TreeFrog: trying to stabilize from Cymbalta withdrawal

[TreeFrog]

Altostrata, I'm not sure if you will want to respond to any questions from me, but I thought I would try asking.

 

As I mentioned earlier, I restarted 5 mg citalopram on March 29, so today was my 6th dose. The first couple of days my anxiety level seemed lower, but my anxiety seems to be increasing and yesterday and today my anxiety has been extreme, and I have had two nights of little sleep. I have noticed that my anxiety level has gone up about 1-2 hours after I take my daily dose at 9:30 am.

 

I am concerned that I may be in a kindling reaction and if so, I am not sure if I should stop the citalopram, or if I can just stop it.

 

Although you may not want to respond to questions that have come up from not following your advice, I hope you will consider it.

 

Thank you.

[Altostrata]

@TreeFrog, what do you think you should do? Did you talk to your doctor about this?

[TreeFrog]

I have an appointment with my doctor tomorrow morning and I will certainly let him know what's going on. I will have been on 5 mg  for a week, and I expect he will advise me to go up to 10 mg. I expect that advice is based on what happened the last time I had this kind of anxiety, in 2019. I was on 5 mg when it started but after 4 weeks of no improvement I went up to 10 mg, then to 15 mg after a week, then to 20 mg after 2 days. After 2 more weeks, I felt more or less back to normal. So he is expecting/hoping for that same outcome, based on his understanding of all this. And, I really want to believe him.

 

Of course this is a different situation: I came off duloxetine, not citalopram, and there was a 5 week gap of no drugs before I reinstated duloxetine. When I look back at the notes from the past 2 weeks, the difference between how I felt on the duloxetine beads and on the citalopram isn't that hugely different, except that as I said, the last couple of days have been exceptionally bad, which has me questioning my decision to go back to citalopram and with the hope of getting a similar outcome as in 2019. Or maybe this is just a "normal" fluctuation, a wave? Looking back at my somewhat sparse notes from 2019, I see I did have several days of intense anxiety on both 5 mg citalopram and then after I went up to 10 mg.

 

As far as what I think I should do, I am really struggling with the fact that my doctor, whom I generally trust, has such a different approach to this than what you had suggested (though I don't know if it's desirable or even possible now to go back to very small doses of duloxetine). So maybe now the path I'm on is the only option I have, other than to stop taking citalopram altogether... As I said, I'm really struggling with this, and it's certainly adding to my anxiety.These seem like critical decisions that I am having a hard time thinking through.

 

Thanks, TreeFrog

[ChessieCat]

Alto already stated the following:

 

On 3/26/2022 at 7:50 AM, Altostrata said:

 

As it takes several days for a duloxetine increase to ramp up to full effect, appears that 10 beads is too much. Suggest you try 6 beads. Yes, people are that sensitive -- skipping doses can do that.

 

 

It takes about 4 days for a dose to get to full level in the blood and a bit longer for it to register in the brain.

 

Q:  Have you read Post #1 of the reinstatement topic?

 

About reinstating and stabilizing to reduce withdrawal symptoms

 

24 minutes ago, TreeFrog said:

I expect he will advise me to go up to 10 mg.

 

Something to consider:  With the above information (both what Altostrata said and Post #1 of the reinstatement topic) do you think that increasing you dose might help or make things worse?

 

26 minutes ago, TreeFrog said:

As far as what I think I should do, I am really struggling with the fact that my doctor, whom I generally trust, has such a different approach to this than what you had suggested

 

When consulting medical professionals I always remind myself that I am the one that is going to be affected by what they want me to do or take.  I had a doctor want me to take an very strong antibiotic for a suspected infection.  I did my own research and found that there are several FDA warnings about this drug.  I refused to take it.  Several days later I had a follow up blood test and the infection markers had dropped.

[TreeFrog]

Thank you ChessieCat. Well, I can either go up or go down but not both. One problem with going down though, is that I can't really go below 2.5 mg. That's a quarter of a 10 mg tablet, which is the lowest formulation you can get here in Canada. Unfortunately we don't have liquid citalopram up here, and I think my chances of getting my doctor to prescribe a compounded formulation are basically nil. Maybe he would consider it for tapering, but since he believes I should be increasing my dose I don't think he will prescribe it in this case.

[ChessieCat]

5 hours ago, TreeFrog said:

One problem with going down though, is that I can't really go below 2.5 mg. That's a quarter of a 10 mg tablet, which is the lowest formulation you can get here in Canada.

 

You can make your own liquid using a tablet of citalopram.

