Sunday: Should I Trust My Doctor and Switch SSRI's?

[sunday]

Hello,

I was misdiagnosed with depression about 25 years ago and began taking various SSRI's. Ten years ago I was misdiagnosed with Anxiety. At that time I was switched from zoloft to lexapro, and given klonopin.  I was diagnosed with a sleep disorder two years ago and put on Xyrem, which helps tremendously.  I am working with a great doctor who believes that the acute anxiety and following deep depression that came on two years ago is from the klonopin.

I am so depressed.  I am taking 4mg of Lexapro now down from 5 (was going to taper while coming off the Klonopin but stopped).  My doctor asked me if I'd like to try Prozac.  It was the first SSRI I took, and way back then, I liked the activating side effect because I wasn't anxious or depressed but I was TIRED. Even though it messed with my sleep, I had energy and that felt good and positive. Now I'm terrified of those side effects and also concerned that it will not help the depression any better than Lexapro, and will be as hard or worse to taper off of when I'm ready. 

I tried to come off of Lexapro about 5 years ago and lost my mind.  It was a fast taper, and it was awful. For two weeks I felt fantastic, better than I had in all the time on SSRI's, and then BAM, I was thrown in to a pit of hell.  

 

I need some input, please!  I'm scared, depressed, and don't want to screw my head up any more than it already is.  Should I raise the Lexapro? I've never taken more than 5mg...

 

Thank You

[mammaP]

Hi Sunday, welcome to SA. You are right to be cautious about switching to prozac, which could cause more problems for you. 

Could you answer some questions for us so we have a clear picture of what has been going on? 

Are you still taking klonopin, and how have you tapered it so far?  

You say that the anxiety and deep depression came on 2 years ago, also that you were diagnosed with a sleep disorder and given xyrem 2 years ago, which suggests that it could be the xyrem, or the combination of drugs that caused the depression, which is listed as a side effect of xyrem.  

Did the sleep disorder arise from prozac, as you said that it messed with your sleep?  

How long have you been taking 4 mg of lexapro and how did you cut from 5 to 4?  It is likely that you are suffering from withdrawal after cutting lexapro and possibly withdrawal from the klonopin too. Don't panic though, we can help you to find what is causing the problems for you and work out the best way forward. 

 

It would help us if you can put your drug history in your signature strip, you can find how to do that here.... http://survivingantidepressants.org/index.php?/topic/893-please-put-your-withdrawal-history-in-your-signature/

 

I put your drugs into the interactions checker and there are reactions listed that indicate that they could be causing some problems. 

you can see the report here.  http://www.drugs.com/interactions-check.php?drug_list=703-357,1013-565,2091-10778

PLEASE don't stop any of them suddenly, we will do our best to help you find the right way forward. You have come to the right place. 

[sunday]

Wow, 

Thanks for the great reply. The Xyrem was considered as the problem however, the anxiety and panic started prior to taking Xyrem as I was abruptly withdrawn from the Klonopin before I could take the Xyrem. The depression came on many, many months after being on Xyrem. I was also given two different benzos to try before Klonopin was reinstated a few months after trying the other benzos. I have tapered down to 4mg of Lexapro from 5mg over a long period of time, and I have been holding there for several months now. I tried a more rapid taper, and felt it immediately.  For the record, I was in bad emotional shape when I saw the sleep doctor. I was depressed but not the way I am now. I still had a range of moods and I was able to laugh and enjoy myself.  

 

I started the Klonopin taper in January 2015:  1mg AM, 1mg PM and additional PRN. I am now taking .25am, and .375pm.  My cuts are 10% with a two week hold.  The depression will not relent.  There was a brief period early in to the Klonopin taper where I felt some relief, but it was short lived.  By the way, when I look at my profile, it appears I have a signature.

 

The sleep disorder pre-existed the Prozac.  I was prescribed Prozac based on complaints about sleep disturbance. I did not express any other symptoms of depression and did not exhibit signs. I was fully functional, productive, good relationships, etc... The Prozac "pooped" out - not really if you think about it, I didn't need it for depression.  Then I tried Paxil for a day, couldn't tolerate it, Wellbutrin did nothing but make me irritable, then Zoloft. I was on Zoloft for many years before being switched to Lexapro 10 years ago.  I have never felt "great" on any SSRI, and the SRNI's that were tried did not make it beyond one pill - too enervating and crazy-making.  I think the SSRI's gave me problems instead of helping me.  

[Altostrata]

Welcome, Sunday.
 
