki74]

25 minutes ago, Shep said:

 

 

The way to help with physical dependency is through a slow taper, but the psychological - the "craving" form - of addiction is something that you'll need to address. It's very important that you find ways of self-soothing to replace the benzo (and prior to that, alcohol). You will need to explore ways of being drug and alcohol free and knowing you'll be okay. 

 

Thank you Shep. I understand.

I ended up on benzos because of the cold turkeys last year (before I knew I had akathisia and was experiencing withdrawals) and then the clonazepam when the akathisia went so severe (and I’m back there now basically) in January. 

 

If only I’d not.

 

When I got sober 6 years ago it was the best experience. Then somehow this drug mess occurred which is a million times worse.

 

I don’t want any drugs. It’s the akathisia that is my biggest hurdle.

Quote

For me, and many other people on this forum, finding ways to self-sooth are extremely difficult, especially when you're in crisis states, but it's important. 

 

I have a "toolkit" linked in my signature that I spent a couple of years coming up with as I was going through withdrawal. Please start one of your own. I can't emphasize how much having those resources helped me deal with the psychological and the physical aspects of coming off these drugs. 

 

Thanks. 

Quote

When you are posting your drug and symptoms journal, please list any videos, exercises (including breathing exercises), or other ways of coping that you are doing. Please don't say that "nothing works". This is about exploring and trying to see what may lessen your symptoms in the long run. Starting out, very few things work, but over time, learning to breathe works, learning to become The Observer to your thoughts work because it keeps you from going into emotional spirals. This is VERY important to learn when you're dealing with akathisia. 

I will try to observe more.

The physical akathisia is one thing but the mental akathisia is a whole other level added. I find it hard to observe in that state.

 

My toolkit so far comprises:

repeating affirmations

breathing when I remember to

using a heat pad and weighted blanket 

prayer

clinging on and crying

nature sounds on YouTube 

Quote

Simply letting the uncomfortable feelings wash over you without attaching your thoughts can help, but it does take time. Bringing in short meditations and breathing exercises every couple of hours will help over the long term. 

 

 

This is why we were trying to get you to space the benzo out - to reduce the surges. By spacing out the benzo doses, you have a lower blood concentration level in your blood stream. The closer you take the doses together, the higher the blood concentration level. 

 

 

Visual distortions are very common with benzo withdrawal. I often referred to it as Psychiatry's Acid Trip. I used to put on Pink Floyd and kick back and watch the distortions play out as a form of entertainment.

 

The less power you give your symptoms, the less they will have power over you. 

 

 

Thanks Shep. So are you suggesting a slow taper off this drug? 

 

Do you think it’s made/ making the akathisia worse in the long run being on benzos?

 

Is there hope I’ll be free of aka one day?

 

 

Edited September 6, 2018 by Nikki74
Extra questions

[Shep]

11 minutes ago, Nikki74 said:

So are you suggesting a slow taper off this drug? 

 

Eventually, yes, a slow taper off all of your drugs.

 

For now, please work on the benzo spacing and on finding ways of self-soothing. These videos are a great start:

 

The Breathing Space by Jon Kabat Zinn video (4 minutes)

 

The Power Of Letting Go - Jon Kabat-Zinn video (3 minutes)

 

If you don't like these, please explore and find ones that speak to you and then bring them into your day every few hours so you're training your brain to relax, for just a moment at a time. Eventually, those moments build into a solid minute, than 5 minutes, and then more and more. 

 

Please remember to post in your drug and symptoms journal when you are doing this and other non-drug coping skills that you find. Again, not a quick fix, but over time they will feed into the neuroplasticity and put you on a better path through withdrawal. 

[Nikki74]

1 hour ago, Shep said:

 

Eventually, yes, a slow taper off all of your drugs.

 

For now, please work on the benzo spacing and on finding ways of self-soothing. These videos are a great start:

 

The Breathing Space by Jon Kabat Zinn video (4 minutes)

 

The Power Of Letting Go - Jon Kabat-Zinn video (3 minutes)

 

If you don't like these, please explore and find ones that speak to you and then bring them into your day every few hours so you're training your brain to relax, for just a moment at a time. Eventually, those moments build into a solid minute, than 5 minutes, and then more and more. 

 

Please remember to post in your drug and symptoms journal when you are doing this and other non-drug coping skills that you find. Again, not a quick fix, but over time they will feed into the neuroplasticity and put you on a better path through withdrawal. 

Thank you Shep.

 

With the lexapro and the benzo giving me surges and adverse effects, how do I stay on them? 

 

Which one should I be tapering when I’ve got more skills in place? 

[manymoretodays]

Hi Nikki,

1 hour ago, Nikki74 said:

Which one should I be tapering when I’ve got more skills in place? 

 

I think it's one thing at a time, time Nikki.

First, work on the benzo spacing...... along with coping skills.  When you get to the new schedule, be sure to share an entire day of your daily symptom/drug/coping.

Then......it will be clearer what next should be tapered.  Or which drug to give priority to.

Include the coping skills that helped in your daily logs.

 

I'm proud of you Nikki!!

Good job!!

Hugs.

Love, peace, healing, and growth,

mmt

[Shep]

On 9/5/2018 at 2:27 PM, Nikki74 said:

Yes I’m in the process but got stuck at the 10am and 1pm position because I feel desperate for the benzo by 10am even though it’s horrible!

 

Nikki, Alto had a thought about dealing with the need to take an earlier benzo dose - move .10 mg of the morning dose to 10 am so you're actually taking the benzo 4 times a day instead of 3 times a day (and getting it earlier to help with breakthrough morning withdrawal).  This will still get you that 10 am dose. 

 

What do you think about the below schedule?

 

8 am - 4.5mg Lexapro 

10 am - .10 mg clonazepam

11 am - .11 clonazepam 

2 pm - .22 clonazepam 

5pm - .375 clonazepam 

11pm -15mg mirtazapine