dangerous7: tapering amitriptyline after one week

[dangerous7]

Yes, medicines got added on the way and never removed by the doctor since I never felt any better. I only got moved from one SSRI(Escitalopram) to the next(Fluoxetine) to the mood stabilizer(Vortioxetine)

 

Benzos(Clonazepam and then Etizolam) for 6 months in all till now

 

@Onmyway @Shep I am really sorry for being an idiot earlier, I would request you to please help me if you can. I am in a very bad state, and even a few words from you will give my some hope and help me ride this out.

 

 

 

 

 

[Doctorsrcrap]

Good luck.  I hope someone can help. 

[Altostrata]

11 hours ago, Doctorsrcrap said:

You said one drug in particular is making you depressed. If it were me maybe that's a good place to start?

 

Oh, dear. There's some common sense. Tips for tapering off vortioxetine (Trintellix, previously called Brintellix)
 

@dangerous7 Let me be very clear. We do not substitute for doctors. You are looking for someone else to make decisions for you, which you've done dozens of times already in your visits to doctors to get new drugs.

 

I am not going to get involved because there is nothing peer support can suggest that will instantly fix your situation. I am quite certain that you will not be satisfied with any result, as evidenced already by your drug history. If you want to go off your drugs, you need to commit to doing it yourself.

 

If by any chance you're taking the other 3 drugs in your stupid drug cocktail  -- etizolam, quetiapine, and mirtazapine -- to counter adverse effects of vortioxetine, reducing vortioxetine would eliminate any reason to take the other drugs.

 

Too bad you didn't go off vortioxetine 2 weeks ago when you noticed its bad effects, you might have just quit it instead of being at risk for withdrawal, which increases after you've been taking a drug for a month or more. Now you have to figure out how to taper it.

 

 

[Doctorsrcrap]

Looks like alto has given you some advice here. 

Looks like vort would be the first to go. 

And I'm pretty sure she will want you to hold everything else steady and def not take anything new. 

What are your thoughts? 

[dangerous7]

Thanks @Altostrata 

I have reduced Vortioxetine by 25% to 15 mg three days back(I know it's too huge a drop but I am not able to live with this depression at all, the symptoms alternate between severe depression and anxiety caused by depression). I was scared of making the huge drop at end of two weeks of 20 mg Vortioxetine(even though nothing felt right about it) since in December I had stopped Fluoxetine quite rapidly when the doctor moved me from Fluoxetine to Vortioxetine.

 

I have been labeled as suffering from treatment-resistant depression since last month. Tired of these labels, don't even know how a person's diagnosis can change from having premorbid personality to clinical anxiety to GAD to depression to anxiety-along-with-depression to treatment resistant depression.

 

Could you please help me about when I can do the next taper of Vortioxetine. Every time I hold that medicine in my hand, I want to stop eating it completely but with all the time I have spent on this website, I know that's not the right thing to do since I might end up in a worse state by messing up my CNS even more.

 

Etizolam 1.5mg CR in morning is quite a high dose too, don't know when I will be able to taper it. Praying for everyone else on this website, hopefully all of us can heal and get out of this mess

 

thanks for responding to me @Doctorsrcrap, seeing a message from you is such a Godsend right now.

 

 

[Altostrata]

How do you feel after reducing vortioxetine?

[dangerous7]

depression feels lesser, @Altostrata but then my old friend anxiety begins rearing its head...I am trying so hard to accept it but it's like an all-encompassing feeling...

 

On Vortioxetine 20mg, I was waking up with severe depression. On 15 mg, depression begins slightly later in the day and intensity is lower.

 

There is another thing I wanted to share and check about, is it normal to have different kind of mood at different times in the day? For example, mornings I am awake by 5 to 5:30 am but never able to get off the bed since I am busy thinking about things like will I ever be well again, I must be going mad. The psychotherapist has taught me to challenge those negative feelings but I feel completely wiped out by those and am not able to challenge it(at least not as well as I can during daytime). By evening 5-6pm, sometimes the day is more manageable. 

 

I have external stressors like, not being able to do well at work, feeling bad about ignoring the kids and my share of chores and leaving everything on my wife...but some times the feeling-bad-and-panicking-as-a-result comes over me without any warning or without any stressors causing it.

 

 

[Altostrata]

Most likely, you reduced vortioxetine too much and now you have a withdrawal symptom you're calling "anxiety". There's a reason we recommend 10% reductions and not 25% reductions.

 

Not a surprise you have mood changes and fatigue after going on and off dozens of drugs. Sorry, we don't treat depression here, we help people taper. If you want to go off your drugs, you have to take responsibility to deal with your problems without drugs.

