HardTimes: late onset withdrawal from long-term citalopram disaster

[HardTimes]

SO... Just discovered something at once kind of terrible and absurd. The drug the doctor gave me was ESCITALOPRAM, not CITALOPRAM. Which are not the same thing (one is sold as "Celexa" and the other as "Lexapro"). I can't entirely account for how I screwed this up so badly - I think I thought the "escitalopram" was the French way of naming it (I live in France), or a french brand, or maybe a generic brand of the same drug. But it isn't. Either my doctor or the pharmacist or my language skills screwed up somewhere along the way.

 

So this means that when I decided back in august to try to reinstate, I tried to reinstate on the WRONG F%^&ing drug. I worked my way up to 5mg and felt totally crazy. Apparently from what I just started reading today, EScitalopram is also twice as strong, such that 5mg of "es" is closer to 10mg of regular citalopram. So I was actually taking way, way, way too much of the stuff back in August. 

 

Now, as I write this, I am on my seventh day of an attempted reinstatement, but again, this has been on the wrong drug! I've been taking a very, very small dose (0.25mg) with a syringe. While it has changed my symptoms somewhat, it hasn't exactly relieved them. Today, a few hours after that very small dose, I feel pretty stoned and glassy eyed, unmotivated, and with tingling sensations on the back of my head. The hot flashes have returned, though not as severe as they once were. I fall asleep much more easily than before reinstatement, but I still wake up after only four hours with a hot flash and difficulty sleeping again. I'm also still pretty depressed, though it can be hard to feel much of anything when the "stoned" sensation hits. I can feel that the impact now after 7 days is stronger than it was, that a pattern is developing, even though it is such a tiny dose and such a short time. 

 

I'm such an idiot for making a complicated situation even more complicated. It seems pretty clear to me that I should immediately stop taking this (I don't think I need/want to taper after so small a dose and after so short a time, right?). So the new strategy is to get this stuff out of my system, give myself a couple of weeks with nothing at all, and then reassess yet again. @DataGuy, you seem to be my moderator advisor on all this, so if you have a moment to confirm and console that would be great. I'm going to force myself off for some exercise now - I've had several days now where all I really want to do is stare at the TV. Not good!

 

 

[arbor]

Oh yecchh, this certainly sounds like an easy mistake to make.  Hope you feel better soon, Hard Times--

Arbor

[DataGuy]

Hi @HardTimes,

 

Sorry to hear about the mishap, but it probably is not as big of a deal as it seems. Escitalopram and Citalopram are very similar. Both have strong action on the serotonin transporter and not much else. Escitalopram is a bit stronger, and that definitely could have thrown things off during the prior reinstatement, but this time it likely did not affect things too much. You may have gotten the same reaction with Citalopram. We have reinstated people who stopped Escitalopram with Citalopram before with not terrible results. 

 

If the current dose you are on is making you feel stoned, you could always lower to 0.1mg. Just have to decide whether you feel better with a tiny amount of drug or none. It's very tough and any evaluations will be necessarily subjective. I am actually a bit skeptical of the scales they use to evaluate whether these drugs make people less depressed, like HAM-D or Montgomery-Asperg. There is an inherent problem that the person has no objective anchor for how they feel and a very imperfect memory of how they felt off-drug (or on drug, depending on when the measurement is taken). Also tough to evaluate dose changes. I feel like this is where patients run into trouble. They take the drug and feel worse, but mistake the worsened feeling as not being caused by the drug. The doctor, trained to think the drug helps, increases the dose and the patient feels even worse and thinks they are hopeless. Very insidious. 

 

I will leave the evaluation as to whether you feel worse or better to you, but I would recommend you step down to 0.1mg for awhile before stopping altogether. This may be a more appropriate dose, as ridiculously trivial as it seems. 

 

This is the difficulty of withdrawal. Symptoms can often be refractory to any treatment, especially initially. All I can tell you is that it will, very slowly, get better. Surviving and protecting your health is your priority. If you do that, you will eventually get your old self back. Please keep that in mind and be sure to enjoy any windows you get. 

Edited October 26, 2020 by DataGuy

[HardTimes]

Hi @DataGuy . I completely agree about the difficulty of measuring all these subjective feelings. I'm trying to keep track of symptoms, and quantify the overall level of symtoms in the AM, PM and evening, but I can see that I'm not always in the best place to judge because the numbers are comparative to feelings I had previously that I cannot correctly remember. It really isn't easy. But it can be helpful, I guess, to be able to look back and see some general trends of some kind. Sometimes lately I've just become exhausted by the whole tedious process and I've been too depressed to be bothered to note things in a journal, and then have to try to remember a day later. 

 

Having discovered the EScitalopram vs Citalopram error, and based on your comments that maybe this wasn't a HUGE deal, I decided NOT to stop this attempt at reinstatement, but I did drop down a level to 0.125mg. So, for the record, this current reinstatement has been:

0.5mg - one day, thought it was too much.

0.25 mg 5 days, until discovering the error

0.125mg 2 days, instead of stopping entirely. 

All of this was Escitalopram, when it should have been Citalopram. 

 

However, from some of my reading, it looks to me that while the difference between EScitalopram and Citalopram isn't that huge, there IS a difference. And it makes sense to me that if I've been on something for so long I should reinstate the same thing. The dosage difference is in fact double, and some of the side effects are a little different (https://www.singlecare.com/blog/celexa-vs-lexapro/). So I've looked around and found one last pill of Citalopram that I can dilute and turn into quite a few doses if I want to.  Do you think it is safe to switch like this? Or should I stop the Escitalopram for a week first? Or, since the doses are so small, likely moving from one to the other won't be a problem? I think I'll feel more comfortable, somehow, knowing I'm taking the same stuff I was supposed to be taking, and maybe that placebo effect will help too... Advice appreciated.

 

Another bad night of sleep last night - I wish I could explain it better to you. It is not that I'm not sleepy and yet forcing myself to try to sleep. In that case I could just get up and write a novel or whatever. Instead,  I'm exhausted, and physically out of it, yet my mind is dancing around all over the place, and I get a strange nervous panicky feeling. If I turn on the light and read for a while, or maybe turn on the tube, I cool off and sometimes my brain settles to the point where my eyelids are falling and the book falls out of my hands. But then there is an unexplained rush of heat and panic and I'm "awake" again. For hours on end! I'm at the end of the rope on this. My wife has booked me acupuncture on Saturday, which I'm not all that optimistic about, but at this stage I'll try anything if it keeps me safe. 

 

Thanks again for your efforts. I really am just so sick of all this and finding it difficult to put a brave face on it all and keep making the effort. But I have to!

[DataGuy]

Yes, there is a difference between Citalopram and Eschitalopram, however, the main pharmacological effect, which is likely the culprit in the withdrawal syndrome, is the same. Both bind to the serotonin transporter, with escitalopram having a slightly higher affinity for it and thus being stronger. However, the drugs likely do have off-target effects. If these are the source of your problems, it is possible you could have an easier time with citalopram. It is worth a try, but I would not depend on it to make a huge difference. 

 

I would not get too hung up on differences in reported side effects. These are often recorded and reported haphazardly and can vary by trial even with the same drug, since they can be confounded by a number of factors, one being that a certain percentage of trial participants are already taking psychotropics, are usually cold-turkeyed off of them prior to the trial, and are then randomized to the placebo or drug groups. So a certain percentage of participants taking the placebo are in drug withdrawal and will have withdrawal symptoms which could dampen the signal for side effects in the drug group when they are compared. The amount of patients taking psychotropics and what percentage are randomized to placebo will vary by trial and is essentially just unpredictable.

 

Yes, at such a low dose, it is pretty safe to switch from escitalopram to citalopram. I would start low, then if that doesn't help after a few days you can try increasing it. The falling asleep and then being jolted awake by adrenaline is pretty unmistakably a withdrawal symptom, so you may benefit from increasing the reinstatement dose if you can tolerate it. 

