namastejen: Remeron, Klonopin, cannot tolerate SSRIs any longer, getting saliva testing

[namastejen]

I was not sleeping well at 45mg...I had to clarify...and felt jittered and shaky on 45mg...but not as bad as now on the reduced for 2 nights + the holistic stuff in my system...but this is without any sleep last night...so it can be amplified.

[namastejen]

I called my regular doc to see what she thinks...

[Narcissus]

They won't be able to do much for you at the hospital, and will likely throw some new drugs at you.At what dose of Remeron have you felt most comfortable at?  30, 37.5, or 45 mgs?  Whichever it is, I'd return to (or stay at)  that dose and hold until things calm down a bit, then we can go from there.  The most important thing is that you stop going up and down on the drugs and throwing new substances at your nervous system.  Check out this thread on reinstatement in addition to the Remeron thread Alto has referred to.http://survivingantidepressants.org/index.php?/topic/3079-about-reinstating-and-stabilizing-to-stop-withdrawal-symptoms/ 

[namastejen]

I am not sure what comfortable feels like...but I guess it is at 30...the pdoc tried putting me on other things to help me feel better quicker but everything was too much and then he wanted to up the Remeron to 45mg but I only went up to 37.5 and then down to 30 and then again he thought 45 was maximizing things so that is what I did for 2 nights and then I have been back to 30 again for the past 2 nights.  This is all too crazy in my opinion...and I guess I should not have but the herb and amino acid in the mix--but I was told there should be no interactions (b.s.)!  So Nortriptyline is what the doc wanted to put me on when 45 was not working...but he agreed to stay at Remeron 30mg and taper down.  Do people taper down one drug while getting on another or should this be cold turkey switch?  I do not like being a lab rat.  I love yoga but that retreat threw me over the edge and brought all of this out...for healing of course but this is nuts.

 

I feel like Restless Leg Syndrome...shakes...and still is in my head.  I want to be out of my head enjoying my family and life. I know this is passing...it is just a season...and I am healing every moment and with every breath.

[namastejen]

Okay I read the literature from Narcissus' suggestion...so perhaps I should just stay at 30mg...so as not to keep going up and down.  Is that what you are saying?  If I was on 45mg for 2 days...would my CNS really get used to it that fast?  I just pray for relief of all of this.  I would like to give the Nortriptyline a chance because at least a blood level can be measured for a therapeutic window....but I need to stabilize  and taper with Remeron first, right?  It would not be in my best interest to switch when I am like this, right?

[namastejen]

Anyone, Bueller?

[dalsaan]

Hi Jen,

 

There are no magic bullets here, nothing that is going to fix this immediately, not a new drug, a change in dose or something herbal.  You need to give you nervous system the opportunity to settle down and then taper slowly.  Pick a dosage and then stick to that for a couple of weeks and monitor what happens.  Your sleep issues are probably a combination of withdrawal and too much stimulation from the herbs.

 

Dalsaan

 

Edited June 30, 2020 by ChessieCat
name change

[Altostrata]

When your nervous system is already destabilized, a cold switch is not a good idea.It seems that you are confused by getting instructions from too many directions. If you wish to follow your psychiatrist's instructions, stick with them. If you wish to follow your alternative doctor's instructions, stick with them.If you go wrong with any of this, we can't give you a simple plan that will instantly set you right.Here are most of the posts I've made in response to your questions. I don't believe you've followed any of my suggestions.

On 10/14/2013 at 4:14 AM, Altostrata said:

I agree, you'll have to be careful with herbs and supplements. Always try a very small amount first to see if you're sensitive to it. About fish oil and magnesium supplements, seehttp://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/http://survivingantidepressants.org/index.php?/topic/1300-magnesium-natures-calcium-channel-blocker/

  

On 10/20/2013 at 3:14 AM, Altostrata said:

The paradoxical reaction -- waking in the middle of the night -- to Remeron suggests to me you might try decreasing it. See http://survivingantidepressants.org/index.php?/topic/2028-tips-for-tapering-off-remeron-mirtazapine/ Quite often, withdrawal syndrome sensitizes your nervous system. It wants to stay at a higher "wired" state than normal. When you use drugs or supplements to reduce this, they may work for a while but eventually the alerting system rebels with paradoxical reactions. The tendency to "wired" needs to be managed with very gentle techniques so as not to set off the alerting system. The alerting level is reduced very gradually. It sounds to me like the yoga retreat was overstimulating. People with withdrawal syndrome often need to avoid excess stimulation. This may be light, noise, exercise, heat, etc.

