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

[Shep]

@Altostrata That looks like an excellent plan.

 

@Kernol Please move the vortioxetine dose one hour earlier tonight and then you'll move it one hour earlier the next night and so on until it's gradually moved to the morning. Please keep posting your daily notes to gage your progress. 

[Kernol]

Ok thanks I will do that. 

[Kernol]

10/10
8.00am got up and had shower
9.00am took 2mg diazepam, very anxious, my eyes look wild today, i look drugged, my husband thinks they look a bit off too
9.30am intrusive memory when doing my work emails with strong anxiety
10.00am cannot concentrate, pacing, very worried about the state of my mind, I feel confused like I dont really know what day it is or what I am doing
10.30am try and lie down, start the intrusive memory dreaming before I have even closed my eyes, half asleep half awake, very drowsy
11.45am - get up
12.30pm - husband wants me to eat lunch but i cant get anything down so have a meal replacement drink 
1.00pm - go back to bed as the anxiety is so strong and I cannot self soothe it even with my usual techniques and I am very drowsy

2.00pm took 1mg diazepam
4.00pm - slept but in and out of  panic with lots of intrusive memories - these are definitely increasing
5.00pm - got up - tried to do work emails, I dont even know how I am doing it, I feel totally out of it drowsy and just not with it but very anxious at same time
7.00pm - took 2mg diazepam, had dinner then took 2.5mg vortioxetine, strange thing happened after about 45 minutes, the extreme anxiety when thinking of intrusive memories seemed to be less intense, I dont know if it was a coincidence or the vortioxetine
8.00pm - took 16mg sertraline
10.00pm - 2.30 - slept ok but teeth clenching  bad
2.30-7.00am - waking up with cortisol rushes, teeth clenching and noticed my hands are moving like I am pressing them into my legs in my sleep, some electric shocks too

Today was really very difficult, I honestly don't think I can stand much more of this level of chemical anxiety. I can usually somehow get through the day but this is on another scale. 

Is there anything I can do to get through this other than the coping techniques which are just not helping me right now? I am trying my best but I can't take many more days like today. 
 

[Shep]

1 hour ago, Kernol said:

7.00pm - took 2mg diazepam, had dinner then took 2.5mg vortioxetine, strange thing happened after about 45 minutes, the extreme anxiety when thinking of intrusive memories seemed to be less intense, I dont know if it was a coincidence or the vortioxetine
8.00pm - took 16mg sertraline
10.00pm - 2.30 - slept ok but teeth clenching  bad

 

You're seeing some improvements, which is a good sign. These changes will come in windows and waves, completely non-linear, but as you continue to move the vortioxetine, hopefully you'll see some more progress like this.

 

 

1 hour ago, Kernol said:

Is there anything I can do to get through this other than the coping techniques which are just not helping me right now? I am trying my best but I can't take many more days like today. 

 

You've had a lot of changes over the past few months, but you are seeing some improvements with the diazepam updose and now, moving the vortioxetine to earlier in the day. 

 

It may help to settle into an attitude of acceptance as you ride out this difficult time.

 

Acceptance

 

This is a great post by moderator Brassmonkey with his explanation of Acknowledge, Accept, Float. 

 

On 10/15/2015 at 2:01 PM, brassmonkey said:

Acknowledge, Accept, Float.  A concept stolen from Clair Weekes.  It is a process for handling situations that you have no control over.  Acknowledging the situation/symptom, getting to know it on a personal level.  Accepting that the situation/symptom is there, its real and there is nothing you can do about it. Letting the Situation/symptom Float off as you get on with your life as best as you can.  It's sort of like dealing with an unwanted house guest.  At first you get to know them and make them comfortable.  Then you realize they are not making any effort to leave and there is nothing you can do, but ignore them as best as you can until they go away.

[Kernol]

Thanks @Shep I do try and use acceptance - and I am a great fan of Claire Weekes.

 

One thing that is bothering me is whether taking two SSRI drugs at the same time is possibly causing some of this and I am very worried about that - I know I am supposed to be holding everything but if the vortioxetine is interacting with the sertraline, then i am concerned i will not stabilise until i am rid of the vortioxetine.

