Snorky: Reinstatement of amitriptyline

[Gridley]

1 hour ago, Snorky said:

b) relapse causing chemical imbalance 

 

The chemical imbalance concept, made up by the pharmaceutical companies, has been thoroughly debunked. 

Again, chemical imbalance is a myth. Stop the lies, please ...

 

 

[Snorky]

26 minutes ago, Gridley said:

 

The chemical imbalance concept, made up by the pharmaceutical companies, has been thoroughly debunked. 

Again, chemical imbalance is a myth. Stop the lies, please ...

 

 

I understand that. The problem is something has triggered this new, debilitating and terrifying symptom. I don’t think I’ve ever experienced something like this. Hopefully it’s adverse reaction and will go when I stop. Otherwise WD, but probably impossible to treat other than new meds????

[Gridley]

45 minutes ago, Snorky said:

Hopefully it’s adverse reaction and will go when I stop. Otherwise WD, but probably impossible to treat other than new meds????

Unfortunately, the effects of adverse reaction don't stop immediately upon cessation of the drug, though they do go away in time. Regarding withdrawal, these symptoms also go away in time, though in both cases we can't tell you how much time.  

 

No, there is no treatment for withdrawal that we offer, except time and techniques and recommendations based on our experience.

 

Whether or not you go on a new med is of course up to you.   

Edited November 25, 2019 by Gridley

[Snorky]

19 minutes ago, Gridley said:

Unfortunately, the effects of adverse reaction don't stop immediately upon cessation of the drug, though they do go away in time. Regarding withdrawal, these symptoms also go away in time, though in both cases we can't tell you how much time.  No, there is no treatment for withdrawal that we offer, except time and techniques and recommendations based on our experience.

 

Whether or not you go on a new med is of course up to you.   

Hi

 

Believe me, if you had this particular symptom, you’d not be able to tolerate for more than a day or so. Ironically, I asked Doc last week about risk of permanent nerve damage due to pain on 5mg. He reassured me on that, particularly as Amitriptyline is used to combat nerve pain😀 I think I’ll ask him equivalent question about longevity of these mood/psychological symptoms following discontinuation. I wouldn’t have thought a common withdrawal symptom as only kicking in 10 weeks after initial withdrawal and also severity.

 

[Gridley]

44 minutes ago, Snorky said:

I wouldn’t have thought a common withdrawal symptom as only kicking in 10 weeks after initial withdrawal and also severity.

 

It is very common for withdrawal to commence around the three month mark.

 

44 minutes ago, Snorky said:

I think I’ll ask him equivalent question about longevity of these mood/psychological symptoms following discontinuation.

 

Doctors generally know nothing about protracted withdrawal and in fact don';t believe it exists, though perhaps your doctor is better informed.

The UK recently revised its guidelines to caution about severe and prolonged withdrawal.

 

UK's NICE health guidelines now caution about severe and ...

 

From the guidelines:

"Symptoms can vary in form and intensity and occur in any combination. They are usually mild and self-limiting, but can be severe and prolonged, particularly if withdrawal is abrupt. ...

The symptoms of a discontinuation reaction may be mistaken for a relapse of illness or the emergence of a new physical illness (Haddad, 2001) leading to unnecessary investigations or reintroduction of the antidepressant. Symptoms may be severe enough to interfere with daily functioning."

 

[Snorky]

29 minutes ago, Gridley said:

 

It is very common for withdrawal to commence around the three month mark.

 

 

Doctors generally know nothing about protracted withdrawal and in fact don';t believe it exists, though perhaps your doctor is better informed.

The UK recently revised its guidelines to caution about severe and prolonged withdrawal.

 

UK's NICE health guidelines now caution about severe and ...

 

From the guidelines:

"Symptoms can vary in form and intensity and occur in any combination. They are usually mild and self-limiting, but can be severe and prolonged, particularly if withdrawal is abrupt. ...

The symptoms of a discontinuation reaction may be mistaken for a relapse of illness or the emergence of a new physical illness (Haddad, 2001) leading to unnecessary investigations or reintroduction of the antidepressant. Symptoms may be severe enough to interfere with daily functioning."

 

Hi again

 

Will read those articles. I guess I’m hanging onto hope that it’s adverse effects. After all, would just be my luck for it to be WD symptom which coincides with exact time I took the 2.mg dose?

