Arshness: Wellbutrin Taper and a dilemma

[Arshness]

So hello, I have been reading these forums for weeks but just joined because I want to ask for help. I am miserable right now and I feel I am helpless. Here's my situation.I started taking Wellbutrin SR 150mg earlier this year, I think in June or July. My doc moved me up to 2/day after a few months and then I started having serious, terrible anxiety attacks. She gave me Attarax 25 mg as needed then upped it to 50mg 3/day when I continued having serious consistant anxiety. This hasn't stopped the anxiety. So finally she gave me klonopin .5mg as needed for serious panic attacks. Unfortunately, the klonopin only helps some of the time, the Attarax doesn't seem to help at all (maybe I'm wrong but...) and the Wellbutrin... I finally figured out that it is what was causing my serious anxiety. I NEVER had anxiety this bad before I started Wellbutrin. I didn't realize it until last week when my doc sent me to a specialist about another issue and I was told my hormones are probably imbalanced badly and given a new treatment for that which I start tomorrow. I am now thinking that my depression in the first place was caused by the underlying hormonal imbalance and hopefully the new hormone balancing meds will solve that. However, here is what happened... I have a bad schedule. I worked night shift for years and I'm terrible at going to bed at a certain time. I have insomnia and that doesn't help. So one week I was doing pretty badly on my schedule and I was all off kilter and didn't keep track of the days well for a few days... and missed probably most of a week of my pills. I started having NASTY anxiety attacks and that's when I talked to the doc and she put me on the Attarax and klonopin. Now it's been I think about a month since then and I had been taking my Wellbutrin as prescribed, but I was getting anxiety attacks most nights anyway. I asked her to move me off of Wellbutrin and she set me up for a taper from Wellbutrin to Effexor. Her schedule for tapering is: (Starting from Wellbutrin SR 150mg 2/day)Take Wellbutrin 75mg twice daily for 2 weeks (Note that's a drop of HALF dosage to IR tablets from SR)Take Wellbutrin 75mg daily x1 (at night) and Effexor in the morning for one week. Continue Effexor Daily and take Wellbutrin every other day for 1 week.Then stop Wellbutrin and continue daily Effexor.I am really concerned however because I have read everywhere online that you should not taper Wellbutrin by skipping doses (as per her schedule) and I'm worried maybe she doesn't know enough about Wellbutrin (after all, she did prescribe it to someone with panic disorder) and I'm really scared it's not going to go well. The other part of the issue is because the Wellbutrin is causing me serious anxiety, I don't want to stay on it longer than I have to but I'm scared she's moving me off of it too quickly also.I started the 75mg 2/day as of yesterday. Last night I had the most terrible anxiety attack I've had to date. Today I have felt paresthesia all day and anxiety most of the day as well. I am so tired of feeling this way. I'm so miserable. I need a break from my nerves feeling wired and this is driving me so crazy.Please tell me if you have any advice on how I can make this taper successful without as much withdrawal as I'm dealing with now. I really don't think I want to start a new AD considering how terrible this has felt. I don't know what to do.Thank you for any advice,Arsh

Edited November 11, 2013 by Petu
Member name added to title

[Petunia]

Hi Arsh,

Thank you for joining and for posting an introduction.  I'm sorry you are feeling so miserable at the moment.

 

Wellbutrin often causes increased anxiety, so its not surprising you are feeling unwell.  Have a look at our Wellbutrin topic for some information:

 

http://survivingantidepressants.org/index.php?/topic/877-tips-for-tapering-off-wellbutrin-sr-xr-xl-buproprion/?p=7534&hl=wellbutrin&fromsearch=1#entry7534

 

What symptoms were you having which caused your doctor to prescribe this medication?

 

 I really don't think I want to start a new AD considering how terrible this has felt.

 

I think this is a good decision, Effexor is another nasty drug which causes side effects and is very difficult to withdraw from.  There are much healthier, more natural methods to deal with anxiety and depression, you may want to get some ideas from our topic on non-drug methods for dealing with emotional symptoms:

 

http://survivingantidepressants.org/index.php?/topic/1112-non-drug-techniques-to-cope-with-emotional-symptoms/

 

You will find a lot of friendly, helpful support here.

 

I hope you feel better soon, please let us know what you decide to do.

 

Petu.

[Arshness]

Thanks, Petu. I was originally treated for depression. I believe it was caused by my hormones being imbalanced, but I also had a huge flare-up of PTSD again this March when our house was destroyed in a storm (and I was hit by a tree that fell on the house). After that, my panic was bad and my depression got so badly I couldn't feel feelings anymore.If I felt anything, it was just stress.I really want to give my hormone adjustment medication a chance to fix the depression. For now all I care about is getting off Wellbutrin without losing it. I will look at the non-drug treatments. I was always against prescriptions. I only did these because I was so bad off none of the naturals I tried were working and I felt I had no choice. Any advice on keeping the anxiety at bay while I taper would be so appreciated and does my taper sound too rapid or otherwise not a good idea? Thank you.

[mammaP]

Hi Arsh, you've been through a lot there, no wonder you became depressed! Like Petu I'm also glad you decided not to switch to Effexor, I am tapering effexor and it is an awful drug. 

 

SA recommends no more than 10% reduction with a few weeks between drops, this way it can be done with minimal withdrawal symptoms. That's not to say there are NO withdrawal but it is very much better than going too fast and suffering more. 

I felt a tiny bit better after each drop, it was so gradual I hardly noticed until I suddenly realised I was doing more than I had for years. 

 

It would help if you could add your drug and taper history in your signature line, so it's easy to see where you are at without having to go back to the first post. Here's how to do it.  http://survivingantidepressants.org/index.php?/topic/893-please-put-your-withdrawal-history-in-your-signature/

[Altostrata]

Welcome, Arshness.

 

It seems like you might have the same intuition I have -- that your doctor doesn't know what she's doing with these psychiatric drugs.

 

She should have recognized that you were having a very common adverse effect from Wellbutrin, yet she overprescribed benzos to compensate. (Insomnia is another common side effect of Wellbutrin; anxiety and insomnia are also common side effects from Effexor. )

 

Benzos should never, ever be used to cover up adverse effects from other drugs. A common side effect of benzos is rebound anxiety and insomnia, which makes the whole cycle even worse.

