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thesureshot

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Moderator's note:  link to benzo thread - Thesureshot - The Benzo Thread

 

Hi everyone! 

First and foremost, I'm so grateful to have found this website and thank you for sharing all of your stories - they've really helped me realize that I'm not alone.

 

A little on my background -- had a major life event (move abroad) in 2016 that eventually lead to a nervous breakdown in early 2017. Severe depression, anxiety, several panic attacks a day -- all that kind of fun stuff. I was referred to a psychiatrist in the UK who put me on Effexor and Xanax almost immediately. In desperate need of relief, I acquiesced. After 2 months, the drugs weren't helping and my company decided to move me back to my home in the US -- a major disappointment. There I was referred to another "highly regarded" psychiatrist who CT'd me from Effexor and immediately put me on Cymbalta. I suffered severe withdrawal -- nausea, sweating, zaps for a month. After "overcoming" the Effexor withdrawal, I CT'd Xanax because I thought it was making me lethargic. I experienced no withdrawal symptoms, thankfully.

 

Cymbalta was proving to be ineffective, so Abilify was added at 2mg to help "boost" it. This is where things started going off the rails. My spending became out of control for the first time in my life (normally very frugal), and I started exhibiting classic hypomanic behavior. I couldn't sleep, so I was put on Trazadone 50 mg to help with that issue. I missed more work than I ever have in my life.
 

This eventually led to a BP2 diagnosis, which in turn led to a Latuda 20 mg prescription. I was also switched to Lexapro 10 mg, then eventually to 20, and CT'd off Cymbalta upon starting the Lexapro. I stayed on Abilify. This is where the anhedonia set in. I used to be a big music lover, an avid nature enthusiast, a gym rat, a writer -- and all of these things stopped giving me any pleasure at all. Apathy set in. I quit my job. My psychiatrist started reducing the Latuda rapidly, dropping me from 40 to 10 mg within a span of three weeks. Shortly thereafter, she recommended stopping the Latuda and put me on Trileptal and reduced my Lexapro to 10mg. At this point, I developed excruciating headaches and SEVERE anxiety that led to a one-week hospitalization. This was in early June of this year. In the hospital, I refused Lithium and started Lamictal as well as Wellbutrin 150mg to "help with the side effects of the Lexapro." I was taken off the Abilify and Trileptal. After my first dose increase of Lamictal, I developed the rash so had to CT after two weeks. I was feeling uncomfortably jumpy on the Wellbutrin so I CT'd that after 10 days. Oddly enough, I finally "stabilized" from the bipolar-like symptoms on just the 10 mg Lexapro, 50 mg Trazadone, and .5 mg Klonapin. That's when I started to realize that maybe the pharmaceuticals were the problem. I found a new psychiatrist who supported me going off meds and recommended I try to cut the Trazadone and Klonopin in half in early July. I did so with little issues.

 

That brings me to today. My poor nervous system and brain! I've been yanked on and off so many drugs that I'm not sure which way is up anymore. I'm currently on 10 mg Lexapro in the morning, and 25 mg Trazadone & .25 mg Klonopin nightly. My current symptoms are:

- Brutal anhedonia
- Apathy/lack of motivation
- Hair loss

- Morning anxiety

- RLS/(possibly akathisia? More like uncontrollable leg and foot twitching) especially in the morning (this is new and started after discontinuing Wellbutrin)

- Agitation

- Sexual Dysfunction

- Night sweats

- Reduced Cognition/Concentration

- Memory Issues

- Inability to lose weight/gain muscle mass despite strict diet and exercise
 

I do think that most of these are simply side effects of the SSRI/SARI and not necessarily withdrawal. After reducing from 20 mg of Lexapro to 10, I experienced much more severe anxiety and headaches/head pressure that have subsided significantly over the past 6 weeks or so. Regardless, I think it's too late to reinstate the 20mg dosage. I also believe that my morning anxiety/rls/akathisia could be rebound anxiety from the klonopin I'm taking at night, despite the long half-life. My new psychiatrist recommended eliminating the Trazadone first, then doing 25% cuts of the Lexapro for a month at a time, but from the research I've done here that seems far too quick with far too drastic reductions, so I plan to do a 10% taper schedule on the Lexapro every 3-4 weeks, possibly alternating dose reductions of the Trazadone, and to leave the Klonopin for last. Any suggestions are welcome.

My goals are simple: to live a psychotropic-free life and reclaim my passion for living. I want my love for music back. I want my sexuality back. I want the driven, goal-oriented, outgoing individual that my friends know back. I'm fortunate to have a supportive wife, a great therapist, and at least the next two months off work to start this process. Even though I've lost my motivation, I'm determined to repair myself. I just hope and pray that the damage isn't permanent.

I wish all of you all the best things in this world, and hope that healing comes to all of us. Thanks for reading!
 

 

Edited by Shep
added link to benzo forum thread

2017: Started Effexor, CT'd by p-doc after two months with brutal withdrawal for a month. Was on 1-2 mg of Xanax a day from Jan-March, CT'd with no withdrawal. Brief stint on Cymbalta 60mg, started Abilify 2mg. Switched to Lexapro 10mg, CT'd from Cymbalta by p-doc. Started Trazadone 50 mg for sleep.

2018: Lexapro bumped to 20 mg, added Latuda 20 mg, worked up to 40 mg, and eventually back down to 10 with a rapid taper then CT'd. Xanax .5 nightly for sleep. Lexapro reduced to 10 mg. Was hospitalized after the Lexapro reduction/Latuda CT. Placed on Lamictal briefly, developed the rash and CT'd. CT'd Abilify. Switched to Klonopin .5 mg for sleep.
July 2018 - Reduced Trazadone to 25 mg, Klonopin to .25 mg. Current dosages: Lexapro 10mg, Trazadone 25mg, Klonopin .25 mg.

