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Survivor1: sleeping after trazodone (and benzo)


Survivor1

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Alto,

 

Appreciate the advice.  I will begin the reduction of seroquel soon (perhaps tonight?).  Have to psych myself up for this as I am not stable yet.  I will try a version of BrassMonkey's slide, beginning with 0.1mg, not exceeding 10% every 4-6 weeks.

 

I will post updates as the reduction progresses.

 

Thanks.

PAST

Gabapentin:  about 6 months in 2015, 300-900 mg, cold turkeyed Sept 2015 (at same time dc'd Klonopin)

Klonopin: June 2014- Sept 2015; 1mg tapered over 6 mths, dc'd at 0.25mg, withdrawal hellish (perhaps because of concurrent dc of gabapentin)

Mirtazepine: Jumped off at 2.4 mg. (stable in 8 months).

Seroquel:  June 14 - July 24, 2016, 25 mg alternate nights; smaller doses for shorter periods. Total use about 3 months 

Lamictal: March 19, 2018 - 1 mg; March 23 - 1.25 mg; April 6 - 2mg. Discontinued at 2 mgJuly 1, 2018 due to Steven Johnson Syndrome.

 

CURRENT

Supplements: Vit D, turmeric

Naturethroid: 65 mcg for hypothyroidism

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d after 3 weeks. Reinstatement: 07/25/16 - 25 mg; updosed 08/03/16 - 50 mg;  10/01/16-  62mg; 03/24/17 dropped to 50 mg (stable in 2.5 months)

                           Current psych meds: Trazodone 50 mg

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After much thought, research and soul-searching, I have decided to hold off on the tapering.  

 

I am not in a mental place to do it.  My symptoms are not tolerable yet and I want to give it until end of March and revaluate.  I would like to start then; I hope the stars will be aligned.

 

I seem to be in a wave at the moment: ramped up anxiety, 5 hours sleep, jerking, mild depression, and the d*** ear myoclonus.  If none of these improve, I will have to start reducing.

 

Will update as time goes on.

PAST

Gabapentin:  about 6 months in 2015, 300-900 mg, cold turkeyed Sept 2015 (at same time dc'd Klonopin)

Klonopin: June 2014- Sept 2015; 1mg tapered over 6 mths, dc'd at 0.25mg, withdrawal hellish (perhaps because of concurrent dc of gabapentin)

Mirtazepine: Jumped off at 2.4 mg. (stable in 8 months).

Seroquel:  June 14 - July 24, 2016, 25 mg alternate nights; smaller doses for shorter periods. Total use about 3 months 

Lamictal: March 19, 2018 - 1 mg; March 23 - 1.25 mg; April 6 - 2mg. Discontinued at 2 mgJuly 1, 2018 due to Steven Johnson Syndrome.

 

CURRENT

Supplements: Vit D, turmeric

Naturethroid: 65 mcg for hypothyroidism

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d after 3 weeks. Reinstatement: 07/25/16 - 25 mg; updosed 08/03/16 - 50 mg;  10/01/16-  62mg; 03/24/17 dropped to 50 mg (stable in 2.5 months)

                           Current psych meds: Trazodone 50 mg

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A setback ...

 

On March 5 & 6, I accidentally took 2.23mg of mirtazepine (I had diluted the suspension too much), instead of 2.4mg.  Yesterday, I had anxiety throughout the roof - it was 10/10 - along with incredible shakiness.  I got to the point of two panic attacks, which I managed to avert somehow.  Luckily I realized what happened and last night I corrected to 2.4mg and am feeling a little better, but anxiety is still high this morning and I feel like I have been through the wringer (after only 1 day of this!).

 

This goes to show how ill-prepared I am for any tapering.  And also adds another level of anxiety as I know I should be getting off the seroquel as soon as possible, but may not be able to handle the wd from going off it ... this stinks.

PAST

Gabapentin:  about 6 months in 2015, 300-900 mg, cold turkeyed Sept 2015 (at same time dc'd Klonopin)

Klonopin: June 2014- Sept 2015; 1mg tapered over 6 mths, dc'd at 0.25mg, withdrawal hellish (perhaps because of concurrent dc of gabapentin)

Mirtazepine: Jumped off at 2.4 mg. (stable in 8 months).

Seroquel:  June 14 - July 24, 2016, 25 mg alternate nights; smaller doses for shorter periods. Total use about 3 months 

Lamictal: March 19, 2018 - 1 mg; March 23 - 1.25 mg; April 6 - 2mg. Discontinued at 2 mgJuly 1, 2018 due to Steven Johnson Syndrome.

 

CURRENT

Supplements: Vit D, turmeric

Naturethroid: 65 mcg for hypothyroidism

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d after 3 weeks. Reinstatement: 07/25/16 - 25 mg; updosed 08/03/16 - 50 mg;  10/01/16-  62mg; 03/24/17 dropped to 50 mg (stable in 2.5 months)

                           Current psych meds: Trazodone 50 mg

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  • Moderator Emeritus

Giving yourself time to settle after the unintentional dose change sounds like an excellent plan.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results

Cymbalta 60 mg 2012 - 2015; 2016: 20 mg to 7 mg exact doses and dates in this post; 2017: 6.3 mg to  0.0 mg  Aug. 12; details here


scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet

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SW, I will do that.  Hopefully I haven't undone any progress :(

PAST

Gabapentin:  about 6 months in 2015, 300-900 mg, cold turkeyed Sept 2015 (at same time dc'd Klonopin)

Klonopin: June 2014- Sept 2015; 1mg tapered over 6 mths, dc'd at 0.25mg, withdrawal hellish (perhaps because of concurrent dc of gabapentin)

Mirtazepine: Jumped off at 2.4 mg. (stable in 8 months).

Seroquel:  June 14 - July 24, 2016, 25 mg alternate nights; smaller doses for shorter periods. Total use about 3 months 

Lamictal: March 19, 2018 - 1 mg; March 23 - 1.25 mg; April 6 - 2mg. Discontinued at 2 mgJuly 1, 2018 due to Steven Johnson Syndrome.

 

CURRENT

Supplements: Vit D, turmeric

Naturethroid: 65 mcg for hypothyroidism

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d after 3 weeks. Reinstatement: 07/25/16 - 25 mg; updosed 08/03/16 - 50 mg;  10/01/16-  62mg; 03/24/17 dropped to 50 mg (stable in 2.5 months)

                           Current psych meds: Trazodone 50 mg

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Wow! What a horrid 24 hours.  

 

Woke up from 5 hour sleep with anxiety.  Now it's through the roof again.  Even during acute wd I did not have anx this unmanageable.  It is constant, unrelenting, no breaks, 10/10.  My poor adrenals.  I don't know if its my unintentional drop in mirt for two days, or just a wave (seems like the latter, a wave would not be this bad).

 

Added to that is my internal dialogue that my taper has not even begun, at least I would have had that to pick me up.  For the first time during this whole process, I bawled this morning.  No silent tears, no sniffling, just outright loud bawling.  It shocked me; I was considered stoic at one time, now I am this emotional coil about to be undone at the slightest touch.

 

I know I must get off these drugs and taking years does not faze me.  But I fear this tapering process, I truly do.  I cannot even stabilize after three months; I thought I was doing OK, but this, this is torture.  If I have this reaction everytime I make a drop, I don't know what I will do!  Through all this, I must find the wherewithal to be a mother to my kids, (nevermind a proper wife).

