Oh my, your psychotherapist is way out of touch. It has been well known for many years (at least 50) that withdrawal from a ssri or snri causes serotonin imbalance in the amygdala and hippocampus in the brain. These two areas control fear, paranoia, anxiety, worry and much more. They are closely linked to a condition called chronic adrenergic state (see ebook) which is a heightened state of adrenaline/noradrenaline production which causes significant anxiety. This serotonin and adrenaline imbalance expresses itself in heart pounding, PVCs, cardiac arrythmias, digestive tract disorders and much much more. This condition and its effects were first documented in soldiers during the civil war (De Costa’s Syndrome if I remember correctly).
Tappering For Two Years. Help!
Posted 11 October 2022 - 10:37 AM
Posted 11 October 2022 - 01:04 PM
I have all the pack: fear, worry, obsessions, nervousness, panic and so on.
IUN, I would like to answer your last message with some more words, but now, everything stresses me out. I like also research work and writing papers although last years (8 already) have not being good for me and I stoped doing it (one day I will return to it). I am an associate profesor in the university, but I have been working with reduction of working hours since my daughter was 4 to take care of her. Good luck with your studies.
Posted 13 October 2022 - 09:03 AM
Posted 14 October 2022 - 07:06 AM
I took 25 mgrs of hydroxyzine at two in the morning (the goal is to sleep) and 12 hours later I'm like a zombie. Is this normal? Does the body need time to adapt? Or is it perhaps due to its combination with alprazolam (4 mgr / day)?
Posted 15 October 2022 - 07:24 AM
The hydroxyzine has an 11 hour half life so when taken this late at night will lead to a drugged feeling in the morning. It also takes around a week or two for your body to get accustom to it where the effects are not so sharp. Due to its half life my dr said to take it about 30 minutes to an hour before bedtime.
Sorry it took me so long to respond but something came up yesterday.
Posted 15 October 2022 - 11:27 AM
Yes my doctor said me also to take it about 30 minutes before bedtime. But I usually go late to bed and wake up late. I am not working and I am alone in the mornings, so I prefer to stay in bed until late.
I will see how the hydroxyzine works on me. The first night I slept better, but tonight has been as hard as last weeks, a big part of the night in panic state, without sleeping. I always wake up (at any time) in panic right now.
Thanks a lot.
Posted 06 November 2022 - 08:51 AM
I hope you all are feeling well.
I'm still horrible.
I remind you that in addition to the withdrawal of cymbalta, there was an attempt to lower 0.5 mg of alprazolam on September 5 with withdrawal symptoms.
Now I have had for a whole week, since Monday, pain in the high part of my stomach and I have constant stomach discomfort, wanting to vomit. Could it be because of the cymbalta? Or is it more likely to be the alprazolam?
Any ideas to improve the inconvenience?
On Monday I started a neurofeedback therapy (called neurooptimal). I'll let you know if it helps me with the anxiety.
All the best,
Posted 06 November 2022 - 01:01 PM
The stomach issues are probably related to both Cymbalta and the benzo. there is a section in the ebook on controlling digestive issues and I have found it extremely helpful to treat my ibs. I will post it below.
Hang in there. Things should start to get better in a couple of months.
Posted 06 November 2022 - 01:13 PM
Posted 19 November 2022 - 10:01 AM
I am very sorry for my absence here on the forum. I have been very unwell and having many tests and staying a lot of time in bed due to my fatigue. I really understand the getting up late part. For me it actually makes things easier for me, but at this time of year, it can lead to depression due to not getting enough sunlight. I have a condition known as delay sleep phase disorder which means that my body clock (serotonin and melatonin production) works at different times to normal people, so it is quite impossible for me to sleep before around 3 or 4am.
I am really sorry to hear about your issues, but it looks like Hat has done his usual fantastic job in giving you a lot of good information.
Also glad that you are using the eBook as there is a lot of information in there which has been gathered over a long period of time and so can be very reliable.
Keep us posted on how you are getting on,
Posted 02 December 2022 - 11:11 AM
Thanks IUN for being here feeling so bad yourself. An of course, than you FH for all the help and information.
I am going through a very hard time since I lowered 0.5mg of alprazolam on September 6 (although after a few days I raised the dose again). And I'm really frustrated because on August I had started to feel much better from the cymbalta withdrawal. With really good days.
Now, I feel completely different from how I have been feeling for the last two or 3 years wiht the cymbalta withdrawal.
I am going through a benzodiazepin withdrawal now.
