Goldensun - my Avanza withdrawal nightmare

[Altostrata]

Thank you for that information, Goldensun.

 

We find that often drugs intended to help insomnia have a paradoxical effect in people sensitized by withdrawal syndrome. It sounds like this happened to you with Seriphos, too.

[goldensun]

All is going really terrible at the moment. It has now been 5 days since I stopped the amitriptyline and low dose naltrexone. I had three reasonable nights sleep of about 5 hours each, which is a lot of sleep for me, and also my heart rate came right down. The fourth day I started to get a racing heart, nauseous, low back pain, feeling very anxious and basically no sleep for the last 2 nights. All the signs of withdrawal. I only took the amitriptyline for 6 days and a low dose of 10mg. I stopped it cold turkey. Am I experiencing withdrawal symptoms from the amitriptyline after a such a short period of time and at such a low dose? If so, how long does anyone think this is going to last?

 

I just need to get back to having 5 hours sleep a night, because I find I can function quite well. I cannot function on only 2 or 3 hours of sleep. I have been doing this for about 3 months and it has worn me down. I feel that there is no hope of being able to get some sleep. The fact that I could sleep ok before the naltrexone and the amitriptyline is the only thing that gives me any hope that I may be able to sleep again. I really don't know how much longer I can do this. I am getting very, very desperate.

 

I am sorry I have not been any good at offering people support,  but I am thinking of you all everyday and wish you the best.

 

Alto can you please give me some hope that this can be sorted out.

[goldensun]

I would really appreciate if someone would reply. I am losing hope all the time.

[Petunia]

Hi Goldensun,

I'm so sorry you are not sleeping again.  My guess is that stopping two medications has caused further destabilization of your n/s.

 

If you can hang in there, it may settle down again in a few days, do what you can to rest and relax, even if you are not actually sleeping very much. Humans can actually survive on very little sleep, as long as you get some.  Of course its not pleasant or easy. I wish I could offer more help, but hopefully someone else with more experience will be able to offer some suggestions.

 

You will get your proper sleep back, once you become stable again.

 

Petu.

[dalsaan]

Hi Goldensun

 

I've been where you have been. It does get better. You need to stabalze your regime rather than starting and stopping medications

 

I also strongly recommend that you give up trying to sleep and instead focus on relaxing as much as you can. Go to bed when you are sleepy, lie down slow your breathing down and take long slow breathes. Start at your feet, slowly tense then relax each of your muscles, working your way up your body.

 

Again don't focus on whether or not you are sleeping just focus on relaxing knowing that if you relax as much as possible you will be more refreshed in the morning

[goldensun]

Thanks Petu and Dalsaan

I know what you are saying is commonsense, but sometimes it is very difficult to be rational when you are in such a state. Thank you for putting in black and white the obvious. It kind of brings you back down to earth and look at things more calmly and sensibly.

 

I hope one day I can be where you are Dalsaan and be at the other end of this journey, and give others hope and inspiration.

 

Thanks again

[goldensun]

Hi everyone

Does anybody know where I may be able to buy 0.5ml syringes. I am interested in giving microtapering a go. Any help would be much appreciated.

 

Thank you

 

Goldensun

[Altostrata]

You may be able to get them at a compounding pharmacy or veterinarian http://survivingantidepressants.org/index.php?/topic/235-using-an-oral-syringe-and-other-tapering-techniques/

 

http://survivingantidepressants.org/index.php?/topic/1425-compounding-pharmacies-us-uk-and-elsewhere/

[goldensun]

At the start of my journey I did not realise how exhausting this whole process was going to be. I find the fatigue and exhaustion quite depressing. Trying to focus on other aspects of your life is so difficult when this journey takes up so much time and energy. There is not only the withdrawal symptoms to cope with but the daily recording of symptoms, tapering schedule and the keeping of a sleep journal etc. I know these are all useful tools to make the whole withdrawal process as smooth as possible, but it is so mundane and sometimes I don't want to do it anymore, I would rather be focusing on much more pleasant things. ot to mention the fact that it took me three months to stabilise after dropping too quickly. Sigh....

