Untethered: Delayed withdrawal from Lexapro or benzo tolerance?

[Untethered]

Last summer (July 2021), I had issues with renewing my Lexapro. As my signature shows, I’ve been on it since 2008. I naively decided to just stop taking it cold turkey. At the time, I was working extremely long hours, so I thought that my mood swings and crying were due to stress and fatigue. To deal with the stress, I occasionally started taking a second dose of alprazolam (I had been taking 0.25 in the am only until that point). I didn’t give it another thought. I had some depression for a few months, but I’ve struggled with depression since I was 16, so it was nothing new. I carried on. The main things I noticed once off the Lex were that I no longer had a voracious appetite, and that I actually ended up feeling a bit less depressed. I started feeling better, so I stopped taking the second dose of alprazolam unless it was really needed for anxiety. 
 

All hell broke lose Dec-Feb. In December, I had a recurring UTI.
At the end of January, I developed the following symptoms, that progressively got worse:

• intense head pressure
• stiff neck and shoulders
• fullness in ears
• occasionall tinnitus
• occasionall vertigo
• severe TMJ

 

The head pressure was the worst. It felt like my brain was being squeezed out of my skull. I went to emerg and was told it was a tension headache. I’m also in perimenopause, so my mood swings were attributed to that. 
 

Needless to say, I thought something was severely wrong with me and my anxiety ramped up. I once again started taking a second dose of alprazolam. It didn’t do much, but it helped me relax a little bit and not worry so much that I had a brain tumour or something. (I recently had an MRI and it came back normal). 

I started researching, and my symptoms seemed to align with benzo tolerance. I started to taper the alprazolam on my own. I had a very bad reaction to cutting my pm dose from 0.25 to 0.125, so I was advised to go back to 0.25 twice daily (I never stopped taking 0.25 in the am) in order to “stabilize”.  Against my better judgment, I did so. Unfortunately, I had maybe 2 days where I felt almost normal, but then it was like I had hit a wall. The benzo takes the edge off slightly, but I feel sick most of the time. I could barely keep my head upright and needed to lie down constantly. The 2 hours before my second dose were the worst. This is what is known as interdose withdrawal. Because of this, I was advised to follow the Ashton method and crossover to diazepam, as it is longer acting. I am currently doing this. It is extremely difficult and my only peace is the 5 hours of sleep I get a night. It does help with the interdose withdrawal somewhat, but I definitely feel the decrease of the alpraz. 
 

Now I’m wondering if my cold turkey from escitalopram (Lexapro) is the root of everything. I didn’t make the connection before. Why, I dont know. Obviously, I still intend to taper off the alprazolam, but is it possible that I foolishly did this to myself?

 

1. Can it take months for severe withdrawal symptoms to appear?
2. Did I do damage to my brain by this cold turkey? 
3. Is it possible that my being on Wellbutrin and alprazolam helped “cushion” the withdrawal?
4. Is my benzo taper going to be more difficult because of it?
5. Would reinstating the Lexapro after all this time help? My Dr has suggested it

 

I have other questions, such as how to taper the Wellbutrin when it’s an XL, but I want to focus on the other stuff first. 

 

I’m scared and angry at myself for what I’ve done. I can’t change it, so am looking for insight and support. 
 

Thank you for reading. 

 

 

 

[Untethered]

2nd topic:  Untethered: Delayed withdrawal from Lexapro or Benzo tolerance?

 

Last summer (July 2021), I had issues with renewing my Lexapro. As my signature shows, I’ve been on it since 2008. I naively decided to just stop taking it cold turkey. At the time, I was working extremely long hours, so I thought that my mood swings and crying were due to stress and fatigue. To deal with the stress, I occasionally started taking a second dose of alprazolam (I had been taking 0.25 in the am only until that point). I didn’t give it another thought. I had some depression for a few months, but I’ve struggled with depression since I was 16, so it was nothing new. I carried on. The main things I noticed once off the Lex were that I no longer had a voracious appetite, and that I actually ended up feeling a bit less depressed. I started feeling better, so I stopped taking the second dose of alprazolam unless it was really needed for anxiety. 
 

All hell broke lose Dec-Feb. In December, I had a recurring UTI.
At the end of January, I developed the following symptoms, that progressively got worse:

• intense head pressure
• stiff neck and shoulders
• fullness in ears
• occasionall tinnitus
• occasionall vertigo
• severe TMJ

 

The head pressure was the worst. It felt like my brain was being squeezed out of my skull. I went to emerg and was told it was a tension headache. I’m also in perimenopause, so my mood swings were attributed to that. 
 

