Tomasz: help with future steps to recovery

[Tomasz]

Last four days I developed early morning waking with high anxiety following with anxiety and depression through day. Evenings are ok. I dont know if it is because clonopine looses it's efficacy or lamictal withdrawal(just week after it  completely leave my body) or because last week we started working season and Im too tired. Maybe all of those three. I'm going to cut my work days from five to four or three. Will consult this with my psychologist and psychiatrist. If it is lamictal withdrawal how long it should take to stabilize?

[Tomasz]

@Shep my morning anxiety followed by day anxiety, depression, anhedonia and tiredness is still persistent. Could it be because I stopped Lamictal at thursday feb.12 and this anxiety started exactly two weeks after last dose of Lamictal (I'v seen Lamictal stay in your system about 354 hours - so aprox.two weeks). Or could it be Clonazepam loses it's efficacy after 2months of continual dosing? It is not because of diet or something stressfull in my life. Previous two weeks where fine.  Is there anythig I could do to alleviate symptoms. Thank you.

[ChessieCat]

From https://drugabuse.com/klonopin/effects-of-clonazepam-use/

 

Quote

Clonazepam is not generally recommended for long-term use because it is known to be a habit-forming substance. Over time, the patient's body tends to build a tolerance to clonazepam. This means that the body adapts to the presence of clonazepam in its system, and the patient's usual dose of clonazepam ceases to be as effective.

 

[Tomasz]

4 hours ago, ChessieCat said:

From https://drugabuse.com/klonopin/effects-of-clonazepam-use/

 

 

@ChessieCat I know about this, but since I was intolerable to ADs I had to take them PRN on docs advice. So when I got here on forum I was adviced by mods to take klonopin regularly which I did. The question is what is causing me now anxiety in the morning and during the day. Is it klonopin(dosed 0.5mg twice a day) poop out, lamictal withdrawal or too much trazodone (updosed from 50 to 150mg since Christmass). How should I know what is causing my problems and should I do something to feel better or I just have to wait it out and for how long it can last. You can find info in my  previous posts. Thank you.

[Shep]

5 hours ago, Tomasz said:

@Shep my morning anxiety followed by day anxiety, depression, anhedonia and tiredness is still persistent. Could it be because I stopped Lamictal at thursday feb.12 and this anxiety started exactly two weeks after last dose of Lamictal (I'v seen Lamictal stay in your system about 354 hours - so aprox.two weeks). Or could it be Clonazepam loses it's efficacy after 2months of continual dosing? It is not because of diet or something stressfull in my life. Previous two weeks where fine.  Is there anythig I could do to alleviate symptoms. Thank you.

 

Tomasz, it's unknown what is causing what. You posted last week that you were feeling better and I suggested a long hold. Please see my post here:

 

On 2/25/2021 at 7:01 AM, Shep said:

Thomas, it's unclear if you're feeling better because you're off Lamictal or because you're now taking 3 times your previous dose of trazodone and double the amount of Klonopin since you posted in December 2020. 

 

Since you're feeling better, I would hold for several months. These are major drug changes and you really need to establish a baseline on a consistent drug schedule. 

 

Please note we can't help you unless you're willing to stick to a regular drug schedule. 

 

[Tomasz]

Ok, so as I understand I should (will) stick to schedule and wait several months. I hope it is not going to get much worse. Thank you very much :).

[Shep]

Sounds like a wise plan, Tomasz. 

[Tomasz]

Update after long time.

Needed guidance from moderators.

So it has been rough time with divorce, break up with girlfriend and moving back to town where my son lives. I have been off work for 5months. Break down in mid July after moving to new apartment, with no sleep and extreme anxiety. Was taken off Trazodone and put on Venlafaxine 150XR and Quetiapine 25mg. 

What I consider as a great success is that I stopped to take benzos in August. So benzo free almost 2months. 

I still experience very high anxiety sometimes caused by stressful situations(going on a date for example) and usually physical morning anxiety which lasts from 1h till the afternoon. Sometimes I have a day without anxiety at all.

I have a new psychiatrist which is very strict and doesn't listen to what I say. She wanted me to raise Venlafaxin to 300mg, I refused because ongoing anxiety on 225mg and serious side effects. She told me I metabolise meds in strange way, because I don't really respond to any and I should deal with my head by myself.

Also I stupidly reduced Venlafaxine to 100mg last week while I was in high anxiety and don't want to experience side effects, especially sexuall because of a new girlfriend.

Now I'm back to 150mg of Venlafaxine after about 6 days.

 

So recent situation:

VenlafaxineXR 150mg

Seroquel (Quetiapine) 0mg - reduced by quarters from 25mg in one month.

Clonazepam 0mg for 2 months.

