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Nikki74: Lexapro mirtazapine diazepam akathisia

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baroquep

Let me talk with Shep and see if it would be best if you switched back to your regular schedule and then retry by moving it a little slower.  Hang in there until you get a response.

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Nikki74
4 minutes ago, baroquep said:

Let me talk with Shep and see if it would be best if you switched back to your regular schedule and then retry by moving it a little slower.  Hang in there until you get a response.

Ok thanks, he's already shown concern that I did it that way and at the same time as reducing diazepam.

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baroquep

I've just send a message to Shep to see if there is anything we can tweak to get you back on track.  Try and take it easy today.  

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Nikki74
3 minutes ago, baroquep said:

I've just send a message to Shep to see if there is anything we can tweak to get you back on track.  Try and take it easy today.  

Thank you. I don't know when this will all settle down. Do you think there's a chance I will stabilise eventually on this?

 

What are your thoughts on akathisia or withdrawal? I've read so much and feel sure it's akathisia but then my cns is in such chaos I don't know.

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baroquep

In my opinion, if we take things slowly and use a lot of caution when making decisions about reducing or changing doses, we have a much better chance at recovery.  I de-stabilized at the beginning of the year and did a three-month-long hold and it made a world of difference.  Unfortunately these drugs change the way the brain works and if we are not careful, we can add to our suffering.  Withdrawal from these drugs is not easy, it takes a tremendous amount of patience to get off of them carefully and safely.  This will likely be the hardest thing that you will ever experience, it has been for me.  Try to remember that these drugs are very powerful, even in small doses and whatever decisions you make with respect to dosages, timing, etc. must be made with as clear a head as possible so that you can make the best decision and change things in the gentlest way possible.  When the CNS has been destabilized, you have to treat it gently so that it has time to heal and reach homeostasis again.  

Unfortunately I have never experienced akathisia but imagine it must be very challenging to deal with.  I've attached a link to see if there is something in these threads that can help you manage.  Sorry to leave you now but I do have to head out for the day but will check in on you later.  Please take good care of yourself today and treat yourself gently with as much compassion as you can.  

 

Akathisia vs Restlessness/Anxiety/Agitation
Akathisia Survivors

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Nikki74
29 minutes ago, baroquep said:

In my opinion, if we take things slowly and use a lot of caution when making decisions about reducing or changing doses, we have a much better chance at recovery.  I de-stabilized at the beginning of the year and did a three-month-long hold and it made a world of difference.  Unfortunately these drugs change the way the brain works and if we are not careful, we can add to our suffering.  Withdrawal from these drugs is not easy, it takes a tremendous amount of patience to get off of them carefully and safely.  This will likely be the hardest thing that you will ever experience, it has been for me.  Try to remember that these drugs are very powerful, even in small doses and whatever decisions you make with respect to dosages, timing, etc. must be made with as clear a head as possible so that you can make the best decision and change things in the gentlest way possible.  When the CNS has been destabilized, you have to treat it gently so that it has time to heal and reach homeostasis again.  

Unfortunately I have never experienced akathisia but imagine it must be very challenging to deal with.  I've attached a link to see if there is something in these threads that can help you manage.  Sorry to leave you now but I do have to head out for the day but will check in on you later.  Please take good care of yourself today and treat yourself gently with as much compassion as you can.  

 

Akathisia vs Restlessness/Anxiety/Agitation
Akathisia Survivors

Thank you. 

 

I wish I'd found this site in May before I went off pregabalin and lexapro and upped the Mirtazipine which is when all this kicked off.

 

I appreciate your support and advice. Nikki

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Shep
1 hour ago, Nikki74 said:

Yes, well I took mirtaz at night on Thursday (so have done two nights of that) and took lex in the morning for the first time yesterday, so it's my second day today. Though of course I had a double dose of mirtaz on Thursday as had had it in the morning too.  I have the best sleep and morning I've had in months Thurs/ Fri morning. Bit of a false window I think...

 

Hi, Nikki.

