Advice needed for rebound insomnia after lorazepam tapering

[[ma...]]

Dear all,

I need your help and expertise for my problems connected to lorazepam tapering and withdrawal. Not an English native speaker, so there could be language mistakes. F, 46 years old.

Long story (not) short:

Diagnoses:

§  Hashimoto’s thyroiditis with hypothyroidism (diagnosed in 2009), medicated at present with Euthyrox 100 (4 days/ week) and Euthyrox 125 (3 days/ week)

§  MTHFR mutation heterozygote, no medication, except during the pregnancy with my second child in 2015

§  As of January 2022, after a very stressful 2021, in which I utterly took no rest, I started to feel terrible: felt exhausted, needed a lot of sleep, dizziness, sensation of floating, light headedness, muscle weakness in the scapula, sensation as if the head was trembling. Aggravated in March and April with tingling sensations in hands and feet, increased heart rate, extreme fatigability, shortness of breath. Diagnosed with Sjogren’s syndrome by lip biopsy in Oct. 2022 terrible joint pain and stiffness throughout the summer. Insomnia was on and off, one night a week or so. Fatigue had mostly subsided by September. Started to take Hydroxychloroquine (Plaquenil) 300/ day. I was warned that it takes at least 6 weeks to work. After starting the Plaquenil, in the first three weeks, the pains got worse and the insomnia started to aggravate to. In November and December I did not sleep more then 3 hours/ night, even if the joint pain and stiffness was progressively subsiding. I tried sleeping supplements, but no results. Doctors did not take my complaint of insomnia seriously.

§  End of December 2022, I took a cold, just like my husband and daughter, but for me it was hard to bear. I asked my general doctor to give me something to sleep, as I was a wreck.

 

And now comes my trip with psychiatric drugs, with me totally ignorant in the field:

 

§   23.12.2022- 11.01.2023: ½ Zapiclone 7.5 mg  – slept well. Was advised to take it for 2-3 weeks, then taper it.

§  11.01-13.01. 2023: ¼ Zapiclone 7.5. - didn’t sleep almost at all. Tried to go back to ½ but didn’t sleep, either. Decided by myself to see a psychiatrist.

§   16.01. 2023: the psychiatrist recommended me to take 1 full Zapiclone 7.5., as ½ did not work.

§  17.01-23.01. 2023: 1 full Zapiclone 7.5- slept 4-6 hors a night, but started to have terrible anxiety. It was then that I realized what anxiety is like. I had always been more like a cautious person, worrying maybe too much over certain things, but I had normal feelings. This was something scary. The psychiatrist recommended ½ Xanax 0.25 once or twice per day to ease anxiety.

§  23.01. 2023: 1 full Zapiclone 7.5 + ½ Xanax 0.25. A bit less anxiety, but still a lot.

§  24.01.2023: The psychiatrist recommends trying Trittico 50 mg (Trazadone) + ½ Xanax 0.25 for one night, “to see if it works”. Two hours of sleep.

§  25.01-02.02. 2025: 1 mg Anxiar (Lorazepam) + ½ Cinolazepam 40mg . Slept well for 5 days. Psychiatrist decides to add Sertraline.

§  03.02.2023- 08.02.2023: 0.5  mg Lorazepam +  1 full Cinolazepam 40mg  + ½ Sertraline 50mg (1/4 the first night, then, ½) each night. Psychiatrist also recommended 0.5 Lorazepam x2/ day, but only took ½ only one day. Felt terrible, no appetite, stomach ache, diarrhea all these days, extreme anxiety, between end December and beginning of January, lost 3 kg (had 57 in December). Decided to quit the first psychiatrist and ask for a second opinion.

§  09.02.2023-10.02.2023. The new psychiatrist gives the diagnosis of Anxiety disorder. Recommends 15 mg Mirtazapine and ½ Lorazepam 1mg. Slept for just 4 hours, so decides to increase dosage.

