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Lookinup's intro: please help

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Shep
11 minutes ago, Lookinup said:

Please let me know if there is anything else you suggest I do.

 

Daily drug and symptoms notes. Without this, we're only guessing. It's up to you how much you want to put into this. 

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Lookinup
35 minutes ago, Shep said:

 

Daily drug and symptoms notes. Without this, we're only guessing. It's up to you how much you want to put into this. 

I want to put a lot into it.  I will keep sending notes.  You know what you are doing.

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Lookinup

Wednesday:

 

5:30 a.m. Awoke - sweats during night; started feeling twitches

6:00 Took thyroid med.- slight twitches continued

7:00 Breakfast - twitches

8:00 Prozac

9:00 .a.m. brain fog; twitches; numbness in finger

10:00 took 1/2 (5 mg) propanolol

10:30 - 12:)0 Grocery shopping ; needles, brain fog

12:30- 3:30 errands - needles, twitching; panic like anxiety

3:30 10 mg Propanolol — some relief with anxiety

6:00 dinner - twitches, anxiety and needles, numbness in hands, anxiety

7:00 Took 1/2 (.25 Klonopin)

7:30 Felt some relief - still some needles

8:30- Took 10 mg. Propanolol - some relief with needles

9:30 Took 1/2 (.25 Klonopin)- ok, some calming down of twitches

11:00 Took 7.5 mg. Ambien - raised heart rate; did not fall asleep for awhile -

5::00 a.m. awoke with twitches 

 

I like being able to split the Klonoin dose; some relief between. I actually think I slept through better. I don’t like the way I feel after taking the Ambien. How do I ever get rid of that. Do you think that drug is causing more problems than Klonopin?  This is awful!  I fiollow you advice. Notice spacing and reduced Propanolol.  Maybe the interdosing is helping without as much of that.  Thank you for hanging in with me.  I hope I get to the other side of this some day.  I know Mirtz. Has a lot of  horrible side effects and I did not taper that properly as NOW know, so confusing.  But I’ve read that “if looks like a duck and quicks like a duck” and you are on a benzo, it is probably giving you some issues!  Thanks again!

 

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Lookinup

Oops, a few things in my notes I neglected to put in above.

12:30 to 3:30 cold nose

10:00 p.m. to 11:00 - lots of needles and twitches awaiting Ambien

 

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Lookinup
11 hours ago, Lookinup said:

Oops, a few things in my notes I neglected to put in above.

12:30 to 3:30 cold nose

10:00 p.m. to 11:00 - lots of needles and twitches awaiting Ambien

 

I am getting twitches upon waking.  Do you think Ambien is causing that?  Is there anyway I can start tapering that?

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Shep

Questions - if you remove the Ambien, are you going to be able to sleep? Do you start to get sleepy after taking your 9:30 PM Klonopin dose? If so, then you may want to make a 10% reduction in the Ambien to see how you do.

 

You may want to space out your Klonopin to 12 hours apart to help with interdose Klonopin withdrawal. Please post your thoughts on this. 

 

Here is some information for you to read over to decide if you wish to use a scale or do a liquid taper for the Ambien. Please don't worry about doing the math, we can help you out with that. For now, just take a look and see which method is most comfortable for you and then you can order the supplies. 

 

For using a scale, please see:

 

Using a digital scale to measure doses

 

A scale that many members recommend is this one:

 

Gemini 20 Scale

 

This is a video for how to do a taper using a scale. Please note this is for a benzo taper, but the same principle applies:

 

Scale use video (6.5 minutes)

 

This thread is for doing a liquid taper:

 

How to make a liquid from tablets or capsules

 

This post in that thread contains a video.

 

Another option is to use a compounding pharmacy:

 

Getting custom dosages at compounding pharmacies (US, UK, Canada, and elsewhere)

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Lookinup

I am afraid of not sleeping.   Have not felt sleepy after Klonopin In many years.  I never feel tired, always wired and now feeling horrible from withdrawal effects from Klonopin and Ambien.  Feeling worse each day with symptoms.  This morning I had ringing. In my ear with fullness and super sensitive to the slightest sounds.  The twitching, needles and numb feeling in hands, etc. is all day.  I truly think my body is in withdrawal  and this will continue until I get off.  Is it ever necessary to dose up a bit to stabilize? If I didn’t have the thyroid level problem going on right now, I would be starting a taper.  Have to get that straightened out first but am getting eaten up alive with these awful symptoms.

