Tanha: never stabilize under diazepam but want to taper

[Tanha]

Anhedonia and hyperarousel and sickness getting worse and worse hour by hour. 

[Altostrata]

I'm sorry, I cannot read your notes the way you're posting them. Please clean them up before posting them here so an ordinary human being who has lots to do can read them without undue effort.

 

When you take your drugs inconsistently, you can expect to have an increase in symptoms some time afterward.

[Tanha]

20. dec

 

6 am.         Woke with bad anxiety

7:30.           meat cucumber

                   Hempprotein, oats

                   Vitamin d

                   Magnesium

                   50 mg quetiapine        

                    1 mg diazepam

9 am          Bad muscleweaness, 

                    feeling of no musclecontrol,

                    nausea, depressed, 

                     No feelings

10: 30        Hyperarousel,

                   Feeling sick, nausea, all day

                    Slight tremor, flue

11.               Muscles a little better

Noon.        Meat vegetables

                   hempprotein,

                    fishoil

                    55 mg quetiapine

                     1,5 mg diazepam

1 pm            nausea and flue better

                     Muscleweakness Bad again

                     eyesight worse

2 pm.          Vitamine juice

                    Magnesium

2;30.            anhedionia, akathisie,

3 pm.          Hyperarousel worse

3:30 pm      Hyperarousel extreme until late

5:30 pm.     Meat, cucumber

                     Oats, hempprotein, 

                     Magnesium

                      1,5 mg diazepam

                      62,5 mg Quetiapine

8 pm.           16 mg mirtazapine, 

                      arousel bearable

 

21. Dec

 

5:30 am.      Woke, ruminate, feeling sick

7:30 am.      Meat cucumber

                      Vitamin d

                      Magnesium

                      50 mg quetiapine     

                      1 mg diazepam

 

                       Feeling very sick and weak

 

[Tanha]

Eyesight and accommodation of the eye worse

[Tanha]

33 minutes ago, Altostrata said:

I'm sorry, I cannot read your notes the way you're posting them. Please clean them up before posting them here so an ordinary human being who has lots to do can read them without undue effort.

 

When you take your drugs inconsistently, you can expect to have an increase in symptoms some time afterward.

Have cleaned things up

tjank you for being honest 

[Tanha]

12 hours ago, erer said:

Hi,

 

I have been off Zyprexa(Olanzapine) since spring. (Getting off got me a big part of my life back. I am able to work now, go outside etc).

I am currently tapering Diazepam and holding Valdoxan.

 

My akathisia was from Cymbalta. If you read my  thread, you will find out how I almost died

The strong akathisia came in bouts about 3 months after the CT and a slightly milder version persisted in the mornings for... a long time. But it was not the same intensity than it was right after CT from Cymbalta. I also do believe olanzapine added sooo many symptoms to my list and being off it has made such a difference.

 

Thank you,

this information is really valuable for me. How long was the overall duration of the severe Akathisie and how long did you suffer during day or week in that time?

was it painful?

 

can you tell my what makes you think that the olanzapine meds symptoms worse?

during withdrawl?

you also mean Akathisia? 

What other symptoms. 

 

Sorry for asking again. I have severe brainfog and don‘t know how to get to your thread. 

 

How long and fast did you taper olanzapin?

[Tanha]

Yesterday and today it seems yet another old pattern coming up again:

 

just ist before the next dose of quetiapine and diazepam is up I have worsening of hyperarousel. That makes me always think I have an underlying damage and that I need this medication. 

I started to have an urge for it again. Didn’t have that at higher doses.

 

don‘t get me wrong: I still and always want to continue tapering meds. 

[JanCarol]

Hey Tanha - 

 

On 12/14/2018 at 11:59 PM, Tanha said:

is it true that quetiapine gets more sedating and causes lower bloodpressure the lower the dose gets?

as this is the case with mirtazapin. 

 

Yes, but those doses are much lower than what you are on.  After 25-50-75 maybe even 100 mg (depending on metabolism), the quetiapine starts to go more towards Dopamine receptors.

On these lower doses, it hits the histamine receptors, inducing sleepiness.

 

I have seen (and experienced) that 12.5 mg is more sedating than 25 mg.  But at doses over 200 mg, this is unlikely.

 

Have you run a drug interaction report yet?

Drugs.com Drug Interaction checker 

 

On 12/15/2018 at 2:52 AM, Tanha said:

 

But if one can only taper one medication at a time and this takes very long, often months and years. So how can one find out which is the cause in such polytox settings? 

 

does anybody know a better way then tapering each for long months without knowing if it is the cause or the cover/protection against Symptoms?

 

If we did, we wouldn't be here.  People would just waltz off their complex cocktails with no problem.

 

If you go off too fast, you can suffer setbacks, and what would have been a 3 year taper might become a 5 year one, or longer.

The tortoise wins this race, not the hare.

We don't know a better way.  So - the long way is actually the shortest way, because when you take shortcuts like,

• tapering multiple drugs at the same time
• shortening tapering times (less than a month between changes)
• fiddling with supplements and other drugs to try and improve symptoms, and
• tapering larger chunks (more than 10%)

 

then you might get into strife, and a taper which might take 3 years, might be irritated and take even longer.

 

So - the tortoise gets to the finish line before the hare.

On 12/15/2018 at 7:09 PM, Tanha said:

Until 26. oct

24 mg mirtazapine

24 oct forgot to take mirtazapine

 

26. oct

20 mg Mirtazapin

Levomepromazine 0 mg

 

2. nov

quetiapine 275 mg ( 4 times daily)

 

13. nov 

20 to 15 mg mirtazapin 

 

14. nov 

20 mg mirtazapin 8 pm

 

Until 31. oct

275 mg quetiapine

 

1.nov.

250 mg quetiapine

 

1. nov 

271 mg quetiapine 

 

2. nov 262,5 mg quetiapine 

 

This is too many adjustments in too short of a time.

