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Golrabs: Antidepressants since 2000


Golrabs

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1 hour ago, manymoretodays said:

How much do you have to do with this psychiatrist?  Are they your prescriber?  Or can you stick with your previous prescriber?   Can you resisit if "they" start suggesting more medications or medication changes?

 

I don't have to do anything with the psychiatrist at this place if I don't want to. They can't make me change anything and if I needed new prescription I could always ask my previous prescriber or fine a primary care doctor. I can resist medication change suggestions. 

 

1 hour ago, manymoretodays said:

Where are you at now with the liquid Lexapro?

 

Can you consider any tapering now?  Or is that out of the question?

 

I'm still doing the same thing with the liquid Lexapro - taking 2.5 ml (=2.5mg) along with the 10 mg tablet. 

 

I'm hesitant about tapering now, because the distress has been bad enough during those "waves" that last 7-10 days that I'm afraid that tapering right now would cause worse dysregulation of my system. It's really hard to gauge "stability" but I certainly don't feel near it. Then again, I'm not sure how long I should stick with this current cocktail. I still have it very fresh in my memory of how bad it felt the first 2 months after I tried to quit cold turkey and a return to that isn't something I could handle. 

 

Does anyone actually feel relieve from anything during a taper? 

2000-2018 Paroxetine

2018-2021 Prozac 20 mg 

2020-2022 Pramipexole .25 mg

2022 Pristiq 25 mg cold turkey May 1 (inpatient in 20 June 2022)

2022 Mirtazapine 15 mg cold turkey 20 June -  15 July 2002

2022 Escitalopram 5 - 15 mg  as 1 Jul 2022 - 30 November 2022

2022 Escitalopram 12.5 mg Dec 1 2022 - May 12 2023

2023 Escitalopram 11.5 mg May 2023 - June 2023

2023 Escitalopram 10.5 mg  as of June 12, 2023

2022 Clonazepam .375 mg  as of March 2023 - present

2022 Oxcarbazepine 300  mg  as of 1 Aug 2022 - present

2023 Escitalopram 10 mg  as of June 24, 2023

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Hello, @Golrabs

 

Since you're just getting used to this drug change, it's too soon for you to taper. We like to see a long period of stability before you rock the boat again.

 

Why are you taking clonazepam 0.5 mg and oxcarbazepine 300mg? Please put ALL your current drugs in this Interactions Checker and post the report or a link to it in this topic.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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I had severe restless leg syndrome start immediately after Clonazepam in late 2020. I was prescribed Pramipexole soon after which helped for a few months, until it actually augmented the restless leg. I guess this is common with dopamine agonists - they work for RLS, then make it worse.  Fast forward to 2022 to when I quit my antidepressant CT (Pristiq), had to go to psychiatric hospital, and stopped the Pramipexole in hospital.  I was going to bad withdrawal, the restless legs were just as bad and other autonomic disturbances were going on where my body would jolt every time I started to fall asleep and I'd wake up in a panic attack. After two months of this my psychiatrist said an anticonvulsant might help so she prescribed Oxcarbazepine at night to go along with the Clonazepam, since I hadn't been able to get any more than 2 hours of sleep at a time even with the Clonazepam. My restless leg started subsiding a month later, but I have no idea if that is from the reintroduction of an SSRI (Lexapro), the Oxcarbazepine or the Clonazepam. 

2000-2018 Paroxetine

2018-2021 Prozac 20 mg 

2020-2022 Pramipexole .25 mg

2022 Pristiq 25 mg cold turkey May 1 (inpatient in 20 June 2022)

2022 Mirtazapine 15 mg cold turkey 20 June -  15 July 2002

2022 Escitalopram 5 - 15 mg  as 1 Jul 2022 - 30 November 2022

2022 Escitalopram 12.5 mg Dec 1 2022 - May 12 2023

2023 Escitalopram 11.5 mg May 2023 - June 2023

2023 Escitalopram 10.5 mg  as of June 12, 2023

2022 Clonazepam .375 mg  as of March 2023 - present

2022 Oxcarbazepine 300  mg  as of 1 Aug 2022 - present

2023 Escitalopram 10 mg  as of June 24, 2023

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On 12/20/2022 at 3:00 AM, Shep said:

As you can see from this drug interaction report, there are several potential moderate drug interactions:

 

Drug interaction checker - lexapro, oxcarbazepine, clonazepam

 

Why do you take oxcarbazepine and clonazepam at approximately the same time? What is oxcarbazepine supposed to be doing for you?

 

Many people find fish oil and magnesium supplements helpful, see

 

https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

 

https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

Magnesium in particular is a muscle relaxer that has been effective for "restless legs". You might try a little bit of one at a time to see how it affects you.

 

Please continue your daily notes.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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3 hours ago, Altostrata said:

Why do you take oxcarbazepine and clonazepam at approximately the same time? What is oxcarbazepine supposed to be doing for you?