[Kernol]

11/10
8.00am got up had shower
9.00am took 2mg diazepam
10.00am - tried to work, lots of intrusive images, same song looping round my head, intense anxiety in stomach, feels electric
11.00am- feel v tired so not pacing but very anxious, try to change channel, try to accept but its hard when things seem to be getting worse not better
12.00pm -electric shocks on stomach, burning strong on back
1.00pm - keep trying to work, 
2.00pm - took 1mg diazepam
3.00pm - still v drowsy tired but anxiety constant, I cant think straight
4.00pm - tried some deep breathing, trying to accept this for now but its hard when things seem to be getting worse
5.00pm - had some dinner
6.00pm - took 2.5mg vortioxetine, no difference in anxiety
7.00pm - took 2mg diazepam, tried to watch TV but anxiety too strong it made me feel worse
8.00pm - took 16mg sertraline
9.00pm - tried to sleep
10.00pm - woke with a panic attack
11.00pm - woke again with nightmare and cold night sweat
12.00am -4.00am - repeated waking with anxiety, burning sensations bad, teeth clenching is so strong it is waking me too
4.00am - 7.00am - in and out of cortisol rushes and lots of intrusive memories, old dreams, half awake, half asleep, hands numb

 

@Shep @Altostrata last 2 nights sleep have been worse, could this be to do with moving the vortioxetine up?  I dont know how many more days of this I can take,  I have to have some respite from this chemical anxiety as I am having SI now that there is no end to this. I keep thinking is it because I have the vortioxetine as well as the sertraline and it is too much for my brain to handle and if so what can I do?  I am concerned that the teeth clenching has worsened too.  Please help me

[Kernol]

12/10
8.00am - got up had shower
9.00am - took 2mg diazepam, put washing on, very tired, drowsy, cant stop yawning and very anxious
10.00am - laid down, slept until 12.00pm
12.00pm - got up, still couldnt keep my eyes open. Anxiety is electric, got head vice feeling back (have had this on previous sertraline drops but not for a few weeks)
1.00pm - went back to bed, slept 
2.00pm - had 1mg diazepam, slept again until 4pm
4.00pm - got up still very tired, very anxious, extremely depressed
5.00pm - tried to do some deep breathing, took 2.5mg vortioxetine
6.00pm - anxiety seems even worse, forced some dinner down
7.00pm - took 2mg diazepam
8.00pm - took 16mg sertraline
9.00pm - tried to sleep, lots of anxiety and panic and intrusive memories, feel like my brain is so broken
10.00pm - had nightmare, woke burning hot but with cold sweat on chest
11.00pm - 4.00am - restless sleep, head tingling and feeling of a needle being pressed into my scalp
5.00am - cortisol rushes started, extremely depressed

 

I am getting worse, I am so scared, 6 weeks now since the updose in sertraline and I am trying to keep hold of hope of stabilising but I feel like I am deteriorating - what do I do??

[Shep]

On 10/11/2019 at 11:23 AM, Kernol said:

One thing that is bothering me is whether taking two SSRI drugs at the same time is possibly causing some of this and I am very worried about that - I know I am supposed to be holding everything but if the vortioxetine is interacting with the sertraline, then i am concerned i will not stabilise until i am rid of the vortioxetine.

 

Yes, there is an interaction, which is why Alto suggested spacing these two drugs out. That will help with the interaction.

 

You'll have to weigh the severity of the symptoms of the interaction against the severity of the symptoms of tapering off it too soon. I would give yourself time to adjust to spacing these drugs out. 

 

On 10/12/2019 at 5:21 AM, Kernol said:

last 2 nights sleep have been worse, could this be to do with moving the vortioxetine up?  I dont know how many more days of this I can take,  I have to have some respite from this chemical anxiety as I am having SI now that there is no end to this. I keep thinking is it because I have the vortioxetine as well as the sertraline and it is too much for my brain to handle and if so what can I do?  I am concerned that the teeth clenching has worsened too. 

 

Since you've been on the vortioxetine for several months, you may be dealing with battle fatigue more than with the interaction. Being chronically ill for so long is exhausting.