 

Overall, are you feeling better? How many hours did you sleep the last two nights that you've taken the mirtazapine at night? 

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Nikki74
13 minutes ago, Shep said:

 

Hi, Nikki.

 

Overall, are you feeling better? How many hours did you sleep the last two nights that you've taken the mirtazapine at night? 

I'd say I'm feeling as bad as I have for past few weeks but that appears to be mainly akasthisia (I've diagnosed myself!) which has been worse this past week, but I slept last night maybe 5/6 hours and the night before. Yesterday I thought I had a window in the morning. 

 

Ive been dry retching today :/ 

Edited by Nikki74

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Shep
2 minutes ago, Nikki74 said:

I'd say I'm feeling as bad as I have for past few weeks but that appears to be mainly akasthisia (I've diagnosed myself!) which has been worse this past week, but I slept last night maybe 5/6 hours and the night before. Yesterday I thought I had a window in the morning. 

 

You went from zero sleep to sleeping 5 - 6 hours a night. That's great news, Nikki. It sounds like the switch was a success. Please try not to go into catastrophic thinking that because it was such an abrupt change, you'll pay for it later. Just getting sleep may be more than enough to power you through the uptick of symptoms from switching. Take it day by day. And remember to breathe. 

 

The akathisia can be rough. I had that severely and there were many days and nights were I could do nothing for it but rock back and forth and pace. But it will pass. 

 

Please use as much self care as you can now. 

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Nikki74
2 minutes ago, Shep said:

 

You went from zero sleep to sleeping 5 - 6 hours a night. That's great news, Nikki. It sounds like the switch was a success. Please try not to go into catastrophic thinking that because it was such an abrupt change, you'll pay for it later. Just getting sleep may be more than enough to power you through the uptick of symptoms from switching. Take it day by day. And remember to breathe. 

 

The akathisia can be rough. I had that severely and there were many days and nights were I could do nothing for it but rock back and forth and pace. But it will pass. 

 

Please use as much self care as you can now. 

:) I guess. I hope sleep continues!

 

i know you can't say but if you had to guess, what's caused the akasthisia and might it abate if I stabilise on this cocktail and routine? 

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Shep

When can you first remember having akathisia? Did it start back in September or is it more recent? 

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Nikki74
51 minutes ago, Shep said:

When can you first remember having akathisia? Did it start back in September or is it more recent? 

Hmm.

 

i was thinking it kicked off after I'd quickly come off pregabalin and the lexapro in June but that could have been acute withdrawals! Then doubling the Mirtazipine dose straight after o got the severe churning and rls. I didn't know about akasthisia then... only found out the name and what it is about three weeks ago researching online.

 

the ants under skin feeling and all that I reckon started more early Sept after seeing the psychiatrist and being told to stop the Zopiclone and halve the lexapro and upped the diazepam!

Edited by Nikki74
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Nikki74

Dry retching so much. Wondering if it's the lower diazepam. Been 7 days now on 5.5mg apart from one day at 6mg (Thursday). 

 

Only sharing in case it's a dangerous sign?

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Shep

The akathisia and the dry wrenching and are likely all due to a severely destabilized nervous system. Most withdrawal symptoms are not dangerous or life threatening. It could be due to changes in the diazepam, the mirtazapine  / Lexapro switch, a delayed reaction to the one-off of the propranolol, or it could be a combination of everything you've been through the past few months. All of these changes are catching up to you now. 

 

Thanks for the information on how long you've been dealing with akathisia. It looks like you've been dealing with it for a long time, so I'm glad you have a name for it, as it makes it easier to handle.  I had a friend on a benzo withdrawal forum who used to crank up the stereo and dance when she got hit with akathisia. I used to listen to either quiet music with nature sounds to ease my CNS or crank up some very loud and obnoxious Metallica just for equilibrium. I think we all find different ways to deal with it. 

 

One powerful tip I can share is something I learned from a mindfulness teacher, Mooji.