 

Your doctor is STILL ignoring your adverse reaction to Wellbutrin. It sounds like 75mg twice a day is too much for you. Are you still taking the benzos, how often and how much?

 

If I were you, I would not take any more advice from this doctor about psychiatric drugs. If she's a psychiatrist, you need to find a new doctor.

 

And, oh yeah, you need to get serious about your sleep hygiene and circadian rhythm. Only you can do this. This could be at the root of all your problems. See http://survivingantidepressants.org/index.php?/topic/604-important-topics-about-symptoms-including-sleep-problems/

[Arshness]

Thank you for the responses... Let me see...

 

1. I did add info to my signature. It says the Admin has to approve it first. 

2. I literally have no other doctor to turn to for help. I wish I could just get a doc that knew what they were doing with Pdrugs but I don't have a Pdoc available to me at all in any way. There are literally only two in my area, one of which will not see someone who is self-pay like me at ALL and one of which has no openings at all until January which won't help me now. :/

 

3. I am taking the klonopin only on an as-needed basis which is all I've ever had them only, and now there have only ever been a total of 45 .5mg tablets in my hands to date. I have asked her to call in more to help me get through this withdrawal period but not sure if she will or not. I just know I won't survive nights like that first one if they continue throughout this whole time. 

 

4. Last night wasn't AS bad as the night before. I still had an anxiety attack at bed time, but it wasn't as bad as it had been before. 

 

5. I am aware of my poor sleeping habits but am trapped in several ways regarding them. Aside from habit which I am willing to break even tho it's difficult, I have my wife and daughter also who are always trying to keep the same schedule with me (and I with them) so I don't have to adjust just me, I have to adjust all of us which is hard, especially with a 6 year old. We have been trying to do this literally for years with only minimal success.

 

We end up with a day schedule, getting up really early and going to bed at a reasonable hour and then all it takes is one day over sleeping or staying up a bit too late and our hard-won schedule starts to slip again and we can't seem to fix it. Why? Because my wife and I both have anxiety issues especially at bed time and my daughter has trouble sleeping when she's not tired. I know I need to get us all to bed earlier and up earlier, but it has been a fight we've been fighting for a long time with minimal success. I think we're just wired to night time.

 

I was ALWAYS a night person, even when I was a kid and I hated having to go to bed at a certain hour, and never managed to go to sleep when I was put to bed anyway. I always stayed up and read or watched muted TV because I could not sleep no matter what I did. I have made changes to try to help me rest better (sleep hygiene) such as cutting out caffeine within 6 hours of bed time (tho lately I've cut it out almost entirely due to anxiety. It doesn't seem to help and actually seems to make it quite worse.

 

So I went from 3-4 sodas/day to caffeine free sodas only when I drink soda and more water instead of soda when I'm not having a meal.) But that's about all I can get out of this bunch as far as those recommendations go. Our living situation isn't perfect right now. We lost our home in March and there was literally nowhere for us to go that we could afford at that point. (My wife is disabled and I am disabled but not recognized as disabled so I receive no benefits.)

 

So we ended up moving in with my sister who only had one spare bedroom. My daughter sleeps in the living room for now, but we share one room during the day: my bedroom. It's all we have. It's where our computers are. We're computer people. We end up playing video games late into the night and I know we shouldn't, but this is just our thing. It's been our hobby since we were dating (which is 13 years) and our whole family plays games with us. It's hard to get not only myself but my wife and my daughter to change our favorite hobby or stop doing it hours before bed when that's always been the way we do things too. I am not stuck in my habits but it's hard to change all of us when I'm the only one who seems to suffer from it. My wife doesn't sleep as well without a screen on at night due to her anxiety issues as turning to the screen (where she puts soothing pictures on screensaver) will actually keep her calm if she wakes up in anxiety.

 

I prefer the screens off for bedtime but we've gone rounds on this for years. I don't think my circadian rhythm even matches the normal one anymore if it ever did. I only get sleepy in the early morning hours and if I swap my schedule around over the course of a couple of weeks, I will be exhausted in the afternoons and usually end up eventually unable to get through an afternoon without a nap which ruins the schedule right there because it pushes bedtime back by a few hours (because I'm not one of those people who can power nap. I have trouble waking up again. But I literally fall asleep in my seat otherwise.)

 

Which, all of this is not to say I am unwilling to try suggestions regarding ways to move forward with this. I just want to make clear the very long struggle I've had with sleep since my childhood and the difficulties involved and what we've already tried. I wanted to try to get back on a day schedule this previous week, but with a taper on Wellbutrin going on it seems i just sleep ridiculously long periods of time. It's double bad because I get up later than usual and then I can't even get to sleep when I want to (because I know to get to sleep before about 5am or I'll have an anxiety attack, but it's hard to sleep at 3-4am when you got up at 4pm). I'm in a really bad cycle on this right now because I swear the meds are making me sleep long and deep when I otherwise wouldn't be sleeping this long. And my wife has tried to get me up but it's impossible. I'm too out of it. 

 

6. That all said, I feel *better* today than I did yesterday waking up. Not sure if this is a good sign of how the taper is going or if it's just me calling it too early. I woke up yesterday with creeping anxiety already starting. Today I feel more or less fine. I think the suggestion that I was sensitive to too much Wellbutrin is spot-on. I realize when I was taking the 150mg I don't think I had started having the anxiety at all. It was only when she moved me up to 300mg that I started having the serious problems. She had done that because my depression was creeping back in, but at that point I was only taking the Wellbutrin, iron pills for my anemia and my usual allergy medicine (that I've taken for years and years with no problem. It's Cetirizine 10mg) 7. I am hoping against hope that tonight will be better and maybe the first couple days were the roughest and maybe it will keep getting better from here since I'm  down to the amount that originally didn't make me have anxiety. Maybe. Maybe. Maybe. Is 2 days long enough for the higher dose's halflife to have worn off? Would that make sense?

