Sagebug: CT Prozac and benzo withdrawal

[Sagebug]

On a nutshell. Ive been free of Prozac or 4 months. Free of Klonopin for 3 months. I've had windows and waves this whole time but the windows were not that great and the waves seemed to be getting worse. I was at the end of my rope this last week. About to loose my business. It makes perfect sense to me that after 33 years of not being able to shake panic disorder that it may be a real thing and not some childhood hormonal issues. I've been doing midfullness, guided meditation, new hobbles, working, cut out gluten, sugar caffiene, coffee, strict diet, etc. Follow Weekes book, cbt therapy books, floating with it facing it. Everything. 

[Sagebug]

8 minutes ago, Shep said:

Sage, you can consider the two benzo pills you've taken as rescue doses and stop.

 

I don't think Alto realized you had been off the benzo for 3 months and only just reinstated it yesterday. You're correct that it's safe to stop. 

 

 

Looks like the number of hours was left out of your sentence. From what you wrote, it sounds like it was a good night. 

 

Did the Klonopin help with sleep or did you fall asleep on your own? 

 8 hours I can only imagine it's from the Klonopin. 

Last night was the first time I could have the lights on in the house and actually have a meaningful conversation with my wife. I ate dinner at a slow pace instead of woofing it down so I could lay down in the dark.

[Shep]

Just now, Sagebug said:

8 hours I can only imagine it's from the Klonopin. 

 

Thank you for this information, Sage. Are you going to be okay without Klonopin to sleep?

 

1 minute ago, Sagebug said:

It makes perfect sense to me that after 33 years of not being able to shake panic disorder that it may be a real thing and not some childhood hormonal issues.

 

There's something called oppositional tolerance that explores how something very temporary can become a chronic illness when treated with antidepressants. For more, please see:

 

Now Antidepressant-Induced Chronic Depression Has a Name: Tardive Dysphoria

 

Some of your anxiety over the years may have been medication-induced anxiety and akathisia. 

 

Robert Whitaker is a medical historian and science journalist who comes highly recommended on this site. You may want to get a copy of his Anatomy book: 

 

Anatomy of an Epidemic

 

A book trailer video by the author: 

 

Robert Whitaker, author Anatomy of an Epidemic video (11.5 minutes)

 

This is a great article that shows how patterns of recovery have changed since the use of these drugs.

 

 

History We Can’t Overlook Anymore: Details Before the Anti-Depressant Era

 

You're doing all of the right things regarding non-drug coping, but withdrawal can last a really long time. But that doesn't mean you have anything more wrong with you than these drugs. And for those of us who started on these drugs young, we have to learn to feel our real emotions again. 

 

But again, that doesn't mean we have any disorder or disease. 

 

Here are some threads about non-drug coping that are specific to withdrawal symptoms and the length of time it can take to recover: 

 

Tips to help sleep: so many of us have that awful withdrawal insomnia

 

Dealing With Emotional Spirals

 

Neuro-emotion

 

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

 

Creating a new self after withdrawal

 

Please check out Robert Whitaker's book, as I think it will answer a lot of questions for you. 

 

[Altostrata]

34 minutes ago, Sagebug said:

after 33 years of not being able to shake panic disorder that it may be a real thing

 

The Prozac and Klonopin you took 1995-2018 did not help you all the time you took them?

 

On 2/16/2019 at 2:04 AM, Sagebug said:

....

I stopped the Prozac on November 1st after just taking a dose two weeks apart. I had brain zaps and just over all feeling crappy but I was starting my Klonopin rapid taper as well (6 weeks from 2mg to 0). I felt pretty good untill 5 days after quitting the Klonopin (39 days after Prozac) and all heck broke loose. I have a laundry list of problems that I thought were due to the benzodiazipine withdrawal but stumbled on this site after researching trazadone taper ( been using 50mg for sleep) I am in complete shock. It would appear both drugs have similar effects after wd....

