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deg1979: Lexapro advice needed


deg1979

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On Sept 3rd I began taking 2.5 mg Lexapro. I took it for six days. In the middle of the night I awoke to rolling panic attacks. I went to the ER to get it to stop. They advised I not take the Lexapro anymore. Within a week, I had to go back to the ER, this time for emotional lability, paresthesia, akathisia, insomnia, distress, extreme anxiety, and the desire to off myself in order to make it stop. So now I’m almost a month out, suffering very much still, and all my drs say is that Lexapro must have brought about a hidden panic disorder. Um, no. There is nothing normal about this. It sounds just like the withdrawal symptoms I have read here and on other sites. My PMHNP already told me he is planning to prescribe another SSRI on Oct. 18th. My GP dr thinks I have developed panic disorder and wants me go try the PMHNP’s treatment first, and if it doesn’t work she will help me treat the anxiety and panic with Klonopin, Dr. Shipko style. I am considering reinstating, but don’t know if it’s a good idea in my case since my reaction the Lexapro was never a good one. I was not depressed prior to taking it. It was prescribed, ironically, because if I am worries I have some insomnia occasionally. I so wish I could go back one month! I am not a functional person right now. The very first day after taking Lexapro, I woke up feeling sick with a slight fever. This persisted each day, along with mounting anxiety, until the night of panic attacks when I discontinued. Any advice greatly appreciated! I know I’m at my one month out mark for reinstating.

 

med history

2.5 mg Lexapro for six days starting 9/3

9/3/21-9/8/21--6 doses 2.5 mg escitalopram (adverse reaction)

9/9/21-9/16/21-5 doses .5 mg lorazepam

9/17/21-10/17/21-.25 mg clonazepam (used at bedtime 2-3x/week)

 9/19/21-present-25 mg hydroxyzine (3x daily for anxiety)

MTHFR C667T homozygous mutation

COMT val/val homozygous mutation

Supplements: 300 mg magnesium glycinate, ProBiota HistaminX, SmartyPants women’s multi, .5 mg melatonin, starting trial of methylated B complex 

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  • ChessieCat changed the title to deg1979: Lexapro advice needed!

I should add a bit more. I realized there are other meds. The first night in the ER, with the panic attacks, I was given 4 tablets of .5 mg Ativan. I used them basically as a rescue; used the last one a few nights ago. I don’t sleep. I’m up all night, feeling like a live wire. I can fall asleep very briefly in a very light sleep, then I jolt awake quickly as if I were never asleep. It seems like no matter how calm I get myself, one or two hours after falling asleep this happens. That is new this week. I am in week 5 now, I believe. The second time in the ER, I was given 14 tabs of .5 mg Klonopin and an rx for  10 mg Propranolol. The ER dr intended for me to take .25 mg Klonopin twice a day to try to get my body out of panic mode. I didn’t use them that way, because he also referred me out to a PMHNP who said he absolutely would not prescribe any benzos. So I thought, why even start them? And yet, it does help me to know they are sitting there in case I’m desperate. And hopefully taking them sporadically will keep me from any dependency. The last two weeks, after so many night with zero sleep to 1 or 2 hours I realized I was definitely getting worse. Wed I took a .5 mg Ativan around 5 am to sleep. It didn’t help (It was also my last one). Thursday I took .5 mg Klonopin at 5 am; it also didn’t help much. The live wire feeling is so persistent. It causes my anxiety to spiral as I wonder what it would take to calm it down! I had 8 Klonopin tabs left. I feel to sole extent, even with sporadic use, I have developed a dependency to them. The week I didn’t take any was when the live wire feeling and extreme sleeplessness really intensified. I am complicating my journey with them but still need sleep, so I decided to break the remaining eight tabs down this way:

 

.25 mg @ 10 pm night 1

.25 mg @ 10 pm night 2

.125 mg @ night 3

.25 mg night 4

.125 mg night 5

.25 mg night 6

.125 mg night 7

.125 mg night 8

.125 mg night 9

0 night 10

.125 mg night 11

 

and so on until it’s gone. With that schedule I think it should last out to several weeks. My question is, I haven’t taken them consistently for two weeks. I have only taken them several times a week for the past month. Am I doing the right thing with this schedule (with the goal of sleep and preventing dependency)? Last night I had my first full night’s sleep in two weeks, and it was a beautiful thing. Also, my GP will treat with Klonopin if needed (but I do not want it); she has been our family dr for 15 years and delivered my babies via waterbirth. The PMHNP says I now have a major anxiety disorder, possibly panic disorder, and will need SSRIs now. HA! He prescribed 25 mg hydroxyzine to be taken 3 times daily. I take it five times daily in bad weeks, and 3 times daily during a good week. I should point out I have had one good week. That week made me think I was almost done. From you guys, I have learned it was a window; now I’m back in a wave. My GP can’t believe I’m still like a live wire taking 5 hydroxyzine a day. Any experience with the hydroxyzine? I haven’t noticed anyone on here taking it.

 

 Med history

9/3/21-9/8/21 2.5 mg Lexapro

sporadic rescue use of .5 mg Ativan (4 tabs’ worth—rx gone)

sporadic use of .25 mg Klonopin (14 tabs .5 mg prescribed; 8 tabs left)

currently taking:

25 mg hydroxyzine 3-5 times daily

10 mg propranolol as need for racing heart & physical panic symptoms

Planning to taper the Klonopin; see schedule above

I also take 50 mg spironolactone twice daily for acne

Old supplements I have been on long term:

1300 mg evening primrose oil

1000 mg cod liver oil

7.5 mg L-methylfolate

2000 IU D3

10,000 mcg biotin

3 mg melatonin

Preservision AREDS 2–half dose

(250 mg Vitamin C, 90 mg Vitamin E, 40 mg Zinc, 1 mg Copper, 5 mg Lutein, 1 mg Zeaxanthin)

Garden of Life Vitamin Code Raw Prenatal

Garden of Life Primal Defense Ultra Probiotic

 

New supplements my dr wants me to take, just started:

1600 mg Ashwagandha

400 mg magnesium

750 mg GABA

 

 

9/3/21-9/8/21--6 doses 2.5 mg escitalopram (adverse reaction)

9/9/21-9/16/21-5 doses .5 mg lorazepam

9/17/21-10/17/21-.25 mg clonazepam (used at bedtime 2-3x/week)

 9/19/21-present-25 mg hydroxyzine (3x daily for anxiety)

MTHFR C667T homozygous mutation

COMT val/val homozygous mutation

Supplements: 300 mg magnesium glycinate, ProBiota HistaminX, SmartyPants women’s multi, .5 mg melatonin, starting trial of methylated B complex 

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  • Administrator

Welcome, @deg1979

 

We have a group of people here who had fairly immediate adverse reactions to a drug (see "immediate adr" tags), often an antidepressant. Like you, these people don't take the drug long enough to be at risk for withdrawal, yet they have symptoms identical to withdrawal symptoms.

 

See Adverse reactions to an antidepressant within a few doses -- how long for recovery?

 

We presume that the drug has shaken your nervous system and that is why it is producing these symptoms of instability. The recovery process is the same as for withdrawal syndrome: Very slow, gradual, frustrating with waves and windows over months as long as you don't upset your nervous system again.

 

Other drugs, alcohol, even antibiotics can cause further upset in this vulnerable period. If I were you, I would definitely NOT take another antidepressant.

 

From what I've observed, as long as they take care of themselves, the immediate ADR folks recover sooner than people with true withdrawal syndrome.

 

You will need to assess whether your symptoms are intolerable before taking the risk of trying a benzodiazepine. If you take it every day, it is likely you will need to taper it to go off. Propanolol is somewhat lower risk. Always try something at a very low dose to start, one drug at a time.

 

Many people find fish oil and magnesium supplements helpful, see

 

https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

 

https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

You might try a little bit of one at a time to see how it affects you.

 

Please let us know how you're doing.

 

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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I have not been taking the Klonopin every day. I have taken it 3-4 nights per week for the past month in low doses, usually .25 mg. The thing is, I feel like it’s affecting my recovery and my mood, even though it does help me sleep through the night. If I go several days without taking it, I stay up all night. I’m afraid that’s dependency already, with my super sensitive brain. 
 

My question is how to taper? Does it make sense to take a daily dose to taper down when I have not been taking a daily dose to begin?

 

The taper schedule I am considering now is this:

week 1– 1/3 of a .5 mg tablet 

week 2-1/4 of a .5 mg tablet

week 3–1/8 of a .5 mg tablet

 

The doses would go from .17 mg, to .125 mg, to .0625 mg. It’s equivalent to 3.3 mg Valium, to 2.5 mg, then down to 1.25 mg the final week.