 

See

 

 

Non-drug techniques to cope with emotional symptoms

 

Easing your way into meditation for a stressed-out nervous system

 

Music for self-care: calms hyperalertness, anxiety, aids relaxation and sleep

 

Ways to cope with daily anxiety

 

Dealing With Emotional Spirals 

 

Shame, guilt, regret, and self-criticism

 

Health anxiety, hypochondria, and obsession with symptoms

 

[Doctorsrcrap]

How u doing

[dangerous7]

Thanks for sharing the links, @Altostrata

They are quite helpful, just need to convince myself to re-read them while I am having sticky thoughts and extreme anxiety.

 

@DoctorsrcrapI am alternating between anxiety(same or higher than before) and depression((slightly lesser than before I cut down Vortioxetine surely), like @Altostrataalready said the cut was too big and I was concerned about ending up in this state. I have been dealing with anxiety for the past 8 months or so, the only difference between then and now is that I have learnt some coping strategies. On bad days, those don't work though 😞

 

My tapering becomes hard each time(since tapering of Escitalopram last year when I first felt this) since my mind keeps on trying to convince me I have same disease as my father. I spent a lot of time taking care of him while he was dealing with Paranoid schizophrenia, so I heard a lot of his persecution theories and now my mind replays those in a loop. I know my fears are irrational(I am able to challenge them when I am slightly calm) but I can not figure out how to do it while it's happening to me. I just go panicky in a loop and lose control of my emotions totally. So hard to function with this sticky thoughts, I wish there was a way to just flush these out of my head. Only good thing happened to me two days back when my boss told me there is some improvement in my task delivery at work(I have been put on a personal-improvement-plan since December 2022, I would lose my job till Jan end if there is no improvement), it's a different thing that I am not able to feel the joy(so much apathy in me), maybe just slight relief. 

 

How have you been doing @Doctorsrcrap

[NardilTime]

I’m really sorry you are going through this @dangerous7. It’s a horrible place to be. I started having adverse reactions in 2014. I believed the doctors when they told me I was experiencing a worsening of an underlying condition and let them switch me from drug to drug. I got progressively worse and ended up in psychiatric institutions. It’s hard to resist them when you have such doubts. You don’t know who to trust, them or your gut feeling that the drugs are killing you. It’s even harder when you don’t have the full support of your family. An impossible situation. I was so inebriated, confused, and scared that I followed the same path you are following. Always looking for the magic bullet drug to save me. It wasn’t until I came to this website that I had the faith and courage to believe in myself instead of the doctors. I slowly weaned myself off nardil over 8 months and I’ve been clean for 17 months. The difference is extraordinary. I’m not completely healed but I’m getting much closer to the person I was before they drugged me and destroyed my nervous system. You have to resist the urge to keep changing your medications and you must slowly begin to reduce. Once you are at zero the healing is inevitable. 

[Doctorsrcrap]

Thank you for asking after me but you just worry about yourself. 

I understand trying to use coping strategies we have learned cam be difficult in this process as it feels like we are contending with a whole new kind of monster. 

I think since your drop maybe you need to hold a while as the drop was quite large but I'm not sure. At least the depression has lessened. 

[Altostrata]

 

@dangerous7 The important question is do you feel better or worse after decreasing vortioxetine? Did you get NEW symptoms after the reduction or do you have the same symptom pattern as before?

[dangerous7]

No new symptoms I think , just that the fear and anxiety keeps on coming back in a loop and it doesn't let me relax. After the Etizolam, I feel better for 2-3 hours and then same feelings are back. I am lying down in the bed from 5-7:30 am , only catastrophising. I know that I should get up, do affirmations, meditate or at least begin my morning with a cup of tea. I feel caught up in the fear(its as if i am hypnotized and am not able to accept/challenge the anxiety or fear), I have made list of coping techniques but I am not able to  remember any(when I feel fearful) or shake out of the fear/anxiety for those few seconds. That scares me and makes me feel very very hopeless. 

 

Are there others who feel like a deer caught in the headlights during anxiety/fear? Even though I have read and I understand and I agree with the non drug coping techniques, I feel powerless while I am fearful(same old fears, of me staring at people, trying to figure out what they think about me, how will I face the world, I will always be like this, those only feel more intense since i keep on getting more and more afraid of them each time). 

[dangerous7]

thanks for sharing your experience @NardilTime

I cant even trust myself to follow this taper well, I keep on getting confused and doubting myself, questioning all my decisions. 

Is it possible that these medicines broke my will so completely that i lost all confidence in myself..therapist tells me to practice self-compassion and self-love...

 

@Doctorsrcrapmonster is the right word, I want to cry loudly but can't even do that in the last six months or so. I only have to contend with the tears building up in my eyes and not even falling off. Another side effect of medicines...

 

[Doctorsrcrap]

I believe the anxiety you are experiencing is normal for this situation. Espcially if you weren't prone to anxiety to start with. I believe the idea of coping skills wont actually get rid of the anxiety because you aren't causing it but the idea is it helps you adding second fear on top of it. Easier said than done believe me. I struggle with this a lot. See if you can just see thoughts as words. They arent you they are literally just words. Sometimes thoughts are pictures but thsts all it is a picture in your mind it's not really happening. And things like a racing hard can you just observe it. Can you see its a sensation in the body and nothing else. I know its all very hard. I struggle to practice what i preach. 