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Lookinup
1 hour ago, Lookinup said:

I am afraid of not sleeping.   Have not felt sleepy after Klonopin In many years.  I never feel tired, always wired and now feeling horrible from withdrawal effects from Klonopin and Ambien.  Feeling worse each day with symptoms.  This morning I had ringing. In my ear with fullness and super sensitive to the slightest sounds.  The twitching, needles and numb feeling in hands, etc. is all day.  I truly think my body is in withdrawal  and this will continue until I get off.  Is it ever necessary to dose up a bit to stabilize? If I didn’t have the thyroid level problem going on right now, I would be starting a taper.  Have to get that straightened out first but am getting eaten up alive with these awful symptoms.

And thank you very much for the taper information.  We purchased a scale.  Too bad about the short life of  Ambien messing with things.  Sleep is so critical and don’t want to lose that.  All good information for when the time is right.  And yes, going try spacing out the Klonopin 12 hours.  Makes sense and maybe will help with the Ambien short life and eventual taper.

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Shep
20 hours ago, Lookinup said:

I am afraid of not sleeping.   Have not felt sleepy after Klonopin In many years.

 

Are you going to be able to sleep if you remove the Ambien? If not, you may want to come off Prozac first. 

 

Spacing out the Klonopin to 12 hours a apart may be helpful as a next move before any other changes. As you wrote, it may help with the Ambien taper. 

 

20 hours ago, Lookinup said:

 Is it ever necessary to dose up a bit to stabilize?

 

Yes, periodic updoses are okay. However, it's not guaranteed to fix a too-rapid taper and if it's too abrupt and too large, it can create kindling in the nervous system. Be very gentle with your nervous system. 

 

20 hours ago, Lookinup said:

If I didn’t have the thyroid level problem going on right now, I would be starting a taper.

 

I can't remember if anyone has posted this link or not, but if you haven't seen it, this thread has a ton of information on thyroid issues during withdrawal and you may find it useful: 

 

Thyroid symptoms: hypothyroid, Hashimoto's

 

 

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Lookinup

Hi Shep,

Just came from endocrin. She keeps trying to make adjustments to help me feel better,   Problem is, I don’t think my feeling this way is thyroid related.  As I write, I am twitching all over in anticipation of my Klonopin dose.  Well, problem is that dose and the nightly one really aren’t bring much relief.  And, the Ambien is barely working.  I do believe I feel the withdrawal effects from that as early as morning also.  Now, to make matters more complicated, I still think about the Mirtzapine quick taper done in June and can’t help but wonder if I am really suffering from that or all of the aforementioned.  I am so frustrated.  My schedule of symptoms hasn’t changed,  but now includes chest burning and gurgling when I lay down.  Night time is horrible and I am not getting much sleep,which I desperately need.   Can you give me any advice?  Should I push on and start a taper of Ambien to get rid of that?  Do drugs eventually just stop working and throw you into withdrawal?  Where do I go to seek help for that—certainly not my GP or the psychiatrist who told me to jump from 1.8 mg. Remeron.  I am so upset feeling this way and need to proceed somehow.  Thank you for your understanding and guidance.

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Shep

How are you doing with the propranolol reduction? As we've discussed, you likely are getting some paradoxical and rebound symptoms from this drug, so reducing the nightly propranolol was recommended.

 

And then this:

 

On 11/8/2019 at 7:49 AM, Shep said:

Are you going to be able to sleep if you remove the Ambien? If not, you may want to come off Prozac first. 

 

Spacing out the Klonopin to 12 hours a apart may be helpful as a next move before any other changes. As you wrote, it may help with the Ambien taper. 

 

When are you taking your drugs now and at what doses? 