 

Many people find fish oil and magnesium supplements helpful, see

 

https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

 

https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

Magnesium in particular is a muscle relaxer that has been effective for "restless legs". You might try a little bit of one at a time to see how it affects you.

 

Please continue your daily notes.

I take the Oxcarbazepine at night because it has a sedating effect and taking it during the day really would mean I wouldn't be able to do much other than watch TV.  I suppose I could take it a hour or two earlier. I believe the psychiatrist that prescribed it was hoping the Oxcarbazepine could replace Clonazepam eventually, since she preferred that as a long term solution rather than Clonazepam and apparently "OXcarbazepine may reduce the blood levels and effects of clonazePAM" and I think she said it has been used to help people get off Clonazepam. It's a lot easier nowadays to find psychiatrists who think benzos are dangerous and want to get you off of them, yet they don't do any better at suggesting how to taper than they do with antidepressants. 

 

I should have asked the psychiatrist about the drug interactions today, but my previous one was unconcerned about potential interactions, so It's likely my new one at the PHP program will think the same thing.  Plus I was already on 450 mg of Oxcarbazepine for one month back in August, but I dropped it myself to 300 mg because I felt it too drugged in the mornings, and just as anxious.


Would you still suggest - when things are more stable - that I start to taper with Lexapro or is Oxcarbazepine something I should start with? 

 

2000-2018 Paroxetine

2018-2021 Prozac 20 mg 

2020-2022 Pramipexole .25 mg

2022 Pristiq 25 mg cold turkey May 1 (inpatient in 20 June 2022)

2022 Mirtazapine 15 mg cold turkey 20 June -  15 July 2002

2022 Escitalopram 5 - 15 mg  as 1 Jul 2022 - 30 November 2022

2022 Escitalopram 12.5 mg Dec 1 2022 - May 12 2023

2023 Escitalopram 11.5 mg May 2023 - June 2023

2023 Escitalopram 10.5 mg  as of June 12, 2023

2022 Clonazepam .375 mg  as of March 2023 - present

2022 Oxcarbazepine 300  mg  as of 1 Aug 2022 - present

2023 Escitalopram 10 mg  as of June 24, 2023

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20 hours ago, Golrabs said:

Would you still suggest - when things are more stable - that I start to taper with Lexapro or is Oxcarbazepine something I should start with? 

 

About how many hours are you sleeping at night?

 

 

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I'm getting about 5-6 hours of sleep a night (I may even get 7 once a month), which is great compared to the 2-3 hours I was getting for few months in the summer.

2000-2018 Paroxetine

2018-2021 Prozac 20 mg 

2020-2022 Pramipexole .25 mg

2022 Pristiq 25 mg cold turkey May 1 (inpatient in 20 June 2022)

2022 Mirtazapine 15 mg cold turkey 20 June -  15 July 2002

2022 Escitalopram 5 - 15 mg  as 1 Jul 2022 - 30 November 2022

2022 Escitalopram 12.5 mg Dec 1 2022 - May 12 2023

2023 Escitalopram 11.5 mg May 2023 - June 2023

2023 Escitalopram 10.5 mg  as of June 12, 2023

2022 Clonazepam .375 mg  as of March 2023 - present

2022 Oxcarbazepine 300  mg  as of 1 Aug 2022 - present

2023 Escitalopram 10 mg  as of June 24, 2023

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On 1/31/2023 at 9:14 PM, Golrabs said:

Would you still suggest - when things are more stable - that I start to taper with Lexapro or is Oxcarbazepine something I should start with? 

 

5 hours ago, Golrabs said:

I'm getting about 5-6 hours of sleep a night (I may even get 7 once a month), which is great compared to the 2-3 hours I was getting for few months in the summer.

 

If oxcarbazepine is helping with sleep, you'll want to come off the Lexapro first. Please see:

 

Taking multiple psych drugs? Which drug to taper first?

 

Preserving sleep is a priority. 

 

 

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I wish I knew if Oxcarbazepine was definitively helping my sleep or not or if I'd get the same sleep benefit from just being on Clonazepam. I drive myself mad thinking about if it's actually helping with sleep. As with all these drugs, it could be making things worse in other areas such as depression.  