In regards to the medication and taper you need not make rash decisions. You need to follow this through sensibly.

Good luck 

[Doctorsrcrap]

How's it going?

[Altostrata]

On 1/21/2023 at 10:16 PM, dangerous7 said:

After the Etizolam, I feel better for 2-3 hours and then same feelings are back.

 

This is because you are physically dependent on etizolam and experiencing benzo withdrawal between doses.

 

Interestingly, you chose to deal with this by increasing vortioxetine.

[Sinanz]

On 5/20/2022 at 7:09 PM, dangerous7 said:

Hello friends,

I started on-demand Clomipramine & Tramadol for severe PE(premature ejaculation) about 6 years back. Worked very well for PE. As lockdown happened, gradually increased the dose and frequency. Stopped cold
turkey in mid-April 2022. Now have broken sleep and diagnosed with mild/moderate sleep apnea. I find myself waking up a lot from dreams and find myself not breathing. Sleep apnea AHI is 10 in a level-4 sleep study and AHI is 14 in a level-3 sleep study. Also now have anxiety about broken sleep and "getting back to normal fast". After going cold turkey off Clomipramine and Tramadol, I developed broken sleep (waking up from dreams not breathing) and gradually developed anxiety about "getting back to normal". Currently, I seem to be stuck in fight/flight mode and have most of the symptoms of Adrenal Fatigue syndrome. While working on the computer, I frequently 'forget' to breathe and then suddenly realize that I need to breathe. I think the same thing is happening while sleeping. Started CPAP about 3 weeks back for sleep apnea. Seemed to have about 10%. Now that I think about it, the sleep issues started around the same time I started Clomipramine and Tramadol. However, I was functioning 'normally' by sleeping late and taking an afternoon nap.

 

Now, I have been taking Amytriptaline for 8 days for insomnia and anxiety

 

Day 1 & 2: 25mg
Day 3-7:   50mg
Day 8:     35mg (started tapering)

 

The psychiatrist wants me to increase Amytriptaline to 75mg and added Clonazepam but the neurologist asked me to stop Amytriptaline as I have sleep apnea. I want to get off all psychiatric medicines. Planning to manage my insomnia using Melatonin/on-demand Alprazolam/Zolpidem. 

 

How do I taper Amytriptaline down to 0? I have tablets of 25mg and 10mg size. 

 

Since I took Amytriptaline for a week, can I just stop cold-turkey?

 

Supplements (after dinner):
- Multivit/Multimineral
- Calcium carbonate 500mg
- Vit K2
- Magnesium 500mg
- Selenium 200mg
- Ashwagandha 
- N-Acetyl Cysteine (NAC)
- Vit C
- Zinc 25mg (added recently)
- vegan omega-3

 

Pulse stays high a lot even at rest. Blood pressure stays 130-140/90-95.

 

Doing Intermittent fasting/OMAD (one meal a day). Feel good after tea/coffee. Have 3 cups daily.

 

Age: 42

 

Thanks for reading.

 

PS: Will add more details shortly.
 

Hello dangerous7 I think Magnesium is caused your apnea I had it too when eat food include of high magnesium or magnesium pill and magnesium cause my nervous system on fire and rev my symptoms include breathing , vatamines :b6,b12,D,C and sugar revs symptoms if you take more than your body needs. 

[dangerous7]

Would like to start with a big thanks to this wonderful group, reading the posts here has given me some hope on the darkest days of despair.

In Dec 2022, On the recommendation of my psychologist, I went to another psychiatrist to get my 'suidical ideation' checked out. The new psychiatrist made me CT three of my ongoing medicines and switch to 3 new drugs:

- Switched out Clonazepam (medium half-life) to Etizolam (short half-life = 3.5 hours)
- Switched out Olanzapine to Quetiapine
- Switched out Fluoxetine to Vortioxetine

 

I was admitted in psych ward from end of Jan to Feb end as I had extreme anxiety and suicidal ideation. doctor started me on venlafaxine 37.5 mg  for 18 days but no relief in anxiety and I had myoclonic jerks(upto 100 at a time) while lying down. Eventually started on clomipramine since the SNRI didnt help me at all(just like the SSRI last year)

Got 40 sessions of rTMS while in the hospital to help with the ocd and depression symptoms, no help at all

 

I was discharged with a prescription of:
- Etizolam 2mg/day
- Clomipramine 25mg/day
- Olanzapine 5mg/day

I had lesser anxiety upon getting back home but the depression was still quite unbearable. Following are the drug changes since then.