 

How much on average are you sleeping per night? How much are you exercising per day? Would be good to get a daily schedule of activities so that you can see what impact your behavior may be having on your sleep and symptoms. 

 

Yes, the goal is survival. I think when you look back, you will be proud of your resourcefulness under exceptionally difficult circumstances. 

Edited November 1, 2020 by DataGuy

[HardTimes]

Hi again. Mostly just to say thank you to @rupa for reaching out to me. Amazing that someone in India can take the trouble to communicate with a total stranger in France! 

 

As you'll see if you read my most recent posts, I have indeed attempted to reinstate (I started about a month ago). I should update my signature. I am now taking a very low dose (0.375mg) of Citalopram (not Escitalopram). However, it doesn't seem to me that I'm really stabilizing, exactly. I think it is a little different from those nights before reinstating when I wasn't getting any sleep at all, so maybe it is a little better. But it is still pretty rough going. Before (many months ago, when all this started) I would bolt awake at 5am, feeling really hot and grumpy, but emotionally I wasn't that bad. It seemed a purely physical/chemical reaction. More recently, however, the psychological and the physical have joined forces. Last night I woke after only 2-3 hours of sleep in a panic, had an enormous hot-flash sensation, and felt very emotional and anxious about my career/future. I read a bad novel and eventually fell back asleep, only for the sequence to repeat an hour or two later. This sort of thing is now typical, and I'm still finding my days are often filled with fierce psychological symptoms: anxiety, depression, self-loathing, narcissism (everything seems to be only about me), a total lack of self-confidence, regret, etc. Physical symptoms persist as well, though by far the worst is the "insomnia", since it can leave me feeling totally drained and depleted and unmotivated all day. This wasn't as evident in the early days, when it seemed to be primarily a strange physical sensation.

 

I started this reinstatement on 0.25mg, and after a couple weeks bumped it up a tiny smidge to 0.375mg. My thought was that, since I hadn't stabilized much, I should try increasing. I've also tried changing when I take the stuff - I thought maybe before bed might help with the sleep, but then I started to think that maybe the hot flashes were actually being caused by the medicine, so have slowly moved back to taking it at mid-day. At this point I don't know if I should be a) aiming to increase the dose (slowly, carefully) until the symptoms are greatly reduced, b) decrease the dose because apparently I'm not overreacting to this amount, or c) quit this reinstatement entirely. Either way I want to try to talk to a psychiatrist about some kind of solution, even if it involves some other medication? It has been 10 months, and those good long patches of good days I had over the summer feel very far away. Between taking drugs and a stress induced heart attack (or something even worse), I'll take the drugs. 

 

So I guess my questions are: Has my attempt at reinstatement failed? Have I just not given it enough time? Do I need to increase the dosage? Or go back down? Or just stay the same and be patient? 

 

And to finally respond to @DataGuy regarding exercise: We're under lockdown here. I'm still getting out for at least a boring walk everyday, and running for half an hour or so every other day, unless my symptoms prevent me (like bad pressure headaches or fatigue). On the rare day (I think there have been 2 since I last posted) that I'm feeling OK, I might do some other sporty activities with some local kids. So not a huge amount, but I'm getting out every day. I recently read something about low-intensity exercise (yoga?) might be better for reducing cortisol levels, rather than heavier cardio-vascular stuff like running, which apparently can actually increase cortisol production. I suppose it is likely a balance - but maybe I'll have to start trying yoga of some sort. 

 

Thanks again to both of you for caring about strangers!

[rupa]

@HardTimes

 

Dear ,There is no such thing as stranger as our forum made us all living in one global village.

I appreciate very much you reinstated.

As long as we are on the drug,irrespective of quantity,it effects brain.Same time ,if we stop suddenly ,that too effects the brain.

So,

Steabilizing means,keeping same dose for four weeks.Without giving a damn to symptoms.

For sleep quality,you should use turmeric mixed warm milk,butter milk with turmeric etc.soft mashed Rice with raw onion and buttermilk helps greatly.

The key is ,every four weeks ,steadily reducing the quantity,as per our forum suggests,10%,would help the brain rewire eventually.

Once I reach zero,then it took 2 years for me to reach before the drug use state.

I believe,food habits greatly helped for eventual recovery,Once sleep quality improves,thats what I call it recovery.

 

[DataGuy]

Thanks for the update @HardTimes,

 

I would not rule the reinstatement a failure yet. It can sometimes take months to stabilize after reinstating. I think the fact that you are able to get back to sleep sometimes after waking up early is a good sign. I hope you are still recording significant symptoms changes and what you think is affecting them. Keep in mind that you were taking the anti-histamine and Xanax (alprazolam) for awhile. I hope you are staying away from these now. It is very possible that withdrawal from these drugs is confounding your recovery at the moment. The good thing is you did not use them too much and did so intermittently. However, they are sedatives, and your nervous system will generally react to sedation by downregulating inhibitory receptors. Thus you are left in a more excited (and unpleasant) baseline state of activity. The Xanax is also neurotoxic, as the antihistamine likely was too. Not good for brain health, mental health or physical health, and likely not great for recovering from an injury induced by citalopram withdrawal. 

 

Of course none of this is your fault. You were simply given poor advice from doctors who prescribe these drugs without knowing much about the consequences or how to safely taper them. There have been some studies published now that withdrawal syndromes can last months or years, but that is after these medications have already been on the market for many decades, so you could argue the medical profession has been negligent in warning their patients. The best thing you can do now is stay drug and supplement free (other than the reinstated citalopram) and do things that are good for you with a high probability (exercise, socializing, some work, trying to relieve stress with meditation, yoga or quiet reading etc). It sounds like you are doing everything right, but it will still be tough for awhile. Just hang in there.

 

As to whether you should increase the dosage: did you feel any improvement when you moved up the dosage last time? Any increase in adverse effects? It is very hard to say whether you have improved simply from your description. You will have to look at your symptom pattern if you are keeping a log. 

 

Re: talking to a psychiatrist about a solution. There isn't any effective treatment for withdrawal syndrome that we know of. They have done no formal trials as far as I know, and the vast majority of drugs tested for problems of the nervous system demonstrate no health benefit (no decrease in all-cause mortality risk vs placebo). I think your best bet for a full recovery and happiness is to aim to eventually be drug free. More psychotropics are just likely to exacerbate your problem. Seems the conclusion that researchers have reached regarding off-label prescribing (which any prescription you receive will be, since they are not studied or approved for that usage) is that it is unethical, because it is very much more likely to harm the patient than to help. If you want to read why, check out Ending Medical Reversal by Vinay Prasad MD and Adam Cifu MD. I am doing my best to prevent further harm to you. Hope that you get some relief soon @HardTimes.

Edited November 15, 2020 by DataGuy

[HardTimes]

Thanks for the replies. @DataGuy, I have no doubt at all that you are doing your best to prevent further harm, and I hope I have clearly expressed my gratitude for your efforts. My desire to seek whatever other solutions I can isn't based on you or your advice at all, just on my frustration with the situation and my sense that 10 months on I feel I'm actually worse in many ways, so it becomes increasingly more difficult to just keep telling myself that time will heal all wounds. 

 

However, on a positive note, the day after my last post (which was a pretty bad day) counted as a genuine window, and several days this week have been reasonably good as well, though I really have to monitor my thoughts very strictly. I've managed to get a bit more sleep, and the morning heat/panic/nervous electrical sensations were improved. And this IS an improvement on the period before reinstating, when I had those nights with no sleep at all, and was overcome by feelings of shame during the day. My inclination is still to try to increase the reinstatement, as I really want to be relatively symptom-free for a decent period before I do anything else. But it isn't easy to figure out what the medicine is doing. Or rather, it isn't always clear what symptoms are being caused by the medicine, and which are being helped by it. Even on this very low dose, which I now take with food at midday, it seems to me that I can feel the drug hit me 3-4 hours later, giving me a strange pressure-headache, sort of stoned yet anxious sensation (we've already talked about the difficulties of rating and ranking symptoms). It sometimes seems to help, and sometimes seems to hinder. Now I think I'm going to just stick where I am until the end of the month and then maybe go up another tiny notch. 

