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BfromNJ: mirtazapine taper

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BfromNJ

Can withdrawal exaserbate an already existing condition?  If I have tmj disorder, could the tapering make symptoms of tmj disorder worse or different? 

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brassmonkey

TMJ is frequently a symptom of ADWD. Tapering will usually help the situation over time. Many people find that a mouth guard at night is a big help.  You can get them at any sporting good store and many drug stores.  They are pretty easy to fit and inexpensive.  When I first started using one I chewed through it in a matter of weeks, but over time they started lasting longer and longer. I was able to quit using one before my taper was over and haven't used one since.

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BfromNJ
32 minutes ago, brassmonkey said:

TMJ is frequently a symptom of ADWD. Tapering will usually help the situation over time. Many people find that a mouth guard at night is a big help.  You can get them at any sporting good store and many drug stores.  They are pretty easy to fit and inexpensive.  When I first started using one I chewed through it in a matter of weeks, but over time they started lasting longer and longer. I was able to quit using one before my taper was over and haven't used one since.

Yeah I believe I had this prior to withdrawal.   I've had a lot of dental work done over years, pulled teeth, root canals and i can actually feel and hear the joint grinding.  It's out of whack.  I already have a guard from dentist as i grinded my teeth.  But when I wear it now I feel worse. I suspect I may not be grinding anymore.   But with it in I know something is there and clench.  I think seroquel knocks me out so much I dont even grind.  My grinding was prozac induced years ago. 

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BfromNJ

@Shep

@brassmonkey

 

So I have been having some trouble with terrible burning in my chest, lips, one ear, tongue.  I thought maybe I was having a reaction to the capsules I am using to fill my gabapentin.  They are colored.  So I thought I would test it and put the med in water and drink it instead.  Well this morning I woke up with terrible anxiety and unable to fall back asleep.  

 

My question is-  did drinking it make it go through my system quicker,  thus wearing off quicker since it didnt have to dissolve? 

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brassmonkey

Hi B-- it shouldn't make any difference. It takes about fifteen minutes to half an hour for the gel cap to dissolve and the contests to start to be absorbed, where as with the water method the medication would start to be absorbed in just a few minutes.  Either way it would absorb at the same rate.  The big question is, did it stop the burning?

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BfromNJ
2 hours ago, brassmonkey said:

Hi B-- it shouldn't make any difference. It takes about fifteen minutes to half an hour for the gel cap to dissolve and the contests to start to be absorbed, where as with the water method the medication would start to be absorbed in just a few minutes.  Either way it would absorb at the same rate.  The big question is, did it stop the burning?

Well it still bugging me today.  So I thought if that was it maybe it needs a day or so.   But I'm clueless if not.  I guess its either withdraw or something else. It's very uncomfortable.  Its been almost 4 weeks since my reduction.  

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brassmonkey

Various burning sensations are a typical symptom of WD.  We've had a lot of people reporting them lately.

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BfromNJ
7 minutes ago, brassmonkey said:

Various burning sensations are a typical symptom of WD.  We've had a lot of people reporting them lately.

I suppose it subsides.  At least I hope so.  I am holding a bit now and after my vacation I may do your slide

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BfromNJ

@shep

@ChessieCat

@brassmonkey

 

so, I am super imcomfortable.  Not so much emotional wise, but physically.  I am burning up, particularly on my right ear (if I touch it or even brush my hair, touch my face, etc, it gets worse), stomache, chest and back.  also, my tongue is raw, my face is tingling. 

 

I dropped 5% .  I think it may have been more of a 10%  now that I am weighing out my current capsules (still within SA guidelines) , they seem to be on the higher side than I initially weighed.  But, I went from .250 average capsules weight (or so I think)   to .238 .  Since this really is a small reduction, is it silly to updose it?  Should I wait it out some more?  its been 4 weeks tomorrow.  I seem to be someone who doesn't feel symptoms as much until I am farther out, so obviously I have to go slower.  I may even do a brassmonkey taper going forward. 

 

 

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brassmonkey

Hi B-- sorry to hear that you are feeling so bad.  That burning symptom is one of the worst, but it will eventually go away.  Seems that a lot of people age getting it right now. A very small updose might help, but I wouldn't count on it. Although it's painful, I would hold where you're at and let things stabilize before making any dose changes.

