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SeptGirl: Zoloft taper

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SeptGirl

I’ll try it!  Being such a low dose shouldn’t give nasty side effects either like nausea...which is the LAST thing I need !! Thanks again.

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SeptGirl

After three days on 0.5mg of Celexa, I feel worse.  My symptoms have increased exponentially.  Increased blood pressure and heart rate, more nauseated, stomach distress, dizziness, jelly legs, increased anxiety, extended areas of paresthesia, and less sleep.  I think this experiment has failed.  If I feel worse three days in, chances are my symptoms won’t improve with continued low dose or increased in dose.  Any suggestions or comments are certainly welcome.  I’ve been off Celexa five months and off Zoloft more than two months.  Still on Alprazolam 2.50mg/day.  

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Altostrata

That doesn't sound good. What is your daily symptom pattern, with your drugs and their dosages?

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SeptGirl

No matter what time I go to bed, I’m awake between 4:30 and 5:00 a.m. every day. (I’ve had normal cortisol testing).  Once I’m awake, there’s no hope of falling asleep again.  My heart rate is in the high 80’s and my blood pressure is usually in the mid 150’s/high 80’s as soon I settle on the sofa. Morning anxiety is terrible!! I NEVER had BP issues prior to Celexa/Zoloft change/discontinuation. I work on an anxiety app...setting daily goals, mindfulness, meditation, deep breathing exercises, etc.  I wake up nauseated, anxious, dizzy, tinnitus, stressed, stomach pain, no appetite and paresthesia.  EVERY.SINGLE.DAY.  I eat yogurt and a banana between 7:00 and 8:00 a.m. I take my first dose of Alprazolam .75mg at 8:00 a.m. That actually doesn’t relieve my anxiety anymore but I am tapering. Late morning I usually take a half mile walk with my husband.  I’m dizzy and off balance walking.  I stopped driving because I’m so dizzy. I take levothyroxine .05mcg at 11:30 a.m.  NOTE: ER visit because of symptoms on 10/27/18.  My TSH was 1.83 and all  blood work, X-rays, CT scan in ER were all normal.  Lunch is a small sandwich at 12:30 p.m.  Second dose of Alprazolam at 2:00 p.m. is .75mg. Symptoms are still the same.  I have a cracker snack and high protein/vitamin/mineral drink at 3:30 p.m.  Blood pressure and heart rate “usually” go lower late afternoon.  Small dinner at 6:30-7:00 p.m.  Some evenings the symptoms aren’t as severe. Third Alprazolam dose .05mg at 8:00 p.m. Final dose of Alprazolam .50mg is at 1:30 a.m.  I’m usually still awake but set my alarm in case I fall asleep.  Recap: 2.50mg/day Alprazolam dosed every six hours (except between 1:30 a.m and 8:00 a.m. which is 6.5 hours)  and levothyroxine .05mcg daily.  No other supplements.  It’s maddening.  I’ve lost 30 pounds in four months. Thanks for your response. 

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SeptGirl

UPDATE: I called my primary care doctor.  I told him what’s been going on with the psychiatrist and my thought/research this could be discontinuation syndrome and not just “anxiety”.  Both docs believe there is discontinuation syndrome but not convinced it would persist this long.  I’ve been off Celexa for five months; off Zoloft for two months.  However, primary doc thinks trying 5mg of Celexa is a good idea. I had previously mentioned going back on 5mg of Celexa to the psychiatrist.  He said 5mg wouldn’t be therapeutic; maybe a 10mg dose.  I’m not looking for therapeutic...I’m looking for relief!!!  The psychiatrist theory is the cross over in June from Celexa 30mg to Zoloft 25mg/50mg wasn’t adequate. The Zoloft dose should have been 100mg.  In the meantime, as suggested here, I tried 0.5mg of Celexa for a few days and felt worse.  These debilitating symptoms didn’t start until the ADs were switched.  I thought I was having a bad reaction to Zoloft when all along it could have been discontinuation from Celexa.  Should I try the 5mg and feel crappier than I do now?  Will I screw my brain up even more?  Will there be permanent damage?  Should I try to heal without psych drugs???  I need to do something.  I can’t take it anymore!  Thanks again. 

