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Lookinup's intro: please help

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Altostrata

For Thursday, please post at least 24 hours of notes in one post. Your notes for Wednesday are missing the middle of the day.

 

Please try to make this easy for me to understand. Thanks.

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Lookinup

I’m sorry.  From 12:30 - 4  Had extreme anxiety., as indicated.  That is what the day looked like.  My anxiety is as intense as panic attacks. Obviously sleep is a horrible problem because of the Ambien.  I hope I have given you enough information.  I Thought this was Mirtz. Withddrawal, but now i worry it is more.  Thank you, Altostrata.  

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Altostrata

When you have enough information, please post 24 hours of notes in this format:

On 10/30/2019 at 3:05 AM, Shep said:

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

 

When you post your notes piecemeal, I have to go back and forth among your posts to piece together a whole day's cycle. This is very time-consuming. As a courtesy to me, please post notes in the format requested.

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Lookinup

I know.  I apologize.  I was not feeling well and really struggled to get the notes in.  Would you like me to retype then.  I know you are busy and in high demand.  I feel. Very fortunate to have your attention.  I will do that if you wish in the morning. 

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Lookinup

I think I am in interdose withdrawl and the Propanolol is taking the edge off temporarily throughout.  I have a strong feeling that the Mirtz. discontinuation significantly altered my levels of Klonopin and that .5 dose at night taken for so long does not take me through the day any longer.  Adding the Ambien (and Prozac) most likely made things worse.  This is my take after thinking about the way I feel and what has gone on.  I know Mirtz. Withdrawal can be wicked too and have been attributing everything to that.  I really need to focus on stabilizing as much as possible to get thyroid levels under control.  If this is my issue, would you suggest splitting that nightly dose?  If you don’t think it is my problem, I am willing to follow through with whatever you suggest.  Thank. You very much for your time and effort on my behalf.  My goals:  Stabilize thyroid levels, slow taper of Prozac, slow taper of Ambien, slow taper of Klonopin.

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Shep
11 minutes ago, Lookinup said:

I think I am in interdose withdrawl and the Propanolol is taking the edge off temporarily throughout.  I have a strong feeling that the Mirtz. discontinuation significantly altered my levels of Klonopin and that .5 dose at night taken for so long does not take me through the day any longer.  Adding the Ambien (and Prozac) most likely made things worse.

 

You may be getting interdose withdrawal, but all of your drugs have "moderate" interactions.

 

Please see this report:

 

Drug Interaction Report - Klonopin, Ambien, Prozac, Propranolol

 

Propranolol interacts with all of the other drugs and with inconsistent dosing, you may be conflating interdose benzo symptoms with drug interactions.

 

Alto also pointed this out:

 

17 hours ago, Altostrata said:

Propanolol lowers heart rate. If you take it regularly, you may get rebound heart rate increase when it wears off (half-life 3-6 hours). This is what seems to be happening when you feel you "need" to take a dose.

 

So we need to see what your symptom pattern is over several days before giving any advice. 

 

Please post daily notes over the next few days (24 hours in one post) with your symptoms (how you feel before and after you take each drug).  We need this for several days before making any recommendations. This will also give you time to set up a regular schedule for your Propanolol. This drug should be taken two hours apart from the other drugs to prevent any interactions. 

 

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Lookinup

Wednesday into Thursday

5:00 Awoke from broken sleep

6 a.m tooo. .88 thyroid med (Tirosent)

6:30 Felt twitching, tingling/numbness in foot

7:30. Ate breakfast

8:00 Took 5 mg. Prozac

8:30 twitching

9:00 took 10 mg.Propanolol

10-12 - Shopping - Brain fog, runny nose and fullness in ear

12:  Lunch

1:00 p.m. Took Propanolol - increasing HR, twitching, anxiety

2 -3:30 Some brain fog

4-5:30 anxiety, twitching 

5:30 Propanolol

6:30 dinner - anxiety

7:00 twitching continued

8-9:45 p.m. twitching and sharp pins in hands

9:45 .5 Klonopin.  Stopped twitching, increased HR

10:15. Twitching started again

10:30 Propanolol

11:00 p.m. Ambien, increased HR (noticed for 1st time)

