LotusRising: Buspar, Ativan

[LotusRising]

@Frogie I don't know if I can do that? I tried the 0.5mg 3 times yesterday (0500/1300/1900) and I had the worst anxiety I've experienced yet, that lasted from 745pm yesterday, until about 130 this morning when I think I fell asleep. Then I woke up again at 430, straight into anxiety. It's like my body was in a constant anxiety state and the 0.5mg provided no relief. I took 0.75mg this morning for my 0500 dose and even now, 2 1/2 hrs later, I still have mild anxiety. I'm not expecting it to disappear but I'm not getting much relief.

[Frogie]

Without reading your signature, how long have you been on the Ativan? 
 

If it hasn’t been too long we could do a fast taper off of it and see it that will relieve your anxiety.

 

You also might try taking extra magnesium. Sometimes that helps.

 

 I’m sorry you’re going through this. Let’s see what we can do to bring some relief to you.

Edited October 22, 2021 by Frogie

[LotusRising]

 I think I’m on 16 days straight Ativan. But just prior to daily dosing, I was taking it 10-12 times a month since November, for situational anxiety. 

[Altostrata]

12 hours ago, MedRN said:

Felt mostly normal until the big waves of panic in the evening. Does this mean anything?

 

My guess this is from the schedule change. It's causing fluctuation of drug level in your bloodstream. You're getting rebound anxiety symptoms when it dips. It will take about 3 days for this to settle out to a more consistent blood level.

 

4 hours ago, Frogie said:

I’m thinking maybe you should try .5 mg 3 times a day because Ativan only lasts 8 hours or so in your system. It could be wearing off before the next dose.

 

Yes, try to take the 0.5mg 8 hours apart. You might need a rescue dose somewhere to smooth the symptoms out, but I would avoid increasing total daily dosage, you might be able to get by with 3 x 0.5mg.

[Greatful]

@MedRN

 

The last thing I want to do is add in more meds, but I'm wondering if anyone has had success with pregablin or seroquel. I'm scared and have no idea what to do.  

 

I know you are in a panic, your mi Take a deep breath, go outside find something to distract yourself.  Remind yourself this will  not hurt you, yes, you will feel uncomfortable but it will not hurt you.  You will be okay.  

 

 I was in a mess last winter and tried Seroquel I went up to 175mg and I still was in a mess.  I found out this is very hard to get of off.  I ct'd after 6 weeks and became paranoid.  I thought I was going crazy.   Trying new drugs will may not cover up the WD from the other drug.  Then you  will have start up side affects from the new drug and still be in WD from the other.  This happened to me last winter now I am poly-drugged and still trying to stabilize.  My brain is still trying to get it straight from the on, off, try this, try that.  Chemicals, chemicals, chemicals.

Please give the mods time to work with you and give things time to adjust.

 

You are not alone.❤️

You know you can do this.  What is your mantra for the day.  "  I am okay at this moment."

Find your center.  

I know that it is easy to get overwhelmed with trying to learn this learn, do  that.  A big one is accepting were you are today and know that you are going to get through it.  Then add in some skills to help you get through.  There is nothing you can do about tomorrow except worry about it and do wishful thinking.  Today is all you can really do anything about.  So live for today.  Then do this everyday. 

 

Have you tried visualization

Assign the color black to depression, red for anger, green for jealousy, yellow for anxiety, panic, restlessness then visualize the dot's of color  it in your brain away from you and say this is not me, this is WD and I it is only an experience that I am having.  Sometimes this will center you to look at the real you and know that yeah that is not me.  Then distract yourself.  Remember dwelling or trying to run from your thoughts will only drag you in to the thought spiral and we all know where that lead too, frustration, more anxiety, more depression and worthlessness thinking and that you want to give up.  If you have to do do this constantly at first so be it .  This is were the meditation heals you learn to not get attached to your thoughts

 

Hang in there, you can do this❤️

 

 

[Frogie]

7 hours ago, MedRN said:

 I think I’m on 16 days straight Ativan. But just prior to daily dosing, I was taking it 10-12 times a month since November, for situational anxiety. 

You’ve been on it long enough to become dependent on it unfortunately. A fast taper would probably wreak havoc on your CNS.

 

Let’s try the 3 0.5 mg doses a day, evenly spaced. Like Alto said you may need a rescue dose here and there. It should start evening out in 4 days or so.