 

Yes, it appears you have a combination of Prozac and Klonopin withdrawal. The brain zaps from going off Prozac indicated your nervous system was already in distress when you went off Klonopin.

 

Withdrawal symptoms are not related to a relapse or continuation of "panic disorder." They are withdrawal symptoms.

 

4 hours ago, Sagebug said:

Trazadone is down to 12.5 mg. Although I skipped last night.

Haven't been feeling any issues tapering. 

When I took the [0.25mg] Prozac I got anxiety and a little dread feeling. I kind of figure it was just me being so afraid to take it causing it. I am giving it a real chance this time since I have something to help with anxiety but then again I'm not seeing a huge difference with the Klonopin. 

For the record I never really wanted to stop anything....

 

44 minutes ago, Sagebug said:

After you take 12.5mg trazodone, do you have any symptoms?

 

----Slight heart palpitations

 

What exactly is your daily symptom pattern? What times of day do you take your drugs, and their dosages? How much Klonopin are you taking now? Please update your signature.

---I just, yesterday started .5 Klonopin. Today I took 2mg of Prozac and have slightly sweaty hands and mild chest discomfort.

 

What are the symptoms you get at night? Do they happen at any particular time in the evening?

--- starts about 4pm all the way to need at midnight to 2am dread and anxieties, reslestness, derealization, pins and needles arms and back.

 

The palpitations from trazodone are concerning. I would continue to reduce it.

 

How long have you been having these symptoms that start around 4 p.m.? Have they changed since you reduced trazodone?

 

When you change more than one drug at a time, we can't tell what's causing what. You are reducing trazodone and you started Klonopin and Prozac at the same time. It's going to take about a week for Prozac to ramp up to full 2mg effect.

 

I am confused about why you say you never wanted to stop anything. How is it you stopped Prozac and Klonopin at about roughly the same time? Is it your intention to go back on Prozac and Klonopin?

 

 

[Sagebug]

2 hours ago, Shep said:

 

Thank you for this information, Sage. Are you going to be okay without Klonopin to sleep?

 

 

------Up to this point nothing has netted me more than 2-3 hours sleep and it was spotty at that. I would say if you averaged a weeks nights, it would need 1.5 hours sleep.

 

Edited March 11, 2019 by ChessieCat
extracted response

[Sagebug]

1 hour ago, Altostrata said:

 

The Prozac and Klonopin you took 1995-2018 did not help you all the time you took them?

 

 

---Absolutely helped although I always wonder about Prozac, seemed like I always felt a little better when I missed a few doses.

1 hour ago, Altostrata said:

 

 

Yes, it appears you have a combination of Prozac and Klonopin withdrawal. The brain zaps from going off Prozac indicated your nervous system was already in distress when you went off Klonopin.

 

Withdrawal symptoms are not related to a relapse or continuation of "panic disorder." They are withdrawal symptoms.

 

 

 

The palpitations from trazodone are concerning. I would continue to reduce it.

 

How long have you been having these symptoms that start around 4 p.m.? Have they changed since you reduced trazodone?

- ---it's been like this since the begining, and even before I stopped them. Evenings have always brought some edginess my whole life. I attribute it to artificial lighting and shadows. Always reminds me of derealization which started as a kid.

1 hour ago, Altostrata said:

 

When you change more than one drug at a time, we can't tell what's causing what. You are reducing trazodone and you started Klonopin and Prozac at the same time. It's going to take about a week for Prozac to ramp up to full 2mg effect.

 

I am confused about why you say you never wanted to stop anything. How is it you stopped Prozac and Klonopin at about roughly the same time? Is it your intention to go back on Prozac and Klonopin?