 

See Post #1 of this topic:

 

Tips for tapering off citalopram (Celexa)

 

And:

 

how-to-make-a-liquid-from-tablets-or-capsules

[TreeFrog]

Thank you for that information, ChessieCat. It's very encouraging, especially because I know my doctor will not give me a prescription for compounded citalopram. When I saw him today, he repeated his advice to go up to 10 mg and disagreed with the idea that perhaps my nervous system is so sensitized that a lower dose might be better (no surprise there). He also said that  after 7 weeks off duloxetine my receptors would have adapted to the absence of the drug (I haven't yet found any scientific papers to either support or refute that statement).

 

In hindsight I am sorry that I didn't stick with Altostrata's advice and continue with a trial of 6 beads of duloxetine...I think my expectations were unrealistic and I gave up on that approach way too soon. But now that I've restarted citalopram, I have to go on from here, with that, I assume, for better or worse.

[ChessieCat]

1 hour ago, TreeFrog said:

He also said that  after 7 weeks off duloxetine my receptors would have adapted to the absence of the drug (I haven't yet found any scientific papers to either support or refute that statement).

 

This is correct.  When we reduce/stop a drug the brain gradually adapts to not getting as much/getting any drug.  This is why tapering, and holding as needed, is recommended as the way to get off a drug.  When updosing/reinstating a drug, it is better to start with a low dose than to risk taking too much, for the same reason, the brain having adapted during the time at a lower dose/off the drug.  And there is no way to know how much adaptation has occurred.  So starting with a low dose and increasing by small amounts is suggested.

 

Also be aware that the idea of updosing/reinstating/bridging is not to get rid of withdrawal symptoms completely but to bring them to a bearable level.  Some members have tried to find the "perfect dose" and have ended up making things worse.

[TreeFrog]

Given everything we've discussed, it sounds like I might want to try 2.5 mg citalopram instead of 5 mg? My symptoms feel like they are on the borderline of being bearable, especially now that the insomnia is getting worse, despite the trazodone.

 

Here are my notes from the past three days on citalopram...I hope that ChessieCat or Altostrata might be able to take a look and let me know if you have any comments. I would very much appreciate it. The numbers for anxiety, etc. are on a scale of 1 to 10.

 

4/2:

6:30: awake; anxiety ~5

9:30: took 5 mg citalopram

9:45: anxiety up to 7-8

11: anxiety 10

2:30: friend came over; anxiety 8-9

5: did guided meditation; anxiety ~4

6: anxiety 10

7: anxiety 7-8; stomachache until 9

9:45: took 37.5 mg trazodone

10:15: lights out (total sleep ~4 hours)

 

4/3:

3:30 am: awake; anxiety ~7

6:45: got up

9:30: took 5 mg citalopram

10:30: heartburn 7

11: anxiety 10

1: took 0.5 mg ativan; heartburn 7-8

1:15: slept about 1 hour

3: got up; anxiety ~5, then 3

8: anxiety 7

10: took 50 mg trazodone

10:30: lights out (total sleep ~ 8 hours)

 

4/4:

7: awake; anxiety ~7

8:30: got up

10: took 2.5 mg citalopram; anxiety 8

noon: took another 2.5 mg citalopram; heartburn 5; visited friend; anxiety 6

3: nap; heartburn 6; slept 1 hour

4:15: got up; anxiety 6-7

6: heartburn 7

10: took 50 mg trazodone

10:45: lights out (total sleep ~4 hours)

 

 

 

 

 

 

 

[TreeFrog]

Hello, @Altostrata. I am hoping that you might be willing to take another look at my situation, or let me know if that's not possible. 

 

As you know, I only followed your advice to reinstate duloxetine for 8 days, and then I reverted to my doctor's advice to restart citalopram and trazodone. At that point I thought that if a low dose of duloxetine hadn't produced any improvement by then, it wasn't going to. I understand now that I was far too impatient for immediate results and didn't give it enough time, but that's purely hindsight. And citalopram/trazodone did stabilize me the last time this happened, in 2019, though under different circumstances, so it was easy for me to convince myself that it would work for me again. 

 

So I reinstated citalopram at 5 mg on March 29th (3 weeks ago), and took my doctor's advice to increase to 10 mg after one week and to 15 mg after 1 week. I have been at 15 mg of citalopram for a week, and despite some brief windows, my symptoms are overall somewhat worse than they were when I reinstated citalopram. My anxiety is more intense and prolonged, my sleep is deteriorating despite the trazodone, and I have no appetite. 