Needless to say, I thought something was severely wrong with me and my anxiety ramped up. I once again started taking a second dose of alprazolam. It didn’t do much, but it helped me relax a little bit and not worry so much that I had a brain tumour or something. (I recently had an MRI and it came back normal). 

I started researching, and my symptoms seemed to align with benzo tolerance. I started to taper the alprazolam on my own. I had a very bad reaction to cutting my pm dose from 0.25 to 0.125, so I was advised to go back to 0.25 twice daily (I never stopped taking 0.25 in the am) in order to “stabilize”.  Against my better judgment, I did so. Unfortunately, I had maybe 2 days where I felt almost normal, but then it was like I had hit a wall. The benzo takes the edge off slightly, but I feel sick most of the time. I could barely keep my head upright and needed to lie down constantly. The 2 hours before my second dose were the worst. Because of this, I was advised to follow the Ashton method and crossover to diazepam, as it is longer acting. I am currently doing this. It is extremely difficult and my only peace is the 5 hours of sleep I get a night. It does help with the interdose withdrawal somewhat, but I definitely feel the decrease of the alpraz. 
 

Now I’m wondering if my cold turkey from escitalopram (Lexapro) is the root of everything. I didn’t make the connection before. Why, I dont know. Obviously, I still intend to taper off the alprazolam, but is it possible that I foolishly did this to myself?

 

1. Can it take months for severe withdrawal symptoms to appear?
2. Did I do damage to my brain by this cold turkey? 
3. Is it possible that my being on Wellbutrin and alprazolam helped “cushion” the withdrawal?
4. Is my benzo taper going to be more difficult because of it?
5. Would reinstating the Lexapro after all this time help? My Dr has suggested it

 

I have other questions, such as how to taper the Wellbutrin when it’s an XL, but I want to focus on the other stuff first. 

 

I’m scared and angry at myself for what I’ve done. I can’t change it, so am looking for insight and support. 
 

Thank you for reading. 

 

Edited June 7, 2022 by ChessieCat
added Intro topic title before merging with intro topic

[Altostrata]

Welcome, @Untethered

 

Please stop changing any drug dosage for now. What has been your benzo schedule for the last few months, with times o'clock and dosages?

 

When did you start diazepam?

[Untethered]

13 hours ago, Altostrata said:

Welcome, @Untethered

 

Please stop changing any drug dosage for now. What has been your benzo schedule for the last few months, with times o'clock and dosages?

 

When did you start diazepam?j

 

My benzo schedule (alprazolam) the last few months:

Jan - March: 0.25 x 6am, sporadic use of 0.25 4pm

March-April: 0.25x at 6am and 4pm

April 7: Cut 4pm dose to 0.125. About a week later I had a 2 day panic attack, insomnia, etc. Managed to hold this dose for 3 weeks. 
April 28-May 21: Advised to reinstate 4pm 0.125 dose back to 0.25mg. Did so against my better judgment. Had a few days of feeling pretty good but then hit a wall. 
 

I started my crossover to diazepam on May 21.

May 21-June 3: 0.25 alpraz 6am, 0.125 alpraz + 2.5 diazepam at 4pm

June 4-present: 0.125 alpraz + 2.5 diazepam at 6am and 4pm. There is less interdose withdrawal, but symptoms still present. 

 

Additional meds:

I take Wellbutrin 150xl at 6am with my other meds above

i take Seroquel 25mg between 8:30-9pm

 

In regards to stopping changes of meds, my hands are tied. I have committed to tapering off the benzo and don’t have a prescriber willing to prescribe long term. It’s conditional on my getting off of it. The taper schedule is way too fast and I’m not even sure I can get them to slow it down. It’s a really stressful situation. 
 

My Dr recommends reinstating the escitalopram or adding another a/d and I’m scared to do so as my nervous system is shot. 

 

 

[Untethered]

* Sorry for any duplicate posts/responses. I keep getting error message stating site temporarily unavailable and to try again*

 

My benzo schedule (alprazolam) the last few months:

Jan - March: 0.25 x 6am, sporadic use of 0.25 4pm

March-April: 0.25x at 6am and 4pm

April 7: Cut 4pm dose to 0.125. About a week later I had a 2 day panic attack, insomnia, etc. Managed to hold this dose for 3 weeks. 
April 28-May 21: Advised to reinstate 4pm 0.125 dose back to 0.25mg. Did so against my better judgment. Had a few days of feeling pretty good but then hit a wall. 
 

I started my crossover to diazepam on May 21.

May 21-June 3: 0.25 alpraz 6am, 0.125 alpraz + 2.5 diazepam at 4pm

June 4-present: 0.125 alpraz + 2.5 diazepam at 6am and 4pm. There is less interdose withdrawal, but symptoms still present. 