Also, your body may still be dealing with all of the benzo changes. This can take awhile to settle down. 

 

Are you able to take a short leave of absence from work to give yourself time to rest? 

[Kernol]

thank you @Shep I will see how things go with the spacing out. I have been only working part time at home since this all happened last November so I have been off work only doing light duties for nearly a year as I have never been well enough to return due to the high anxiety and depression I have had every single day since they put me back on the high dose of Sertraline and have spent all year trying to taper off it. I only had one real window which was in April for 4 days where I felt almost normal but other than that each day has been a struggle and I have been pretty much housebound apart from going out for walks when I have felt well enough. I only hope that a lot of this has been to do with tapering every single month and that maybe now I am not touching the sertraline dose, I will stabilise. Of course some of it could be to do with tapering down the diazepam at the same time since Februrary as well. My poor brain has had a lot to cope with and then the addition of the Vortioxetine has probably made things worse. I only let them give me this because I was so depressed and they told me it would help me come off the sertraline (how wrong they were) so I was never meant to be taking the two drugs together for more than a few weeks crossover.

[Kernol]

13/10
8.00am - got up had shower
9.00am - extreme anxiety, pacing, took 2mg diazepam
10.00am - did some housework
11.00am - still v anxious, trying to tell myself I will get better
12.00pm - tried to force some lunch down, very hard
1.00pm - walked to corner shop, anxious but managed it
2.00pm - took 1 mg diazepam, had a lie down, fairly restful sleep, bit of teeth clenching
4.00pm - took vortioxetine, anxiety seems worse, not sure if coincidence
5.00pm - deep breathing
6.00pm - ate a small amount of dinner
7.00pm - took 2mg diazepam
8.00pm - took 16mg sertraline
9.00pm - slept although lots of anxiety dreams and intrusive memories
12.00am - teeth clenching is so strong it is waking me every 30 minutes or so
2.00am - nerve and burning pain in stomach and back and cold sweats, teeth clenching waking me
3.00am - cortisol rushes start, feel very chemical, teeth clenching so bad I cant sleep, head feels like it is in a vice and tingling (usual sertraline withdrawal after tapering)
6.00am - this continued until i got up 

 

hi @Altostrata @Shep can it be a coincidence that my sleep the teeth clenching, the classic sertaline withdrawals have been worse since moving the vortioxetine up? I can't believe just doing this would make a difference but I cant think of any other reason - can you find any logic behind this? I am so scared, my teeth were literally smashing together during the night and my face was grimacing when i woke from it repeatedly. Mouthguard is not doing much as it is such a strong force. \i cant continue like this

[Shep]

20 hours ago, Kernol said:

I only had one real window which was in April for 4 days where I felt almost normal but other than that each day has been a struggle and I have been pretty much housebound apart from going out for walks when I have felt well enough.

 

From your signature, you were on 37.5mg sertraline at that time in April. 

 

5 hours ago, Kernol said:

hi @Altostrata @Shep can it be a coincidence that my sleep the teeth clenching, the classic sertaline withdrawals have been worse since moving the vortioxetine up? I can't believe just doing this would make a difference but I cant think of any other reason - can you find any logic behind this?

 

This is from an earlier post:

 

On 9/28/2019 at 6:51 AM, Kernol said:

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 

 

It sounds like a lot this is related to getting below 25 mg on the sertraline. You likely were stabilizing at the 37.5 mg dose back in April. That window was a sign that you should have held, not continue tapering. This is an opportunity to learn for the future. Please do not rush your taper. 

 

I'm not sure that increasing the sertraline at this point will help, but looking at this history can help answer the question about what may be causing this. 

 

You may want to stop moving the vortioxetine for a few days and see if you can stabilize. Even if the problem is the result of the sertraline and not directly related to the vortioxetine, you are dealing with a profoundly destabilized nervous system, so any kind of change may cause upticks in symptoms. 