August - Starting a proper taper schedule to get off everything.

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  • Moderator Emeritus

WOW, my eyes are popping out on stalks reading all that!! :blink:   All those drugs and C/T's in 18 months, there is no wonder you are having all those symptoms. 

On 7/24/2018 at 10:01 PM, thesureshot said:

My poor nervous system and brain! I've been yanked on and off so many drugs that I'm not sure which way is up anymore

 

On 7/24/2018 at 10:01 PM, thesureshot said:

I started to realize that maybe the pharmaceuticals were the problem.

 

Spot on!   It is going to take some time but you need to stabilise before making any more changes.  It would be great if you could make a symptoms jpournal and post it here. Start when you wake up. How do you feel? Log when you take the drugs, and again how you feel. We need to know how you are an hour after taking them, then again before you take them.  Something like this.

7am  anxious, dizzy

7.15 breakfast, coffee cereal, toast etc.

7.30 dizziness gone Take lexapro

9am headache

12pm nausea

etc etc.  This helps to differentiate between withdrawal and side effects. If you use a laptop you can log all this in the reply box during the day, each time you come back and click the box the text will still be there if you haven't posted it. At the end of 24 hours you can click post. Hope that makes sense! I do it often when I am replying to someone and get called away or need to do research. 

 

You need to stabilise before starting to taper, your nervous system is very unstable . When you are stable you can start to taper slowly.  Stick with the doses you are taking to stabilise, same dose, same time every day. @Shep is our benzo expert and will advise if the doses need adjusting or seperating from each other.  Please don't change anything else until she has looked at them. She will ask you topost in the benzo forum here. https://www.survivingantidepressants.org/forum/29-benzo-tapering-and-recovery/

You also need to put the drugs into the interactions checker at www.drugs.com and post the results here.   

 

These links will take you to topics that will explain withdrawal. 

Rhi's explanation 

https://www.survivingantidepressants.org/topic/603-what-is-withdrawal-syndrome/?do=findComment&comment=88441

 

What is withdrawal syndrome. Withdrawal includes adverse effects and interactions, all of which lead to autonomic instability.

https://www.survivingantidepressants.org/topic/603-what-is-withdrawal-syndrome/

 

While you are stabilising you will experience windows and waves, which is a pattern of healing. It can be quite scary until you recognise what is happening. 

https://www.survivingantidepressants.org/topic/82-the-windows-and-waves-pattern-of-stabilization/

 

 

**I am not a medical professional, if in doubt please consult a doctor with withdrawal knowledge.

 

 

Different drugs occasionally (mostly benzos) 1976 - 1981 (no problem)

1993 - 2002 in and out of hospital. every type of drug + ECT. Staring with seroxat

2002  effexor. 

Tapered  March 2012 to March 2013, ending with 5 beads.

Withdrawal April 2013 . Reinstated 5 beads reduced to 4 beads May 2013

Restarted taper  Nov 2013  

OFF EFFEXOR Feb 2015    :D 

Tapered atenolol and omeprazole Dec 2013 - May 2014

 

Tapering tramadol, Feb 2015 100mg , March 2015 50mg  

 July 2017 30mg.  May 15 2018 25mg

Taking fish oil, magnesium, B12, folic acid, bilberry eyebright for eye pressure. 

 

My story http://survivingantidepressants.org/index.php?/topic/4199-hello-mammap-checking-in/page-33

 

Lesson learned, slow down taper at lower doses. Taper no more than 10% of CURRENT dose if possible

 

 

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1 hour ago, mammaP said:

WOW, my eyes are popping out on stalks reading all that!! :blink:   All those drugs and C/T's in 18 months, there is no wonder you are having all those symptoms. 

 

 

Spot on!   It is going to take some time but you need to stabilise before making any more changes.  It would be great if you could make a symptoms jpournal and post it here. Start when you wake up. How do you feel? Log when you take the drugs, and again how you feel. We need to know how you are an hour after taking them, then again before you take them.  Something like this.

7am  anxious, dizzy

7.15 breakfast, coffee cereal, toast etc.

7.30 dizziness gone Take lexapro

9am headache

12pm nausea

etc etc.  This helps to differentiate between withdrawal and side effects. If you use a laptop you can log all this in the reply box during the day, each time you come back and click the box the text will still be there if you haven't posted it. At the end of 24 hours you can click post. Hope that makes sense! I do it often when I am replying to someone and get called away or need to do research. 

 

You need to stabilise before starting to taper, your nervous system is very unstable . When you are stable you can start to taper slowly.  Stick with the doses you are taking to stabilise, same dose, same time every day. @Shep is our benzo expert and will advise if the doses need adjusting or seperating from each other.  Please don't change anything else until she has looked at them. She will ask you topost in the benzo forum here. https://www.survivingantidepressants.org/forum/29-benzo-tapering-and-recovery/

You also need to put the drugs into the interactions checker at www.drugs.com and post the results here.   

 

These links will take you to topics that will explain withdrawal. 

Rhi's explanation 

https://www.survivingantidepressants.org/topic/603-what-is-withdrawal-syndrome/?do=findComment&comment=88441

 

What is withdrawal syndrome. Withdrawal includes adverse effects and interactions, all of which lead to autonomic instability.

https://www.survivingantidepressants.org/topic/603-what-is-withdrawal-syndrome/

 

While you are stabilising you will experience windows and waves, which is a pattern of healing. It can be quite scary until you recognise what is happening. 

https://www.survivingantidepressants.org/topic/82-the-windows-and-waves-pattern-of-stabilization/



 

 


Thank you so much for the thoughtful and lengthy response, @mammap!

I will start logging my symptoms journal as suggested. Here is a list of the interactions from drugs.com:
https://www.drugs.com/interactions-check.php?drug_list=2228-0,703-357,1013-565

Seems scary that there's a major interaction between Trazodone and Lexapro that could result in seratonin syndrome! 

