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Tootles: Please help don't know where to go from here - reinstating medication

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Tootles

This painful journey started when i was 21 years old...

 

I was addicted to Cannabis, had a difficult adolescence and all i needed was help to stop using drugs, my hormones checked, and therapy. I know that now.

 

After a bad break up due to my addiction and mental health i was put on Citalopram. I was still smoking Cannabis chronically every day, and as i was showing little improvement they increased my dosage to 40mg after nearly 2 years on them. It made me manic, indifferent, and dangerously wreckless. I crashed my car at 100 mph having woken up late for work far too many times due to how drowsy i always was on the meds, and i was driving as if i was possessed. I survived an operation to fix a bleed on my brain. However in hospital they stopped the Citalopram dead. They never even mentioned it, and i couldnt remember and it obviously wasn't of a concern at all to them. 6 months after i went back to the doctors with a feeling of something missing from myself. I'd gone back to Cannabis after my accident for the same reason, something was missing and i felt so weird like everything i used to enjoy just meant nothing to me. Like id lost my soul, and i needed to feel happier. Not the long term answer. So they put me on Duloextine (cymbalta). Never discussed the side effects, withdrawl, possible permanent damage, effectiveness of these drugs ever, it wasnt once mentioned. Just that they woulld make me feel better,  I had a chemical imbalance that needed to be fixed.

 

So they parked me on them for 8 years ignoring all my worries over things i was experiencing whilst on the medication. Every concern was met with them upping my dosage. It didnt stop me smoking Cannabis infact it only compounded my addiciton, as the meds gave me what i now know as Akathesia and the only thing that helped was smoking Cannabis. The only time i was anywhere close to being content whilst on the medication was when i smoked. I finally decided i didn't want to be on the medication anymore, i went to the doctor and said that i wanted to see how id feel without them, and my GP said to simply reduce the tablets over 2 weeks. I was on 90mg of Duloxetine (cymbalta) at the time. I never realised the seriousness of not properly tapering,  and being told to do so over such a short period of time was clearly detimental. Especially after 10 years of medication.

 

It's been 3 years since my last dose. I don't speak to my friends, all desire has gone. My anxiety is through the roof, i'm never calm. I have no real life. I'm even finding work near impossible.

The cannabis turned on me as well when i stopped talking the Duloxetine (cymbalta) , the withdrawl i think has been a big reason for that, but i decided to try and stop smoking.  Never made me feel like that before i was put on antidepressants but it was making me worse at the time. I am now left pathogically anxious alot of the time, like i said no desire to do anything, all my loves, my hopes, my dreams have died. I was never this bad before i started taking meds. I don't know who i am without them but i dont want to be on medication, certainly cant accept being on them for life to regain some normality.

 

I've been praying that time would heal me but it appears it has done nothing to help. 

 

My question to the community 

 

I've been struggling with whether to go back on them at a low dose. But i'm scared, and i didn't want them in the first place, i've gone 3 years, but it's not been a happy time. I dont want to have to go through any elevated Akathesia again, or be left with more permanent side effects by going back on them at all. My family and girlfriend don't want me to take them again. I'm being pulled every which way. But i can't stay this way :( I've waited over 18 months so far for therapy with a Neuro Phyiatrist and the NHS still havent approved it. I don't know if it will even help...  

 

- Should i talk to my doctor about going on a very low dose of my previous meds? Or has it been too long now?

 

- Should i entertain taking these sketchy things ever again?

 

I would really appreciate the communties advice.

 

The only other thing i have left to try is looking down the route of thinking my testosterone has always been an issue. But most doctors in the UK dont subscribe to it but i haven't totally given up on the thought of trialling TRT to see if it makes a differnence. I've had a blood test my serum levels are considered normal however guidleines are vitally flawed, and i have had no idea what they were before i started taking Anti-Depressants) but i have high SHBG which means my free testosterone is very low. But doctors won't offer any diagnosis or solution to that issue.  Has anyone had any experience or success with this? 

 

Many Thanks ❤️ 

 

 

 

 

 

Edited by Shep
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Gridley

Welcome to SA, Tootles.

