newmom: low dose Lexapro - severe insomnia

[newmom]

I have been thru this cycle about 5 times, each one seems to get worse. I am trembling so hard i am practically convulsing and i cant sleep. No i am not interested in taking an antipsychotic but i also cant tolerate this.

[Shep]

21 hours ago, newmom said:

Please help- could i be having ativan withdrawal from just a handful of doses? It seems 4 days after i take one, a switch gets turned on causing complete terror, insomnia, and agitation. This causes me to take another, which keeps me feeling fine for 4 days then repeat cycle. I have had about 6 doses over the past 1.5 months.

 

18 hours ago, Jen1234 said:

I don’t know, but given you’ve only had a handful of spread out doses my thought would be that perhaps the ativan is counteracting the symptoms from the reaction to the lexapro. So when it leaves your system completely those symptoms from the original reaction come back, rather than it being withdrawal from the ativan.

 

@newmomI think @Jen1234is spot on here. 

 

Ativan's half-life is 10 - 20 hours. This is a half-life calculator:

 

Half-Life Calculator

 

If you plug in 20 hours for the half-life, you would still have 25% of the drug in your system 40 hours (1.67 days) later. It's down to 3% at the 100 hour (4.16 day) mark. You may be a slow metabolizer of this drug and at around 4 days, the drug has almost left your system. 

 

You probably haven't taken Ativan long enough to become dependent, but if it was masking symptoms from an adverse reaction to an antidepressant, then those symptoms are now unmasked and unleashed in full force. Not to mention the sleeping problems you had prior to going on Lexapro. 

 

Please note that 2.5 mg of Lexapro is not a small dose. It may help to put this into perspective. From the Tips for Tapering Off Lexapro thread:

 

"A significant characteristic of Lexapro is that milligram for milligram, it is much stronger than other SSRIs. Chemically, Lexapro is a variation of Celexa; the molecule was re-engineered to be patentable as Celexa's patent was about to expire. The streamlined molecule is a more potent SSRI, 2 to 4 times stronger than others. . . .  If you are taking 5mg of Lexapro, it's not tiny, it's equivalent to 10-20mg Paxil or Celexa. . . ."

 

So it's not surprising that anyone sensitive to medications would have a severe reaction to 2.5 mg of Lexapro. That's a full dose of many other drugs in its class. 

 

Knowing that may ease your mind that this is not all in your head. 

 

 

[newmom]

I am in the ER. I cant cope.

[newmom]

ER gave me a diazepam shot and recommended inpatient treatment. The diazepam was chosen because of the longer half life so maybe it will leave my system more gradually. I declined inpatient. I need to choose between trazodone or low dose olanzapine for the insomnia because white knuckling through it isnt working and is actually harming me further. I will probably do trazodone since depression and poor sleep were my reason for trying lexapro in the first place. Maybe i can use the olanzapine if i need rescuing from agitation and insomnia. I know this site is for going off drugs, but after 3 days of insomnia and agitation from ativan withdrawal i was throwing myself on the floor and writhing around, beating myself in the head- my husband said i was acting legitimately crazy. So what am i to do? I refuse to suffer for months because that means my family has to suffer too. I am the mama bear and if i am not well, my family will feel it no matter how hard i try to pretend everything is ok. If i stabilize on the trazodone, i can always do a very slow taper later to become drug free. Does this sound like a terrible plan?

[JesusSavemefromWD]

You have to do what you think is best for you. If you decide to go with trazodone treatment, I would just recommend to ask the doctor to start u with subtherapeutic doses because sometimes they work and youbdon’t have to take too much of the drug. If the subtherapeutic dose doesn’t work after a couple of weeks, you can updose. 
Praying for you to make the right choice 

[Jen1234]

Sending lots of love and hugs your way. Ive been in your position and I too have been hospitalized inpatient for the same reasons. Writhing on the floor, screaming, because of the fear and terror and extreme sleep deprivation associated with insomnia. It’s a tricky situation because it’s hard to know if you most definitely suffered an adverse reaction or if the start up side effects from the lexapro (insomnia, increased anxiety) spiraled into a vicious cycle of psychophysiological insomnia. If you were already having poor sleep and depression this could have been the last straw and when you are a mom sleep is so very important. It can feel like the most important thing has been taken away from you when you can’t sleep and it becomes a beast and monster if it’s own. As anxiety about sleep increases the insomnia gets worse and therefore the anxiety continues to increase. These types of explanations are likely the explanation that your doctors are giving you. When I am on the receiving end, this explanation bothers the heck out of me. I’ve always felt mine was directly a result of the meds, however I’ve learned a lot about trauma and how the body stores it and I’ve learned a ton about insomnia and have spoken with individuals who have taken, or not taken drugs and have the same severity of insomnia so it makes me think and wonder. Depression is linked to abnormal hypnograms and very closely linked with sleep disorders which makes it even more difficult to tease apart. Personally,  I’ll never rly know. I chose to stay off meds because I’ve mostly felt it was the meds, but I could be wrong.  In the end, only you know yourself best and can make this decision. I’m praying whatever decision you make is the best one for you. 

