Fightingawar: Withdrawals after having serotonin syndrome

[Fightingawar]

@manymoretodays I’m sorry I’m confused as to what I haven’t done yet they she told me to do. I fixed my signature of the medication I am on currently and what is was on before. Is there something else I need to do on there. And as far as reinstatement I believe everything she tells me is accurate I can’t really help that I’m scared it’s part of my anxiety that I have plus the serotonin syndrome diagnosis doesn’t help much with my anxiety even though I feel like I didn’t have that. Am I supposed to keep a daily log at home or on here? I’m trying to make sure do everything right but I think I’m getting confused. So is my signature still not right?

[Audrey88]

Hello , I wanted to check how you are doing. I see you have started your medication again which I really hope it helps you out. If it makes you feel any better the first time I tried to stop Lexapro, I also had a really bad reaction and had horrible withdrawals so I went back on my medication and it took about two weeks but then I started feeling a lot better again, totally normal. I have recently took up walking and jogging which have helped me a lot. Maybe just a short walk around the block would help get your mind off of things. I really hope you feel better soon.

[Fightingawar]

Thanks @Audrey88 I have t started back yet I’m supposed to tonight, I’m asking God for courage because right now I have none I’m so scared of a reverse reaction that I’m literally in a panic about it 😪

[manymoretodays]

FAW,

 

It will be really helpful if you keep a daily log on here using the format in the link.  Keep it simple: times, symptoms, drugs taken and doses.  Most likely you will need to do it on paper, a notepad, or day planner type page, before transferring it here to your introduction.  Try and account for a whole day including wake ups.  You could look at how Hazel is doing hers.

http://survivingantidepressants.org/topic/14445-hazel-struggling-with-paxil-to-prozac-bridge/?page=15&tab=comments#comment-354874

 

Try and keep it separate from the other more narrative posts.  Try and account for 24 hours. 

 

4 hours ago, Fightingawar said:

Is there something else I need to do on there

 

Not until you change something.   Just update the signature when you start the new tricyclic with the dose and date.  And any other drug or medication changes if/when they come up.

 

And I know.......I know it's a struggle now for you........   The neuro anxiety....... and the obsessions about the serotonin syndrome are really playing havoc with you. 

You're doing good........keep at it.  You've made progress already since you first arrived.   It gets better.  Believe that!

 

Love, peace, healing/inrecovery, and growth.......

mmt

 

[Audrey88]

I know I was scared as well when I went back on Lexapro but try and stay positive because negative thoughts and emotions are not going to help anything get better.  I'm sure everything is going to go just fine. You have a lot of great people here to help you through this. You got this!

[Fightingawar]

If I’m trying to take .50 mgs how much is that is mls? 

It says Nortriptyline 10mg/5ml

but I want to take .50 mgs and I only have a ml dropper

[Altostrata]

5 minutes ago, Fightingawar said:

It says Nortriptyline 10mg/5ml

 

That would be 2mg in a milliliter. You would take 0.25 milliliter of the liquid.

 

Look carefully at your syringe. How much does it hold when full? Is it 1 milliliter, 5 milliliters, or 10 milliliters? Where are the tick marks on the side?

 

Post a photo if you can.

[Fightingawar]

It want download the picture for some reason but it holds 5ml

[manymoretodays]

Hi Fightingawar,

 

I think for accuracy you should consider getting a 1 ml(millileter) syringe to draw up 0.25 ml which contains 0.5 mg(milligrams) of the nortriptyline.  If you take a look at the first couple of posts in the following link you'll see why.  It shows both a 1 ml syringe and a 10 ml syringe.  You'd have much better accuracy with a 1 ml syringe if you use the solution as is.  You could call the pharmacy and see if they have a 1 ml syringe, check with a vet, or order something online.......amazon is usually good.  I've never checked but possibly a pet supply store might have a 1 ml oral syringe as well.  Syringes are better than droppers as far as accuracy goes.

http://survivingantidepressants.org/topic/235-using-an-oral-syringe-and-other-tapering-techniques/

 

The other possibility would be to further dilute your nortriptyline solution with water.  Accuracy and then consistency of both dilution and measuring are important.  So once again you would need to get some further supplies.  I used to use urine specimen cups with lids to liquify my last medication in and then would put the final solution in a brown paper bag in the fridge.  The urine cups had markings on the side in larger quanities of millileters.   