2000-2018 Paroxetine

2018-2021 Prozac 20 mg 

2020-2022 Pramipexole .25 mg

2022 Pristiq 25 mg cold turkey May 1 (inpatient in 20 June 2022)

2022 Mirtazapine 15 mg cold turkey 20 June -  15 July 2002

2022 Escitalopram 5 - 15 mg  as 1 Jul 2022 - 30 November 2022

2022 Escitalopram 12.5 mg Dec 1 2022 - May 12 2023

2023 Escitalopram 11.5 mg May 2023 - June 2023

2023 Escitalopram 10.5 mg  as of June 12, 2023

2022 Clonazepam .375 mg  as of March 2023 - present

2022 Oxcarbazepine 300  mg  as of 1 Aug 2022 - present

2023 Escitalopram 10 mg  as of June 24, 2023

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  • Moderator Emeritus

@Golrabs You could separate the Oxcarbazepine and the clonazepam by an hour tonight and another hour tomorrow night, so they're two hours apart by tomorrow night. That might help clarify which one is best for sleep. That kind of gradual move is gentle on your nervous system and shouldn't rock the boat, while giving you the answer you seek. You can always move the doses back after the experiment. 

 

 

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  • 1 month later...

It's been a minute since I last posted. I've been in a PHP program to help manage some of the symptoms, but the program ends for me at the end of the week. I started PHP to take advantage of the opportunity for the intensive therapy while I still have insurance.

 

I haven't taken any of the PHP psychiatrist's recommendations. Her diagnosis is that I've been misdiagnosed for 23 years and that I have cycling mood disorder (aka a less extreme bipolar disorder) and recommended upping the Oxcarbazepine I'm on and over time weening off Lexapro. Had I not read on SA that it is common to give a new diagnosis for people who have had severe symptoms when trying to come off ADs I might have thought that was the case. Still, when you're suffering during a wave it's hard to not to want to believe that you're a pill away from things being "ok". 

 

The positive news over the last 4 weeks is that my windows appear to be lengthening. I have about 10 day windows where things are manageable, albeit nowhere near I'd like to be. Acceptance of this is hard. The waves are still very jarring and still last just as long, 7-10 days and I'm marginally better and riding them. The loneliest thing about it is that, outside of the online community, no one really gets what a wave is like and when I'm in a window, I'm not as sharp minded and I doesn't experience much pleasure in anything. You're walking and talking like everyone else and everyone expects that you're the same, but you're not the same.  My outside therapist is the only one who seems to sympathize and admit that protracted wd from stopping antidepressants too quickly seems more like the truth than that I'm bipolar. Long story short, I'm still trying to stabilize more before I start a Lexapro taper. It's getting close to 4 months since I've held all the doses of the drugs I'm on and I'm doing what I can to stay hopeful and patient that with several more months I will stabilize more and my waves will shorten and perhaps drop a notch in severity. 

2000-2018 Paroxetine

2018-2021 Prozac 20 mg 

2020-2022 Pramipexole .25 mg

2022 Pristiq 25 mg cold turkey May 1 (inpatient in 20 June 2022)

2022 Mirtazapine 15 mg cold turkey 20 June -  15 July 2002

2022 Escitalopram 5 - 15 mg  as 1 Jul 2022 - 30 November 2022

2022 Escitalopram 12.5 mg Dec 1 2022 - May 12 2023

2023 Escitalopram 11.5 mg May 2023 - June 2023

2023 Escitalopram 10.5 mg  as of June 12, 2023

2022 Clonazepam .375 mg  as of March 2023 - present

2022 Oxcarbazepine 300  mg  as of 1 Aug 2022 - present

2023 Escitalopram 10 mg  as of June 24, 2023

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3 hours ago, Golrabs said:

Had I not read on SA that it is common to give a new diagnosis for people who have had severe symptoms when trying to come off ADs I might have thought that was the case. Still, when you're suffering during a wave it's hard to not to want to believe that you're a pill away from things being "ok". 

 

Absolutely! Good observation.

 

3 hours ago, Golrabs said:

The positive news over the last 4 weeks is that my windows appear to be lengthening.

 

Yay! Hang in there.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • 5 weeks later...
On 12/27/2022 at 5:55 PM, Shep said:

 

You may find this post helpful on what it means to be stable before tapering: 

 

Withdrawal Normal

 

 

I would be very hesitant to add in Buspar. You're already on three other drugs, two of them with sedating qualities. Buspar also has sedating qualities. The problem with drugs with sedating effects is they tend to turn paradoxical - the more you dampen down the nervous system with sedatives, the more it fights to stay awake. 

 

 

From your signature, it looks like you've been holding all three drugs at the same dose each for the past few months. Does anything else change that would cause your symptoms to improve after 6- 8 days and then get worse after the following 5 - 6 days? 

 

Also, what time(s) of the day are you taking your drugs? What time(s) of the day are your symptoms worse? 

I am going through the paradoxical effect with imipramine now and my restless legs insomnia are driving me insane.  I did a small taper last night and the restless legs were better but I only slept two hours.  I have a feeling I’m going to battle insomnia for a long time.