[Altostrata]

On 10/10/2019 at 7:10 AM, Kernol said:

Interactions between your drugs

Major

sertraline  vortioxetine

Applies to: sertraline, vortioxetine

Using sertraline together with vortioxetine can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention if you experience these symptoms while taking the medications. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Minor

diazePAM  sertraline

Applies to: diazepam, sertraline

Consumer information for this minor interaction is not currently available. Some minor drug interactions may not be clinically relevant in all patients. Minor drug interactions do not usually cause harm or require a change in therapy. However, your healthcare provider can determine if adjustments to your medications are needed.

For clinical details see professional interaction data.

No other interactions were found between your selected drugs. Th

 

 

Yes, there is a serious interaction between vortioxetine and sertraline, as we've discussed before. In addition, "The risk or severity of adverse effects can be increased when Diazepam is combined with Vortioxetine" per https://www.drugbank.ca/drugs/DB09068

 

Vortioxetine was a very poor choice for your doctor to add to sertraline. Since vortioxetine has a long half-life, my guess is your change in symptom pattern is due to its drug-drug interactions with diazepam. 

 

When you reduced vortioxetine before, what happened? I am thinking I would start to eliminate vortioxetine completely.

 

 

 

[Kernol]

Hi @AltostrataIt’s so hard to say what happened when I reduced the vortioxetine as I also had updosed the sertraline at the same time so impossible to know what was due to what. 
 

I don’t want to destabilise myself further however I think I need to eliminate it too. I have been having the intrusive random memories for most of the time I have been on it which is not something I have had before in sertraline withdrawal. Also the teeth clenching started on week 4 of being on it although this was also when I did a drop in sertraline however again this is not a withdrawal symptom I had had from sertraline previously. 

 

How should I go about this best? 

[Altostrata]

Since you're already down to 2.5mg, I would try a reduction of 0.5mg for 2 weeks, keep everything else the same, post daily notes.

[Kernol]

14/10
8.00am - got up had shower, very depressed, cartoon songs in my head looping
9.00am - took 2mg diazepam, did some work emails
10.00am - dont know what to do with myself, the anxiety is so strong, lay down, try and sleep but teeth clenching too much
11.30am - get up, pacing, tell my husband i want to give up, I don't know when or if this will ever end
1.00pm - go back to bed, try and sleep, keep waking with strong anxiety, deep breathing
2.00pm - take 1mg diazepam
3.00pm - try some work emails, almost impossible to concentrate, the world feels so unfamiliar
3.30pm - have bath, get strong intrusive memory of a restaurant where I used to live with intense anxiety reaction
4.00pm - take 2mg vortioxetine
5.00pm - get husband to read me some success stories
6.00pm - eat dinner, christmas carol looping round my head
7.00pm - anxiety and intrusive memories, vision seems a bit jumpy, took 2mg diazepam
8.00pm - took 16mg sertraline
9.00pm - tried to sleep, lots of images when i close my eyes
10.30pm - wake with all body adrenalin rush (not had this for about 2/3 weeks now)
11.30pm - wake with restless legs (not had this for about 2 weeks now)
12.00pm - 4.00am - teeth clenching and panic attacks waking me continuously
 

@Altostrata @Shep hi,  I seem to be having a lot of the issues I was having 2 or 3 weeks ago. Last night  was not a good night and restless legs returned along with the full body adrenalin rush and panic. I can't believe the moving the vortioxetine and then the drop would cause this so soon but I dont know what else to think?

[Altostrata]

5 hours ago, Kernol said:

10.00am - dont know what to do with myself, the anxiety is so strong, lay down, try and sleep but teeth clenching too much

 

Did the anxiety increase after you took diazepam?

 

My guess is you are taking TOO MUCH diazepam and experiencing paradoxical reactions. Because diazepam and vortioxetine interact, changing vortioxetine might affect this. @Shep what do you think?

[Kernol]

hi @Altostrata I dont think i have  noticed my anxiety increase after the morning dose of diazepam, I usually experience a slight lessening in anxiety but it wears off or it doesnt appear to do anything at all. 

[Shep]

29 minutes ago, Altostrata said:

My guess is you are taking TOO MUCH diazepam and experiencing paradoxical reactions. Because diazepam and vortioxetine interact, changing vortioxetine might affect this. @Shep what do you think?