 

Nortriptyline is soluble in water, and from what I was able to find is stable in solution for up to 8 days if refrigerated and protected from light.

More on notriptyline here:  http://survivingantidepressants.org/topic/4011-tips-for-tapering-off-nortriptyline/

I would suggest a graduated cylinder with measurements on the side, preferably glass and then another amber colored bottle with lid to put the final more dilute solution in for at least 3 days of dosing.

 

I hope that helps.  Let us know if you need further assistance with getting the 0.5 mg dose going and any other updates.

Love, peace, healing/inrecovery, and growth.....

mmt

 

ml=millileter

mg= milligrams

 

 

 

Edited May 27, 2018 by manymoretodays
clarification

[Fightingawar]

I have a couple of questions how do you know if your body is sensitized? And if you are does that mean to all medications? 

[Gerg]

Dear Fighting a war.

I am a follower. I apologise in advance if what I am about to say comes across as simplistic for what you are experiencing. What you are coping with and the process of coping is a topic I have considered for the past 50 years now. Coping with is to me more than a drug you are withdrawing from. 

There are other important factors involved your the fight to survive this parasite. Again I do not want you to think I am being simplistic about your plight. While I have never had an extreme withdrawal reaction even though I was on Zoloft for 23 years on a unusually high dosage of 300mg, plus an array of other physical, and mental irritants called drugs so as to survive and cope.

There other factors to consider when it comes to your fight, some of which you are doing already, for your mind is not static when you have a critical need.

The areas I have I mind are as follows. 

The process you use when drawing conclusions about your 1. Physical needs 2. Mental needs 3. Your spirit inside needs, 4. Your spiritual welfare involving the drug you are on. Sometimes we place emphasis on the cure in a drug when it is really the processes we use that we need to look at regardless or aside from the drug. In many cases the drug is used really to cover over or hide what is the underlying problem, so we can hide for many years with the use of a drug. I am not saying it is psychosomatic that it is all in the mind as it were. In fact I would like to "emphasize" this is not what I mean.

I am now going to bow out of this question.

I will not my continue this blog unless you want me too, as there are many areas to consider in this quest to be free of life's parasites that are called drugs.

I would like to close this thought with 2 quotes.

1. "There is more to you than the sum total of your thinking, feeling and outworking".

2. "You are more precious than Coral's"

Gerg

 

 

 

[SkyBlue]

On 5/29/2018 at 10:32 AM, Fightingawar said:

I have a couple of questions how do you know if your body is sensitized? And if you are does that mean to all medications? 

 

Well, most of our bodies are sensitized in withdrawal. The stress response is on high alert. We might be easily startled, for example. 

 

We (temporarily) might not tolerate caffeine, exercise, stimulation, socializing as well as before. 

We can often be more sensitive to medications, even non-psych drugs. 

 

Are you generally curious about the idea, or are you referring to a specific situation?

[Fightingawar]

I’m just wondering about taking any kind of other medications rather it be prescription supplements or anything even like Tylenol. This whole experience has traumatized me literally I still haven’t reinstated because I’m so scared of a reaction like a permanent one or something worse then what I’m already experiencing and I can’t handle worse I’m already above my limit is suffering right now. My doctor started me on a new birth control and I’m even scared to take that. How do I get past this fear? 

[Fightingawar]

How do I know that this severe anxiety that I’m having all day everyday is from withdrawals and not my original anxiety that I had from the beginning 16 years ago?

[Altostrata]

Because you're 16 years older, have been on drugs for ages, and recently went cold turkey, triggering severe withdrawal symptoms.

 

It's not like the symptoms came out of the blue. It's like a cement block has fallen on your foot and you're asking why your foot hurts.