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Lookinup
1 hour ago, Shep said:

How are you doing with the propranolol reduction? As we've discussed, you likely are getting some paradoxical and rebound symptoms from this drug, so reducing the nightly propranolol was recommended.

 

And then this:

 

 

When are you taking your drugs now and at what doses? 

6 a.m Tirosent .88 (Thyroid)

8 a.m Prozac 5 mg

10:00 Propanolol .5

12:00 Klonopin .25

2:00 Propanolol 10 mg

7:00 Propanolol 10 mg

9:30 Klonopin .25

11:00 Ambien 7.5 mg

 

Have reduced the night time dose.  Thyroid still a bit on hyper side, so continuing Propanolol for now.  Not feeling well.  Lots of twitching, vibratory feeling in a.m. shortly after taking thyroid.  To be honest, I feel my best immediately upon waking at about 5:00 (if I can sleep after waking from Ambien). When everything has worn off and before I take anything!  The thyroid med is very stimulating.  Never was before the Mirtz. Withdrawal and levels were constant.  Immediately after stopping Mirtzapine, thyroid levels destabilized. Never had a problem with the .5 Klonopin either until that time.  Now, I seem to be feeling withdrawals from so many things I can’t put my finger on it.  Separating the Klonopin has made the needles all day feeling somewhat better.  But I am definitely getting withdrawal symptoms that are unbearable.  I worry about whether I am now paradoxical to meds.  Never felt that way shortly after taking them before.  The Ambien worries me because of its short half life and maybe getting symptoms from that now.  Now I am getting needles in my hands.  Thanks for your help, Shep.  I am lost in all of this and very worried.  

 

 

 

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Shep

 

On 11/6/2019 at 5:59 PM, Lookinup said:

8:30- Took 10 mg. Propanolol - some relief with needles

9:30 Took 1/2 (.25 Klonopin)- ok, some calming down of twitches

11:00 Took 7.5 mg. Ambien - raised heart rate; did not fall asleep for awhile -

 

 

23 hours ago, Lookinup said:

7:00 Propanolol 10 mg

9:30 Klonopin .25

11:00 Ambien 7.5 mg

 

23 hours ago, Lookinup said:

Have reduced the night time dose.

 

I've listed your last journal from November 6 and then the one you just posted. Which night time dose did you reduce? 

 

23 hours ago, Lookinup said:

Thyroid still a bit on hyper side, so continuing Propanolol for now.  Not feeling well.  Lots of twitching, vibratory feeling in a.m. shortly after taking thyroid.

 

You mentioned seeing your thyroid doctor earlier this month. How did you check out? 

 

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Lookinup
11 hours ago, Shep said:

 

 

 

 

I've listed your last journal from November 6 and then the one you just posted. Which night time dose did you reduce? 

 

 

You mentioned seeing your thyroid doctor earlier this month. How did you check out? 

 

Dose adjustment again.  Still a bit on hyper side.  On another note, finally found a psy willing to do a taper when ready.  He. Is suggesting crossing over from both Ambien and Klonopin with Valium and getting rid of the Ambien.  What are your thoughts about that?  I have heard that some have a difficult time crossing to Valium.  Thank you, Shep.

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Shep
14 hours ago, Lookinup said:

Dose adjustment again.

 

What dose and drug did you adjust? 

 

On 11/13/2019 at 8:06 AM, Lookinup said:

Have reduced the night time dose.

 

Asking about this again. Which night time drug did you reduce? 

 

14 hours ago, Lookinup said:

On another note, finally found a psy willing to do a taper when ready.  He. Is suggesting crossing over from both Ambien and Klonopin with Valium and getting rid of the Ambien.  What are your thoughts about that?  I have heard that some have a difficult time crossing to Valium.  Thank you, Shep.

 

Crosses over to Valium work best for people who aren't already destabilized. You'll go into withdrawal from Ambien and Klonopin when you cross over, so it depends on whether the Valium will cover the withdrawal from these other drugs or not. If you decide to do this, you'll need to crossover very gradually, giving your nervous system time to adjust. 

 

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Lookinup
55 minutes ago, Shep said:

 

What dose and drug did you adjust? 