I'm eager to start the taper process but understand the wisdom of waiting to stabilize before moving on. The only issue is that because I do believe some of these symptoms to be side effects, it's difficult to distinguish what's coming from withdrawal and what isn't. The only symptoms I can really identify as being almost certainly withdrawal related are my morning RLS/akathisia and morning anxiety. I also believe the hair loss could be withdrawal-related because that's also a more recent development, though it doesn't seem like a very common withdrawal symptom. I suppose my question would be: what does CNS stabilization look like?


@Shep I look forward to hearing from you. From everything I've read here so far, it seems like the Klonopin will be the last thing that I'm reducing from my cocktail. I'm fortunate that I haven't had issues withdrawing from periods of relatively heavy benzo use in the past, but also understand my recent polydrugging/CT history could seriously affect future attempts at discontinuation. I am, however, concerned that my dependence will increase with further use, despite being at "only" a .25 mg dose nightly.

I'm so frustrated that I'll be looking at a long journey ahead, and seriously concerned about my ability to work and possibly go back to school while facing this taper - my wife and I will be facing dire financial straits soon if I'm unable to work. I hate to victimize myself, but I'm so upset at how this allegedly "highly regarded" psychiatrist treated my brain and CNS. Like many others here, I'm sure, I was never warned of withdrawal effects. When I was CT'd off Latuda and had my Lexapro dose halved, when I started to feel the insane levels of anxiety, her response was to "go to the hospital immediately," as it was likely a rebound effect - she never suggested it could be from the dose reductions or to reinstate. I now realize it was, in all likelihood, withdrawal.

Well, every long journey begins with a single step. Thanks for your help... I suppose we'll all make it together.

2017: Started Effexor, CT'd by p-doc after two months with brutal withdrawal for a month. Was on 1-2 mg of Xanax a day from Jan-March, CT'd with no withdrawal. Brief stint on Cymbalta 60mg, started Abilify 2mg. Switched to Lexapro 10mg, CT'd from Cymbalta by p-doc. Started Trazadone 50 mg for sleep.

2018: Lexapro bumped to 20 mg, added Latuda 20 mg, worked up to 40 mg, and eventually back down to 10 with a rapid taper then CT'd. Xanax .5 nightly for sleep. Lexapro reduced to 10 mg. Was hospitalized after the Lexapro reduction/Latuda CT. Placed on Lamictal briefly, developed the rash and CT'd. CT'd Abilify. Switched to Klonopin .5 mg for sleep.
July 2018 - Reduced Trazadone to 25 mg, Klonopin to .25 mg. Current dosages: Lexapro 10mg, Trazadone 25mg, Klonopin .25 mg.

August - Starting a proper taper schedule to get off everything.

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  • Moderator Emeritus

Doctors don't have a clue! I was very sick when I used the checker and discovered that my drugs should never have been prescribed together.   Do you take trazodone and lexapro at the same time of day?   There are also interactions with clonazepam and trazodone, do you take those together at night? And clonazepam and lexapro too.  While we are waiting for Shep, maybe you could start a topic in the benzo forum and I will let her know. 

https://www.survivingantidepressants.org/forum/29-benzo-tapering-and-recovery/

Edited by mammaP

**I am not a medical professional, if in doubt please consult a doctor with withdrawal knowledge.

 

 

Different drugs occasionally (mostly benzos) 1976 - 1981 (no problem)

1993 - 2002 in and out of hospital. every type of drug + ECT. Staring with seroxat

2002  effexor. 

Tapered  March 2012 to March 2013, ending with 5 beads.

Withdrawal April 2013 . Reinstated 5 beads reduced to 4 beads May 2013

Restarted taper  Nov 2013  

OFF EFFEXOR Feb 2015    :D 

Tapered atenolol and omeprazole Dec 2013 - May 2014

 

Tapering tramadol, Feb 2015 100mg , March 2015 50mg  

 July 2017 30mg.  May 15 2018 25mg

Taking fish oil, magnesium, B12, folic acid, bilberry eyebright for eye pressure. 

 

My story http://survivingantidepressants.org/index.php?/topic/4199-hello-mammap-checking-in/page-33

 

Lesson learned, slow down taper at lower doses. Taper no more than 10% of CURRENT dose if possible

 

 

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6 hours ago, thesureshot said:

Well, every long journey begins with a single step. Thanks for your help... I suppose we'll all make it together.

Yes we are all in this together. :)

**I am not a medical professional, if in doubt please consult a doctor with withdrawal knowledge.

 

 

Different drugs occasionally (mostly benzos) 1976 - 1981 (no problem)

1993 - 2002 in and out of hospital. every type of drug + ECT. Staring with seroxat

2002  effexor. 

Tapered  March 2012 to March 2013, ending with 5 beads.

Withdrawal April 2013 . Reinstated 5 beads reduced to 4 beads May 2013

Restarted taper  Nov 2013  

OFF EFFEXOR Feb 2015    :D 

Tapered atenolol and omeprazole Dec 2013 - May 2014

 

Tapering tramadol, Feb 2015 100mg , March 2015 50mg  

 July 2017 30mg.  May 15 2018 25mg

Taking fish oil, magnesium, B12, folic acid, bilberry eyebright for eye pressure. 

 

My story http://survivingantidepressants.org/index.php?/topic/4199-hello-mammap-checking-in/page-33

 

Lesson learned, slow down taper at lower doses. Taper no more than 10% of CURRENT dose if possible

 

 

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23 minutes ago, mammaP said:

Doctors don't have a clue! I was very sick when I used the checker and discovered that my drugs should never have been prescribed together.   Do you take trazodone and lexapro at the same time of day?   There are also interactions with clonazepam and trazodone, do you take those together at night? And clonazepam and lexapro too.  While we are waiting for Shep, maybe you could start a topic in the benzo forum and I will let her know. 

https://www.survivingantidepressants.org/forum/29-benzo-tapering-and-recovery/


Just so happened to be updating my journal when you posted this -- thanks so much again for the reply! So sorry you had such a bad experience with your prescriptions as well! Indeed, doctors in my experience have been pretty clueless -- prescription dart-throwing at best.

