Emma7855: request for help with Lamictal withdrawal symptoms

[Jmizz]

On 12/29/2019 at 10:24 AM, Emma7855 said:

and I'm starting to think that I developed the DP/DR the same day that I also developed the photophobia, palinopsia, and tinnitus (aka, day after I had some alcohol with a friend in mid-August

 

@Emma7855

im new to the struggle myself, so take this with a grain of salt. Alcohol seems to be bad news. I quit drinking once I figured out the alcohol probably destabilized me when I was still on the lexapro. Hadn’t drank since. On Christmas Eve I didn’t even want to drink, but after about the 12th time my wife’s family asked if I wanted a beer, just in order to fit in and avoid the questions of why I’m not, I took one and drank 4 sips And then walked off and set it down somewhere  just to give the appearance of it to stop the questions. I had horrible DP/DR, tinnitus the following two days and honestly think I’m still trying to recover a week later...4 sips. It sounds like you were sensitized by the klonopin CT and Lamictal drops and alcohol made your symptoms worse. I would steer clear. I won’t be doing it again until this is all a distant memory.

[Emma7855]

Thanks, @Jmizz -- Yeah, I'm not surprised at all. I'm just so frustrated that the one glass of champagne destabilized me so much that I'm still recovering 5 months later. It's like I'm living in a nightmare 24/7. How are you doing now? Also, how did your DP/DR manifest itself? I think I have it but I'm not 100% sure, since my symptoms don't seem typical and don't match up with everyone else's -- I'm instead concerned that I've developed some sort of memory loss, since I can't remember who I am. 

[Emma7855]

Thanks, @Altostrata. Not sure if I'm actually improving or if my mood temporarily better (it tends to wax and wane -- some days I feel amazing, like I'm on top of the world, and other days I feel incredibly depressed and suicidal -- haven't been able to pinpoint any sort of pattern, though I think the low points are triggered by stress from work mixed with anxiety about the future). Of course it helps that I'm on vacation right now and so my stress levels are low!

 

Quote

 

It takes about 4 days for a Lamictal dosage change to take full effect. Looks like you're doing better.

 

Too much melatonin can cause grogginess in the morning.

 

Alcohol doesn't go well with withdrawal. Marijuana is unpredictable. Best not to take any chances with psychoactive substances.

 

You haven't irreversibly damaged neurons. The nervous system is a complex web that can be thrown off-balance by psychotropics. It takes time to re-establish normal communication routes.

 

 

I've cut my melatonin from 3 mg to 1.5 mg. I think the grogginess was due to lack of sleep, but I'll see if taking a smaller amount affects anything. And yes, I've completely cut out alcohol and marijuana. The one time that I tried drinking recently, I had only a few sips of a mixed drink and woke up with a terrible hangover. It's as if my body's forgotten how to process the alcohol.

 

Thanks for the reassurance about my nervous system. I was curious, though -- the reason why I CT'd the Klonopin was because after taking a small dose on and off for a few months, I started noticing that I couldn't recall words (would mix up similar sounding ones, or would forget common phrases, or would forget the prepositions that come after verbs/nouns), and that my short-term memory had deteriorated. Is it normal for this to happen while still on benzos, rather than after going into withdrawal from stopping them? Is there a timeline for recovery, or is it similar to that for withdrawal (aka, everyone is different and so it's impossible to say)? Thanks.

[Altostrata]

3 hours ago, Emma7855 said:

after taking a small dose on and off for a few months, I started noticing that I couldn't recall words (would mix up similar sounding ones, or would forget common phrases, or would forget the prepositions that come after verbs/nouns), and that my short-term memory had deteriorated

 

These are common benzo adverse effects. You will slowly recover from this.

[Emma7855]

Thanks so much, @Altostrata.

[Emma7855]

Hi all - I was wondering if someone could help me determine whether what I am experiencing is DP/DR or something else (memory loss or amnesia?). I posted on the DP/DR thread a while ago, but no one has responded.