 

ONE drug.  10% .  One month.

When you do it like this, you can't tell - was it the change in mirt?  or quetiapine?  that messed you up?  There are more changes like this - all too fast, and complicated.
3 KIS's Keep It Simple, Slow, Stable

Until you have held for a long time, we don't know what is happening with you.  Additionally, you are in hospital - the fastest way out of hospital is to comply.

 

 

On 12/15/2018 at 8:59 PM, Tanha said:

i am cutting quetiapine into many small pieces and that's how I take them. The amount of pieces per dose differs greatly. Hope this is no problem ...

 

I thought you said you had a precision scale?

 

This is a problem.  It is very important that you take the same dose at the same time every day.

 

On 12/15/2018 at 9:02 PM, Tanha said:

And I always have Bad diarrhea. Doctors said this doesn't affect the effect of the pills 

 

Cymbalta, Seroquel hit serotonin receptors.  90% of your serotonin receptors are in the gut.

 

Please be sure and drink plenty of water.  Take electrolytes (minerals & salts, available as a drink mix), as that will help with your blood pressure as well as keeping you from getting dehydrated from diarrhea.  How long have you had it?

I have a chart I've made.  You are asking why you are not stable.  WHen you look at this chart - which only covers 2 months (remember we advocate one change a month) you will see that your quetiapine goes up and down.  You CT'd the Levopromazine in October (Okay, you tapered over a week, but that's really a cold turkey), and you have also tapered your Mirtazapine during this time.

 

Do you see that drop and spike at the end of November?  That might take 3-6 months to clear.  Additionally, because you have changed 3 drugs in the past 2 months, we have no way of knowing whether it was the CT of the Levomepromazine, the spikey dosing of quetiapine, or the drop in Mirtazapine which is affecting you.  Think of this like a science experiment - it is vital that you only change one variable at a time, so that you know what is really happening.  Changing multiple variables might make you feel this or that - but it is not accurate information.

 

I haven't finished your thread, but what I've read here about your drug patterns indicates to me that you need to stay stable, on the same doses, every day at the same time for at least a month, and I would prefer to see that for 3 months total.

i know you are having symptoms.  But if you complain to doctors about your symptoms, they will only seek to change your drugs - and you need stability.

Please explore our forum on Non Drug Techniques for Coping with Emotional Symptoms 

 

I hope you see the sun today!

 

Edited December 21, 2018 by JanCarol

[Tanha]

Wow jancarol,

 

i appreciate your help so much. 

 

I have read all the 10% and triple k and other guidelines long ago.

 

what gives me such a hard time doing slow taper is that I think I have interdosewithdrawl from diazepam and so much problems with the quetiapine. 

 

Tapering one at a time is necessary but means having interdosewithdrawl and sideeffects for years. I am afraid of that.

 

what do you mean my serotonin receptors are dead? Can i heal? It doesn‘t feel like it.

did you heal? Can things heal while I am on those drugs sufficiently to get off them?

my hyperarousel is now with me againthe whole day. Doesn‘t feellike being manageable in the long run.

 

That gives me such a fright although kind of knew this. 120 mg cymbalta have killed my system.

 

Thanx for visualizing my situation. 

Great stuff. 

Little inaccuracy: I tapered levomepromazine for four months and did my first cut from 50 mg to 25 mg two weeks after starting this med.

 

My hyperarousel is going through the roof all day.

 

tanhs

Edited December 23, 2018 by Carmie
Got rid of long quote

[Tanha]

You are telling me no more cuts for at least three months, right?

 

this is pure hell.

Edited December 23, 2018 by Carmie
Got rid of long quote

[Tanha]

 

 

That drop of quetiapine end of November is that the one day I forgot to take it.

Edited December 23, 2018 by Carmie
Got rid of long quote

[JanCarol]

This chart does not take into consideration that sometime around June/July, you were on 50 mg Levomepromazine and 400 mg Seroquel, and the 4 x 50 mg doses of Chlorprotixen.

 

In order to get stable, you need to stop making changes.  I know you are feeling compelled to get off - but if you melt down and have a crisis, that will not make it any easier.

 

Slow and steady is the best way to go.

 

Yes, you are on a lot of brakes.  You are asking for a quick fix for something that's been fiddling your neurotransmitters for awhile now, and in complex ways.  This will not be fixed in a week or a month.  

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

 

Slow down and hold.  Then maybe we can start to understand what your symptoms are and why you are having such a hard time.  It may be that your drug fiddling is the cause of your more extreme symptoms.

I would also like to hear more about your feelings.  Maybe this isn't the place for it - maybe a journal is.  But instead of using symptom words like "anhedonia" and "dp/dr" I would like you to explore feelings.

 

 

Some examples might be - "I am scared that the drugs are causing harm," or "I am angry that I have been carelessly drugged."  Or maybe even the feelings that landed you in hospital in the first place.

 

You got drugged for a reason - was it that you "got caught"?

 

Here's what I write about "getting caught:"

Quote

I believe in "mental diversity" (that is what I learned from Will Hall, a link that Alto gave you).  You can believe in whatever you want, and listen to whomever you want, including voices that nobody but you can hear - but when your behaviour crosses a certain line, you GET CAUGHT.  One of the early goals is to learn what behaviours get you CAUGHT and never go there.  Yelling loudly in public places.  Hiding on store shelves behind the merchandise.  Threatening behaviour (even if it is harmless, it makes people uncomfortable).  Publicly proclaiming your deep spiritual belief and asking others to join you in your revelation.  Public self harm.  Crying loudly in a public place but not talking to anyone for hours.  These are just a few examples that I personally have experienced with myself and close loved ones.  If you are trapped in hospital, you did something to GET CAUGHT.

You may not feel like moulding your behaviour to some sort of external standard, but it is very useful if you want to stay out of hospital and learn to take care of yourself and heal.

