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Nikki74: Lexapro mirtazapine diazepam akathisia

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Boris

Hi

 

I turned to smoking each time I went through akathisia. It was the only thing I could l could feel a tiny a bit of relief with. I would then also get anxious about doing it.

 

I've always been sensitive to smoking as well, it would make fatigue/brain fog worse but I always ended up doing it.

 

Have you considered vaping? Lowering the nicotine over time but still having that mechanical ritual to do? When my bladder/pelvis problems started after my main withdrawal I found myself buying tobacco again which is a big no no for bladder problems. So I picked up the vape with the lowest nicotine and used that instead. I'm still not happy about using it but I've cut down as my problems have eased a bit with the aim to go no nicotine then no vape. I don't get the symptoms I do with vaping like I do with tobacco.

 

Obviously no smoking/nicotine would be best but don't beat yourself up over it.

 

Sorry if you've been suggested this before as I've not read your whole thread.

 

Hang in there.

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Nikki74

Thank you @Boris

 

Kind of you to write. Yes I’ve tried vaping and gum, both made me worse. It’s like any change at all is bad.

 

so I feel stuck.

 

Ive had akathisia without a single break for 35 months. 

 

I don’t think anyone can help me as it’s been so long. And I react so badly to the smallest reduction. It becomes utterly horrific. 

 

Apart from quitting smoking, I don’t know what else to try. The akathisia makes me smoke! No one can understand this unless they’ve experienced this.

 

Thank you for writing, Nikki

 

 

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Frogie

Nikki:

 

2 hours ago, Nikki74 said:

Apart from quitting smoking, I don’t know what else to try. The akathisia makes me smoke! No one can understand this unless they’ve experienced this.

 

 I know exactly how you feel. I smoked for 40+ years. The akathisia is horrific during wd. I’m going through some internal shaking right now. At one point I was smoking almost 2 packs a day. I tried Chantix. I had to take it twice but it worked for me. I don’t know if you could try it? The only thing it did was give me very vivid dreams. It’s the hardest thing in the world to do. But I’ve been off for 4 years now.

 

I wish you all the luck in the world to stop smoking and with your taper. You have had it rough.

 

 I have to tell myself look how far I’ve come, not how far I have to go. 
 

Hope you feel better soon.

 

Take care,

 Frogie xx

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brassmonkey

Something that most doctors won't tell you and advertising avoids telling you is that Chantix is just a brand name for Bupropion or Welbutrin. It is a low dose of an antidepressant that many of our members are having a very had time getting off of. I very happy that it has helped Frogie, but SA can not and will not recommend taking this drug for smoking related WD.

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Frogie
Posted (edited)
2 hours ago, brassmonkey said:

Something that most doctors won't tell you and advertising avoids telling you is that Chantix is just a brand name for Bupropion or Welbutrin. It is a low dose of an antidepressant that many of our members are having a very had time getting off of. I very happy that it has helped Frogie, but SA can not and will not recommend taking this drug for smoking related WD.

@brassmonkey

 

I’m sorry I ever mentioned it. I had no idea what it was. It did work for me and hubby.

 

 I would never recommend anything like that to anyone if I knew what it was.

 

 I hope I didn’t offend anyone.

 

Frogie xx

Edited by Frogie

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brassmonkey

No problem Frogie-- you didn't actually recommend it, you just said it worked for you. Which is fine. But because it's really an SSRI as a moderator I have to say something on behalf of the site. No harm, no fowl.

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Nikki74
9 hours ago, brassmonkey said:

No problem Frogie-- you didn't actually recommend it, you just said it worked for you. Which is fine. But because it's really an SSRI as a moderator I have to say something on behalf of the site. No harm, no fowl.

Thank you Frogie and Brassmonkey.

 

I had heard of it and remember a smoking cessation worker telling me about it a few years ago. She’d said it can cause depression and I looked it up. I would not have taken it. I know Frogie too was just trying to help. Thank you for explaining Brassmonkey.

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ChessieCat

Hi Nikki,

 

Just a thought, please do your research.  I'm under the impression that nicotine patches provide a low dose of nicotine throughout the day.  It could be that nicotine gum provides too much in one go.  Also, the patches might be able to be cut down.  I haven't used them or know of anyone who hasm.  Maybe someone here might know more about them.  You could check out this topic:  smoking-cessation-nicotine-e-cigs

 

And you could ask your doctor.