5:30 Woke with twitching

 

Thursday evening:

9:45 Klonopin - increased HR (noticed for 1st time)

10:30 Propanolol

11:00 Ambien - increased HR

 

Friday morning

6:00 Took thyroid med

8:00 Took Prozac -

9:00 - pins and needles in hands and legs,

 

 

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Lookinup

I feel much better before taking Prozac.  Also notice physical tension from that (clenching, etc.).  Wish i could start tapering that. Propanolol does calm things down.  Wonder why feeling the increased HR now after Ambien and Klonopin?  What a mess.  What are your suggestions?  I will pay attention to the exact timing of Propanolol. Does this look like a Mirtz pitcture at all?  Should I try separating does of Klonopin?  Do Benzos ever go paradoxical?  Very confused.  Right now feeling panicky and twitchy with needles.

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Lookinup

Thank you, Shep for all of your time.  I really appreciate your effort on my behalf.

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Lookinup

The Propanolol was prescribed in the summer for my thyroid issue by my endocrinologist.  I understand the implications of this medication with the others. Maybe I can do a slow taper of it by starting with 1/2 of one of the doses for a week, etc.  I also think the Prozac is stimulating throughout the day and actually worsens anxiety.  And, who knows if the Klonopin is causing issues too.   And about the Mirtz discontinuation. . .   That is when most of these meds came on board due to the panic attacks/insomnia after stopping.  This is so complicated.  Grateful to have your help in sorting through it.   Is there any slight change to try at this point?

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Lookinup
2 hours ago, Shep said:

 

You may be getting interdose withdrawal, but all of your drugs have "moderate" interactions.

 

Please see this report:

 

Drug Interaction Report - Klonopin, Ambien, Prozac, Propranolol

 

Propranolol interacts with all of the other drugs and with inconsistent dosing, you may be conflating interdose benzo symptoms with drug interactions.

 

Alto also pointed this out:

 

 

So we need to see what your symptom pattern is over several days before giving any advice. 

 

Please post daily notes over the next few days (24 hours in one post) with your symptoms (how you feel before and after you take each drug).  We need this for several days before making any recommendations. This will also give you time to set up a regular schedule for your Propanolol. This drug should be taken two hours apart from the other drugs to prevent any interactions. 

 

I am collecting notes. 

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Altostrata

We need to see DOSAGE FOR EACH DRUG in your daily notes.

 

Please be more explicit about the "twitches." Are you getting shakes or jumps? Are these internal vibrations? Are they shooting electrical sensations? How is it different from pins and needles or tingling?

 

It looks to me like you are at least getting interdose withdrawal from overuse of propanolol and perhaps a paradoxical reaction when you take Klonopin and then Ambien. It is not clear what Prozac is doing.

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Lookinup

Twitches are small vibrations in muscles and around eye. .  Needles is just like sticking a needle in leg, hands. All of a sudden runny nose, ear fullness, cold nose also.  Took only 1/2 propanolol this morning.  Watching timing on that carefully.  Thank you.  

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Altostrata

Twitches are a mild symptom, would you say?

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Lookinup

Not like jerks, but definitely felt. Same as eye twitch. Sometimes goosebump like feeling over scalp too.   I am documenting the day for you.  Thank you!

 

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Lookinup

Friday:

 

5:00 Woke after on and off sleep - night sweats

5:30 Thyroid med

6-8 a.m. twitching

7:30 Breakfast

8 a.m Prozac 5 mg

10. Took 10 mg. Propanolol

11:30 Lunch - noticed runny nose,numbness around chin and bottom lip, sensations like goosebumps onscalp

12=12:30 Shopping - fullness in ear, runny nose off and on,needles in various s pots (hands, legs) Anxiety

1:30 Twitching inbuttocks muscles, eyelid and numbness in pinky figer

3:00 Propanolol 10 mg. 

