Kernol: was doing well on my sertraline taper but now in hell and doc reinstated

[Altostrata]

Hi, Kernol. It may take more time for the lorazepam schedule to settle out, but so far it looks promising.

 

Since the nighttime Zoloft might be interfering with your sleep, can you move it earlier in the day, by an hour each day?

 

You'll have to post notes every day about what times you're taking your drugs, their dosages, and your symptoms. That way, we'll be able to tell if this is a good change.

 

If this helps your sleep, you'll be in a better situation to decrease the Zoloft.

[Carmie]

Hi Kernol, 

 

How are you doing?💚

[Kernol]

Will I ever stabilise!? What should I do!?

 

This is my first post since I wrote about coming off setraline in Nov 18 and then all the nasty withdrawals kicked in and so I was put back on setraline and ramped up to 150mg telling me I was in relapse not withdrawal  along with 20mg of diazepam a day. So some 10 months later I have cut down a lot and have suffered a lot  but I have done two stupid things - too fast taper at end and a reinstatement too high. I am  suffering from terrible burning sensations, increasing constant unrelenting anxiety, panic attacks, insomnia/nightmares, vice like headaches, episodes of derealisation and random memory recalls. It has never been as bad as it is now since they put me back up on it at the beginning of the year so I am certain it is sertraline and I dropped too quick and then reinstated too much. Have I now damaged my brain forever I am so scared it will not stabilise from this awful mess? I know it got better when it happened early in the year but what if it doesn’t this time? I feel without hope

 

I managed to get down to 8mg of Sertraline (take at night just before going to sleep) and 3.5mg of Diazapam which I take during the day and I’ve also been given 5mg of vortixitine as the psychiatrist wants me off setraline and only to use vortixitine. But the withdrawals have got worse and I’ve not reacted well to vortixitine at all. So now I’m tapering off the vortixitine (2.5mg) and gone up to 16mg of setraline. And 3.5mg of diazepam still. But the anxiety is getting worse along with all the withdrawal symptoms mentioned above.

 

I really can’t cope and need to know what I should do for the best. I’ve constantly been either going up or down on all these drugs every month, so will ever stabilise if I stay on the amounts I am now? Last week a new psychiatrist wanted me to come off setraline and start 2 anti psychotic drugs which I really don’t want to do. Any help please would be much appreciated as I can’t take it anymore.

 

[ChessieCat]

2 Intro topics merged - each member has only 1 topic where they can ask questions about their own situation and journal their progress.

 

We need to know the dates and dose changes for each of the drugs you are taking.  We also need to know what time you take each of the drugs.  If you stopped a drug, please include the last dose you took.  Please list the following information for 2019 in a post here in your Introduction topic (not your drug signature) in this format:

 

drug name:  date, dose; date, dose; date, dose;

drug name:  date, dose; date, dose; date, dose;

drug name:  date, dose; date, dose; date, dose;

 

I will ask the other mods for their assistance.

 

[Kernol]

Thanks Chessie Cat - the info is here. I’ve made a right mess for myself....

 

 

Sertraline: 5 Feb 100mg 23 Feb 75mg 18 Mar 50mg 23 Apr 37.5mg 1 Jun 25mg 3 July 16mg 3 Aug 8mg 1 Sep 16mg - taken at night 8pm

 

vortioxetine: started 1 Jul 5mg 10 sep 3.75mg 18 Sep 2.5mg
 

diazepam: 10 March 20mg dropped every 2/3 weeks by 1mg until 5mg reached then 0.5mg drops. Now at 3.5mg. Split morning lunch and evening 

[Shep]

On 1/3/2019 at 4:14 AM, Kernol said:

ive been taking lorazepam more than once a day for most of this 7 week period back on sertraline 

 

57 minutes ago, Kernol said:

diazepam: 10 March 20mg dropped every 2/3 weeks by 1mg until 5mg reached then 0.5mg drops. Now at 3.5mg. Split morning lunch and evening 

 

Kernol, when did you crossover from lorazepam to diazepam?

 

Please tell us more about your crossover.