 

Still experience almost daily morning anxiety ongoing thru the day.

Evenings are usually ok from about 17pm.

 

Anxiety in stressful situations - still approaching them with help of CBT.

But get very exhausted after or anxiety for longer time.

 I visit psychotherapy every second week.

I work as a gardener 3-4 days a week with disabled people. Fresh air, sunshine, but very physical. 

 

I realized western medicine didn't help in the long run so I have to deal with it by myself. Learn how to cope with stress, relax properly, change thought patterns. It is slow, but I see light in the and of the tunnel.

 

I have a few questions for mods.

What about medication regiment? I think I shoul stick to Venlafaxine now and don't do any changes in meds.

 

What supplements I can try?

I take fish oil and magnesium citrate.

 

Can I try taurin for gaba?

 

How can I reduce morning anxiety - lower cortisol? Any supplement?

 

I suspect exhausted adrenaline glands. What can I do about it?

I use to be adventurous person,

ride enduro mtb etc.

Adrenaline release when doing something dangerous (climbing, riding rock cliff) or arguing with exwife really helps with anxiety and I feel completely normal afterwards but second day a have very bad drop in mood. Also physical exhaustion from work dramatically worsen my anxiety. So what are your suggestions for that?

 

Thank you 🙂

 

 

 

 

[ChessieCat]

Drug interaction from https://reference.medscape.com/drug-interactionchecker

 

Monitor Closely

• venlafaxine + quetiapine

  venlafaxine, quetiapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

[Tomasz]

Yes I know. Im off Seroquel now. Only Effexor. Can anyone help me with questions I asked? Thanks

[Tomasz]

Hi everyone, I have an update after very long time. I have been free from antidepressants for about 5 months now (after last year's try for 5 months).  I reinstated in 12/2022 for couple of months after break up with my girlfriend but it didn't help. So I went of Venlafaxine completely (gradually) again in this May. Beginning was difficult with crazy mood swings, anger etc. while trying to manage new relationship. What I realized, antidepressants didn't calm down my anxiety but made it worst with some kind of  artificial nervous energy which forces me to be over active, erratic and too much into sex. So when my natural anxiety subsided, I was still chemicaly anxious and full of negative energy from pills (bad sleep, agitation, nervousness etc.) But after stopping poping pills it subsided a lot. Sometimes when I'm in big crisis I have to take Clonazepam for few days to slow my brain down otherwise I will spin out of control. I still have disability  and work half time as a gardener with other mentally ill people (mostly schizophrenic) which is sometimes challenging and makes me stressed. But this year was better than previous years and I was able to travel more and see places and do things and enjoy life more. More clear thinking, reading books, enjoying nature.

The main problems I struggle with are unexpected mood swings, very low tolerance to stress (even positive one) and anger or irritability which I try to not put on anyone. 

I have failed multiple romantic relationships, mostly because It was just too much for me and after some time I started to feel overwhelmed and think erratic and crazy. Every minor glimpse of something grows in my head into a big problem and I better run away. Which is frustrating because after some time when I chilled down I realized I was wrong. I hurt my girlfriends and couldn't go back, so result was despair from loosing loved one for nothing and consequentially another break down, depression and hopelessness. It's like I have low capacity and couldn't handle too many things at once. To selfcare, work part time, take care of my son every second week, have hobbies and be in a relationship. Just too much of everything. Which is frustrating because I want to live sort of normal life. My psychotherapist suggest I might have a borderline personality but I'm not sure. I haven't been like this 9 years ago when I've had my first break down and was put on AD's (SSRI) which put me into very very deep hole (adverse reaction) and I thought, well this is my end, something got wrong deep inside of me ( on subconscious level somewhere). So is it borderline, high anxiety or something else? Any one can relate on this or have advice how to deal with this in withdrawal? Do you have similar symptoms? How do you manage them? What I feel I need is to calm down and not act on a trigger. But easy to say than done. 

Thank you. 

[Tomasz]

For mods: Probably posted on wrong subforum, please transfer to Introduction and updates. Thank you 

[Altostrata]

Hello, @Tomasz

 

On 9/13/2023 at 1:49 AM, Tomasz said:

Beginning was difficult with crazy mood swings, anger etc. while trying to manage new relationship.

 

This is what happened after you stopped venlafaxine in May, correct?

 

On 9/13/2023 at 1:49 AM, Tomasz said:

The main problems I struggle with are unexpected mood swings, very low tolerance to stress (even positive one) and anger or irritability which I try to not put on anyone. 

 

How has your symptom pattern changed since May? How's your sleep?

 

It appears that you had withdrawal symptoms after you went off venlafaxine in May and you may have protracted withdrawal syndrome now.