 

A little magnesium in between might help also. Just take a small amount at first though.

 

What helps me is some deep breaths, getting fresh air, and holding my puppy. At the moment, I’m making quilted Christmas ornaments for family, so that is keeping my mind very occupied. You might find something to keep your mind busy, even if it’s doing a word search puzzle or reading a magazine.
 

It’s going to work out, you just have to give it time. 
 

Take care,

 Frogie xx

Edited October 22, 2021 by Frogie

[Altostrata]

9 hours ago, Greatful said:

The last thing I want to do is add in more meds, but I'm wondering if anyone has had success with pregablin or seroquel. I'm scared and have no idea what to do. 

 

@Greatful are you asking this question for yourself?

 

MedRN can increase Ativan if she chooses, or possibly cross over to diazepam. It doesn't make sense to start adding other drugs, which will also incur dependency.

 

MedRN, you can take occasional rescue doses, perhaps of 0.25mg at a time, to get past this transition.

 

[Greatful]

@Altostrata No this question is one from medrn she posted a few post back, I'm not sure  how to  use the quotes from a different page, so I copied and pasted it.  Sorry for the confusion.

[Greatful]

@MedRNHow are you doing today❤️

[LotusRising]

@Greatful @Altostrata @Frogie

Honestly, not that great. 

 

A doctor has switched me to clonazepam, as I was having a lot of breakthrough panic attacks with the ativan at 0.5mg 3x/day. I was having upwards of 3-4/day and felt in a constant state of anxiety. So, as I said, I'm trialling clonazepam 0.75mg 2x-day. I don't know anything about conversions from ativan to clonazepam, so I don't know if this is equivalent to more or less ativan. I just know that clonazepam has a longer half life, so I should have better coverage of symptoms. I still don't know if the switch is good or bad, but I did get more sleep last night, even though I still woke up 3 times.

 

The tingling/numbness and tinnitus have not been as bad, but still tend to flare up in the evening. I am trying to stay distracted and have been out for 4 walks today, which is way better than what I was up to for the last two weeks, which was not leaving the house at all. 

 

It's hard to tell how my body is reacting to the clonazepam and if it is accepting it.

[LotusRising]

@Altostrata @Frogie

 

I wonder if I should be dosing this 3 times a day instead of 2. It seems to me over the last couple days it may be making my anxiety worse. I'm aware that the constant fluctuations are likely not good for my brain, but have no idea what to do and am being told differing things from every provider I see.

[Frogie]

I think the conversation is .25 mg of clonazapam for .5 Ativan. It does last a lot longer. Did you just stop the Ativan and start the clonzapam? That could be causing your anxiety to increase also. I’d give it 4 days of taking it consistently and see how you do. It takes a few days to get into your system. Please keep notes so we can figure out how you’re doing. Hopefully you’ll be better in a few days.

 

Take care,

 Frogie xx

[LotusRising]

@Frogie @Altostrata

Yes, she switched me right from Ativan to clonazepam. I know this was not ideal.  I was taking 1.5mg Ativan as a daily total, so that would be approx .75mg of clonazepam right?  I was told by my pharmacist to take .75mg twice a day so it sounds like I’m taking way too much so it makes sense that  I’ve been getting a flare of symptoms when the medication kicks in.  I’ve been taking it twice a day for two days. Would it be reasonable to take .25mg 3 times a day (6hrs apart) of the clonazepam? I know I’m a fast metabolizer. I have so much anxiety about the whole process that I haven’t slept in 2 weeks. 

[LotusRising]

@Altostrata @Frogie

 

Here's my last couple days of notes

 

Oct 22 - saw a provider at urgent care - recommendation to start clonazepam directly

0745 - anxiety with increased HR, shaking

300pm - 0.75mg clonazepam (directed by both provider and pharmacist)

430pm - mild tingling and tinnitus

600pm - starting to feel mildly anxious so went for a walk, walking increased the tingling sensations in my body

800pm - took 0.75mg clonazepam (pharmacist recommended to get plasma levels up)

930pm - mild tinnitus, numb spots on legs/feet

 

Oct 23

130am - dozed for a bit, woke with anxiety 3/10

330am - dozed for a bit, woke with anxiety 4/10, tinnitus

500am - took clonazepam 0.75mg and fell back asleep until 800am

800am - woke with anxiety 3/10

nothing to report for most of day

500pm-635pm - watching TV and HR started to increase, anxiety so went for a walk, followed by some breathing exercises, followed by a very emotional cry

