SSRI support group - tapering while on benzo's or after recovery

[[...]]

Hi Buddies!

 

I've discovered this thread thanks to our brilliant Mind  :thumbsup:

 

I am currently attacking Clonazepam but you will see from my signature that I've been badly polydrugged 

 

Not only am I on clonazepam, I take diazepam at night and this has nothing to do with crossing over, I was just prescribed those drugs.

 

On the ADs front, I am on Escitalopram 15mg and Venlafaxine MR 75mg.

 

In 2011, my GP had convinced me to lower Escitalopram on the grounds of it being dangerous for my heart ( ) and I managed, over time, to come from 60mg/day to 15mg. I hadn't a clue about getting off psychoactive drugs and trusted my GP who told me to go down in 5mg steps. However, in January 2013, after managing to come from 20 to 15mg/day, I began to feel even more tired during the day - by that I mean exhaustion, and this terrible burden has subsided ever since...

In theory, lowering Escitalopram should have the opposite effect, right? I have no idea how this works 

 

Apart from that, my experience of Escitalopram withdrawal is very much uneventful. I might have felt slightly "weird" at times but I carried on going to Uni, I was fine! Even in such "steps".

 

So I went to my GP telling him I wanted to get off benzos instead... the "depressants" making me drowsy, sluggish, flat... it made sense in my mind as I had researched the subject.

 

I now realise that all my drugs are a problem 

I don't know which drug to get off once I am done with K, do I keep going with benzos?

 

Then Venlafaxine... with its very short half-life. I believe I can still get 37.5 mg pills but shouldn't cut MR drugs?...

 

Sorry, too many questions I am not asking for answers LOL I still have a long way to go before I get off clonazepam and I don't think I should interrupt this taper now that I'm well into it.

I'm glad that there is support for polydrugged "patients", I'm delighted that it is on BBs 

 

Good Luck to All,

Julia xxx

[Guest [Mi...]]

Hi, Julz. Good to see you in the SSRI support group. 

 

I'm going to link you to the articles on Surviving Antidepressants about tapering off your two AD's, escitalopram (Lexapro) and venlafaxine (Effexor):

 

Tips for tapering off Lexapro (escitalopram)

 

Tips for tapering off venlafaxine (Effexor)

 

If you don't already have an account with Surviving Antidepressants, I would encourage you to do so. You can get an account for free and they give really great advice there.

 

Escitalopram can be a bit misleading because the dose is low. However, it is an extremely potent medication, so you may want to consider a liquid taper. The information about its potency is in the article I linked, so please read over both of these articles carefully. I think you'll find a lot of good information there.

 

You may have already seen this since you read my AD sticky, but if not, please also read through this article: Taking multiple psych drugs? Which drug to taper first?

 

You may want to consider coming off of one or both AD's before completing your benzo taper. Since your doctor mentioned the Escitalopram causing heart problems, that might be the one to target first. As you come off the clonazepam, you may pick up more of the side effects of the AD's, and I'm concerned that that may become dangerous for your heart.

 

Are you going to taper off the diazepam? You mention it being prescribed at night, but that it's not a crossover, so I'm wondering how the diazepam plays out in your strategy to come off all or most of your medication.

 

You're doing really well, Julia, and I admire the positive attitude you have (and your cat memes on LF's blog). And that's important and will definitely help you throughout your taper. 

[[...]]

Hi, Julz. Good to see you in the SSRI support group. 

 

I'm going to link you to the articles on Surviving Antidepressants about tapering off your two AD's, escitalopram (Lexapro) and venlafaxine (Effexor):

 

Tips for tapering off Lexapro (escitalopram)

 

Tips for tapering off venlafaxine (Effexor)

 

If you don't already have an account with Surviving Antidepressants, I would encourage you to do so. You can get an account for free and they give really great advice there.

 

Escitalopram can be a bit misleading because the dose is low. However, it is an extremely potent medication, so you may want to consider a liquid taper. The information about its potency is in the article I linked, so please read over both of these articles carefully. I think you'll find a lot of good information there.

 

You may have already seen this since you read my AD sticky, but if not, please also read through this article: Taking multiple psych drugs? Which drug to taper first?

