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Nikki74: Lexapro mirtazapine diazepam akathisia

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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 

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Nikki74
4 minutes ago, Shep said:

 

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 

Thanks Shep

 

Yes I can try this. I hope I can do the math to split it like that. It might not be a perfect split as I’m dry cutting. 

 

Do you think im in tolerance wd on the benzo? 

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Shep
52 minutes ago, Nikki74 said:

Do you think im in tolerance wd on the benzo? 

 

It sounds more like interdose withdrawal (or what's sometimes called breakthrough withdrawal) because you're going from that 5 pm dose to the next day's dose. 

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Shep

Nikki, please see the below schedule. You may want to also split out the 5 pm clonazepam dose. This will give you extra protection against the morning breakthough symptoms, as you'll be getting the clonazepam in you later in the day, so your last benzo dose will be at 8 pm instead of 5 pm.

 

You may want to go ahead and move the morning dose first and then move the 5 pm dose into two doses. We recommend only moving a dose an hour a day, as this is gentlest on your nervous system.

 

Please let us know your thoughts and if you have any questions. 

 

8 am - 4.5mg Lexapro 

10 am - .10 mg clonazepam

11 am - .11 clonazepam 

2 pm - .22 clonazepam 

5pm - .187 clonazepam 

8 pm - .188 clonazepam 

11pm -15mg mirtazapine 

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manymoretodays

Hi Nikki,

19 hours ago, Nikki74 said:

Thanks Shep

 

Yes I can try this. I hope I can do the math to split it like that. It might not be a perfect split as I’m dry cutting. 

 

 

So okay.  The first change will be with your morning dosing.  Instead of the 0.21 dose at 10 am.  You will want to do 0.10 mg at 10 am.  Then 0.11 mg at 11 am.  And that's kind of nifty how that worked out, easy to remember times and dosages. 

 

It's going to be evening I assume when you read this.  Sooo.........you might want to get tomorrows doses measured and weighed when you are feeling at your best tonight.  I know you have not been doing great in the morning.    You could get creative and then put the doses onto some folded over paper, like origami(yet not......just safely folded in).  And then mark each paper with the time that corresponds with the dose.   Find some colorful paper. 

 

Or you could put the doses into empty capsules and then into separate marked bottles.

 

If you are feeling really ambitious and I bet you are B)........go ahead and set up your 2 pm and 5 pm doses too.  Then all you have to do tomorrow is take them at the appropriate times.

 

Does that sound doable?  Then.......we give it a week of just one change.  The 10 am and 11 am doses.  And continue to do your notes.......post the whole 24 hours,  times, drugs, dosages, symptoms........only add in the self soothing and coping skills you have tried this time.  The 4 or 5 minute meditations Shep linked, your self hugs, rocking, drawing or even coloring, ice cubes, face dunks, singing, listening to music.........almost anything goes for coping.   If you need to pace......can you get outside briefly and make it a walk?  Do some crazy dancing, in your own home of course.......I don't know, I kitchen dance and have to recommend it!

 

Okie doke Nikki.  You keep up the good hard work.

 

Love, peace, healing, and growth,

mmt

 

Oh......stay in the now as much as you can........I'm noticing a bit of what I call past tripping and future tripping, in your narratives lately.

 

Edited by manymoretodays

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manymoretodays

.......and this Nikki.  If you are feeling up to reading this evening/morning/whenever.  A wonderful post in What does healing from Withdrawal feel like?,  in the symptoms and self care section.

 

Ugh hugs,  And peaceful calm Sunday to all!!!

L, P, H, and growth,

mmt

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Nikki74
On 9/8/2018 at 7:23 PM, Shep said:

Nikki, please see the below schedule. You may want to also split out the 5 pm clonazepam dose. This will give you extra protection against the morning breakthough symptoms, as you'll be getting the clonazepam in you later in the day, so your last benzo dose will be at 8 pm instead of 5 pm.

 

You may want to go ahead and move the morning dose first and then move the 5 pm dose into two doses. We recommend only moving a dose an hour a day, as this is gentlest on your nervous system.

 

Please let us know your thoughts and if you have any questions. 

 

8 am - 4.5mg Lexapro 

10 am - .10 mg clonazepam

11 am - .11 clonazepam 

2 pm - .22 clonazepam 

5pm - .187 clonazepam 

8 pm - .188 clonazepam 

11pm -15mg mirtazapine 

Ok thanks Shep

My cognitive ability is much slower these days, my brain feels quite disabled and my eyesight is getting blurry (and I’ve noticed my right eyelid droops a bit sometimes) so I’m finding it hard to make sense of stuff but I’ll screen shot this then work on these changes.

 

I’ve noticed the Mirtazipine seems much more sedating lately. It’s weird because even though the lexapro cut seems to have made the akathisia worse, the Mirtazipine seems to be heavier. I don’t think I’m even making sense.

 

Sorry, Nikki 

 

 

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Nikki74
21 hours ago, manymoretodays said:

.......and this Nikki.  If you are feeling up to reading this evening/morning/whenever.  A wonderful post in What does healing from Withdrawal feel like?,  in the symptoms and self care section.

 

Ugh hugs,  And peaceful calm Sunday to all!!!

L, P, H, and growth,

mmt

Thank you mmt

ive read that before but did again. I wish it expanded more on akathisia. The author talks about it coming and going, I wish! 

 

It is a helpful read though. Pretty much every symptom I can rationalise except akathisia when it’s gone on this long.

 

I’m concerned about my eyesight which seems to be worsening. I feel it’s the benzo.

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manymoretodays

Hi Nikki,

 

First, you ARE making sense.  B)

Yes, I had read that before too.........it just is such a nice hopeful synopsis.  I liked the part about akathisia, when she said a good cry in the bathtub could completely remove it for her.