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Shep

Please see: 

 

About reinstating and stabilizing to reduce withdrawal symptoms

 

On 10/8/2012 at 7:17 PM, Altostrata said:

How long should you give reinstatement?

  • It takes at least 4 days for your body to fully register the addition of a neuroactive drug. Unless you have an immediate bad reaction, observe your symptom pattern for about a week to see if the reinstatement is helping. If you have an immediate bad reaction, reduce or stop taking the drug.
  • After reinstatement, the amount of time needed to alleviate withdrawal symptoms (stabilizing) varies according to the individual. Relief can be felt immediately, after some weeks, or after some months.
  • Once you feel withdrawal symptoms are reduced after reinstatement, give your nervous system time to stabilize before attempting dosage reduction. Think in terms of months, not days.
  • Be patient after you reinstate. Reinstatement may not immediately eliminate all withdrawal symptoms. You may still experience waves of symptoms, which usually lessen as time goes on. Do not attempt to taper again until you feel symptom-free, or at least until your withdrawal symptoms are mild and tolerable.
  • The dose needed for effective reinstatement varies according to the individual.

 

 

19 hours ago, SeptGirl said:

After three days on 0.5mg of Celexa, I feel worse.  My symptoms have increased exponentially.  Increased blood pressure and heart rate, more nauseated, stomach distress, dizziness, jelly legs, increased anxiety, extended areas of paresthesia, and less sleep.

 

8 hours ago, SeptGirl said:

Should I try the 5mg and feel crappier than I do now?

 

 

If .5 mg of Celexa is too activating, 5 mg is likely to be much worse. 

 

 

On 10/2/2018 at 7:26 AM, SeptGirl said:

I’m reducing the Alprazolam dose .25mg every two weeks.  Tomorrow my dose will decrease to 3mg/day.

 

This quote is from your benzo thread from last month. Per your latest update, you are now down to 2.5 mg alprazolam. Please update your signature to include when you made reductions in the alprazolam. Some of your symptoms may be from benzo withdrawal, especially at rates this fast. 

 

Account - Settings - Create or Edit Your Signature

 

 

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SeptGirl

Hi.  I’ve been awake since 3:30 a.m trying to make this decision.  Despite what I felt may have been worsening symptoms at .5mg, I may have been overwhelmed with just the thought of reinstating.  I may have had increased anxiety due to starting a high protein drink with vitamins and minerals.  I noticed my sleep has been interrupted since starting them too. My nutrition has been poor so maybe that extra boost was too much?  As far as the Alprazolam, the dose reduction is under 10% every two weeks.  Do you consider that too fast?  I can slow the taper rate if needed.  The Alprazolam certainly isn’t as effective as it was before but I can’t just stop taking it without weaning. I’m very conflicted.  

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WiggleIt
8 hours ago, SeptGirl said:

UPDATE: I called my primary care doctor.  I told him what’s been going on with the psychiatrist and my thought/research this could be discontinuation syndrome and not just “anxiety”.  Both docs believe there is discontinuation syndrome but not convinced it would persist this long.  I’ve been off Celexa for five months; off Zoloft for two months.  However, primary doc thinks trying 5mg of Celexa is a good idea. I had previously mentioned going back on 5mg of Celexa to the psychiatrist.  He said 5mg wouldn’t be therapeutic; maybe a 10mg dose.  I’m not looking for therapeutic...I’m looking for relief!!!  The psychiatrist theory is the cross over in June from Celexa 30mg to Zoloft 25mg/50mg wasn’t adequate. The Zoloft dose should have been 100mg.  In the meantime, as suggested here, I tried 0.5mg of Celexa for a few days and felt worse.  These debilitating symptoms didn’t start until the ADs were switched.  I thought I was having a bad reaction to Zoloft when all along it could have been discontinuation from Celexa.  Should I try the 5mg and feel crappier than I do now?  Will I screw my brain up even more?  Will there be permanent damage?  Should I try to heal without psych drugs???  I need to do something.  I can’t take it anymore!  Thanks again. 


