Should I switch to Valium or increase my SRNI?

[[Mi...]]

 

Hi everyone, 

 

I am not feeling well but I don’t know what to do next.  Any advice? My doctor wants me to wait a month and do nothing.  But my anxiety is becoming paralyzing and leading to depressive symptoms.  Here is my history 

 

2012 - prescribed ssri and nightly 0.125 klonopin for post partum anxiety 

 

2012 - 2022 - tried several times to get off (way too fast I now know) - despite taking a low dose of klonopin at bedtime - I always struggled with daytime fatigue 

 

2022 - I had brilliant an idea (really dumb idea) to switch to Xanax at bedtime in the hopes I’d have less daytime fatigue.  My psychiatrist agreed with no warnings of what could happen.  I was clueless because I try to stay off of websites like benzo buddies because I get very scared - so I was relying on my psychiatrist to guide me (very stupid idea that I also regret

 

2022 - 2023 - Was on 25mg Prozac with 0.5 Xanax and 25mg trazadone at bed. I felt great for a while - however I still couldn’t get through the day without a nap

 

summer 2023 - started getting light headed and dizzy spells, numbness on one side of body, I was convinced I had MS - I went to several doctors, got MRI - felt like I had traumatic brain injury sometimes, then I got super anxious and depressed, finally 

 

December 2023 - couldn’t eat couldn’t or sleep - realized it was Xanax 

 

December 2023 - switched immediately to 0.75 klonopin (highest dose I’ve ever taken) and about 80mg trazadone, was on 40mg Prozac (I wish I would have gradually implemented the klonopin while still on the Xanax but once again I was desperate and clueless 

 

january 2023 - felt exhausted all the time - like a zombie, also fighting depression.  I Switched to 40mg cymbalta to try to help. 
 

february 2023 - Tried decreasing klonopin by .03mg - had a lot of “afternoon anxiety” so reinstated; around this time increased to 50 cymbalta (a dose I’d done well on before) 

 

late February/early March 2023 - was panicking because we had a bunch of travel plans so reduced trazadone way too fast - by about 50% over one week (I don’t think I was thinking straight - I was desperate - I very much regret this decision); also increased the cymbalta to 60mg around this time 

 

early March 2023 - started having alot of anxiety; reinstated maybe 20% of trazadone, 

 

April and May 2023 still having this anxiety - sometimes it was a panic attack feeling like feeling agitated and rapid heart beat; other times it was a lot of mental worry 

 

June 2023 (today) - I’ve realized one things that’s going on is that I basically don’t handle ANY anxiety triggers well.  If it’s coffee - it will give me horrible physical anxiety; if I’m tired my heart starts pounding; if my kids are acting up I feel very anxious 

 

Right now this is my medication - 

62mg trazadone 

60mg cymbalta 

0.75 klonopin 

 

I need to solve this daily anxiety.  My doctor has suggested I take Klonopin during the day but I can’t do it.  I get tired and find it very hard to parent.  I’ve tried taking cymbalta in the morning - it helps with the anxiety but I am very tired and sluggish during the day.  

 

It seems my options are - 

1. Increase cymbalta to see if this helps with anxiety (I was encouraged that when I took it in the morning it did seem to help with anxiety, maybe I just need more for now as a band aid while I’m trying to stabilize?) 
2. Gradually switch to valium because perhaps this is inter dose withdrawal (it’s odd that it would be - because I took a lower dose of klonopin for 10 years with no interdose withdrawal) (my psychiatrist is against this option because she says Valium “builds up” in the system) 
3. Add back more trazadone? Sleep at night is not my problem by the way.  I sleep very well right now.  Sometimes too much.  

 

I feel very hopeless and I don’t know whose advice to trust.

I don’t see how I’ll ever be able to taper klonopin until I’m able to stabilize.  

I would appreciate any opinions or thoughts - please know I get very very scared and triggered by this topic - so please try to be kind.  Thank you so much.  
 

PS - since I switched from Xanax to klonopin - is this considered cold Turkey? Do you think I’m having protracted withdrawal from Xanax? Trazadone? Or both? 

 

 

[[Cr...]]

I believe that Xanax and Klonopin have very similar potentcy. So your switch from .5 Xanax to .75 Klonopin was actually an updose negating most withdrawal issues from Xanax. Even though both are benzos, even slight differences can require a period of adjustment and that can cause symptoms.

If crossing over to Valium is not something you are able to do, perhaps splitting your klonopin dose up may help you stablize.

Since daytime fatigue is an issue but you are still feeling anxiety, maybe taking just .125 mg in the morning and .625 mg at night may help? Or keeping your dose even at .375 twice a day may help the drowsy effects. The .75 mg at night may be a lot for your body at one time and the effects last well into the morning.

Is it also possible that cymbalta, or increasing it, could be causing dome anxiety?

Edited June 8 by [Cr...]

[[Mi...]]

Thank you so much Crono… I am going to message you - I don’t think the cymbalta increase is causing anxiety.  When I’ve tried taking it during the day I am super lethargic and sleepy all day… also - I’ve been on a very similar dose (50mg) before - thank you again.  

[[Cr...]]

By message did you mean a private message? For general support and guidance you are more than welcome to. If you are looking for more specific answers in regards to dosing and tapering suggestions or you want to know if certain symptoms are common in withdrawal then your best bet is to have those issues brought up in a public thread like this where you will get input from a lot of members.

If mistakes are ever made in any suggestions usually other people will point them out. Strength in numbers 

Edited June 8 by [Cr...]

[[Mi...]]

Ok no problem - sorry I am new to the site I will cut and paste what I just sent to you thank you so much 

[[Mi...]]

 

Thanks for your response Crono so as I said  - I currently take - 60mg cymbalta; 62mg trazadone and 0.75 klonopin.  My psychiatrist does not want me to switch to Valium bc she says it “builds up in your system”.  but I think I could talk her into it or maybe find a different doctor if needed.  
 

I’ve tried splitting my dose as you recommended and no matter what the dose it seems - it instantly makes me want to take a nap.  I was on 0.125mg for years at bedtime.  Never had interdose withdrawal and that dose usually helped me sleep at least 6 hours straight.  
 

I’m wondering - do you think a dose of Valium at bedtime would accomplish what splitting the dose of Klonopin would accomplish? Since it has a long half life do you think it would help my anxiety during the day? It confusing to me because klonopin also has a long half life.  
 

I spoke with someone knowledgeable on this who said - all benzos build up in your system and are stored in your fat.  On the flip side - I’m scared to switch to something (like Valium) bc I’m worried that it may cause even more daytime fatigue. 

any advice from you or the group is greatly appreciated - thank you. 

 

[[Cr...]]

Is your psychiatrist familiar with the Ashton Manual? Crossing over to Valium is a common and recommended method for benzo withdrawal for several reasons.

However, that does not mean it works for everyone. It depends on a couple factors, first being the person's ability to stabilize on Valium to even begin a taper.

[[Mi...]]

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

Is your psychiatrist familiar with the Ashton Manual? Crossing over to Valium is a common and recommended method for benzo withdrawal for several reasons.

However, that does not mean it works for everyone. It depends on a couple factors, first being the person's ability to stabilize on Valium to even begin a taper.

Yes she’s heard of it. It might be a matter of talking to her more about it.  I might start another thread with some questions about Valium.  Thank you.