  

On 10/20/2013 at 3:26 AM, Altostrata said:

No, I did not say to lower the Remeron from 30mg to 15mg. That is a 50% decrease. We recommend much smaller decreases. Please read http://survivingantidepressants.org/index.php?/topic/2028-tips-for-tapering-off-remeron-mirtazapine/ Large decreases disturb nervous system stability. Regaining nervous system stability and healthy homeostasis is a gradual process over time. Carefully used supplements may help; see the Symptoms and Self-care forum. Many people do well with fish oil and magnesium supplements, seehttp://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/http://survivingantidepressants.org/index.php?/topic/1300-magnesium-natures-calcium-channel-blocker/

  

On 10/20/2013 at 3:35 AM, Altostrata said:

If you take Klonopin regularly, you may have problems stopping that, too.We suggest going off the antidepressant first, as the benzo might cushion some withdrawal symptoms.If your side effects from Remeron are going away, you may wish to hold for a bit before starting a 10% taper so as not to destabilize your sleep again.

  

On 10/21/2013 at 4:06 AM, Altostrata said:

If you are getting side effects from Remeron and a slight reduction also reduces the side effects, that indicates you are taking too much Remeron. You would continue to taper at 10%. I would not worry about it being excessively sedating in lower doses. Most often, the problem in reducing it is rebound insomnia, which you want to avoid.

  

On 10/23/2013 at 4:02 AM, Altostrata said:

You may wish to get a second opinion. See http://tinyurl.com/7cp8l8v More is not always better when it comes to psychiatric drugs. Side effects of benzos can be depression and rebound anxiety.

  

On 10/24/2013 at 8:42 AM, Altostrata said:

Continue to taper off 15mg as gradually as you can.You have a belief that the lower dosage is more sedating, but I don't think this is generally so.If I were you, I would not stay on the psychiatric drug merry-go-round. It's your choice, not your psychiatrist's.I hope the holistic treatments help you. To my knowledge, nothing "buffers" withdrawal or we would be recommending it here.Let us know how you're doing.

  

On 10/25/2013 at 4:00 AM, Altostrata said:

Jen, the danger in too-fast Remeron reduction is rebound insomnia. You may think that since it seems to be making you oversleep now, this is not possible -- but it is, and you will like it much less than you like oversleeping.Even though you've been on it only 6-7 weeks, you are at risk for this and other withdrawal symptoms.Very gradual reduction enables your nervous system to re-adjust. You might try a 10% reduction for a week and see how that goes. If you have no problems at all, you might want to try another 10% reduction for a couple of weeks. I wouldn't reduce more often than 10% every 2 weeks.

  

On 10/25/2013 at 4:17 AM, Altostrata said:

It's up to you. You can see if the rebound insomnia goes away after a few days (it may not) or you can reinstate now, stabilize, and taper more gradually.Ashwaganda or Phosphatidylserine can have powerful and unpleasant effects on nervous systems destabilized by dosage changes in psychiatric drugs. I would not take anything more until you understand your withdrawal symptom pattern.

  

On 10/25/2013 at 4:47 AM, Altostrata said:

Reinstate, stabilize, and taper.PLEASE read http://survivingantidepressants.org/index.php?/topic/2028-tips-for-tapering-off-remeron-mirtazapine/

Our understanding is the nervous system does best when stable. Throwing drugs and supplements at it is destabilizing. Going up and down in dosage is destabilizing. Make changes very cautiously.Your nervous system has become destabilized. All bets are off. Pick a dosage, stick with it, and deal with any withdrawal symptoms.

 

Edited June 30, 2020 by ChessieCat
name change

[namastejen]

I just need to slow down and breathe.  I am going to stay at 30mg, so as not to disrupt things anymore by going up again, and wait for the storm to pass. I was taking doctors' orders but I chose two different styles which did not really connect well--traditional and holistic.  The holistic psychiatrist said that there should be no interactions but he was wrong.  The Ashwagandha and Phosphatidylserine should exit my system by tonight or tomorrow--I did not take any today.  So that just leaves the Remeron to deal with.  That will be my learning point here. I do have fish oil and magnesium and will use these as you suggested, Alto.  I read that you said that if 30 is still not a good point for me, I may need to lower it gently.  How long should I wait at 30 in order to slowly lower down to 26.25mg? It sounds like 2 weeks from previous posts.  Pray for me that I do get some wonderful sleep tonight and moving forward and can stabilize soon.

 

Thanks everyone...I appreciate your help.

[dalsaan]

I would suggest waiting 2 weeks minimum to see what's happening with your nervous system.  The aim is to get greater stabiliy which means a lessening of withdrawal symptoms and then the next aim is to reduce your dose gradually so you don't destabalise again and trigger withdrawals when you drop

 

I understand and value sleep but my best advice to you is to concentrate on relaxing when you go to bed rather than sleeping.  If you 'look' for sleep and cant find it, it is anxiety provoking and this diminishes your chances of sleeping.