 

Thanks for letting me vent, all.

PAST

Gabapentin:  about 6 months in 2015, 300-900 mg, cold turkeyed Sept 2015 (at same time dc'd Klonopin)

Klonopin: June 2014- Sept 2015; 1mg tapered over 6 mths, dc'd at 0.25mg, withdrawal hellish (perhaps because of concurrent dc of gabapentin)

Mirtazepine: Jumped off at 2.4 mg. (stable in 8 months).

Seroquel:  June 14 - July 24, 2016, 25 mg alternate nights; smaller doses for shorter periods. Total use about 3 months 

Lamictal: March 19, 2018 - 1 mg; March 23 - 1.25 mg; April 6 - 2mg. Discontinued at 2 mgJuly 1, 2018 due to Steven Johnson Syndrome.

 

CURRENT

Supplements: Vit D, turmeric

Naturethroid: 65 mcg for hypothyroidism

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d after 3 weeks. Reinstatement: 07/25/16 - 25 mg; updosed 08/03/16 - 50 mg;  10/01/16-  62mg; 03/24/17 dropped to 50 mg (stable in 2.5 months)

                           Current psych meds: Trazodone 50 mg

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Today anxiety is still fierce.  It really feels different.  I have never had it this bad, even through ct of seroquel or other wd. Is something going paradoxical?  

 

Two questions:

1) Should I even attempt a (micro)taper at this time?

 

2) As one gets lower down on a med (in my case, trazodone), could sleep actually improve?  For me trazodone has lost its effectiveness, and I fear that the seroquel taper could take a couple of years.  I really don't know if I can cope with 5 or less hrs of sleep for that long.  If I choose to taper trazodone first and get it down at least half of my dose, could I possibly sleep better, or will I likely be at the baseline I was at the beginning of the taper?  I know one can't predict for sure, but I'd like to know what the mods (or others who have tapered a sleep drug) think.

 

Thanks.

PAST

Gabapentin:  about 6 months in 2015, 300-900 mg, cold turkeyed Sept 2015 (at same time dc'd Klonopin)

Klonopin: June 2014- Sept 2015; 1mg tapered over 6 mths, dc'd at 0.25mg, withdrawal hellish (perhaps because of concurrent dc of gabapentin)

Mirtazepine: Jumped off at 2.4 mg. (stable in 8 months).

Seroquel:  June 14 - July 24, 2016, 25 mg alternate nights; smaller doses for shorter periods. Total use about 3 months 

Lamictal: March 19, 2018 - 1 mg; March 23 - 1.25 mg; April 6 - 2mg. Discontinued at 2 mgJuly 1, 2018 due to Steven Johnson Syndrome.

 

CURRENT

Supplements: Vit D, turmeric

Naturethroid: 65 mcg for hypothyroidism

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d after 3 weeks. Reinstatement: 07/25/16 - 25 mg; updosed 08/03/16 - 50 mg;  10/01/16-  62mg; 03/24/17 dropped to 50 mg (stable in 2.5 months)

                           Current psych meds: Trazodone 50 mg

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The only time my sleep improved with the trazodone taper was when I had a long hold (about a month). I then had days where I would get 7 hours with some wakeups. The dose did not matter.

 

When you taper a med and you are on several meds for sleep the med you are tapering will affect your sleep even if you are holding steady on the other sleep meds. The other sleep meds will help somewhat and at least you'll get some sleep. This has been my experience so far.

 

Sleep improved with long holds on all meds I find. But we want off so what do we do. Well at least for me I taper and lose sleep and hold a while. Then I get some really good days of sleep. I catch up a bit then I taper and rock the boat again. I have accepted the poor sleep nights. It's easier if you can do that.

 

Marie

10/13--10/14 Ambien. Started tapering 1/14  Jumped 10/14.  Done.                                                                              

3/14        7.5 Remeron  still taking this.                              

2/14         75 Trazodone   -    Tapered by dry cutting all the way down.

1/16        4 mg Trazodone  -  Jumped. Bad mistake. Got hit with late withdrawal 6 weeks later. Reinstated.

4/16        Reinstated 1 mg, updose to 2 mg Trazodone

2/19        .04 Trazodone. Walked off.  Done.

10/3/19  Started 7.5 Mirtazapine taper cut to .073 gram weight, pill weighs .076

4/5/20    New Mirtazapine Taper - Compound Liquid 7.35 mg April '20, 7.25 mg May, 7.05 mg June, 6.99 mg June, 6.78 mg July, 6.57 mg Aug, Sept 6.35 mg, Sept 6.24 mg, Sept 6.21 mg, Oct 5.99 mg, Oct 5.90 mg, Oct 5.70 mg.

1/11/21 6.05 mg Messed up taper due to syringe change. Must remember the 1 ml syringe contains 1.5mg! 1/16/21 5.99 mg

2/21 5.75 mg, 3/21 5.6 mg, 4/7 5.45, 4/14 5.30, 5/12 5.15, 5/25/21 4.99 mg, 6/29 4.87 mg, 7/14/21 4.74 mg, 8/5 4.62 mg 8/17 4.5 mg, 8/30 4.38 mg,9/16 4.26 mg,10/9 4.14 mg, 10/23 4.05 mg, 11/6 3.96 mg,11/17 3.87mg.***Jan 22 Liquid was changed/couldn't tolerate***Changed back to pills. Feb 22/3.9 mg, 2/17/22 3.8 mg, 3/23 3.7 mg, 4/7 3.6 mg, 5/10 3.5mg,6/10/22 3.4 mg, 7/4 3.3 mg, 7/25 3.2 mg, 8/20/22 3.1 mg, 9/15 3 mg, 10/8/22 2.9 mg., 12/15 2.8 mg, 1/6/23 2.7 mg, 2/16/23 2.6 mg, 3/9 2.5 mg, 4/4 2.4 mg, 4/29/23 2.3 mg, 5/26 2.2 mg, 6/22/23 2.1 mg, 10/14 2 mg, 11/12 1.9 mg, 11/28 1.8 mg , 12/14/23 1.7, 12/31/23 1.6 mg, 1/20 1.5 mg, 2/6/24 1.4 mg, 2/12 updose 1.5 mg. Taking multi-vitamin, vit. D, cholestoff, psyllium husk, and fish oil.

 

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Thank you, Marie. 

 

I am trying to psych myself up for the first taper especially because my baseline is so poor (no more than 5 hours).  So if I get less than that for days on end waiting to stabilize (to 5 hours, I guess), I have to find the strength to do it.

 

I wonder if the baseline can actually improve during tapering.  Mods?

 

On another note, that inadvertent drop in Mirt really set me back.  These past few days have been some of the toughest I have had to deal with this entire process.  I am hoping to restabilize.  Tapering is even further away now.  But it will happen.

 

Thanks for listening.

PAST

Gabapentin:  about 6 months in 2015, 300-900 mg, cold turkeyed Sept 2015 (at same time dc'd Klonopin)

Klonopin: June 2014- Sept 2015; 1mg tapered over 6 mths, dc'd at 0.25mg, withdrawal hellish (perhaps because of concurrent dc of gabapentin)

Mirtazepine: Jumped off at 2.4 mg. (stable in 8 months).