[Snorky]

Forgot to mention. My particular nasty symptom seems so sudden, tangible and out of sync with anything before. I don’t know how something of that magnitude would be improved by “time and techniques”? Please don’t think I’m sceptical, v grateful and receptive. Am just experiencing v terrifying symptom currently.  Will let you know what Doc says tomorrow, but definitely stopping tonight.

 

Thanks

[Gridley]

1 hour ago, Snorky said:

v terrifying symptom

 

I'm sorry you're having such a difficult time.  Believe me, I sympathize.

 

Here's something that might help.  We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system. Magnesium glycinate is a good form of magnesium.

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Please add in one at a time and at a low dose in case you do experience problems.

 

[Snorky]

12 minutes ago, Gridley said:

 

I'm sorry you're having such a difficult time.  Believe me, I sympathize.

 

Here's something that might help.  We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system. Magnesium glycinate is a good form of magnesium.

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Please add in one at a time and at a low dose in case you do experience problems.

 

Hi

 

I’m willing to try anything. My main worry is the mental exhaustion type feeling is less likely to respond to supplements than the nervy symptoms and shakes. I have to say they’re just become a sideshow.

 

Thanks

[Snorky]

Wondering whether it could be serotonin syndrome?

[Gridley]

36 minutes ago, Snorky said:

serotonin syndrome?

 

Here's a link so you can see if your symptoms match what's described.

Serotonin Syndrome or Serotonin Toxicity - Symptoms and ...

[Snorky]

30 minutes ago, Gridley said:

 

Here's a link so you can see if your symptoms match what's described.

Serotonin Syndrome or Serotonin Toxicity - Symptoms and ...

Thanks. Looked at SS symptoms. Certainly ticks some boxes, agitation, confusion, restlessness, tremors, muscular rigidity, goosebumps, shivering, nausea and loss of appetite.

[Snorky]

34 minutes ago, Gridley said:

 

Here's a link so you can see if your symptoms match what's described.

Serotonin Syndrome or Serotonin Toxicity - Symptoms and ...

Thanks. Looked at SS symptoms. Certainly ticks some boxes, agitation, confusion, restlessness, tremors, muscular rigidity, goosebumps, shivering, nausea and loss of appetite.

[Snorky]

Other thing is why only kick in on 2.5mg, not 5? (Maybe a combined effect). Also not multiple meds.

[Gridley]

2 minutes ago, Snorky said:

agitation, confusion, restlessness, tremors, muscular rigidity, goosebumps, shivering, nausea and loss of appetite.

Of course, these could also be withdrawal or adverse reaction symptoms.  The fact that you didn't have these symptoms on the much higher doses you were on previously would seem to argue against serotonin syndrome.

 

 

 

 

[Snorky]

6 minutes ago, Gridley said:

Of course, these could also be withdrawal or adverse reaction symptoms.  The fact that you didn't have these symptoms on the much higher doses you were on previously would seem to argue against serotonin syndrome.

 

 

 

 

Agreed. Thanks

[Snorky]

Update

 

Just saw Doc. 

 

Emphasised scale of v recent crushing mental, mood symptoms, agitated etc. Also loss of appetite and insomnia.

Review to see if symptoms improve (adverse reaction)

Consider next steps once med washed out (few weeks) 

He reiterated his view that some anxiety about med May have contributed.

 

Thanks

 

[Snorky]

Further update 

 

Been off 2.5 mg for two days. Feel v anxious, confused, agitated, gnawing in stomach. Also still some of the depressed, restlessness, hopelessness symptoms. A nervous wreck in fact.

 

Feel like double whammy of continuing “adverse effects” and mini cold turkey (initial cold turkey Sept, followed by reinstatement cold turkey???)

 

Thankd

[Gridley]

3 hours ago, Snorky said:

followed by reinstatement cold turkey???)

I doubt if that is the main problem.  However, your system is adapting to the dose change, which would cause some symptoms.  I'd still think it's a combination of adverse effect and WD.

 

 

[Snorky]

1 hour ago, Gridley said:

I doubt if that is the main problem.  However, your system is adapting to the dose change, which would cause some symptoms.  I'd still think it's a combination of adverse effect and WD.