 

On the eyesight.......it could be related to your drug interactions as well.........I mean it's hard to always know.  I just did a quick look at interactions.  Are you using any glasses for reading or otherwise at this point?  I started with reading glasses in my 40's.  And of course......it could be secondary to your benzo.  Could you ask for an eye exam?

 

Let's assume your aka means healing.  I know Nikki, you've had a tough go of it.  Did you see the neurologist........and did that visit help at all?

 

What are your thoughts on Shep's newest schedule above?  There are some changes in the evening dosing that were added.  Does that sound doable a step at a time?  First change would be the morning dose split.

 

In any-case.  Keep up with your notes on paper.  They do help us.  I'm also hoping.......... that they will help you identify some of your best times of day, as well as improvements and progress.  Use some colored pens or paper if you'd like at home.  Let's try and get your creative spark lit again.

 

Love, peace, healing, and growth,

mmt 

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Nikki74
20 minutes ago, manymoretodays said:

Hi Nikki,

 

First, you ARE making sense.  B)

Yes, I had read that before too.........it just is such a nice hopeful synopsis.  I liked the part about akathisia, when she said a good cry in the bathtub could completely remove it for her.

 

I wish! I do get in the bathtub for the heat but no amount of crying or heat or bathtubbing removes it. Heat is definitely a short term relief of sorts though when it’s not severe.

20 minutes ago, manymoretodays said:

On the eyesight.......it could be related to your drug interactions as well.........I mean it's hard to always know.  I just did a quick look at interactions.  Are you using any glasses for reading or otherwise at this point?  I started with reading glasses in my 40's.  And of course......it could be secondary to your benzo.  Could you ask for an eye exam?

 

I dont use glasses and have always had 20:20 vision. I noticed when I accidentally made those two days of lower benzo in the mornings, my vision went really blurry then and it’s been that way since.

20 minutes ago, manymoretodays said:

Let's assume your aka means healing.  I know Nikki, you've had a tough go of it.  Did you see the neurologist........and did that visit help at all?

 

I hope it does mean healing.

I did see the neurologist and it was very disappointing! He had no clue about these drugs, said I had restlessness (I was sitting there marching my legs and shaking) and said they’d normally prescribe a much higher dose of clonazepam for it...

20 minutes ago, manymoretodays said:

What are your thoughts on Shep's newest schedule above?  There are some changes in the evening dosing that were added.  Does that sound doable a step at a time?  First change would be the morning dose split.

 

I’ve been thinking today and am worried about taking 5 doses and all uneven. I’m wondering if I could do 3 more even doses?

20 minutes ago, manymoretodays said:

In any-case.  Keep up with your notes on paper.  They do help us.  I'm also hoping.......... that they will help you identify some of your best times of day, as well as improvements and progress.  Use some colored pens or paper if you'd like at home.  Let's try and get your creative spark lit again.

 

I use orange for days/ spells when aka is a bit lower but I’ve not had one for a while. I’ll try to engage my creativity that way more. I’m just too uncomfortable to focus on anything much but I do manage a couple minutes of doodles.

20 minutes ago, manymoretodays said:

Love, peace, healing, and growth,

mmt 

Xxx

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manymoretodays
15 minutes ago, Nikki74 said:

I’ve been thinking today and am worried about taking 5 doses and all uneven. I’m wondering if I could do 3 more even doses?

 

I'll confer on this ^ Nikki.  And get back to you.  Don't worry so much(I know, easier said than done). 

Where are you at with the 2pm dose now?  Are you taking it at 2pm?

I'm just going to recopy Shep's post with the latest proposed schedule here too.

 

On 9/8/2018 at 12:23 PM, Shep said:

Nikki, please see the below schedule. You may want to also split out the 5 pm clonazepam dose. This will give you extra protection against the morning breakthough symptoms, as you'll be getting the clonazepam in you later in the day, so your last benzo dose will be at 8 pm instead of 5 pm.

 

You may want to go ahead and move the morning dose first and then move the 5 pm dose into two doses. We recommend only moving a dose an hour a day, as this is gentlest on your nervous system.

 

Please let us know your thoughts and if you have any questions. 

 

8 am - 4.5mg Lexapro 

10 am - .10 mg clonazepam

11 am - .11 clonazepam 

2 pm - .22 clonazepam 

5pm - .187 clonazepam 

8 pm - .188 clonazepam 

11pm -15mg mirtazapine 

 

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Shep
18 hours ago, Nikki74 said:

I’ve been thinking today and am worried about taking 5 doses and all uneven. I’m wondering if I could do 3 more even doses?

 

We discussed this, Nikki, and Alto came up with a good solution. It's important that you take more than 3 doses because you're dealing with interdose withdrawal. What about this schedule?

 

8 am - 4.5mg Lexapro 

10 am - .10 mg clonazepam

11 am - .10 clonazepam 

2 pm - .20 clonazepam 

5pm - .20 clonazepam 

8 pm - .20 clonazepam 

11pm -15mg mirtazapine 

 

In order to even out the doses, there will be a reduction, however, it's a very slight reduction of .005mg, which is only 0.62%. Considering how easy it would be to make a mistake with a more complicated schedule, this slight reduction will be worth it in order to have this cleaner schedule.

 

Please let us know what you think. 

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Nikki74
10 hours ago, Shep said:

 

We discussed this, Nikki, and Alto came up with a good solution. It's important that you take more than 3 doses because you're dealing with interdose withdrawal. What about this schedule?

 

8 am - 4.5mg Lexapro 

10 am - .10 mg clonazepam

11 am - .10 clonazepam 

2 pm - .20 clonazepam 

5pm - .20 clonazepam 

8 pm - .20 clonazepam 

11pm -15mg mirtazapine 

 

In order to even out the doses, there will be a reduction, however, it's a very slight reduction of .005mg, which is only 0.62%. Considering how easy it would be to make a mistake with a more complicated schedule, this slight reduction will be worth it in order to have this cleaner schedule.