The more you can use the feeling words on this wheel (even if just in your personal journal) - the more articulate you become about your feeling states.  Knowing your feeling states intimately is like a beacon, a guiding light.  Your extreme feelings are trying to teach you something - and the drugs are just driving the feelings deeper.  As you come off your drugs, you will begin to feel more, and it is vital to learn to explore and manage these feelings so that they don't get you "caught" again with extreme behaviours.

On 12/17/2018 at 5:03 PM, Tanha said:

4:30 am wake up with hyperarousel that stays whole morning

 

This is cortisol spikes:  Waking with Panic or Anxiety - Managing Cortisol Spikes  It is normal when your body is in a state of dysregulation from the drugs, and your doses have been so irregular, it would not surprise me if you were in a state of dysregulation.

 

On 12/17/2018 at 5:03 PM, Tanha said:

7:30 meat, vegetables, oats and oatmilk, hempprotein

 

Why do you take hemp protein in addition to meat?  Are you losing weight and trying to gain it back?  Generally, a human cannot absorb more than 20-30 g of protein in a serving.  

 

On 12/17/2018 at 5:03 PM, Tanha said:

55 mg quetiapine, 1 mg diazepam, vitamin d, magnesium

 

A half hour later you start to go into hyperarousal.  What do you mean by anhedonia?  Please use feeling words instead of symptom words.

The Vitamin D might be contributing to the hyperarousal.  You might try not taking it for a day, and seeing if you do better.  You may be Vitamin D deficient, but when in withdrawal, Vitamin D can be overstimulating.  Many of us have gone for long periods in a state of deficiency - to get through the withdrawals, and address the deficiency later:  http://survivingantidepressants.org/index.php?/topic/39-vitamin-d3-cholecalciferol-or-calcitriol/  

On 12/17/2018 at 5:03 PM, Tanha said:

2:30 pm magnesium and Vitamine juice, magnesium

3 pm akathisia 

 

How much magnesium per day are you taking total?  What form is the magnesium?  Magnesium Oxide?  Magnesium Glycinate?  Magnesium Citrate?  

This may be a clue to your diarrhea, as well.  Too much magnesium gives you loose stools.

Additionally, the akathisia "kicks in" a half hour after your "Vitamin Juice" - what is in your vitamin juice?  It may be overstimulating.  This hyperarousal after the Vitamin Juice seems to be pretty consistent. 

 I know you want to get healthy and keep your nourishment up - but when in withdrawal, some of this stuff can kick off symptoms.

 

That's why Alto asked for your dosing and symptom patterns.

 

On 12/18/2018 at 4:32 AM, Tanha said:

sleep from 10 pm to 7 am, since November only until 5 am.

 

This is still really good sleep.  Be thankful!

 

On 12/18/2018 at 5:57 AM, Tanha said:

It says waiting until I stabilize and then wait four werks and more.

yet i do not stabilize. I tried that before.

 

According to your chart, the longest you were on the same dose from October to December was 2 weeks. 

 

That is not a long enough hold to be stable.

 

Continuing to fiddle is like wanting the basketball to settle down, but you hit it every time you change your doses.  So the basketball (your brain) keeps bouncing.

You have to stop bouncing the basketball - and learn to survive and tolerate the symptoms - in order to be ready to taper again.

 

I hope you see the sun today!

[Tanha]

Hi jancarol,

 

thank you so much for all your thoughts. It is more I ever expected.

 

actually some of my weird tapering happend because doctors told me end of October that they ct me from mirtazapin and put me on a new ad which name I am not allowed to know. Otherwise have to leave the clinic. Believe me, i am not capable of going anywhere (cannot even wash myself properly). So I tapered as Slow as i could and asked for more time to finish the levomepromazine taper which is the only taper I told them about at that time. (They believe Ian still on 400 mg quetiapine and 30 mg mirtazapin).

i was in such fear that the new drug would interact with levomepromazine that I insisted on tapering that before I get the new one. But you can imagine what timeframe doctors have for such a taper.

Later I somehow could stop them from giving me the new drug (cardiologist said the bloodpressure is to low and the new med is not going well with that). 

 

 

they refused the other tapers (which I asked for in summer) simply because they can only give me the official pillsize (no compound liquid, no cutting pills). 

 

I am working hard to be able to sit and walk again and get anxiety and hyperarousel stabilized so I can go home. I also have to put on weight and I faint a lot when getting up. Bloddpressure is extremely low All the time.

 

actually while on levomepromazine and much more quetiapine i could only stabilize my bloodoressure a bit with putting myself in withdrawl which raised the pressure only for days but at least icould get more active for a few days. I knew how stupid this was but Kamin such agony all the time tomorrow was non existent for me. Only today

 

thank you so much for all your thoughts. It is more I ever expected.

Edited December 23, 2018 by Carmie
Got rid of long quote

[JanCarol]

Okay, so I adjusted your chart for some of the other things I found in your posts (really, Tanha, going through your posts was tedious, you've got to go easy on us!  We are volunteers!)

 

 Of course, these adjustments make it look even worse, as far as stability goes.

 

If, as you claim, you are familiar with the Simple, Stable, Slow, then why are you making sometimes DAILY changes?  Why are you going up and down on the quetiapine like a yoyo? 

19 minutes ago, Tanha said:

That drop of quetiapine end of November is that the one day I forgot to take it?

 

No, you reduced it - my chart shows that you dropped from 262.5 to 237 to 230 - in just 3 days.

 

21 minutes ago, Tanha said:

You are telling me no more cuts for at least three months, right?

 

this is pure hell.

 

Actually, I am telling you to stop changing your doses until you are more stable.  It's called "Holding," and is the hardest part of tapering.

 

That may be one month, it may be 6.  Some people have held for 18 months with good effect.

