Summer1: reinstate or hope to stabilize

[Shep]

Summer, I noticed you just posted the same drug and symptoms journal twice and it looks like you may have missed Chessie Cat and my posts above that. 

 

I just want to make sure you see our posts, as we've answered the questions and concerns raised in your journal. 

[Summer1]

Not sure why the above post showed up twice. It was there when I opened my reply box. I had a duplicate post yesterday as well, except there was a place to clear the info. I pressed reply hoping it would clear. Bad idea!! Next time I will see if I can delete the info by backspacing. Sorry. I did see Chessie Cats answer.

 

Shep I already had started to space my evening dose. I took one Alprazolam .125mg at 9:00 pm and the next at 3:00am. I will fall back on the morning schedule you have provided though.

 

Will I be slightly adjusting the Sertraline time as needed to keep it separate from the Alprazolam during the progressive spacing? For instance moving it to 10:00 on the day Alprazolam would be ready for an 11:00 dose? 

 

I was hoping a spread night dose might ease the early morning cortisol and possibly help me get more sleep.  I don't know for sure how the split dose worked last night. I slept till 12:30am when i woke with some sweating and anxiety. Got back to sleep until a unexpected phone call woke me at 2:30. A family member without heat and the temperatures at -24 degrees. Husband went to help. Took the 3:00 am dose while I was awake. Went back to bed around 3:30. I rested but had waves of chills for several hours until a hot flash lessened them. Anxiety levels through the night seemed typical.

 

It is 8:00 so I will go take my first dose of Alprazolam.

 

Edited January 30, 2019 by ChessieCat
unbolded

[Summer1]

In case I wasn't clear I will not space a night dose again, but will follow your schedule.

 

Edited January 31, 2019 by ChessieCat
unbolded

[Summer1]

12:30 am Woke with anxiety and sweating. Settled back down.

2:30  Phone call woke me. Up till around 3:30. Felt fine

3:30 Tried to go back to sleep. Had chills in waves for over an hour. 

5:30 Had a hot flash with some morning anxiety. Felt stiff. Arms a bit numb and tingly. Slept till around 6:30 Got up at 7:00

8:00 Alprazolam .125 mg 

9:00 Alprazolam .125 m Some morning anxiety still. No more than usual.

9:30 Breakfast, all supplements, first dose Energy lipids and D-Ribose.

11:00 Sertraline 2mg

2:00 Lunch. Began to feel more anxious in the afternoon. On computer. Legs felt very tingly in the afternoon. Lower legs felt dry and itchy.

3:30 Feeling more anxious. Decided to go outside

4:30 Outside briefly. Felt somewhat less anxious. Second dose energy lipids and D-Ribose. Practiced breathing relaxation. Worked with color pencils to relax. Felt more relaxed. Wrote in positive thought journal.

6:30 Supper. Legs still tingly. Felt chilled, especially legs.

8:00 Feeling sleepy

8:45 Alprazolam .5mg

9:30pm Bed

 

 

[Altostrata]

A phone call woke you up at 2:30 a.m.? I'd turn off the phone at night (I often unplug my landline because I get unwanted spam calls in the morning.)

 

Can you take a short walk in the morning and another in the afternoon? That might help the leg symptoms and calm you down more.

 

That alprazolam dosing looks a bit irregular. This can cause you problems.

 

It looks to me like your symptoms are weaker since you started 2mg sertraline?

[Summer1]

Altostrata the call was on my cell phone. It was a family member whose heat went out during our cold spell of record lows. Thankfully we don't usually get calls in the early am.

 

As for walking , I do miss being outside more. Right now we have deep snow and bitter cold. We don't have sidewalks which makes it hard with snow. I try to get out in our yard using paths from the snow blower but it is limiting. I have been trying to get my exercise  by using our stairs frequently. I don't have much strength and wear out quickly. 

 

 I have been on the Sertraline 2mg for a week now. Should I hold or try a small increase? I have been trying to decide if it helps. I think I have been able to enjoy things a bit more. It is also possible my legs are some better.  My sleep is maybe improving.  Sometimes I get a short period of lessened anxiety after taking it.

 

I just started dividing my Alprazolam doses to go from 2 daily to 4 eventually. Shep gave me a sample  schedule of gradual increasing spacing. I think I could manage longer spaces between doses now if that is better. I think my body may be adjusting to the difference in a split ER tablet versus a regular tablet. Seems like I have more burning in my chest.

 

 

 

[Summer1]

I don't think I want to change my Sertraline dose until I get settled into the dose spacing of my Alprazolam. My body seems to be doing some adjusting to the Alprazolam changes.I know it is the same amount of Alprazolam, but it is feeling like less. I had more anxiety and burning/tightness in the chest today. My legs also had more buzzing/tingling. I had a stiff sore neck also.

 

9:30 pm  Bed

1:30 am  Awake with anxiety and overall sweating. Tried calming breathing. Fell asleep.

3;30 am Startled awake by loud noise. This triggered anxiety, pounding heart and sweating followed by chills. Rested but did not fall back asleep.