I don't have panic crisis like before. But now it's worse because I don't have a second of rest. I have the highest level of anxiety and fear that I have ever had in my life. I have had severe depression with suicidal ideation, although this has passed. I have a lot of physical symptoms that I didn't have before. My body reacts with panic to any stupid thinking. I have completely stopped my social life...
And I'm scared because even though this is more intense, it's a lot like my initial problem, generalized anxiety, that I had already gotten over.
Do you think it's a good idea to start alprazolam tritilazion right now? The ten cymbalta beads I am taking will have to wait.
Anaway, I know patience.
Thank you, thank you, thank you... to infinity.
Posted 02 December 2022 - 12:26 PM
Posted 03 December 2022 - 08:16 AM
I would most definitely wait to do the titration. It will only add to the withdrawal. Right now is the time to be kind to yourself, rest and avoid stress as much as possible. You are right, it is time for patience. This will get better but unluckily it takes time.
It is interesting to note, that like so many cases we have seen here, going back up on a benzo or AD often provides little help.
Posted 04 December 2022 - 10:25 AM
- fishinghat likes this
Posted 16 March 2023 - 10:38 AM
It is a long time since I wrote last time.
I have had a couple of better months between December and January and now I'm really bad again (near constant panic level anxiety, with panic attacks, obsessions and also depression). I do not understand why. I feel that my GAD is back.
Once again thinking of following a ketamine treatment in a specialized clinic. My husband is contacting a couple of clinics. He's really worried. I guess because I have lost all hope. I have tried meditation, yoga, physical therapy, acupuncture, coherent breathing...
And I don't believe in God as you do. The only thing that keeps me alive is not creating mental problems (the same suffering I have) to my family due to my suicide.
I remind you that in September I dropped 0.5mg of alprazolam and that this caused me a very intense withdrawal syndrome (mixed probably with cymbalta withdrawal). According to wikipedia it can last between 6 and 12 months, but always improving. That was how it was going until February 17, when things began to get complicated.
Meanwhile I continue with my last 10 cymbalta beads, they will have to wait their turn to be wean off, alprazolam has gain priority.
I remember when FH told me that alprazolam withdrawal was worse than cymbalta withdrawal and it sounds impossible to me, because I had wean off a low dose of alprazolam previously.
Although this forum is about cymbalta I know there is a lot of knowledge about other medications. Benzobbudies makes me crazy. Just reading is a difficult task for me right now. It is clear that I am addicted or dependent to alprazolam. I think I'm building also tolerance and alprazolam itself makes me anxious. At the same time, I feel very bad to start lowering the dose. It seems like a dead end.
The question is, if I used the titration system FH proposed, with a very, very low reduction at first, could it be possible not to get any worse?
I know it is a difficult question. But my psychiatrist is offering me antipsychotics. It sounds very bad to me.
I wish you all the best.
Posted 16 March 2023 - 03:49 PM
Sorry you have had so much problems Iratxe.
First of all lets break this down into smaller parts.
Things were better for a couple months and then it went downhill. My experience with others on here has showed that several things can commonly cause that. Sudden changes in caffeine, alcohol, cigarette or marijuana use. Weight loss (it can release stored Cymbalta into your system) as well as sudden increases in sugar or salt intake. Of course sudden changes in stress levels can set you back dramatically. Most psychiatrists/researchers are of the opinion that it takes around 2 years for your nerves to recover after fully coming off of one of these drugs. My experience here would say 2 to 3 years for most of our members. During those times your brain is very sensitive to any changes like those items I mentioned above. You might think back to the time frame where things got worse and see if you can come up with a change in lifestyle that may account for this abrupt change.
The 6 to 12 months for a benzo withdrawal varies considerably. I would agree with that in general but have seen it take 2 years or even slightly less after your last dose.
Ahhh, the last 10 beads of Cymbalta are a bear. I have seen so so many members, including myself, that have only taken 4 to 8 months to drop from their original dose to say 3 mg only to take 6 months to a year to come off the last 10 to 12 beads. I don't know why these last few beads are so difficult for many to handle but they are. I do know that the Cymbalta that your body does not process when you are on a regular dose is stored in fat tissue. It has been shown that as your dose decreases some of this Cymbalta is released back into the body and of course that can extend the withdrawal. I have seen many members who have tried to lose weight while weaning from Cymbalta and have horrible issues. There will be time enough to address the weight issues later.
"I think I'm building also tolerance and alprazolam itself makes me anxious. At the same time, I feel very bad to start lowering the dose. It seems like a dead end."