[Fightingawar]

I understand that but does the original problem that you were treated for just go away? I had severe panic attacks to the point I couldn’t get out of bed sort of like now. So I just didn’t know if it could also be that returning.

[ChessieCat]

7 minutes ago, Fightingawar said:

does the original problem that you were treated for just go away?

 

Whether the original cause was situational or not we need to learn non drug ways of coping.  All the drugs did/do is numb our feelings.  Even though the anxiety I have been experiencing is WD related (the reason for going on AD was situational) I have found the non drug techniques I have learned since joining SA help me to cope with it.  Several times using them I have been able to stop myself from going into full blown panic attack and at least once I managed to stop myself from becoming hysterical.  

 

Non-drug techniques to cope

 

Claire Weekes' Method

 

Audio:  First Aid for Panic (4 minutes)
 

CBT Course:  An Introductory Self-Help Course in Cognitive Behaviour Therapy
 

Audio:  How to Recover from Anxiety - Dr Claire Weekes
 

Anxiety Stuff - all kinds of stuff about anxiety attacks and things that help ...

 

[Altostrata]

Your brain and body are not the same as they were 16 years ago. You don't go cold turkey, suffer severe withdrawal, and then, blam, revert to where you were 16 years ago.

 

Did you reinstate anything yet?

[Fightingawar]

No I have not reinstated I had a personal medical situation come up that I might not be able to reinstate and just have to fight through it.

[JLex1981]

I'm sorry to hear that fightingawar... I hope your medical situation improves. 

 

John. 

[Fightingawar]

Thank you @JLex1981

[JLex1981]

20 hours ago, Altostrata said:

Your brain and body are not the same as they were 16 years ago. You don't go cold turkey, suffer severe withdrawal, and then, blam, revert to where you were 16 years ago.

 

Did you reinstate anything yet?

 

I agree with this... your underlying symptoms might be there.. but I bet you were not losing 45 pounds in 3 months 16 years ago... there are obviously withdrawal symptoms there. 

[Skeeter]

On ‎5‎/‎30‎/‎2018 at 9:03 PM, Fightingawar said:

I’m just wondering about taking any kind of other medications rather it be prescription supplements or anything even like Tylenol. This whole experience has traumatized me literally I still haven’t reinstated because I’m so scared of a reaction like a permanent one or something worse then what I’m already experiencing and I can’t handle worse I’m already above my limit is suffering right now. My doctor started me on a new birth control and I’m even scared to take that. How do I get past this fear? 

 

War,

 Panic attacks are awful. I am sorry you have to deal with them.

 

What I personally have found, and read from the hundreds of threads I have read beginning to end, for normal everyday substances, if you react to it, you will generally know right away, and the side effects go as soon as you are off of the offending substance.  Benzo WD is VERY similar to AD WD, and my only sensitivity is to artificial sugar, but it took about a week to build up for me to feel it the first time I tried it after 2 years of abstaining).  Within 12 hours of stopping, I was fine.  Had a couple of minor symptoms, but that is all.  There is no need to worry unnecessarily about non-prescription substances, with the exceptions of supplements.  Most supplements, esp B vitamins, can increase feeling of anxiety.  The only 2 we have found to be helpful over and over are magnesium citrate and Fish Oil, capsules but some people cannot handle these, but they try, if they do not feel good, they stop, no problem.  If you are worried about aspirin or Tylenol, you can try low dose aspirin first to make sure it is okay, or regular strength Tylenol, one capsule instead of two of extra strength Tylenol, same with ibuprofen (note, ibuprofen can be irritating to the stomach, take with a full meal if you have this issue, personally.  I do hope this will help calm your mind.  I have not yet seen a severe reaction to anything a person was not not allergic to before.  Most people just feel "off" or have GI upset if they will have an issue.  So do not take anything you could not try before. 

 

If anyone disagrees with this, as there is someone in every crowd that has had something odd, they will speak up, but remember, that is one case of such an event, it does not mean it will happen to you.  I was never sensitive to artificial sugar or anything else before this.  Prescription medications are not included in the "safe to take" category.  Certain antibiotics are not good for those in WD.  Fluoroquinolones are a class of antibiotic that should never be prescribed to anyone , IMHO, unless there are no other options, especially for those in WD. If you have questions about  specific prescription drug, please ask.

