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Miller2018 New Mom, Rough Year, Looking for Support


Miller2018

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Hi All -

 

I won't repeat my story (in my signature), but this year has been both the best and worst of my life. I had a sweet baby boy who I love so much, but I am suffering from non-stop medical issues and feel devastated that I cannot be the mother I envisioned myself being. I'm not sure exactly what I am looking for here...strength, support, hope, clarity? My situation is not so straight forward as I also have Chiari Malformation Type I. I had two brain surgeries in 2005 and 2010, but since 2005 I have been pretty much asymptomatic from a neurological standpoint. Many of the symptoms of Chiari also overlap with conditions like psychotropic withdrawal, lyme disease, chronic fatigue syndrome, etc., so now that I am feeling so terrible I feel confused about what is really causing it. Is it withdrawal? Is it Chiari? Could it be something else? Have any of you pursued additional workups like looking for lyme disease or being evaluated for chronic fatigue syndrome? My main symptoms currently are brain fog (like my eyes won't focus or almost like I'm not fully present in a room), general malaise, fatigue, tension-type headaches, and limb weakness. Like so many of you, I fear this is my new normal and my new life. I don't know how I will cope with that. I was an active woman, I worked in the medical field, I loved to travel with my husband and socialize with friends, I loved to spend time outdoors and try new activities. Now, each day feels like an uphill battle. I feel too anxious to plan any activities or trips because I don't know how "bad" I will feel any given day or any given moment of a day. It has been 4 months which I realize is probably short in the scheme of things. Would appreciate any advice. Thank you so much. 

 

 

 

*of note, I have a neurologic condition called Chiari Malformation Type I for which I had 2 brain surgeries (2005 and 2010). I have been stable/virtually asymptomatic from a CM Type I standpoint since 2005. 

- 2007 - Jan 2021 Citalopram 20mg - 40 mg well tolerated

- October 2021 gave birth to first child 

- January 2021 psychiatrist thought I should try Zoloft due to PPA after traumatic childbirth 

- January - March 2021 weaned off Celexa while uptitrating Zoloft. Process was seamless, no side effects. 

- April 2021 Zoloft increased from 100 to 125 to 150 mg in a period of 3 weeks. I developed severe anxiety + OCD symptoms, insomnia, tremor, tachycardia, body aches, clonus, myoclonic jerks, muscle weakness and muscle fasciculations.

- May 13, 2021 diagnosed with serotonin syndrome by neurologist and Zoloft discontinued cold turkey. Within 36 hours my anxiety, OCD, tremor, tachycardia, fasciculations and clonus resolved.

- Within 2 weeks I developed withdrawal symptoms. Severe unbearable akathisia/sensory symptoms in limbs preventing me from sleeping, insomnia, nausea and diarrhea.

- May 29, 2021 restarted on Citalopram 10 mg which helped take the edge off. Also started on Ativan 0.5 mg PRN TID for akathisia as well as iron supplementation (for possible restless leg syndrome component).
- June - July 2021: Akathisia/RLS greatly resolved with the Ativan and iron. Decreased Ativan to either once daily or none at all. Went from 10/10 discomfort to 1/10.  

- July - August 2021: Suffering from fatigue, brain fog, light sensitivity, limb weakness. Feel sad about it all.

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  • Altostrata changed the title to Miller2018 New Mom, Rough Year, Looking for Support
  • Administrator

Welcome, @Miller2018

 

It looks like you got withdrawal syndrome from going off 150mg Zoloft May 13 and this was partially resolved by your taking another SSRI, 10mg citalopram May 29.

 

How did you feel while you were reducing Ativan? How long have you been off it? How's your sleep?

 

Serotonin syndrome and then antidepressant withdrawal syndrome are both fairly serious drug-induced conditions. What we see is that when someone's nervous system is rocked by these types of iatrogenic conditions, it can take many months for it to settle down. "Fatigue, brain fog, light sensitivity, limb weakness" are not unusual 

 

How has your symptom pattern changed in the last month?


 

 

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

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

All postings © copyrighted.

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HI @Altostrata

 

Thank you for the reply! I am still on the Citalopram 10mg daily and plan to stay on that for the foreseeable future. I just cannot rock the boat anymore. I am taking Lorazepam 0.5 mg TID right now. It helped dramatically with the akathisia type symptoms, and it is helping with my sleep. I don't think I can afford to go off of it right now as I am taking care of my baby by myself (husband is deployed with the military). 