Seroquel:  June 14 - July 24, 2016, 25 mg alternate nights; smaller doses for shorter periods. Total use about 3 months 

Lamictal: March 19, 2018 - 1 mg; March 23 - 1.25 mg; April 6 - 2mg. Discontinued at 2 mgJuly 1, 2018 due to Steven Johnson Syndrome.

 

CURRENT

Supplements: Vit D, turmeric

Naturethroid: 65 mcg for hypothyroidism

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d after 3 weeks. Reinstatement: 07/25/16 - 25 mg; updosed 08/03/16 - 50 mg;  10/01/16-  62mg; 03/24/17 dropped to 50 mg (stable in 2.5 months)

                           Current psych meds: Trazodone 50 mg

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Survivor, I just read through your thread - wow. What a story! I am so very sorry you are going through all this awful withdrawal. I have been on and off Trazodone for years. I am currently on it to help me sleep as I taper Paxil (another AD). I was never told Traz was an AD, so that is super fun. I've never had any trouble getting off traz and very quickly too. This time, probably my 5th time on it and I am having trouble getting off and still getting sleep. Do you have a good support system? I always find myself falling back on my husband and friends when I am having a really rough couple weeks/months. What dose are you on now? Hoping you stabilize fully and are able to taper in a few months!!

 

best wishes, 

meg

Sep '18 - became pregnant  in late August, then on 9/5 insomnia/anxiety went THROUGH the roof. I tried a lot of things but here is what is current: 

Paroxetine: 6.2mg (began 9/5/18, and there was a new manufacturer of which I just found out 2 days ago) during the day

Olanzapine 7.5mg at night

Ambien: 5-10mg at night

Xanex: 5-10mg at night

Fish Oil: for prenatal things

 

  • Aug '18: Paroxetine 6.6mg, (30mg thyroid hormone, fish oil, vit D3, SBI protect, probiotic. Following AIP diet)
  • Mar '16: began taper from 20mg. Decreasing .75mg or less each month or more. Sporadically used Ambien &/or Trazodone for insomnia. 
  •  Sep'15: tried to come off slower. Used fish oil, vit D3, and regular exercise/healthy diet to assist. (Taper sched= 18mg for 60days, 15mg for 60d, 10mg for 30d, 8mg for 30d) At my 3rd week of 8mg in Nov '15, insomnia and panic attacks began. Back up to 20mg after a month of horrible withdrawal. 
  • Oct'12-Sep'15: 20mg Paxil
  • Sep'12: 1st attempt to get off, naively tried cold turkey per Dr. suggestion. Couldn't work for 2 months. Another Doc upped dose to 20mg.
  • Jun '09-Aug '12: 10mg Paxil for severe insomnia due to anxiety. Also took Ambien/Trazodone for sleep.  Other meds taken sporadically: Ativan, Abilify, Xyrem 

 

My hope is built on nothing less, than Jesus' blood and righteousness. 

 

 

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  • Administrator

Five hours of sleep a night is not bad compared with what many others experience in withdrawal insomnia.
 
My sense is your drugs rank like this, in order of severity of overall risk:
 
1. Seroquel -- most likely responsible for the movement disorder, which can become very serious. Can also disorder insulin metabolism.
 
2. Trazodone -- has an active metabolite, mCPP, which interacts with other drugs during the day and has awful side effects (see Tips for tapering off trazodone (Desyrel) ). Adverse symptoms of mCPP can be anxiety, fast heartbeat, more.

3. Mirtazapine

 

 

If your sleeplessness is a paradoxical result of too many sleep drugs, which my guess is your situation, reducing one or more drugs can improve sleep.

 

It's up to you to decide what to do. In my opinion, your drug burden is excessive and you are experiencing no benefit from it.

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

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

All postings © copyrighted.

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Alto, MegB, thank you for your responses.

 

What is surprising to me is that I was able to sleep well in Jan and Feb, then it deteriorated.  JanCarol had posted way back that with all my drug changes in a short period, I could kindle.  I am thinking this is what is happening.  

 

I was healing up nicely until last week when I messed up the mirtazepine.  I am now plagued with sky high anxiety and more depression.  I am hoping to stabilize somewhat and begin tapering asap as I feel that the meds are pooping out.  The taper will be at a super slow speed as I can't imagine increased wd sxs throughout the many years of tapering.  It's one thing to deal with little sleep, it's another to compound it with high anxiety, depression, and other sxs.  I am barely functioning with these three biggies.

 

Finally, I feel that there is some good news: there seems to be some improvement in the jerking.  They are still present but feels less intense.  I am hoping they will continue to improve.  Which drug to taper first will be dependent on this.  If more improvement, then trazodone first; if not, then seroquel.  

 

MegB, over a decade ago I was on trazodone too.  I was able to taper over 3 months with zero problems.  Even my rapid taper from klonopin, while horrific, I was able to recover from.  I believe that after too many uses of drugs, they becomes increasingly harder to discontinue.  So go really slow.

 

I have a small support system.  My husband works long hours so I try not to burden him with my challenges too much.  A few friends have offered help when I need it.  Yesterday, I had a conversation with my two teenagers about my condition and that I will likely deteriorate as a I taper.  They see a mother who is on the couch a lot and doesn't participate much in their lives, and I wanted them to know that while things may get worse, it will eventually get better, but will take a while.  My 15 year old daughter teared up.  I have made an appointment with a CBT therapist to provide me with some coping skills as I need to be prepared for a worsening situation.

 

Thanks again for listening.

PAST

Gabapentin:  about 6 months in 2015, 300-900 mg, cold turkeyed Sept 2015 (at same time dc'd Klonopin)

Klonopin: June 2014- Sept 2015; 1mg tapered over 6 mths, dc'd at 0.25mg, withdrawal hellish (perhaps because of concurrent dc of gabapentin)

Mirtazepine: Jumped off at 2.4 mg. (stable in 8 months).

Seroquel:  June 14 - July 24, 2016, 25 mg alternate nights; smaller doses for shorter periods. Total use about 3 months 

Lamictal: March 19, 2018 - 1 mg; March 23 - 1.25 mg; April 6 - 2mg. Discontinued at 2 mgJuly 1, 2018 due to Steven Johnson Syndrome.

 

CURRENT

Supplements: Vit D, turmeric

Naturethroid: 65 mcg for hypothyroidism

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d after 3 weeks. Reinstatement: 07/25/16 - 25 mg; updosed 08/03/16 - 50 mg;  10/01/16-  62mg; 03/24/17 dropped to 50 mg (stable in 2.5 months)

                           Current psych meds: Trazodone 50 mg

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Mixed bag update ...

 

 

The good:

  • Anxiety is down (but not gone).  To about 3/10.  
  • Depression is down 2/10.

 

The bad:

  • Shakiness is still there
  • Sleep has worsened to 4 hours/night.  Does not seem like wd insomnia.  I fear the drugs are losing their effect.
  • Twitching is still there and is really worrying me.  It is primarily in my face/head and fingers, with some in feet.  The face ones in particular scare me as they involve my lips and tongue, sometimes my throat and eyelids.  For now they are "just" twitches, and not the contortions/grimacing/etc that are normally associated with TD.  Am trying to see a movement disorder specialist hopefully to get reassurance that this isn't the beginning of TD.  (Whatever the outcome, I need to get off the drugs.)