 

When do you take your drugs? Please list the time of day, the drug, and the dose. 

[Kernol]

I think it was 10 March and I did a staggered cross for a couple of weeks to get across to diazepam and then held for a couple of weeks before reducing at a rate of 1mg every 2/3 weeks until I got to 5mg then slowed to 0.5mg drops. to be honest I have not had any problems with reducing compared to the sertraline.

 

930am - 1.5mg

 

2pm - 1mg

 

7pm 1mg

 

 

 

[Shep]

Thanks for the additional information, but I should have been more clear. Please provide the time of day and dose you are taking for ALL your drugs, not just the benzo.

 

How many hours are you sleeping at night? Are you taking any supplements? If so, please list them, along with when you are taking them. 

[Kernol]

I take sertraline and vortioxetine at night at 8pm

 

no supplements

 

i sleep in and out of panic maybe 3 hours a night 

[Shep]

Were you sleeping better when the Valium was at a higher dose or have you had this level of insomnia throughout the past year? 

[Kernol]

Yes I was sleeping better on a higher dose although as sertraline withdrawal has become destabilised I am having panics, nightmares etc that happened when I was destabilised at beginning even when on higher dose of benzo

[Shep]

You may want to increase the benzo. If you kept notes, please go through them and see where you were at 1 month ago. Since benzo updoses work best 2 - 4 weeks since the last decrease, you'll want to target a dose that you were on within the past month.

 

What dose of sertraline were you last on where you were feeling better? Also look through your notes for that, as well. What date were you on that sertraline dose where you felt better? Do you feel better since you increased the sertraline on September 16? 

 

The goal will be to updose to get you to a more functional state and then go into a very long hold. 

 

Please post your thoughts on this. You've made a lot of rapid reductions over the past few months, but you may be able to updose the benzo and / or sertraline and see if you feel better. 

 

Concerning the vortioxetine, do you feel better now that you've decreased this drug? 

[Kernol]

Every day I am feeling worse on the 16mg of sertraline (it has been 3 weeks now) and before that I was dreadful on 8mg for 4 weeks hence why I updosed. I felt better on 25mg which was in June. But I can’t touch it again now can I? Will I ever stabilise again on 16mg if things are getting worse at 3 weeks into the change??

 

i don’t think I have felt any better on vortioxetine - maybe a slight mood lift at first but did nothing on the anxiety and it certainly hasn’t helped the sertraline withdrawals. I am not sure I have felt any different reducing it either but difficult to tell. Most if not all of what I am experiencing now feels very much like sertraline destabilised. 

 

i can increase the diazepam but I don’t think 0.5mg is going to help me much? I was on 4mg 2 weeks ago 

 

 

[Kernol]

hi there

 

what should I do with my vortioxetine do you think? I don’t want to rock the boat now I have destabilised on sertraline but also I don’t want to be on vortioxetine much longer as been on it 12 weeks now and it’s not working. I reduced to 2.5mg from 3.75mg a week ago. 
 

The skin burning and skin pain are very bad today, is it normal to get worse 3 weeks into an up dose of the sertraline - I am so scared of what is happening??

 

thanks 

[Shep]

22 hours ago, Kernol said:

i can increase the diazepam but I don’t think 0.5mg is going to help me much? I was on 4mg 2 weeks ago 

 

22 hours ago, Kernol said:

Yes I was sleeping better on a higher dose although as sertraline withdrawal has become destabilised I am having panics, nightmares etc that happened when I was destabilised at beginning even when on higher dose of benzo

 

It's possible you may benefit from going back to 4 mg Valium, but no guarantee, of course. If you feel it will help with sleep even a little, it's worth updosing because you're getting so little sleep right now. Even an hour extra would be helpful. 

 

14 minutes ago, Kernol said:

what should I do with my vortioxetine do you think? I don’t want to rock the boat now I have destabilised on sertraline but also I don’t want to be on vortioxetine much longer as been on it 12 weeks now and it’s not working. I reduced to 2.5mg from 3.75mg a week ago. 

