Valerio: Help withdraw clonazepam after quetiapine

[OldDodgy]

@Valeria

 

It does sound as though you are incredibly sensitive to antipsychotics.  I got the mildest Tarditive Dyskinsea on 100:Quetiapine.  
 

But as I understand it, second generation antipsychotics are less likely to do this in the longer term.  
 

The need to stabilise with good sleep is pretty important, which is why I take 12.5 and that’s made a huge difference to my days. 
 

I expect @Altostrata will comment too.  I look forward to her advice. 
 

Yours OldDodgy 

 

 

[Valerio]

21 minutes ago, OldDodgy said:

@Valeria

 

It does sound as though you are incredibly sensitive to antipsychotics.  I got the mildest Tarditive Dyskinsea on 100:Quetiapine.  
 

But as I understand it, second generation antipsychotics are less likely to do this in the longer term.  
 

The need to stabilise with good sleep is pretty important, which is why I take 12.5 and that’s made a huge difference to my days. 
 

I expect @Altostrata will comment too.  I look forward to her advice. 
 

Yours OldDodgy 

 

 

This movements begins when the effect of quetiapine ceases. During the night I feel nothing. Involuntary movements begin in the morning.

Thank you for your support @OldDodgy

[Altostrata]

4 hours ago, Valerio said:

This movements begins when the effect of quetiapine ceases. During the night I feel nothing. Involuntary movements begin in the morning.

 

This would indicate that this is an interdose withdrawal effect of quetiapine, not an adverse effect of 6.25mg.

 

It will take about a week for the 6.25mg to take full effect.

 

What effect have you observed for the pregabalin?

[Valerio]

6 minutes ago, Altostrata said:

 

This would indicate that this is an interdose withdrawal effect of quetiapine, not an adverse effect of 6.25mg.

 

It will take about a week for the 6.25mg to take full effect.

 

What effect have you observed for the pregabalin?

Hello @Altostrata

 

Pregabalin side effects:

• Breast pain
• Headache
• Loss of memory
• Brain fog (feeling today)
• Mental confusion
• Apathy

I'll keep the 6.25 mg. 🍀

Once again...Thank you!

[Altostrata]

38 minutes ago, Valerio said:

Pregabalin side effects:

• Breast pain
• Headache
• Loss of memory
• Brain fog (feeling today)
• Mental confusion
• Apathy

 

You felt these effects after you take pregabalin in the evening (before reinstating 6.25mg quetiapine)?

[Valerio]

2 hours ago, Altostrata said:

 

You felt these effects after you take pregabalin in the evening (before reinstating 6.25mg quetiapine)?

Yes. Bit It is a little bit better.

[Altostrata]

30 minutes ago, Valerio said:

Bit It is a little bit better.

 

You mean you don't feel these effects of pregabalin now? When did they lessen?

[Valerio]

1 hour ago, Altostrata said:

 

You mean you don't feel these effects of pregabalin now? When did they lessen?

@Altostrata

I still feling these symptons. ☹️ They improved a little bit since yestarday.

[Valerio]

5 hours ago, Altostrata said:

You felt these effects after you take pregabalin in the evening (before reinstating 6.25mg quetiapine)?

Yes, I have been feeling since first week of pregabalin

[Valerio]

03/25

AM
8: breakfast (free gluten bread and ricotta)
8 – 12: fatigue, brain fog and sutil involuntary movements
12: lunch (rice and grilled chicken)
PM
01: Omega 3
01-04: strong muscular tension
05 – 8: feeling OK

8: quetiapine 6,25 mg

9: feeling OK

10: pregabalin 50 mg

11 – 4 AM: superficial sleep and mental confusion

4 – 8 AM: sleep

8 AM: wake up with sutil involuntary contractions and strong paresthesia (both hands)

 

Improvement of symptoms: Less anxiety feeling. I´m much calmer.

Worse of symptoms: involuntary movements and paresthesia.

Symptom return: muscle contractions in waves (involuntary movement) and strong paresthesia. Both always been a symptom of my WD. These symptom disappear when I stop quetiapine.

@AltostrataIt seems that my dopaminergic system is very injured. I felt these symptoms during 1 year after decreased the dose to 25 mg. I didn´t have those when I was taking 50 mg.

[Valerio]

On 3/25/2022 at 8:01 PM, Altostrata said:

 

You mean you don't feel these effects of pregabalin now? When did they lessen?

03/26

AM

8-9: paresthesia at rest

9: breakfast

9-11: fatigue

12: lunch

PM

1-4: fatigue

4-5: anxiety

5-8: fatigue and sadness

8: quetiapine 6,25 mg

8:30 dinner

9: feeling OK

10: pregabalin 50 mg

11: mental confusion

12 - 2 AM: superficial sleep, mental confusion, agitation

2 AM - 5 AM: sleep (nightmares)

5 AM: wake up feeling OK

5-6 AM: sleep

6 AM: paresthesia/wake up

6: 30 AM paresthesia/wake up

7 AM: paresthesia/wake up

7: 40 AM: paresthesia/wake up

 

⬆️: Less anxiety feeling. 

