WilliamAtheling: Off ADs for first time in thirty years

[composter]

5 hours ago, WilliamAtheling said:

Have to assume the “rewiring” also affects moods as well as devastating impact on nerve function?

 

Most definitely true that the withdrawal process affects mood and emotions. I also experienced grinding physical pressure to the brain in my Amitriptyline withdrawal, as well as lots of impatience/snapping which kind of sounds like the anger you describe. It was horrid, and the suffering is very real, I'm sorry you are experiencing this now.

 

Have you tried the reinstatement? I was also hesitant to try the reinstatement but once I did, I saw immediate difference within 4 days...the depression/anguish/paranoia I experienced were the first symptoms to disappear. I think I am much better off now because I did reinstate, and it took me around 8 months to stabilize after I held at that dose. I would have been a sorry shell of myself if I had not reinstated; it was the only thing that could have turned me around. 

 

It takes patience, and a sense of listening to your body to track changes. But after 2 weeks or so on the reinstatement I was infinitely better off than my acute withdrawal state--physical and emotional symptoms had improved and some even disappeared. The thinking goes like this: Since the Amitriptyline is the drug that your receptors have become molded around, tapering too quickly caused havoc in the brain as the receptors did not have time to re-adjust their levels (this neuro-modulation takes time!). At this time, adding the drug back in with a small reinstatement would be a way to help stabilize your brain over the next several months, so that you can get to a better place and taper off slowly and effectively in the future.

[WilliamAtheling]

Thanks. I get that. It’s just I didn’t expect the severity of the withdrawal symptoms to increase over time. It’s like the reward for surging seven weeks is that you feel much worse than you did after four weeks. Another complication in my case is that I was only ever on the amitriptyline for one year. (Venlafaxine for years before that) Previously Doc advised going back on ven, as I seemed to do “well” on that for so long. (Relatively)

Surviving, not surging.

[WilliamAtheling]

Surviving, not surging.

[Sassenach]

Hi William

 

Let us know what Doc says tomorrow.

 

Sassenach

[WilliamAtheling]

Thanks S

 

Will do. Physical nervy symptoms, shaking now intolerable. Seven weeks is obviously a watershed in my case. V dramatic and sudden deterioration. Also, believe it or not, I accidentally took two 25mg amitriptyline tablets Saturday and Sunday. (confused with bp meds) I’m pretty certain this has utterly disabled and confused my nervous system😡

[Altostrata]

On 10/26/2019 at 1:10 PM, WilliamAtheling said:

Thank you again. Have scheduled conversation with Doc on Tues. Will let you know after that. This anguish I’m reporting is not brain fog, brain zaps. It’s like a sort of grinding physical pressure feeling that actually makes your brain hurt when you try to think or communicate. (I’d give a million bucks to have brain fog)

 

Yes, we are very familiar with the entire range of psychiatric drug withdrawal symptoms, including the shaking.

 

Don't expect understanding from your doctor when you discuss taking 5mg amitriptyline for withdrawal. How to talk to a doctor about tapering and withdrawal? What to expect?

 

You might just say you want to titrate up again and see how you feel.

[WilliamAtheling]

28 minutes ago, Altostrata said:

 

Yes, we are very familiar with the entire range of psychiatric drug withdrawal symptoms, including the shaking.

 

Don't expect understanding from your doctor when you discuss taking 5mg amitriptyline for withdrawal. How to talk to a doctor about tapering and withdrawal? What to expect?

 

You might just say you want to titrate up again and see how you feel.

Thanks again. Will report back tomorrow. My shaking is now like Parkinson’s and mental state v confused and edgy. What an own goal to take the amitriptyline at this delicate time.

[WilliamAtheling]

Hi

 

Doc happy to prescribe 10mg amitriptyline. Do I just cut these with a knife?  I sincerely hope they take edge off symptoms, as nerve pain, tremors and muscular stiffness now unbearable.

 

Thanks

 

 

[Sassenach]

Hi William

 

Happy your doctor was understanding.

You can cut them in half with a knife but you can buy pill cutters online or in a chemist for £2-£5 and they ensure consistent doses.

You should take it at the same time every night as it is a sedating drug.

I would suggest you begin tonight.