Dear SeptGirl,

I'm so sorry you are suffering.  I'm not an expert at giving tapering advice, because I did not benefit from a taper; therefore, please take my personal opinion that I am about to offer with a grain of salt: I don't think going UP on a dose sounds smart.  It also sounds to me as if you've had an immediate bad reaction to the reinstated 0.5 Celexa, so I'm not sure why you should stay on it, but the mods here know more than I do.  And as one mod said above, if you can't handle 0.5, then there's no way that 5 sounds like a good idea.  

Am I correct that you are currently on Xanax and currently on 0.5 Celexa, and that's it?

You're going to get better.  You are.  It might take a bit to figure out, but you'll get better.  So many people here have gotten better.  I got better, and I had a similar situation where I was switched from one AD to another, so I didn't know if I was having a bad reaction to the new AD or having withdrawal from the old AD.    

Also, your doctors are flat-out stupid.  There was a recent study published in a VERY credible medical source on a government medical website that PLAINLY shows that discontinuation syndrome can last for over a year.  If needed, print the link below and show this to your doctors.  This research is current, it proves what people here on SA and other psych med support groups have been trying to tell doctors for YEARS, and it's your doctors' faults if they are not up on this research:

https://www.ncbi.nlm.nih.gov/pubmed/30292574




 

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SeptGirl

Hi WiggleIt!  I stopped the .5mg of Celexa.  My current meds are 2.50mg/day (divided doses) of Alprazolam and .50mcg of levothyroxine for hypothyroidism.  Did you suffer from discontinuation syndrome?  If so, how long and what were your symptoms?  Did you reinstate?  Thanks! 

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WiggleIt

Hi SeptGirl!

Off topic: I have to ask... is your nickname based off of the Big Star song?  Or off of the Bangles cover of the Big Star song by any chance?

On topic: Yeah, my withdrawal syndrome (a.k.a. discontinuation syndrome) was unholy hell from top to bottom.  BUT!!!  The good news: I got better.  I never reinstated because I was too scared.  I figured better the devil I know, but I have seen people here reinstate successfully.  I actually just read someone's signature who did that very thing.  My whole history is in my signature.  My story's pretty intense, but I'll tell you this: my life is SO different now and so much better than it was four years ago when I was in acute WD.  So incredibly much better!  

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Shep
21 minutes ago, SeptGirl said:

 I may have had increased anxiety due to starting a high protein drink with vitamins and minerals.

 

Did you add this in since you reinstated the Celexa? Please see:

 

Supplements - what helps, what doesn't?

 

Right now, you need to simplify. 

 

The rule of 3KIS: Keep it simple. Keep it slow. Keep it stable.

 

At some point, once you not in the midst of making changes, you may want to consider fish oil and / or magnesium We don't recommend a lot of supplements, as many members report their nervous systems are simply too fragile to handle them. However, magnesium and fish oil tend to be calming to the nervous system and many people report they do help. Please only add in one supplement at a time and at a small dose. For more, please see:

 

King of supplements: Omega-3 fatty acids (fish oil)

 

Magnesium, nature's calcium channel blocker

 

22 minutes ago, SeptGirl said:

As far as the Alprazolam, the dose reduction is under 10% every two weeks.  Do you consider that too fast?

 

Yes, that's way too fast. Please see: 

 

Why taper by 10% of my dosage?

 

That's 10% every month, not every two weeks. And even that rate can be too fast, especially for people dealing with long term polypharmacy. 

