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Zeena: 72 year old mom severe anxiety and insomnia and vocalizations


Zeena

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I am here to help my 72 year old mother who suffers from severe anxiety and negative thoughts and vocalizations. Some have even diagnosed her to be hypochondriac. It all started in Feb 2018 when all of a sudden she started to get a panic attacks, she couldn't fall asleep. Because of lack of sleep she couldn't function properly in the morning and was very groggy. She had severe constipation which after year of investigation was due to the hernia blocking the rectum. On 7th June 2018 she was prescribed Paroxetene 12.5 mg (twice a day) and clonezepam (0.25 mg) for as and when needed. I can't say whether she took these regularly or not herself because i was not there with her at the time. The consultant psychiatrist told us that she is not feeling better because she is not taking these regularly as he could see how much prescription was being dispatched. After a lot of telling and making sure she takes these regularly she was able to get some sleep with clonazepam but also got hooked onto it. On the 6th April 2019 she had a hernia operation to clear the entry into the rectum and was told by the surgeon to not take these SSRI's before the surgery so naturally she was in a major state of panic. Since then she was taking the prescribed dosage of paroxtene regularly and clonezepam as and when needed. Then in Sept 2019, after realising the terrible side effects of these SSRI's i wanted to help wean it off. So i started gradually reducing the Paroxetene only once a day which was 12.5 gm and stopped clonozepam as she was able to sleep. In addition to this i was also giving her other herbal supplements (by Dr Christopher (mindTrac, Relax Eaze, Primrose oil, fish oil, multivitamins and LoveHemp CBD Oil (50mg))

From Oct 2019 until now she is not on any Paroxetene or clonezepam. She was doing and looking really well from Sept 2019 - Jan 2020 and then i started noticing some of her older symptoms returning back starting with complaining a lot about physical issues (hypochondria) like eye pain, blurry vision, headache and she was not able to sleep at night. Naturally i got very concerned and consulted a naturopath who advised to give valerian for sleep and CBD oil for anxiety,which i did however Valerian gave her nightmares and she would wake up in a state of anxiety from those nightmares so i stopped Valerian. All in all i would say she has been off the prescribed SSRI's for 3 months and so i am wondering is this is the withdrawal effect that she is facing now. I list her current condition below:

1. Not able to sleep at night for more than 2 hours (she wants to sleep but can not stay asleep)

2. She is so anxious that she can not sit in one place and walks around the house during the day and night and pretty much all day

3. She makes vocalisations, more like a hmmming sound all the time. 

4. Morning's are particularly difficult as she wakes up with a lot of anxiety and wakes everyone up saying "My brain isnt working" "I do not know what will happen to me" "I can't see" etc 

5. She doesn't feel hungry. She purposely resists eating

6. At time it feels she does exactly opposite of what I tell her to do for instance i will say let us go for a walk, her first response would be No. A lot of negativity 

7. Although she is physically able, she is showing a lot of dependency on others specially me. She doesn't take showers or change her clothes until I push her to. 

 

Funnily enough the only time her vocalisations stop is when she watching a movie. 

I list below the medicines/supplements she is on at the moment. 

1. Dr Ohhira’s probiotics

2. Naturelo’s whole food multivitamins

3. White Willow bark standardised as a herbal replacement to Aspirin (twice a day)

4. Dr Christopher’s Mind Trac (twice a day)

5. Dr Christopher’s RelaxEaze (twice a day)

6. Primrose Oil capsules (stopped it)

7. LoveHemp CBD oil (50 mg)

8. Homeopathic medicine of OAK 10M once a week, Ignatia 10M once a week, Carc/Horn/Ches-W/Thym G/Foll 10 M once a week and Amethyst LM1 3 drops daily 

 

Looking for some help and comfort here and genuine advice.What should she do?