With regards to your questions, I take the Lexapro in the morning and the Trazodone and Klonopin together at night. Fortunately, the interactions look like they have more to do with waking function, and I usually pass out shortly after taking them. Going to try to stay off the forum tonight and hang out with my wife and not obsess over my symptoms (which has become quite the pastime these last few days since discovering this site!) but I'll be sure to post an intro in the benzo forum tomorrow.

Again, just wanted to ask -- what would you consider "stabilized?" Though I'm eager to get started, I do want to get this process right and have no issues holding for a few more weeks if need be, but I'm not sure if I'm in the midst of withdrawal from recent dose reductions and discontinuations or dealing with adverse side-effects from my current cocktail. I suppose my diary will help clear some of that up.

 

20 minutes ago, mammaP said:

Yes we are all in this together. :)


I take such great solace in this, thank you so much. I'd cry, but the Lexapro has made that physiological function impossible.

2017: Started Effexor, CT'd by p-doc after two months with brutal withdrawal for a month. Was on 1-2 mg of Xanax a day from Jan-March, CT'd with no withdrawal. Brief stint on Cymbalta 60mg, started Abilify 2mg. Switched to Lexapro 10mg, CT'd from Cymbalta by p-doc. Started Trazadone 50 mg for sleep.

2018: Lexapro bumped to 20 mg, added Latuda 20 mg, worked up to 40 mg, and eventually back down to 10 with a rapid taper then CT'd. Xanax .5 nightly for sleep. Lexapro reduced to 10 mg. Was hospitalized after the Lexapro reduction/Latuda CT. Placed on Lamictal briefly, developed the rash and CT'd. CT'd Abilify. Switched to Klonopin .5 mg for sleep.
July 2018 - Reduced Trazadone to 25 mg, Klonopin to .25 mg. Current dosages: Lexapro 10mg, Trazadone 25mg, Klonopin .25 mg.

August - Starting a proper taper schedule to get off everything.

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  • Administrator

Welcome, TSS.

 

As mammaP so wisely suggested, please keep notes of your symptoms so we may determine whether your symptoms are side effects from particular drugs. Do not change the dosage of anything while we figure this out.

 

Many people do better with fish oil and magnesium supplements, see
http://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

http://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

A lot of people find them helpful. The magnesium in particular can help with so-called "restless legs," another over-diagnosed condition. Try a little bit of one at a time to see how it affects you.

 

Are you still seeing the psychiatrist who prescribed all these drugs for you? The diagnosis of bipolar II is, of course, ludicrous.

 

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Just now, Altostrata said:

Welcome, TSS.

 

As mammaP so wisely suggested, please keep notes of your symptoms so we may determine whether your symptoms are side effects from particular drugs. Do not change the dosage of anything while we figure this out.

 

Many people do better with fish oil and magnesium supplements, see
http://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

http://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

A lot of people find them helpful. The magnesium in particular can help with so-called "restless legs," another over-diagnosed condition. Try a little bit of one at a time to see how it affects you.

 

Are you still seeing the psychiatrist who prescribed all these drugs for you? The diagnosis of bipolar II is, of course, ludicrous.

 


Thanks so much for the kind welcome, @Altostrata! I certainly will hold steady on my current dosages until we gain a little more clarity.

Thanks also for the recommendations on the fish oil and magnesium. I currently already take fish oil as part of my daily vitamin regimen, but also just ordered some magnesium glycinate from Amazon which should arrive Saturday. For what it's worth, I've also ordered some CBD oil to experiment with my morning anxiety -- but will likely hold off on using that until my symptom pattern is more well-established here. It's been very helpful for my anxiety in the past.

I RAN from my old psychiatrist after my stay in the hospital in June, and currently have a new one who came recommended from my therapist (who has been awesome and supportive of my decision to come off meds). Unfortunately, my new p-doc's recommended taper schedule would lead me to believe that she doesn't have much experience in this area. However, she's receptive to the idea that I prefer to go with a much more conservative approach.  I also have an appointment with my GP, who I highly trust (and incidentally was the only person who ever warned me about these meds) next week to get her opinion.

Thanks again so much for stopping by and replying here -- been reading your a lot of your introductory posts and find them all very informative. I truly appreciate all of the hard work and dedication of the mods here!

2017: Started Effexor, CT'd by p-doc after two months with brutal withdrawal for a month. Was on 1-2 mg of Xanax a day from Jan-March, CT'd with no withdrawal. Brief stint on Cymbalta 60mg, started Abilify 2mg. Switched to Lexapro 10mg, CT'd from Cymbalta by p-doc. Started Trazadone 50 mg for sleep.

2018: Lexapro bumped to 20 mg, added Latuda 20 mg, worked up to 40 mg, and eventually back down to 10 with a rapid taper then CT'd. Xanax .5 nightly for sleep. Lexapro reduced to 10 mg. Was hospitalized after the Lexapro reduction/Latuda CT. Placed on Lamictal briefly, developed the rash and CT'd. CT'd Abilify. Switched to Klonopin .5 mg for sleep.
July 2018 - Reduced Trazadone to 25 mg, Klonopin to .25 mg. Current dosages: Lexapro 10mg, Trazadone 25mg, Klonopin .25 mg.

August - Starting a proper taper schedule to get off everything.

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  • Administrator

You're welcome.

 

Very few doctors know anything about tapering. Sounds like you have two who are at least supportive, good work.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • Moderator Emeritus
21 hours ago, thesureshot said:

@Shep I look forward to hearing from you. From everything I've read here so far, it seems like the Klonopin will be the last thing that I'm reducing from my cocktail.