March:
- Etizolam 2mg daily (split into 1.5mg CR + 0.5 mg) ,began doctor assisted tapers of etizolam 
    04 March(12% reduction from 2mg to    1.75mg and 20 days hold)
    25 March(14% reduction from 1.75mg to 1.5mg and 20 days hold)
- Clomipramine 25mg upped to 37.5mg(11 march)
- Olanzapine 5mg

April:
- Etizolam 1.5mg daily , two tapers this month
    15 april(8% reduction from 1.5mg to 1.275mg, 9 days hold) 
    24 april(9% reduction from 1.275mg to 1.25mg, 9 days hold)  
- Clomipramine 37.5mg upped to 43.75mg(6 april)
- Olanzipine 5mg

May:
- Etizolam 1.25mg daily, one taper this month
    3 may(10% reduction from 1.25mg to 1.125 mg, 57 day hold)
- Clomipramine 43.75mg 
    13 may(upped from 43.75mg to 50mg)
- Olanzipine 5mg divided into 2 doses of 2.5mg each
    27 may(12% reduction from 5mg to 4.375mg), severe withdrawal for about three weeks.it felt like all of the etizolam reductions and single olanzapine reduction hit me like a brick)

June:
- Etizolam 1.125mg(taken as 0.125mg once and 0.25mg four times a day), 
    one taper this month
    27 june(5% reduction from 1.125 to 1.06mg, 7 days hold)
- Clomipramine 50mg
- Olanzipine 3.382 split into 2 doses (morning 0.625mg & evening 2.5mg)

July:
- Etizolam 1.06mg
    5 July(5% reduction from 1.06 mg to 1mg, 20 days hold)
    26 July(6% reduction from 1mg to 0.94mg, 9 days hold)
- Clomipramine 50mg divided into 2 doses (morning & evening)
    31 july(5% reduction to 47.5mg, taken in two doses, 25gm morning and 22.5mg evening)
- Olanzipine 3.9mg split into 2 doses (morning 1.4mg & evening 2.5mg)
    26 july(5% reduction to 3.75mg)

Aug:
Due to intra dose withdrawal of etizolam(which i had managed somehow with olanzapine and clomipramine combo), doctor prescribed 5gm valium
along with 0.75mg etizolam. I took valium 2.5mg(and not 5mg) for three nights starting 08/01 and could not go to work due to excessive sedation in morning.
went to Etizolam 0.875mg after stopping Valium completely
- Etizolam 0.94mg
    4 aug(7% reduction from 0.94mg to 0.875mg, 10 days hold)
    14 aug(7.2% reduction from 0.875 to 0.812 mg, 7 days hold)
    21 aug(8% reduction from 0.812mg to 0.75mg)
- Clomipramine 47.5mg divided into 2 doses (morning & evening)
    8 aug(6% reduction from 47.5mg to 44.65mg, 13 days hold)
    21 aug(6% reduction from 44.65mg to 42.41mg, 7 days hold)
    28 aug(2.5% reduction from 42.41mg to 41.35mg)
- olanzapine 3.75mg
    8 aug(5% reduction from 3.75mg to 3.56mg, 14 days hold)
    20 aug(5% reduction from 3.56mg to 3.38mg, 8 days hold)
    28 aug(2.5% reduction from 3.38mg to 3.29mg, 8 days hold)

Sep:
added valium back since either due to fast taper of etizolam or all of the previous withdrawals adding up, I became too anxious and couldnt manage the intra dose withdrawal. Depression never left my side in middle of all this. I tapered Etizolam faster for getting some break from the deep depression(possibly due to high dose of etizolam?)
- Etizolam 0.625mg (0.125mg taken 5 times a day every 2 hours) + valium 1.25mg taken at night
- Clomipramine 41.35mg divided into 2 doses (25mg morning & 17.35mg)
- Olanzipine 3.29 split into 2 doses (0.79mg morning & 2.5mg evening)

 

I am suspecting that being on benzo for a year has caused depression. These days, I don't feel like doing anything or enjoy the company of my family members or anyone else. Nothing feels good. I sleep/lie in bed for hours to escape life. Sometimes, I find myself staring at the computer screen (not doing anything). My pdoc wants to increase Clomipramine to 62.5mg/day from 50mg/day but I am not doing it hoping that reducing the benzo will relieve the depression. Passing each day is a challenge, to say the least. My life situation is very good - loving family, good finances, well-paying job but I still feel sad for a large part of the day.