 

I know there are a lot of people out there doing it really tough, and I think of you everyday......I am only venting. Thanks for listening

[Petunia]

I read your post Goldensun and I know you were only venting, but I'm sorry you are feeling down at the moment.  I'm sure a lot of members going through the seemingly endless taper process can relate to what you wrote.

 

But the good thing is that you have stabilized and there will be an end to this.

 

Maybe you would feel better if for a few hours, you forgot you were on this withdrawal journey and really did focus on something more pleasant.

 

Petu.

[dalsaan]

Hi Goldensun

 

This might be a controversial comment but I have never systematically recorded those things. Sometimes I note symptoms changes if I'm a bit confused about what's happening. I keep track of my drops here via my signature and have never kept a sleep journey. I have found recording that detail makes me obsess on things too much and is not positive for me. This is particularly the case with sleep.

 

I recover better when I can put these things in the background rather than paying them too much attention You should engage these things if you have a need and know that they contribute positively to your recovery

 

Wishing you the best

 

Dalsaan

[goldensun]

At the moment I am micro tapering and seem to be having some success, although everybody knows not to get to excited as things can change very rapidly.I was just wondering if any body had any ideas or thoughts about what I could take to help lower back pain. This seems to be my worst symptom at the moment, and I don't want to stop tapering because of this. Even my sleep, touch wood isn't to bad. The lower back pain is like a burning sensation just at the base of my spine. It is quite unbearable at times and I don't want to rely on panadol all the time. Is this a common withdrawal symptom in general,  or do other people specifically relate it to mirtazapine withdrawal. Any thoughts would be appreciated. 

[dalsaan]

Hi Goldensun

 

I've never experienced that on remeron

 

Dalsaan

[Altostrata]

I suggest chiropractic or acupuncture treatment for the back pain.

[goldensun]

I wish to thank the moderators for their support and time in helping people like myself going through this journey. I know you all have your own horrible experiences to deal with, so passing on valuable information and suggestions is worth its weight in gold to others travelling on this same road.

 

My biggest regret is that I did not come across this website before I started my journey of withdrawal. I could have saved myself so much time, pain and effort otherwise. It makes me really angry that people like myself only start doing their own research, once they are at a point that they have suffered so badly under the advice of their doctors. Somehow we must be able to get the message out there, that it makes really good sense to do your homework first before commencing a tapering program, and not to just be blindly led by your doctor.

 

This whole experience has turned me into a very selfish person. I can think of nothing else but getting off this drug. I have lost interest in the important people in my life because I am so self consumed with my own worries. One of the hardest things to do is have acceptance of how long this process is going to take. I always have my mind on the end goal, and I get impatient and rush my taper, and land in trouble. I then have to go back to where I was last stable and start all over again. This is pointless and self sabotaging.

 

So the most important piece of advice that I can give anyone who is about to start tapering is to maybe consider a multi year taper. I wish I had done this on the outset. It is still hard for me to accept that it will probably take at least another 4 years from now for me to be completely drug free, and that. I have stuffed my nervous system up with trying to go too quickly and now all it can handle is a very, very , very slow taper.

 

I want the best chance of having a full recovery and I also want to enjoy life along the way. I have tried to shift my focus from trying to get this over and done with as quickly as possible, to ok this is how life is at the moment. If I can function and get small pleasures from the people around me and can give something back, then that is way better than being sick, having no connection with anybody, and possibly losing those closest to me.

 

I don't want to think about withdrawal anymore, the whole thing has exhausted me and consumed my life so far. I just want it to be in the background as something that I am chipping away at slowly, with the knowledge that I will get to my goal of being drug free no matter how long it takes. But I want to arrive at that place happily, healthily and as with as little scars as possible.

 

So I have to accept that and get on with the rest of my life as best as I can and enjoy my new appreciation for the simple things in life.

[Altostrata]

Sounds like a good plan.