 

I have this existential fear I will never get better. I think it is complicated by the fact that I have other neurological conditions, and had a really rough/nutritionally draining pregnancy, as well as a complicated delivery which ultimately left me so weak, deconditioned, and quite honestly, malnourished. I worry that my symptoms are not, in fact, a protracted withdrawal, and are instead something else....neurological? Lyme Disease? Chronic Fatigue Syndrome? If I can't be sure about the cause, how can I attempt to heal? 

 

How do members manage this? Do they pursue other workups to rule out other causes for their symptoms?

 

I also had maybe one week where I felt a bit better...less tired, stronger, able to get things done. I wasn't myself, but maybe I was 60% of myself versus 30% of myself. I now feel so much worse. Is it typical for symptoms to ebb and flow? By the hour? By the day? By the week?

 

I miss my old life. I feel such empathy for those struggling with chronic symptoms of any sort, especially those that cannot be easily explained. 

*of note, I have a neurologic condition called Chiari Malformation Type I for which I had 2 brain surgeries (2005 and 2010). I have been stable/virtually asymptomatic from a CM Type I standpoint since 2005. 

- 2007 - Jan 2021 Citalopram 20mg - 40 mg well tolerated

- October 2021 gave birth to first child 

- January 2021 psychiatrist thought I should try Zoloft due to PPA after traumatic childbirth 

- January - March 2021 weaned off Celexa while uptitrating Zoloft. Process was seamless, no side effects. 

- April 2021 Zoloft increased from 100 to 125 to 150 mg in a period of 3 weeks. I developed severe anxiety + OCD symptoms, insomnia, tremor, tachycardia, body aches, clonus, myoclonic jerks, muscle weakness and muscle fasciculations.

- May 13, 2021 diagnosed with serotonin syndrome by neurologist and Zoloft discontinued cold turkey. Within 36 hours my anxiety, OCD, tremor, tachycardia, fasciculations and clonus resolved.

- Within 2 weeks I developed withdrawal symptoms. Severe unbearable akathisia/sensory symptoms in limbs preventing me from sleeping, insomnia, nausea and diarrhea.

- May 29, 2021 restarted on Citalopram 10 mg which helped take the edge off. Also started on Ativan 0.5 mg PRN TID for akathisia as well as iron supplementation (for possible restless leg syndrome component).
- June - July 2021: Akathisia/RLS greatly resolved with the Ativan and iron. Decreased Ativan to either once daily or none at all. Went from 10/10 discomfort to 1/10.  

- July - August 2021: Suffering from fatigue, brain fog, light sensitivity, limb weakness. Feel sad about it all.

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  • Administrator

We cannot tell you if you have those other medical conditions. It's possible, but it's clear that you had a serious adverse reaction -- serotonin syndrome -- followed by withdrawal syndrome. Sometimes people do not bounce back from these conditions.

 

On 8/1/2021 at 5:09 PM, Miller2018 said:

brain fog (like my eyes won't focus or almost like I'm not fully present in a room), general malaise, fatigue, tension-type headaches, and limb weakness

 

These are your current potentially drug-related symptoms. How have they changed since you went on 10mg citalopram at the end of May?

 

What week was it you felt better?
 

Quote

 

Is it typical for symptoms to ebb and flow? By the hour? By the day? By the week?

 

 

This is the hallmark of withdrawal syndrome. See


What is withdrawal syndrome? 
 
About reinstating and stabilizing to reduce withdrawal symptoms 
 
The Windows and Waves Pattern of Stabilization

 

What is your daily  drug schedule, with times o'clock and dosages? Benzodiazepines such as lorazepam can also cause these symptoms.

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

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

All postings © copyrighted.

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Wow. It is a lot to hear that people sometimes don’t bounce back. Was hoping for some initial support, not such terrifying news. Heartbreaking, really. 


 

*of note, I have a neurologic condition called Chiari Malformation Type I for which I had 2 brain surgeries (2005 and 2010). I have been stable/virtually asymptomatic from a CM Type I standpoint since 2005. 

