Qextor: Trying to figure things out

[Qextor]

I live in the Metro Vancouver area, one of the biggest cities in it.  I used to work night shift for several years, but left when I struggled with sleep.  Unfortunately not soon enough.  Still couldn't sleep even  at night. Even with gravol and trazodone (my NP prescribed) , My anxiety issues increased, and after a really concerning stunt, I was sent to a psychiatrist who prescribed 0.5 quetiapine and 0.25 clonazepam for high-level anxiety and restlessness, insomnia, obsessive thoughts all about how badly I had screwed things up, and panic about the future, if I couldn't sleep, which all led to that concerning stunt. This was back in the beginning of August.  August 20, he upped the clonazepam to 0.5, and the quetiapine down to 0.25, which was raised to .37 (1.5 tablets), along with lomotrigine, which was supposed to stabilize my mood, and the other two were to calm things down while the lomotrigine built up from 0.25 over the following 4 months to 200.  When the tried a small taper of the quetiapine, (1.25 tablets instead of 1.5 tablets) the anxiety, shakyness, and obsessive thoughts shook me like a rag doll.   Going back up to 1.5 tablets helped a little, but I was far more shaky than I had been for awhile. 

 

It's hard to shake the fear of having to eventually try tapering again, experiencing that level of anxiety every day, especially when the family you live with thinks it's all in your head, and you just need to learn how to relax more, get out and do stuff more (I have no idea what to do with myself, and not much money to do it with since I'm not working) when there's a nuclear bomb going off in your head, erasing any ability to focus on anything.   There is a little calm in the evening, because that is when I am normally awake, and the drug cocktail is helping things there. But without the quetiapine, and my nightly oatmeal,  I wouldn't be able to sleep. But my brain just doesn't want to be awake during the day, and I get so shaky/tearful/very wide awake like I'm on stimulants until the afternoon, when I start feeling cranky and a little tired.  I just can't feel tired or sleepy anytime of the day, at least enough fall asleep.

 

I do have a online course learning about becoming a tax preparer to keep myself busy, since I don't go out much.  It's going decently well, if sometimes a little overwhelming.

 

I'm here mainly for help with managing all the anxiety/obessive thoughts/ insomina once I start tapering.  My psych has 'left if up to me' so far, but both efforts have crashed with even small reductions.

[manymoretodays]

Hi there Qextor and welcome aboard!

Glad you've arrived and are wanting to taper.

12 hours ago, Qextor said:

I'm here mainly for help with managing all the anxiety/obessive thoughts/ insomina once I start tapering.  My psych has 'left if up to me' so far, but both efforts have crashed with even small reductions.

 

Where are you at now with your fears/anxiety, obsessive thoughts, and insomnia now?  And this is good that you wish to taper and go with non-drug coping.  And I think you will be able to come up with a suitable taper plan here as well.

We do encourage non-drug coping here, rather than finding yet another drug to treat WD.  If you go to the main page here, and scroll on down you'll see the Symptoms and Self Care forum

It's full of wisdom and discussions around coping with the myriad of symptoms often experienced in WD.

 

You've started your Introduction topic and introduced yourself to the community......

What we need you to do now is to give us an idea of what you are taking now, in this format:

How to summarize your drug history in your signature

this is different from any profile information, that you may have put in on registration, and will appear below your posts, once you have gone to:

Account Settings/signature

and put in something like the example given, and then hit save.  For any previous drug trials, just note the year or years, and the name of the drug or drugs, and then when you discontinued them.

 

Just click on the underlined passages, those are links.  Be sure and note full names of your drugs, and dosages in mg(milligrams of active ingredients in your drugs, rather than 1/2 tablet).

 

As your narrative reads now, it may be that you have just been on 3 or 4 psychoactive drugs since early August of this year.  Is this correct?  The Gravol, is an antihistamine, used for nauseau, vomiting, dizziness, and motion sickness, etc.  It's marketed as Dramamine in the U.S.  It's an over the counter medication, OTC, and not really meant to be used for long periods.  See how you do using Drugs.com too.  You can find more about each of drugs singularly there, AND you might want to put your current drugs in the Interactions checker as well.  If you'd do that, that would be great, and then do share, either with a link to your interactions report, or copy it over into a reply here.  You may be blown away.......I have no doubt that you have been feeling pretty wobbly, since taking your prescribed and OTC drugs.

