Bmoremp19: Intro - my journey and questions

[Bmoremp19]

Hi-thanks for the join! I feel like I'm on this never ending journey to feel better. Long story short, about two years ago I had PPA with the birth of my daughter. Was on klonopin for a few months and Zoloft for a year. Got off fine, no issues. Fast forward to last November, started having terrible sleep issues and found out I was preg but it was ectopic. Had methotrexate and started back on Zoloft and klonopin. I worked up to 200 mg of Zoloft and 1.25 mg of klonopin. I cross tapered w gabapentin, for about five weeks-highest dose was 1200 mg for a week. I'm now on 25-50 of trazodone at night for sleep and 150 mg of Zoloft. I don't think it's working as well as it should this round. I also have these weird pings in my legs. Like someone is flicking my calves. I also have tremors in my hands. I'm wondering what is causing this?! My doctor is considering changing to Prozac or a higher dose of traz so I can use it for both anxiety and sleep. Anyone on just traz? I'm just over it, nothing seems to be doing the trick. My husband is out of town and last night the traz did nothing and I only got 4 hours of sleep ???? What to do?! Thanks

[Madeleine]

The tremors and pinging feeling can very likely be from the meds.

[Bmoremp19]

Which ones do you think? I never had leg pings till after I got off klonopin and and went up on gaba. Off both and still have then

[Bmoremp19]

Them! Have Them! Maybe the trazodone makes it worse? Do you know if there is a traz forum? Thanks!!

[Survivor1]

Bmoremp,

 

It's hard to know what to advise without a timeline of knowing when exactly you added/dropped your drugs.  The moderators usually advise to create a signature to show this.  But I will continue none-the-less

 

I am currently on traz, just weaned down to 52.  

 

When did your tremors start?  I could be that the Zoloft/traz combo (and not necessarily the drugs separately) is causing the problem (google serotonin syndrome).

 

When I was only on trazodone 75 mg, it worked well for sleep, with no problems.  After I rapid tapered, reinstated, I added remeron.  I then developed twitching, limb jerking, etc from too much serotonin.  When I take remeron at night 1 hour before taking traz, I have no issues for that 1 hour.  After taking traz, I start getting increase in heart rate, insomnia, jerks and twitching.  Heart rate and jerks gets better during the day, repeat at night.

 

Both trazodone and Zoloft are serotonergic, and could very well be adding to the insomnia and tremors (along with your klonopin wd).  If so, be careful that the doctor does not add more traz, or other serotonergic drugs for sleep like remeron.  They could make your insomnia and other sxs worse!  (Without Zoloft, your trazodone may work fine for sleep, don't know how long you have been on Zoloft and if you still need to be)

 

I think one can help you more when you add your signature.

 

All the best!

There are not many on traz here, but there are a few people tapering it (google "survivingantidepressants.org and trazodone"), including myself.

[Bmoremp19]

Hi-thanks for connecting. What was the highest dose of traz you were on? My doc is interested to switch me to just traz if I can handle the higher doseage, for both sleep and anxiety. I want to get preg, so being on one med would be better.

 

I thought I put my med info in my signature-but here is a quick recap. Started Zoloft again in early November-got up to 200 and now at 150. Have had hand tremors since I started. Never knew if it was Zoloft or nerves. I also took 1.25 of klonopin till 3.17.17, I weaned down and cross tapered w gabapentin. I got up to 1200 mg of gaba for a week and that's when the pricks started. I started traz almost a month ago and the pricks are still here. They went away or diminished a bit but are back now.

 

So-I also have been feeling really tired during the day, I don't know if it's from traz-like my eyes hurt. Could be sinus stuff too. I tried 25 mg last night and I only slept a few hours. To be fair-my husband is traveling for work and my toddler woke up three times.

 

I would be surprised if I had seratonin syndrome. I do have night sweats and the tic but that's it. Did you stop remeon? Are you using them mainly for sleep? I'm glad that we can chat about traz! Seems like not many people take it. Oh-do you take any supplements?

[Bmoremp19]

Is it possible I'm still having klonopin withdraw issues?

[PoetJester]

Hey Bmoremp19

 

the tiredness is probably from the Zoloft. a lot of people develop fatigue from it. I am on a Zoloft facebook page and there are a ton of posts about becoming fatigued on it. I developed anemia from taking either taking Zoloft or prevacid or both which probably led to my feeling tired all the time for years. when you say your eyes hurt, does you mean you are sensitive to sunlight or that your eyeballs actually hurt? Mine have been sore to the touch for a long time now and I am not sure what it is.

 

 

poetjester

[Bmoremp19]

I haven't felt this way till recently. I assumed it was the weather, allergy and sinus season but ?? It is a combo, sensitive to light but also feel droopy and heavy and my veins are more noticeable. I started protonix last week for possible heart burn. Interesting that you had issues from similar thing.