 

Unfortunately last night was pretty bad again, and all morning I've been gripped by these shooting sensations of nervous energy - like you would have if you were about to go on stage before some huge crowd, or were about to go in for a huge job interview or face some really difficult emotional situation. But I have nothing really to be nervous about! So strange, and I can't help but feel ashamed of it, even if I can rationally tell myself it isn't my fault. It feels like it is my fault - I'm just not sufficiently "British", so to speak. 

 

Anyway. Again, I appreciate your help and wish I could buy you a beer (not that I'm able to drink alcohol anymore!). I'll likely check in again after I try bumping up the dosage a bit in a few weeks time. Does that sound about right? I don't want to be posting on here and harassing you every day!

 

[DataGuy]

On 11/19/2020 at 6:22 AM, HardTimes said:

Thanks for the replies. @DataGuy, I have no doubt at all that you are doing your best to prevent further harm, and I hope I have clearly expressed my gratitude for your efforts. My desire to seek whatever other solutions I can isn't based on you or your advice at all, just on my frustration with the situation and my sense that 10 months on I feel I'm actually worse in many ways, so it becomes increasingly more difficult to just keep telling myself that time will heal all wounds. 

 

-------------------------------

 

Anyway. Again, I appreciate your help and wish I could buy you a beer (not that I'm able to drink alcohol anymore!). I'll likely check in again after I try bumping up the dosage a bit in a few weeks time. Does that sound about right? I don't want to be posting on here and harassing you every day!

 

 

@HardTimes I think you should seriously consider that Xanax, Nyquil etc have hindered your recovery, and that is why you feel almost worse off 10 months later. These drugs are unlikely to be good for your health long term and the research showing that they (Xanax anyway, but likely Nyquil as well) result in neurotoxicity seems like a solid confirmation of that. Xanax is regularly on the top 10 of the CDCs most deadly drugs for drug toxicity and it is only a single benzodiazepine. Doctors are free to prescribe any of 10 other ones, so it is fairly impressive to be consistently on the list. 

 

Perhaps you can buy me a root beer, I don't think I will be drinking anytime soon either : )

 

Here is Xanax (alprazolam), right up there with cocaine and heroin https://www.cdc.gov/nchs/data/nvsr/nvsr67/nvsr67_09-508.pdf: 

Edited November 22, 2020 by DataGuy

[HardTimes]

So last night was pretty weird and not very good at all. The only reason I can think has to do with my attempted reinstatement, so I'm seeking community advice.

 

Here's a recap of my situation: At the end of October I was feeling increasingly desperate about my situation (10 months after stopping), and decided I needed to try to reinstate again. After a bad attempt at reinstatement in August (during which I increased my dosage too quickly and eventually felt I was really going crazy - and learned later that it was EScitalopram, not Citalopram...), I knew I had to go very carefully. Long story short (the long version is above), I have been for several weeks on 0.375mg of Citalopram, and before that a couple weeks at 0.25mg. I was ambivalent about whether or not this reinstatement was working: some of the worst symptoms had improved, but it seemed others had simply changed form. Ultimately I decided there had been some improvement, and I thought that increasing the dose (just by another tiny bit to 0.5mg) would further help me stabilize.  That was about a week ago, so the new 0.5 dose has had time to fully work into my system.

 

SLEEP: My sleep has continued to be bad during the reinstatement so far, marked by hot flashes that wake me not just at 5am, but also very often at 2am as well. Sometimes I can go back to sleep, but sometimes not, and either way I feel pretty terrible during the night and for the next morning (I often find it hard to do anything other than vegetate in front of terrible television until noon). Still, I thought this was an improvement on pre-reinstatement, when I sometimes had no sleep at all and felt very panicky and erratic. So last night I was pretty much asleep when a noise woke me at midnight, and for the rest of the night I just felt really weird. I felt "high" somehow, but not at all in any kind of good way (I don't have much experience with recreational drugs, but it felt like a kind of "bad high"). It isn't easy to explain! Sometimes pounding heart, long-lasting "internal" heat (rather than the regular flushes), sleepy at first, but then not so much... Yet at the same time MENTALLY I felt unusually calm and free of panic ("it isn't that big a deal to go without sleep for a night"), and kind of glassy-eyed. So I read, I watched TV, I closed my eyes and just lay there for several hours with my mind jumping around, telling myself it would pass, that the drug would eventually diminish, that I just had to stay calm. But it was really not a nice feeling!

 

My interpretation of this reaction (which, when I read what I've written sounds much less horrible than it was) is that my body is not tolerating the slight increase to 0.5  and that I should drop back at least to 0.375. But I'm not sure? Is it the case that during upward dosing one should just expect a few particularly bad days that will calm as the body adjusts? I realize the idea is to get to the minimum dosage that allows some decent stability, but it can be AWFULLY hard to figure this out. A few weeks ago I had several pretty decent days in a row and thought I had successfully stabilized, only to find it was just a short-lived "window". The whole windows and waves pattern makes it very difficult to tell if any particular change in supplement, diet, exercise or drug intake is responsible for any given effect.

 

I'm terrified that this might mean that the reinstatement has failed, that reinstatement is not possible for me!!! Because everything I've read on this site tells me there are three and three only ways out of this whole nightmare for all of us: 1) reinstate, stabilize, very gradually diminish, 2) use lifestyle techniques (breathing, yoga, music, supplements, exercise, etc.) and 3) time (just wait - maybe it will take years, but eventually the CNS will heal itself). I've seen what life is like just trying to rely on 2 and 3, and it wasn't very pretty, so I was really hoping that this very gentle reinstatement would help. If it fails, a certain amount of my hope falls apart too.

 

This is now too long for anybody to be able to read. But it is good to write sometimes. If anybody has thoughts or experience with difficult, late re-instatement, please get in touch. Or even if anybody can just continue to reassure me that even if this reinstatement fails all is not lost... I want to survive this!

 

Can I do hashtags here? #Reinstatement

[DataGuy]

Hi @HardTimes,

 

I've added a "reinstatement" tag to your post, so if people search for that tag they should be able to find you. 

 

I'm not really sure what to say about the reinstatement. Only you can decide whether it constitutes an improvement over the initial withdrawal. Have you still been keeping the symptom journal? Have you scores been better since the reinstatement?

 

It sounds like you had an odd state of consciousness, perhaps induced by the drug. I can't say I know your exact feeling, but you may be able to find someone on the forum who has had something similar. There is a section of the forum called "neuro-emotions" about strange feelings people will get from withdrawal (or from the drugs), which might be of some help. Sounds like you were just very uneasy and uncomfortable, but not in a "normal" way. 

 

From what you have written, my opinion is that the reinstatement has been a very marginal improvement. You had some very bad days prior to reinstating. Although your night did not sound fun at all, it didn't sound quite as bad as some previous days you've had in withdrawal. However, I do think it might be a good idea to lower the dose a bit. The best we can hope for with a reinstatement - especially one as late as yours - is for some marginal improvement. I think you have had that, although since it is difficult for you to tell, the improvement is pretty minor. 

 

Have your symptoms been stable, for the most part? Have you been avoiding the Alprazolam and any other sleep aides? 

 

It's now been about 6 weeks since you reinstated. The marginal improvement could be partially due to the reinstatement and partially due to more time passing. It also could have something to do with ditching the alprazolam and antihistamine. Very tough to tell. I don't think there is any harm in making a minor reduction and then holding for awhile to see if things stabilize further. 