 

 

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Nikki74
Posted (edited)
2 hours ago, ChessieCat said:

Hi Nikki,

 

Just a thought, please do your research.  I'm under the impression that nicotine patches provide a low dose of nicotine throughout the day.  It could be that nicotine gum provides too much in one go.  Also, the patches might be able to be cut down.  I haven't used them or know of anyone who hasm.  Maybe someone here might know more about them.  You could check out this topic:  smoking-cessation-nicotine-e-cigs

 

And you could ask your doctor.

 

 

Thank you for commenting ChessieCat.

 

Everyone is being so kind in coming forward with suggestions and yet I must sound I’m not taking them on board when I say nope can’t do that.

 

Unfortunately even before wd I couldn’t tolerate the patches as they caused itching. It’s a listed side effect. Just not doable. 

 

I had a read of the thread you gave me a link to. 

 

Mixed experiences as with everything. 

 

I feel my only option is the one to cut down. Taper. 

 

But i do this, very strictly, by writing down the times I had a cigarette which helps me to see if I’m sticking to things. So I get down to 8. Then after a while symptoms get worse because of a cut or wave on a wave, and it creeps up again and I’m back to 12. This is better than 20-26 I was smoking in 2017-18 but it’s not quitting.

 

Can anybody tell me if there is any hope for me at all regarding the relentless akathisia now 34 months since cold turkeys never ever having gone? It gets so severe with a reduction and I don’t know what to do anymore. I don’t.  Because I’m truly feeling that I’m an exception and this is it. I am terrified. I have fought with every sinew I have to keep going. Thank you. 

 

Does my recovery hinge on quitting smoking? 

 

@manymoretodays 

 

Edited by Nikki74

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Altostrata

Please discuss smoking cessation in this topic

 

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Nikki74
Posted (edited)

Log for @manymoretodays

11am wake with adrenaline surging, panic heart ponding and forced to move (akathisia)

 

severe diarrhoea 

 

11.15 2.5mg escitalopram, some agitation comes down 

 

11.30 .25mg Klonopin 

some more reduction in adrenaline, panic, agitation 

 

12 noon unable to stay still so get up again and smoke, then lie down, full body and mind agitation continues 

 

12.30 eat eggs and rice crackers

body is shuddering all over, lie down crying with the intensity

 

Suddenly get explosive level akathisia and start pacing. Can’t sustain due to weakness and have to sit with legs juggling up and down. 

 

2pm movement akathisia stops, inner continues, lie exhausted.

 

put tv on for distraction 

 

3pm .25mg Klonopin 

3.15 tears, feel like disappearing into a hole of nothingness, panic, heart rate increases

3.30 feel drunk, drugged, awful empty feeling. Cry curled up on sofa.

 

4 cigarette, heart rate increases 

4.30.  able to watch some tv

 

5 cig craving. Resist, eat a carrot stick instead.

 

Feel drowsy but also a bit calmer 

 

6.30 sudden onset of 

Terror

Visual distortions 

feeling of going to scream

feeling of rage

fear of doing something violent, horrific 

Mind racing too fast to feel any control 

stuttering speech when try to tell carer

see strange shapes in things on tv

feel like disappearing down a hole

horror

tree outside seems to be swaying in slow motion

panic

feel will pass out

carer sits down in peripheral vision and looks like a completely different person, like a hallucination 

Start crying because it’s all so horrific 

Feel like body will start convulsing 

 

Massive cig craving

desoerate to eat

 

Have Cig (been 2.5 hours since had one, don’t normally leave it so long but was trying to cut back)

Eat meal carer has made

7.10 Symptoms come down and I am absolutely void of all strength. Lie in a blanket on sofa, feel paralysed by the weakness. 

 

7.15 .28mg Klonopin 

Don’t feel much. Yesterday started pacing after this dose. 

Shocked by how severe the mental symptoms got there. 

 

Takes an hour before I can even move my arms.

 

8.30 manage to go to bathroom

have cigarette

lie down and stare at tv

 

9.30pm talk to friend via video message, not much strength to talk,  we then stay on not talking but knowing each other is there. 

 

Feel like a zombie but the inner restlessness and mental restlessness means not relaxed.

 

Eat potato chips 

 

11.00 last cigarette, 10 small half size cigarettes today. 

 

11.30 go to bed

12 midnight 15mg Mirtazipine 

Have to Eat a lot 

2am ish fall asleep 

...........................

 

Cutting down cigarettes is very very hard and it scared me what happened after I held off today. 