94-2000 Prozac, 2000-2001 zoloft

2001-2003 paxil, 2002 1 mg klonopin

2003-2004 effexor,  ct  klonopin,  in hospital  put on Seroquel & lexapro , 2005 Ct lexapro, in the hospital again, imipramine 250mg, 2009-2010 weaned off seroquel, 2016-17tapered imipramine to 150, 2017-19 100 mg, 2020 jumped to 50 mg a week later went back up to 60. 11/22 56 mg

12-22 50mg 4/5/23 - 47mg 4/16 - 40 mg 6/27/23-35mg 

1/20 1 mg ropinirol  3/21 ropinirol 2 mg 

4/23 Ozempic .25, 6/26/23 .37mg 12/1/23 .39mg

Supplements: boron, Vitamin C, diatomaceous earth, cream of tartar  and Celtic sea salt, transdermal magnesium oil

 

 

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What times o'clock do you take your drugs, with their dosages?

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Lexapro 7:45 am

Oxcarbazepine 9:00 pm

Clonazepam 10:30 pm 

 

2000-2018 Paroxetine

2018-2021 Prozac 20 mg 

2020-2022 Pramipexole .25 mg

2022 Pristiq 25 mg cold turkey May 1 (inpatient in 20 June 2022)

2022 Mirtazapine 15 mg cold turkey 20 June -  15 July 2002

2022 Escitalopram 5 - 15 mg  as 1 Jul 2022 - 30 November 2022

2022 Escitalopram 12.5 mg Dec 1 2022 - May 12 2023

2023 Escitalopram 11.5 mg May 2023 - June 2023

2023 Escitalopram 10.5 mg  as of June 12, 2023

2022 Clonazepam .375 mg  as of March 2023 - present

2022 Oxcarbazepine 300  mg  as of 1 Aug 2022 - present

2023 Escitalopram 10 mg  as of June 24, 2023

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10 hours ago, Golrabs said:

Lexapro 7:45 am

Oxcarbazepine 9:00 pm

Clonazepam 10:30 pm 

 

 

Please also list the doses for each drug.

 

Have you made any drug changes since what you have in your signature from 2022? 

 

 

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Lexapro 12.5 mg 7:45 am 

Oxcarbazepine 300 mg  9:00 pm

Clonazepam .375 mg 10:30 pm 

2000-2018 Paroxetine

2018-2021 Prozac 20 mg 

2020-2022 Pramipexole .25 mg

2022 Pristiq 25 mg cold turkey May 1 (inpatient in 20 June 2022)

2022 Mirtazapine 15 mg cold turkey 20 June -  15 July 2002

2022 Escitalopram 5 - 15 mg  as 1 Jul 2022 - 30 November 2022

2022 Escitalopram 12.5 mg Dec 1 2022 - May 12 2023

2023 Escitalopram 11.5 mg May 2023 - June 2023

2023 Escitalopram 10.5 mg  as of June 12, 2023

2022 Clonazepam .375 mg  as of March 2023 - present

2022 Oxcarbazepine 300  mg  as of 1 Aug 2022 - present

2023 Escitalopram 10 mg  as of June 24, 2023

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Lexapro 12.5 mg 7:45 am 

Oxcarbazepine 300 mg  9:00 pm

Clonazepam .375 mg 10:30 pm 

 

I made one small change. I reduced the clonazepam at night a little, otherwise I haven't changed anything. Slowly starting to stabilize a bit these last two months. 

2000-2018 Paroxetine

2018-2021 Prozac 20 mg 

2020-2022 Pramipexole .25 mg

2022 Pristiq 25 mg cold turkey May 1 (inpatient in 20 June 2022)

2022 Mirtazapine 15 mg cold turkey 20 June -  15 July 2002

2022 Escitalopram 5 - 15 mg  as 1 Jul 2022 - 30 November 2022

2022 Escitalopram 12.5 mg Dec 1 2022 - May 12 2023

2023 Escitalopram 11.5 mg May 2023 - June 2023

2023 Escitalopram 10.5 mg  as of June 12, 2023

2022 Clonazepam .375 mg  as of March 2023 - present

2022 Oxcarbazepine 300  mg  as of 1 Aug 2022 - present

2023 Escitalopram 10 mg  as of June 24, 2023

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6 hours ago, Golrabs said:

I made one small change. I reduced the clonazepam at night a little, otherwise I haven't changed anything.

 

Please update your signature to reflect this change. Your signature is here:

 

Account Settings – Create or Edit a signature

 

6 hours ago, Golrabs said:

Slowly starting to stabilize a bit these last two months. 

 

That's great you're stabilizing. 

 

Can you tell which drug is the most helpful for sleep? Does clonazepam help with sleep? If so, you may want to hold that drug to come off last. Prioritizing sleep is key. Please see:


Taking multiple psych drugs? Which drug to taper first?

 

You may wish to taper Lexapro first. 

 

 

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13 hours ago, Golrabs said:

Oxcarbazepine 300 mg  9:00 pm

 

Does this make you sleepy? For what reason were you prescribed it?