 

Additional meds:

I take Wellbutrin 150xl at 6am with my other meds above

i take Seroquel 25mg between 8:30-9pm

 

In regards to stopping changes of meds, my hands are tied. I have committed to tapering off the benzo and don’t have a prescriber willing to prescribe long term. It’s conditional on my getting off of it. The taper schedule is way too fast and I’m not even sure I can get them to slow it down. It’s a really stressful situation. 
 

My Dr recommends reinstating the escitalopram or adding another a/d and I’m scared to do so as my nervous system is shot. 

 

[Altostrata]

Why did you convert to diazepam? What symptoms are still present? What is your sleep pattern?

 

If you have no control over tapering the benzo, we can't help you with that. 

 

Your symptoms might have been cold turkey of the escitalopram, but since then you've added benzo withdrawal symptoms or other adverse effects. You are also taking other drugs that might be adding adverse effects. Please put ALL your drugs in this Interactions Checker and post the report or a link to it in this topic.

 

By the way, tinnitus can be an adverse effect of bupropion.

 

On 6/10/2022 at 3:41 AM, Untethered said:

My Dr recommends reinstating the escitalopram or adding another a/d and I’m scared to do so as my nervous system is shot. 

 

What symptoms would be addressed by addition of a second antidepressant?

[Untethered]

I converted to the diazepam because it has a longer half life and helps with the interdose withdrawals. I was really suffering between my am and pm alprazolam doses because of the short half life. It’s called the Ashton protocol and is apparently a common method for getting off benzos.
 

My symptoms wax and wane, and some days are better than others. The main ones are the following:

-anxiety

-stiff neck

-sore jaw/TMJ 

-lack of appetite 

-heart palpitations 

-headache 

 

Sleep pattern: Since the last 2 months or so, I’ve been waking up at 4-4:30am daily, so I try and be asleep by 10pm. I figured it’s due to cortisol surges? I typically feel shaky and anxious when I wake up, often with a bit of heart palpitations. 
 

 

Drug interaction:

https://www.drugs.com/interactions-check.php?drug_list=440-2469,1979-1274,862-0,133-0

 

The above indicates several  adverse reactions. I’m particularly worried about the risk of seizures due to the bupropion. I took what my psychiatrist (now retired) prescribed me and didn’t question it. My Dr kept the refills going. Obviously I regret it. If I could go back I would not touch any of theses meds. I’m still in the middle of crossing over to diazepam to replace the alprazolam, so that’s 1 less med soon. 

In my experience, most Dr’s don’t seem to recognize discontinuation syndrome and/or tolerance, and just think that the original condition has returned. I guess she thinks that by reinstating the escitalopram or adding another a/d that it will help stabilize me, particularly the anxiety. If my symptoms are a delayed reaction to my cold turkey, then perhaps they will go away if I reinstated it. My reading has told me that this is not necessarily the case and it could make things worse. 

I have an appt with my Dr on Monday and am hoping to convince her to let me taper the diazepam as slowly as I can. I know you can’t help me with that, but advice from someone knowledgeable in these matters (psych meds)may help me better convince my dr, which is why I’m asking. Especially if I can explain that I’ve already damaged my system from the cold turkey of the escitalopram. Or maybe I can see if I can taper the Wellbutrin first. 
 

I don’t know what to do and am frightened. I guess i thought I could get some advice from people who have gone through this stuff and are more knowledgeable. 
 

Edit: I should add that I initially thought my symptoms were due to benzo tolerance and not the cold turkey off the escitalopram, mainly because they happened 5 months later. This is why I initiated the taper off the benzo. I’m not purposely putting myself through all this. I was ignorant. 

Edited June 12, 2022 by Untethered
To clarify all the med changes.

[Altostrata]

We're very familiar with the Ashton manual.

 

Your symptoms may be from switching benzos, tapering benzos, drug interactions, adverse effects of one of more drugs, or escitalopram cold turkey a year ago. It would not be unusual for your doctor to be completely ignorant of any of these adverse consequences.

 

Seizures are not as likely from your drug combination as tinnitus or vertigo.

 

To understand this, we would need to look carefully at your symptom pattern. Please keep daily notes of times o’clock you take your drugs, their dosages, and your symptoms throughout the day. We need to know how you feel before and after taking each drug, and your symptoms in between. Post 24 hours of notes at a time in this topic, in a simple list format with time o’clock on the left and notation (symptom or drug and dosage) on the right. This can show if your symptoms are adverse effects from one of your drugs.