3:30-6:00 Time with granddaughter - needles,like voodo doll!

6:30 p.m. dinner - vibratory feeling in legs (fine tremors)

7:30 Watching T.V. - high anxiety, cold nose, shakiness

8:00. Propanolol 10 mg

8:30 continued stabbing pins

10:- klonopin - felt heart rate increase

11:00 Ambien - same

 

Feet numbness not dissipating.

Feeling more and more numbness in chin and lower lip

Adrenaline surges thourhout day - Somewhat calmed by propanolol

No sense of tiredness despite very little sleep

 

Thank you for your help with this.  Is this looking like Mirtazapine protracted symptoms or something else?

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Altostrata

When you note "twitching", please indicate what part of the body is involved.

 

It appears to me the combination of propranolol, Klonopin, and Ambien in the evening is causing an adverse reaction. @Shep, is Ambien taper in the cards?

 

We already know you are overusing propranolol. I thought you were going to reduce the dosages? If I were you, I'd cut the evening 10mg propranolol to 5mg.

 

On 11/1/2019 at 10:03 AM, Lookinup said:

Took only 1/2 propanolol this morning.

 

Please give the dosage in numbers. I don't know what "1/2 propanolol" means.

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Lookinup
8 minutes ago, Altostrata said:

When you note "twitching", please indicate what part of the body is involved.

 

It appears to me the combination of propranolol, Klonopin, and Ambien in the evening is causing an adverse reaction. @Shep, is Ambien taper in the cards?

 

We already know you are overusing propranolol. I thought you were going to reduce the dosages? If I were you, I'd cut the evening 10mg propranolol to 5mg.

 

 

Please give the dosage in numbers. I don't know what "1/2 propanolol" means.

Ok. And how do I taper ambien?  Should I split dose of k into a daytime dose?  I feel definite w/d from that. Getting worried about neuro issues.  I wonder if I have been withdrawal if fir months without getting rid of any of the drug. 

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Lookinup
1 hour ago, Altostrata said:

When you note "twitching", please indicate what part of the body is involved.

 

It appears to me the combination of propranolol, Klonopin, and Ambien in the evening is causing an adverse reaction. @Shep, is Ambien taper in the cards?

 

We already know you are overusing propranolol. I thought you were going to reduce the dosages? If I were you, I'd cut the evening 10mg propranolol to 5mg.

 

 

Please give the dosage in numbers. I don't know what "1/2 propanolol" means.

Ok. Yes, I wold like to reduce the Ambien. Does that cause a problem Klonopin?  I am very concerned about the neuro side effects I have - numbness in spots on feet, numb feeling in chin and bottom lip.  Is it possible that since coming off without a slow taper from Mirtazapine that the whole balance was off and the Klonopin dose was drastically reduced?  I could have been withdrawaling from that for the past 5 months without getting rid of any of the poison!  Will spreading out the dose into two times a day help?  I know the half life of Ambien is very short also.  I am so overwhelmed by this and not knowing if these symptoms are Mirtz. only related, needing time,both Mirtz and benzo or benzo, in both cases needing some kind of action.  Thank you!

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Shep
17 hours ago, Altostrata said:

It appears to me the combination of propranolol, Klonopin, and Ambien in the evening is causing an adverse reaction. @Shep, is Ambien taper in the cards?

 

We already know you are overusing propranolol. I thought you were going to reduce the dosages? If I were you, I'd cut the evening 10mg propranolol to 5mg.

 

Yes, there likely are adverse and paradoxical reactions going on with Klonopin, Ambien, and propranolol being taken so close together at night.

 

Lookinup, you have 300 mg magnesium at night listed in your signature but not in your daily notes. Please note we need to see ALL of your drugs and supplements in your daily notes. 

 

I have a feeling that the magnesium is also in play when it comes to a paradoxical reaction in the evening due to its possibly sedating effects. When you dampen down the nervous system with a lot of drugs and / or supplements, the nervous system fights to stay alert. This is the paradoxical reaction. 