⬇️ Paresthesia, mental confusion (after pregabalin) and nightmares.

Symptom return: strong paresthesia (maybe neuropathy). It´s get better when a move my hands.

[Altostrata]

You may still be having an adverse reaction following your dose of pregabalin. How are you taking pregabalin? Is it one 50mg capsule or 2 capsules?

[Valerio]

3 hours ago, Altostrata said:

How are you taking pregabalin? Is it one 50mg capsule or 2 capsules?

 

3 hours ago, Altostrata said:

You may still be having an adverse reaction following your dose of pregabalin. How are you taking pregabalin? Is it one 50mg capsule or 2 capsules?

Yes, i think so.

I am taking 2 capsules of 25mg/day at 10pm. 

[Altostrata]

Keeping everything else on exactly the same daily schedule, if I were you, I'd start moving one 25mg pregabalin capsule gradually earlier by one hour each day, until you are taking it at 10 a.m. Please continue to keep daily notes during this process.

[Valerio]

11 hours ago, Altostrata said:

Keeping everything else on exactly the same daily schedule, if I were you, I'd start moving one 25mg pregabalin capsule gradually earlier by one hour each day, until you are taking it at 10 a.m. Please continue to keep daily notes during this process.

03/27

AM
8-11 brain fog
11-12 brain fog
12 lunch
PM
1 Omega 3
1-4 feeling Ok  
5-8 feeling Ok and optmistic
8 quetiapina 6,25 mg
9 feeling Ok
10 preganalin 50 mg
11 apathy
12 - 2 AM superficial sleep and agitation
2 - 3:30 AM sleep Ok

3:30 wake up OK

4 - 6 AM: sleep Ok
6 AM paresthesia/wake up
7:30 AM Wake up OK

 

 

⬆️ Less anxiety feeling. I feel more peaceful and calm 

⬇️ Paresthesia, brain fog in the morning, apathy (after pregabalin)

 

@Altostrata I´m going to take pregabalin 25 mg at 9 PM today. Thank you 🙏 

 

[Valerio]

19 hours ago, Altostrata said:

I'd start moving one 25mg pregabalin capsule gradually earlier by one hour each day

@AltostrataI´m thinking ... maybe works better to me postpone an hour per day instead of antecipate pregabalin. Is it a good ideia? I need to be functional in the afternoon. 

[Altostrata]

Did you ever take 25mg pregabalin rather than 50mg? How did it affect you?

[Valerio]

12 hours ago, Altostrata said:

Did you ever take 25mg pregabalin rather than 50mg? How did it affect you?

Yes. When I took pregabalin 25 mg, I felt brain fog.

[Valerio]

03/28

AM
8-10 agitation and brain fog

10 breakfast

10 - 12 agitation and brain fog
12 lunch
PM
1 omega 3
1-4 agitation and anxiety 
5-8 agitation and palpitation
8 quetiapina 6,25 mg
9 agitation
10 preganalin 50 mg
11 strong brain fog and mental confusion
12 - 2 AM superficial sleep, agitation and mental confusion
2:30 AM wake up/paresthesia, numbness, intense pain in the left wrist.

3 AM panic attack

4 - 6 AM superficial sleep/paresthesia and intense pain in the left wrist.
6 AM wake up

 

⬇️ Paresthesia, brain fog, anxiety, etc

New symptom: intense pain in the left wrist.

 

 

@AltostrataWhen I was tapering quetiapine first time, I felt paresthesia in both hands and it stopped after tapered off. But this night I felt a strong paresthesia and pain in my left wrist. It´s the first time that in felt pain.

Is it a good idea keep quetiapine? Could quetiapine injury my nerves ?

[OldDodgy]

@Valerio

 

Hi 

I escaped any neuropathic pain reducing mirtazipine. 
 

It’s just my view, and I am happy to be corrected, is that each drug variation should be assessed over several days or even weeks before making a judgment. By keeping regular notes as @Altostrataadvocates prevents us from jumping to conclusions too readily.
 

You are reducing mirtazipine quite quickly—just an observation. 
 

Yours

 

OldDodgy  

[Valerio]

Hi

another doubt

Split pregabalin dose and take twice a day, make future tapering off easier or worse? 

 

 

[OldDodgy]

@Valerio

i had to split doses below 50 because of the short half life. 
 

it mad a huge difference to daytime anxiety and enabled a slow taper. 
 

Best wishes 

 

OldDodgy. 

[Altostrata]

Splitting the dose would reduce the adverse reaction you're getting after taking pregabalin at 10 p.m.

