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#1 Mocha

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Posted 20 November 2022 - 03:51 PM

Hi all,

 

I am hoping to get some advice and support. 

 

I believe I am having severe withdrawal, from which medication I am not entirely sure. In approx October 2021 I quit taking Pristiq 50mg cold turkey to switch to Citalopram, as advised by my doctor.  I realise now that probably shouldn't have happened. I had been taking Pristiq for about 6 years at that point.

 

I started Citalopram a couple of weeks later, going up to 30mg over about a month. 

 

In January 2022 I began experiencing some neurological symptoms. In July of 2022 after having lots of tests done I was diagnosed with Functional Neurological Disorder (FND). To help with this, I was put on Lyrica 100mg daily (2 x 25mg in morning, 2 x 25mg at night). 

 

At that point I began having increased anxiety symptoms and was not sure the Citalopram was helping at all.  After doing some research, my doctor advised to try Cymbalta, which has been known to help with nerve pain. I lowered Citalopram from 30mg to 0mg in about 3 weeks, and started the Cymbalta 30mg during that period.

 

About 5 weeks later, I started feeling quite dissociated. I had never experienced dissociative symptoms before. This made me panic and I wanted off the Cymbalta. Went back to doc, and it was decided to just quit taking the Cymbalta.

 

I am now about 4 weeks down the track and am in a mess.  I have constant anxiety, panic attacks have returned full blast and I am suddenly having OCD self-harm thoughts. I feel like I've developed a phobia of suicide which sounds bizarre to me but when I get anxious, I start thinking I will lose control of my mind. I have dissociation on a daily basis, nothing looks real, I start questioning reality and can't seem to get my mind out of the loop.

 

My doctor gave me Valium and said to take 2.5mg when things get super bad.  I have done this a couple of times. It does help, but I am terrified of becoming dependent on it, so have only taken it a few times. 

 

I have an appointment tomorrow with my doctor.  I am considering re-introducing Citalopram at a low dose, say 5mg, and see if it helps with this horrendous withdrawal.  I am not sure how else I am going to function soon and am terrified I am going to lose my mind. I was hoping to get some advice and whether to give this a try, or just keep trying to stick this withdrawal out. I am concerned I may get worse re-introducing, and am concerned I may get worse anyway if I don't! I work full-time and this is starting to impact my work, my life. I don't want to re-introduce Cymbalta, I am terrified of this drug. 

 

Thank you for reading!!!

 


#2 fishinghat

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Posted 20 November 2022 - 04:56 PM

Welcome Mocha

 

Let me cut to the chase on your situation...

 

First of all what your dr has done is not uncommon.

 

Second - Pristiq 50mg cold turkey can cause severe withdrawal and some suicidal thinking, BUT the Citalopram normally (not always) helps offset this withdrawal but it can take 6 to 8 weeks to fully kick in. If I read between the lines on your post it sounds like you were on the Citalopram for at least 7 months. Definitely long enough to see releif if it was going to help.

 

Third - As it says in Wikipedia "functional neurologic disorder or functional neurological disorder (FND) is a condition in which patients experience neurological symptoms such as weakness, movement disorders, sensory symptoms and blackouts."

It is a condition is NOT a disease. It is a set of symptoms that often appear in unison and does not reflect a specific cause. Certainly, withdrawal can be a cause of FNC as can other causes. 

 

Fourth - Lyrica 100mg daily is certainly commonly prescribed for these symptoms and could have helped significantly with the anxiety but a significant amount of people using Lyrica often see little to no improvement in anxiety.

 

Fifth - The lowering of Citalopram from 30mg to 0mg in about 3 weeks and started the Cymbalta 30mg is a routine cross-over [period when switching antidepressants. 

 

Sixth -  The anxiety, panic attacks, OCD self-harm thoughts and dissociation after 4 weeks on Cymbalta are very common and a strong indicator that you should not be taking it.

 

Seventh - "I start thinking I will lose control of my mind. Actually very accurate. Antidepressants have a very significant effect on serotonin in the brain as well as other neurotransmitters. These neurotransmitters control your moods and emotions. These chemical reactions are beyond your control. The good news is that they will stabilize in time. The bad news is that it may take a while. 

 

Eighth - 2.5 mg valium can be very addictive but an occasional use is fairly safe depending on your vulnerability to addiction. You are correct in using it on a limited basis. Was this to be used 2.5 mg per day or 2.5 mg every 4 hours as needed?

 

Ninth - Re-introducing Citalopram at a low dose is an iffy situation. It has been my experience on this website that going back on a recently discontinued antidepressant is only successful about 50% of the time. The issues are that it will again take up 8 weeks to fully kick in and if it does not help then dropping back off of it will only add to your withdrawal. 