§  11.02.- 25.02.- 22.5 Mirtazapine and 1 Lorazepam 1mg – slept so well. A bit drowsy during the day in the first week, some slight trembling of hands, but no anxiety during the day. Felt almost normal again.  Dr recommends tapering Lorazepam after 2 weeks of good night’s sleep, which I did. I was supposed to cut down 0.25 every three days. I didn’t really do so, but I got to 0.75 Lorazepam by 12.03. slept

§  26.02.- 12.03.2023- 22.5mg  Mirtazapine and tapering 1 Lorazepam 1mg. I was supposed to cut down 0.25 every three days. I didn’t really do so, but I got to 0.75 Lorazepam by 12.03. Slept not so good for three nights, but then good sleep.

§  15.03.- 20.03.2023-  dr. suggests tapering again, 22.5 mg Mirtazapine and 0.5 Lorazepam for 5 days, then 22.5 mg Mirtazapine and 0.25 Lorazepam. No big issues during the first 5 days, but when getting to 0.25 I had electric sensations in the leg, was agitated during the night, sort of myoclonus movements during sleep. He advised me to go beck to 3/4 and taper again after one week.

§  21.03- 27. 03. 2023 - 22.5 mg Mirtazapine and 0.65 Lorazepam (approximately, it was something in between 0.5 and 0.75, since I had a feeling I should not updose so much). Started having heart serious palpitations and my legs hurt. General dr thought the palpitations were caused by the combinations of psychiatric drugs with Plaquenil, sent me to Cardiologist who did investigations and concluded the palpitations and slightly high heart rate (75) had an emotional cause. The new psychiatrist dismissed any connection between leg pain and medication and I attributed it to Sjogren’s. I didn’t know anything about tapering correctly or withdrawal symptoms.

§  28.03- 08. 05. 2023 - 22.5 mg Mirtazapine and Lorazepam tapering to 0.25. Stupidly enough, I also started tapering Mirtazapine, practically shaved very little, about 3 mg probably. Palpitations somehow improved with magnesium orotate and the pain in the legs subsided.

§  05.05 -15.05– about 19 mg Mirtazapine and tapering 0.25 Lorazepam to 0.125. Had rebound insomnia, electric sensation in legs (Jittery legs?), stuffy nose but no secretions. Talked to the dr who did not worry at all. Advised updosing lorazepam to 0.75…

§  15.05 – 22. 05. 2023 - 22.5 mg Mirtazapine and 0.25 Lorazepam; accelerated digestion, very little sleep

§  22.05 – 15. 07. 2023 - 22.5 mg Mirtazapine and 0.5 Lorazepam; accelerated digestion, variable sleep in June, no palpitations, heart rate returned to under 70. Everything well in July.

§  15. 07. – 31.06.2023 - 22.5 mg Mirtazapine and tapering 0.5 Lorazepam to 0.45 (approximately, by eye). No issues

§  31. 07. – 20.08.2023 - 22.5 mg Mirtazapine and 0.45 Lorazepam.

§  21. 08. – 26.08.2023 - 22.5 mg Mirtazapine and tapering Lorazepam 0.45. Just shaved a little bit, but noticeable by eye. Rebound insomnia, so updosed to 0.45. The doctor kept reassuring me that I am on such low dose of medicine that I can forever stay on it.

§  26.08. – 22.12.2023 - 22.5 mg Mirtazapine and Lorazepam 0.45. Variable sleep until mid November, nights with good sleep, then, just like in June, evenings when it was hard to fall asleep, some others when I woke up at 5. But it was also a stressful period, with a lot of work. Slight eye twitching once in a while, but good sleep after mid November and no issues.

§  23.12.2023 – 01.01. 2024 - 22.5 mg Mirtazapine and tapering Lorazepam 0.45. Shaved a bit of it, like in August. Perfect sleep, no issues until the night of 1^st/ 2^nd January. Then rebound insomnia for 3 days, with variable sleep, so updosed to 0.45.