 

I think you might be on gravol, trazodone, clonazepam, quetiapine, and lamotrigine at present, yet it's not quite clear to me in your narrative.  It sounds like you may be experiencing some WD(withdrawal), and maybe even along with some adverse effects and/or interactions of some pretty powerful and dependency causing drugs.  We can sort things out a bit further when you get things organized into a signature for us.

And.....I understand that you might be feeling a bit over-drugged, or even pretty confused right now.  So take your time, it'll be a good challenge for your brain now to sort things out a bit logically.  Might take a bit of time and study.  I came in here, to the site, pretty darn wobbly and confused myself......much improved now, yet, it has taken much time, and patience on my part.   Sorry it's been tough on family relations for you as well.......we get that, many here that you may be able to commiserate with.  Sometimes, for some of us, we just have to find a way other than just relying on doctors prescriptions to get well, be well, have a healthier life.

 

Then, just in a reply here, on your Introduction, note the times of day that you take your drugs, along with their names and doses.  It will be helpful.

 

We take a harm reduction approach to tapering psychoactive drugs.  You can read more about that here:
Why taper by 10% of my dosage?

Additional basic topics for you, as you are new to this site, and it may take you a bit of time to find your way around:

What is Withdrawal Syndrome?

Brain Remodelling

Dr.Glenmullen’s withdrawal symptom list

The Windows and Waves Pattern of Stabilization

 

When we take medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made.  The CNS likes stability. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms may occur.

 

Welcome again Qextor.  This is your introduction/journal page where you have now introduced yourself to the community. You can ask further questions here regarding your case, and tapering, give updates, and also keep a record of your journey too.

 

Best, Love, peace, healing, and growth,

manymoretodays(mmt)

 

 

Edited November 2, 2021 by manymoretodays

[Qextor]

Now that I've had two nights at quetiapine 37 mg, I'm calm and the obessive thoughts have calmed too.  Almost a depressive, less than motivated kind of calm.

I looked into L-theanine, hoping it would calm my fast heart beat,  (normal resting is 75-80 bpm, when I get up and walk it can reach 120.  I don't even do light jogging any more.)

But then I read it can increase GABA levels, which I really don't need with all the clonazepam I'm talking. The atom bomb from Sunday is gone, at least.

[manymoretodays]

Hey that sounds good Qextor.

And good initial try on the signature.   You got a first try done, excellent.  What really got my attention though is.......huh, what......are your really taking 50 mg of clonazepam now?  Up to 3 times a day?  That would be an extremely large dose.

 

Here's what we'd like to see and the sample note from the "How to Summarize Your Drug Signature"

• A list is easier to understand than one or multiple paragraphs
• Include ALL drugs, doses, and dates (starting and stopping)
• Any drugs prior to 24 months ago can just be listed with start and stop years
• Use actual dates or approximate dates (e.g. mid-June 2018) rather than relative time frames (e.g. 3 months ago)
• Spell out months (e.g. "January" or "Jan" as 9/1/2016 can be interpreted as 9 Jan 2016 or 1 Sept 2016)
• Please leave out symptoms and diagnoses

Example:

2001–2002 paroxetine 
2003  citalopram 
2004  paroxetine
2008  paroxetine slow taper down to 2016 Aug off paroxetine
2016  citalopram May 20mg  Oct slow taper down
2018  citalopram 13 Feb 4.6mg 15 Mar 4.4mg 29 Apr 4.2mg

 

Go on back to AccountsSettings/Signature, and if you are working from a desktop PC, that should bring you right to it again, so that you can edit it a bit, for further clarity for our ease in understanding, a bit more about where you are at now, on arrival(drugwise), and then how you got to this point(drugwise).

Symptoms, tapering goals, etc. can all go into narratives, or in the reply box.

 

Hoping you are not taking 50 mg of clonazepam a day, that would be most concerning, to say the least.

 

And then, when you can, try and attend to the other stuff I bolded in my initial welcoming post too.

Thanks Qextor.......I'm glad you are here to try to figure things out now. 

 

And best, L, P, H, and G,

mmt

Would like to see a year mentioned somewhere, and I'm not seeing the Trazodone at all either.  For that, if you are off it now, just note approximate date started, dose, and approximate date ended, and how you discontinued it(briefly, with final dose)

Yours is going to be more focused on the last 4 months, but do attempt to briefly mention any other psychoactive drug trials, beginning with the year, if you will humor me.

