Could Liquid Switch Have Injured Me?

[[mi...]]

Ever since I switched to Liquid compounded K (ora plus with pure K powder) for one week (this was almost a month ago) I haven’t been the same. I’m back on my original pills but that one week on liquid destroyed my body. I have severe benzo belly with constant cramping, bloating, gas, pain that never stops. Happens whether I eat or not. I’ve lost 15 lbs, my heart rate is still up to 140bpm even when lying in bed in the morning, my breathing is short and labored, I have zero sex drive. I am completely at a loss. This happened on my second dose of liquid and only at 25% liquid as I was crossing over. Is it even possible to explain this? My gut is the worst part of this as I have had zero benzo belly symptoms in two years of tapering and it went from that to a 10/10 overnight. My system is on overdrive and it’s living hell. Felt like a light switch went off and all these changes happened. The liquid definitely absorbed quicker and didn’t last as long but to happen so quick with a reaction. To the same medicine I am already on but in a different form/company. Any theories? I’ve been off for 3.5 weeks so far and no real improvement on any of it. Am I injured from something as stupid as that? Is it just a reaction? Will it settle? Did my receptors get hit too hard by a fast absorbing liquid? How would this start symptoms I’ve never experienced in my life when they weren’t there in any capacity the day before. It isn’t getting better and I am not functioning well at all.

[[Li...]]

 

I wonder if there might be multiple factors contributing to your current distress?

For example, am I remembering correctly that you had issues with a switch from one generic manufacturer to another before you switched to the compounded liquid?   As you may know, the amount of API (Active Pharmaceutical Ingredient) in tablets can vary from one manufacturer to another.  If the original generic manufacturer tended to produce tablets with more API than the brand standard and the second manufacturer tended to produce tablets with an equal or lower amount of API than the brand standard, you may have experienced a reduction in dose (e.g. if the first generic manufacturer was 10% above the standard and the second generic manufacturer was 10% below the standard, the reduction could have been 20%).

It would also be helpful to know more about your medication/supplement and taper history.  

Have you made any changes in medications or supplements recently?

What was your original starting total daily dose of clonazepam?  What was your total daily dose on the first day of the month for the 3-6 months prior to the generic switch?

 

[[mi...]]

@[Li...] Thank you for your reply. I was on several ADs and some short term use of Ativan andK from 2000-2003. I don’t remember everything but lots of switches and rapid tapers off of those and I did have symptoms for years afterwards that I never really knew were WD. Since then I’ve always used Ativan intermittently, sometimes 1 pill per month, sometimes 15. Never daily but sometimes 3-4 days a week. Done this for 20 years. I know it sensitized my body but I could always stop using it for weeks is needed without crashing. Fast forward to today. I’ve been doing wonderfully on Accord K for nearly two years where I started in 0.5mg after a bad reaction to Flagyl (this reaction threw me into acute and ironically put me into a similar GI state). Actually I did 2 months on 0.5mg Ativan before being switched immediately over to 0.5mg K inpatient. So my daily use of benzos started in Aug 2921 and I started K in Oct 2021. The first few weeks on K I felt overstimulated so I cut after two weeks to .375 since I hadn’t been on it long and I know K is double the potency of Ativan. I felt better at that dose. Once I healed from flagyl I started feeling good on K and started tapering. I tapered approx 2-6% per month since but have been consistently every two weeks since November of last year at about 3% per two weeks. A few mini waves but super smooth otherwise. When I was forced to switch over to Teva from Accord I felt within a week that I had been updosed. A little history I have never been able to updose. Even if I do a small cut and try to reverse it in a couple days I react horribly paradoxical. Extreme agitation and terrible out of my skin intolerable symptoms. If I steady taper down I feel ok. Well Teva felt horrible and j was losing my mind. Constantly felt like I was on the edge of a panic attack, full WD type symptoms, surreal overstimulation followed by depressions. All over the place. Couldn’t sleep without a weighted blanket. Got worse and worse. Holding made me feel like my brain and body were shutting down so I kept cutting. After five or six weeks I started to feel a little more stable but still felt drugged out of my mind. I couldn’t get out of bed. I looked stoned. So I figured I’d try to switch to liquid K since I could have it made and they could switch brands to pure K powder. It hit my system hard. Even at just 25% liquid and the rest Teva at first I could feel it work quick and fast and while I didn’t feel agitated I felt instantly destabilize the first night. My poor cns. Within two doses of that my stomach went insane with hyper nerve discomfort and awareness of every sensation. At the same time my weight started dropping 1-2 lbs a night for a week. My heart rate went to 140. BP 140/100. Sweating, freaking out, everything hyper real. Hyper aware of everything. All five senses turned up to 1000. Smelling things that weren’t there, hearing songs playing, taste all off, can’t be touched. It was/is insane. At day 4 I switched to 100% liquid and By day 5 or 6 I was on the couch sweating all day and shaking violently. So I went back to Teva which was hell but it wasn’t doing that. Stomach settled for a day and then came back but then the agitation started back and within 3 days I got intrusive thoughts and almost lost it all. It was like my brain couldn’t handle it even in the slightest. I miraculously was able to find a local pharmacy that had Accord brand in stock still with a decent supply that will last me 10 months. So I started taking it. Immediately felt relief from the agitation. Felt 60% improved including stomach sxs and everything else for the first week but my sleep was shortened to about 5 hours. It felt weaker but it was nice relief. After five or six days I started crashing and felt like WD again and couldn’t get off the couch. Then I started feeling horribly depressed. On a drug I felt amazing in for two years. Same brand. I imagine it’s my cns trying to adjust back to it after being yanked around so badly. It’s almost been 3 weeks on accord and still losing tons of weight and sweating. I am hoping that settles down over the next few weeks. But since Teva switch 11 weeks ago I am down 26 lbs and feel like my body has been through 3 separate shocks. The gut stuff started on the second switch to liquid. I’m currently on .163mg K on accord brand tablets that I file and weigh on a scale. I’ve slowed my taper way down during this time to less than 3% per month just to mitigate drug side effects as holding makes me feel worse since the beginning. As to your other questions I have taken no other meds or supplements in last two years. Here’s my recent taper history.