 

With your blood pressure the way it is, you probably don't want to hold that long - but you will want to simplify EVERYTHING.  Your diet is nice and clean and simple - but your supplements may be overstimulating.  What about your daily activity?  I know you are in hospital - but what is it like?

 

I'm looking for more than just a clinical report - I want to hear how you are.  What is a typical day look like for you?  Do they bring your food to you?  Do you get choices with your food?  Are there classes or groups or activities that you can attend?  How do you feel about them?  How often are you getting medical (doctor) attention, and how often do you get therapy?

What do the medical people say about your blood pressure?  What are you calling "low blood pressure"?  I walked around for 20 years with 90/70, and was fine.  Fatigued, but fine.

I still have one more page to read....BTW, you can highlight JUST the part of the post you wish to respond to instead of quoting the entire post - that will make your thread more compact and easier for other mods to follow. 

I suspect it is the repetitive and long posts which is making it difficult for moderators to make sense of what is happening with you.

[Tanha]

A great wheel.

i have others not as detailed.

 

well I have borderline personality disorder. Feelings come in clusters and I have a very hard time giving them names. This process is also very painful for some reason. It reminds me of who I was before that do/dr crash in December. 

Dp/dr started suddenly in December and I knew immediately thatthis is it cause I still had feelings but they were not mine. Other symptoms fit to that, too, 

after one year taking cymbalta i got the personalitydisorder which is very unusual at the age of 45. since then i had dissociation auf emotions are overwhelming. But no dp then.

i think since I reduced mirtazapin I have stopped to have any feelings except anxiety and sadness. I am utterly empty all day. Often I am In a good mood but not able to have any interest. I try every day to find words for this mood but I can‘t. My therapist and i work on that. The only thing that helps is to throw me into „interest“ and by that throwing me into emotions. Animalthrtapy does that once a week and whenever i can i follow a fellow patient to where she wants to go and without thinking i allow a sudden am within a supermarket and overwhelmed by feelings which i cannot sort out. 

Then i have to deal with many days in bed in apathy because the painful anhedonia as i call her and the nausea and flue have to be endured. Then there is one hour again where Ivan work on emotions again.

 

i must be honest and say that i also stopped to have feelings during the traumatic and failed diazepam taper. 

I am traumatized by those weeks (e.g. after a 0,5 mg reduction  I could Not close my eyes for 96 hours because I fainted and got adrenalinespikes if I did. We could only stop this by a Heavy updose of my medication). 

Then i stopped to think of any withdrawl ever being possible. I lost all interest (also with the help of 400 mg quetiapine and 15 mg diazepam then.

 

I love dbt and tich nah than. I try walkingmeditation as often as possible.

 

at the moment I run away from feelings, for many reasons. Too overwhelming. 

Anhedonia is for me the painful sister of depression although anhedonia is part of depression.

i was always wondering why my 

Depression started to become so painful a couple of months Ago and that I have a good mood with it but no interest.

 

Then i found that I have akathisia. I have the painful version not being able to sit still and being too weak to walk all day. 

I noticed that my akathisia was very physical in May after trying to go from 0,5 mg lorazepam to 0 mg. 

Now it is more mental (I want to jump out of my skin badly all day). 

I can differentiate that very well from hyperarousel

 

Because i have so many different symptoms changing during the day it is easier for me to give the symptom a quick name in order to say to myself: ah it is this symptom again, I say hello ind try to forget about it as good as I can.

 

My feelings are numbed away and as I am being an artist this is so discouraging for me. Depression is giving me a very hard Time since summer.

 

i will try and incorporate your wheel of emotions into my work. But at the moment it is hard to get into feelings at all no matter how hard I try. 

 

Thank you so much with your patience and thoughts.

 

 

Oh, the Vitamine juice is very strong and with fermented vegetables also. I thought it could cause problems. I don‘t take it with medicine. i cannot eat properly and am loosing weight day by day. I cannot eat bread or fruit for Somerset of and no pasta.

the hemp is a „good“ protein I thought and the oats and oatmilk is given to me by the nurses to put on weight.

 

i wonder what you think of Noni juice. 

Edited December 23, 2018 by Carmie
Got rid of long quote

[JanCarol]

From Drugs.com:

 

Quote

Interactions between your drugs

Moderate

diazePAM  mirtazapine

Applies to: Valium (diazepam), mirtazapine

Using diazePAM together with mirtazapine may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. 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

Moderate

diazePAM  QUEtiapine

Applies to: Valium (diazepam), quetiapine

Using diazePAM together with QUEtiapine may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. 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

Moderate

mirtazapine  QUEtiapine

Applies to: mirtazapine, quetiapine

Using QUEtiapine together with mirtazapine can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a rare side effect. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). 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. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether together or alone. Avoid driving or operating hazardous machinery until you know how the medications affect you. 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.

 

So - how many of your symptoms are from withdrawal (CT of cymbalta - which I didn't even put in your chart) and how many of them are from drug interactions?

Valium has a very long half life - It is probably not necessary to dose it several times a day.  It may benefit you - during your hold time - to find a way to take your valium *not at the same time*  as your quetiapine.

It's good that your mirtazapine is at a separate time, as the "long QT syndrome" is very undesirable.  Keep these drugs apart!

When you've held, without any adjustments for long enough to get stable (it may be stable-unpleasant - but stable, see Brassmonkey's excellent:  brassmonkey on "Withdrawal Normal" to help figure out what is stable), then we can work on reducing the quetiapine - only.  No other adjustments to mirtazapine or diazepam.  Just the one taper.  We can address the other drugs when you have stabilised on your quetiapine taper.

 

On 12/20/2018 at 5:21 PM, Tanha said:

If I taper quetiapine 10% a month and wait with the diazepamtaper until quetiapine is being finished (in three years) I would not be able to reduce the paradoxical reaction soon. Is that the way I have to accept?