I don't know what to do.  I am in a bad state to start tapering, yet the longer I wait, the twitches could worsen.

 

I don't wish this on my worst enemy.

PAST

Gabapentin:  about 6 months in 2015, 300-900 mg, cold turkeyed Sept 2015 (at same time dc'd Klonopin)

Klonopin: June 2014- Sept 2015; 1mg tapered over 6 mths, dc'd at 0.25mg, withdrawal hellish (perhaps because of concurrent dc of gabapentin)

Mirtazepine: Jumped off at 2.4 mg. (stable in 8 months).

Seroquel:  June 14 - July 24, 2016, 25 mg alternate nights; smaller doses for shorter periods. Total use about 3 months 

Lamictal: March 19, 2018 - 1 mg; March 23 - 1.25 mg; April 6 - 2mg. Discontinued at 2 mgJuly 1, 2018 due to Steven Johnson Syndrome.

 

CURRENT

Supplements: Vit D, turmeric

Naturethroid: 65 mcg for hypothyroidism

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d after 3 weeks. Reinstatement: 07/25/16 - 25 mg; updosed 08/03/16 - 50 mg;  10/01/16-  62mg; 03/24/17 dropped to 50 mg (stable in 2.5 months)

                           Current psych meds: Trazodone 50 mg

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Update...

 

I have really deteriorated since my accidental drop in Mirt on 03/05.  Anxiety is back, shakiness is through the roof and depression is heavy, legs feel like they could buckle any minute.  This feels like acute wd.  It has been almost eleven days since I corrected for the error, but I feel that the meds seem now truly paradoxical.  A 9% (unintentional) drop has done me in!

 

I am absolutely shaken.  Do I even have any hope of stabilizing? Today I was non-functional.  We have been ordering in food as I'm unable to cook.  My sister is visiting with her daughter for spring break and has been taking over, but she returns home tomorrow.  

 

Mods, what would you do if you were in my situation?  Hope for some stability by waiting a little, or suffer (big time) though a taper?  I truly feel I cannot handle a further deterioration due to wd, but would tapering possibly make the situation improve somewhat if I got down to a lower dose of something?

 

I feel so helpless, hopeless, frightened.

 

Thanks for all your help.

PAST

Gabapentin:  about 6 months in 2015, 300-900 mg, cold turkeyed Sept 2015 (at same time dc'd Klonopin)

Klonopin: June 2014- Sept 2015; 1mg tapered over 6 mths, dc'd at 0.25mg, withdrawal hellish (perhaps because of concurrent dc of gabapentin)

Mirtazepine: Jumped off at 2.4 mg. (stable in 8 months).

Seroquel:  June 14 - July 24, 2016, 25 mg alternate nights; smaller doses for shorter periods. Total use about 3 months 

Lamictal: March 19, 2018 - 1 mg; March 23 - 1.25 mg; April 6 - 2mg. Discontinued at 2 mgJuly 1, 2018 due to Steven Johnson Syndrome.

 

CURRENT

Supplements: Vit D, turmeric

Naturethroid: 65 mcg for hypothyroidism

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d after 3 weeks. Reinstatement: 07/25/16 - 25 mg; updosed 08/03/16 - 50 mg;  10/01/16-  62mg; 03/24/17 dropped to 50 mg (stable in 2.5 months)

                           Current psych meds: Trazodone 50 mg

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  • Administrator

....

Major trazodone  mirtazapine

Applies to: trazodone, mirtazapine

Using traZODone together with mirtazapine can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention if you experience these symptoms while taking the medications. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. 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 trazodone  quetiapine

Applies to: trazodone, quetiapine

Using traZODone together with QUEtiapine can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a rare side effect. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether together or alone. 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 mirtazapine  quetiapine

Applies to: mirtazapine, quetiapine

Consumer information for this interaction is not currently available.

GENERALLY AVOID: There is some concern that quetiapine may have additive cardiovascular effects in combination with other drugs that are known to prolong the QT interval of the electrocardiogram. In clinical trials, quetiapine was not associated with a persistent increase in QT intervals, and there was no statistically significant difference between quetiapine and placebo in the proportions of patients experiencing potentially important changes in ECG parameters including QT, QTc, and PR intervals. However, QT prolongation and torsade de pointes have been reported during postmarketing use in cases of quetiapine overdose and in patients with risk factors such as underlying illness or concomitant use of drugs known to cause electrolyte imbalance or increase QT interval. In general, the risk of an individual agent or a combination of agents causing ventricular arrhythmia in association with QT prolongation is largely unpredictable but may be increased by certain underlying risk factors such as congenital long QT syndrome, cardiac disease, and electrolyte disturbances (e.g., hypokalemia, hypomagnesemia). The extent of drug-induced QT prolongation is dependent on the particular drug(s) involved and dosage(s) of the drug(s). In addition, certain agents with anticholinergic properties (e.g., sedating antihistamines; antispasmodics; neuroleptics; phenothiazines; skeletal muscle relaxants; tricyclic antidepressants) may have additive parasympatholytic and central nervous system-depressant effects when used in combination with quetiapine. Excessive parasympatholytic effects may include paralytic ileus, hyperthermia, mydriasis, blurred vision, tachycardia, urinary retention, psychosis, and seizures.

 

MANAGEMENT: Coadministration of quetiapine with other drugs that can prolong the QT interval should generally be avoided. Caution and clinical monitoring are recommended if concomitant use is required. Patients should be advised to seek prompt medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, lightheadedness, fainting, palpitation, irregular heart rhythm, shortness of breath, or syncope. In addition, if combination therapy with agents with anticholinergic properties is required, caution is advised, particularly in the elderly and those with underlying organic brain disease. Patients should be advised to notify their physician promptly if they experience potential symptoms of anticholinergic intoxication such as abdominal pain, fever, heat intolerance, blurred vision, confusion, and/or hallucinations. Ambulatory patients should be counseled to avoid activities requiring mental alertness until they know how these agents affect them. A reduction in anticholinergic dosages may be necessary if excessive adverse effects develop.

 

 

I cannot guarantee you will be able to go off any one of your drugs without sleep disturbance. You probably are dependent on this cocktail.

 

Your nervous system may now be hypersensitive to the drugs due to drug changes, but it is impossible to tell which drug is causing what, or which interaction is involved. You could be reacting to mCPP from trazodone. 

 

The twitching is not good, and probably due to Seroquel or Seroquel's interaction with the other drugs.  If your doctors have not noted this, they are not paying attention.

 

I can't see how increasing any of the drugs would help. That leaves stay the same, decrease, or quit.

 

I don't know what to tell you. You will need to pick your poison. 

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

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

All postings © copyrighted.

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Alto, 

 

Thanks for your response.  For the moment, I have decided to wait until the anxiety and depression become manageable .  Hopefully I will see improvement in these.  I am not sure that quitting is an option (I assume you meant ct?), as I don't think I could deal with the fallout.

 

As soon as the anx/depr become manageable, I will start reducing one of them.

PAST

Gabapentin:  about 6 months in 2015, 300-900 mg, cold turkeyed Sept 2015 (at same time dc'd Klonopin)

Klonopin: June 2014- Sept 2015; 1mg tapered over 6 mths, dc'd at 0.25mg, withdrawal hellish (perhaps because of concurrent dc of gabapentin)

Mirtazepine: Jumped off at 2.4 mg. (stable in 8 months).