 

Here are my symptoms:

- Loss of identify (don't remember who I am, what I enjoyed, my habits, my fears, my aspirations, etc.)

- Loss of connection with family and friends (don't remember how I would interact with them)

- My apartment, work, current home all feel foreign to me (it's as if I just moved here and just started this job)

- Photosensitivity, palinopsia (afterimages stay for ~30 seconds), see tracers, issues with focusing

- Intense brain fog

- Problems with keeping track of time (things that happened recently feel distant and far-removed)

- No longer care about my body, my looks, or how I'm perceived by others

 

I'm confused about whether I have DP/DR because I don't have the other symptoms like observing my body from the outside, seeing the world through coke-shaped glasses, living in a dream-like state, feeling like a robot, OCD, ruminating thoughts, etc.

 

Thanks so much.

[Jmizz]

@Emma7855 it’s confusing to me as well. I tend to get it in times of feeling overwhelmed from stress. My psych said it sounds more like disassociation that I’m describing. I just feel like get foggy and it’s like the world is going on still but I’m stuck in the mud. 

[Altostrata]

You may be feeling a combination of confusion, foggy brain, and depersonalization.

[Jmizz]

@Emma7855 how are you, are you still feeling ok mixing the different tablets?

[Emma7855]

Hi @Jmizz - Thanks for checking in and the response. I haven't sensed any difference between the normal tablets and the chewables. How about you?

[Emma7855]

Thanks for the response, @Altostrata. That makes sense. Is the theory that this will improve once I fully get off the Lamictal? I'm now fully convinced that the visual snow, tinnitus, and depersonalization/confusion all started the day after I had some alcohol, a few weeks after reinstating the Lamictal, and that the bruxism started after I increased the dose the following day. 

 

Also, thinking back, I believe the aphasia and problems with short-term memory started after I stopped taking birth control in March 2019 (after 10 years of taking it non-stop). It's possible that this raised the levels of Lamictal in my blood (there's a moderate interaction between the two) and caused these side-effects. Or maybe it's the Klonopin, but I had been taking it for 9 months as needed without issue. It's so hard to say, since they both have similar cognitive side effects. Do you think it would be worthwhile to start taking birth control pills again, in case the former theory is correct? Sorry for all of the questions!

 

Here are my daily notes:

 

Tuesday, December 31st
- 5:30 AM: Wake up, anxious about flight tickets
- 5:30-9:30 AM: In and out of sleep
- 9:30 AM: Wake up; feel groggy and out of it; low tinnitus
- 4 PM: Work 
- 8 PM: Dinner
- 7:30 PM: Lamictal 25 mg regular + 10 mg chewable
- 12 AM: Go out with friends for NYE

- 7 AM: Sleep

 

Wednesday, January 1st
- 11:30 AM: Wake up; feel out of it
- 1 PM: Lunch; good mood
- 7:30 PM: Lamictal 25 mg regular + 10 mg chewable
- 8:30 PM: Dinner
 

Thursday, January 2nd
- 8 AM (?): Wake up; feel sad, strong brain fog and tinnitus
- 1 PM: Lunch
- 4 PM: Work
- 7:30 PM: Lamictal 25 mg regular + 10 mg chewable
- 7:30 PM: Dinner
- 11 PM: Feel sad 
- 12 AM: Sleep

 

Friday, January 3rd
- 6:30 AM: Wake up
- 8 AM: Fall back asleep
- 9:30 AM: Wake up; feel tired, sad, foggy
- 10:30 AM: Coffee
- 1 PM: Lunch, feel sad
- 8 PM: Dinner
- 8 PM: Lamictal 25 mg regular + 10 mg chewable
- 12 AM: Sleep

 

Saturday, January 4th
- 6:30 AM: Wake up
- 7:30 AM: Fall back asleep
- 9:30 AM: Wake up; feel tired, foggy, sad
- 10:30 AM: Coffee (a couple of sips)
- 11:30 AM: Walk
- 2 PM: Tea with friend; feel better
 

[Altostrata]

How are you sleeping?

 

Are you less groggy in the morning with less melatonin?