Boy is that a true statement. Most people don't realize that benzos manufacturers of benzos only recommend the use of benzos for 4 weeks or less. There is a whose section in our free ebook on this subject and it documents this recommendation from many pharmaceutical companies that it only be used for short term use only. even the FDA takes that position. You are absolutely correct that after a few months you become tolerant and it CAN make you even more anxious. At that point it is best to continue the very slow titration I gave to you until you are off and recovered. As benzos and Cymbalta effect two different neurotransmitters and their synapses it is advisable to wean off of one of these first and let your body adjust to the lower levels of the other drug while weaning off the first on. For example, wean off the benzo slowly while staying on the 10 beads of Cymbalta. While weaning off the benzo the parts of the nervous sytem effected by the Cymbalta will have time to recover some and become less sensitive. So, when the benzo withdrawal is over you can then start working on the last 10 beads of Cymbalta with less issues.
Of course, you can do the Cymbalta first as well and then the benzo later if you desire BUT I would suggest the benzo first considering you have built up tolerance to it. That is up to you though. By the way, I have been a member of Benzobuddies for around 15 years and also have trouble sometimes with that site. I have many members that are very opinionated and there was is the only way and that can be quite rude about it. We are all different and have different genetics, diets, medical conditions, etc. There is no one size fits all answer to these issues. My opinions expressed above are just that opinions. They are based on my 10 years on this site as well as Benzobuddies and my education but they are still just that, opinions. I don't have all the answers but I can share my experience as well as the experiences with other site members. I can tell you that I deeply sympathize with what you are going through as I still clearly remember the suffering I had to tolerate when I weaned off Cymbalta.
You have been strong and determoined so far. You can do this. Just remember, slow and steady wins the race. Be sure and be kind to yourself and do not put too much pressure on yourself. This takes considerable time.
By the way, antipsychotics may help BUT they also have a withdrawal and will only delay the suffering until you try and come off them. Based on my experience here, the two most successful approaches have been a slow wean over years or come of the meds as far as you can until the withdrawal symptoms get bad and then go on a weaker ssri like Zoloft, Prozac or Lexapro. Stabilize and then wean off that. It took me a year to wean off my Cymbalta and then went on Zoloft to handle the Cymbalta withdrawal I was having and now I have spent 9 months weaning off the Zoloft and am only 18% of the way off that BUT I am weaning off it so slowly I still have a good quality of life with no apparent withdrawal symptoms. Of course, that is just one person's experience.
Posted 18 March 2023 - 02:59 PM
I don't know how to thank you for taking the time to write this message. Very interesting information. And thanks for your words of encouragement.
FH, do you have a crystal ball? Yes, I have lost weight. It has not been deliberate; I do not have any weight issue. I lost 7 kg during the hardest period after trying to drop the 0,5 mgrs. of alprazolam (September/November/December), gain 3 kg when I started to feel better and lost 3kg again in February. When the depression is significant it is difficult for me to eat before dinnertime (I sometimes have dinner twiceJ). Right now, the big problem is anxiety; depression is already softer so I eat normally. But what you say confirms me something that I had felt, that I was having significant Cymbalta withdrawal symptoms since January, in addition to the withdrawal symptoms of alprazolam.
I completely agree that it is better to stop taking benzodiazepines first. I'm pretty sure I'm developing a tolerance to the dose of alprazolam I'm taking. The dose is high, 4mgr a day of alprazolam retard, 1mgr every 6 hours. Anxiety is tremendous before and especially after the dose, until it reaches its maximum effect (2 hours).
I'm in trouble with benzos. I haven't started the titration yet. To use the titration system, when dissolving the alprazolam it ceases to have the retard property. The anxiety is harder taking 1mgr of normal alprazolam in each intake. I am trying these days taking 0.5mg of alprazolam retard and 0.5mg of normal together in an intake to see how it goes. The experience is not being good, some better moments and high agitation when the higher effect of the normal alprazolam downs. But I think that the only way to do this, is to start the titration process is disolving 2mg of alprazolam and at each intake take a 0.5mg tablet of alprazolam retard along with 50ml of the solution (the solution will have normal alprazolam). Any better idea?
I will probably need years to wean off 4 mgrs. of alprazolam. The withdrawal symptoms I already have will not disappear in all these time if i start the weaning off process with tolerance and high dependency? Apart from the suffering, my job is in risk. I am not able to work.
Right now the 10 Cymbalta beads don't worry me a lot, when the time comes I will probably drop 1 or 2 beads a year to make sure I don't suffer consequences. I hope that by then the sensitivity of the nervous system you mention has passed. I already take another antidepressant, Brintelix. This antidepressant is not among the ones you mention that help the most in the withdrawal of Cymbalta, but I have to take the medication that is safer in the cardiac aspect. I have a genetic mutation that predisposes me to long QT syndrome. And I already have the QT longer than normal.
