Worthy: tapering advice wanted

[Worthy]

any advantage to reinstating benzo and holding if not doing anything.  

[Shep]

When was the last benzo reduction made and from what dose? 

 

Are you taking any supplements? If so, please list the name, dose, and time(s) of the day you take them.

 

Are you taking any other drugs besides Cymbalta and Ativan? If so, please list the name, dose, and time of day you take them. 

[Worthy]

Last reduction 10 days.   5% reduction.   No supplements. No other drugs.  Severe akasthisia 

[Worthy]

Should I take extra ativan now as in severe way

[Worthy]

Shep can you suggest anything to help now as in severe wave 

[Worthy]

Is anybody able to help me with some advice on how to carry on as i dont know what to do.  

[manymoretodays]

6 hours ago, Shep said:

When was the last benzo reduction made and from what dose? 

 

Are you taking any supplements? If so, please list the name, dose, and time(s) of the day you take them.

 

Are you taking any other drugs besides Cymbalta and Ativan? If so, please list the name, dose, and time of day you take them. 

 

Hi Worthy,

When did this wave start?  What is going on, what kind of symptoms are you having?

 

When did you do that 5% reduction, and what did you reduce?

 

What's your right now drug and supplement intake look like?  Note the times(on the left), drug or supplement name and dose on the right.

 

Then tell us too, anything different in recent days......such as life happenings, alcohol intake or other recreational drugs.  Are you eating?  Sleeping?  Have you seen the Sun, or the Moon, or the Stars?  Have you been outside in other words.

 

It sound like a brutal wave Worthy, and I am so sorry.  It will pass.......hold on tight.  Give us a bit more information too, when you can........as that will help us further support and advise.

 

L, P, H, and G,

mmt

[Worthy]

I have had bad withdrawls from the,start of tapering but the last few months it has really deteriorated and I am hardly able to do anything.  I am having major tremors,  panic attacks, zero,sleep, sweating, myclonic jerks, sometimes can’t walk, vertigo, extreme anxiety, deoression, electric shocks especially in my back, inner restlessness, sui cide ideation, zero motivation, extreme sensitivity to sound and to a lesser extent light and movement.  Memory,loss.  Agitation, confusion.  Blurred vision.   
 

Been doing 5% reduction every 2 weeks,on ativan.  Reduced..034mg.  Also,reduced cymbalta by one bead every 2 weeks.  

  
 

change in last few days major stress due to financial worries, daughter having marital problems and I can’t help with my grandchildren as to unwell 

 

Can eat but often very nauseous.   Not sleeping, max 2 hours a night

 No alcohol as not a drinker and never touched recreational drugs.  

 

Been out in the garden a few times but mostly bedridden

 

thank you so much for reaching out.  Any help or advice will be so appreciated 

[manymoretodays]

When do you take the Ativan, and at what dose presently?  The time or times of day.

When do you take the Cymbalta, and at what dose presently?  The time or times of day.

28 minutes ago, Worthy said:

Been doing 5% reduction every 2 weeks,on ativan.  Reduced..034mg.  Also,reduced cymbalta by one bead every 2 weeks.  

 

If you can remember even approximate dates of your last reductions that will be helpful.

 

And that's so tough.....I'm sorry and sad.......as I know you'd like to engage and help with your grandkids.

 

Can you relate worsening symptoms after either of your tapering changes?  And if so which drug change?

Just do your best to recall, and then let us know on the bolded questions.  That will help determine, if we might advise a updose of either drug right now.   I do believe that perhaps you might well have been tapering a little too rapidly and that your symptoms are a result of your CNS/body/mind not being able to re calibrate enough between reductions.  We can likely help to try and minimize further WD symptoms from here on out.  Often we'll recommend to taper the AD's first, in hopes that the benzo(your Ativan) may help with WD symptoms, and save that for last.  Let us get more details here and further get to know your recent history.  So hold tight Worthy.  You are oh so Worthy.