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Yes, Clonazepam helps with sleep. I don't plan on reducing it anymore, at least for the time being. My plan was to start with Lexapro first, but I really am taking it easy to stabilize first since the last 10 months were so dysregulated. It's been close to 5 months since I stopped switching medications, or increasing doses.  The Oxcarbazepine was prescribed August 2022 to help alleviate the "cycling moods" I was having (still have), with the hope that it would even things out, particularly the severity of the symptoms.   

2000-2018 Paroxetine

2018-2021 Prozac 20 mg 

2020-2022 Pramipexole .25 mg

2022 Pristiq 25 mg cold turkey May 1 (inpatient in 20 June 2022)

2022 Mirtazapine 15 mg cold turkey 20 June -  15 July 2002

2022 Escitalopram 5 - 15 mg  as 1 Jul 2022 - 30 November 2022

2022 Escitalopram 12.5 mg Dec 1 2022 - May 12 2023

2023 Escitalopram 11.5 mg May 2023 - June 2023

2023 Escitalopram 10.5 mg  as of June 12, 2023

2022 Clonazepam .375 mg  as of March 2023 - present

2022 Oxcarbazepine 300  mg  as of 1 Aug 2022 - present

2023 Escitalopram 10 mg  as of June 24, 2023

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@Golrabs Stabilizing first sounds like a great plan. This post may help, as it describes the place you want to be when you taper next, as Brassmonkey describes it, you want to be at Withdrawal Normal: 

 

Withdrawal Normal

 

 

 

 

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On 4/8/2023 at 4:30 PM, Golrabs said:

The Oxcarbazepine was prescribed August 2022 to help alleviate the "cycling moods" I was having (still have)

 

Please describe your current "cycling moods".

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Cycling moods was how my psychiatrist described the fluctuations I have where I'm a mess for 7-10 days and then a bit better (more functional)  for 7-10 days, generally in a pattern like that. The bad days I have body feels very unsettled, usually from the moment I wake up, not long after I wake up. Almost like akathisia. My body is tense and shaky, nausea sets in, my mind races, I get day-long headaches, my eyes burn, concentration is difficult; generally it's as if my body is stuck in flight mode.

2000-2018 Paroxetine

2018-2021 Prozac 20 mg 

2020-2022 Pramipexole .25 mg

2022 Pristiq 25 mg cold turkey May 1 (inpatient in 20 June 2022)

2022 Mirtazapine 15 mg cold turkey 20 June -  15 July 2002

2022 Escitalopram 5 - 15 mg  as 1 Jul 2022 - 30 November 2022

2022 Escitalopram 12.5 mg Dec 1 2022 - May 12 2023

2023 Escitalopram 11.5 mg May 2023 - June 2023

2023 Escitalopram 10.5 mg  as of June 12, 2023

2022 Clonazepam .375 mg  as of March 2023 - present

2022 Oxcarbazepine 300  mg  as of 1 Aug 2022 - present

2023 Escitalopram 10 mg  as of June 24, 2023

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Quote

 

2022 Pristiq 25 mg cold turkey May 1 (inpatient in 20 June 2022)

2022 Mirtazapine 15 mg cold turkey 20 June -  15 July 2002

2022 Escitalopram 5 - 15 mg  as 1 Jul 2022 - 30 November 2022

2022 Clonazepam .375 mg  as of March 2023 - present

2022 Oxcarbazepine 300  mg  as of 1 Aug 2022 - present

 

 

Frequent drug changes are a more likely cause of those "cycling moods". You may have had spells of withdrawal or adverse drug effects.

 

So now you've been taking oxcarbazepine for a while, what was your psychiatrist's plan for tapering clonazepam?

 

On 4/7/2023 at 8:27 PM, Golrabs said:

Lexapro 12.5 mg 7:45 am 

Oxcarbazepine 300 mg  9:00 pm

Clonazepam .375 mg 10:30 pm 

 

I made one small change. I reduced the clonazepam at night a little, otherwise I haven't changed anything. Slowly starting to stabilize a bit these last two months. 

 

In what way have you stabilized? What are your current most prominent symptoms? Are they better or worse at particular times of day?

 

 

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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I haven't made any drug changes since since early December 2022. The same 3 drugs at the same does, except of what I mentioned about the Clonazepam, which I cut down about a month ago, I can't tell if there has been any effect though, which I've been getting the "cycling mood disorder" diagnosis. I've had the same up and down pattern for almost 10 months now since I quit Pristiq cold turkey.

 

The first 2 months I barely had any days that weren't the worst I've every felt. Then I started having more tolerable days, may 3-5 in a row. That improved over the last 7 months where I'm starting to having longer streaks of tolerable days, about 7-10 in a row, but it's always followed by 7-10 rough days. That pattern has remained pretty consistent, but over time the bad streaks are a little less painful and the tolerable days I sometimes feel pretty functional.  Don't get me wrong, the rough days are downright awful still. 