 

 

Asking about this again. Which night time drug did you reduce? 

 

 

Crosses over to Valium work best for people who aren't already destabilized. You'll go into withdrawal from Ambien and Klonopin when you cross over, so it depends on whether the Valium will cover the withdrawal from these other drugs or not. If you decide to do this, you'll need to crossover very gradually, giving your nervous system time to adjust. 

 

How do you do this gradually?  Take some K and some Valium?  I feel like I need to make some kind of move, maybe a tiny updose to help settle things?  How do you figure out how much Valium/Klonopin to cover those drugs?  Thanks for your help.  In the long run, is it a smoother move?

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Lookinup
Just now, Lookinup said:

How do you do this gradually?  Take some K and some Valium?  I feel like I need to make some kind of move, maybe a tiny updose to help settle things?  How do you figure out how much Valium/Klonopin to cover those drugs?  Thanks for your help.  In the long run, is it a smoother move?

Oh, I no longer take the Propanolol at night.  

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Shep
On 11/15/2019 at 10:13 AM, Lookinup said:

How do you do this gradually?  Take some K and some Valium?  I feel like I need to make some kind of move, maybe a tiny updose to help settle things?  How do you figure out how much Valium/Klonopin to cover those drugs?  Thanks for your help.  In the long run, is it a smoother move?

 

Crossovers work best for people who aren't already destabilized, so it's likely not going to be a smooth move because you're dealing with a traumatized nervous system, not just interdose withdrawal issues. 

 

Since you're already on Klonopin, you're already on a long-acting drug. If you need to make a slight updose, that's fine. The rule with benzo updoses is to only updose to where you were within the past month AND only if you were more stable at that prior dose. 

 

 

On 11/15/2019 at 10:15 AM, Lookinup said:

Oh, I no longer take the Propanolol at night.  

 

Please update your signature to reflect the drugs and doses you're currently taking and when you made your earlier reductions. 

 

A direct link to your signature is here: 

 

Account Settings - Create or Update Your Signature

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Lookinup
3 hours ago, Shep said:

 

Crossovers work best for people who aren't already destabilized, so it's likely not going to be a smooth move because you're dealing with a traumatized nervous system, not just interdose withdrawal issues. 

 

Since you're already on Klonopin, you're already on a long-acting drug. If you need to make a slight updose, that's fine. The rule with benzo updoses is to only updose to where you were within the past month AND only if you were more stable at that prior dose. 

 

 

 

Please update your signature to reflect the drugs and doses you're currently taking and when you made your earlier reductions. 

 

A direct link to your signature is here: 

 

Account Settings - Create or Update Your Signature

I have never started to taper.  Am in what I believe is tolerance.  Added .125 split between the 2 doses.  Really need to start a taper and get off but waiting for thyroid stuff!

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Altostrata
On 11/13/2019 at 5:06 AM, Lookinup said:

 Thyroid still a bit on hyper side, so continuing Propanolol for now.

 

Lookinup, how long have you been treated with thyroid drugs? If you get too much stimulation from them, that can affect your sleep. If you get a reaction after you take your thyroid dose, that's an indication it's too high.

 

We need to see if your symptoms follow any daily pattern. Please keep daily notes of times of day you take your drugs, their dosages, and your symptoms throughout the day. You can post 24 hours of notes at a time in this topic, with a simple list format with time of day on the left and notation (symptom or drug and dosage) on the right.

 

Did your sleep problems start when you started thyroid drugs? Adjusting your psychiatric drugs is not the way to correct over-stimulation from thyroid hormone. Please include the thyroid drugs in your signature.

 

It's good you found a psychiatrist who would help you taper. We don't advise risking a switch in drugs unless a direct taper doesn't work. As Shep said, tapering directly from Klonopin usually works well without having to switch to diazepam.