 

Please see:

 

How psychiatric drugs remodel your brain

 

What is happening in your brain?

 

27 minutes ago, SeptGirl said:

can slow the taper rate if needed.  

 

Not slow it down - STOP tapering the benzo.

 

From your benzo thread: 

 

On 10/2/2018 at 8:09 AM, Shep said:

Please STOP tapering. You are setting yourself up for a severe withdrawal, SeptGirl.

 

On 11/3/2018 at 4:03 PM, Altostrata said:

Please consider stopping the benzo taper,

 

I also posted about that here in your main intro thread

 

After 10 years using Xanax, to come off this quickly is really setting yourself up for a severe withdrawal. It's possible that the AD crossover and discontinuation destabilized your nervous system and now it's exasperated by the rapid benzo taper. This is the danger in polypharmacy and why it's especially important to give your nervous system time to rest. 

 

Again, please update your signature to reflect when you made reductions in your benzo so moderators aren't having to read through your entire threads here and over in your benzo section. 

 

32 minutes ago, WiggleIt said:

You're going to get better.  You are.  It might take a bit to figure out, but you'll get better.  So many people here have gotten better.  I got better, and I had a similar situation where I was switched from one AD to another, so I didn't know if I was having a bad reaction to the new AD or having withdrawal from the old AD.    

 

Just now, WiggleIt said:

On topic: Yeah, my withdrawal syndrome (a.k.a. discontinuation syndrome) was unholy hell from top to bottom.  BUT!!!  The good news: I got better.

 

Thank you for adding your experience and encouragement, WiggleIt. This is so spot on. 

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SeptGirl

No my nickname is just because I was born in September and I’m female! I’m afraid to reinstate too but I don’t think I can live like this much longer.  I’m still considering it.  Your symptoms were much more harsh than mine.  I’m hoping to recover without reinstatement but every day living like this is killing me.

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SeptGirl

I don’t know how to reply to @Shep comments so I’ll answer here.  I started the protein drink a couple of days before I reinstated to .5mg of Celexa.  I’m not going to drink them anymore.  I am so nutritionally starved, my husband thought it would help me. I will try magnesium first.  How long before introducing the fish oil if I find magnesium is helpful?  I will stop the Alprazolam taper.  I see the psychiatrist on Monday.

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Shep
1 hour ago, SeptGirl said:

I will stop the Alprazolam taper.

 

This is good to read. Please update your signature to reflect the dates of your decreases.

 

Account - Settings - Create or Edit Your Signature

 

1 hour ago, SeptGirl said:

I will try magnesium first.  How long before introducing the fish oil if I find magnesium is helpful?  

 

Please yourself a week or more to see if you have any reactions before adding a new supplement. Please read the links to find the appropriate dose. Select a very low dose and then increase as you feel able. 

 

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Altostrata
22 hours ago, SeptGirl said:

My heart rate is in the high 80’s and my blood pressure is usually in the mid 150’s/high 80’s as soon I settle on the sofa.

 

This was your blood pressure when you were off Celexa altogether? Or did it start when you took 0.5mg Celexa?

 

What happens in the hours after you take 0.5mg Celexa?  We need times of day for your symptoms before and after you take your drugs. Please keep daily notes on paper about your symptoms, when you take your drugs, and their dosages. Use a simple list format with time of day on the left and notation (symptom, drug and dosage) on the right.

 

A lot of people react badly to high doses of B vitamins. Are these part of your protein drink? We need to see if discontinuing the drink reduces your symptoms.