 

Dropping from 250mgpw to 238mgpw is a proper 5% reduction.

 

I highly recommend doing a Brassmonkey Slide. We can calculate it out so you do a total reduction of 5% every six weeks if you're interested.

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Altostrata
2 hours ago, BfromNJ said:

But, I went from .250 average capsules weight (or so I think)   to .238 .

 

Does this refer to gabapentin? What is the capsule dosage?

 

Are these symptoms better or worse at any particular time of day? Please keep daily notes of times of day you take your drugs, their dosages, and your symptoms. You can post them in this topic with a simple list format with time of day on the left and notation (symptom, drug and dosage) on the right.

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BfromNJ
9 minutes ago, brassmonkey said:

Hi B-- sorry to hear that you are feeling so bad.  That burning symptom is one of the worst, but it will eventually go away.  Seems that a lot of people age getting it right now. A very small updose might help, but I wouldn't count on it. Although it's painful, I would hold where you're at and let things stabilize before making any dose changes.

 

Dropping from 250mgpw to 238mgpw is a proper 5% reduction.

 

I highly recommend doing a Brassmonkey Slide. We can calculate it out so you do a total reduction of 5% every six weeks if you're interested.

Okay.  I will be holding until after my cruise on 7/21.  Then I think I'll do the slide.  And just for piece of mind I am going to doctor, since right before I had the burning, I did have a sore on my lip. I called and they want to see me to rule out shingles.  It cant hurt.

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brassmonkey

Good idea. Enjoy the cruise, where are you going?

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BfromNJ
7 minutes ago, Altostrata said:

 

Does this refer to gabapentin? What is the capsule dosage?

 

Are these symptoms better or worse at any particular time of day? Please keep daily notes of times of day you take your drugs, their dosages, and your symptoms. You can post them in this topic with a simple list format with time of day on the left and notation (symptom, drug and dosage) on the right.

Yes the gabapentin.  And it doesnt seem to correlate to any particular dosage time.  But tomorrow I will try and record it.  It's a pretty consistent thing

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Altostrata

What dosage is your gabapentin capsule?

 

Need to see your daily drug schedule and symptom pattern.

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Altostrata

Keep in mind that changes in any of your drugs might trigger adverse effects from other of your drugs -- since they all affect each other.

 

On 4/5/2019 at 11:19 AM, BfromNJ said:

Yes I did this.  They all interact with each other.  althought what can I do about interactions until im off of them?    here it is:

 

Interactions between your drugs

Moderate

gabapentin fluvoxaMINE

Applies to: gabapentin, Luvox (fluvoxamine)

Using gabapentin together with fluvoxaMINE 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

gabapentin QUEtiapine

Applies to: gabapentin, Seroquel (quetiapine)

Using gabapentin 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

fluvoxaMINE QUEtiapine

Applies to: Luvox (fluvoxamine), Seroquel (quetiapine)

FluvoxaMINE may increase the blood levels of QUEtiapine. You may be more likely to experience side effects such as dizziness; drowsiness; dry mouth; constipation; increased appetite; weight gain; increased blood sugar and cholesterol or triglyceride levels; cognitive and motor impairment; involuntary muscle movements involving the face, tongue, or other parts of the body; difficulty swallowing; low blood pressure (especially at the start of treatment or after a dose increase); blood pressure increases (reported in children and teenagers); irregular heart rhythm; and seizures. Let your doctor know if your condition changes or you experience increased side effects. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. 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.

 

 

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BfromNJ
9 minutes ago, brassmonkey said:

Good idea. Enjoy the cruise, where are you going?

Bermuda. 

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BfromNJ
14 hours ago, Altostrata said:

Keep in mind that changes in any of your drugs might trigger adverse effects from other of your drugs -- since they all affect each other.

 

 

thanks Alto.  Guess i just need to ride this out longer.  its funny you say that because i did notice that my muscle twitches seemed to have worsened.  