Seroquel:  June 14 - July 24, 2016, 25 mg alternate nights; smaller doses for shorter periods. Total use about 3 months 

Lamictal: March 19, 2018 - 1 mg; March 23 - 1.25 mg; April 6 - 2mg. Discontinued at 2 mgJuly 1, 2018 due to Steven Johnson Syndrome.

 

CURRENT

Supplements: Vit D, turmeric

Naturethroid: 65 mcg for hypothyroidism

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d after 3 weeks. Reinstatement: 07/25/16 - 25 mg; updosed 08/03/16 - 50 mg;  10/01/16-  62mg; 03/24/17 dropped to 50 mg (stable in 2.5 months)

                           Current psych meds: Trazodone 50 mg

Link to comment

I think I can be sure that the twitching (and now heart rate has increased again after abating for a while) is due to my drug (or combination) and less to wd.  

 

I have been keeping a keen eye on the sxs and see that they begin about 1 hour after taking all meds.  I take traz and ser around 9:30 pm.  Twitching/jerks and increased heart rate begin around 10 to 11 pm.  During the day, there is noticeable relief.

 

In post #160, we had come to the same conclusion and the recommendation was to take mirt earlier.  I was wondering if I should take mirt (or ser), or even partial doses, in the morning instead, as an experiment.  

 

I know that the "solution" to my issues is ideally to reduce/eliminate at least one of the drugs for now, but I am so fragile at the moment that even a slow taper is terrifying, much less a ct.

 

Just looking for opinions as to whether this is worth a shot and any recommendation as to doses to take.

 

Sleep is just 4 hours, and am wondering how long before it diminishes further.

 

A bit of good news: the anxiety and depression were more manageable yesterday and today.   I hope it continues.

 

Thanks.

PAST

Gabapentin:  about 6 months in 2015, 300-900 mg, cold turkeyed Sept 2015 (at same time dc'd Klonopin)

Klonopin: June 2014- Sept 2015; 1mg tapered over 6 mths, dc'd at 0.25mg, withdrawal hellish (perhaps because of concurrent dc of gabapentin)

Mirtazepine: Jumped off at 2.4 mg. (stable in 8 months).

Seroquel:  June 14 - July 24, 2016, 25 mg alternate nights; smaller doses for shorter periods. Total use about 3 months 

Lamictal: March 19, 2018 - 1 mg; March 23 - 1.25 mg; April 6 - 2mg. Discontinued at 2 mgJuly 1, 2018 due to Steven Johnson Syndrome.

 

CURRENT

Supplements: Vit D, turmeric

Naturethroid: 65 mcg for hypothyroidism

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d after 3 weeks. Reinstatement: 07/25/16 - 25 mg; updosed 08/03/16 - 50 mg;  10/01/16-  62mg; 03/24/17 dropped to 50 mg (stable in 2.5 months)

                           Current psych meds: Trazodone 50 mg

Link to comment
  • Moderator Emeritus

I can only speak from my own experience but think it worth mentioning.

 

I was on Pristiq 100mg and believe I was suffering mild serotonin toxicity.  I started researching it because I was sweating a lot with only a small amount of exertion in the middle of winter.  My blood pressure also increased.  Once my dose got lower I started feeling overall improvement.  It was once I started feeling a bit better that I realised how "anxious" I had been.  However, thinking back now, it wasn't what I would normally think of anxiety.  I can recall at times not being able to settle.  Even watching TV I had to be doing something else at the same time.  Knowing what I know now, it was probably restlessness.

 

My reason for relating this is that it may be the drugs that are causing what you label anxiety and depression.

 

"For the moment, I have decided to wait until the anxiety and depression become manageable .  Hopefully I will see improvement in these."

 

So if it is the drugs that are causing your "anxiety and depression" then it will not become manageable.

 

If you decide to move the doses further apart it may be better to take the more sedating drug at night and move the other drug earlier by 1 hour each day.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

Link to comment

ChessieCat, 

 

Thank you for responding.  

 

I assume you are suggesting I consider a taper?  The inadvertent drop in mirtazepine made me feel so destabilized that I fear even a mere fraction of that drop would do me in.  I am still very shaky.

 

I do agree the drugs/combo is causing my issues, but I am so afraid of ruining this tenuous baseline I have.  I am barely functional and worry that I would be completely non-functional if I start to taper.  

 

One thing I do know: at some point I will have to start to taper to see any real improvement.  I am trying to psych myself up for beginning that taper; I  have already made an appt with a CBT therapist to help provide me with coping skills when the situation worsens during it.

 

From your experience I take heart that I do not have to be entirely off any/all drugs to see improvement.  

 

Thanks again ChessieCat

PAST

Gabapentin:  about 6 months in 2015, 300-900 mg, cold turkeyed Sept 2015 (at same time dc'd Klonopin)

Klonopin: June 2014- Sept 2015; 1mg tapered over 6 mths, dc'd at 0.25mg, withdrawal hellish (perhaps because of concurrent dc of gabapentin)

Mirtazepine: Jumped off at 2.4 mg. (stable in 8 months).

Seroquel:  June 14 - July 24, 2016, 25 mg alternate nights; smaller doses for shorter periods. Total use about 3 months 

Lamictal: March 19, 2018 - 1 mg; March 23 - 1.25 mg; April 6 - 2mg. Discontinued at 2 mgJuly 1, 2018 due to Steven Johnson Syndrome.

 

CURRENT

Supplements: Vit D, turmeric

Naturethroid: 65 mcg for hypothyroidism

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d after 3 weeks. Reinstatement: 07/25/16 - 25 mg; updosed 08/03/16 - 50 mg;  10/01/16-  62mg; 03/24/17 dropped to 50 mg (stable in 2.5 months)

                           Current psych meds: Trazodone 50 mg

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  • Administrator

As I've pointed out a couple of times, it's highly irregular to take all those drugs at once.

 

If you take any of them earlier, it's possible it will make you sleepy. It's up to you to figure out a strategy. Taking a small amount of one earlier in the day is one way to reduce the drug burden at night.

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

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

All postings © copyrighted.

Link to comment

Alto,

 

I have been taking the mirtazepine two hours before the others, but the twitching starts about an hour after the final meds and lessen during the day following.  I suspect that I have mild serotonin toxicity, something I had suspected since last Nov/Dec.  At that time though I was unsure as I was in seroquel/mirt wd too.  I have an appt with a movement specialist next week. I hope she can send some light, and help me determine which way to proceed.

 

If serotonin toxicity, that would explain the twitching, rapid heartrate, and maybe even the diminishing sleep.  And the only way out is to taper either trazodone or mitt.  

 

My dilemma is that I am finding it really hard to stabilize at the moment and don't feel well to begin a taper.  The most debilitating sx is shakiness/anxiety, and of course sleep which is now 4 hrs (depr is manageable).  I may have to suck it up at some point if I can't see improvement.

 

Thank you for your input.