8:00 Alprazolam .125mg     Cleaning kitchen. Feeling some anxiety all morning. Tingling legs. Unmotivated. Mind kept drifting.

9:30 Breakfast. No supplements taken.

10:00 Sertraline 2mgs   About 30 minutes after taking Sertraline I felt more relaxed. This lasted about an hour. Then I got more anxious as day progressed.

11:30 Anxiety and burning in chest. Legs tingling with some throbbing.

Noon  Alprazolam .125  mg       Energy Lipids and D-Ribose first dose.  Slight shivers and chills right after Lipids and Ribose. Yesterday I had an anxious afternoon. So I tried stretching the morning dose out till noon. That didn't seem to help though. Tomorrow I will move it back. 

1:00 cleaning dusting vacuum. Burning in chest and anxiety increasing. Neck stiff and sore

3:00 Energy Lipids and D-Ribose   I got some immediate relief from the burning in my chest. Anxiety lessened some. Walked in house and up stairs for exercise for 20 minutes.

4:30 Ate. Went outside for 15 minutes. Ate some fruit.

6:00 Feeling drowsy. Legs very tingly with some mild throbbing. Neck sore.

8;30 Alprazolam .125mg   Bath with epsom salt. Legs less sore 

9:30 Alprazolam 125mg  Though this dose is just an hour later I was hoping it might give me some buffer against morning cortisol and anxiety.

 

 

Edited February 1, 2019 by ChessieCat
unbolded

[Summer1]

Having a rough night. Bed at 9:30. Woke at 12:30  with strong anxiety- increased heartbeat and burning in chest.  Did breathing. Fell back asleep. Woke again at 1:50 with same symptoms. Hot but not sweaty each time  both times hot but not sweaty. Felt very thirsty.

Between 3 and 3:30 got chills. My legs are extremely cold with achy muscles. My neck is sore and stiff. I have not been doing well on the new pills. I don't if it is the change from a split ER pill to regular,  the change in my dosing schedule or a change in brand. I feel like I would if  I was missing a dose. Do you have any insight?  My Alprazolam Er were from Aurobindo. The .25 pills are made by Centaur Pharmaceuticals in India and distributed by Brekenridge Parmaceuticals. 

[Shep]

6 hours ago, Summer1 said:

I don't think I want to change my Sertraline dose until I get settled into the dose spacing of my Alprazolam. My body seems to be doing some adjusting to the Alprazolam changes.I know it is the same amount of Alprazolam, but it is feeling like less. I had more anxiety and burning/tightness in the chest today. My legs also had more buzzing/tingling. I had a stiff sore neck also.

 

This sounds wise, Summer. One change at a time. 

 

The reason that it feels "like less" is because, even though your total daily dose is the same, when you take a lower dose (even though it's being taken more often), the peak concentration level is less. This is why we advocate such a gradual movement - it gives your nervous system time to adjust to the changes in the peak concentration level. 

 

On 1/30/2019 at 9:26 AM, Summer1 said:

Will I be slightly adjusting the Sertraline time as needed to keep it separate from the Alprazolam during the progressive spacing? For instance moving it to 10:00 on the day Alprazolam would be ready for an 11:00 dose? 

 

Sorry, I missed this earlier post. It's okay to overlap for a short time period. The goal is to get the spacing in the end to avoid the overlap. 

 

[Shep]

1 minute ago, Summer1 said:

Having a rough night. Bed at 9:30. Woke at 12:30  with strong anxiety- increased heartbeat and burning in chest.  Did breathing. Fell back asleep. Woke again at 1:50 with same symptoms. Hot but not sweaty each time  both times hot but not sweaty. Felt very thirsty.

Between 3 and 3:30 got chills. My legs are extremely cold with achy muscles. My neck is sore and stiff. I have not been doing well on the new pills. I don't if it is the change from a split ER pill to regular,  the change in my dosing schedule or a change in brand. I feel like I would if  I was missing a dose. Do you have any insight?  My Alprazolam Er were from Aurobindo. The .25 pills are made by Centaur Pharmaceuticals in India and distributed by Brekenridge Parmaceuticals. 

 

Any of these changes could cause an uptick in symptoms. 

 

Or it could be from the AD reinstatement in addition to the changes in alprazolam. 

 

Please give yourself time to adjust. These are a lot of changes in a short time and your nervous system was already unstable prior to these changes. 

 

Changes in manufacturers, brands, doses, timing, etc. are all bumps to the nervous system. Once the benzo timing is sorted out, go into a long hold and really give your nervous system time to adjust. 

 

You mention eating breakfast and fruit later in the day in your last drug and symptoms journal, but are you also eating lunch and dinner and having high protein, low sugar snacks throughout the day? Diet is very important, as well as getting plenty of clean water throughout the day. Low blood sugar from skipping meals and dehydration have the same symptoms as withdrawal, so please be mindful of eating and drinking water throughout the day. 

 

 

[Summer1]

Shep Thank you for your reassurance and calm patience this morning. I hope you are well.

 

9:30 pm Bed

12:30 am  Woke with wave of anxiety, burning in chest, increased heart rate. Felt hot with mild sweating.Thirsty. Drank water. Did breathing. Fell asleep.