 

I know that I have not followed the advice to reinstate at a very low dose, but let myself be swayed by my doctor and what worked for me in the past. But now that I am here, I don't know whether to stick with the 15 mg and hope things level out, or to go back down to 10 mg or even lower. Or maybe there are other options? 

 

Re trazodone, since it doesn't seem to be helping me sleep anyway, I was thinking I should step down to 25 mg and then stop.

 

I sincerely hope that you will be willing to respond to me, despite my blundering.  I've been acting out of sheer desperation, grabbing at whatever I think might relieve the relentless anxiety and everything that goes with it. It would make the intensity of withdrawal a lot more bearable if I feel that at least I'm on a path that is likely to be going in the direction of stability. If that's possible. 

 

I would be deeply grateful, Altostrata, for whatever help you can give me. 

 

 

[manymoretodays]

Spring Greetings TreeFrog, 

And hey there, I am not Altostrata, yet I just read through your "trying to quit antidepressants story".

 

I'm on extended break, happy to offer a few isolated suggests however.

 

Don't let your fear or anxiety control you, or fear your fear anymore.  Stay determined on your drug free quest.

 

And some assignments that should help empower you through knowledge, and then practice.

I'd suggest you get to know your drugs.

Looks like you've opted to try citalopram to see if it might take the edge off your duloxetine withdrawal.

And then added in some trazodone.

 

Can you get to Drugs.com  Bookmark it too.  Check the interactions of your present drugs.  Don't freak out.  Work on copying and pasting the results, or the link to the results.  Do that right here on your Introduction page.

You can use the top box there to check out any drugs too well before you ingest them, and do so.  Also check interactions before you agree to any new drug combinations too(should you ever take that route again).

Sadly, forget the idea that your GP or even shrinking psychiatrist actually cares about this stuff.  They are automated prescription writers, the latter often with huge egos to boot.  No doubt they care about people, in general.......they are just not the end all to healing.  As yet........ever hopeful.

 

Links to your specific drugs with some more specific drug information AND more specific tapering advice are linked to below.  Just hit the underlined passages to get to the links.

Tips for tapering off trazodone

 

Tips for tapering off citalopram

 

Tips for tapering off duloxetine

( it did read like you could not get to a week of a harm reduction reinstatement despite some initial improvements, and that you opted otherwise.....so......  the last one ^...........just for informational purposes)

 

I put trazodone first and ***** very much want you to look at that link, and and then get to the part about it's secondary metabolism mCPP.  I think if I was you.......I might ditch the trazodone.  It's been 3 weeks and 1 day now since you started that usage.  And I don't know for sure, likely about a month for the likes of trazodone, to fully get it's hooks into you(or establish physiological/physical dependency).  I might even do half of the 37.5 mg present dose tonight and then half again the next night and then off.  Either or and up to you at this point.  Me, I'd ditch it as soon as possible.  I did not see insomnia as prominent in your reports either.........  and........ there are better non drug ways..............

Between the interactions between the citalopram and trazodone, and then just the nastiness of trazodone itself..........again, if I were you, I'd ditch it, as soon as possible.  Within the next week.  You noted going to 25 mg next, and you are on the right track.  Perhaps keep quartering your tablet/pill every couple of days until you just have crumbs.  I am hoping that by a weeks time you can get off.  With another week, feeling some improvement, and then from there.........get on a more reasonable dose of citalopram to stabilize on.  Which may take some time, yet improvement from desperation.  You can do this!

Ultimately, your choice.

 

If you'd like to try back some of your Magnesium Citrate, do so.  Only I'd suggest you don't do the whole whopping 500 mg dose at once as you had been.  If it's capsule form you can open the capsule and put the contents in a large water bottle.  It will suspend to a point after shaking it up well.  That way you can sip it over the day or evening or 24 hours even.  And see how that goes.

Better choice than trazodone by far.

 

And then okay.......I spied what I quoted below and it might be telling, or helpful, or a clue you can use to guide your future choices.

 

 

On 3/18/2022 at 9:06 PM, TreeFrog said:

After four weeks of this, I went back up to 10 mg citalopram, then up to 15 mg a week later, then back to 20 mg two days after that. And within 2 weeks or so, I was feeling MUCH better (except for the appetite loss and GERD; legacies of the freak out).

 

It looks like you've already gone up to 15 mg with the citalopram, and today marks a week.  Might I suggest you at least just HOLD there, and let's see how that anxiety/fear and insomnia does once you've gone off the trazodone?

Tempting to tell you to back on down with the citalopram and that is a real possibility, in perhaps another week.  I think for the next week though........for you, just avoid any further increase on the citalopram.  You didn't give it much time previously, and let your anxiety guide you(and perhaps your doctor).

