Arthur: looking for insight

[Arthur]

I will take them regularly.. also I’m going to the dentist to get a mouth guard made and some new false teeth then going to a medical school to get a nerve conduction study.. it’s very difficult to distinguish what is drug withdrawal, my previous terrible anxiety and nerve and jaw joint problems.. I will keep taking them at 10 and 10.. vivid vivid dreams last night which I think is the side affect of the melatonin.. thank you guys for sticking it out with me.. I am also a chronic pain patient..

[Altostrata]

18 hours ago, Arthur said:

I’m just in constant pain.. I know you are right.. need to do something about the pain..

 

Are you talking about jaw pain? Have you tried acupuncture? Or jaw stretching exercises?

[Arthur]

my trigeminal nerve has been damaged on both sides. need to do my jaw stretching as well.. I’m going to do them everyday.. I had a infection run up my lingual nerve from a dentist that butchered me.. it’s why I was but on the antidepressants to begin with.. that’s why the drs what me to take Amitriptyline.. for the pain.. caused by the damage to the nerve.. over filled root canal on one side and a botched wisdom tooth on the other..

 

[Arthur]

Acupuncture didn’t help.. thinking about stem cell or low level laser therapy..

[Arthur]

Should I reinstate.5 mg lexipro??  Having a rough time..

[Gridley]

1 hour ago, Arthur said:

Should I reinstate.5 mg lexipro??  Having a rough time..

Reinstatement works most predictably within 3 months of last dose.  You're a month outside that but it could work.  0.5mg would be a good dose to try.  You might feel some relief within a day or two but it takes a week or so to take full effect.  I wouldn't reinstate more than 0.5mg at this point.

 

 Please read:

 

About reinstating and stabilizing to reduce withdrawal symptoms. -- at least the first page of the topic

 

It's a good idea to keep daily notes on paper about how you're doing to see how the reinstatement is working.  I

 

f you feel worse after reinstating, stop immediately.

 

 

[Arthur]

I feel as tho I’ve had my life robbed from me as I think that reinstatement would only rev me up worse.. I’m at an impass and I need to make a decision.. the only medication at this point I would consider taking would be the low dose of Amitriptyline for the nerve damage in my face.. I’m just having a hard time finding the strength to continue thru the years this will take to feel somewhat normal..

[Altostrata]

We don't know anything about treating pain from dental injuries here. I have no idea if Lexapro would help the pain, all we do is address withdrawal symptoms and tapering.

 

Hypersensitivity from psychiatric drug adverse effects or withdrawal can exacerbate existing aches and pains.

[Arthur]

Well I went to the pain management clinic today and he admitted that that lexapro was probably keeping the nerve pain at bay and by the dr taking me off cold turkey it screwed up my central nervous system so now I have been sensitizated and that anything I do until the sensitization is calmed will exasperate it..  you guys have been great with trying to help me thru this.. 

[Heath]

Arthur , Altostata is definitely right ,  during withdrawal of ssris the pain is more intense.  I to have physical pain and when I change dose all my old injuries will began to hurt more and the daily pains I have is worse. I can tell you this happens every time with me!!!!!Then we become more sensitive to the pain and think about 24/7 then we become hypersensitive to any pain. Here is a prime example of ssri withdrawals- When my nerves are stable I’m ok working and living but when I have withdrawals tapering too fast I start heading to dr to talk about back surgery or something because pain is very bad. I read an article once that pictured a circle with <- depression -> <- anxiety -><-pain -> . All these feed off each other. It’s a cycle break the cycle . Right now you could reinstate some lexapro as Gridley said bring the anxiety symptoms down a little which will bring the pain down. That is something you could do to break the cycle.

[Arthur]

This is sound advice.. thank you..

[Arthur]

I’ve had a rash on both sides of my stomach for the past month.. could this be a side effect of the trilptal or from coming of the lexapro?? It is small and has not spread but I also get a bloody sore in my nose as well.. I’m worried about Steven Johnson’s syndrome.. but my body is in such a state of shock that’s I’m scared of dropping the trilpetal cold turkey as it give me alittle sleep..

[Gridley]

53 minutes ago, Arthur said:

’ve had a rash on both sides of my stomach

 

Skin issues are a common withdrawal symptom.  

Skin issues: hives, acne, dryness, itching etc. - Symptoms and ...