 

Thank you all so much for your support and advice. If it seems like I don't listen to the advice, please understand that's not true. I do not mean to "combat" your advice by saying all the difficulties I have with it. I only mean to shed light on my situation because some of this is nothing I haven't tried, but I do appreciate all advice. Maybe something I haven't tried will work. I am ALWAYS willing to try to make an improvement for my lifestyle and my health. One other note I should make: I tried 5-htp for the anxiety I had back in Fall of last year which came up around some stressful times in my schoolwork. It worked wonders for a couple of months, then I started getting insane anxiety, way worse than when it started. I read that seratonin basically makes your anxiety go down at some levels, then at some higher levels, it makes anxiety worse. I think I reached the wrong levels. 

 

I took Melatonin before to try to help with sleep (early in this ordeal since March when I was having trouble sleeping through the fits of flashbacks from the storm (PTSD)) and it made me feel awful. I felt so groggy and not-there when I woke up. I didn't feel it helped me fall asleep or stay asleep or sleep deeper/better, but when I would wake up, it'd feel like I'd slept horribly. I didn't take it more than a week I think. At that point I was not taking any other meds. 

 

My doctor tried me on tramadol for sleep, but I hated them. Again, made me feel awful. I only tried that twice before saying "no more of this ever please". I try a lot of homeopathy and naturals to try to help me with things. I drink chammomile sometimes to help relax me, but it's never been strong enough to help with my anxiety. I have tried so many natural herbs and such over the years to try to get me where I want to be instead of meds, and only turned to pharma when I felt I was without any choice as none of the things I read would help depression were helping me. 

 

Again, Wellbutrin DID get me out of the worst depression of my life, but it also gave me the worst anxiety of my life. Which is saying a lot as I had PTSD pre-dating the storm in March and have always had issues with that. I'd never had anxiety attacks of the degree Wellbutrin has caused me tho. 

Edited November 11, 2013 by Altostrata
added paragraphs breaks for readability

[Altostrata]

Arsh, please add paragraph breaks, those long paragraphs are hard to read.

 

Your signature is not subject to admin approval, try again.

 

How much Wellbutrin are you taking now? Yes, the higher dosage might have worn off.

 

How often do you take klonopin?

 

Interactions between Wellbutrin and cetirizine http://www.drugs.com/interactions-check.php?drug_list=569-0,440-203

 

Any doctor can prescribe psychiatric drugs. You don't need to see a psychiatrist.

 

If I were you, I would not take further advice about psychiatric drugs from your current doctor.

 

Both Wellbutrin and Klonopin can exacerbate anxiety and sleeplessness. And so can the light from a video screen into the night!

 

See http://survivingantidepressants.org/index.php?/topic/604-important-topics-about-symptoms-including-sleep-problems/

 

Both you and your wife may find fish oil and magnesium supplements to be helpful, 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/

[Arshness]

Alto,Okay I'll check the signature. I swear when I signed up there was a little note that said it would be approved by an admin before appearing and I did enter information into the sig box at that time and it's not showing up on my posts, so I dunno.I am taking 150mg of Wellbutrin as 75mg 2/day IR version currently. I was taking 300mg as 150mg SR 2/day before this week.I only take the klonopins as needed. She gave me like... 12 of them the first time and they were used in a couple of weeks because that was when I was having the severe anxiety attacks with the time I came off my meds accidentally.I then received 30 more and those were used in about a month and a half (not always taking them, just as needed, sometimes 2 at once instead of 1 as recommended by her when the anxiety was really bad).I have just received one more refill of them from her and been told she won't be able to give me any more script for them, so probably all I will have of them. But that's okay. I only wanted them for the emergency panic attacks.Additionally, as stated previously: I can not see another doctor. There is literally no one else to see in my area at this time. I don't have transportation to travel far out to get another doctor. My current doc is my only choice at this point. And sorry for the long paragraph. I got kinda carried away trying to explain the situation. 

[Petunia]

Hi Arsh,

You certainly have some challenges in your current situation, its not surprising you are experiencing increased symptoms.  I admire you for doing your best to take care of yourself and your family.

 

Most likely, the best advice anywhere regarding withdrawing from these medications is from Alto, she has an incredible amount of experience.

 

Given your difficult situation, if I were you, I would just do what you can to follow her suggestions and take things one day at a time.

 

Perhaps when your situation changes, in the future, you could have some counseling or therapy for dealing with your PTSD and trauma from the storm to deal with anxiety, rather than taking drugs which just suppress symptoms.

 

Petu.

 

 

 

 

 

 

[Arshness]

Petu, Thanks. I don't plan on going back on a pharma for these problems. The sad thing is my anxiety was decidedly mild before Wellbutrin to how it is now. :c I'm seriously hoping that dropping the dose back will resolve the anxiety and soon. I have way too much dread and terror to be a happy person right now. :c I'm constantly afraid I'm dying.Arsh

[Arshness]

So can anyone tell me if my prescribed taper is too fast? Should I do something different than the doc said? Should I do a 10% anyway even tho she suggested the other? I don't know. She's actually an LPN. I hadn't thought about that in a while, but the clinic I go to doesn't have a doctor except one who oversees the clinic and doesn't see patients. He approved the benzos but he hasn't interacted with me at all. I wish I had a pdoc I could go to but I don't have one available at all here. There is only the clinic I go to and they are general practitioners only. :c

[Altostrata]

Drug interactions http://www.drugs.com/interactions-check.php?drug_list=569-0,1303-774,703-357,440-203

 

Are all your drugs absolutely necessary? You'll have to read up on all of them since it seems your medical authorities are not reliable.

 

See this topic for tapering off Wellbutrin http://survivingantidepressants.org/index.php?/topic/877-tips-for-tapering-off-wellbutrin-sr-xr-xl-buproprion/

 

Since you dropped from 150mg twice a day to 75mg twice a day LAST WEEK, what has your symptom pattern been?

 

I am thinking your current "anxiety" attacks, which may be getting better, are a withdrawal reaction from that drop. In that case, if your symptoms continue to lessen, if I were you I would hold at 75mg twice a day until they go away, then reduce by a quarter of a tablet every week or two, since you seem to have an adverse reaction to Wellbutrin in general.

 

What is your symptom pattern in relation to the times you take Atarax and cetirizine? You may be having paradoxical reactions to one or both, see http://www.drugs.com/mmx/hydroxyzine-pamoate.html

 

Do you at least have a good gyn? You cannot evaluate those surgical options without one.