 

Please let us know what you think. 

Ok.

im trying to figure out how I weigh it out.

 

Sorry if this is a silly question but I normally use one .5mg pill to do the daytime doses then another .5mg pill for the 5pm dose (easy to cut and weigh 3/4 of that pill to get the .375).

 

If I weigh both pills then calculate 80% of the total weight, cut enough off one pill to give me that 80% then hopefully get the doses you suggest as even as possible from that. Does it matter than I’m changing the way I cut from both pills? Ie It won’t affect the amount of active ingredient I get?

 

Im not even sure how to ask the question clearly! And I can’t work out if it’s a silly question anyway!

 

whereas I’ve been chopping both pills, I’ll now chop from one to get 80% of the total ie .80. So does that matter?

 

 

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Nikki74

Today my dosing was thus:

 

8am 4.5mg lexapro 

10am .20 clonazepam 

1pm .20 clonazepam

5pm .20 clonazepam

8pm .20 clonazepam

11pm 15mg Mirtazipine 

 

As you see I’ve not split the 10am dose and I’m taking the second dose at 1pm rather than 2pm.

 

I weighed both .5mg pills, chopped off 20% then did my best to cut what was left into 4 even doses but it was more eyeballing than weighing as I had so many chunks and chips. 

 

I am pretty sure I am tolerant to this stuff now (well that happens quickly anyway doesn’t it) and as you say am experiencing interdose wds. Each dose doesn’t last long. 

 

I will post my symptom log as the days go by. 

 

My main coping tool is a full size heated blanket that I need to be under when not pacing in order to bring some small relief to the akathisia. 

 

Plus prayer, nature sounds, breathing. 

 

I am entirely consumed by surviving the akathisia plus whatever other symptoms/ drug reactions arise and doing what small chores I can in brief spells. 

 

If youve ever had akathisia non stop for 14 months plus accompanying misery, you’ll know it’s about survival. 

 

I used to have a great sense of humour, it’s still in there, but I’m afraid I’m pretty ragged now. 

 

One more day done, for my son.

 

 

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manymoretodays

Hi Nikki,

S'okay.

6 hours ago, Nikki74 said:

8am 4.5mg lexapro 

10am .20 clonazepam 

1pm .20 clonazepam

5pm .20 clonazepam

8pm .20 clonazepam

11pm 15mg Mirtazipine 

 

Was today the first day that you did the 5pm .20 mg and then 8pm .20 mg?

If so, I don't think you should attempt any of the other changes for a least a week.  Stay with what you posted above.   We can work on the "how to do them", together, however, the rest of the changes in the meantime. 

What kind of scale do you have to work with now?

I did see that you are working with 0.5 mg clonazepam tablets.  They appear to be tiny little buggers to boot.......so I expect that they crumble up when cut.

Do you have a crushing device....... or a mortar and pestle?  If not, is this something you could get?  I'm thinking e-bay or amazon might be easiest.

 

We are eventually......not all at once, going to work to get your dosing like this:

On 9/11/2018 at 3:54 AM, Shep said:

8 am - 4.5mg Lexapro 

10 am - .10 mg clonazepam

11 am - .10 clonazepam 

2 pm - .20 clonazepam 

5pm - .20 clonazepam 

8 pm - .20 clonazepam 

11pm -15mg mirtazapine 

 

On 9/10/2018 at 9:38 AM, manymoretodays said:

You may want to go ahead and move the morning dose first and then move the 5 pm dose into two doses. We recommend only moving a dose an hour a day, as this is gentlest on your nervous system.

This was a Shep quote ^ .  I don't know why it sometimes switches names on quotes.

 

using a digital scale to measure doses

I'm posting this ^ for easy reference

 

Soooo.......I'm wondering if, with my help, you might consider using the scale a bit more after this week? 

 

On 9/11/2018 at 2:06 PM, Nikki74 said:

Sorry if this is a silly question but I normally use one .5mg pill to do the daytime doses then another .5mg pill for the 5pm dose (easy to cut and weigh 3/4 of that pill to get the .375).

 

If I weigh both pills then calculate 80% of the total weight, cut enough off one pill to give me that 80% then hopefully get the doses you suggest as even as possible from that. Does it matter than I’m changing the way I cut from both pills? Ie It won’t affect the amount of active ingredient I get?

 

Hey.......I think I understand what you are doing here.  80% of a 0.5 mg tablet would be approximating 0.4 mg active ingredient.........is that what you are going on?  I do see that the 0.5 mg klonopin tablets are scored as well.  And then you dry cut from there?  Have you been weighing again at that point?

Here's a nugget from the using a digital scale link about the active ingredient in tablets, and then the weight of the tablet.  This should help us as we go along, so am including it here for reference.

important note when weighing tablets

and another one so that I can reference and use to explain, as we go along

mgai and mgpw explained

It might be more accurate to get the average weight of your 0.5 mg tablets.   So first thing.......you could weigh several of the tablets and then we can get an average weight calculated.  Even though the mg is 0.5...........they don't always weigh exactly 0.5 mg due to fillers and such.

 

I'm going to close this post now, as it's getting long.

Let me know on the couple of questions I asked.  I'll go back and bold them now.  And let me know if I followed your present method okay........and then how you followed my stuff posted here.   B)  You are doing great Nikki.  I think we both may have creative math brains.

Edited by manymoretodays
added another ? and elaboration, another link

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manymoretodays
4 hours ago, Nikki74 said:

My main coping tool is a full size heated blanket that I need to be under when not pacing in order to bring some small relief to the akathisia. 

 

Plus prayer, nature sounds, breathing. 