 

Hi, Sureshot. Welcome to SA from me, too. 

 

Yes, it's likely that Klonopin will be the last to go. You sound like you've already done some reading and may have already seen this thread, but just to be sure, this is a great thread on knowing which drug to taper first:

 

Taking multiple psych drugs? Which drug to taper first?

 

21 hours ago, thesureshot said:

I'm fortunate that I haven't had issues withdrawing from periods of relatively heavy benzo use in the past, but also understand my recent polydrugging/CT history could seriously affect future attempts at discontinuation.

 

Yes, this is quite possible. There's a great thread that explains "kindling":

 

Limbic Kindling -- Hardwiring the brain for hypersensitivity

 

Benzos seem to be especially problematic when it comes to kindling and many people find that even though they've been able to withdrawal from them easily in the past, each time it gets more difficult. And this is due to kindling. 

 

21 hours ago, thesureshot said:

I am, however, concerned that my dependence will increase with further use, despite being at "only" a .25 mg dose nightly.

 

Not necessarily. There are a lot of urban myths involving benzos and tolerance. Some threads that may help unpack this concept:

 

"Benzo Tolerance withdrawal" during tapering -- does it exist?

 

Ashton and beyond in benzo tapering

 

Benzos are effective for about 2 - 4 weeks, and then the only reason we keep taking them is to stave off withdrawal. So you have to weigh the problems of the drug not working against the symptoms of withdrawal. Many people find that the symptoms of withdrawal (especially insomnia) make it a poor choice to taper first, and they prefer to come off the stimulating drugs first. As you see in the above link on "Taking multiple psych drugs? Which drug to taper first?" thread, maintaining sleep is the number one priority. 

 

Some more information on psych drug withdrawal: 

 

Why taper by 10% of my dosage?
The general philosophy of gradual tapering

 

Micro-taper instead of 10% or 5% decreases
Decreasing your dosage by very tiny amounts more often might be more tolerable than 5% or 10% decreases. Know your symptom pattern first so you can estimate how often you can reduce.

 

The Brassmonkey Slide Method of Micro-tapering

One way you can micro-taper.

 

How psychiatric drugs remodel your brain

 

What is happening in your brain?

 

Please keep and drug and symptoms journal in this format:

 

Drug and symptoms journal format

 

As you post your drug and symptoms journal over the coming days, we'll be better able to advise you. One thing to look out for is inter-dose withdrawal from the Klonopin (meaning you're getting break-through symptoms of withdrawal due to Klonopin's half life). The half-life of Klonopin is 18 - 50 hours, so some people do go into withdrawal in between doses and other people don't, depending on how quickly you are metabolizing it. 

 

The drug and symptom journal will let you see if you are getting these types of withdrawal symptoms. 

 

As you are doing your drug and symptoms journal over the coming days, please have a read of all of the links provided, explore the site, and let us know if you have any questions. 

 

 

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7:30 - Wake up, uncontrollable leg twitching/movement, moderate anxiety
8:30 - Leg twitching subsides

8:45 - Out of bed, take Lexapro 10 mg 

9:45 - An hour after Lexapro, still feeling some anxiety but not as severe as upon waking
10:00 - Oatmeal & 2 Eggs with seltzer

10-1 - Little anxiety, extreme lethargy/apathy, intermittent foot twitching
1:15 - Lunch of 2 crabcakes with roasted potatoes
2:30 - Noticed I've been clenching my jaw a lot today
4:00 - 3 mile walk
5:00 - Feel very lethargic/anhedonic
7:00 - Dinner - cheeseburger and broccoli
10:30 - Take Trazodone, Klonopin, Melatonin 3mg
11:00 - Sleep

2017: Started Effexor, CT'd by p-doc after two months with brutal withdrawal for a month. Was on 1-2 mg of Xanax a day from Jan-March, CT'd with no withdrawal. Brief stint on Cymbalta 60mg, started Abilify 2mg. Switched to Lexapro 10mg, CT'd from Cymbalta by p-doc. Started Trazadone 50 mg for sleep.

2018: Lexapro bumped to 20 mg, added Latuda 20 mg, worked up to 40 mg, and eventually back down to 10 with a rapid taper then CT'd. Xanax .5 nightly for sleep. Lexapro reduced to 10 mg. Was hospitalized after the Lexapro reduction/Latuda CT. Placed on Lamictal briefly, developed the rash and CT'd. CT'd Abilify. Switched to Klonopin .5 mg for sleep.
July 2018 - Reduced Trazadone to 25 mg, Klonopin to .25 mg. Current dosages: Lexapro 10mg, Trazadone 25mg, Klonopin .25 mg.

August - Starting a proper taper schedule to get off everything.

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57 minutes ago, Shep said:

 

Hi, Sureshot. Welcome to SA from me, too. 

 

Yes, it's likely that Klonopin will be the last to go. You sound like you've already done some reading and may have already seen this thread, but just to be sure, this is a great thread on knowing which drug to taper first:

 

Taking multiple psych drugs? Which drug to taper first?

 

 

Yes, this is quite possible. There's a great thread that explains "kindling":

 

Limbic Kindling -- Hardwiring the brain for hypersensitivity

 

Benzos seem to be especially problematic when it comes to kindling and many people find that even though they've been able to withdrawal from them easily in the past, each time it gets more difficult. And this is due to kindling. 

 

 

Not necessarily. There are a lot of urban myths involving benzos and tolerance. Some threads that may help unpack this concept:

 

"Benzo Tolerance withdrawal" during tapering -- does it exist?