To put it another way, the entire taper would use 5 .5 mg tablets of Klonopin. 
 

I just don’t want to do the wrong thing by taking it daily if I have only been taking it 3-4 days at a time for the past month. 

 

9/3/21-9/8/21--6 doses 2.5 mg escitalopram (adverse reaction)

9/9/21-9/16/21-5 doses .5 mg lorazepam

9/17/21-10/17/21-.25 mg clonazepam (used at bedtime 2-3x/week)

 9/19/21-present-25 mg hydroxyzine (3x daily for anxiety)

MTHFR C667T homozygous mutation

COMT val/val homozygous mutation

Supplements: 300 mg magnesium glycinate, ProBiota HistaminX, SmartyPants women’s multi, .5 mg melatonin, starting trial of methylated B complex 

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Also, I’m not that great. I have an extreme amount of anxiety. I take 25 mg hydroxyzine as needed for it. I can’t avoid that right now. It’s keeping me out of the psych ward. I take .5 mg propranolol only as needed for racing heart, etc, which generally only bothers me when I wake up suddenly at night. 
 

I have been able to manage symptoms much better now that I realize what is wrong with me and that it’s part of the healing process. I am so grateful for all the resources I’ve come across on this site. 
 

The last week of September was a great one for me. I felt like the despair and panic was a shadow; I barely felt parasthesia (icy hot sensation that floods my body) or hot/cold flashes or racing heart. Thought I was going to be done soon!

 

Then this last week was really rough & I wasn’t really able to leave the house. This is by far the most challenging experience of my life. I know recovery has ups and downs, but I worry I sabotaged myself with the Klonopin use to sleep, even though it was low dose and sporadic. I want to try to get off of it ASAP, but without more shock to my CNS and without the nights of no sleep. After those nights, I am so unstable I feel like I need to check into the ER for psych eval. I’ve done that, though, and it wasn’t very fun!

 

Thank you so much for your response and your support. This has been terrifying!

9/3/21-9/8/21--6 doses 2.5 mg escitalopram (adverse reaction)

9/9/21-9/16/21-5 doses .5 mg lorazepam

9/17/21-10/17/21-.25 mg clonazepam (used at bedtime 2-3x/week)

 9/19/21-present-25 mg hydroxyzine (3x daily for anxiety)

MTHFR C667T homozygous mutation

COMT val/val homozygous mutation

Supplements: 300 mg magnesium glycinate, ProBiota HistaminX, SmartyPants women’s multi, .5 mg melatonin, starting trial of methylated B complex 

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  • Administrator

You had a window in the last week of September? That's a good sign.

 

16 minutes ago, deg1979 said:

The thing is, I feel like it’s affecting my recovery and my mood, even though it does help me sleep through the night. If I go several days without taking it, I stay up all night.

 

This is probably the iatrogenic condition, not a sign of dependency yet. Sleep is important. It's up to you to decide whether Klonopin offers so much benefit, you are willing to risk dependency. You will need assurance from your doctor that your prescription for 0.5mg Klonopin will be continued as long as you need it.

 

If you decide to take it, it's best to take it at the lowest effective dosage and at the same time every night. You may be able to get by with cutting a 0.5mg tablet in half, making the prescription last longer & reducing dependency issues.

 

We can help you to taper Klonopin when the time comes to go off.

 

To help us out, follow these instructions Please summarize your drug and withdrawal history in your signature You may need to use a computer to do this.

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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Thank you, Alostrata! 

 

I think it was a window, yes! I thought I was almost better, and I was mostly myself, just a little shaken and stirred by the trauma of the whole experience, I suppose. I was able to perform all of my usual responsibilities. I was even able to do start an organizing project, which during waves I cannot fathom doing because of concentration issues & just sheer volume of overwhelming emotion. I was still taking hydroxyzine, but I was taking the prescribed amount, which is 25 mg 3x daily. The week prior and the week following (this past week), I was taking 5 hydroxyzine a day plus occasional propranolol and still feeling like I had no control over my brain and body. 

 

So, what's the deal with hydroxyzine? I've searched the site but haven't found much about it. I take it the idea is basically to avoid it, but if necessary it's not as bad as taking benzos or more psych meds? I have also seen some members talk about tapering off of it, while my PMHNP told me it is not addictive and there is no need to taper. Is the tapering necessary to avoid disrupting the CNS since we're all so sensitive while healing?

 

Also, what is the consensus on continuing to take supplements and medications we have been taking long term. I take a bunch, but each has a medical purpose, and I did not see any of them on the lists of things to avoid. If someone wouldn't mind, maybe just skim my list and double check for me?

 

Thank you in advance, and I am so thrilled to find this community! You guys are literally life-savers!

 

9/3/21-9/8/21--6 doses 2.5 mg escitalopram (adverse reaction)

9/9/21-9/16/21-5 doses .5 mg lorazepam

9/17/21-10/17/21-.25 mg clonazepam (used at bedtime 2-3x/week)

 9/19/21-present-25 mg hydroxyzine (3x daily for anxiety)

MTHFR C667T homozygous mutation

COMT val/val homozygous mutation

Supplements: 300 mg magnesium glycinate, ProBiota HistaminX, SmartyPants women’s multi, .5 mg melatonin, starting trial of methylated B complex 

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  • Moderator Emeritus

Hi deg and welcome to SA,

 

SA members have different experiences with different supplements.  Some members have taken a supplement for a while and then it "turns on them".

 

There are many existing topics on SA.  Use an internet search engine and add site:survivingantidepressants.org to the search term.  Search for each of your supplements or the ingredients of a supplement one at a time.

 

Hydroxyzine is an antihistamine.  Here is the link to SA's discussion topic: 

 

antihistamines-for-withdrawal-insomnia-diphenhydramine-doxylamine-hydroxyzine

 

When I did my search I found this post in another topic:

 

On 5/5/2015 at 10:45 AM, Petunia said:

Atarax (Hydroxyzine) is an antihistamine. For someone recovering from antidepressant withdrawal, antihistamines can make symptoms worse and possibly slow recovery because they affect some of the same family of receptors that antidepressants target.

 

Please see this topic for more information:

 

Antihistamines

 

 

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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Hmm, I am wondering. I did find some of that when I did my searching. However, I suppose I am not actually in true Lexapro withdrawal. I only took it for six days, so I am struggling with issues that are experienced during withdrawals but are actually mostly the shock to my CNS. Prior to starting hydroxyzine, I was afraid I would have to admit myself to the psychiatric ward (I had already been to the ER once a few days prior for psych eval). For me, hydroxyzine is currently my ticket to normalcy. 

 

I will continue taking it, but take it with the goal of getting off of it as soon as I can comfortably do so to avoid further disruption to my CNS and allow my brain to heal sans hydroxyzine. 

 

I have taken Zyrtec for many years. I do get a little itchy if I don't take it for several days, but it's really very minor. I'm leaning toward staying on it for now just because I have taken it for so many years & don't want to mess with things. Are there any members who have had experience with this? Taking Zyrtec long term and having it "turn" on them? Has anyone found eliminating Zyrtec to help with their symptoms of CNS activation? 

 

Sometimes I just feel like a live wire, vibrating with energy, cringing every time one of my five kids makes a single noise! It's impossible to calm down!

9/3/21-9/8/21--6 doses 2.5 mg escitalopram (adverse reaction)

9/9/21-9/16/21-5 doses .5 mg lorazepam

9/17/21-10/17/21-.25 mg clonazepam (used at bedtime 2-3x/week)

 9/19/21-present-25 mg hydroxyzine (3x daily for anxiety)

MTHFR C667T homozygous mutation

COMT val/val homozygous mutation

Supplements: 300 mg magnesium glycinate, ProBiota HistaminX, SmartyPants women’s multi, .5 mg melatonin, starting trial of methylated B complex 

Link to comment
  • Moderator Emeritus

Q:  Was Lexapro that you started in September this year the first psychiatric drug you took?

 

If there were other drugs prior to this, please add them to your drug signature so that we have your full drug history.  Thank you.

 

An adverse reaction to a psychiatric drug happens very quickly after starting the drug for the first time.

 

Withdrawal symptoms happen when the drug is reduced too quickly or stopped completely (cold turkey) after the brain has acclimated to the drug.  Some people can do a fast taper off a drug if they have taken it for a short period of time.  It can take as little as 1 month for the brain to fully adapt to a psychiatric drug.

 

Even though they have different causes withdrawal symptoms and adverse drug reaction symptoms can be similar.