 

I advised Kernol to updose the diazepam due to a rapid reduction, as well as the introduction of periodic lorazepam (which was stopped). Please see my posts here and here. 

 

My best guess is Kernol is dealing with a very destablized nervous system from the earlier rapid reductions of both the sertraline and the diazepam, the adding and then removing of lorazepam, and the introduction of vortioxetine. 

 

It's only been a couple of weeks since the benzo updose, and after so many changes, my best advice would be to hold. If reducing the vortioxetine is helpful, that's a good plan. But I would hesitate to recommend a lot more changes. 

[Altostrata]

I apologize, I see the recent diazepam changes, with Kernol reporting an improvement in some symptoms.

 

Kernol, I agree with @Shep, your nervous system is very destabilized and sensitized. However, my feeling is that the vortioxetine in the mix is causing trouble. As it has such a long half-life, moving the dosing an hour should not have caused such a big wobble in your symptom pattern. The surge in symptoms might be due to something else. Can you hold on moving the vortioxetine a couple of days and see what happens? Please continue to post your daily notes.

[Kernol]

hi @Altostrata yes I will keep it the same time as yesterday then? I down dosed yesterday to 2mg from 2.5mg - should I just take 2mg at the same time as yesterday?

[Altostrata]

Yes, I would do that. Perhaps the surge in symptoms is unrelated.

[Kernol]

ok thanks @Altostrata I will do that. The only thing I could think of was that I was taking them both at bedtime together and that maybe my system had got used to them both together to sleep and then moving it back an hour each day somehow it didnt like it when it came to sleeping without the two but who knows as you say may be nothing to do with it. 

[Kernol]

15/10

8.00am got up had shower, depressed because of the bad sleep

8.30m - walked to corner shop, hard going feel very anxious and edgy 
9.00am  took 2mg diazepam, had psychologist appt, helped calm me a bit 
10.30am - did some work emails, still feeling heavy depression and anxiety 
12.00pm - managed to eat lunch, still anxious 
1.00pm - starting to feel a bit less anxious, not sure why
2.00pm - take 1mg diazepam, carry on working, change the bedding, put a wash on - pleased with myself for doing this
3.00pm - able to sit down and work, not as restless and the heavy feeling of depression feels a bit lighter
3.30pm - strong intrusive memory hour - all coming at once with panicky electric feeling in stomach each time, it upsets me but I try and let it wash over me
4.00pm - actually feel a bit hungry - this hasnt happened for a while at this time of day, eat some crisps, a banana, some grapes
5.00pm - take 2mg vortioxetine as forgot to take it at 4pm
6.00pm - still able to sit on sofa, not too restless, eat a sandwich
6.30pm - try to watch big bang theory which is the programme I have usually been able to watch over the last year but this time I get strange feelings when watching it, like intrusive memories but very vague and i feel anxious
7.00pm - take 2mg diazepam
7.30pm - try and read a book but same feelings of strong dread anxiety are there in my stomach so I have to give up
8.00pm - take 16mg sertraline
9.00pm - try and sleep, cant get off to sleep but no restless legs
12.00am - get off to sleep, no restless legs, no adrenalin rushes, a couple of times woken with the teeth clenching and also waking disorientated takes me a while to work out where i am but overall manage to sleep until 5.50am
6.00am - usual cortisol rushes
7.00am - wake in a panic with the thought that the vortioxetine combined with the sertraline has caused permanent brain damage and the intrusive memories will never go. Try and tell myself I have no evidence for this.

 

burning sensations slightly less possibly, still a few electric shocks

[Shep]

44 minutes ago, Kernol said:

12.00am - get off to sleep, no restless legs, no adrenalin rushes, a couple of times woken with the teeth clenching and also waking disorientated takes me a while to work out where i am but overall manage to sleep until 5.50am

 

This is an excellent improvement. 

 

19 hours ago, Altostrata said:

Can you hold on moving the vortioxetine a couple of days and see what happens? Please continue to post your daily notes.

 

Kernol, please continue to hold everything steady, as Alto mentions. 

 

Last night was a better night. Hopefully this will continue. 