 

It only takes one month to become dependent on a psychiatric drug, so if you're already dependent, removing it could cause more problems than holding it steady. 

 

14 minutes ago, Kernol said:

The skin burning and skin pain are very bad today, is it normal to get worse 3 weeks into an up dose of the sertraline - I am so scared of what is happening??

 

I think what you're dealing with isn't just about sertraline, but about overall nervous system dysregulation. All of these changes have injured your already traumatized nervous system. 

 

At this point, I would updose the Valium if you think it would help get even just a tiny bit more sleep. 

 

And then go into a very long hold. It's going to take awhile before your nervous system stabilizes, so work on non-drug coping skills to help you navigate withdrawal symptoms.  

 

These links can be very helpful for understanding what's going on:

 

How psychiatric drugs remodel your brain

 

Healing from antidepressants. Patterns of recovery video (4 minutes)

 

The Windows and Waves Pattern of Stabilization

 

What is happening in your brain?

 

Are We There Yet? How Long is Withdrawal Going to Take?

 

You'll find some helpful information to handle your symptoms here: 

 

Non-drug techniques to cope with emotional symptoms

 

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

 

If you're not sensitive to magnesium, you may want to take epsom salt baths before bedtime to help you relax and settle the nervous system down. 

[Kernol]

Thank you Shep - I will try this and read through the materials. I really appreciate your advice. 

[Kernol]

@Shep I have had to resort to taking 1mg of lorazepam over the last few days as diazepam increase did nothing and i have been suicidal.

 

I am disappointed I became this desperate as I had done so well getting off it from my 4 months use at beginning of year with a cross taper to diazepam I was down from 20mg to 3.5mg but now I have had to resort to lorazepam as an emergency measure whilst I am so destabilised. How will I get off it again? If I take it for another week say in hope that things settle a little would I just go back to my 3.5mg diazepam or would I have to do something different now?

[Shep]

You can become dependent on a benzo in 2 - 4 weeks and there are reports on the benzo withdrawal forums of people developing dependency in as little as 10 days, so you'll have to decide if you can cope without the lorazepam or if you need to continue taking it. 

 

I would updose the diazepam rather than bringing in another benzo. Keep in mind that 1 mg of lorazepam is equivalent to 10 mg of diazepam, so that's quite an increase in your overall benzo usage.

 

You've been tapering too fast and coming off more than one drug at a time. It's going to take awhile to stabilize from all of these changes, but continuing to make changes like this are going to make this worse in the long run.

 

If you can stabilize where you are without adding in more drugs and then taper one drug at a time and very slowly, I think you'll feel better. 

[Kernol]

Please someone help me. It has now been nearly 4 weeks since the upside of sertraline and every day this past week things are getting worse. I am non functioning. Extreme electric anxiety, I can’t think of any normal memory or anything without a bolt of anxiety coming with it, I have random memories popping into my head all day. Songs repeating round. I am so anxious and depressed and I can’t even sleep well as all the random memories ramp up when I am going off to sleep like some kind of weird movie. I also have intense burning across my back and stomach with some skin pain down my leg and when the anxiety escalates the burning feels like it’s going into my brain.

 

i can’t bear not knowing when this will stabilise. Please help me anyone with anything that can give me hope I can’t be like this for much longer.

 

it was like this when it was reinstated and they kept increasing the dose at the end of last year although I don’t remember having the random memories then. 

[Shep]

Please start a drug and symptoms journal in the format listed below.

 

 

On 9/27/2016 at 2:49 PM, Altostrata said:

In the course of discussion in your Introductions forum topic, you may be asked to keep notes on paper of your daily symptom pattern, including when you take your drugs, their dosages, and any symptoms. We ask this because there may be something we can do to reduce the symptoms.

 

What we need to see for every single day over several days is what symptoms you get before and after you take your drugs. If you're not taking any drugs and have withdrawal symptoms, we still need to see your symptom pattern throughout the day:

 

The time of day, dosage, and severity of symptoms are essential information. Include

 

- Time and dosage for all drugs taken throughout the day, psychiatric and non-psychiatric.