 

 

 I was a happy person, went on trips, spent time with family, always cooked, built a successful business but then my doctor said he couldn't prescribe my Klonopin like he did before that I could only have a 2 week supply every 2-3 months. It infuriated me and I thought like some, I may have just grown out of it, so I decided to withdrawl from everything. I do think I may get back on both meds, get stable and do a super slow withdrawal over a period of years. Yesterday was 3 months to the day I started having this nightmare. My life around me has falling apart and I was just getting to a point that I was willing to do anything. I don't have 6months, 2 years, however this lasts. I just don't. I would be homeless, dead or in a mental hospital. I'm telling you, I would sit in my house for days, with zero light just laying there like my body and mind was at war. I had no inner peace. Some5I would have a moment of clairiy and think about what I was doing and thinking and it made me ill. " How am I living like this?" I would ask myself.

[Altostrata]

If you look around the Introductions forum, you will see many people experiencing withdrawal syndrome like you are.

 

Each person does the best he or she can.

 

5 hours ago, Sagebug said:

 

 

---Absolutely helped although I always wonder about Prozac, seemed like I always felt a little better when I missed a few doses.

- ---it's been like this since the begining, and even before I stopped them. Evenings have always brought some edginess my whole life. I attribute it to artificial lighting and shadows. Always reminds me of derealization which started as a kid.

 ....

 

What times of day did you used to take Prozac and Klonopin?

 

You seem to have a strange attitude towards your drugs and your condition. After all that time, you're saying you went off your drugs in a fit of pique?

 

We're not going to be able to recommend a good cocktail together for you so you continue on drugs. What we do here is try to reduce withdrawal symptoms, get people on the path to self-care, and reduce drugs. 

 

As far as how much time it will take for you to do this, we can't tell you.

[Sagebug]

9 hours ago, Altostrata said:

If you look around the Introductions forum, you will see many people experiencing withdrawal syndrome like you are.

 

Each person does the best he or she can.

 

 

What times of day did you used to take Prozac and Klonopin?

I took the Prozac and half the Klonopin in the morning and the second dose of Klonopin in the evening aroind 5-6

Quote

 

You seem to have a strange attitude towards your drugs and your condition. After all that time, you're saying you went off your drugs in a fit of pique?

 

We're not going to be able to recommend a good cocktail together for you so you continue on drugs. What we do here is try to reduce withdrawal symptoms, get people on the path to self-care, and reduce drugs. 

 

As far as how much time it will take for you to do this, we can't tell you.

I completely understand this isn't about helping me get back on, although I am a little confused about always suggesting people going back on their antidepressant to stabilize because of a cold turkey withdrawal like I did. Same with the Klonopin, I was told it was way too fast. 

I guess the question I'm most curious about is do the people of this board believe in Psychiatric problems requiring meds anyway? (Not being combative, trust me) And if so, should those people try to get off all meds no matter what?  I have read CBT therapy can be just as helpful as any medicine but what happens when that person is in such bad shape they can't go to their therapy appointments?

When I first came here I was adamant about not going back on anything, but it started to become clear to me I wasn't going to be one of the lucky ones to have a quick withdrawal, and my protracted withdrawal was real and lengthy. Like I mentioned, I'm very close to losing everything I've worked 30 years to build. No sleep, can't go anywhere, couldn't spend time with my kid, dread and panic all day, everyday and to think I've always had a panic disorder and it just might always be this way has made me think twice. 

And yes, I quit my meds out of anger of being told I couldn't have them anymore. I felt in control of everything, granted I wasn't perfect, I was in control. I was in such a good place. I too had thought it was just some adolescent problem I was carrying around. If I were to tell you about my childhood, half of which I can't remember, it may help you understamd why I am the way I am. I didn't take meds because my parents spanked me, or I had one bad life event, or I was withdrawn shy kid, nor anything else like that. I would wake up to police raids, not knowing where my parents were for a week, moving schools 8 times a year, living on my own since 16, 3rd generation anxiety/panic disorder, That's the short list. Although I don't use these things as a crutch, They did something to me.

Is it totally ignorant of me to think If I went back on, got the therapy I needed and then ween back off like I was supposed too?

 

Edit to add. I can take the Klonopin for a week or two to stabilize on the Prozac and then just quit, right? I've read countless places that say physical dependence doesn't start for 2-4 weeks. I do not want to be back on Klonopin. I couldnt take the withdrawal from that again. 