- 2007 - Jan 2021 Citalopram 20mg - 40 mg well tolerated

- October 2021 gave birth to first child 

- January 2021 psychiatrist thought I should try Zoloft due to PPA after traumatic childbirth 

- January - March 2021 weaned off Celexa while uptitrating Zoloft. Process was seamless, no side effects. 

- April 2021 Zoloft increased from 100 to 125 to 150 mg in a period of 3 weeks. I developed severe anxiety + OCD symptoms, insomnia, tremor, tachycardia, body aches, clonus, myoclonic jerks, muscle weakness and muscle fasciculations.

- May 13, 2021 diagnosed with serotonin syndrome by neurologist and Zoloft discontinued cold turkey. Within 36 hours my anxiety, OCD, tremor, tachycardia, fasciculations and clonus resolved.

- Within 2 weeks I developed withdrawal symptoms. Severe unbearable akathisia/sensory symptoms in limbs preventing me from sleeping, insomnia, nausea and diarrhea.

- May 29, 2021 restarted on Citalopram 10 mg which helped take the edge off. Also started on Ativan 0.5 mg PRN TID for akathisia as well as iron supplementation (for possible restless leg syndrome component).
- June - July 2021: Akathisia/RLS greatly resolved with the Ativan and iron. Decreased Ativan to either once daily or none at all. Went from 10/10 discomfort to 1/10.  

- July - August 2021: Suffering from fatigue, brain fog, light sensitivity, limb weakness. Feel sad about it all.

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When I was taken off the SSRI on 5/13 my symptoms were severe inner restlessness, muscle twitching, brain zaps, nausea, diarrhea, general malaise. My anxiety completed improved and my mood actually also improved and has stayed stable (little to no depressive symptoms).

 

The above symptoms improved throughout June and by the July 9th weekend I was able to actually travel and enjoy myself, though took it easy and still was on the Ativan. 
 

Since July 15th I have been feeling quite ill again. I did menstruate for the first time in 15 months (pregnant and breastfeeding) and experienced a very stressful two weeks (husband deployed, moved states by myself). The new symptoms are the fatigue, brain fog, etc. 
 

 

*of note, I have a neurologic condition called Chiari Malformation Type I for which I had 2 brain surgeries (2005 and 2010). I have been stable/virtually asymptomatic from a CM Type I standpoint since 2005. 

- 2007 - Jan 2021 Citalopram 20mg - 40 mg well tolerated

- October 2021 gave birth to first child 

- January 2021 psychiatrist thought I should try Zoloft due to PPA after traumatic childbirth 

- January - March 2021 weaned off Celexa while uptitrating Zoloft. Process was seamless, no side effects. 

- April 2021 Zoloft increased from 100 to 125 to 150 mg in a period of 3 weeks. I developed severe anxiety + OCD symptoms, insomnia, tremor, tachycardia, body aches, clonus, myoclonic jerks, muscle weakness and muscle fasciculations.

- May 13, 2021 diagnosed with serotonin syndrome by neurologist and Zoloft discontinued cold turkey. Within 36 hours my anxiety, OCD, tremor, tachycardia, fasciculations and clonus resolved.

- Within 2 weeks I developed withdrawal symptoms. Severe unbearable akathisia/sensory symptoms in limbs preventing me from sleeping, insomnia, nausea and diarrhea.

- May 29, 2021 restarted on Citalopram 10 mg which helped take the edge off. Also started on Ativan 0.5 mg PRN TID for akathisia as well as iron supplementation (for possible restless leg syndrome component).
- June - July 2021: Akathisia/RLS greatly resolved with the Ativan and iron. Decreased Ativan to either once daily or none at all. Went from 10/10 discomfort to 1/10.  

- July - August 2021: Suffering from fatigue, brain fog, light sensitivity, limb weakness. Feel sad about it all.

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Hi Miller, 

I’m so saddened to had to go through all of that with a baby. The advice from the mods here are is priceless . Stay strong 

  • 1995 started Paxil 20mg slowly increasing to 50mg 2014 I decided to tapper myself not knowing how too and crashed , DR added 50mg of Seroquel

  • Through the years made many mistakes tapering

  • Started Tapering Both drugs at the same time 7.5% per month Paxil 9% Seroquel doing daily micro-taper 

  • Guided by Mark Horowitz

  • 31/3/24 Paxil 10.31mg

  • 31/3/24 Seroquel 9.9mg

 

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  • Moderator
5 hours ago, Miller2018 said:

Wow. It is a lot to hear that people sometimes don’t bounce back. Was hoping for some initial support, not such terrifying news. Heartbreaking, really. 