S-J Syndrome is rare but if you're worried check it out with a doctor.

Edited December 5, 2019 by Gridley

[Heath]

I also broke out one time  cting off Zoloft. Like hives. Withdrawals will make you think the worst of everything. Try to let things be and relax I know this is hard I been there when folks would tell me. If you have access to you tube type in honest guys meditation and get some earbuds this would relax me when I was bad off. 

[Arthur]

So this is where I am at now.. I went to the pain management dr and have started 5 mg of Amitriptyline.. this is the last drug I will try for my condition of nerve pain.. the past 3 days have been terrible.. basically what I’m asking is if it would be ok to try .5 mg of lexapro next week if things do not settle down.. every morning im pacing and cannot stand to be alone until symptoms start to settle down when my wife gets home.. also if I react badly to this medication after another 7 days will it be ok to drop it cold turkey after 10 days of usage.. this is my last grasp at meds for the nerve pain.. my life is not very manageable and I live in constant fear..  I’ve let my family down by not being educated on these drugs.. I have a very strong feeling that this will not help.. but it is the standard for nerve damage.. 

[Arthur]

Dec 6

wake up at 3. Cannot go back to sleep

6 am severe anxiety 

930 take 45 mg trilpetal 

in consolable all day

2pm eat oatmeal’s and take 500 mg fish oil

4 pm start the feel alittle better anxiety lessening 

7 pm relaxing

8 pm 5 mg Amitriptyline

10pm 45 mg trilpetal 

sleep wake up at 445 go back to sleep till 630

lay in bed till 830

 

 

Worried about akathasia I am unable to relax and lay down until the evenings.. 

[Arthur]

All the day time is difficult until around 6 or 7

[Arthur]

So I’m refusing to go up on anymore meds.. these things cause dementia and all sorts of problems.. going to Johns Hopkins tomorrow to see nerve doctor.. I want to look into stem cell and non drug treatments.. between the 45 mg trilpetal and 5 mg Amitriptyline my sleep is around 6 hrs..  I take the ami at 8 pm and the trilpetal at 10 with 2 mg melatonin.. I checked the drug interface and saw that if both are taken together the trilpetal could increase the level ami.. I seem to be stabilizing alittle on the 5 mg of ami.. how long should I hold till I start on the trilpetal taper baring everything going ok.. I want to keep my brain intact as much as possible.. the stress from the nerve pain and worry and withdrawal have left my memory very poor..

[Arthur]

I basically cold turkey lexapro..I’m just gonna keep checking in and asking for advice and not add anymore drugs.. sleep is the biggest priority.. wish me luck in this journey.. you guys keep me sane in knowing I’m not alone.. my job is physical so I get exercise daily but the sleep and the facial tension and burning has been the biggest dilemma.. I will write my symptoms for tomorrow 

[Gridley]

31 minutes ago, Arthur said:

sleep is the biggest priority..

Sleep is the big thing for many of us.  Magnesium can help. Start with a low dose. Mag glycinate is a good form for sleep.

 

Magnesium, nature's calcium channel blocker 

 

Here are some other links that might help:

 

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

 

Relaxation exercises, guided meditations, calming videos, sleep hypnosis

 

Trick and tips to fall asleep faster

http://articles.mercola.com/sites/articles/archive/2017/02/16/tips-tricks-fall-asleep-faster.aspx?utm_source=dnl&utm_medium=email&utm_content=art1&utm_campaign=20170216Z1&et_cid=DM133787&et_rid=1889748952

 

This link contains helpful information, including insomnia and also non-drug coping skills.  

 

 Important topics about symptoms, including sleep problems

 

Some members have found Melatonin helpful with insomnia.   

 

 Melatonin for sleep   

 

It's best to start at a very low dosage, such as .25mg, and gradually increase if needed to the lowest effective dose.  

 

 

 

 

 

 

 

[Arthur]

My depression is very deep right now.. adjusting to this life of withdrawal is very hard.. I’ve always felt things too deeply.. I don’t know what is withdrawal and what is me.. I’ve been on drugs for along time..