We don't do such large dose reinstatements here of any drug.  I'm assuming you might have looked at the reinstatement topic.  If not let's just go with my suggest of HOLDING.  And if total freak out occurs, lowering it.  You are on enough.  Trust me on that.  Less is more when WITHDRAWAL is involved.  You're in withdrawal, don't let anyone doctor dispute it.

 

 

Meantime.........non drug coping can come in real handy. 

The Dr. Claire Weekes Method of Recovering from a Sensitized Nervous System

Read about the "second fear" or fear of the feeling of fear itself.  Roam around and explore Claire Weekes.  There are videos and all kinds of self help to be found around this.  And TreeFrog your sensitized, you are in withdrawal.  Welcome aboard our healing hardy ship of cheerful(sometimes not) survivors.

 

A nice indexed list, with links, can be found with much more in the topic:  Non-drug techniques to cope with emotional symptoms

 

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

 

And then, another nice indexed list can be found in the topic:  Important topics about symptoms, including sleep problems

 

*try and stay away from introducing any additional supplements right now too.

Explore  "Finding Meaning" or  "Off Topic"(when signed in) other forums, outside of Introductions, which is where each persons individual case is.

 

Enjoy your Spring, however it may be.  Let your light shine.  Stop acting out of sheer desperation.  You are among kin here, people who get it.  No need to be desperate......that's a feeling.........this all takes time.  And trust me.......it gets better.  Enjoy the journey as much as possible.  Stay cheerful and hopeful and optimistic.  That all helps. 

 

Love, peace, healing, and growth,

moderator manymoretodays(mmt)

 

Edited April 20, 2022 by manymoretodays
link checks, one additional comment

[TreeFrog]

(Post moved from tips-for-tapering-off-trazodone-desyrel)

 

I've been taking trazodone in dosages from 25 to 50 mg (currently taking 37.5 mg) for the past 23 days, as a sleep aid. Can anyone advise on how quickly I could taper it? I intend to go down to 25 mg tonight. After reading this topic, I'm wondering if it's making my anxiety worse.

 

Edited April 21, 2022 by ChessieCat
added note

[ChessieCat]

If you are only taking the trazodone once a day then you may be experiencing interdose withdrawal due to the drug's half life not covering a full 24 hours.  If, related to the time you take your dose, your symptoms appear at about the same time every day, and ease at about the same time every day then that may indicate that this is what is happening.

 

It can take as little as 1 month for the brain to become fully adapted to getting a drug.  You might be able to do a fast taper off it.

 

It takes about 4 days for a dose to get to a steady level in the blood and a bit longer for it to register in the brain.  The rate at which you are able to get off will depend on how you feel.  It will be important to listen to your body/symptoms.  If you experience additional symptoms then hold on that dose for longer before making the next reduction.

 

Try to keep your reduction steady and not jump around with your doses.  The brain likes consistency and going up and down in dose is like playing ping pong with your brain.

[TreeFrog]

Thank you, MMT. I really appreciate hearing back from you and your warm words; it immediately made me feel less alone with and overwhelmed by this. And it's clear that you read my story very closely.

 

3 hours ago, manymoretodays said:

Can you get to Drugs.com  Bookmark it too.  Check the interactions of your present drugs.  Don't freak out.  Work on copying and pasting the results, or the link to the results.  Do that right here on your Introduction page.

 

Yes, I did this for trazodone and citalopram. The results are at https://www.drugs.com/interactions-check.php?drug_list=2228-0,679-0. And yes, there is a major interaction; though my doctor told me at the dosages I am on it would not be an issue. Nevertheless....

 

3 hours ago, manymoretodays said:

I did not see insomnia as prominent in your reports either.........  and........ there are better non drug ways..............

Between the interactions between the citalopram and trazodone, and then just the nastiness of trazodone itself..........again, if I were you, I'd ditch it, as soon as possible.  Within the next week.  You noted going to 25 mg next, and you are on the right track. 

 

I've asked a question re how fast I could taper trazodone. As I mentioned, it doesn't seem to be doing wonders for my sleep (which it did seem to help the last time I took it in 2019), but insomnia actually is a problem. For the past week I'm averaging 6 hours a night, 2 or 3 less than before this started, and I feel like a zombie.

 

3 hours ago, manymoretodays said:

If you'd like to try back some of your Magnesium Citrate, do so.  Only I'd suggest you don't do the whole whopping 500 mg dose at once as you had been.  If it's capsule form you can open the capsule and put the contents in a large water bottle.  It will suspend to a point after shaking it up well.  That way you can sip it over the day or evening or 24 hours even.  And see how that goes.

