Amy238: dealing with gasping/choking Zoloft withdrawal symptoms

[AliG]

Amy, I'm so pleased that you are feeling better and less symptomatic. You did the right thing sticking to the dose of 1.5mg rather than risk another change.

 

It will take a while longer to stabilize. So far, it is looking positive but I would take each day as it comes. Your nervous system has experienced a lot of changes and is struggling to adapt so it needs lots of gentle care and time to re - calibrate. It's encouraging that you have had a lessening of symptoms but it's still early days and we need to remain ultra cautious.

 

After you stabilize, it will be a very slow and gentle 10 % taper right down to 0. This stabilization may occur over many months and you will be able to ascertain this from the intensity of your symptoms. It may also take a few months of slow tapering but if it means staying functional and still engaged in life, then it's worth it in my opinion. I hope you agree.

 

Ali

[Amy238]

Thank you Ali for helping me monitor my dose and looking out for me.

 

I agree, I get into a window and am quick to feel over-enthused.

One day at a time sounds more realistic and reasonable. It's early days. I need to give nervous system time to rebuild and re-strengthen itself.

I understand it's a slow process, requires patience.

 

Nights are the worst, scary place to be at. I agree that minimizing WD symptoms would be in best interest, going slow seems like the best way to tackle it.

Thank you for bearing with my ramblings each night, and making time to respond. I can't imagine the dark place I might have been in, without the strength and support I found here on this forum.

[apace41]

Amy,

 

Great post from Ali!  She has provided you with the most critical point which is to recognize the individuality of this process for each of us, try not to preordain what will happen and be as accepting and flexible as possible as it unfolds.  We give advice here at SA based on what we have seen in many patients over many years, but the caution YMMV (your mileage may vary) must be recognized.

 

In that vein, once you are really and truly stable, and there is no rush getting there or getting off from there, you come off the med as you are able.  Ali has indicated the "standard" 10% reduction that is typically espoused, but there is NO MAGIC to that and some people will feel better coming off at slower rates than that depending on how they react. I amend that to say that the only MAGIC is that 10% should be your upper limit but there is no lower limit.  Slow and steady wins the race.  Think tortoise, tortoise, tortoise.

 

Glad you are doing better.

 

Best,

 

Andy

[Amy238]

Took 1.5 mg at noon again. Slept at midnight last night, woke up at 2 am, was little panicky, nauseous, restless, went back to sleep at 5 am, slept till 9 am. No more crazy cortisol spikes though. Just have become sensitive to any ups and downs in heart rates.

By 3 pm, felt extreme fatigue and exhaustion, slept from 3:30 pm until 4:45 pm. Am grateful though, no more gasping and choking.

 

Noticing a  pattern, since WD started I would feel the fatigue around 6-7 pm, now it's happening earlier in the day around 2-3 pm. Sleeping for an hour helps. Thankfully I work remote and I am able to cope with these symptoms. Appetite is better.

 

It's 11 pm, feeling restless, little panick-stricken and a bit nauseous, similar to last night. I think I can handle it. Will stick to 1.5 mg zoloft regime unless advised otherwise.

[Amy238]

Slept at 1:30 am ,woke up at 4:45 am. Went back to sleep at 7 am , woke up at 9 am. Am sleepy but not sleeping due to fear and anxiety.

It might be since I am completely off of any sleeping pill. But am scared of feeling the drowsiness that comes with sleeping pills.

 

Doctor had suggested last week if there is not enough quality sleep that I should try Temazepam, wondering if I should.

[Amy238]

Read the posts on "how long to stabilize after reinstating, did reinstatement work". I understand it could turn out to be a long haul :-(.  Andy has already emphasized on that quite a bit.

Insomnia caused by anxiety - again seems to be a very common symptom. I am on my 5th day of re-instatement with 1.5mg of zoloft.

[apace41]

1 hour ago, Amy238 said:

Slept at 1:30 am ,woke up at 4:45 am. Went back to sleep at 7 am , woke up at 9 am. Am sleepy but not sleeping due to fear and anxiety.

It might be since I am completely off of any sleeping pill. But am scared of feeling the drowsiness that comes with sleeping pills.

 

So, Amy, overall it sounds like you are showing signs of improvement but still a ways to go.  That is totally normal.  Your body needs to figure out how to do all of this without the meds it has relied on for a long time.  The fact that some of the really bad symptoms are gone is a huge plus.  Recognize that depending on how regularly you were taking the sleeping pills (what kind by the way?) you can be having some withdrawal from those as well.