 

so relax your body as much as possible, do a body scan and contract and relax each muscle, when you are finished that lie there and imagine that you are in a room with friends and family, then imagine that one of them yawns, and then imagine the next person yawning and so on.  Yawning is catching so this gives your brain a message that its tired and needs sleep.

[Altostrata]

Jen, I must say I've gotten thoroughly confused about the ups and downs in your Remeron dosage. I don't know if 30mg is the right dosage for you. At what dosage were you sleeping? Go back to that one.

 

You may just have to stay at 30mg for a while until your symptoms lessen. I can't tell the future. I don't know if this is 2 weeks or 15 weeks.

 

In my opinion, both of your doctors are clueless about withdrawal syndrome, adverse effects of drugs, and tapering.

 

Edited June 30, 2020 by ChessieCat
name change

[namastejen]

Thanks Dalsaan and Alto....yes, they both are clueless about each others' methods and about withdrawal symptoms.  I am looking into going Dr. Prundy or another person to go to because I am not sure what is truly going on here and I need a second opinion.  Dr. Pundy is about 45 minutes away--so not too bad.

[Altostrata]

Very few doctors grasp the problems. You may find, like most of us here, that you have to make your own decisions.

[namastejen]

Hi Alto or anyone else who has seen a neuropsychiatrist,

 

Could you kindly tell me what this neuropsychiatrist did for you?  Any tests, medicines, supplements, anything else of relevance that I did not ask?  Alto, I know you had wrote about it and that is how I found this site but I am looking for more specifics to see if this is what I am going through.  And how did you regain your sleep? Was it with fish oil and magnesium or where there other things that helped?  I am not sure if you had or still have a lot of anxiety but that is what I am having which is pushing depression to the fore because this has been 3 months of trying to feel like me and all I have had is more problems with being on all these different meds.

 

All I know is when the doc put me on a low dose of Zoloft 25mg with the Remeron 30mg, I sort of felt better and was able to sleep well (and actually nap one the five days I was on it)...but when he increased it to 50mg after being on 25mg for 5 days, I became really jittered, anxious, and felt awful and could not sleep--so we discontinued that.  I was on 50mg for 2 days and then 25mg for 2 days and then zero.  I had a couple difficult nights of sleep but then I seemed to be okay to good for about a week and then it has been hit or miss.  Now remember I was on Zoloft 50mg for 9 months postpartum with my baby, then off of it for 5 months before this yoga retreat.

 

So last night, it was okay sleep but not the type I used to get--like 6.5-7 hours per night. I keep waking up at 1 or 2 but was able to get back to some sort of sleep last night but not always.  I took 200mg of magnesium, 3mg melatonin, and my 30mg of Remeron.  Having high cortisol levels with the saliva test, means that I am not making enough melatonin in the brain.  Any other suggestions?

 

How could I find a good neuropsychiatrist out this way (near Chicago)?  I have the other list of doctors that taper and deal with withdrawal--the 2 doctors out by me.  What would a neuropsychiatrist do that a typical psychiatrist would not do? 

 

I think I may be reacting weird to the Klonopin?  I am having muscle rigidity and shaking--especially in my legs, my body rocking/moving back and forth slightly, crying (but I was doing this before I got on anything)--high cortisol = anxiety-- but when I get a little anxious it all gets worse.  I know I need to find my center in all of this.  I want to get off of all these meds.  I have seen this http://www.thecolemaninstitute.com/rapid-benzodiazepine-detoxification-faq#long --what do you think about this?  Anyone have knowledge or experience with them?  Could my reactions be to the Remeron instead or in addition to the Klonopin?  I know I need to taper the Remeron slowly but if I have a more rapid detox of the Klonopin, would that be a good idea?

 

Thanks so much...I am having a better day because I got some sleep...definitely more than yesterday.  Have a good day!

[Altostrata]

You need to educate yourself further about withdrawal syndrome. Your questions are too complex to answer quickly. The answers are spread out in dozens of pages on this site.

 

Read http://survivingantidepressants.org/index.php?/topic/603-what-is-antidepressant-withdrawal-syndrome/

 

http://survivingantidepressants.org/index.php?/topic/392-one-theory-of-antidepressant-withdrawal-syndrome/

 

Very, very few doctors of any type know anything about tapering, much less withdrawal syndrome.

 

As I said before, those cortisol tests really do not show anything useful.

 

Good to hear you did better with sleep. Keep at it.

[namastejen]

What about your experience, how did you get well?  What did this neuropsychiatrist specifically do for you--tests, etc.? I just do not want to waste my time seeing one if they are really no different than a regular psychiatrist.