§  02.01- to date - 22.5 mg Mirtazapine and Lorazepam 0.45. Slightly higher heart rate just in the first days, palpitations (once-twice/ day, not all days), very variable sleep since the beginning of the month. Even worse since the 26the of January. After one night with no sleep (30^th January), the following night I slept from 9pm to 7am, which was very refreshing. Since the beginning of February, I can fall asleep at around 10-11pm, generally easily, but I wake up at 4 or 5, with very few exceptions. Even if sleep is continuous during those hours, it’s not enough for me and I’m getting more and more tired.  For three days, I updosed a bit, to 0.48 probably, so still less than ½ 1mg. During the day, I am worried only when I get little sleep at night.

 

Because of the Plaquenil, I only rarely have slight joint pain, noting notable. Only some muscle weakness persists most in the scapula. The psychiatric medication I received also has had many benefits: I could do my job, go on holidays with my family, helping kids with chores, start doing housework again, start meeting friends.

But since September, I have been researching the topic of benzo withdrawal and ever since I have realized how many errors there have been in my lorazepam tapering. But I just did not realize that patients need to be informed. It’s a must actually. I was not so worried until this weekend, as I expected sleep to improve, but it didn’t. .

Some more remarks:

-          - I have just ordered an analytical scale, but I will only receive it at the end of February/ beginning of March.

-          - The anxiety I felt in January 2022 has not come back, thanks God, but, when getting insomnia from tapering, I do sometimes ruminate and think I will never be ok again. Nevertheless, I try to be positive in general, as there are days when i feel great (if I get 7 hours of sleep...)

-          - Was very active but sedentary before 2022, just going to work and doing a lot of house work (house and garden), not doing any sport, not fond of walking. It got worse with the poor health and pain in 2022. Still quite slim always. In January 2023 started walking at least 6000 steps dily and in October started Pilated twice/ week. Also have been going to psychotherapy since January last year.

-          - Caught Covid two times, in Feb 2023 and Nov. 2023, without issues.

-          - Tried to supplement with pharmagaba 100 and Glycine in September, probably 5 times with each. No results with Gaba. Glycine taken at night did not let me fall asleep after the 3rd day of use and gave me vivid dreams. Also tried Sedivitax pills a few times in autumn last year and last night, with 0 results.

-          Have been on magnesium orotate 500 twice/ day since April 2022, Omega 3 since May 2022, Vit D3 2000 since May 2022. Apart from Euthyrox, Plaquenil, Mirtazapine and Lorazepam.

 

 Still, some things that could be attributed to anxiety. I have never known if they have been cased by anxiety or by Sjogren’s:

-          - Trembling sensation mainly in the trunk right upon waking; it always completely stops after waking up. First experienced in May 2022, so before starting psychiatric drugs, then in autumn 2022, end of May and June 2023, and now, since mid January, at different intensities.

-          - Vibrating sensation in legs in May 2022, and slightly at the beginning of January this year, for three or so days.

-          I would very much appreciate some expert opinions on my current situation. I consider your advice priceless. Sorry for writing such a long story, but I felt that the background is meaningful.

Also, I would like to ask you:

-           Shall I updose a bit more, at 0.50, in order to stabilize? I have to catch up with sleep because I am much too tired.

-          Or shall I use Benadryl/ hydroxyzine or something else (B6, for instance) for sleep if it does not improve in the near future?

-          The psychiatrist has just advise me to increase Mirtazapine, which I haven’t, since I understand it is more sedating at lower doses. And also to increase Lorazepam if needed, since I am on such a low dose. Plus not to try again tapering, as the NS gets too sensitive and i will need higher doses in the future.

Thank you all wholeheartedly!

I need some expert objective opinions, but I must say I also need some encouragements...

[[Co...]]

Hello @[ma...]. Welcome to BenzoBuddies.

It seems that you are having a difficult time. But our members will be able to help you.

Apologies, but I do not have time to respond to your post properly right now. But I wished to approve your introduction so that other members can respond to you.