 

1 hour ago, Amy238 said:

Doctor had suggested last week if there is not enough quality sleep that I should try Temazepam, wondering if I should.

 

Temazapam is a benzodiazepine which, if you take it for a while, will create its own dependency and require tapering.  Some people us a little of a benzo to help them taper off the antidepressant, but it is certainly preferable if you can avoid it because they can be difficult to taper as well (some would argue more).

 

It's only been 5 days and you've shown marked improvement.  Stick with the program and let's see where you are this weekend.  Are you doing some self-help things like deep breathing, meditation, visualization, etc?

 

Best,

 

Andy

[Amy238]

Thank you for your inputs Andy.

 

I was on Temazepam couple years ago, then Seroquel 50 mg for almost 2 years every single night, until 3 weeks ago when zoloft WD symptoms became intolerable and I felt I would rather be awake and tackle the WD symptoms(shortness of breath, dry mouth) then be drowsy and be experiencing these. 

 

Since yesterday, I am feeling a bit of tightness in throat and dry mouth coming back. Might be the result of anxiety.

 

I did go lax when the symptoms improved, I agree I need to stick to a healthy regime, exercise, deep breathing. I downloaded "headspace" couple days ago.

I will stick with the program for now.

[AliG]

Amy. I'm a little confused and concerned about your Seroquel and Trazadone use. Seroquel needs to be tapered using the 10% taper method, just like all other psychiatric medications. Could you please try to give an exact timeline of when you stopped each;  when you restarted ; how long you were on each of them etc. and what you are taking now.

 

I realize that some drugs/ dates etc are in your signature but I'm finding it unclear. Did you stop the Seroquel , cold turkey?  If so, when? Are you still on Trazadone? Or have you stopped them both?

 

Thanks in advance,

Ali

[Amy238]

Hi Ali,

 

It's been crazy few weeks, and I haven't had lot of stamina or clear mind to be able to put together all my notes and organize them. But I more and more am realizing the importance of it.

 

Thank you again for attention to detail. I wasn't taking notes on paper at the time I stopped Seroquel but thankfully I have messages I left with my doctor.

I have been on Seroquel 50 mg every night since late 2015 or early 2016. Basically, almost 2 years. I think I stopped taking Seroquel on 10/29.

 

Here's the timeline since Sep 27th,

2017/09/27 -   Stopped zoloft, continued to take Seroquel 50 mg every night until 10/26.

10/27 -  Took 0.5 Lorezepam during the day and 25 mg Seroquel at night. Had very dry mouth, hands, feet felt dry, felt air was so dry that I couldn't breathe. I bought a humidifier, and a new pillow to ease symptoms.  Because I read this somewhere and thought Seroquel was causing the gasping,

"Avoid alcohol, sleeping pills, and sedatives, especially before bedtime, because they relax the muscles in the throat and interfere with breathing."

10/28 - No Seroquel, took 0.5 Lorezepam at night.  Doctor advised "Take the ativan in the evening and do not take the seroquel. Seroquel is a low dose and we don't need to taper that off".

10/29 - 25 mg Seroquel, 0.5 Lorezepam

10/30 -  0.5 Lorezepam

10/31 - 1 Lorezepam

11/1 - 0.5 Lorezepam

11/2 - 12.5 mg Trazadone, 0.5 Lorezepam

11/3 - 12.5 mg Trazadone, 0.5 Lorezepam

11/4 - 12.5 mg Trazadone, 0.5 Lorezepam

11/5 - 11/10 - 12.5 mg Trazadone, no Lorezepam

11/11 - Reinstated zoloft 1.5mg , no Trazadone

 

 

You are right I have stopped Seroquel cold turkey. At the moment, I am only taking zoloft 1.5 mg.

Though it has relieved a lot of symptoms, I am now experiencing night-time anxiety, some trepidation. I do feel I might need something to relieve anxiety, and then may be I will be able to sleep as well.

 

I have some

Alprazolam 0.25 mg

Trazadone 25 mg 

Seroquel 50 mg

0.5 mg Lorezepam

The new doctor I saw also suggested that I could try Temazepam.

 

I was trying to stick it out until weekend and see if things got better. But honestly I am feeling wiped out tonight due to lack of sleep and anxiety.

I am so tempted to take Alprazolam 0.25 mg or 0.5 mg Lorezepam and see how I feel.

 

[Amy238]

Ali, if you see this message, could you please respond tonight ?