 

Please see:

 

But I only took it for a Week

 

immediate-adverse-reactions-to-an-antidepressant-or-within-a-few-doses-how-long-for-recovery

 

There is also this research paper:

 

elbe-2010-how-does-this-happen-part-i-mechanisms-of-adverse-drug-reactions-associated-with-psychotropic-medications

 

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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I thought I with in withdrawals after taking 2.5 mg for six days, but Altostrata thinks it was an adverse reaction, which does seem to make sense. I’m sorry, I don’t really know how to do the quotes yet.

 

I have no previous history of psychiatric drug use. I don’t even drink caffeine. I avoid it because I hate the jittery feeling and don’t want to develop a dependency to it. I don’t even take pain pills after having babies. Maybe I had some codeine after I had my tonsils out when I was 18? The psychiatrist in the ER called me “pharmaceutically naive.” I’m 42, I’ve had four babies, and this is by far the most horrific experience of my life. I have never had a drink or a cigarette (my Dad used both way too much). I’ve never smoked pot, or done a drug at a party. 
 

I guess the question is really how much my brain was altered during those six days and how much of my symptoms are pure CNS upset. I don’t know how to tell the difference. I just refilled my supplements for this week. I left out the Zyrtec to see if that helps. 

 

6 hours ago, Altostrata said:

Welcome, @deg1979

 

We have a group of people here who had fairly immediate adverse reactions to a drug (see "immediate adr" tags), often an antidepressant. Like you, these people don't take the drug long enough to be at risk for withdrawal, yet they have symptoms identical to withdrawal symptoms.

 

See Adverse reactions to an antidepressant within a few doses -- how long for recovery?

 

We presume that the drug has shaken your nervous system and that is why it is producing these symptoms of instability. The recovery process is the same as for withdrawal syndrome: Very slow, gradual, frustrating with waves and windows over months as long as you don't upset your nervous system again.

9/3/21-9/8/21--6 doses 2.5 mg escitalopram (adverse reaction)

9/9/21-9/16/21-5 doses .5 mg lorazepam

9/17/21-10/17/21-.25 mg clonazepam (used at bedtime 2-3x/week)

 9/19/21-present-25 mg hydroxyzine (3x daily for anxiety)

MTHFR C667T homozygous mutation

COMT val/val homozygous mutation

Supplements: 300 mg magnesium glycinate, ProBiota HistaminX, SmartyPants women’s multi, .5 mg melatonin, starting trial of methylated B complex 

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  • Administrator

@deg1979 you'll probably gradually recover, but be prepared for setbacks.

 

Hydroxyzine is not as much as a problem as some drugs. It is an antihistamine and may stop working. Since you're taking it every day, you should plan to do a rapid taper off when you decide to stop it, even if it's stopped working.

 

Quote

I have taken Zyrtec for many years. I do get a little itchy if I don't take it for several days, but it's really very minor.

 

If you have been taking Zyrtec regularly, your system becomes accustomed to it and rebound itching may occur if you stop. It's a little like psychotropic drugs in that regard. To go off it, you'll need to taper it by a little each day. 

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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Thank you, Alostrata, that’s a good point. What normally occurs when I stop taking it also may not be what will occur this time when I stop taking it. I will taper it.

 

When you mentioned tapering the hydroxyzine, you said I should make sure to do a rapid taper off—did you mean that I should NOT do a rapid taper, or did you mean that it’s OK to do a “typical” rapid taper like we normally associate with tapering (vs. the incremental tapers we need to do with psych meds)?

9/3/21-9/8/21--6 doses 2.5 mg escitalopram (adverse reaction)

9/9/21-9/16/21-5 doses .5 mg lorazepam

9/17/21-10/17/21-.25 mg clonazepam (used at bedtime 2-3x/week)

 9/19/21-present-25 mg hydroxyzine (3x daily for anxiety)

MTHFR C667T homozygous mutation

COMT val/val homozygous mutation

Supplements: 300 mg magnesium glycinate, ProBiota HistaminX, SmartyPants women’s multi, .5 mg melatonin, starting trial of methylated B complex 

Link to comment
  • Administrator

Hydroxyzine is actually similar to Zyrtec (cetirizine), as it's active metabolite is cetirizine. See

 

 

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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Oh, wow. That seems bad. Like I’ve been taking way too much of it. My dr prescribed 25 mg hydroxyzine 3 x daily as needed. He said I could take 50 mg at once if necessary, but to avoid it if possible. 
 

Taking it three times daily would have been once every 8 hours, but I have been taking it once every 6 hours. So 4-5 times daily. AND taking Zyrtec. 
 

Yikes? I will definitely focus on getting that all lowered. 
 

Thank you again, you are helping me make informed choices about what is best for my health. It’s invaluable because I know my GP and my new PMHNP think I have panic disorder and need SSRIs! That’s the last thing I need. 
 

My GP had me do a cheek swab DNA test for psych meds. Not sure what brand. Do those give any useful information for those of us who are not planning to take any psych meds? I know my daughter’s gave an indication she needed to take L-methylfolate. Are you familiar with these tests?

9/3/21-9/8/21--6 doses 2.5 mg escitalopram (adverse reaction)

9/9/21-9/16/21-5 doses .5 mg lorazepam

9/17/21-10/17/21-.25 mg clonazepam (used at bedtime 2-3x/week)

 9/19/21-present-25 mg hydroxyzine (3x daily for anxiety)

MTHFR C667T homozygous mutation

COMT val/val homozygous mutation

Supplements: 300 mg magnesium glycinate, ProBiota HistaminX, SmartyPants women’s multi, .5 mg melatonin, starting trial of methylated B complex 

Link to comment
  • Administrator
15 hours ago, deg1979 said:

My GP had me do a cheek swab DNA test for psych meds. Not sure what brand. Do those give any useful information for those of us who are not planning to take any psych meds? I know my daughter’s gave an indication she needed to take L-methylfolate.

 

Not very useful. May help you avoid adverse drug effects from specific drugs in the future. Not at all useful for withdrawal.

 

Those results your daughter got probably could be resolved by her eating more leafy green vegetables to get folate. A purpose of some of the tests is to sell supplements.

 

Hydroxyzine needs a fast taper, similar to Zyrtec and PPIs, over a few weeks, according to your tolerance.

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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@Altostrata, the past few days I have been experiencing a increase in anxiety and agitation with the feeling I need to pace or move and can’t sit still. I wake up this way about 5 am regardless of how much I slept prior to that. It is accompanied by strong diarrhea and nausea, as well as typical pounding heart and hot/cold flashes. I am taking 25 mg hydroxyzine at 8 am, 3 pm, and 9:30 pm. I am avoiding Klonopin; however I am trying to be aware that it may be hard for my body to switch from taking .25 mg 3-4x a week to not taking it at all. Tues morning I took .125 mg during a particularly anxious episode. I also took .125 mg around 1 am this morning because I was unable to sleep due to anxiety. I have something important I want to attend today, but my anxiety and akathisia-like symptoms are so much stronger after sleepless nights that I don’t think I can be in public. 
 

I hope this is not a contributing factor, but I also stopped taking Zyrtec. I looked at my records and realized I did not take it during the two weeks following my adverse reaction on 9/9. I resumed taking it 9/22 while staying at a friend’s house (due to lots of cat dander, which I am allergic to). I discontinued 10/9.  I have been taking Zyrtec for years, but I often forget to take it because it’s in my morning pills, which I tend to forget. I took Zyrtec in the morning because antihistamines can be paradoxical for me (Benadryl), but only when taken on an empty stomach. I am also afraid if I take Zyrtec with hydroxyzine it may be more likely to turn paradoxical on me. That and the fact that Zyrtec is a metabolite of hydroxyzine, which I am taking regularly, led me to see what happened if I just cut the Zyrtec out. Allergy wise I don’t notice anything other than that my eyes seem a little itchy. I strongly feel I can’t manage or function as a semi-sane person without the hydroxyzine.

 

I have some concerns about taking hydroxyzine, as well. I know my anxiety is very obvious in these fears, but it seems like even rare things are possible after experiencing all of this. And my symptoms are so bad I can’t imagine tolerating more! I mentioned before that I have parasthesia sensations. I believe they are in some way connected to hydroxyzine  and the anxiety. It feels like an icy hot sensation that starts around my neck and flows down my arms. Sometimes it can be more full body; other times it can go up my neck to my scalp. 
 

I am also experiencing what is similar to akathisia, but I don’t think is true akathisia—I think it may just be a symptom of the anxiety. I sometimes feel almost like I am a live wire; like electricity is buzzing through me. Like if I don’t control it I shake a tiny bit. And if it happens at night I simply cannot lie down anymore. I have to get up and pace. During the day, I just keep moving and busy. I think it is happening more this week. I’m having trouble figuring out the cause. It’s currently my most disruptive and distressing symptom combine with the despair/anxiety that always accompanies it. I use my toolbox of anxiety coping mechanisms, but it is exhausting. It creeps back in as soon as it can. I am desperately trying to avoid more pharmaceuticals. 
 