 

You may want to consider coming off of one or both AD's before completing your benzo taper. Since your doctor mentioned the Escitalopram causing heart problems, that might be the one to target first. As you come off the clonazepam, you may pick up more of the side effects of the AD's, and I'm concerned that that may become dangerous for your heart.

 

Are you going to taper off the diazepam? You mention it being prescribed at night, but that it's not a crossover, so I'm wondering how the diazepam plays out in your strategy to come off all or most of your medication.

 

You're doing really well, Julia, and I admire the positive attitude you have (and your cat memes on LF's blog). And that's important and will definitely help you throughout your taper. 

 

Thank you so much, dear Mind 

 

I have indeed seen your sticky post and have just registered with "Surviving Antidepressants" 

 

I can hardly believe my eyes when I read about Escitalopram... and I thought I was on a "low" dose!

 

I have checked for interactions and here is a summary of the results:

Escitalopram + Venlafaxine: major

- "...can increase the risk of a rare but serious condition called the serotonin syndrome"

- "...can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect."

Fortunately I have never experienced either... so far...

 

All the other combinations: Moderate

"dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment."

 

As I said in my first post, I will get off clonazepam, after that, in the light of new information, I might consider staying on Valium while I get off one of the ADs - which means I would not be crossing over to valium to finish my K taper? ...I'm still confused about tolerance too as I'm quite sure I hit a wall at some point, and more recently as I was holding on 2mg K for 4 months and symptoms just appeared again 

 

I will definitely stick around and gather as much information as I can regarding this deathly cocktail.

Thank Goodness for such a wonderful website and forum  :thumbsup:

 

Good Luck to All!!!

Julia xx

[Guest [Mi...]]

Hi, Julia.

 

Thanks for checking your meds in the Drug Interaction Checker. It does sound like you've hit on an interaction that should be addressed. If it were me, I would make coming off the Escitalopram a priority, holding everything else steady. Take care of your heart first.

 

And then gauge where you're at. Hopefully, you'll see a reduction in some of your symptoms.

 

Saving the Valium until last sounds like a good plan, especially if it's helping you sleep.

 

If you get some more information from Surviving Antidepressants, please let us know. They also have a members-only benzo forum within their site - http://survivingantidepressants.org/index.php?/forum/29-members-only-benzo-forum/

 

The moderators who post in that area have experience with both benzos and AD's, so you'll be in good hands. 

[[...]]

Thank you so much, Mind 

 

I will definitely let you know how things go, if I discover anything new, I now know where to share information 

Still quite shocked about Escitalopram... and that I'd been going down in freakin steps  :'( (sorry)...makes you wonder whether I am now experiencing anything from that!...

 

Anyway, let's keep going, knowledge is power  :thumbsup:

[[si...]]

I am on lexapro and tapering off K.  I'm at about 9mg of lex and just below 0.175mg of K.  I started at .25 of K back in October.  It was suggested tapering the ssri first, but I went with the the K.  I take the lex first thing in the morning.  I know it has a peak blood plasma level of around 5 hours.  This week I noticed that that is just about the time I get really ramped up with a lot of anxiety, like I'm ready for the nuthouse.  It's just like the anxiety I felt when I was having the startup effects of the lexapro and I went on the K.  So I'm in a dilemma now.  If I want to hold K, can I start tapering the lex?  Do you have any suggestions?  Or I wonder if it's a paradoxical effect of the k?

 

[Guest [Mi...]]

I am on lexapro and tapering off K.  I'm at about 9mg of lex and just below 0.175mg of K.  I started at .25 of K back in October.  It was suggested tapering the ssri first, but I went with the the K.  I take the lex first thing in the morning.  I know it has a peak blood plasma level of around 5 hours.  This week I noticed that that is just about the time I get really ramped up with a lot of anxiety, like I'm ready for the nuthouse.  It's just like the anxiety I felt when I was having the startup effects of the lexapro and I went on the K.  So I'm in a dilemma now.  If I want to hold K, can I start tapering the lex?  Do you have any suggestions?  Or I wonder if it's a paradoxical effect of the k?

 

Hi, Sierra.

 

Here's a really good article about tapering off Lexapro that may useful - http://survivingantidepressants.org/index.php?/topic/406-tips-for-tapering-off-lexapro-escitalopram/.