1:50 Woke with same symptoms.Did not go back to sleep. 

3-3:30 am Building chills. Legs very cold and achy. Stiff, sore neck.

4:00  Ate a handful of mixed nuts and drank half a cup of OJ. Had about 10 mg magnesium.

5:30  Less cold. Rested till 7:00 then read some.

7:00 Slightly less anxiety.

8:00 Alprazolam .125mg   Breakfast  

9: 40  Took all supplements and half of first dose Energy Lipids and D-Ribose. I think I feel better after Lipids and D-Ribose so I am seeing what spreading it out does. 

10:00 Alprazolam .125 mg   I got confused yesterday and took the dose at noon. Today I am moving it back and will move it only one hour each day. Anxiety is doing better now.

11:10 Sertraline 2mg  

12:00 -12:30 Lunch  Second half of first dose of Energy Lipids and D-Ribose 

2:00 Snack. Anxiety getting quite strong. I am having heavy sinus drainage and coughing a lot. 

4:00 Anxiety intense. Burning in chest and stomach. Arms and legs sore and heavy feeling. Stiff neck with headache. Chilling sensation of water running under my skin. Restless but no energy. Depressed. Try second dose of Energy Lipids and D-Ribose

4:30 Feeling some better. 

6:30 Supper  

7:30 Headache worse. Legs sore. Less chilling.  Cough and drainage the same. Chest still burning but less intense. Stomach still upset.

8:00  Alprazolam .125 mg     magnesium about 10m g

9:00 Alprazolam  .125 mg I tried spacing the evening a bit to see if It would help me go longer in the morning.

9:30  Feeling much less anxiety. Minor chest tightness. Stomach ache mostly gone. Less leg pain. Still some chilling and Headache.  I seem to be having less sinus drainage. still coughing though. Getting sleepy.

10:20 bed

 

 

 

 

 

 

 

 

 

 

[Shep]

11 hours ago, Summer1 said:

9: 40  Took all supplements and half of first dose Energy Lipids and D-Ribose. I think I feel better after Lipids and D-Ribose so I am seeing what spreading it out does. 

 

Let us know how you do if you decide to space out your supplements more. Do they make you sleepy? Give you energy? 

[Summer1]

The Energy Lipids and D-Ribose are for energy. They get mixed with half a bottled water. They seemed to make a difference in energy when I first started. I think I would notice if I stopped. Right now I am interested in seeing how they work on my anxiety symptoms. A few times I thought they helped with those symptoms, making the burning in my chest for instance lessen. Yesterday when I was at my worst I thought they provided some relief. Sometimes I do seem to get mild leg chills after. I am going to try spacing again today.

 

[Shep]

Please keep in mind that constantly making changes is hard on your nervous system. And your nervous system is now in flux, so what helps today may make it worse. 

 

These threads may help place this in context:

 

How Psychiatric Drugs Remodel Your Brain

 

What is happening in your brain?

 

You will be much better off in the long run setting a consistent schedule and sticking to it. 

[Summer1]

10:30 Bed. Sinus drainage and coughing. Woke at 1:00 and 2:00 feeling warm, minimal sweating some anxiety. Slept Again.

4:30 am  Hot flash with anxiety and some sweating. Rested but did not go back to sleep. Chills. 

8:00 Alprazolam .125mg  

9:00 Breakfast, all supplements, Energy Lipids and D-Ribose first dose. Housework

11:00 Alprazolam .125mg and Sertraline 2mg  Manageable anxiety. Some tingling in arms and legs. Mild stomach upset.

1:30 Lunch. Afternoon increase in anxiety. A few seconds of tinnitus.  Happened yesterday also but I forgot put it down. Mention it now because this is new for me. Not a big deal unless it develops. I am hoping it won't.

3:00 Second dose Energy Lipids and D-Ribose.  Walked outside 20 minutes. At 4:00 ran errand with husband

4:00 Tired drowsy.  Drainage and cough less frequent. Less anxiety 

5:00 Sleepy. Ate supper. 

6:00 Anxiety is returning, legs more achy and tingly, Headache

7:30 Bath with epson salt. Legs are improved

8:00 Alprazolam .125 mg  Headache

9:00 Alprazolam .125mg   Headache and stiff neck. Sleepy. 

9:30 Bed

 

 

 

 

 

 

[Shep]

On 2/2/2019 at 10:10 PM, Summer1 said:

8:00 Alprazolam .125 mg  Headache

9:00 Alprazolam .125mg   Headache and stiff neck. Sleepy. 

 

Do you think spacing these two doses farther apart may help? Perhaps move the 8 pm dose back to 7 pm and then to 6 pm and to 5 pm, gradually moving it an hour a day.

 

You could even out your spacing to 4 times a day, as shown below (with your AD kept in the morning): 

 

 8 AM Alprazolam .125mg  

12 PM Alprazolam .125mg

 5 PM Alprazolam .125 mg  

 9 PM Alprazolam .125mg   

 

 

Edited February 4, 2019 by Shep
corrected timing

[Summer1]

Hi Shep, On the spacing you mentioned above were you thinking 8AM and Noon? So I would have a 9:00 at night dose and an 8 in the morning dose?  I want to make sure I can get through the night. I thought maybe the two doses at night were helping me manage the longer stretch. But with the short half life maybe it doesn't make a difference? I had imagined the one of the evening doses would get moved -I just wasn't sure where.