One that has been bothering me more but is hopefully being paranoid is I find myself strongly clenching my jaw. It feels new and unusual for me. I became worried because last night as I tried to sleep, I had many jerks and twitches in my body, including puckering my lips a few times and my left cheek twitching. So now I am worrying about tardive dyskinesia as well. 
 

I know I am a ball of anxiety of unreal proportions. I never knew it was possible for humans to feel anxiety this extreme. I am in therapy and working on coping mechanisms. I am also very good at using meditation. I used it during a natural water birth with my last born five years ago. The problem comes when symptoms are so persistent that I never get a break or even real sleep. Then my ability to cope takes a sharp nosedive. 
 

I would greatly appreciate any and all advice. My brain is toast & can’t sort this out!

9/3/21-9/8/21--6 doses 2.5 mg escitalopram (adverse reaction)

9/9/21-9/16/21-5 doses .5 mg lorazepam

9/17/21-10/17/21-.25 mg clonazepam (used at bedtime 2-3x/week)

 9/19/21-present-25 mg hydroxyzine (3x daily for anxiety)

MTHFR C667T homozygous mutation

COMT val/val homozygous mutation

Supplements: 300 mg magnesium glycinate, ProBiota HistaminX, SmartyPants women’s multi, .5 mg melatonin, starting trial of methylated B complex 

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@Altostrata, I also stopped taking 50 mg spironolactone twice daily, also on 10/9, because I looked it up and read it causes cortisol to spike 100% an hour after taking and that it continues to rise and peaks at two hours. As with the Zyrtec and all my other supplements, I stopped taking it for two weeks following my adverse reaction because I was afraid to take anything. I added it back in around 9/22, and again, I took it sporadically even after that because I was worried about whether or not I should take it while also taking propranolol. I take spironolactone for hormonal acne, and I tend to have lower blood pressure genetically, so I felt the need to take my blood pressure before taking propranolol. I do have times when I feel like I am about to faint while standing, where my vision starts to fade, but I am confident it is what others on the site commonly report during withdrawal. It is happening even when I am not taking spiro or propranolol. When it happens, I take my blood pressure and it is fine; around 116/70. Normal for me is about 110/60.

 

9/3/21-9/8/21--6 doses 2.5 mg escitalopram (adverse reaction)

9/9/21-9/16/21-5 doses .5 mg lorazepam

9/17/21-10/17/21-.25 mg clonazepam (used at bedtime 2-3x/week)

 9/19/21-present-25 mg hydroxyzine (3x daily for anxiety)

MTHFR C667T homozygous mutation

COMT val/val homozygous mutation

Supplements: 300 mg magnesium glycinate, ProBiota HistaminX, SmartyPants women’s multi, .5 mg melatonin, starting trial of methylated B complex 

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Hello @deg1979 sorry to hear the challenges with symptoms and reactions you’re going through. You’re not alone in this fight.

 

I myself suffer from pretty bad anxiety that got worse after my adverse reaction with Zoloft.

 

>I am also experiencing what is similar to akathisia, but I don’t think is true akathisia—I think it may just be a symptom of the anxiety. I sometimes feel almost like I am a live wire

 

From what I learned on this site so far, our body is trying to get back to homeostasis, which could lead to symptoms like the feeling of akathisia. I experienced akathisia-like symptoms the first few nights after discontinuing my ssri and others on here have experienced it at differing lengths and times.
 

>One that has been bothering me more but is hopefully being paranoid is I find myself strongly clenching my jaw. It feels new and unusual for me. 
 

Bruxism seems to be another symptom I’ve come across on these forums as well. I personally didn’t have this but I’ve dealt with excessive saliva and trouble swallowing/ throat tightness, that has since gone away.
 

What keeps me going is trying to remember that these symptoms will eventually resolve with time. I encourage you to continue to use therapy and techniques to cope with your anxiety and keep reminding yourself it will get better.
 

As for your sleep issues, I hope you can find a way to get more rest because I find that my symptoms feel much less intense if I get a decent nights rest. 
 

I personally take 5mg of melatonin if I struggle to fall asleep. (Caution using you might be sensitive to certain supplements) Otherwise I drink chamomile tea before bed and try to limit screen time in bed. I also use an eye mask and dark curtains to sleep better.
 

 

9/03/2021 25mg Sertraline

9/04/2021 25mg Sertraline

9/05/2021 25mg Sertraline

9/06/2021 25mg Sertraline

9/07/2021 12mg Sertraline

9/08/2021-Present 0mg Sertraline

Supplements: Fish oil, Magnesium body wash

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I am completely recovered from DP/DR within a mouth after Sertraline-induced DP/DR. You wanna recover: do the opposite; I mean involve in daily life tasks; don't pay attention to DP/DR and you notice it has already gone like it was never there at all!  These videos were my gold standard: https://www.youtube.com/c/Dpmanual/videos

 

You CAN recover and it takes time!

Edited by Erfan

Have been on many medications (for around 10 years!), but two main SSRIs were Lexapro and Zoloft. Many side effects (weight gains +40 kg!!!, constant sweating no matter how hot/cold or humid the weather was!, gynecomastia, ...) which I was ignoring them for a long time as I thought not being depressed is more important than having side effects...
Been medication-free since April 2021! Lots of ERP, CBT, and mindfulness practices have helped me to live my life without medications.
You are not broken. It takes time...

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@john856, I think we are adverse reaction twins! I, too, began taking an ssri for the first time on 9/3, though I was taking escitalopram. I took mine for 6 days rather than your 5. I’ve followed you so I can keep up with how you are doing. Do you mind if I ask what specific symptoms led you to stop the ssri? I read your thread but don’t recall seeing it.

 

I had anxiety before taking the ssri, but NOTHING like now. This a whole different animal! A very scary one! I am really struggling to cope, and I am already pretty good at coping with this stuff. It really is more difficult when you don’t get a break from symptoms, or after a sleepless night, or after a window when you get your hopes up. 
 

I am staying hopeful for us! Just five or six days on the evil meds won’t ruin us! My daily windows are mid-day, sometimes later evening, with mornings pretty reliably horrible. I really think it’s the cortisol wake up response. I’m doing what I can to convince my body all day long that it really can take a rest and come out of fight or flight mode! 
 

I tried napping this morning, but I’m not a great napper and I have a lot of kids. They kept waking me up. I do feel like I’ve been knocked into my daily “somewhat calmer” window, so I am ready to carry on. One of my kids has something important going on today, and I really want to be there!

9/3/21-9/8/21--6 doses 2.5 mg escitalopram (adverse reaction)

9/9/21-9/16/21-5 doses .5 mg lorazepam

9/17/21-10/17/21-.25 mg clonazepam (used at bedtime 2-3x/week)

 9/19/21-present-25 mg hydroxyzine (3x daily for anxiety)

MTHFR C667T homozygous mutation

COMT val/val homozygous mutation

Supplements: 300 mg magnesium glycinate, ProBiota HistaminX, SmartyPants women’s multi, .5 mg melatonin, starting trial of methylated B complex 

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@deg1979

 

>"Do you mind if I ask what specific symptoms led you to stop the ssri?"

 

Basically I had a steady decline of cognitive function, derealization, and visual symptoms but decided to keep pushing thru because it was 'supposed to get better'. Instead this culminated in a very sudden and scary panic attack on my bathroom floor. Up until that point, I've dealt with anxiety, but never on the level where I had a panic attack (extreme racing heart, uncontrollable racing thoughts, sweats, etc.)

 

I knew then and there that I had basically poisoned myself unknowingly and decided I needed to stop 'pushing thru' the symptoms, so I quit the zoloft.

 

I agree with your statement that this level of anxiety was a whole different animal. I've since had one other panic attack but (knock on wood) haven't had anymore since. I think it's too early for me to tell if I'm back at my pre-zoloft anxiety levels. But one things for sure, is that those pills made my anxiety worse while I was taking them. I never had a history of panic attacks.

 

Right now though, my major issues are mainly cognitive and concentration issues.

 

I'm glad to hear you have windows around mid-day and sometimes in the evening. I'm trying to get back to those precious windows. Mine are about the same, with anxiety in the mornings. I agree that it's the cortisol levels in the morning, and I try to do some breathing exercises to try to calm down. That said, I feel like I'm in a wave right now. About 2 weeks ago, I had about a week-long window where I almost felt like my old self, which was nice. Hopefully we can get more windows!