Now, I have many symptoms; not sure which ones are from my original disease vs which ones is caused by my meds over the last 1 year vs which ones are due to withdrawal:
- Anxiety/Panic/Fear. Continuous/Repeated thoughts of "How will I spend my day; I am feeling anxious/depressed/bad now; I will continue to feel this way." Start getting very restless/panicky just thinking these thoughts continuously. Is it akathisia? When anxiety reduces (probably due to Etizolam), then I get bad depression. Depression reduces when anxiety peaks. I have never had a panic attack.
- Depression, 
- Anhedonia - nothing feels good/no one feels good
- Feeling of meaninglessness of any action (what's the point? I am always going to be like this)
- Confused thinking (not sure what exactly I have been feeling...
- Fatigue/Tiredness (most probably due to the drugs) - To get out of depression, I am supposed to do things like go for a walk/ gym/ swimming/ something physical but difficult to do  these due to fatigue and tiredness.
- Very little motivation (somehow holding a job)
- Fear of forgetting context while speaking (short-term memory messed up) - bad benzo brain (brain damage?). Fear of driving discussions/ or do impromptu whiteboarding at work. Sometimes blank out while talking to someone in office: I need help about x and <blank out> .... and y (remember after some time)
- Deep depression
- Feel like crying sometimes but unable to cry. Felt like spontaneously crying while playing tennis with wife and kids the other day.
- Big pot belly. Gained about 20 pounds in last few months (most probably due to Olanzapine & Clomipramine)
- Low to non-existent libido
- Blunted emotions; Very difficult to cry. Feel distant from family members and friends. Developing a kind of don't-care attitude towards them
- Having difficulty making emotional connection with people. Can it be caused by Antidepressant/Antisychotic? Don't feel like calling any friend/relative on the phone or meeting anyone but when I do call them/meet them (usually arranged by my wife), I do enjoy the talk/meetup somewhat.
- Hyper-awareness (almost a pang of fear) of some words that I read/hear(like thief/police/theft/disclosure/income tax/cheating/record/arrest/alert/audit/Ministry of Defence/security point/ tax liability/sue/tax return/fraud/fraudster/impersonating/surveillance/camera/government/police/monitoring/thief/theft... - anything that signifies power/authority/persecution) or see cctv cameras
- Hyper-awareness of seeing people coming towards me or walking outside or laughing (Triggers thoughts like: Are they laughing at me? Do they know about my condition? Can they tell that I am a mental patient?)
- Generalized fear of not sure what (especially of security guards/soldiers in army/commando uniform AND of seeing a group of people together OR someone shouting outside my house)
- Almost akathisia like panic/restlessness. Anxiety has gone up recently. Extremely high. Extremely restless. Almost like akathisia. No physical symptom. Just in the mind. Almost feels like I have benzo withdrawal. I feel I have many symptoms of benzo withdrawal like generalized fear, high anxiety, background thoughts, difficulty concentrating...
- Avoidance going out (due to fear?)
- Background thoughts
- Difficulty concentrating/learning/focusing on my work due to background thoughts. I am a software engineer and need to concentrate/focus while writing/reading code.
- music that I used to love in college doesn't feel that good.
- urge to always eat something sweet/drink tea/coffee or else I start feeling low/down. Seem to need something external to keep me afloat.
- Don't feel like going out of the house.
- Don't have anything to look forward to.
- I am running out of things to talk about (could be due to brain damage?) - Either I don't have anything to talk about or I don't care about finding interesting things to talk about :-(
- Strange confusion sometimes - not sure how to describe (brain damage?)

- Basically, I am not stable or at peace most of the day.

 

Out of desperation to temporarily fix depression, I had tried:

- Tramadol 50/100mg on and off for a couple of weeks in March
- Bupropion 150mg for 5 days in July
- Modafinil 25mg/50mg/100mg/200mg for 4-5 days

over the last few months. I felt that Tramadol had an anti-depressant effect which gave me good focus for few hours. Regarding Modafinil, I felt that it had an anti-depressant effect the first day or two I took it but it didn't last.

 

I have been watching Youtube videos and reading books of Dr. Robert Whitaker, Peter Breggin, Dr Witt Doerring, Dr Joanna Moncrieff, Dr Daniel Amen and a few others and have now decided that I want to taper off all psychiatric drugs. I have finally concluded that psychotropic medicines are not for me.

 

Which one of should I taper first henceforth - Etizolam/Clomipramine/Olanzapine?

 

I have an intuition that one or more of my current drugs are causing deep depression. So, I want to get off these drugs ASAP. My wife feels that I should do a slow taper.

This is a case study of a girl in Japan who was a long-term user of 5mg Etizolam per day:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4149439/

She was tapered at 0.3mg/week. Do you think I can follow a similar schedule? Basically, I will be going from 1mg to 0mg in a 4 weeks.

 

Maybe, I am having intra-dose withdrawal between Etizolam during day time and at night - my last dose is around 7-8pm and first dose of the day is around 8-10am.

 

I do get small windows here and there but they don't last and then followed by deep/high waves.

 

Thanks for your help!

 

PS: Can you help me change the title of my thread to:

Tapering off Etizolam (benzo) + Clomipramine (anti-depressant) + Olanzapine (anti-psychotic) after 1-year polypharmacy and multiple cold-turkeys

 

[Altostrata]

@dangerous7 It's been a long 7 months, hasn't it?

 

Are you still trying to treat your symptoms by changing your drugs and adding others?

 

I can't quite follow what you're asking now. You've changed up your cocktail, now you want to know what to taper in the new batch?

