CharlieBrown13: Reducing venlafaxine and escitalopram

[CharlieBrown13]

Im so so hopeless today and it’s been only two and a half weeks after having to quit CT. I’m so very afraid what will come next. I woke up with massive fear and the feeling that I don’t want to live any more.

[CharlieBrown13]

@Altostrata

It is now day 20 after stopping medication with venlafaxine and escitalopram.  
In the meantime, a massive, horrible feeling of fear has set in, it starts in early morning and remains throughout the day. It almost takes my breath away.  
Sleep gets worse and there is a very deep, undulating hopelessness.  I have no active thoughts of suicide, but I have a strong feeling that I no longer want to live (although I do).  The fear is terrible.  Reinstatement is not a good option, I think, after overdosing in the past few months.  But I don't know how to hold out like this.  You once said, maybe a tiny amount of a benzo?  I am very afraid of even that….

[Altostrata]

Hang in there, @CharlieBrown13 Your nervous system is trying to recover. 

 

I can't tell you what you might take for this. You may be extremely sensitive to any drug. Commonly, doctors will prescribe benzos or propranol. FYI 

 

[CharlieBrown13]

Thank you, @Altostrata,

I keep trying to get along without medication, but I asked my doctor to write out 0.25 mg lorazepam as a reliever medication, if I need it.
I'm very unsure about lamotrigine.

[Memphisto]

Hello Charlie,

 

I'm very sorry that you're in such a bad place right now. I suspect that you may be in acute withdrawal right now. Your symptoms look very familiar to me. The good thing is that you are now free of psychotropic drugs and your nervous system can fully recover without their presence. You are way ahead of me on that. 

 

Please hang in there! It will get better eventually and windows will open again. Unfortunately, it doesn't happen overnight. It will be a gradual process and there will be setbacks or days when it feels like actual withdrawal again. Last week I was hopeless too and then it got easier again. Then yesterday I was hopeless again from the time I woke up until late afternoon, but the evening was blissful again. I was able to say to myself yesterday when I woke up with anxiety "you'll be fine tonight, you just have to make it through the hours" and it did. Today I awoke completely free of anxiety and I have a good appetite again. 

 

Hang in there Charlie, we will get there and be free to enjoy life. I hope the next bad day I can believe my own words. 

 

Warmest regards to Munich

 

https://uelpsych.eu.qualtrics.com/jfe/form/SV_0AR9IsQ61jsiXBk?fbclid=IwAR1njY-12TPe9_J4mXFmBM7RA-5dt3KBh8Vs2aaqsdml6Hqnz2V_GlZ_OlM

 

You may want to participate in this survey. I think it is important for the world to know more about the harm of psychotropic drugs.

 

[CharlieBrown13]

Dear Memphisto,

thank you for your very kind words !!  

Yes, the acute withdrawal has started now and it really is hell. I don't know how to get through this.  I also don't know whether a tiny amount of benzo will do any good.  Right now I'm sitting here with severe chills, burning skin and such a fear.  I hope it subsides a bit in the evening.  
I don't know how to do it and actually I'm pretty strong mentally.  

 

Warm greetings!

Charlie

[CharlieBrown13]

Now I gave in and took 0.25 mg Lorazepam.  The fear got a bit easier and I’m calmer.

[Memphisto]

If you have Spotify you can listen to this restorative music to relax. It sometimes helps me through the worst anxiety spikes during the day or in the morning when I can't sleep. 

 

There are many beautiful 428 Hz or 528 Hz endless loops on YouTube as well.

 

I hope the lorazepam helps you get through these bad waves. And if it smooths out the anxiety spikes, it makes a lot of things more bearable.

[CharlieBrown13]

Thank you so much, Memphisto, that’s a very good suggestion! I can (and will) listen to it on my mobile and I will start now.

I will take the lorazepam only If I can’t take it any more and today was the day… . The symptoms are not gone, but it’s not so absolutely overwhelming like it was the first six hours (until I took it) today.

 

thanks again for your help, your Input and the music, I appreciate that a lot! 
And I hope your waves are getting smaller and smaller, then tiny and then they’re gone…

 

Greetings back from Munich 

 

Charlie

[Altostrata]

Please keep notes of when you take lorazepam, and the dosage. This may be important later.