 

Ashton and beyond in benzo tapering

 

Benzos are effective for about 2 - 4 weeks, and then the only reason we keep taking them is to stave off withdrawal. So you have to weigh the problems of the drug not working against the symptoms of withdrawal. Many people find that the symptoms of withdrawal (especially insomnia) make it a poor choice to taper first, and they prefer to come off the stimulating drugs first. As you see in the above link on "Taking multiple psych drugs? Which drug to taper first?" thread, maintaining sleep is the number one priority. 

 

Some more information on psych drug withdrawal: 

 

Why taper by 10% of my dosage?
The general philosophy of gradual tapering

 

Micro-taper instead of 10% or 5% decreases
Decreasing your dosage by very tiny amounts more often might be more tolerable than 5% or 10% decreases. Know your symptom pattern first so you can estimate how often you can reduce.

 

The Brassmonkey Slide Method of Micro-tapering

One way you can micro-taper.

 

How psychiatric drugs remodel your brain

 

What is happening in your brain?

 

Please keep and drug and symptoms journal in this format:

 

Drug and symptoms journal format

 

As you post your drug and symptoms journal over the coming days, we'll be better able to advise you. One thing to look out for is inter-dose withdrawal from the Klonopin (meaning you're getting break-through symptoms of withdrawal due to Klonopin's half life). The half-life of Klonopin is 18 - 50 hours, so some people do go into withdrawal in between doses and other people don't, depending on how quickly you are metabolizing it. 

 

The drug and symptom journal will let you see if you are getting these types of withdrawal symptoms. 

 

As you are doing your drug and symptoms journal over the coming days, please have a read of all of the links provided, explore the site, and let us know if you have any questions. 


Thanks for the welcome @Shep and all of the helpful information! About to head out for the day with the wife, but will read up on these links and keep my journal going.

2017: Started Effexor, CT'd by p-doc after two months with brutal withdrawal for a month. Was on 1-2 mg of Xanax a day from Jan-March, CT'd with no withdrawal. Brief stint on Cymbalta 60mg, started Abilify 2mg. Switched to Lexapro 10mg, CT'd from Cymbalta by p-doc. Started Trazadone 50 mg for sleep.

2018: Lexapro bumped to 20 mg, added Latuda 20 mg, worked up to 40 mg, and eventually back down to 10 with a rapid taper then CT'd. Xanax .5 nightly for sleep. Lexapro reduced to 10 mg. Was hospitalized after the Lexapro reduction/Latuda CT. Placed on Lamictal briefly, developed the rash and CT'd. CT'd Abilify. Switched to Klonopin .5 mg for sleep.
July 2018 - Reduced Trazadone to 25 mg, Klonopin to .25 mg. Current dosages: Lexapro 10mg, Trazadone 25mg, Klonopin .25 mg.

August - Starting a proper taper schedule to get off everything.

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7/27

6:00 - Wake up, leg/foot twitching, moderate anxiety

6-8:00 - Try to fall back asleep fruitlessly
8:30 - Out of bed, breakfast of almonds and watermelon, twitching subsides, post update to thread
9:00 - Take Lexapro 10 mg

9:30 - Allergy shots

10:30 - Head to in-laws with wife, pool time!

10:30-4:00 - Watch nieces and nephews, relax by the pool, little-to-no anxiety

12:30 - Lunch of tuna salad on scooped everything bagel

4:00- 4:45 - Short Nap

5:00 - 6:30 - More pool time, a little lethargic (probably nap-related)

7:30 - Dinner of grilled burger and hot dog with some potato chips, 2 beers

10:45 - take .25 mg Klonopin, 25 mg Trazodone, 3 mg Melatonin
11:30 - Sleep

2017: Started Effexor, CT'd by p-doc after two months with brutal withdrawal for a month. Was on 1-2 mg of Xanax a day from Jan-March, CT'd with no withdrawal. Brief stint on Cymbalta 60mg, started Abilify 2mg. Switched to Lexapro 10mg, CT'd from Cymbalta by p-doc. Started Trazadone 50 mg for sleep.

2018: Lexapro bumped to 20 mg, added Latuda 20 mg, worked up to 40 mg, and eventually back down to 10 with a rapid taper then CT'd. Xanax .5 nightly for sleep. Lexapro reduced to 10 mg. Was hospitalized after the Lexapro reduction/Latuda CT. Placed on Lamictal briefly, developed the rash and CT'd. CT'd Abilify. Switched to Klonopin .5 mg for sleep.
July 2018 - Reduced Trazadone to 25 mg, Klonopin to .25 mg. Current dosages: Lexapro 10mg, Trazadone 25mg, Klonopin .25 mg.

August - Starting a proper taper schedule to get off everything.

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  • Moderator Emeritus
1 hour ago, thesureshot said:

7:30 - Dinner of grilled burger and hot dog with some potato chips, 2 beers

10:45 - take .25 mg Klonopin, 25 mg Trazodone, 3 mg Melatonin

 

Thanks for the journal, Sureshot.

 

I would avoid beer and any other form of alcohol until you are completely off these drugs. Alcohol and Klonopin act on the same GABA receptors. Dr. David Healy, a well-known expert in psychiatric drug withdrawal, refers to drugs like Klonopin as "alcohol in a pill". I've seen many people have setbacks from even small amounts of alcohol during withdrawal. Once you heal, you'll be able to get back into life as usual. For now, please nurture your nervous system. 

 

The 3 mg of Melatonin may be too high a dose, especially since you're taking it at the same time as the Klonopin and the Trazodone. By combining so many sedating drugs and supplements, you are stamping down hard on your nervous system. Your nervous system may fight back to stay alert, creating a paradoxical reaction. 

 

Please see:

 

Melatonin for sleep

 

How is your sleep? Do you sleep throughout the night or do you find yourself with any wake ups? Please include the number of hours you sleep in your journal. 

 

 

 

 

 

 

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2 minutes ago, Shep said:

 

Thanks for the journal, Sureshot.