 

Looking back over your posts, I just realized you said you were taking some sort of herbal concoction which I had somehow missed. Can you tell me what exactly is in this? Can you link to the product or a list of ingredients? Some of these herbal supplements can have pretty substantial effects on your nervous system. Thanks, and I'm sorry I'd missed that before. 

[HardTimes]

Thanks for the response. Briefly, since that bad, weird, druggy night two nights ago (and the rather emotionally crappy period in the days before), I've had two very decent nights, and yesterday was a genuine window. No reason I can think of - in fact, I was expecting a bad night/day as I had a language exam for my citizenship that would have been normal to have some anxiety about. But the night was fine, the day was fine, last night was pretty fine and today is looking good too! So now the trick is to try to keep this window, or this period of stability, going for as long as possible. I'm not going to screw with my reinstatement amount (though I might change my dilution technique - it occurs to me that it might be somehow possible that each time I pull the suspension into the syringe I'm not getting exactly the same amount somehow...), and today I'm feeling like the reinstatement has been, overall, somewhat stabilizing. It might be the case that going up even further eventually will have further positive benefits, but for now I'm just going to hold and wait and try not to change anything too much... And be grateful for this window!

 

As for the herbal concoction: This stuff is awesome. Now I don't take it unless I need it (if I've tried sleeping and, after a couple hours have not fallen asleep). Mostly I don't have a problem falling asleep - my problem is waking up too often and too early and feeling really hot and crazy when I do. It is a liquid that comes in little glass ampules I've never seen before (a french thing?). It is a "high concentration" mix of valerian, Passiflore (Passionflower) and "Escholtzia"... Hell, maybe it is just placebo, but I found it worked great when I needed it. But like I say, I now try my best to steer clear of everything unless I really need it.

 

I'll report back in a couple weeks again - I don't want to spend any more of my window time ruminating on this stuff right now! But thanks very much once again for your input - it isn't easy to figure out, and even just having a place to formulate questions and think out loud can be helpful. 

[ChessieCat]

Hi HardTimes,

 

Please condense your drug signature.  We do not need any story.  That is better posted in your Introduction topic not the signature.

 

All we need are drug name, dose, and date that the dose was changed.  The reason for the drug signature is so that we can see your drug history at a glance and not have to read through it to find the information.  Thank you.

 

You will need to copy and paste it into a post BEFORE you change it.

 

Please see these instructions:

 

Instructions:  Withdrawal History Signature

 

20 years on a low dose of citalopram (10mg)

2019 sometime I dropped to 5mg with no problems. Stayed on that for 6 months or so? 

Feb 2020 went from 5mg to zero, thinking that I had sufficiently "tapered"

May - June 2020 - sometimes taking sleeping pills, thinking I had a sleep problem, not SSRI withdrawal

Sometime around June learned about withdrawal syndrome

Entire month of August - Attempted reinstatement, but with Escitalopram, not Citalopram. Apparently increased dosage too quickly, and ended up in really bad shape. 

Since ending reinstatement, I immediately had several week+ long windows, alternating with waves. But life seemed pretty good.

Last wave hit hard and wasn't going away, so mid-october started a new reinstatement that doesn't seem to be working.

Feb - Current: occasionally (rarely) using .125 or .25 Alprazolam to treat severe anxiety symptoms if necessary.

 

[HardTimes]

Not really sure what I should write here. I'm not doing great and feel I need to reach out somehow, but not really sure what to say or who I'm reaching out to. It feels like my will and resolve to cope with this whole situation is slipping. This site is all about giving advice and info to people who are willing to fight for themselves, but what happens when that will itself starts to fall apart? I'm sick of journaling, of trying to rationally figure out what activities/foods/supplements/situations cause what symptomatic responses. There is just no pattern that I can see, and I'm worn out from every day being such an effort. I'm beginning to have those thoughts about what a burden I am on my dear sweet wife, and I know that is not a good sign. I feel like a melting pile of sludge, slowly dripping down a drain. My self-confidence is destroyed.

 

I guess it would just be nice to hear that this will eventually go away? Do we all heal eventually? I'm beginning to accept that my former life is gone and not likely to be coming back, but is THIS the rest of my life? Does it get better if I just wait long enough? I guess I should search for some success stories. 

 

I realize I'm writing now at a low point, and I'm likely experiencing "neuroemotions" (which I'm going to go read about now - thanks for the tip). 

 

My symptom pattern for the last few days is fairly simple compared with at the start: I get into bed at a good hour, but then, in the transition from hypnogogic imagery to actual sleep I get a wave of heat/nervous energy. It feels like warm mercury or electric ants rushing through my veins. I can't sleep, even though I'm really sleepy - if I get up and move around, the heat dies down, but as soon as I try to nod off again, ZAP, it flashes back. Sometimes I put on the TV and am able to fall "asleep" in front of it, still twisting and turning, awake enough to change the volume sometimes, but I can't recall any of the show. If it was just lack of sleep it wouldn't be so bad, but the next day (like today) I'm so depressed, just totally drained and feeling hopeless and lacking any will to try to help myself. I just want to stay under the covers. Later in the day things improve a bit. Then, after such a bad day, I might get really sleepy really early (8-9pm). So I go to sleep, and have a very GOOD night, sleeping through till 5 or so with only short heat-flush wake ups (9-5 is a solid 8 hours!). Then the following day is much better, and I can take on various tasks, exercise, and feel like I can fight this and keep going. Then, the next night I go ZAP again, for no reason I can find, and the next day is bad again. So lots of one good(ish) day, one bad day, one good(ish) day...

 

Drug wise: I has been about two months since I tried reinstating at a very tiny dose (0.25mg, then 0.375mg). It has been almost three weeks since I increased a tiny bit to 0.5mg. Am I "kindling", and should therefore take a little less? Or have I simply not yet moved up to a level where the drug has the power to help stabilize me? Maybe it isn't having any effect at all, since the dose is so tiny? Then again, I know it isn't a good idea to make a lot of changes, so maybe I just stay the same? I think I'm inclined to try to increase to maybe 1mg (or at least 0.75) and hold for two or three weeks and try to make the effort to keep a decent record of the effects. If I have a bad reaction I can go back down. However, the sensation of heat flashes really FEELS like it is caused by taking a drug (even though I had them before trying to reinstate too), so I'm kind of terrified of taking it. Maybe I should take a little less? But I'm also terrified of just staying in this pattern forever, and it seems reinstatement plus time is the only possible solution, so I want to make the reinstatement work. 

 

Anyway. I guess it helps to get that off my chest a bit. And I know SO many people are going through so much during this holiday period of Covid, even if they don't have SSRI problems, I really shouldn't complain. Sorry to be a drag. What are the ethics of posting when you're down? How does that help anybody? I just feel the need to reach out somehow, to not be quite so alone in all this. I don't know what to do. 

 

I'll try to edit my signature now, @ChessieCat

[arbor]

Dear Hard Times--I'm so sorry that it's taken me awhile to respond.  I'm just now catching up with my email.  Please don't feel alone with your feelings.  What you're describing I certainly struggle with as well.  I do believe the hopelessness and despair is related to the cock-eyed levels of neurotransmitters, cortisol, etc. in our brains, and the derangement of our neurons--or whatever.  Anyway, it's a nightmare.  I keep reading that time is the cure and when I read how long that time can be for some people, I question my stamina.  For you though, I feel more positive because you have in fact experienced some good sleep.  I'm sure I haven't had 8hrs in one night since a few days after I reached zero.  Eventually you're going to reset your circadian clocks and grow the transporters, or whatever, you need.  I agree with you that there don't seem to be very many reliable patterns.  Just this Zen "sweeping the stairs" thing that you mentioned--I think of it every morning as I confront preparing the ultra healthy, time-consuming breakfast that I'm hoping will help--even if it's just a placebo effect.  The present moment has become extremely present-momenty.  When I'm walking, to divert the darkness of my thoughts, I stare at the bright wet leaves melting into the path.  At least they have beautiful shapes.  You can see how rudimentary I've had to go to resonate with the world while I'm going through this.  I never knew such imposed, internal horror could exist.  A kind of neurological rape by the pharmaceutical industry.  Don't give in to the degradation of our thoughts this trespass has created.  I truly believe for you that your brain will heal, that your life is important, and that you deserve all the support in the world.