 

Be well!

Skeeter

[Fightingawar]

What do you think about reinstatement and out of the stories you read do you think it helps or hurts more? I was on clomprimine been off 3 months they want not to reinstate nortriptyline? But I’m scared of adverse reactions @Skeeter 😞

[Altostrata]

Please note we have suggested a very low dose of whatever drug you try, far lower than your doctors think is appropriate. We recommend very low doses to lessen the risk of adverse reactions.

[Skeeter]

I restarted a different antidepressant after having been pulled off CT of 2 different AD's. I was on a 300mg Wellbutrin and 50mg of Cymbalta, (plus 50mg of Trazodone at night), no wonder I had serotonin syndrome.  I was told I could try 10mg of Lexapro, but my fear was so bad that I went up to 20mg after several weeks.  I regret that even now a bit, but with the info I had at the time, I cannot blame myself, and I accept the fact that it will take me about 2.5 more years to taper than it would have, but tapering was not on my mind at the time, or on my radar.  I agree with Alto, trying a low dose is best. 

 

Some people have problems with crossovers, which is trying to taper one drug while adding another, notorious for causing issues.  This is a bit different.  I think the CNS responds differently after a CT, a bit better for some perhaps.  I certainly know my taking my new one, Lexapro, was very easy on me, much easier than so many have while doing a crossover.  So please try not to worry about everything.  Start your dose low, and go slow, that way any reaction will be minimized. For me, it was a relief of symptoms (but, as the ID WD was an issue, that only happened at specific times, so I was able to appreciate the difference, still.  Maybe ask your doctor to start with a conservative/low dose, so that you have lower mg pills.  Sadly most doctors do not understand reinstating or withdrawal, and that includes psychiatrists.  I just read an article in a psychiatric online magazine that stated something quite similar, so they are realizing there is an issue, FINALLY, and I could not be happier, but change is slow (more like snails pace), so I do not expect to see it for years, sadly.  Please let us know what dose of what prescription you actually get, in case your doc changes his mind on what s/he is going to prescribe.  Will offer any help needed!  I hope this calms your fears a bit, anyway.  At least you do not have to worry about 2 different antidepressants reacting against the other in unknown ways. You are doing this in the safest way possible.

Hang in there, hopefully you will feel better soon!

[Fightingawar]

@Skeeter how long were you off before you reinstated? We’re you symptoms really severe from CT? 

[Skeeter]

OMG!  War, YES!!! Severe breakthrough anxiety that the benzo was not controlling, SI (had to give my sidearm to my other half, because having it near me scared me so much that I was afraid I would do something to myself in my sleep), I thought I was going crazy.  I tried to call psychiatrists to make an appointment, but the second they would pick up the phone, I would sob so hard that they could not understand me. Luckily, I held on long enough on the phone to make an appt with my GP, a much better decision in my case.  I was so depressed that I had zero joy, and thought it would never end.  I had periods of confusion, unusual fears, agoraphobia, insomnia, was unable to eat much even, I lost a ton of weight. I was miserable and felt it would never end. When I went to the doc, and she said she would prescribe something that day, I did not even believe her.  I do not know why, but I was so distraught, that I thought she was going to make me see her a second time before she prescribed, my other half even had to drive me, I was bedbound and I was afraid to leave the house.  Relief came slowly, after about 2 was when I started to really notice a change, but Lexapro/escitalopram is about twice as strong as other antidepressants (a bad thing when looking at tapering, it will be a long road for me). It does not mean you will feel it in more or less time, I have another health issue with my nervous system, and I do not respond to everything like a healthy person. I just remember that the darkness started to slowly lift, and I literally felt lighter, as my limbs felt so heavy

 

Now remember, after you start to feel better, you should hold a good long  while- until you are as stable as possible, if you can, before starting to SLOWLY taper.  I wanted to start right after I came here, 5 months from starting Lexapro,as soon as I learned about it, but for me, I went into instant benzo withdrawal, within about 5 weeks, I think, of starting my AD so I cannot tell you how long total it took to fully help me. I was so ill from benzo WD when I first came here, it was not wise to taper, and  I am so glad I did not in my situation, but for everyone, it is different

I hope you see your doc soon!