 

Currently my daughter is giving birth. She went to the hospital at 5am. So I don't know what tomorrow will be like as far as posting on SA.

 

I have one new symptom I wanted to mention. Right now it is nothing major. Friday and Saturday I had a a few seconds of tinnitus. Today it happened twice. Hopefully it won't develop any further.

 

9:30pm  Bed. Slept till 3:40 with only minor anxiety waves and sweating. After that the hot flashes, chills sweating and anxiety would wake me. I was able to sleep occasionally till 6:00 Felt hopeful.

8:00am  Alprazolam .25mg Legs felt chilled

9:00 -10:00 Breakfast, all supplements, First dose Energy Lipids and D-Ribose.  Call that daughter is in labor.

11:00 Sertraline 2mg     Had sharp pains in right thigh. Legs tingly.Tired. Headache. Whole head feels a bit tingly. Sore stiff neck.

12:00 Alprazolam .125mg  Feeling cold. Walked 15 minutes.

1:30 Lunch

3:00 Leg pains calming down. Headache worse.

4:00 Second dose energy lipids and D-Ribose

5:00 Supper. Headache spreading, Feeling frustrated. Had a short cry.  6:00 brief tinnitus

8:00 Alprazolam .125mg, magnesium 10 mg, Bath 8:30,  Legs improved. Headache improved

9:30pm Alprazolam ,125mg  Still waiting for news. Anxiety is very mild for now. Nite

 

 Also thanks for the excellent threads from the other day on the brain and healing. 

 

 

 

 

 

[Shep]

6 hours ago, Summer1 said:

Hi Shep, On the spacing you mentioned above were you thinking 8AM and Noon? So I would have a 9:00 at night dose and an 8 in the morning dose?  

 

Yes, you are correct. I'm sorry, I wrote 8 PM when I meant 8 AM in my earlier post. I've edited my post above to reflect this:

 

8 AM Alprazolam .125mg  

12 PM Alprazolam .125mg

 5 PM Alprazolam .125 mg  

 9 PM Alprazolam .125mg   

 

6 hours ago, Summer1 said:

 I want to make sure I can get through the night. I thought maybe the two doses at night were helping me manage the longer stretch. But with the short half life maybe it doesn't make a difference? I had imagined the one of the evening doses would get moved -I just wasn't sure where.

 

If you're more comfortable taking the two doses at night, that's fine. I just wanted to make sure it was intentional. Some people take the shorter half-life benzos only at night to make sure they sleep and then they deal with inter-dose withdrawal issues during the day with non-drug coping skills. So it's a personal choice whether or not to space it out during the day. 

 

I just went through your drug and symptoms journal since you reinstated Sertraline and it really looks like your sleep has gotten worse. 

 

Your reinstatement was on January 24 - in this post. 

 

Prior to that, you were sleeping 10 PM to around 4 AM.

 

After that post, you're waking up around 2 AM every night. 

 

And this was prior to splitting out the alprazolam, so it may not be the change in benzo timing that caused the decreased sleep. 

 

On 1/31/2019 at 12:39 PM, Summer1 said:

 I have been on the Sertraline 2mg for a week now. Should I hold or try a small increase? I have been trying to decide if it helps. I think I have been able to enjoy things a bit more. It is also possible my legs are some better.  My sleep is maybe improving.  Sometimes I get a short period of lessened anxiety after taking it.

 

 

On 2/1/2019 at 5:23 AM, Summer1 said:

I have not been doing well on the new pills. I don't if it is the change from a split ER pill to regular,  the change in my dosing schedule or a change in brand. I feel like I would if  I was missing a dose. Do you have any insight?

 

 

These posts are from last week. You mentioned that your sleep is better with the sertraline but then a day later, that you are feeling worse on the new brand of alprazolam. Is the quality of sleep better even though the quantity is less? 

 

Please read over your journal starting from that January 24 post and let me know your thoughts. It's been 10 days since you reinstated and I just want to make sure that the sertraline reinstatement is working. 

 

6 hours ago, Summer1 said:

Currently my daughter is giving birth. She went to the hospital at 5am. So I don't know what tomorrow will be like as far as posting on SA.

 

This sounds exciting. I hope all goes well with the birth of your new grandchild. 

 

6 hours ago, Summer1 said:

I have one new symptom I wanted to mention. Right now it is nothing major. Friday and Saturday I had a a few seconds of tinnitus. Today it happened twice. Hopefully it won't develop any further.

 

This could be from the benzo or from the antidepressant. Please see:

 

Tinnitus: What does all that noise mean?

 

[Summer1]

I tried to make notes on my symptoms since Sertraline. Overall it looks like I did not sleep as long after reinstatement. My notes indicate the sweating and hot flashes were not as bad. I wasn't waking up so wet that I needed to change clothes and dry my hair.That is probably what made me think my sleep might be improving. 