[[Pa...]]

Hello @[ma...], you've kept amazing records of what you've been going through, this will help you as you continue your journey because we sugget tapering according to your symptoms.  Your observations can guide you and hopefully keep you functioning.

First, do you agree with your doctor?

7 hours ago, [[m...] said:

The psychiatrist has just advise me to increase Mirtazapine, which I haven’t, since I understand it is more sedating at lower doses. And also to increase Lorazepam if needed, since I am on such a low dose. Plus not to try again tapering, as the NS gets too sensitive and i will need higher doses in the future.

While I'm no "expert" I believe if you decide its in your best interest to taper off of the Lorazepam then we can help you accomplish this.  

[[ma...]]

Hello, @[Pa...], thank you very much for your kind response. No, I do not agree with my doctor. His point is that increasing mirtazapine would help the NS be more stable, but I cannot understand why I should increase it. It has been prescribed for insomnia caused by anxiety and not for depression and the sedative effect seems to be greater at smaller doses, while the adrenergic effect is more significant at higher doses. Or this is the conclusion I grew while researching, after my discussion with the doctor. If I had had this information, I could have discussed this point with him. Secondly, provided I feel ok again, I would not like to live on lorazepam forever. I accept the medication now, and it has helped me a lot over the last year, but I would not think of taking it forever. Again, provided I feel balanced enough.

Following my research on this site, I realized that, even if the withdrawal symptoms subside, it would be wise for me to wait at least two months until the next change. Am I right?

At the moment i would be interested to know if experienced members here would advise the use of Benadryl or hydroxyzine, B6 (or other Bs) or aminoacids to help with insomnia. Because insomnia is the main issue. I would not use them on a daily basis, just when the sleep debt is too high.

Also, I need some advice on the use of green tea. I gave up coffee before starting the psychiatric medication and started one cup of green tea in the morning. This was my great pleasure in the morning. But I renounced it because of the recent rebound insomnia. Should I continue to stay away from it or it actually does not impinge so much on the sleep problems.

Thank you very much again!

[[PE...]]

1 hour ago, [[m...] said:

Hello, @[Pa...], thank you very much for your kind response. No, I do not agree with my doctor. His point is that increasing mirtazapine would help the NS be more stable, but I cannot understand why I should increase it. It has been prescribed for insomnia caused by anxiety and not for depression and the sedative effect seems to be greater at smaller doses, while the adrenergic effect is more significant at higher doses. Or this is the conclusion I grew while researching, after my discussion with the doctor. If I had had this information, I could have discussed this point with him. Secondly, provided I feel ok again, I would not like to live on lorazepam forever. I accept the medication now, and it has helped me a lot over the last year, but I would not think of taking it forever. Again, provided I feel balanced enough.

Following my research on this site, I realized that, even if the withdrawal symptoms subside, it would be wise for me to wait at least two months until the next change. Am I right?

At the moment i would be interested to know if experienced members here would advise the use of Benadryl or hydroxyzine, B6 (or other Bs) or aminoacids to help with insomnia. Because insomnia is the main issue. I would not use them on a daily basis, just when the sleep debt is too high.

Also, I need some advice on the use of green tea. I gave up coffee before starting the psychiatric medication and started one cup of green tea in the morning. This was my great pleasure in the morning. But I renounced it because of the recent rebound insomnia. Should I continue to stay away from it or it actually does not impinge so much on the sleep problems.

Thank you very much again!

Hi and welcome to benzobuddies. 

To my knowledge green tea has no negative effect on sleeping.

[[Pa...]]

I'm happy to see you research the use of these medications, too many of us didn't do our due diligence when originally prescribed them.  I'm not sure your conclusions about mirtazapine would be welcomed by your doctor, some don't like to have their recommendations challenged which can lead to a strained relationship.  We've seen this a lot here because the medical establishment has been slow to recognize our plight in the benzodiazepine community. 

