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embd

embd: updosing or holding for a bad wave?

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embd

That's what I was hoping! Thanks for confirming. :) The insomnia had been held at bay for the most part so far during the Paxil taper due to a wonderful amino acid supplement I've been using called Eden. It seemed to cover the nights that sleep was an issue. But Eden hasn't really been able to touch the insomnia during this wave, probably due to the severity of the other symptoms. Hopefully it will start to work again within a few weeks. Hope you're sleeping well right now!

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brassmonkey

Please list the Eden and any other supplements you may be taking in your signature.  It is very important that we know about them.  Many supplements or some of the ingredients in mixtures may be helpful for a one or two time use, but will cause problems if taken regularly.

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embd

OK, @brassmonkey. I'll add in my supplements in my signature. I experienced that last week when I tried a magnesium-based supplement called Natural Calm that worked wonders the first night but had a paradoxical reaction that kept me up all night the second night. In the case of Eden, it's a benign blend of amino acids that I've been using for a few years (all through my Ativan taper and through the first year of my Paxil taper) on a cyclical basis and it has never caused me problems (other than not working on occasion). I usually use it for three weeks out of the month, then take a week off to give it a rest.

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embd

Is Valerian one of those supplements that is okay to use on a semi-regular basis to help with sleep, or does repeated use seem to cause problems? I'm trying to find something to use on the days/week I'm cycling off of the Eden amino acid supplement. I've used Valerian every few nights over the last month and had mixed results - sometimes it helps and sometimes it doesn't seem to make a difference. Just wanted to be sure it wasn't doing any harm. I've also tried using Cortisol Manager on the nights I could feel my cortisol spiking during the acute withdrawal phase, and that seemed to help me calm down and sleep. I don't seem to be having quite as many cortisol spikes or hot sweats at night these days, but they were awful a couple of weeks ago.

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Gridley

15 minutes ago, embd said:

Is Valerian one of those supplements that is okay to use on a semi-regular basis to help with sleep,

 

I'd stay away.  This is from a post by GiaK, one of our members, from a few years back:

 

"Valerian is risky in withdrawal for those of use who become hyper-sensitive to medications and supplements etc. 

Because of it's affinity to GABA receptors its somewhat like a benzo and it can act as a harsh reintroduction into bad withdrawal symptoms in some cases.

It's one of those things that if people used it judiciously BEFORE ever getting strung out on drugs...it would most likely be totally safe...

but once we're in withdrawal we definitely run the risk of it going paradoxical and harming us.

that said, people do use it successfully coming off benzos, but it's a risk and people need to know it can throw some of us right back into ugly withdrawal symptoms. Once people become sensitized it's best avoided and/or eliminated."

 

 

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embd

Good to know.  Perhaps it's not as much of an issue if you're tapering from an AD instead of a benzo, but good to be aware of the warning. Do you have any supplement or sleep aid support you use at night to help fight the insomnia? I'm just looking for something safe to use on the nights I'm cycling off Eden. I already use Melatonin (doesn't seem to do much) and magnesium.

 

I was also wondering about this concept of a sensitized system. I've read on quite a few threads something like "once your system becomes sensitized." I know I'm currently sensitized during this wave and am holding to stabilize. Once I stabilize and have 2-3 months of little to no symptoms, does that mean I'm still sensitized and will be throughout the rest of my slllooowww taper? Or at that point am I considered stable again and no longer as sensitive to things like supplements, food, sugar, etc. as long as I remain fairly stable with only mild symptoms?

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Gridley
8 minutes ago, embd said:

 

I was also wondering about this concept of a sensitized system. I've read on quite a few threads something like "once your system becomes sensitized." I know I'm currently sensitized during this wave and am holding to stabilize. Once I stabilize and have 2-3 months of little to no symptoms, does that mean I'm still sensitized and will be throughout the rest of my slllooowww taper?

 

Unfortunately, yes, you'll still be sensitized throughout the tapering and recovery process, though as you heal more and more you'll likely be less so.  "Stabilized" means your symptoms are tolerable--not absent--but without big swings or changes.  But even when stabilized, your system, once you're in withdrawal and while healing, remains sensitized, meaning you'll likely still have to be careful with sugar, supplements, etc.  We've thrown our systems into disequilibrium with these drugs and then with

recovering from the imbalance caused by the drugs, and can't tolerate things that the undrugged can.

 

Melatonin and magnesium are the only sleep aids I know about.  I take 0.5mg Melatonin and I think it helps a bit.  A couple of years back I tried one of the cortisol supplements, Enorphos, for a few months and it didn't help.  I recall later a post from Brassmonkey warning against the use of these supplements.