 

And I'm rooting for you- cheering you on and up........we all are.  You just need to do the next hour, or 30 minutes, and then repeat, and get through today.  Some of those symptoms are most definitely WD(withdrawal) symptoms.  Little meals, more frequent.  And some expert sleep tips start here:

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

 

 

L, P, H, and G,  your not alone anymore with all this.

mmt

 

Edited September 19, 2022 by manymoretodays
more, grammar corrections too

[Worthy]

Thank you so much for your reply.   It means so much to me.  

 

I take the Ativan 10 am and 10pm twice a day.  Currently on 0.38% twice a day. 
 

cymbalta once a day 7@am.  Currently on 1.5%

 

dropping both everyn2 weeks.   Last dropped 10 days ago 

 

No worsening symptoms after drug chsnges.    Feel I am getter no relief from either drug.  Think kindled and in tolerance to the benzo.

[Worthy]

I live in Zimbabwe so quite a time zone difference.  Nearly 10.30 pm here.

[Worthy]

No reply to my answers.   Please many more today's can you or anybody else give me some guidance on best way forward.  

[ChessieCat]

We understand that you want to get assistance quickly but this is only an online forum and the response is NOT immediate; there can be a time lag between you asking a question/providing information and when staff are available to assist.  SA is staffed by a small number of unrostered, unpaid peers (people who are tapering/have tapered/got off their drug too quickly so have their own issues to cope with as well as their own lives; some work full time, some part time and some have families to care for and are NOT online every waking moment of their day), not medical professionals, and assist members as they are able.  Most of the staff are located in different parts of the USA or Europe so the time that they come online can vary.

 

Please be patient.  The staff are doing the best they can.

[Worthy]

Thank you so much for your reply. I understand 

[Worthy]

I realise this is not an online forum but I really am struggling.   I answered questions put to me and hope that I can get some guidance on a way forward as I am  barely coping.  Thsnk.you to those who replied 

[manymoretodays]

Hi Worthy,

23 hours ago, Worthy said:

I take the Ativan 10 am and 10pm twice a day.  Currently on 0.38% twice a day. 
 

cymbalta once a day 7@am.  Currently on 1.5%

 

dropping both everyn2 weeks.   Last dropped 10 days ago 

 

No worsening symptoms after drug chsnges.    Feel I am getter no relief from either drug.  Think kindled and in tolerance to the benzo.

 

We still need a little more clarity.

For example, when you say 0.38% twice a day I have no idea what dose that is.  We need to see the dose in mg.  38% of what?  Please though, note a dose.

Same with the Cymbalta.  I don't know what 1.5% is.

 

Your signature states:

1st May 2022

24 beads cymbalta 4mg

2mg Ativan 

 

We need to know what dose(s) you were on 10 days ago, and also what dose you tapered to, with dates for starters. 

To update or edit your signature go to AccountSettings/signature, don't forget to hit SAVE when done

 

You might also go back to the start of your topic and review some of the links.  We don't recommend tapering 2 drugs at a time.  When you are having WD symptoms, often that is not a good time to be tapering......yet you have continued to taper for the last few months.  I don't get why.  And why are you tapering both drugs at the same time?

On 9/19/2022 at 1:28 PM, Worthy said:

I have had bad withdrawls from the,start of tapering but the last few months it has really deteriorated and I am hardly able to do anything.  I am having major tremors,  panic attacks, zero,sleep, sweating, myclonic jerks, sometimes can’t walk, vertigo, extreme anxiety, deoression, electric shocks especially in my back, inner restlessness, sui cide ideation, zero motivation, extreme sensitivity to sound and to a lesser extent light and movement.  Memory,loss.  Agitation, confusion.  Blurred vision.   
 

Been doing 5% reduction every 2 weeks,on ativan.  Reduced..034mg.  Also,reduced cymbalta by one bead every 2 weeks.  

  
 

change in last few days major stress due to financial worries, daughter having marital problems and I can’t help with my grandchildren as to unwell 

 

Can eat but often very nauseous.   Not sleeping, max 2 hours a night

 No alcohol as not a drinker and never touched recreational drugs.  