 

I'll give you a follow too to keep up with your progress. Hopefully we can feel better soon so we can get back to our lives with our loved ones!

9/03/2021 25mg Sertraline

9/04/2021 25mg Sertraline

9/05/2021 25mg Sertraline

9/06/2021 25mg Sertraline

9/07/2021 12mg Sertraline

9/08/2021-Present 0mg Sertraline

Supplements: Fish oil, Magnesium body wash

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  • Administrator
6 hours ago, deg1979 said:

I am trying to be aware that it may be hard for my body to switch from taking .25 mg 3-4x a week to not taking it at all.

 

Did you just stop taking Klonopin frequently?

 

6 hours ago, deg1979 said:

I also stopped taking 50 mg spironolactone twice daily, also on 10/9

 

I cannot address withdrawal from steroids, sorry.

 

It appears you made a lot of drug changes simultaneously. I cannot even follow them. Most of them aren't psychiatric drugs and I cannot analyze fallout from those drug changes. I have no idea how to treat your allergies. You might have to hold on until those drug changes settle out over a few weeks.

 

What exactly are you taking now, at what times o'clock and dosages? How do you feel before and after taking each dose?

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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@john856, I also had a "window week" where I thought I was better! It was the last week of September. I was not thrilled when the weekend came and the window ended! 

 

When I started Lexapro, I woke up the next morning feeling chills and aches, and I thought I was sick. In fact, each day my temperature would rise a couple degrees above normal. It was right before my kids were supposed to start school, so I went to get a covid test (I ended up getting a few; all were negative). I was also extremely angry. I thought I was angry because my husband had exposed us to covid by hanging out with a family member and choosing not to wear masks. The next day that family member tested positive for covid. So I had reason to suspect covid (and reason, I felt, to be angry). But I was SO angry. In fact, I remember saying to him, "I don't think I have ever been this angry." But I didn't tie it to the new Lexapro yet. It was the next day, how would it affect me so quickly? 

 

The next five days I took it I mostly remember that the feeling I was coming down with something stayed around without getting worse, and I noticed my "normal" anxiety was getting much worse. The pharmacist warned me of this; I googled it, everything seemed normal, so I kept taking it. But that Wednesday night at 1 am I woke up having a panic attack. It scared me because I had never had one, but I after it subsided I realized it was just a panic attack and went back to bed. Three hours later I had another panic attack, but this time they were rolling, or back to back, one after another, and I could no longer gain any control to stop them. I wasn't sure what to do, but I was also having intrusive thoughts because I was wishing I could die in order to end the agony! So I made my husband take me to the ER. They were very thorough, tested everything they could think of, and we finally decided Lexapro was something I should never take again. The ER dr said I could immediately quit because I was taking half a normal starting dose and had only take six doses. 

 

I actually felt better for a couple days, but then I began having really wild mood swings. It was really just the despair/anxiety waves coming on. But it was terrifying! My husband realized it was somehow neurological and began calling them waves before I ever found this community. He said, I noticed these waves of anxiety aren't tied to anything--they just come and go. You just have to ride out the waves. Easier said than done! The waves became progressively worse, and I didn't understand what was going on yet. I was afraid I was going insane, or that maybe the SSRI had induced bipolar disorder (some people in my family have it). I ended up having to go to the ER again, this time for a psych eval, because the intrusive thoughts about wanting to die were really scaring me. They did not think it could possibly have been caused by the Lexapro for so few days at such a low dose, so they decided I had basically developed a severe anxiety/panic disorder and the Lexapro was the final "straw that broke the camel's back." 

 

I went a few more weeks thinking that, but really knowing deep down that was NOT it and the medication DID cause it, before I found this community the same way you did; by searching for SSRI withdrawal symptoms. Here's to more week long windows!

9/3/21-9/8/21--6 doses 2.5 mg escitalopram (adverse reaction)

9/9/21-9/16/21-5 doses .5 mg lorazepam

9/17/21-10/17/21-.25 mg clonazepam (used at bedtime 2-3x/week)

 9/19/21-present-25 mg hydroxyzine (3x daily for anxiety)

MTHFR C667T homozygous mutation

COMT val/val homozygous mutation

Supplements: 300 mg magnesium glycinate, ProBiota HistaminX, SmartyPants women’s multi, .5 mg melatonin, starting trial of methylated B complex 

Link to comment

@Altostrata, I'm sorry, I think I dumped way too much info at you at once! I'll try to streamline it.  I asked you last week about discontinuing the Klonopin .25 mg. I was given a limited prescription for it a month ago in the ER, but my current psychiatric provider does not believe in prescribing them so I am attempting to cut back. I suggested a tapering schedule, but I wasn't sure it was the right plan because I have never taken Klonopin daily so it did not seem to make sense to take it daily to taper. I think you agreed. I was having some insomnia, and you thought it was more likely iatrogenic and not caused by Klonopin withdrawals given my history.

 

Since my adverse reaction occurred last month, I have taken Klonopin about 3 nights a week to sleep. I have nights where I don't sleep at all.  After one of those, I will take .25 mg Klonopin a few nights in a row hoping to set my sleep schedule back. My problem is mainly massive anxiety. I feel like I am vibrating with it all the time. I also feel the akathisia-like feeling, which I think is anxiety related rather than true akathisia. The akathisia feeling and vibrating feeling are two I have more trouble controlling using coping mechanisms. They are a real struggle for me. I haven't found a reliable way to deal with them yet. I also wonder sometimes if hydroxyzine or Klonopin could be causing those symptoms. I take hydroxyzine regularly every 8 hours; I only take Klonopin as needed a few nights a week. 

 

This week I decided I would take .125 mg on the nights I felt I needed Klonopin. So twice this week I have taken .125 mg Klonopin at night to sleep. I usually do this around 1 am if I have been lying awake for a couple hours unable to sleep. I have only taken Klonopin 3x a week at night at a .25 mg dose for the last month, since my adverse reaction. I think you were correct about sleep; lowering my Klonopin dosage this week did not seem to affect my sleep either way. It was actually a better week, sleep wise. I have more struggles with the high anxiety and anxiety-akathisia; however, I could just be experiencing a two-steps-back wave. Do you think I need to do anything differently in my "taper" off of Klonopin, or do you think it's OK given my past usage?

 

The only other medications I am currently taking are hydroxyzine 25 mg three times a day and 5 mg propranolol, as needed (infrequently). I have concerns it will turn paradoxical on me, but when I tried cutting back to two pills a day I had a couple of very bad mornings, so after two days I brought it back to three times and decided to focus on the Klonopin instead. The hydroxyzine worries me because I have been twitching a lot as I fall asleep, sometimes with lip puckering or a cheek spasm, but it is very gentle, so I am hoping it may just be normal. After researching hydroxyzine, I found it can sometimes cause tardive dyskinesia. With my high anxiety, I have been worrying about that. Another member shared their taper schedule for hydroxyzine with me. I will use that when I have quit the Klonopin and feel like I'm ready to take it on. Do you think there is any real basis to my worries about hydroxyzine and tardive dyskinesia? If so, should I fast taper? Do members generally tolerate fast tapers off hydroxyzine well?

 

I don't think we need to worry about the two medications I stopped taking. One was Zyrtec, which you mentioned is actually a metabolite of hydroxyzine. The other is a diuretic, which I only take for acne and discontinued because research shows it causes cortisol spikes and lowers blood pressure. I feel faint enough as it is! I only mentioned them in case they mattered. Also, I had not been taking them regularly since my adverse reaction. 

 

Thank you again. I know I'm an anxious mess. I'm just trying to sort it all out so I know what my plan is for getting off of all the medications. 

9/3/21-9/8/21--6 doses 2.5 mg escitalopram (adverse reaction)

9/9/21-9/16/21-5 doses .5 mg lorazepam

9/17/21-10/17/21-.25 mg clonazepam (used at bedtime 2-3x/week)

 9/19/21-present-25 mg hydroxyzine (3x daily for anxiety)

MTHFR C667T homozygous mutation

COMT val/val homozygous mutation

Supplements: 300 mg magnesium glycinate, ProBiota HistaminX, SmartyPants women’s multi, .5 mg melatonin, starting trial of methylated B complex 

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  • Administrator

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. I would appreciate your follwoing this very simple list format. Thank you.

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

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@Altostrata
I began tapering hydroxyzine. It is not going well. 
 