[goldensun]

I was wondering if it is possible that all of a sudden I could be experiencing side effects from my avanza. I have been at 21.9 mg for weeks now and have not dropped in dose due to stress at home. I have just experienced the most stressful couple of weeks in my life and have not been able to recover. I have a constantly high heart rate, my blood pressure is low and I have had unstoppable diarrhoea, and my anxiety levels are through the roof. I have not had more than a couple of hours sleep in over two weeks. I have removed the stress from my life for the last 4 days and nothing seems to have improved. Is it possible that after such a stressful time that my body is rejecting the medication?? I was thinking of reducing my medication say to 10mg to see if this makes a difference or even maybe skipping a dose. Has anyone experienced this, I would really appreciate hearing from someone real soon as I am very desperate........thank you.

[Petunia]

Hi Goldensun,

I'm sorry to hear you're having a rough time at the moment.

 

If I'm reading your post right, are you saying that you have been experiencing increased stress because of circumstances at home?  In other words, you can locate the source of the increased stress?  Because it also sounds like you might be attributing the stress to a sudden adverse reaction to your avanza, which in my opinion, would be unlikely, especially because you have been holding for so long.

 

Withdrawal can often increase our susceptibility to stress, once our nervous system becomes destabilized, it reacts easier and takes longer to calm back down again.

 

If I were you, I wouldn't make any more changes.  Four days of being without the stress inducing situation may not be long enough for your body to calm down again, especially as it sounds like whatever it was, has been going on for a while.  Maybe give it some more time and make an extra effort to take care of yourself with calming, relaxing activities.

 

This also could be a random wave of increased symptoms, which is very common in the pattern of withdrawal, even if someone has been holding for a while, or is completely free from medication.

 

I hope you start to feel better soon.

 

Petu.

[goldensun]

I had developed severe akathisia and could not sleep, sit still and felt like I was crazy. I upped my dosage to 27mg which seemed to settle things for half a day, I became almost normal again. I kept at this dose for the next 2 days, but the akathisia increased again to the point that I wanted to commit suicide. After the 3rd day at 27mg I dropped the dose to 24mg and had instant relief the next day and was fairly normal. The next day I thought I would take the 24mg again and managed to get some sleep. This morning I woke up with the worst panic attack which has since eased a little bit. Can someone please tell me if I should drop my dosage to 23mg and see if this makes things better? Any help would be appreciated. Someone please help.

[Altostrata]

Have you added or discontinued any drugs, prescription or otherwise?

[goldensun]

Hi Altostrata I have been taking buscopan for the nausea and stomach cramps. Other than that I have not added or discontinued any other medications prescriptions or otherwise. Thanks for your quick response. I am really really desperate to get this sorted. I don't like being suicidal all the time and not being able to sleep or sit still.

[Altostrata]

http://www.medicinenet.com/hyoscine_butylbromide-oral/article.htm
 

GENERIC NAME: HYOSCINE BUTYLBROMIDE - ORAL (HI-oh-seen BYOU-tull-BROH-mide)

BRAND NAME(S): Buscopan
SIDE EFFECTS: Constipation, dry mouth, trouble urinating, or nausea could occur. If these continue or are bothersome, notify your doctor promptly. Very unlikely but report: rash, itching, swelling of the hands or feet, trouble breathing, increased pulse, dizziness, diarrhea, vision problems, eye pain.
....
DRUG INTERACTIONS: Tell your doctor of all nonprescription or prescription medication you use, especially of: antidepressants (tricyclic type), MAO Inhibitors (e.g., phenelzine, linezolid, tranylcypromine, isocarboxazid, selegiline, furazolidone), quinidine, amantadine, antihistamines (e.g., diphenhydramine), anticholinergics, potassium chloride supplements, antacids, absorbent-type antidiarrhea medicines (e.g., kaolin-pectin). Do not start or stop any medicine without doctor or pharmacist approval.

There is a serious interaction with mirtazapine (see below). I can't find exactly what happens in the interaction, you might Google mirtazapine (Avanza) and Butylscopolamine (Buscopan) to see if you can find anything (I have a US version of Google).
 