[Kernol]

has anyone out there had a similar experience to me that can give me any hope?? Anxiety so bad I can't even think of going outside or doing anything, I just feel so lost in all this. Its been a year now and everything is worse since they added Vortioxetine and then I went too fast on my Sertaline taper and updosed and destabilised further. Not to mention I am on diazepam as well. I feel like all of these drugs together may mean I will never recover and the worst of all is these weird random memories that started over 3 months ago that come with a big jolt of electric anxiety. Songs looping round my head all the time, I feel deranged and damaged. It is so hard every day to try and convince myself I will stabilise out of this mess - any words of encouragement to help me I would really appreciate it. 

[Shep]

40 minutes ago, Kernol said:

any words of encouragement to help me I would really appreciate it. 

 

You slept nearly 6 hours last night. That's an improvement!  It's definitely not a sign of damage - it's a sign of neuroplasticity. 

 

Get away from the mindset that this is permanent - neuroplasticity is a science that says that isn't so:

 

Healing from antidepressants: The power of neuroplasticity video (7.5 minutes)

 

Try to avoid catastrophic thinking because that will lead to the "dark side of neuroplasticity" if you stay in a hopeless spiral. 

 

Norman Doidge - The Dark Side of Neuroplasticity video (2 minutes)

 

Here is how to stop these catastrophic thoughts. It doesn't happen overnight and it does take repeated attempts:

 

 

Dealing With Emotional Spirals

 

"Change the channel" -- dealing with cognitive symptoms

 

Find some distractions to get you through the day. When the intrusive memories pop up, have a list of "change the channel" type of activities to turn to. After you do this enough times, it will become a habit. And then you'll build positive neuroplasticity and aid in your healing. 

 

 

43 minutes ago, Kernol said:

has anyone out there had a similar experience to me that can give me any hope??

 

There are many success stories: 

 

Success stories: Recovery from withdrawal

 

[Kernol]

16/10 
8.00am - got up had shower, feel edgy and anxious, bit of derealisation
9.00am - took 2mg diazepam, try and do some work emails, burning nerve sensation on back quite strong, vision jumping a little bit
11.00am - derealisation and anxiety quite strong, just feel peculiar - try and accept it and tell myself it will pass
11.30am - electric anxiety feeling in my stomach is really strong, feels like all my nerve endings are electrified. This is intense. I know I need to calm down and accept it but its hard
12.20pm - random memory of my brother going to a football summer camp as a kid because i saw what looked like a football pitch online - god this is so weird how the brain is connecting these random things at the moment (i am 44 what a stange old memory to throw out) Trying not to get upset by it
12.30pm - read shep's comments and watch the videos on neuroplasticity, trying to believe it will happen for me
1.00pm - manage a sandwich
1.30pm - anxiety is taking on a new feeling today - it feels so chemical so unfamiliar, not felt this before. Its so strong and relentless today
2.00pm - take 1mg diazepam
2.30pm - try and lie down but derealisation is bad, more random memories, trying to let them pass, have to close the curtains as looking at sky makes derealisation worse, feel like im going crazy but I tell myself it is just anxiety and exacerbated by the chemicals and only temporary
3.00pm - try and do some work emails, look in the mirror my eyes look glassy like a drug addict, they have looked like this for 3 months, it upsets me 
4.00pm - have epsom salt bath, take 2mg vortioxetine, derealisation is still strong
5.00pm - eat small meal, get husband to read my pug's success story
6.00pm - play quiz with husband, anxiety is strong, deep in my stomach, electric
7.00pm - take 2mg diazepam read more success stories, feel slightly calmer 
8.00pm - take 16mg sertraline
9.00pm - try and sleep, intrusive memories of streets in town near where i used to live causing big waves of anxiety, same streets I have had before, no reason for it, upsets me, will this ever go away, I tell myself it will, I have had them for more than 3 months now it must be the vortioxetine i think but then i think if thats the case why hasnt the reduction in dose made them less, i tell myself there is no answer so no point trying to work it out
10.30pm - fall asleep, no restless legs, teeth clenching there but not waking me up
5.00am - wake up to strong panic attack and burning, with strong dread. 
6.30am - listening to people going off in their cars to work brings on strong anxiety, I feel so removed from the world cant imagine going to work 

[Shep]

3 hours ago, Kernol said:

10.30pm - fall asleep, no restless legs, teeth clenching there but not waking me up
5.00am - wake up to strong panic attack and burning, with strong dread. 