 

We are a site for going off psychiatric drugs and helping members deal with withdrawal from those drugs.  As such, it's beyond our purview to recommend drugs.  The major exception to that is a reinstatement of a small dose of the original drug.  However, at three years out reinstatement could be risky and might make matters worse (three months is the time frame that reinstatement most predictably works).

 

Unbelievable as it may seems, three years out is not extremely long in terms of experiencing withdrawal, what we call PAWS (post-cute withdrawal syndrome), especially after your virtual cold turkey of Cymbalta.  Doctors don't believe protracted withdrawal exists.  As you know, it does.  All the symptoms you describe are typical withdrawal symptoms.  You will heal, but unfortunately we can't tell you how long it will take.

Protracted Withdrawal or PAWS (post-acute withdrawal ...

What is withdrawal syndrome.

 

Glenmullen’s withdrawal symptom list.

 

When we take medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.  

 

Since our systems are so sensitized during withdrawal, I would be wary of testosterone therapy.  Altostrata, founder of this site wrote:

 

"In general, I would be careful with any steroid therapy during withdrawal (or any other time). Bumping up one hormone tends to imbalance everything else, because the body depends on self-regulation."

 

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.

 

We recommend no drug coping skills to deal with withdrawal.  Take a look at the technique in the following link and see which you think might be beneficial to you.

 

Non-drug techniques to cope

 

These techniques re designed to help copy with anxiety.

 

Audio:  First Aid for Panic (4 minutes)
 

 Audio:  How to Recover from Anxiety - Dr Claire Weekes
 

VIDEO:  Peace from Nervous Suffering - Claire Weekes (1 hour) (http://sendvid.com/vgquc1dg)
 

Anxiety Stuff - all kinds of stuff about anxiety attacks and things that help …

 

10 minute Restorative Yoga for Relaxation | Up the wall

 

This is your Introduction topic where you can ask questions and connect with other members.  We're glad you found your way here.

 

 

 

 

 

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Tootles

I really appreciate your reply and the advice than reinstatement is a risky affair having been off of the meds for 3 years now. Has anyone had experience of going back on meds after that sort of time and then tapering off properly once some sort of normality has been reached within yourself? 

 

I just need something to change. I miss whatever normality i had before. It's come to the point now after 3 years where if i have to choose between the way i've been left feeling,  and just letting my doctors put me back on AD's.... i feel like just giving in to them now :( 

 

 

 

 

 

 

 

 

 

 

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manymoretodays

Welcome aboard Tootles,

 

18 hours ago, Tootles said:

I just need something to change. I miss whatever normality i had before. It's come to the point now after 3 years where if i have to choose between the way i've been left feeling,  and just letting my doctors put me back on AD's.... i feel like just giving in to them now :(

 

Sounds trite, but this too, will pass.  Keep on working on some of the things, that had you seeking out psychiatric care, more than 10 years ago.  Some of us do therapy, once we've established a good connection with a therapist.  Or do it on our own.  No doubt we've all got extensive collections of self help books of all kinds.  And more than likely, you are just in a protracted acute withdrawal wave.  On to the windows!!!

The Windows and Waves Pattern of Stabilization

L, P, H, and G,

mmt

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Ogres
On 12/12/2019 at 11:48 PM, Tootles said:

The only other thing i have left to try is looking down the route of thinking my testosterone has always been an issue. But most doctors in the UK dont subscribe to it but i haven't totally given up on the thought of trialling TRT to see if it makes a differnence. I've had a blood test my serum levels are considered normal however guidleines are vitally flawed, and i have had no idea what they were before i started taking Anti-Depressants) but i have high SHBG which means my free testosterone is very low. But doctors won't offer any diagnosis or solution to that issue.  Has anyone had any experience or success with this? 

 

Hi Tootles,

I've noticed similar thing with my testo. Firstly, I noticed it in the gym and in the mirror. And then I got tested, the result for serum testosterone was still within normal range, however, both SHBG and prolactin were somewhat high. And even serum testosterone dropped lower than it should have done with normal aging (I tested it several years prior). I was reading on this subject and the mechanism might be that 

when SSRIs (or getting off of them) deplete the brain of dopamine (manifesting in the well known symptom anhedonia), prolactin occupies the same receptors which in turn inversely correlate with LH and FSH levels (precursors to testosterone). It's probably a very simplistic explanation, but the only one I could find.