I'm relieved to hear you don't wish to stay on Lorazepam forever because the manufacturers suggest only using them for 2-4 weeks.  What we've found is the drug begins to cause the issues they are prescribed to fix only much worse.  Panic attacks will last all day instead of minutes, anxiety will be constant and breathing or other natural techniques are ineffective and insomnia can be relentless.  Raising the dose once tolerance sets in is unsustainable because eventually we reach the point where no dose is effective and its legally impossible to prescribe more.

You ask about going up in dose to stabilize, let me share with you what we mean by stable.  We define is as able to perform your basic daily tasks, it doesn't mean feeling good which we rarely feel while undergoing this process.  So, its your call if you feel you should go back up in dose with the knowledge that insomnia will be your constant companion as you taper then recover from your use.

I don't have experience with supplements but I have read that while some members will benefit, others can be harmed, we never know how our sensitive central nervous system will react to other medications and supplements.  A good place to discuss this is the Alternative Therapies group.  Just click join and you can post your questions. Topics - Benzodiazepine Withdrawal Support (benzobuddies.org)

[[Co...]]

3 hours ago, [[n...] said:

Hi and welcome to benzobuddies. 

To my knowledge green tea has no negative effect on sleeping.

Actually, green tea does contain caffeine, but it is a bit more complicated than that. This article seems quite informative about caffeine content and how it is not the be all and end all. (If that translates.  )

https://www.saratogateaandhoney.com/blogs/blog/does-green-tea-have-more-caffeine-than-black-tea

[[PE...]]

Ok good to know @Colin!

I had a girlfriend drinking it at night to het calm that's why i thought it was ok.

[[Co...]]

33 minutes ago, [[n...] said:

Ok good to know @Colin!

I had a girlfriend drinking it at night to het calm that's why i thought it was ok.

It can have as much caffeine as black tea, but it has much more of another chemical which binds with the caffeine, making the caffeine less available, which results in less of a stimulating effect compared with black tea. (Or, that's my limited understanding of it.)

[[PE...]]

11 minutes ago, [[C...] said:

It can have as much caffeine as black tea, but it has much more of another chemical which binds with the caffeine, making the caffeine less available, which results in less of a sedating effect compared with black tea. (Or, that's my limited understanding of it.)

 

[[PE...]]

Yeah ok.. I have never tried it. I zipped it but didn't like the taste. I stick with black coffee 

2 minutes ago, [[n...] said:

16 minutes ago, [[C...] said:

It can have as much caffeine as black tea, but it has much more of another chemical which binds with the caffeine, making the caffeine less available, which results in less of a sedating effect compared with black tea. (Or, that's my limited understanding of it.)

 

[[Co...]]

I meant to write 'stimulating effect' in my previous post. Edited.

[[Di...]]

On 12/02/2024 at 02:13, [[m...] said:

Dear all,

I need your help and expertise for my problems connected to lorazepam tapering and withdrawal. Not an English native speaker, so there could be language mistakes. F, 46 years old.

Long story (not) short:

Diagnoses:

§  Hashimoto’s thyroiditis with hypothyroidism (diagnosed in 2009), medicated at present with Euthyrox 100 (4 days/ week) and Euthyrox 125 (3 days/ week)

§  MTHFR mutation heterozygote, no medication, except during the pregnancy with my second child in 2015

§  As of January 2022, after a very stressful 2021, in which I utterly took no rest, I started to feel terrible: felt exhausted, needed a lot of sleep, dizziness, sensation of floating, light headedness, muscle weakness in the scapula, sensation as if the head was trembling. Aggravated in March and April with tingling sensations in hands and feet, increased heart rate, extreme fatigability, shortness of breath. Diagnosed with Sjogren’s syndrome by lip biopsy in Oct. 2022 terrible joint pain and stiffness throughout the summer. Insomnia was on and off, one night a week or so. Fatigue had mostly subsided by September. Started to take Hydroxychloroquine (Plaquenil) 300/ day. I was warned that it takes at least 6 weeks to work. After starting the Plaquenil, in the first three weeks, the pains got worse and the insomnia started to aggravate to. In November and December I did not sleep more then 3 hours/ night, even if the joint pain and stiffness was progressively subsiding. I tried sleeping supplements, but no results. Doctors did not take my complaint of insomnia seriously.