 

I am entirely consumed by surviving the akathisia plus whatever other symptoms/ drug reactions arise and doing what small chores I can in brief spells. 

 

If youve ever had akathisia non stop for 14 months plus accompanying misery, you’ll know it’s about survival. 

 

I used to have a great sense of humour, it’s still in there, but I’m afraid I’m pretty ragged now. 

 

One more day done, for my son.

 

Oh Nikki,

I honestly never had non stop aka yet I CAN sympathize.  And yes, you ARE a survivor!

Awesome coping!!!!  And it's okay to be ragged sometimes.

 

Good job Nikki!!

 

Love, peace, healing, and growth,

mmt

((((((Nikki and her son)))))))))

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Nikki74

Been trying to post but cognitive functioning is worse and worse. Zombie. Don’t know what’s going on.

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manymoretodays

Hi Nikki,

I wondered where you went.  So I'm glad that you popped in.

Are you able to stay consistent with your drug dosing and measurement?  That's really important now.  And the times.

It hasn't even been a week since you made this change:

On 9/12/2018 at 3:58 PM, Nikki74 said:

8am 4.5mg lexapro 

10am .20 clonazepam 

1pm .20 clonazepam

5pm .20 clonazepam

8pm .20 clonazepam

11pm 15mg Mirtazipine 

 

.......for now.......just work on consistent measurement and dosing..........what I mean is measuring doses the same way day to day.  And then taking each dose on time.

Use your coping tools now too.......make that high priority.  Just go back in this thread or head on over to your benzo thread to review some of them, if need be.

And then get us a nice couple of days of notes..........keep it simple........time on the left, drug, dose, and symptoms, and coping tools used.  Even if they, the coping tools just helped a little.......put them down.

If you have veered from what you posted on the 12th........just let us know.  Okay?

 

It could be due to your most recent change in the evening dosing........it may take a bit for you to get used to that.  I think, in time.......the latest schedule should help with the interdose withdrawal.

 

And then here is what we'd like you to get to........not all at once though:

On 9/11/2018 at 3:54 AM, Shep said:

8 am - 4.5mg Lexapro 

10 am - .10 mg clonazepam

11 am - .10 clonazepam 

2 pm - .20 clonazepam 

5pm - .20 clonazepam 

8 pm - .20 clonazepam 

11pm -15mg mirtazapine 

I'm just posting it again for easy reference for all.

 

Love, peace, healing, and growth,

mmt

get a good nights rest Nikki........tomorrow may be better.

 

 

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Nikki74
22 minutes ago, manymoretodays said:

Hi Nikki,

I wondered where you went.  So I'm glad that you popped in.

Are you able to stay consistent with your drug dosing and measurement?  That's really important now.  And the times.

It hasn't even been a week since you made this change:

 

.......for now.......just work on consistent measurement and dosing..........what I mean is measuring doses the same way day to day.  And then taking each dose on time.

 

Yes though I’m struggling to get them exact, currently the 8pm dose is a bit smaller than the others.

 

i have terrible migraine. Common for me. The mental blankness has been more evident in the last month. 

 

Akathisia everyday as always.

Paradoxical reaction to evening Klonopin dose last night and this morning’s dose. Includes stuttering which I’ve been getting more often over time when I take the benzo. 

22 minutes ago, manymoretodays said:

Use your coping tools now too.......make that high priority.  Just go back in this thread or head on over to your benzo thread to review some of them, if need be.

And then get us a nice couple of days of notes..........keep it simple........time on the left, drug, dose, and symptoms, and coping tools used.  Even if they, the coping tools just helped a little.......put them down.

If you have veered from what you posted on the 12th........just let us know.  Okay?

 

It could be due to your most recent change in the evening dosing........it may take a bit for you to get used to that.  I think, in time.......the latest schedule should help with the interdose withdrawal.

 

And then here is what we'd like you to get to........not all at once though:

I'm just posting it again for easy reference for all.

 

Love, peace, healing, and growth,

mmt

get a good nights rest Nikki........tomorrow may be better.

 

 

Thanks.

I don’t get any better days anymore. They were rare anyway but things are on a downwards slope for long time now.

 

will try for journal update on here soon xxxx

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Shep

How many hours of sleep are you getting these days, Nikki? 

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Nikki74
21 hours ago, Shep said:

How many hours of sleep are you getting these days, Nikki? 

About 7 hours, waking once or twice. It’s my only saving grace but I know when the akathisia was severe in January I was getting 2 hours.

 

7 hours sleep

wake with akathisia increasing badly, diahrrea 

8am 4.5 lexapro

surge in agitation

Legs rubbing together    

Lie under heated blanket feeling agitated throughout.

 

Send messages on phone to others in wd

 

10am .20 clonazepam 

Surge in adrenaline

stuttering

shaking

pacing and moving 

 

10.45 

shaking stops 

 

11.30 pacing and movements lower

 

need heated blanket for some small relief and try to rest

 

12.30 

Increase in agitation, twisting body and movements due to it

Terror

visual distortions 

 

under heated blanket, cry, pray

 

1pm .20 clonazepam 

pacing 

Intrusive thoughts 

 

2.30pm 

Pacing and agitation much lower and able to do some chores

 

4pm

agitation increases, panic, terror

 

under heated blanket, breathe, distract a bit when son comes in from school by asking about his day, v hard to engage and retain info, agitation makes interactions hard 

 

5pm .20 clonazepam 

Tears, some sedation, intrusive thoughts 

 

make dinner

try to watch some tv, restless 

 

8pm .20 clonazepam 

mental slowness 

panic

depression

 

Try to watch tv, restless 

Support son with homework

 

10.30 bed

11pm 15mg Mirtazipine 

sleep

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Shep
On 9/17/2018 at 12:02 PM, Nikki74 said:

Paradoxical reaction to evening Klonopin dose last night and this morning’s dose. Includes stuttering which I’ve been getting more often over time when I take the benzo. 