21 hours ago, WilliamAtheling said:

I’m pretty certain this has utterly disabled and confused my nervous system😡

It will certainly have confused matters but the CNS is remarkably resilient and will settle around the new dose, might just take a little longer than normal.

We have all messed up our doses at some point, just don't do it too often.

Please keep in touch so we can monitor your progress preferably daily for the first couple of weeks.

I would be grateful if you could add the dose to your drug signature so any visiting mod can see instantly you have reinstated.

 

Sassenach

[WilliamAtheling]

1 hour ago, Sassenach said:

Hi William

 

Happy your doctor was understanding.

You can cut them in half with a knife but you can buy pill cutters online or in a chemist for £2-£5 and they ensure consistent doses.

You should take it at the same time every night as it is a sedating drug.

I would suggest you begin tonight.

It will certainly have confused matters but the CNS is remarkably resilient and will settle around the new dose, might just take a little longer than normal.

We have all messed up our doses at some point, just don't do it too often.

Please keep in touch so we can monitor your progress preferably daily for the first couple of weeks.

I would be grateful if you could add the dose to your drug signature so any visiting mod can see instantly you have reinstated.

 

Sassenach

Hi S

 

Have had four days of absolute hell, ranging from unbearable nerve pain to equally unbearable mental anguish and confusion. I will do as you advise, but with a heavy heart.  What if the  “reinstated” dose doesn’t help? Would I end up titrating right back to the level where I had v nasty side effects?) So much so, decided to taper off)

[Sassenach]

2 minutes ago, WilliamAtheling said:

What if the  “reinstated” dose doesn’t help? Would I end up titrating right back to the level where I had v nasty side effects?) So much so, decided to taper off)

Under no circumstances should you go back to the full dose it would carry a real risk of Serotonon Syndrome.

That is why we start a small dose.

It will take a week for the drug to reach full strength in your body.

It is important to keep in touch during this time.

Please advise your symptoms daily starting tomorrow.

If you could post a diary in the following format it would be a big help to us.

DATE:

 

6 a.m. Woke with anxiety 5
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 3
10:00 p.m. Took 50mg Seroquel
10:20 p.m. Feeling dizzy 6
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

The numbers are severity 0-10

 

Don,t forget to update drug signature. It is very important now you are reinstating.

 

Sassenach

[WilliamAtheling]

6 minutes ago, Sassenach said:

Under no circumstances should you go back to the full dose it would carry a real risk of Serotonon Syndrome.

That is why we start a small dose.

It will take a week for the drug to reach full strength in your body.

It is important to keep in touch during this time.

Please advise your symptoms daily starting tomorrow.

If you could post a diary in the following format it would be a big help to us.

DATE:

 

6 a.m. Woke with anxiety 5
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 3
10:00 p.m. Took 50mg Seroquel
10:20 p.m. Feeling dizzy 6
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

The numbers are severity 0-10

 

Don,t forget to update drug signature. It is very important now you are reinstating.

 

Sassenach

 Thanks. Difficult to know what “the full dose” is/was. (0, 25, 50, 75, 100..)

 

(Thought I had updated the signature. 

[Sassenach]

The full dose was 100mgs ie the highest.

Your signature has now updated, thanks.

The reinstatement is not a backward step but a way of taking control back from the drug.

[WilliamAtheling]

12 minutes ago, Sassenach said:

The full dose was 100mgs ie the highest.

Your signature has now updated, thanks.

The reinstatement is not a backward step but a way of taking control back from the drug.

Thanks. 

[Altostrata]

A lot of people do fine with low-dose reinstatement. You may be one of them.

[WilliamAtheling]

35 minutes ago, Altostrata said:

A lot of people do fine with low-dose reinstatement. You may be one of them.

Thanks. If someone told me this agony would only go on for another few weeks, I’d willingly forego the reinstatement with all that it entails and risks. That said, I don’t suppose anyone can predict the pathology of withdrawal?

[Altostrata]

No, cannot predict.

[composter]

8 hours ago, WilliamAtheling said:

If someone told me this agony would only go on for another few weeks, I’d willingly forego the reinstatement with all that it entails and risks. That said, I don’t suppose anyone can predict the pathology of withdrawal?

