Caterpillar: Withdrawal or something else?

[Caterpillar]

Hello, I finished my taper around June/July of last year and after a while I started feeling better. However I am now experiencing symptoms similar to those in withdrawal. I got on quetiapine 25 mg in 2020 at the beginning of November and kept taking it until March 2021, when my dose was increased to 50 mg.

 

Around the beginning of April I started having trouble sleeping because of physical pain unrelated to the meds, so I was given Lendormin 0.25 mg (Brotizolam). I was on it for two months and I took it before bed. I also got COVID a couple days after I started taking it. 

After these two months I wanted to stop taking it and I was told to simply cut it in half for a couple days and then stop completely. I did it and had 3 sleepless nights in a row. It was weird, because I wasn't feeling anxious at all, but my mind would not fall asleep, even though it felt like it really wanted to. I decided to taper more slowly and took a month (June), but I still slept very badly... not to mention I started to notice my breath and other involuntary movements of my body. While I was tapering the benzo, I also tapered Quetiapine to start Risperidone (still at the beginning of June) 

 

I took Risperidone 1 ml for a month, but the side effects were bad and I got scared of everything that was happening, so I decided to stop with the meds altogether. I did a fast taper of Risperidone (more or less a week) and had a weird restless sensation in my legs for 5 days, which luckily subsided, however now each time I am anxious my legs ache, something that never happened before, also I again couldn't sleep at all for days. 

 

Everything got better after a vacation away from home in August, where I started to sleep (although the first week I had broken sleep). Everything was calm even after returning home in September, however, after I stopped taking the meds I developed some sort of health anxiety I never had before and that never went away (this also caused sleeping problems, but not as bad as before and I was still able to keep calm about my sleep over all). This health anxiety changed from physical symptoms (rabies, tumor ecc.) to psychological ones around the end of December and became much stronger. January 8 of this year I had an anxiety attack at night because I feared I had OCD (I was thinking about the weird fixations during withdrawal and how they had returned stronger than before in December). I didn’t sleep at all, the next night I did and then I had another sleepless one. Scared that the insomnia I had in 2021 would return, I took a quetiapine 25 mg and slept normal.

I had no more problems except some mild anxiety about OCD, until I had another sleepless night for the same reason as before and out of nowhere on January 28.

Now it’s January 31 and I have not slept at all for 3 nights in a row (Or I slept very little, like 1 hour). I tried to take another quetiapine, but it didn’t work.

 

I realize I did not take the meds for long and maybe I am overreacting, but because the insomnia I am experiencing now is the same as the one I had during my tapers and withdrawals, I am afraid I triggered something in my brain that caused this. Basically, even when I feel calm of my anxiety isn’t strong, my brain won’t shut down, no matter hoe tired I am. Even when I took quetiapine, I felt super sleepy, but still I wouldn’t fall asleep.

I decided to write this in hope someone knows what to do and to seek reassurance.

 

I am taking fish oil (2 weeks), various types of herbal teas (since august), zzzquil gummies (The ones without benadryl, but with melatonin - I took them all august without problem, then stopped and took them again at the end of December) and I will try some lavender capsules. I often drink cappuccino in the morning and it didn’t seem to cause any problems.

 

I don’t go to a psychiatrist since September 2021. I tried to go to a therapist, but she is pushing meds and I am too scared to take them)

 

 

 

 

[Erell]

Hello @Caterpillar, 
 

Welcome on SA.

 

Thank you for your signature, it will help us to see your history at a glance.

Question : 
1. Can you please include in your signature the dates of your quietapine taper ?
If I understand well, you went from 50mg quietapine to 0mg between March 2021 and July 2021, is that right ? How did you taper ?

 

This would represent a more rapid tapering than we recommend: on SA, in order to minimize the risk of withdrawal symptoms, we recommend no more than a 10% drop every 4-6 weeks.
I invite you to read these two links that will help you understand these suggestions: 

1. how-psychiatric-drugs-remodel-your-brain

2. why-taper-by-10-of-my-dosage

 

It is possible that you are currently experiencing withdrawal symptoms after a too fast taper and the destabilising effects of other drug trials.

I don't know if reinstating a low dose of quietapine could be an option, I will ask to the rest of the team.

 

In the meantime, I invite you to take the time to look for non-drug coping skills that might help you live with these symptoms: here is a link dedicated to insomnia : tips-to-help-sleep.

Several members note that stopping caffeine also helps.

 

I found the following post from one of our moderators, a veteran of the sleep wars, to be helpful :

 

There is, unfortunately, no "silver bullet" to withdrawal or any of its symptoms, including insomnia.  If there were, SA would be a much smaller site than it is at this point.  Sadly, it continues to grow as more and more people get caught in the psychiatric medication "web."