[Fightingawar]

Do you think it will still work it I have been off for 3 months? What if it didn’t work will I be like this forever? I’m sorry I’m so terrified and your withdrawal symptoms sound just like mine I have lost 45 pounds in 3 months and that’s causing me to have worst anxiety. Why is this desision the hardest I have ever had to make? When you reinstated did you get any worse before you got better? I’m on Ativan 3 times a day and it’s doing nothing. 

[Gerg]

I am confused here. You talk about withdrawal as if you are fighting some unknown enemy. I do not get this picture when it comes to drugs. How can you be sure that your body is not actually defending itself from the attack of this drug attack. You have been on these drugs of and on for a long or short duration with the attitude that you must protect your mind.

Your mind then your body is the unfortunate recipient of your effort the get well.  Have you not realized that it is your whole self, your body is that placed under attack when you go onto an outside peculiar (unknowable) influence for relief. "Outside Drugs can be a good source of food for your body" but this is not the case when it comes into direct contact with your mind.  You are attacking the brains capacity to function as it was designed. Your mind may be in trouble but when you take drugs it is your brain as well as your mind and even your body that suffers. To protect your physical brain and body your body comes to its defense this is why we suffer the various initial, then the  ongoing debilitating effects of the drug and the accompanying withdrawal symptoms. "Our defense mechanism does not recognize or differentiate one form of attack from another for it is immune protective". So you substitute one form of reaction due to going on the drug and replace this attack on your brain with another attack on your mind and your body. In this your body as  suffers accordingly. Really the question is not "how can I get off this drug" but how can I protect my body from this onslaught either from stating or continuing.

1 and 1 = 2, drugs are actually that, they come from an outside source, they are not a food and they are designed to interfere with a presumed, real or imagined inadequacy, they (health professionals) think they can, or may fix, with much experimenting. They are interferes, persuading our mind to accept a course of treatment that eventually hurts us big time.

 

Quote: If you are what you eat , what you have become is a concoction it is not the real you.

[Skeeter]

War,

I personally only got better.  I cannot speak for everyone.  Just keep us abreast of any changes.  Here is what I know from reading so many case histories here, and in my medical career, as I used to do psychiatric runs all of the time.  People that stop cold turkey (CT) seem to suffer years longer than those who reinstate (RI).  For me the answer was very easy, as I could see that I could not stand much more.  As one of our mods says on his thread, I am paraphrasing here- he did a slow taper.  He had other people he knew stop cCT around the time he started his taper, (and he is high functioning, work, modding, family, etc), and the people that went CT before him are STILL suffering.  Some people cannot RI.I part ways with Greg above in a big way.  I have watched people suffer, and held their hands when I have been able to, and I would not wish a CT stop on my worst enemy.  Your weight loss is alarming to me.  You are going to have to do something.  I am afraid if you try to wait it out, you will end up being hospitalized because your health may collapse, the body was not meant to lose that much weight, 45 pounds in 3 months?  I used to work in EMS, and just hearing that makes me worry a ton about you.  I started out 1-2 months out past where you are now.  If any new symptoms arise, let us know.  We are not perfect, but keep our eyes open.  Talk to your doc if you are worried, but in the same way, do not let fear cause extra symptoms if you do choose to reinstate.  Do not ask me or anyone else what to look for as warning signs, you have enough to worry about, and the mind is very powerful,  Do not let anyone put symptoms in your head.  I was lucky, I had the new 3mg of Xanax to keep the fear down, you have nothing new for that.  I would suggest, if it were me, I would RI very soon.  Starting now, journal your symptoms on pen and paper, start a new page every day, this way you can watch for things getting better or worse after starting the new drug, if you choose to try it.  You can rate your symptoms on a scale of 1-10 each day, and if they change, put a time on it, and rate it, 1 for almost non-existent, 10 for the worst you can imagine, and for it to be 10, think of, if it were physical pain, pain that would make you pass out, if that makes sense.  Like you arm got torn off type pain.