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BfromNJ
On ‎6‎/‎3‎/‎2019 at 3:40 PM, brassmonkey said:

Seeing that the half life of gabapentin is 5-7 hours it is quite possible that you are getting interdose withdrawal symptoms.  Because this has just started it seems to me that it could be the first signs of the drug starting to poopout,  It's also possible that this is just a wave and will pass in a few days.  Being alright over night would indicate that it is not interdose WD but rather something else. If it is poopout, then the only way out is down.  So proceeding with your taper is the best option.  Being nervous about starting a taper is quite common, I was scared to death when I started mine, but once it gets going things stabilize and smooth out.

Just a question about interdose withdrawal.  How does one combat as best as they can? I mean if its interdose withdrawal, there is no way to really wait for it to settle is there, versus regular withdraw?    Obviously I cant take the medication any more times a day, that would be too much , its 3 times already. And since I am in the middle of a taper, I think its not best to change this up anyway.    I think my interdose withdrawal is probably worsening since I reduced.   I seem to be getting some brain zaps and increase in tinnitus close to my dose time.  Wll it settle out maybe in time once I adjust to the reduction?

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brassmonkey

Gabapentin is a very touchy one to try and taper, a lot of people have a very difficult time with it because of the short half life.  The only way to try and control interdose withdrawal is to split the dose.  Which you've already done.  With the symptoms kicking up just before the next dose does indicate that interdose WD is the problem. Possibly a very small updose would take the edge off, you might try using 580mg instead of the 570 your signature says you are taking.  Otherwise waiting it out is the best bet.

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Altostrata

When you discuss your symptoms, please specify which drug you're talking about, with daily symptom notes. We cannot answer questions about interdose withdrawal without seeing a series of daily symptom notes.

 

On 5/14/2019 at 4:53 PM, Altostrata said:

Let's make this a rule: If you want an answer to a question about your taper, you need to post daily notes. Otherwise, no answers from the staff, we'll assume you don't expect an answer.

 

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BfromNJ
35 minutes ago, Altostrata said:

When you discuss your symptoms, please specify which drug you're talking about, with daily symptom notes. We cannot answer questions about interdose withdrawal without seeing a series of daily symptom notes.

 

 

7/3-

5:30 am- gabapentin 190 mg and probiotic

various burning sensations throughout body, but mainly in the chest, mouth, ear on right side (this will get worse if I touch my ear, rub it or do anything in that area, it also seems to trigger it in other areas of my face and head) , head and torso, come and go through out the day

6:30 - breakfast

some acid reflux

11:00 am - bit of anxiety creeping in and ear ringing, some mild zaps?  - THIS WAS WHAT MADE ME ASK ABOUT INTERDOSE WITHDRAWAL. 

12:30 - gabapentin 190 mg and luvox 18.75 mg

start to feel a bit down and apathetic around this time of day.  But not horrible. 

1:00 pm - various burning sensations throughout body, but mainly in the chest, mouth, ear on right side, head and torso, come and go through out the day

3:30 pm - burning sensation on nose, left side , tongue (this is all day) , arm (severe) , hard to tell sometimes where it burns if that makes sense

 

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Altostrata

Have you tried skipping the probiotic?

 

Why are you taking gabapentin and Luvox together at 12:30?

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BfromNJ
57 minutes ago, Altostrata said:

Have you tried skipping the probiotic?

 

Why are you taking gabapentin and Luvox together at 12:30?

Would the probiotic have adverse effects on the meds?  I can try skipping it.  And I take the luvox that time because I dont want to take it close to my seroquel.  It said on drugs.com that luvox can increase side effects of seroquel.  Since I take gaba 3x a day, no matter when I take it, it will be with it.  And I didn't want to take it at yet another time.   

 

 

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BfromNJ

edited my journal, added more of the day in bold. 

 

7/3-

5:30 am- gabapentin 190 mg and probiotic

feet hurt bad, burning

various burning sensations throughout body, but mainly in the chest, mouth, ear on right side (this will get worse if I touch my ear, rub it or do anything in that area, it also seems to trigger it in other areas of my face and head) , head and torso, come and go through out the day

6:30 - breakfast

some acid reflux

11:00 am - bit of anxiety creeping in and ear ringing, some mild zaps?  - THIS WAS WHAT MADE ME ASK ABOUT INTERDOSE WITHDRAWAL. 