§  End of December 2022, I took a cold, just like my husband and daughter, but for me it was hard to bear. I asked my general doctor to give me something to sleep, as I was a wreck.

 

And now comes my trip with psychiatric drugs, with me totally ignorant in the field:

 

§   23.12.2022- 11.01.2023: ½ Zapiclone 7.5 mg  – slept well. Was advised to take it for 2-3 weeks, then taper it.

§  11.01-13.01. 2023: ¼ Zapiclone 7.5. - didn’t sleep almost at all. Tried to go back to ½ but didn’t sleep, either. Decided by myself to see a psychiatrist.

§   16.01. 2023: the psychiatrist recommended me to take 1 full Zapiclone 7.5., as ½ did not work.

§  17.01-23.01. 2023: 1 full Zapiclone 7.5- slept 4-6 hors a night, but started to have terrible anxiety. It was then that I realized what anxiety is like. I had always been more like a cautious person, worrying maybe too much over certain things, but I had normal feelings. This was something scary. The psychiatrist recommended ½ Xanax 0.25 once or twice per day to ease anxiety.

§  23.01. 2023: 1 full Zapiclone 7.5 + ½ Xanax 0.25. A bit less anxiety, but still a lot.

§  24.01.2023: The psychiatrist recommends trying Trittico 50 mg (Trazadone) + ½ Xanax 0.25 for one night, “to see if it works”. Two hours of sleep.

§  25.01-02.02. 2025: 1 mg Anxiar (Lorazepam) + ½ Cinolazepam 40mg . Slept well for 5 days. Psychiatrist decides to add Sertraline.

§  03.02.2023- 08.02.2023: 0.5  mg Lorazepam +  1 full Cinolazepam 40mg  + ½ Sertraline 50mg (1/4 the first night, then, ½) each night. Psychiatrist also recommended 0.5 Lorazepam x2/ day, but only took ½ only one day. Felt terrible, no appetite, stomach ache, diarrhea all these days, extreme anxiety, between end December and beginning of January, lost 3 kg (had 57 in December). Decided to quit the first psychiatrist and ask for a second opinion.

§  09.02.2023-10.02.2023. The new psychiatrist gives the diagnosis of Anxiety disorder. Recommends 15 mg Mirtazapine and ½ Lorazepam 1mg. Slept for just 4 hours, so decides to increase dosage.

§  11.02.- 25.02.- 22.5 Mirtazapine and 1 Lorazepam 1mg – slept so well. A bit drowsy during the day in the first week, some slight trembling of hands, but no anxiety during the day. Felt almost normal again.  Dr recommends tapering Lorazepam after 2 weeks of good night’s sleep, which I did. I was supposed to cut down 0.25 every three days. I didn’t really do so, but I got to 0.75 Lorazepam by 12.03. slept

§  26.02.- 12.03.2023- 22.5mg  Mirtazapine and tapering 1 Lorazepam 1mg. I was supposed to cut down 0.25 every three days. I didn’t really do so, but I got to 0.75 Lorazepam by 12.03. Slept not so good for three nights, but then good sleep.

§  15.03.- 20.03.2023-  dr. suggests tapering again, 22.5 mg Mirtazapine and 0.5 Lorazepam for 5 days, then 22.5 mg Mirtazapine and 0.25 Lorazepam. No big issues during the first 5 days, but when getting to 0.25 I had electric sensations in the leg, was agitated during the night, sort of myoclonus movements during sleep. He advised me to go beck to 3/4 and taper again after one week.

