Catwoman35: withdrawal or relapse?

[Catwoman35]

Hi everybody!

 

First I have to say I am so happy I have found this place and I hope that I will find answers and support.

 

I have been on antidepressants for 15 years for panic disorder, first on Paroxetine and then on Sertraline. I had CBT also and that was very helpful. My panic disorder eased up pretty quickly after I started antidepressant and CBT (back in 2006), and I was almost completely anxiety free for years, but was afraid to stop taking antidepressant pills. They were my "safety" and I was terrified of going back to the state I was in before I started taking them.

 

I have started very gradual tapering about 2-3 years ago, going really slowly (Zoloft 50mg): one pill to 3/4 of the pill, to half of the pill, to 1/4 and finally reduced to nothing and stopped in late December 2020. I think first symptoms of withdrawal started when I started tapering off two years ago, like being grumpy and just generally unhappy about life, but I did not pay too much attention to them and they were not debilitating in any way. At the same time when I started tapering antidepressant, I also started trying different contraceptive pills so I thought they were making me moody. So I eventually stopped taking antidepressant completely in December 2020 (contraceptive pills too). I was feeling OK in January and February and even beginning of March (2021), but then I developed quite strong symptoms of anxiety and depression and have been suffering since then.  It started with anger bursts, then crying spells and ended up with anxiety and fearfulness. It has now been about 3 weeks and I am a complete mess. I still remember CBT and am able to use some coping skills I have learned then. But I am always on the verge of tears and everything feels scary and unsafe.

 

I am not suicidal but don´t want to live like this, every day is a struggle and I am happiest when I sleep. I have been using Oxazepam in moments when I feel anxiety is overwhelming me. I don´t know what to do. Could this be withdrawal or am I relapsing? Doctors are useless, they only want to put me back on medication but it took me so long to taper off that I really don´t want to go back. I have read that it is possible to have delayed onset withdrawal but there is not much information about it online. 

 

Thank you in advance for your help.

[Catwoman35]

Forgot to add, just before I started feeling really bad (late Feb/ early March), I was diagnosed with benign positional vertigo that subsided after 2 weeks. Not sure if that is the same vertigo that people in withdrawal experience or something different.

[Catwoman35]

Reading through Zoloft withdrawal thread, I am now thinking I might have went too fast from 1/4 of the pill to zero. I was on 12,5mg for only few months before going down to zero. Maybe I should reinstate 12,5mg? I took last doze just before New Years. Is it too late now?
I am desperate and don´t know what to do. 

[Catwoman35]

I reinstated Sertraline (12.5mg) yesterday because my anxiety has become unbearable. Not noticing any improvement just yet. The only thing that seems to help is Oxazepam (7,5mg to 15 mg).

 

 I did not know what to do. I wrote my original post many days ago and still waiting for it to be moderated and approved. So I panicked. That is what I am good at.

[Altostrata]

Welcome, @Catwoman35

 

I am sorry there has been a delay in responding to your topic.

 

How do you feel, having taken 12.5mg sertraline? How long have you been taking oxazepam, and how often? What is your daily drug schedule?

[Shashal]

On 4/1/2021 at 9:40 PM, Catwoman35 said:

Forgot to add, just before I started feeling really bad (late Feb/ early March), I was diagnosed with benign positional vertigo that subsided after 2 weeks. Not sure if that is the same vertigo that people in withdrawal experience or something different.

Hi Catwoman，

 

I think we are in the same boat, now I had a very bad setback or relapse whatever, and my major symptom now is anxiety.

 

I found that the trigger for me is also the positional vertigo (most likely it’s benign paroxysmal positional vertigo BPPV) which happened 1 week ago, after the vertigo gone, the anxiety came, so I don’t know if I should reinstate Zoloft and tapper again, my doctor said if the medication treatment is not long enough will cause the relapse, and when you use them again it may not works again, I don’t know if it’s true.

 

I hope someone can give us some advice, doctors can only put you on meds...