1. Is this a withdrawal effect of the SSRI's ? 

2. Should she re-initiate to the SSRI'S?

3. What should she do ?

4. How can she stop the vocalisations and get some good sleep?

 

Thank you 

 

 

Feb 2018 - April 2019 - On 25mg Paxil (12.5 mg in the morning and 12.5 mg at night) and clonezepam (0.25 mg at night as and when needed)

In April had a break from both for 15 days due to surgery 

End of April - Sept 2019 - Was able to gradually stop both Paxil and Clonezepam 

Oct 2019 - Jan 2020 - Had the best days and was not taking any of the above two (started to take supplements as listed in the post)

End of Jan 2020 - Severe anxiety kicked in and a really bad insomnia ( for the last two months have only been able to sleep for 2 hours continous, wake up night and start to walk around and vocalizations seem to be getting worse)

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  • manymoretodays changed the title to Zeena: HELP! 72 year old mom severe anxiety and insomnia and vocalizations
  • Moderator Emeritus

Welcome to SA, Zeena.  I'm sorry you and your mother are going through this.  Let me go through your post and answer your questions.

On 3/7/2020 at 7:11 PM, Zeena said:

Then in Sept 2019, after realising the terrible side effects of these SSRI's i wanted to help wean it off. So i started gradually reducing the Paroxetene only once a day which was 12.5 gm and stopped clonozepam as she was able to sleep.

This is a very fast taper and your mother very likely is experiencing withdrawal from both the Paxil and the benzo (Clonazepam).

On 3/7/2020 at 7:11 PM, Zeena said:
 

What is withdrawal syndrome.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

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.  

 

On 3/7/2020 at 7:11 PM, Zeena said:

From Oct 2019 until now she is not on any Paroxetene or clonezepam.

 

This is 5 months, not the three months you mentioned later.

 

On 3/7/2020 at 7:11 PM, Zeena said:

 

1. Not able to sleep at night for more than 2 hours (she wants to sleep but can not stay asleep)

2. She is so anxious that she can not sit in one place and walks around the house during the day and night and pretty much all day

3. She makes vocalisations, more like a hmmming sound all the time. 

4. Morning's are particularly difficult as she wakes up with a lot of anxiety and wakes everyone up saying "My brain isnt working" "I do not know what will happen to me" "I can't see" etc 

5. She doesn't feel hungry. She purposely resists eating

6. At time it feels she does exactly opposite of what I tell her to do for instance i will say let us go for a walk, her first response would be No. A lot of negativity 

7. Although she is physically able, she is showing a lot of dependency on others specially me. She doesn't take showers or change her clothes until I push her to. 

Most of these are typical withdrawal symptoms.  See the Daily Checklist link above.  #2 sounds like akathisia.  According to the  link below this resolves with time.

Akathisia vs restlessness, anxiety, agitation - Symptoms and ...

On 3/7/2020 at 7:11 PM, Zeena said:

I list below the medicines/supplements she is on at the moment. 

1. Dr Ohhira’s probiotics

2. Naturelo’s whole food multivitamins

3. White Willow bark standardised as a herbal replacement to Aspirin (twice a day)

4. Dr Christopher’s Mind Trac (twice a day)

5. Dr Christopher’s RelaxEaze (twice a day)

6. Primrose Oil capsules (stopped it)

7. LoveHemp CBD oil (50 mg)

8. Homeopathic medicine of OAK 10M once a week, Ignatia 10M once a week, Carc/Horn/Ches-W/Thym G/Foll 10 M once a week and Amethyst LM1 3 drops daily 

 

 

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 (glycinate is a good form) and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

 

 

Add in one at a time and at a low dose in case you do experience problems.
 
On 3/7/2020 at 7:11 PM, Zeena said:

 

1. Is this a withdrawal effect of the SSRI's ? 

2. Should she re-initiate to the SSRI'S?

3. What should she do ?

4. How can she stop the vocalisations and get some good sleep?

 

 

1.  As stated above, many of the symptoms are due to withdrawal.

 

2. Reinstatement of a very small dose of the original drug is the only known way to help alleviate withdrawal syndrome.  The only other alternative is to try and wait out the symptoms and manage as best you can until your central nervous system returns to homeostasis.  Unfortunately no one can give you an exact timeline as to when you will start feeling better and while some do recover relatively easily, for others it can take many months or longer.  