[Emma7855]

@Altostrata I've been sleeping okay for the past few months (give or take), but for the past few days I've been waking up early. I think the grogginess was a one-time thing since I usually just wake up with anxiety, sadness, and fear. Maybe I should go back to 3 mg of Melatonin? 

 

Also, I've been taking Lamictal 25 mg regular + 10 mg chewable for a week now. Should I start taking the chewables in the morning? 

 

Thanks for your help.

[Sassenach]

16 hours ago, Emma7855 said:

I believe the aphasia and problems with short-term memory started after I stopped taking birth control in March 2019 (after 10 years of taking it non-stop).

 

16 hours ago, Emma7855 said:

Do you think it would be worthwhile to start taking birth control pills again

@Altostrata

Hi Emma, please do not consider doing this until Alto has a chance to comment.

 

Sass

[Emma7855]

Ok sounds good, thanks so much @Sassenach. 

[Altostrata]

I wouldn't experiment with birth control.

 

Can you start moving 10mg earlier by an hour each day, until you're taking it at noon? Please keep daily notes:

 

[Emma7855]

Ok I'll start that tonight. Thanks @Altostrata.

[Emma7855]

Out of curiosity, has anyone tried non-psychiatric ways of improving their symptoms, and if so, did any of it help? For example, light therapy or cognitive rehabilitation training. I'm wondering if I should take a more active approach to my healing rather than sitting back and waiting for time to pass. Then again, whenever I see a doctor or therapist or focus on my symptoms in some other way, I get incredibly upset, sad, and even occasionally suicidal. These feelings tend to pass, but it usually takes a few days, and the entire time I'm non-functional. I'll go through the therapy/training if it means speeding up my recovery, but otherwise I'd rather not. I tend to fare best when I can ignore everything and pretend that my life is normal -- but is this healthy? Couldn't that be seen as living in a state of denial, which is the opposite of radical acceptance? What are other people's thoughts on this? Thanks.

[Altostrata]

Very good idea! Try different things. See our Symptoms and Self-Care forum for lots of ideas.

[Emma7855]

Thanks, @Altostrata!

[Emma7855]

If I have Tylenol or Advil, will that make my symptoms worse? I have a bad cold and am wondering if I can take something to relieve some of my discomfort (maybe Alka Seltzer?). Thanks.

 

Hi @Altostrata (or anyone else who might know) -- Sorry to belabor the point, but I left out a detail from my history (I didn't think it was pertinent, but in retrospect it definitely is) and I'm wondering if you think it'll affect my recovery. In May of 2015 I went to a festival and took a few recreational drugs (first and last time) while also taking Xanax at the time for my anxiety; afterwards I developed a the following symptoms: tracers, photosensitivity, mild brain fog, mild depersonalization. None of these went away; instead, I learned how to live with them. I didn't get new symptoms until I started messing with my medication doses last year (Prozac) and this year (Klonopin and Lamictal). Do you think my current symptoms are related to these previous ones? Will this extend the length of my recovery, considering I never recovered the first time around? I'm just having this inner monologue saying that if I didn't get better in 4 years, what's to say that I'll get better this time around? It's making me feel really hopeless and upset. Thanks so much. 

[Altostrata]

Your entire history of psychotropic drugs influences how your nervous system reacts to them. It sounds like you got destabilized in 2015, but that is ancient history now.

 

You have used #psychotropic intermittently ever since, plus there are various withdrawals and adverse reactions. Your nervous system will do much better with stability, you'll need to stop occasionally upsetting it with psychotropics and let it heal. This can take a long time but probably is not permanent. You need to take care of yourself and your vulnerable nervous system.

[Emma7855]

Thanks, @Altostrata. Yes, I've learned my lesson; I'm trying my best to give my CNS stability. Dumb question, but is there any way to know whether or not this will be permanent? Also, what are your thoughts on Advil/Tylenol/cold medicine? Thanks.

[Altostrata]

I think I may have answered this before. Because our nervous systems naturally change and adapt all the time, we do not expect withdrawal syndrome to be permanent.