645pm - took clonazepam 1.0mg (pharmacist recommended to hopefully have me sleep)

750pm - increased HR, tinnitus, increased anxiety 4/10, went for another walk and it passed by 900pm

940pm - feeling nauseous, drugged feeling (this dose was obviously way too much), anxiety up to 4/10

1000pm - went to bed

1145pm - straight awake with anxiety, did not sleep entire night

 

Oct 24 (today)

600am - anxiety 1/10 - took clonazepam .25mg

 

As mentioned above, should I be taking .25mg 3 times a day? 6hr or 8hr intervals? Or, what should I be doing? I know I need to keep a consistent schedule. And can I take any ativan if I have breakthrough anxiety?

 

[Frogie]

I would try .75 mg at first and see how you do. You can always increase if needed, but as you know, it’s difficult to decrease.
 

You could try .25 mg three times a day. Maybe try 7:00 am, 1:00 pm and 7:00 pm. You can always make a schedule to fit you. You could try a tiny bit of Ativan for breakthrough anxiety, but I’d try to stay away from it as much as possible or your body will become dependent on it also.

 

It’s going to take a few days for your body to get used to the switch. Try a walk like you did, getting some fresh air, and you could also try meditation.

 

Let me know how you are doing 😊

 

Take care,

 Frogie xx

Edited October 24, 2021 by Frogie

[LotusRising]

@Frogie Ok, and you anticipate this will be enough, considering my pharmacist had me taking .75mg 2x/day for the last 2 days? Is this because of the half-life of clonazepam?

[Altostrata]

37 minutes ago, MedRN said:

@Frogie Ok, and you anticipate this will be enough, considering my pharmacist had me taking .75mg 2x/day for the last 2 days? Is this because of the half-life of clonazepam?

 

The pharmacist made a mistake.

[Frogie]

Like @Altostratasaid, the pharmacist made a mistake. That is way too much.

[LotusRising]

@Altostrata @Frogie

 

Oh yes! I completely agree now that I am more familiar with conversions. I was mostly asking because I was wondering if I should do a gradual decrease from the .75mg 2x/day to the .25mg 3x/day. So, I'm basically going from 1.5mg to .75mg in one day. I don't need to taper that down? Or because it was only for two days on the higher dose, I should be ok?

 

[Frogie]

You should be fine because you only took the 1.50 mg a few days. Just keep on a consistent schedule. You may have a few rocky spots until your body gets used to it.

[LotusRising]

@Altostrata@Frogie

 

Just a quick question - is it normal that I can feel the clonazepam when it kicks in? It seems to cause a quick exacerbation of the AD withdrawal symptoms - tingling/burning sensation, slight uptick in anxiety - and then it passes.

[Altostrata]

13 minutes ago, MedRN said:

tingling/burning sensation, slight uptick in anxiety

 

This sounds like a little bit of paradoxical effect. Yes, it's normal, but if it lasts, dosage may be too high.

 

May be bumps as steady state evens out.

[LotusRising]

Ok, thank you @Altostrata  I will continue to post my notes. 

[LotusRising]

@Altostrata@Frogie

 

Oct 24

600am - took clonazepam .25mg

             - woke with lots of anxiety, went for a walk

845am - tinnitus, chest tightness, increase in anxiety

1115am - tinnitus

1230-200pm - surge of chest tightness 6-7/10, yoga for 1hour helped

1300 - took clonazepam .25mg

1630 - tinnitus

1745 - another surge of chest tightness and panic 5/10, breathing for 45 mins to calm

1845 - took clonazepam 0.25mg

1930 - felt clonazepam kick in with burning/tingling/slight uptick in anxiety

2045 - chest tightness 4-5/10, dissipated by 2115, used meditation

2115 - in bed , tinnitus

0330 - still awake

          - chest very tight (yoga for 30mins)

          - shaking

          - burning in scalp

          - waves of anxiety every time I closed my eyes to try and sleep

          - took ativan 0.25mg breakthrough, no effect

0445 - all 0330 symptoms still occurring

          - can feel anxiety escalating

          - took another ativan 0.25mg breakthrough, some calming effects within an hour

 

I don't know what to do at this point. I haven't slept in two weeks, some nights with no sleep at all. The clonazepam does not seem to be covering me enough. I feel like when we started the whole process, I was likely at tolerance to the 1.5mg of ativan, so perhaps we're not working with enough medication. I know it is not good to go up, but it feels as though I am constantly chasing the anxiety. I am due to take my clonazepam 0.25mg at 700, which I will, but what would your recommendations be. It seems I am also getting tingling and an uptick in anxiety when the clonazepam starts working - as mentioned in another post, this will either get better, or suggests the dose needs to be smaller. Should I be dosing more frequently during the day? 