§  21.03- 27. 03. 2023 - 22.5 mg Mirtazapine and 0.65 Lorazepam (approximately, it was something in between 0.5 and 0.75, since I had a feeling I should not updose so much). Started having heart serious palpitations and my legs hurt. General dr thought the palpitations were caused by the combinations of psychiatric drugs with Plaquenil, sent me to Cardiologist who did investigations and concluded the palpitations and slightly high heart rate (75) had an emotional cause. The new psychiatrist dismissed any connection between leg pain and medication and I attributed it to Sjogren’s. I didn’t know anything about tapering correctly or withdrawal symptoms.

§  28.03- 08. 05. 2023 - 22.5 mg Mirtazapine and Lorazepam tapering to 0.25. Stupidly enough, I also started tapering Mirtazapine, practically shaved very little, about 3 mg probably. Palpitations somehow improved with magnesium orotate and the pain in the legs subsided.

§  05.05 -15.05– about 19 mg Mirtazapine and tapering 0.25 Lorazepam to 0.125. Had rebound insomnia, electric sensation in legs (Jittery legs?), stuffy nose but no secretions. Talked to the dr who did not worry at all. Advised updosing lorazepam to 0.75…

§  15.05 – 22. 05. 2023 - 22.5 mg Mirtazapine and 0.25 Lorazepam; accelerated digestion, very little sleep

§  22.05 – 15. 07. 2023 - 22.5 mg Mirtazapine and 0.5 Lorazepam; accelerated digestion, variable sleep in June, no palpitations, heart rate returned to under 70. Everything well in July.

§  15. 07. – 31.06.2023 - 22.5 mg Mirtazapine and tapering 0.5 Lorazepam to 0.45 (approximately, by eye). No issues

§  31. 07. – 20.08.2023 - 22.5 mg Mirtazapine and 0.45 Lorazepam.

§  21. 08. – 26.08.2023 - 22.5 mg Mirtazapine and tapering Lorazepam 0.45. Just shaved a little bit, but noticeable by eye. Rebound insomnia, so updosed to 0.45. The doctor kept reassuring me that I am on such low dose of medicine that I can forever stay on it.

§  26.08. – 22.12.2023 - 22.5 mg Mirtazapine and Lorazepam 0.45. Variable sleep until mid November, nights with good sleep, then, just like in June, evenings when it was hard to fall asleep, some others when I woke up at 5. But it was also a stressful period, with a lot of work. Slight eye twitching once in a while, but good sleep after mid November and no issues.

§  23.12.2023 – 01.01. 2024 - 22.5 mg Mirtazapine and tapering Lorazepam 0.45. Shaved a bit of it, like in August. Perfect sleep, no issues until the night of 1^st/ 2^nd January. Then rebound insomnia for 3 days, with variable sleep, so updosed to 0.45.

§  02.01- to date - 22.5 mg Mirtazapine and Lorazepam 0.45. Slightly higher heart rate just in the first days, palpitations (once-twice/ day, not all days), very variable sleep since the beginning of the month. Even worse since the 26the of January. After one night with no sleep (30^th January), the following night I slept from 9pm to 7am, which was very refreshing. Since the beginning of February, I can fall asleep at around 10-11pm, generally easily, but I wake up at 4 or 5, with very few exceptions. Even if sleep is continuous during those hours, it’s not enough for me and I’m getting more and more tired.  For three days, I updosed a bit, to 0.48 probably, so still less than ½ 1mg. During the day, I am worried only when I get little sleep at night.

 

Because of the Plaquenil, I only rarely have slight joint pain, noting notable. Only some muscle weakness persists most in the scapula. The psychiatric medication I received also has had many benefits: I could do my job, go on holidays with my family, helping kids with chores, start doing housework again, start meeting friends.

But since September, I have been researching the topic of benzo withdrawal and ever since I have realized how many errors there have been in my lorazepam tapering. But I just did not realize that patients need to be informed. It’s a must actually. I was not so worried until this weekend, as I expected sleep to improve, but it didn’t. .