 

 

Thanks again. I’m wondering whether it’s more WD, as such a small dose to provoke adverse reaction? (5mg for three weeks causing physical symptoms, followed by 2.5mg causing unbearable mental/mood changes)

 

Other palpable thing earlier was very obvious loneliness and need to seek out company of others. 

[Gridley]

2 minutes ago, Snorky said:

WD, as such a small dose to provoke adverse reaction?

Could be, from the drop from 25mg.  There's no way to really tell; symptoms are very similar.

[Snorky]

4 hours ago, Gridley said:

Could be, from the drop from 25mg.  There's no way to really tell; symptoms are very similar.

17.24 here. Feeling v frequent awful waves of horrendous mental feelings, while watching TV. Like a grinding feeling that stops you listening, enjoying, understanding. Seem to be accompanied by black/hopeless feelings. Feel just as bad as I did on Monday. This is following two consecutive nights of not taking the 2.5mg. Came on about an hour ago. Not sure they’d be considered as “zaps”? 

[Snorky]

Think zaps are more physical sensations. These are v much psychological feelings.  A sort of tightening/shuddering , but accompanied a powerful depressive sensation. Everything black and hopeless.

[Snorky]

10.53 Nov 28 (three days after stopping) 

 

Continuation of mental anguish, confusion, agitation and strain. Also tremors and dizzy.  Just my luck that this is looking increasingly like longer term WD, than simple adverse reaction to 2.5mg amitriptyline. 

 

Keep sitting here waiting for inevitable waves of unbearable mental strain and depression/hopelessness symptoms. 

 

Have a med cert until 9 Dec. Condition either has to improve by then, either naturally or via new ADs. If further deterioration, would have to stay off and risk half pay/no pay.

 

Thanks

 

 

[Snorky]

Hi

 

Update

 

17.16 and another “wave” of crucifying mental confusion and anguish. Stops you in your tracks, whether watching YV, listening, communicating. A palpable tightness and strain which is unbearable. Mentioned b4 I don’t think these are conventional zaps. Can I reach out to anyone who can explain or relate to these ghastly symptoms?

 

Thanks

[Snorky]

Watching “TV”

[Freedom15]

Hi Snorky

 

i think it may be a good idea to have a look at my post as i have been in the same situation as you with regards

to coming off amitriptaline cold turkey being left with horrific withdrawl and then having to reinstate.

 

Reinstatement for me was vary hard as it did not get me to what a normal human being would consider

to be stability and it took a good 6 months for me to be in place where i was able to get out the door

every day. I had to live with horric side effects so i could stay on the meds and slowly taper down.

 

Everything that you have shared i have proberbly had at a point in the last 5 years. It's also vary hard to

decide which is WD or Side effects.

 

The first thing to do is remember that even tho it may feel like you are in not a vary good place right now long term

you will improve. It takes time and no body has any idea how long tho unfortunatly.

 

Sending prayers out to you that you get some rest from the symptoms soon.

 

I started my journey in 2014 and i am still here now in 2019 and i did not think i was going to make it

so it is possible to carry on and get through this. Altho it is the tuffest thing i have ever had to do in my life.

 

 

[Snorky]

18 minutes ago, Freedom15 said:

Hi Snorky

 

i think it may be a good idea to have a look at my post as i have been in the same situation as you with regards

to coming off amitriptaline cold turkey being left with horrific withdrawl and then having to reinstate.

 

Reinstatement for me was vary hard as it did not get me to what a normal human being would consider

to be stability and it took a good 6 months for me to be in place where i was able to get out the door

every day. I had to live with horric side effects so i could stay on the meds and slowly taper down.

 

Everything that you have shared i have proberbly had at a point in the last 5 years. It's also vary hard to

decide which is WD or Side effects.

 

The first thing to do is remember that even tho it may feel like you are in not a vary good place right now long term

you will improve. It takes time and no body has any idea how long tho unfortunatly.

 

Sending prayers out to you that you get some rest from the symptoms soon.

 

I started my journey in 2014 and i am still here now in 2019 and i did not think i was going to make it

so it is possible to carry on and get through this. Altho it is the tuffest thing i have ever had to do in my life.

 

 

Hi again

 

Many thanks for your kind thoughts. I know I’m a naturally anxious and negative type, so that doesn’t help.  When I feel such obvious, rapid deterioration in symptoms, I begin to think chemical triggers/imbalance (for whatever reason). I know that goes against the grain as far as many are concerned.  I don’t think I can reinstate again, after what I’ve been through in last month.