 

I just looked up your earlier thread that you're referring to and I'm going to link it here because you gave a good account of how these meds were affecting you - http://www.benzobuddies.org/forum/index.php?topic=143768.0.

 

Lexapro is misleadingly potent, so please go very slowly and carefully. It's hard to say whether you're getting symptoms from the Klonopin or from the Lexapro. From your earlier thread, Lexapro was the reason you started on Klonopin, so it's quite possible that as you decrease the Klonopin, the stimulating side effects of the Lexapro are being unleashed. And if your central nervous system is in anyway destabilized from your benzo taper, you may be more sensitive to medications now.

 

If it were me, I would come off the SSRI first while holding the benzo steady. You may even wish to go with a liquid suspension. The article I linked from Surviving Antidepressants gives more information about this. 

 

Also, are you still taking Trazodone? If so and it's still helping you sleep, I would leave that drug at a steady dose and only taper if after you're off everything else.

 

 

 

 

 

[[si...]]

Yes, I am still taking trazodone.  Will I stabilize at the klonopin dose that I'm at?

[Guest [Mi...]]

Yes, I am still taking trazodone.  Will I stabilize at the klonopin dose that I'm at?

 

It's hard to say if you'll stabilize on that low dose of Klonopin; however, it may keep you from hitting the acute part of benzo withdrawal if you wanted to go ahead and taper the Lexapro.

 

Are you still able to sleep on the trazodone?

[[si...]]

Yes I am able to sleep on the trazodone.

 

That would mean I would have to hang out at this level of K for up to 10 months.  This all so complicated.

[Guest [Mi...]]

Yes I am able to sleep on the trazodone.

 

That would mean I would have to hang out at this level of K for up to 10 months.  This all so complicated.

 

I would go ahead and make a very small cut in your Lexapro according to the guidelines in the Surviving Antidepressant article. You may even want to get an account with them if you haven't already. They give really excellent AD withdrawal advice.

 

And once you've reduced the Lexapro enough that some of the stimulating side effects have subsided, you may be able to hold the Lexapro steady and slide off that last amount of Klonopin.

 

So that's another way to go. But see how you do with a very, very small cut in the Lexapro.

 

The fact that you've sleeping is excellent. The point is to be as functional as possible during all of this, so even if it does take 10 months, as long as you're able to sleep and function, you're doing everything right.

[[si...]]

Yes I am able to sleep on the trazodone.

 

That would mean I would have to hang out at this level of K for up to 10 months.  This all so complicated.

 

I would go ahead and make a very small cut in your Lexapro according to the guidelines in the Surviving Antidepressant article. You may even want to get an account with them if you haven't already. They give really excellent AD withdrawal advice.

 

And once you've reduced the Lexapro enough that some of the stimulating side effects have subsided, you may be able to hold the Lexapro steady and slide off that last amount of Klonopin.

 

So that's another way to go. But see how you do with a very, very small cut in the Lexapro.

 

The fact that you've sleeping is excellent. The point is to be as functional as possible during all of this, so even if it does take 10 months, as long as you're able to sleep and function, you're doing everything right.

 

Thanks Mindseeker.  I'm going to ponder this a day or so.  Even if I could get it down half way, that would be great.

[[He...]]

I am 5 months off of Klonopin.  In the beginning of withdrawal, I dealt a lot with depression as a symptom so my doc upped my 20 mg of Celexa to 40 mg.  It didn't help (I honestly do not believe andidepressants help in benzo withdrawal), so I successfully weaned myself back down to the 20 mg.  I have been on 20 mg of Celexa for about 5 years.  I don't think it does a thing for me so I want off of it.  This morning, I shaved a little off of the 20 mg pill.  I will continue to shave off, hoping to be at 10 mg within a month.  Will let everyone know how I do.  Really want off of it.  Prior to Celexa, I took Paxil 20 mg for about 10 years.  Got off of that but when the depression came back, my doctor told me I had to be on something.  Looking back, I realize that the "depression" at that time was a few moments of a low mood.  Not real depression like I am experiencing with benzo withdrawal, so I really wish I would never had gone back on an antidepressant.  Should have stayed off.  Well, I am determined to get off of it now.