[AliG]

Amy. I tried to send a pm - it's not going through. Please check.

 

Perhaps, I would try the Trazadone 12.5mg as that was the last and most recent sleep medication. You could try a reduced dose.

 

I will check with the mods and we can establish an ongoing plan for the future.

[Amy238]

Ali,  I did receive this message from you. Not sure what pm refers to though.

Thank you very much for responding. I will take Trazodone 12.5 mg tonight.

 

I do not even know if I can express how grateful I am for all the support and kindness I receive here.

 

[Amy238]

Hi Ali, I didn't take Trazodone since it states that Trazodone has a high risk drug interaction with zoloft.

https://www.drugs.com/drug-interactions/trazodone-with-zoloft-2228-0-2057-1348.html

 

Went without sleeping pill again, slept at 1:30 am, woke up at 3 am with a jolt, heaviness in chest, anxiety.. can't go back to sleep.

It's 4:27 am, took 0.25 Lorezepam just now, since in the past it would really help with anxiety. Desperately want to get some sleep.

 

 

[powerback]

4 hours ago, Amy238 said:

Ali,  I did receive this message from you. Not sure what pm refers to though.

Thank you very much for responding. I will take Trazodone 12.5 mg tonight.

 

I do not even know if I can express how grateful I am for all the support and kindness I receive here.

 

hi Amy 238 since I'm floating about the site today ile answer the PM question .it stands for personal message .

I'm no use to you for medication query's ,Ile leave that to the mods .

PB

[Amy238]

1 minute ago, powerback said:

hi Amy 238 since I'm floating about the site today ile answer the PM question .it stands for personal message .

I'm no use to you for medication query's ,Ile leave that to the mods .

PB

 

Got it powerback. Thank you !

 

I didn't receive any pm from Ali so there might be some technical issues.

[powerback]

1 minute ago, Amy238 said:

 

Got it powerback. Thank you !

 

I didn't receive any pm from Ali so there might be some technical issues.

Ye that's all ide say 

[Altostrata]

17 hours ago, Amy238 said:

Hi Ali,

 

It's been crazy few weeks, and I haven't had lot of stamina or clear mind to be able to put together all my notes and organize them. But I more and more am realizing the importance of it.

 

Thank you again for attention to detail. I wasn't taking notes on paper at the time I stopped Seroquel but thankfully I have messages I left with my doctor.

I have been on Seroquel 50 mg every night since late 2015 or early 2016. Basically, almost 2 years. I think I stopped taking Seroquel on 10/29.

 

Here's the timeline since Sep 27th,

2017/09/27 -   Stopped zoloft, continued to take Seroquel 50 mg every night until 10/26.

10/27 -  Took 0.5 Lorezepam during the day and 25 mg Seroquel at night. Had very dry mouth, hands, feet felt dry, felt air was so dry that I couldn't breathe. I bought a humidifier, and a new pillow to ease symptoms.  Because I read this somewhere and thought Seroquel was causing the gasping,

"Avoid alcohol, sleeping pills, and sedatives, especially before bedtime, because they relax the muscles in the throat and interfere with breathing."

10/28 - No Seroquel, took 0.5 Lorezepam at night.  Doctor advised "Take the ativan in the evening and do not take the seroquel. Seroquel is a low dose and we don't need to taper that off".

10/29 - 25 mg Seroquel, 0.5 Lorezepam

10/30 -  0.5 Lorezepam

10/31 - 1 Lorezepam

11/1 - 0.5 Lorezepam

11/2 - 12.5 mg Trazadone, 0.5 Lorezepam

11/3 - 12.5 mg Trazadone, 0.5 Lorezepam

11/4 - 12.5 mg Trazadone, 0.5 Lorezepam

11/5 - 11/10 - 12.5 mg Trazadone, no Lorezepam

11/11 - Reinstated zoloft 1.5mg , no Trazadone

 

 

You are right I have stopped Seroquel cold turkey. At the moment, I am only taking zoloft 1.5 mg.

Though it has relieved a lot of symptoms, I am now experiencing night-time anxiety, some trepidation. I do feel I might need something to relieve anxiety, and then may be I will be able to sleep as well.

 

I have some

Alprazolam 0.25 mg

Trazadone 25 mg 

Seroquel 50 mg

0.5 mg Lorezepam

The new doctor I saw also suggested that I could try Temazepam.

 

I was trying to stick it out until weekend and see if things got better. But honestly I am feeling wiped out tonight due to lack of sleep and anxiety.