 

And unfortunately for many people on here, it takes months and even years to recover from a fast taper or cold turkey. Based on what I've read on here, it is unlikely that the suffering will only last a few weeks. If I were you I would choose the reinstatement, as I think the benefits (improvement and stability) outweigh risks (being on the drug for "longer"). However, if you do feel hypersensitive to the reinstatement, that would be a sign it may not work for you. But at this time, better not to be crippled to inaction by thinking of all the possibilities.

 

To echo previous advice about splitting the 10 mg to 5 mg. You can easily obtain either a pill splitter or pill crusher from Amazon/online. Many of us also purchase a jewellers' scale from Amazon as well that can measure precise weights. You want to be as precise as possible while you're trying to reinstate and stabilize, so weighing would help ensure your precision. Take some time to check out some of the guides on this site under the "Tapering" section to learn how you would use the scale and/or pill crusher. Hoping that things turn around for you very soon, friend!

[WilliamAtheling]

11 hours ago, composter said:

 

And unfortunately for many people on here, it takes months and even years to recover from a fast taper or cold turkey. Based on what I've read on here, it is unlikely that the suffering will only last a few weeks. If I were you I would choose the reinstatement, as I think the benefits (improvement and stability) outweigh risks (being on the drug for "longer"). However, if you do feel hypersensitive to the reinstatement, that would be a sign it may not work for you. But at this time, better not to be crippled to inaction by thinking of all the possibilities.

 

To echo previous advice about splitting the 10 mg to 5 mg. You can easily obtain either a pill splitter or pill crusher from Amazon/online. Many of us also purchase a jewellers' scale from Amazon as well that can measure precise weights. You want to be as precise as possible while you're trying to reinstate and stabilize, so weighing would help ensure your precision. Take some time to check out some of the guides on this site under the "Tapering" section to learn how you would use the scale and/or pill crusher. Hoping that things turn around for you very soon, friend!

Hi again

 

Thanks for your interest. Update- I chickened out, so didn’t take the reinstated amitriptyline dose. I dragged myself into work, unable to function with unbearable mental confusion and the usual basket of physical symptoms. 

 

I am am listening to the advice, experience and expertise on here. I think it’s inevitable that I’ll have to go for it. However, it’s like I’m convincing myself I’m v close to the prize of being both clean and well. (Aside from bp reduction, my capacity for exercise has marginally improved)  I think I saw somewhere on here that reinstatement works best within seven months. Is that right? What happens  after that? (Massive relapse, return to original AD at higher dose, death etc?)

 

Thank you.

[Rhiannon]

William, it's hard for us here to strike the right balance between honesty and not scaring people. We have seen a LOT of suffering here. 

 

Today I'm going to take the chance that I might be too scary, and tell you what I honestly think, on the off chance that I might save you some of that suffering. I think that with your long history on so many psych meds and rapid tapers off venlafaxine and amitriptyline recently, and your current symptoms, that what you are feeling now as far as withdrawal is the first rumbling of a coming storm.

 

I could be wrong, sometimes I am, but usually that's in the simpler cases, which sometimes surprise me by going better than expected. I am not often wrong in my expectations with cases like yours. 

 

People can and do spend years disabled and recovering after too-rapid tapers and CTs. 

 

Please consider trying a reinstatement before things get worse.  It probably won't fix you, but it can cushion the harsh landing ahead, and it's a small amount and worth a try. 

 

[WilliamAtheling]

51 minutes ago, Rhiannon said:

William, it's hard for us here to strike the right balance between honesty and not scaring people. We have seen a LOT of suffering here. 

 

Today I'm going to take the chance that I might be too scary, and tell you what I honestly think, on the off chance that I might save you some of that suffering. I think that with your long history on so many psych meds and rapid tapers off venlafaxine and amitriptyline recently, and your current symptoms, that what you are feeling now as far as withdrawal is the first rumbling of a coming storm.

 

I could be wrong, sometimes I am, but usually that's in the simpler cases, which sometimes surprise me by going better than expected. I am not often wrong in my expectations with cases like yours. 

 

People can and do spend years disabled and recovering after too-rapid tapers and CTs. 

 

Please consider trying a reinstatement before things get worse.  It probably won't fix you, but it can cushion the harsh landing ahead, and it's a small amount and worth a try. 