 

And will save your first signature try here as well:

June 23-july 20 dramamine 50 mg or melatonin 0.7 mg or nothing, depending on the night

July 21-July 29 either 50mg or 100 mg depending on the night.

Aug 05 50 mg quetiapine and 25 mg clonazepam (3 per day, morning afternoon, evening)

Aug 20 Lomotrigine, 25 mg, increasing by 25 mg every two weeks until 200 mg.

Aug 20-30 25 mg quetiapine, 50 mg clonzepam, x3

Sept 1 50 37 mg quetiapine, 50 mg clonzepam x3

Sept 21 to Oct 1 37 mg quetiapine, but reduced afternoon clonzepam to 25 mg. 

Oct 2 37 mg quetiapine, increased afternoon clonazepam to 50 mg.

Oct 31 reduced quetiapine to 30 mg, 50 mg clonazepam x3

Nov 1 resumed quetiapine 37 mg, clonazepam 50 mg x3

 

Hoping that helps you with some of the preliminaries to getting you started here.  And best.

 

 

Edited November 2, 2021 by manymoretodays

[Altostrata]

Hello, @Qextor

 

What are all of the drugs you're taking now, at what times o'clock and dosages? When was the last time you made a dosage or schedule change in any of your drugs? Which was it, and what was the change?

[Qextor]

My signature should be fairly accurate now.  In more depth: 

8:30am - 0.5 mg Clonazepam and vitamin D supplement (it helps with the hyperglycemia associated with quetiapine)

9:00am (or there abouts) 150 mg Lomotrigine (will be going up to 175 on Nov 8, and 200 on Nov 23rd)

2:00 pm - 0.5 mg Clonazepam

7:00pm  - 0.5 mg Clonazepam

11:30 pm 37.5 mg Quetiapine.

 

Last change was cutting the half of the quetiapine in half, so roughly a smidge over 6mg reduction, on Oct 31.  I'm still mad at myself for that one, because I was at a very stable state, and wasn't planning at all to taper for another few weeks.  It was just an impulsive decision, and ruined what was supposed to be a fun day out, a day trip up to Whistler and Pemberton, and then dinner at White Spot.  I spent the whole day panicked and cranky from 12pm until my 2pm clonazepam, which calmed things down by half, which is twice what they were the day before. Nov1 I went back to my 37.5 mg. Things calmed down in the evening, at least. Today, things are calmer and I am more functional.  The only good that came out of it is that now the obsessive thoughts and feelings of teariness/dread are much less intense.

[Altostrata]

If you're feeling better, why are you planning to escalate lamotrigine? That is also a drug that requires tapering, by the way.

 

What are the current symptoms that you find most concerning? 

 

We can look at whether any of your symptoms are drug-induced and suggest ways to adjust them to reduce those symptoms. But as this is a site for going off drugs, we're not about increasing them for no good reason.

[Qextor]

I was feeling better. I impulsively jumped the gun on tapering and it exploded on me. The quetiapine and clonazepine were always meant to be temporary, so I was exploring options about how best to withdraw safely, since I have a bad habit of jumping into the middle of anything before figuring out what to do.  Right now, if I thought my Psych would agree, and the two (Q/C) weren't so toxic, I would keep things the way the are.  But I think his patience will run out, so it's best to taper off sooner (not faster) than later.

 

The Lomotrigine (prescribed at 200mg but needs to build up slowly) I think will be ongoing for awhile (I never asked my Psych how long).

 

The symptoms most concerning are heart rate/adrenaline required to make it beat that fast (I don't care what everyone else thinks, 75-80 while sitting quietly when you are otherwise physically fit and healthy is *not* normal, nor is 100-110 bpm when doing nothing more than climbing stairs.  But maybe I am wrong) and how to deal with the insomnia once I do start tapering.  I think my Psych thought once the Lomotrigine was at a sufficent level, I would be calm enough for normal sleep to return.  The quetiapine was primarily for sleeping, the clonazepam for the anxiety/restlessness.

 

When all this started, I was rather out of touch with reality, so I didn't really look into what the Psych was prescribing and why.  I had my mom with me to help, but she has a rather blind faith in Doctors, so there wasn't anybody 'running interference' for me, to ask about why and wherefore and goals, and what-ifs.