 

Thanks for reaching out,

Arbor

[HardTimes]

So nice to hear from you, @arbor.

No problem with response times, ever! Never let SA become a stressor if you can help it. I've been vicariously soaking up all the good vibes everybody has been sending you over the past little while. How funny that just a few short days ago I was writing you with encouraging words, and yet by yesterday I was the one feeling really bleak. Yup, this really sucks, no two ways around it. Once DataGuy encouraged me with the suggestion that I would look back and see the kinds of inner resources I had, and actually feel kind of proud of it. It isn't easy to see that when those inner resources feel depleted, but I certainly think in your case it is true! The ability to keep making that effort of time-consuming breakfasts - very impressive! And I will try to learn from you about getting even more present-momenty (I LOVE the way you put that!). I've noticed that it is part of the process for any illness, to an extent. When I've visited people in the hospital, their whole world revolves around that one corridor, the flavour of the Jello that night, very small local things. So we share that with all those ailing in the world. 

 

Let's help each other get through this winter. I'm not sure how much "seasonal affective disorder" plays a role in this for anybody, but I know I'm going to have just that little tiny bit more hope when the days start getting a little longer again in a day or two. The Christmas season is a bit hard, with all the expectation to be living a life from a Hallmark Card, but this too shall pass soon. I'm feeling a bit better today than yesterday morning. Every day you have to tell yourself in the morning that you'll be feeling a little better in the afternoon, because those mornings are brutal. It is so strange how inverted, how topsy-turvy everything is: Sleep is supposed to be the most relaxing thing there is, and you're supposed to wake up refreshed, and then the stress builds during the day's activities. I'm the opposite. I go calmly to bed and somehow freak out with some sort of crazy nervous energy, and wake up feeling like I've been brainwashed at Guantanamo, and then slowly manage to calm down during the day. So bizarre. I wonder what your sleep pattern is? Is it that you can never fall asleep? Or you wake up every ten minutes? Do you have lots of "monkey brain" whirling thoughts, or are you fairly calm? Do you have a lot of physical symptoms at night? Consistently through the night, or at certain times? It sounds like almost everybody on this forum has described having "insomnia", but it might aid us all to be a bit more specific eventually. There are loads of ways to have "insomnia," and it might help diagnose the specific problem. I've been reading, and it looks like for me at least it might have something to do with shifting between different levels of sleep, maybe. But that's the subject of a different thread, maybe.

 

Thanks back to you for reaching out. Sometimes I don't just need advice on my constant reinstatement anxiety, I just need someone who understands to say it will all be OK somehow. Hey - what success stories do you recommend, for the next time I'm hurting? 

 

Thanks again.

[DataGuy]

Hi @HardTimes, I hope you are feeling a bit better. I think you should stick with your current reinstatement dosage. Although the bad days sound difficult, alternating between one good day and one bad day is not a terrible outcome. Many people would kill to have one good day every 2nd day. I know it is our nature to always want a bit more after we improve, but I think right now it is best to be thankful for the good days. I wish I could write a more complete response, but it is the middle of the night here and I should probably try to get back to sleep before work tomorrow. 

 

One thing I meant to address was the supplement. I believe I have looked up passionflower and valerian previously and found that they had significant effects on neurotransmitters. I will have to look them up again, but you are right, best to be cautious when using something like this. Often these supplements are pretty unregulated but can have similar effects to prescription drugs. The safety of them is mostly unstudied. I used to take supplements myself and would rationalize that they would not leave dangerous products on the market, but turns out they are quite willing to do that. And of course they leave drugs like antidepressants and benzodiazepines on the market, which have dangerous side effects that are unknown to most doctors even though they are purportedly "well-studied". I would trust your body and your biology to know what to do. If you can't sleep, you can't sleep. You may feel very bad as a result, but part of that may simply be from ruminating about the poor sleep and being very frustrated at the condition. Or not. Very hard to know exactly what determines our mood. But I know the feeling of being completely exhausted and simply wanting to stare vacantly at nothing in particular (while also not wanting to do that and hating it...ugh.) 

 

In any case, recommendations are:

1) stay away from herbal supplement. Sedatives can often have depression as a possible side effect and sedatives in general (and all psychotropics, really) are definitely not conducive to health, especially when taken on a regular basis. 

 

2) Be very open about what you are going through with your wife. It seems you have a good relationship and it can help for her to know what you are experiencing so she do what is best to help you. At the very least she will understand better what is happening and be sympathetic. You two can still enjoy the good days together and she can help you endure the bad days. I'm sure you would do the same thing for her. 

 

3) Perhaps on your good days you can write yourself a little message for your bad days. It can be difficult when we are feeling depressed to imagine feeling any other way. So maybe some encouragement from yourself would be a nice reminder that the bad feelings are temporary. You'll eventually have another good day. 

 

I hope that was coherent enough...it is 3am here and I've gotten 4 hours sleep so far. Hoping to get more, but that is something I have pretty limited control over. I'm sort of glad we have this little insomnia club, though. Odds are good at least one of us will be having a good day in any given time period, and we can then encourage the others from our perch of optimism : )

[HardTimes]

Hey @DataGuy. Thanks for the post, even so late at night. It can be tough to know what to do at 3 or 4, huh? Too early to just give up and get up, yet not always an easy time to sleep. I try to give myself a long "sleep-opportunity" by just staying in bed and reading if I wake around then. If I fall back asleep, great, and if I don't I'm trying not to worry about it too much (though I am pretty much an emotional wreck that next day, very bad.).

 

Actually, I wonder if I'm allowed to open a new topic on the theme of "insomnia"? I think it might be helpful to clarify this notion a bit, both for users (to share stories about the kinds of insomnia they experience) and for researchers (to see if there are specific sleep-related issues at play with withdrawal). Sleep, as you likely very well know, is all about an ongoing, rhythmical pattern of neurochemical modulation as we move through the different stages. In my own case, I'm beginning to suspect I have some sort of complication that makes the move from Stage 1 (hypnogogic images, almost pre-sleep stage) into stage 2 sometimes very difficult. I get stuck in an uncomfortable, not-awake-not-asleep brain swirl of stage one. Others, I know, wake  at dawn, and the explanation is given in terms of an overreaction to natural dawn cortisol release. But there are other kinds of sleep "insomnia", and it might be useful to see what is most common, and to maybe to think about how neurotransmitter levels that fluctuate so much during sleep are impacted by SSRI withdrawal. Just a thought. Since insomnia is such a common symptom, it might be worth articulating in more detail, and it might even be that more specific treatment options could be discovered. 

 

Thanks for reaching out in spite of your own sleeplessness, and for the advice. By the way, I already took the plunge and went up a tiny notch, from 0.5 to 0.75. I'm determined to try to do a better job at symptom tracking to see if indeed this helps or not. Unfortunately the good-day, bad-day pattern didn't stabilize, and the bad days are really bad, so I thought a change was in order. I've also reached out to a therapist in Canada, who might be able to help provide an outlet for all these negative, catastrophizing, self-destructive thoughts if she can squeeze me in. Today I managed to get out for another little run, which I haven't been up to in a while, so that's good. 

 

Hoping you got a few more hours! At least you are able to hold down a job with all this - it must be very stressful and difficult at times, but being jobless right now might well be much worse. I'm hoping that by the spring I'll be able to face looking for something... but one day at a time. 

[HardTimes]

Happy Holidays, everybody!

 

Here's a quote from a poem by Rilke (which I poached from the end of the Jojo Rabbit...). I thought it was good for this community. Wishing peace to everybody out there.