Some more remarks:

-          - I have just ordered an analytical scale, but I will only receive it at the end of February/ beginning of March.

-          - The anxiety I felt in January 2022 has not come back, thanks God, but, when getting insomnia from tapering, I do sometimes ruminate and think I will never be ok again. Nevertheless, I try to be positive in general, as there are days when i feel great (if I get 7 hours of sleep...)

-          - Was very active but sedentary before 2022, just going to work and doing a lot of house work (house and garden), not doing any sport, not fond of walking. It got worse with the poor health and pain in 2022. Still quite slim always. In January 2023 started walking at least 6000 steps dily and in October started Pilated twice/ week. Also have been going to psychotherapy since January last year.

-          - Caught Covid two times, in Feb 2023 and Nov. 2023, without issues.

-          - Tried to supplement with pharmagaba 100 and Glycine in September, probably 5 times with each. No results with Gaba. Glycine taken at night did not let me fall asleep after the 3rd day of use and gave me vivid dreams. Also tried Sedivitax pills a few times in autumn last year and last night, with 0 results.

-          Have been on magnesium orotate 500 twice/ day since April 2022, Omega 3 since May 2022, Vit D3 2000 since May 2022. Apart from Euthyrox, Plaquenil, Mirtazapine and Lorazepam.

 

 Still, some things that could be attributed to anxiety. I have never known if they have been cased by anxiety or by Sjogren’s:

-          - Trembling sensation mainly in the trunk right upon waking; it always completely stops after waking up. First experienced in May 2022, so before starting psychiatric drugs, then in autumn 2022, end of May and June 2023, and now, since mid January, at different intensities.

-          - Vibrating sensation in legs in May 2022, and slightly at the beginning of January this year, for three or so days.

-          I would very much appreciate some expert opinions on my current situation. I consider your advice priceless. Sorry for writing such a long story, but I felt that the background is meaningful.

Also, I would like to ask you:

-           Shall I updose a bit more, at 0.50, in order to stabilize? I have to catch up with sleep because I am much too tired.

-          Or shall I use Benadryl/ hydroxyzine or something else (B6, for instance) for sleep if it does not improve in the near future?

-          The psychiatrist has just advise me to increase Mirtazapine, which I haven’t, since I understand it is more sedating at lower doses. And also to increase Lorazepam if needed, since I am on such a low dose. Plus not to try again tapering, as the NS gets too sensitive and i will need higher doses in the future.

Thank you all wholeheartedly!

 

I need some expert objective opinions, but I must say I also need some encouragements...

I am glad you are documenting your journey, something I ought to do.  I am also tapering off of Ativan and I decided to shave the dose.  For me, as I am cutting each tablet, I give myself four or five days before I start cutting again and ever so slightly.  You really need to go slow on this drug to avoid any repercussions.   If you cut slowly, chances are you will not have insomnia.  This is my story at least.  

[[Kh...]]

On 13/02/2024 at 08:35, [[n...] said:

On 13/02/2024 at 08:21, [[C...] said:

It can have as much caffeine as black tea, but it has much more of another chemical which binds with the caffeine, making the caffeine less available, which results in less of a sedating effect compared with black tea. (Or, that's my limited understanding of it.)

Try chamomile tea for evening calming 

[[Kh...]]

14 hours ago, [[K...] said:

Try chamomile tea for evening calming 

The only thing is I seem to pee a lot during the night when drinking chamomile tea 😩

[[Br...]]

9 hours ago, [[K...] said:

The only thing is I seem to pee a lot during the night when drinking chamomile tea 😩

One solution to this is to steep two teabags in a half cup of hot water - so the tea is stronger and you're taking in less fluid.

[[ma...]]

Thank you all for your advice. Not much has changed since I last wrote. I succeeded in having good sleep for two nights one week ago, which was wonderful, I suppose it was a window. But I have only slept about 4 hours/ night ever since, which is very little for me. Hope to be better in the following period.