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ShiningLight: brain injury with gabapentin WD want off others

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ShiningLight

Thanks, @Shep. I take responsibility for my decision and whatever the long term outcome is (hopefully off klonopin with no problems!), but it is you who gave me the courage to listen to my inner voice that was screaming to get off it now, and try. Everyone else kept saying you're stable now, why risk that, but inside I was thinking that I would harm myself in the long run if I continued, and that really bothered me.

 

Coming off Zoloft and Trazodone after a waiting period from when I finish the gabapentin is enough, why add another hurdle for me with klonopin as well?! Especially since I already struggle with anxiety and depression and klonopin would make that worse. 

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ShiningLight

April 19, 2019

@Shep see concern of tremors below. I will keep the klonopin at 0.125 tomorrow and make better notes of the times that the tremors occur. I do know I get them in the morning before my gabapentin dose but they are more widespread than what I was noticing today.

12:45 am Fell asleep. This has always been a pattern when I’m not working, go to bed later and later. Will try to start reversing it, esp since I’m not waking up any later.

5:30 am woke up. Took 100 mg gabapentin. I can’t remember if I slept through the night or not. I think so! If I woke up it certainly didn’t bother me. Ate some macadamia nuts.

8:30 am 150 mg zoloft

10:00 am met friend for a movie. The noise was too loud and my eyes had a hard time with all the camera shot changes, but this has been going on for awhile and it’s not the klonopin, it’s the gabapentin w/d.

11:15 am 100 mg gabapentin

I started noticing that I was having some tremors in my ankles when I extend them after flexing them. I can't recall the time I noted this though. Was it before the gabapentin dose or after???

1:00 pm Lunch with friend, cheese quesadilla, horchata, salad

4:15 pm 100 mg gabapentin

5:30 pm Noticing that I have some tremors when I move my L bicep. It happens with bicep muscle extension. I will see if it goes away after the klonopin dose tonight. I’m scared about it as it’s similar to a permanent L wrist tremor I got in the distant past after stopping zoloft too quickly once. I don’t want it to be permanent. They are action tremors; only occur with certain voluntary muscle movements.

I don’t know whether the tremor is due to going too fast with the klonopin or from the gabapentin. I am suspicious of the klonopin. I don’t want to updose. 

I had a lot of tremors during my large gabapentin decreases early on and they went away. Maybe this is the same thing? Hard to tell.

7:00 pm .125 Klonopin

7:45 pm Tremor improved with klonopin dose but still intermittently here upon movement

9:35 pm 100 mg gabapentin

10:10 pm Bicep tremor is gone now, maybe it was a gabapentin w/d?

The link on emotional spirals was very helpful. I've had those for years and they take a ton of my energy/life force. I wonder if those are due to the SSRI. That is something I really struggle with, thanks for the link!

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ShiningLight

I think maybe I was over-reacting to the tremors, I'm not sure. I find tremors to be very scary, especially since I have the persisting one. That one doesn't bother me much because it only comes up with a certain hand movement that I hardly ever do; but the thought of having others that might remain terrifies me. It's also the thought of having permanent nervous system damage that's traumatizing to me, and it being my fault or related to decisions I made...self-blame. There's a lot to work with there, I will talk with my therapist about it.

 

Also I'm noticing that after I took the gabapentin and klonopin, the tremors are intermittent. That is comforting.

 

I'm going to hold my dose at .125 and see how I do over the next few days, which was the plan anyway.

 

My stomach has been settling down a bit. I'm really not seeing any drammatic signs of klonopin w/d. Some minor muscle twitches that seem different than the ones I got on gabapentin, an uptick in anxiety that I can weather, more emotional spirals (but that's how I was before the klonopin! lol only it's not funny), but overall feeling pretty stable. In fact, even the hyper-alerting from the gabapentin has calmed down. Now when I hyper-alert, it feels like a wave going through my brain instead of actually having the jumping response, and it only happens a few times a day. Overall, my nervous system feels increasingly stable. That's pretty great, considering that I've made big cuts in the past week! I think the meditation has really been helping me get into my sympathetic nervous system at least for 2 half hours a day. My pattern has been to live in the parasympathetic flight or fight, lifelong. :(

 

I told my sister that I'm doing pretty good today. She said I haven't said that in months. She has been a wonderful and generous support to me. We talk almost every day and text every day.