12:30 - gabapentin 190 mg and luvox 18.75 mg

start to feel a bit down and apathetic around this time of day.  But not horrible. 1:00 pm - various burning sensations throughout body, but mainly in the chest, mouth, ear on right side, head and torso, come and go through out the day

3:30 pm - burning sensation on nose, left side , tongue (this is all day) , arm (severe) , hard to tell sometimes where it burns if that makes sense

4:00 - gym workout ellipitical and abs

6:00 - some   zaps, a bit of ringing.  Not real bad though.  lips tingling (happens through out day),  ear is burning bad and continues .   vaginal area burning. 

next dose of gabapentin is at 8:30 pm 

seroquel is at 9:30-10 pm

 

when i go to sleep at night, every night, i have this internal kind of twitching, shaking feeling.   has been on going.  my boyfriend said i sometimes shake.  I dont realize i am doing it and it does not wake me up. 

sleep is pretty consistant.  I am knocked out by the seroquel i think.    

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BfromNJ
1 hour ago, BfromNJ said:

edited my journal, added more of the day in bold. 

 

7/3-

5:30 am- gabapentin 190 mg and probiotic

feet hurt bad, burning

various burning sensations throughout body, but mainly in the chest, mouth, ear on right side (this will get worse if I touch my ear, rub it or do anything in that area, it also seems to trigger it in other areas of my face and head) , head and torso, come and go through out the day

6:30 - breakfast

some acid reflux

11:00 am - bit of anxiety creeping in and ear ringing, some mild zaps?  - THIS WAS WHAT MADE ME ASK ABOUT INTERDOSE WITHDRAWAL. 

12:30 - gabapentin 190 mg and luvox 18.75 mg

start to feel a bit down and apathetic around this time of day.  But not horrible. 1:00 pm - various burning sensations throughout body, but mainly in the chest, mouth, ear on right side, head and torso, come and go through out the day

3:30 pm - burning sensation on nose, left side , tongue (this is all day) , arm (severe) , hard to tell sometimes where it burns if that makes sense

4:00 - gym workout ellipitical and abs

6:00 - some   zaps, a bit of ringing.  Not real bad though.  lips tingling (happens through out day),  ear is burning bad and continues .   vaginal area burning. 

next dose of gabapentin is at 8:30 pm 

seroquel is at 9:30-10 pm

 

when i go to sleep at night, every night, i have this internal kind of twitching, shaking feeling.   has been on going.  my boyfriend said i sometimes shake.  I dont realize i am doing it and it does not wake me up. 

sleep is pretty consistant.  I am knocked out by the seroquel i think.    

wanted to add that i also had feelings of deep sadness around 7:00.  very depressed by ear problem,  its so uncomfortable.  and some anxiety. 

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Altostrata
20 hours ago, BfromNJ said:

when i go to sleep at night, every night, i have this internal kind of twitching, shaking feeling

 

What time of night does this occur? I need to see this in your daily symptom notes.

 

Please post your daily symptom notes for a full 24 hours without the discursive commentary. I have been requesting this for months.

 

You are poly-drugged, your situation is very complicated, and we cannot answer questions when you vent about your symptoms without the context of your daily drug schedule and symptom notes.

 

Please make an effort to provide the information we have repeatedly requested.  Otherwise, you're wasting your time and our time here.

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BfromNJ
1 hour ago, Altostrata said:

 

What time of night does this occur? I need to see this in your daily symptom notes.

 

Please post your daily symptom notes for a full 24 hours without the discursive commentary. I have been requesting this for months.

 

You are poly-drugged, your situation is very complicated, and we cannot answer questions when you vent about your symptoms without the context of your daily drug schedule and symptom notes.

 

Please make an effort to provide the information we have repeatedly requested.  Otherwise, you're wasting your time and our time here.

I did yesterday's just not the evening.  And working on today.  I just added that about the shaking because its every night, when I go to bed.   I didnt do symptom notes for a while because I was fairly well.  And I apologize I dont know what discursive means..  I receive very good advice here.   I didnt feel like I was wasting my time because its helpful.   If I'm wasting others time sorry for that.  

