Antidepressant - considering post benzo

[[Js...]]

Hi all, I thought I would get off my long going thread posted on the general forum and start this one here because my question is specific to depression and what to consider.

 

As you may know I had a reaction to another non-pysch drug that gave me wicked anxiety and insomnia, thus the Klonopin. While taking the other drug I did have a couple of morning of very deep depression, something that I had never had previously, I should have suspected something then and quit taking the stuff but I listened to the doc and pharmacist that said oh no, could not be causing a problem & if it is it will go away after, etc... to live and learn!

 

Anyway, all the while I was on Klonopin I had depressive episodes that would come and go. Something I blamed on the Klonopin and I do say the benzo made it worse but to be honest, in hind sight, I don't think it was the main cause, I think the original ADR was. There are "alot" of people that have had similar problems as I and that describe the same depression/despair that comes and goes like the wind as part of their reaction.

So, here I am 2 1/2 weeks post benzo and the depression is still with me, not all the time but still with me. After a fairly good couple of days over the weekend, this week has been really tough. I can work but it doesn't help, I can participate in hobbies but not the same enjoyment, I can interact with others (work and socially) but difficult and never feel good. So I know with all that said that I'm not doing too bad when compared to some, but this really is beginning to wear on me. I can't stop working, that is not an option. I can't just lay on a couch and let it resolve itself, that is not an option.  I have to stop thinking about taking the bridge if ya know what I mean!

 

I'm at a cross roads, I want so badly to try to get through this all with the help of another drug but I'm not sure that I can. I had a worry (GAD) problem, though minor, before this all began. Now compound a toxic reaction that may have long term (maybe permanent) effects along with a benzo withdrawal and I am feeling lost and hopeless. In the past I would self medicate my GAD with a glass or 2 (3,4,...) of wine, I don't have that option now, no more crutch. I'm trying to work on my coping techniques and have a good therapist but to be honest I think I am losing the battle. Again, pre-exisiting worry + chronic health condition that has psychological effects + benzo withdrawal = a mess!

 

I know that many have said wait the depression out, that it is a side effect of the benzo withdrawal, but the on the other hand even Prof. Ashton states that depression that lasts 3 weeks after the final dose is not probably related to the benzo withdrawal and should be treated accordingly, possibly with medication. My PDoc and therapist also agree with her, that anxiety and of sx's yes but not the on going depression.

So, not sure who to believe and thus not sure what to do, all I know is that I feel like I'm crumbling rapidly.

 

Finally here are my questions:

A. is Ashton right or wrong on the depression after 3 weeks?

 

B. is starting an AD after 2 weeks post benzo done, is it done successfully?

 

C. do you think it would help the benzo anxiety too? how about the pre-existing anxiety?

 

D. thinking about Lexapro starting at 5mg, comments?

 

E. I know that AD can cause increased anxiety/insomnia in some, any comments especially about the Lexapro?

 

 

Just an observation that I have made talking to many over the past few months. I know that a number of you were on or still are on an AD pre & post taper. It seems that those that were taking an AD have done better overall than those that didn't use them. Think this applies to a number of moderators too. That is just what I have seen, not sure it's completely accurate, but just an observation.

 

Please look at my big picture, look at what I'm dealing with and let me know what your thoughts are. I know this is a personal decision but would appreciate any thoughts and wisdom I could get.

 

 

Thanks,

 

Jim

 

[[Be...]]

Deciding to add any drug or supplement is tough in my opinion.  They all have potential side effects and you have to try to weigh the risks against the possible "rewards".  I'm one of those who was on an A/D before I started my taper and I have had depression for about 20 years, so mine pre-dated my benzo use.  I was tried on Lexapro and it did nothing for me but others have had a good response.  You could try a forum search and probably find a lot of posts about that particular A/D. To search the whole forum, you need to ckcik on the "Forum" link at the top and then enter Lexapro in the Search box at the right (where the little magnifying glass is.) 

 

Some A/D's are supposed to help with anxiety but I don't know which ones.  I don't know about the 3 week cut-off for depression post-benzo.  Sorry.

 

Jim, I don't remember what non-psych drug you are referring to re: bad reaction.  I know you want to avoid anything that has any of the same ingredients.