 

Please look in the Symptoms and Self-Care forum for discussions of over-the-counter drugs and supplements.

[Giulietta]

Hello Emma - I finally posted some info I have on working with EF -it's on my thread and 10 a.m. today. Hope it is helpful.  I'm better at providing advice/information than I am following it. With practice we can improve our EF skills. Gridley says WD impairs them - and sorry to say - mine were not up to specs to begin with. That  being said, I'm great at a bunch of other cognitive tasks even though WD impacts them now too.

[Emma7855]

Thanks for the info on EF, @Guilietta -- I really appreciate it.

 

@Altostrata here are my symptoms over the past week. I didn't start moving the Lamictal up an hour until last week because I got sick the week before that. Thanks.

 

Thursday, January 9th (starting to recover from cold)
- Kept waking throughout night
- 9:30 AM: Wake up; everything is bright and visual snow is bad
- 10 AM: Coffee
- 2 PM: Lunch
- 6:30 PM: Dinner
- 8 PM: Lamictal 25 mg regular + 10 mg chewable
- 11:30 PM: Melatonin 3 mg
- 12 AM: Sleep

 

Friday, January 10th (almost recovered from cold)
- 9:00 AM: Wake up; everything is bright, visual snow is strong, and tinnitus is strong
- 10 AM: Coffee
- 1:30 PM: Lunch
- 7:30 PM: Dinner

- 7 PM: Lamictal 10 mg chewable
- 8 PM:  Lamictal 25 mg regular
- 11:30 PM: Melatonin 3 mg 
- 1 AM: Sleep

 

Saturday, January 11th
- Woke up early; couldn't fall asleep for a few hours
- 10:00 AM: Wake up; everything is bright, visual snow is strong, and tinnitus is strong
- 10:30 AM: Coffee
- 1 PM: Lunch

- 6 PM: Lamictal 10 mg chewable
- 7 PM: Dinner
- 8 PM:  Lamictal 25 mg regular
- 11 PM: Melatonin 3 mg 
- 12:30 AM: Sleep

 

Sunday, January 12th
- Woke up early; couldn't fall asleep for a few hours
- 9:30 AM: Wake up; jaw hurts slightly
- 10 AM: Coffee

- 5 PM: Lamictal 10 mg chewable
- 7 PM: Dinner
- 8 PM:  Lamictal 25 mg regular
- 11 PM: Melatonin 3 mg 
- 12 AM: Sleep

 

Monday, January 13th
- 3:30 AM: Wake up; feel numb; everything is bright, visual snow is strong
- 3:30-7 AM: Fall in and out of sleep
- 7:30 AM: Tea
- 10 AM: Breakfast (sautéed potatoes)
- 12:30 PM: Lunch (oatmeal)

- 4 PM: Lamictal 10 mg chewable
- 4:30 PM: Snack (treats from India)
- 8:30 PM: Lamictal 25 mg regular
- 8:30 PM: Dinner (Trader Joe's chicken tikka masala, cookies, pate de fruit)
- 9 PM: Melatonin 1.5 mg
- 10:30 PM: Sleep

 

Tuesday, January 14th
- 5:30 PM: Wake up; feel relaxed but foggy
- 5:30-7:30 AM: Fall in and out of sleep
- 8 AM: Tea
- 10:45 AM: Breakfast (banana)
- 12 PM: Lunch (potatoes and carrots)

- 3 PM: Lamictal 10 mg chewable
- 6 PM: Dinner (potatoes and carrots)
- 7:30 PM: Dessert (Salt and Straw ice cream)
- 8 PM: Lamictal 25 mg regular

- 8:30 PM: Cry because can't recognize my apartment
- 11 PM: Snacks (chocolate, cookie)
- 12 AM: Melatonin 1.5 mg
- 1 AM: Sleep

 

Wednesday, January 15th
- Wake up early; fall in and out of sleep
- 8:30 AM: Wake up; no anxiety but everything is bright, visual snow is strong
- 10:30 AM: Tea
- 12 PM: Lunch (rice and beans, sweet potatoes and peppers)