I have also seen that the antipsychotics that my psychiatrist mentions prolong the QT.
I do not have many options. And patience is not enough, I need to be strong. I've been down for a while. I hope to obtain strength from somewhere.
Posted 19 March 2023 - 08:21 AM
The weight loss/withdrawal issue has been a relatively consistent problem with many members. You will stabilize with time though.
I am not familiar with the term "alprazolam retard". What is it you are referring to?
"I will probably need years to wean off 4 mgrs. of alprazolam." Well said. for me and others I have talked to, in order to come off with little to no withdrawal, it would take around 2 years.
Any withdrawal symptoms you have from Cymbalta will fade as you wean off the alprazolam BUT due to the tolerance to the benzo you will be experiencing little anxiety control from it during the withdrawal. Normally the anxiety side effect of the alprazolam you are currently experiencing will only very slowly decrease during your withdrawal. As far as your job is concerned, many have lost their jobs during withdrawal. It is so sad but true. I wish there was some words of encouragement I could give you except just do the best you can. Life is not easy sometimes.
I have nothing against the use of Brintellix it is just that not many members have used it for antidepressant or benzo withdrawal so I have little experience with it. What dose are you on and how long have you been on that dose? I may do a little reading on that subject later today. I fully understand the QT issue and the decision to go with the Brintellix.
You are always welcome hear and we will do anything we can to help. It does take an incredible amount of strength to deal with these issues and you have demonstrated that you possess that strength. It is tough but you can do it.
Posted 19 March 2023 - 08:31 AM
Well, I learned something today.
"Xanax [alprazolam] Retard is a triazolobenzodiazepine used to treat certain anxiety and panic disorders. Xanax Retard acts on benzodiazepine receptors BNZ-1 and BNZ-2. The active metabolites 4-hydroxyalprazolam acts on these receptors with 0.20 times the potency of alprazolam and alpha-hydroxyalprazolam acts on these receptors with 0.66 times the potency."
Because of the triazole component added to the alprazolam the retard is much less potent than regular alprazolam.
Posted 20 March 2023 - 11:32 AM
Yes, that's it, Xanax Retard. It is an extended release form of alprazolam, less powerful but with a longer mean half-life.
The question is that if Xanax Retard pills are broken or dissolved, they are no more extended release pills. The pharmacokinetic changes. Alprazolam 1mg is powerful but it generates me a high anxiety peak before the next dose.
That is why I am thinking of making a solution for 3 days with 6 mg of alprazolam, and take another 4 tablets of 0.5 mg of Xanax Retard per day. Every 6 hours I would take a 0.5 mg tablet of Xanax Retard and 50 ml of the alprazolam solution. At the end of this titration, I would still have to withdraw another 2 mg of Xanax Retard, changing them to alprazolam to start with the titration again. This does not worry me; I have been taking this dose of alprazolam for 3 years, until a year ago when the psychiatrist raised my dose from 2 mg of alprazolam to 4 mg of Xanax Retard. I can't think of a better way to carry out the titration process.
Today, I am trying taking some of the intakes with 0,5 mg of Xanax Retard and 0,5 mg of alprazolam. I don't know what to say… and my psychiatrist tells me to do whatever I want.
I have been taking 15 mg of Brintelix once a day since January 2019, when I started the weaning off Cymbalta. I think that Brintelix has not been of much help.
I'm glad you're not having a problem coming off Zoloft. Good for you.
By the way, I'm curious, it's something personal but not intimate, are you a chemist, biologist, pharmacist, doctor...? It is difficult to know so much about these topics without having any prior knowledge.
Posted 20 March 2023 - 01:57 PM
That sounds like as good a titration method as I could come up with.
I have a Master's Degree in Physiology (From back when God first made dirt. lol). I also have a Bachelor's Degree in both Biology and Chemistry as well as 30 years experience in the environmental health field. I also served as an Intensive Care Unit medic during the Vietnam War.
Posted 21 March 2023 - 09:13 AM
I almost hit in everything, you are a "all in one" man.
Posted 21 March 2023 - 03:36 PM
God knows I sure spent a lot of years in school!! lol
Posted 23 March 2023 - 08:15 AM
The combination of 0,5mgr of alprazolam and 0,5 mgr of xanax retard is not giving good results. What about if I change the Xanax Retard to clonazepam before starting the titration? Is hard for the body to adapt to a change of a benzo?
As clonazepam has a longer mean half-live I might not feel so much anxiety from one dosis to the other.