 

And is there an opinion out there about the quicker detox program?

 

I will read what you wrote but I wonder if there is a documentation out there or if this is what others have put together from only their personal experiences.

 

Thanks!

[Altostrata]

No tests, just his expertise, which I've detailed in 11,000 posts on this site.

 

No quicker detox program.

 

No expert roadmap to dealing with this.

 

No shortcuts, no silver bullets, no spoonfeeding. You have to do the work yourself.

 

Every single person on this site and on others, in hundreds of thousands of posts all over the Web is in the same situation as yourself. Medicine does not recognize the problem of withdrawal syndrome and few practitioners know anything about tapering.

[namastejen]

I saw that you took Lamictal...and I know you have probably painstakingly wrote about all of this numerous times.  Could you kindly let me know how fared with the Lamictal and how long it took to help you? Is there anything else to be done--like staying away from the herbs? staying away from more drugs?  Because I do not think I am faring better with any of the drugs I am on, I want to stop the merry go round, get off, and heal what needs to be healed.

[Altostrata]

I believe I already gave my opinion of herbs, drugs, and supplements in this topic.

 

My estimate is that it takes about 2 years for recovery from post-withdrawal syndrome with the support of lamotrigine. In my case, I had a setback due to reducing it too soon and it took 5 years.

 

Given you are still taking Remeron, it probably is not a good idea for you to experiment with lamotrigine. You would also need to find a doctor who understands how to use it and takes the idea of micro-dosing seriously.

 

Please do not make me repeat information I've already posted in your topic. For reasons of time, I cannot recount every detail of my journey since 2004 for you. Please explore this site and educate yourself.

[namastejen]

Thank you for helping me.  I know that this is the right thing for me to do...I can feel it is right.  I will show it to my pdoc tomorrow.  He may not agree but then I have 2 other people on your list of pdocs I can go see in the area that have helped with tapering. 

 

So to recap what you have written--

1) magnesium and fish oil to help with sleep, melatonin in lowest dose for best effect, I saw phosphatidylserine on your list under self-care---but this may not be an option for me right because I am on Remeron (has serotonin in it already)--I think it was too stimulating for me.

2) Taper slowly 10% every 2 weeks

3) Taper Remeron, then Klonopin--but I think I am having an adverse reaction/withdrawal effect to the Klonopin (as noted above) and would like to come off of it ASAP.  I do not think it is helping me but creating more problems.  I am holding out at .25mg a day just to keep myself on it until I can figure out how to get off of it.  My pills come in 0.5mg...so I can cut them into 1/4th but that is about it.  I know people have titrated.  I guess when I am ready I will have to look into that as a means to getting down to what number?

 

I guess I wonder why the high cortisol levels do not mean much to you in the condition I am in.  I also have very low progesterone that I need to supplement 1/8 tsp 2x a day staring on the 31st--I had extremely low numbers.

 

Am I missing anything that would help me from your perspective?

 

Thanks again for your time.

[Meimeiquest]

Hi J,

 

I'm surely not Alto, but I know she would add daily gentle walking in nature and blocking out all light from LED devices and sun/moonlight in your bedroom, and eating whole foods.

 

Also, an e-book that I have found helpful is Unraveling CFS. Not that you have chronic fatigue syndrome at all, but both conditions share dysregulation of the autonomic nervous system and high levels of cortisol. If you follow his hypothesis, the conditions arise from different brain issues but cause similar problems.

 

Wishing you the best!

[Altostrata]

Jen, have you read Tips for Tapering off Remeron http://survivingantidepressants.org/index.php?/topic/2028-tips-for-tapering-off-remeron-mirtazapine/

If you are not suffering adverse effects, we recommend a 10% taper per MONTH. A faster taper with reductions every 2 weeks may be justified if you are suffering adverse effects, but you risk withdrawal symptoms.

It is very possible you are suffering adverse effects from Klonopin. This may be adversely effecting your sleep. Coming off benzos requires special techniques; see http://survivingantidepressants.org/index.php?/forum/29-members-only-benzo-tapering-discussion/

 

About cortisol -- I would not be surprised if you did have elevated cortisol, that's common in psychiatric drug withdrawal, though I am dubious about the saliva test. See the Symptoms and Self-care forum for our extensive discussions of cortisol.

Yours is not an exceptionally difficult situation. Look around the Intro forum and see what other people are going through.

 

Edited June 30, 2020 by ChessieCat
name change

[Meimeiquest]

Also, I'm not reading back...did Alto tell you 10% every two weeks (she does tell some that)? Every 4 weeks is the usual recommendation until you get an idea of how symptoms appear and resolve. The Klonopin may be helping you avoid more over-stimulation and insomnia from the Remeron.