Better choice than trazodone by far.

 

Thank you for this suggestion. I will give it a try.

 

4 hours ago, manymoretodays said:

It looks like you've already gone up to 15 mg with the citalopram, and today marks a week.  Might I suggest you at least just HOLD there, and let's see how that anxiety/fear and insomnia does once you've gone off the trazodone?

 

I will hold at 15 mg citalopram while I work on getting off trazodone...this feels like good advice to me.

 

4 hours ago, manymoretodays said:

Meantime.........non drug coping can come in real handy. 

 

I will explore these links. I have been listening to a lot of guided meditations that really do help, even if only temporarily. And for sure the hardest part is not to react to these powerful waves of anxiety with fear and aversion. I know that makes things worse, but man, it is so hard to accept things as they are right now.

4 hours ago, manymoretodays said:

*try and stay away from introducing any additional supplements right now too.

 

I just got some more of the omega 3 fish oil that I was taking before this started...do you think I should hold off on that too?

 

Thank you again, MMT, and my best wishes to you. I hope you are enjoying  your spring!

[ChessieCat]

27 minutes ago, TreeFrog said:

I'm wondering if it's making my anxiety worse.

 

Because of the many changes you have made in such a short period of time it is difficult to know what is causing what.

 

Please note that I have provided you with information so you can make your own decision about what to do.  I am not a medical professional; I am an unpaid peer.  

 

[ChessieCat]

4 minutes ago, TreeFrog said:

I just got some more of the omega 3 fish oil that I was taking before this started...do you think I should hold off on that too?

 

Only make one change at a time.  If you are going to reduce trazodone, then it is not a good idea to start trying a supplement as well.

 

the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable

 

[TreeFrog]

7 minutes ago, ChessieCat said:

If you are only taking the trazodone once a day then you may be experiencing interdose withdrawal due to the drug's half life not covering a full 24 hours.  If, related to the time you take your dose, your symptoms appear at about the same time every day, and ease at about the same time every day then that may indicate that this is what is happening.

 

Thank you, ChessieCat. If I take it a half hour before lights out (around 9:45 pm), when would interdose withdrawal symptoms be likely to appear? The only thing I notice with trazodone is that the anxiety seems to decrease about half an hour after I take it and is usually less overnight. The anxiety starts almost as soon as I wake up and often builds from there until I go back to bed. Unless I'm on a "good" day, when the anxiety eases for whatever reason. I'm not having much in the way of good days lately.

 

I will go down to 25 mg tonight and see how that goes.

[TreeFrog]

7 minutes ago, ChessieCat said:

Only make one change at a time.  If you are going to reduce trazodone, then it is not a good idea to start trying a supplement as well.

Right, thank you.

[TreeFrog]

Just have one other question: Can the title of my introduction change to "Trying to stabilize from Cymbalta withdrawal"? The current title doesn't really seem to fit now...:-(

[ChessieCat]

1 hour ago, TreeFrog said:

The only thing I notice with trazodone is that the anxiety seems to decrease about half an hour after I take it and is usually less overnight. The anxiety starts almost as soon as I wake up and often builds from there until I go back to bed.

 

Another mod wrote this to another member:

 

  

2 hours ago, Shep said:

 

Interdose withdrawal means going into withdrawal in between doses, which is common with short-acting Z-drugs like Ambien.

 

You can tell it's interdose withdrawal because your symptoms resolve when you take the drug.

 

 

[ChessieCat]

I've just noticed this in Post #1 of the Tips for Tapering Trazodone topic.  Note what I have highlighted in blue.

 

  

On 7/20/2012 at 12:40 PM, Altostrata said:

 

Half-lives
trazodone (8-15 hrs) ---> mCPP (2-6 hrs) ---> other metabolites (inactive)

 

The metabolism of trazodone is highly variable among individuals. mCPP can be produced during the initial 8-15 hours; its clearance from the body can be blocked by other drugs (see explanation below).
 

mCPP is used to induce anxiety for study in the laboratory, e.g. http://www.ncbi.nlm.nih.gov/pubmed/20828578

For some people, mCPP produces not only anxiety but headaches and a hallucinatory effect. So while trazodone may help you sleep at night, mCPP might make you feel sick, anxious, and out of control during the day.
 
http://www.ncbi.nlm.nih.gov/pubmed/19384678

 

 

[Shep]

17 hours ago, manymoretodays said:

Can you get to Drugs.com  Bookmark it too.  Check the interactions of your present drugs.  Don't freak out.  Work on copying and pasting the results, or the link to the results.  Do that right here on your Introduction page.