 

Your sleep is getting better and the teeth clenching has lessoned to the point where it's not waking you up.

 

Very good signs that you are stabilizing. 

[Kernol]

thanks @Shep i am grateful to have slept better the last 2 nights! I guess I need to be much more patient with the chemical feeling anxiety and the random memory stuff?- especially the latter as we are not sure which drugs are causing it over the last 3 months. I do also think (although I am always hesitant to say!) that the burning on my stomach has maybe lessened in intensity - it is still there and on my back but I know it has been stronger than today.  I am hoping that at least lowering the vortioxetine and eliminating it when @Altostrata thinks is right might help further. Although I can't be certain, I do feel like it has made things worse for me, as I never had the random memories before I started it and it seems to be a drug that acts on lots of receptors. 

[Kernol]

17/10
8.00am - got up had shower, feel same as yesterday morning
9.00am - took 2mg diazepam, do some work emails
10.00am -do some vacuuming, read some positive affirmations
11.00am -burning on back still present but not too much on stomach so far today 
12.00pm -have sandwich
12.50pm -just calmed myself a bit, doing some work then have random memory with adrenalin jolt - weird - almost same time as yesterdays ones started? Not sure if there is a pattern
1.45pm - just doing some work and another random memory pops in of an old dream this time - they seem to be becoming more frequent this week - I need to try and get used to them but I am still freaking out a bit when they happen. 
2.00pm take 1mg diazepam, trying to calm myself down and change the channel
3.00pm - feeling anxious, every time I do my mind takes me to the random places in my past that I have been having the random memories of - it is so weird, I hate it
4.00pm - took 2mg vortioxetine
5.00pm - dial into work call. had sandwich. Lots of electric anxiety in my stomach and my head and face feels electric and tingling, telling myself it is just temporary whilst I stabilise   
6.00pm - such strong anxiety I vomited - this has never happened before. Is this vortioxetine withdrawal or too early?
7.00pm - took 2mg diazepam, no relief at all from the anxiety. Its so strong and feels so alien to me this feeling. Random memories just one after the other
8.00pm - took 16mg sertraline
9.00pm - drowsy - try and sleep
10.30pm - woken in panic attack and teeth clenching
12.00am - woken in panic attack
12.00am - 6.00am - no sleep, just strong electric anxiety and burning down my back and in my head

 

random memories and electric anxiety so high today and yesterday - feels different physically - has got worse as the day has gone on.  Are frequent random memory pops like this normal for 3 months like this - I dont see many people on here talking about them? I have seen some people in benzo recovery with them. I feel like im going crazy. What on earth causes them? Is it just serotonin receptors - taking 2 SSRIs even at this low dose together? - I know they affect memory?  @Altostrata can this be vortioxetine withdrawal already? I feel like something is really wrong. I am now desperate. Should i just stop Vortioxetine altogether or will that make things worse? 

 

[Shep]

2 hours ago, Kernol said:

Are frequent random memory pops like this normal for 3 months like this - I dont see many people on here talking about them?

 

Yes, this is an extremely common symptom. Please see:

 

Withdrawal causing intrusive or repetitive thoughts, rumination, and increased panic?

 

Mindfulness exercises can be very helpful for this. You may benefit from finding mindfulness videos on YouTube and learning how to distance yourself from any painful or difficult thought or memory.  As my favorite YouTube guru Mooji says, "Your thoughts are just visitors and you are NOT a hotel. Don't invite them in!"

 

In other words, just because you have a memory pop up in your head, you don't need to attach any thoughts to them. Look at them as annoying commercials on TV or loud neighbors in the apartment next door. Just do a breathing exercise, thank the intrusive memory for giving you the opportunity to practice (gratitude is great for neuroplasticity), and go on with your day. 

 

Once you learn how to do this, you've learn a very powerful skill that you'll take with you after the withdrawal experience is over.  These types of memories and thoughts give us plenty of opportunity to practice. 