[namastejen]

Hi M,

 

Thanks for sharing your information.  I love being in nature...it has been cold here in Chicago the past week...so I have not taken my little guy 17 months old out for walks recently. I was doing a lot of this earlier in the season and in the summer.  It is such good therapy, walking...just like gentle yoga, swimming, biking, dance--where you are balancing out both sides of the body with movement that is usual symmetrical on each side.  I am a health nut too so whole foods are my favorite.  And I try to block out as much light as possible in our bedroom at night.

 

Take care.

[Jemima]

  

On 10/26/2013 at 5:15 AM, namastejen said:

Thank you for helping me.  I know that this is the right thing for me to do...I can feel it is right.  I will show it to my pdoc tomorrow.  He may not agree but then I have 2 other people on your list of pdocs I can go see in the area that have helped with tapering. 

 

So to recap what you have written--

1) magnesium and fish oil to help with sleep, melatonin in lowest dose for best effect, I saw phosphatidylserine on your list under self-care---but this may not be an option for me right because I am on Remeron (has serotonin in it already)--I think it was too stimulating for me.

 

Magnesium and fish oil help with recovery from antidepressants overall. They won't necessarily help you sleep.  Magnesium doesn't do much of anything for me with regard to sleep, but it takes care of restless leg syndrome, which I get from time to time and which tells me that I'm not getting enough magnesium. You can try Melatonin for sleep--sublingual was the only kind that worked for me--but taken regularly, it can result in some sadness or weepiness.  That's what happened to me, but I was taking two to three milligrams a night.  Alto's recommendation of .5 mg. is likely best.

 

2) Taper slowly 10% every 2 weeks

 

Considering all the drugs you've been off and on in the past year, your best bet is to stabilize at whatever dose of Remeron you're on now - say for two weeks to a month - and then taper by ten percent, which would take you down to 27 mg., assuming you haven't already changed your dose. When tapering,  THERE IS NO SET TIME FOR STAYING AT ANY PARTICULAR DOSE, although it's generally best to stabilize for a month or more before proceeding with another cut. You have to pay attention to how you feel and make adjustments accordingly.  There is no way to set a schedule in advance.

 

3) Taper Remeron, then Klonopin--but I think I am having an adverse reaction/withdrawal effect to the Klonopin (as noted above) and would like to come off of it ASAP.  I do not think it is helping me but creating more problems.  I am holding out at .25mg a day just to keep myself on it until I can figure out how to get off of it.  My pills come in 0.5mg...so I can cut them into 1/4th but that is about it.  I know people have titrated.  I guess when I am ready I will have to look into that as a means to getting down to what number?

 

Tapering the antidepressant first is generally the way to go. That way the benzo can cushion the effects of withdrawal symptoms.  It's impossible to say whether or not you're habituated to Klonopin without knowing your pattern of use, and even then it's difficult to tell. Are you taking it every day?  If so, how long have you been taking it every day? Regardless of your answers, tapering the K should wait until after you're off the Remeron.

 

I guess I wonder why the high cortisol levels do not mean much to you in the condition I am in.  I also have very low progesterone that I need to supplement 1/8 tsp 2x a day staring on the 31st--I had extremely low numbers.

 

Because:

 

1) Nearly everybody who's gotten off an antidepressant has abnormal cortisol levels, often daily swings up and down that are very uncomfortable; and

 

2) Saliva tests for cortisol are unreliable.

 

The problems you're having are most likely due to antidepressant withdrawal, possibly aggravated by supplements. I doubt you're going to uncover a physical condition that can be "cured" relatively quickly.

 

 

Am I missing anything that would help me from your perspective?

 

Yes, you need to browse this site, especially the 'Tapering' and 'Symptoms and self-care' discussions to find out all that you can about your condition.  The mods and administrators cannot possibly reiterate everything there is to learn on this site.

 

Thanks again for your time.

 

I realize that a lot of your questioning comes from withdrawal jitters and a strong desire to have some certainty in this process, but as of now you've got all the information you need to get started.  If you have more questions, please read back over this thread and read the links that have been recommended. As for certainty, there just isn't any in withdrawal.  There is very, very little that's documented, and everyone's experience is different.  There are as many ways to get through withdrawal as there are people going through it. You really have to get a grip on the basics and then chart your own course.

 

 

Edited July 1, 2020 by ChessieCat
requoted after name change

[namastejen]

Alto and Others,

 

Why was lamotrigine/Lamictal chosen to help you with your withdrawal?  Are there other things that people have used or do people just come off meds slowly when things are not working well on the merry-go-round and deal with what is?