[Catwoman35]

@Altostrata Thank you so much for reply. I am currently third day on 12,5mg of sertraline that I take in the morning (10am). Did not notice any improvement yet. My anxiety is terrible. I have been taking Oxazepam (15mg) on/off for several years, but not daily or regularly, only when I felt very stressed/anxious or as a sleeping aid. For the last 3 weeks, it is daily. I usually take half (7.5mg) around 2-4pm when my anxiety becomes unbearable, and then half (7.5mg) in the evening so I can get some sleep. The most I ever take is 1.5 pill (22,5mg).

 

I spoke to a psychiatrist yesterday and sure enough, he wanted to either put me on a new SSRI (Celexa 10mg) or reinstate 50mg of Sertraline (that he said we would need to raise later to 100mg and then 150mg!!). Also told me to take 7.5mg of Oxazepam in the morning, 7.5mg in afternoon and 15mg in the evening because apparently my "amygdala is freaking out". I did not take his advice yet, the thought of being put back on medication is making me really sad and defeated. 

 

 

[Catwoman35]

2 hours ago, Shashal said:

I found that the trigger for me is also the positional vertigo (most likely it’s benign paroxysmal positional vertigo BPPV) which happened 1 week ago, after the vertigo gone, the anxiety came, so I don’t know if I should reinstate Zoloft and tapper again, my doctor said if the medication treatment is not long enough will cause the relapse, and when you use them again it may not works again, I don’t know if it’s true.

 

I hope someone can give us some advice, doctors can only put you on meds...

 

Hi Shashal, sorry to hear you are also struggling.  My vertigo was BBPV as well. I reinstated Zoloft on small dose but not sure if that helps. And yes, doctor I spoke to wanted to put me back on meds. It is terribly frustrating.

[Shashal]

Hi Catwoman, 

 

do you think your anxiety could cause by oxazepam as well? I think you had used them for a long period although you used it occasionally. For me, the “original anxiety” was caused by Xanax inter dosage withdrawal I believed.

 

hope reinstatement works for you and get better soon

[Catwoman35]

Hi Shashal, yes, I guess that is possible. I think I have been using Oxazepam a bit carelessly, not really knowing the dangers.
Didn´t take any Oxazepam today though (at least not yet), feeling annoyed that the doctor wanted me to take more. 

 

I don´t know if anyone ever complained about this, but my face broke out in many small, dry pimples about the same time I started having anxiety again (so a month ago). I never had any skin issues before.

[Altostrata]

Catwoman, we need to track the oxazepam effects. Please keep daily notes of times of day you take your drugs, their dosages, and your symptoms throughout the day. Post 24 hours of notes at a time in this topic, in a simple list format with time of day on the left and notation (symptom or drug and dosage) on the right. This can show if your symptoms are adverse effects from one of your drugs.

[Shashal]

19 hours ago, Catwoman35 said:

Hi Shashal, yes, I guess that is possible. I think I have been using Oxazepam a bit carelessly, not really knowing the dangers.
Didn´t take any Oxazepam today though (at least not yet), feeling annoyed that the doctor wanted me to take more. 

 

I don´t know if anyone ever complained about this, but my face broke out in many small, dry pimples about the same time I started having anxiety again (so a month ago). I never had any skin issues before.

 

Hi Catwoman,

 

how is your reinstatement? If you regularly took Oxazepam for a while then you may not stop taking it suddenly, for benzodiazepines tapering you can refer to the Ashton Manual https://benzo.org.uk/manual/index.htm

 

 

[Catwoman35]

Altostrata, I will do as you say. Will track next 24h.

 

Shashal, thank you for the resources, I will read through.

 

When it comes to oxazepam, my use was occasional, sometimes I would go several months that I would not have any. And small doses of 7.5mg or 15mg still work the same as they did at the beginning. That is why I thought that oxazepam is not a problem. But not sure anymore.

Reinstating 12.5mg of sertraline did not do anything, thinking whether I should reinstate 25mg instead. I could not work today, took a day off and spent 4h in bed during the day. Having a really bad time

 

[Catwoman35]

@Altostrata Here are my daily notes for yesterday.

 

9am - reinstated 25mg sertraline 

10.30am - 7.5mg oxazepam

10.50am - cold chills

11.40am - anxious, panicky

12.30am - anxious, a bit better

2pm - driving to see dermatologist, feeling OK, slightly anxious

5pm - anxious again

16pm- called my parents to tell them what´s going on, able to have conversation, slightly less anxious

7.30pm - getting overwhelmed by sadness and self-pity, still on skype with parents

8pm - crying, getting some relief from that

10pm- feeling better

11pm zolpidem 10mg and went to sleep

Woke up next day 8am.