 

Thanks for weighing in with a great post, @manymoretodays!

 

@TreeFrogI think you may have missed Manymoretoday's post. Please scroll up and read it. It's full of great information.

 

I'm quoting the part where she's sending you to the drug interaction checker. Please go ahead and do that part. 

 

Also, please let us know the time(s) of day you take each of your drugs and any supplements you're taking. Edited because Treefrog has already answered this. 

 

@ChessieCatlinked to the mCPP issue with Trazodone, and I think there's a lot to that. Please let us know your thoughts. 

 

13 hours ago, TreeFrog said:

Just have one other question: Can the title of my introduction change to "Trying to stabilize from Cymbalta withdrawal"? The current title doesn't really seem to fit now...:-(

 

Sure, I'll take care of that for you. 

Edited April 21, 2022 by Shep

[Shep]

13 hours ago, TreeFrog said:

Yes, I did this for trazodone and citalopram. The results are at https://www.drugs.com/interactions-check.php?drug_list=2228-0,679-0. And yes, there is a major interaction; though my doctor told me at the dosages I am on it would not be an issue. Nevertheless....

 

Sorry, TF. I just saw you already posted this. Thank you. 

 

13 hours ago, TreeFrog said:

I will hold at 15 mg citalopram while I work on getting off trazodone...this feels like good advice to me.

 

This sounds like a great plan. And sorry I missed your post on this. 

 

Please let us know how you're doing. 

[TreeFrog]

Thank you, Shep!

[Shep]

You're welcome, TF, but I didn't say anything you, Manymoretodays, and ChessieCat hadn't already figured out. 

 

Let us know how you're doing over the coming days. 

[TreeFrog]

So things seem to have shifted majorly this morning. I had a decent night's sleep of over 7 hours, after 25 mg trazodone, despite waking up five or six times to visit the bathroom.

 

However, I woke up feeling kind of dizzy, weak, very sedated and stunned. Anxiety is virtually non-existent, but I feel like I've been hit by a truck. I just did a rapid test, thinking, could it be Covid? The result was negative. Been feeling this way now for 3.5 hours and it is not easing up.

 

I felt like this a few mornings when I was taking 50 mg trazodone, and I figured it was a trazodone hangover so that's when I cut back to 37.5 mg, but it never lasted this long before, or happened at this dose. If it has anything to do with the trazodone that is.

 

It would be great to get some feedback on this latest development. Thanks!

[manymoretodays]

9 hours ago, TreeFrog said:

However, I woke up feeling kind of dizzy, weak, very sedated and stunned. Anxiety is virtually non-existent, but I feel like I've been hit by a truck. I just did a rapid test, thinking, could it be Covid? The result was negative. Been feeling this way now for 3.5 hours and it is not easing up.

 

How did the rest of the day go TreeFrog?  Could be......trazodone hangover.  Beats desperate panic for a change.

 

Would you, could you give us some NOTES, daily drug and symptom logs, if at all able.  Do todays retrospectively and then keep your notepad or paper and pen handy tomorrow.

Look at the sample note in the link.  Times to the left, and then on the right all drugs, and supplements(by name with dosage) and symptoms.  Give us 24 hours when posting them here.

 

They can prove to be ever so helpful.

What's tonights plan?

 

L, P, H, and G,

mmt

 

 

 

[TreeFrog]

11 hours ago, manymoretodays said:

Would you, could you give us some NOTES, daily drug and symptom logs, if at all able.  Do todays retrospectively and then keep your notepad or paper and pen handy tomorrow.

Look at the sample note in the link.  Times to the left, and then on the right all drugs, and supplements(by name with dosage) and symptoms.  Give us 24 hours when posting them here.

 

No problem, MMT. I have been keeping track for a while now anyway:

 

April 22:

7:15 am: woke up; felt a bit dizzy and nauseated and very sedated/stunned/dull. Anxiety 3-4/10. Got about 7 hours sleep; mild night sweats; got up 6-8x

7:45 am: one cup black tea

9:30 am: breakfast; citalopram 15 mg; bromelain papain + digestive enzymes

11:30 am: toast

2:00 pm: protein shake

2:30 pm: dull sedated feeling starts to lift; go to appointment

4 pm: home again

5 pm: anxiety up to 4-5/10

6:15 pm: tylenol 500 mg; ibuprofen 400 mg

6:30 pm: dinner; bromelain papain + digestive enzymes

8:30 pm: anxiety up to 5-6/10

9:45 pm: trazodone 25 mg

10:15 pm: tylenol 500 mg; ibuprofen 400 mg; lights out

 

The tylenol and ibuprofen are for lower back pain that started (for no apparent reason) about a week ago. I take the digestive enzymes to try and keep my digestion working and to hopefully counter the heartburn, gas, loose stool, etc.