 

Let everything happen to you

Beauty and terror

Just keep going

No feeling is final

 

 

[arbor]

Thank you, @HardTimes😊🎄!!  Happy Holidays.  And what a quote from Rilke!

[DataGuy]

Hi @HardTimes,

 

Hope you are doing ok with the dose increase. I'm sure it would be fine to start an insomnia discussion group. There are a few threads on insomnia, including this one, which has various tips on how to improve sleep (I hope I have already linked that here). 

 

I think seeing a therapist is a good idea. Unfortunate it cannot be in person in these times, but hopefully still helpful. 

 

It is indeed difficult working with this level of sleep deprivation, stomach problems and other symptoms. But most of the time it's ok and I'm glad for the opportunity to socialize in person. I know that is being denied for many people right now. I have the odd day where I am exhausted and feel like I am going to collapse near the end of my workday, but luckily those days are a minority. 

 

For me I have really failed to find a solution to the insomnia, so I don't know how helpful I can be. I do like to try CBT for insomnia every once in awhile to make sure I am not getting into bad habits and making it a psychological problem, but I have come to believe it is more a biological problem (with a bit of uncertainty of course). It really doesn't seem amenable to any form of intervention, although some things are marginally helpful for getting back on track. I think a big strike against the idea that difficulty sleeping is psychological is that CBT for insomnia tends not to improve the amount of sleep people get for the average person, according to a meta-analysis I read. But it does tend to reduce their distress at the lack of sleep. And psychotherapy is considered the gold standard treatment for insomnia! So not exactly encouraging, but good to know, I suppose. From what I have seen from other people, our sleep should improve as we heal. So the trick is healing...In the meantime, I think talking out the problems with people experiencing the same problem can be very helpful.

 

Happy holidays, and thanks for the Rilke quote : )

Edited December 26, 2020 by DataGuy

[manymoretodays]

  

5 hours ago, HardTimes said:

Question: How long does the suspension/solution last?

 

Apologies if this has been answered - I searched but found nothing so far. I've been successfully making suspensions of Citalopram, where a 20mg tablet is put into 80ml of water (so: 10mg = 40ml, 1mg = 4ml, 0.5mg = 2ml, etc.). A couple of days ago I tried to go UP from 0.75mg to 1mg (as I'm trying to reinstate and stabilize). I was doing comparatively well at 0.75 for over two weeks, and thought a bump up would further resolve my symptoms. However, I quickly had a reaction to the increased dose (heart palps, jittery, nervous, felt like some sort of bad "high"). But that was also a fresh batch of solution. So I'm wondering if the efficacy of the solution goes down over time or not? Meaning a fresh batch might pack a larger punch? Theoretically, taking 1mg per day would mean the solution could last for 20 days (though I've generally made a new batch after 10-12 days). I'm too new at this to notice whether a fresh batch had a larger impact previously. I keep the solution in the fridge, as suggested.

 

SO: Does the efficacy of the solution diminish over several days? Meaning a fresher batch is more powerful? Or perhaps my reactions are just fairly coincidental, part of the waves and windows randomness of this whole thing?

 

(And FYI: I dropped right back to 0.75 the next day, but am still feeling super depressed, with weird bouts of nervousness, boiling blood, hot flashes, self-loathing thoughts, etc etc... THIS STINKS!)

 

Hi HardTimes,

Yah, that does stink, huh?

 

I did a liquid with my last drug to taper.  And I always remixed a batch every 3 days.  I just thought I would err on the side of caution, and had plenty of the medication to work with too.

 

Generally, I advise a fresh batch, every week, or 7 days.  I think yes, at some point the efficacy of a homemade solution, would go down over time.  It may vary medication to medication too. 

 

If you've mixed fresh batches, when not having a medication updose, and have not had a problem you might conclude that it was the updose.

 

It is, however hard to know for sure.

 

When did you drop back down to 0.75 mg?

And how are you doing now?

 

Would you update your signature too please.  Thank you.

 

Have you started any Omega 3's or Magnesium yet?  Many members(including me) have benefited from these.  Of course, just start one or the other at a time, and at a low dose.  That way you'll know if it helps.  I got immediate relief with the Magnesium.  And then over time, I really do believe the Omega 3's have helped as well.

 

BASIC SUPPLEMENT TOOLKIT

King of supplements: Omega-3 fatty acids (fish oil)

Magnesium, nature's calcium channel blocker

 

And best.  L, P, H, and G,

mmt

 

 

[HardTimes]

Hi @manymoretodays. Thanks very much for pitching in - it feels good to think there is another new person keeping an eye on me!

 

Ok, I'll refresh the batch every 7 days. I dropped back down to 0.75 the very next day, as my reaction to 1mg felt pretty intense. Still, it is really hard to know what is going on. When I reached .75 I eventually had something like 5 pretty good days in a row, so I came to believe I was finally "stabilizing". But given that the whole recovery process generally involves moving through a series of waves and windows, it is really hard to know if a given symptom or improvement is due to a particular behaviour, drug intake or supplement, or if it is just part of the rhythm of recovery. There is a logical fallacy known as "Post hoc, ergo propter hoc", (After this, therefore because of this), and it is easy to fall into. So I'm still not sure if:

 

a) My attempt at reinstatement has had no effect because the doses are just way too low to be registering, and any sense that I'm getting better or worse are just part of the natural pattern (i.e, No Impact)

 

b) The drug itself, even at this small dosage, does have a fairly considerable impact on my system and is in fact making things worse. It often seems like that - I take a dose and an hour or two later I have heart palps and sweats and blood-tingling, so if feels like cause and effect. But maybe I'd have that w/o the drug? (i.e. Too Much Impact)

 

c) The reinstatement was working a little bit, but I screwed it up by trying to go up too quickly too soon. (Even though .75 to 1mg doesn't seem like a big step?) (Just Right Impact!)

 

Anyway, since my try at 1mg a few days ago I've been back to pretty lame, unmotivated days stuck in front of the TV, maybe getting out for a walk or a few activities, but just not able to face much. So it feels very disappointing after thinking I was finally stabilizing. I'm going to stay at .75 for at least a month, I guess, and see if I find it helps. It is hard though, because sometimes it feels like the problem, not the solution. But I know what it was like when I had nothing at all, and that was pretty bad too!

 

Question Re: Supplements. One time I tried a certain kind of magnesium and immediately had a decent window (back when things were better). But again, was that the magnesium, or the rhythm? It (obviously) went away, and now I'm not sure if it helps. For a while I would take it at 5am when I was awake, but I can't say that it helped a lot. So: When do you take it? At night before bed? Or whenever things feel crappy? Or with breakfast? I have not yet tried Omega threes - I was at the pharmacy and got overwhelmed by the options, figured I needed to do more research and then did't get around to it. Is there a particular kind that is good?

[arbor]

Yes!  "Post hoc, ergo propter hoc"--I've been using it (and a few other logical fallacies all over the place.)  I notice some of the scientific studies use the word "association" to hint their way round it.

 

 

[HardTimes]

Need to vent, feeling like I'm back in a kind of crisis, but at the same time not certain about the value of posting stuff here, exactly. The night before last, because I was so very tired, I managed to get a really long, decent night of sleep. But last night I had another absolutely terrible night that has left me grasping at straws. Zero sleep, leading to a bad place.

 

Description: I feel I'm just approaching stage 1 sleep, the short, hypnogogic stage. But it is as if my body panics, and I get this shot of what feels like maybe adrenaline (?) - a rush of nervous energy from around my heart. I start having heart palpitations, there is a bit a heat flush (though milder than before), my blood feels like it is electrified... yet I am sleepy. I tried reading, watching some TV, just listening to some TV with my eyes closed, but every time I approached sleep I had this sensation. At first I tried to be accepting and OK, but eventually I just feel so horrible.