 

Good luck and let us know what you decide and how it goes, okay?

[[Ho...]]

This is a very tricky and complex topic. On one hand, most members do not feel comfortable suggesting that you take an anti-depressant, but there are many members on here who take them or have had experiences with them.

 

I'm not saying that I do not believe you, I am just wondering, where did you read that Ashton said that if the depression continues 3 weeks after your last dose it's not related to w/d? I just want to be sure that she said this, as it puzzles me a bit. Dr. Ashton is one of the few who recognized protracted withdrawal (symptoms lasting for months), so I'm not sure how she could say a particular symptom 3 weeks after your last dose could not be related to the w/d. IMO, from reading many people's stories, the depression could definitely be a s/x of w/d even 2 months after the last dose...

 

Most people would not suggest starting an a/d 2 weeks post benzo. Here is why: your body is still healing it's receptors, and is very vulnerable to anxiety, ect. SSRI's (Lexapro) are known to cause intense feelings of anxiety/nervousness for the first few weeks after you begin them. You might not want to take the risk of the Lexapro flaring up your w/d symptoms.

 

IMO, the fact that your doctors have jumped immediately to “Lexapro!” as the answer is the very problem with western medicine in general. I feel that there are simply too many other options to pursue to treat depression before jumping to an a/d. Yet I can probably guarantee you that your doctors didn’t suggest any of the following as ways of treating depression:

-Highly concentrated Omega 3,6,9 pills.

-5-htp (very effective). 5-htp is  an amino acid that is the precursor to serotonin. When you take it, your body converts it to serotonin, just as it converts amino acids in food to serotonin. It has very few side effects compared to SSRI’s and the rest of a/d’s, and does not require a prescription.

-St.Johns wort. It’s exact mechanism is not known, but scientists think it may be a much more mild version of an SSRI. But it has fewer side effects then a/d’s.

-Exercise, at least 5 days a week, for at least 30 minutes. Study after study confirms that exercise is one of the best ways to treat depression and anxiety.

-An overall excellent diet. No fast food, no junk food, just whole food. Think veggies, fruits, yogurt, all different whole grains, fish, and lean chicken/turkey.

 

I had some pretty bad depression at the beginning of my taper, and found that with exercise, the omega 3/6/9 pills, and 1 50mg 5-htp every night, my depression has virtually gone away, and only rears its ugly head out every few days and is usually mild.

 

Also, although this is not everyone’s experience, this is what I have noticed about SSRI’s from watching friends get on them: I don’t talk to my friends anymore, I talk to their SSRI. What I mean by that is their personalities literally did a 180 over the course of a month, and they appear to be happily content, yet something is very off.

 

HOWEVER, this is when the exceptions come in. Some people DO have depression, and some people cannot shake it without the use of SSRI’s or other a/d’s. I truly believe that some people are better off taking them. But I would not even THINK about taking them until I tried every other natural/safe/effective option available to me.  

 

I myself would rather live life content on an SSRI then be in the throes of horrible depression. Some people also have “chemical depression” which means no matter how wonderful everything around them is, they can still have severe depression because their body simply does not produce enough serotonin.

 

I would wait a bit longer and also try some of the options I listed. Other’s may also have more alternative options to give you. In the end, this is your personal choice, but most people can work it out and push through it. But as I said before, some people do need these medicines…but there are too many on them who don’t.

 

 

[[Be...]]

HY -

 

This is what I found in The Ashton Manual about post-benzo depression (underline is mine):

 

"Depression in withdrawal may become protracted (see section on protracted symptoms) and if it does not lift within a few weeks and is unresponsive to simple reassurance and encouragement, it is worth seeking a medical opinion and possibly taking an antidepressant drug (see section on adjuvant medication). Depression in withdrawal responds to antidepressant drugs in the same way as depressive disorders where benzodiazepines are not involved."

[[Js...]]

Thanks Beeper for researching that for me, I intended to do the same today. So I am wrong about her saying that after 3 weeks it should be gone, sorry for the mis-understanding. But, I am still at the same point in that she says after a Few weeks (what is a few weeks?) that you may want to consult with a doctor and consider an AD. So I'm still kind of in the same boat other than what is considered a "few weeks".