 

Thanks for your honest assessment. I’m not naive about the fragile state of my ns after so many ADs. Fast taper of ven- you’re right about that, but influenced by Dic assurance that I could transition seamlessly to amitriptyline (even though SNRI to TCA). This contrasts with mirtazapine, as I spent two years coming off that. 

 

A “coming storm” is stark and frightening, especially as I feel ghastly now....

[Altostrata]

Just about every one of the people on this site got their doctor's assurances about this or that drug change. Doctors do not know what they do not know about psychiatric drugs.

 

How are you doing on 5mg amitriptyline?

[WilliamAtheling]

4 hours ago, Altostrata said:

Just about every one of the people on this site got their doctor's assurances about this or that drug change. Doctors do not know what they do not know about psychiatric drugs.

 

How are you doing on 5mg amitriptyline?

Hi 

 

Not sure if you read my previous post. Has said I had “chickened out”. 

[Sassenach]

Hello William

 

@Rhiannon assessment unfortunately is not unrealistic.

Because of your med history the longer you delay the worse the symptoms may get.

23 hours ago, WilliamAtheling said:

 I think I saw somewhere on here that reinstatement works best within seven months. Is that right? What happens  after that? (Massive relapse, return to original AD at higher dose, death etc?)

Not sure where you saw 7 months, within one month is our usual recommendation but many including myself can do it successfully later.

You will almost certainly reach a point where the symptoms become intolerable, and reinstatement will become less of a possibility the longer you wait.

It is better to learn from other's mistakes than make your own.

The support on here is the best.

There is really no more I can say.

 

Sassenach

[WilliamAtheling]

16 minutes ago, Sassenach said:

Hello William

 

@Rhiannon assessment unfortunately is not unrealistic.

Because of your med history the longer you delay the worse the symptoms may get.

Not sure where you saw 7 months, within one month is our usual recommendation but many including myself can do it successfully later.

You will almost certainly reach a point where the symptoms become intolerable, and reinstatement will become less of a possibility the longer you wait.

It is better to learn from other's mistakes than make your own.

The support on here is the best.

There is really no more I can say.

 

Sassenach

Hi S

 

Going to start 5mg tonight (7.5 weeks). God knows what I’ll do if reinstatement doesn’t work? (After all, you said going back to original med and dose could produce serotonin syndrome??)

 

Thanks

 

 

 

[Sassenach]

31 minutes ago, WilliamAtheling said:

Going to start 5mg tonight (7.5 weeks). God knows what I’ll do if reinstatement doesn’t work? (After all, you said going back to original med and dose could produce serotonin syndrome??)

Going back to the original dose can cause Serotonin Syndrome.

You are reinstating at 5% of your highest dose.

ie. you will be fine.

 

Sassenach

[Altostrata]

Not serotonin syndrome, but an adverse reaction called kindling, where your symptoms of activation are increased.

 

If 5mg seems too much, try 2.5mg.

[Rhiannon]

23 hours ago, Rhiannon said:

It probably won't fix you, but it can cushion the harsh landing ahead, and it's a small amount and worth a try. 

 

 

57 minutes ago, WilliamAtheling said:

God knows what I’ll do if reinstatement doesn’t work? (After all, you said going back to original med and dose could produce serotonin syndrome??)

 

Thanks

 

 

 

 

At this point there is no magic pill or dose that is going to fix you, but this small reinstatement should help relieve some symptoms and prevent things from getting as bad as they otherwise would have with the CT. 

 

Keep a daily record of your symptoms. I believe there is a thread in the Tapering section about how to do that.  If you find you do well with the 5 mg and you think you may do better on more, you can gradually titrate up until you get to the right reinstatement dose for you. Check in for advice as you go.

 

Don't expect immediate results. You should notice good or bad changes within a week or so, I think. I'm not really expert on the nuts and bolts of reinstatement, Alto and the mods know a lot. More in fact than all but maybe a small handful of doctors anywhere around the globe, unfortunately.

 

Take the time to read as much as you can on the various instructional and informative threads on this site. 

 

 

Edited October 31, 2019 by Rhiannon

[WilliamAtheling]

4 hours ago, Rhiannon said:

 

 

At this point there is no magic pill or dose that is going to fix you, but this small reinstatement should help relieve some symptoms and prevent things from getting as bad as they otherwise would have with the CT. 