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ShiningLight

@Shep yeah...after paying more attention this morning, I think the tremors are due to gabapentin withdrawal because I had the same kind of tremor in multiple muscles this morning before I got up and took the gabapentin. Made worse yesterday by worry about klonopin. I've had these tremors for weeks, especially worse in the morning due to short half life of gabapentin. Just a sign that I shouldn't go too fast when I cut the gabapentin in a few months, that's it! :)

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ShiningLight

OK I have no idea bout the tremors now because I took a nap and woke up and had them. Whatever.

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ShiningLight

It could be anything; these were gaba withdrawal symptoms. I'm not sure if I would experience different withdrawal symptoms from klonopin.

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Shep
17 hours ago, ShiningLight said:

It could be anything; these were gaba withdrawal symptoms. I'm not sure if I would experience different withdrawal symptoms from klonopin.

 

It could overall nervous system destabilization, one or the other drug, or a combination. 

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ShiningLight

Thanks @Shep. Agree. I reviewed my journal...I did have burning hands before even while I was on the .25 klonopin dose. I am going to stay the taper course and be very careful with nutrition and self care. I appreciate your help and support so much.

 

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ShiningLight

Apr 21, 2019

1:00 am fell asleep

3:15 Woke up briefly; went back to bed

6:10 Woke up; 100 mg gaba. Ate rice cake. Was in a cold sweat and shivering when I woke up. Was tremulous. Have pain in my head for brief moments.

8:15 am ate a small bite of chicken, then cooked an egg and potato

9:00 am I feel like my head is going to explode. I also feel inner tension, like I need to shake it out or I am going to have an involuntary movement. But I didn’t have any involuntary movements. I did my meditation.

9:50 am Neuropathic pain in hands; feels like acid. A little jittery but not tremulous right now. I’m going to go to church to distract myself from the fear. My blood pressure is 118/73. My head pain lessened after awhile.

10:45 am neuropathic pain appeared in my brain which felt like it was burning for about 5-10 min. Time for my gabapentin dose. My symptom journal shows I also had acid hands when I was on .25 klonopin.

11:00-11:30 am Somewhere in this timeframe brain pain went away. Acid hands are more mild now.

12:15 pm Loose stool

12:35 pm Hot flash

Ate a piece of chicken. Also almond butter and grape jelly rice cake, banana. Having trouble tolerating vegetables with my gut.

1:00 Epsom salt bath

Meditated again and rested. Stomach feels pretty bad. Still having tremors on and off.

3:45 pm Took 100 mg gabapentin. Chatted with friend in gaba facebook group, she reminded me that others have felt like I do with the setback and it’s probably the gabapentin, as she reads similar statements all the time. I was so grateful for the feedback.

4:30-5:15 took dogs on a walk. Also made me feel better.

6:00 Ate dinner: chicken, corn, a little squash, a little carrot, applesauce

7:00 Took 0.125 klonipin. Tomorrow I will reduce again. I didn’t want to do it today because I’m seeing my doctor tomorrow and didn’t want to risk feeling weird.

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ShiningLight

Apr 22, 2019

10:00 pm (Apr 21) Went to bed. Woke up about 3 times in the night, but was able to get back to sleep until 7 am. The interrupted sleep is the only symptom I think I can for sure pin to the klonopin w/d. Apparrently klonopin changes the sleep cycles somehow (and not for the better). That's probably why I'm waking up.

7:00 am 100 mg gabapentin, rice cake cream cheese and jam for breakfast. I’m feeling better today. I think it was probably some M&Ms I ate and some macadamia nuts over the past 3 days that made me so much worse. I have a hard time staying away from sugar, but I had neither yesterday and I feel so much better today! I used to eat a ton of sugar but I don’t seem to tolerate it at all in w/d.