Your symptoms would be consistent with inhibition of mirtazapine metabolization.
 
http://www.inhousepharmacy.biz/p-836-buscopan-10mg.aspx
 

When should Buscopan not be used?
You should not use Buscopan tablets 10mg if you:

[*]are allergic to hyoscine or any ingredients in Buscopan [*]are pregnant or are breastfeeding [*]have myasthenia gravis, a neuromuscular disorder, or megacolon a bowel condition [*]untreated narrow angle glaucoma, intestinal or urinary obstruction, tachyarrhythmia (rapid heart beat) [*]are taking medicines that interact with Buscopan, including: anticholinergics like tiotropium and ipratropium for asthma, tricyclic antidepressants like amitriptyline and imipramine, tetracyclic antidepressants like mirtazapine, antihistamines like loratadine for allergy, antipsychotics like piozide, the antiarrhythmics quinidine and disopyramide, amantadine for Parkinson’s Disease, metoclopramide for nausea, beta-adrenergic drugs like salbutamol for asthma.

What medications interact with Buscopan?
Several medications interact with Buscopan and should either not be taken while you are taking Buscopan or only after discussion and instruction from your doctor:

[*]Drugs that cause a serious reaction with Buscopan: beta-adrenergic drugs like salbutamol for asthma [*]Drugs that affect Buscopan: metoclopramide for nausea [*]Drugs that are affected by Buscopan: anticholinergics like tiotropium and ipratropium for asthma, tricyclic antidepressants like amitriptyline and imipramine, tetracyclic antidepressants like mirtazapine, antihistamines like loratadine for allergy, antipsychotics like piozide, the antiarrhythmics quinidine and disopyramide, amantadine for Parkinson’s Disease, metoclopramide for nausea

[goldensun]

Thanks for that Altostrata, but I only had a couple of doses after the symptoms of akathisia, nausea, extreme anxiety, hot and

cold flashes and suicidal thoughts had been there for a few days. I seem to be responding to a decrease in my dosage. Originally I was on

21.9 and upped it to 27mg. This would good for half a day but then my symptoms got much worse for two days, and then when I

decreased my medication to 24mg my symptoms almost went a way the next day. After the second dose at 24mg I woke up with heart racing and nausea and panic attack but not as severe as before and this has lessened as the day has progressed. To my way of

thinking I seem to be responding to a drop in my dosage. Should I aim to get back to my original dose of 21.9 and see if I can

stabilise on that again? I feel that this is the correct move to take. Thankyou, thankyou again for your quick responses. I reallyappreciate it.If I am to get back to my original dose of 21.9 which I had been stable on for weeks, what cuts should I make and over what period of time? Once again thankyou.

[Petunia]

Hang in there Goldensun, its good you are responding to a decrease.  Do whatever you can to stay calm, you will get through this and become stable again.

Alto will be able to advise you about your current dose, and should be back soon.

[goldensun]

Thanks heaps Petu, that means a real lot to me. You nearly made me cry with relief. Thank you

[Altostrata]

Thanks for that Altostrata, but I only had a couple of doses after the symptoms of akathisia, nausea, extreme anxiety, hot andcold flashes and suicidal thoughts had been there for a few days. I seem to be responding to a decrease in my dosage. Originally I was on21.9 and upped it to 27mg. This would good for half a day but then my symptoms got much worse for two days, and then when Idecreased my medication to 24mg my symptoms almost went a way the next day. After the second dose at 24mg I woke up with heart racing and nausea and panic attack but not as severe as before and this has lessened as the day has progressed. To my way ofthinking I seem to be responding to a drop in my dosage. Should I aim to get back to my original dose of 21.9 and see if I canstabilise on that again? I feel that this is the correct move to take. Thankyou, thankyou again for your quick responses. I reallyappreciate it.If I am to get back to my original dose of 21.9 which I had been stable on for weeks, what cuts should I make and over what period of time? Once again thankyou.

 

I really can't say, goldensun. Can you hold at 24mg for a few days?

[goldensun]

If that is what you think I should do then I will try Alto. If I find things get worse after a couple of days I might try a decrease after that. Thank you very much for your words of support.

[Altostrata]

I can't tell you what will work. That's my best guess, it's what I would do.