 

Here are some non-drug skills for dealing with insomnia:

 

Tips to help sleep - so many of us have that awful withdrawal insomnia
 
 
Trick and tips to fall asleep faster
 
This link contains helpful information, including insomnia and also non-drug coping skills.  
 


 

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embd

Those are great links - thank you! I so appreciate your wisdom and the advice you generously share, even while you're going through your own taper and WD issues. What a wonderful forum this is!!

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embd

@brassmonkey or @Gridley, at what point is it too late to updose a bit to try to take the edge off a bad wave? My last cut to 5.05mg was on July 5. My bad symptoms started around August 5 and have come and gone in bad waves and brief windows ever since. I'm hoping to continue to ride this out until it resolves, but the insomnia in particular is getting to be a bit too much. Two weeks ago Brassmonkey had suggested not going up to more than 5.2 mg if I do updose, but had suggested I try to hold a bit longer. Since it's now been 11 weeks since my cut, would it even do much good at this point to go up to 5.2mg, or would it cause more trouble than it's worth? If I knew I only had to hold out another week or two, I could do it, but if this wave will stretch another 2-3 months, I'm not sure I can make it that long with so little sleep. Thank you!

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Gridley
4 minutes ago, embd said:

would it cause more trouble than it's worth?

 

Reinstatement works most predictably within 3 months of the cut, so you're within that window but barely.  ,It's best to reinstate/updose as soon as possible after the cut.  The updose could help but it could also make things worse, so it's a risk.  It's a tough decision.  I'd continue to hold.

 

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embd

I'm not suggesting reinstating, just updosing. My last dosage before my cut was 5.61 mg, down to 5.05 mg. Brassmonkey had suggested three weeks ago that I might go back up to 5.2 mg to take off some of the edge. I really tihink I need some relief from the insomnia. It appears to be getting worse and I haven't been able to get out of bed to function over the last few days. I have a three-yea-old daughter and I haven't been able to care for her. When you say updosing could make things worse, what do you mean? Would it be a temporary blip as I adjusted to the new dose, or a significant long-term worsening of symptoms? Is 5.2 mg enough of an updose to help with insomnia? I've only slept one hour so far tonight and am quickly getting in a bad way, with no relief in sight. If I end up needing to updose, I want to do so while I'm within the three-month window rather than waiting another week and it being too late.

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embd

@Altostrata, what is your opinion? Can I safely updose to 5.2mg Paxil from 5.05 mg? My last cut was from 5.61 mg on July 5. I truly don't think I can handle the insomnia any longer.

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Gridley
7 hours ago, embd said:

 Is 5.2 mg enough of an updose to help with insomnia?

 The reason Brssmonkey suggested 5.2mg is the risk of overshooting the mark and giving your system more than it can handle, which can cause long-term worsening.  As I said, it's a tough decision, and you must be the one to make it.

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embd

What do you mean by long-term worsening? Do you mean kindling? Would it be apparent right away? Is the risk because it's already been 11 weeks or because there's always a risk in updosing? Could such a small updose truly cause such significant problems, especially within the three-month window?

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Gridley
6 minutes ago, embd said:

What do you mean by long-term worsening? Do you mean kindling? Would it be apparent right away? Is the risk because it's already been 11 weeks or because there's always a risk in updosing? Could such a small updose truly cause such significant problems, especially within the three-month window?

 

The fact that the updose is so small lessens the chance of problems.

 

The risk is because there's always a risk is updosing.  

 

 If there is a problem, it could be apparent right away, like an adverse reaction, in which case you should stop the updose immediately.  

 

 The updose might be fine.  Some people have had successful updoses/reinstatements outside the 3-month window.  

 

 

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embd

OK, good to know. I think I would like to take the chance, as I don't think my body is stabilizing as it should right now.

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Gridley
16 minutes ago, embd said:

think I would like to take the chance,

 

We recommend taking daily notes on paper to keep track of how your updose is going.  Sometimes the beneficial effects of an updose can be felt within a day or two.  Sometimes it takes longer.  It takes about 4 days for a dose change to get to get to full state in the blood and a bit longer for it to register in the brain.

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embd

OK. If there is an adverse reaction, what would that look like so I know what to look out for?

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Gridley
2 minutes ago, embd said:

adverse reaction,

 

You will feel much worse, ramped up symptoms and/or new symptoms.  