 

My confusion, anxiety and anguish is so bad, I can hardly communicate with my husband and 17 year old son. 

 

I’ve already had two weeks off work. I have another week left, and then will have to go back to Doc or somehow go back to work. I was v conscious that there were Would stress and anxiety associated with going back to work, in addition to specific med issues (WD and adverse effects). However, the bigger risk is that of being on the verge of some sort of breakdown and not being able to ever go back😡

 

Thanks

[Snorky]

Hi All

 

Further update. 9.57 am here, and stiff suffering with awful mental anguish. Like a constant crushing internal pressure that stops you sleeping, thinking and communicating. Had it solidly since 16.00 Friday, so 42 hours now. Isn't that a bit long for a "wave"?

 

It's accompanied by a palpable feeling of depression. 

 

Needless to say, also only getting about 2 hours sleep a night. 

 

Thanks

[Snorky]

Hi again

 

At the end of my tether now. As well as constant mental anguish, now feel in 

palpably depressed mood. Can’t sustain this situation much longer. Also saw pharmacist today. (She’s a fellow sufferer and been on ADs for years. I hadn’t seen her for ages, so had a catch up, explaining all symptoms. She said so should reinstate Venlafaxine. (previously on this for ages b4 amitriptyline) She also advicated the Keto diet and some supplements. She takes supplements alongside her ADs, not instead of them.

 

No idea what to do now.

 

1. Carry on fighting, hoping gloom, anguish and other symptoms will ease.

2. Restart ven with all the risks of side effects, destabilisation and playing Russian Roulette again.

 

Thanks

 

 

[Gridley]

53 minutes ago, Snorky said:

 

1. Carry on fighting, hoping gloom, anguish and other symptoms will ease.

2. Restart ven with all the risks of side effects, destabilisation and playing Russian Roulette again.

 

 

I wish I could tell you what to do, but I can't.  It will have to be your decision.  We are a site for going off drugs.  Going by what you wrote in option 2, you have a clear understanding of the risks involved.  I would only add that your central nervous system is not the same CNS it was when you were previously on ven, having been sensitized and destabilized by what you've gone through with the amitriptyline, whether it's withdrawal or adverse reaction or some combination.

 

You know our view on supplements, so that will have to be your decision also.

[Snorky]

13 minutes ago, Gridley said:

 

I wish I could tell you what to do, but I can't.  It will have to be your decision.  We are a site for going off drugs.  Going by what you wrote in option 2, you have a clear understanding of the risks involved.  I would only add that your central nervous system is not the same CNS it was when you were previously on ven, having been sensitized and destabilized by what you've gone through with the amitriptyline, whether it's withdrawal or adverse reaction or some combination.

 

You know our view on supplements, so that will have to be your decision also.

Hi again

 

Can you refresh my memory on use of supplements?

 

Thanks

[Gridley]

8 minutes ago, Snorky said:

Can you refresh my memory on use of supplements?

 

Here it is:

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Please research all supplements first and only add in one at a time and at a low dose in case you do experience problems.

[Snorky]

21 minutes ago, Gridley said:

 

Here it is:

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Please research all supplements first and only add in one at a time and at a low dose in case you do experience problems.

Thank you. Yes, pharmacist also recommended magnesium to sort the awful insomnia I’ve been having. 

 

Re two options. I’d willingly go through pain barrier if there was a scintilla of hope, improvement (aka window). It’s all downhill at moment, with last few days worse than anything before. As well as intensification, adding new ones, like the insomnia and sudden loss of appetite.

 

I’d love to know how/what others would do  on these circumstances.

 

Thank you.

[Snorky]

Final update

 

Had about five mins sleep last night, so insomnia unbearable now. Just when you thought it couldn't get any worse, suddenly started hearing "sounds". One like bell ringing, the other birds singing even though midnight. Clearly not happening, but brain obviously creating this impression. Is this psychotic type of episode another feature of WD, or an indication of a more serious change?

 

Thanks

[Snorky]

Hi again

 

Was wondering if others/other mods might report on their experiences where symptoms of withdrawal became intolerable (reinstatement failed etc)

 

Also particularly interested in others experiences re sounds/hallucinations during withdrawal.

 

Thanks as always.