Please give me your best educated opinion

[[Mi...]]

Hello - I’ve had a lot of instability with my meds this year causing me to have a very sensitive nervous system.  I’m recovering from a few months of what I now realize were withdrawals from a big reduction in trazadone.

current meds - 70 cymbalta; 88 trazadone; 0.75 klonopin 

I’m not sure what to do tomorrow.  If you have a “best guess” please feel free to share - 

 

Due to my sensitive nervous system I’ve become super agitated with coffee - I am in process of withdrawing from a hefty coffee habit right now to just 8 ounces of half caff.  I would like to get off completely but right now my dr says to stay here and stabilize.  I still have anxiety in the afternoons many times leading to a several hour panic attack - here’s how past couple of days have gone - 

friday - panic attack for 2 hours post nap, crying at my sons summer football game, heart palpitations, tried all the tricks, just had to power through 

Saturday - napped, woke up tried to run errand, got paralyzing anxiety in store. Came home, took part of my cymbalta dose - 20mg.  It made me super tired, basically total slug until bedtime. Took remaining 50mg at bedtime. 
 

Sunday - took 20mg cymbalta with lunch, makes me very tired when first taking it, took nap.  Woke up still groggy no anxiety - was able to run an errand. But then it was like 4 hours after taking it, I felt my energy return, I was crying, had some heart palpitations - took nighttime meds felt better. 

Monday (today) - against my doctors advice (she has given me so much bad advice idk) - I took 0.125 klonopin at lunch (she didn’t want me to do this bc last time I took klon during day I had very weird almost scary reaction of 1/2 tired, 1/2 akathisia, very low mood - this was during the worst of my withdrawals and I was very agitated at the time) - anyway the 0.125 klonopin made me pretty tired but I could. Not. Fall. Asleep. It was like nap insomnia. I was very sluggish until about 4pm but this afternoon is probably most calm/stable I’ve felt.  I still don’t have much appetite, but I have not cried, no heart palpitations, no anxiety.  I just get so tired first few hours I take it and can’t sleep it off it seems.  So please feel free to tell me your opinion of what I should do tomorrow…. 
tomorrow I could take .03 klonopin at lunch and see if it works

or I Could take 06 klonopin at lunch. 

I could also NOT take it at lunch.  Take a nap first and then take .03 after that.  

I deeply hope I don’t have inter dose withdrawal from klonopin.  But I guess it is what it is.  At some point I would have to take during the day in order to taper I guess - do you think this is right?  Any wisdom much appreciated.  
 

here’s a summary of my benzo story - 

 

2012 - prescribed ssri told to take 0.125 Klonopin nightly for sleep 

 

2022 - switched from nightly 0.125 klonopin to nightly .5 Xanax and 25mg trazadone 

 

December 2023 - realized having interdose withdrawals from Xanax - immediate switch to 0.75 klonopin and 88 mg trazadone 

 

January 2024 - just 10 days after this big switch I tried reducing trazadone.  Too much anxiety so reinstated.  I tried reducing klonopin - to much anxiety so reinstated.  I switched from Prozac 40 to cymbalta 40.  So basically (I now know it was horrible I did all this, I never let myself stabilize) 

 

February 2024 - was impatient - kept trying to fiddle with medication,  ended up reducing trazadone by about 50% in one week 

 

February - april 2024 had anxiety and panic attacks but dr said to wait it out wasn’t trazadone 

 

April 2024 - updosed trazadone by 12mg seemed to help a little 

 

june 12th 2024 - was having panic attacks akathisia anxiety - dr had me increase cymbalta by 10mg to 70mg total 

 

June 15th 2024 - reinstated trazadone back to 88 - could sleep through night and within 2 days Akithisia gone 

current problems - coffee gives me anxiety; weaning off that; anxiety after I take a nap (I have young children so I usually nap); many times anxiety takes the form of crying, heart pounding, sometimes a several hour panic attack 

 

Current medications - 

70 cymbalta (duloxetine) (at night) 

0.75 klonopin (at night) 

88mg trazadone (at night) 

 

 

 

 

 

[[Pa...]]

Hi @[Mi...], I'm glad to see you're working on giving up coffee, I had to for awhile too.  

Can you help me understand what you need from us?  Are you trying to decide if you should split your dose and take it in the daytime as well?  

[[Mi...]]

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

Hi @[Mi...], I'm glad to see you're working on giving up coffee, I had to for awhile too.  

Can you help me understand what you need from us?  Are you trying to decide if you should split your dose and take it in the daytime as well?  

Thank you @[Pa...] maybe I’m using this forum incorrectly - I was just sort of “crowd sourcing” to see what everyone’s opinion is.  I have 2 doctors that tell me to do two different things.  I have sought out some private benzo counselors as well.  I was just wondering if anyone had been through similar and could offer what worked for them, etc.  it’s ok if this is not the right place to ask this question.  It’s hard to make a decision bc everyone tells you something different.  

[[Bu...]]

Hi @[Mi...],

Gosh, I'm sorry for everything you're dealing with!  You've had so many changes in such a short time; it's a lot for our brains and CNS to adjust to.  I am wondering if maybe you just need to leave everything where it is for a while and see if things calm down a bit. 

I know how awful the panic and non-stop crying is, but I am wondering if that might be a result of all the switching, not just an underlying condition.  Just my thoughts.  

[[Mi...]]

17 minutes ago, [[B...] said:

Hi @[Mi...],

Gosh, I'm sorry for everything you're dealing with!  You've had so many changes in such a short time; it's a lot for our brains and CNS to adjust to.  I am wondering if maybe you just need to leave everything where it is for a while and see if things calm down a bit. 

I know how awful the panic and non-stop crying is, but I am wondering if that might be a result of all the switching, not just an underlying condition.  Just my thoughts.  

Thank you @[Bu...].  Yes basically trying to figure out if afternoon anxiety is a result of a compromised nervous system or if it’s inter dose withdrawals.  I have PTSD about interdose withdrawals bc had it with Xanax for 6 months and didn’t realize.  Thanks again for your reply.  
xoxo 

[[Bu...]]

@[Mi...],

I took my Klonopin 2 times a day, once in the morning  and at night.  I did feel it if I forgot my dose.  If you were going to make any changes at all, you could try splitting it and see if that helps.

[[Mi...]]

15 minutes ago, [[B...] said:

@[Mi...],

I took my Klonopin 2 times a day, once in the morning  and at night.  I did feel it if I forgot my dose.  If you were going to make any changes at all, you could try splitting it and see if that helps.

Thank you so much.  Yes I’ve Always been able to take it only at night until this big mess :-) 

[[Pa...]]

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

Thank you @[Pa...] maybe I’m using this forum incorrectly - I was just sort of “crowd sourcing” to see what everyone’s opinion is.  I have 2 doctors that tell me to do two different things.  I have sought out some private benzo counselors as well.  I was just wondering if anyone had been through similar and could offer what worked for them, etc.  it’s ok if this is not the right place to ask this question.  It’s hard to make a decision bc everyone tells you something different.  

You're using the forum correctly, I was just having difficulty figuring out what you were asking, but it appears @[Bu...] had no trouble. 

I like the idea of splitting your Klonopin dose, because you're right, you'll probably need to dose more often when you start tapering. 

[[Mi...]]

12 hours ago, [[P...] said:

You're using the forum correctly, I was just having difficulty figuring out what you were asking, but it appears @[Bu...] had no trouble. 

I like the idea of splitting your Klonopin dose, because you're right, you'll probably need to dose more often when you start tapering. 

Thank you so much @[Pa...] really appreciate it. 
take care 

Megan