 

 

I feel like I am anxious all day, only occasionally I get distracted by something and "forget" about it for a bit. Every day is a struggle. Worst seems to be in the afternoon.

[Altostrata]

Because you took oxazepam so close to the sertraline, we cannot tell which drug caused you to feel better a few hours later. It will take at least 4 days of 25mg sertraline for it to fully reach effect. It will not instantly reverse withdrawal symptoms, that is likely to be gradual.

 

If I were you, I'd avoid using both oxazepam and zolpidem. You can get physiogically dependent on them, too. 

 

Please continue to post 24 hours of notes at a time.

[Catwoman35]

Hi! Thank you so much for your help Altostrata!  I did not realize it would take at least 4 days to notice the difference. I kind of assumed it was like with any other drug, that the withdrawal would stop as soon as the substance is back in the bloodstream. I am aware that oxazepam and zolpidem are addictive but my anxiety is unbearable, and sleeping is impossible without any aid. I am still working every day, if what I do can even be called working as I am not very productive, but at least work provides some kind of distraction.

 

Today the day has been a bit of a blur, I tried not to take oxazepam during the day.

 

9am - 25mg sertraline

11 am- very anxious

3pm- slight reduction in anxiety

6pm - very anxious

7pm - crying, getting some relief, less anxious

8pm- anxiety rising again

9pm- 15mg oxazepam

 

This is day 3 or 4 that I am back on 25mg of sertraline, I don´t even know myself because I started with reinstating 12.5mg first and then raised to 25mg.

 

I will continue with notes. At the moment, it is hard to notice changes in my anxiety levels, I seem to be anxious whenever I am awake, on the scale from 1-10 (10 being a panic attack), I´d place myself to 7 or 8. I get distracted at work when I am in the meetings and trying to appear normal (no video in the meetings and we are working remotely) so I don´t know does that count as anything. I could get sick leave but I am afraid that would just give me more time to be in my own head.

 

[Catwoman35]

I have read some forum posts about reinstating and realized that I have likely reinstated too high of a dose, and should have started with lower. Before I reinstated, I was in such a bad anxious and panicky state that I could not even read properly. I was close to checking myself in a hospital. But anyway, I guess now it is too late and if I calculated well, this is Day 5 on sertraline. I am planning to drop oxazepam and zolpidem as soon as I stabilize on sertraline. At this stage, I feel like they are giving me a little bit of relief that I so desperately need.

 

6.30 woke up very very anxious, close to panic, level 8-9, lots of negative thoughts, reliving bad memories, tightening in chest, feelings of sheer terror

7am - took oxazepam 7.5mg to manage severe symptoms (I'm sorry, I know I shouldn´t have but I was desperate)

8am - still very anxious, in a little bit of haze, not sure if awake or asleep

9am - took 25mg sertraline

9.30am - very sleepy, fell asleep

11.30am -  woke up, less anxious

1pm -6pm pm less anxious, my husband is trying to keep me engaged with other things, anxiety somewhere on level 6

6pm - anxiety getting a bit worse, I am trying to distract myself with different activities, anxiety level 6/7

9pm - anxious, somewhere on level 7, but I think I am feeling "better" than yesterday, however slight that is

11pm - zolpidem 10mg, went to bed

4.30am woke up very anxious

 

 

 

 

 

 

[ChessieCat]

taking-multiple-psych-drugs-which-drug-to-taper-first

 

Because you are taking 2 brakes it might be better to taper one of them first but stay on the other whilst you taper sertraline.

Edited April 11, 2021 by ChessieCat

[Catwoman35]

Thank you @ChessieCat, that was very useful. Should I already be attempting to reduce oxazepam? (I think zolpidem will not be a problem to just stop completely).

Yesterday I had only 7.5mg oxazepam in the morning. Today I did not have any oxazepam yet (12pm). Will post my daily notes for today in the evening.

[ChessieCat]

I'm not able to make any suggestions because I do not have very much knowledge about oxazepam and zolpidem.