[CharlieBrown13]

Thank you, @Altostrata.
Yes, I will do that.  And I’m glad that small dosage helped. Although the nurse here was very irritated that I didn’t want to take 1 mg and said I was not doing myself a favor ...

[Altostrata]

It's definitely better to take the lowest effective dose.

 

Most likely, because lorazepam has such a short half-life, you'll end up taking small doses 12 hours apart. But don't do that until you need to.

[CharlieBrown13]

@Altostrata

I know, but sometimes I wonder why you can say over and over again that you only need very low doses of medication, actually all your life, and yet nobody believes it.

It should also be known by now that there are big differences between men and women.  And generally everyone reacts differently.  
That just doesn't matter and I find that very annoying.

 

I will try, as far as possible, to do without the lorazepam.

 

Today I have a severe headache (and new muscle cramps) but when I took an ibuprofen four days ago I had several bruises on my body the next day, so I better leave that as well.

[Altostrata]

For some reason, common sense about lowest effective dose is not applied to prescription psychotropics. Rather than understanding the effect is individual, doctors follow the model of antibiotics, to strenuously crush the symptom utterly with a standard dose or greater (unfortunately, not with the limited time course of antibiotics).

[CharlieBrown13]

@Altostrata

Now it’s 3 am Sunday morning, this fear is like nothing I ever endured in my life before. So I took another 0.25 mg Lorazepam. It’s 37 hours since I took the last dosage.

 

Do you think this terrible fear will stay longer or will recede a bit in the near future?  What do I have to prepare for? It’s now exactly 3 weeks since CT.

 

Is it ok for you that I take the Lorazepam? I didn’t want to, but I don't see any other way out at all…

[Altostrata]

You may need the lorazepam to calm your nervous system, which is hyper-activated. Lorazepam is an anti-epileptic, it reduces nervous system activity (as is lamotrigine).

 

One dose lasted 37 hours before you got rebound symptoms. Washout is 72 hours. You might be able to get by with initially taking one dose every 24 hours.

 

If you need to take it more often, you might take doses 12 hours apart. Diazepam might be better, its half-life is much longer and a very small dose once a day might be enough.

 

Talk to your doctor about this, because he or she will have to continue your prescription so you can eventually taper off.

[CharlieBrown13]

Thank you, @Altostrata

I can buy it myself, that is a small advantage….

What dosage of Diazepam would you recommend? 1 mg? I think it’s available in liquid form.

Would you then help me tapering off the benzo, when this horror is over, eventually?

 

[CharlieBrown13]

@Altostrata

I really don’t know what to do, the lorazepam I took at 3 am didn’t help at all this time. Every one or two minutes a physical wave of fear and dread and terror crashes over me and settles in my solar plexus or stomach,and I have diarrhea and chills all the time,  whatever, and I can’t stand it any longer. I really don’t know how to get through this day, let alone many days. Sorry for the whining but please help me somebody, this is pure hell.

[Altostrata]

How did you feel before and after you took lorazepam?

 

You may be sensitized to it.

[CharlieBrown13]

@Altostrata

The first time I took it, when the fear was overwhelming, it got better after maybe half an hour, it subsided. The second time it didn’t get better until the following morning (ca 6 h after I took it)

[Altostrata]

That indicates to me you are sensitized and you're taking too much lorazepam. You get a paradoxical reaction at first and beneficial effects when it partly wears off.

 

If you're taking half a tablet, you might try a quarter of a tablet, or even less.

 

I am also concerned about rebound when lorazepam wears off the next day. Diazepam would be smoother.

[CharlieBrown13]

@Altostrata

What dosage of diazepam Tablets would you recommend? Or should I take liquid diazepam, then I can get even smaller doses?

[CharlieBrown13]

Dear @Altostrata,

what worries me so much - for a few days now I have felt nothing but fear and hopelessness, I can no longer cry either.  
All joy is gone (again). It feels so cold inside of me, it's almost unbearable.  Do you think this is still a withdrawal phenomenon? And does that go away again?  What if my neurotransmitters ARE too low?  And the ZNS can not heal itself properly (sorry, I had a terrible night)? What if it’s a rebound phenomenon? 

I'm so so insecure ...