I am so tempted to take Alprazolam 0.25 mg or 0.5 mg Lorezepam and see how I feel.

 

 

Amy, your disrupted sleep may be related to your abruptly going off Seroquel and then lorezapam.

 

Seroquel, lorazepam, and trazodone are all "brakes" -- they cause your CNS activity to decrease. When your nervous system activity is pushed down too much, it will fight back. That could be why you were having that distress in the middle of the night -- overdrugging was causing your vital functions to slow down too much and your nervous system was sounding the alarm.

 

This is called a paradoxical reaction; it's very difficult for most doctors to understand this. They always want to add more drugs.

 

When do you feel the nighttime anxiety? What is your sleep pattern?

[Amy238]

@Altostrata, yesterday I took 1/2 of 0.5 Lorezepam(Ativan) at 5:30 am after having been sleepless almost all the night. Fell asleep around 6:30 am and slept for 5 hours straight.

Woke up feeling much better. Ativan has been this wonder drug all throughout WD symptoms that has temporarily helped relieve all of my symptoms. But I am out of it now :-(

 

Most nights, here's how my sleep pattern has been.

 

1. Fall asleep say anytime between 12 am - 1:30 am

1. Jolted out of sleep after having slept for about 1-3 hours between 2-4 am - (1-3 hours of sleep)

2. Stay awake for next 3-4 hours out of fear, anxiety.

3. Go back to sleep closer to dawn(4 am - 6:30 am) - 2-3 hours of sleep.

 

So, in all I have been getting < 5 hours every day, unless I take Ativan.

 

I can't be 100 % sure but Seroquel and Trazadone just made me very sleepy and aggravated my symptoms by overdrugging me (like you said by causing vitals to slow down and causing nervous system to raise an alarm.)

[Amy238]

Today I slept around 12:30 am, was very sleepy (I believe little bit of Ativan was still in my system), woke up at 2:45 am, sweaty, feeling heart palpitations, heaviness in chest.

 

Though I don't remember much but do feel like heart was trying hard to cope while I slept.

Trying to go back to sleep now, actually feel drugged even though didn't take any sleeping aid last night.

[Amy238]

I have a feeling Alprazolam 0.25(Xanax) will help with sleep and anxiety too. But not sure if I should take it. It might create dependence but then if that would mean increased quality of life, better sleep cycles I don't mind. And once am stable, may be try tapering off of it.

[apace41]

1 hour ago, Amy238 said:

I have a feeling Alprazolam 0.25(Xanax) will help with sleep and anxiety too. But not sure if I should take it. It might create dependence but then if that would mean increased quality of life, better sleep cycles I don't mind. And once am stable, may be try tapering off of it.

 

Amy,

 

This is one of the very difficult choices.  Some people use a small amount of a benzo to act as a "cushion" as they taper off the SSRI/AD, but, as  you say, it creates another dependency that one needs to address afterwards.  At .25 of xanax you are on the equivalent of 5mg of valium which is a fairly low dose (people in the benzo world frequently look at valium equivalency because (i) valium was the primary benzo for a long time and (ii) Dr. Ashton's protocol for withdrawal involves crossing over to valium to withdraw because of its longer half life.  Your case is a little different because you were not regularly on the xanax so you would essentially be "adding" it to the mix (at least as a regular med).  Only you can judge what makes the most sense for you and your body.  If the difference is that dramatic and you are, for example, functional with the xanax and not functional without, that makes the decision easier.  Discomfort and function are very different.

 

In a perfect world you would be able to get off the zoloft without the xanax cushion, but this is far from a perfect world.  When you say, however, that you "may" try tapering off the xanax after the fact, that concerns me because it suggests a desire to substitute one med for another which I would not encourage.  I would hope you would be looking to get off the xanax as well because it can be too easy to simply say, "hey, this is working -- I'll just stay like this" and then the xanax gets deeply ingrained in the GABA system.  

 

As I said, at the end of the day, it is your call and it is hard to measure on a day by day/hour by hour basis.  Sometimes you need to let things stay the way they are for 3-4 days to see what is helping and what is not.  If you keep changing things up you can't tell what is causing what.

 

Best,

 

Andy 

[Amy238]

Another point I wanted to add in my sleep pattern on Step 4.