[Rhiannon]

Alto is The Bawse where AD tapers are concerned, but I'm pleased (with myself) to see that my first thought (that for now, given how activating Wellbutrin has been for you, it might be best to stay with the 150 a day even though that was a big reduction) is what she recommends too.  Maybe I'm catching some clues...?

 

You need to be aware that you have almost undoubtedly developed dependence on the Klonopin. Benzos are extremely and quickly addictive. If you took 12 pills in 14 days and then 30 pills in 45 days that is more than enough to develop dependence, in which case the drug itself, when you don't take it, causes "rebound" anxiety.

 

Klonopin is not an appropriate benzo for interrupting panic attacks. (I agree, your doc sounds remarkably clueless, and it doesn't sound like she's even bothered to read up on the drugs before prescribing them). Klonopin is long-acting; for panic attacks, short-acting benzos are the appropriate drug, as long as you don't take them more than twice a week or so. 

 

Best thing to do to prevent rebound anxiety due to Klonopin dependence is pick a dose and stick with it, taking the same amount at the same time every day. You will probably be okay with Klonopin with taking it just once a day, until you're ready to taper off, when you may want to split the dose and take it twice a day.

 

But it's early days to think about tapering Klonopin. Your doctor seems to have flung you rapidly into polypharmacy chaos (way to go doc). You will need to disentangle yourself systematically and carefully, particularly given the other stressors in your life. 

 

As for the sleep issues, well, I think you know that you need to do something about that. Even with your current living conditions there's a lot you could tweak, a bit at a time. I'd start with the danged monitor screens. Computer monitors put out blue light. Blue light prevents your brain from producing melatonin. Melatonin is absolutely required for sleep and to regulate your circadian rhythm.

 

It sounds like you've heard this before. It's true. You absolutely must limit your exposure to blue light for several hours before bedtime. I know it's your hobby, but maybe you can practice your hobby during the earlier hours of your day, and stick with books and conversation in the "evening" (whatever time your evening is). I just came off a year of working graveyard shift and I used blue-blocker goggles in the mornings (basically just orange goggles) because morning light contains more blue light than afternoon and evening light. If I need to get on the computer before bedtime I pull out the orange goggles, and they do help, but not as much as just staying away from the danged screen altogether.

 

And TV screens produce blue light too, although we don't sit as close to them as we do to our computers so the effect is weaker.

 

It might be easiest, rather than trying to tackle changing everything up at once, to just tweak one thing at a time. I think from what you have described that your best bet for "first tweak" would be getting some control over your patterns of light exposure. The pineal gland (which produces melatonin and controls the sleep/wake cycle) is exquisitely sensitive to light exposure, and most of all to blue light, so I think you'll get the most "bang for your buck" if you start there.

 

I know this is a lot of information and it can seem overwhelming, especially since your life right now is pretty stressful anyway. Hang in there. Take it in and make changes a bit at a time. Forgive yourself when you screw up and just get back on your feet and keep going. You can do it.

[Arshness]

Thank you for all the advice. There are a few issues. One, I can't take klonopin daily and then taper it. She said she can't get me another refill after this one and it's only 30 pills. So I wouldn't have enough to taper it if I started taking it daily. I don't know what to do on that. I just know I'm tired of throwing my money at pills she tells me will work only to find out they were bad for me in the first place. I won't be buying any more pharms at her recommendation. I'm very upset about that. :c It's not right. I should be able to get my money back if she's been utterly incompetent and pushed me in all the wrong directions. She's put me through half the pain I've asked her for relief from! That's BS!And this is why I didn't trust doctors and didn't want to go to one in the first place... sigh. It was good I did because Anemia would have landed me in the hospital if it'd gone much longer unknown but the rest of what happened as a result isn't really a good thing. :c Back to skeptical for me.She gave me no instruction what soever on the klonopin in regard to how often = addicted. She just gave me the pills and said to take no more than 2 per day as needed. But made it clear I wouldn't be getting them on a regular basis and now she has told me this is the last time, so I can't even taper those off effectively. :cAs for the Attarax, I don't know... I'm not even sure it causes me a reaction. I kinda want to stop taking it too but I think the idea was to keep it until my Wellbutrin settles down so maybe the anxiety won't come back so bad. I don't know which thing to do tho. Should I continue taking it 2/day or ... I don't know on it. I will hold for now on 75mg 2/day with Wellbutrin to see how that goes as you suggested. As for my meds necessity: Wellbutrin was for depression. I needed something for depression and I likely will go back into depression if it's removed completely. I still want off of it. I will find other ways out of my depression. The Cetirizine is the only allergy medicine that works for me. It has never bothered me or caused me symptoms. I'd say that one stays.Attarax is not necessary if the anxiety stops from the Wellbutrin... which... it isn't stopping anyway. I'm not sure if it's reducing it anymore. I wouldn't know without stopping taking it, but I don't know how to or if I should yet. Klonopin is definitely not necessary if it's just going to cause more anxiety. I'm really angry that I was prescribed medicines for anxiety repeatedly that will make anxiety worse! What the hell!? Come on! I know she's just an LPN but ... really? Why does she even touch these meds if she doesn't know what she's doing with them... she's playing Russian roulette with my nervous system when I'm already fragile goods in that area from MS. I'm so glad I found this forum. I don't know what I'd do without someone knowledgeable to talk to about this. I can't go to my doc for that anymore, obviously. -_-I had less anxiety all day yesterday, then an attack at bed time again. I didn't get to bed when I wanted. I was getting settled in at 4am trying to beat the 4:30-5am anxiety times, but my daughter asked me to read to her before bed so I ended up awake longer than I intended then the anxiety hit me before I could get to sleep. I tried to get up at 11am but it was like I was made of stone. My wife tried to get me up since then until it finally worked at 3:30pm. I'm feeling so zonked and groggy still. Now that I got up even a little earlier than the day before tho, hopefully I will be able to get to bed a little earlier too. It's been so hard making myself sleep when I am having anxiety and I'm not even sleepy enough  to fall asleep.I will talk to my wife about the screens issue. It's ... difficult.. Because most of the things we do involve the screens. Even our other hobbies which involve more conversation and such have lots of screen involvement due to reference books and sheets and such. How many hours before bed do I absolutely need to cut screens out? And does my Kindle paperwhite count? It's not a blue light is it? It's just a white light. I read myself to sleep a lot, so I'd hate to not be able to use that too. I keep it on lower settings around bed time, but... it's kinda necessary for me to be able to read to sleep when my anxiety is bad. Thank you again. 