Yesterday I took 2mg of Prozac and got clammy hands and a small bit of anxiety in my chest. I took 3mg today and same thing. I do wonder if it's because I am so scared about all this. 

[Altostrata]

14 hours ago, Sagebug said:

I took the Prozac and half the Klonopin in the morning and the second dose of Klonopin in the evening aroind 5-6

 

It looks to me like you were having an adverse reaction to Prozac in the afternoon. It can take 6-8 hours for fluoxetine to reach peak plasma after a dose. Anxiety or overstimulation are common adverse effects of SSRIs.

 

Suggest you think about it: Much of what you think is your psychiatric disorder is caused by the drugs. You seem to have difficulty untangling your obvious withdrawal symptoms from relapse.

 

14 hours ago, Sagebug said:

Is it totally ignorant of me to think If I went back on, got the therapy I needed and then ween back off like I was supposed too?

 

It's possible you'll eventually stabilize on a drug or drugs and then taper off. Therapy can always be rewarding, but it will never explain an adverse drug reaction or withdrawal symptoms.

 

14 hours ago, Sagebug said:

 

Edit to add. I can take the Klonopin for a week or two to stabilize on the Prozac and then just quit, right? I've read countless places that say physical dependence doesn't start for 2-4 weeks. I do not want to be back on Klonopin. I couldnt take the withdrawal from that again. 

 

We don't know. We've seen people get physiologically dependent on Klonopin within a week. I wouldn't count on being able to quickly go off it.

 

14 hours ago, Sagebug said:

Yesterday I took 2mg of Prozac and got clammy hands and a small bit of anxiety in my chest. I took 3mg today and same thing. I do wonder if it's because I am so scared about all this. 

 

It could be that you're scared, or it could be that you have always had an adverse reaction to Prozac. You will need to become a dispassionate observer of your own symptoms to assess them accurately.

 

Why did you increase from 2mg to 3mg? In order to see the effect of a change, you need to keep daily notes every day of when you take your drugs, their dosages, and your symptoms. Do not randomly change your drugs, or you'll become confused and feel out of control.

[Shep]

3 hours ago, Altostrata said:

In order to see the effect of a change, you need to keep daily notes every day of when you take your drugs, their dosages, and your symptoms.

 

Sage, the below format is the best way to give us the information.  Please also include your supplements and the number of hours of sleep you get each night. 

 

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

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

 

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

 

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

 

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

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

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

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

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

 

[Sagebug]

 Yesterday I had a pins and needles feeling in back and arms but very mild from 6pm to 12pm. Took 1mg Klonopin at 9pm and slept 8 hours solid.

8:00am- woke up felt some anxiety.

9:00- took 3mg of Prozac and .5 Klonopin.

9:45- anxiety diminished

11- started feeling a little dizzy, not bad just a little faint.

11-3 Felt pretty good, was very productive at work, low grade dizziness / faintness .

3pm- anxiety kinda starting creeping in and started to get little twinges in the head. I wouldn't call them brain zaps, but very mild twinges.

4pm- took .5 Klonopin and nothing changed, had energy enough to work around the house.

6pm- no real anxiety but still slightly light headed.

Now I still feel a little light headed with some twinges. No bothersome but seem like if they were stronger they would be brain zaps 

Today I felt pretty good. I got a lot accomplished, plenty of energy, no sign of panic, but somewhat of a low mood.

 

 

[Sagebug]

19 hours ago, Altostrata said:

 

It looks to me like you were having an adverse reaction to Prozac in the afternoon. It can take 6-8 hours for fluoxetine to reach peak plasma after a dose. Anxiety or overstimulation are common adverse effects of SSRIs.

 

Suggest you think about it: Much of what you think is your psychiatric disorder is caused by the drugs. You seem to have difficulty untangling your obvious withdrawal symptoms from relapse.