 

Now I feel awful because around 7 I sought some comfort from my wonderful wife, but in the course of doing so made her upset and worried that I might try to kill myself. I've had these thoughts before, but last night was the first time I started looking into methods, which is surely not a good sign at all. Now I feel terrible for making her worry and for being just such a pathetic piece of ****. It is such a catch-22. You have to reach out to people, some people, any people, something, if you want to survive this. But then the very act of reaching out can make you feel terrible for dragging other people into your wretched situation, which just reinforces that nagging thought that everybody would be a whole lot better if you weren't around.

 

What a nightmare. I feel like I've been doing everything right, but am totally lost and have only the advice of a couple volunteer strangers on this site to guide me. (Which I AM grateful for, don't get me wrong!!!) Looking at the little journal thing I'm trying to keep, I can see that things were bad a month ago, but started to improve slowly after I moved up to 0.75 from 0.5. Coincidence? I then had FIVE good days, starting on Jan 1. Still bad sleep and some so-so mornings, but much better moods overall. I thought I had stabilized. But I decided to go up to 1mg three weeks after the last increase to try to improve the sleep (since the last increase seemed to help, so too should this one?), but that one-day attempt at just 0.25 more seems to have totally ruined everything, and here I am again.

 

So again, how to interpret? What to do? One instinct says it is the dose that is causing the awful nervous constant blood-boiling and heart palps, since it somehow just feels like a drug reaction. If that's right then I should abandon this attempted reinstatement. But against this is the fact that I did have a decent long window, and that was fairly shortly after increasing the dose by a smidge. If that's right then ... I need to stick with it. But what about my Doctor's advice, that I need to take at least 5mg and just stick with that? I feel like if I tried it my head would truly explode, but maybe she's right? Maybe if I did that and stuck to it for a couple weeks my symptoms would subside? Everything I've read here is helpful but confusing - am I "kindling", or what?

 

Another day down the tubes. Almost a whole year down the tubes now. I used to have a life, a good job, options, friends. Now I feel like a sack of dog crap stinking in the corner making life bad for everybody, with no vision of a way forward, only a fixated regretful look at the past. How pathetic. I don't know what I expect to come from posting here, but it feels good to vent, and is likely better to write here than to write an email. Thoughts, advice, suggestions appreciated. I think I've got to look into more resources in my area, doctors, therapists, psychiatrists, 1-800 numbers, sleep labs, I don't know. Something has got to change.

[arbor]

@HardTimes--I so hear you--After another sleepless night of despair, I'm just crawling across the kitchen to open my email, and found you expressing so much of what I'm experiencing.  I'm going to try to pull things together so that I can focus on responding.  Please know you're not alone--Best, best wishes, Arbor

[manymoretodays]

On 1/11/2021 at 4:26 AM, HardTimes said:

There is a logical fallacy known as "Post hoc, ergo propter hoc", (After this, therefore because of this), and it is easy to fall into. So I'm still not sure if:

 

Hi @HardTimes

Here's something that should help. 

Keep daily notes of drug schedules and symptoms to track patterns and progress

Then go ahead and post a couple days, right here, in a reply.  Try and get the whole 24 hour segment in, for each day.  You'll see a sample note too, right in the first post, when you open the quote by Alto.  And then, I'm happy to confer on your behalf as well.......to see, if there are some other suggests that might help.

 

On 1/11/2021 at 4:26 AM, HardTimes said:

Question Re: Supplements. One time I tried a certain kind of magnesium and immediately had a decent window (back when things were better). But again, was that the magnesium, or the rhythm? It (obviously) went away, and now I'm not sure if it helps. For a while I would take it at 5am when I was awake, but I can't say that it helped a lot. So: When do you take it? At night before bed? Or whenever things feel crappy? Or with breakfast? I have not yet tried Omega threes - I was at the pharmacy and got overwhelmed by the options, figured I needed to do more research and then did't get around to it. Is there a particular kind that is good?

 

And yes, the overwhelm, and sometimes almost overload of information........very much used to get to me too.  I think part of it, is that while I was in acute withdrawal, I really WAS so cognitively impaired at times, it made it real hard.  Add in the neuroemotions and so very tough.  Just keep going HardTimes.  It gets better, and easier......it does.  I'll be an example of that for you too, as it has, is, so much better now, for me.

 

With the Omega's, I just almost randomly went with a brand called Barlean's, as it seemed to meet most all of the criteria mentioned.  And another member mentioned they used this brand, and I found it locally as well.  I'm at 1800 total combined EPA + DHA per day.  And over time, I do believe it has helped with my nervous system, brain function, overall balance of things, and healing.

King of supplements: Omega 3 fatty acids(Fish Oil)

I am still working on getting some of the post numbers into links, in the first post there, and checking and rechecking that links are all functional in that topic too. 

So just post here, if you spy something that would help me in that effort, or find a broken link anywhere in that long topic.

 

And we are here HardTimes, to listen.  Sometimes, for me at least, just to have someone listen, who gets it can help so very much.  For many of us, it hasn't been so much the family members that can help and support, but the ones who are going through, or have been through something similar.  Your wife IS wonderful, give her a hug.  And other resources or doctors in France......hmmm,  oh my gosh......we've got Erell, @Erell and sharing this post:

from French members, please check in here

https://www.survivingantidepressants.org/topic/13547-french-members-please-check-in-here/?do=findComment&comment=506775

 

((((((HardTimes))))))

 

L, P, H, and G,

mmt

 

* On the Magnesium, most will space theirs, throughout the day.  I, at one time mixed 300 mg of a MagCitrate complex capsule(it just had Magnesium Citrate in it though) in a liter of water, just the capsule contents, and then would sip it throughout the day.  I also still use the Epsom Salts, in a bath from time to time.  Others will, will use different forms, check the link again for those, it's up just a couple of posts.  And many do take a capsule a couple of times a day, as well and find that helpful too.  I think you'll see members experiences in the Magnesium link.  (edited in, sorry, just noticed I had not attended to your question about Magnesium)

 

 

 

 

Edited January 13, 2021 by manymoretodays
Magnesium

[arbor]

Hi @HardTimes--Sooo sorry that we were both trying to cope with the insomnia.   Maddening.  Almost unbearable (speaking for myself).  Here's a quote I lifted from Gridley:   "Sleep issues, like other withdrawal symptoms, do typically resolve over time."  Others keep posting this as well.  I hope tonight goes better--Arbor

[HardTimes]

Thanks for the replies, and particularly to @manymoretodays for offering to review some journal entries and advise. I'll try to be briefer today!

 

Update: After zero sleep, that lead to my terrible post yesterday, last night I pretty much passed out at 8:30 and slept til 4:30, and then even dozed some more, so a really solid night of sleep, and I'm feeling stronger today (as everybody said I would!).

 

More importantly: I was so freaked and concerned that it was the dose that was causing these symptoms that I decided to postpone taking it yesterday. So I took nothing at lunchtime. Still, similar symptoms started to emerge in mid-afternoon. Conclusion: Possibly the drug ISN'T quickly causing the symptoms, but possibly not: Obviously it is still in the system. I ended up taking nothing all day. Today I tried taking it in the morning, at 7:30 or so. Interestingly, I began exhibiting the same symptoms (heart palps, blood tingling, fatigue, spaceyness) about three hours later (about when they'd arrive normally after lunch), suggesting the dose DOES have a fairly immediate effect.

 

This all leads me to conclude that instead of trying to reinstate, to build up the amount of drug I'm taking till the symptoms subside, maybe the drug is making it worse (the "kindling" effect"), or at least changing the symptoms into something weirder and worse. And if that's the case I should in fact be reducing the dose or just stopping the reinstatement altogether.