 

Please reduce the propranolol per Alto's instructions first. Then we'll address interdose Klonopin and Ambien issues. 

 

Also, you're varying when you're taking the propanolol by as much as 2.5 hours. PLEASE BE VERY CONSISTENT WITH YOUR PROPRANOLOL USE. It makes it very hard to see any patterns when you're taking it sometimes at 10:30 at night and sometimes at 8 at night. 

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Lookinup

I have been going to half for a.m use and night and being consistent.  Yes, should have included magnesium.  I take that right after dinner.   The Ambien is really not working  well other than to put me to sleep.  Using deep breathing when I wake up to go back to sleep. Sometimes it works, sometimes not.  Want to address either that or Klonopin and don’t know how.  Thank you.  Getting down in dose of Propanolol, but getting adrenaline surges and needles.  

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Lookinup
1 hour ago, Lookinup said:

I have been going to half for a.m use and night and being consistent.  Yes, should have included magnesium.  I take that right after dinner.   The Ambien is really not working  well other than to put me to sleep.  Using deep breathing when I wake up to go back to sleep. Sometimes it works, sometimes not.  Want to address either that or Klonopin and don’t know how.  Thank you.  Getting down in dose of Propanolol, but getting adrenaline surges and needles.  

As I mentioned earlier, I believe I am in acute benzo withdrawal and have been for a few months.  

 

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Altostrata

Given you seem to be having a paradoxical reaction from TOO MANY sedating drugs at night, it's hard to call your condition acute benzo withdrawal. It looks like you're having adverse reactions to the drugs you're taking.

 

It's possible that dividing the Klonopin dose might be a good idea, but we're trying to clear away the rebound from propranolol and the nighttime drug-drug interactions first.

 

On 11/2/2019 at 5:20 AM, Lookinup said:

10:- klonopin - felt heart rate increase

 

We definitely need to see the Klonopin dosage in your daily notes.

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Lookinup
10 minutes ago, Altostrata said:

Given you seem to be having a paradoxical reaction from TOO MANY sedating drugs at night, it's hard to call your condition acute benzo withdrawal. It looks like you're having adverse reactions to the drugs you're taking.

 

It's possible that dividing the Klonopin dose might be a good idea, but we're trying to clear away the rebound from propranolol and the nighttime drug-drug interactions first.

 

 

We definitely need to see the Klonopin dosage in your daily notes.

 

11 minutes ago, Altostrata said:

Given you seem to be having a paradoxical reaction from TOO MANY sedating drugs at night, it's hard to call your condition acute benzo withdrawal. It looks like you're having adverse reactions to the drugs you're taking.

 

It's possible that dividing the Klonopin dose might be a good idea, but we're trying to clear away the rebound from propranolol and the nighttime drug-drug interactions first.

 

 

We definitely need to see the Klonopin dosage in your daily notes.

The Klonopin dose is .5 mg.  The Propanolol came on board with the hyper state of my thyroid levels.  It has eased the adrenaline surges as well.  I am cutting back by taking 1/2 of 2 doses.  I’m not sure that is what is giving me the horrible sensory symptoms—needles, twitches, etc.  Had diarrhea today for first time, losing weight, brain fog, etc. and have felt horrible for months and attributed it to Mirtz. Withdrawal.  I know Ambien has a very short l/2 life and I worry about dependence at that level of Klonopin since it has been so long.  Very anxious and sick over this.  Thank you for your help in sorting it out.  

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Lookinup

I am very frustrated and have to resist urges to just to the hospital and let them sort it out!  Fortunately, I know to listen to you instead.  From your experience, can this still be Mirtz. Related or is it sounding more benzo like?  

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Lookinup

Last night before taking Ambien, HR spiked and anxiety attack.  Had already taken .5 Propanolol 2 hours before.   I am sure I have to get off that drug.  I believe the addition of Ambien really messed with the Klonopin dose also and I am in withdrawal from both.  I don’t know where to go with this.  Woke up with completely numb arms after a few hours of “Ambien” sleep.  

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Lookinup

Forgot to mention, completed soaked when I awoke with numb arms.  