[Altostrata]

It would help if you kept notes of your symptom pattern on paper, with the times you take any of your drugs.

 

It's possible Atarax is contributing to your symptoms http://www.medicines.org.uk/guides/hydroxyzine%20hydrochloride/anxiety

[Arshness]

I should add that I haven't had a klonopin in several days. I think the last time I took one was either Saturday or Sunday. I haven't felt more anxious, actually less anxious. Maybe I'm not dependent yet? Could I just not take them anymore since it was only .5mg doses anyway? 

[Arshness]

I'll start noting those things on paper as you say.If I want to stop Attarax should I just stop it or is it also going to need a taper? Since it's not an Anti-depressant I don't know what applies to it. I am kinda horrified by the fact that every med she's given me so far has the effect of worsening anxiety. Yay medical community!

[Altostrata]

You may be overdosed with Atarax and cetirizine:
 
http://www.medicinenet.com/hydroxyzine/article.htm

Hydroxyzine is an antihistamine with anticholinergic (drying) and sedative properties that is used to treat allergic reactions. The body releases histamine during several types of allergic reactions and, to a lesser extent, during some viral infections, such as the common cold. When histamine binds to its receptors on cells, it causes the cells to release chemical messengers that lead to sneezing, itching, and increased mucus production. Antihistamines, like histamine, binds to the histamine receptors, but when they bind to the receptors they do not stimulate the cells to release chemical messengers. In addition, they prevent histamine from binding and stimulating the cells. Hydroxyzine itself has no histamine-like activity. After ingestion, it is converted to its active form. The active form of hydroxyzine is a drug called cetirizine (Zyrtec). Although, both hydroxyzine and cetirizine act as antihistamines, hydroxyzine causes more sedation than cetirizine. The FDA approved hydroxyzine in 1956.

 

 

http://www.drugbank.ca/drugs/DB00557

Hydroxyzine half-life 20 to 25 hours

[Altostrata]

With that half-life, and your taking it twice a day, it's going to be difficult to figure out if Atarax is causing any of your symptoms.

 

http://www.mybwmc.org/library/41/065900HydrOXYzine 

Adverse Reactions Central nervous system: Drowsiness, headache, fatigue, nervousness, dizzinessGastrointestinal: XerostomiaNeuromuscular & skeletal: Tremor, paresthesia, seizureOcular: Blurred visionRespiratory: Thickening of bronchial secretions

 

 

What is your symptom pattern during the day?

[Arshness]

OMG are you serious? Uuggh. I can't believe the ignorance of my doc.:cOkay, so basically I wake up with mild anxiety and paresthesia in the arms especially. When I take my Wellbutrin, it calms down after an hour ish. I might have mild anxiety or anxiety spikes, or paresthesia spikes at different points in the day, tho it doesn't seem to follow a precise pattern. I take my second Wellbutrin about 12 hours after the first one and if I am not asleep already by 3-4am, I will have a massive anxiety attack around bed time. I am trying to go to bed earlier to avoid this. I still have increased anxiety when I lay down regardless of the time because I have palpitations and can feel my heart racing and it scares me and I get anxiety. Even if I lay on my right side, it will happen some. I usually read myself to sleep as a result. Anxiety/panic and paresthesia, racing heart sometimes/palpitations are the only symptoms I can really name that I have. I got some fish oil, some oily fish to eat, some walnuts and some vitamin E as per the recommendations. My store didn't carry any Rhodiola :c I did get some magnesium lotion tho. I will try that later. It sounded like a good idea. I also have a ton of oranges, some spinach and some dark chocolate. I've read up on cortisol reduction and I'm going to do it. I have black tea already and normally drink some, but going to try to drink a cup a day instead of 1-2 per week and see if that helps too. I already quit caffeinated sodas a few weeks ago due to the increase in anxiety they caused me. Hopefully this will all be over soon. Hopefully.

[Altostrata]

When do you take the Atarax and when does the parasthesia start??

 

It sounds like you might have light-triggered anxiety at night. This causes cortisol, the anxiety hormone which is a daytime hormone, to rise, often around 3-4 a.m.

 

You might block out all light in your bedroom at night, with blackout shade and curtains, and use a sleep mask. See http://survivingantidepressants.org/index.php?/topic/604-important-topics-about-symptoms-including-sleep-problems/

 

Please see our topic on rhodiola. This is a supplement that sometimes backfires for people with withdrawal sensitivities.

[Arshness]