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Lookinup

Oh my, wrote a long explanation and lost it.  I started taking thyroid meds five years ago after having my thyroid removed for what ended up being benign nodules.  Never sensitive to the meds and had stability in levels up until June of this year when I stopped Mirtzapine.  Thyroid levels crashed and I believe my Klonopin level was also affected.  Panic attacks started one week later and intense anxiety has persisted.  Also think it is when I began to experience tolerance withdrawal for the first time since taking Klonopin.  Sleep gone, the reason Ambien started.   Prozac was added too for the intense anxiety.  Did not have the knowledge I have now about discontinuing, etc.  Listened to doctor, ugh!  I believe I have had protracted withdrawal ever since AND now the Klonopin/ambien issue.  Without Propanolol, my heart rate would be very high throughout the day with adrenaline spikes.  Sometimes I even think of taking Mirtazapine again to see if this all stops!!!!

 

I have an appointment with a Penn sleep psy. on Tuesday but don’t know whether I should even bother going as so many do not believe in discontinuation syndrome, etc. and want to pile on more meds.  My endocrinologist keeps lowering the med hoping I start feeling better, but my problem is obviously bigger than than.  I really don’t know where to go from here.  I feel stuck even though I have someone now to help with a taper.   I am afraid if I stop the Ambien, I won’t sleep at all.   Would love to have some direction with all of this.  Thank you for any suggestions you can provide.  

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Lookinup
21 hours ago, Lookinup said:

Oh my, wrote a long explanation and lost it.  I started taking thyroid meds five years ago after having my thyroid removed for what ended up being benign nodules.  Never sensitive to the meds and had stability in levels up until June of this year when I stopped Mirtzapine.  Thyroid levels crashed and I believe my Klonopin level was also affected.  Panic attacks started one week later and intense anxiety has persisted.  Also think it is when I began to experience tolerance withdrawal for the first time since taking Klonopin.  Sleep gone, the reason Ambien started.   Prozac was added too for the intense anxiety.  Did not have the knowledge I have now about discontinuing, etc.  Listened to doctor, ugh!  I believe I have had protracted withdrawal ever since AND now the Klonopin/ambien issue.  Without Propanolol, my heart rate would be very high throughout the day with adrenaline spikes.  Sometimes I even think of taking Mirtazapine again to see if this all stops!!!!

 

I have an appointment with a Penn sleep psy. on Tuesday but don’t know whether I should even bother going as so many do not believe in discontinuation syndrome, etc. and want to pile on more meds.  My endocrinologist keeps lowering the med hoping I start feeling better, but my problem is obviously bigger than than.  I really don’t know where to go from here.  I feel stuck even though I have someone now to help with a taper.   I am afraid if I stop the Ambien, I won’t sleep at all.   Would love to have some direction with all of this.  Thank you for any suggestions you can provide.  

Not going to the appointment.  I sure it will involve more drugs.  Even though I am not feeling well, I think I am going to have to start eventually on getting rid of Klonopin and Ambien.  I am going with your advice to just taper from Klonopin. Is it best to make cuts in each dose?  5% every two weeks?  I would at least like to have a plan. Maybe put up with the Ambien tolerance symptoms to continue sleeping. And do that after?

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Shep
On 11/8/2019 at 7:49 AM, Shep said:

Are you going to be able to sleep if you remove the Ambien? If not, you may want to come off Prozac first. 

 

Spacing out the Klonopin to 12 hours a apart may be helpful as a next move before any other changes.

 

Have you already spaced out the Klonopin? That may be your next step. And then you'll want to come off the Prozac before removing the Ambien and Klonopin. Please note what you wrote earlier about Prozac:

 

On 11/1/2019 at 10:46 AM, Lookinup said:

I also think the Prozac is stimulating throughout the day and actually worsens anxiety.

 

If you haven't already read this thread, please read the first post. It will explain more:

 

Taking multiple psych drugs? Which drug to taper first?

 

Please note the concept of "brakes versus accelerators." You want to come off any accelerators first, which in your case, is Prozac. That way sleep is preserved with the benzo and z-drug. 

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Lookinup

Shep, I am considering just starting with the Prozac and getting it out of the way.  5% every two weeks sound reasonable?

Thank you. Lookinup

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Shep

Yes, that's a total of 10% for the month, which is reasonable. And then you'll want to hold for a week or more.

 

Please let us know how you do. 

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