- 2 PM: Lamictal 10 mg chewable
- 2:30 PM: Tea
- 4:30 PM: Snack (potato, carrots)
- 8:30 PM: Dinner (broccoli, cauliflower, potatoes, keto chocolate) 
- 8:30 PM: Lamictal 25 mg regular
- 10:30 PM: Melatonin 1.5 mg
- 11 PM: Sleep

 

 

Thursday, January 16th
- 7 AM: Wake up; feel okay
- 10:30 AM: Tea
- 12 PM: Lunch (carrots, apple, string cheese)

- 1 PM: Lamictal 10 mg chewable
- 2:30 PM: Tea
- 4:30 PM: Snack (potato, carrots)

- 8 PM: Lamictal 25 mg regular
- 8:30 PM: Dinner (Indian food) 
- 10:30 PM: Melatonin 1.5 mg
- 11 PM: Sleep

 

Friday, January 17th 

- 7 AM: Wake up, no anxiety but everything is bright, visual snow is strong; feel sad

- 11:30 AM: Breakfast (almond milk vanilla latte, pastry)

- 12 PM: Lamictal 10 mg chewable
- 1 PM: Lunch (carrots, apples, string cheese)
- 3:30 PM: Snack (dried bananas) 

[Altostrata]

Overall, do you feel better having separated the lamotrigine doses?

 

Do you eat only a little meat and no dairy? Have you been keeping your eye on your vitamin B12 levels?

 

How much coffee do you drink?

 

I like Indian food, too.

[Emma7855]

Hi @Altostrata -- It's hard to say whether I feel better. My bruxism is less pronounced, but I'm not sure if that's from splitting the lamotrigine or feeling less stress from being on vacation. Everything else is the same, though -- 24/7 depersonalization/dissociation/amnesia/confusion (who am I?), visual anomalies, tinnitus, brain fog, blank mind, and aphasia. I just started trying to improve my eating habits; I'm attempting a whole-food, plant-based diet (Jennifer Leigh, PsyD recommends this -- she went through benzos withdrawal for many years and said that adopting that diet was the last step in her recovery), but I haven't been on it for long enough to tell whether it's helping. If I do adopt the diet long-term, then I'll be sure to regularly test my vitamin B12 levels. Is there a specific supplement brand that you recommend? As for coffee, I was drinking one cup/day but I'm trying to cut back on that too. I find that I sleep better (and my heart racing is less extreme) if I haven't ingested any caffeine that day.

 

Would you recommend that I cut the lamotrigine from 35 mg/day to 31.5 mg/day? If so, would I remove the 3.5 mg from the morning dose or evening dose?

 

Yes, I love Indian! So good. How often do you eat it? What's your favorite dish? Definitely one of my guilty pleasures.

[Emma7855]

@Altostrata, do you have any insights as to whether I should decrease the lamotrigine again? (See previous post.) Thanks!

[Emma7855]

Hi all. I'm currently doing the following:

- Nightly light therapy sessions (where I stare at a lightbulb wearing glasses with pink and then green lenses)

- Weekly EMDR therapy sessions with a counselor who specializes in dissociative disorders

- Weekly CBT therapy sessions with a counselor

- Weekly coaching sessions with someone who went through benzo withdrawal herself

- Biweekly cognitive rehabilitation meetings with a speech-language pathologist 

 

Meanwhile, I'm still attempting to hold down a full-time job.

 

Nothing seems to be working. I'm still having an incredibly hard time coping. Not a single day passes where I don't cry. When I'm by myself, I think about how I don't know how to act or behave, how the old me would have felt this or that way about something, had these thoughts, done these things, etc. When I'm with others, I think about how I can't talk well anymore, my words are all jumbled, nothing makes sense. At work I don't know what to do with myself, everything is too hard. My brain isn't as quick, perceptive, or insightful as it used to be. 

 

I feel so lost and alone. 

 

Please help me.