 

Perhaps moving 12.5mg pregabalin to the morning would reduce those interdose withdrawal effects but not make you too dopey, and reduce the adverse reaction in the evening, when you'd be taking 37.5mg instead.

 

You made a drug change only 6 days ago, when you reinstated 6.25mg quetiapine. This is just settling in, so I am hesitant about moving your drugs around now. Let's see a few more days of daily notes before making another change.

 

Where's mirtazapine in this mix??

 

 

[Valerio]

1 hour ago, Altostrata said:

Splitting the dose would reduce the adverse reaction you're getting after taking pregabalin at 10 p.m.

 

Perhaps moving 12.5mg pregabalin to the morning would reduce those interdose withdrawal effects but not make you too dopey, and reduce the adverse reaction in the evening, when you'd be taking 37.5mg instead.

 

You made a drug change only 6 days ago, when you reinstated 6.25mg quetiapine. This is just settling in, so I am hesitant about moving your drugs around now. Let's see a few more days of daily notes before making another change.

 

Where's mirtazapine in this mix??

 

 

Hi @Altostrata

I Will think about pregabalin. Thank you for the answer.

 

About quetiapine... I Felt a intense paresthesia and pain last night. I Hope that will improve. The pain was unbearable.

 

I never take mirtazapina. ☺️

[OldDodgy]

@Valerio and @Altostrata

 

My sincere apologies to you both. 
 

I mentioned mirtazipine in error instead of the Quetiapine which halved recently . 
 

I am very sorry for the confusion caused. 
 

OldDodgy 

 

[Altostrata]

Thanks, @OldDodgy

 

52 minutes ago, Valerio said:

I Felt a intense paresthesia and pain last night.

 

Please describe this more. What part of your body? What was the sensation? When was this, how long did it last? What was your drug schedule yesterday?

[Valerio]

16 hours ago, Altostrata said:

Please describe this more. What part of your body? What was the sensation? When was this, how long did it last? What was your drug schedule yesterday?

I am feeling this most frequently on left wrist. I am feeling tingling inside my left wrist during the night, i just feel this when i am resting. Also i am feeling pain and loss of sensitivity in both wrist. 

I am taking quetiapine pill at 08pm and pregabalin at 10pm

 

 

 

[Valerio]

@AltostrataHi, here is Flávia's husband. 

I am writing because she had a crise today and is not capable to do it.

 

Yesterday after took quetiapine (using the water titration method at 8pm) she felt a mental confusion, burning head, wrist tingling and tachycardia. After took pregabalin (2 pills at 10pm) the physical symptoms get i little bit better but she had a superficial and restless sleep. Today she woke up with akathisia, panic attack and aggressive. 

We are thinking that quetiapine is not making good to her. is it a good idea keeping it?  

 

thank you so much 

 

[Valerio]

03/28

AM
8-10 Brain fog, intense pain in the left wrist

10 breakfast

10 - 13 Brain fog, intense pain in the left wrist
PM
1 lunch/omega 3
1-4 agitation and anxiety 
5-8 Brain fog, intense pain in the left wrist
8 quetiapina 6,25 mg
9 agitation, tachycardia, brain on fire, the worst mental confusion ever
10 preganalin 50 mg
11 mental confusion anda body on fire
11:30 - 4 AM superficial sleep and mental confusion
4 AM wake up unable to think

4 - 7 AM superficial sleep anda mental confusion
7 AM akathisia

 

⬇️ mental confusion, low pressure and brain on fire.

New symptom: I can´t word and think straight

 

[Altostrata]

Hello, @Valerio. Are you left-handed?

 

We have suggested moving 12.5mg or 25mg pregabalin to the morning to reduce interdose withdrawal effects and that adverse reaction after you take 50mg in the evening. This may also be more calming during the day. You say you have brain fog now, so the effects of a morning pregabalin dose probably would not be worse.

[OldDodgy]

@Valerio

 

Hi

When I moved to the twice daily regime suggested by @Altostrata I felt much calmer during the day and certainly didn’t have brain fog with it. 
 

I hope that encourages you.  
 

OD 

[Valerio]

10 hours ago, Altostrata said:

Hello, @Valerio. Are you left-handed?

 

We have suggested moving 12.5mg or 25mg pregabalin to the morning to reduce interdose withdrawal effects and that adverse reaction after you take 50mg in the evening. This may also be more calming during the day. You say you have brain fog now, so the effects of a morning pregabalin dose probably would not be worse.

 Hi @Altostrata  No, I am not. I am right-handed. My wrist and hand pain is a neuropathic pain that has begun last year while I was taking quetiapine. But now (after reintroduction) it is in both wrist and came together with tingling and paresthesia.