 

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Shep
16 hours ago, Lookinup said:

From your experience, can this still be Mirtz. Related or is it sounding more benzo like?  

 

I think you're dealing with a destabilized nervous system, which means your nervous system is hyper-reacting to the other drugs and you're now more susceptible to paradoxical reactions. So in that sense, yes, it does involve the mirtazapine. However, I wouldn't fixate on the mirtazapine because you've been off it so long and had so many other changes, going back on it isn't a good idea. 

 

These threads may help explain:

 

How psychiatric drugs remodel your brain

 

Healing from antidepressants. Patterns of recovery video (4 minutes)

 

The Windows and Waves Pattern of Stabilization

 

What is withdrawal syndrome?

 

Please keep posting daily notes. 

 

1 hour ago, Lookinup said:

Forgot to mention, completed soaked when I awoke with numb arms.  

 

 

Were you sleeping on your arms when you woke up? That's very common and can cause your arms to go numb. 

 

Edited by Shep
added response to last post

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Lookinup

Thanks, Shep. I don’t want to go back to the Mirtz.  Just having a feeling that the Benzos are taking on their own problems now and I would like to deal with them.  Do you think it may help to separate the dose of K into an earlier in the day dose to see if some of these  symptoms dissipate?  And I would love to taper down the Ambien.  The feelings of numbness comiing on are bothersome. In Mirtazapine withdrawal, do symptoms get worse after 5 months?  LIke this or is more likely due to the Benzos?

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Shep

Yes, dealing with interdose benzo withdrawal is something you'll want to target after you reduce the propranolol. And you may want to come off Ambien before the other drugs. 

 

Daily symptoms notes are needed. You haven't posted any since Friday's. 

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Lookinup

No, wasn’t sleeping on it.  Both arms went numb.  Still have some residual numbness in left hand.  Seems like my body knows when it is time for  these drugs and goes into withdrawal.  I have to get rid of the Ambien.  How can I do this safely? 

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Lookinup

I know.  Yes, I am reducing the Propanolol.  Hope I can last before dividing that dose of Klonopin, especially if it would be helpful. I would like to get a milligram scale and think about going slow on the Ambien also.  It just added to the benzo load and I believe due to the short half life is giving me a lot of problems.  I’ve got to get started on something.  Thank you, Shep.

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Lookinup

I am documenting the day.  Will send tomorrow.  What I  Keep wondering is if my system is destabilized since the Mirtz withdrawal and has gotten worse from interdose benzo withdrawal, how will I heal without getting rid of the poison? I feel Ike I live in a panic attack and now with neuro and sensory symptoms all day.  

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Shep

Lookinup, you are reducing the propranolol and also wanting to remove the Ambien and posting about moving the Klonopin. Please note that it is best to make one change at a time. Please see:

 

           The rule of 3KIS: Keep it simple. Keep it slow. Keep it stable.

 

Once you've finished reducing the propranolol, you may want to split out the Klonopin. to prevent interdose withdrawal. A gradual move is best. We recommend moving the benzo one hour a day. To space Klonopin out for interdose withdrawal, divide your daily dose into two doses. Move one dose one hour a day. To help prevent adverse reactions, you may want to move it two hours in one day to skip over taking it with a conflicting drug (such as the propranolol). 

 

Whether you're really getting interdose withdrawal or not is unclear. It could be rebound propranolol issues or adverse reactions, etc. We've asked repeatedly for daily drug and symptom notes but you haven't posted any since Friday, so I don't know if reducing the propranolol has had any effect or not. Reducing the propranolol may reduce your daytime symptoms. If not, then you may want to split out the Klonopin. Klonopin has a half-life of 18 - 50 hours, so it depends on how fast you're metabolizing the drug as to whether or not you're getting interdose withdrawal. 

 

By splitting out the Klonopin and moving it away from the nighttime dose, you may not sleep as well. That's why we were concentrating on working with the propranolol first. 