 

However, I don't want to make any fast decisions, as I know that making lots of changes and experimenting too much isn't a good idea. Maybe others can give me some advice (though I realize only I can ultimately figure out if the reinstatement is making things better or worse). I read another story on this site of someone who eventually escaped the nightmare by reinstating, and I wanted to try her path. But if I'm having such reactions to only 1mg, only moving up 0.25mg, maybe reinstatement won't work for me? My huge fear here is that ... well, there aren't any other options. If reinstatement doesn't work, all that's left is TIME, magnesium, meditation, yoga, etc., none of which have been super helpful thus far. So I'm scared to stop, but I'm scared to continue... But for now I'll continue with the same dose for a few more days at least, and take it in the morning to see if the symptoms arrive earlier as they did today.

 

@manymoretodays: I have been keeping various kinds of journals. I started with complex excel spreadsheets, when I was feeling highly motivated and strong. But quantifying symptoms was tricky, and maybe too complex - I shifted to a more narrative model. Eventually, through a lens of fatigue and depression, this started feeling pointless. But for the last couple months I've been doing a much simplified note form, I think closer to what you suggest. I'm not sure what if any to post for your review - the last couple of days have been so all-over the place they won't really reveal much. The most obvious thing I can see is a connection between sleep and a somewhat better day. Maybe I'll type them up (it won't take long) and attach the most recent page or so, if you have time to take a look. It will be an opportunity to do a bit of review and analysis too.

 

Thanks again. And you (many more) are right, and echo something somebody else said, that sometimes just crying out into the community and feeling like I'm being listened to is enough. I sometimes just need to talk, but (like @arbor) worry about exhausting others or upsetting them. So I guess just venting here is a good option, even if nobody can miraculously make it all better for me.

 

Guess I'm not good a being brief! 😐

[DataGuy]

Congrats on your great sleep, @HardTimes! Yes, you are in a bit of a tricky situation. We always advise people to avoid skipping doses, but I'm glad that when you did, the result was a good one. These drugs have a very strange effect on us. I don't think the solution to your problem lies in completely stopping the reinstatement. It would be very strange if you suffered terrible withdrawal, reinstated and couldn't tell if you felt better or worse, and then cold stopped the reinstatement and felt much better than before. Perhaps you can start a slow taper once you are satisfied that the reinstatement isn't doing much to help. Just remember (I know you know this) that the effects of dose reduction can take quite some time to manifest their full effect. So if you reduce the dose and feel better, this may be followed days (or weeks) later by worsening withdrawal symptoms. I'm sorry, I'm not trying to cause any unnecessary anxiety, but I'm just hoping you'll be cautious. Whatever you decide to do, I want the result to be good.

 

Really appreciate your concern and comments on my thread. I hope one day I'm able to sleep as long as you did the other night! Withdrawal is a funny thing. One day we are feeling downright awful and the next we are feeling not bad at all. Really hope you start to have more good days than bad : )

[DataGuy]

Hi @HardTimes,

 

I was just wondering if you could update your signature with the full list of drugs and supplements you have taken and are currently taking? Here is a link directly to your signature.

 

Putting it in the format described here makes it easier for people to read, so that if a new person (like @manymoretodays ) comes to try and help, they can quickly see what you have taken and are currently taking. Your current signature is mostly ok, it just makes it much easier on people when you have all drugs and supplements listed very clearly at the top. Example: 

 

Example:

2001–2002 paroxetine 
2003  citalopram 
2004  paroxetine
2008  paroxetine slow taper down to 2016 Aug off paroxetine
2016  citalopram May 20mg  Oct slow taper down
2018  citalopram 13 Feb 4.6mg 15 Mar 4.4mg 29 Apr 4.2mg

 

Thanks @HardTimes. Hope you are enjoying your day!

[HardTimes]

Quick update. I took the time to type up the "journal" entries in order to post, which started me really reviewing my records since starting this reinstatement attempt. I also started reading more threads about reinstatement here. I decided it is probably more productive to read all those other posts rather than to rant and rave in my own (though that can be very therapeutic too!). So rather than post and hope for answers I'm going to just read and study some more. My sense at the moment is that the reinstatement has created more problems than it has solved, but I won't make any changes till I'm sure. However, there is only so much you can read in a day, and I don't think it is very healthy to spend all day (after day) hunched at the computer reading about all this stuff, so I'm trying to limit it. This forum is awesome, but it is MASSIVE, such that even reading about something fairly simple like what's up with Omega 3's can chew up a whole day! 

 

Tried to fix my signature, but it still isn't as clean as I think it is supposed to be. @DataGuy Thanks for the concern - I will proceed with caution. However, just in response to your comment

 

Quote

On 1/14/2021 at 6:28 PM, DataGuy said:

It would be very strange if you suffered terrible withdrawal, reinstated and couldn't tell if you felt better or worse, and then cold stopped the reinstatement and felt much better than before.

 

It is worth noting that when I first went off this stuff (from 5mg to 0), I felt totally great for quite a while. Then, when I tried to get back up to 5mg in August  I also had a really nice long patch as soon as I quit! Of course, I didn't entirely stay that way, but this sort of suggests that stopping might have the very strange effect you mention. But it isn't worth the risk, and I hear what you are saying - if I end the reinstatement I'll go slow. 

 

Today is the first time in ages I had the energy to get out for a run, so as predicted I am better than when I last posted. Hoping to go from strength to strength. Thanks for your thoughts! And @arbor I'm enjoying our direct messages, and hope to be back to you soon!

[manymoretodays]

On 1/16/2021 at 10:10 AM, HardTimes said:

Today is the first time in ages I had the energy to get out for a run, so as predicted I am better than when I last posted. Hoping to go from strength to strength. 

 

Hi HardTimes,

And that is wonderful.  Can you say Window?  Say it loudly and clearly.  Very hopeful.

Signature looks good, and captures the past several months well.  You can further adjust it, as time goes on.

 

Seriously, I think if I were you, I would just sit pretty for awhile, HOLD, in other words.  Give your nervous system the stability it so is craving, and then give it a chance to recover a bit.  Sometimes 3 months, better yet 6 months, and then you may be good to begin to taper down from the 0.75 mg.  You'll know I think.

 

What do you think?

 

Oh best, L, P, H, and G,

mmt

[DataGuy]

@HardTimes your signature is looking good, thank you! I agree with @manymoretodays. Stability is probably best right now. We can always adjust later if necessary. Congrats on feeling good and the run : )

[HardTimes]

Thanks for the positive attitude! I know how important that is. Unfortunately, the fact that I was able to go for one run is actually evidence that things have deteriorated - I used to be running around 3 days a week not so long ago. 

 

I've spent likely too much time over the last few days reading this forum and have just this morning re-read every post I've made here. Amazing how similar they all are! They all are asking about reinstatement, whether to go up or down. I've also been scrutinizing my journals. Trying to be as objective as possible, overall I think this 3 month reinstatement has made my situation WORSE, comparatively. Of course, I have no way of knowing how I would have felt w/o doing it. One comment from @DataGuy on Oct 26th stood out: "...They take the drug and feel worse, but mistake the worsened feeling as not being caused by the drug. The doctor, trained to think the drug helps, increases the dose and the patient feels even worse and thinks they are hopeless. Very insidious." I think that might apply here... often right after updosing I felt worse for a while. 

 

I've prepared a document that sort of summarizes and analyzes my journaling and overall situation, and I'm attaching it here. DataGuy and @manymoretodays, I know it is kind of a lot to ask as you have your own struggles to deal with, but if you have time over the next day or two to glance through this I'd be very appreciative (though of course I don't hold anybody but myself responsible...). It is three pages, but really only the first page of "conclusions" matters. I wouldn't ask except I feel I need other (perhaps more objective and experienced) eyes on this and have nobody else to ask. I know the worst thing is to go on  and off or up and down every few days (which I have not been doing), and it seems to me that if I taper down now that's it, no more chances to reinstate later. So it feels like a big, important health decision I have to make. 

 

Thanks again for all your help, and I hope your own situations are holding steady!

Analysis of Hardtimes Reinstatment.docx