 

PAST

Gabapentin:  about 6 months in 2015, 300-900 mg, cold turkeyed Sept 2015 (at same time dc'd Klonopin)

Klonopin: June 2014- Sept 2015; 1mg tapered over 6 mths, dc'd at 0.25mg, withdrawal hellish (perhaps because of concurrent dc of gabapentin)

Mirtazepine: Jumped off at 2.4 mg. (stable in 8 months).

Seroquel:  June 14 - July 24, 2016, 25 mg alternate nights; smaller doses for shorter periods. Total use about 3 months 

Lamictal: March 19, 2018 - 1 mg; March 23 - 1.25 mg; April 6 - 2mg. Discontinued at 2 mgJuly 1, 2018 due to Steven Johnson Syndrome.

 

CURRENT

Supplements: Vit D, turmeric

Naturethroid: 65 mcg for hypothyroidism

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d after 3 weeks. Reinstatement: 07/25/16 - 25 mg; updosed 08/03/16 - 50 mg;  10/01/16-  62mg; 03/24/17 dropped to 50 mg (stable in 2.5 months)

                           Current psych meds: Trazodone 50 mg

Link to comment

This is just a post to let me unload...please indulge the negativity.

 

Why do I feel so hopeless?

 

Is it because I cannot find any stability after almost four months?  

Is it because I cannot sleep for more than 4 hours a night?

Is it because for me to possibly find relief, I need to taper but will fall apart at even a small increase in wd sxs?

Is it because I cannot be a decent parent to my kids?  Unable to drive them to school, to help with homework?

Is it because this anxiety is crippling me?

Is it because as night approaches, I feel uneasy taking the drugs that are undoing me?

Is it because on this beautiful, sunny, spring day that was begging me to take a walk, all I could do was stare up in the sky and sigh 

 

Will I be even remotely stable again?  I am not living, I am just existing.

PAST

Gabapentin:  about 6 months in 2015, 300-900 mg, cold turkeyed Sept 2015 (at same time dc'd Klonopin)

Klonopin: June 2014- Sept 2015; 1mg tapered over 6 mths, dc'd at 0.25mg, withdrawal hellish (perhaps because of concurrent dc of gabapentin)

Mirtazepine: Jumped off at 2.4 mg. (stable in 8 months).

Seroquel:  June 14 - July 24, 2016, 25 mg alternate nights; smaller doses for shorter periods. Total use about 3 months 

Lamictal: March 19, 2018 - 1 mg; March 23 - 1.25 mg; April 6 - 2mg. Discontinued at 2 mgJuly 1, 2018 due to Steven Johnson Syndrome.

 

CURRENT

Supplements: Vit D, turmeric

Naturethroid: 65 mcg for hypothyroidism

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d after 3 weeks. Reinstatement: 07/25/16 - 25 mg; updosed 08/03/16 - 50 mg;  10/01/16-  62mg; 03/24/17 dropped to 50 mg (stable in 2.5 months)

                           Current psych meds: Trazodone 50 mg

Link to comment

Survivor my heart hurts for you! Do you have a support system in your spouse, friends, church, or community? I found such comfort in my people during the worst moments. Are you having suicidal thoughts or idealization? Those are normal for WD and important to remember it is not you it is the wd. Praying for you right now friend...

Sep '18 - became pregnant  in late August, then on 9/5 insomnia/anxiety went THROUGH the roof. I tried a lot of things but here is what is current: 

Paroxetine: 6.2mg (began 9/5/18, and there was a new manufacturer of which I just found out 2 days ago) during the day

Olanzapine 7.5mg at night

Ambien: 5-10mg at night

Xanex: 5-10mg at night

Fish Oil: for prenatal things

 

  • Aug '18: Paroxetine 6.6mg, (30mg thyroid hormone, fish oil, vit D3, SBI protect, probiotic. Following AIP diet)
  • Mar '16: began taper from 20mg. Decreasing .75mg or less each month or more. Sporadically used Ambien &/or Trazodone for insomnia. 
  •  Sep'15: tried to come off slower. Used fish oil, vit D3, and regular exercise/healthy diet to assist. (Taper sched= 18mg for 60days, 15mg for 60d, 10mg for 30d, 8mg for 30d) At my 3rd week of 8mg in Nov '15, insomnia and panic attacks began. Back up to 20mg after a month of horrible withdrawal. 
  • Oct'12-Sep'15: 20mg Paxil
  • Sep'12: 1st attempt to get off, naively tried cold turkey per Dr. suggestion. Couldn't work for 2 months. Another Doc upped dose to 20mg.
  • Jun '09-Aug '12: 10mg Paxil for severe insomnia due to anxiety. Also took Ambien/Trazodone for sleep.  Other meds taken sporadically: Ativan, Abilify, Xyrem 

 

My hope is built on nothing less, than Jesus' blood and righteousness. 

 

 

Link to comment

Megb,

 

Your words mean so much to me, I thank you for the support.  As you can imagine, no one really understands how it feels in wd, so I pretty much go it alone.  Thankfully no SI, and hope none in the future!

 

I do have some good news:  huge anxiety window yesterday, almost 8 hours! And today so far, faint in the early morning but gone now!  That accidental mirtazepine drop really did me in, but I can see some light now.

 

Your prayers worked!  Thanks again. 

PAST

Gabapentin:  about 6 months in 2015, 300-900 mg, cold turkeyed Sept 2015 (at same time dc'd Klonopin)

Klonopin: June 2014- Sept 2015; 1mg tapered over 6 mths, dc'd at 0.25mg, withdrawal hellish (perhaps because of concurrent dc of gabapentin)

Mirtazepine: Jumped off at 2.4 mg. (stable in 8 months).

Seroquel:  June 14 - July 24, 2016, 25 mg alternate nights; smaller doses for shorter periods. Total use about 3 months 

Lamictal: March 19, 2018 - 1 mg; March 23 - 1.25 mg; April 6 - 2mg. Discontinued at 2 mgJuly 1, 2018 due to Steven Johnson Syndrome.

 

CURRENT

Supplements: Vit D, turmeric

Naturethroid: 65 mcg for hypothyroidism

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d after 3 weeks. Reinstatement: 07/25/16 - 25 mg; updosed 08/03/16 - 50 mg;  10/01/16-  62mg; 03/24/17 dropped to 50 mg (stable in 2.5 months)

                           Current psych meds: Trazodone 50 mg

Link to comment

Update:

 

On 03/24, I bade goodbye to the dreaded anxiety :)

 

Even though I ordinarily would have waited for more stability, I decided to drop trazodone that very night.  So I decreased T to 52mg.  I realize that this is more than the 10% recommended, but I needed to address the twitching issue.  Lo and behold, the twitching/jerks reduced by 75% by the next morning!

 

That validated my suspicion that I was suffering mild serotonin toxicity (see post I made earlier, below).

 

Please help!

 

Since starting mirtazepine on 11/14, I had noticed an increase in body jerks and loud rapid heart rate.  I thought it was a wave from trazodone/seroquel ct.  After I dropped the dosage to 1.5 these had decreased, but other symptoms (anxiety, shakiness) increased.  I have updosed back to 2.5 (12/4) in the hopes of eliminating what I thought were wd from dropping to much.  But now the jerks and rapid heart rate - along with some sweating and shakiness - are back.  Serotonin syndrome?  If so, what to do? I read that the only solution is to eliminate the offending drug, but I cannot do this very fast without risking wd.  