12:30 pm 100 mg gabapentin. I started to feel shaky but realized I hadn’t eaten lunch yet and also was a little late taking it. Turkey sandwish with bacon, avo, and greens, on chiabatta for lunch

2:00 pm  Went to MD for recheck of gaba w/d issues. Having tremors/cogwheeling.

5:00 pm 100 mg gabapentin, don’t want to be up late tonight, will take at 10 pm

7:00 pm I tried to quarter the 0.125 klonopin, but I am dry cutting so it was hard. It was probably ¾ of the .125, that was the best cut I could get. I think tomorrow I’m just gonna take the other ¼ and then call it quits. Also, I mini hyper-alerted 10 minutes after taking the klonopin. I don't think it's helping me. It just makes me feel weird now.

@Shep I’m feeling close to w/d normal today. I was able to walk the dogs, meet a friend for lunch, and go to the MD. I think this is going well so far. 

 

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Shep
18 hours ago, ShiningLight said:

I’m feeling close to w/d normal today. I was able to walk the dogs, meet a friend for lunch, and go to the MD. I think this is going well so far. 

 

Excellent. Glad you are doing well. 

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ShiningLight

@Shep well it's such a toss-up. Day by day, moment by moment, I guess. I haven't kept much of a symptom journal today. I'm taking my last dose of klonopin tonight. It's been 6 weeks, but somewhat irregular, half of that tapering. I do feel mildly dizzy.

 

I've felt really scared and sad because I'm not sure what's going to happen in the next few days and weeks. I feel a little bit like a sitting duck waiting to see if I'm going to have withdrawal symptoms. I've allowed myself to feel this some today; now I need to change the channel and think more inspiring thoughts.

 

This morning, I asked my MD today about the chorea movement disorder I developed during the fast taper of gabapentin. Is it going to return? If so, is it going to be permanent? He said he didn't know, either way is possible, and we'd just have to wait and see how I do. I've felt the stirrings of the movement disorder, it's like a physically disinhibited feeling, like it's about to happen but it doesn't. There would be no guarantee if I went back on the klononpin that it would stop it, and even then of course the klonopin would cause more problems than it would fix, so I'm not going back on it.

 

Tonight is just a good night to shut it down and go to bed early.

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ShiningLight

@Shep I am three days from last klonopin dose and continue to do well! Tremors are still here but have lessened. Looks like I was overmedicated! 😜 😬

I’m still sleeping 6-7 hours a night which is pretty good for withdrawal. Yesterday I slept 5 but I’m hoping that was an anomaly. I took a nap this morning.

I think most of my symptoms are still from the gaba withdrawal. I am close to WD normal. I have mild dizziness. Yesterday I had some DR/DP that occured about 20 minutes after taking an Align probiotic (I took it due to my stomach bloating drammatically). The DR/DP lasted about 4 hours and went away after I meditated and rested. I couldn’t meditate sooner because I was at a support group.

Plan is to hold for a few months, hopefully stabilize my work situation, then drop 5% from the gabapentin,

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ChessieCat

I've moved your post to an existing topic:  preparing-to-taper

 

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ShiningLight

A vent. I am so frustrated by the apathy and fatigue I have. They are such quality of life issues. Apathy from long term zoloft use. Fatigue is newer, maybe from gabapentin and gabapentin taper.

 

I did finally return to work part time today after 10 weeks off due to being incapacitated from w/d. I got a warm welcome, but it was also awkward and I understand that I will have to earn back my reputation as a good employee (the norm is that "good employees come to work even when they're sick" but that was out of the question for me, I couldn't put sentences together or get out of bed for awhile), which makes me sad. I am thankful to have a job and I'm lucky that they are allowing me to be part time as I transition back. I still feel uneasy that there may be some further consequences to my job but I just have to wait and see.

 

Today was my first day back and I'm already on myself about how "all I can do is go to work and come home, that's no life!" That may be true, but it's great progress because for 10 weeks I couldn't even do that much! These kinds of negative thoughts are well-trodden patterns in my mind.

 

It is just frustrating being so limited. However, I've been limited like this for at least the past 2 years, so why all the sudden is it an emergency? I guess because I see it, and I realize that it's actually *not* "me," it's the drugs. In addition to apathy, there is also a capacity component to this, in that I really find that I do have to pace myself and limit my activities now because I get overstimulated very easily due to my w/d.