 

Some information on mindfulness and other helpful tips are here;

 

Non-drug techniques to cope with emotional symptoms

 

This thread can be particularly helpful:

 

"Change the channel" -- dealing with cognitive symptoms

 

Perhaps make a list of activities that you can do when these types of intrusive thoughts and memories occur. 

 

[Altostrata]

Kernol, can you take 2.25mg vortioxetine tomorrow? We need to track your symptom pattern.

[Kernol]

18/10
8.00am - got up had shower, feel overhwelming dread in stomach
9.00am - took 2mg diazepam, try and do some work emails
10.00am - put washing on, so much dread its constant. I think of anything and its there
11.30am - lie down, I cant sleep, old dreams and memories one after another with surge in anxiety
12.30pm - I despair, I feel so trapped, things are getting worse. I talk to my husband about how I feel
2.00pm - take 1mg diazepam, dread is just relentless, no respite
3.00pm - lie down, I start to fall asleep and its the only relief I feel
4.00pm - wake up but reality hits me and I feel worse, have epsom salt bath, take 2mg vortioxetine
5.00pm - I feel worse, like I am in a parallel universe, the dread is overwhelming, I notice more little electric shocks on my stomach
6.00pm - eat something
7.00pm - take 2mg diazepam, it doesnt give any relief 
8.00pm - take 16mg sertraline, start to feel very drowsy
10.00pm - fall off to sleep but woken with a nightmare and burning, small amount of restless legs
12.00am - fall off to sleep again but woken with strong pain in my eyeball
3.00am - woken by bad teeth clenching, dread and panic starts again
4.00am - 6.00am - just in and out of dreams and memories and dread, not really sleeping

Today was the worst day, I tried every coping mechanism I have but it was too strong for me. @AltostrataAm I too late for an updose in sertraline now? I can only relate the worsening to 2 things over the last few months - reducing sertraline below 25mg which is when I had problems on my first withdrawal last year or the vortioxetine - so I feel like my only hope is to change one of these but I know changes are destabilising however I am so desperate and I have no evidence of stabilisation only deterioration. I can take 2.25mg vortioxetine today but part of me feels like I am just going backwards

 

 

[Altostrata]

I don't know what an updose in sertraline would do.

 

It seems you get an adverse reaction to vortioxetine within an hour after you take it. This could be an interaction with the other drugs. My sense is you'd be better off without vortioxetine, but going off might be bumpy. Do you want to continue to reduce it? Going off by 10% every week might work.

 

Hang in there, you're being very brave.

[Kernol]

19/10

 

8.00 - get up have shower feel drowsy 

9.00 - take 2mg diazepam do some housework feeling lots of dread but not as extreme as yesterday 

11.00 - deep breathing

12.30 - have sandwich

1.00pm - take 1mg diazepam 

2.00pm manage to do crossword still dread feeling but again not as extreme as yesterday 

3.00pm walk to corner shop with husband panicky but not horrendous

4.00pm - have Epsom salt bath take 2mg vortioxetine 

5.30pm - have dinner 

6.30 play an online quiz game, still lots of dread but I’m just thankful not as bad as yesterday 

7.00pm take 2mg diazepam

8.00 take 16mg sertraline

9.00 lie in bed trying to sleep fairly ok not got the random memories running round my head as I try and fall asleep

11.30pm - woken with Very strong teeth clenching 

12.30am - nightmare and lots of burning 

1.00am - 6.00am - random memories continuously, brain wont switch off, nightmares,  teeth clenching, hands are moving like my fingers are tapping when I wake up? Panic attack at 4am, Burning strong, head tingling

 

so not such a bad day as day before but very bad night - doesn’t seem to be any pattern?

 

@Altostrata I will stick at 2mg and try the 10% weekly drop. And thank you for saying I’m being brave - that means a lot 

 

[Shep]

5 hours ago, Kernol said:

so not such a bad day as day before but very bad night - doesn’t seem to be any pattern?

 

Withdrawal is non-linear, but it looks like you are stabilizing some. Decreasing the  vortioxetine seems to be helping. 

 

The Windows and Waves Pattern of Stabilization