I was taking the Attarax morning and evening with my Wellbutrin. I was supposed to take it 3/day but only did that for like a week. (I'm bad at remembering meds and my pill case only has morning and evening boxes, so I rarely remembered noon pills). Paresthesia had been going on every morning just after I woke up and then off and on all day. I did not take my attarax at all yesterday and this morning I do not have paresthesia (*knock on wood*) or anxiety yet. I actually woke up feeling pretty normal today. I have a mild headache (not uncommon for me even before meds) and I think that's mostly coming from a sore neck that I feel pulling tension in the back of my head. Will stretch it out throughout the day.My bedroom already has blackout shades and curtains and I sleep facing away from the window. I can't tell if it's night or day when I wake up. I could try adding a sleep mask but not sure how I'll feel about that. I get panic sometimes when something is on my face. I will read the topic on Rhodiola.I'm actually beginning to doubt that I have had withdrawal reactions as much as that I was extremely sensitive to higher doses of Wellbutrin. I might have had a reaction when I almost accidentally stopped cold turkey those few weeks ago, but now, as I my dose has settled at only 150mg a day again, and I stopped taking klonopins and didn't take attarax at all yesterday and now I'm suddenly feeling... dare I say... normal? Maybe my symptoms were being caused by the drugs themselves and not by withdrawal from the other drug as I was lowering it?I don't know where I am on this right now. I'm too afraid to hope I will just be fine from here on out, but I can't help wishing for it!The magnesium lotion really seemed to help calm me down last night too. Before it I was having a mild anxiety attack and paresthesia, after it went on, I settled down more than I expected and didn't have massive difficulty getting to sleep. My wife is now eyeing her attarax with distrust and wondering if it's what's been causing her to gain weight she hasn't been able to lose easily despite changing her diet and lowering her calories appropriately. It seems that others have gained weight with atarax as well. Strangely, I've only lost weight in the past month, dropping 15 pounds within 3 weeks between doctor trips and I hadn't done anything difference except having stopped drinking caffeinated sodas (still drinking sodas with similar calories, but no caffeine). But I don't know how to combat her serious anxiety and paranoia without the atarax. It was the only thing that so far had taken the edge off. She has never taken any pharmaceuticals for any serious length of time. Her trials with anti-depressants and other anti-psychotics were always like a month or less each and none of them ever worked for her so she never took them. There was nothing that worked for her anxiety until she was given atarax which helps blunt the anxiety but doesn't get rid of it of course. I want to find some natural options to try with her. Especially since she will definitely stop taking the atarax if she thinks its why she's gained so much weight. It upsets her enough to bring on depression. So I'm trying to figure out how to combat her anxiety with something natural so that when she drops the atarax she will be okay.

[Altostrata]

You and your wife may both find taking magnesium glycinate in divided doses throughout the day helps with anxiety.

 

Many people are low in magnesium and supplementation helps quite a bit.

[Arshness]

What form does it come in and how much do you think we should take? I have never heard of glycinate. I've heard of several other forms but that one is new to me.

[Altostrata]

see http://survivingantidepressants.org/index.php?/topic/1300-magnesium-natures-calcium-channel-blocker/

[Arshness]

Okay so an update on me.I have not taken atarax since Monday. My paresthesia and anxiety have both become less frequent. My Wellbutrin is still at 75mg 2/day right now. I still take cetirizine for allergies, 10mg/day.And I've been eating dark chocolate 40g/day. Yesterday, I began magnesium citrate (found the liquid at my Walmart) starting with about .5 ounce of it in water. Last night, I took that at 4:40am. I had been going to bed every day by 3am and was doing better on night-time anxiety attacks, but last night, lost track of the time completely and didn't realize until 4:30am. I took the magnesium with plans to go right to bed and started to get settled in, then started having an anxiety attack, of course since it was close to 5am and we're on daylight saving's time so that's about my time for starting anxiety (4:30-5:30am right now).  

I felt that the magnesium relaxed me a little, then the anxiety attack started so I couldn't decide how I felt about it. I read that if you're severely magnesium deficient, it can cause some anxiety and stuff when you start it. Not sure if it was that or just the time of night.Couldn't get to sleep til about 7am when the anxiety finally passed after, in desperation, I tried EFT.Went to sleep, got up at 3pm thankfully and had felt very mild anxiety/uncomfortable feeling but I wasn't sure if it was anxiety or just me feeling a bit ill as I'd started having chest congestion yesterday. I didn't know if it was a legit cold or withdrawal effects from something. (Still haven't taken klonopin again at all and not planning on it. I quit the atarax all at once, but I don't think it's an AD so that should be okay right? Anyway, I did start the nuva ring last week. I'm scared of the blot clot risk, but it's a tiny percent chance and SOMETHING has to stop me from bleeding myself to death. After a few days, my bleeding stopped completely and I was happy with that at least. But I had some pain in my chest last night as I went to sleep (I figured from congestion) and then woke up this morning with the pain still persistent even tho I stopped coughing stuff up last night. So then I had a panic attack with fear it was a pulmonary embolism (even tho I don't think that could have come up suddenly when I just started the ring a few days ago?) and had to go do reading on PE's to try to determine if it was that or congestion. Finally decided it has to be congestion because I don't have other symptoms that match and I DID have congestion yesterday.However, haven't been able to shake mild anxiety since then. Just took my magnesium and my anxiety seems to be rising a little. Going to try EFT again and see how it works. My wife also started magnesium and is taking it in place of her atarax. So far she hasn't freaked out so here's hoping. I just want this anxiety to end. I can handle any of the rest of it, but the anxiety is my bane. I can't handle this level of stress and panic all the time. The few days I've had with mostly no anxiety have been blissful. I've cried, I've thanked, I've begged the universe to continue that relief.  

[Arshness]

EFT worked again. I admit I was skeptical because I tried it years ago and got no results, but twice in a row it has helped calm my anxiety down. Of course, both times, I did it after I'd taken magnesium too... But if it helps me handle the feeling until the magnesium kicks in or whatever, that's good enough. Tho I think there's something to this "self love" idea inherent to EFT. So maybe. Gonna keep doing it when I get attacks to see how it goes.

[Arshness]