Here are some more tips on journaling:

Hang in there!

Skeeter

[Petunia]

On 6/1/2018 at 6:55 AM, Fightingawar said:

@Petunia.... I’m only 3 months in to this and I’m already so tired and scared I don’t want to die but sometimes I feel like I am I don’t see the light yet and I imagine I have awhile before I do....Did you have loss of appetite and lose a lot of weight? I have lost 45 pounds in 3 months and I’m trying not to freak out but I don’t know how to make myself eat because then I’ll throw up. Any advice on this? 

 

Hi Fighting, I'm sorry you have to go through this too. But you are going to get better. I remember early on I really believed I was dying. I was also losing a lot of weight. I've had weight problems most of my life, I usually put on weight just from looking at food and have a hard time getting it off. But early in withdrawal the weight just started falling off me and it wouldn't stop. I got really scared, my hair was falling out in clumps too, I thought I was going to end up completely bald, that's if I managed to survive. That lasted about a year, but then I slowly started putting all the weight back on, and then more. My hair stopped falling out and has mostly grown back now.

 

Yes I had a difficult time with nausea, I never actually threw up, but for most of the day it was almost impossible to eat, but later in the day it was possible. No appetite and for a long time, food was tasteless, I thought I would never enjoy eating again. I had to force myself to eat something. At first I ate a lot of plain rice, warm milk with a teaspoon of honey, plain toast, really bland foods that I thought I could tolerate. I was too sick to cook most of the time. Its difficult to remember the details now, but I just ate whatever I could manage to make and keep down. I was managing to get to the store about once a week and I would buy prepared foods that I could just heat up.

 

Try eating small amounts of bland foods when you're not feeling quite so bad. Smoothies can sometimes work, but I had to find a protein source which I could tolerate. I reacted badly to whey, but pea protein was ok. If you can get some leafy greens in there, that will help too. I'm currently back into the green smoothies big time, I think they help with energy because they are easy to digest.

 

 

 

 

[Fightingawar]

So I’m in severe withdrawals still from going off my antidepressant abruptly because of serotonin syndrome that i did not have. It’s been 3 1/2 months off now, but my question is I’m still on Ativan 3 mg a day and some people are saying I could be having symptoms of tolerance from that so when should I start to taper off of it? I don’t feel stabile enough to do it right now but how do I know it’s not causing some of my symptoms? I just don’t know if I could be in a double withdrawal and survive it which I don’t see how I can get any worse because I feel like im already in hell but I know it can get worse I have heard the stories. So what do I do and how do you taper a benzo I have been on it for 3 years.

[Altostrata]

Please review the responses you have already received from the staff. Thank you.

[Audrey88]

Hi , I wanted to check on you. Have you been in contact with your doctor about your symptoms? About the Ativan if you need to get off of that as well I suggest going very very very slowly because your body is already very sensitive right now. But I would talk to your doctor as well. Have you been able to get out and get some exercise ? Are you eating more now ? I hope you start to feel better soon.

[Fightingawar]

@Audrey88 I really don’t talk to my doctor unless I have to because they don’t believe this is withdrawals so what’s the point. I’m going to wait and get off the Ativan if and when I stabilize I can’t be in withdrawals from both. I haven’t really been able to excercise because I’m so weak I walked to the mailbox and my legs were shaking so so bad. I am eating a little more not a lot but better then I was I’m not rapidly losing weight like I was just a little here and there. I really hope there is nobody who has stayed like this permenatly because this is brutal. I’m 3 1/2 months in I thought I would feel a little better by now but it’s the same I do get windows once in a while that will last a day thank God for those. I woke up yesterday morning thinking I was getting Akathisia my insides were vibrating and I was shaking it lasted it about 30 mins and went away I hope I never have it again sent me straight into panic it was terrible.