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embd

And it would generally show up quickly? Do people frequently experience adverse reactions with a small updose, or is it rare?

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Gridley
8 minutes ago, embd said:

And it would generally show up quickly? Do people frequently experience adverse reactions with a small updose, or is it rare?

Quickly.  I don't know how common it is.  My guess is that with a small updose it would be fairly rare.

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embd

My doctor just called in the updose, only she called in 5.25 mg (not 5.2) for some reason. By my calculations, that's about a 4% increase. Hopefully that's small enough but still big enough to be effective. It won't be ready at the pharmacy until Thursday so I'll start it then, and note my symptoms.

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StrongEnough

Hi embd.

I find our situation very similar, so I'm glad to have encounter this post.

I also began encountering problems in wd recently after a relatively smooth road from 20mg Paxil. 

I'm on 5.5mg about the same as you, and for me it also came from nowhere and in full force.

I experience bouts of panic, tremors, feeling hot, dizziness, nausea and also this gurgling in stomach while having low appetite that you were talking about. 

I also did 10% monthly from 20 to 7 or 8 mg BUT from then I switched to 5-6% a month. 

really thinking about either holding or slowing this down to a real gariatric snail pace. 

 

I hope this resolves for us soon! courage to you!

 

 

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ChessieCat

@StrongEnough

 

Hi StrongEnough and welcome to SA,

 

Thank you for participating on our site. Please start a topic for yourself in the Introductions and Updates forum so we can get to know you better and help you with your taper.

Edited by Shep
updated with new username

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embd

Journal entry: My symptoms so far in this bad wave (starting around August 6) have been as follows, listing most severe first:

 

Insomnia (anywhere from 0-6 hours per night, broken sleep)

Fatigue

Blocked ears

Cog fog

Digestive issues (diarrhea)

Body shakes

Cortisol spikes at night

Hot flashes

Confusion/memory issues/trouble concentrating

Anxiety/panic episodes

Coordination problems/delayed reflexes

Dizziness

Depression

Akathesia

Constant churning in stomach, like I'm hungry

Poor appetite

Weight loss

 

Symptoms get more severe during week I get my period. Generally I have one really bad night (0-2 hours of sleep) per week. While some symptoms have become a bit less problematic over the weeks (no more anxiety or depression), others (like insomnia) have remained steady. I have had very few windows since August 5, and have been fairly symptomatic every day.

 

Prior to this wave, my symptoms were very predictable and manageable. After a cut, I would have trouble falling to sleep from about Day 5-19 (which was pretty well managed by taking the amino acid supplement Eden - I rarely had less than 7 hours of decent sleep), and I would also have muscle cramps in my lower legs. Those were really the only symptoms.

 

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embd

 

On 9/19/2019 at 9:26 AM, Gridley said:

 

With catching-up symptoms, I would say at the low end of 3-4 months to resolve (maybe less), though of course we can't predict for sure but that's my best guess.  Insomnia is a tough one, not necessarily the last to resolve, but a symptom that can be persistent.  It does improve though.  

 

Just wondering, when you say the low end of 3-4 months to resolve, do you mean from the time the symptoms first appeared or from the last cut? My last cut was July 5, but the symptoms didn't appear until about Aug. 5. Also, during that 3-4 month period would the symptoms typically be getting gradually better along the way?

 

I saw that you're experiencing an uptick in insomnia and anxiety. So sorry to hear that. I hope they resolve soon.

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Gridley
13 minutes ago, embd said:

when you say the low end of 3-4 months to resolve,

I would say from the time the symptoms first appeared.  Probably the symptoms would be up and down for a while, then toward the end gradually improving.  

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embd

OK, thank you. Trying to decide if I think I have the strength to dig down and refrain from updosing. It's so tempting because I want to sleep so badly, but I really don't want to have to cover this terrain again when coming back down. I'll give it another couple of nights and see if anything turns...

 

And to compound it, there's no guarantee the insomnia will improve just by updosing .25 mg, so it could be a wasted effort if I can just hold on a while longer.

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embd

Well, THAT was unexpected. I had a very difficult time falling asleep last night and had only slept four hours by 6:30, but then rolled over and slept until 11:30am. So a total of nine hours...the first time in seven weeks. I'm taking that as a sign to not updose for now...if I can get a good night like that every so often, I think I can hold on until the symptoms resolve, even if it's a few more weeks. I've also started napping an hour or two in the afternoon if I can, which helps take the edge off just a bit.