 I was also trying to see if I began to have more daytime anxiety. It is possible there has been an increase. There was a real change when I began to work on my Alprazolam doses. There seems to be an anxiety increase around that time with more burning in chest and stomach and more headaches. The change could still be related to the Sertraline with it causing continued changes.

Originally I was taking the Sertraline to prevent a CT situation to develop from the antidepressants I stopped. Not sure what ramifications stopping might have.  I am not sure how I would go about tapering. Right now I am not thinking clearly. It has been a long day with a new  grandaughter. 

 

10: 30 Bed. Waiting for news of baby

1:30 and 2:30 woke with some anxiety spikes. I had chills, some sweating, stomach, burning. Rested between waves of chills and anxiety for remainder of the night. Got word of baby's birth around 1:30

8:00am Alprazolam.125 mg  Headache, sore neck and shoulders and upper arms. Upset stomach. Burning in chest/anxiety. symptoms more pronounced than usual. Sore legs with some muscle spasms in thighs.

9:00 breakfast. First dose Energy Lipids and D-Ribose

10:00 All supplements  Brief tinnitus. Stressful phone call about family.

11:00  Sertraline 2mg

12:30 Alprazolam .125 mg  Symptoms are very uncomfortable. I am not aware of either of my medications helping today's symptoms.

1:30 Lunch 

4:00 Second dose Energy Lipids and D-Ribose. Anxiety and other symptoms worse today. 

4:30 Bath Feeling a little better.

5:00 Cereal for supper due to upset stomach

6:00 to 8:00  Went to see Grandaughter and ran errands. Chest and stomach are better.

8:00 alprazolam .125 mg. Feeling tired

9:30 Alprazolam .125 mg   very sleepy Will go to bed soon,

 

 

 

 

 

 

 

 

[Shep]

8 hours ago, Summer1 said:

I tried to make notes on my symptoms since Sertraline. Overall it looks like I did not sleep as long after reinstatement. My notes indicate the sweating and hot flashes were not as bad. I wasn't waking up so wet that I needed to change clothes and dry my hair.That is probably what made me think my sleep might be improving. 

 I was also trying to see if I began to have more daytime anxiety. It is possible there has been an increase. There was a real change when I began to work on my Alprazolam doses. There seems to be an anxiety increase around that time with more burning in chest and stomach and more headaches. The change could still be related to the Sertraline with it causing continued changes.

 

Sometimes sleep quality trumps sleep quantity. 

 

8 hours ago, Summer1 said:

Originally I was taking the Sertraline to prevent a CT situation to develop from the antidepressants I stopped. Not sure what ramifications stopping might have.  I am not sure how I would go about tapering. Right now I am not thinking clearly. It has been a long day with a new  grandaughter. 

 

Congratulations on your new granddaughter. 

 

No worries on not thinking clearly, completely understandable. Sounds like you had a very busy day. 

[Summer1]

Hi Shep, I keep hoping for a little more quality and quantity with my sleep. Right now the early stretch isn't as deep. I am more aware of anxiety waves, hot flashes and chills happening. I am just able to ignore them for a few hours until they get to strong. I don't know if spreading the dose would allow me to go back to sleep or not. I think anxiety levels are more even overall with the spread doses. Early am surges are usually the strongest still. But I am not as calm during the early portion of sleep. 

I have wondered if  Sertraline is part of the problem. My 1mL syringe is marked with 5 lines between each  .1mL segment.  My dose is .1 mL which equals 2mg.  I considered dropping down one mark to see if this made a difference. Do you have any thought on this?  Would that be .08 mL / 1.6mg ?

 

9:50pm Bed. Slept but aware of several anxiety waves, hot flashes and chills. Woke briefly at 2:00

3:00 Woke with hot flash, sweating and anxiety. Thirsty so drank water. Got chilled. Rested till 6:00

6:00-8:00 Mopped floor, cleaned bath. This is exercise for me with my current level of strength. Some aching of hip joints and stiff legs with some morning anxiety.

8:00  Alprazolam .125mg

8:30 breakfast, Energy Lipids and D-Ribose. All supplements except R-lipoic Acid which I am out of.

11:00 Sertraline 2mg  Overall much better than yesterday with mild physical symptoms. Almost no tingling.Head and neck felt much better.

1:00 Alprazolam .125mg , Lunch Legs have felt chilled much of the day.

2:00 Outside 20 minutes to walk

3:00-4:30 housework, reading, vacuumed stairs

5:30 Supper  Missed second dose lipids and D-Ribose. Was afraid to take it this late in the day. Legs chilled.

7:30 Chilled and drowsy so got under covers and rested. Got warm

8:00 Alprazolam .125mg Tired

9:45  Going to bed ASAP will take Alprazolam .125 right before lights out. Good night

 

Thank you for your steady reassuring support. Wishing you peace and continued healing.

 

 

 

 

 

[Shep]

8 hours ago, Summer1 said:

I have wondered if  Sertraline is part of the problem. My 1mL syringe is marked with 5 lines between each  .1mL segment.  My dose is .1 mL which equals 2mg.  I considered dropping down one mark to see if this made a difference. Do you have any thought on this?  Would that be .08 mL / 1.6mg ?