 

This morning I woke at 5 with anxiety at 7/10 and didn't sleep after that. Feeling dull and nauseated, but not anywhere near as much as yesterday and the anxiety is definitely back. Thinking I might back down to 12.5 mg trazodone tonight.

[TreeFrog]

Anxiety is very intense this morning...and I'm tempted to take 0.5 mg lorazepam to dial it down for a while. Does this seem like a reasonable idea? I wouldn't do this more than twice a week.

 

[manymoretodays]

Hey TreeFrog,

Well you asked and my inclination would be to say no on the Ativan/Lorazepam.

It's only going to muddy the waters of observation/interpetation of the trazodone fast taper.

Could be the ibuprofen/tylenol wearing off.......it's not unheard of.  That would be wearing off around now.  And look here:

Painkillers in withdrawal: including ibuprofen, tylenol

(you'll get some other determined members experiences and wisdom ^)

 

Maybe because it's Saturday........I mean I don't know........no holidays this week.  Just saying to keep your expectations realistic as far as symptoms go right now.

 

1 hour ago, TreeFrog said:

Anxiety is very intense this morning...and I'm tempted to take 0.5 mg lorazepam to dial it down for a while. Does this seem like a reasonable idea? I wouldn't do this more than twice a week.

 

Try not to make plans around using another drug.  A couple times a month maybe when you are not in the midst of making observations, collecting data, making one drug change already.   And yeah, using Ativan today is really going to mess with your data collection.  I see tonights plan for 12.5 mg of trazodone and my thinking tells me, that we won't really have any idea how that goes with the overlap of Ativan/lorazepam. 

Good notes by the way.  Looking forward to seeing the today and then tomorrows too.

And so good of you to include everything.

 

Anyway......your post says one hour ago........give or take, as the timekeeper isn't always foolproof here.  Hoping it's abated with time, or distraction, even a little bit.

I'd have to add too, that you might get into the habit, begin to build a habit of thinking first what non-drug things you might do.

I don't know why but some form of posture or Yoga might help and you know you can always modify poses to suit too.  And I don't know about you but I sure like baths and books, oh, and music, and journaling.

On 4/20/2022 at 2:16 PM, manymoretodays said:

A nice indexed list, with links, can be found with much more in the topic:  Non-drug techniques to cope with emotional symptoms

 

On 4/20/2022 at 2:16 PM, manymoretodays said:

And then, another nice indexed list can be found in the topic:  Important topics about symptoms, including sleep problems

 

This is your time to hone on up.  You know that emotional symptoms list has other stuff listed there for back pain, or that musculo skeletal pain you have mentioned.  Likely you'll see continued aches and pains of many different origins.  Find just a few new things to try this weekend in the non-drug coping department. 

I think dysregulation will continue for awhile, in any case.........your poor battered nervous system.......give it a room, keep it warm, and just a little comfortable............beats fighting it all the time.

 

Thankful for......and...... oh wow.......it's snowing!!!  I've been feeling overwhelmed with the upped responsibilities of my home and property lately.  Looks like it may be inside work today in more ways than you can imagine.  Cleaned the cookies and caches in computer land, anyway so far.  And will walk.......yes, you too, no doubt you can walk a little bit today and breathe.  Let us give thanks(solly, just me, I type or talk myself into good cheer)

 

Keep up the good work, and determination.

 

L, P, H, and G,

mmt

 

[TreeFrog]

Right, that makes sense re the lorazepam. Today has been one of the worst days I've had; as a result, I'm second-guessing everything, and very very sorry that I ignored the low-dose advice and shot up to 15 mg citalopram. But that's what I did so here we are.

 

A neighbour introduced me to tapping, and I've tried it a couple of times today. It does help, even if only for a short time. And a nice walk with her (today here it is sunny and even warm) helped me too.

 

Snowing! well, keep warm and enjoy.

 

And thank you for keeping an eye on me. It helps so much.