 

Keep a daily record of your symptoms. I believe there is a thread in the Tapering section about how to do that.  If you find you do well with the 5 mg and you think you may do better on more, you can gradually titrate up until you get to the right reinstatement dose for you. Check in for advice as you go.

 

Don't expect immediate results. You should notice good or bad changes within a week or so, I think. I'm not really expert on the nuts and bolts of reinstatement, Alto and the mods know a lot. More in fact than all but maybe a small handful of doctors anywhere around the globe, unfortunately.

 

Take the time to read as much as you can on the various instructional and informative threads on this site. 

 

 

Thanks

 

I haven’t changed my mind, just about to take the 5mg tablet. I forgot to mention another weird symptom I’ve had since stopping- a permanent hoarse throat. Not remotely sore, just constantly hoarse.  Have others experienced this?

 

 

[Altostrata]

Please read some of the other Introductions topics to get a larger view of psychiatric drug withdrawal syndrome and how others experience it.

[WilliamAtheling]

5 hours ago, Altostrata said:

Please read some of the other Introductions topics to get a larger view of psychiatric drug withdrawal syndrome and how others experience it.

Ok. Had a quick search, but couldn’t see this specific symptom.

[composter]

13 minutes ago, WilliamAtheling said:

Ok. Had a quick search, but couldn’t see this specific symptom.

 

Sometimes you're not going to find your exact symptom on a thread on here. And that might feel make you feel alone, but remember that we are all different and our withdrawal patterns/symptoms are uniquely our own, like some indiscernible fingerprint. I have a symptom I have never come across in anyone's thread, but it is my most persistent: My head is constantly cold and I wear hats or earmuffs every day, no matter the weather. It's gone on for over a year now through withdrawal, reinstatement, stabilizing, and now tapering. But I will gladly deal with this compared to my 10-12 physical and emotional symptoms in withdrawal.

 

At this point, I would focus on finding stability (my hope is that you truly feel better on the reinstatement) and building acceptance of whatever symptoms cycle in and out, because this process is going to be more of a marathon than a quick sprint. Good to take a long range view to know that it will take time to get out of the worst of it, but things will pass and you will heal. Take a step back from this site if you need. My prayers are with you that you will find some relief on the reinstatement.

[WilliamAtheling]

26 minutes ago, composter said:

 

Sometimes you're not going to find your exact symptom on a thread on here. And that might feel make you feel alone, but remember that we are all different and our withdrawal patterns/symptoms are uniquely our own, like some indiscernible fingerprint. I have a symptom I have never come across in anyone's thread, but it is my most persistent: My head is constantly cold and I wear hats or earmuffs every day, no matter the weather. It's gone on for over a year now through withdrawal, reinstatement, stabilizing, and now tapering. But I will gladly deal with this compared to my 10-12 physical and emotional symptoms in withdrawal.

 

At this point, I would focus on finding stability (my hope is that you truly feel better on the reinstatement) and building acceptance of whatever symptoms cycle in and out, because this process is going to be more of a marathon than a quick sprint. Good to take a long range view to know that it will take time to get out of the worst of it, but things will pass and you will heal. Take a step back from this site if you need. My prayers are with you that you will find some relief on the reinstatement.

Hi

 

Many thanks for your v sincere thought. I v much appreciate and hope you also find some comfort and remission from this ghastly condition.

 

 

[Sassenach]

Hi William

 

How are you doing after reinstatement?

 

S

[WilliamAtheling]

1 hour ago, Sassenach said:

Hi William

 

How are you doing after reinstatement?

 

S

Hi

 

Took first 5mg tablet yesterday (bought pill cutter) Probably too early to discern any difference. Still have shakes, stiffness, and nerve pain. Also heightened anxiety, confusion etc. Good change (I think) is that I slept a bitter better. (Less butterflies waking me up at 4am)

 

Will let you know how I progress. 

 

Much appreciated.

[WilliamAtheling]

Three days after reinstalling 5mg.

 

Suffering with awful mental anguish. This breaks down as uncontrollable anger outbursts, confusion and mental anguish trying to think or communicate etc. (Physical nerve related symptoms just as bad)

 

Will give it a bit longer, but not a good start.  I hope my worst fears are not being realised.