 

insomnia and disordered sleeping is a hallmark of psychiatric medication withdrawal.  It starts earlier than that with many studies making it clear that SSRIs (and other psych meds) frequently suppress REM sleep for those who take the meds.  https://www.sleepio.com/articles/sleep-aids/antidepressants-and-sleep/  Given this as a backdrop, it should be no surprise that coming off the meds can wreak havoc on sleep.  The good news, however, is that the brain works hard to achieve homeostasis and, all other things being equal, the brain will return to a place where sleep becomes, as it should be, a matter of routine.  How long that takes for any one person is impossible to predict.  

 

So, what do you do?  In no particular order, some of the things to try:

 

• Don't place too much significance on sleep.  Rest should be the key and when your body absolutely needs to sleep it will.  The anxiety that comes with lying awake and saying "I must sleep" is far worse than the not sleeping.  It's hard but it can be done.
• Try a journaling practice before bed -- get out the things that are on your mind and add 3 things you are grateful for from the day
• Get a sleep ritual in place so that you do the same thing day after day and start to repair your circadian rhythms
• Take a warm bath with epsom salts few hours before bedtime and add in a cup of chamomile tea
• Use lavender essential oils in a diffuser at bedtime
• Exercise early in the day so that you aren't activated near bedtime
• Get outside and get some sunlight early in the day so that your rhythms are reestablished
• Make sure you have a consistent bedtime 
• Try not to be too activated in the couple of hours before bed and, of course, no caffeine
• Add a meditation practice
• Try yoga
• Go for walks in nature

Most insomnia is the result of the body being "hyperstimulated."  It is very hard to calm down an overstimulated body, especially when it is the result of chemical cascades that come as a result of medication use and withdrawal.  But, it can be done to a certain degree and the skills learned will provide valuable as your body improves over time.  

 

From my own perspective, my sleep is still not great, but it it better than it was.  I went through many stretches of 2 or 3 days with zero or an hour or two a night of sleep.  At this point, I have the occasional sleepless night, but most nights I'm good for at least 5 and usually closer to 6 hours.  By "normal" people standards that's not great, but it feels pretty good when compared to 0 or 2-3 hours a night.  As the saying goes, "in the land of the blind the one-eyed man is king!"

 

Try not to let it become the dominant factor in your life.  Over time, it will get better and you will heal.  Just do your best to continue to live your life what your brain is repairing itself.

----

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

magnesium-natures-calcium-channel-blocker

 

 

omega-3-fatty-acids-fish-oil

 

 

Only add in one at a time and at a low dose in case you do experience problems.

 

Regarding melatonin, we recommend starting with a very low dose, around 0.3mg.  Too much melatonin can have a paradoxical effect, meaning that it will keep you awake. (melatonin-for-sleep).

 

Ok caterpillar, that's a lot to read and digest for a first post : welcome again, keep us updated.

 

Take care.

 

 

 

 

 

 

 

[Caterpillar]

Thank you for having me.

 

I think I tapered quetiapine in a week, not sure when. Probably at the end of May a little before tapering Lendormin. 

I halved the pill for 3 days, then took a quarter of it for another 3 days. 

Like I said, I'm not sure if this is withdrawal but it's true that after I finished with the meds I started to have much more anxiety than before that comes and goes. Luckily I was able to sleep last night, although I woke up with my teeth hurting.

 

I also noticed some spelling errors in the initial message, sorry I was in a hurry.

[Altostrata]

Welcome, Caterpillar.

 

It appears you had been taking quetiapine and Lendormin (what is this? a benzo?), then went off both of them in May, in order to switch to risperidone? You also got covid at this time?

 

On 1/31/2022 at 11:48 AM, Caterpillar said:

I took Risperidone 1 ml for a month, but the side effects were bad and I got scared of everything that was happening

 

Very possible these "side effects" were withdrawal symptoms from your going off quetiapine or Lendormin.

 

On 1/31/2022 at 11:48 AM, Caterpillar said:

Scared that the insomnia I had in 2021 would return, I took a quetiapine 25 mg and slept normal.

 

This was in early January? Did you take 25mg quetiapine only once?

 

Have you drunk any alcohol or taken antibiotics in the last year?

[Caterpillar]

6 minutes ago, Altostrata said:

It appears you had been taking quetiapine and Lendormin (what is this? a benzo?), then went off both of them in May, in order to switch to risperidone? You also got covid at this time?