 

Jim

[[ma...]]

This is a very tricky and complex topic. On one hand, most members do not feel comfortable suggesting that you take an anti-depressant, but there are many members on here who take them or have had experiences with them.

 

I'm not saying that I do not believe you, I am just wondering, where did you read that Ashton said that if the depression continues 3 weeks after your last dose it's not related to w/d? I just want to be sure that she said this, as it puzzles me a bit. Dr. Ashton is one of the few who recognized protracted withdrawal (symptoms lasting for months), so I'm not sure how she could say a particular symptom 3 weeks after your last dose could not be related to the w/d. IMO, from reading many people's stories, the depression could definitely be a s/x of w/d even 2 months after the last dose...

 

Most people would not suggest starting an a/d 2 weeks post benzo. Here is why: your body is still healing it's receptors, and is very vulnerable to anxiety, ect. SSRI's (Lexapro) are known to cause intense feelings of anxiety/nervousness for the first few weeks after you begin them. You might not want to take the risk of the Lexapro flaring up your w/d symptoms.

 

 

This is Mary.  I have had depression prior to this and I personally think that it is better to take an SSRI then to fall into a hole. 

 

Of course I am speaking of those who had pre-existing depression.

 

From what I have been told is to take the SSRI for a minimum of six months to a year or else you risk a return of the depression.  I started taking 25mg of Zoloft,

 

Lexapro does seem to work but my insurance only covers generics.  Zoloft in some studies in the "safest' of the SSRI's.  Anyway I have been hospitalized for pre-existing depression and it is not a pretty sight. 

 

Some SSRI's are made to specifically target anxiety and OCD WITHOUT messing around with the GABA system.

I personally am offering MY opinion along with what I have read, and I am not advocating one way or another.

again this is Mary

 

 

IMO, the fact that your doctors have jumped immediately to “Lexapro!” as the answer is the very problem with western medicine in general. I feel that there are simply too many other options to pursue to treat depression before jumping to an a/d. Yet I can probably guarantee you that your doctors didn’t suggest any of the following as ways of treating depression:

-Highly concentrated Omega 3,6,9 pills.

-5-htp (very effective). 5-htp is  an amino acid that is the precursor to serotonin. When you take it, your body converts it to serotonin, just as it converts amino acids in food to serotonin. It has very few side effects compared to SSRI’s and the rest of a/d’s, and does not require a prescription.

-St.Johns wort. It’s exact mechanism is not known, but scientists think it may be a much more mild version of an SSRI. But it has fewer side effects then a/d’s.

-Exercise, at least 5 days a week, for at least 30 minutes. Study after study confirms that exercise is one of the best ways to treat depression and anxiety.

-An overall excellent diet. No fast food, no junk food, just whole food. Think veggies, fruits, yogurt, all different whole grains, fish, and lean chicken/turkey.

 

I had some pretty bad depression at the beginning of my taper, and found that with exercise, the omega 3/6/9 pills, and 1 50mg 5-htp every night, my depression has virtually gone away, and only rears its ugly head out every few days and is usually mild.

 

Also, although this is not everyone’s experience, this is what I have noticed about SSRI’s from watching friends get on them: I don’t talk to my friends anymore, I talk to their SSRI. What I mean by that is their personalities literally did a 180 over the course of a month, and they appear to be happily content, yet something is very off.

 

HOWEVER, this is when the exceptions come in. Some people DO have depression, and some people cannot shake it without the use of SSRI’s or other a/d’s. I truly believe that some people are better off taking them. But I would not even THINK about taking them until I tried every other natural/safe/effective option available to me.  

 

I myself would rather live life content on an SSRI then be in the throes of horrible depression. Some people also have “chemical depression” which means no matter how wonderful everything around them is, they can still have severe depression because their body simply does not produce enough serotonin.

 

I would wait a bit longer and also try some of the options I listed. Other’s may also have more alternative options to give you. In the end, this is your personal choice, but most people can work it out and push through it. But as I said before, some people do need these medicines…but there are too many on them who don’t.

 

 

[[ma...]]

Sorry I don't think I was suppose to press quote on that last entry.

 

Two weeks into withdrawal?  My personal view is that it is too soon.