 

Nervousness, Anxiety & Fear ~ Spoken by Mooji - video (10 minutes)

 

As Mooji says, "You can feel a tremendous amount of nervousness in the body and be totally free."

 

Keep in mind that the akathisia is a "chemical" reaction in your mind/body due to the drugs. If you can look at it that way, you can learn not to attach your thoughts to it. Akathisia is a powerful force, but it doesn't have to control your thoughts. Forgive me for continuing to quote Mooji, but another great mindfulness teaching he states:

 

Your thoughts are like visitors and you are NOT a hotel. Don't invite them in. 

 

This is not easy when you are in the grips of akathisia, but if you work on it, practice letting your thoughts pass knowing that the "chemical" reaction in your mind/body will not hurt you, you'll be just fine. 

 

Another good video is a brief 3 minute breathing space:

 

The Breathing Space by Jon Kabat Zinn - video (3 minutes)

 

If you can bring these skills in now and work on them, they will serve you well on your journey to be drug free. 

 

 

 

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Nikki74
23 minutes ago, Shep said:

The akathisia and the dry wrenching and are likely all due to a severely destabilized nervous system. Most withdrawal symptoms are not dangerous or life threatening. It could be due to changes in the diazepam, the mirtazapine  / Lexapro switch, a delayed reaction to the one-off of the propranolol, or it could be a combination of everything you've been through the past few months. All of these changes are catching up to you now. 

 

Thanks for the information on how long you've been dealing with akathisia. It looks like you've been dealing with it for a long time, so I'm glad you have a name for it, as it makes it easier to handle.  I had a friend on a benzo withdrawal forum who used to crank up the stereo and dance when she got hit with akathisia. I used to listen to either quiet music with nature sounds to ease my CNS or crank up some very loud and obnoxious Metallica just for equilibrium. I think we all find different ways to deal with it. 

 

One powerful tip I can share is something I learned from a mindfulness teacher, Mooji.

 

Nervousness, Anxiety & Fear ~ Spoken by Mooji - video (10 minutes)

 

As Mooji says, "You can feel a tremendous amount of nervousness in the body and be totally free."

 

Keep in mind that the akathisia is a "chemical" reaction in your mind/body due to the drugs. If you can look at it that way, you can learn not to attach your thoughts to it. Akathisia is a powerful force, but it doesn't have to control your thoughts. Forgive me for continuing to quote Mooji, but another great mindfulness teaching he states:

 

Your thoughts are like visitors and you are NOT a hotel. Don't invite them in. 

 

This is not easy when you are in the grips of akathisia, but if you work on it, practice letting your thoughts pass knowing that the "chemical" reaction in your mind/body will not hurt you, you'll be just fine. 

 

Another good video is a brief 3 minute breathing space:

 

The Breathing Space by Jon Kabat Zinn - video (3 minutes)

 

If you can bring these skills in now and work on them, they will serve you well on your journey to be drug free. 

 

 

 

Thanks Shep.

 

i love putting on my nature sounds at night. 

 

I'll check out the mooji resources. 

 

Ive joined an Akathisia page on FB and have made a friend.

 

so I think all the changes are done now. After months of muddled and conflicting instructions from doctors and psychiatrist and mental health team. 

 

Praying for some stability (I pray a lot!). 

 

I've had some prayer ministry over the past week. I'm holding onto an image that one of the gifted people who prayed for me had of me recovered in a place she didn't know I loved. 

 

Bless you for your help Shep. 

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Nikki74

So I slept well last night. Probably 7 hours with a bit of waking up. 

 

I felt pretty calm for the first time in forever this morning. Even got to lay in bed watching the clouds listening to peaceful music and not feel I had to move, fidget etc. Distinct absent of akasthisia type symptoms.

 

My friend took me to church and I coped better than last week.

 

Managed a nap this afternoon, again first time in months! 

 

I'm wondering why this is?!

 

Only now at around 5pm am I getting the agitated feeling.

 

 

 

 

 

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Shep

This is great news, Nikki. Very nice to read about your improvements. 