 

 

[TreeFrog]

Here are my notes from yesterday:

 

April 23:

5 am: awake; anxiety 6-7/10

7:45 am: got up; anxiety 7-8/10; nausea

9 am: breakfast; anxiety 8-9/10; digestive enzymes, tylenol 500 mg and ibuprofen 400 mg

9:30 am: citalopram 15 mg

10 am: anxiety 9-10/10

10:30 am: tried tapping; anxiety 7/10

11 am: laid down; listened to guided meditation

11:30 am: anxiety 9-10/10

noon: toast

1 pm: protein shake

1:15 pm: walk; anxiety 7-8/10

2:30: lunch

3-4 pm: lay down; listened to guided meditation

4:30 pm: anxiety 8-9/10; tapped

6:45 pm: dinner

7:30 pm: digestive enzymes; anxiety 7-8/19

9:45 pm: trazodone 12.5 mg; anxiety 5-6/10

10:15 pm: lights out

 

Unfortunately, I woke up around 3:15 am and that was it for sleep, so maybe 4.5 hours in total. I'll try to get some rest during the day.

 

Re magnesium citrate, I mixed 500 mg from a capsule into 3 cups water in a metal water bottle. I probably drank half of it over the course of the day. It did cross my mind to wonder if mixing it in a metal bottle was ok, though?

 

[TreeFrog]

Here are my notes from yesterday:

 

April 24:

• 3:15 am: awake; anxiety 6-7/10; got up
• 4:45 am: back to bed but didn't sleep
• 7 am: got up; very tired; anxiety 7-8/10
• 9 am: breakfast; digestive enzymes
• 9:30 am: citalopram 15 mg
• 10 am: grocery shopping; anxiety 10/10
• 11 am: guided meditation; anxiety 7-8/10
• noon: toast; anxiety 8-9/10
• 12:10 pm: massage; anxiety 7-8/10
• 1:30 pm: protein shake
• 2 pm: walk with friend; anxiety 4-5/10
• 6:30 pm: dinner; anxiety 5-6/10
• 9:30 pm: epsom salt bath
• 9:50 pm: trazodone 12.5 mg
• 10:20 pm: lights out

Last night I was awake for a while at 3 am and 5:30 am, but managed to go back to sleep for a while. I also had night sweats, enough to make the sheet damp.

 

I have a question about the trazodone taper: I've been at 12.5 mg for the past 2 nights. How should I proceed from here? I've been taking trazodone now for 26 days. @Manymoretodays, can you advise me? Thanks.

[TreeFrog]

Here are my notes from yesterday:

 

April 25:

• 3 and 5 am: awake but went back to sleep; had night sweats enough to make sheet damp
• 7:30 am: got up; felt stunned, down; anxiety 6-7/10
• 8:30 am: zoom session with counsellor
• 9:30 am: breakfast; digestive enzymes; citalopram 15 mg
• 10 am: anxiety 9-10/10
• 11 am: guided meditation; anxiety 6-7/10
• 11:30: toast; anxiety 8-9/10
• 12:15-12:45: walk; anxiety 8-9/10
• 1 pm: protein shake; anxiety 7-8/10
• 3 pm: acupuncture; anxiety 4-5/10
• 5 pm: anxiety 6-7/10
• 6:30 pm: dinner; anxiety 7-8/10
• 9:15 pm: epsom salt bath
• 9:50 pm: trazodone 12.5 mg
• 10:15 pm: lights out

I'm having a hard time figuring out what the effect of the trazodone taper is...I can't really tell from my notes if anxiety is worse than it was before I went down to 12.5 mg. It's been generally quite intense for days except for a few short windows. Last night I only got about 3 hours of sleep and a lot more jolts of anxiety than usual, so it seems like that may be getting worse. But I guess that was predictable. Looking back at what ChessieCat said last week, I think I need to hold at 12.5 mg for a while?

 

 

[TreeFrog]

Just realized that for the past 2-3 nights, I've had night sweats. Haven't had that since I was on Cymbalta.

[TreeFrog]

April 26:

1:15 am: awake; night sweats; got upset; anxiety 7-8/10

2:30 am: got up for one hour

3:45 am: back to bed; slept ~one hour

6 am: awake; anxiety 7-8/10

7 am: got up; very tired after 3 hours sleep

9:30 am: breakfast; citalopram 15 mg; digestive enzymes anxiety 8-9/10

1:30 pm: lunch with friend

2:30 pm: anxiety 9-10/10

3 pm: laid down; anxiety 8-9/10; dozed 15? minutes

4:15 to 4:45 pm: walk; anxiety 7-8/10

6:30 pm: dinner; digestive enzymes

9:40 pm: trazodone 12.5 mg; anxiety 6-7/10

10:20 pm: lights out

 

I just had an appointment with my psychiatrist. As always, her advice is totally the opposite of what I've read here: go up to 20 mg citalopram immediately (because 15 mg isn't enough) and wait to taper off trazodone until I've been on 20 mg for a week or so.