 

In past i went 12 hours and experienced such intense paranoia and panic, I caved in and smoked.

 

I cut .001mg from .047mg escitalopram weight pill on 16th April. 

 

What shall I do about tapering to move forwards? 

 

 

 

 

 

 

Edited by Nikki74
Extra detail and notes at the end

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Nikki74
Posted (edited)

Extreme Terror (with additional symptoms) 

 

Just wanted to post about the terror I get. It can surge up at any point of the day or evening, I often wake with it. I had it for months after the cold turkeys. It never left completely but lowered when I took clonazepam, yet within a week or two that was causing it when I took it so I tapered some of it. And it’s got more prominent the past year with escitalopram reductions. Becoming worse between 3mg down to 2.5mg.

 

It grips my mind and body. It feels like I’m going into a psychotic kind of state where I feel extremely detached from everything. My heart pounds, I shake, I feel I will run screaming, or attack myself in some way, intrusives of this and at worst, urges totally against my will that I have to fight,  (I hope that’s ok to share, I have a wd friend who has same tapering valium and has the akathisia too). I have an intense fear of sharp objects, even non sharp like pens! No I’ve never had this in my life ever before these drugs. It feels like I’m falling into a hole, away from reality, the akathisia inside is intense, everything is too much (sound, movement, my surroundings). I repeat to myself that I’m safe. I hug myself which then makes me cry. 

 

My head squeezes. It’s hard to catch my breath. I can only hide in my bed or under a blanket, in a ball. 

 

It is terrifying. As terror suggests! 

 

All of what I’ve described above went pretty much completely (not the akathisia, the terror etc) for a couple of weeks in December and again mid March until about week 3 in this reduction (though in the three weeks it had surged here and there). 

 

I could do with some normalising of this. Or anyone who has it like this. And what this means for my path coming off these drugs. As I’m back to where I was after cold turkeys and before I took the clonazepam. The clonazepam can sometimes cause this symptom after dosing, it’s not consistent though. 

Edited by Nikki74
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siwoue

Youre not alone. i have it too. The akathisia inside. All day, everyday. Sometimes it gets so intense im starting to either run in circles til i collapse or i scratch myself to feel something on the outside.. and crawl to a Little ball. Terror haunts me aswell. I would say those two along with the flu/virus/infection-feeling goin on nonstop are my worst 3 sympthoms. So, i just wanted to let you know youre not alone in this. Im almost 21 months from ads and benzos. But we will make it! We will! 

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Nikki74

Thank you for replying and identifying @siwoue and I’m so sorry you have this lot too!

 

i’m 34 months out from ct off ssri and pregabalin then short use Zopiclone but trying to get off ssri, Mirtazipine and Clonazepam. Taking years. One cut sends me into worst state of all this stuff which I had already before going on clonazepam. Praying I can survive the tapers to healing 💕 

Got to make it!! X

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siwoue
2 minutes ago, Nikki74 said:

Thank you for replying and identifying @siwoue and I’m so sorry you have this lot too!

 

i’m 34 months out from ct off ssri and pregabalin then short use Zopiclone but trying to get off ssri, Mirtazipine and Clonazepam. Taking years. One cut sends me into worst state of all this stuff which I had already before going on clonazepam. Praying I can survive the tapers to healing 💕 

Got to make it!! X

 

Its so strong to taper! I can only imagine the shock after each drop. I wish i knew about tapering.. but Im too impatience as a person so even if i knew i prob would have done all cts anyhow ^^  Hows pregabalin working out for you? Do you take it for nervepains, im guessing you have them too? I got a lots of them, moving around everyday. Stabbing in my inner ear, head, eyes, tooth, hands. lungs or whereever. 

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Nikki74
47 minutes ago, siwoue said:

 

Its so strong to taper! I can only imagine the shock after each drop. I wish i knew about tapering.. but Im too impatience as a person so even if i knew i prob would have done all cts anyhow ^^  Hows pregabalin working out for you? Do you take it for nervepains, im guessing you have them too? I got a lots of them, moving around everyday. Stabbing in my inner ear, head, eyes, tooth, hands. lungs or whereever. 

I wish I’d known to taper too. I just did what my Dr said and stopped 5 years of ssri and pregabalin and I’ve been in hell since, nearly three years. I was put back on ssri, was given benzos and was already on Mirtazipine so I’m in cold turkey and trying to taper for past two years and only dropped 2.5mg ssri. Now can hardly cut a pin prick without more torment for weeks on end. Never get stable. Akathisia never goes. 