 

It sounds like switching the mirtazapine and Lexapro helped. 

 

1 hour ago, Nikki74 said:

Only now at around 5pm am I getting the agitated feeling.

 

Please list the times you are taking your drugs now. It will be helpful to see this symptom in context with the timing of your drugs.

 

I really hope you continue to stabilize and feel better. 

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Nikki74
1 hour ago, Shep said:

This is great news, Nikki. Very nice to read about your improvements. 

 

It sounds like switching the mirtazapine and Lexapro helped. 

 

 

Please list the times you are taking your drugs now. It will be helpful to see this symptom in context with the timing of your drugs.

 

I really hope you continue to stabilize and feel better. 

Ok so I'll give you a summary of last few days. I've now been on 5.5mg diazepam for 6 out of the last 8 days. The other days I took 6mg. 

 

Sun 1st to Wed 4th 5.5mg diazepam a day. Took that 40mg propranolol on Wed 4th. Had the worst night which threw out my diazepam routine.

 

Thur 5th

4.30am 2mg Diaz

8.15am 15mg Mirtazipine 

10.30am 2mg Diaz

2pm 2 mg Diaz

Midnight 15mg Mirtazipine (the night I started the mirt/lex swap)

 

Fri 6th

8.15 5mg lexapro (first day of swap to morning)

11am 2mg diaz

 3pm 2mg diaz

8pm 1.5mg diaz

11.30pm 15mg Mirtazipine 

 

Sat 7th

7am 2mg diaz

8.15 5mg lexapro 

11am 2mg diaz

4.45pm 2mg Diaz

11.30pm 15mg Mirtazipine 

 

(Migraine started, v agitated all day, dry retching a lot)

 

Sun 8th

8.15am 5mg lexapro 

9am 2mg Diaz 

1pm 2mg Diaz

5pm 1.5mg Diaz

will take 15mg Mirtazipine 11.30pm

 

much more calm, migraine present all day, no dry retching (correction! It's kicked in a bit now, 8pm) agitation minimal apart from about 4/4.30pm. Feel more drowsy than I usually do.

 

Because of the swap over of mirt/lex my diazepam times have not been in an exact routine. I know! Not good. But I'm hoping I can now get it in a routine after this final change.

 

Also as you'll see I took 6mg on Thursday and Saturday (yesterday). Was worried my terrible night of severe Akathisia on Wed was due to diazepam drop so took 6mg Thur. Yesterday was worried the dry retching was withdrawal from diazepam. 

 

In total this week ive taken 39.5mg diazepam as opposed to previous weeks at 48.5, 54, 52.5, then the weeks prior when I was on Zopiclone and taking 14mg diazepam per week.

 

If I was going to suffer because of this drop in diazepam, when would it hit so you think?

 

i know it's still muddled but this last change has made diazepam timing hard to work out. My main aim the last three days has been to take my three diazepam doses relatively evenly between waking and 5pm as don't want to take it close to Mirtazipine at bedtime.

 

Clear as mud I'm sure (that's maybe a British saying?). 

 

Edited by Nikki74

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Nikki74

Terrible night again. Woke after two hours. Head rushes and depression and anxiety through the night with broken sleep.

 

i though I was onto something with the sleep! 😕 

 

 

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Altostrata

You'll have bad nights and better nights, Nikki.

 

Please keep those notes, it will help us figure out what's what.

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Nikki74
3 hours ago, Altostrata said:

You'll have bad nights and better nights, Nikki.

 

Please keep those notes, it will help us figure out what's what.

Thanks.

 

I started getting more OCD intrusive thoughts from last night and panic attacks. I'm feeling kind of paranoid as well today. Panic attacks continuing today.

 

I've not had these symptoms since before I was on higher dose of diazepam, back when I first stopped the lexapro and doubled the Mirtazipine.

 

Feels too much right now.

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Nikki74

Am I going into diazepam withdrawal from lowering it this past 8 days? 