 

Are you getting a paradoxical reaction regularly with specific Klonopin doses?

 

From your latest journal entry, it seems that it's only for an hour or so after dosing and then it decreases. 

 

1 hour ago, Nikki74 said:

10am .20 clonazepam 

Surge in adrenaline

 

1 hour ago, Nikki74 said:

10.45 

shaking stops 

 

11.30 pacing and movements lower

 

1 hour ago, Nikki74 said:

1pm .20 clonazepam 

pacing 

Intrusive thoughts 

 

2.30pm 

Pacing and agitation much lower and able to do some chores

 

1 hour ago, Nikki74 said:

5pm .20 clonazepam 

Tears, some sedation, intrusive thoughts 

 

1 hour ago, Nikki74 said:

8pm .20 clonazepam 

mental slowness 

 

It looks like you're getting surges of adrenaline at the 10 am and the 1 pm dose that decreases after an hour or so and then the 5 pm one caused some sedation, and then you felt slowed down by the 8 pm one. 

 

1 hour ago, Nikki74 said:

8am 4.5 lexapro

surge in agitation

 

Is the Lexapro consistently causing a surge in agitation now? 

 

Please keep going with the drug and symptoms journal, as you had let that go for awhile. 

 

If the benzo is causing a paradoxical reaction consistently, then you may want to reduce that first, but if the Lexapro is consistently causing akathisia, then you may want to reduce that first. 

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Nikki74
2 minutes ago, Shep said:

 

Are you getting a paradoxical reaction regularly with specific Klonopin doses?

 

Yes, consistently with the 10am dose and today it’s lasted 2 hours.

 

Inconsistently with the 1pm dose

 

Inconsistently with the 5pm and 8pm dose, I have had paradoxical reactions to both recently.

2 minutes ago, Shep said:

From your latest journal entry, it seems that it's only for an hour or so after dosing and then it decreases. 

 

 

 

 

 

 

It looks like you're getting surges of adrenaline at the 10 am and the 1 pm dose that decreases after an hour or so and then the 5 pm one caused some sedation, and then you felt slowed down by the 8 pm one. 

 

 

Is the Lexapro consistently causing a surge in agitation now? 

 

This is hard to tell as the agitation is getting bad before I take it anyway.

 

Some days it briefly lowers the agitation a bit then it rises again. Today I was shaking after taking the lexapro and a definite surge after taking it. 

 

Then took the 10am clonazepam and it all went pretty severe for two hours. 

2 minutes ago, Shep said:

Please keep going with the drug and symptoms journal, as you had let that go for awhile. 

 

If the benzo is causing a paradoxical reaction consistently, then you may want to reduce that first, but if the Lexapro is consistently causing akathisia, then you may want to reduce that first. 

Thanks Shep.

i wake with the akathisia so it’s hard to tell what’s what. I’m as confused as you guys probably are!

 

The one consistent is the 10am clonazepam dose causing it to get worse. 

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Shep
12 minutes ago, Nikki74 said:

The one consistent is the 10am clonazepam dose causing it to get worse. 

 

Does that dose consistently get better an hour to two hours later? 

 

Also, how often are you eating? Please include meals and snacks in your journal, as it's possible you may be getting shaking and other symptoms from low blood sugar that resolves itself when you eat. Do you eat when you take the Klonopin dose or take it on an empty stomach? Do you sometimes eat when you take the Klonopin and sometimes not? These are all important factors. 

 

Also, do you see any correlation with when you have a cigarette and any increases or decreases in akathisia and restlessness? Do you smoke more in the morning than in the afternoon? Having inconsistent levels of nicotine can also factor in. 

 

Let's not assume everything is connected to the drugs, especially when they are changing so much, without exploring other things. 

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Nikki74
7 hours ago, Shep said:

 

Does that dose consistently get better an hour to two hours later? 

 

No

7 hours ago, Shep said:

Also, how often are you eating? Please include meals and snacks in your journal, as it's possible you may be getting shaking and other symptoms from low blood sugar that resolves itself when you eat. Do you eat when you take the Klonopin dose or take it on an empty stomach? Do you sometimes eat when you take the Klonopin and sometimes not? These are all important factors. 

 

I dont eat often

cereal at about 10.30am (no sugars)

chicken pieces at about 2pm

A full meal 6/7pm

cereal or boiled eggs at 10pm

snack on plain potato chips through the day

 

i used to eat a lot of almonds but I suffered severe diahrrea and bleeding after the lexapro reduction and cut out nuts as they seemed to be not digesting and aggravating the bleeding.

7 hours ago, Shep said:

Also, do you see any correlation with when you have a cigarette and any increases or decreases in akathisia and restlessness? Do you smoke more in the morning than in the afternoon? Having inconsistent levels of nicotine can also factor in. 

 

I wish i could cut back

I smoke about 6 hand rolled cigarettes by 11am, I do have 2 or 3 by 9.30am

Yes it increases agitation,

but if I try to miss some out, the agitation rises and I get relief by smoking. I crave them all day. I was smoking 12 a day in December, and it’s doubled (21-24 a day). Yes I can start shaking in the morning after my first cigarettes.

 

Smoking is an additional prison in this.

 

Though I reach for it as a sort of different sensation, or if DR is bad, to try to change that and put me in the now.

7 hours ago, Shep said:

Let's not assume everything is connected to the drugs, especially when they are changing so much, without exploring other things. 

 

 

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Nikki74

Ok I’ve spent 30 minutes stuttering, head shaking and nodding, adrenaline surge, heartrate up, nausea, crying, shaking and salivating after my 8pm dose.

 

I ate dinner at 7.30pm

 

I will do more notes over coming days.