 

Exactly what are you taking now? At what times o'clock do you take your drugs, with their dosages? 

 

On 9/4/2023 at 8:16 AM, dangerous7 said:

- Difficulty concentrating/learning/focusing on my work due to background thoughts. I am a software engineer and need to concentrate/focus while writing/reading code.

 

I'm surprised you're still working.

 

On 9/4/2023 at 8:16 AM, dangerous7 said:

PS: Can you help me change the title of my thread to:

Tapering off Etizolam (benzo) + Clomipramine (anti-depressant) + Olanzapine (anti-psychotic) after 1-year polypharmacy and multiple cold-turkeys

 

Sorry, with the many changes in your cocktail, this would be pointless. We generally do not change topic titles.

[dangerous7]

Thanks for responding, @Altostrata

 

>> Are you still trying to treat your symptoms by changing your drugs and adding others?

No. I have been watching videos and also reading books of Dr. Robert Whitaker, Peter Breggin, Dr Witt Doerring, Dr Joanna Moncrieff, Dr Daniel Amen and a few others and have now decided that I want to taper off all psychiatric drugs. I have finally concluded that psychotropic medicines are not for me. I request guidance with day to day functioning to somehow hold on to my job and be there for my children.

 

>> I can't quite follow what you're asking now. You've changed up your cocktail, now you want to know what to taper in the new batch?

Yes, I want guidance on tapering all the meds. Which one should I taper first?
Do you suggest doing a Etizolam -> Valium crossover and then Valium taper? Etizolam has a half-life of 3.5 hours.
I need some guidance to get relief for my symptoms mentioned in my previous post.

Do you think I have benzo tolerance/withdrawal?

 

>> Exactly what are you taking now? At what times o'clock do you take your drugs, with their dosages? 

- Etizolam(0.125mg five times a day, at 9:00am ,11:00am, 1:00pm, 3:00pm and 5:00pm)

- Valium(1.25mg at 9:00pm)

- Clomipramine(25mg at 10:00 am and 17.35mg at 12:00pm)

- Olanzapine(0.79mg at 10:00am and 2.5mg at 9pm)

 

>> I'm surprised you're still working.

I lost my job in February this year while I was in the psych ward. Got another one in July. But, I, for sure, am not performing at peak performance.

 

If you change the title of my thread to "Tapering off Etizolam + Valium (benzo) + Clomipramine (anti-depressant) + Olanzapine (anti-psychotic) after 1-year polypharmacy and multiple cold-turkeys", I might get folks who are on Clomipramine/Olanzapine/ Etizolam/Valium to look at my thread. The current title "Tapering Etizolam ..." is obsolete.

Thanks for your help & time.
 

[Altostrata]

This is what you were taking a year ago.

 

On 8/24/2022 at 2:57 AM, dangerous7 said:

Thanks for responding 🙂

---

10 am Omega-3 supplement(sometimes)

11 am Nexito(5 mg) [escitalopram]

 

9 pm Magnesium (400 or 600 mg alternate days)

         Melatonin(6 mg)

         Gaba(500 mg or 1000 mg sometimes)

         Calcium(500 mg sometimes)

         Levocetrizine(5 mg) and Montelukast(10 mg) for asthma

         B-complex tablet(sometimes)

         

Currently on Augmentin(625 mg) [amoxicillin and clavulanate] for past 2 days(due to cold which lasted for a long time)

         

Between 3-5am Clonazepam(0.25 mg) 

to finish my sleep, I get 2-3 hours without it 

 

This is your current batch of drugs.

 

7 hours ago, dangerous7 said:

- Etizolam(0.125mg five times a day, at 9:00am ,11:00am, 1:00pm, 3:00pm and 5:00pm)

- Valium(1.25mg at 9:00pm)

- Clomipramine(25mg at 10:00 am and 17.35mg at 12:00pm)

- Olanzapine(0.79mg at 10:00am and 2.5mg at 9pm)

 

I do not see an overall reduction of your drugs. What symptoms have you been chasing?

 

Sorry, no topic title changes. I assure you that people will be able to find you by searching for your drugs.

[dangerous7]

Hello Altostrata,

 

> I do not see an overall reduction of your drugs.

 

Compared to last year, I am on more drugs. However, compared to Feb of this year, I am on lesser meds.

The reduction started a some time after I was discharged from psych ward around March this year.

 

Drugs at the time of discharge:

Clomipramine 25mg, Olanzapine 5mg, Etizolam 2mg

 

Drugs after a few months of discharge:

Clomipramine gradually increased to 50mg (for treatment-resistant depression) & Etizolam slowly tapered to .75mg

 

Drugs now:

Clomipramine 42.5mg, Olanzapine 3.38mg, Etizolam .625mg, Valium 1.25mg (switched .125mg Etizolam to Valium 1.25mg due to extreme anxiety during the day)

 

> What symptoms have you been chasing?