 

To complicate matters, I reinstated 2 mg seroquel (Dec 6).  Since I had severe anx and depr before starting mirtazepine, I assumed the jerks and rapid heart rate were part of the same wd from seroquel and that this reinstatement would reduce any residual wd symptoms from the ct'ing.

 

Throughout all, my sleep had gone to bits.

 

I am really worried about possible serotonin syndrome.  I am not sure about seeing my doctor as she would likely advise me to taper over a few weeks.

 

Any advice is much appreciated!.  

 

 

 

I also had sharp knee pain, goosebumps, rapid heart rate all of which reduced/disappeared by day 3 of drop!  Sleep has also improved to 5.5 hrs.  With this dramatic improvement in this short time, I decided to stay the course.  I am now experiencing some wd from the too large T drop, and am bracing for worsening sxs in the next few weeks.  But I cannot/will not updose.  

 

 

I will stay at this dose and stabilize, and start making at most 10% drops/mo.

 

With the depression and anxiety gone (I hope for good!), I feel much better today than I did a few weeks ago, despite the wd from T.  I am very optimistic.  Wish me luck!  Will update with new developments.

 

Thanks for the support, all.

PAST

Gabapentin:  about 6 months in 2015, 300-900 mg, cold turkeyed Sept 2015 (at same time dc'd Klonopin)

Klonopin: June 2014- Sept 2015; 1mg tapered over 6 mths, dc'd at 0.25mg, withdrawal hellish (perhaps because of concurrent dc of gabapentin)

Mirtazepine: Jumped off at 2.4 mg. (stable in 8 months).

Seroquel:  June 14 - July 24, 2016, 25 mg alternate nights; smaller doses for shorter periods. Total use about 3 months 

Lamictal: March 19, 2018 - 1 mg; March 23 - 1.25 mg; April 6 - 2mg. Discontinued at 2 mgJuly 1, 2018 due to Steven Johnson Syndrome.

 

CURRENT

Supplements: Vit D, turmeric

Naturethroid: 65 mcg for hypothyroidism

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d after 3 weeks. Reinstatement: 07/25/16 - 25 mg; updosed 08/03/16 - 50 mg;  10/01/16-  62mg; 03/24/17 dropped to 50 mg (stable in 2.5 months)

                           Current psych meds: Trazodone 50 mg

Link to comment
  • Moderator Emeritus

Really pleased to hear of the improvement.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

Link to comment

Thank you CC, also for sharing your own experience with serotonin toxicity.

PAST

Gabapentin:  about 6 months in 2015, 300-900 mg, cold turkeyed Sept 2015 (at same time dc'd Klonopin)

Klonopin: June 2014- Sept 2015; 1mg tapered over 6 mths, dc'd at 0.25mg, withdrawal hellish (perhaps because of concurrent dc of gabapentin)

Mirtazepine: Jumped off at 2.4 mg. (stable in 8 months).

Seroquel:  June 14 - July 24, 2016, 25 mg alternate nights; smaller doses for shorter periods. Total use about 3 months 

Lamictal: March 19, 2018 - 1 mg; March 23 - 1.25 mg; April 6 - 2mg. Discontinued at 2 mgJuly 1, 2018 due to Steven Johnson Syndrome.

 

CURRENT

Supplements: Vit D, turmeric

Naturethroid: 65 mcg for hypothyroidism

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d after 3 weeks. Reinstatement: 07/25/16 - 25 mg; updosed 08/03/16 - 50 mg;  10/01/16-  62mg; 03/24/17 dropped to 50 mg (stable in 2.5 months)

                           Current psych meds: Trazodone 50 mg

Link to comment

So it has been two weeks since the large drop of traz.  I am really feeling it now, and I think it will only worsen as the last few days have been getting progressively worse.

 

I have to admit I have thoughts of updosing (to perhaps 55?).  At the moment I can manage the sxs, but I am at the threshold.  Should I be patient since I have held for two weeks?   I assumed that wd would have been felt almost immediately after dropping, but I had only mild sxs for the first week, and was hopeful that I could pull through.  But after this week, I know that I will not be this lucky.  Any thought on updosing or riding it out?

 

Trying to stay strong ...

PAST

Gabapentin:  about 6 months in 2015, 300-900 mg, cold turkeyed Sept 2015 (at same time dc'd Klonopin)

Klonopin: June 2014- Sept 2015; 1mg tapered over 6 mths, dc'd at 0.25mg, withdrawal hellish (perhaps because of concurrent dc of gabapentin)

Mirtazepine: Jumped off at 2.4 mg. (stable in 8 months).

Seroquel:  June 14 - July 24, 2016, 25 mg alternate nights; smaller doses for shorter periods. Total use about 3 months 

Lamictal: March 19, 2018 - 1 mg; March 23 - 1.25 mg; April 6 - 2mg. Discontinued at 2 mgJuly 1, 2018 due to Steven Johnson Syndrome.

 

CURRENT

Supplements: Vit D, turmeric

Naturethroid: 65 mcg for hypothyroidism

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d after 3 weeks. Reinstatement: 07/25/16 - 25 mg; updosed 08/03/16 - 50 mg;  10/01/16-  62mg; 03/24/17 dropped to 50 mg (stable in 2.5 months)

                           Current psych meds: Trazodone 50 mg

Link to comment
  • Moderator Emeritus

Hi Survivor,

 

Because you are borderline and (I'm assuming) that you have kept everything the same for the 2 weeks, you might consider updosing by a very small amount.  As little as 0.5mg - 1mg may be enough to take the edge off the worst of the symptoms without bringing on the side effects.

 

If you haven't already seen this topic, I suggest you read Post #1 before making your decision:  About reinstating and stabilizing to reduce withdrawal symptoms

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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Hello CC,

 

Yes, I have kept everything unchanged.  Today seem a little better so far, so have decided to play it by ear for the next week and then decide what to do.

 

Thanks for the advice.

PAST

Gabapentin:  about 6 months in 2015, 300-900 mg, cold turkeyed Sept 2015 (at same time dc'd Klonopin)

Klonopin: June 2014- Sept 2015; 1mg tapered over 6 mths, dc'd at 0.25mg, withdrawal hellish (perhaps because of concurrent dc of gabapentin)

Mirtazepine: Jumped off at 2.4 mg. (stable in 8 months).

Seroquel:  June 14 - July 24, 2016, 25 mg alternate nights; smaller doses for shorter periods. Total use about 3 months 

Lamictal: March 19, 2018 - 1 mg; March 23 - 1.25 mg; April 6 - 2mg. Discontinued at 2 mgJuly 1, 2018 due to Steven Johnson Syndrome.

 

CURRENT

Supplements: Vit D, turmeric

Naturethroid: 65 mcg for hypothyroidism

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d after 3 weeks. Reinstatement: 07/25/16 - 25 mg; updosed 08/03/16 - 50 mg;  10/01/16-  62mg; 03/24/17 dropped to 50 mg (stable in 2.5 months)

                           Current psych meds: Trazodone 50 mg

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  • Moderator Emeritus

Thank you for confirming that everything is unchanged.  It's good that you seem a bit better.

 

Holding at the current dose is better if you are able to live with the symptoms.  However, if you do decide to increase, please do not panic and take too much.  These drugs are strong and it is better to try a tiny bit and give it some time and then increase a tiny bit more if needed than to start out with too large an increase.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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Since my last post, things have gotten progressively better.  I did not have to updose.  