 

Reinstatement isn't a guarantee of diminished symptoms for everyone but it's the best tactic available.  At 5 months, your mother is a bit outside the time period where reinstatement predictably works, up to 3 months after last dose. So reinstatement might work and it might not.  (Too much time has elapsed to reinstate the Clonazepam.)  We usually suggest a much smaller reinstatement dose than your last dose.  These drugs are strong,  your mother's system has become sensitized and If you take too much it may be too much for your brain and can cause you become more unstable.  unstable.   Then, once she has stabilized on that dosage, which can take several months,  you can begin a 10% per month taper down to zero.   Please read:

 

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

 

If you want to try reinstatement of Paxil, I'd recommend 1mg--no more.  The following link tells how to get the small Paxil dose you'll need for the reinstatement. 

 

Tips for tapering off Paxil (paroxetine)

 

4.  Regarding sleep--

Tips to help sleep - so many of us have that awful withdrawal insomnia
 
 
Trick and tips to fall asleep faster
 
This link contains helpful information, including insomnia and also non-drug coping skills.  
 
 
Some members have found Melatonin helpful with insomnia.   
See Melatonin for sleep   It's best to start at a very low dosage, such as .25mg, and gradually increase if needed to the lowest effective dose.  
 
This is your Introduction topic, where you can ask questions and connect with other members.  We're glad you found your way here.
 

 

 

 

 

Gridley Introduction

 

Lexapro 20 mg since 2004.  Begin Brassmonkey Slide Taper Jan. 2017.   

End 2017 year 1 of taper at 9.25mg 

End 2018 year 2 of taper at 4.1mg

End 2019 year 3 of taper at 1.0mg  

Oct. 30, 2020  Jump to zero from 0.025mg.  Current dose: 0.000mg

3 year, 10 month taper is 100% complete.

 

Ativan 1 mg to 1.875mg 1986-2020, two CT's and reinstatements

Nov. 2020, 7-week Ativan-Valium crossover to 18.75mg Valium

Feb. 2021, begin 10%/4 week taper of 18.75mg Valium 

End 2021  year 1 of Valium taper at 6mg

End 2022 year 2 of Valium taper at 2.75mg 

End 2023 year 3 of Valium taper at 1mg

Jan. 24, 2024: Hold at 1mg and shift to Imipramine taper.

Taper is 95% complete.

 

Imipramine 75 mg daily since 1986.  Jan.-Sept. 2016 tapered to 14.4mg  

March 22, 2022: Begin 10%/4 week taper

Aug. 5, 2022: hold at 9.5mg and shift to Valium taper

Jan. 24, 2024: Resume Imipramine taper.  Current dose as of Feb. 22: 7.6mg

Taper is 90% complete.  

  

Supplements: multiple, quercetin, omega-3, vitamins C, E and D3, magnesium glycinate, probiotics, zinc, melatonin .3mg, anti-candida, iron, serrapeptase, nattokinase


I am not a medical professional and this is not medical advice but simply information based on my own experience, as well as other members who have survived these drugs.

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40 minutes ago, Gridley said:

Welcome to SA, Zeena.  I'm sorry you and your mother are going through this.  Let me go through your post and answer your questions.

This is a very fast taper and your mother very likely is experiencing withdrawal from both the Paxil and the benzo (Clonazepam).

What is withdrawal syndrome.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

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.  

 

 

Quote

 

This is 5 months, not the three months you mentioned later.