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Altostrata

I WANT TO SEE THOSE 24-HOUR SYMPTOM NOTES.

 

OTHERWISE, NO ANSWERS FROM THE STAFF. IS THAT CLEAR?

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BfromNJ
1 hour ago, Altostrata said:

I WANT TO SEE THOSE 24-HOUR SYMPTOM NOTES.

 

OTHERWISE, NO ANSWERS FROM THE STAFF. IS THAT CLEAR?

Workin on it.  

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Dejavu

@BfromNJ, maybe I can help. Alto needs to see a full day of notes, from wakeup to bedtime, all in one post. Dividing notes from a single day into multiple posts is confusing and makes causation and symptoms very hard for her to track. For example, you would keep notes for today, and post them in total tomorrow.

 

Examples of discursive commentary from your notes:

22 hours ago, BfromNJ said:

(this will get worse if I touch my ear, rub it or do anything in that area, it also seems to trigger it in other areas of my face and head) , head and torso, come and go through out the day

 

 

23 hours ago, BfromNJ said:

THIS WAS WHAT MADE ME ASK ABOUT INTERDOSE WITHDRAWAL

 

23 hours ago, BfromNJ said:

Not real bad though.

 

As far as daily notes are concerned, just the facts: times and amounts you dose and the symptoms you experience throughout the day. The above comments I have quoted are fine to put in other posts, just not when the mods are trying to carefully analyze your situation.

 

If it helps, I try to think of posting on my thread as consisting of two different types of entries: one when I'm discussing my situation in general and looking for support among all members, and the other when I am seeking specific assistance from the mods. In the first, the type of information I have quoted above is very appropriate. It is helpful for us all to share information and concerns with one another.  

 

In responding to requests for information from the staff, however, we need to stick with cold  hard facts. They are all volunteers and they are already spread very thin, and in order to help, they need to see the information in a certain way. Rest assured, Alto has her reasons for asking the questions she does. In their experience, they can see things in our notes that we can't. She and the other mods on this site most likely know more about this syndrome than anyone else on the planet, and none of them have ever failed to steer me in the right direction as long as I give the exact information that is asked for.

 

Here is an example of the form in which the mods need to see your daily notes. This was sent to me by Songbird when I first joined.

 

23 June

7 a.m. woke up, anxiety 3/10

8 a.m. ate breakfast, took 20mg Prozac tablet

10 a.m. anxiety 7/10, nausea 3/10

12 p.m. ate lunch, anxiety 5/10, nausea 1/10

2 p.m. anxiety 4/10, nausea 2/10

6 p.m. ate dinner, took magnesium tablet 200mg, anxiety 2/10, no nausea

8 p.m. anxiety 1/10

11 p.m. went to bed, anxiety 2/10, difficulty falling asleep for 2 hours

4 a.m. woke up, no anxiety, went back to sleep for 3 hours

 

I hope this helps to clarify. I know this is a very frightening and confusing time. Please feel free to reach out to be when you need moral support. I am happy to help.

 

DV

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BfromNJ
2 hours ago, Dejavu said:

@BfromNJ, maybe I can help. Alto needs to see a full day of notes, from wakeup to bedtime, all in one post. Dividing notes from a single day into multiple posts is confusing and makes causation and symptoms very hard for her to track. For example, you would keep notes for today, and post them in total tomorrow.

 

Examples of discursive commentary from your notes:

 

 

 

As far as daily notes are concerned, just the facts: times and amounts you dose and the symptoms you experience throughout the day. The above comments I have quoted are fine to put in other posts, just not when the mods are trying to carefully analyze your situation.

 

If it helps, I try to think of posting on my thread as consisting of two different types of entries: one when I'm discussing my situation in general and looking for support among all members, and the other when I am seeking specific assistance from the mods. In the first, the type of information I have quoted above is very appropriate. It is helpful for us all to share information and concerns with one another.  