 

Are you still on zo? I might wean off and try something else here soon.

[Survivor1]

Hi 

 

The highest dosage of traz I was on was 100, but only for a few days.  I was mostly on 75, then 62.5. Did ok at all levels.  It is the combo of traz/remeron that I'm having problems with and am on both of these still for sleep.  However, the combo is giving me insomnia!

 

When I weaned off klonopin (too fast) my withdrawal lasted for at least 8 months!  But my circumstances were different from yours.  Wd can last for months depending on how you taper, etc.  One of my sxs then ( and now to some extent) is sharp nerve pain like pinpricks, but it is manageable now.

 

Since you have not been on Zoloft long maybe you maybe you could taper quicker.  A moderator would know better.

 

Night sweats and tremors are signs of many things including serotonin syndrome and wd.  So it's hard to know which is causing what.  Just be aware at the very least.

 

Best wishes

[PoetJester]

No, I quit Zoloft and zyprexa cold turkey 3 years ago. read my intro for the details. it's been 3 years of bad sleep to no sleep and if you saw my face and the huge bags under my eyes from all the sleep deprivation you would shudder. it's bad news. Now that I think about it, I did have pretty bad sensitivity to sunlight when I was on Zoloft. Sensitivity to light is a pretty common side effect of anti depressants. it went away when I quit zoloft, but instead I got a case of permanent insomnia and depression. I was pretty optimistic when I first got off the drugs, my thinking was clearer and I had more energy, but my sleep never really healed and is still screwed up three years later which is totally frustrating and leads to being depressed along with a host of cognitive problems including having very poor short term memory.

[Bmoremp19]

thanks to both of you for the info. i updated my signature. 

Survivor1- are you going to stop the remeron? can you take either but not both? so, i tapered off the klon semi-fast, but was only on it for 3 months. i reduced .25 a week and cross tapered with gabapentin-so i went to 1 mg and took 300 mg of gaba, .75 of klon and took 600 of gaba and so on till i was taking .125 of klon and 1200 of gaba. it was since then, i have had these weird pricks around my legs and sometimes other parts of my body-they don't hurt, just an odd sensation. i am sweating so much all the sudden--this started with the traz/zoloft combo. gross. why did you stop the higher traz dosage? PoetJester-i am so sorry to hear that. what are you on now, i will look at your signature. yes-my eyes hurt, again this started right when i got off klon and was on a higher dose of gabapentin and carried over till now. my doc wants to either switch me to prozac or have me take a higher dose of traz (150 or above) at night for both sleep and anxiety.  

[Bmoremp19]

Anyone here take traz? Hope I'm posting this right. I mentioned in my intro that I'm on 150 mg of Zoloft and 50 mg of traz. Been on traz for about a month. I'm using it mainly for sleep. Since using it, I've had a few issues. I feel itchy, have leg pings and can't shake this fog-tired and slow to respond. I felt some of this before starting the traz so I'm kinda at a loss.

 

Anyone have these issues? Does anyone just take traz for sleep and anxiety? My doc is considering getting me off Zoloft and just taking trazodone. What other meds would you rec that can help w sleep and anxiety? Thanks!

[Bmoremp19]

Somehow I forgot a huge issue-night sweats!! Like huge amounts of sweat every night!

[Survivor1]

Hi, I plan to reduce remeron eventually, tapering of course.  I am currently stabilizing after a large trazodone drop.  I had to reduce either the remeron or trazodone because they are both serotonergic and the combo was causing some serotonin toxicity (recall my twitching, rapid heart rate, etc.).  I chose trazodone because I can't tolerate a drop in remeron just yet.

 

I frankly did not need the remeron, I was having insomnia from seroquel wd (which I have since reinstated at a low dose), but did not know it then, so added remeron in a panic.

 

If you read my thread, one of the moderators, ChessieCat, had shared her experience with serotonin toxicity that included sweating.  If this symptom started with the traz/zoloft combo, you definitely should not increase one without discontinuing the other (even individually, too high doses of either could cause the syndrome); I think you need to reduce the dose of one of these.  I'll let the moderators weigh in, but based on your last post I think serotonin toxicity is likely an issue.

[Bmoremp19]

Hmmmm, I wonder??! My eyes kill me too-like can't open them fully. I would love to hear what others think! It's really just the physical stuff that I can't get passed.

 

So you will stick w traz once you drop rem? Did the doctor tell you about the serotonin issue? I'm curious if these tics are from it or my nerves and lack of sleep. Fun stuff! Thanks for answering my questions!

[mammaP]

Hi B, welcome to SA. I am so sorry to hear of your miscarriage, it must have been traumatic for you. 

 

You are likely to be suffering klonopin withdrawal, dependence can be within a couple of weeks and should only be prescribed for very short periods. The gabapentin is a different drug so isn't really ideal for cross tapering. 