[goldensun]

Can someone please explain to me what is happening. I stupidly increased my medication to 27mg after being on 21.9. I had been

stable on 21.9 for quite a few weeks. I experienced some horrendous stress for a couple of weeks and I went into full blown panic attack that lasted 24/7, where everyday I wanted to kill myself, and that is when I increased it to 27mg. This seemed to work for a day, but by the second day I was back to full on akithisia. I decreased my dose to 24mg and had relief the next day. Once again

same pattern appeared. The second day on 24mg I was back to full on panic attack and could not keep still or even lie down for.

days

Next day dropped the dose to 23mg and felt better. I now have myself back to 22mg and for the first couple of days ok, and now back to full on akithisia. I don't want to reduce again because then I will below where I was when I was last stable. The only sleep I have had was when I was one night on 23mg and one night on 22.5mg. Can someone suggest what I should do. I cant stand this

anymore, all I want to do is kill myself. Do I stay on 22mg which is nearly impossible how I am feeling now, or should I go back

up to 23mg or 22.5mg where I was at least able to get some sleep for a night or two. I know all these changes are unstabling me

even further, I would just like to know do I increase or stay where I am. I am getting really desperate and want this to end. I know I should pick a dosage and stick to it, but which one??

I became unstable on 21.9, should I therefore try and stabilise on something a little higher say 23mg. I know this is hard for you

to give me the right answer, but I would appreciate any advice. Thank you in advance, I really would appreciate an answer really

soon. I hope all this makes sense.

[goldensun]

Just to amend the above post, I only had 2 nights sleep, one on 23mg and one on 22.5mg. I know it doesn't mean that I will

necessary get some sleep on those dosages again, but I thought it was worth a try.

[goldensun]

I know you are also busy and have your own issues but I would really appreciate a reply so I can make some common sense of this.

[Petunia]

I'm so sorry you are still suffering, I know how awful it can be, I had a bad morning with a combination of immobilizing panic and akathisia.

 

I became unstable on 21.9, should I therefore try and stabilise on something a little higher say 23mg. I know this is hard for youto give me the right answer, but I would appreciate any advice.

 

I can give you my opinion based on what you have written, my own experience and what I've learned here.

 

I don't think you became unstable on 21.9, but that you were experiencing a wave of symptoms which was unrelated to the actual dosage.  If you had stayed at 21.9, the wave most likely would have passed.  Making several dosage adjustments has exacerbated the problem, by increasing nervous system instability.

 

I suggest you read through the windows and waves topic here:  http://survivingantidepressants.org/index.php?/topic/82-the-windows-and-waves-pattern-of-recovery/

 

Even when someone is doing a slow, steady taper, its still possible to experience symptoms which increase and then decrease in no relation to the amount of medication being taken.  Usually this is a cue to stop tapering for a while, to hold at the current dose and let the nervous system settle down again.  Sometimes people find they have to hold for several months in the middle of a taper which was progressing smoothly.  Its important to listen to your body, because everyone is unique.

 

Unfortunately, human nature seems to be geared towards making changes when things become uncomfortable, but usually, the opposite is needed when withdrawing from these medications.

 

If I were you, I would hold on whatever dose you are on right now and do whatever you need to do to stay calm and in control until your nervous system settles down again.  Don't expect to feel better any time soon, aim to get through each day the best you can until this wave passes..... and it will pass.

 

Have a look at the symptoms and self care sections for some ideas and this topic http://survivingantidepressants.org/index.php?/topic/1112-non-drug-techniques-to-cope-with-emotional-symptoms/

 

Some of the things I find helpful when it gets really bad is to listen to comforting or relaxing meditations, music or spiritual talks. Breath meditation.  Having an epsom salt bath, drinking camomile tea or warm milk.  A lot of people find that going for a gentle walk in nature helps.

 

Posting here and reading other people's stories helps some people get through difficult times.  Its ok to just write about what you are going through without needing any specific advise.  Sometimes just getting your feelings out can provide some relief.

 

I wish I could fix this for you or give you an answer.  But you are not alone, many people here have gone through what you are experiencing and managed to taper and get off their medication.  Hang in there, you will be ok.

 

 

[goldensun]

Thank you Petu for your very caring reply. I understand what you are saying, but if this a wave how come I can feel better after a

change in my dosage the very next day, and then I feel worse and then I feel better when I have adjusted the dosage again.