 

I would avoid beer and any other form of alcohol until you are completely off these drugs. Alcohol and Klonopin act on the same GABA receptors. Dr. David Healy, a well-known expert in psychiatric drug withdrawal, refers to drugs like Klonopin as "alcohol in a pill". I've seen many people have setbacks from even small amounts of alcohol during withdrawal. Once you heal, you'll be able to get back into life as usual. For now, please nurture your nervous system. 

 

The 3 mg of Melatonin may be too high a dose, especially since you're taking it at the same time as the Klonopin and the Trazodone. By combining so many sedating drugs and supplements, you are stamping down hard on your nervous system. Your nervous system may fight back to stay alert, creating a paradoxical reaction. 

 

Please see:

 

Melatonin for sleep

 

How is your sleep? Do you sleep throughout the night or do you find yourself with any wake ups? Please include the number of hours you sleep in your journal. 

 

 

 

 


Thanks for the recommendations, @Shep. My alcohol consumption is very limited and I'll continue to keep it that way -- those will likely be my only drinks for the next few weeks, and I rarely, if ever, drink to the point of intoxication. I wasn't aware that such little consumption could be a hinderance to recovery, but if I find it ever interfering, I'll happily cut it out completely. As for last night/this morning, I can't say it really made a difference either way.

As for the melatonin/sleep -- I tend to wake up once or twice during the night to urinate/get water, but other than that, I generally sleep well. I'll be sure to add the number of hours of sleep I get going forward. I'll also experiment with perhaps halving the melatonin dose. I've had severe insomnia issues in the past, so I'm hesitant to mess with what's working at the moment. That said, my doctor did suggest maybe switching out the melatonin for benadryl at one point -- any thoughts there?

2017: Started Effexor, CT'd by p-doc after two months with brutal withdrawal for a month. Was on 1-2 mg of Xanax a day from Jan-March, CT'd with no withdrawal. Brief stint on Cymbalta 60mg, started Abilify 2mg. Switched to Lexapro 10mg, CT'd from Cymbalta by p-doc. Started Trazadone 50 mg for sleep.

2018: Lexapro bumped to 20 mg, added Latuda 20 mg, worked up to 40 mg, and eventually back down to 10 with a rapid taper then CT'd. Xanax .5 nightly for sleep. Lexapro reduced to 10 mg. Was hospitalized after the Lexapro reduction/Latuda CT. Placed on Lamictal briefly, developed the rash and CT'd. CT'd Abilify. Switched to Klonopin .5 mg for sleep.
July 2018 - Reduced Trazadone to 25 mg, Klonopin to .25 mg. Current dosages: Lexapro 10mg, Trazadone 25mg, Klonopin .25 mg.

August - Starting a proper taper schedule to get off everything.

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  • Moderator Emeritus
7 minutes ago, thesureshot said:

I've had severe insomnia issues in the past, so I'm hesitant to mess with what's working at the moment. That said, my doctor did suggest maybe switching out the melatonin for benadryl at one point -- any thoughts there?

 

Thanks for the additional information.

 

I understand not wanting to mess with what's working. The paradoxical reactions tend to happen more often to people who have destabilized nervous systems, so you may be in a place where that's not happening. If you feel things change, you may want to decrease the melatonin and see if "less is more" so to speak. 

 

Benadryl is not advised during withdrawal. There are actually connections between Benedryl and the SSRI. As Alto writes in one of her posts in the thread below, "The SSRIs evolved from antihistamines."

 

Antihistamines for withdrawal insomnia (diphenhydramine, doxylamine, hydroxyzine)

 

Melatonin is a much safer choice during withdrawal than Benadryl. 

 

You may benefit from doing gentle yoga, mindfulness, guided meditations, etc. to calm your mind/body in the evenings before bed. Here's a thread with a wealth of information on these types of non-drug techniques:

 

Non-drug techniques to cope with emotional symptoms

 

It will be good to get started finding ways of calming that you find interesting and will stick with. This will prepare you for handling waves during withdrawal and make your overall journey much easier. 

 

 

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16 minutes ago, Shep said:

 

Thanks for the additional information.

 

I understand not wanting to mess with what's working. The paradoxical reactions tend to happen more often to people who have destabilized nervous systems, so you may be in a place where that's not happening. If you feel things change, you may want to decrease the melatonin and see if "less is more" so to speak. 

 

Benadryl is not advised during withdrawal. There are actually connections between Benedryl and the SSRI. As Alto writes in one of her posts in the thread below, "The SSRIs evolved from antihistamines."

 

Antihistamines for withdrawal insomnia (diphenhydramine, doxylamine, hydroxyzine)

 

Melatonin is a much safer choice during withdrawal than Benadryl. 

 

You may benefit from doing gentle yoga, mindfulness, guided meditations, etc. to calm your mind/body in the evenings before bed. Here's a thread with a wealth of information on these types of non-drug techniques:

 

Non-drug techniques to cope with emotional symptoms

 

It will be good to get started finding ways of calming that you find interesting and will stick with. This will prepare you for handling waves during withdrawal and make your overall journey much easier. 


Thanks for the recos - I'll stick with the melatonin, and try reducing the dose, probably after this bottle runs out. Had no idea that SSRI's developed from antihistamines - FWIW, I'm usually on Allegra daily during the spring and the fall for seasonal allergies (and as-needed during high-pollen summer days or if I'm visiting a home with dogs or cats). I'm currently getting allergy shots (approximately one year into it) so within a couple of years hopefully there will be no need for any allergy meds!

Thanks also for the thread on non-drug techniques for coping with emotional symptoms -- will absolutely look into this and start developing some skills to help. 

2017: Started Effexor, CT'd by p-doc after two months with brutal withdrawal for a month. Was on 1-2 mg of Xanax a day from Jan-March, CT'd with no withdrawal. Brief stint on Cymbalta 60mg, started Abilify 2mg. Switched to Lexapro 10mg, CT'd from Cymbalta by p-doc. Started Trazadone 50 mg for sleep.