 

Now, I have many symptoms; not sure which ones are from my original disease vs which ones is caused by my meds over the last 1 year vs which ones are due to withdrawal:

 

- Anxiety/Panic/Fear. Continuous/Repeated thoughts of "How will I spend my day; I am feeling anxious/depressed/bad now; I will continue to feel this way." Start getting very restless/panicky just thinking these thoughts continuously. Is it akathisia? When anxiety reduces (probably due to Etizolam), then I get bad depression. Depression reduces when anxiety peaks. I have never had a panic attack.
- Anhedonia - nothing feels good/no one feels good
- Feeling of meaninglessness of any action (what's the point? I am always going to be like this)
- Confused thinking (not sure what exactly I have been feeling...
- Fatigue/Tiredness (most probably due to the drugs) - To get out of depression, I am supposed to do things like go for a walk/ gym/ swimming/ something physical but difficult to do these due to fatigue, tiredness & fear.
- Very little motivation (somehow holding a job)
- Fear of forgetting context while speaking (short-term memory messed up) - bad benzo brain (brain damage?). Fear of driving discussions/ or do impromptu whiteboarding at work. Sometimes blank out while talking to someone in office: I need help about x and <blank out> .... and y (remember after some time)
- Deep depression
- Feel like crying sometimes but unable to cry fully.
- Big pot belly. Gained about 20 pounds in last few months (most probably due to Olanzapine & Clomipramine)
- Low to non-existent libido
- Blunted emotions; Very difficult to cry. Feel distant from family members and friends. Developing a kind of don't-care attitude towards them
- Having difficulty making emotional connection with people. Can it be caused by Antidepressant/Antisychotic? Don't feel like calling any friend/relative on the phone or meeting anyone but when I do call them/meet them (usually arranged by my wife), I do enjoy the talk/meetup somewhat.
- Hyper-awareness (almost a pang of fear) of some words that I read/hear(like thief/police/theft/disclosure/income tax/cheating/record/arrest/alert/audit/Ministry of Defence/security point/ tax liability/sue/tax return/fraud/fraudster/impersonating/surveillance/camera/government/police/monitoring/thief/theft... - anything that signifies power/authority/persecution) or see cctv cameras
- Hyper-awareness of seeing people coming towards me or walking outside or laughing (Triggers thoughts like: Are they laughing at me? Do they know about my condition? Can they tell that I am a mental patient?)
- Generalized fear of not sure what (especially of security guards/soldiers in army/commando uniform AND of seeing a group of people together OR someone shouting outside my house)
- Almost akathisia like panic/restlessness. Anxiety has gone up recently. Extremely high. Extremely restless. Almost like akathisia. No physical symptom. Just in the mind. Almost feels like I have benzo withdrawal. I feel I have many symptoms of benzo withdrawal like generalized fear, high anxiety, background thoughts, difficulty concentrating...
- Avoidance going out (due to generalized fear?)
- Background thoughts about not being well OR how will I taper off the 4 drugs.
- Difficulty concentrating/learning/focusing on my work due to background thoughts. I am a software engineer and need to concentrate/focus while writing/reading code.
- music that I used to love in college doesn't feel that good.
- Urge to always eat something sweet/drink tea/coffee or else I start feeling low/down. Seem to need something external to keep me afloat.
- Don't feel like going out of the house.
- Don't have anything to look forward to.
- I am running out of things to talk about (could be due to brain damage?) - Either I don't have anything to talk about or I don't care about finding interesting things to talk about :-(
- Strange confusion sometimes - not sure how to describe (brain damage?)

 

Basically, I am not stable or at peace most of the day.

 

As I am on benzo for 1+ year now, is my GABA system dysregulated and contributing to generalized fear. What do you think?

 

I would appreciate some guidance to get relief for my symptoms.

 

Thank you for your time!

[Altostrata]

What symptom have you been chasing with all these drugs and drug changes?

 

Highly likely none of your current symptoms are due to withdrawal, as they probably are adverse effects of your absurd drug cocktail:

 

On 9/8/2023 at 10:50 AM, dangerous7 said:

- Etizolam(0.125mg five times a day, at 9:00am ,11:00am, 1:00pm, 3:00pm and 5:00pm)

- Valium(1.25mg at 9:00pm)

- Clomipramine(25mg at 10:00 am and 17.35mg at 12:00pm)

- Olanzapine(0.79mg at 10:00am and 2.5mg at 9pm)

 

[dangerous7]

> Highly likely none of your current symptoms are due to withdrawal, as they probably are adverse effects of your absurd drug cocktail:

OK.

 

I am thinking of doing a valium crossover taper. That is why I replaced the night time Etizolam .125mg with Valium 1.25mg. I am trying to figure out if I should do a valium taper or not as there is little information about Etizolam here.

 

Out of the Etizolam+Valium/Clomipramine/Olanzapine, which one would you recommend that I taper first?