From Sept 2019 - Jan 2020 - she didnt take any SSRI's or the benzo (This is the 3 months off period i meant)

 

 

Most of these are typical withdrawal symptoms.  See the Daily Checklist link above.  #2 sounds like akathisia.  According to the  link below this resolves with time.
Quote

She does sit for a while but then gets up and starts walking down the hallway. there is no other movements other than this apart from her walking up and down the hallway. When i tell her to sit down she does for a while and then again gets up and paces the room 

 

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 (glycinate is a good form) and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

 

 

Add in one at a time and at a low dose in case you do experience problems.
Quote

Thank you - I will get these, do you recommend any specific dosage and/or brands

 

 

 

1.  As stated above, many of the symptoms are due to withdrawal.

 

2. Reinstatement of a very small dose of the original drug is the only known way to help alleviate withdrawal syndrome.  The only other alternative is to try and wait out the symptoms and manage as best you can until your central nervous system returns to homeostasis.  Unfortunately no one can give you an exact timeline as to when you will start feeling better and while some do recover relatively easily, for others it can take many months or longer.  

 

Reinstatement isn't a guarantee of diminished symptoms for everyone but it's the best tactic available.  At 5 months, your mother is a bit outside the time period where reinstatement predictably works, up to 3 months after last dose. So reinstatement might work and it might not.  (Too much time has elapsed to reinstate the Clonazepam.)  We usually suggest a much smaller reinstatement dose than your last dose.  These drugs are strong,  your mother's system has become sensitized and If you take too much it may be too much for your brain and can cause you become more unstable.  unstable.   Then, once she has stabilized on that dosage, which can take several months,  you can begin a 10% per month taper down to zero.   Please read:

 

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

 

If you want to try reinstatement of Paxil, I'd recommend 1mg--no more.  The following link tells how to get the small Paxil dose you'll need for the reinstatement. 

 

Tips for tapering off Paxil (paroxetine)

 

4.  Regarding sleep--

Tips to help sleep - so many of us have that awful withdrawal insomnia
 
 
Trick and tips to fall asleep faster
 
This link contains helpful information, including insomnia and also non-drug coping skills.  
 
 
Some members have found Melatonin helpful with insomnia.   
See Melatonin for sleep   It's best to start at a very low dosage, such as .25mg, and gradually increase if needed to the lowest effective dose.  
Quote

 

Would Melatonin have an adverse effect or addiction?
She is able to fall asleep but has problems staying asleep. 

 

 

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

Thank you so much for responding. It means a lot. Do you have any pointers as why she has vocalizations which are continuous and very annoying. Funnily enough the only type she doesnt do "hmmm" vocalisations is when watching a movie  

 

 

 

 

 

 

 

Feb 2018 - April 2019 - On 25mg Paxil (12.5 mg in the morning and 12.5 mg at night) and clonezepam (0.25 mg at night as and when needed)

In April had a break from both for 15 days due to surgery 

End of April - Sept 2019 - Was able to gradually stop both Paxil and Clonezepam 

Oct 2019 - Jan 2020 - Had the best days and was not taking any of the above two (started to take supplements as listed in the post)

End of Jan 2020 - Severe anxiety kicked in and a really bad insomnia ( for the last two months have only been able to sleep for 2 hours continous, wake up night and start to walk around and vocalizations seem to be getting worse)

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  • Moderator Emeritus
32 minutes ago, Zeena said:

Do you have any pointers as why she has vocalizations which are continuous and very annoying.

 

I'm sorry, that one is beyond me.

Gridley Introduction

 

Lexapro 20 mg since 2004.  Begin Brassmonkey Slide Taper Jan. 2017.   

End 2017 year 1 of taper at 9.25mg 

End 2018 year 2 of taper at 4.1mg

End 2019 year 3 of taper at 1.0mg  

Oct. 30, 2020  Jump to zero from 0.025mg.  Current dose: 0.000mg

3 year, 10 month taper is 100% complete.

 

Ativan 1 mg to 1.875mg 1986-2020, two CT's and reinstatements

Nov. 2020, 7-week Ativan-Valium crossover to 18.75mg Valium

Feb. 2021, begin 10%/4 week taper of 18.75mg Valium 

End 2021  year 1 of Valium taper at 6mg

End 2022 year 2 of Valium taper at 2.75mg 

End 2023 year 3 of Valium taper at 1mg

Jan. 24, 2024: Hold at 1mg and shift to Imipramine taper.

Taper is 95% complete.

