Starting an antidepressant or immunosuppressant?

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My taper started klonopin 1.5 mg daily and I did it over 7 months.  I took the jump around Feb 12, 2024 so about 5 weeks ago now.  My wd symptoms were primarily psychological and constitutional (insomnia, anxiety, depression, SI, delusions, fatigue, etc).  I initially started klonopin for insomnia/anxiety.  I've made tremendous progress since my jump- I have more energy, I can hold a conversation, I'm not in bed all day, I have more ranges of emotions, I smile, I'm not delusional.  I still struggle with depression, insomnia, and anxiety, restlessness though to a much lesser degree than a few weeks ago.  I'm at the point of considering starting an anti-depressant.  I've been on them before (while taking benzos) and they never were really helpful.  I'm an otherwise healthy 30 yo male, the only medication I take now is trazodone to sleep (though I'm going to have to stop this due to side effects).  Truth is, I really don't want to be on medication but my anxiety/symptoms are persistent and causing dysfunction in my life.  I'm not sure how much of my current symptoms are withdrawal or just underlying anxiety/depression.  Not sure if I should just give it more time. For those of you who considered anti-depressants around tapering, do you have any thoughts or advice?

In the midst of withdrawal, I went in to the doctor for not feeling well and fatigue.  I got bloodwork which showed a +ANA and + anti-ro, everything else was normal.  They diagnosed me with Sjogren's disease, though outside of fatigue and insomnia I do not have the typical symptoms of this disease.  They offered an immunosuppressant (plaquenil).  I'm considering taking this instead of an antidepressant.  I'm not sure if I actually have an autoimmune illness or if my body has gone haywire during the withdrawal and created autoantibodies.  Not sure if this will just go away as things normalize with me.   Or do I have an autoimmune illness this entire time and this is why I feel bad?  

These medications come with risk and take weeks or months to work.  So I'm trying to figure if I need to be patient and see if my symptoms get better with time or trial something.  

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Hello @[...], 

I am sorry you are going trough such difficulties, but I applaud you for getting off of Klonopin in 7 months. 

I am not sure if I can recall properly but you have been on a benzodiazepine and on a Z-drug for a few years? I hope I am not mistaken. You are 5 weeks off, this is fantastic news! Five weeks, however, seems to be quite the acute part of our withdrawal journey. It is very likely that the symptoms you have been experiencing are to some extent indeed withdrawal related. These are going to get better - you yourself know this - given enough amount of time. 

People have different experiences taking antidepressant medications during withdrawal. Some negative because of the sensitized state of our central nervous system is in, some say it helped them quite a bit. It is impossible - I believe - to tell how you will react. What absolutely certain is - and I find this important point - that these symptoms will continue to ease up, very gradually.

The activity rate of your autoimmune disease, and if you can wait with beginning the immuno-suppressant therapy should be made by you and your doctor. However, feeling unwell and fatigued during withdrawal is anything but surprising. But, and I would like to make this clear, this goes far beyond the scope of this forum. It might be helpful what people often say here, if one is to try any new medication, they should do it really slow and begin at a really low dose - if possible.

I understand your confusion of being diagnosed with an autoimmune disease and having heightened anxiety, I am so sorry and I imagine it is very difficult for you. The withdrawal process often leads to these very intense looping thoughts and doubts, quite often health anxiety is involved,  I know this state of mind very well. I believe there are people in your life who can help you to see own situation more realistically, and I encourage you to have a discussion and express your concerns. 

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This is just an observation from what I have seen here from the years I have been here on and off. Almost 90 percent of the time it seems members like TheWay and many others who just go through the hell without other meds seem to really do well LONG TERM. I think Short term other meds may help, but you have to look at the high chance that they can poop out and now you have a whole other dependance and a harder time down the line. Just the fact that doctors won't recognize your issues as med induced withdrawal or side effects will make your nervous system stressed more. This doesn't even include the effects of another med. Once again I have seen over and over again that the people that keep doctor shopping for a solution always do worse than the people that run from them and do major lifestyle changes. I think the psychological aspect of them gaslighting you and not looking at the body and brain as a complete system, but parts is going to make you worse. I can't tell you what to do, but these are my observations only. 

And WOW no offense, but your taper from that high of an amount is SUPER fast. 7 months is intense. But you actually sound really good considering. I would tough it out and exercise, lots of water, electrolytes, and really good diet and distractions as much as you can. 

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If you don't mind me asking, what dose did you jump at?

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@[re...] sorry for the late reply.  I jumped at 0.01mg Klonopin.  But I was reducing pretty quickly (0.01 mg reduction per day the last month).

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Wow that is pretty fast at the end and you seem to be somewhat functional so to me this is an amazing accomplishment. I would stay off anything until you give it some more time. And you are only 30 yo. Plenty plenty of time to go thru withdrawal and still have an amazing and productive life. 

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Edited April 11 by [Re...]

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Thank you for the reply.  I'm struggling with making a decision here.  Autoimmune disease/sjogrens disease can cause mental illness (amongst many other things).  I ask myself, have I had an autoimmune disease this entire time which has caused my mental distress (insomnia, depression, anxiety)?  Or has my benzodiazepine withdrawal/chronic benzo use/chronic insomnia caused an autoimmune illness?  Do I have both? 

It's chicken or the egg kinda questions.  I'm getting a second opinion which should help me make some decisions.

I know these questions are out of the scope of this forum.  But this is currently what I'm struggling with thus support is  much appreciated.  I don't have many people to help me through my withdrawal thus I appreciate everyone on this forum.

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I think it's is definitely wise to get all the testing  you need to determine things. My biggest recommendation though if you are leaning towards an autoimmune condition is "the wahls protocol" book.

Please get this book and it will floor you what that woman went through with a serious case of MS where she was wheelchair bound and started making major changes. She was previously a vegetarian and had to really adapt to eating meat and all these things she did. And she actually got the hell out of that wheel chair and started being able to walk again. Put her disease in remission. Miraculous!!!!!!!!!!!! She was an actual doctor in the medical field so of course all her colleagues really put up their noses at her and her discoveries, HMMM...... Imagine THAT!!!!!!!!! Doctors being pompous and passive aggressive sheeple. Who woulda thunk    I am getting so SICK of that look they have on their faces like a deer in headlights or something when you try and talk to them about your condition with these chemical adverse reactions from pills

But her determination is amazing and she started even doing smaller clinical trials on her diet. She has said over and over again. In healing you have to stop looking at food as enjoyable or an experience, but literally look at it as medicine. I couldn't agree with her more. The modern doctor is a symptom management practitioner. And could care less about curing you.

That is on you and never forget it. 

I have to be hopeful in all this so I choose to get angry at the whole modern medical model and I may fall as well. But for now I stay strong and hopeful.

I mean for the love of god now they are talking OZEMPIC now for big people in the US.

Lifestyle change be damned. We are in a world of trouble and hurt at this point and it's not going back as long as pharmaceutical giants keep funding the bulk of "the science" 

Cigarette science at it's finest.