 

Alto is SA's founder and has a lot of knowledge.  Please re-read the posts you she made.

 

 

Edited April 11, 2021 by ChessieCat
corrected

[Catwoman35]

I think I am able to stop zolpidem completely. As for oxazepam, that might be a bit more difficult because I am so anxious.

What is wrong with the post I made? I re-read it but I don´t get it. My mind is not working properly.

[Catwoman35]

4.30am - woke up very anxious, trying to sleep more
7.00am - still in bed, anxious, negative thoughts, shaky
9am - 25mg sertraline
11am- anxious, crying spells
12pm - feeling very slightly better
1pm - very shaky, cold shivers
2pm - very anxious again, took 7.5mg oxazepam
3pm - slightly less anxious
3.30pm - sad and crying, some relief
4pm - slightly better, trying to do yard work
5pm - crying again, some relief
6pm - slightly better 
8pm - still feeling better, but still teary
8.30pm - starting to feel worse again

9pm- very anxious
10pm - 7.5mg oxazepam, will attempt to sleep without anything else

 

This was Day 6 on sertraline 25mg. It´s hard to know whether I have "waves and windows" or whether the moments I feel slightly better are the moments when there is some distraction around. It is hard to even be sure of my own feelings. I decided to drop zolpidem, I did not use it for long so I am hoping there are no side effects of just stopping. I think oxazepam works to "soften" my anxiety but at this point I am using it only when I reach panicky state. I don´t know if I am addicted to it or not. I am taking omega 3, B12, and magnesium.

[Altostrata]

How often have you taken oxazepam in the last 2 weeks? Have you been taking zolpidem? I don't see it in your daily notes.

[Catwoman35]

Hi @Altostrata. I took oxazepam almost daily for the last 2 weeks, up to 15mg per day (rarely 22mg). I took Zolpidem only few times on particularly bad days when I just wanted to get some sleep.

[Catwoman35]

5.30am - woke up, negative thoughts but reduced anxiety, wanted to sleep more
8am - woke up again, got out of bed, feeling ok

9am - 25mg sertraline
10am - slightly anxious/afraid of anxiety coming back
12pm - still relatively ok, anxiety level 6/7, cold chills, shivers
1.30pm - anxiety getting worse
2pm - 7.5mg oxazepam
3pm - calmer
5pm - feeling ok, anxiety lower
7pm - still feeling ok, some anxiety but not terrible
8pm getting a bit more anxious, feeling tightness in arms
10pm 7.5mg oxazepam 

 

Overall, today was a slightly better day than yesterday.

[Catwoman35]

8am - woke up
9am - 25mg sertraline
11am- feeling ok, busy at work, able to focus
12pm - anxiety increasing, worrying, panicky thoughts, cold shivers
2pm- 7.5mg oxazepam
4pm- feeling okay, slight anxiety level 6
6pm - still feeling ok, anxiety level 5/6
8pm- anxiety increasing again
10pm- 7.5mg oxazepam

 

Overall, today has been better than yesterday, I think I am slowly stabilizing on 25mg of sertraline. I have been sleeping without zolpidem, that one was not hard to eliminate. I notice my anxiety gets worse around 1-2pm and then in the evening before bed.

[Altostrata]

2 hours ago, Catwoman35 said:

12pm - anxiety increasing, worrying, panicky thoughts, cold shivers

 

Does this continue until you take oxazepam at 2 p.m.? Does it continue after you take oxazepam at 2 p.m.?

 

Why are you taking oxazepam at 2 p.m. and 10 p.m.?

[Catwoman35]

Hi @Altostrata, I am taking oxazepam at 2pm and 10 pm because that is when my anxiety peaks and becomes unbearable. It helps when I take them, anxiety goes down.

After I take oxazepam at 2pm, already at 3pm I feel better. Same in the evening, I progressively start feeling worse and then finally take it at 10pm and then my anxiety calms down and I can get some sleep.

 

Except last night, last night I took oxazepam at 10pm and hoped to go to sleep but around midnight I started feeling very anxious and almost getting panic attacks. This was caused by my own thoughts. See, I turned 40 and considering whether I should have a baby or not, because this is likely the last chance. I think that dilemma and conflict in my head might have caused this crisis. 