 

One cool thing is that I made a new friend in a support group I attend and I got to talk to her today after I came home from work. She actually gave me her phone number, and that was so nice because that doesn't often happen to me. So I am going to nurture this friendship. It's been a long time since I made a new friend and it is such a good feeling!

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Mirthazard

Hello Shininglite,

 

I was also put on gabapentin to aid in severe mirtazapine withdrawal, its helping on my feet and hand pain. I also get drowsiness, so that i have to take 2 100 MG capsules at 00:00 and other two at 8 am, then one 100mg at 13:00 PM and another 100mg at 19:00 PM, because its too strong at night so i take less during the day. I Will have to fight withdrawal sooner or later. Did you get drowsiness from gabapentin?

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ShiningLight

@Mirthazard yes I do get drowsiness from it, but it's inconsistent. I don't always get the drowsiness. It's weird.

 

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ShiningLight
Posted (edited)

I am popping in for an update on my progress with the gabapentin taper.

 

I've been holding my dose at 400 mg since April 4. I was able to get liquid gabapentin from my MD so 2 weeks ago, I started to transition my doses from capsule to liquid at the same dose. This has gone smoothly. Right now I'm taking 3 out of the 4 doses in liquid form.  I would transition a dose and wait 4+ days and then transition the next dose. My plan is to make my first reduction in the middle of next week because I have some time off. I am going to reduce 20 mg.

 

I still have some symptoms but they’re relatively mild compared to what I had before. Right now I have the hot flashes maybe twice a day, twitching in response to using the heating pad, tight muscles, muscle spasms, pupil reactivity problems especially in the morning, and the feeling that I might have involuntary movements but usually I don’t. I also have the mood stuff, very intense moods that come on for no apparent reason. Rage, depression, panic, etc. I also have some brain fog. I think transitioning to liquid kicked up the withdrawal symptoms a bit, but it's quite tolerable and also may be reflective of carelessness with caffeine and sugar rather than the gabapentin.   

 

I’m able to function at work. Not as well as before, but passably. I just finished my first month back full time. I am tired! 

 

I got some 1 oz glass bottles on Amazon to store the pre-measured doses in so I don't have to go lugging around the huge liquid bottle and also decreases the likelihood of spills from the large bottle. After I take the dose from the bottle, I pour water in the bottle to get any remaining liquid residue, because the doses are so small.

 

Edited to add: Oh--I forgot to say, I am REALLY, REALLY enjoying not having any medical appointments lately. Trying to stay as far away from doctors as possible. But also, not needing to be seen.

Edited by ShiningLight
forgot something

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Altostrata

That sounds good! Also, that you're working.

 

And, you're off Klonopin.

 

Could be you have some dopiness in the morning and brain fog from the gabapentin. You're well-situated for a reduction.

 

Please update the "Current meds" line in your signature. As your signature events are most recent first, it will be clearer if you move "Current meds" to the top of your list from the ancient history position.

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Dejavu

I'm so happy to hear it's going well. My transition from pill to liquid went smoothly also. Not everyone has issues with it. 

 

Returning to work can be taxing, as you probably already know. Make sure to carve out relaxation and/or meditation time. It's especially important during this period. Be good to yourself - you're doing very well!

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ShiningLight

@Altostrata thank you for the feedback and suggestion for my signature. I put some thought and planning into how to proceed after the initial lengthy incapacitation I experienced!  It takes some discipline to hold off from making cuts during a stable period.

@Dejavu I appreciate the reminder re meditation. I spend so much of my time sitting now at work and in the car it's really difficult, the last thing I feel like doing is meditating. I do take long relaxing walks with my dogs most evenings and that helps. Maybe I can do it on the weekend or find some other way to do it...since it's so  important and helpful.  

 

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Altostrata

Since you're taking 3 drugs, their interactions may be causing your symptoms. Please put ALL your drugs in the Drug Interactions Checker https://www.drugs.com/drug_interactions.php
and copy and paste the results or a link to them in this topic.