[ChessieCat]

31 minutes ago, Qextor said:

The Lomotrigine (prescribed at 200mg but needs to build up slowly) I think will be ongoing for awhile (I never asked my Psych how long).

 

It is better to take the "lowest effective dose".  The medical profession (which gets their training about drugs from the pharmaceutical representatives) thinks in terms of "therapeutic dose" which is a arbitrary term and a dose that a pharmaceutical company decide on.

 

So that you have the information, Post #1 of this topic has links to different drugs and how to get non standard doses as well as links to some other helpful topics:

 

important-topics-in-the-tapering-forum-and-faq

[Qextor]

37 minutes ago, ChessieCat said:

It is better to take the "lowest effective dose".

Of Lomotrigine, no idea what that even would be. I have no idea what symptoms are caused by what drug, because I am on three. I've already made so many screw ups with meds, I have no confidence in what to do next, and I only see my Psych about every 2.5 months.  I am thinking of holding the Lomotrigine and seeing what happens.  I have had issues with forgetting words, staring off blanking, a lot of tears and anxiety/fear, but no real content feelings.  Neutral is the best I can get.  I need to do some research to have a more informed discussion with my Psych in December, but like in the topic, trying to figure out just what that would look like. Thanks for letting me vent.

[ChessieCat]

18 minutes ago, Qextor said:

Of Lomotrigine, no idea what that even would be.

 

The lowest effective dose is NOT a specific dose.  It is the amount that you take that gives you the result that works for you,.

 

From:  https://medical-dictionary.thefreedictionary.com/minimum+dose

 

Quote

the smallest amount of a drug or other substance needed to produce a desired or specified effect. Because of individual variations in drug response, the minimal dose for one person may be either excessive or insufficient for another patient.

 

[manymoretodays]

On 11/2/2021 at 6:44 PM, Qextor said:

My signature should be fairly accurate now.  In more depth: 

8:30am - 0.5 mg Clonazepam and vitamin D supplement (it helps with the hyperglycemia associated with quetiapine)

9:00am (or there abouts) 150 mg Lomotrigine (will be going up to 175 on Nov 8, and 200 on Nov 23rd)

2:00 pm - 0.5 mg Clonazepam

7:00pm  - 0.5 mg Clonazepam

11:30 pm 37.5 mg Quetiapine.

 

Last change was cutting the half of the quetiapine in half, so roughly a smidge over 6mg reduction, on Oct 31.  I'm still mad at myself for that one, because I was at a very stable state, and wasn't planning at all to taper for another few weeks.  It was just an impulsive decision, and ruined what was supposed to be a fun day out, a day trip up to Whistler and Pemberton, and then dinner at White Spot.  I spent the whole day panicked and cranky from 12pm until my 2pm clonazepam, which calmed things down by half, which is twice what they were the day before. Nov1 I went back to my 37.5 mg. Things calmed down in the evening, at least. Today, things are calmer and I am more functional.  The only good that came out of it is that now the obsessive thoughts and feelings of teariness/dread are much less intense.

 

Hi Quextor,

I think that all that is being said, is that if your intention is to attempt to taper of drugs......albeit someday.  That it might not make a ton of sense to be increasing doses of drug, specifically your Lamictal(I'm just going with one of the brand names, easier to spell).

 

And you also just did a biggie change, down, then up again, with the Seroquel too.

I am thankful to learn that you are not on Trazodone as well, as the others now.

And many thanks, appreciated, and very helpful to us......that you did your signature!!

Thank you.

 

What has your symptom pattern been like?

You did so great in the post that I quoted above, that I'd like you to go one step further now, and do a daily symptom log or notes.

Here's a good way to do that:

NOTES

and then the topic from which that link came: 

Before you begin tapering -what you need to know

*Recording drug schedule and symptoms to track progress and patterns

 

Well, there are 2 topics that the Notes are mentioned in, so gave you both. 

I do want you to try to do a daily symptom log or notes as soon as possible though.

When you post one, use the sample format shown in the link

 

I also thought I would give you this link:

Taking multiple psych drugs? Which drug to taper first?