2018: Lexapro bumped to 20 mg, added Latuda 20 mg, worked up to 40 mg, and eventually back down to 10 with a rapid taper then CT'd. Xanax .5 nightly for sleep. Lexapro reduced to 10 mg. Was hospitalized after the Lexapro reduction/Latuda CT. Placed on Lamictal briefly, developed the rash and CT'd. CT'd Abilify. Switched to Klonopin .5 mg for sleep.
July 2018 - Reduced Trazadone to 25 mg, Klonopin to .25 mg. Current dosages: Lexapro 10mg, Trazadone 25mg, Klonopin .25 mg.

August - Starting a proper taper schedule to get off everything.

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  • Administrator
2 hours ago, thesureshot said:

10:45 - take .25 mg Klonopin, 25 mg Trazodone, 3 mg Melatonin

 

Hello, TSS. Why are you taking these 3 brakes at the same time? Which did you start first? When did you add melatonin? What effect did it have?

 

When you said you had problems with insomnia before, when was that and what was your sleep pattern?

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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1 hour ago, Altostrata said:

 

Hello, TSS. Why are you taking these 3 brakes at the same time? Which did you start first? When did you add melatonin? What effect did it have?

 

When you said you had problems with insomnia before, when was that and what was your sleep pattern?

 

Hi Alto,

 

I started with the melatonin first actually, which I was taking along with Benadryl as needed prior to psych meds. The Trazodone was added last summer, and the Xanax/Klonopin as of March. As to why all three, this was recommended by my previous psychiatrist.

 

My prior insomnia issues (before psych meds) were with falling asleep. Once I got to sleep, 7-9 hours wasn’t an issue, unless of course I needed to be up earlier for work. It wasn’t uncommon to operate on many days on less than 4 hours of sleep and catch up on sleep debt the following night(s). When I fell into my depression, I overslept - in the months following my breakdown, 12-16 hours of sleep a day weren’t uncommon. 

 

On psych meds, the insomnia issues became exacerbated I believe when I went on Abilify. I suddenly couldn’t fall of to sleep at all, and had trouble staying asleep. Shortly thereafter, Trazodone was added. 

 

Hope this helps clarify.

2017: Started Effexor, CT'd by p-doc after two months with brutal withdrawal for a month. Was on 1-2 mg of Xanax a day from Jan-March, CT'd with no withdrawal. Brief stint on Cymbalta 60mg, started Abilify 2mg. Switched to Lexapro 10mg, CT'd from Cymbalta by p-doc. Started Trazadone 50 mg for sleep.

2018: Lexapro bumped to 20 mg, added Latuda 20 mg, worked up to 40 mg, and eventually back down to 10 with a rapid taper then CT'd. Xanax .5 nightly for sleep. Lexapro reduced to 10 mg. Was hospitalized after the Lexapro reduction/Latuda CT. Placed on Lamictal briefly, developed the rash and CT'd. CT'd Abilify. Switched to Klonopin .5 mg for sleep.
July 2018 - Reduced Trazadone to 25 mg, Klonopin to .25 mg. Current dosages: Lexapro 10mg, Trazadone 25mg, Klonopin .25 mg.

August - Starting a proper taper schedule to get off everything.

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7/28


7:30 - Wake up, moderate anxiety, restless legs (but much reduced intensity)
8:00 - Fall back asleep! (Hasn't happened since the RLS/akathisia started 
9:30 - Wake up again, take 10 mg Lexapro, moderate anxiety (slept total 9 hours)

10:00 - Breakfast, seltzer, watermelon, almonds, cheese

11:00 - Anxiety subsides, read for an hour

12:30 - Lunch, avocado, walnuts, watermelon

3:00 - Spike in anxiety seemingly without rhyme or reason, lasts approximately an hour

5:00 - Movies - split a soda and popcorn

7:30 - Minor depressive wave, lasted about an hour

8:15 - Hummus and carrots

10:15 - Take Trazodone 25 mg, Klonopin .25 mg, melatonin 3 mg
10:30 - asleep

2017: Started Effexor, CT'd by p-doc after two months with brutal withdrawal for a month. Was on 1-2 mg of Xanax a day from Jan-March, CT'd with no withdrawal. Brief stint on Cymbalta 60mg, started Abilify 2mg. Switched to Lexapro 10mg, CT'd from Cymbalta by p-doc. Started Trazadone 50 mg for sleep.

2018: Lexapro bumped to 20 mg, added Latuda 20 mg, worked up to 40 mg, and eventually back down to 10 with a rapid taper then CT'd. Xanax .5 nightly for sleep. Lexapro reduced to 10 mg. Was hospitalized after the Lexapro reduction/Latuda CT. Placed on Lamictal briefly, developed the rash and CT'd. CT'd Abilify. Switched to Klonopin .5 mg for sleep.
July 2018 - Reduced Trazadone to 25 mg, Klonopin to .25 mg. Current dosages: Lexapro 10mg, Trazadone 25mg, Klonopin .25 mg.

August - Starting a proper taper schedule to get off everything.

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  • 6 months later...
  • Moderator Emeritus

Hi thesureshot, 

 

How are you doing?💚

Seroquel. 2019:➡️ From 7.25mg to 5.80mg✔️ 2020➡️From 5.60 to 4.80✔️ 2021➡️From 4.60 to 4.0✔️ 2022➡️From 3.95 to 3.55✔️2023➡️ Jan 26=3.50✔️March 17=3.45✔️ June12=3.40✔️ July30=3.35✔️ Sep14=3.30✔️ Oct31=3.25✔️
2024➡️Jan15=3.20✔️ Feb19=3.15✔️ March26=3.10✔️This is NOT medical advice.Consult your doctor.

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