 

In responding to requests for information from the staff, however, we need to stick with cold  hard facts. They are all volunteers and they are already spread very thin, and in order to help, they need to see the information in a certain way. Rest assured, Alto has her reasons for asking the questions she does. In their experience, they can see things in our notes that we can't. She and the other mods on this site most likely know more about this syndrome than anyone else on the planet, and none of them have ever failed to steer me in the right direction as long as I give the exact information that is asked for.

 

Here is an example of the form in which the mods need to see your daily notes. This was sent to me by Songbird when I first joined.

 

23 June

7 a.m. woke up, anxiety 3/10

8 a.m. ate breakfast, took 20mg Prozac tablet

10 a.m. anxiety 7/10, nausea 3/10

12 p.m. ate lunch, anxiety 5/10, nausea 1/10

2 p.m. anxiety 4/10, nausea 2/10

6 p.m. ate dinner, took magnesium tablet 200mg, anxiety 2/10, no nausea

8 p.m. anxiety 1/10

11 p.m. went to bed, anxiety 2/10, difficulty falling asleep for 2 hours

4 a.m. woke up, no anxiety, went back to sleep for 3 hours

 

I hope this helps to clarify. I know this is a very frightening and confusing time. Please feel free to reach out to be when you need moral support. I am happy to help.

 

DV

I am doing my daily log.  I have started it.  I have also done it in past.  Thank you.  

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BfromNJ

7/4 drug & symptom journal

 

6:00-woke up 
-190 mg gabapentin
9:30 - tums 2 750 mg for reflux 
8:30-  zaps and ear ringing (this has been not happening much, intercourse last night may have shaken things up?)
-lips tingling 
10:00- burning in chest, back, forehead, eyes , ear, (seems to get aggravated by touching my right ear) 
11:30- burning tongue and mouth , tingling in mouth area,  burning ear,  mild anxiety
12:30- gabapentin 190 mg 
luvox 18.75 mg
2:30-  burning in chest, ear, tongue 
ringing still more prominent today
3:00- headache, went away after an hour
burning persisted thru afternoon
5:30- felt odd, out of sorts and dizzy.  legs felt like I needed to move them.  some anxiety over it. passed after about an hour. 
7:45-  ears ringing terrible.  burning bad in chest area 
8:30-  gabapentin 190 mg
9:30- burning subsides some
10:00- 25 mg seroquel
- legs feeling activated 

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BfromNJ

@Altostrata

HI Alto.  You previously asked whether I have tried eliminating the probiotic.  I was reading up on it in the forums, but not clear to me on whether they can be detrimental to your taper or withdrawal.  Should I drop it and see if it helps?   does it interact with the medication? 

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BfromNJ
8 hours ago, BfromNJ said:

7/4 drug & symptom journal

 

6:00-woke up 
-190 mg gabapentin
9:30 - tums 2 750 mg for reflux 
8:30-  zaps and ear ringing (this has been not happening much, intercourse last night may have shaken things up?)
-lips tingling 
10:00- burning in chest, back, forehead, eyes , ear, (seems to get aggravated by touching my right ear) 
11:30- burning tongue and mouth , tingling in mouth area,  burning ear,  mild anxiety
12:30- gabapentin 190 mg 
luvox 18.75 mg
2:30-  burning in chest, ear, tongue 
ringing still more prominent today
3:00- headache, went away after an hour
burning persisted thru afternoon
5:30- felt odd, out of sorts and dizzy.  legs felt like I needed to move them.  some anxiety over it. passed after about an hour. 
7:45-  ears ringing terrible.  burning bad in chest area 
8:30-  gabapentin 190 mg
9:30- burning subsides some
10:00- 25 mg seroquel
- legs feeling activated 

I just wanted to add a note to this - the only thing different in my regiment is I have been taking tums.  and I have been mindful of not taking it within two hours of my gabapentin.  You will see where I did so in the am at 9:30 am.  I have been taking them one to two times a day for the last few days.  did not today though, 7/5.  Not sure if its causing me harm so I will avoid it today (7/5). 

 

And I also forgot to enter the feeling I get when I go to lay down.  it is an internal shaking, vibrating type of sensation. I feel it constant during the day to, like an internal tremor, but during the day not as aware of it, as I am busy.  but when I lay down it bothersome. its a daily thing.   

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