 

1. Fall asleep say anytime between 12 am - 1:30 am

2. Jolted out of sleep after having slept for about 1-3 hours between 2-4 am - (1-3 hours of sleep)

3. Stay awake for next 3-4 hours out of fear, anxiety.

4. Go back to sleep closer to dawn(4 am - 6:30 am) - 2-3 hours of sleep. These hours are full of cortisol spikes or something that keeps waking me, it feels like one happens every 10-15 min, I am constantly checking watch, waking up, putting my hand on my chest because that's where most of the discomfort is, dry mouth, shortness of breath.

 

Andy, everything you said makes perfect sense, I wish I could stand test of time longer before breaking down.

 

I know you have re-iterated that these are all VERY common symptoms but they are hard to live with every night. Taking an Ativan a night allows me to sleep and be rid of these but I also realize that unless I take it regularly, the next day the whole experience feels worse than before. But after 3 days of being without sleep, anxiety just grows and then I end up taking day off to fight off fatigue, take something like Ativan and spend the day sleeping to make up for lost sleep. Unfortunately I have a job which I can't afford to loose because that would be equivalent to leaving the country, otherwise I would take a few weeks off to detox.

 

Also, you are right when it comes to Xanax I almost thought I can stay on it forever if it would help get rid of WD symptoms. I would certainly want to taper off it some time but is it too bad an idea wanting to use it as cushion for some time ? Is it a beast in itself and comes with similar WD symptoms ? 

 

[apace41]

1 minute ago, Amy238 said:

I know you have re-iterated that these are all VERY common symptoms but they are hard to live with every night. Taking an Ativan a night allows me to sleep and be rid of these but I also realize that unless I take it regularly, the next day the whole experience feels worse than before. But after 3 days of being without sleep, anxiety just grows and then I end up taking day off to fight off fatigue, take something like Ativan and spend the day sleeping to make up for lost sleep. Unfortunately I have a job which I can't afford to loose because that would be equivalent to leaving the country, otherwise I would take a few weeks off to detox.

 

We all understand, Amy, and all of the "rules" we set on this site come with the understanding that people need to do what they have to do to survive -- which frequently involves jobs, families, etc.  So, when push comes to shove, you do what you have to do and if that includes a Xanax to get some sleep nobody here is going to tell you that you can't do that or that it will come with some huge punishment.  The reality is that we don't know.  Nobody does.  

 

3 minutes ago, Amy238 said:

Also, you are right when it comes to Xanax I almost thought I can stay on it forever if it would help get rid of WD symptoms. I would certainly want to taper off it some time but is it too bad an idea wanting to use it as cushion for some time ? Is it a beast in itself and comes with similar WD symptoms ? 

 

Further to the above point -- for some people Xanax withdrawal is horrific and for others it isn't.  Key factors, as is the case in AD withdrawal for most -- are how long you have been on the med and at what dose.  I would be lying if I said, "oh, don't sweat it -- getting of Xanax is a breeze."  Point of fact is that we can't know that now and the receptors involved with Xanax are different (with some overlap) than with you Zoloft.  Whether they are equally, more or less susceptible in you is impossible to say.  

 

I know that doesn't help much but the bottom line is to tread where you must -- but tread as lightly as you can.

 

Best,

 

Andy

[Amy238]

In the past when I would run out of Seroquel, and hadn't had time to go to the pharmacy to get the refill, I used to take Alprazolam 0.25(my mom takes these and had given me a pack of these for emergencies), and I didn't really feel a lot difference other than it was less sedating than Seroquel.

 

I would once in a while only take half of it that is 0.125 and would get some sleep still.

 

I have been on one or other sleeping aid for years now, never thought much of them until now when I decided to taper off of zoloft.

May be I taper off of zoloft first completely and then attack the night-aid.

[apace41]

6 minutes ago, Amy238 said:

I have been on one or other sleeping aid for years now, never thought much of them until now when I decided to taper off of zoloft.

May be I taper off of zoloft first completely and then attack the night-aid.

 

If you could stabilize on zoloft at 1.5 and .125 of xanax for sleep and feel pretty good for a several week/month period, that would not be the worst place to be.  Then you could slowly taper off the zoloft with the xanax "covering" you and then get off the xanax thereafter.  

 

I'm not a huge fan of the "rotation" of seroquel, trazadone, xanax, etc. because your body/brain react differently to each of them and they each may interact with the zoloft in a different fashion.  If you can find one that "works" and then stabilize I think that is preferable.

 

Best,

 

Andy

[Amy238]

Thank you Andy. I really like the idea of trying to stabilize at 1.5mg Zoloft and 0.125 mg Xanax.