 

Ideally no a/d would be good but there are exceptions like she said.

 

No shame in asking for advice.

 

 

 

I have just been prescribed Zoloft which I have taken before and seemed to work.

Lexapro worked well but could not afford it,

 

I have mixed feelings about it

 

I had preexisting depression so this is just my opinion

 

So I'm sure somebody with more experience will respond

 

Mary

[[...]]

Hi Jim,

 

Please read my "signature box" below.  I am on 10 mgs of lexapro and I'm very happy that I am taking it.  I started with 5 mgs, though, and I did that because of reports re anxiety increasing for 1-3 weeks at the beginning.  I did not really notice any increase in anxiety.  I was taking 10 mgs of valium at the time, and had struggled mightily in the past with withdrawal tapers - and was feeling "tolerance withdrawal" at the time I started the lexapro.  It has helped me sleep - absolutely amazing to me - while I'm going through this taper...a good 8 or more hours, almost every night...not at all what I have been experiencing the last 10 years.  I'm almost done with the benzo taper (2 to 4 weeks, I figure), and it really has been quite easy.  I am going to try to get off the lexapro after waiting about a month after benzo withdrawal - if I am feeling good, that is.

 

I hope this was of some help.  Feel free to post or send me a PM.  I am happy to answer questions or help in any way I can.

 

Rumi

[[Js...]]

Thank you both for the insight and advice. I am now at about 5 1/2 weeks and can say that the depression is getting better, not perfect, still have my down days but not that deep, dark stuff anymore and when I feel that coming on I can usually shake it off. I still have not totally thrown out the idea, I'm dealing with some other things beyond benzo withdrawal that may cause me to try an AD but for now I am monitoring my progress daily and as long as I continue to see positive improvement I will stay the course. Who knows, tough to determine what tomorrow may bring, just living in the moment and being thankful for what I have.

 

Jim

[[Js...]]

well, maybe I spoke too soon. The past 3 days have been less than stellar. Gonna stick with my plan and give it 2 months but I am definitely not discounting the fact that I may try an AD at some point, we'll see what the next few days bring.

[[ma...]]

Hi Jim,

 

Please read my "signature box" below.  I am on 10 mgs of lexapro and I'm very happy that I am taking it.  I started with 5 mgs, though, and I did that because of reports re anxiety increasing for 1-3 weeks at the beginning.  I did not really notice any increase in anxiety.  I was taking 10 mgs of valium at the time, and had struggled mightily in the past with withdrawal tapers - and was feeling "tolerance withdrawal" at the time I started the lexapro.  It has helped me sleep - absolutely amazing to me - while I'm going through this taper...a good 8 or more hours, almost every night...not at all what I have been experiencing the last 10 years.  I'm almost done with the benzo taper (2 to 4 weeks, I figure), and it really has been quite easy.  I am going to try to get off the lexapro after waiting about a month after benzo withdrawal - if I am feeling good, that is.

 

I hope this was of some help.  Feel free to post or send me a PM.  I am happy to answer questions or help in any way I can.

 

Rumi

 

 

10mgs of Lexapro, maybe I will try that, I am currently trying 25mg of Zoloft-cant tell the difference in how I feel, maybe I'll try the Lexapro.

I pressed quote don't tell Treehealing because I'm trying to act as if I know what I am doing. :laugh:

[[ma...]]

I do not know the answer but....but I LEND you my support. 

Mary

[[sp...]]

Ive found depression comes and goes with the waves of sxs I get post benzos.  eventually I did start an a/d, amitriptylene and have found it has helped with my sleep and depression.  Only take 10mg at night (small dose for this med) and still go through low periods and lack of sleep but not horrendous and real black like in the past.

I was dead against taking anything and fought it for a long time, but once I did I havent regretted it and it has helped me keep going with my journey.  One thing I was told is that with benzo w/d we should only take a small dose of an a/d as we are generally more sensitive to these meds at this time (drug counsellors advice) and often get the same result with less than normal.

This is a personal choice - we are all different and only you can decide what suits you best.  I think its wise to give it time, but dont feel bad if you decide to go the a/d route - this is an incredibly hard process and sometimes some of us need an extra hand to go forward and heal     Best of luck with your journey

Spring