Posted 24 March 2023 - 07:36 AM
Ii will not make this change.
Anyway, I feel so bad that I have programed 4 ketamine sessions in a clinic of Barcelona the first week of april. I will post to share the experience.
Posted 24 March 2023 - 07:51 AM
I look forward to the updates on the ketamine.
Just a gut feeling, no science to back it up, but I would think changing to just the regular alprazolam, stabilizing and then weaning would be a better choice. Just a guess though.
Posted 26 March 2023 - 06:27 PM
Looks like Hat has had some good insights into some possibilities as to what has been going on.
I can certainly vouch for the tolerance to the benzos. When taken quite as often as they are, they simply become a habit and that is when it becomes a real problem to remove oneslf from them. It is the same with alcohol - when all it does it maintain a baseline, you know that you are dependant on them and thus there will be a problem in withdrawal.
But as you have said, one thing at a time.
You don't have to concern yourself with the religious aspects you mentioned in your first reply - we never judge here. I am a spiritualist myself - quite a mix of thoughts and beliefs, but never forget that those around around you on this plain of existence wants the best for you. If nothing else, we are here to help you through the toughest parts. We have had many members who have been in isolation relating to their recovery.
I cannot really add to what my dear brother Hat has already said. He has said what I would have done, plus more that I myself would not have known. He is a gem of information, but I am also here to help, and should you need and comfort, please do not hold back in dropping a line.
We are not here only for medical advice, but also for comfort that you might need that you may not be getting anywhere else.
I myself have a partner who is suffering from severe mental health and cannot help me whatsoever, and I am trying to help them as well as myself. It drove me to drink problems since we last spoke, which I am not proud of in the slightest, but I haven't found support anywhere else. We just all need to stick together and work our way through that which we have unfortunately got ourselves into.
Take care, and please do keep in touch,
Posted 30 March 2023 - 09:10 AM
I am not alone, I have my partner and my daughter. I try to worry my daughter as little as possible, she has recovered very well from her anorexia nervosa and now she is happy. Luckily when she was sick I felt much better.
My partner is very pragmatic, the type of person: "give me a task that I will take it to the end of the world". He does all he can, but what he cannot do is understand my suffering, no one who has not gone through it can, not even the doctors. That's why I appreciate a lot you being here.
I am getting worse and worse. The depression is worsening every day. I am also very nervous apart from the panic, neurosis, more frecuent panic attacks. And something little times happened before, I don't feel better at nights. My nervous system is more sensitive than ever.
The ketamine therapy sessions are putting me nervous too. Not for the ketamine itself but because I have to stay out of home 6 days. I need my bed, my living room...I am going to take with me my pillow and all I can. We will travel on Sunday to Barcelona.
The worst is that I have lost the hope. I feel that I will not be able to get out of this big hole. I am too scared.
I hope you solve your own problems IUN.
I will keep in touch.
Posted 30 March 2023 - 03:26 PM
Hate to see you getting worse Iratxe. I wonder if it is because you are away from hope those 6 days at a time. Most people who suffer from anxiety or withdrawal consider home "a safe" haven and relax more when there. Away from home they are more hypervigilant and more intense. Did the drs tell you how long it would take the ketamine to kick in?
Posted 02 April 2023 - 01:18 PM
Just to drop you a message Iratxe as you start your brave journey. Not sure if you can pick up messages, but we are all with you in spirit.
It is good that you have your family around you, but I am so sorry that your symptoms have gotten worse.
I used to suffer severe anxiety some time ago, and whilst I still go through depression from time to time (largely due to personal circumstances), the anxiety is as good as gone. I never thought it would. Pills just never helped me. What turned me around was the books of Dr Claire Weekes. She was a miracle worker when she was alive, but she wrote 4 books which I read every morning when I woke up and practised her techniques until it passed. This was my last attempt and I was not at all hopeful. So I can assure you that it wasn't a placebo at all.
Hat... the Ketamine should have an almost immediate improvement should it work for our friend. The injections are a follow up after the initial treatment which involves being quite literally, on a trip. It will be the same as what LDN had a couple of years ago.
The results are as clear and night and day. It will work or it won't. And there is little grey area. If it works, it is known to be quite substantial, rather than... it worked a little bit...
I can understand the anxiety about this initial start as some can have a "bad trip", and that can cause more complication, but as far as the data shows, it is worth the risk.
Iratxe, please let us know how it goes. As this treatment is still relatively new, it really interests both Hat and myself. We both have a background in neurology and find this stuff fascinating.
I, as am sure Hat is, will be thinking of you as you undergo the treatment tomorrow. Stay strong!!!
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