 

After looking at the chart I posted - we don't know what you are having reactions to.  It could even be from the Cymbalta CT earlier this year.

The best way to get away from symptoms is to stabilise, then slowly taper.  Yes, you will need to have some acceptance and tolerance of symptoms, because it will be awhile before you are out from under this heavy drugging regimen.

 

Mindfulness and Acceptance 

[Tanha]

Jancarol, how do I highlight the post?

 

sorry, I have severe brainfog. I don‘t know how to keep my posts short. I work on that very hard. 

I really know that they are too difficult to read. I really do. 

I am a teacher and know how it is reading hundreds of pages throug students thoughts .....

 

 

well er my daily routine

if I have a good day I can attend:

i have dogtherapy

worktherapy

walktherapy

gardentherapy

speakingtherapy

gymnastics (while sitting)

 

but since I cannot sit still and am so sick most of the day I start therapy but often cannot stay with it.

I walk around the building twice a day if possible. Once every week I manage to go further into the forest or else to confront my anxiety (I fear normal life).

 

bloodpressure 90/65 but I think what makes it terrible is the akathisia and hyperarousel with it. I feel like being constantly torn apart between fatigue, pacing and inner agitation.

 

i get my food into a cup and eat it while walking. 

I do not change clothes and I wash myself once a week. I know how ugly that is. I cannot stand water on skin. I am not interested in being clean. Sorry, I have never been like this before. 

 

I cannot listen to music, cannot watch tv, cannot read newspaper or anything from the outsideworld. I have problems sitting still, concentrating, finding interest and I run away from imagining that I could be part of the normal world one day again. 

 

I attend therapies even when i faint or feel too sick for that. The akathisia and anhedonia make it difficult to stick with it for more than 30 minutes though. 

Edited December 23, 2018 by Carmie
Got rid of long quote

[Tanha]

11 minutes ago, JanCarol said:

From Drugs.com:

 

 

So - how many of your symptoms are from withdrawal (CT of cymbalta - which I didn't even put in your chart) and how many of them are from drug interactions?

Valium has a very long half life - It is probably not necessary to dose it several times a day.  It may benefit you - during your hold time - to find a way to take your valium *not at the same time*  as your quetiapine.

It's good that your mirtazapine is at a separate time, as the "long QT syndrome" is very undesirable.  Keep these drugs apart!

When you've held, without any adjustments for long enough to get stable (it may be stable-unpleasant - but stable, see Brassmonkey's excellent:  brassmonkey on "Withdrawal Normal" to help figure out what is stable), then we can work on reducing the quetiapine - only.  No other adjustments to mirtazapine or diazepam.  Just the one taper.  We can address the other drugs when you have stabilised on your quetiapine taper.

 

 

After looking at the chart I posted - we don't know what you are having reactions to.  It could even be from the Cymbalta CT earlier this year.

The best way to get away from symptoms is to stabilise, then slowly taper.  Yes, you will need to have some acceptance and tolerance of symptoms, because it will be awhile before you are out from under this heavy drugging regimen.

 

Mindfulness and Acceptance 

Thank you. 

 

Any idea how when to take quetiapine and diazepam? 

Actually I freaked out when I took these medications less often or in higher doses at a time. Hm. 

I thought having a certain bloodlevel causes druginteractions 

anyway no matter when I take this or that during the day. 

 

I read almost everything by brassmonkey! 

Very good info and thoughts. 

 

Thank you so much. 

I am too afraid to change anything at the moment not even the vitamins (or nonijuice at 11 am). But I put it on my agenda. 

 

I am glad that you remind me of stabilizing. It will be done! 

Preparing my medication on my own by weighting it is very difficult and i make mistakes due to brainfog. I have to work on that.

 

i had the 4pm hyperarousel ever since i am on this medication or ct cymbalta., long before I took Vitamine juice.

 

can my receptors regenerate ever?

[JanCarol]

Hey T - 

 

1 hour ago, Tanha said:

what do you mean my serotonin receptors are dead? Can i heal? It doesn‘t feel like it.

did you heal? Can things heal while I am on those drugs sufficiently to get off them?

 

What did I say that made you think your serotonin receptors are dead?

There are adjustment periods for all neurotransmitters, but I don't think I said anything about them being "dead."  I did say that 90% of the serotonin receptors are in the gut - which might explain your upset tummy and losing weight.

 

Yes.  You heal the less drugs you have in your body.

 

Each time you escape (not just reduce, but ESCAPE) by lowering dose, you are healing.

What do I mean by escape?  Well, you could quit taking quetiapine tomorrow - but that wouldn't free you of the drug, it would send you into deeper crisis.

 

But when you taper a small amount off, and get stable after the taper - then that is an escape.  
 

36 minutes ago, Tanha said:

well I have borderline personality disorder. Feelings come in clusters and I have a very hard time giving them names. This process is also very painful for some reason.

 

We don't put much value in diagnostic labels here.  "Borderline Personality Disorder" is a junk diagnosis for people who don't fit other diagnoses, or who have become "treatment resistant" (usually due to the drugs).  To me, it is probably more accurate to say, "I've been traumatised and don't deal well with feelings and expressing them, and have difficulty figuring out where I end and other people begin."  (at least the people I know who were so diagnosed were like that)

 

I like your description about "feelings come in clusters and I have a hard time giving them names."  There was a therapist who taught me that sometimes trauma is like a coke bottle that has been shaken.  You cannot open the bottle quickly, or you will spray coke everywhere.  She recommends just a little release, then waiting, before releasing a little more.

I'm guessing the process is painful due to early trauma.

But honestly, it's not the feelings that will hurt you.  It is how you deal with them.  Feelings are natural human experiences.  Some of us are more sensitive or volatile than others - but the feelings won't hurt or kill you.  Your judgement, suppression, reaction to those feelings is what you have control over - and that is where the hazards (and benefits) lie.