 

My psychiatrist doesn't have any plans for getting me off Clonazepam at this time. I've seen a couple of psychiatrist and they both recommended that I increase the Oxcarbazepine. One of them said I should increase it and if things are going better I would reduce the Lexapro, but I refused to increase anything. That was 2 months ago.

 

My current prominent symptoms are anxiety that manifests itself with shaky extremities, tense body, and a general nausea. It can be accompanied by an intense rumination at it's worst, day-long headaches, burning eyes, sensory hypersensitivity, and naturally concentration is difficult. I'd say this is worst from 9 - 5 pm.  My depression has also vacillated quite a lot, but that has been a lifelong and it's nearly impossible to tell how much my depression is exacerbated by the antidepressants since I've been on antidepressants since 2000, at 20 years old.

2000-2018 Paroxetine

2018-2021 Prozac 20 mg 

2020-2022 Pramipexole .25 mg

2022 Pristiq 25 mg cold turkey May 1 (inpatient in 20 June 2022)

2022 Mirtazapine 15 mg cold turkey 20 June -  15 July 2002

2022 Escitalopram 5 - 15 mg  as 1 Jul 2022 - 30 November 2022

2022 Escitalopram 12.5 mg Dec 1 2022 - May 12 2023

2023 Escitalopram 11.5 mg May 2023 - June 2023

2023 Escitalopram 10.5 mg  as of June 12, 2023

2022 Clonazepam .375 mg  as of March 2023 - present

2022 Oxcarbazepine 300  mg  as of 1 Aug 2022 - present

2023 Escitalopram 10 mg  as of June 24, 2023

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  • Administrator

How has your symptom pattern changed since you reduced clonazepam to 0.375mg in March?

 

41 minutes ago, Golrabs said:

 I've had the same up and down pattern for almost 10 months now since I quit Pristiq cold turkey.

 

The first 2 months I barely had any days that weren't the worst I've every felt. Then I started having more tolerable days, may 3-5 in a row. That improved over the last 7 months where I'm starting to having longer streaks of tolerable days, about 7-10 in a row, but it's always followed by 7-10 rough days. That pattern has remained pretty consistent, but over time the bad streaks are a little less painful and the tolerable days I sometimes feel pretty functional.  Don't get me wrong, the rough days are downright awful still. 

 

This is a pretty good description of what we know as The Windows and Waves Pattern of Stabilization

 

It appears you might have protracted withdrawal syndrome from going off Pristiq, which your psychiatrists have mistaken for "cycling mood disorder". This is not unusual, all of this site's members who have protracted withdrawal have been told it's some mysterious psychiatric disorder or the other.

 

You are now taking 2 powerful "brakes", clonazepam and oxcarbazepine, plus Lexapro, which usually is an accelerator. Clonazepam and oxcarbazepine are duplicative in effect.

 

On 1/22/2023 at 12:43 PM, manymoretodays said:

 

41 minutes ago, Golrabs said:

My current prominent symptoms are anxiety that manifests itself with shaky extremities, tense body, and a general nausea. It can be accompanied by an intense rumination at it's worst, day-long headaches, burning eyes, sensory hypersensitivity, and naturally concentration is difficult. I'd say this is worst from 9 - 5 pm.

 

Very possible these symptoms are adverse effects from your drugs or drug combinations. 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. Post 24 hours of notes at a time in this topic, in this simple list format.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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1 hour ago, Altostrata said:

Very possible these symptoms are adverse effects from your drugs or drug combinations. 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. 

Yes, quitting Pristiq CT really kicked off this hell and PWS is the closest thing I read about that describes this.  I also transitioned off Paxil after 18 years and onto Prozac and then quit Clonazepam a couple of years before the PWS from Pristiq so I really don't know what my body is going through. 

 

My notes are very much unchanged since I last posted them on January 26th.  I know you don't want general notes, but it's pretty much the same as follows

 

8:30 AM      wake-up; drowsy but limbs oftentimes shaky; take Lexapro 12.5 mg

9:00 AM      Eat breakfast       

9 AM - 5 PM     if it's a bad 7-10 days the symptoms I mentioned grow stronger at this time and remain for the whole day, peaking between 11-3 shaky extremities, tense body, general nausea, rumination, headaches, burning eyes, sensory hypersensitivity  

6:00 PM   Dinner; symptoms start to lessen at this time

8:00 PM   Symptoms are better but not gone

9:00 PM take Oxcarbazepine 300 mg  

10:00 PM   Symptoms have usually subsided to a minimal amount    

10:30 - 11:00 pm  Take Clonazepam .375 mg

11:30 Usually tired enough to fall asleep

       