I'm 3 year and 4 months off of ADs and wondering whether this situation will resolve on its own.. Or I should try some TRT cycle to jump start the system. Or maybe dopamine agonists would help to restore dopamine levels... Who knows...  Just don't won't to mess it up even more.

Would be good to know if anyone had the same situation with hormones and whether and how it has resolved. 

all the best 

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Tootles

Hi many more todays, thankyou for your reply.

 

It doesn't sound trite just hard to believe that's where i am at, (meaning in a 'post withdrawal wave') . I must admit i don't feel i ever have any 'windows'. The trouble i have is i have never known where i start and end. I'm massively struggling not to buckle, I have a box of Cymblata in my drawer that i keep picking up and holding in my hands with the thoughts of just giving in, that i cant live a happy life without them, just a low dose couldn't hurt.

 

That's the trouble i have every doctor telling me it wont hurt to just try a low dose. Alot of my friends are on AD's and of course our relationships have broken down and i have isolated myself because i get pulled every which way by the fact they are all on medication and stand behind them. They see them as necessary and don't agree that they are detrimental in any way. They are happier on them.

 

You only get one life and i feel i am wasting so much of it going through something i don't have to, :( i could just go back on medication. The trouble is i honestly have read and absorbed so much conflicting information surrounding AD's i don't even know what to believe anymore... It's driving me crazy.

 

 

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Tootles

Hi Ogres. thankyou for your reply, i have been battling with the same thoughts, could a short course bump start you? I fear it's not how it works and TRT is something you have to commit to, obviously with it's own side effects and will stop your natural production totally. And as soon as you stop taking it you are going to revert back to how you were before. Interesting you should mention the dopamine aspect though, i am yet to find an Endo/Androgen doctor that is open minded enough/cares enough to do the appropriate investigations leaving no stone unturned. I had a severe head injury which could have exacerbated my issues, as the hypothalamus is responsible for distributing hormones, and yet i've never had a scan to check my pituitary gland etc. Again any artificial stimulation re:dopemine agonists is probably only going to be effective for the time you are taking the medication. Like you said who knows though. Again like you my friend i don't want to mess anything else up, i feel that's how the cocktail of medication begins. One thing to fix the other and so on and so forth, my apologies i can't be of much help, i'm just as much at a loss as to the answers, but if you are in the GYM good on you! because that's something i still cant bring myself to do! :( 

 

All the best, 

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manymoretodays

Hi Tootles,

Yes, many of us go through the same thing when our old understanding, shifts to something new.

There are a lot of books out there now, that support your present paradigm.  Take a look at some of the Success Stories too!  FarmGirlWorks just did one, and there are some references listed there(books) that might help.

Also in our media and journals forums.

 

It does get easier, with the friends who follow a different drummer.......or it has for me.  I was much sicker on the meds/drugs........I have no doubt in my mind about that, and so.......sometimes will just share how much better I am now.......overall, with a caution too.......so that no-one will misconstrue and go out and suddenly CT off their medications.  I do include that, I finally tapered carefully to get off my medications......and that I believe that is the best way.

 

Could you do a signature Tootles?

Please put your withdrawal history in your signature

^ just follow the instructions

 

Try some of the stuff that Gridley gave you too, on anxiety, and take a look at all the non-drug coping ideas now.  There are so many non-drug skills to learn and hone up on, which can really help one get through some of the hardships of WD.

 

Best,

L, P, H, and G,

mmt

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Ogres
On 2/8/2020 at 2:30 PM, Tootles said:

Hi Ogres. thankyou for your reply, i have been battling with the same thoughts, could a short course bump start you? I fear it's not how it works and TRT is something you have to commit to, obviously with it's own side effects and will stop your natural production totally. And as soon as you stop taking it you are going to revert back to how you were before. Interesting you should mention the dopamine aspect though, i am yet to find an Endo/Androgen doctor that is open minded enough/cares enough to do the appropriate investigations leaving no stone unturned. I had a severe head injury which could have exacerbated my issues, as the hypothalamus is responsible for distributing hormones, and yet i've never had a scan to check my pituitary gland etc. Again any artificial stimulation re:dopemine agonists is probably only going to be effective for the time you are taking the medication. Like you said who knows though. Again like you my friend i don't want to mess anything else up, i feel that's how the cocktail of medication begins. One thing to fix the other and so on and so forth, my apologies i can't be of much help, i'm just as much at a loss as to the answers, but if you are in the GYM good on you! because that's something i still cant bring myself to do! :( 