 

Imipramine 75 mg daily since 1986.  Jan.-Sept. 2016 tapered to 14.4mg  

March 22, 2022: Begin 10%/4 week taper

Aug. 5, 2022: hold at 9.5mg and shift to Valium taper

Jan. 24, 2024: Resume Imipramine taper.  Current dose as of Feb. 22: 7.6mg

Taper is 90% complete.  

  

Supplements: multiple, quercetin, omega-3, vitamins C, E and D3, magnesium glycinate, probiotics, zinc, melatonin .3mg, anti-candida, iron, serrapeptase, nattokinase


I am not a medical professional and this is not medical advice but simply information based on my own experience, as well as other members who have survived these drugs.

Link to comment

What amazes me is that she had no withdrawal symptoms when she completely came off Paxil (12.5 mg) for about 3 months and now after 3 months she is experiencing them? Is that possible to the withdrawal symptoms to kick in this late? 

Feb 2018 - April 2019 - On 25mg Paxil (12.5 mg in the morning and 12.5 mg at night) and clonezepam (0.25 mg at night as and when needed)

In April had a break from both for 15 days due to surgery 

End of April - Sept 2019 - Was able to gradually stop both Paxil and Clonezepam 

Oct 2019 - Jan 2020 - Had the best days and was not taking any of the above two (started to take supplements as listed in the post)

End of Jan 2020 - Severe anxiety kicked in and a really bad insomnia ( for the last two months have only been able to sleep for 2 hours continous, wake up night and start to walk around and vocalizations seem to be getting worse)

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  • Mentor
34 minutes ago, Zeena said:

What amazes me is that she had no withdrawal symptoms when she completely came off Paxil (12.5 mg) for about 3 months and now after 3 months she is experiencing them? Is that possible to the withdrawal symptoms to kick in this late? 


‘Hi Zeena, yes it absolutely is. This is a very common pattern.

 = medication taken now

2007 quetiapine to March 2019 200mg

2019 quetiapine March to present 225mg 

2007 citalopram to present 40mg 
2018 March Abilify 5mg  
2019 Abilify February rapid taper over 3 weeks from 5mg to off

2019 March Clonazepam as required, taken very occasionally, then taken 0.5mg for 2 days 28th and 29th March, now phased out

2019 1st April reinstated Abilify 0.5mg / day 

2018 to 2020 Liquid B12 2g twice daily (diagnosed B12 deficiency) 

2020 July reduced quetiapine to 200mg

2022 October began taper of Abilify
 

Link to comment

Thank you @RichT  

So it this a withdrawal symptom or a relapse? I was in london for my mum's treatment and consulted a homeopathic consultant who have prescribed the listed homeopathic prescritions. she has been on them for two weeks and i am unsure if they are working for her or not. 

Really difficult to see her in this condition 

Feb 2018 - April 2019 - On 25mg Paxil (12.5 mg in the morning and 12.5 mg at night) and clonezepam (0.25 mg at night as and when needed)

In April had a break from both for 15 days due to surgery 

End of April - Sept 2019 - Was able to gradually stop both Paxil and Clonezepam 

Oct 2019 - Jan 2020 - Had the best days and was not taking any of the above two (started to take supplements as listed in the post)

End of Jan 2020 - Severe anxiety kicked in and a really bad insomnia ( for the last two months have only been able to sleep for 2 hours continous, wake up night and start to walk around and vocalizations seem to be getting worse)

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  • Administrator

Welcome, Zeena.

 

On 3/7/2020 at 4:11 PM, Zeena said:

Then in Sept 2019, after realising the terrible side effects of these SSRI's i wanted to help wean it off. So i started gradually reducing the Paroxetene only once a day which was 12.5 gm and stopped clonozepam as she was able to sleep.

 

Zeena, what exactly was the tapering schedule for each of these drugs?

 

On 3/9/2020 at 3:43 PM, Zeena said:

What amazes me is that she had no withdrawal symptoms when she completely came off Paxil (12.5 mg) for about 3 months and now after 3 months she is experiencing them? Is that possible to the withdrawal symptoms to kick in this late? 