 

Been out in the garden a few times but mostly bedridden

 

I suspect, but I don't know from the information provided that it's possible you are tapering too fast.  And at some point this caught up to you.  The above is a good report of symptoms and then yes, I did see additional stressors as well.  Thank you for that information.

On 9/19/2022 at 6:06 AM, Shep said:

When was the last benzo reduction made and from what dose? 

 

Are you taking any supplements? If so, please list the name, dose, and time(s) of the day you take them.

 

Are you taking any other drugs besides Cymbalta and Ativan? If so, please list the name, dose, and time of day you take them. 

 

Let us know the answers, in a reply, to the questions Shep asked.  I bolded the one on the Ativan.

We do need the doses reported in mg, not %........that is very confusing.

 

Try and do some NOTES again as well.  Here (and just click on the underlined Here, to see your post) you did one.  You left out the doses taken though, and that will need to be included.

 

Good job on getting the Ativan moved away from the Cymbalta.  I'm glad to see you were able to do that.

 

Okay......so, from you we need:

 

Times again, on the left,  then drug names, as well as doses reported in mg(milligrams), not %age.  Keep going with the times on the left and then on the right symptoms(NOTES in other words).  You did it before and you can do this.

 

(Let us know what dose(s) you decreased from in mg too.  That would have been 10 days ago.  If you can edit that in, with the date(s) and doses in mg, into your signature, that will be welcomed too)

 

I know it's tough and you want/expect a change that might change things or symptoms for you as soon as possible.  We can only work with what you give us though in information.  And it is still so very confusing.  Help us out.

 

Thank you.

L, P, H, and G,

mmt

 

 

 

 

 

[Shep]

On 9/19/2022 at 7:13 AM, Shep said:

Are you having trouble getting your prescriptions? Is that why you are rushing this taper? 

 

@Worthy Please let us know the answer to this. It's important. The advice we give you depends on whether or not you're able to get your two drugs. You mentioned earlier in your thread back in 2020 that you were having trouble getting your prescriptions. If you're not able to get continuing supplies, you may not want to updose. But we need to know more to give you advice. 

 

 

[Worthy]

Yes I am having trouble getting both.   I have seen too many drs as each time I see one they just want to cold turkey me on what I am on and add yet another benzo or ad or mood stabikizer.  None believe there are withdrawls from the drugs I am on.   

[Worthy]

   I am reducing the ativan by .05mg  every 2 weeks and the cymbalta by .14 mg every 2xweeks.  I battle to do the signatures notes as my brain so muddled from so many drugs. I.doubt the Dr will continue giving me enough ativan to do a slower taper.  They have stopped giving me the cymbalta as they wanted me to go cold turkey and refused to give me more.  I have enough to last me another 22 weeks. I have 60 ativan left.  The Dr told me to drop .05 every 2 weeks.  I do hope this answers your questions.  

[Shep]

4 hours ago, Worthy said:

Yes I am having trouble getting both.   I have seen too many drs as each time I see one they just want to cold turkey me on what I am on and add yet another benzo or ad or mood stabikizer.  None believe there are withdrawls from the drugs I am on.   

 

Worthy, please go see your doctor (any doctor can prescribe these drugs) and tell them the drugs are working great. That way they will continue to prescribe them so you can taper. The doctor doesn't need to know you're tapering. It's none of their business what you put into your body. Their role is to be a legal drug dealer. That's it.

 

You're putting your health in jeopardy by trying to convince ignorant doctors of something and you don't need to do that. When doctors are told the drugs are working, they keep prescribing them. 

 

[Shep]

@Worthy This thread may be helpful for you and your husband to read over:

 

How to talk to a doctor about tapering and withdrawal? What to expect.

 

 

[Worthy]

Thank you for your reply.  I have read through all this.  I see its not good to be on benzos long term.  I wonder if its the benzo doing the most damage.  I know from reading lots drs are no longer prescribing these as they are so addictive and you reach tolerance very quickly.  Also that it is never a good idea to reinstate a benzo.  I know this site is mostly for anti depressants.  Can you give me your views on benzos. Sorry to ask.  