 

Today I feel about 80% stable!  I will wait for as long as is necessary to stabilize fully and then make 10% drops.  

 

Thanks for your support, all.

PAST

Gabapentin:  about 6 months in 2015, 300-900 mg, cold turkeyed Sept 2015 (at same time dc'd Klonopin)

Klonopin: June 2014- Sept 2015; 1mg tapered over 6 mths, dc'd at 0.25mg, withdrawal hellish (perhaps because of concurrent dc of gabapentin)

Mirtazepine: Jumped off at 2.4 mg. (stable in 8 months).

Seroquel:  June 14 - July 24, 2016, 25 mg alternate nights; smaller doses for shorter periods. Total use about 3 months 

Lamictal: March 19, 2018 - 1 mg; March 23 - 1.25 mg; April 6 - 2mg. Discontinued at 2 mgJuly 1, 2018 due to Steven Johnson Syndrome.

 

CURRENT

Supplements: Vit D, turmeric

Naturethroid: 65 mcg for hypothyroidism

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d after 3 weeks. Reinstatement: 07/25/16 - 25 mg; updosed 08/03/16 - 50 mg;  10/01/16-  62mg; 03/24/17 dropped to 50 mg (stable in 2.5 months)

                           Current psych meds: Trazodone 50 mg

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  • Moderator Emeritus

Wonderful to read that you're seeing light at the end of the tunnel ... and that it's sun, not an oncoming train. ;)

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results

Cymbalta 60 mg 2012 - 2015; 2016: 20 mg to 7 mg exact doses and dates in this post; 2017: 6.3 mg to  0.0 mg  Aug. 12; details here


scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet

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Thanks SW.  I was indeed lying in wait for the train but thankfully the sun showed up instead  :lol:

 

I am still plagued by the serotonin toxicity as I still have some sweating, rapid heart rate and twitching at night, but not as severe as before the  traz drop.  Will drop traz, all in good time.  At least I am sleeping 6 hrs /night.

PAST

Gabapentin:  about 6 months in 2015, 300-900 mg, cold turkeyed Sept 2015 (at same time dc'd Klonopin)

Klonopin: June 2014- Sept 2015; 1mg tapered over 6 mths, dc'd at 0.25mg, withdrawal hellish (perhaps because of concurrent dc of gabapentin)

Mirtazepine: Jumped off at 2.4 mg. (stable in 8 months).

Seroquel:  June 14 - July 24, 2016, 25 mg alternate nights; smaller doses for shorter periods. Total use about 3 months 

Lamictal: March 19, 2018 - 1 mg; March 23 - 1.25 mg; April 6 - 2mg. Discontinued at 2 mgJuly 1, 2018 due to Steven Johnson Syndrome.

 

CURRENT

Supplements: Vit D, turmeric

Naturethroid: 65 mcg for hypothyroidism

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d after 3 weeks. Reinstatement: 07/25/16 - 25 mg; updosed 08/03/16 - 50 mg;  10/01/16-  62mg; 03/24/17 dropped to 50 mg (stable in 2.5 months)

                           Current psych meds: Trazodone 50 mg

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So I feel the wd increasing in intensity now.  It has been three weeks since dropping.  I expect symptoms to worsen over the next few weeks.  

 

I desperately do not want to updose because of the serotonin toxicity, and hope that I can hang on.  Just looking for reassurance that a LONG hold can pull me through.

 

Thanks.

PAST

Gabapentin:  about 6 months in 2015, 300-900 mg, cold turkeyed Sept 2015 (at same time dc'd Klonopin)

Klonopin: June 2014- Sept 2015; 1mg tapered over 6 mths, dc'd at 0.25mg, withdrawal hellish (perhaps because of concurrent dc of gabapentin)

Mirtazepine: Jumped off at 2.4 mg. (stable in 8 months).

Seroquel:  June 14 - July 24, 2016, 25 mg alternate nights; smaller doses for shorter periods. Total use about 3 months 

Lamictal: March 19, 2018 - 1 mg; March 23 - 1.25 mg; April 6 - 2mg. Discontinued at 2 mgJuly 1, 2018 due to Steven Johnson Syndrome.

 

CURRENT

Supplements: Vit D, turmeric

Naturethroid: 65 mcg for hypothyroidism

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d after 3 weeks. Reinstatement: 07/25/16 - 25 mg; updosed 08/03/16 - 50 mg;  10/01/16-  62mg; 03/24/17 dropped to 50 mg (stable in 2.5 months)

                           Current psych meds: Trazodone 50 mg

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I couple cuts ago I held for two months and stabilized nicely with a lot of windows.

 

Marie

10/13--10/14 Ambien. Started tapering 1/14  Jumped 10/14.  Done.                                                                              

3/14        7.5 Remeron  still taking this.                              

2/14         75 Trazodone   -    Tapered by dry cutting all the way down.

1/16        4 mg Trazodone  -  Jumped. Bad mistake. Got hit with late withdrawal 6 weeks later. Reinstated.

4/16        Reinstated 1 mg, updose to 2 mg Trazodone

2/19        .04 Trazodone. Walked off.  Done.

10/3/19  Started 7.5 Mirtazapine taper cut to .073 gram weight, pill weighs .076

4/5/20    New Mirtazapine Taper - Compound Liquid 7.35 mg April '20, 7.25 mg May, 7.05 mg June, 6.99 mg June, 6.78 mg July, 6.57 mg Aug, Sept 6.35 mg, Sept 6.24 mg, Sept 6.21 mg, Oct 5.99 mg, Oct 5.90 mg, Oct 5.70 mg.

1/11/21 6.05 mg Messed up taper due to syringe change. Must remember the 1 ml syringe contains 1.5mg! 1/16/21 5.99 mg

2/21 5.75 mg, 3/21 5.6 mg, 4/7 5.45, 4/14 5.30, 5/12 5.15, 5/25/21 4.99 mg, 6/29 4.87 mg, 7/14/21 4.74 mg, 8/5 4.62 mg 8/17 4.5 mg, 8/30 4.38 mg,9/16 4.26 mg,10/9 4.14 mg, 10/23 4.05 mg, 11/6 3.96 mg,11/17 3.87mg.***Jan 22 Liquid was changed/couldn't tolerate***Changed back to pills. Feb 22/3.9 mg, 2/17/22 3.8 mg, 3/23 3.7 mg, 4/7 3.6 mg, 5/10 3.5mg,6/10/22 3.4 mg, 7/4 3.3 mg, 7/25 3.2 mg, 8/20/22 3.1 mg, 9/15 3 mg, 10/8/22 2.9 mg., 12/15 2.8 mg, 1/6/23 2.7 mg, 2/16/23 2.6 mg, 3/9 2.5 mg, 4/4 2.4 mg, 4/29/23 2.3 mg, 5/26 2.2 mg, 6/22/23 2.1 mg, 10/14 2 mg, 11/12 1.9 mg, 11/28 1.8 mg , 12/14/23 1.7, 12/31/23 1.6 mg, 1/20 1.5 mg, 2/6/24 1.4 mg, 2/12 updose 1.5 mg. Taking multi-vitamin, vit. D, cholestoff, psyllium husk, and fish oil.

 

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