 

Also, I need some guidance to get relief for my symptoms mentioned in my previous post.

 

Thanks for your help and time.

[Altostrata]

3 hours ago, dangerous7 said:

Also, I need some guidance to get relief for my symptoms mentioned in my previous post.

 

You're taking too much of everything, and your "akathisia" is a paradoxical reaction.

 

You could reduce almost anything and be better off. 

 

3 hours ago, dangerous7 said:

I am thinking of doing a valium crossover taper.

 

From your history, it's pretty obvious that you and your doctors have been continually creative in adding, switching, adjusting, and reducing your drugs.

 

It appears you are still very much devoted to this. You have been making your own problems. We're only a peer support group, we cannot stop people from doing this, and it's very frustrating for us when people come back here over and over on new cocktails.

 

I hope you understand, your problems are beyond what we can do for you as peer support. 

[dangerous7]

Thanks @Altostrata.

 

> From your history, it's pretty obvious that you and your doctors have been continually creative in adding, switching, adjusting, and reducing your drugs. It appears you are still very much devoted to this.

 

I can understand why it looks that way. After I got admitted to the psych ward in Feb (due to extremely high anxiety and SI), I 'had' to take their new combo while being inpatient which is what I have been for last ~6 months. I have been gradually tapering all three drugs. 10 days back, I have started Valium cross-taper. Some months back, I had decided that I want to taper off all psychiatric drugs.I have tried SSRI/SNRI/TCA/Vortioxetine/... and none of the meds helped me and not willing to try MAOI inhibitor. I have finally concluded that psychotropic medicines are not for me as I don't seem to be getting better on the new cocktail or any of my previous cocktail.

 

> You're taking too much of everything, and your "akathisia" is a paradoxical reaction. You could reduce almost anything and be better off. 

Ok. That is what I need guidance on. Which ones should I reduce; by how much and in which order? Currently, I am doing 2.5%/week reduction of Clomipramine and Olanzapine.

 

Do you think it is prudent to try a valium cross taper from .75mg/day of Etizolam which has a short half-life? My wife says that I should taper Etizolam more to a lower daily dose and then switch to Valium. I am not finding much information about Etizolam here. Most of the commonly prescribed benzos have a longer half life.

 

Thanks for your support!

[Altostrata]

8 hours ago, dangerous7 said:

Which ones should I reduce; by how much and in which order? Currently, I am doing 2.5%/week reduction of Clomipramine and Olanzapine.

 

8 hours ago, dangerous7 said:

Do you think it is prudent to try a valium cross taper from .75mg/day of Etizolam which has a short half-life?

 

We have advised you to change only one drug at a time.

 

We have advised you not to do unnecessary drug switches.

 

You're continuing to mix up your own cocktail and make your own drug adjustment schedule, which you've done for over a year. There really is no point in your getting opinions from peer counselors. Your situation is too complex for peer support. Good luck.

[Doctorsrcrap]

I'm not a mod but the general rule for you to follow which you should know by this point. 

. Only make one change at a time, do not taper 2 drugs together. 

. Taper the most activating drug first 

. Keep the most calming drug till last because this will preserve sleep

. If you have done a crossover you would need a hold period first so your body adjust to yet another change 

 

But as I say. I'm not a mod but thought these were the general rules you can use if you wish to follow them 

[dangerous7]

Thanks @Altostrata & @Doctorsrcrap.

 

Is the general guidance to taper AP, then AD, then benzo, in that order? So, is this the right order of tapering:

- Olanzapine

- Clomipramine

- Etizolam + Valium?

 

Any tips to deal with mental akathisia and deep depression?

 

Really appreciate your help and advice.

[Altostrata]

I cannot even begin to address your cocktail or what you should taper first. Your guess is as good as anyone else's. It's beyond our abilities here.

[dangerous7]

Any non-drug techniques/tips/helpful links to deal with deep depression?

[littlebird]

2 hours ago, dangerous7 said:

Any non-drug techniques/tips/helpful links to deal with deep depression?

The stuff that's hardest to do when you're depressed tends to be helpful: getting outside, going for a walk, gardening, socializing with emotionally safe people, volunteering. Working on making your self-talk more positive and compassionate can be a game-changer too.

 

I rarely have taken benzos like Valium, but they consistently have made depression worse for me. Maybe that's adding to yours too?

[dangerous7]

I am feeling very sad from inside (automatically; almost like some chemicals in the brain are out of balance) without any trigger just walking around the house or brushing my teeth and feel like crying. It is getting difficult to hide my crying face from  my kids. I am not comfortable to go outside the house as I see security guards/folks in uniforms/other people and that gives me fear. Any tips to manage this? My wife is saying that I tapered Etizolam too fast - 20% reduction in 1 month and 10% replaced by Valium - so a total of 30% benzo reduction in a month.

[Altostrata]

You're still taking that complicated cocktail of drugs that may have an adverse effect of depression?