- Following each dose, note any symptoms. If you are having a reaction to the drug, it may take hours for a symptom to show up -- that's why we ask you to keep notes all day long.

- If you're not taking any drugs, your symptoms throughout the day.

- Your sleep pattern. Since so many drugs disturb sleep, if you find you're waking in the middle of the night, it could be from a drug you took earlier in the evening. If you're not taking any drugs, there may be ways you can improve your sleep.

And so forth. A diary, in chronological order, looking something like this:
 

Example:

DATE:

 

6 a.m. Woke with anxiety
8 a.m. Took 2.5mg Lexapro
10 a.m. Stomach is upset
10:30 a.m. Ate breakfast
11:35 a.m. Got a headache, lasted one hour
12:35 p.m. Ate lunch
4 p.m. Feel a bit better
5 p.m. Took 2.5mg Lexapro
6 p.m. Ate dinner
9:20 p.m. Headache
10:00 p.m. Took 50mg Seroquel
10:20 p.m. Feeling dizzy
10:30 p.m. Fell asleep
2:30 a.m. Woke, took 3mg Ambien (NOT "took 1/2 tablet Ambien")
2:45 a.m. Fell asleep
4:30 a.m. Woke but got back to sleep

 

 

[Shep]

On 9/23/2019 at 7:01 AM, Kernol said:

I think it was 10 March and I did a staggered cross for a couple of weeks to get across to diazepam and then held for a couple of weeks before reducing at a rate of 1mg every 2/3 weeks until I got to 5mg then slowed to 0.5mg drops. to be honest I have not had any problems with reducing compared to the sertraline.

 

On 9/25/2019 at 9:02 AM, Shep said:

Keep in mind that 1 mg of lorazepam is equivalent to 10 mg of diazepam, so that's quite an increase in your overall benzo usage.

 

Kernol, the memory flashbacks you're reporting sound like they may be related to your benzos. You did a rapid crossover from lorazepam to diazepam and then reinstated the lorazepam at a high dose (high for a reinstatement - we recommend starting out with very low doses). 

 

What date did you reinstate the lorazepam? 

 

 

[Kernol]

I have been having the random memories for 8 weeks so it can’t be to do with the lorazepam. This timing coincides with my drop down from 16mg to 8mg of sertraline. 

[Shep]

27 minutes ago, Shep said:

What date did you reinstate the lorazepam? 

 

Please answer this question. 

 

16 minutes ago, Kernol said:

I have been having the random memories for 8 weeks so it can’t be to do with the lorazepam. This timing coincides with my drop down from 16mg to 8mg of sertraline. 

 

Has this symptom improved since you updosed back to 16 mg 22 days ago? 

[Kernol]

Lorazepam I have been on for 5 days now. I have not noticed any change since the updose in sertraline - perhaps slightly worse? 

[Kernol]

24/9

7.00am woke
8.30am - strong electric anxiety attack with random image of ashridge park (random place I havent been to in years)
8.30am took 1mg lorazepam
10.00am tried to walk to corner shop, had strong electric anxiety and burning right through into my brain when in shop in queue
11.00am - 3pm working on emails
5.00pm feel a bit better late afternoon
6.00pm Tried to watch programme - got strong anxiety, just thinking about myself in the situations of the characters as I cannot go anywhere without strong anxiety
8.00pm took 16mg sertraline, 2,5mg vortioxetine Went to bed - restless legs and extreme burning and pain and then when i slept i got very fast images of random places with strong anxiety kept waking me

 

25/9

7.00am depression and strong anxiety on waking
8.30am took 1mg lorazepam
10.00am was able to work a bit
12.00pm had sandwich
3.00pm no random images/memories as of 3pm
then looked at surviving antidepressant website saw success story but took 4 years - all these years and years makes me feel hopeless
worried about the lorazepam situation but what choice do i have at the moment?
wrote a story poured it all out tried to include the good memories and cherish those
4.00pm a bit of pain emerging again in my middle 
6.00pm electric anxiety in chest at memory of my sister in law's wedding (which was a happy memory)- upset me as so random
8.00pm not too bad 
9.00pm took 16mg sertraline, 2.5mg vortioxetine
slept a bit better, weird dreams but not bad emotions in them, restless legs not there 