Edited by Nikki74

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Altostrata
On 9/19/2018 at 3:50 AM, Shep said:

Please keep going with the drug and symptoms journal, as you had let that go for awhile. 

 

If the benzo is causing a paradoxical reaction consistently, then you may want to reduce that first, but if the Lexapro is consistently causing akathisia, then you may want to reduce that first. 

 

My thoughts exactly.

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Nikki74

7 hours sleep

drowsy on waking, akathisia starts when I get up

cigarette

8am 4.5mg lexapro 

shaking

cigarette

eat a piece of chicken

akathisia increasing badly

cigarette

10am .20 clonazepam 

brief surge then sedation

cigarette

restless as always

cigarette

11.15 pacing, quite intense akathisia and feelings of not being able to cope 

cigarette

cigarette

12.30 panic, mental akathisia, feel like going insane, horrid intrusive thoughts 

cigarette

1pm .20 clonazepam 

sedation

cigarette

2pm v drowsy, eat 2 pieces of chicken 

2.30 movements in legs needed, agitation rising, things look eerie

cigarette x3

4.30 agitation lowers a bit but v restless

cigarette

5pm .20 clonazepam 

dark intrusive thoughts, depression, restless 

cigarette 

cigarette

Make dinner - fish, potatoes, peas

great difficulty retaining anything or thinking 

things also looping in my head

cigarette

cigarette

8pm .20 clonazepam

Stuttering, shaking, head bobbing and shaking, salivating, adrenaline surge

8.45 effects reduce

exhausted and depressed

 

Cigarette

Cigarette

10pm boiled eggs and rice cakes 

11pm 15mg Mirtazipine 

 

 

What i know:

I experienced akathisia for sure before cts last year but no movement, more internal and intermittent 

 

cts caused it and its been constant since. It worsened taking Zopiclone and coming off that and halving the lexapro.

 

It went severe in January for no apparent reason, mental and physical torment for 3 weeks, unable to function, 2 hours sleep, constant movement.

 

I ended up taking Klonopin.

 

This stopped all movements, lowered agitation, but I still felt akathisia internally. Quite quickly I was getting instant depression on it and dark intrusive thoughts and dry retching when I took my doses.

 

After 4 weeks on it, I’d take the morning .5mg and it’d make my hyper, I’d be on my feet and not able to be still so I decided to start tapering. Akathisia obviously worsened again but not like it’s been since the start of August.

 

Ive had confusing mixed reactions since.

 

The Lexapro started to give me severe adverse reactions in June so I made that reduction at the start of July. Start of August, some switch went and the akathisia ramped right up and has been very volatile since as well as drug reactions.

 

I know any reductions make the akathisia worse. 

 

I know I haven’t been stable on psych drugs since mid 2016.

 

I have akathisia all the time, no windows, for 14 months.

 

I used to get occasional lowering but not since the start of August.

 

I can’t see my way off the drugs as I seem so sensitive.

 

i wonder about holding for a long time, if I’m just too unstable. But if the drug reactions were due to an unstable cns surely the Mirtazipine would be adverse too?

 

I feel horribly trapped. 

 

 

 

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Altostrata

Nikki, thanks for those detailed symptom notes.

 

As we've discussed, it looks like both drugs are causing adverse reactions. We're working on a plan to reduce the reactions from clonazepam first, then taper the Lexapro.

 

Hang in there, you are a trooper.

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Shep
Quote

 

8am 4.5mg lexapro 

10am .20 clonazepam 

1pm .20 clonazepam 

5pm .20 clonazepam 

8pm .20 clonazepam

11 pm 15 mg mirtazapine

 

 

Nikki, the above schedule is where you're currently at, but Alto mentioned making a change that will give you a night time benzo dose at 11 pm, which may help with your morning symptoms. 

 

Please let me know what you think about the below schedule. This will take .10 mg off the 5 pm and .10 mg off the 8 pm dose and place the .20 mg at 11 pm. 

 

Quote

 

8am 4.5mg lexapro

10am .20 clonazepam 

1pm .20 clonazepam 
5pm .10 clonazepam

8pm .10 clonazepam

11pm .20 clonazepam and 15 mg mirtazapine

 

 

If this is something that will work for you, please let us know. If so, here is the day-by-day method to get you there gradually:

 

Step 1 - Move half of the 8 pm dose an hour a day toward 11 pm 

 

Day 1

 

8am 4.5mg lexapro 

10am .20 clonazepam 

1pm .20 clonazepam 

5pm .20 clonazepam 

8pm .10 clonazepam

9pm .10 clonazepam

11 pm 15 mg mirtazapine

 

Day 2:

 

8am 4.5mg lexapro 

10am .20 clonazepam 

1pm .20 clonazepam 

5pm .20 clonazepam 

8pm .10 clonazepam

10pm .10 clonazepam

11 pm 15 mg mirtazapine

 

Day 3:

 

8am 4.5mg lexapro 

10am .20 clonazepam 

1pm .20 clonazepam 

5pm .20 clonazepam 

8pm .10 clonazepam

11pm .10 clonazepam and 15 mg mirtazapine

 

Step 2 - Move half of the 5 pm dose an hour a day toward 11 pm

 

Day 4:

 

8am 4.5mg lexapro 

10am .20 clonazepam 

1pm .20 clonazepam 

5pm .10 clonazepam 

6pm .10 clonazepam

8pm .10 clonazepam

11pm .10 clonazepam and 15 mg mirtazapine

 

 

Day 5:

 

8am 4.5mg lexapro 

10am .20 clonazepam 

1pm .20 clonazepam 

5pm .10 clonazepam 

7pm .10 clonazepam

8pm .10 clonazepam

11pm .10 clonazepam and 15 mg mirtazapine

 

 