And I went to bed early, 2:30ish which is quite early for me actually. I took a 5mg melatonin before laying down to try getting better sleep. I was fine until I suddenly woke up because it got hot in my room and my daughter bumped into my bed on her way to her bed. (My wife was up with her after me).After I woke up, I couldn't sleep because it was hot in my room. I had to go turn the AC on by which time I'd woken up substantially.I tried to lay back down but was too hot still and started having uncomfortable feelings. I realized it was about 4:30 and likely I was going to start having panic again. I tried to get to sleep anyway. I kept almost falling asleep, then my breath would slow like it does when you fall asleep and my brain would panic that I was dying. I hate hate hate this.I got up and laid back down repeatedly for a few hours, trying to get to sleep, then being too panicked to attempt it, on and on. I woke up again about half an hour ago and I decided to go turn the ac up a few notches to avoid it getting TOO cool in my room since it was nicely cool now. I ended up talking with my sister for a while about my fears. I'm terrified I'm going to die suddenly. I know I didn't have this before the anxiety. I know I didn't have the anxiety before the meds. I know I didn't have panic attacks at all before the meds. I am so angry that these medications which I PAID for, money from my tight, tiny budget that could have benefited my family in other ways have caused me more agony than they have solved. I am so angry that my doctor has taken my copays for so many visits which only resulted in her giving me bad medical advice and it's not like I can get that money back even tho she caused me more harm than good. I'm so angry that there are literally zero good options for health care available to me and that I am pretty much on my own so far as it goes. The nuva ring's warnings for increased risk of blood clot got me to read about blood clots and pulmonary embolisms. Now I'm terrified I'm going to get a blood clot and die suddenly. Sudden death is a huge phobia for me. Especially since our local hospital is so terrible I do not trust them to save my life if I was even gotten to them quick enough. Our local ambulance and paramedic service is notoriously horrible. (I had to call them once at a restaurant I used to work at when a customer suddenly had a seizure on our front patio. They went to our store in a neighboring city despite being told which store it was and being given the correct address. When they finally got there, they tried about 20 times to get an iv on the man's arm and could simply not do it. They couldn't even control him from bashing himself open on the concrete. Then when the waitress and I who had been tending him while they arrived asked if they had something for us to clean the blood off of our hands with (from the man hitting his arms on the concrete and such) they shrugged as if it didn't matter and suggested "there may be something on the back of the truck". Without even remotely attempting to direct me to where to find such a thing, and definitely without say, actually giving it to me. Okay. I'll just have a stranger's blood on me, not like it matters to you. Our local health care is absolutely horrifying. I can't afford decent health care, but it's not like there even is any to be had in this area. I'm so angry that my options feel so limited while I'm suffering mainly because of medical steps that were taken incorrectly in the first place. 

 

So back to tonight... I remember now why I didn't like taking melatonin. it makes me feel weird. I get too relaxed and it has this weird effect on me where I feel kinda numb. I hate it because anxiety can mimic the symptoms of MOST of the things I'm breath-takingly afraid of. Like shortness of breath. I have asthma to boot and have had possible congestion in my chest the last few days. But of course my anxiety-ridden mind says "WHAT IF ITS A PULMONARY EMBOLISM = SHORTNESS OF BREATH OMG I AM GOING TO DIE". I had muscle spasms earlier. I figure because it was getting cold in the room and my body has issues at the best of times with little quirks of the muscles or nerves like that. Probable MS makes this really something I'm used to, but its still scary. What if it means something is horribly wrong with me?So here I am at 7am having barely gotten any sleep, exhausted, still anxietied to hell and back, not sure what to do, feeling trapped and helpless and pretty hopeless. I just don't want to suddenly drop dead. I'm 28. I'm obese and sedentary and that scares me. I try to be otherwise, but I had a slew of medical issues that lead me into obesity despite attempted dieting and exercise, and now that I'm this big, my body hurts so much if I move around a lot that I just don't very much anymore. With anemia it's hard to exercise at all. With anemia plus asthma it's dangerous for me to do anything that really elevates my breathing. And with heart arrhythmia, palpitations and fear of sudden death, it is REALLY hard to get my heart rate up without anxiety attacks. I feel so screwed. The meds are being slowed dialed away but I'm still so scared when these attacks hit me. The severity of them seems to still be potentially just as bad as they were earlier on. The frequency has settled a lot, but it feels now like I'm walking a tight rope. If I stumble just a little I fall right into the panic attack. It's hard enough for me to make myself go to sleep without this ****...

 

I just want to be able to let all of this go and get  back to my normal life. I hope hope hope this will all be just a bad memory in another week or two. I can hope. 

[Rhiannon]

This will all be a bad memory eventually, but to really stabilize is going to take much longer than a week or two.

 

Here's my pep talk:  Hang in there and keep tweaking your life to improve things bit by bit. It sounds like you know what you need to do, just take it in small steps and give yourself lots of praise for every little thing.  

 

For example, don't push yourself to work out, just get out and walk down the block and back and then give yourself props for it, rather than thinking "well that was nothing so it doesn't count." Moving at all does count. Moving even just a little is way better than not at all. And in a few days or a week or two you will be going all the way around the block, and then maybe two blocks. That's enough. That's huge!

 

And the same way with the sleep improvements. Just do what you can. Turn the lights and monitors off at 1 a.m., or 2 a.m. if 1 seems impossible. Whatever seems possible, a bit of a push but do-able.

 

And the same with getting the Klonopin to be regular--I think that's pretty important for you from what you describe, I think you may be having some induced anxiety due to roller coaster blood levels and you'd be better off taking the same amount at the same time every day.

 

I know it's a lot, but just focus on today, and just do at least one thing, one tweak, whatever seems do-able right now, and then--this is important--give yourself the props for it. Because it's hard, and you're climbing a mountain, even if it's invisible to other people.

 

You can do this but it's a big mountain. Climb it one step at a time. Baby steps if necessary. You can do it.

[Altostrata]

Taking melatonin at 2:30 a.m. signals to your brain that it is nightfall. It resets your entire circadian rhythm. You're training it not to sleep at real nightfall, but artificial nightfall.

 

Taking melatonin at real nightfall -- and dimming the lights -- reinforces a natural circadian rhythm.

 

Why are you eating 40g of chocolate? Chocolate may contain caffeine. This will also disrupt your sleep.

[mattinsmom]

You may want to talk w/ your gyn about hormonal changes. I know nothing of the nuvoring but some of the symptoms you describe, ie racing heart, are also symptoms of changing levels in estrogen. I found it reassuring to know this after I had my hysterectomy. The heart palpitations lead to panic led to heart palpitations..... I'm beyond post-menopausal so it doesn't happen as frequently but in the beginning slow, deep breathing usually helped slow my heart rate down. 

 

Anemia will cause feelings of your heart racing as well. As that improves you should feel less of the flutters. 

 

I, too, have panic attacks and the most helpful thing I have ever used is a reminder that panic will always reach a peak and come back down. Cortisol will kick in, just remind yourself and ride it out. Easier said than done but thinking "this will stop on its own, there is nothing I need to do but wait" has helped me with mine. 

 

I hear a lot of ptsd coming thru your writing. I understand that your access to medical care is limited at best. It might help to try guided relaxation techniques to help release some of the tension that comes w/ the ptsd hyper-vigilance. I am also a night owl, always have been. Night time was never a "safe" time for me growing up. When that 3-4am rolls around I remind myself that I am safe and I give myself permission to go to sleep. Sometimes it works. 