 

Did you ask her how she felt in September-December after she came off Paxil and clonazepam simultaneously? Is she capable of speaking for herself?

 

Did she seem to have a cold or flu during these months? How was her sleep?

 

On 3/7/2020 at 4:11 PM, Zeena said:

She was doing and looking really well from Sept 2019 - Jan 2020 and then i started noticing some of her older symptoms returning back starting with complaining a lot about physical issues (hypochondria) like eye pain, blurry vision, headache and she was not able to sleep at night. Naturally i got very concerned and consulted a naturopath who advised to give valerian for sleep and CBD oil for anxiety,which i did however Valerian gave her nightmares and she would wake up in a state of anxiety from those nightmares so i stopped Valerian.

 

If you talk to her, when does she say these symptoms started?

 

Did valerian help her sleep? What dosage valerian did you give her?

 

It's very difficult for us to counsel someone through a third party. Our ability to help you and your mother may be limited.

 

Paxil often incurs withdrawal symptoms; it can be very dangerous to suddenly stop a benzodiazepine such as clonazepam.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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2 hours ago, Altostrata said:

Zeena, what exactly was the tapering schedule for each of these drugs?

@Altostrata  She went from 25mg Paxil to 12.5 mg for 3 weeks in Sept and then to 0 mg from Sept 21st 2019 till now.

As far as Clonezpam is concerned she was never on it for a regular dose. She used to take 0.2mg of it when she struggled to sleep. The doctors told us to give her Klonopin as and when required and the last one she had was sometime in Aug. 

2 hours ago, Altostrata said:

Did you ask her how she felt in September-December after she came off Paxil and clonazepam simultaneously? Is she capable of speaking for herself?

 

Did she seem to have a cold or flu during these months? How was her sleep?

I was with her from Sept till March 5 2020 and i was so happy to see her active and taking charge of her own health, she did make the vocalizations sometimes, very rarely. Her sleep improved significantly and she had wonderful days. Infact she used to tell everyone that she never thought she would feel this way. 

She did not have a cold or a flu since Sept 2019. 

2 hours ago, Altostrata said:

f you talk to her, when does she say these symptoms started?

I was with her when i noticed the symptoms which was on 19th Jan 2020

2 hours ago, Altostrata said:

Did valerian help her sleep? What dosage valerian did you give her?

Valerian did help her. I gave her Dr Christopher's Fresh valerian extract one full dropper before bed time. However this gave her nightmares which i later realised was one of known effects of Valerian and she would wake up with a lot of anxiety and then not able to sleep again. So i stopped giving it to her. 

 

2 hours ago, Altostrata said:

It's very difficult for us to counsel someone through a third party. Our ability to help you and your mother may be limited.

 

I am so glad that i bumped into this forum. I appreciate the work everyone is doing here.Gives me a lot of hope so i understand the extent of help. I really appreciate everything you are contributing here. 

 

2 hours ago, Altostrata said:

Paxil often incurs withdrawal symptoms; it can be very dangerous to suddenly stop a benzodiazepine such as clonazepam.

I have realised this the hard way however seeing her now makes my heart sink and i do not know what to do. Since she has been off SSRI's for about 4 months should she go back on them and try to taper or just let the body heal itself. Like i mentioned in my original post she is on a homepathic medicine for her anxiety but i don't know how long they will take to work. 

Feb 2018 - April 2019 - On 25mg Paxil (12.5 mg in the morning and 12.5 mg at night) and clonezepam (0.25 mg at night as and when needed)

In April had a break from both for 15 days due to surgery 

End of April - Sept 2019 - Was able to gradually stop both Paxil and Clonezepam 

Oct 2019 - Jan 2020 - Had the best days and was not taking any of the above two (started to take supplements as listed in the post)

End of Jan 2020 - Severe anxiety kicked in and a really bad insomnia ( for the last two months have only been able to sleep for 2 hours continous, wake up night and start to walk around and vocalizations seem to be getting worse)

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  • ChessieCat changed the title to Zeena: 72 year old mom severe anxiety and insomnia and vocalizations

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