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embd

I've been able to sleep between 6-9 hours the last four nights, which is a HUGE improvement over the last two months. Granted, it is mostly a light, artificial sleep where I'm aware of a lot of what's around me,  and it requires me sleeping in until about 10am (my best sleep is often after the cortisol spike at 6am), but it's enough to help me stay functional and out of bed during the day. Thank you so much for encouraging me to keep holding, @Gridley. I'm so glad I didn't end up updosing when a window (however short-lived it might be) was so close to opening up. I still feel my other symptoms cycling unpredictably (lots of anxiety and blocked ears and stomach pain today), but it's all more manageable if I slept the night before. And these symptoms I'm still experiencing are less severe than they were during the last few cycles of the same symptoms.

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Gridley
14 minutes ago, embd said:

Thank you so much for encouraging me to keep holding

That is great news, embd!

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embd

I think I'm finally moving from a pattern of one step forward, five steps back to two steps forward, one step back. Sunday night was unexpectedly awful, with only about two hours of light sleep. But yesterday I was able to take an afternoon nap and then I lay down early at 8pm, dozed right off, and basically slept through the night til 6am! It seems my body is starting to remember how to sleep, in fits and starts. I know there will still likely be some rough insomnia patches in the coming weeks, but hopefully this is a start of recovery.

 

Gridley, I noticed in your signature that you're taking Mag Glycinate. Is this the best form of magnesium to take? I've been taking Magnesium Taurate, but I'm sure some forms are better than others. How often throughout the day do you take it? With food or without?

 

 

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Gridley
9 minutes ago, embd said:

 

Gridley, I noticed in your signature that you're taking Mag Glycinate. Is this the best form of magnesium to take? I've been taking Magnesium Taurate, but I'm sure some forms are better than others. How often throughout the day do you take it? With food or without?

 

 

I take it in the morning and at night before bed.  Also, if I wake up in the middle of the night, I keep a tablet by the bed and it seems to help with relaxing me to get back to sleep, though it's not foolproof.  I am going to start dissolving a tablet in water and sipping it throughout the day, as is recommended on this site.  I've haven't found it makes any difference whether or not I take it with food.  

 

I don't know glycinate's relative merits with taurate, but glycinate is definitely regarded as one of the best forms of magnesium, especially in terms of its calming effect.  Here's a little information:

 

5. Magnesium glycinate

Feeling stressed? This may be the form for you. While magnesium in its many different forms has been shown to naturally support muscle relaxation, magnesium glycinatemight just take the cake (to note: the amino acid glycine is known for the calming impact it can have on the mind and body).† Additionally, it has optimum bioavailability and, unlike some of its kin, isn’t known for its laxative properties.

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embd

That makes a lot of sense, with glycinate being calming. Glycinate is in the Eden amino acid supplement I take, which helps me relax at night. (But I can only take it five nights a week - I need to cycle off it the other two nights to give my receptors a rest.)  I think I'll make the switch over to that form. I know amino acids are supposed to be taken on an empty stomach, which is why I wondered about timing of taking it. I like all of your suggestions, including sipping water throughout the day. The bottle my husband has says to take three 100mg tablets per day. If I take one in the morning, one at night, and sip one throughout the day, I wonder if I could still take one in the middle of the night on occasion. 

 

In addition to calming, I'd imagine Mag Glycinate tablets help with the sore muscles and nighttime cramps, right? Or is that more from the Epsom baths?

 

Do you have a brand you recommend? I know the quality of some is much better than others. I'm wondering about this one: https://smile.amazon.com/Pure-Encapsulations-Magnesium-Glycinate-Physiological/dp/B0058HWV9S/ref=sr_1_6?crid=1984J4F034M9&keywords=magnesium+glycinate+metagenics&qid=1569944251&s=gateway&sprefix=magnesium+glycinate+metag%2Caps%2C147&sr=8-6.

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Gridley
2 minutes ago, embd said:

I wonder if I could still take one in the middle of the night on occasion. 

The limiting factor would be whether that much had a laxative effect.  As always with supplements, start low and work up.  How much have you been taking up to now?  If necessary, you can cut tablets in half.  

 

 I'd try the morning dose, the daytime water dose and the nighttime dose first and see how that works.  If no problems, you can work in the middle of the night dose. 

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embd

I've been taking two 125mg tablets each morning and two at dinnertime of the Mag Taurate. I don't think I've had a laxative problem, although I've had diarrhea for the last two months during this wave, but I took the Mag Taurate long before that started. I think I'll just use the nighttime one for occasional, as-needed use and use the Eden amino acid blend most of the time. Thank you!

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