 

Until this is ascertained, we cannot tell if reinstatement of escitalopram may be beneficial.

[Untethered]

Thanks, Alto. I will start the record of symptoms. 
 

I should clarify that my physical symptoms started before I started tapering/switching benzos. In fact, these symptoms were the reason I started taking a second dose of the alpraz in the first place. No painkillers would help and my anxiety got worse because nobody could tell me why it was happening and it was unrelenting. 
 

That’s interesting about the tinnitus/vertigo connection to bupropion.  They have come and gone for several years now, particularly the vertigo. I have a history of migraines since childhood and it was attributed to perhaps a change to vestibular migraines. 
 

[Altostrata]

You need to research the adverse effects of every drug you take.

[Untethered]

June 12

 

4:30am: woke up, stayed in bed and dozed until 6am

6am: Bupropion Xl150mg, alprazolam 0.125, diazepam 2.5

8:30-9: Decaf coffee

9:15-9:30: Eggs and toast

9:30: minor heart palps, anxiety 

10:30: crying spell, low mood

1:30pm: lunch

2:30pm: feel a bit better 

4pm: 0.125 alprazolam, 2.5 diazepam 

5pm: anxiety

6:45pm: dinner

8:30pm: 25mg Seroquel 

10pm: bed

 

notes: will try cutting out decaf coffee and be more vigilant about recording symptoms and times. 

[Altostrata]

Why are you taking 3 drugs together at 6 a.m., and why both alprazolam and diazepam twice a day?

[Untethered]

10 hours ago, Altostrata said:

Why are you taking 3 drugs together at 6 a.m., and why both alprazolam and diazepam twice a day?

I’ve just always taken all my morning meds at the same time. When I was still on Lexapro, i took that at 6am too. 
 

I am still crossing over from alpraz to diazepam as per Ashton. The goal is to be off the alpraz and then taper the diazepam. Because I’m so sensitive, I’m doing the stepwise crossover rather than immediately switching to the diazepam. 
 

 

[Untethered]

June 13

4am: woke up with minor heart palps, anxiety. Couldn’t go back to sleep 

6am: Bupropion 150 XL, alprazolam 0.125, diazepam 2.5

8am: breakfast, no decaf

10am: anxiety, heart palpitations 

11am: burning scalp, 

1pm: lunch

4pm: alprazolam 0.125, diazepam 2.5

5pm: tense jaw, ear popping

7pm: supper

8:30pm: Seroquel 25mg

10:30pm: bed 

 

notes: bad symptomatic day in general. Stressed and anxious. 

[Altostrata]

7 hours ago, Untethered said:

The goal is to be off the alpraz and then taper the diazepam. Because I’m so sensitive, I’m doing the stepwise crossover rather than immediately switching to the diazepam.

 

What is your plan for this?

 

Please put ALL your drugs in this Interactions Checker and post the report or a link to it in this topic.

[Untethered]

1 hour ago, Altostrata said:

 

What is your plan for this?

 

Please put ALL your drugs in this Interactions Checker and post the report or a link to it in this topic.

I did. I posted the link to the drug interactions in Saturday’s post further up, where I mentioned I was worried about seizures.  Here is the link. If it doesn’t work, let me know and I will copy/paste the results. 

Drug interaction:

https://www.drugs.com/interactions-check.php?drug_list=440-2469,1979-1274,862-0,133-0

My tapering history was posted above as well (on Friday). My plan is to continue to follow the Ashton protocol by substituting the continuing decreasing alpraz with the equivalent dosage of diazepam. I meet with my pharmacist next week, but I assume the next step is to remove one of the alpraz doses and replace it with the equivalent dose of diazepam. So if I’m currently taking 0.125alpraz and 2.5mg diazepam twice daily, I will remove one dose, and take 0.125 alpraz and 2.5mg diazepam in the am and 5mg diazepam in the pm. Then a week or 2 later do the same for the am dose, so that the alpraz is gone and I’m only on diazepam. Once I stabilize on the diazepam, I will start to taper it. 
 

 

 

[Altostrata]

On 6/11/2022 at 6:32 PM, Untethered said:

Drug interaction:

https://www.drugs.com/interactions-check.php?drug_list=440-2469,1979-1274,862-0,133-0

 

Thanks, I missed this. 

 

19 minutes ago, Untethered said:

I meet with my pharmacist next week, but I assume the next step is to remove one of the alpraz doses and replace it with the equivalent dose of diazepam.

 

Is your pharmacist supervising this process? Have you reported your symptoms to this pharmacist?