 

I'm not sure that I understand your daughter's sleep pattern but it is imperative that she sleep on a night-time rhythm. Her brain is developing all kinds of automatic behaviors and you don't want her to have your sleepless nights as a pattern.

 

I am sorry that you are having a rough go at it.  

[Arshness]

Rhi,

 

Thank you for the advice and encouragement.  

 

I can't walk around the block. There are literally no sidewalks where I live. The place I live is quite steep-hilled and kills my back to walk around on. Right now, with the anemia, I can't even really manage a walk around a store when I go shopping. I'm doing my best to start a habit of getting up every 15 minutes for a stretch and a little Ta'i Chi and Yoga in the day since I need SOMETHING.

 

 

As for Klonopin, like I said, I can't take some every day and start a taper later. My doc won't give me more and there's not a single place in town I can go to that will. (The other clinics all refuse to prescribe it *at all*). As for taking it now... It's already been over a week since I have had any at all. I'm really uncomfortable with trying to keep taking it any, but I don't have a choice because I can't get it anymore. I don't think 30 pills is enough to take some everyday then taper properly is it?

 

 

I had a rough day due to melatonin. It made me sleep literally all day. I didn't get to sleep until super late due to anxiety this morning, but the melatonin would NOT let me wake up. I got up at 6pm and now I'm both miserable and uncomfortable about the prospect of getting to bed before anxiety hour tonight. Uggh. :c I couldn't help it because I could not fight my way free of sleep, but I seriously won't take melatonin again. 

 

Alto:

 

I have maintained a "sleep starts when the sun comes up" cycle literally my entire adulthood, and as a child, the only thing that stopped me from that was my parents and school. I have *never* felt right on a fully diurnal schedule. I took melatonin an hour before I wanted to go to sleep, like it suggested on the bottle. It didn't work for me. It made me anxious and I could not get to sleep, then when I finally passed out, it made me sleep ridiculously way too long.  I don't like how it made me feel at all.

 

 

I will have to do a lot of working to push myself back from where I am currently. I can't change my schedule all at once. I literally will not be able to fall asleep.

 

 

I am eating *dark* chocolate because it has natual antioxidants which can help lower your cortisol levels and keep them from spiking.  There is a tiny amount of caffeine in 40 grams of dark chocolate, but I am not 100% caffeine free anyway, so I actually feel it's helping me avoid total caffeine withdrawals. I still tend to drink Coca-cola when we go out to eat even if I've cut it out at home. I also drink tea some days. Tho I take decaf tea later in my day, I don't avoid all caffeine just a lot more than I used to. I'm tapering that off too really. 

 

 

mattinsmom,

I really appreciate your words. My gyn is unfortunately very far away from me and my travel capabilities are limited. There is no reasonably skilled gyn in my area so I had to go to a neighboring city to find one. The nearest city that has a decent doc is way further than I can drive myself. Unfortunately, my sister doesn't drive. The rest of my family can't drive me except my sister's husband who already took a day off from work this month to drive me in the first place. He can't just keep doing that and he works M-F. 

I feel so trapped with our local medical situation, but there is nothing I can do about it. 

I do still have the anemia and I do get racing heart, palpitations and other scary stuff that makes me feel like I'm dying. I don't enjoy it at all. It makes me panic. 

I have never had proper counseling for my PTSD. I have no therapist available in my area at all. :c 

I really want to move to the PNW and if we end up around Portland I'm sure the medical community can't be as lacking as it is here. 

As for my daughter, I can only do so much. I unschool her and feed her an excellent diet. I spend so much time with her and I give her everything I can to help her in her life. However, she goes to sleep roughly when we do. She hates going to bed before us as it means she'll wake up before us. The only thing I can do is try to move my schedule into a better place and adapt her with me. I can't simply change our schedule right now. It wouldn't stick. We've tried that before. It just made everyone miserable. 

I am feeling terribly overwhelmed this morning. I can't do all the things. I'm just going to try to do some of the things today. The others will come in time. 

[Arshness]

Decided to stay up all night so we can go to bed at a reasonable hour. My current goal is to go for 1am-9am for sleep. It's not perfect, but I can't move it back too many hours at once or I'll end up passing out in the afternoon and ruining it. I know this from experience.

 

I went through 4-5am with no problem today. I took my mag citrate earlier and then around 4 rubbed mag lotion on. Yay! no anxiety!So happy! I mean ridiculous happy!

[mattinsmom]

That is so wonderful to hear. 1-9 is excellent! So happy you are feeling better

[Arshness]

I really am feeling fine today and that's fantastic for me. Feeling NORMAL is amazing! :)Now just wish me luck making it to 1am tonight so I can get the schedule fixed easily XD

[Arshness]

Sunday: Woke up at 6pm. Had a hell of a time waking up even then. No mor melatonin for me. Took Wellbutrin and cetirizine. Took .75ounce magnesium citrate. ate dark chocolate. Mild anxiety early on. stress levels not feeling incredible. Since at 3am I had only been awake 9 hours, I decided to stay up all day to reset mys chedule. Going to make 1am-9am my sleep time.Must be adamant about this. MUST. Still having some mild congestion sometimes. Still having spikes of anxiety over this. Used magniusm lotion at 4:15am. Not feeling anxiety yet at 4:26. Good. 9 am still no anxiety. Nice. About 10am, nerves got a bit frazzled, started feeling a little depressed. Went to bed, attempting to get up in 3 hours so the schedule change could happen.

 

Monday: Forgot to record. Failed to get up on time. Got up at 6pm. :c Had anxiety spikes. Too much anxiety to sleep that night. Tried to go to bed at 3am, no success. Read for an hour before giving up and getting up again. Took Wellbutrin and cetirizine as per normal. Took mag via epsom salt lotion and ate dark chocolate.Couldn't sleep till around 11am. 

 

Tuesday: Woke up at 4:30ishpm. Mostly okay today. Took Am Wellbutrin and cetirizine. Did a foot soak in epsom salt. Had some caffeine earlier when we ate out. Coke. Not feeling bad tho. Have had a few uncomfortable feelings today, but no serious anxiety yet. Feeling tired and sore tonight.