 

pain maybe a bit less on stomach, felt closer to skin less deep and intense

 

26/9
7.00 woke up okay not too drowsy, smelt bacon as usual which wasnt there
830 took 2mg diazepam 
9.00 random memory in bathroom of a road in chesham
9.30 electric anxiety ran right through me from head to toe head tingling burning strong electric fear in stomach after hearing a bird outside at about 930 
9.30 took another 2mg diazepam
10.00 hoovered around, emptied dishwasher, loaded dishwasher, answered a couple of emails 
12.00 started to feel desperate
12.30 tried to lie down, calmed down slightly but had strong derealisation looking out window
400pm took 0.5 lorazepam after i had strong suicidal ideation that i will never stabilise
4.30pm slept for an hour and a half felt ok nice calming sleep
6pm laid down again as couldnt stand any more of the dark thoughts
8pm took 16mg sertraline and 2.5mg vortioxetine

 

stomach and back burning about the same but think there might be less pain in the stomach

[Kernol]

27/9
12.45am awake with restless legs, didnt really sleep after that well, just running in and out of random memories
4.00am woke with strong panic attack, burning through back, stomach and head
7.00am desperate so took 1mg lorazepam and slept til 9am
9am feel very down and very anxious but no electric anxiety because the lorazepam calms this down
10.00am had a shower
11.00am doing some work emails - ok but underlying fear all the time that my brain will not stabilise again and I will have to end my life
12.00pm forced down a sandwich
1.00pm went to lie down, had a sleep for 2 hours
4.00pm had epsom salt bath, back is burning, skin is hurting a bit, head feels tingly, no extreme anxiety
5.00pm no random memories today as of 5pm apart from during night. It could be the lorazepam has stopped them? They tend to happen a lot when going off to sleep and waking.
6.00pm ate some dinner
8.00pm took 16mg sertraline, 2.5mg vortioxetine and went to bed. will wear the mouthguard tonight as have also been grinding my teeth badly for the last 8 weeks. Dont know if it is the fluctuating dosage of sertraline or the vortioxetine causing this 
11.00pm cannot sleep due to restless legs, lots of random memories coming with jolts of adrenaline
12.00am drift off but have nightmare with cold sweats
1.00am wake up again with intense nerve pain and burning all over back and stomach and tingling and burning in my head
5.00am wake with strong electric panic attack

 

Teeth clenching very bad - I think it is getting worse. I had thought it was the vortioxetine as started 4 weeks after commencing that but it was also the time when the sertraline was dropped below 25mg which of course was when i had the withdrawals start on my first withdrwal journey last year so now I am wondering if it is that causing it 
 

[Shep]

On 9/27/2019 at 8:21 AM, Kernol said:

Lorazepam I have been on for 5 days now. I have not noticed any change since the updose in sertraline - perhaps slightly worse? 

 

I would highly recommend stopping the lorazepam.

 

Benzo reinstatements work best within 2 - 4 weeks of coming off.  Since you did your crossover in March, you've been off lorazepam for 6 months and you reinstated at a high dose. Please note the below information on benzo kindling:

 

Kindling (sedative–hypnotic withdrawal)

 

As you read in that link:  Each withdrawal leads to more severe withdrawal symptoms than in previous episodes. Individuals who have had more withdrawal episodes are at an increased risk of very severe withdrawal symptoms.

 

You may find yourself trapped on the lorazepam and unable to taper without very severe symptoms. Benzos tend to stop working after a couple of weeks and then we stay on them to stave off withdrawal symptoms. Please consider the consequences of going back on it.