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SeptGirl

My blood pressure and heart rate have been higher since being off Celexa altogether. Could be anxiety and feeling horrible EVERY DAY doesn’t help!!  BP increased somewhat the few days on low dose...my sleep was more interrupted too.  I felt more shaky and wobbly for most of the day.  After I took it, my head felt more full and dizzier than usual.  My heart rate felt like it was pounding and I felt more nauseated. I took the Celexa after eating at 8:00 a.m.  I’m not having any more protein drinks.  I just checked the label...there is B6, B12, calcium, riboflavin, folic acid, magnesium, manganese, zinc, vitamin K, niacin, iron, phosphorus, biotin, thamin, vitamin D, copper, iodine, pantothenic acid, vitamin E, vitamin C.  None of the values of the vitamins/minerals seemed overly high percentage wise.  My eating has been horrendous for months so my body was probably shocked getting nutrients.  I’ve ordered magnesium glycinate and hope it offers some relief.  I’ve read great reviews and articles!!  I’m keeping notes in my journal.  Thanks again! 

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Altostrata

Have you been taking 0.5mg Celexa at the same time as your protein drink?

 

Your symptom pattern is also confounded by reducing the alprazolam dose.

 

I am hesitant to suggest stopping Celexa because it might not be responsible for your increased symptoms. Could be the B vitamins, could be alprazolam withdrawal.

 

Your symptom pattern is important, including your sleep pattern. Please keep daily notes on paper about your symptoms, when you take your drugs, and their dosages. Use a simple list format with time of day on the left and notation (symptom, drug and dosage) on the right.

 

If you're losing weight, you have permission to eat high-calorie foods and put butter on everything.

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SeptGirl

No.  I had the protein drink at around 3:00 p.m.  This all started to go downhill FAST when I was switched from Celexa to Zoloft back in June.  I was still on higher doses of Alprazolam then.  I understand it could now be the taper too.  There are a lot of variables.  At this point, I think the most prudent thing to do is try the magnesium. I stopped the low dose Celexa and really hesitant to go back on it again.  One more thing...tinnitus and paresthesia seemed to increase while on the tiny bit of Celexa too.  I’ve lost 30 pounds....I’d love to eat a stick of butter!  Unfortunately, my tummy is too sick to eat anything tasty!  I barely get down what I do eat in a day.  I’m trying REALLY hard to eat and snack when I can. I know nutrition is important.  One thing that really sets off my symptoms is sugar.  No sweets anymore.  I gave up coffee months ago...I drank that since I was a teenager (many, many many moons ago!).  I miss that most of all in the morning.   I want my old life back again!  Thanks again! 

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WiggleIt

Hi SeptGirl,

I'm sorry that I can't be helpful in terms of advice for the tapers, but Alto and Shep look to me to be giving you good tips.  Ultimately, you have to make the decision yourself after you weigh all the information, and I definitely remember when I was faced with the daunting decision of whether or not to reinstate.  We all make the best decisions we can with the information we have.  I'll do my best to listen and encourage you and to check in on your thread.

I've been where you are now with paresthesia and tinnitus and weight loss, and I promise you that I improved.  

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SeptGirl

Thanks WiggleIt!  I’m going to give the magnesium a try.  To me this is the best decision to make st this time.  Hopefully it’s the right one and I can move forward and heal without reinstatement.  I’m staying positive this may be the best alternative for me right now.  💜 

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Altostrata

Please post your daily symptom pattern notes.

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SeptGirl

Where do I post daily symptom pattern notes @Altostrata ??  Here?

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Altostrata

Yes, in this topic. We can track your progress here.

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SeptGirl

MORNING:

4 to 5:00:  Wake up anxious after very poor quality sleep.  

Blood pressure and heart rate are elevated mid 150’s/80’s. Nauseated, anxiety, tinnitus, paresthesia, dizzy.

 7 to 8:00  Breakfast 

 8:00:  .75mg Alprazolam 

11:30:  .50mcg levothyroxine 

AFTERNOON:

12:30: Lunch 

 2:00:  .75mg Alprazolam 

 3:30:  carb snack...saltine crackers 

 4:00  Blood pressure/heart rate stabilizes

 7:00:  Dinner

 8:00:  .50 Alprazolam 

MIDNIIGHT...or later

Bedtime (Lol)

 1:30 a.m.: .50mg Alprazolam 

Symptoms are pretty consistent all day.  Nausea/dizziness beginning to lessen late afternoon/evening. Paresthesia and tinnitus are constant. 