 

In order to unravel this, we'll need to see your daily symptom notes for several days at least, with times of day for your drug schedule and symptoms.

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ShiningLight

I've gotten lazy with my daily symptom log and will start it up again today.

 

Today I decreased my gabapentin for the first time since April 4. It feels so good to be on the move again!!! I cut 20 mg--5 mg from each dose. So now I'm on 95 mg of the liquid 4x/day. I'm doing well. I feel like I'm about 95-98% of wd normal. Occasionally today I've felt a little odd; it passes in a few minutes. I also have quite a bit of hip pain. I get that sometimes. I feel like having the pain today may be related because it's in both hips. Ice is helping that. I also feel a little of threshold lowering for movement--don't know how else to describe that--it feels like I'm going to have an involuntary movement but I don't. Like my nerves are over-firing.
 

I'm going to do Brass Monkey slide. If I continue to feel well this week, next Thursday I'll cut another 20 mg and then hold for at least 2 weeks.

 

It's so nice to make a dose reduction. It is making me feel hopeful again.

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ShiningLight

@Altostrata here is the drug interaction info:

 

https://www.drugs.com/interactions-check.php?drug_list=2057-0,2228-0,1147-0

 

There are a lot of "moderate" drug interactions on my medications. Which is another reason to be very, very glad I'm off the klonopin.

 

Mostly I'm doing ok. A bit uncomfortable in terms of physical sensations/pain but ok. Maybe 3/10 for pain. I know it's the gabapentin.

I have constant muscle stiffness; I've had that most of the time I've been on the gabapentin. Then after I take a dose, maybe 20 minutes later, I have an acute pain somewhere in my body, usually a joint. It's like a dull, expansive kind of pain. I've had it in my elbows, knees, and hips. It doesn't last long, maybe 5 seconds. I think it's a reaction to the medication as opposed to withdrawal itself.

 

I also have about 4 severe hot flashes a day. Those are usually before a dose is due. 

 

What amazes me is how quickly one can forget. I was in fullscale withdrawal h*ll just a few short months ago and I'm suddenly delusional thinking what a great idea it would be to make a big cut and get off this garbage once and for all. :lol:  I'm not going to do that, I'm going to stick to my plan. But just, wow. To even be thinking that.

 

I just realized Brass Monkey slide is 2.5% cuts, so I'm not doing a full Brass. I'm starting with 5% two weeks in a row, then hold for 2 weeks or until ready. If I feel up to it, my next cut is this Thursday. If not I'll wait a little bit. If the second week cut causes an increase in symptoms, I'll revise the plan. I'm happy enough with my response to the 5% cut; only a slight uptick in symptoms and NO hyper-alerting! That makes me very happy because I took hyper-alerting to be a sign of serious brain trouble. Right now I am continuing to work full time and to have 3-4 social plans a month. My goal is at least one a weekend. Slow, but truckin'!

 

It's been very hot here for days, which is frustrating because I don't tolerate the heat and I miss taking my dogs for long walks. Some days it's not even cooling off enough in the evening to go. Hope all reading are doing well and staying cool.

 

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Altostrata

Do you feel any of the symptoms described in the drug interactions report?

 

If you spend a lot of time at the computer, your hip pain may be caused by posture habits.

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ShiningLight

@Altostrata muscle stiffness in hamstrings. They're hard as a rock and snap back if I try to stretch them. Periodic excessive sweating.

 

Some impulsivity which I can mostly compensate for. When i was in severe wd (Feb-May) I had confusion and dizziness and not thinking clearly.

 

Nothing acute or severe; don't think I have serotonin syndrome.

 

Agree re hip pain cause.

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Altostrata

 

Quote

 

Interactions between your drugs

Major

traZODone sertraline

Applies to: trazodone, sertraline

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

 

 

Excessive serotonergic stimulation can cause symptoms short of outright serotonin syndrome. This is not a beneficial effect. If I were you, I'd be very concerned about what might be warning flags regarding the trazodone-sertraline interaction.

 

Trazadone is a treacherous drug, read the background here Tips for tapering off trazodone (Desyrel)

 

We still need to see those daily symptom notes. Thanks.