 

Hello, yes Lendormin/Brotizolam is a benzo. I got COVID short after I started my first dose in early April, it lasted a month. I went off Quetiapine in May and Lendormin in early June. While I was quitting Lendormin I also started Risperidone.

 

11 minutes ago, Altostrata said:

This was in early January? Did you take 25mg quetiapine only once?

 

Have you drunk any alcohol or taken antibiotics in the last year?

 

I took quetiapine again in January only twice. 

 

I usually never drink, but I did during the holidays in December. I don't take any antibiotics.

 

[Altostrata]

If your nervous system has been sensitized by adverse effects from psychiatric drugs or withdrawal, drinking alcohol can evoke bad neurological symptoms, such as insomnia or anxiety. Covid can also do this.

 

Since you were in the process of a switch to risperidone, have you taken your questions to your prescriber?

 

What is your question here?

[Caterpillar]

Yes I talked to him about what I was feeling and he said it was normal. Since I wanted to stop with meds I haven't been seeing him anymore. 

I had started feeling better some time in August so I thought everything would be fine, but then my intial symptoms started returning. They've been coming and going.

 

As for my question, I was wondering if what I was feeling could be connected to the meds and I wanted some input.

[Altostrata]

Your drinking during the holidays is probably contributory, as was your bout with Covid. 

 

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.

[Caterpillar]

Thanks, I will try to take it easy and be careful with what I eat/drink.

 

[Caterpillar]

My sleep has gotten better, but I still feel agitated, especially in my legs. Although I'm not quite as anxious as I was in January for now.

I was wondering, since I need to get the third dose of the vaccine at the end of the month, will that affect me?

[Altostrata]

Please describe more about the leg symptom. When does this occur?

 

I would get the third dose of vaccine, but quit drinking alcohol.

[Caterpillar]

Yes, I usually never drink, during the holidays it was an exception. I also decided to stop drinking coffee for now.

 

As for my legs, they suddenly start aching around afternoon/evening. In July of last year it was worse and I needed to move them all the time, now they feel a bit restless, but not as much. I don't have it every day, yesterday I didn't for example.

[Altostrata]

Those leg symptoms can be caused by being dehydrated, not getting enough leg-stretching exercise, or sitting too long in one place causing varicose veins.

 

They often can be eliminated by drinking water, getting exercise, doing leg stretches, and elevating the feet. Magnesium can help the twitching, see https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

[Caterpillar]

I'm trying magnesium and I don't notice much of a difference, but I will continue to use it.

I try to take a walk every day, but it's true that I sit a lot and don't drink much water, so I will follow your advice. 

Sometimes I feel the same sensation on my arms, although not as bad.

[Caterpillar]

Unfortunately, after saying I was sleeping better, tonight I had a total night of total insomnia and no sleep

 

What happened was that while I was starting to drift off I was hit by a rush of adrenaline that made my heart beat fast for a couple seconds. After this, each time I started to relax to try to fall asleep again my legs and arms would ache more and my body would become rigid and feel "nervous" ( I have no idea how to explain what exactly happened). Now I am really tired and my legs hurt even more than yesterday. Guessing the two things are related? 

 

I have no idea what happened, but I've had more sleepless nights now after January than my whole life before any of this (I am 23). I sleep fine for like a week and then I have various sleepless nights for no apparent reason. The thing is my mind was calm, it's my body that apparently wasn't.

 

I'm quite worried and tired and I don't know what to do, before trying meds my legs never hurt like this for no reason and I never had completely sleepless nights. 

Not to mention that today is especially bad, like I previously said, after July, they didn't ache as much as this, so I have no idea what happened yesterday afternoon...

 

I am only taking some Magnesium, a low dose of fish oil and Lavender oli before going to sleep. Maybe I ate something I shouldn't?

[Caterpillar]

Alright, I managed to calm down a bit, still don't feel that good, but better than this morning. 

[Altostrata]

Your leg and arm symptoms sound like they might be from inactivity and may be relieved by exercise, stretching, and proper hydration.

 

 

You may have occasional bad patches. See The Windows and Waves Pattern of Stabilization

[Caterpillar]

I am indeed trying to do more exercise, had a nice long walk today. I will try to drink more water too, but for some reason I often forget.

 

I'd say the worst is the insomnia. For some reason It comes and goes even when I'm not particularly anxious (or at least I don't feel like I am). It's been 3 days that I get adrenaline rushes while I'm drifting off. Other times I can't even arrive to the point where I drift off because my body tenses up on its own. It's difficult to stay calm because my whole body is tense. Tried to do some meditating today and felt all tingly, don't know if it's normal, but maybe it'll help if I keep up at it.