 

3 hours ago, Untethered said:

June 13

4am: woke up with minor heart palps, anxiety. Couldn’t go back to sleep 

6am: Bupropion 150 XL, alprazolam 0.125, diazepam 2.5

8am: breakfast, no decaf

10am: anxiety, heart palpitations 

11am: burning scalp, 

1pm: lunch

4pm: alprazolam 0.125, diazepam 2.5

5pm: tense jaw, ear popping

7pm: supper

8:30pm: Seroquel 25mg

10:30pm: bed 

 

notes: bad symptomatic day in general. Stressed and anxious. 

 

Generally, we can view psychiatric drugs as "brakes" or "accelerators". You are taking 3 brakes, alprazolam, diazepam, and quetiapine, with one accelerator, bupropion.

 

It makes no sense at all to take a brake with an accelerator. The 3 drugs you take together at 6 a.m. are probably causing the palpitations a couple of hours later via drug-drug interactions (your interactions reports shows several of them) or paradoxical reactions from too many brakes at once.

 

Given brakes are overrepresented in your cocktail, what symptom are they supposed to address?

 

My guess is that you are taking too many brakes and your benzo dosage, in combination is too high.

[Untethered]

19 hours ago, Altostrata said:

 

Thanks, I missed this. 

 

 

Is your pharmacist supervising this process? Have you reported your symptoms to this pharmacist?

 

 

Generally, we can view psychiatric drugs as "brakes" or "accelerators". You are taking 3 brakes, alprazolam, diazepam, and quetiapine, with one accelerator, bupropion.

 

It makes no sense at all to take a brake with an accelerator. The 3 drugs you take together at 6 a.m. are probably causing the palpitations a couple of hours later via drug-drug interactions (your interactions reports shows several of them) or paradoxical reactions from too many brakes at once.

 

Given brakes are overrepresented in your cocktail, what symptom are they supposed to address?

 

My guess is that you are taking too many brakes and your benzo dosage, in combination is too high.

Thanks, Alto. My pharmacist is currently on vacation. Honestly, his solution is always to increase everything. His proposed plan had been to add the diazepam without removing the alprazolam, initially. I took it upon myself to follow Ashton by decreasing the alpraz and adding the corresponding amount as per her (Ashton) schedules. And this is the only person in my city I can find who has actually heard of Ashton. I’ve tried so many avenues and can’t find anyone familiar with ad discontinuation syndrome or safe benzo withdrawal. 
 

My Dr keeps pushing me to reinstate the escitalopram or adding another a/d. 
 

I’m actually wondering if I’m not tolerating the diazepam. I feel like I felt when I was in withdrawal from the alpraz. I would think that the diazepam would have had enough time to build up on my system by now? 
 

I also wonder if the bupropion (accelerator) is increasing my anxiety, especially since it’s no longer being taken in conjunction with the escitalopram. I suspect this is another reason why my Dr is pushing for reinstatement or adding another a/d. 
 

 In regards to your question re: what are brakes supposed to address, I would say anxiety and insomnia. But obviously they are not working. 
 

I realize there are so many variables, that it’s difficult to ascertain. Is it due to my c/t of the escitalopram, or a combo of everything?

 

I’m scared. I’m trying to stay positive, but it’s been difficult. 

[Greatful]

@Untethered

Welcome to SA, so sorry you are going through this...Try not to panic, I know how hard that is. I did it and ended up on a drug merry-go-round.  

You should be proud of yourself,  You made it through a  whole year in WD.  You were less depressed, that's great.  Is your main symptom anxiety right now?  I think you will be okay if you can get your panic down.  

Try not make any rash decsion because of panic. The mod's will try and help.  In the mean time take a look around SA, learn as much as you can about physic drugs, tapering, what ever you can so you can be your own advocate in your health. 

go to the forums section and click on the links that interest you.  

 

Remember you are not alone.  Reach out to others, post on here.  There is a wealth of support and caring people on SA.  We are all trying to come to terms with what happened to us, how we can help ourselves.😊

 

[Altostrata]

Sometimes the diazepam substitution doesn't work. We know Ashton well, but we recommend attempting a direct taper from the first benzo rather than a drug switch, which always carries the risk of inadequate substitution.

 

You'll have to decide whether you want to work out a plan with peer support or follow your pharmacist's plan. If your goal is to get off benzos, "add the diazepam without removing the alprazolam" makes no sense at all.

 

If you are still experiencing withdrawal syndrome from escitalopram cold turkey, reducing the benzo at all is questionable. It could be what's controlling your withdrawal syndrome to some extent. 

 

All together, your drug cocktail indicates your prescribers are throwing "brakes" at your withdrawal syndrome and probably added bupropion to lift your mood without regard to adverse effects of bupropion, which tend to be activation. None of this makes any sense, but we see a lot of that here because prescribers don't know what they're doing.