 

All the best, 

Hi Tootles,

Agree with what you’re saying re TRT (it being a long term solution with side effects, etc). But at the same time, what if low hormones are the reason for a lot of our symptoms, and not the withdrawal itself? Like many examples on SA can confirm, sometimes, people are being put on ADs unnecessary without proper examination for hormonal issues which are the root causes in the first place. Same thing might be with withdrawal. I sometimes think that at least TRT might give answers to whether some of the symptoms are due to hormones or not. Obviously, we must exhaust all non-drug ways first. But for me, it’s soon going to be 3.5 years off of ADs. How long more should I wait for the improvement (though, I’ve made progress, no question about that)? I think I’m doing what can possibly be done to enable natural healing: nutrition, exercise, no alcohol, sleep quality, etc. What if full recovery never comes? What if hormonal issues are only going to get worse and already causing symptoms which I wrongly assume to be due to WD? One can argue what is worse: exogenous testosterone or Prozac. Well, at least there are actual testosterone receptors in our bodies. And no one knows how exactly ADs work and there are certainly no Prozac receptors. Who knows maybe normal levels of testo will trigger cascade of all sorts of favorable reactions and processes (dopamine, etc) which were dormant after SSRIs/WD and will continue after TRT discontinuation. Of course, the reaction might be unfavorable. But if comparing how many lives have been ruined by steroids and by ADs, I think ADs certainly are a winner even though steroids are normally taken in supra-physiological doses. And TRT is completely different to taking steroids for enormous muscles gain. But rather for normalization of low levels. Anyway… One can argue for a long time about this.

I hope you’re feeling better and continue to improve. Just a suggestion that maybe you try exercise if you’re safe to do so. From experience, when I was in the middle of WD and feeling very anxious, exercising (and lifting weights in particular) helped me greatly. I felt markedly calmer afterwards. 

Wishing you all the best. 

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miomio
On 12/13/2019 at 9:42 PM, Gridley said:

Welcome to SA, Tootles.

 

We are a site for going off psychiatric drugs and helping members deal with withdrawal from those drugs.  As such, it's beyond our purview to recommend drugs.  The major exception to that is a reinstatement of a small dose of the original drug.  However, at three years out reinstatement could be risky and might make matters worse (three months is the time frame that reinstatement most predictably works).

 

Unbelievable as it may seems, three years out is not extremely long in terms of experiencing withdrawal, what we call PAWS (post-cute withdrawal syndrome), especially after your virtual cold turkey of Cymbalta.  Doctors don't believe protracted withdrawal exists.  As you know, it does.  All the symptoms you describe are typical withdrawal symptoms.  You will heal, but unfortunately we can't tell you how long it will take.

Protracted Withdrawal or PAWS (post-acute withdrawal ...

What is withdrawal syndrome.

 

Glenmullen’s withdrawal symptom list.

 

When we take medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.  

 

Since our systems are so sensitized during withdrawal, I would be wary of testosterone therapy.  Altostrata, founder of this site wrote:

 

"In general, I would be careful with any steroid therapy during withdrawal (or any other time). Bumping up one hormone tends to imbalance everything else, because the body depends on self-regulation."

 

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.

 

We recommend no drug coping skills to deal with withdrawal.  Take a look at the technique in the following link and see which you think might be beneficial to you.

 

Non-drug techniques to cope

 

These techniques re designed to help copy with anxiety.

 

Audio:  First Aid for Panic (4 minutes)
 

 Audio:  How to Recover from Anxiety - Dr Claire Weekes
 

VIDEO:  Peace from Nervous Suffering - Claire Weekes (1 hour) (http://sendvid.com/vgquc1dg)
 

Anxiety Stuff - all kinds of stuff about anxiety attacks and things that help …

 

10 minute Restorative Yoga for Relaxation | Up the wall

 

This is your Introduction topic where you can ask questions and connect with other members.  We're glad you found your way here.