 

 

On 9/27/2019 at 8:23 AM, Kernol said:

24/9
8.30am took 1mg lorazepam
8.00pm took 16mg sertraline, 2,5mg vortioxetine 

 

25/9

8.30am took 1mg lorazepam
9.00pm took 16mg sertraline, 2.5mg vortioxetine

 

26/9

830 took 2mg diazepam 
9.30 took another 2mg diazepam
400pm took 0.5 lorazepam 
8pm took 16mg sertraline and 2.5mg vortioxetine

 

 

9 hours ago, Kernol said:

27/9

7.00am desperate so took 1mg lorazepam 
8.00pm took 16mg sertraline, 2.5mg vortioxetine 

 

Kernol, unless you are able to take your drugs consistently, we can't help you. There's no way of knowing what symptoms are coming from what. You may be getting interdose withdrawal from the lorazepam (going into withdrawal in between doses due to lorazepam's short half-life). Or it could be benzo rebound anxiety. Plus you only took diazepam one day out of the 4 days you listed. 

 

This inconsistent dosing is very destabilizing to the nervous system. 

 

Please see:

 

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

 

It looks like you're going into a lot of catastrophic thinking based on the memories you're having and then you panic and reach for a benzo. You need to learn how to distract and self-soothe without resorting to a drug. Please see:

 

Dealing With Emotional Spirals

 

"Change the channel" -- dealing with cognitive symptoms

 

For more ideas:

 

Non-drug techniques to cope with emotional symptoms

 

 

 

[Kernol]

Thanks @Shep I will not take the lorazepam anymore. I have done so welll tapering down on that this year I don’t want to make matters worse. 
 

@Shep @AltostrataOne thing that I am finding really hard to deal with is the fact that my first withdrawal from sertraline was without problems until I dropped from 25mg to zero and then the psychiatrist messed me up by putting me back on it and raising dose high and I have been basically withdrawing ever since January and every day has been a struggle to live through with the anxiety and depression plus the burning sensations the nightmares and many other symptoms and now when I reduced below 25mg this time it has been even harder and I of course dropped too quick and now I have updosed I know I have destabilised like when they put me back on it first time. Have you come across anyone that has had this happen and did they stabilise again? I know you can’t give assurances but in your experience has this happened to anyone else and if I hold at this dose should it settle? I am just very scared because I have read about people never stabilising and I am scared I will stay like this forever? Any hope you can give me??

[Shep]

13 hours ago, Kernol said:

I will not take the lorazepam anymore.

 

This sounds like a great plan, Kernol. I'm glad you're stopping this drug.

 

13 hours ago, Kernol said:

One thing that I am finding really hard to deal with is the fact that my first withdrawal from sertraline was without problems until I dropped from 25mg to zero and then the psychiatrist messed me up by putting me back on it and raising dose high and I have been basically withdrawing ever since January and every day has been a struggle to live through with the anxiety and depression plus the burning sensations the nightmares and many other symptoms and now when I reduced below 25mg this time it has been even harder and I of course dropped too quick and now I have updosed I know I have destabilised like when they put me back on it first time. Have you come across anyone that has had this happen and did they stabilise again? I know you can’t give assurances but in your experience has this happened to anyone else and if I hold at this dose should it settle? I am just very scared because I have read about people never stabilising and I am scared I will stay like this forever? Any hope you can give me??

 

Yes, having problems reducing on the lower doses is common. This thread explains why:

 

Why taper? SERT transporter occupancy studies show importance of gradual change in plasma concentration

 

Please note these two paragraphs from the first post in that link: 

 

Most psych drugs work by changing the levels of a specific neurotransmitter in the body. They usually increase the amount of the neurotransmitter by shutting down the receptor that absorbs it. This is called "down regulating" and a receptor that is down regulated is referred to as being "occupied".  These charts show the percentage of receptors in the body that are "occupied"  at a give dosage of the medication.  The percentage is on the left scale and the dose is across the bottom. Both charts are showing the same thing but the one on the left show the affects of the listed strength of the dose while the one on the right shows the affects of how much of the drug ends up in the blood from taking that dose.

....