[[si...]]

 

 

The fact that you've sleeping is excellent. The point is to be as functional as possible during all of this, so even if it does take 10 months, as long as you're able to sleep and function, you're doing everything right.

 

 

Mindseeker - is coming off trazodone a huge challenge too?

[Guest [Mi...]]

 

 

The fact that you've sleeping is excellent. The point is to be as functional as possible during all of this, so even if it does take 10 months, as long as you're able to sleep and function, you're doing everything right.

 

 

Mindseeker - is coming off trazodone a huge challenge too?

 

It really depends. Your best chances of it not being a challenge is to wait until your CNS is stable after you come off the other drugs, and then to taper slowly.

 

When you're ready for the trazodone taper, we can help get you set up at a safe rate.

 

For now, try to go one drug at a time and focus on the big picture of being medication free. If you had trouble sleeping prior to psychiatric drug use, you may wish to explore non-drug ways of dealing with this.

 

Changes in nutrition such as eliminating caffeine, exercising, and using guided sleep meditations may all be things you can do well in advance of your trazodone taper. Any non-drug coping skills you can do will help.

[Guest [Mi...]]

I am 5 months off of Klonopin.  In the beginning of withdrawal, I dealt a lot with depression as a symptom so my doc upped my 20 mg of Celexa to 40 mg.  It didn't help (I honestly do not believe andidepressants help in benzo withdrawal), so I successfully weaned myself back down to the 20 mg.  I have been on 20 mg of Celexa for about 5 years.  I don't think it does a thing for me so I want off of it.  This morning, I shaved a little off of the 20 mg pill.  I will continue to shave off, hoping to be at 10 mg within a month.  Will let everyone know how I do.  Really want off of it.  Prior to Celexa, I took Paxil 20 mg for about 10 years.  Got off of that but when the depression came back, my doctor told me I had to be on something.  Looking back, I realize that the "depression" at that time was a few moments of a low mood.  Not real depression like I am experiencing with benzo withdrawal, so I really wish I would never had gone back on an antidepressant.  Should have stayed off.  Well, I am determined to get off of it now.

 

Hi, Herckie.

 

Reducing 50% in one month is really fast, especially since you may not notice withdrawal symptoms right away. With antidepressants, the withdrawal may not hit for a month or longer after you come off the medication.

 

I'm going to give you a couple of links about coming off Celexa that may help:

 

Antidepressant Withdrawal

 

Tips for tapering off Celexa

 

The second link is from the website Surviving Antidepressants. They recommend reducing by no more than 10% and that seems to be a really good rule, especially since your central nervous system may already be compromised due to your benzo taper.

 

Please keep us posted on how you're doing.

 

[[si...]]

 

 

The fact that you've sleeping is excellent. The point is to be as functional as possible during all of this, so even if it does take 10 months, as long as you're able to sleep and function, you're doing everything right.

 

 

Mindseeker - is coming off trazodone a huge challenge too?

 

It really depends. Your best chances of it not being a challenge is to wait until your CNS is stable after you come off the other drugs, and then to taper slowly.

 

When you're ready for the trazodone taper, we can help get you set up at a safe rate.

 

For now, try to go one drug at a time and focus on the big picture of being medication free. If you had trouble sleeping prior to psychiatric drug use, you may wish to explore non-drug ways of dealing with this.

 

Changes in nutrition such as eliminating caffeine, exercising, and using guided sleep meditations may all be things you can do well in advance of your trazodone taper. Any non-drug coping skills you can do will help.

 

I never had trouble sleeping.  I went into a depression and developed insomnia.  Then I went  on meds.  I was very active with exercise and lead healthy lifestyle prior to all this.  Hopefully once I get through with I'll get back into the exercise and get back on track with everyting.

[Guest [Mi...]]

 

 

The fact that you've sleeping is excellent. The point is to be as functional as possible during all of this, so even if it does take 10 months, as long as you're able to sleep and function, you're doing everything right.

 

 

Mindseeker - is coming off trazodone a huge challenge too?

 

It really depends. Your best chances of it not being a challenge is to wait until your CNS is stable after you come off the other drugs, and then to taper slowly.

 

When you're ready for the trazodone taper, we can help get you set up at a safe rate.