As you were misdiagnosed and prescribed antidepressants for no good reason, then developed "depression" as a side effect of the benzos, why would you want to risk the switch to another SSRI? And while you're tapering Klonopin?

 

(Kudos to your doctor for recognizing a side effect of Klonopin.)
 
Additional drug changes will certainly muddy the waters regarding any problems you have reducing Klonopin. Please see

Taking multiple psych drugs? Which drug to taper first?
 
Why taper by 10% of my dosage?
 
Please put ALL the drugs you take in the Drug Interactions Checker http://www.drugs.com/drug_interactions.html and copy and paste the results in this topic.

[sunday]

Sadly, I have already been on Lexapro (SSRI's in general) long before the Klonopin.  The Klonopin has created such intolerable effects that I have to get off of it right now.  If I could do the Lexapro first, I would, but having tried that in the past with the Klonopin doing nothing to alleviate the WD symptoms, it's a 6 to one half dozen to the other.  I'm screwed.

[mammaP]

There is a major reaction between klonopin and xyrem, which would be why your doctor would have stopped it before prescribing the xyrem. There is  moderate reaction between lexapro and xyrem. 

 

Interactions between your selected drugs

Major clonazepam  sodium oxybate

Applies to: Klonopin (clonazepam), Xyrem (sodium oxybate)

Using sodium oxybate together with other medications that can affect the central nervous system such as clonazePAM may increase side effects like drowsiness, dizziness, lightheadedness, confusion, depression, low blood pressure, and slow or shallow breathing. Occasionally, severe reactions may result in coma and even death. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Do not drive, operate machinery, or perform other hazardous activities for at least six hours after taking sodium oxybate and until you know how these medications affect you. You should also avoid the use of alcohol during treatment with these medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate clonazepam  escitalopram

Applies to: Klonopin (clonazepam), Lexapro (escitalopram)

Using clonazePAM together with escitalopram may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

 

Unfortunately your nervous system is unstable with all the drug changes and needs to settle down. 

I know you need to be off the klonopin but maybe  hold will help you to stabilise. I also suspect that you may be suffering interdose withdrawal as it is only taken twice a day and so you could be going into withdrawal between those doses. I will ask someone with more benzo experience to take a look, it might help to spread the doses so you are taking it several times a day instead of twice. Not increasing the dose but spreading it out.  

[Altostrata]

Seems like going off Klonopin first is a reasonable plan.

[sunday]

Yes, going off of the Klonopin is the best choice.  I never thought about spreading out the Klonopin dosage throughout the day because I don't notice anything particular between doses.  If i missed one completely I would, but if I take the evening dose much later than usual, if I notice anything different it is that I feel a little unbalanced, not anxious.

[mammaP]

I asked about and the half life of klonopin is not as short as some benzos so can be taken twice a day if it's working for you that way. It is a fst taper 10% every 2 weeks, I think I would make smaller cuts and hold the lexapro. It's always hard to know what is best but often withdrawal can be worse than the side effects. 

[btdt]

Hello,

I was misdiagnosed with depression about 25 years ago and began taking various SSRI's. Ten years ago I was misdiagnosed with Anxiety. At that time I was switched from zoloft to lexapro, and given klonopin.  I was diagnosed with a sleep disorder two years ago and put on Xyrem, which helps tremendously.  I am working with a great doctor who believes that the acute anxiety and following deep depression that came on two years ago is from the klonopin.

I am so depressed.  I am taking 4mg of Lexapro now down from 5 (was going to taper while coming off the Klonopin but stopped).  My doctor asked me if I'd like to try Prozac.  It was the first SSRI I took, and way back then, I liked the activating side effect because I wasn't anxious or depressed but I was TIRED. Even though it messed with my sleep, I had energy and that felt good and positive. Now I'm terrified of those side effects and also concerned that it will not help the depression any better than Lexapro, and will be as hard or worse to taper off of when I'm ready. 

I tried to come off of Lexapro about 5 years ago and lost my mind.  It was a fast taper, and it was awful. For two weeks I felt fantastic, better than I had in all the time on SSRI's, and then BAM, I was thrown in to a pit of hell.  

 

I need some input, please!  I'm scared, depressed, and don't want to screw my head up any more than it already is.  Should I raise the Lexapro? I've never taken more than 5mg...

 

Thank You

Hi Sunday I was hoping for an update if you can I am curious about the xyrem as it is a new name to me trying to keep up to date.  

wishing you peace B

 

ps 

any drug use 25 years ago before this "Misdiagnosed with Depression 25 years'

legal or illegal it all counts any trauma or other disease or disorers?  I am just curious