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ShiningLight

@Altostrata thanks for the warning about trazodone-Zoloft interaction. Some clown put me on both of those together in 2004. I can't sleep on the Zoloft without trazodone. The trazodone is to medicate the insomnia the Zoloft gives me. :(

 

Today:

6 am woke up with very tight hamstrings in both legs, tighter than when I went to bed last night, severity 6/10; enough to make me grumpy. I actually want to call out sick; I am irritable and it's so hot and I feel like I can't tolerate the heat and misery being in my body. 

6:15 am 95 mg gabapentin

7:00 am driving to work; burning hands for about 5-10 min; intensity 4/10

8:00 am at work, still irritable and upset, feeling agitated

9:30 am 150 mg Zoloft--was late in taking this

10:00 am Hot flash, severity 7/10, lasted about 5 min. I turn off the office lights while I work and somehow this helps with my mood and sense of agitation.

10:15 am 95 mg gabapentin

12 pm lunch

2:00 pm L foot pain, dull, intensity 5/10, lasts about one minute. Same kind of pain I get in other parts of my body.

3:30 pm 95 mg gabapentin

5:00 pm going home from work

5:10 pm R wrist pain intensity 5/10

6:00 pm R shoulder joint pain intensity 5/10  

6:30 pm L burning cheek pain; intensity 4/10; lasts maybe 1 min

7:00 pm R inside elbow/forearm pain intensity 5/10

8:15 pm 95 mg gabapentin. Went for a walk with dogs which I enjoyed

9:30 pm R elbow joint pain, severity 3/10, L elbow joint pain, severity 3/10. Actually both forearms hurt. R Quad twitches for a second. L quad hurts briefly.

 

Goodnight...

 

 

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Altostrata

If Zoloft is too activating for you to sleep, if I were you, I'd reduce Zoloft. This also will reduce the interaction with trazodone. I think many of your symptoms are due to this. See Tips for tapering off Zoloft (sertraline)

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ShiningLight

I actually cut the trazodone to 50 mg two nights ago. I will update my signature. I know this is not recommended: too big cut, drug order of tapering, cutting one drug while in the middle of tapering another. This change did give me enough relief to make my hamstring problem immediately tolerable the next day. I realize that sounds dumb but I had my reasons, and there were several.

 

I have some general malaise and nausea and sleeping too lightly due to the trazodone but thus far it's not too bad. I can actually still fall asleep on 50 mg. That's what it was for...initial insomnia, so I'm reassured that the dose is working for that. I notice now when I go up stairs or sit down, my legs are noticeably stronger. So @Altostrata

you were right about the cause of my hamstring problem.

 

I'm holding the gabapentin where it is for as long as I can tolerate that while I settle from the trazodone. Provided the rest of the withdrawal process goes ok, I'll keep the trazodone at 50 mg until one day in the distant future when I'm done with both my gabapentin and zoloft tapers.

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Altostrata

For sleep, 100mg trazodone is a large dosage. I am not surprised your leg symptoms were from the drug-drug interaction.

 

Please do not make any more drug changes for several weeks, let the trazodone reduction settle.

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ShiningLight

Checking in. I seem to be close to wd normal from the trazodone drop. The nausea has greatly improved. Still not sleeping the best, but now only waking up once a night instead of every 2 hours. Will hold off cutting gabapentin for a few weeks if not more.

 

Tonight I came home from work and made chicken tikka masala. I usually hate to cook and making a new dish is usually beyond my reach on a work night for sure. I thought, 'well let me just prep it, and tomorrow I can finish it.' However I wanted to find out how it would turn out. It turned out ok. Not quite restaurant quality, but certainly edible and not overspiced. I was surprised at how much I ended up really enjoying spending a night at home taking care of myself! After I finished cooking and eating dinner, I finished reading Talking Back to Prozac.

 

I'm wondering about higher level things tonight, like who am I, what am I about, what do I want? It makes me sad that I feel like I don't know. I am so very sad about what these "meds" have done to my life.

 

At the same time, even if I feel turmoil about those overarching questions: a quiet night at home, making a new dish, and reading a book is a sweet place to start.  

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