 

For now, try to go one drug at a time and focus on the big picture of being medication free. If you had trouble sleeping prior to psychiatric drug use, you may wish to explore non-drug ways of dealing with this.

 

Changes in nutrition such as eliminating caffeine, exercising, and using guided sleep meditations may all be things you can do well in advance of your trazodone taper. Any non-drug coping skills you can do will help.

 

I never had trouble sleeping.  I went into a depression and developed insomnia.  Then I went  on meds.  I was very active with exercise and lead healthy lifestyle prior to all this.  Hopefully once I get through with I'll get back into the exercise and get back on track with everyting.

 

That sounds like a great plan.

 

It seems like by the time members get through the lengthy withdrawal from multiple meds, they've developed some really phenomenal coping skills. And since you were active and healthy prior to withdrawal, that should be your path, too. 

[[He...]]

Thanks for the links Mindseeker.  I am just desperate for something to get better with my withdrawal from Klonopin.  I want to heal so badly!  I just thought maybe the Celexa was prohibiting the healing.  I will take it slow and just continue to shave a little off of the 20 mg pill each night for a while.  I will see how I feel with that before going any lower.  I was reading about low Gaba and quite frankly, I am freaking out about this because I have all of the symptoms of low Gaba.  I makes me wonder if I will ever feel normal again.  Was hoping that if I got off the Celexa it would help to heal faster so my Gaba levels could start to increase naturally.  I am at my wits end and don't know what to do at this point.  I honestly thought I would be healed by now and am so frustrated that I am not.

[Guest [Mi...]]

Thanks for the links Mindseeker.  I am just desperate for something to get better with my withdrawal from Klonopin.  I want to heal so badly!  I just thought maybe the Celexa was prohibiting the healing.  I will take it slow and just continue to shave a little off of the 20 mg pill each night for a while.  I will see how I feel with that before going any lower.  I was reading about low Gaba and quite frankly, I am freaking out about this because I have all of the symptoms of low Gaba.  I makes me wonder if I will ever feel normal again.  Was hoping that if I got off the Celexa it would help to heal faster so my Gaba levels could start to increase naturally.  I am at my wits end and don't know what to do at this point.  I honestly thought I would be healed by now and am so frustrated that I am not.

 

I know and I completely understand, Herckie. 

 

I thought the same thing at 6 months off Klonopin but I still had to get off my last drug, Seroquel. So it's definitely a lengthy process.

 

Even though Celexa doesn't effect GABA like benzos, it does affect the central nervous system (CNS), so letting your CNS get stable after your benzo withdrawal is really key to mitigating the withdrawal symptoms from your other meds.

 

So by going slow and giving your CNS time to recover as your GABA system recovers, you're going to have the best shot at staying as healthy as possible throughout this entire process.

[[Sh...]]

Sierra, I think Mindseeker is right on on this one.  I think you are on the right track here.  It just makes sense.  I have learned to be very careful in qualifying what works for me, as it may not work for others.  We have such different histories, and definitely different drugs!  Never thought I would say I agree you should stay on the Trazodone for now!  Hope things get better soon. 

[[la...]]

I came off Zoloft (15 years on) in just 4 weeks...STUPID....after 4 weeks I started to get slammed with sx...they have not let up and its been 7 months

 

doesn't help that I am trying to get off lorazepam with a c/o to diazepam right now either

[[si...]]

Sierra, I think Mindseeker is right on on this one.  I think you are on the right track here.  It just makes sense.  I have learned to be very careful in qualifying what works for me, as it may not work for others.  We have such different histories, and definitely different drugs!  Never thought I would say I agree you should stay on the Trazodone for now!  Hope things get better soon. 

 

Thanks Shadow, I'm planning to stay on it.  :'(  I think it's best for now.

 

[[si...]]

Mindseeker-  I still haven't done anything with the lexapro and I'm still getting that ramped up feeling about 5 hours after I take it.  Think it's safe to do an experiment and try taking the lexapro a little later than my usual time, to see if it affects me later.

[[Sh...]]

Sierra, Mindseeker's signature says she is taking a forum break.  I think she is off for awhile.  I hope someone can respond.  I think it sounds like a good experiment, but have no experience with it.