[manymoretodays]

41 minutes ago, Worthy said:

I see its not good to be on benzos long term.  I wonder if its the benzo doing the most damage.  I know from reading lots drs are no longer prescribing these as they are so addictive and you reach tolerance very quickly.  Also that it is never a good idea to reinstate a benzo.  I know this site is mostly for anti depressants.  Can you give me your views on benzos. Sorry to ask.  

 

Hi Worthy,

We're finding that AD's can cause as much as the same dependencies(physiologically) as benzos really.  And that the tapering picture, or best plan for, harm reduction wise is the same.......benzo's or AD's.

As far as the benzo potentially doing more damage.......hmmm.

It's not that these drugs directly do  "damage" to the brain.......they alter the brain though, and as far as we are concerned, with tapering and WD, do need to be tapered carefully.  We are after harm reduction, or best practices to tapering, or deprescribing..........in hopes that for some, we can guide them into judicious tapers and perhaps they won't have to suffer WD symptoms like yours.

Have you looked at these links? :

What is withdrawal syndrome?

How psychiatric drugs remodel your brain

 

Some doctors are becoming more aware of AD's and their dependencies.  We don't call it "addiction" here, just physiological dependencies.  It's obvious to me that you are not "craving" either of your current drugs but you have gotten yourself into WD symptoms from going too, too fast from the get go........and I know, due to circumstances outside of your control.

 

I think you've been on the benzo, your Ativan(lorazepam) long enough that you are already physiologically dependent on it.  However, it would be unwise to just ditch it and go cold turkey.........likely more WD symptoms from that.  And yes, it can be updosed within a certain amount of time.

Yet..... your leaving us in the dark, as to what doses(in milligrams(mg) you take) twice a day........and what dose you changed it from.

 

6 hours ago, Worthy said:

 I am reducing the ativan by .05mg  every 2 weeks and the cymbalta by .14 mg every 2xweeks.

What dose do you take of Ativan at 10am and 10pm now?

Just post time, drug by name and dose

7:00 am- cymbalta, dose in mg

10 am-  ativan, dose in mg

10 pm- ativan, dose in mg

When did you start taking ativan? Year, month, day?  

I think it's unlikely that dependency has not set in, and it's foolish to reduce it too quickly, as it's foolish to reduce both drugs simultaneously.

Shep definitely has more benzo expertise than I and I expect will weigh in further, if/when time to do so.

Keep in mind how busy it is here.  We all just volunteer time. 

I sure don't know which drug is causing your present WD symptoms now. 

I get that you are cognitively comprimised now.  Look at doing a day of NOTES(full notes, with symptoms before and after your drugs are taken) as a good brain exercise.  A challenge even.

Those providing more information, are going to get priority.  Or if brand new.  You've been here for 3 years and we are doing are best for you Worthy........with the confusing and sparse information you provide.

You don't seem to want to listen to us Worthy.  Do you really want our help? 

We can't endorse your continuing tapering how you are.

 

I do understand it's tough, and I have to agree with Shep.......that it's not your job, right now, to convince any doctor of WD, and how drugs need tapering, and how bad this has been for you.  That's just going cause undue stress on top of stress, both physiological and your present illness(withdrawal and now protracted withdrawal syndrome)

 

All from me, for now.  Keep plugging along.

L, P, H, and G,

mmt

 

 

[Worthy]

Thank you both for your replies.  I am trying to provide as much information as you are asking for.   Yes I REALLY do want your help as think the drs have no clue as they just keep updosing the Ativan and now think this  has not helped so are wanting me off .  
 

7 a.m.   cymbalta 1.2mg

10a.m. Ativan 0.34 mg

10p.m. Atuvan 0.34 mg

 

i stsrted taking the Ativan 25 July 2019.  I reduced to 0.5 by 25th August 2020 (13 months).  On the advice of a psychiatrist I increased to 1.5 mg for 3 months on the 25th August as i as struggling.  