Last year I was in that deep depression with anhedonia for almost 5 months without taking any medication, I was a living zombie. 

I really really don’t want to take anything anymore (and I do think I won’t) but living like this is not worth it.

 

P.S. I bought liquid diazepam.

[Altostrata]

7 hours ago, CharlieBrown13 said:

 What if my neurotransmitters ARE too low?

 

Please do not worry about this. The neurotransmitter deficiency theories are not supported by science.

 

You are experiencing the after-effects of a severe adverse reaction, plus possibly withdrawal syndrome. Your situation is more like this: 

 

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

 

Hang in through this bad time, it will slowly get better. Your nervous system wants to go back to stability.

 

@Shep @Frogie what would be diazepam dosage equivalent to 0.125mg lorazepam? Estimates should be at the lower end of the range, CharlieBrown13 may be hypersensitive.

[CharlieBrown13]

17 minutes ago, Altostrata said:

what would be diazepam dosage equivalent to 0.125mg lorazepam? Estimates should be at the lower end of the range, CharlieBrown13 may be hypersensitive.

I looked it up it’s 1:10, that means 1.25 mg diazepam is equivalent to 0.125 mg lorazepam.
But I think I try 0.5 mg Diazepam, that’s one drop. If I need it.

 

And thank you again for your help and your encouraging words!

[5uff3r3r]

Hey Charlie, could you try and ask for a very low-dose Lamictal from your doctor? I think Altostrata already mentioned it some time ago. 

 

I have been just reading through. You are going through a lot of pain. I wish you well.

[Frogie]

@Altostrata

 

I wouldn’t go over 1 mg diazepam. Maybe start at .50 mg and see how @CharlieBrown13feels after a few days.

[Altostrata]

Thanks, @Frogie. 

 

@CharlieBrown13 the benzo equivalencies are only approximate, better to err on the low side than the high side. As one drop is the smallest you can measure, it will do as a starting point.

 

4 hours ago, 5uff3r3r said:

Hey Charlie, could you try and ask for a very low-dose Lamictal from your doctor? I think Altostrata already mentioned it some time ago. 

 

I have been just reading through. You are going through a lot of pain. I wish you well.

 

Thanks, 5uff3r3r. Charlie has decided to try a benzo first.

[CharlieBrown13]

5 hours ago, Frogie said:

I wouldn’t go over 1 mg diazepam. Maybe start at .50 mg and see how @CharlieBrown13feels after a few days.

Thanks, @Frogie, for your help!

[CharlieBrown13]

5 hours ago, 5uff3r3r said:

Hey Charlie, could you try and ask for a very low-dose Lamictal from your doctor? I think Altostrata already mentioned it some time ago. 

 

I have been just reading through. You are going through a lot of pain. I wish you well.

Dear @5uff3r3r,

I’m very very unsure about Lamictal for me. And the doctors here would definitely not give it to me in a very low dose ...

 

Thank you for your kind words though, I appreciate that very much!

[Frogie]

2 hours ago, CharlieBrown13 said:

Thanks, @Frogie, for your help!

You're very welcome. Good luck!

[CharlieBrown13]

Dear @Altostrata,

Sorry for posting again with no news, just because the fear and anxiety is so overwhelming in the moment. I’m awake since 1am, now ist 5.40 and I want to give in. 

How long do you think this acute withdrawal will last, have you any idea? The worst symptoms started a week ago…

[CharlieBrown13]

I really don’t know if I will survive this.

[CharlieBrown13]

@Altostrata

or should I try to reinstall a tiny dose of Venlafaxin? I’m really suicidal, I think.

Help me anybody, please.

[CharlieBrown13]

I took the diazepam 0.5 mg at 8.00 am, now it’s 9.30 and it’s a little bit better. Should I take it every day, one drop?

My doctor (who doesn’t know about the diazepam) now suggested olanzapin in a small dose, what do you think about that?

[CharlieBrown13]

So, it’s not better with the diazepam, I’m much more sensitive to noises now as I was anyway. My body is burning, it feels like fire in my stomach and guts. 
Since I’m now labeled suicidal, the doctors go no longer with wait and see. I have to take a small dose of olanzapin twice daily, otherwise they would move me to the closed ward, I no longer have the possibility to go out anyway.