 

Hi Miller, 

don't bounce back as in don't immediately get better upon stopping the drug in the case of adverse drug effect or upon the resolution of the serotonin syndrome when one of the drugs is stopped. This will get better over time but we just don't know how long.

 

"Nothing so small as a moment is insurmountable, and moments are all that we have. You have survived every trial and tribulation that life has thrown at you up until this very instant. When future troubles come—and they will come—a version of you will be born into that moment that can conquer them, too." - Kevin Koenig 

 

I am not a doctor and this should not be considered medical advice. You can use the information and recommendations provided in whatever way you want and all decisions on your treatment are yours. 

 

In the next few weeks I do not have a lot of capacity to respond to questions. If you need a quick answer pls tag or ask other moderators who may want to be tagged. 

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week (off by 4/14/19- no tapering)

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785, 8/18/22 - 0.59, 12/15/2022 - 0.48, 2/15/22 - 0.43, 25/07/23 - 0.25 (mistake), 6/08/23 - 0.33mg

 

Supplements: magnesium citrate and bi-glycinate

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  • Administrator
23 hours ago, Miller2018 said:

Wow. It is a lot to hear that people sometimes don’t bounce back. Was hoping for some initial support, not such terrifying news. Heartbreaking, really. 

 

@Onmyway said it for me. Usually, no bouncing. It's a slow, frustrating gradual recovery, with lots of waves and windows.

 

However, you've seen improvement and are likely to keep on improving, as long as you don't do anything else to upset your nervous system.

 

Many people find these to be helpful:

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

You might try a low dose of one at a time to see what it does for you.

 

23 hours ago, Miller2018 said:

Since July 15th I have been feeling quite ill again. I did menstruate for the first time in 15 months (pregnant and breastfeeding) and experienced a very stressful two weeks (husband deployed, moved states by myself). The new symptoms are the fatigue, brain fog, etc. 

 

Was this shortly after you stopped Ativan? What was your daily intake of Ativan like in the 3 weeks prior to July 15?

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

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

All postings © copyrighted.

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  • 3 months later...
On 8/3/2021 at 7:06 PM, Miller2018 said:

 

HI @Altostrata

 

Thank you for the reply! I am still on the Citalopram 10mg daily and plan to stay on that for the foreseeable future. I just cannot rock the boat anymore. I am taking Lorazepam 0.5 mg TID right now. It helped dramatically with the akathisia type symptoms, and it is helping with my sleep. I don't think I can afford to go off of it right now as I am taking care of my baby by

 

How is going for you? Im on the same dose of citalopram plus ativan up to 3 mg a day. I have paused my taper due to difficult life circumstances including separation from my spouse. Just wondered how you’re getting along.. 

1980s: First diagnosed with depression. Treated with a tricyclic. 1988: Switched to Prozac 20 mg.  1990s to 2010: On and off Prozac. Increased dose led to side effects. 2011: Put on Zyprexa. 2011: Work burnout and breakdown. Hospitalized for suicidal depression. Switched to Seroquel. Switched to Celexa 40 mg and lithium 300 mg. 2019: Stopped Seroquel. 

2020 July: Decreased Celexa to 30 mg in attempt to alleviate sexual dysfunction. Worked somewhat.

2020 August: Decreased Celexa to 20 mg. Sexual function improved but w/d effects started. 

2020 September: Maintaining Celexa at 20 mg. Experiencing w/d effects - fatigue, dysphoria, mood instability

2020 September 13: Increased Celexa to 30 mg due to w/d effects. Still on lithium 300 mg/day.

2020 October 3: Reduced Celexa to 27 mg. Started taper. 10% per month as recommended.

2020 October 18: Reduced to 24 mg.

2020 December 4: Reduced to 21 mg.

2020 December 23: Reduced to 20 mg (spacing out taper intervals due to persistent w/d effects)

2021 September 23: Several reductions over the past 9 months to 7.0 mg. Stressful life circumstances led me to feeling very depressed with suicidal feelings, so upped to the dose to 10 mg until I feel better. 