42 minutes ago, Tanha said:

after one year taking cymbalta i got the personalitydisorder which is very unusual at the age of 45. since then i had dissociation auf emotions are overwhelming

 

So it might be accurate to say that you don't have a "personality disorder" at all - but an iatrogenically (medical/drug) induced reaction.  

 

44 minutes ago, Tanha said:

i wonder what you think of Noni juice. 

 

😝 That's some awful tasting stuff!  I trialled some about 5-7 years ago, and could barely get through the bottle.  It's just intense bioflavinoids.  You can always skip it to see if you feel better.  But it is, at least, a food.  I'm more in favour of food-like supplements (like teas instead of tablets, spices instead of supplements), especially in withdrawal.

Thich Nhat Hanh was my first meditation teacher!  I'm glad you have some walking practices, and animal therapy.  I've given you a lot of links and information to work on.  I don't come on SA very often, and you are due for a long hold.  So - I hope that, by the time I come back, you will be out of hospital and more stable and able to taper.

 

When you are having symptoms is not the time to taper.

 

I wish I could tell you it's gonna be easy, but that would be dishonest.

I can tell you that you can get better, you can take charge of your moods and states, and learn and explore what your feelings are trying to teach you, and when you get out of hospital - then you can start tapering and healing.  It can get better, you can get better.  It's hard work, but you can do it.

 

[Tanha]

Thank you so much.

sorry that I got the serotonin gut connection wrong. 

Thought you ment „they went down the drain“. 

Of course the gut is very important. 

I know supplements are too strong. 

 

By the way I take magnesium glyzinate. 

 

Thank you so much for sharing your thoughts and experience. 

 

By the way:

 

how are you doing these days?

 

Tanha

Edited December 23, 2018 by Carmie
Got rid of long quote

[Tanha]



21. Dec

 

5:30 am.     woke, ruminate, feeling sick

7:30 am.     Meat, cucumber

                     Vitamin d, magnesium

                     50 mg quetiapine     

                     1 mg diazepam

                     Vision impaired all day

                     Feeling sick and weak

                     Dizzy, burning skin

                     arousel

                     muscleweakness all day

8:30 am.     More Hyperarousel 

9:30 am      Suddenly arousel better,

                    sore throat but less sick

                     Fatigue, depressed,

                     Anhedonia 

9:50 am      Heartracing, chestburning

                     Akathisia,

                     anxiety

10:30 am   Good mood, sickness is

                    gone,

                    muscleweakness worse

11am          noni juice

11:45 am   severe hyperarousel

Noon.         Meat vegetables

                    Hempprotein,

                    fishoil

                    55 mg quetiapine

                    1,5 mg diazepam

1:30 - 5 pm  hyperarousel unbearable

                     Mild akathisia

                     Depressed

2:30 pm.     Vitamine juice

                    Magnesium

5:20 pm.     Arousel bearable

5:30 pm.     Meat, cucumber

                     Oats, hempprotein, 

                     Magnesium

                     1,5 mg diazepam

                     62,5 mg Quetiapine

6:15 pm.     Arousel much better, 

                     anxiety

8 pm.           16 mg mirtazapine, 

                      arousel bearable

9:30 pm.      67,5 mg quetiapine     

                      1 mg diazepam     

                       magnesium

 

to sum it up:

Almost the whole day terrible hyperarousel and anxiety but only very short flue/sickness, no nausea,

muscleweakness and the feeling not being able to control arms and legs is worse during late morning and after lunch but it remains throughout the whole day. It is a new symptom like the vision problems

[Tanha]

22. dec

 

5:30 am.     woke, nausea, diarrhea 

7:30 am.     Meat, salad,

                     hempprotein, oats

                     Vitamin d, magnesium

                     50 mg quetiapine     

                     1 mg diazepam

                     nausea

8:10 am.     hyperarousel, akathisia,

                     Burning Skin, burning chest

                     Muscleweakness, sick,

                     sore throat, depressed,

                     tired, no feelings but 

                     anxiety

[Tanha]

Hi @brassmonkey

Hi @JanCarol

you told me about wd normal.

 

does that mean one goes on tapering although withdrawl symptoms are still present?

how did you decide between pushing on and further holding?

 

how did you find your wd normal?

[ChessieCat]

 

BrassMonkey is on holidays at the moment.  But this is what he wrote about Withdrawal Normal:

 

On 8/24/2016 at 3:49 AM, brassmonkey said:

 

Hi Wantrelief-- Thanks for dropping by.  I posted this to DesertChild yesterday where I talk about poopout, stabilization and WDnormal.  I gives a bit of my background.

 

"You call it withdrawal normal, as said above when you have reached a base-line which is as good as it gets for you. Now I guess, I can start to think about that. "

 

As good as it gets for that moment.  WDnormal is a sliding scale of reference for tracking overall improvements in ones condition. As you're learning this is a very slow process and at first changes in WDnormal are very small and slow in coming. As time passes and ones body heals those changes become more pronounced and more frequent. But it can be frustratingly slow at first.

 

I'll bore you with a bit of my history so you can see how I came up with the idea of WDnrmal.  Many people find the time frames upsetting but I truly advocate going very slowly.   I'm one of the "lucky ones" in that I have only been on one drug, all be it for 23 years now, which makes things a lot easier to sort out. I originally started on Paxil for Spontaneous Outbursts of Violent Anger and it really helped.  In reality I should have been through counseling instead of being drugged, but that's an irrelevant part of the story.  After many years on the drug it wasn't working as well so I updosed.  That helped sorta but a few years later I needed to updose again.  That helped for a few months, then I started down hill.  It took a number of years and becoming totally messed up to figure out I was in severe tolerance, or what we lovingly call "poopout".