 

 

It's possible you'll eventually stabilize on a drug or drugs and then taper off. Therapy can always be rewarding, but it will never explain an adverse drug reaction or withdrawal symptoms.

 

 

We don't know. We've seen people get physiologically dependent on Klonopin within a week. I wouldn't count on being able to quickly go off it.

 

 

It could be that you're scared, or it could be that you have always had an adverse reaction to Prozac. You will need to become a dispassionate observer of your own symptoms to assess them accurately.

 

Why did you increase from 2mg to 3mg? In order to see the effect of a change, you need to keep daily notes every day of when you take your drugs, their dosages, and your symptoms. Do not randomly change your drugs, or you'll become confused and feel out of control.

I was increasing because the doctor wanted me at 10mg in 10 days. I will go back to 2mg tomorrow or do you think I should hold at 3mg?

 

How much time do I get to try this out before I can just quit without tapering? I have a sneaking suspicion Prozac isn't going to go well. Do you think I should try the Lexapro or Zoloft like he had mentioned?

I may make Friday my last day for Klonopin.  Gawd I'll miss the sleep it's giving me. 

I know one thing, I need to get this protracted withdrawl under control and then do the 10% every month taper. I can't go on with it.

[Altostrata]

When did you start 2mg Prozac? When did you increase to 3mg?

 

Why do you take Prozac and Klonopin together? What happened to the trazodone?

[Sagebug]

8 minutes ago, Altostrata said:

When did you start 2mg Prozac? When did you increase to 3mg?

 

Why do you take Prozac and Klonopin together? What happened to the trazodone?

I started Klonopin Saturday at 4pm. Prozac 2mg Sunday morning, and 3mg Monday and today. (Morning)

Trazadone is now at 10mg as of today. I take at 7-10pm

[Altostrata]

Why do you take Prozac and Klonopin together? Since you take them together, it's impossible to tell if either drug is causing your symptoms.

 

You may be taking too much Prozac again. If Prozac is stimulating, the Klonopin can be canceling that out.

 

Are you still taking Klonopin? What times of day do you take it, and at what dosages?

[Sagebug]

15 minutes ago, Altostrata said:

Why do you take Prozac and Klonopin together? Since you take them together, it's impossible to tell if either drug is causing your symptoms.

 

You may be taking too much Prozac again. If Prozac is stimulating, the Klonopin can be canceling that out.

 

Are you still taking Klonopin? What times of day do you take it, and at what dosages?

I take Klonopin when I get up around 8, along with the Prozac,  then I take Klonopin again at 8ish pm  I take .5mg in am and 1mg at night 

I always took them that way. 

Isn't there a chance I am dealing with protracted benzo withdrawal too? On Sunday when I only took Klonopin my Dr, inner tremble, being very cold and restless legs went away, along with 75% of my anxiety. 

Are you suggesting I just quit the Klonopin? 

When I just take the Klonopin at night, nothing really happens other than getting sleepy 

 

[Altostrata]

On 2/16/2019 at 11:28 AM, Altostrata said:

The combination of SSRI and benzo withdrawal syndromes can be gnarly, to say the least. We must assume that your nervous system is now hypersensitive to neuroactive drugs, supplements, and even foods and treat it very gently.

 

1 hour ago, Sagebug said:

4pm- took .5 Klonopin and nothing changed, had energy enough to work around the house.

 

Did you also take 0.5mg Klonopin at 8 p.m. today? That would be 3 doses of Klonopin.

 

@Shep suggested on March 10 you stop taking Klonopin to avoid dependency.

 

Since you're making so many changes at once -- having just reduced trazodone again -- we can't figure out what's going on. We have to see a baseline symptom pattern. When you keep making changes, we can't tell what's causing what.

[Sagebug]

18 minutes ago, Altostrata said:

 

 

Did you also take 0.5mg Klonopin at 8 p.m. today? That would be 3 doses of Klonopin.

 

@Shep suggested on March 10 you stop taking Klonopin to avoid dependency.