 

Tonight after took quetiapine I have felt arrythmias and this morning I have felt uncontrollable urge to move my body. I am getting worse day by day. Because that I´m thinking about reduced the quetiapine dosage, is it good reduce 10% per day?

 

About moving pregabalin, tonight I tried but I couldn’t sleep and ended up taking 50mg. I took 27,5mg at 10pm and 12,5mg at 00:30am.

I will move my pregabalin doses, but I am thinking going slowly. Is it a good idea?

 

thank you

 

and tks @OldDodgy🌻

[Valerio]

03/31

AM

7-8 uncontrollable urge to move my body (maybe akathisia or maybe restless legs syndrome. I don´t no)

8-9 brain fog, neuropathic pain and high anxiety
10-1 PM anxiety and panic attack (a lot of crying, screams and hopelessness)
PM
1 Lunch/Omega 3
1-3 Brain fog, pain and anxiety
4 snacks 
4-8 feeling a little better and calmer
8 quetiapina 6,25 mg
9 arrhythmias and strange feeling in the chest
10 preganalin 37,5  mg
11-00 arrhythmias and strange feeling in the chest

00:30 pregabalin 12,5 mg
2 AM-5 AM superficial sleep, mental confusion and strange feeling in the chest
5-6AM wake up/uncontrollable urge to move my body
6 AM - 8:30 sleep OK
8:30 wake UP/uncontrollable urge to move my body

 

⬇️ anxiety, panic attacks mental confusion, arrhythmia, urge to move my body, low pressure, brain fog - I was incapable of think and work all day. 

 

Do you have any idea what this strange feeling in the chest (after take the medicine) with arrhythmia can be? I felt this same sensation when I tried to reintroduce clonazepam. This feeling is very agonizing.

[OldDodgy]

@Valerio

 

i had several episodes of irregular beats during my reductions of meds. 
 

I attended ER for reassurance that they were due to anxiety. I am quite old so they are being monitored but I was strongly reassured and they rarely occur now. 
 

I hope your problem settles soon. 
 

OD
 

 

Edited March 31, 2022 by OldDodgy
Spelling error

[Altostrata]

11 hours ago, Valerio said:

I took 27,5mg at 10pm and 12,5mg at 00:30am.

 

Please do not take random doses of pregabalin. Every time you make a dosage change, it takes days for your symptom pattern to settle down again.

 

Without making any other drug changes, suggest you reduce quetiapine to 5mg. You may need to use a liquid.

 

 

 

Suggest you move 

[Valerio]

12 hours ago, Altostrata said:

 

Please do not take random doses of pregabalin. Every time you make a dosage change, it takes days for your symptom pattern to settle down again.

 

Without making any other drug changes, suggest you reduce quetiapine to 5mg. You may need to use a liquid.

 

 

 

Suggest you move 

04/01

AM

7-8 uncontrollable urge to move my body 

8-9 brain fog and total mental confusion
10-12 brain fog and total mental confusion
PM
1 Lunch/Omega 3
1-4 brain fog and total mental confusion
4 snacks 
5-8 feeling a little better
8 quetiapina 6,25 mg
9  arrhythmia 1. It´s a similar arhythmia that I felt when tried to reintroduce clonazepam. I felt this when I wastaking pregabalin but just once at night and twice a week. I think it must be a disease I developed while taking quetiapine. I already made an appointment with the cardiologist.
10 preganalin 50  mg
11-00 arrhythmia 2

00 arrhythmia 3

00:30 arrhythmia 4

1 AM arrhythmia 5 and stranger feeling in the head (like someone pumpimg a hot liquid in my brain)

1:45 arrhythmia 6 and stranger feeling in the head (like someone pumpimg a hot liquid in my brain)

2:30 arrhythmia 7 and stranger feeling in the head (like someone pumpimg a hot liquid in my brain)

3:15 arrhythmia 8 and stranger feeling in the head (like someone pumpimg a hot liquid in my brain)

4:30 arrhythmia 8 and stranger feeling in the head (like someone pumpimg a hot liquid in my brain)

5 - 8 AM superficial sleep, mental confusion and strange feeling in the head
8 AM: Wake up crying a lot/desperation/total mental confusion/low pressure/muscular weakness/pallor/low pressure/I can´t stand up.

 

⬇️ anxiety/ panic attacks mental confusion/ arrhythmia/low pressure/ brain fog - I was incapable of think and work all day/stranger feeling in the head (like someone pumpimg a hot liquid in my brain) etc etc etc

 

@AltostrataI´m so sorry. I took pregabalin 37.5 mg at 10 PM and tryied to move 12.5 mg as you suggest, but I can't do it.

What is the plan? Taper off quetiapine? My impression is that quetinapine and pregabalin is having a terrible interaction. 

Reintroduce quetiapine was my last hope to be free from this hell. Now I don´t have no more ideia. Today is my birthday and I prefer to be dead.