[namastejen]

Thank you for helping me.  I know that this is the right thing for me to do...I can feel it is right.  I will show it to my pdoc tomorrow.  He may not agree but then I have 2 other people on your list of pdocs I can go see in the area that have helped with tapering. 

 

So to recap what you have written--

1) magnesium and fish oil to help with sleep, melatonin in lowest dose for best effect, I saw phosphatidylserine on your list under self-care---but this may not be an option for me right because I am on Remeron (has serotonin in it already)--I think it was too stimulating for me.

 

Magnesium and fish oil help with recovery from antidepressants overall. They won't necessarily help you sleep.  Magnesium doesn't do much of anything for me with regard to sleep, but it takes care of restless leg syndrome, which I get from time to time and which tells me that I'm not getting enough magnesium. You can try Melatonin for sleep--sublingual was the only kind that worked for me--but taken regularly, it can result in some sadness or weepiness.  That's what happened to me, but I was taking two to three milligrams a night.  Alto's recommendation of .5 mg. is likely best.

 

2) Taper slowly 10% every 2 weeks

 

Considering all the drugs you've been off and on in the past year, your best bet is to stabilize at whatever dose of Remeron you're on now - say for two weeks to a month - and then taper by ten percent, which would take you down to 27 mg., assuming you haven't already changed your dose. When tapering,  THERE IS NO SET TIME FOR STAYING AT ANY PARTICULAR DOSE, although it's generally best to stabilize for a month or more before proceeding with another cut. You have to pay attention to how you feel and make adjustments accordingly.  There is no way to set a schedule in advance.  I am staying at 30 for a couple of weeks and then making my cuts by 3.75mg...unless there is a way to get in liquid form (?) My pills are 15mg and I can cut them down to 3.75 (a quarter) at a time.  So people will go all the way down to zero from what I see.  This could take about 4 months--longer than being on currently.  This does not make sense to me.  Why would someone want to taper longer than being on it?

 

3) Taper Remeron, then Klonopin--but I think I am having an adverse reaction/withdrawal effect to the Klonopin (as noted above) and would like to come off of it ASAP.  I do not think it is helping me but creating more problems.  I am holding out at .25mg a day just to keep myself on it until I can figure out how to get off of it.  My pills come in 0.5mg...so I can cut them into 1/4th but that is about it.  I know people have titrated.  I guess when I am ready I will have to look into that as a means to getting down to what number?

 

Tapering the antidepressant first is generally the way to go. That way the benzo can cushion the effects of withdrawal symptoms.  It's impossible to say whether or not you're habituated to Klonopin without knowing your pattern of use, and even then it's difficult to tell. Are you taking it every day?  If so, how long have you been taking it every day? Regardless of your answers, tapering the K should wait until after you're off the Remeron.

 

I guess I wonder why the high cortisol levels do not mean much to you in the condition I am in.  I also have very low progesterone that I need to supplement 1/8 tsp 2x a day staring on the 31st--I had extremely low numbers.

 

Because:

 

1) Nearly everybody who's gotten off an antidepressant has abnormal cortisol levels, often daily swings up and down that are very uncomfortable; and  I had this for a couple of weeks while coming off the Zoloft back in March but felt okay after that...maybe a bit more irritated at times but I felt like myself up until the yoga retreat.

 

2) Saliva tests for cortisol are unreliable.

 

The problems you're having are most likely due to antidepressant withdrawal, possibly aggravated by supplements. I doubt you're going to uncover a physical condition that can be "cured" relatively quickly.  Well, my progesterone is really low, and I have hypothyroidism.  So I am going to start using progesterone cream on the 29th of this month.  I am hoping that this will relieve some of the problems I have been having with sleep and anxiety.  Estrogen dominance can do that.

 

 

Am I missing anything that would help me from your perspective?

 

Yes, you need to browse this site, especially the 'Tapering' and 'Symptoms and self-care' discussions to find out all that you can about your condition.  The mods and administrators cannot possibly reiterate everything there is to learn on this site.  I have been looking at these sections...it shows Klonopin withdrawal using Valium.  I think I would like to do that.  I think the Klonopin is making me depressed.  I was not feeling any depression..just anxiety, these crying jags that would just come on out of nowhere and then stop, and insomnia from time to time.  Now I am feeling depressed due to continued insomnia from time to time and I really think the Klonopin.  My pdoc now says that I can just stop taking it but now I know better...and will work to get off of it soon.  I know you say to do the Remeron reduction first, I am just not sure I can handle the Klonopin anymore.  I will really have to consider this.  I want to take all of the forums advice since you have been there and done that.

 

Thanks again for your time.