 

Yes, if .1 mL = 2 mg, then .08 mL = 1.6 mg

 

This would be a 20% reduction. Since you started the reinstatement about 2 weeks ago, you may want to try to reduce this. 

 

A question first. 

 

8 hours ago, Summer1 said:

Overall much better than yesterday with mild physical symptoms. Almost no tingling.Head and neck felt much better.

 

Do you want to give yourself another day or two to see if you can build on these kinds of improvements before reducing? 

 

If not, reducing down to 1.6 mg sounds like a reasonable thing to do in hopes of getting better sleep. 

 

This is difficult to decide when the Sertraline may be improving some things but your sleep is less than before the reinstatement. 

 

Overall, do you feel better now than before the reinstatement? 

[Summer1]

I am trying to listen to my body but it sends very confusing messages. On Sertraline  I think perhaps I have an increase in anxiety. Other symptoms are maybe a little better..  Before Sertraline I had a week with lots of appointments and errands. It was difficult but I managed. It is hard to imagine having the energy for that now mentally or physically. I find myself not really wanting  to go anywhere. Not interested in eating or self care. Just do things cause I know I must. I can hold a bit to see what happens. 

My symptoms are very influenced by how much stress I have during any given day. When that gets in the way it is hard to tell what things are helping or hurting.  Since going through withdrawal many things that never would have bothered me are stressful.  Even things which I once enjoyed can provoke stress. I am trying to work on coping skills.

Right now I am nervous I might be getting a UTI. Just some very mild discomfort and slightly increased frequency. I am going to push water today. I have been waking up thirsty during night anxiety. I think drinking water seems to help with some of the anxiety. I drank 2 bottles of water (16.9 oz each) last night. I still kept waking up thirsty. I am looking on SA for tips-going to look into D-Mannose. 

Only slept from 10:15 to 2:20. May try a nap after morning anxiety goes down.

[Summer1]

10:00  Alprazolam .125mg

2:20 am Woke with anxiety and some sweating. Felt thirsty throughout the night and drank water. Water seemed to help anxiety some but caused chills. Continued having anxiety in waves with hot flashes and chills. Rested but did not sleep

6:00 am Up for the day-morning anxiety

7:40 Breakfast

8:00  Alprazolam .125 mg

10:30 Supplements except R-Lipoic Acid which I am out of. Energy lipids and D-Ribose  Call asking if I could help with Grandbaby

10:45 Sertraline 2mg

2:00 Alprazolam .125mg Thought I felt and increase in anxiety after Alprazolam. Managing pretty well helping with baby despite some stress. Only mild symptoms today except for pain in hip joint.

 No second dose Lipids and D-ribose because I was helping with grandbaby.

6:30 supper very tired.

8;30 Alprazolam.125 mgs exhausted and sleepy

 

 

 

[Gracee]

Hi Summer1,

Congratulations on your new Grandbaby!!!!!!   Family additions create stress and some chaos with everyone.   Be good to yourself.  I'm sending best wishes.

G.

[Shep]

22 hours ago, Summer1 said:

My symptoms are very influenced by how much stress I have during any given day. When that gets in the way it is hard to tell what things are helping or hurting.  Since going through withdrawal many things that never would have bothered me are stressful.  Even things which I once enjoyed can provoke stress. I am trying to work on coping skills.

 

Yes, stress intolerance is very common during withdrawal. There's a theory that we can re-frame stress to become more resilient. Easier said than done during withdrawal, but might be worth a read: 

 

Reframe stress to become more resilient

 

How to make stress your friend | Kelly McGonigal video (14.5 minutes)

 

22 hours ago, Summer1 said:

Right now I am nervous I might be getting a UTI. Just some very mild discomfort and slightly increased frequency. I am going to push water today. I have been waking up thirsty during night anxiety. I think drinking water seems to help with some of the anxiety. I drank 2 bottles of water (16.9 oz each) last night. I still kept waking up thirsty. I am looking on SA for tips-going to look into D-Mannose. 

 

UTI's are common during withdrawal. You may have already read this thread, but I'm posting in case you haven't. Members discuss this here (and I saw a few mention D-Mannose): 

 

Urination and bladder issues (male and female)

 

[Summer1]

Shep Thanks for the videos. Food for thought is always helpful and appreciated. 

 I am having less concern about a UTI today. Sometimes I can prevent one if I notice it soon enough.

 

Today was dreary like yesterday with sleet pelting the house and ice encasing everything. I miss my little walks in the yard. 

I got home late last night after helping with my granddaughter. I had to have a bath to ease my hip pain. Then I wanted to type here. I was so exhausted! Didn't make it to bed until 10:30 and woke at 2:30. It was very discouraging. So today I was tired and draggy. But not tired enough to be able to sleep. My brain won't shut down enough.

 

Yesterday evening...

8:30 Return home. Coughing spell. Exhausted. Took Alprazolam .125mg.  Typed here- I am very slow

9:30 Bath to help sore hip joints. Better afterwards.