 

 

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Hi there. Regarding the symptoms (particularly the neurological ones) I was experiencing during the withdrawal, I am honestly doing fabulous, and I hope that gives you a lot of hope! The fatigue, brain fog, muscle cramping and pain, muscle fasciculations, nausea, and the akasthesia are entirely resolved. (Just of note, I was also diagnosed with small fiber neuropathy in August so I do think the serotonin syndrome + SSRI withdrawal + SFN created an unusual reaction). I stopped the SSRI in May, and I will say it took until September for the symptoms to subside. Almost five full months. I also have a lot of stressors currently, plus some other health issues, so I plan to stay on the low dose of celexa and lexapro for now. Maybe not ideal, but do not be swayed by people’s total negativity towards SSRIs and benzos. Like all medications and medical interventions, a small subset of people have reactions. However, there are times they are useful and if you are in a place where you need to take a pause, absolutely do that for yourself. 

*of note, I have a neurologic condition called Chiari Malformation Type I for which I had 2 brain surgeries (2005 and 2010). I have been stable/virtually asymptomatic from a CM Type I standpoint since 2005. 

- 2007 - Jan 2021 Citalopram 20mg - 40 mg well tolerated

- October 2021 gave birth to first child 

- January 2021 psychiatrist thought I should try Zoloft due to PPA after traumatic childbirth 

- January - March 2021 weaned off Celexa while uptitrating Zoloft. Process was seamless, no side effects. 

- April 2021 Zoloft increased from 100 to 125 to 150 mg in a period of 3 weeks. I developed severe anxiety + OCD symptoms, insomnia, tremor, tachycardia, body aches, clonus, myoclonic jerks, muscle weakness and muscle fasciculations.

- May 13, 2021 diagnosed with serotonin syndrome by neurologist and Zoloft discontinued cold turkey. Within 36 hours my anxiety, OCD, tremor, tachycardia, fasciculations and clonus resolved.

- Within 2 weeks I developed withdrawal symptoms. Severe unbearable akathisia/sensory symptoms in limbs preventing me from sleeping, insomnia, nausea and diarrhea.

- May 29, 2021 restarted on Citalopram 10 mg which helped take the edge off. Also started on Ativan 0.5 mg PRN TID for akathisia as well as iron supplementation (for possible restless leg syndrome component).
- June - July 2021: Akathisia/RLS greatly resolved with the Ativan and iron. Decreased Ativan to either once daily or none at all. Went from 10/10 discomfort to 1/10.  

- July - August 2021: Suffering from fatigue, brain fog, light sensitivity, limb weakness. Feel sad about it all.

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That’s good to hear. Very encouraging. The only meds I’m on are Celexa 10 mg and Ativan 1 mg as needed. I’m trying to avoid adding or switching while I go through a difficult period which could last a while. I’m a bit depressed due to a separation but that’s normal and I’m not going to medicate it. It’s normal grief. Painful, but not a disorder.

1980s: First diagnosed with depression. Treated with a tricyclic. 1988: Switched to Prozac 20 mg.  1990s to 2010: On and off Prozac. Increased dose led to side effects. 2011: Put on Zyprexa. 2011: Work burnout and breakdown. Hospitalized for suicidal depression. Switched to Seroquel. Switched to Celexa 40 mg and lithium 300 mg. 2019: Stopped Seroquel. 

2020 July: Decreased Celexa to 30 mg in attempt to alleviate sexual dysfunction. Worked somewhat.

2020 August: Decreased Celexa to 20 mg. Sexual function improved but w/d effects started. 

2020 September: Maintaining Celexa at 20 mg. Experiencing w/d effects - fatigue, dysphoria, mood instability

2020 September 13: Increased Celexa to 30 mg due to w/d effects. Still on lithium 300 mg/day.

2020 October 3: Reduced Celexa to 27 mg. Started taper. 10% per month as recommended.

2020 October 18: Reduced to 24 mg.

2020 December 4: Reduced to 21 mg.

2020 December 23: Reduced to 20 mg (spacing out taper intervals due to persistent w/d effects)

2021 September 23: Several reductions over the past 9 months to 7.0 mg. Stressful life circumstances led me to feeling very depressed with suicidal feelings, so upped to the dose to 10 mg until I feel better. 

 

 

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