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Nikki74

Today, 9th Oct 

 

2am woke up

in and out of sleep until 7am

7am got son up, fed dog, anxiety 6/10

8.15 5mg lexapro

restless

9am 2mg diazepam went back to bed and tried to sleep, listened to relaxing music and spiritual resources

 

11.30 feelings of panic, OCD thoughts, got paranoid I'm just going mad and my increasing passion for God and reaching out in prayer is a sign of my losing it

 

12 noon got up feeling desperate, low, anxious, panicky and racing OCD thoughts. Ate muesli, realised I'm not mad but al definitely suffering!

 

12.30pm 2mg diazepam 

anxious restless afternoon, read a little, prayed, GP phoned and was encouraged I'd got a bit of sleep and had a relatively good bit of time yesterday. 

Ate a pork pie. 

Anxiety, churning tummy, waves of despair 7/10

 

3.45pm son home from school, made a sandwich

 

4.30pm 2mg Diazepam 

slightly drowsy for a bit, relief!

 

5pm anxious, restless, ate almonds 

Spoke to my dad, I was tearful but trying to be hopeful

6pm made dinner, anxiety 6/10

really enjoyed dinner as sooo hungry and feel I could eat it three times over (sausages, potatoes and broccoli)

 

7pm sitting but v restless and anxious, had to keep tucking arms under cushions. 

8pm calmed down a bit, less churning, restless legs though. Gonna try to watch a bit of tv. 

 

Brain fog most most of the day, worst symptoms high anxiety, panic attacks, OCD/ bit paranoid, inner churning and restlessness. 

 

I have zero interest in what I put on or in personal hygiene, same as for many weeks. Feel too restless to shower, I dread it. Exhausted too. 

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Nikki74

7am I slept better again. I was exhausting when I went to bed at 11pm and nearly fell asleep before taking the Mirtazipine. Took it at 11.30pm. Woke at some point drenched in sweat but that's been a regular thing (plus my period has arrived and that always causes sweats, extra fatigue, and worsened anxiety in the week leading up to it) and with back pain but I think that was the weighted blanket. 

 

7.15 up now to sort son for school. Churning in tummy has started. Anxiety 5/10. A bit shaky. Restlessness starting. 

 

Will add to later.

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Nikki74

9am diazepam 2mg

made me very sleepy so have been in bed for nearly two hours dozing and listening to spiritual resources online. Minimal akasthisia but at 10.45am can now feel those feelings starting up: restlessness inside, prickling in arms, churning tummy.

 

I'm feeling quite dark in my mood again like yesterday morning, lonely yet I don't want to see anyone. Feel I've lost so much these last few months since June when all this started. Time and the world seem strangely distant. Worried about my dog as she's showing signs of her health deteriorating (she's old and has a heart murmur). 

 

11am Will get up.

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Nikki74

12.40am things have been quite calm, had a shower, did a short meditation on YouTube, ate a chicken sandwich. I'm due to take a diazepam soon but don't want to! Don't feel I need it (I get that somedays) but know I must.

 

As you will see I had 6mg yesterday. Diazepam since Sun 1st:

 

sun 1st 5.5mg

mon 5.5mg

tue 5.5 mg

wed 5.5 mg 

thur 6mg good sleep

fri 5.5 mg better day

sat 6mg tough day, good sleep

sun 5.5 mg better day

mon 6mg tough day, good sleep

tue ? better day 

 

That's an average of 5.66 a day.

I KNOW I need to stick to a dose!

 

I sleep better the nights I've taken 6mg but if I end up sticking to 6mg  I could find it's too much everyday.

 

 

 

 

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Nikki74

1pm 2mg diazepam. Starting to feel a bit of churning and head fuzz and restlessness now at 2pm. 

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Nikki74

2pm-4.30pm pretty calm, ate a chicken and ham sandwich, some almonds, really hungry but I cut out sugary foods about a week ago and that includes fruit apart from sultanas. So struggle to know what to eat (I'm gluten free for 11 years). Scared to eat cheese as dairy hasn't always agreed with me. Feel I could eat a whole roast chicken! 