 

18 November 2020 I was at 1.5 mg and reduced to 0 mg by 9 February 2022.  
Again on the advice of a psychiatrist I went back up to 1mg on 15th February and have since reduced to 0.68.  
 

i hope this clarifies the Ativan.

 

Cymbalta I started on 10 July 2019  at 60mg and have been reducing steadily since then with no up-doses.  I started faster but since July 2022 I have been dropping by .14mg every 2 weeks.  

 

 

 

 

 

[manymoretodays]

Good information.  Your welcome Worthy.  And thank you for providing even more.

I'll see if I can work that into your signature next.  I'll save a copy of the original present signature, and just try to update it.

 

 

2 hours ago, Worthy said:

7 a.m.   cymbalta 1.2mg

10a.m. Ativan 0.34 mg

10p.m. Atuvan 0.34 mg

 

i stsrted taking the Ativan 25 July 2019.  I reduced to 0.5 by 25th August 2020 (13 months).  On the advice of a psychiatrist I increased to 1.5 mg for 3 months on the 25th August as i as struggling.  

 

18 November 2020 I was at 1.5 mg and reduced to 0 mg by 9 February 2022.  
Again on the advice of a psychiatrist I went back up to 1mg on 15th February and have since reduced to 0.68.  
 

i hope this clarifies the Ativan.

 

Cymbalta I started on 10 July 2019  at 60mg and have been reducing steadily since then with no up-doses.  I started faster but since July 2022 I have been dropping by .14mg every 2 weeks.  

 

You've been saying it's been a couple of months since you've been struggling with symptoms even more.  Can you pinpoint or identify, what you were on when you last felt like it was more tolerable?  As far as you being more functional?

When is your worst time of day now, and how?  Describe the symptoms.  And if you've noticed certain times of day when they peak.

 

And good, good.  I'm not going to suggest any changes right now.   More questions.....of course.  Meantime, just HOLD.  No further tapers right now, or anytime soon please.  Or that is what I would do.

 

 

 

[Worthy]

Thank you so much for your reply.  I honestly cannot remember when it was more tolerable.   I think it’s been getting worse and worse since I reinstated the Ativan in February.  
The worst time of day is from about 4am in the morning till about 4pm.    They peak about 6am and are awful till late afternoon.  Some evenings are bearable and I am ok till about 4 am but not always.  My worst symptoms are severe tremors, panic attacks, vertigo, sometimes can’t communicate as words are jumbled.  Sometimes too dizzy to walk, chills and sweats.  Depression and anxiety.  My hair is falling out.  No motivation to do anything.  Severe memory loss and significant decline in cognitive skills.  Confusion.  Agoraphobia.  

i will Hold.   Thank you again do much for your support 

 

 

 

 

[Worthy]

Forgot to add have major sui cidal ideation and electric like jolts especially in my lower back.  

[Worthy]

I left out many symptoms.  I am also extremely sensitive to sounds

[manymoretodays]

Hey there Worthy,

I do hope this finds you doing just even a tad better, as it sounds fierce, what you are dealing with now.

One thing to be aware of, is that some of the FT(faster tapers) may have caught up to you back when symptoms got worse.

 

Looking at the Cymbalta reduction, since May 1st to present(or Sept 10), I come up with a 70% reduction in 4 months time.

Then with the Ativan, since February 15th to September 10th, I come up with a total of a 32% reduction, over now about 8 months time total........and so that is a little better.

 

I'm pretty sure you must be familiar now with our:

Why taper by 10% of my dosage?

harm reduction model for tapering, but will leave the link again, for your further perusal and understanding.  Often it can be empowering to "get it" so to speak.

 

I really would suggest that you stop doing tandem tapers at this time.  Or tapering both drugs.

 

Hold steady with your Cymbalta now and I would suggest for a couple of months, before then attempting to taper again.

And then 10% of your present dose of 1.2 mg would look like this:

1.2 mg X 0.90 = a dose of 1.08 mg which would represent a 10% taper from the present 1.2 mg dose

And of course you could try tapering by less than 10% too.