 

I realize that a lot of your questioning comes from withdrawal jitters and a strong desire to have some certainty in this process, but as of now you've got all the information you need to get started.  If you have more questions, please read back over this thread and read the links that have been recommended. As for certainty, there just isn't any in withdrawal.  There is very, very little that's documented, and everyone's experience is different.  There are as many ways to get through withdrawal as there are people going through it. You really have to get a grip on the basics and then chart your own course.  Amen!  Thanks!

[Altostrata]

  

On 10/26/2013 at 7:44 AM, namastejen said:

Alto and Others,

 

Why was lamotrigine/Lamictal chosen to help you with your withdrawal?  Are there other things that people have used or do people just come off meds slowly when things are not working well on the merry-go-round and deal with what is?

 

I have already answered the Lamictal question, at length.

 

The best way to come off is to taper slowly so as to avoid withdrawal symptoms. As I've said before several times, there is no remedy for withdrawal symptoms. There is no regimen to make withdrawal faster.

 

Jen, please take your time and read the responses to your questions. I find repeating information for you to be very frustrating. You need to make your own decisions and stop debating.

 

As for taking Valium to get off Klonopin, you need to read more than the titles of the topics. Switching drugs is always risky, and you need a doctor who knows what he or she is doing.

 

Edited July 1, 2020 by ChessieCat
requoted after name change

[namastejen]

Alto, I do not mean to frustrate you. I found this link to your explanation of Lamictal http://survivingantidepressants.org/index.php?/topic/392-one-theory-of-antidepressant-withdrawal-syndrome/?hl=lamotrigine.  I had to search for it though.  I guess I am so freaked out about this because I am doing poorly right now.  I do not think that any of the drugs that have been thrown at me recently have helped me one bit.  Maybe the Remeron on and off at 30mg has helped me to get some sleep.  But now I feel empowered with the knowledge gained here and want to do the best possible thing for myself.  I am looking for some reassurance that weaning myself off of Remeron and then Klonopin would be the best thing. I believe you said that you thought I was suffering from withdrawal effects from even before (Zoloft) as to why what happened after the retreat happened. So I get that now and even more so after reading about it.  I have been doing my best to research as much as I can. I feel consumed by it because I want to know what the h@ll is wrong here.  Would I have to then wean myself off of the Zoloft too?!  Or would weaning off of what I have been on now be enough?

 

Thanks and sorry if I missed this information somewhere on the forum.  Take care.

[Altostrata]

Jen, you're managing to confuse both of us.

 

If you're having adverse effects from Remeron, yes, you'd want to reduce it. If you're having adverse effects from Klonopin, yes, you'd want to reduce it.

 

It's entirely possible neither is helping with the underlying Zoloft withdrawal syndrome, or making it worse.

 

I cannot predict what will happen when you're off both. You might feel better, or you might still have to contend with the underlying Zoloft withdrawal syndrome, which would put you in the same situation as many people here.

 

If you want to hear reassuring lies, pay a psychiatrist for them.

 

You're not taking Zoloft now, it's been 7 months, why are you asking if you should taper Zoloft? That ship has sailed.

 

Edited June 30, 2020 by ChessieCat
name change

[namastejen]

Thanks, have a great weekend.

[namastejen]

Okay...my pdoc pulled me off of Remeron a few nights ago.  I am now on a sleep aid which has given me about 5 hours a sleep a night randomly.  I am looking for help in the next steps of what to do.  Tapering is not an option unfortunately.  Please include your neuropsychiatrist's name and all contact information. I would like to know if this neuropsychiatrist who helped you to get better knows of anyone out my way or if s/he can consult with my psychiatrist.  I humbly ask for your help Alto. 

 

The only time that I felt good in all of this recent "stuff" was when I was on a lower dose of Zoloft with the Remeron but when my pdoc wanted to increase it to 50mg like I had before (June 2011-March 2012), it was too much.  So you have merit to what you say.  I am not sure that Lamictal would work for me but I need something that takes me off the merry-go-round of meds.  Pamelor is next up on my pdoc's list. I know he is trying everything he can.  Nothing else has worked quite as well as the combo of Zoloft 25mg/Remeron 30mg.  If you need to message me personally, I would appreciate it or have it out in the forum.  You are close to my last hope here.  I really hope that you help me by providing your neuropsychiatrist's information.  God wants me to live a whole life again and I must have stumbled across your protracted withdrawal story for a reason.

 

Thank you.

[Altostrata]

Personal message sent.

 

Jen, why was tapering not an option? Why didn't you give a reduction in Remeron a chance? What is this "sleep aid"? (One of the "Z" drugs? They're similar to benzodiazepines and incur rebound symptoms when they wear off.)