 

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SeptGirl

@Altostrata @Shep I went to the psychiatrist today.  My symptoms have been increasing to the point I can barely function.  I asked him if I could try longer acting clonazepam while weaning off short acting alprazolam.  I feel the alprazolam has become ineffective and I’ve stopped tapering.  My current alprazolam dose is 2.5mg/day.  He reluctantly agreed “to put my mind at ease” but he still feels my ever increasing anxiety is from NOT being on an antidepressant and not benzo withdrawal.  He wants me to start on Lexapro (5mg/day for the first week, then 10mg/day) after the “experiment” of being on both the clonazepam and alprazolam for five days if the therapy isn’t effective.  So my dosing schedule now includes 2.5mg/day of alprazolam and an additional 1mg of clonazepam daily....05mg twice a day.  IF the clonazepam helps and I stabilize, I will begin to wean off alprazolam.  He said if taking clonazepam helps, we’ll work on another benzo taper schedule in a couple of weeks and no Lexapro.  I really hope it’s the benzo and not from being off an antidepressant.  Looking for guidance.  Thanks. 

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Altostrata

Please see

 

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Altostrata
4 hours ago, SeptGirl said:

@Altostrata @Shep I went to the psychiatrist today.  My symptoms have been increasing to the point I can barely function.  I asked him if I could try longer acting clonazepam while weaning off short acting alprazolam.  I feel the alprazolam has become ineffective and I’ve stopped tapering.  My current alprazolam dose is 2.5mg/day.  He reluctantly agreed “to put my mind at ease” but he still feels my ever increasing anxiety is from NOT being on an antidepressant and not benzo withdrawal.  He wants me to start on Lexapro (5mg/day for the first week, then 10mg/day) after the “experiment” of being on both the clonazepam and alprazolam for five days if the therapy isn’t effective.  So my dosing schedule now includes 2.5mg/day of alprazolam and an additional 1mg of clonazepam daily....05mg twice a day.  IF the clonazepam helps and I stabilize, I will begin to wean off alprazolam.  He said if taking clonazepam helps, we’ll work on another benzo taper schedule in a couple of weeks and no Lexapro.  I really hope it’s the benzo and not from being off an antidepressant.  Looking for guidance.  Thanks. 

 

If you had a bad reaction to 0.5mg Celexa, you'll have a much worse bad reaction to 5mg Lexapro, millligram for milligram, it's several times stronger than Celexa.

 

Your psychiatrist wants to treat you as though you have relapse of "depression" or whatever. He doesn't know anything about withdrawal syndrome, unfortunately.

 

Changes in your symptom pattern tell us what might be working and what might be hurting. Making a lot of changes at once, including taking large doses of supplements, clouds the picture, we have to wait weeks for everything to settle out -- and we still need to know your state before a change and after a change.

 

This inclination to take more of a benzo when it stops "working" is exactly how people become addicted to them. But benzos don't work like that. Take too much, and they cause the symptoms they're supposed to smother. (Then, of course, you want to take more.) This is called a paradoxical reaction.

 

What we see here is that, after going on and off drugs, people often become hypersensitive to drugs and sometimes supplements and foods. That is why we suggest very low doses of anything. More is not better, it can make you a lot worse.

 

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SeptGirl

I understand exactly what you’re saying.  But in order to avoid alprazolam withdrawal, the crossover is just until Friday.  If it doesn’t work, it’s back to just alprazolam and no more tapering. The purpose is to see if the longer acting benzo would alleviate my symptoms.   It’s five days after months of suffering.  The only supplement I’m taking is magnesium glycinate as recommended here.  No more protein drinks and eating what I can manage to maintain some sort of nutrition.  I appreciate your response and advice.  

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