 

Please keep daily notes of times o’clock you take your drugs, their dosages, and your symptoms throughout the day. We need to know how you feel before and after taking each drug, and your symptoms in between. Post 24 hours of notes at a time in this topic, in a simple list format with time o’clock on the left and notation (symptom or drug and dosage) on the right. This can show if your symptoms are adverse effects from one of your drugs.

 

 

[Untethered]

1 hour ago, Altostrata said:

Sometimes the diazepam substitution doesn't work. We know Ashton well, but we recommend attempting a direct taper from the first benzo rather than a drug switch, which always carries the risk of inadequate substitution.

 

You'll have to decide whether you want to work out a plan with peer support or follow your pharmacist's plan. If your goal is to get off benzos, "add the diazepam without removing the alprazolam" makes no sense at all.

 

If you are still experiencing withdrawal syndrome from escitalopram cold turkey, reducing the benzo at all is questionable. It could be what's controlling your withdrawal syndrome to some extent. 

 

All together, your drug cocktail indicates your prescribers are throwing "brakes" at your withdrawal syndrome and probably added bupropion to lift your mood without regard to adverse effects of bupropion, which tend to be activation. None of this makes any sense, but we see a lot of that here because prescribers don't know what they're doing.

 

Please keep daily notes of times o’clock you take your drugs, their dosages, and your symptoms throughout the day. We need to know how you feel before and after taking each drug, and your symptoms in between. Post 24 hours of notes at a time in this topic, in a simple list format with time o’clock on the left and notation (symptom or drug and dosage) on the right. This can show if your symptoms are adverse effects from one of your drugs.

 

 

I’m stuck because nobody believes that I’m in withdrawal from the escitalopram and nobody wants to continue to prescribe benzos long term so I can do a microtaper. When I mentioned to my dr my concerns about delayed withdrawal, she said it’s not possible. She also said she trusts that the pharmacist knows what he is doing. 
 

I will continue to log. Feeling defeated. 

[Untethered]

@Altostrata is reinstating escitalopram almost a year later an option? I’ve heard mixed things. 
 

Edit: I just checked my previous cocktail in the interaction checker. Jesus. I guess reinstating would be bad? 
https://www.drugs.com/interactions-check.php?drug_list=440-2469,1013-0,133-0,1979-1274

[Altostrata]

You're already taking 4 drugs, you want to add another?

 

You don't have to debate delayed withdrawal with your prescriber, you went off escitalopram cold turkey. That should be enough of a red flag.

 

Do you mean protracted withdrawal?

 

You're already getting a double prescription of benzos. 

 

Need to see those daily notes, your current drug cocktail may be causing a lot of your problems.

 

[Untethered]

6 minutes ago, Altostrata said:

You're already taking 4 drugs, you want to add another?

 

You don't have to debate delayed withdrawal with your prescriber, you went off escitalopram cold turkey. That should be enough of a red flag.

 

Do you mean protracted withdrawal?

 

You're already getting a double prescription of benzos. 

 

Need to see those daily notes, your current drug cocktail may be causing a lot of your problems.

 

No, but if there is a chance that reinstating the Escitalopram can help, I thought it might be an idea. I guess I’m desperate.
 

After seeing the interactions, the bupropion seems to be a major issue. It interacts with everything. I’m already on the lowest dose of the XL. They sure don’t make it easy for people to come off these drugs. 
 

I guess I mean protracted withdrawal, yes. As I mentioned earlier, when I mentioned it to my GP she dismissed it altogether. 

 

Anyhow, thanks for your patience with all my questions and comments. I did 2 days of daily notes, but skipped yesterday. I will get back to it. Thanks again. 

[Untethered]

June 15

4am: woke up, dozed on and off until 6am

6am: Bupropion 150 XL, alprazolam 0.125, diazepam 2.5

9am: breakfast 

1pm: lunch

2pm: headache 

4pm: alprazolam 0.125, diazepam 2.5

6pm: anxiety, heart palpitations

7pm: supper

8pm; a little better, but heart still fluttery 

8:30pm: Seroquel 25mg

10:30pm: bed. 

[Altostrata]

My guess is you are taking too much benzo. A paradoxical reaction to this is what is causing the palpitatons.

 

On 6/10/2022 at 3:37 AM, Untethered said:

I started my crossover to diazepam on May 21.

May 21-June 3: 0.25 alpraz 6am, 0.125 alpraz + 2.5 diazepam at 4pm

June 4-present: 0.125 alpraz + 2.5 diazepam at 6am and 4pm. There is less interdose withdrawal, but symptoms still present. 