 

I did some spiritual scrap booking and was able to enjoy some comedy on tv, well more than I have in weeks.

 

Due my last diazepam dose soon. Still confused about dose. Wish I had scales so I could weigh out 5.66 as that's my average over last ten days.

 

If the drop from my three heavier diazepam weeks was going to hit, would it have by now?!

 

 

Edited by Nikki74

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Nikki74

5pm took 2mg diazepam 

migraine has been taking hold again since about 5pm. Churning stomach feeling and lump in throats feeling like dry retching might happen.

 

6pm foggy head, fatigued but also slightly activated feeling in chest and legs and heart. Made dinner, rice, salmon and broccoli.

 

I'm truly stuck with what's best with the diazepam dose. 5.5 felt too low but maybe I haven't given it long enough. 6 feels better some days. 

 

Im doing my best to get a routine now but that one is my big question. I hate that drug!!

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Nikki74

Just feel like ranting about diazepam! I hate the fact I'm stuck on this hideous drug! I know the others aren't much better but this is my newest addition (ok apart from clonazepam years back when I didn't even know what kind of drug it was) and I feel most trapped by it than any of the others. Why do mental health teams push this rubbish? When I was in crisis (July) I'd call them and they'd say 'have you taken any diazepam today?' And I'd maybe had one or none and they'd say 'take one now to give your head a break' so I did and had no idea what I was getting into. Then being told to use it to get off zopiclone (another awful hellish drug). And here I am stuck on the stuff and hating its effects and what it's done to me already. And facing at some point a long and probably tricky taper and withdrawal. Just feeling so imprisoned by all this pharma junk! 

 

Argh! 

 

Thank you, rant over. Phew. 

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Nikki74

7.30pm migraine pretty strong. But today I've had barely any hint of akasthisia. Why? No idea. Wish it could stay that way! 

 

slight nausea and lump in throat/ feeling I might dry retch. But haven't yet.

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Nikki74

9.30pm well I've had a pretty reasonable day with v little anxiety, barely any sign of akathisia (if it has been that? Or withdrawal/cns chaos?). Ive got some skin prickling and muscle twitch. now and then. My migraine has eased a bit but I'm wondering if I've got sugar withdrawal as been craving it and had a spoonful of ice cream. Migraine eased after that (?!) 

 

I've been largely alone (as I often am) and could not contemplate going out or dealing with people or any kind of pressure at all. Even my son talking about something that might need my input (a phone call with his tutor) raised my anxiety and restlessness. I truly need to be in a bubble it seems, which I hope isn't going to be the case here on in!

 

But compared to the utter misery of my days and nights for months, today has been like heaven. 

 

Only yesterday I was feeling desperate and scared. So I know this is likely to return!

 

Of course, I'm trying to work out what caused/causes the akasthisia and how the heck I can avoid it!!

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Nikki74

11pm off to bed. Have had prickling skin the past hour and a hint of the akathisia and churning. 

 

Had a bowl of muesli but feel so hungry. I don't seem to be able to get enough food in.

 

going to listen to some relaxing music then take the Mirtazipine.

 

That's my diary for Tuesday 10th October. 

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Nikki74

6.40am, Wednesday 11th Oct

restless night. By the time I got to bed last night I didn't feel sleepy and was quite agitated. I've been awake since about 5 but was in and out before that.

 

Restless inside and out. Can't lie still, feeling down and extremely tired. Also had my first nightmare for many weeks last night.

 

i don't understand. The akathisia had really calmed yesterday.

 

What am I doing wrong here? 

 

 

Edited by Nikki74
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Nikki74

8.15am took 5mg lexapro 

started to feel woozy about 8.45 but akasthisia still strong, very sensitive to sounds. 

 

9am 2mg diazepam 

 

9.40 am anxiety 9/10, internal and external agitation, full on

 

 

Edited by Nikki74

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Nikki74

11.30 akathisia unbearable. Not even my music or spiritual meditation helps. 

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