Also I noticed that if I have even a small amount of pain on one part of my body, it suddenly intensifies in my sleep and it wakes me up... or it intensifies as I am about to fall asleep, waking me up instantly only to notice it wasn't that painful to begin with. 

 

Hope everyone else is doing fine.

[Altostrata]

3 hours ago, Caterpillar said:

It's been 3 days that I get adrenaline rushes while I'm drifting off.

 

This is pretty common. See 

 

[Sekai8894]

Hey @Caterpillar idk much about benzo and risperidone to offer any insightful comment so I leave that to the staff. 

 

But I took seroquel, currently in a few Seroquel support groups on Facebook, talked to a number of Seroquel users on twitter and have not come across anyone who experiences the withdrawal symptom of insomnia /only/ months after quitting it. Usually insomnia is the first problem to appear and the last to resolve (bc sleep is elusive that way) when CT-ing Seroquel. I'm just saying that based on what I read and saw. Again, every individual's brain is so different so there will always be exceptions. The staff here is so much more experienced than I am and I defer to them if they think otherwise. 

 

It seems to me that you might have a case of sleep anxiety. I know it's easier said than done but try to not stress over the lack of sleep too much. It will only make matter worse. 

 

I hope your sleep problem resolves soon. Take care of yourself!

[Caterpillar]

@Sekai8894 I was thinking that too, but it's odd how this problem arose without no apparent reason and while I was feeling rather calm, so I'm at the end or my rope. 

I think regrdless of sleep or not, the meds definitely increased my anxiety in general unfortunately, I wasn't like this before taking them. But I do understand what you are saying and even partly agree.

[Caterpillar]

Ah I forgot to say I was still taking benzos after quitting Seroquel so I don't know if it caused me insomnia. I did have it after I quit the benzo as well. It got better in August and then came back a couple times. That's why I'm confused.

[Sekai8894]

@Caterpillar yeah since you used and quit a few drugs in a short period of time, it's hard to pinpoint one single cause. From my conversations with the folks who used Seroquel, the typical withdrawal symptom of rebound insomnia is fragmented / broken sleep. I have heard ppl saying that with benzo, the pattern is insomnia one night, sleeping the other night. Idk if that observation has any merit. Just a thought. 

 

In any case I hope you regain your natural sleep soon. Keep your stress down. Hang in there! 

[Caterpillar]

@Sekai8894 Thank you for your input. I'm trying to keep calm, but sometimes it's hard.

 

I hope you'll be okay too.

[Altostrata]

On 2/13/2022 at 3:38 AM, Caterpillar said:

Ah I forgot to say I was still taking benzos after quitting Seroquel so I don't know if it caused me insomnia. I did have it after I quit the benzo as well. It got better in August and then came back a couple times. That's why I'm confused.

 

This is important. Please add it to your signature.

[Caterpillar]

Ok, I tried to fix it.

 

[Caterpillar]

This might sound stupid, but should I ditch herbal teas? I decided to stop with the lavender a couple days ago because I didn't want to take too much stuff (It didn't seem to have much effect anyway).

Maybe they are actually activating and don't help the anxiety, would that be possible?

[Caterpillar]

Sorry for the bother, but something curious happened during the night.

While the past week I was able to sleep mostly fine, something weird heppened last night that mad eme unable to fall asleep. At first, each time I was falling asleep I had the impression my heart started beating faster, however, after the first couple times, each time I tried to fall asleep I would get pain in my chest instead (which went away as I "awoke"). 

 

At first I had the impression the pain was only nex to the heart, but then I atarted to have it my whole chest. 

 

I used my blood pressure monitor, which also measures heartbeats to see if anything was wrong, but it wasn't... My heartbeats were around 75-79.

Could this be a muscle or nerve problem?

 

Other than that, during the day I have moments of pain in my arms and legs, but it doesn't last that long. I also have spikes in anxiety, but overall it was manageable escept a couple of times.

[Caterpillar]

After speaking with my physiotherapist, I think the pain was because of my chest muscles. I did some exercises for my back (my spinal curve is too straightened) and that probably irritated them.

The problem is that my body is always nervous and agitated... and rarely calms down, so it wakes me up as I try to fall asleep. In the case of the pain, I only felt it as I was about to fall asleep, but as I "woke up" I was fine. Because of it I feel like before sleep I unconsciously focus on my heart and that doesn't help.

 

I also have weird obsessive thoughts and worries, but I could accept them if I also didn't have sleep problems. (sometimes I sleep and sometimes I don't, it almost feels random whether I do or don't)