 

Sorry so im not on pregabalin that was a ct. big mistake. 

 

Yeah i I have a lot of pain like you xx

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Nikki74

Dear @Altostrata

I watched your video and read your story. Thank you for your ongoing campaigning.

 

I know you are very busy and I hope it’s ok to write and ask you some questions. 

 

Because I went through numerous cold turkey stops of drugs (2016 and the most in 2017) and have continued to suffer relentlessly since with akathisia, and a multitude of other symptoms including terror (which I wrote about on my thread yesterday) I wonder what my way forward is regarding tapering.

 

The reinstatement of the escitalopram a month after stopping in 2017 (my Dr put me back on, before I knew anything about withdrawal and he was unaware) did not halt my suffering and was further worsened by halving the dose on the instruction of a psychiatrist because at that point they wanted me to stop the escitalopram again and the Mirtazipine so that I could start on Sertraline. 

 

It was at that point with halving the reinstated 10mg and cold turkey stopping the Zopiclone I’d been on for 8 weeks (and suffering severe side effects from) that the akathisia became severe and I started to google what I was experiencing, and found SA. 

 

The damage had been done.

 

it has been nothing but severe since. I have never stabilised.

 

i know you don’t have time to look at everyone’s cases in depth but as you say you’re one of about 5 experts on this in the world, I wonder what you can say about this terrible situation I continue to exist in?

 

I wanted to ask also about recovery, you said in the video everyone recovers. What might be my path to recovery? Is it to get off these drugs (slowly) or should I be not tapering at all until such a time that I barely have any symptoms and the akathisia has gone?

 

Finally, my pattern with any reduction I make goes like this:

make reduction

 

feel uptick within 24 hours

also feel some improvement 

 

gradually things get more difficult

until suddenly at week 3.5-5 into the cut things tip over into extremely severe akathisia, terror etc

 

this continues into weeks 8-12 until things start to return to the miserable baseline of constant but more tolerable akathisia, less or no terror etc. 

 

Why is this? If I cut 5% or a bit more or half that. It’s the same pattern.

 

I wonder if you have insight into why this is the pattern please?

 

In practise it means that I won’t get off the drugs in my lifetime. 

 

As time from the cold turkeys goes on, is this likely to improve? 

 

Kind wishes

Nikki 

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Altostrata
On 5/10/2020 at 12:12 PM, Nikki74 said:

@Altostrata, I feel such strong cravings and agitation that I feel ‘forced’ to smoke. Then I get some relief from the desperate need to smoke but  worse generally.

 

I feel massively toxic from it. Everyday I long to kick it but it’s the first thing I crave once I’m awake and the akathisia is surging.

 

I've been known to have terror and then it’s come down when I’ve smoked. 

 

I know that that sounds contradictory. I want to quit. But it’s like I’m driven to by the akathisia.

 

Right now I’m two days into severe migraine, nausea and worsened fatigue and smoking makes that worse.

 

 

The problems with smoking are still in effect, Nikki. It seems to make you worse.

 

If you are smoking several times a day, this sets you back several times a day.

 

There's a possibility you are experiencing interdose withdrawal from clonazepam, drug-drug interaction between mirtazapine and clonazepam, or you are sensitive to mirtazapine's active metabolite, desmethylmirtazapine.

 

What is your clonazepam schedule? It looks very irregular. Att: @Shep

 

As you know, daily symptom notes are what we use to unravel adverse drug effects. Yours would have to include each cigarette. But this would be difficult to interpret with adverse reactions to the cigarettes you're smoking X times per day.

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Nikki74
1 hour ago, Altostrata said:

 

The problems with smoking are still in effect, Nikki. It seems to make you worse.

 

If you are smoking several times a day, this sets you back several times a day.

Thank you @Altostrata

Ok.  Yes. If I try not to smoke, the symptoms get worse eventually. So then I smoke.

1 hour ago, Altostrata said:

There's a possibility you are experiencing interdose withdrawal from clonazepam, drug-drug interaction between mirtazapine and clonazepam, or you are sensitive to mirtazapine's active metabolite, desmethylmirtazapine.

 

I have wondered about Mirtazipine. When I went through the change in generic, it was like I was on a completely different drug. It revved me up, I hardly slept, I’d wake up with vomit I’m my mouth two hours after falling asleep, the akathisia went to extreme levels. That was in February. 