 

 

 

 

 

Thanks for the answer even if wasnt my question. but i had the same Question i am 2 years off escitalopram and still suffer as hell,iam not sure if i can manage this any longer.

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Tootles

Hey everyone, just an update, my mood you could argue has slightly improved in some ways, but i am still not speaking with my friends i don't answer msgs i don't feel passionate about life or the things i used to love still, i miss being 'me' etc etc,

 

But i resisted going back on the Cymbalta, i decided especially until i had spoken with the NHS Neuro psychiatrist to see their take on my situation.

 

They off course dismissed that any anti depressants had caused me any harm and it 'was impossible' to still be suffering with any problems caused by the medication. (infuriating) 

 

They did however agree, as i did, that i had a addiction issue with my Cannabis use. So he prescribed me a 4 week course of low dose Clonazepam (1mg - of which i have been only taking 0.5mg a night) to help me sleep and get me away from smoking myself to sleep. Found that astounding considering they are Benzo's and highly addictive but i have already made the right step to half the dose he prescribed me from the very beginning. I have no idea how things will be when i finish the 4 week course as that will be all i am allowed to have, and i would not want anymore as it is i do not want to swap one addiction for another and go through Benzo withdrawl.

 

The most concern i have is he also insisted on prescribing 'Carbamazapene' (100mg to start with) which i have NOT collected from the pharmacy. It's an anticonvulsant that i know is used to treat schizophrenia and bi-polar disorder along with epliepsy etc. I am not at all happy about this, has anyone had any experience with this drug? 

 

I have never had a diagnosis of any of the conditions it is designed to treat....

 

The plot thickens...

 

Much Love

❤️

 

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DataGuy

Hi Tootles,

 

If you like, next time you go see a doctor in the NHS, you can show them this article: https://www.karger.com/Article/Abstract/506868

 

In it, you will find an admission that withdrawal syndromes from antidepressants can last months or years. 

 

Clonazepam is most definitely not a treatment for cannabis addiction or antidepressant withdrawal syndrome, so I am fairly confident you were given poor advice by whoever you saw in the NHS. Clonazepam is mostly used to treat anxiety and insomnia. However, it causes very strong physical dependence that can occur in 2-4 weeks. I think the best thing you can do for yourself is to taper what you have left of the clonazepam and avoid stopping it suddenly. You do not want to add clonazepam withdrawal to your problem caused by Cymbalta. You were wise to avoid the anticonvulsant. 

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DataGuy

Tootles, have you tried any of these techniques to help you sleep? 

 

It sounds like you have been smoking cannabis during your withdrawal to help this problem. This could also be contributing to your medical condition. Like other psychotropics, cannabis can make you feel better temporarily but can cause problems (neuropsychiatric problems like depression, anxiety, psychosis, cognitive problems, loss of motivation etc) with long term use. It seems fairly unlikely that it would help you heal or is conducive to brain health. The best advice I can give is to avoid it, along with other psychotropics like caffeine, sedatives found in teas, energy drinks, supplements that have sedative or "anti-anxiety effects" (most supplements are not tested for effectiveness or safety) and anything else other than food and water which has an effect on your mood or arousal levels. Your brain will do the best it can to heal, but feeding it psychotropics is only likely to prevent your brain from adjusting back to its natural state. 

 

Doctors will most likely continue to offer various antidepressants, benzos, anticonvulsants, or even antipsychotics. It's up to you if you want to go this route. If I were in your position, I would try to connect with a therapist. There are some in the UK who have been given guidelines on how to deal with medication withdrawal. They may not know how to reverse PAWS, but they can give you some guidance on non-drug coping techniques and encouragement when you need it. Hope you begin to feel better soon and good luck. Please continue to update your situation and provide a drug history signature so that peers and moderators can more easily help. 