10:15 Alprazolam .125mg 

10:30 Bed

2:30 Woke to anxiety with hot flash and moderate sweating.  Got up changed and dried my hair. Drank water.

3:30 Back to bed. Rested but could not sleep. Had chills till around 5:30. Tried breathing through anxiety. I can't tell if it helps but it gives me something to do while I wait. had trouble with negative memories and worries popping into my head when I tried to sleep. Some of these were things from the past I haven't thought about for a long time. This is a problem I had before the drugs. 

6:00 Awake reading.

8:00 Alprazolam .125mg  I did not notice in change in morning anxiety afterwards. Read. Zoned out and not very alert. Slow start to the day.

9:30 -10:30- Breakfast, first dose Energy Lipids and D-Ribose, all supplements except R-Lipoic acid which I am out of. Anxiety not as bad as during the night but still hangs on. Feels like a tight  lump in my chest. It is manageable.

11:15 Sertraline 2mg 

1:30 Lunch.  Legs began to tingle as afternoon wore on. I had bone broth soup for lunch and wondered if it cause the uptick. I've heard a few people say it can cause symptoms.

2:00 Second dose Lipids and D-Ribose. Alprazolam .125mg. Anxiety has remained the same all day. Tried to rest but couldn't. Did some art.

5:50 Supper 

8:20 Alprazolam.125mg  Almost no physical discomfort today in arms, neck, and head. Cough continues.

8:30 bath  Relaxing and physically soothing

9:20 snack unsalted nuts and mandarine oranges in natural juice.

I am going up to bed to try and sleep. It will be almost 10:00 when I take my final Alprazolam .125mg. I hope to start gettin a longer stretch of sleep soon. I have been wondering if taking two dose only slightly spaced could cause issues. Maybe I would be better off moving one into the night or taking the entire .25 at once. 

 

Peace to you as you journey.

 

 

 

 

[Gracee]

I hope you can treat yourself to a day of rest on Friday.   Best to you.

[Shep]

7 hours ago, Summer1 said:

I had to have a bath to ease my hip pain.

 

Are you able to do very gentle yoga to help with pain? The Beyond Meds site is written by someone who survived these drugs and provides a wealth of information. Here is the yoga archives. 

 

Beyond Meds - Yoga Archives

 

7 hours ago, Summer1 said:

I have been wondering if taking two dose only slightly spaced could cause issues. Maybe I would be better off moving one into the night or taking the entire .25 at once. 

 

You may want to try taking the .25 mg at once. The peak concentration level will be higher and it may help with sleep. 

[Summer1]

10:00 pm  Alprazolam.125mg  Bed. Slept till around 3:45 with only minor interruptions.

3:45 am Woke with anxiety, hot flash and some sweating. Did breathing. Drank water. Took 20mg magnesium. Rested till 5:30. mild chilling

6:00 Snack- banana , walnuts

7:30  Outside for about 25 minutes

8:15 Alprazolam .125mg Still having morning cortisol anxiety but good otherwise.

9:00 Breakfast, Energy Lipids and D-Ribose, Supplements except R-Lipoic Acid

11:00 Sertraline 2mg   Go to help with grandbaby. Legs and hip joints are feeling a little sore.

2:20 Alprazolam .125mg    Legs and hips more sore as afternoon progresses

3:00 Lunch. Wearing out

6:30 Home. Legs and hip joints ache, No 2nd dose Lipids and D-ribose today. Will have to try to take it along next time.

7:00 Supper Exhausted tired/sleepy

7:40 Legs are getting quite tingly. Bath. Legs feel better. Nose feels stopped up.

8:30 Alprazolam .125 mg 

9;00 Feeling heaviness in chest, some anxiety. Alprazolam .125mg

9:15 going to try to sleep

 

 

 

 

 

[Summer1]

10:00 pm -4:10  Slept with occasional  waves of anxiety with sweating

4:10  Woke with anxiety wave. Did breathing. It maybe helped some.Thirsty. Drank most of a bottled water. Felt some relief. Rested till 7:00am

7:00am Anxiety began to build till strong. Got up and ate banana. Tired

8:00 Alprazolam  .125 mg . Felt slightly better.

9:15 Breakfast

10:00 Anxiety building, burning in chest and stomach. Belching. Tired

10:30 Energy Lipids and D-Ribose, all supplements except R-Lipoic Acid.

11:00 Sertraline 2mg. Brief improvement of symptoms.I am wondering if drinking water makes me feel better briefly for some reason.

12:00 Anxiety, burning in chest and stomach uncomfortable. Tired.

12:30 Rested. Did some relaxation breathing. Brief Tinnitus.

1:30 lunch

2:00 Second dose Lipids and D-Ribose.

2:30 - 6:30- With grandbaby to help. Legs /hip joints feeling a little sore.

7:20 Dinner. Still having Anxiety with chest and stomach burning. Sleepy

8:30 Alprazolam .125mg

8:40 Bath- Not as much relief to legs as usual. I want to get more Epsom salts soon. Very sleepy but still having anxiety.

9:30 Alprazolam .125 mg Going up to bed. 

 

Must confess I was disappointed to get hit with so much anxiety after getting a slightly longer stretch of sleep. it is amazing how different I can feel only a day apart. 