Day 6:

 

8am 4.5mg lexapro 

10am .20 clonazepam 

1pm .20 clonazepam 

5pm .10 clonazepam 

8pm .10 clonazepam

9pm .10 clonazepam

11pm .10 clonazepam and 15 mg mirtazapine

 

 

Day 7:

 

8am 4.5mg lexapro 

10am .20 clonazepam 

1pm .20 clonazepam 

5pm .10 clonazepam 

8pm .10 clonazepam

10pm .10 clonazepam

11pm .10 clonazepam and 15 mg mirtazapine

 

 

Day 8:

 

8am 4.5mg lexapro 

10am .20 clonazepam 

1pm .20 clonazepam 

5pm .10 clonazepam 

8pm .10 clonazepam

11pm .20 clonazepam and 15 mg mirtazapine

 

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Nikki74
On 9/22/2018 at 10:36 PM, Shep said:

 

Nikki, the above schedule is where you're currently at, but Alto mentioned making a change that will give you a night time benzo dose at 11 pm, which may help with your morning symptoms. 

 

Please let me know what you think about the below schedule. This will take .10 mg off the 5 pm and .10 mg off the 8 pm dose and place the .20 mg at 11 pm. 

 

 

If this is something that will work for you, please let us know. If so, here is the day-by-day method to get you there gradually:

 

Step 1 - Move half of the 8 pm dose an hour a day toward 11 pm 

 

Day 1

 

8am 4.5mg lexapro 

10am .20 clonazepam 

1pm .20 clonazepam 

5pm .20 clonazepam 

8pm .10 clonazepam

9pm .10 clonazepam

11 pm 15 mg mirtazapine

 

Day 2:

 

8am 4.5mg lexapro 

10am .20 clonazepam 

1pm .20 clonazepam 

5pm .20 clonazepam 

8pm .10 clonazepam

10pm .10 clonazepam

11 pm 15 mg mirtazapine

 

Day 3:

 

8am 4.5mg lexapro 

10am .20 clonazepam 

1pm .20 clonazepam 

5pm .20 clonazepam 

8pm .10 clonazepam

11pm .10 clonazepam and 15 mg mirtazapine

 

Step 2 - Move half of the 5 pm dose an hour a day toward 11 pm

 

Day 4:

 

8am 4.5mg lexapro 

10am .20 clonazepam 

1pm .20 clonazepam 

5pm .10 clonazepam 

6pm .10 clonazepam

8pm .10 clonazepam

11pm .10 clonazepam and 15 mg mirtazapine

 

 

Day 5:

 

8am 4.5mg lexapro 

10am .20 clonazepam 

1pm .20 clonazepam 

5pm .10 clonazepam 

7pm .10 clonazepam

8pm .10 clonazepam

11pm .10 clonazepam and 15 mg mirtazapine

 

 

Day 6:

 

8am 4.5mg lexapro 

10am .20 clonazepam 

1pm .20 clonazepam 

5pm .10 clonazepam 

8pm .10 clonazepam

9pm .10 clonazepam

11pm .10 clonazepam and 15 mg mirtazapine

 

 

Day 7:

 

8am 4.5mg lexapro 

10am .20 clonazepam 

1pm .20 clonazepam 

5pm .10 clonazepam 

8pm .10 clonazepam

10pm .10 clonazepam

11pm .10 clonazepam and 15 mg mirtazapine

 

 

Day 8:

 

8am 4.5mg lexapro 

10am .20 clonazepam 

1pm .20 clonazepam 

5pm .10 clonazepam 

8pm .10 clonazepam

11pm .20 clonazepam and 15 mg mirtazapine

 

Thank you Shep and Alto.

 

If I’m honest, I’m concerned about taking a benzo dose with the Mirtazipine as I’m worried about a paradoxical reaction with both being sedating. Also I’m worried about messing up the one drug I don’t get an adverse or changeable reaction to, ie the Mirtazipine.

 

Is the suggestion so as to avoid interdose wds in the morning? Or to maybe relieve the waking akathisia I get? 

 

 

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Shep
1 hour ago, Nikki74 said:

Is the suggestion so as to avoid interdose wds in the morning? Or to maybe relieve the waking akathisia I get?  

 

Yes, this is a suggestion to help with the waking akathisia, as it's likely from interdose withdrawal from the benzo.

 

I do understand your not wanting to mess with the nighttime dosing, since you are sleeping so well.

 

You'll have to weigh the pros and cons. If you decide to leave your schedule as it is, please work on non-drug coping ways of dealing with the early morning symptoms. Make sure you're eating breakfast soon after waking to help with any over-night low blood sugar issues. 

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Nikki74
1 hour ago, Shep said:

 

Yes, this is a suggestion to help with the waking akathisia, as it's likely from interdose withdrawal from the benzo.

 

I do understand your not wanting to mess with the nighttime dosing, since you are sleeping so well.

 

You'll have to weigh the pros and cons. If you decide to leave your schedule as it is, please work on non-drug coping ways of dealing with the early morning symptoms. Make sure you're eating breakfast soon after waking to help with any over-night low blood sugar issues. 

Thank you Shep.

 

A question about being in tolerance on the benzo and therefore getting interdose wds. Isn’t it the case that tapering it is the only option once in this position with a benzo? Or updosing, which I’m not about to do of course. 

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manymoretodays
On 9/22/2018 at 11:41 AM, Altostrata said:

Nikki, thanks for those detailed symptom notes.

 

As we've discussed, it looks like both drugs are causing adverse reactions. We're working on a plan to reduce the reactions from clonazepam first, then taper the Lexapro.

 

Hang in there, you are a trooper.

 

On 9/25/2018 at 4:48 AM, Nikki74 said:

A question about being in tolerance on the benzo and therefore getting interdose wds. Isn’t it the case that tapering it is the only option once in this position with a benzo? Or updosing, which I’m not about to do of course. 