If I was in a wave wouldn't I feel terrible all the time and not have 2 days better days in a row after a dosage change. I thoughtit was my body just trying to find the right dosage it is happy with. It seems to me that my body was very unhappy at the higher

doses but as I have gotten closer to my original dose of 21.9 that it seemed happier. I have responded positively to each dosage cut. I take my medication at night, and when I was on the higher doses, I felt dreadful in the morning but as night time came

around I would feel better. That indicates to me that I am using too much. Now that I have been on 22mg for the last two day,

which was not to bad, I felt ok this morning, but as the day has progressed I have been feeling worse, much worse. This indicates to me that maybe 21.9 or I will just call it 22mg maybe just not be quite enough after a very stressful period of time. I thought that as I was sleeping at 23 and at 22.5mg and did not really have any nausea and agitation that somewhere around these two doses

might be really where I needed to be. I really value your advice. Once again I really appreciate your advice and anyone else that may want to give their opinion on. Thanks

[Petunia]

I'm sorry, but I really don't know for certain what's going on, and I doubt anyone can know, these drugs are messing with our extremely complex brain and nervous systems, both of which are very poorly understood.  The best advice you are going to get here is based on what has worked for most people, most of the time, from years of anecdotal evidence, and that's really the best any of us can do.

 

But having said that, my best guess about what's going on with you is that every time you have made a dose change recently, you have had a placebo effect.

 

When I was in early withdrawal, long before I found this site, I was trying all different kinds of supplements and formulas to 'cure' my symptoms.  Everything I tried, worked for about a day.  I spent hours on the internet, researching various things, then ordering the next combination of herbs/mineral/amino acids etc that was going to fix me.  I would wait for it to arrive from the US, then, when it did, full of hope I would take the first recommended dose and watch for improvement, believing that this one would work, and usually I did start to feel better.  I remember the first morning I took my new GABA supplement.  I waited about an hour and then headed out for a walk.  I was so happy because it was the first time in ages that I managed to walk without being overwhelmed with negative emotions and memories.  But later that night I felt bad again and the next day when I took more GABA, it didn't work at all.

 

The other thing I can comment on is the pattern of feeling worse in the morning and better towards the evening.  This is a very common pattern in people in withdrawal or with a generally destabilized, sensitive nervous system.  Its related to the 'normal' fluctuations of cortisol in the body.  Normally, cortisol peaks around about the time the sun rises, or when a person usually gets up.  In a stable nervous system, this is usually just enough to get you up and engaged in your morning routine, but in a sensitized nervous system, this surge of cortisol can feel overwhelming and cause very physical symptoms of anxiety.

 

Maybe someone else can offer a better explanation or different advice, but if I were you, until then, I wouldn't change anything.

[goldensun]

Thanks Petu, once again I really appreciate your words of wisdom. I know you are right in what you are saying, based on other

peoples experience. I just want to believe that because I have responded to a decrease in my medication after putting it up way

to high, that it is a case of me now being real sensitive to dosage changes, and it is just maybe a matter of finding that right

dose for me, which seems to be not that much far off my original dose of 21.9 (where I was last stable).

 

Alto could you please chime in with your opinion regarding if this could just be a possibility of finding the right dose for me as

opposed to this being some terrible wave. I find it really hard to believe that a change in dosage and me feeling good could be a

purely placebo affect. Petu I know you are right and you give excellent advice and I don't doubt you at all. I just wanted to hear

somebody with different advice, if you don't have any different advice then I respect that. I just thought it may be worth one

more shot at 22.5mg to see if this improves anything. Sorry if this all jumbled up but I am doing the best that I can.

[Altostrata]

goldensun, my guess is your system became destabilized because of the jump up from 21.9mg to 27mg.

 

You are sensitized to the effects of mirtazapine. You get relief when you decrease because of this, but then your system reacts to the drug again.

 

You were not becoming unstable at 21.9mg. I think Petu was correct that you experienced a wave.

 

I don't believe you can go back to a place where you were stable before, you need to find a new level. I don't know at what level you might find relief from the akathisia. I might keep decreasing slightly every few days, maybe by 0.1mg, until the akathisia abates.