Only sleep 4 to 5 broken hrs last 4 days

[Arthur]

My sleep has been terrible the last 4 nights.

sleeping from 1030 till 230 then being in and out till 530

[Arthur]

Just checking in.. been sleeping 4.5 to 5 hr of unrestful sleep for the past 2 weeks.. dropped 1 mg on the trileptal to 43 mg x 2 day.. face hurts and I feel like total poop.. very depressed 

[Gridley]

On 12/16/2019 at 1:42 PM, Arthur said:

Only sleep 4 to 5 broken hrs last 4 days

I know this is very unpleasant, but really ir's not bad for someone in withdrawal.  I'm going to pass along something one of our moderators, Apace, wrote about sleep that I hope might be helpful.  He has battled insomnia in WD for years and knows a good bit about the subject.

 

"As Gridley has said, and I must echo, there is, unfortunately, no "silver bullet" to withdrawal or any of its symptoms, including insomnia.  If there were, SA would be a much smaller site than it is at this point.  Sadly, it continues to grow as more and more people get caught in the psychiatric medication "web."

 

As Gridley said and you by now clearly understand, insomnia and disordered sleeping is a hallmark of psychiatric medication withdrawal.  It starts earlier than that with many studies making it clear that SSRIs (and other psych meds) frequently suppress REM sleep for those who take the meds.  https://www.sleepio.com/articles/sleep-aids/antidepressants-and-sleep/  Given this as a backdrop, it should be no surprise that coming off the meds can wreak havoc on sleep.  The good news, however, is that the brain works hard to achieve homeostasis and, all other things being equal, the brain will return to a place where sleep becomes, as it should be, a matter of routine.  How long that takes for any one person is impossible to predict.  Having "only" been on an SSRI for 2 years is a positive fact in your recovery, as there are plenty who were on 5-10x longer than that who have healed their lives and their sleep successfully.  But there is no easy formula to apply.  If I could tell you that being on the meds 2 years meant X months of recovery I'd gladly tell you that.  It just doesn't work like that.  It should be a positive and mean a shorter recovery, but there is no certainty.

 

So, what do you do?  In no particular order, some of the things to try:

 

• Don't place too much significance on sleep.  Rest should be the key and when your body absolutely needs to sleep it will.  The anxiety that comes with lying awake and saying "I must sleep" is far worse than the not sleeping.  It's hard but it can be done.
• Try a journaling practice before bed -- get out the things that are on your mind and add 3 things you are grateful for from the day
• Get a sleep ritual in place so that you do the same thing day after day and start to repair your circadian rhythms
• Take a warm bath with epsom salts few hours before bedtime and add in a cup of chamomile tea
• Use lavender essential oils in a diffuser at bedtime
• Exercise early in the day so that you aren't activated near bedtime
• Get outside and get some sunlight early in the day so that your rhythms are reestablished
• Make sure you have a consistent bedtime 
• Try not to be too activated in the couple of hours before bed and, of course, no caffeine
• Add a meditation practice
• Try yoga
• Go for walks in nature

Most insomnia is the result of the body being "hyperstimulated."  It is very hard to calm down an overstimulated body, especially when it is the result of chemical cascades that come as a result of medication use and withdrawal.  But, it can be done to a certain degree and the skills learned will provide valuable as your body improves over time.  

 

From my own perspective, my sleep is still not great, but it it better than it was.  I went through many stretches of 2 or 3 days with zero or an hour or two a night of sleep.  At this point, I have the occasional sleepless night, but most nights I'm good for at least 5 and usually closer to 6 hours.  By "normal" people standards that's not great, but it feels pretty good when compared to 0 or 2-3 hours a night.  As the saying goes, "in the land of the blind the one-eyed man is king!"

 

Try not to let it become the dominant factor in your life.  Over time, it will get better and you will heal.  Just do your best to continue to live your life what your brain is repairing itself."

[Arthur]

Thank you so much.. this is the hardest battle I have ever been thru.. these medicines as so much more powerful that ever given credit for.. I had no clue what I was getting myself into going on and coming off these medications 

[Arthur]

Ok.. so I’m having a very hard time.everytime I got to try and rest I just feel my face hurt worse.. my sleep has been very poor.. I’ve changed nothing on my meds.. just trying to connect with people that are going thru this hell.. I have really bad ear worms where I’m constantly repeating the same song in my head morning till night unless I’m engaged in something.. I think it’s my minds way of protecting it self from the pain in my face and the trauma I have received from it.. I think of wanting to die often but continue forward everyday.. my thinking and judgement aren’t clear at all and I’m living like an animal.. this is very hard..and I very sad..