[Rosetta]

For what good it will do: 

 

Alto has raised the possibility that you are having an adverse reaction to Lexapro.  She has suggested that you might be feeling relief from the adverse reaction when you have Ativan in your system.  Are you still taking Lexapro?  If so, has your doctor discussed with you the possibility of an adverse reaction? I assume not.
 

This is what tends to happen when an adverse reaction case is treated with more drugs — the additional drugs cause additional problems.  So, if you are taking Trazodone or Olanzapine, be on the lookout for any changes, and think seriously about whether you want to risk further irritation to your nervous system.

 

This is not to suggest that olanzapine is the answer (I don’t think it is), but my experience with Trazodone makes me want to warn you: it has a very nasty side effect.  It causes anxiety in the daytime — really bad anxiety.

 

I understand the temptation to take a drug given to you by a doctor because you can’t go on, but adverse reaction cases frequently get worse with additional drugs.  If you are having an adverse reaction the answer is to reduce the drug causing it, of course.  I wish doctors knew how to screen for adverse reactions.  I wish they knew to reduce the drug and see if that helps instead of adding another drug which may inflame the situation further.

 

The answer here as SA is almost always Do not add new drugs.  So, no, do not take olanzapine, do not take Trazodone.  That leaves Ativan.  Well, you don’t want to get addicted to Ativan, of course, and it sounds as if that can happen if you take it every 4 days.  

I HOPE A MOD WILL CHIME IN ON WHETHER THIS IS A REASONABLE PLAN:

What I would try to do is First: reduce the Zoloft.  By how much, I don’t know.  Try 10%.  Second, suffer through the fourth day after your Ativan dose, and continue to take it only every 5 or 6 days.  Yes, this means you are nuts for those 1-2 days.  It’s the only way, in my opinion, to avoid addiction.  Can your kids stay with someone else while your husband stays home with you? (To be clear, taking Ativan isn’t ideal either as it can inflame your nervous system’s condition, but sometimes you have to have relief to avoid the hospital.)
 

As you reduce the Zoloft maybe the adverse reaction will subside.  Maybe you can get down to a dose that you can tolerate, stabilize on it and taper when you are feeling better.

 

That’s the best I can think of to avoid addiction and test out whether reducing the Zoloft will get you out of this situation.  I understand how scary it is to be nuts like that.  I have been there.  I don’t even want to describe it to you, but your description is very familiar to me.  I’m so sorry.  
 

You can do it.  I did.  Maybe I didn’t have a choice, but I did it.  I got through the crazies.  Although, I didn’t keep taking a drug to which I was having an adverse reaction.  I was cold turkey from Zoloft, then on Trazodone and Xanax, having the horrible Trazodone daytime, severe anxiety, then cold turkey off everything.  It was awful.  I don’t know if I was addicted to Xanax or not.  I tried not to be, but I thought 3 days between doses was enough.  It may not have been.  I certainly didn’t have a doctor trying to help me avoid it.  Quite the opposite.
 

I wish you had a doctor who knew what to do and who was helping you.  If you don’t, you have to help yourself. Getting stuck on Traz or Olanzapine isn’t going to make you a mama bear again.  It’s not a long term solution.  It will only make things worse.  I’m sorry.

 

Rosetta

 

[Colonial]

On 1/11/2021 at 10:50 PM, newmom said:

most recently it has been every 4 to 5 days. Before that, there was more gaps. I am confident i have not taken more than 7 doses total including the injection given at the ER.

 

Can you advise when that injection in the E.R. was,  and if it was an extended release and if so for how long was it to remain in your system? 

If it was before you started taking it every 4 days and extended, it may have set you up for dependency that the intermittent dosages are giving you relief from the wd symptoms.

 

Your signature only says this:

 

. Ativan 1 shot in the ER, sent home with pills- took 2 doses over 2 weeks then threw them out;

Edited January 16, 2021 by Colonial

[Jen1234]

7 hours ago, Rosetta said:

What I would try to do is First: reduce the Zoloft.

Hi Rosetta,

 

I don’t believe she is on Zoloft. Just a handful of doses of ativan. Otherwise seems like it would have been good plan. ❤️

[Rosetta]

I meant Lexapro, not Zoloft, but maybe you aren’t taking that right now either.

[Wagen]

@newmom

 

Just wanted to say that Im thinking of you. I have become a new mum myself 10 months ago and the whole life of my son have been suffering with severe insomnia. I've been hospitalised too and suffer from many WD symptoms too.

 

Im in the middle of it all but still believe we can get better for our children. Im crying now when writing to you. Im thinking of you and hope there is hope for us. Let me please know how are you doing!! Im wishing you the best!!! YOU WILL GET BETTER !!!!!!!