Prior hydroxyzine dose: 25 mg, 3x daily, every 8 hours
 

Sat., 10/23

8:00 am—18.75 mg hydroxyzine,

                 41 mg magnesium

                 1300 mg evening primrose 

                  1 Garden of Life prenatal 

                 2.5 mg Zyrtec 

                 7.5 mg l-methylfolate

4:00 pm—18.75 mg hydroxyzine

                  41 mg magnesium

10:00 pm—bedtime/sleep

                   1 Garden of Life prenatal 

                   1,000 mg cod liver oil

                   1 Garden of Life probiotic

                    1 Sleep3 10 mg time       released melatonin w/ L-theanine 

11:49 pm—18.75 mg hydroxyzine upon wakeup

 

Sun., 10/24

4:00 am wake & unable to sleep after

8:00 am—18.75 mg hydroxyzine

                  41 mg magnesium

                  1 Garden of Life prenatal

                  1300 mg evening primrose

                   7.5 mg l-methylfolate

                   2.5 mg zyrtec

4:00 pm—18.75 mg hydroxyzine

                  41 mg magnesium

8:00 pm— sudden panic while watching a kids’ comedy sketch; I have been avoiding TV because it feels overwhelming, but my kids asked me to watch

10:00 pm—25 mg hydroxyzine

                   1000 mg cod liver oil

                   41 mg magnesium

                   1 Garden of Life probiotic

                   1 Garden of Life prenatal

                   1 Sleep3 10 mg time release melatonin with l-theanine

normal bedtime, but too anxious to go to bed; journaled feelings & talked to husband

11:00 pm—went to bed; tossed and turned calmly but with little sleep 

3:30 am—anxiety too strong to stay in bed; got up to pace around house and read online

 

I stopped Zyrtec recently with no real issues. Reinstated 2.5 mg (1/4 dose) Sat as I lowered hydroxyzine dose by 1/4 also 

 

Sleep3 10 mg time release melatonin I have taken off and on during WD; I was taking .5-1mg per night for about a week after reading your posts about lower doses, but went back to time release formula last two days to try to combat 4 am wakeup & anxiety

 

other supplements no change 

 

I have tried tapering hydroxyzine two other times in the last month. I had capsules, so I just took two doses per day—one in the morning around 8 am and another in the late afternoon sometime. Both times, by the second evening I experienced marked anxiety which worsened by the following morning.

 

I switched to 25 mg tablets and cut off one quarter (and weighed for accuracy), then spaced 8 hrs apart in hopes of avoiding this.

 

Advice on next steps?

9/3/21-9/8/21--6 doses 2.5 mg escitalopram (adverse reaction)

9/9/21-9/16/21-5 doses .5 mg lorazepam

9/17/21-10/17/21-.25 mg clonazepam (used at bedtime 2-3x/week)

 9/19/21-present-25 mg hydroxyzine (3x daily for anxiety)

MTHFR C667T homozygous mutation

COMT val/val homozygous mutation

Supplements: 300 mg magnesium glycinate, ProBiota HistaminX, SmartyPants women’s multi, .5 mg melatonin, starting trial of methylated B complex 

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  • Administrator

Why are you tapering hydroxyzine?

 

I don't see any clonazapam in your notes, did you stop taking it?

 

7 hours ago, deg1979 said:

10:00 pm—bedtime/sleep

                   1 Garden of Life prenatal 

                   1,000 mg cod liver oil

                   1 Garden of Life probiotic

 

Are you pregnant?

 

If I were you, I would not take these supplements before bed. They may contribute to keeping you awake.

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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  • ChessieCat changed the title to deg1979: Lexapro advice needed

@AltostrataI am tapering it because I have concerns about taking it long term. I’d also like to see how I do off of it. I’m really afraid to take anything now. 
 

I am not pregnant; I have been taking them for years. I will discontinue them. 
 

I did discontinue clonazepam. My last dose was .125 mg on 10/17. 

9/3/21-9/8/21--6 doses 2.5 mg escitalopram (adverse reaction)

9/9/21-9/16/21-5 doses .5 mg lorazepam

9/17/21-10/17/21-.25 mg clonazepam (used at bedtime 2-3x/week)

 9/19/21-present-25 mg hydroxyzine (3x daily for anxiety)

MTHFR C667T homozygous mutation

COMT val/val homozygous mutation

Supplements: 300 mg magnesium glycinate, ProBiota HistaminX, SmartyPants women’s multi, .5 mg melatonin, starting trial of methylated B complex 

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17 minutes ago, deg1979 said:

I did discontinue clonazepam. My last dose was .125 mg on 10/17. 

 

Eight days ago? You didn't taper it? Were there any stretches that you took it every day?

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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On 10/10/2021 at 1:57 PM, Altostrata said:
On 10/10/2021 at 1:35 PM, deg1979 said:

The thing is, I feel like it’s affecting my recovery and my mood, even though it does help me sleep through the night. If I go several days without taking it, I stay up all night.

 

This is probably the iatrogenic condition, not a sign of dependency yet. Sleep is important. It's up to you to decide whether Klonopin offers so much benefit, you are willing to risk dependency. You will need assurance from your doctor that your prescription for 0.5mg Klonopin will be continued as long as you need it.

 

I did taper clonazepam a little, as much as I could before my jeweler's scale came in the mail. 

 

Here is a summary of dates taken (Klonopin .25 mg or Ativan .5 mg--ER prescribed 4 Ativan tablets on 9/9, the night of adverse reaction; these would be the first dates listed; after 9/17, doses refer to Klonopin prescribed at second ER visit for psych consult).

 

To be clear, these dates refer to a single dose taken at night, sometimes before bed, other times in the middle of the night. I did not take it during the day. 

 

9/9, 9/10, 9/12, 9/14, 9/16, 9/17, 9/24, 9/27, 9/28, 9/29, 10/1, 10/7, 10/8, 10/9, started .125 mg dose on "as needed" basis 10/11, 10/16, 10/17.

 

I suggested a daily tapering schedule, but I was hesitant because I did not take it on a consistent daily basis. You thought I probably did not have a dependency yet and sleeplessness was probably just part of the iatrogenic condition. I agree; when I took Klonopin during a sleepless night it did nothing for me. The only way it helped, if it did at all, was if I took it before bed. I honestly think the way it "helped" was that I believed it would. Possibly is lessened anxiety related to fear of not sleeping. 

 

When I decided to cut the dose in half and take it as needed, I only felt the need to take it those three nights because of anxiety at bedtime. I didn't notice any mood or sleep disturbances after discontinuing that seemed to directly correlate. The last week when I did not take any Klonopin, my mood was the best it has been yet. I think it was probably a window that lasted from about 10/14-10/24. I don't know if I can call it a true "window" while I'm taking 25 mg hydroxyzine 3x daily. I don't know how I would feel without it.  

 

The early morning waking is something that naturally developed since I turned 40. My sister is struggling with the same thing. Ironically, it is what my GP prescribed the Lexapro to treat. It used to only happen during times of stress or anticipatory anxiety (a morning flight the next day or a wildfire 2 miles behind my house). Since the Lexapro incident, it happens more often than not. In addition, I have had at least one entirely sleepless night per week. I strongly feel the sleeplessness is anxiety related. I even have the frequent urination you describe in other posts, in addition to diarrhea and elevated heart rate.

 

I am trying to manage it by telling myself it's OK to miss sleep now and then. I will live. I've just go to get through this. Yesterday I also combed through the posts on managing insomnia. Last night I slept with an ear warmer around my eyes (sleep mask improvisation). I slept from 10 pm to 7 am with some early morning panic waking, but went back to sleep after calming myself. I think not being able to look at the clock also helped. It thwarted my anticipatory anxiety!

 

I have concerns about taking hydroxyzine long term. I'd like to cut back over the course of 7 weeks. I would finish tapering mid-December. I have tried to cut back on three other occasions. I believe I was cutting too much, and each time by the end of night 2 or start of day 3 I was a mess of anxiety and despair. I didn't have a jeweler's scale yet to weigh doses. I have one now. 

 

I plan to go back to my stable dose of 25 mg 3x daily until 10/30. 

 

10/31 I will begin to taper by 3.125 mg (12.5% decrease from current dose). My last attempt at tapering was by 6.25 mg per dose (25% decrease). 

 

Each week I plan to decrease by the same 3.125 mg rather than a percentage of the previous week's dosage. For simplicity's sake, and because, if I understand correctly, hydroxyzine does not normally need to be tapered in the same way as true psychiatric medications. 

 

I worry that I am dependent on the hydroxyzine due to its mild SSRI effect. I cannot find much information on its SSRI effect online. I have read what I can find on SAD. I still don't understand how much of an SSRI effect it has. I know I need to find a balance between managing my anxiety symptoms on my own and accepting some pharmaceutical help if needed.

 

I would prefer to eliminate all supplements and medications, but without creating any more stress to my CNS. I have major symptoms of CNS upset. TV is often a trigger for my anxiety. It overwhelms me. I have five kids, ranging in age from 5-19, so it is a challenge to just stay calm and keep my CNS happy!