 

You took 2.5mg diazepam once a day for 12 days (before you upped it to twice a day, plus the alprazolam). What do you mean by interdose withdrawal in that period?

 

What symptoms are still present?

 

What effect did you feel from the increased diazepam dosage (2.5mg + 2.5mg) with reduction of alprazolam to 0.125mg once a day? You've been taking this for 12 days. How has your symptom pattern changed over the last week?

 

 

[Untethered]

17 hours ago, Altostrata said:

My guess is you are taking too much benzo. A paradoxical reaction to this is what is causing the palpitatons.

 

 

You took 2.5mg diazepam once a day for 12 days (before you upped it to twice a day, plus the alprazolam). What do you mean by interdose withdrawal in that period?

 

What symptoms are still present?

 

What effect did you feel from the increased diazepam dosage (2.5mg + 2.5mg) with reduction of alprazolam to 0.125mg once a day? You've been taking this for 12 days. How has your symptom pattern changed over the last week?

 

 

I honestly don’t know if I’m reacting to the cuts of alprazolam, or if I’m not tolerating the diazepam. I’ve been following the Ashton equivalencies:

 

0.5mg alpraz = 10mg of diazepam 

0.25 alpraz = 5mg of diazepam 

0.125 alpraz = 2.5mg of diazepam 

 

I started at 0.25mg alpraz twice daily which is the equivalent of 10mg diazepam. Each cut of alpraz was replaced with the equivalent amt of diazepam to keep the total equivalency at 10mg until I’m completely switched over to diazepam and then start tapering. 

 

 

What I mean by less interdose withdrawal is that it’s better than when I was on the alpraz only and I was really feeling symptomatic between doses (anxiety, heavy head, no appetite, general malaise). By adding the diazepam, this improved, as it’s longer acting than the alpraz. I’ve been more functional between doses. 
 

My symptoms have been pretty much constant since February 2022. They are all over the map and change daily. For example, last week, before I started charting here,  I had bad TMJ symptoms for several days. Then it just went away. Another day I will have muscle stiffness for a days. The only constant is anxiety. That is pretty much 24/7. 
 

I’ve not been doing great since reducing the am dose of alpraz and adding the equivalent dose of diazepam. I attributed it to the following:

1. I’ve been on the am dose for 8 years. The pm dose has only been a few months. 
2. My body seems to react to the slightest cut of alprazolam. 

3. The diazepam needs more time to build up in my system. 
 

It’s difficult to ascertain my symptom pattern the last week as I’ve been suffering the whole way through, honestly. Even before I added the diazepam. The only new thing was the heart stuff, which seems to be finally gone today. It’s definitely concerning and now I’m scared of what will happen once I completely cut out the alpraz. If I can’t tolerate the diazepam, that means going backwards and tapering from the alpraz again, which was a nightmare and the reason it was suggested I do the Ashton method in the first place. 
 

I will continue to log and look for patterns. My brain is not at its best, but I need to be better and more vigilant. 
 

 

 

[Untethered]

June 16

4am: woke up feeling like heart being lightly squeezed, fluttering. Lasted all day.  

6am: Bupropion 150 XL, alprazolam 0.125, diazepam 2.5

9am: breakfast 

1:30pm: lunch

3pm: anxiety

4pm: alprazolam 0.125, diazepam 2.5

5pm: feel better, heart no longer fluttering 

6pm: jaw a little tense

7pm: supper

8:30pm: Seroquel 25mg

10:30pm: bed. 

[Altostrata]

You felt heart palpitations from 4 a.m. to 5 p.m.? How do you feel before and after taking Seroquel? Need to see more daily notes.

[Untethered]

18 minutes ago, Altostrata said:

You felt heart palpitations from 4 a.m. to 5 p.m.? How do you feel before and after taking Seroquel? Need to see more daily notes.

Ok. Will buy an hourly planner so I can be more detailed.
 

I’ve been on Seroquel for years and feel fine after taking it. It’s probably the only thing helping me sleep at this point (I know this is bad but sleep is a small mercy). Perhaps it’s interacting with the diazepam.  
 

Yet another drug I will need to come off of at some point. I hate that I let myself be polydrugged like this. For over 20 years, I blindly took what they told me to take, to cope with trauma in my past. I was young, it became ‘normal” and accepted to be medicated, so just kept going. It’s overwhelming thinking about having to come off everything. I wish I had found this forum years ago. You are doing a great thing here
 

Anyhow, I appreciate your time and input and will be better with my notes. 