The curve tells us several things.  For one thing it shows that the larger the dose the less cumulative affect it has, so in reality a very high dose is not much more effective than a lower one.  But more importantly it shows that at the lower doses (10mg and below) a very small change in dose will result in a very large change in occupancy. A large decrease in occupancy means that there is a lot of healing to be done and a large increase in symptoms is most likely.  The curve also shows why it is so important to go slowly at the lower doses as a very small change in dose causes a very large change in occupancy.

 

 

People can stabilize, but it may take a long time because of all of the changes you've made. Going into a very long hold may be best at this point. Your nervous system needs time to recover. Most people come into this forum very destabilized, but with time and lots of self care, your nervous system will recover.

 

And then going forward, you may want to do a very slow micro taper of 5% or less until you're completely off. This is much better than adding a benzo. 

 

Also, it's important to take the diazepam at the same time each day and at the same dose. This will also help you stabilize. The more consistent you can be, the better. 

[Kernol]

Hi @Shep thank you that makes a lot of sense. I am a bit concerned as my first day going back to the 4mg of diazepam I cannot sleep because I have lots of images like faces turning into gremlins etc when I close my eyes and then when I do finally go off I am immediately woken up by my jaw clenching down so hard. When I looked in the mirror my pupils are dilated and my mouth looks odd like someone who has been gurning on speed. Do you think I have shocked my system by going from 1mg lorazepam back to 4mg diazepam - should I have climbed down slower over a few days. I am so scared I have never clenched my jaw so strongly as to wake me immediately 

[ChessieCat]

If you don't already use a mouth guard it might be a good idea to get one.  facial-tics-jaw-tongue-muscle-tension-and-pain-bruxism-teeth-clenching-tmj

 

[Kernol]

I do use a mouth guard since the last 8 weeks this has been happening but  last night it was so much stronger I was biting down so hard that it instantly woke me and what with all the disturbing images all night and the anxiety I couldn’t sleep at all. Do you think I have shocked my system by coming down from 1mg lorazepam to 4mg diazepam just like that. I had only taken them for less than a week but the previous week I did have 3 over that week as well? Or is this just a worsening effect of the sertraline changes I made? 

[Kernol]

@Shep I need your advice. I spoke to the Bristol tranquilliser project today ( the only UK helpone for SSRI and Benzo withdrawal) I explained everything they know my back history anyway and of course they said to hold the sertraline same as you but they advised I should updose the diazepam to nearer 10mg because of taking the lorazepam recently they thought it was too much of a drop to just go back to 4mg. I wanted to know what you think? 

[Altostrata]

Kernol, you will have to choose one program or the other. Your taking Benzos inconsistently is probably the core of your current problem,.

[Shep]

 

11 minutes ago, Kernol said:

@Shep I need your advice. I spoke to the Bristol tranquilliser project today ( the only UK helpone for SSRI and Benzo withdrawal) I explained everything they know my back history anyway and of course they said to hold the sertraline same as you but they advised I should updose the diazepam to nearer 10mg because of taking the lorazepam recently they thought it was too much of a drop to just go back to 4mg. I wanted to know what you think? 

 

On 9/25/2019 at 9:02 AM, Shep said:

I would updose the diazepam rather than bringing in another benzo. Keep in mind that 1 mg of lorazepam is equivalent to 10 mg of diazepam, so that's quite an increase in your overall benzo usage.

 

They are recommending that you updose to the equivalent of the 1 mg of lorazepam. 

 

If it's been more than a month since you were at 10 mg, it may be too high an updose. Updoses should be done in small amounts (1 mg) and then slowly increased. 

 

Notes on Updosing

 

7 minutes ago, Altostrata said:

Kernol, you will have to choose one program or the other. Your taking Benzos inconsistently is probably the core of your current problem,.

 

I'm going to echo this, too. Please pick where you're going to get advice and then be consistent with the advice. Being consistent with your doses is the most important part. 

 

[Kernol]

Ok thanks I really appreciate it so I will updose by 1mg of diazepam today as you recommend. I do not want to go to 10mg anyway as it seems like a big step backwards I was just worried that my dropping the lorazepam yesterday and taking only 4mg might have caused last nights issues