March .212mg

April .201mg

May .189mg

June .177mg

July .172mg

Aug .166mg

Hope this helps. I hope stabilize on Accord again. I am most distressed about my Gut as I can barely eat before that started even though I crashed I was able to eat meat and normal basic foods  now I can barely eat and don’t want to  thanks for any advice  

 

 

 

 

[[Li...]]

 

Thank you for sharing more of your medication and tapering history with us @[mi...]. It is very helpful to learn that you have a history of using/discontinuing ADs and benzos, a bad experience with an antibiotic (Flagyl) that caused significant GI distress, and multiple dose changes (including recent, likely variations in dose caused by a generic manufacturer change and a change in dosage form from solid to liquid).  The fact that your taper rate was increasing (from 5.19% to 6.35%) at a point in your taper where some individuals find it necessary to decrease their rate may also be significant.

Your situation reminds me of a video (link below) in which Chris Paige, LCSW and Josef Witt-Doerring, MD discuss the impact that multiple changes in psychotropic medications/doses may have on the nervous system. Chris’s hypothesis is that the nervous system (NS) is able to handle such changes until it reaches a tipping point where it cannot.  At that point, the NS becomes dysregulated and expresses this dysregulation via symptoms (including symptoms associated with ‘weak points’ in the NS, which in your case might be the GI system).   

Chris suggests that holding the medication and dose constant may be the best course of action if NS dysregulation occurs. The first goal is to get the NS ‘stable enough’ to regain some quality of life and functionality.  After that, the individual can begin tapering again at a suitably slow, gradual rate.

What tools do you have in your toolbox to help your NS regain stability?  I personally have found Jennifer Swantkowski’s audio/video episodes on feeding your mind a healthy diet— as opposed to feeding it ‘junk food’ such as obsessing over symptoms or catastrophizing — to be helpful.  Also, The Withdrawal Project has an excellent overview of coping techniques.

Re: the question you posed … ‘Could Liquid Switch Have Injured Me?’  …

My take is your current symptoms are a sign that your NS is de-stabilized/dysregulated, most likely due to the multiple changes identified earlier.  In your shoes, I would likely follow Chris Paige’s suggestion — hold my dose constant to give my NS time to re-stabilize, then proceed with a slow, gradual taper.  I would also find/use tools to help my NS regain stability or, at least stop engaging in practices that add fuel to the instability fire.

It sounds like you may already be experiencing signs of re-stabilization — this is encouraging!

Link:
https://youtu.be/XYs7T3UilpA

 

[[mi...]]

@[Li...] this was an excellent response and helped so much. It’s what my wife and others who know about benzos have been suggesting. At a tipping point and I went over my threshold. Basically since i stabilized over the last two years I never had GI issues at all anymore after having them for a long time. My waves were minimal. But once in K I never changed brands and only ever went down in somewhat predictable manners. The brand and form changes shocked my body at the exact time my taper rate had climbed to its highest. And in a flash things went haywire. Do you think as this stabilize I should go back to where I was before this destabilization occurred to my then norm. Is that common or have I put myself into a new norm? I’m just afraid I’ve ruined my gut and I won’t be able to eat normal again. I had ribs and wings a month ago without issue. Destabilized and abdominal cramping won’t leave me. Whole pelvic floor going nuts. So frustrated.

[[Li...]]

@[mi...] I’m glad my response was helpful.  I do not have personal experience with GI issues due to de-stabilization so will defer to other members to address your question. 

[[mi...]]

@[Li...] what about destabilization in general. When you destabilize and then subsequently restabilize, do you often return to your previous norm or is that hard to say. 

[[ji...]]

@[mi...]  I'm sorry you are going through a very tough time.    I agree with @[Li...] and what Chris Paige says to spend some time holding your dose until you can restabilize.   This may take a number of weeks or months.     It takes a lot of patience but know that you will stabilize again, and hopefully back to your previous norm, or even better.   Since you have been stable while tapering there is every reason to believe you will get stable again.

Praying for you too.

[[be...]]

@mikeyjoed, I agree with the others here about holding your dose. Give it time to help, and try to distract all you can. I started doing word search during my first two tapers, and it helped me to take a section of time each day to just let the worries and discomfort go, In other words I needed that time not to dwell on how bad I felt. Holding helped me during my third taper too. Hang in there, you are walking in many Warriors footsteps that have come before you and they are now off, and you will be too one day. Stay Strong.💖Peace and Healing.