2000-2018 Paroxetine

2018-2021 Prozac 20 mg 

2020-2022 Pramipexole .25 mg

2022 Pristiq 25 mg cold turkey May 1 (inpatient in 20 June 2022)

2022 Mirtazapine 15 mg cold turkey 20 June -  15 July 2002

2022 Escitalopram 5 - 15 mg  as 1 Jul 2022 - 30 November 2022

2022 Escitalopram 12.5 mg Dec 1 2022 - May 12 2023

2023 Escitalopram 11.5 mg May 2023 - June 2023

2023 Escitalopram 10.5 mg  as of June 12, 2023

2022 Clonazepam .375 mg  as of March 2023 - present

2022 Oxcarbazepine 300  mg  as of 1 Aug 2022 - present

2023 Escitalopram 10 mg  as of June 24, 2023

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8 hours ago, Golrabs said:

9:00 AM      Eat breakfast       

9 AM - 5 PM     if it's a bad 7-10 days the symptoms I mentioned grow stronger at this time and remain for the whole day, peaking between 11-3 shaky extremities, tense body, general nausea, rumination, headaches, burning eyes, sensory hypersensitivity  

6:00 PM   Dinner; symptoms start to lessen at this time

 

Do you skip lunch or did you just not mention that here? Just checking on this because some symptoms may be from low blood sugar if you're skipping any meals or not getting any snacks in during the day. 

 

Withdrawal can cause drops in blood sugar, which causes anxiety, fatigue, etc., very similar to withdrawal.

 

How is your diet? Are you getting plenty of water throughout the day? Dehydration can also cause anxiety, fatigue, etc. So eating healthy and drinking water throughout the day are also important. 

 

 

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18 hours ago, Golrabs said:

8:30 AM      wake-up; drowsy but limbs oftentimes shaky; take Lexapro 12.5 mg

9:00 AM      Eat breakfast       

9 AM - 5 PM     if it's a bad 7-10 days the symptoms I mentioned grow stronger at this time

 

Please trace how the symptoms get stronger after 8:30 a.m.

 

Quote

2022 Escitalopram 12.5 mg  as of 1 Dec 2022 - present

 

Did you reduce from 15mg escitalopram December 1? Why did you do this? How did your symptom pattern change after you reduced?

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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10 hours ago, Shep said:

Do you skip lunch or did you just not mention that here? Just checking on this because some symptoms may be from low blood sugar if you're skipping any meals or not getting any snacks in during the day. 

 

Withdrawal can cause drops in blood sugar, which causes anxiety, fatigue, etc., very similar to withdrawal.

 

How is your diet? Are you getting plenty of water throughout the day? Dehydration can also cause anxiety, fatigue, etc. So eating healthy and drinking water throughout the day are also important. 

 

I usually try to stay hydrated and my diet is pretty good: no caffeine, alcohol, low sugar. I admit I find it is really hard to eat enough when my symptoms are strong. When I do force some food in me it only helps nominally. On the weeks where my symptoms are better, I eat quite well. I'm surprised how much I eat then.

 

1 minute ago, Altostrata said:

Please trace how the symptoms get stronger after 8:30 a.m.

 

Generally my legs and arms feel tense and restless with some nausea in the gut and around the heart if that makes sense. It's like I need to move, but movement doesn't provide any relief other than my focus might not be as fixated on it. At it's worst, the mind (thoughts) can seem to get stuck in rumination too and this is often accompanied by distressing lightheadedness, sensitivity to sound and light, and emotions like hopelessness or catastrophizing.  I should add that anhedonia is pretty constant. Activity is distraction, not enjoyment.  

 

13 minutes ago, Altostrata said:

Did you reduce from 15mg escitalopram December 1? Why did you do this? How did your symptom pattern change after you reduced?

I reduced the escitalopram from 15 mg - 12.5 mg mid-November.  I had increased from 10 mg - 15mg in the beginning of November but I was feeling more brain fog and depression without any relief of any other symptoms. My pattern didn't change afterward except that the brain fog and deep depression I felt at 15 mg dissipated, but the overall pattern didn't change. I also read on this forum about how many people are affected by drug changes and increases/decreases and thought it was time to just stick at one dose and see how things stabilized over time. At first (in December) I'd say the intensity of the symptom pattern was just as bad but after a couple of months I began to see some slight improvement in the "windows" such as the ability to appreciate beauty in nature or even watch TV with interest, rather than just passing time. The waves are still plenty tough, but when I'm capable of some more objectivity I think there's less rumination and overall they're not quite as intense as they were from August - December.  Am I wrong in identifying the pattern I see as "windows and waves"? The waves are quite long and really let up much over a 7-10 day period. 