There's no rush to the finish line.  Be a turtle now, don't hurry, and especially when into the lower doses.

 

I did confer on your case and here's what we've come up with:

 

I suggest you keep the Ativan as your last drug to taper.  Don't rush it.  You can taper the Ativan after you have completed the Cymbalta taper.  And it just might buffer just a little bit of WD symptoms you experience now.

 

Notes, full notes would really help, when you feel able to do and complete some, like this:

The notes will help us further clarify what possible could be adverse effects of one or the other of your drugs from WD symptoms and be so very helpful Worthy.  So work towards doing some, first on paper and then to share here in a reply.

 

I do appreciate your trying your best to answer all questions, and piece together symptoms and be more exact with reporting drugs changes, and dates, and dosages.  You are doing the best you can.

 

And yes, if you'd like to try an updose of your Ativan now, that would be okay.  You might go on back to the dose you were on, prior to your taper by 0.05 mg of the total daily dose on September 10th.

I come up with 0.73 mg divided into 2 doses after adding 0.05 mg to the present 0.68 dose.

 

Again, Notes would be helpful, to see if you begin to benefit(in the way of improvement with present WD symptoms).  They really do show us just what is happening both before and after your drugs are taken over a 24 hour period.  And then a couple of days worth of Notes really help make it clearer what is happening, so we can further help guide your tapering.

 

Far too wordy......per usual, per me........definitely okay if you'd like to try an updose now of your Ativan.

 

Thank you for your best efforts as well Wordy.

Keep us updated please.

 

L, P, H, and G,

mmt

[Worthy]

Received a link from manymoredays but could not open it.  Said not available on my account.  Please can you resend.  

[ChessieCat]

She gave you this link which was about keeping daily symptoms notes:

 

before-you-begin-tapering-what-you-need-to-know

 

If it is not this link please tell us what information the link was providing.

 

There is a possibility that you clicked on a link which was for the staff which you would not be able to open; because of the message that you received I think that might be the link you mean.

[Worthy]

I have not posted for a long time but now would like to ask if anybody on this group has knowledge of benzodiazepines, Ativan in particular.   I was severely polydrugged previously and have got off all anti depressants but battling with the Ativan.   I did get off it in February 2019 but VERY STUPIDLY took medical advice and went back on.  I have been trying to get off  for over a year but not coping.    I am down to. 0.35mg and going off fast @ .025mg every few days as I believe the drug has turned on me and having the complete opposite effect.   Anybody with benzo knowledge I would like to know how you managed to get off.  I am battling and barely functioning.  

[Altostrata]

Hello, @Worthy Yes, we help people taper Ativan.

 

What happened to the Cymbalta? You joined in 2019 but you seem to keep going back on drugs.

 

18 hours ago, Worthy said:

I am down to. 0.35mg and going off fast @ .025mg every few days as I believe the drug has turned on me and having the complete opposite effect. 

 

Since 2019, you have insisted you need to taper any drug much faster than we recommend. We can't do anything about this. Your situation may be too complicated for our peer support.

[Worthy]

Thank you for your reply.   I am off the cymbajta and did taper slow dropping 1 bead every 3 weeks.  I am only on ativan now and it has never helped .  It's having the opposite effect and i have so many symptoms from it.   It is proving way more challenging than the cymbalta to get off.   Its only suppose to be used short term and I have been.on it too long.   I have tried holding but it didn't help.  When its having the opposite effect whats the best way to get off.  Benzos are very different to any other psych drugs as it is advised to NEVER updose and I did.   Can we start over and can I get help to get off.  

[Shep]

3 hours ago, Worthy said:

Benzos are very different to any other psych drugs as it is advised to NEVER updose and I did.

 

Benzos are generally safe to updose or reinstate within 2 - 4 weeks of decreasing. But it can be tricky. 

 

Please update your signature to include the years for your drug changes. Right now, the only year you have listed in your signature is May 2022. 

[Worthy]

Does it help to updose if you getting zero benefit.  I honestly can't remember how to update my signature.   Severe brain fog.