zinico: dealing with PAWS after 1.5 years

[zinico]

My history is not exactly antidepressant related but I have the same PAWS symptoms that a lot of people are dealing with. So I'm posting this hoping to find some answers and help here.

 

I was a heavy alcohol and cocaine/speed user for about five years. I would typically binge drink and use cocaine/speed 2-3 times per week until the early morning i.e. the next day. I quit all drugs 1.5 years ago.

 

To this day I'm facing strong PAWS symptoms including insomnia, brain fog, feeling spaced out, irritability, mood swings, no motivation and frequent constipation. I've been keeping a spreadsheet where I track my daily sleep, symptoms, medication and supplements. It has helped me figure out what I can tolerate and what not. It has also helped me better understand my condition before finding this forum. When I found Adele's Journal article (https://journals.sagepub.com/doi/full/10.1177/2045125321991274) it was such a relieve to know that many other people are dealing with the same symptoms and knowing that I might just need more time to recover and get better.

 

By tracking my own symptoms in a spreadsheet I was able to find out that my PAWS get triggered by anything that strongly affects my dopaminergic/serotonergic system. Examples include artificial sweeteners, Domperidone (gastroprokinetic which I was prescribed when I had gastritis, it's a dopamine antagonist) and most recently the antihistamine Chlorphenamine. I also don't tolerate zinc very well (seems to have some effect on dopamine/serotonin as well).

 

About a month ago I had Covid and used nasal spray for a period of 10 days. It turns out the nasal spray contained a decongestant and the antihistamine Chlorphenamine which affects serotonin. Ever since I stopped using the nasal spray I have been facing much stronger withdrawal symptoms again. It's almost like it has set me back to the very beginning again. I've been sleeping only five hours per night with carb cravings during the day. Feeling spaced out and just trying to get through the days until it gets better. What's interesting is that while I was using the nasal spray my sleep was much better than without it. The same thing happened when I was briefly taking the gastroprokinetic Domperidone. It improved my sleep while I was taking it but it ultimately triggered strong withdrawal symptoms again.

 

So I'm now 1.5 years into this and I have definitely improved. Before the Chlorphenamine issue, I was doing much better already. Half of the week I would sleep quite well and then I had about two days per week where I wouldn't sleep well and maybe one day per week where I would have very strong brain fog and spaced out feelings.

 

Also, I'm still unable to get much work done. I'm a freelancer and I'm lucky that I have income from long-term clients that require little work to maintain them. I'm really only doing the absolutely necessary work to keep my business alive which is often less than an hour per day. I don't have the motivation and energy to do much more than that. I have big plans to grow my business and trying to motivate myself to get there but it feels like it's still too early for me to accomplish this.

 

What I'm trying to figure out at this point is whether I should see a psychiatrist to get on some kind of medication to help with the withdrawal process? This would potentially help me get back to working on my business earlier again. Or because it's been such a long time already should I just push through it and keep going without any medication? I'm also scared that I will just end up triggering more withdrawal if I start another medication.

 

Thank you in advance for any help and insights!

[getofflex]

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.  Congratulations for getting off the drugs and alcohol!  That is a huge accomplishment.  Did you cold turkey, or taper off of them?  The symptoms you describe do sound like PAWS.  I've seen several people in here have trouble with WD after using domperidone to help with their breastfeeding.  

 

Can you please give us specific information in your signature about your drug history for all drugs you are on and have been on, especially for the past 18-24 months?  It would be especially helpful to have the details of your drugs in a concise vertical list (no symptoms), only drug names, specific dates (as best you can say for example early March if you don't recall the day) and dosages of each medication decrease or increase.  Use this format:

 

Drug name: date, dose, date, dose, date, dose…

Drug name: date, dose, date, dose, date, dose…

Etcetera

 

Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

How to List Drug History in Signature

 

Because your brain was dependent on the drugs and alcohol, removing these substances was a shock to your brain, and it is probably still in state of disequilibrium, and trying to adjust to functioning without the chemicals.  Here are some links that will explain this better than I can - they are for people on psych meds, but probably apply to your case as well.  

 

How Psychiatric Drugs Remodel Your Brain

 

This helps you understand what withdrawal syndrome is: 

 

Video on Recovery from Psych Drugs

 

Windows and Waves Pattern of Stabilization

 

 

Here is a link with checklists of common WD symptoms: 

 

Dr Joseph Glenmullen Withdrawal Symptom Checklists

 

 

Here are some techniques to cope with symptoms: 

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

 

We don't suggest many supplements, but 2 that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you. 

Magnesium

Omega 3 Fish Oil

 

On 3/19/2022 at 10:20 PM, zinico said:

What I'm trying to figure out at this point is whether I should see a psychiatrist to get on some kind of medication to help with the withdrawal process?

If it were me, I would not do this.  The more we go on, off, and then back on any substance or drug that affects the nervous system, the more we put ourselves at risk of kindling.  This could make your situation worse.  As we add and subtract chemicals to and from the brain, it just tends to get more confused and destabilized.  There is no drug that help withdrawal.  Our nervous systems will heal naturally with loads of time and patience.  Here is a link about kindling:  

 

Kindling

 

Antihistamines tend to help with sleep, but then can also cause problems.  Here is our topic about antihistamines: 

 

Antihistamines

 

I've given you quite a bit of information here.  Take your time to look it over, and let us know if you have any questions.  Keep in touch! 

 

[zinico]

Thank you for your detailed answer. I have updated the signature.

 

Yes my brain is definitely still in disequilibrium. Before ultimately quitting cold turkey and sticking with it I also had many periods where I stopped and started using alcohol/drugs again and again. I think this probably made everything worse due to kindling.

 

It helps a lot to finally find a forum where people discuss having the same issues and just knowing that other people face similar issues in  their recovery. I read through a lot of posts on reddit regarding recovery timelines and most people feel fine after a year or so. This forum is the first I found where people actually talk about the fact that PAWS can take much longer to heal. I know the recovery time frame is very individual but it really helps me read through timelines where people give exact time frames on how long it took them to feel better. Is there a thread about recovery timelines? I could only find a few individual posts via the search function.

 

Also, in your experience what are typical recovery timelines for people with protracted PAWS? I'm now at 1.5 years and still facing significant PAWS. Previously, I thought I would probably feel much better at this point. However, I have now revised my expectation and thinking it will probably take at least 3-4 years to feel 80% normal or more. I find it incredibly helpful to have some kind of time frame in mind for my recovery even though it might take longer or shorter to fully recover. It's just something that helps me stay positive and motivated to continue to work on my recovery.

 

Thanks for your opinion regarding dealing with PAWS via medication. My gut feeling has also been that I shouldn't try and get on any medication. My body and nervous system keep telling me that I cannot handle any dopaminergic/serotonergic drugs anymore. I think only time can help me heal my nervous system.

 

[getofflex]

Yes, it can definitely take years to recover from PAWS.  There is a wide range of recovery timelines, and there are many variables involved.  We have a great thread that talks about how long recovery may take: 

 

Are We There Yet?  How Long is Withdrawal Going to Take?

 

We also have a plethora of success stories on here.  You can read them, and find out more about how long it took these people.  

 

Success Stories

 

19 hours ago, zinico said:

My gut feeling has also been that I shouldn't try and get on any medication. My body and nervous system keep telling me that I cannot handle any dopaminergic/serotonergic drugs anymore.

I'm glad that you are being wise and listening to your intuition about this.  I feel the same way about myself, and intend to stay far away from mind altering drugs and substances from now on.