Hope you are well.

 

 

 

 

[Summer1]

I reduced my Sertraline from 2 mg to 1.6mg  as discussed, in the hopes of getting better sleep. I trust I would be able to go back to 2mg if this causes problems.

10:00pm  Bed. Slept with manageable symptoms till 2:20am

2:20 am Woke with anxiety and sweating. Face wet. Chest felt weird. Husband took my blood pressure with his cuff. It came out in the high range of normal. That helped me feel less worried. Did breathing for a while. Drank water. Rested till 3:30 but anxiety to strong for sleep so I got up. Burning in chest and stomach.

8:20 Alprazolam .125mg    

8:45  Seems like anxiety increased

9:30 breakfast

10:30 Energy Lipids and D-Ribose  and supplements except R-Lipoic Acid   Feeling tired.

11:00 Sertraline 1.6mg   Felt calmer for a while afterwards.

12:30 lunch    Tired.

1:00 Go to help with Grandbaby.

1:30 Feeling anxious while helping.  Legs sore.  Brief tinnitus a few times. Did breathing. Tried positive self talk ,  mindfullness and gratitude.

2:00 Alprazolam .125mg

3:00 Energy Lipids and D-Ribose

6:00 Finish helping with Grandbaby.  Stressfull feelings remained throughout the day.

7:00 Supper.  Legs are getting very tingly. Very tired and sleepy

8:00 Bath with epsom salt. Coughing. Legs still tingly. I am not having much evening relief from anxiety. Really haven't been having the release for a while. It's no wonder I don't stay asleep. Tonight I am going to take both evening Alprazolam doses together. I am to exhausted to stay awake long enough to space them. At least I have been able to fall asleep so far. 

9:00 Bed. Alprazolam .25mg

 

 

 

 

 

 

 

 

 

 

 

[Shep]

7 hours ago, Summer1 said:

I reduced my Sertraline from 2 mg to 1.6mg  as discussed, in the hopes of getting better sleep. I trust I would be able to go back to 2mg if this causes problems.

 

7 hours ago, Summer1 said:

Tonight I am going to take both evening Alprazolam doses together. I am to exhausted to stay awake long enough to space them. At least I have been able to fall asleep so far. 

 

Remember - it's best to only make one change at a time. If there's a symptoms change, you won't know if it's from the decreased sertraline or the benzo timing. 

 

Please let us know how you do. 

[Summer1]

Shep sorry about making two changes. My sleep was slightly improved last night. I slept a bit longer and was not hit by morning cortisol. It was wonderful while it lasted. 

My legs felt a little different today. It felt as though cool liquid was running under my skin. A bit different than chills or feeling cold though that was part of it.

I also felt tired most of the day but that could be from overdoing it with the grandbaby for a few days. It doesn't take much to wear me out. Just unloading the dishwasher made me tired.

 

9:20pm -3:30am  Slept. Woke briefly at 3:30. Mild sweating. Used restroom and drank water. 

3:30 -4:30am   Dosed lightly. Drank water then rested till 5:30. Had almost no night anxiety. Did not get hit with morning cortisol. I felt normal which was great.  For myself I want to note that the bedroom seemed darker this morning(fog?). Maybe light blocking curtains would help.

8:15 Alprazolam .125 mg  Still feeling calm. Even managed a phone call about stressful family things around 8:45. Neck feels sore. Legs have odd cool sensation different from usual chills. Hip joints and thigh muscles sore.

9:30 Breakfast. Don't have a much energy. Made myself do two loads laundry.

10:30 For no particular reason my anxiety ramped up fairly quickly. It was like someone turned on a switch. Anxiety moderately uncomfortable most of the day. I had some burning in my chest but it came and went throughout the day. 

11:00 Sertraline 1.6mg  

11:20 Energy Lipids and D-ribose and supplements except R-Lipoic acid.

Feeling cooped up. Can't walk outside because all the yard is still covered in ice. I fell when I went out Saturday.

1:30 Lunch. Tired and a bit sleepy. Legs still have odd cool sensation inside. Neck still sore. Hip joints  and leg muscles sore.

2:00 Alprazolam .125mg

5:00 Supper. Emptied dishwasher. Briefly lightheaded. 

8:20 Bath with epson salts. Legs slightly less sore with some tingling. 

9:20 Feeling less anxiety. Alprazolam .25  Going to Bed. 

.

 

 

 

 

 

[Summer1]

Opps forgot to add the 3:30pm dose of Energy Lipids and D-Ribose. 

[Shep]

8 hours ago, Summer1 said:

Shep sorry about making two changes. My sleep was slightly improved last night. I slept a bit longer and was not hit by morning cortisol. It was wonderful while it lasted. 

 

It's okay, Summer. This is a learning experience. I'm so glad your sleep was better. 

 

Please continue on as you're doing and hopefully, you'll see more improvements. 

 

Are you able to do any form of stretches or gentle yoga to help with pain and soreness? Even a gentle "legs up the wall"? 

 

Legs Up The Wall - Foundations of Yoga video (7 minutes)

 

Beyond Meds - Gentle Yoga