 

Just making the decision to do something about it was a terrifying experience but after 18 years of being drugged, my marriage on the rocks and about to lose everything (probably even my life) I decided to do something about it.     Again I was lucky and found a site called PaxilProgress before I made any changes. That started the entire process.  I liked the idea of the 10% taper, but made a couple of modifications to make it gentler, and started with that.

 

Nothing happened. I felt as bad as I had been.  Six weeks passed and I did my second drop. Nothing happened, except maybe I felt a bit worse.  This pattern kept up for about 18 months.  When one day it hit me, "I hadn't felt as c***** for the past several weeks".  It took another six months before I again noticed that things had improved.  During this whole time all I could do was move doggedly forward making the best of it and learning to put up with and work around the symptoms.  I really had no other choice.

 

A little after two years I had my first widow.  It lasted about fifteen minutes, and it wasn't until several hours later I realized it had happened.  That was the point that it sunk in that the process really did work.  Except for that window the rest of the time was heavy brain fog, DR, no short term memory, dizziness, all the symptoms we know and loath.  Another window opened briefly a few months later, and I noticed that I wasn't as "out of it" all the time and that I was gaining a little control over the symptoms by Acknowledging them, Accepting them and letting them Float off as I went about my life.

 

Finally after three years of tapering I felt like I was making progress. I could see that I was improved from where I had started even though I knew I was by no means better.  I also could see that I was doing better that I was just six months before.  I realized that my "base line of feeling like c***" was improving or how my WD symptoms normally felt was improving.  Hence WDnormal.

 

These last two years, it will be a total of five this fall, have brought fairly steady improvement.  I can see improvements on a month over month and sometimes week over week basis.  To the point that many people would say I'm back to normal by the way I function.  I know I'm not because I am still taking the drug and will be for the next several months. During my time on and tapering off of paxil I have learned a huge amount about myself, life and how to deal with things.  

 

I feel like I'm rambling now, but I hope this helps explain some of the process and you don't find it too disheartening because of the time frames involved.

 

 

[Tanha]

Thank you @ChessieCat

 

i start to experience airhunger or a feeling of not getting enough air as a new symptom. 

Had this before but not as intense.

dry moth, i try not to panic

[Tanha]

Wow, 

how bad can anhedonia and akathisia get.

unbearable right now. 

I fear Christmas because my body and mind are so far away from being calm. This is hell prolonged

[Tanha]

 

I know there is no quick fix but this is really toooo much. 

[Tanha]

Dear @erer

dear @Carmie

 

did you experience hyperarousel (bad restlessness, agitation) during your withdrawl from neuroleptics/antipsychotics or only akathisia?

if you did for how long after each cut or what pattern did the hyperarousel have?

[Tanha]

SA is incredible. The way how so many of us describe their situation and how everybody specially the mods help - I am really thankful for this. 

I am in the beginning or midst of terrible withdrawals yet to come and it helps so much reading through all the real life experience here on SA. 

 

I could not find anything similar in the real world although or because I am in a psychiatric hospital. Just to read what everybody on SA is going through helps to cope and cope and cope. 

My situation is still very bad but at some time i want to be one of so many who can say that they found a way to cope better with meds, no meds, withdrawl and life. 

 

Akathisia, anxiety,anhedonia, hyperarousel and fluelike sickness are giving me a very hard time for many months now. And becoming patient with all this terrible meds.

[Tanha]



22. Dec

 

5:30 am.     woke, bad nausea, diarrhea 

7:30 am.     Meat, salad

                     Vitamin d, magnesium

                     50 mg quetiapine     

                     1 mg diazepam

                     nausea

8:10 am.     burning skin, burning chest,

                     akathisia, muscleweakness,

                    sore throat, depressed,

                     tired, no feelings all day but     

                     Little anxiety, hyperarousel,

                     airhunger, impaired vision

10 am         mental akathisia severe, 

                     severe anhedonia-pain

10:30 am   Good mood, unbearable 

                    depression, anxiety

                    muscleweakness

11am          noni juice

11:45 am   slight nausea, bad eyesight

Noon.         Meat vegetables

                    Hempprotein,

                    fishoil

                    55 mg quetiapine

                    1,5 mg diazepam

12:35.         all a little better but

                    depression

1:15 pm     hyperarousel,

2:15 pm.    sickness better, extreme

                    hyperarousel, akathisia and

                    anhedonia a little better

2:30 pm.     Vitamine juice

                    Magnesium

4 pm.           arousel bearable, anxiety

5 pm.           arousel and/or akathisia

                     a little worse until late

                     anxiety 

5:30 pm.     Meat, cucumber

                     Oats, hempprotein, 

                     Magnesium

                     1,5 mg diazepam

                     62,5 mg Quetiapine

6:15 pm.     Arousel milder, 

                     More anxiety

7 pm.           hyperarousel very severe

                     (Very unusual), anxiety,

                      Fast heartbeat,

                      impaired vision

8 pm.           16 mg mirtazapine, 

9:30 pm.      67,5 mg quetiapine     

                     1 mg diazepam     

                      magnesium

 

compared to days before:

the - now - all time present hyperarousel makes me afraid.

besides the late-afternoon-hyperarousel-pattern is also going on. 

It also seems that also 1,5 hours after taking diazepam/quetiapine I have more hypersrousel.

 

muscleweakness is usually worse during the morning but today not as bad as before, hyperarousel almost all day, anhedonia was really severe, depression and akathisia all day but bearable, flue like sickness and nausea earlier and not as long as usually.

 

yet i am not functioning at all, every time I try to do something (wash myself, walk into a room, search something in the cupboard) I have more anxiety and hyperarousel. i think this could be akathisia but am not sure. Yet my stresslevel is too high to do anything except reading in SA.

[Tanha]

22. dec

 

8:20 pm.       Everything better

[Altostrata]

Please post your notes with one

 

What makes you think you have interdose withdrawal from diazepam?