2000-2018 Paroxetine

2018-2021 Prozac 20 mg 

2020-2022 Pramipexole .25 mg

2022 Pristiq 25 mg cold turkey May 1 (inpatient in 20 June 2022)

2022 Mirtazapine 15 mg cold turkey 20 June -  15 July 2002

2022 Escitalopram 5 - 15 mg  as 1 Jul 2022 - 30 November 2022

2022 Escitalopram 12.5 mg Dec 1 2022 - May 12 2023

2023 Escitalopram 11.5 mg May 2023 - June 2023

2023 Escitalopram 10.5 mg  as of June 12, 2023

2022 Clonazepam .375 mg  as of March 2023 - present

2022 Oxcarbazepine 300  mg  as of 1 Aug 2022 - present

2023 Escitalopram 10 mg  as of June 24, 2023

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27 minutes ago, Golrabs said:

Generally my legs and arms feel tense and restless with some nausea in the gut and around the heart if that makes sense. It's like I need to move, but movement doesn't provide any relief other than my focus might not be as fixated on it.

 

How long does the restlessness in your legs and arms last? Do you have this sensation before you take Lexapro 12.5mg at 8:30 a.m.?

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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17 minutes ago, Altostrata said:

How long does the restlessness in your legs and arms last? Do you have this sensation before you take Lexapro 12.5mg at 8:30 a.m.?

 

If it's a "wave" it lasts until approximately 6pm, sometimes until 8-9 pm. If it's a window it dissipates by 12 pm. I have this sensation before I take the Lexapro. I usually awake with it. 

2000-2018 Paroxetine

2018-2021 Prozac 20 mg 

2020-2022 Pramipexole .25 mg

2022 Pristiq 25 mg cold turkey May 1 (inpatient in 20 June 2022)

2022 Mirtazapine 15 mg cold turkey 20 June -  15 July 2002

2022 Escitalopram 5 - 15 mg  as 1 Jul 2022 - 30 November 2022

2022 Escitalopram 12.5 mg Dec 1 2022 - May 12 2023

2023 Escitalopram 11.5 mg May 2023 - June 2023

2023 Escitalopram 10.5 mg  as of June 12, 2023

2022 Clonazepam .375 mg  as of March 2023 - present

2022 Oxcarbazepine 300  mg  as of 1 Aug 2022 - present

2023 Escitalopram 10 mg  as of June 24, 2023

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I wonder if that might be interdose withdrawal from oxycarbazine or clonazepam. Is the oxycarbazine immediate-release or extended-release?

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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The Oxcarbazepine is not ER. How would I find out if I'm having interdose withdrawal? Wouldn't I need to start tapering to find out for sure?

2000-2018 Paroxetine

2018-2021 Prozac 20 mg 

2020-2022 Pramipexole .25 mg

2022 Pristiq 25 mg cold turkey May 1 (inpatient in 20 June 2022)

2022 Mirtazapine 15 mg cold turkey 20 June -  15 July 2002

2022 Escitalopram 5 - 15 mg  as 1 Jul 2022 - 30 November 2022

2022 Escitalopram 12.5 mg Dec 1 2022 - May 12 2023

2023 Escitalopram 11.5 mg May 2023 - June 2023

2023 Escitalopram 10.5 mg  as of June 12, 2023

2022 Clonazepam .375 mg  as of March 2023 - present

2022 Oxcarbazepine 300  mg  as of 1 Aug 2022 - present

2023 Escitalopram 10 mg  as of June 24, 2023

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@Altostrata I have benzo question since you asked about interdose withdrawal. I stopped taking Clonazepam in late 2019. This was about 1 year after I had switched from Paroxetine to Prozac.  After 2 month taper off of the .5 mg of Clonazepam I began having intense RLS - persistent electric pulses in my limbs whenever I started to dose off (4-6 hours every night). 2 years later, another switch in antidepressants and I went CT on my antidepressant and subsequently ended up in a much worse place. I say all that just for context. Since going CT I've reinstated Clonazepam and started both Lexapro and Oxcarbazepine, I'm wondering is there ever a case where it's better to get off the benzodiazpine first, rather than the antidepressant if it's causing interdose withdrawal? I know the importance of sleep is crucial for mental health and healing and I greatly fear a return of the RLS if I were to taper Clonazepam again and also be dealing with antidepressant withdrawal symptoms.  

 

2000-2018 Paroxetine

2018-2021 Prozac 20 mg 

2020-2022 Pramipexole .25 mg

2022 Pristiq 25 mg cold turkey May 1 (inpatient in 20 June 2022)

2022 Mirtazapine 15 mg cold turkey 20 June -  15 July 2002

2022 Escitalopram 5 - 15 mg  as 1 Jul 2022 - 30 November 2022

2022 Escitalopram 12.5 mg Dec 1 2022 - May 12 2023

2023 Escitalopram 11.5 mg May 2023 - June 2023

2023 Escitalopram 10.5 mg  as of June 12, 2023

2022 Clonazepam .375 mg  as of March 2023 - present

2022 Oxcarbazepine 300  mg  as of 1 Aug 2022 - present

2023 Escitalopram 10 mg  as of June 24, 2023

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