 

[Shep]

On 1/18/2020 at 6:02 PM, Emma7855 said:

Would you recommend that I cut the lamotrigine from 35 mg/day to 31.5 mg/day? If so, would I remove the 3.5 mg from the morning dose or evening dose?

 

Emma, do you feel that the nighttime lamotrigine is helping with sleep? If so, you may want to reduce the daytime dose. 

 

On 1/24/2020 at 12:58 PM, Emma7855 said:

Nothing seems to be working. I'm still having an incredibly hard time coping.

 

On second thought, since you're struggling so much, you may want to continue holding a bit longer.

 

Please post your thoughts on this. 

[Emma7855]

Thanks for your input, @Shep. Yes, everything remains the same, day in and day out. I'll continue holding for the time being. Is it possible that the lamotrigine is exacerbating my symptoms, though? Is there any way to tell? I originally was taking all 35 mg at night, but then I slowly moved 10 mg to noon; the bruxism improved slightly but that's about it. Thanks for your help.

[Shep]

16 hours ago, Emma7855 said:

Is it possible that the lamotrigine is exacerbating my symptoms, though? Is there any way to tell?

 

It can be hard to tell. All drugs come with side effects, so it's a matter of weighing any side effects against withdrawal effects and making sure you taper slow enough that the withdrawal effects aren't worse than the side effects. 

 

16 hours ago, Emma7855 said:

I originally was taking all 35 mg at night, but then I slowly moved 10 mg to noon; the bruxism improved slightly but that's about it.

 

Did anything get worse by making this change or do you feel it went well? 

[Emma7855]

Thanks, @Shep. Sorry for the confusion; I meant whether the lamotrigine is exacerbating my withdrawal symptoms. I think the only side effect I'm experiencing is bruxism, but maybe it's also contributing to my blurred vision and aphasia? Who knows. It's hard to say because those are also withdrawal symptoms. Before I went off the birth control last year, I didn't have any side effects from it. It's not until that happened that I developed aphasia, though it's possible that the intermittent doses of clonazepam were a contributing factor. Then again, I stopped taking the clonazepam shortly thereafter, and the aphasia still persists to this day... so again, who knows. I'm so confused. I guess I just want to know whether it's more prudent to stay on my current dose of lamotrigine in an effort to give my CNS stability or attempt to taper off of it in case it's contributing to my symptoms. I'll do anything to improve my withdrawal symptoms at this point; I don't care whether that means staying on the lamotrigine indeterminately, if need be. 

 

I think I'm just concerned that I'm actually not in withdrawal but am experiencing a plain old brain injury (or maybe that's just semantics?). Is the indication that you're in withdrawal whether you're sensitive to medication and supplements? Because I am -- I can't touch anything anymore, not even fish oil or magnesium. Though I don't seem to be sensitive to food, thankfully (Or maybe I am but can't tell? I haven't experienced any digestion issues -- would this be the only symptom? I have developed acne, but I assumed that was from the stress of dealing with this.)

 

Quote

Did anything get worse by making this change or do you feel it went well? 

No, I don't think anything got worse. The bruxism got marginally better but that's about it.

 

I also was wondering if you knew this: my aphasia manifests itself as the inability to not only recall words, but also 1) determine which preposition comes after a verb or noun ("going to the store"), 2) recall non-literal phrases ("back to square one" or "chip on your shoulder"), and 3) use time-related words ("after" vs. "before" vs "until"). Is this common? Did you experience anything like this?

 

Thanks for your help.

[Shep]

I'm posting some links for you to read over, along with a couple of videos that explain withdrawal. It may help as you try to sort through this. This is about nervous system destabilization due to polypharmacy, which can take a really long time to heal from. But the symptoms you are describing are very common on this forum. 

 

Problems with Speech or Communicating

 

Language problems

 

How psychiatric drugs remodel your brain

 

What is happening in your brain?

 

One theory of antidepressant withdrawal syndrome

 

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

 

Healing from antidepressants: The power of neuroplasticity video (7.5 minutes)

[Emma7855]

Thank you very much, @Shep.