 

I'm seeing a lot of evidence of paradoxical reactions from the way you've overdosed yourself with diazepam and quetiapine.

 

If I were you, I'd start tapering quetiapine -- but you'll have to do it systematically and measure each dose. No more guessing. Tips for tapering off Seroquel (quetiapine)

[Carmie]

14 hours ago, Tanha said:

Dear @erer

dear @Carmie

 

did you experience hyperarousel (bad restlessness, agitation) during your withdrawl from neuroleptics/antipsychotics or only akathisia?

if you did for how long after each cut or what pattern did the hyperarousel have?

 

Hi Tanha, 

 

Yes, I’ve had all those symptoms, and if I taper too quickly I still get them really bad. We need to taper extremely slowly, especially if we’ve been polydrugged. I have been put on n off all kinds of meds and now my body is sensitized. Every time someone is changed from one medication to another it’s like being cold turkeyed, and then one has to cope with the symptoms of the new medication as well. 

 

I can’t answer the question about how long it takes for symptoms to subside after each taper, no one can, because it’s always different. Everyone is different too and symptoms aren’t linear, they are all over the place. 

 

I go slow and steady now, I can only taper by about 4% to 5% a month or so myself. You’ve been given some excellent advice by the other mods. Chopping n changing will make it hard for you to stabilise. 

 

By the way, if you want someone specific to see your post just tag them instead of quoting every thing they said, as your thread gets really confusing to read. 

 

I’m really sorry you’re in this predicament. I’m sorry you’ve been in the psych ward so long, but chopping and changing meds and doses all the time etc can make us very unstable and increase withdrawals. 

 

Take care, sending hugs🤗

 

P.s. I’m going to delete some of the long quotes so others can read your thread more easily.

Edited December 23, 2018 by Carmie
Postscript

[Tanha]

4 hours ago, Altostrata said:

Please post your notes with one

 

What makes you think you have interdose withdrawal from diazepam?

 

I'm seeing a lot of evidence of paradoxical reactions from the way you've overdosed yourself with diazepam and quetiapine.

 

If I were you, I'd start tapering quetiapine -- but you'll have to do it systematically and measure each dose. No more guessing. Tips for tapering off Seroquel (quetiapine)

Dear @Altostrata,

Thank you so much.

 

It seems that you think it is really urgent to reduce quetiapine. I got that. But it will take months or years to see improvement from the paradoxical reaction cause I can cut only very slowly.

 

what do you mean by mentioning again that I should „start“ tapering quetiapine?

i reduced it five days ago (too soon after last cut and updose, biiiig mistake) and I thought I must wait many week now to stabilize?

I am very insecure and cannot think properly.

 

please, understand that I do not updose 

or overdose anything myself. Never. i had only two substantial updosings from doctors during crisis in which I freaked out (due to a small reduction of diazepam I got severe akathisia and hyperarousel). That was in May and in July/august 200 to 400 mg quetiapine and 3 to 15 mg diazepam. 

Since then I only reduce them all the time (too fast) without doctors to know this or help me (I asked for help though but they declined).

the whole medication happend after failed switch from cymbalta to bupropion to mirtazapin in March/April. Doctors put me on this cocktail and said this is only during the switch. But then reducing them failed traumatically many times.

 

10 days ago I did my very first and only updose of quetiapine because I got and I am in severe withdrawls. 

Now after one week on the slightly higher dose I reduced it again (I should have stabilized before, I know)? 

Things are still incredibly bad. I am not functioning at all.

Hyperarousel and anxiety are big issues now besides severe depression and bad Flue and akathisia.

I am panicking all the time about what to do next because of this.

 

i am just afraid of the diazepam, too.

I cannot Imagen not to have interdosewithdrawl.

I am afraid because hyperarousel and anxiety went up so much every time when reducing all the other meds.

 

Anxiety is going through the roof this morning and hyperarousel never seems to stop during the day since three days.

 

yours

tanha

 

Edited December 23, 2018 by Tanha
New

[Tanha]

Dear @Carmie

 

thank you very much.

 

i am in severe hyperarousel and anxiety since I changed quetiapine up and down within the last three weeks.

i am not functioning at all.

is there anything I can do except wait? 

I cannot distract myself at all.

i cannot wash myself

Barely eat

I have a bad fluelike state, nausea,

no feelings, very severe depression. 

My medication cuts were too much for my body. 

I am so afraid now freaking out again and then they put me up on more meds.

i am really on the edge of making it right now. Will this last for long?

[Tanha]

I am so angry at myself to have pushed on the taper much too fast. I always feel urged to get rid of the diazepam but I can‘t. And it is not a feasible way at the moment. Tapering quetiapine is the way but I messed it up badly. Too many changes within a few weeks. And i have been very sick already before these bad cuts. I wonder how bad my body will react on this.

i am also very afraid of the paradoxical reaction. I have it and it always makes me to want to reduce too fast. I know this is not possible but the urge is huge to find some small relief soon. I

am doing this since March. I had not one window. 

 

I am so sick now I don‘t feel I am going to make it. 

Things are really getting worse week by week. I messed it up yet all I wanted was stabilizing. I panic all the time about these strong and changing symptoms and the medication.

i cannot go home for christmas, not even an hour.

 

didn‘t wash myself in weeks now. 

I feel so sick already and I know the worst phase is yet to come. 

I am fully disabled, cannot think, read, walk a bit longer, bad nausea, severe muscleweakness, bad hyperarousel and severe Depression. Akathisia is slowly getting worse and worse.

Sleep is declining, anxiety going through the roof. 

at some point I am going to freak out an they will drug me up then. 

I messed it up, was impatient, didn‘t really get how badly these meds impact me. 

I was so eager to see numbers and amounts reducing that I always tried to deny my terrible condition. 

I will be in this condition for months not being able to find distraction for a minute except reading on SA. 

I am terrified.