 

And then, for the present time frame, if I were you, I would certainly just want to sit tight, and HOLD right now, without any further drug changes.  It hasn't been too long now since you went down and then up, with the seroquel, and so it IS a good idea to just let things settle right now.  Begin to make a plan.  Let us give input too, if you are willing. 
Rule of 3KI's: Keep it simple, slow, and stable.

Best, L, P, H, and G,

mmt

 

Edited November 6, 2021 by manymoretodays

[Qextor]

Thank you.  I think I will wait until my appointment with my Psychiatrist to decide on what to do. Now that I've recovered from my stupid stunt (I was a breech birth -did *not* like being upside down, I guess) and have been doing things the hard way ever since), I am calm during the day and mostly functional,  as long as I eat regularly (about every 3 hours) so I don't get into a bit of a depressive funk. Reactive hypoglycemia, perhaps.

[Altostrata]

If you believe you are having adverse drug effects or withdrawal symptoms, increasing another drug "just because" might only cause more problems. Unraveling that is beyond the scope of this site.

 

Drug combinations and too much of any psychiatric drug, as well as withdrawal, can cause the heart rate symptoms you've described. Please put ALL your drugs in the Drug Interactions Checker https://www.drugs.com/drug_interactions.php and copy and paste the results or a link to them in this topic.

 

Are you a minor? If not, you will need to take charge of your drug treatment. If your current psychiatrist ignores your reports of adverse effects, you may need another doctor.

[Qextor]

Thanks for the advice.  I think my plan is an alternating taper.  Taper the quetiapine until I've gotten rid of the half-tablet (down to 25 mg) Taper the clonazepam until I'm at a half dose (down to 25 mg). Taper the quetiapine until I'm at a half dose (down to 12.5) and the same with the quarter dose, and so forth.

 

As for changing Psychiatrists, that's one of the drawbacks of our medical system. Almost everything is "free" (covered by the taxes we pay - even prescription medication, if your family income level is low enough), but for specialties like Psychiatry, you need a referral from your GP, and even then, you are on a waitlist.  You don't get much choice in the matter. If you have a specialist, it is very hard to get any other to take you on, unless you move far enough away. It is a trade off - less access, longer waits for surgery and other services, but you don't need to worry about cost.

 

[Qextor]

Symptoms from Clonazepam dose delay.

 

I take an online course.  We had last Thursday class off, but I thought it was tonight's class, because I have a really bad sense of time, and very short-term/working memory to speak of. Sustained attention is difficult - I need to take extra time to go through things, and forget things very quickly.  Class starts at 6pm, and it was now 6:30.  I took my clonazepam with me to the dining room, but got so busy trying to keep up, I forgot to take it until 7:30. Normal is 7pm. By 8pm, I was feeling like there was a brick wall between me and my brain, or like my brain felt like a big blur - I couldn't think, or retrieve any thing from memory. By 9:15, once the clonazepam had settled in, I was feeling a little more in touch with myself.  The brick wall had lifted a bit. So, I'm thinking there was a bit of withdrawal involved.  Even on the best times, it's hard to feel any emotion, any spark of being alive beyond worry/anxiety/obsessive thinking , which I still struggle to keep in check.  I used to be a really quick thinker, somebody who 'thinks with their hands', so this feels rather like dementia, because even coming up with words I used to know can be a struggle.  Can anybody relate?  I feel like my brain is being smothered, almost like anesthetic-type feeling.   I guess I just want to know if anybody else has experienced something like that, the trying to think and comprehend anything feels like your brain just won't cooperate, like things have just shut down.

 

Edited November 17, 2021 by ChessieCat
added topic title before merging with intro topic

[ChessieCat]

Hi Qextor,

 

I have moved your new topic to your Introduction topic.

 

Quetiapine and clonazepam are both sedating drugs.

 

Before creating a new topic, please do a search to see if one already exists.  You can either use the site search function or use an internet search engine and add site:survivingantidepressants.org to the search term.

 

Here are SA's topics:

 

Non-drug techniques to cope

 

the-dr-claire-weekes-method-of-recovering-from-a-sensitized-nervous-system

 

brain-fog-blank-mind-comprehension-concentration-cognitive-and-memory-problems

 

apathy-anhedonia-emotional-numbness-emotional-anesthesia

 

obsessive-compulsive-disorder-or-ocd-repetitive-intrusive-thoughts-compulsive-behaviors