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Tootles

@DataGuy Thankyou for your reply and yes this is what i was afraid of, i know how easily addictive the Clonazepan will be, the cannabis has been an issue since i was a teenager (now 36). No i haven't looked at the sleep techniques, but i will, i will admit i'm very down trodden from the fact that my Akathesia when i try to lay down and sleep naturally is so awful that i feel that nothing will change it. Not a very positive outlook but it makes me unbearable. If my girlfriend so much as grazes me with her arm i want to throw her out of bed it makes me so irritable and antsy with the feeling something is slithering inside my body. The only thing that has dulled it is weed or the Clonazepan, and yes in there lies the problem.

 

I would very much like to show the Doctor the article you linked to, however you say there is an admission that it can last months or years?

 

is that specifically worded in that article? i have yet to find a specific statement in the literature and would like to highlight it to him.

 

Thankyou🙏

 

 

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DataGuy

"Finally, since 2006, persistent sexual side effects after
SSRIs and SNRIs discontinuation have been described
[124]. These sexual manifestations have been rapidly
identified as a syndrome called post-SSRI sexual dysfunction
(PSSD) [125], that is a sexual dysfunction, caused by
both SSRIs and SNRIs, characterized by a decrease or absence
of libido, genital anesthesia, numbness in nipples,
orgasmic disorders (i.e., anorgasmia or anhedonic orgasm),
erectile dysfunction, delayed or premature ejaculation,
testicular pain or atrophy (in males), lack of lubrication
(in females) and by psychological symptoms such
as anhedonia, difficulty in concentrating, memory problems,
inability to experience sexual attraction to the sight,
touch, or idea of a sexual partner [125–127]. The symptoms
may last months or even years [127, 128]. Recently, 

it has been described the case of a patient in which PSSD
symptoms were part of a broader syndrome which was
diagnosed as persistent post-withdrawal disorder [129].
This case rises the suspicion that PSSD might be a withdrawal
syndrome occurring after decrease/discontinuation
of SSRIs or SNRIs and that withdrawal symptoms
might include a wider variety of sexual manifestations
which are under-reported, probably due to a poor attention
of clinicians toward sexual symptoms and a lack of
investigations by clinicians as well as researchers [129]."

 

There is also a statement there that benzodiazepine withdrawal syndromes can last years. I expect we'll see more reports like this from Chouinard and similar authors. 

 

The statement about it from this article is a bit more clear:

https://academic.oup.com/braincomms/article/1/1/fcz025/5588408

"SSRIs and SNRIs protracted withdrawal syndrome

Protracted withdrawal symptoms include: tardive insomnia, major depression, bipolar disorder, panic disorder, agitation, anxiety disorders and panic attacks, emotional lability, mood swings, irritability, aggression, impaired concentration, impaired memory and pathological gambling. These disorders can last for several months to years when the previous drug treatment is not restarted (Bhanji et al., 2006; Belaise et al., 2012, 2014; Chouinard and Chouinard, 2015)."

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DataGuy

Tootles, 

 

I am going to be a bit busy today, but I will get back to your other questions later. Suffice to say, I think it's unlikely marijuana will help you recover and could be partly to blame for the lack of progress up to this point.

 

The body has an extraordinary ability to heal from many different injuries, but you need to give it the chance to do this. This means avoiding toxins like marijuana (smoking anything is pretty terrible for you, regardless of what it is) and other substances that interfere with your body's natural biological processes. There have been plenty of people here who have been ill longer than you have and recovered, but you need to treat yourself right to get there. It could be a long haul, but I really don't think you have another good option if you want the rest of your life to be spent in good health. 

 

We will talk later, I promise. 

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DataGuy

Akathisia is a tough one, Tootles. I have tried looking up treatment recommendations in medical journals for some members and often they only list pharmacological options. My problem with this is that they don't really know the cause (suspicion it is something like dopamine supersensitivity), but the only common thread is that it is drug-induced. I don't think akathisia is a condition that occurs in the absence of drug use, so to offer solely drug treatments (some of which can cause akathisia themselves) seems insane to me. 

 

Here is a thread that has some non-pharma options. Seems weighted blankets and bed tents can be of some use for sleep. I suspect the best long term treatment is the same for other drug-induced disorders manifesting in withdrawal: keep away from these drugs and let your body do its thing and heal. 

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