 

I will try that. From my experience last few weeks, neither Seroquel or Trazodone did anything to help with WD symptoms.

Ativan helped and after reading about Xanax, it sounds like it’s in a similar class of med and might help too. Amongst the WD symptoms, the only one that really bothers me is cortisol spikes (15-20) every night, each one feels like an imminent heart attack :-( and keeps jolting me out of sleep. Even though they might be harmless but my body and mind certainly over-reacts each time.

 

I am not sure why the therapist chose to prescribe me Trazodone instead of Xanax when I saw him for WD symptoms. I do remember him saying Trazodone is not habit forming. But honestly a strong sedative while I still had persistent WD symptoms (as was the case with Seroquel too) didn’t seem to suit me much.

[Altostrata]

Doctors are avoiding prescribing benzos these days, they're getting a bad reputation re addiction and overdose in combination with opioids.

[Amy238]

3rd day since I started taking Xanax 0.125 mg at night. I still wake up every few hours due to cortisol spikes(which become very frequent after 4am) but they are more manageable since intensity has reduced.

 

Altostrata, I think I can see how benzos can become addictive. The major reason behind my distress was/is cortisol spikes, and I can see myself reaching out to Xanax every night.

 

After 15-20 of spikes every night, I find myself mentally and physically exhausted. After weeks of craziness I feel like I would do anything to not to be jolted out of sleep feeling as if heart was almost squeezed to stop and resume, followed by some crazy thumping of heart and intense fear.

 

Other than benzos, what else could help with cortisol spikes ? I have been eating healthy, have included Magnesium supplement in my diet, am making it a point to exercise and have an activity-intense day.

 

[apace41]

5 hours ago, Amy238 said:

Other than benzos, what else could help with cortisol spikes ? I have been eating healthy, have included Magnesium supplement in my diet, am making it a point to exercise and have an activity-intense day.

 

Hi, Amy.  You sound like you are doing reasonably well given the circumstance you started in when you arrived.  Kudos to you.

 

It is a very delicate balance when it comes to trying to do what is "best for yourself" and what "calms the CNS" in withdrawal.  So, for example, we all know that exercise is "really good for you."  For some in w/d, however, it can be activating and might result in less than optimal sleep or in greater body pain.  So, what's a person to do?  As in all things, moderation seems to be the key.  In addition, testing different things, in a very low and slow and controlled manner, can be fruitful.  There are any number of herbs that can help people in generally the same way as a benzo without nearly the potential for addiction.  Some can create some level of dependency but they are not nearly as difficult to get off of as xanax.  Of course, some of them can be paradoxical and can result in additional anxiety so it is difficult to know what will work for any one person.  Thus, it is hard to "recommend" anything but I will list some that have worked for people over time should you wish to try them instead of the benzo. I would encourage you to do the research on this site as we have information on all (or most) of these [type in Google "surviving antidepressants and ____________"]:

 

Lemon balm

Chamomile

Lavender

Kava Kava

Holy Basil

Passionflower

Valerian

L-theanine

Bacopa

Ashwaganda

CBD Oil

 

There are others as well.  As I said, some of these might be triggering so there are no guarantees, and any test should be undertaken at a very low level and in isolation without trying multiple remedies at once.  Some would say that there are "no easy fixes" and the only thing to do is to simply wait for the nervous system to return to homeostasis (subject to magnesium and fish oil which are generally recommended here if tolerated).  Others will say that a particular herbal remedy made a huge difference for them in their recovery.  

 

At the end of the day, the choice is yours as we cannot make specific recommendations on this front.

 

Best,

 

Andy

[Amy238]

Hi Andy, it's been a week since the last response from you. I have been researching the herbs you suggested.

 

I have been on Zoloft 1.5mg at 12 noon and Xanax 0.125mg at 10pm for over 10 days now, and it has helped me stabilize.

I no longer have

1. Mid-night cortisol spikes, may be one or two at most on certain days

2. Dry mouth

3. Choking/Gasping

 

Just relapse of some sadness, depression and some irritability. But I can totally handle that.

 

On Thursday, thanksgiving, I  smoked 3-4 puffs of MJ while at a friends, and half a cup of white wine. That night was the first time, I had zero cortisol spikes, was symptom free and slept for 8 hours with fewer interruptions. I wasn't sure if it was Xanax and Zoloft combo, or MJ or wine.

 

On Saturday, I took medical marijuana, a piece of a brownie a friend gave me which was supposed to help me sleep well.