 

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Lookinup
59 minutes ago, Shep said:

Lookinup, you are reducing the propranolol and also wanting to remove the Ambien and posting about moving the Klonopin. Please note that it is best to make one change at a time. Please see:

 

           The rule of 3KIS: Keep it simple. Keep it slow. Keep it stable.

 

Once you've finished reducing the propranolol, you may want to split out the Klonopin. to prevent interdose withdrawal. A gradual move is best. We recommend moving the benzo one hour a day. To space Klonopin out for interdose withdrawal, divide your daily dose into two doses. Move one dose one hour a day. To help prevent adverse reactions, you may want to move it two hours in one day to skip over taking it with a conflicting drug (such as the propranolol). 

 

Whether you're really getting interdose withdrawal or not is unclear. It could be rebound propranolol issues or adverse reactions, etc. We've asked repeatedly for daily drug and symptom notes but you haven't posted any since Friday, so I don't know if reducing the propranolol has had any effect or not. Reducing the propranolol may reduce your daytime symptoms. If not, then you may want to split out the Klonopin. Klonopin has a half-life of 18 - 50 hours, so it depends on how fast you're metabolizing the drug as to whether or not you're getting interdose withdrawal. 

 

By splitting out the Klonopin and moving it away from the nighttime dose, you may not sleep as well. That's why we were concentrating on working with the propranolol first. 

 

Hi Shep,  Thank you for your suggestions.  I am following them.  Haven’t posted because everything is the same with the exception of reducing the Propanolol by 1/2 two times a day for this week, then 1/2 three times a day next week, etc.  Have an appointment with the endo next week so will get a read on current thyroid levels.  Yes, I think holding onto the .5Klonopin for so long was not working for me any longer and it is important for me to stabilize as much as possible for thyroid reasons. Is it ever necessary to updose slightly?  

 

I am really looking forward to getting rid of that Ambien. Guess we can talk about that after the propanolol is reduced to where it should be.  Is Ambien hard to reduce?  That is the one that give me an adverse reaction.  Does any of this sound like protracted Mirtz withdrawal also or would those symptoms look different?  I am really looking forward to getting on with ridding myself of these drugs. Right now I am sitting with the needles feeling, chest burning and numbness around the mouth.  Do you think the Ambien can be causing that too?  Hope moving some Klonopin will keep that in check too.  I know detox facilities are never the answer, but it is hard to not think of that from time to time.  I just want to get on with things!!  

 

I really appreciate all of your and Altostrata’s support.  Please let me know if there is anything else you suggest I do. And is the brain fog normal with Klonopin interdose withdrawal also?

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Lookinup
4 minutes ago, Lookinup said:

Hi Shep,  Thank you for your suggestions.  I am following them.  Haven’t posted because everything is the same with the exception of reducing the Propanolol by 1/2 two times a day for this week, then 1/2 three times a day next week, etc.  Have an appointment with the endo next week so will get a read on current thyroid levels.  Yes, I think holding onto the .5Klonopin for so long was not working for me any longer and it is important for me to stabilize as much as possible for thyroid reasons. Is it ever necessary to updose slightly?  

 

I am really looking forward to getting rid of that Ambien. Guess we can talk about that after the propanolol is reduced to where it should be.  Is Ambien hard to reduce?  That is the one that give me an adverse reaction.  Does any of this sound like protracted Mirtz withdrawal also or would those symptoms look different?  I am really looking forward to getting on with ridding myself of these drugs. Right now I am sitting with the needles feeling, chest burning and numbness around the mouth.  Do you think the Ambien can be causing that too?  Hope moving some Klonopin will keep that in check too.  I know detox facilities are never the answer, but it is hard to not think of that from time to time.  I just want to get on with things!!  

 

I really appreciate all of your and Altostrata’s support.  Please let me know if there is anything else you suggest I do. And is the brain fog normal with Klonopin interdose withdrawal also?

Reducing the Propanolol has not had an effect on my symptoms, but just know it is best to reduce it.  Those symtoms remain:

brain fog, panic like anxiety from time to time, needles, twitching, full ear, runny nose from nowhere

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