 

[Shashal]

6 hours ago, Catwoman35 said:

Hi @Altostrata, I am taking oxazepam at 2pm and 10 pm because that is when my anxiety peaks and becomes unbearable. It helps when I take them, anxiety goes down.

After I take oxazepam at 2pm, already at 3pm I feel better. Same in the evening, I progressively start feeling worse and then finally take it at 10pm and then my anxiety calms down and I can get some sleep.

 

Except last night, last night I took oxazepam at 10pm and hoped to go to sleep but around midnight I started feeling very anxious and almost getting panic attacks. This was caused by my own thoughts. See, I turned 40 and considering whether I should have a baby or not, because this is likely the last chance. I think that dilemma and conflict in my head might have caused this crisis. 

 

Hi Catwoman,

 

sorry to hear that you are still suffering with anxious, as oxazepam has only 4-15hrs half-life period I think that may explain why you always feel anxious back at the same time. As the Ashton Manual advised may be you can switch to Valium which has a very long half-life period and when you feel stabilized you can tapper it slowly. I’m not a doctor so this is only my experience not a medical advice, hope you can get better soon, hang in there 

[Altostrata]

On 4/13/2021 at 11:20 PM, Catwoman35 said:

I am taking oxazepam at 2pm and 10 pm because that is when my anxiety peaks and becomes unbearable. It helps when I take them, anxiety goes down.

After I take oxazepam at 2pm, already at 3pm I feel better. Same in the evening, I progressively start feeling worse and then finally take it at 10pm and then my anxiety calms down and I can get some sleep.

 

These are signs that you are physiologically dependent on oxazepam, and your anxiety symptoms are from interdose withdrawal. Oxazepam has a short half-life somewhere greater than 6 hours. If you progressively start feeling worse about 7 p.m. or so, that's because oxazepam is wearing off. You are fortunate your 10 p.m. dose seems to hold through the night, with interdose withdrawal ramping up around noon the next day.

 

@Frogie will help you go off oxazepam.

[Catwoman35]

Thank you so much @Altostrata 😺. I am so grateful I have found this forum. Thank you for taking time to help me! ❤️

 

Now I am thinking whether I should have reinstated sertraline or not, at all. But my anxiety was through the roof. I am still keeping sertraline on 25mg even that my doctor recommended to increase. I said no. I still feel pretty anxious though. Do you think I am going through sertraline withdrawal too? Looking back, I realize I had a lot of crying spells and anger bursts in Jan and Feb (I quit sertraline in late December). Overwhelming anxiety symptoms came before I started using oxazepam daily in mid March (but I did use it intermittently for few years for sleep issues). 

 

I hope @Frogie will have time to help me get off oxazepam. 🙏 And thank you @Shashal for you support too, it means a lot. 

[Altostrata]

You may have had sertraline withdrawal syndrome in January and February, now you may have interdose withdrawal from too-frequent use of oxazepam.

[Frogie]

When did you increase the sertraline in April to 25 mg? You need to hold on that dose for a couple of weeks to see how wd symptoms go.nutheads; I’ll be happy to help you set up a taper for the oxazepam.

 

After you answer me we can go from there.

 

Take care,

Frogie xx

[Catwoman35]

I think you are spot on @Altostrata. Since my last daily diary update, I have started taking 7.5mg of oxazepam in the morning also. So that dose at 10pm on a previous day, is not regulating my anxiety until next day 12pm anymore.  I notice my tolerance for oxazepam is getting higher. I was hoping sertraline would "kick in" and I would not need oxazepam for long time. I guess I was wrong and this is getting out of control  .

My current schedule is:

 

7.30am or 8am - 7.5 oxazepam

9am- 25 sertraline

2pm- 7.5mg oxazepam

10pm- 7.5mg oxazepam (on few occasions when I started getting panic 15mg)

 

@Frogie I increased sertraline to 25mg on April 6 (thank you for taking time to help me!)

 

[ChessieCat]

 

April 2021- reinstated 12.5mg of sertraline + up to 15mg of oxazepam

April 2021- reinstated 25mg of sertraline + up to 15mg of oxazepam

 

Please put dates in your drug signature.  Thank you.

[Catwoman35]

@ChessieCat Done