 

Since you're making so many changes at once -- having just reduced trazodone again -- we can't figure out what's going on. We have to see a baseline symptom pattern. When you keep making changes, we can't tell what's causing what.

 

Yes, I was going to split up my evening dose, so the 4pm was half of my 8pm dose. I was going to try and see if I didn't need it all tonight actually, I'm pretty tired and calm tonight. I worked 9 hours today.  I'm only three days into this Prozac/Klonopin reinstate so I haven't settled on a schedule, or should I say, I'm  trying to figure one out. The 1mg in the evening is pretty strong. I stumble into bed.

I'll skip Klonopin tonight and tomorrow and just do 3mg of Prozac, then report back. Or do you think I should go lower tomorrow?

If the twinges or slight dizziness stay or get stronger is that considered an adverse reaction or just my brain trying to stabilize on it?

[Shep]

8 hours ago, Sagebug said:

Isn't there a chance I am dealing with protracted benzo withdrawal too? On Sunday when I only took Klonopin my Dr, inner tremble, being very cold and restless legs went away, along with 75% of my anxiety. 

Are you suggesting I just quit the Klonopin? 

When I just take the Klonopin at night, nothing really happens other than getting sleepy 

 

I'm confused. You posted your drug and symptoms journal in this post and you were taking the Klonopin at 9 AM and 4 PM. You posted:

 

9 hours ago, Sagebug said:

4pm- took .5 Klonopin and nothing changed, had energy enough to work around the house.

 

So it looks like the afternoon dose of Klonopin gave you energy or at the least, didn't cause sedation. Are you taking an additional amount of Klonopin later in the day (that wasn't listed in your drug and symptoms journal)? 

 

Is the Trazadone what's helping with sleep? 

 

Please keep posting your drug and symptoms journal. 

[Sagebug]

3 hours ago, Shep said:

 

I'm confused. You posted your drug and symptoms journal in this post and you were taking the Klonopin at 9 AM and 4 PM. You posted:

 

 

So it looks like the afternoon dose of Klonopin gave you energy or at the least, didn't cause sedation. Are you taking an additional amount of Klonopin later in the day (that wasn't listed in your drug and symptoms journal)? 

 

Is the Trazadone what's helping with sleep? 

 

Please keep posting your drug and symptoms journal. 

Yes, I have not been consistent, I now understand I need to be. Just trying to get things worked out because it's all new to me again. Like I mentioned, my old course was 8am and then evenings around 8-9 for klonopin. Always mornings for Prozac  because it has always been stimulating.

Only when I take the full dose of 1mg Klonopin do I get sleepy.

Trazadone does nothing, hasn't for weeks.

I'm about to take 3mg Prozac and no Klonopin, unless I hear otherwise.

Last night another 8.5 hours sleep! So far this morning, just a wee bit anxiety. I'll update my day later on.

 

P.s. I wouldn't say yesterday's 4pm .5mg Klonopin dose gave me energy. I just didn't have any anxiety, and when I feel good I'm always doing things. Anxiety zaps my energy away.

[Altostrata]

14 hours ago, Sagebug said:

If the twinges or slight dizziness stay or get stronger is that considered an adverse reaction or just my brain trying to stabilize on it?

 

Since your drug intake hasn't been consistent, we cannot establish a symptom baseline yet. Mild symptoms may be side effects, reactions to inconsistent dosing, or the underlying withdrawal symptoms.

 

Any of these types of symptoms might come in waves. If you get a mild symptom, please do not panic and add a drug. Just breath through it. They will come and go as your nervous system stabiiizes.

 

It's very important that you settle on a consistent drug schedule in order to identify a baseline symptom pattern. For example, it's possible you're fine with that 3mg Prozac without Klonopin, but we don't know because you've been going up and down in dosing. Or, it's possible 3mg Prozac is too stimulating, 2mg would be fine, and you wouldn't need the Klonopin.

 

The common practice of doctors to mask side effects of drugs like Prozac with Klonopin or other benzos is a very bad medical practice. Please do not assume the drugs belong together.