 

 

Fluctuating between doses of trazodone is not recommended, this is destabilising for the nervous system.  Doses need to be consistent but I can understand why you try.

 

I would nit change anything else yet, doctors rarely know the impact they are causing by experimenting with drugs! 

 

Here is what I have gathered from your posts. It would help if you can list this in your signature so the full picture is there.  

 

2015 Klonopin few months. C/T 

Zoloft C/T 2016

 

November  2016 

 

Methotrexate (eptopic) 

 

200 zoloft 

1,25 klonopin 

 

Gabapentin cross taper. 5 weeks

300, 600, 900, 1200  C/T March

 

Klonopin quit Feb/March

 

Currently 150 zoloft 

25-50 Trazodone. 

 

When did you start trazodone? 

 

That is an awful lot of changes and together have really rocked your nervous system. 

 

It is possible that when you felt so ill with the eptopic pregnancy you had also started to feel withdrawal from the previous zoloft/klonopin use. It is quite common for withdrawal to be delayed. 

 

I am going to ask for the others to take a look as I am not experienced with benzo's and you could be suffering benzo withdrawal. 

[Shep]

Hi, bmoremp19.

 

Welcome to the forum from me, too.

 

 

Is it possible I'm still having klonopin withdraw issues?

 

 

 

Yes, since you are only 5 weeks off Klonopin, you may be having Klonopin withdrawal issues, as well as withdrawal symptoms from coming off the gabapentin.

 

Here is a list of withdrawal symptoms from the Ashton Manual, which is a guide to coming off benzodiazepines:

 

Ashton Manual - Benzodiazepine Withdrawal Symptoms

 

You may find more information in our benzo forum:

 

 

Members-only Benzo Forum

 

 

I want to get preg, so being on one med would be better.
 

 

 

Please research this first. There are articles on the Mad in America site, which give information outside of the pharmaceutical industry's biased information. You may find articles such as this helpful:

 

 

Antidepressant use During Pregnancy may Increase Risk of Birth Defects

 

There's also a free online course about the role of antidepressants during pregnancy:

 

Antidepressants and Pregnancy

 

I've taken some of the free courses offered through the Mad in America Continuing Education site and found them very informative. It's important for us to thoroughly research our drugs.

 

As many of us on this forum have found out, doctors really don't know how to handle these drugs, especially withdrawal. Please do research this. 

 

 

My doc is considering getting me off Zoloft and just taking trazodone. What other meds would you rec that can help w sleep and anxiety? Thanks!

 

 

We can't recommend any drugs to help with sleep and anxiety or any other symptoms. Unfortunately, there is nothing that's been found to help with withdrawal. 

 

There are many things that you can do to help, though. Magnesium and fish oil can help calm the nervous system. 

 

King of supplements: Omega-3 fatty acids (fish oil)
Magnesium, nature's calcium channel blocker

 

You may also find some tips in these links:

 

Non-drug coping skills 

 

Important topics about symptoms, including sleep problems

 

Please keep updating. 

[Bmoremp19]

Sorry, i thought i had updated my sig--here it is:

 

current:

zoloft-150 mg

trazodone-50 mg

 

previous:

Was on 1.25 mg of klonopin-weaned off on march 17, 2017

Was on gabapentin-cross tapered to get off klonopin. started with 300 mg for two weeks, 600 for a week, 900 for a week then 1200 for a week. Stopped because it wasn't helping with sleep. 

 

prenatal vitamin-one time per day

probiotic-every other day

sometimes take protonix for acid reflux 

 

There you have it! i am wondering if it is klonopin withdraw? my doc doesn't seem to think so, but who knows? she has never heard of legs "pings" before. do you think feeling drowsy could be from withdraw too? i was on it for three months. 

 

Ever since i had the methotrexate, i haven't felt right--but at this point, things should be under control. I have been on traz for about a month. i started with 25 mg while stopping gabapentin then upped to 50 mg for past few weeks. it does help with sleep but issues i have encountered are major night sweats and feel foggy and drowsy. my eyes hurt as well (i sound like i am complaining, sorry) hard to tell if its from traz or combo of other things.

 

my other frustration is that i dont think zoloft is helping as it should. it's been almost 6 months and i still have breakthrough anxiety along with a hand tremor. i dont know? i am talking with  my doc tomorrow. part of me wants to taper off z and stick with traz for sleep. thoughts? 

 

can i post in the benzo or do i need an invite?

 

thanks for all of the support and comments. sigh! 

[Bmoremp19]

oh, and i take a prenatal vitamin that has DHA, so that should cover the fish oil. i also drink "calm" https://www.amazon.com/Natural-Vitality-Calmag-Supplement-Ounce/dp/B0053PJH06

 

My doc wants to switch me to prozac, we shall see...