 

The fallacy in your thinking is that some cocktail of pills is going to correct your condition. No doubt you've been told this by psychiatrists. What we've found is that, when destabilization of the nervous system has occurred, all bets are off regarding your response to any neuroactive treatments.

 

Switching from drug to drug is not a good idea. You need to move very cautiously, in either adding to or subtracting from whatever goes into your body.

 

Your psychiatrist is very likely not aware of this. Few are.

 

Edited June 30, 2020 by ChessieCat
name change

[namastejen]

I showed your article and my pdoc will not go for it. He would not taper the Remeron an said that I did not need too even though I asked to do so. So now I am at the ER hoping that someone will listen to me. Thanks for you docs info. Take care and pray for me.

[Meimeiquest]

I'm sorry J. I hope you make it through the ER okay. A journey many of us have to make is changing our relationship with the medical profession from authority figures to consultants. And if it doesn't work, there are more consultants around. The doctor makes recommendations, not prescriptions. And we decide what we would like to do with those recommendations.

Beyondmeds.com has a good article on this.

 

Right now I am just getting scripts from my PCP. Because I have had problems with the doctor thing, I chose this doctor (who has a generally good reputation) because he missed a cancer diagnosis in an acquaintance and she waited 5 yrs. to go to another dr. So I tell myself he can make mistakes and it's my responsibility to make good decisions for myself while I sit in the waiting room.

 

Really hope you can get things worked out soon!

[namastejen]

Alto wanted me to update everyone on how I am doing.  I thought it was a good choice to say "Hello!"  I have been doing much better since the end of October--a real 180 turn around since being in the hospital and meeting an angel.  After my weekly stay at the hospital, I met a psychiatrist (angel) who has had to deal with bipolar disorder within himself, in a professional work group during my stint with intensive outpatient.  We were discussing how to balance what were going through with our work and family lives.  I met other psychology-related professionals too among other professions--but meeting people in the field made me feel good that I was not the only one and that I needed to accept that this happens to anyone and not to be embarrassed by the whole thing--meaning that I needed to let go of the notion: if I am a therapist, how could I have let myself go so deep in this mess without being able to get myself out. 

 

I blame not dealing with past traumas as indepthly as I could have (not should have!)--but I am now!--and the damn merry-go-round of stimulating herbs and prescription drugs.  Perhaps these meds would not be so stimulating but taking thyroid medication throws a whole other variable into the mix. I stopped the merry-go-round of meds in December and continued on Seroquel at night--a very small dose. To back track, this angel psychiatrist, even though he was not mine, suggested that I get off of an SNRI because he has seen the type of reaction I was having to it, that my receptors were most likely downregulated and did not know what to do with the SNRI (or SSRIs beforehand), and that I would feel that caffeine jitter until I stopped talking them.  So I upped the meds with my actual psychiatrist doctor just to see if we needed to do so and on the flip side also to see if this other psychiatrist was right. And by golly, he was straight up correct.  I felt even worse with the dosage increase and my regular psych and I decided enoughs enough. I was scared by the 3 months of roller coaster rides but decided that what could be worse to stop it.  Well, the next time the angel psychiatrist saw me the next week at IOP, he said that I looked so much better and so did all the rest of the group members that I had lunch with over the past 3 weeks.  I felt an immediate release of a nasty hold on me...feeling like I wanted to cry all the time and being jittered like no other.  I felt like a light went on in my brain--all stations ready--like my brain was back to me again and not assaulted by the meds. I stopped it cold turkey and was okay--thank GOD!

 

As for the Seroquel, I continued until recently, slowly tapering off of it and I sleep pretty well. It is not perfect sleep but my husband remembers that I was not ever a superb sleeper.   I have my moments around ovulation and PMS time that can throw me off sleep and emotions-wise but for the most part I am functioning well.

 

I am working through some past traumatic experiences that may have reared their ugly heads during and after the yoga retreat last July.  I have also been working through Ayurvedic principles of food as medicine--some foods, especially dry and raw can increase anxiety and a drying out effect on the body. So I know that these are best to be avoided or reduced.  If eaten, I need to drink a lot of warmed (not necessarily hot--but hot is okay) liquids like herbal teas, milk, water with lemon, etc. to compensate for the drying and raw/uncooked quality of veggies, oats, gassy types of fruits (apples, pears, etc.).  So I am learning to accept that this is how I am and looking at healthier ways to work with it.  Prescriptions are a last resort and I have learned so much about activating meds to know that they are not good for me.  I need things that are calming in nature--lavender oil, jatamansi oil/spikenard, sandalwood oil, grounding techniques, yoga/meditation/relaxation, nature, asking myself--is this something I really need to be upset about?, etc. 

 

So I hope that everyone is doing well. Respond back if you would like and take care of yourselves!