 

 

[Frogie]

You could try cutting the doses in 1/2 and taking it more frequently if you think that might help. But I’m wondering if the dose is too high at the same time.

 

I don’t want to keep changing doses as your body isn’t acclimated to this yet and will just wreak havoc on your CNS.

 

If we keep increasing/decreasing the dose, you will never stabilize and that’s what worries me. You have been through enough. 
 

What do you think about taking it more frequently for 4-5 days, keep notes and see how you do?

 

 

[Greatful]

@MedRN

I am so sorry that you  are struggling so.  My heart goes out to you.  It is so hard to stay sane when you are in so much distress.  You are doing a great job trying to pull it together, meditation, yoga, walking.  You can do this and you will be okay.

Hang in there.❤️

[LotusRising]

@Frogie

 

Yes, I know what you mean about all the changes. 

 

I only have a pill cutter, but I could try that. I guess this would mean dosing 6 times a day. If I cut out the final evening dose, would that affect my overnight coverage? It is seeming to cause a short increase in restlessness, so I wonder if smaller doses would help with this? How far apart would you recommend? I've already taken .25mg at 0700am. I also find that taking it at 7pm, means it's reaching its peak around when I should be falling asleep, so perhaps it would also help with that aspect.

 

On the other hand, I could keep the dose as is and change the timing? I seem to get surges of anxiety/restlessness in the late afternoon and evening, so I end up being a little wound up before bed, despite doing meditations right before. I'm not comfortable taking the ativan overnight for breakthrough, but I was feeling weak, tired and at a loss of what to do.

 

Also maybe worth mentioning is that I don't seem to "feel" the first dose of the day as much as the others. I wonder if that is because of timing between the final dose of the day, and first dose of the morning.

 

Sorry, I know I've asked a lot of questions. But what do you think is the best option?

Edited October 25, 2021 by MedRN
added content

[Frogie]

Let’s try a different schedule but you’ll have to move it by an hour until you get it where you think it will work. Maybe the later you take it, the better you’ll sleep. If that doesn’t bring relief, you could try cutting the daytime doses in 1/2 and keep the evening dose in the .25 mg dose.

[LotusRising]

@Frogie

 

Ok, I'll try advancing by 1 hour today.

[LotusRising]

@FrogieDo you think if I took a half dose in the evening instead of a full dose, it might help? Or would that alter coverage for anxiety overnight.

[LotusRising]

@Altostrata @Frogie

 

Now that this is building up in my system, I don't think it's making me feel all that great. I took the clonazepam at 700, so it would be at its peak effect right now. I feel trembly, restless and tight-chested with a drugged-like feeling. I also have a fullness in my head. I would think if it's working, my chest would become less tight. Is the dose too high maybe?

[Frogie]

You have to remember you took huge doses for a few days so your body has built up a large amount in your system. Maybe cut your afternoon dose in 1/2 and take the normal dose before bed. Let’s see how that does. It’s going to take a few days for your body to regulate because of the up and down in doses and a cold switch from Ativan.

 

Keep your notes and let’s see how you do in a few days.

 

Hang in there. We’ll get it figured out for you.

[Frogie]

1 hour ago, MedRN said:

@Frogie

 

Ok, I'll try advancing by 1 hour today.

That sounds good 😊

[Frogie]

54 minutes ago, MedRN said:

@FrogieDo you think if I took a half dose in the evening instead of a full dose, it might help? Or would that alter coverage for anxiety overnight.

I think for now you’re better off taking the full dose at night so you don’t have breakthrough’s during the night.

[LotusRising]

@Frogie ok, I may check in before that dose just to confirm, based on how I feel from halving the afternoon dose. 

[Frogie]

29 minutes ago, MedRN said:

@Frogie ok, I may check in before that dose just to confirm, based on how I feel from halving the afternoon dose. 

Sounds great😊