[Altostrata]

Hello, bmoremp.

 

It is possible you are suffering from benzo withdrawal, gabapentin withdrawal, some combination of the two, plus adverse reactions to one or more of the drugs you're taking now.

 

Please keep daily notes on paper about your symptoms, when you take your drugs, and their dosages.

 

Do you get these leg pings at a particular time of day? The eye discomfort? Are you sensitive to light, do your eyes hurt after you've been on the computer for a while?

 

When do you get acid reflux, is it connected to a certain food?

 

What is your sleep pattern?

[Bmoremp19]

hi Altostrata-thanks for the reply! 

 

i guess i thought i would "be over" any withdraw, especially since i tapered pretty slow-to me at least. i was on klon for 3 months at 1.25 and then reduced by .25 each week or two along cross tap w gabapentin. i was on gaba at various dosages for 5 or so weeks. one week at 1200 and then off. i am having a hard time knowing what these issues are from. i do know i still have anxiety and should not feel this way 6 months in on zoloft. 

 

i take 150 mg of zo in the morning and take 50 mg of traz 30-45 min before bedtime. with the traz, my sleep has been good for the most part. i sleep 7.5-8.5 hours a night. yet-i still feel super tired and my eyes are bloodshot. i wear a fitbit, so i can see my sleep pattern and it's pretty normal/decent. i did get glasses for the computer and i dont know if they help or not. 

 

i think i am starting to get down about these drug combo's not working for me. blah!! my body just feels tired and heavy. 

 

thanks for listening! 

[JanCarol]

Hey B - 

 

How are you going?

 

Have you started any tapers?

 

I'm very concerned with you for the zoloft trazadone combination:

Interactions between your selected drugs

Major trazodone  sertraline

Applies to: trazodone, Zoloft (sertraline)

Using traZODone together with sertraline 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.

 

I'm also worried that your doctor will make too many changes too fast.  Your "slow" taper of your klonopin was actually quite rapid, see:

Why taper by 10% of my dosage?

 

These drugs are not like aspirin, they actually make changes to your brain's neurotransmitters and nervous system - so - the CT of gabapentin, for example, may have longer term consequences.

Rhi said it like this:

A lot of people, including healthcare practitioners; in fact, I guess, most people-- are operating from entirely the wrong paradigm, or way of thinking, about these meds. They're thinking of them like aspirin--as something that has an effect when it's in your system, and then when it gets out of your system the effect goes away.

 

That's not what happens with medications that alter neurotransmitter function, we are learning.

What happens when you change the chemistry of the brain is, the brain adjusts its chemistry and structure to try to return to homeostasis, or biochemical and functional balance. It tries to restabilize the chemistry. 

For example: SSRI antidepressants work as "serotonin reuptake inhibitors." That is, they cause serotonin to remain in the space between neurons, rather than being taken back up into the cells to be re-used, like it would be in a normal healthy nondrugged brain.

So the brain, which wants to re-establish normal signaling and function, adapts to the higher level of serotonin between neurons (in the "synapse", the space between neurons where signals get passed along). It does this by removing serotonin receptors, so that the signal is reduced and changed to something closer to normal. It also decreases the amount of serotonin it produces overall. 

To do that, genes have to be turned on and off; new proteins have to be made; whole cascades of chemical reactions have to be changed, which means turning on and off OTHER genes; cells are destroyed, new cells are made; in other words, a complex physiologic remodeling takes place. This takes place over time. The brain does not grow and change rapidly. 

This is a vast oversimplification of the amount of adaptation that takes place in the brain when we change its normal chemistry, but that's the principle.

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay.

When the drug is removed, the remodeling process has to take place in reverse.

SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. 

It's a matter of, as I describe it, having to grow a new brain. 

I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long. 

With multiple drugs and a history of drug changes and cold turkeys, all of this becomes even more complicated. And if a person is started on these kinds of drugs at an early age before the brain has ever completely established normal mature functioning--well, it can't be good. (All of which is why I recommend an extremely slow taper particularly to anyone with a multiple drug history, a history of many years on meds, a history of past cold turkeys or frequent med changes, and a history of being put on drugs at a young age.)

This isn't intended to scare people, but hopefully to give you some idea of what's happening, and to help you respect and understand the process so you can work with it; ALSO, because you are likely to encounter many, many people who still believe these drugs work kind of like aspirin, or a glass of wine, and all you need to do is stop and get it out of your system. 

Now you can explain to them that no, getting it out of your system is not the issue; the issue is, you need to regrow or at least remodel your brain. This is a long, slow, very poorly understood process, and it needs to be respected.

 

 

These "little annoying physical symptoms" you are complaining about - are your body's way of telling you that something is not right.

 

Please let us know how it's going, and please update your signature to include dates that you started the zoloft and trazodone.

I hope you see the sun today!