 

Hi Nikki,

What's the schedule like now?  And you are getting good with the detailed symptom notes.  Keep those coming.

 

  I honestly think, all things considered, and from what I'm learning.......that the Lexapro is the next up.  Once you get a comfortable, decent schedule going with the clonazepam.  I really did a long review.......going back to the beginning of your thread........so I could both read and get a better feel for your history with the Lexapro.  It may be that with that last drop down, when you tried to go down 2.5 mg..........things might have leveled out a bit, with some of the immediate symptoms that you reported.  Just my thoughts.  And you ARE working the coping skills now, finding ones that help, and looking at all factors that you can control a bit for. 

 

Eating and smoking come to mind.  I'm in the smoking boat too.......just so you know.  And am tapering down a bit now.  Just now.  After all the rest.  I do know......or have observed, that for myself......... that often each cigarette smoked........only decreases that craving briefly and then it is cyclical........and almost increases the craving after.  I've got a book that states that within about 20 minutes after a smoke.........well, one will crave again.  I'm doing okay with my efforts......not certain of my quit date........yet thankful to be down in the quanity used right now and thinking less about  smoking most days.

I have to eat in the morning too!  Have to.  And lot's of healthy snacks.  My sugars check out fine and the overall function(blood sugar system) to date, has also checked out.  It helps though....with all the rest......just staying steady, and calm, and at my best.

 

I'm not sure what to say as far as your concerns of tolerance.  Does the interdose withdrawal have much to do with tolerance?  Maybe it's not tolerance and just interdose withdrawal now.  Don't become consumed with tolerance.........I guess it's almost unavoidable to get consumed with it, that concept, when on benzos.  So you can give me a gentle swat, virtually of course.

 

All for now Nikki. 

Love, peace, healing, and growth,

mmt

 

 

 

 

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cloud23

Hi Nikki,

 

I did a search on SA for cigarettes, bc I'm struggling with the smoking too..

 

I used Alan Carr's Easy Way to Quit when I quit smoking. Then two months later I started having issues with my Lexapro and did a quick taper. I had a problem finding a new Dr taper me off so I started smoking again bc I was going to taper myself.. found a new doctor, used smoking to help come off Lexapro but I'm in withdrawal hell and smoking a lot again.. (this was all before i found SA)..

 

You are correct about cigarettes cravings. After you finish a cigarette, you crave another one in about 45min* (from what I read). That is bc after you finish a cigarette, you start nicotine withdrawal right away. If you do the math of time frame and how many cigarettes in a box, you'll realize that the tobacco industry were genius to make a pack of cigs 20.

 

Here is what I have done to cut down at least a couple of cigarettes. If possible, it's hard for me on some days as well, wait till you have your 1st cigarette in the day. I sometimes wait till 11am or after lunch at 1pm. That ways I smoke less. Only downfall is as soon as I smoke that 1st cigarette,  I crave them soo much harder.

 

Im still searching SA on when to quit smoking from anyone who has done it. I want to quit now but I don't want to put my body through double the withdrawals from Lexapro and Cigarettes..

 

Hopefully my comment helps with the cigs. If you have any advice for me about cutting down my smoking, I'll take it :D

 

Thanks,

Cloud

 

 

 

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Nikki74
21 hours ago, manymoretodays said:

 

 

Hi Nikki,

What's the schedule like now?  And you are getting good with the detailed symptom notes.  Keep those coming.

 

  I honestly think, all things considered, and from what I'm learning.......that the Lexapro is the next up.  Once you get a comfortable, decent schedule going with the clonazepam.  I really did a long review.......going back to the beginning of your thread........so I could both read and get a better feel for your history with the Lexapro.  It may be that with that last drop down, when you tried to go down 2.5 mg..........things might have leveled out a bit, with some of the immediate symptoms that you reported. 

Hi mmt, thanks for going over my thread!

 

which drop to 2.5mg do you mean?

 

I did one day at 2.5mg 1st of July but then went to a 10% cut rather than 50% and stuck with that.

 

I tried a .25mg cut in August for four days, then reinstated as it was so brutal. Is that the one you mean?

 

Or another one? And what was the levelling out? August and a lot of September has been pretty brutal with the akathisia.

 

Itd be great if you could clarify for me.

 

I assumed tolerance on the benzo because I’m getting interdose wds, I thought they went together. Not sure. 

 

Thanks, Nikki x

21 hours ago, manymoretodays said:

 

Just my thoughts.  And you ARE working the coping skills now, finding ones that help, and looking at all factors that you can control a bit for. 

 

Eating and smoking come to mind.  I'm in the smoking boat too.......just so you know.  And am tapering down a bit now.  Just now.  After all the rest.  I do know......or have observed, that for myself......... that often each cigarette smoked........only decreases that craving briefly and then it is cyclical........and almost increases the craving after.  I've got a book that states that within about 20 minutes after a smoke.........well, one will crave again.  I'm doing okay with my efforts......not certain of my quit date........yet thankful to be down in the quanity used right now and thinking less about  smoking most days.

I have to eat in the morning too!  Have to.  And lot's of healthy snacks.  My sugars check out fine and the overall function(blood sugar system) to date, has also checked out.  It helps though....with all the rest......just staying steady, and calm, and at my best.

 

I'm not sure what to say as far as your concerns of tolerance.  Does the interdose withdrawal have much to do with tolerance?  Maybe it's not tolerance and just interdose withdrawal now.  Don't become consumed with tolerance.........I guess it's almost unavoidable to get consumed with it, that concept, when on benzos.  So you can give me a gentle swat, virtually of course.

 

All for now Nikki. 

Love, peace, healing, and growth,

mmt

 

 

 

 

 

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