I made several mistakes, did not research the dose and ate it on an empty stomach at 6:30 pm. By 7 pm, it hit me full force. Now after doing calculations it must have been at-least 35-40mg of THC. I went through hell to the doors of heaven for next 3 hours. Now I read the thread on WD and medical MJ and realize it's not recommended during WD because you are already hyper-sensitive to stimuli and THC can make it worse. It did. There were couple of big blackouts and several smaller passing out episodes, but I survived. Can't believe how resilient our mind and bodies are. What I felt, felt 1000 times more powerful than WD, so there is a good side to the story that if WD hits me back I might handle it better.

 

I am planning on trying "Holy Basil", "Ashwagandha" and CBD oil. I probably already have developed dependency on Xanax.

I read through most of the thread on CBD oil, and wondering if I try that, which one should I buy ?

How long should I continue on dose of Xanax and zoloft ? When should I plan to begin tapering off of either, and which one should I be tapering off first ?

 

Thank you again for your attention to detail and excellent advice. I am forever grateful for the support I found here.

[apace41]

15 hours ago, Amy238 said:

I no longer have

1. Mid-night cortisol spikes, may be one or two at most on certain days

2. Dry mouth

3. Choking/Gasping

 

Great news, Amy.  This is how reinstatement is supposed to work when it works properly.  Take some time to think about where you were at that point and where you are now so that you can truly feel the gratitude that comes with no longer being "on the edge."

 

15 hours ago, Amy238 said:

On Thursday, thanksgiving, I  smoked 3-4 puffs of MJ while at a friends, and half a cup of white wine. That night was the first time, I had zero cortisol spikes, was symptom free and slept for 8 hours with fewer interruptions. I wasn't sure if it was Xanax and Zoloft combo, or MJ or wine.

 

It could have been any of the combination or it could have been none and would have happened in any event as you were seeing such good progress anyway.  This is one of the reasons we suggest trying one thing at a time because it is hard to isolate what is helping when you do multiple different therapies.  Keeping track of what might have helped is a good way to allow yourself to go back and try them again as and when needed.

 

15 hours ago, Amy238 said:

On Saturday, I took medical marijuana, a piece of a brownie a friend gave me which was supposed to help me sleep well.

I made several mistakes, did not research the dose and ate it on an empty stomach at 6:30 pm. By 7 pm, it hit me full force. Now after doing calculations it must have been at-least 35-40mg of THC. I went through hell to the doors of heaven for next 3 hours. Now I read the thread on WD and medical MJ and realize it's not recommended during WD because you are already hyper-sensitive to stimuli and THC can make it worse. It did. There were couple of big blackouts and several smaller passing out episodes, but I survived. Can't believe how resilient our mind and bodies are. What I felt, felt 1000 times more powerful than WD, so there is a good side to the story that if WD hits me back I might handle it better.

 

One of the big challenges in any therapy, but especially in one with as much uncertainty as medical marijuana, is "how much to try."  We always recommend starting really, really low on anything you try and titrating up if you tolerate it at low levels.  You can always add -- sometimes it's hard to undo the effects of "too much."  I'm sorry you went through that but it was, as it all turns out, a good learning experience.  Just because a little (the MJ) might have been good does not mean a lot will be better.  I know you didn't know how much you were taking and that points to a different issue with the delivery system.

 

15 hours ago, Amy238 said:

I am planning on trying "Holy Basil", "Ashwagandha" and CBD oil. I probably already have developed dependency on Xanax.

I read through most of the thread on CBD oil, and wondering if I try that, which one should I buy ?

How long should I continue on dose of Xanax and zoloft ? When should I plan to begin tapering off of either, and which one should I be tapering off first ?

 

I guess my preference, given how well you have been progressing with just the Zoloft and the small dose of Xanax, would be for you to stay on only those for a little while longer unless there is something that you are needing to achieve with some other intervention.  I know you want to have the 8+ hours of sleep a night that we all desire, but that is more of a "want to" rather than "need to."  If all other things are going well, I'd be hesitant to add something else into the mix.  I would probably advise staying with the current program until mid-December and seeing where you are at that point.  The Xanax dependence is obviously something nobody wants, but the dose is very low and if it is stabilizing for you I would still favor keeping it around and tapering off slowly somewhere down the road.  While both Holy Basil and Ashwaganda can be helpful for some people they can also be activating and I'd rather not see you do anything that triggers your system while you are seeing stabilization.