 

I worry about taking hydroxyzine for months at a time. It was given to me the night of the adverse reaction. I hated the way it made me feel. I refused to take it the second time I went to the ER for a psych consult. I associate it with an increase in/possible cause of my paresthesia symptoms (icy hot feeling pouring from neck down); unsure whether that is founded or just related to my health anxiety. I ended up resorting to hydroxyzine because my anxiety was too much to bear and my psychiatric provider does not support the use of benzodiazepines. I tend to agree with him, because my mother in law has been taking them for over 30 years to treat her anxiety symptoms (she has bipolar disorder).   

 

I don't take it for sleep. Because I stay on a stable dose all 24 hours of the day, I have learned to tolerate any sleepiness. Also, my anxiety is high enough that I remain alert despite any sedative effect. Most cases on SAD I can find of people taking hydroxyzine have been taking it for sleep. Since I take hydroxyzine continuously and seem to "crash" when I lower my dose, I worry that I am dependent on hydroxyzine because of its SSRI effect. 

 

In your opinion, how strong is the SSRI effect of hydroxyzine? Does my proposed taper schedule seem logical and effective? 

9/3/21-9/8/21--6 doses 2.5 mg escitalopram (adverse reaction)

9/9/21-9/16/21-5 doses .5 mg lorazepam

9/17/21-10/17/21-.25 mg clonazepam (used at bedtime 2-3x/week)

 9/19/21-present-25 mg hydroxyzine (3x daily for anxiety)

MTHFR C667T homozygous mutation

COMT val/val homozygous mutation

Supplements: 300 mg magnesium glycinate, ProBiota HistaminX, SmartyPants women’s multi, .5 mg melatonin, starting trial of methylated B complex 

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  • Administrator

You may be dependent on hydroxyzine, but it isn't because of any SSRI effect, it's because you've gotten physiologically dependent on hydroxyzine. It's an antihistamine. You might want to taper off, but if it's working, not sure why you'd do that.

 

The early morning waking is a physiological response to sunrise. See 

 

What is the sleep cycle?

 

Waking with panic or anxiety -- managing the morning cortisol spike

 

Tips to help sleep -- so many of us have that awful withdrawal insomnia

 

Path to Better Sleep FREE online for everyone from the US Veterans Administration

 

Music for self-care: Calms hyperalertness, anxiety, aids relaxation and sleep

 

White noise devices for sleep

 

Melatonin for sleep: Many people find it helpful

 

TV or computer use in evening can disrupt sleep: Bright light signals the brain that it's daytime

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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  • 2 weeks later...

I have continued taking the hydroxyzine. You are right, Alto, why mess with a good thing? It was my newfound medical anxiety that was driving me to stop. Maybe I also had the illusion that if I could just stop taking everything I would be OK. I think I was also a little in denial!

 

Today it has been two months since my adverse reaction and my lovely induction into this set of symptoms we are all experiencing. I made a mistake in attempting to add a supplement back in. I was doing so well I thought it was time. Now I think it's not worth trying anything for a good, long while. I feel discouraged today after a near sleepless night of jolting awake in fight or flight mode repeatedly. It could be the supplement I tried adding in (ashwagandha and L-theanine complex--my doctor was sure it would help me) or it could possibly be my lady cycle. I'm going to start tracking my basal body temp in the mornings to see if I am ovulating and add that to my daily symptom journal. (I have a Mirena IUD, so no idea if I'm ovulating or not.) 

 

I have a wonderful therapist. I am so grateful for her. She also encouraged me to take the hydroxyzine, that it was safe, and if it is helping me I should be grateful for it and take that opportunity. She also suggested I look into the connection between hormonal contraception and natural hormones and cycles. I have been looking into it, and I am investigating whether I could benefit from bioidentical progesterone supplementation. Apparently Mirena IUDs block the body from ovulating (at least some of the time) and therefore prevent the natural production of progesterone, which affects mood and anxiety. I suspect it is blocking ovulation, because I intentionally had my 5 year old Mirena replaced this past May because I was having cyclic ovarian pain that my doctor and I assumed would stop with a new Mirena and fresh batch of hormones. Does anyone have any experience they could share with me along these lines?

 

I am also looking into trying a low-histamine diet, in part to help my husband, who has incredibly awful vestibular migraines. I read a book about vestibular migraines that detailed a diet one neurologist found highly successful in treating his patients who suffer from migraine symptoms. I figure if hydroxyzine is helping me so much, maybe I need to lower my histamine levels!

 

Overall, before I got silly and tried to introduce a supplement, I was sleeping really well. My anxiety had become so much better that I hadn't felt my paresthesia in at least a week. I was very optimistic, and I still am. I know the waves come, no matter what. I'm not going to let this one get me down. It has also been an eye opener for me in how far I have come since this started. You kind of forget how bad it really was, in the same way you forget the pain of childbirth. Last night there were moments that were agony, and yet, I was grateful it has been a while since I experienced them. 

 

Basically, I feel like this taught me what everyone on here seems to be learning or to have already learned--take it slow, be patient, and time will heal. I think I  manage my anxiety by trying to make a plan to fix everything, and it often helps in other situations. I do think I have learned a lot, especially since finding this site (thank you, thank you, all of you), and much of that knowledge has really helped me. But I know I have a tendency to jump down rabbit holes and maybe hyperfocus on things and try too hard to fix things, to the point where I increase my anxiety. I think that's where I am right now, and I need to back off and focus on meditation and calming routines. And stop messing with supplements. 

 

I keep thinking there are certain ones I "need," and therefore I should push to put them back in. So if anyone has any knowledge they can impart to me, have at it! I did add D3 2,000 IU in (taken in AM) without incident a week or so ago, as well as L-methylfolate 7.5 mg. In my elimination diet of sorts, I am removing foods high in nickel (I have a nickel allergy and have developed an allergic reaction on my neck that I can't seem to find a cause for) as well as dairy. Dairy has been a struggle for me since my second pregnancy. I had awful acid reflux and took too much Prilosec and other antacids to counteract it. With each pregnancy, I became more lactose intolerant (there were four), and now I can't really tolerate any measurable amount of lactose in foods. And yet, I love dairy. I eat it all day long, but in fermented and cultured forms that have eliminated the lactose. Those are out on a low histamine diet, plus I really think dairy has become an inflammation-inducing problem for me over time. Dark leafy greens are out on a low nickel diet, though most lettuces are OK (yay, romaine!). These are the reasons I added the D3 and the L-methylfolate back in, with seemingly no adverse effects. 

 

I suspect the problem with my supplement, other than maybe just a rude disruption of my CNS, could be a low quality, impure version of L-theanine. It definitely felt very activating and "caffeine-like" to me. I have no desire to try any other supplements. I need to leave it where it is. Also, thank you, Alto, for suggesting I stop the habitual prenatal multi I was taking. It contained many active cultures and fermented vitamin sources, so if histamine is an issue for me, it was not helping. In addition, I was taking a soil-based probiotic supplement as well as an additional lactose-specific probiotic. I am grateful for the guidance I was given by Alto and others to minimize supplements. I am willing to take D3 and L-methylfolate out if it is wise to do so. 

 

Thank you for reading! I know I'm long-winded. Any and all advice is appreciated!

9/3/21-9/8/21--6 doses 2.5 mg escitalopram (adverse reaction)

9/9/21-9/16/21-5 doses .5 mg lorazepam

9/17/21-10/17/21-.25 mg clonazepam (used at bedtime 2-3x/week)

 9/19/21-present-25 mg hydroxyzine (3x daily for anxiety)

MTHFR C667T homozygous mutation

COMT val/val homozygous mutation

Supplements: 300 mg magnesium glycinate, ProBiota HistaminX, SmartyPants women’s multi, .5 mg melatonin, starting trial of methylated B complex 

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I am struggling to accept. I know on an intellectual level that acceptance is key, but in practice it is difficult. I find myself still trying to control my symptoms and still reacting so strongly when I am unable to. I become deeply discouraged. At the same time, isn’t this part of the iatrogenic problem? It seems like, no matter how badly I want to accept this and relax, during a wave I can’t help getting stuck in the bargaining phase of grief. I desperately seek for a reason for the wave or for something that will prevent the next one.

 

This time I have been diligent about not taking anything else and leaving things the same. I haven’t added anything; I haven’t taken anything away. I have nothing to blame the wave on, other than perhaps going for a run on Monday when I was feeling good. The only other possibility is that I haven’t been great about following the migraine (lower histamine) diet that I mentioned earlier. In my quest to control the waves, I suppose I could avoid runs (but keep up walks) and be more diligent about the migraine diet. It does immensely help my headaches and neck aches. My neck has been in a constant state of needing to be cracked since this adverse reaction began, but that has let up, and I do credit the diet for that. 
 