[Untethered]

On 6/15/2022 at 1:42 PM, Greatful said:

@Untethered

Welcome to SA, so sorry you are going through this...Try not to panic, I know how hard that is. I did it and ended up on a drug merry-go-round.  

You should be proud of yourself,  You made it through a  whole year in WD.  You were less depressed, that's great.  Is your main symptom anxiety right now?  I think you will be okay if you can get your panic down.  

Try not make any rash decsion because of panic. The mod's will try and help.  In the mean time take a look around SA, learn as much as you can about physic drugs, tapering, what ever you can so you can be your own advocate in your health. 

go to the forums section and click on the links that interest you.  

 

Remember you are not alone.  Reach out to others, post on here.  There is a wealth of support and caring people on SA.  We are all trying to come to terms with what happened to us, how we can help ourselves.😊

 

Thank you so much @Greatful  you are very kind. Yes, ironically I’m less depressed now that I’ve been off the Lexapro. It took a few months though. It could be because my anxiety has taken over, but I’ll take whatever reprieve I can get. 

[Untethered]

On 6/15/2022 at 4:17 PM, Altostrata said:

If you are still experiencing withdrawal syndrome from escitalopram cold turkey, reducing the benzo at all is questionable. It could be what's controlling your withdrawal syndrome to some extent. 

I finally figured out how to quote individual paragraphs.
 

That’s what I’m afraid of. Unfortunately the benzos have turned on me though. While any relief I get is minimal, I still get bad withdrawal. Plus, nobody wants to prescribe them anymore (for good reason, but it doesn’t help me). I haven’t given up my search on a benzo-wise professional, or at least a prescriber, but I’ve turned up nothing so far. I’ve searched here, the benzo websites/forums/groups, and all I turned up was the pharmacist who claims to know Ashton but obviously doesn’t really.  It’s really frustrating and scary that I may be forced into a rapid taper and make everything worse. If given the choice, I would prefer a peer driven taper like you suggested, but it likely won’t be an option for me. 
 

[Altostrata]

1 hour ago, Untethered said:

Unfortunately the benzos have turned on me though. While any relief I get is minimal, I still get bad withdrawal.

 

Please continue to post your daily notes. As you can see from the interactions report, the drugs interact. It is also odd that you take 2 benzos at the same time as you take bupropion.

 

My suspicion is you're taking TOO MUCH benzo, and what you think are withdrawal symptoms are paradoxical reactions and maybe interdose withdrawal from the benzos or Seroquel.

[Neon]

Dear Untethered, I just wanted to drop by and say how sorry I am you are in this situation and given time you will definitely get through even though it seems hard right now. So sorry you are suffering this much.

 

I was also put on meds really young and never questioned it until I questioned it but found this site a little too late.

 

Hope you are feeling better soon ❤️

 

PS I would really try to find a doc who lets you taper at a rate that is suitable to you, thats important, I have found one who believes me and my story (at least partially) after looking for a loong time

[Untethered]

6 hours ago, Neon said:

Dear Untethered, I just wanted to drop by and say how sorry I am you are in this situation and given time you will definitely get through even though it seems hard right now. So sorry you are suffering this much.

 

I was also put on meds really young and never questioned it until I questioned it but found this site a little too late.

 

Hope you are feeling better soon ❤️

 

PS I would really try to find a doc who lets you taper at a rate that is suitable to you, thats important, I have found one who believes me and my story (at least partially) after looking for a loong time

Thanks so much. I’m not giving up yet, but it’s hard. That is great that you found someone. Fingers crossed I can too. All the best. 

[Greatful]

@Untethered

On 6/17/2022 at 4:33 PM, Untethered said:

I hate that I let myself be polydrugged like this. For over 20 years, I blindly took what they told me to take, to cope with trauma in my past. I was young, it became ‘normal” and accepted to be medicated, so just kept going. It’s overwhelming thinking about having to come off everything. I wish I had found this forum years ago. You are doing a great thing here

I can so relate.  I wonder how many on this forum would also agree.  It's hard not to get angry and feel overwhelmed by being poly drugged. Most of us blindly trusted our doctors and trusted that these drugs have been fully studied and are safe.  Little did we know how much is hidden from us, doctors.

 

What I a have learned about trauma is that the drugs will not fix it. Yes it will dull you and allow you to move through life but does not address the problem, there is only so much traditional therapy can do.  Understanding it and learning how to address it.  I'm reading  Body Keeps the Score by Bessel  Van Der Kolk.  It is so sad how many children are labeled and put on medication because they have childhood trauma.  They are not mentally ill.

 

Keep working at finding yourself and getting drug free😊

Edited June 21, 2022 by Greatful