 

CBD is an interesting question as you have probably seen from your research.  It is difficult to predict how it will or won't help someone and I would also hold off on that for the time being if I were you.  As and when you are ready to try it (if you even need to go there at all), I would suggest doing a LOT of additional research but, at the end of the day, finding a tincture or spray delivery device that allows you to take a very, very, very small amount would be the way to go.  That is something that you should go low and slow with after finding which of the products is the "purest" you can find.  Given that you are in CA, I would go to one of the dispensaries and just have a conversation with the "bud"tender and see what they have to say.  They are usually very well-informed from what I understand.

 

My overall advice, Amy, is to avoid the dreaded temptation to go "too fast" in the hope of being done with this. You've only been at it a short while and have come a long way.  Let your CNS settle in to the program you are on right now.

 

Best,

 

Andy

[Amy238]

Hi Andy, I seem to have hit a dead end with the doctors.

I had asked the physician to prescribe me Xanax and here's her response.

 

"I do not quite agree with the medications you have been taking,

we have been discussing things very differently on your office visit!

I really don't understand what you are trying to do with a dose of 1.5 mg of Zoloft - those capsules are not meant to be diluted with water, and that is essentially a placebo you are taking right now.

Xanax is not a medication you should be taking on a daily basis, you shouldn't really be taking it at all

I will send a small prescription to your pharmacy but you will have to schedule an appointment with either Dr X or another psychiatrist to follow up and discuss further medication management ASAP, this goes way beyond my scope of practice and I do not feel comfortable managing this!

As for the sleep study, I am not quite sure what you mean with cortisol spikes, and I do not know how to interpret a sleep study; did you discuss this with the specialist?

Essentially it looks like you have minor obstructive sleep apnea and should discuss use of a CPAP."

 

:-(, I had done sleep study when I was in withdrawl full force, since then I am for the most part not having any symptoms.

She wanted me on 12.5 mg Zoloft and 25mg Trazodone at night. I tried and it didn't help that's when I made the switch to Xanax.

It sounds like she simply wants to wash her hands off of me at this point. Dr X referenced above is the psychiatrist who refused to see me once I expressed my desire to be off of zoloft.

 

Please do not be feel obligated to respond if you feel uncomfortable about it.

 

[Amy238]

I will look for another doctor, I didn't intend to stay on Xanax indefinitely, may be a month or two. I have 10 pills each 0.5 mg, so that should last me 20 days for now.

 

I will stick to regime of zoloft 1.5mg and Xanax 0.125mg for now.

 

Interestingly some people would believe that doctor has to be right and there must be something wrong with me for refusing to agree with the doctor.

[apace41]

Amy,

 

You need to find a doctor who has some basic awareness of withdrawal or who is at least willing to read and learn.  The notion of it being a “placebo”at 1.25mg demonstrates no understanding of the way these drugs impact the CNS , but is unfortunately the way most doctors would see it.  The regime you are on right now is working for you so I would not change it unless forced to do so.  

 

One question - if you have 10 pills at .5 mg and are taking .125 mg a day, you should have 40 days’ worth as opposed to 20.  Am I missing something?  

 

Best,

 

Andy

[Amy238]

Andy, I am sorry I typed it wrong. I have 10 pills of 0.25mg.

 

29 minutes ago, apace41 said:

doctor who has some basic awareness of withdrawal or who is at least willing to read and learn.

 

I so agree with this part, there doesn’t seem to be any desire to put efforts into researching or reading, and learning. 

 

I know this doctor had prescribed Temazepam to some patients in the past, and so was comfortable with me starting to take Temazepam. (From little I understand Xanax(Alprazolam) and Temazepam are both benzos, Temazepam being more sedative than Alprazolam.) So I am not sure why there was such strong reluctance towards prescribing Xanax.

 

Even when it came to sleep study results, it’s clear that there was no effort to try to interpret the numbers and examine the results closely. Ironically, during my visit in person I was informed by the same doctor that I can’t possibly have sleep apnea as I didn’t seem to fit the type or criteria for it. 

 

I am grateful to have found kindness and thoughtful feedback here. It would have been hard to have managed without it.

 

But at the same time I so want to fight back these doctors who show little empathy and are engaging in unfounded diagnosis, all to save themselves some extra trouble. Or if there is another reason I really want to understand what’s driving the malpractice. I would be interested in knowing how many of these doctors themselves are on prescription anti-depressant, or if they keep these prescriptions exclusively for their patients.

I am sorry for the rant but I just feel longer such behavior is given a pass, longer it would prevail.