Last night I had a night of waking repeatedly, with shallow sleep and anxiety. I woke with my heart pounding, which does happen most nights, but I have been having more nights of restful sleep. This morning I am in the dark place of hopelessness and anxiety that feels unbearable. The kind I fear most, that is all consuming.  I find when I experience improvement, it makes the return of difficult symptoms emotionally hard for me to accept. I need to change that. I can be grateful for the improvements while still acknowledging the challenging days that lie ahead. It’s not pessimism; it’s acceptance. There will be more sleepless, anxiety tormented nights ahead. If I accept that, then I can stop fighting against it and learn to live with it. 
 

The very minor anxiety I experienced before my adverse reaction to Lexapro was related to specific situations. Public speaking was really the only thing that I had a strong anxious reaction to. If I had an upcoming speaking event, I experienced a lot of lost sleep combined with gastro upset, which then makes it nearly impossible to sleep. I also used to have a much milder version of the same thing if something novel was happening the next day—say we were going on a trip, or it there was some other stressful situation (I think I previously mentioned this really began in 9/2020 when we had a wildfire very close to my house). To me, anxiety and a bit of early morning waking with some gastro upset is “normal” in those situations. I wish I had just accepted it then, rather than asking my dr how I could help it. But then, I had no reason to be suspicious of SSRIs. 
 

Another challenging mindset I experience in my waves is the fear that I will always be this way and that there is no hope for the future. That I am somehow broken. I know that we all feel that way, and when I am not in a wave I know that and am able to reassure others of that. I am sitting here in the dark early morning hours trying to reassure myself and to distract from the awful feelings of anxiety. I have a big family, and I don’t want to wake them, so I am limited in what I can do to distract myself. 
 

Thank you. 

9/3/21-9/8/21--6 doses 2.5 mg escitalopram (adverse reaction)

9/9/21-9/16/21-5 doses .5 mg lorazepam

9/17/21-10/17/21-.25 mg clonazepam (used at bedtime 2-3x/week)

 9/19/21-present-25 mg hydroxyzine (3x daily for anxiety)

MTHFR C667T homozygous mutation

COMT val/val homozygous mutation

Supplements: 300 mg magnesium glycinate, ProBiota HistaminX, SmartyPants women’s multi, .5 mg melatonin, starting trial of methylated B complex 

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@deg1979Hi Deg, I was on hydroxyzine for 4 months before my body told me it was time to start tapering.  Your body will probably tell you, too.  After reading a lot on this website, I have decided that I will try supplementation, but only one ingredient at a time and at a small amount at first.  I'm also only trying supplements that are known to calm the excitatory activity in the brain or calm histamine reactions.  I have a lot of healer friends who have lots of ideas for me, but my nervous system is just different right now and can't accept "normal" courses of treatment.

 

I've felt the same way about acceptance as you do.  Early on, I remember walking around my home saying, "I will not accept this!"  I think I've reached a place of acceptance, but it's just much harder when things are intolerable.  Things are more tolerable for me now.

 

It sounds like you are doing your very best, and this experience is extremely difficult.  Know that you are supported.

 

Take care,

Crochet

2012-present - Escitalopram currently 2.55 mg

Supplements:  Daytime- Green Lipped Mussel 1200mg, Omega-3s 1710mg, Wheat Germ Oil 770mg, Multi-Min 2 tablets, Liposomal Glutathione 4 pumps, Probiotic 1 capsule, Beyond Balance herbal tinctures for lyme and gut healing (including one only taken during menstruation); Nighttime - L-theanine 200mg, melatonin 1mg, magnesium glycinate 400mg.

History:

2012-2017- Escitalopram 10mg

2017-2020 - Escitalopram 5mg

07/2019-11/2019 - Valium 10mg, every 2-3 days, then stopped

11/2020 - Stopped Escitalopram 5mg abruptly (crashed January 2021)

1/2021-12/2021 - Escitalopram Reinstated 2.5mg to 5 to 10 to 7.5 and then started slow taper

1/2021-2/2021 - Ativan .5mg - Took 13.5 pills over the course of 22 days and stopped

2/2021-9/2021  Hydroxyzine - 50-100mg tapering down to .8mg, then cross-tapered to Claritin and stopped

9/2021-9/2022 - Claritin 5 mg (tapered off)

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10 hours ago, deg1979 said:

I am struggling to accept. I know on an intellectual level that acceptance is key, but in practice it is difficult. I find myself still trying to control my symptoms and still reacting so strongly when I am unable to. I become deeply discouraged. At the same time, isn’t this part of the iatrogenic problem? It seems like, no matter how badly I want to accept this and relax, during a wave I can’t help getting stuck in the bargaining phase of grief. I desperately seek for a reason for the wave or for something that will prevent the next one.

 

This time I have been diligent about not taking anything else and leaving things the same. I haven’t added anything; I haven’t taken anything away. I have nothing to blame the wave on, other than perhaps going for a run on Monday when I was feeling good. The only other possibility is that I haven’t been great about following the migraine (lower histamine) diet that I mentioned earlier. In my quest to control the waves, I suppose I could avoid runs (but keep up walks) and be more diligent about the migraine diet. It does immensely help my headaches and neck aches. My neck has been in a constant state of needing to be cracked since this adverse reaction began, but that has let up, and I do credit the diet for that. 
 

Last night I had a night of waking repeatedly, with shallow sleep and anxiety. I woke with my heart pounding, which does happen most nights, but I have been having more nights of restful sleep. This morning I am in the dark place of hopelessness and anxiety that feels unbearable. The kind I fear most, that is all consuming.  I find when I experience improvement, it makes the return of difficult symptoms emotionally hard for me to accept. I need to change that. I can be grateful for the improvements while still acknowledging the challenging days that lie ahead. It’s not pessimism; it’s acceptance. There will be more sleepless, anxiety tormented nights ahead. If I accept that, then I can stop fighting against it and learn to live with it. 
 

The very minor anxiety I experienced before my adverse reaction to Lexapro was related to specific situations. Public speaking was really the only thing that I had a strong anxious reaction to. If I had an upcoming speaking event, I experienced a lot of lost sleep combined with gastro upset, which then makes it nearly impossible to sleep. I also used to have a much milder version of the same thing if something novel was happening the next day—say we were going on a trip, or it there was some other stressful situation (I think I previously mentioned this really began in 9/2020 when we had a wildfire very close to my house). To me, anxiety and a bit of early morning waking with some gastro upset is “normal” in those situations. I wish I had just accepted it then, rather than asking my dr how I could help it. But then, I had no reason to be suspicious of SSRIs. 
 

Another challenging mindset I experience in my waves is the fear that I will always be this way and that there is no hope for the future. That I am somehow broken. I know that we all feel that way, and when I am not in a wave I know that and am able to reassure others of that. I am sitting here in the dark early morning hours trying to reassure myself and to distract from the awful feelings of anxiety. I have a big family, and I don’t want to wake them, so I am limited in what I can do to distract myself. 
 

Thank you. 

You’ve literally spoken from my mind.

 

I had two tolerable days recently and today woke with severe panic and anxiety. It’s so hard to slip back into these moments and accept. 
The roller coaster is wild. 
 

Im keeping your post to refer back to when I feel my my worst. Reminding myself others feel this way and I’m not alone and we’re all going through it. 
 

❤️ Hoping plenty of windows soon for you 

Dec 2017

Zoloft 3 nights - bad reaction end up in hospital  // Jan 2018-Jan 2019- Venlafaxine 75mg Trazadone 200mgstarted in hospital // 2019-2020 - Slow venlafaxine taper ended up at 3 beads in mid 2020 pretty flawless taper with minimal withdrawal Symptoms was on 10-20mg PRN adderall during this time  // Jan 2021-March 2021 Miscarriage, Adderall CT, Vaccine still on 3 beads // April 2021-July 2021 Start experiencing withdrawal type symptoms, depression anxiety not sure why - increased to 5-10 beads over two months // July 2021

Pregnant // August 2021

tried to wean down back to 3 beads // September 2021 Hard crash - insomnia, akathisia, panic attacks, cortisol rushes, constant adrenaline rushes, depression, no appetite, nausea on and off, muscle pain // current: October 7th Reinstated 37.5mg of Venlafaxine 200mg Trazadone // 5-10 mg of propranolol 

Clonazepam PRN last dose Oct 6th

trying to stay off

Supplements: Occasional L-theanine 

Prenatal mag citrate 400–600mg before bed

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