1 hour ago, Altostrata said:

What is your clonazepam schedule? It looks very irregular. Att: @Shep

 

11.30 am 

3/3.30pm 

7/7.30 pm 

 

it is squeezed into too short a time. 

 

The mirtazipine drugs me until 10am or later. So my morning drug doses are pushed to late morning.

1 hour ago, Altostrata said:

As you know, daily symptom notes are what we use to unravel adverse drug effects. Yours would have to include each cigarette. But this would be difficult to interpret with adverse reactions to the cigarettes you're smoking X times per day.

So shall I do the daily symptom notes? 

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Altostrata

You have hangover from mirtazapine? Yes, please post daily notes.

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Altostrata

Please post those daily notes and respond in your benzo topic

 

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Nikki74
46 minutes ago, Altostrata said:

You have hangover from mirtazapine?

Yes, until the akathisia fills me. 

 

I can feel feel the akathisia ‘filling’ my body from about 10am, sometimes later, but cannot move or wake properly.  Then normally around 11am I am shocked awake by it, sometimes shuddering and I involuntarily shout out, then I’m frantic with it. But yet in a very confused state sometimes until 1pm.

 

Also a note on taking it. 

I take it at midnight often, sometimes 11.30. I used to take it maybe 10.30pm I think. But regardless of when I take it, I do not get drowsy until 1.30am sleep around 2am. The inner and mental akathisia persists until that point when I’m knocked out.

 

I also have to eat a lot of snacks after dosing it to get it to ‘work’. 

 

 

46 minutes ago, Altostrata said:

 

Yes, please post daily notes.

Ok. Will do.

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Altostrata

It appears to me your main problem is the clonazepam, Nikki, as it has been for at least a couple of years. Please respond in your benzo topic.

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Nikki74

Daily Notes Monday 

@Shep

10am start to feel adrenaline surging up my back. But still drowsy. 

10.50 whole body is agitated and I must move. Heart racing. Have to rush to bathroom but lose control of bowels before can get there. This happens often.

11am Take 2.5mg escitalopram 

very slight lowering in akathisia, lie down, but uncomfortable inside with inner akathisia. 

11.30 .25mg clonazepam 

Agitation of the inner akathisia lowes briefly then surges again. Have to pace. Heart racing, whole body in high akathisia. Mind racing. 

12.15 small cigarette. Feel some buzzing I’m limbs. 

12.20 sit in lounge. Heart racing. Lie down. Tv on, mind non stop, inner akathisia non stop but not as severe as was just a little earlier. 

12.40 Gut noisy, acidic and churning (this has been for years everyday since CTs)

12.55 wave of shivers through body

Obsessively check phone, rewind tv, ocd bad and mental akathisia. No peace. Try breathing. Too agitated to be still.

1.15 small cigarette as so restless and can’t focus on anything.

1.20 Make eggs and rice crackers. Eat but too weak to sit up and eat it all. Lie back down. Inner akathisia continues. Stomach churning and gurgling.

1.30 Akathisia getting very bad. Panic, shivers, chest is bursting with agitation, adrenaline surging through me, heart pounding.

1.40 whole body now vibrating,feelings of rage, intrusive thoughts of attacking self, heart racing, burning inside. Head racing.

2.30 small cigarette 

Ocd, head just wont stop. 

2.45 Things calm down suddenly. Not gone. But much lower.

3.30pm .25 Clonazepam 

4pm panic inside

4.15 head squeezing 

4.30 small cigarette 

5.15 terror and shaking starting to emerge. Can’t stay still.

5.20 small cigarette in panic 

5.35-6.05 panic, terror, intrusives, si, akathisia bad, fear of objects, mind racing, vibrating inside, crying frantically, reaches a massive peak at 6pm now wailing, mental torment, head squeezing, terror etc.

6.05-6.50 exhausted. Terror stopped, eat dinner made for me by carer.

6.55 terror increases again

small cigarette 

terror, panic, agitation continues then 

7.25pm comes down a few notches 

7.30 .28 clonazepam 

8pm heart pounding and akathisia agitation increasing. 

8.30 small cigarette 

Able to watch some tv

9.15 crying 

9.45 small cigarette 

watch some tv bit feeling very down, another traumatic day, still inner and mental akathisia but lower.

 

11pm small cigarette.

Watch tv, exhausted but never restful.

Midnight go to bed take 15mg Mirtazipine, eat several healthy snacks, try to watch silly stuff on Twitter, drowsy by 1.30, sleep by 2am. 

 

I have Tuesday to post next and then today’s 

 

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