[Arthur]

Haven’t posted in awhile.. my sleep is awful and have constant burning in my face.. I just don’t now what is going on.. I’ve only managed about 8!hrs of sleep the last 3 days.. I dropped 4 mg off rthe trileptal 2 weeks ago.. my brain feels like mush constantly and my body feels like it’s constantly shaking..I remain on 7.5 mg of Amitriptyline.. and refuse to go up.. need sleep to improve as this is causing me not to be able to work as I need too.. I feel completely defeated.. like what is the point in living if I’m just meant to suffer.. 

[Shep]

18 hours ago, Arthur said:

.I remain on 7.5 mg of Amitriptyline.. and refuse to go up.

 

When did you increase the Amitriptyline to 7.5 mg? Your signature has 5 mg. 

 

What drugs are you taking now and what time(s) fo the day? 

[Arthur]

I need to update my signature which I will do today.. I take 40 mg trileptal and 820 am and pm and take 7.5 mg Amitriptyline at 1020.. and 3 mg melatonin with it.. I wake up at 130 and have a very difficult time going back to sleep.. since dropping  from 42 to 40 mg I developed as twitching in my shoulder muscle that lasted for 4 days.. I also started drinking decaf coffee in the morning for the last 3 weeks that I have cut out I case it was the caffeine that was doing it..I went up to 7.5 mg on January 3rd.. could this still be lexapro withdrawals.. I just don’t know about anything anymore.. the amitriptyline seems to have helped my face pain alittle 

[Arthur]

My dreams are so intense and vivid that that they wake me up..

[Arthur]

I don’t know what to do.. I’m in hell.inkeep going one day at a time.. but when I’m awake time nerve pain in my face hurts me and now I don’t even have the sleep to help pull me thru the day..

[Shep]

On 11/28/2019 at 9:03 AM, Shep said:

Your melatonin dose is high, which could be causing a paradoxical reaction, leading you to wake up a couple hours after taking it. Also, you mention depression being a problem. Too much melatonin can cause this or make it worse. For more on melatonin (including the dose), please see:

 

Melatonin for sleep

 

I posted this earlier in your thread. It really looks like you're getting a paradoxical reaction to the drugs and the melatonin you take at night. That may be why you're waking up in the middle of the night. Please see the above link on Melatonin for Sleep.

 

Also, you recently increased your amitriptyline from 5 mg to 7.5 mg and then reduced the trileptal within a period of just a few weeks, so it's unclear what is causing what. 

 

21 hours ago, Arthur said:

the amitriptyline seems to have helped my face pain alittle 

 

You may want to reduce the melatonin and hold everything else steady for a few weeks. Since you're getting some pain relief from the amitriptyline updose, you may see other improvements by holding. 

[Arthur]

Ok.. I’ll reduce the melatonin and post daily journal on here...thank you... I’ve been in constant pain for 6 months with my face.. plus not sleeping it has been very hard to find hope in anything..

[Arthur]

So I would like to make a quick update. My sleep for the past three days has stabilized at 6.5 hours a night. I cut my melatonin to 1.5 mg and have held my other meds. Thank you for the guidance and I hope things continue to sail smoothly..I still have the dilemma of finding non-drug ways to manage the nerve damage that is in my face that was there before antidepressants. But that is a different bottle all together

[Shep]

21 hours ago, Arthur said:

So I would like to make a quick update. My sleep for the past three days has stabilized at 6.5 hours a night. I cut my melatonin to 1.5 mg and have held my other meds. Thank you for the guidance and I hope things continue to sail smoothly..I still have the dilemma of finding non-drug ways to manage the nerve damage that is in my face that was there before antidepressants. But that is a different bottle all together

 

I'm glad you're sleep is better. Hopefully as you sleep better, you'll have less pain. 

 

Here are ideas of non-drug ways of managing pain:

 

Non-drug techniques for dealing with body pain

[Arthur]

I’ve broken my toe and my toenail is lacerated at the Cuticle.. what can I do from a pain relief stand point.. opioids keep me awake and my biggest problem is insomnia.. I’ve taken some willow bark and a Tylenol but don’t want to over do it.. but I need some pain relief as my toe is throbbing