 

Suggestion - Many drs in my area now stay away from the benzos due to their bad withdrawal and addictiveness and have went to hydroxyzine and/or clonidine. Neither are addictive, they kick in within an hour not weeks and have NO withdrawal. I know many who have had good success using these drugs. Hydroxyzine is an antihistamine FDA approved for anxiety and clonidine is an alpha-adrenergic agonist (controls adrenaline levels) and is FDA approved for PTSD, a form of anxiety. This is something you might discuss with your dr.

 

please feel free to let us know if you have any questions as well as giving us feedback on how you progress.


#3 Mocha

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Posted 20 November 2022 - 06:07 PM

Hi fishinghat, thank you so much for your reply.

 

I have been doing a lot of reading the past few weeks, as one would probably do in my situation, looking for help.

 

From my reading I understand going back on might not necessarily be much help. I guess my thinking at the moment is so distorted and anxious that the thought of anything helping feels like its worth a try.

 

I have read about the hydroxyzine and clonidine, actually this morning I was doing some research on the clonidine. I did get a bit concerned about withdrawal from that as well, and also potentially low blood pressure as I do have low blood pressure on some occasions.

 

The Valium 2.5mg was prescribed on an 'as needed' basis. So nothing regular. I typically take it when I feel completely panicked and can't calm down, on average once or twice a week. 

 

I did see my doctor last week, and she was quite concerned about my situation and seemed to want to potentially put me back on something. At that stage, based on my research, I advised I didn't want to go on anything and would see her again in a few weeks to see how I was managing. 

 

I do feel quite confused as to what to do now... I do have good windows.  Yesterday AM I felt almost normal for a few hours, before I crashed again. I am also trying some supplements, and have started taking fish oil once daily, and magnesium twice daily. At this stage can't say I have noticed much difference, but then again maybe yesterdays window was a sign. 

 

I will discuss tomorrow those medications and see what my doctor thinks.  She is just a general doctor so not specialised in this sort of medicine.  She has recommended I see a psychiatrist who would be more familiar with the medication but I probably can't get in to see one for a few months as they have long wait lists. 


#4 fishinghat

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Posted 21 November 2022 - 07:02 AM

If you have low bp then hydroxyzine and clonidine may be a concern. 

 

The good windows are a very good sign. Typically these would indicate a shorter recovery period. 

 

Hang in there and keep us posted. Have you read through our free ebook?

 

I am off to get some routine blood work done but will check back when I get back home to see if you happen to have any questions.


#5 Mocha

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Posted 22 November 2022 - 01:59 AM

I have spoken to my doctor this afternoon. I also had a psychology appointment this morning. 
 

I was feeling okay most of today, woke up feeling more ‘normal’ but then had a panic attack not long after waking. I managed to get through that and straight after had the psychology appointment. I did find this helpful but it is slow going. 
 

I spoke with my doctor and suggested trying either the Hydroxyzine or Clonidine. She was more familiar with the Clonidine but was a bit concerned about some symptoms I’m having and wants me to have a heart check first (I have a history of SVT). 
 

She did not really recommend reinstating Citalopram as it would be more difficult to get off if it doesn’t end up helping. 
 

in the meantime she would like me to try taking Valium 2mg at night for a few weeks to help with sleep and the anxiety and also during the day if I feel like I can’t handle things. I am not too keen on doing this but also concerned I can’t get through this. 
 

This afternoon the OCD thoughts have returned but I’m very tired and body is feeling weak which is probably not helping things. 
 

I have an appointment in 2 weeks with my Neurologist to discuss FND and my doctor has suggested seeing if they are familiar with a psychiatrist who may be able to assist more medication wise. 
 

I am happy my doctor is willing to take on board my suggestions. I will see how things go these next few weeks. I also have a lot of life stresses at the moment (single mum, job interviews coming up, just bought a house) which are no doubt contributing to my anxiety. 


#6 fishinghat

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Posted 22 November 2022 - 07:05 AM

I must say that your dr seems to be giving it her full attention. That is great.

 

One thing that seems to help many members is to take it easy during those good periods. By relaxing when you are feeling better it seems to lengthen those stretches and shorten the bad events.

 

The valium is a risky situation.  I hate to see you swap one issue for another but I would also hate to see you continue to suffer. 

 

Have you tried taking just 1 mg of valium to see if it is just as effective? Sometimes that is the case. 


#7 Mocha

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Posted 22 November 2022 - 10:04 PM

Thanks, yes I am concerned about taking the Valium. I took 2mg before bed last night and it does nothing to help me sleep. I think if anything it’d be better to take during the day to help alleviate symptoms. 
 

Today has been a worse day. I seem to have developed a new symptom, sort of like dissociation except I’m feeling like I can’t feel my legs/arms. They work but it’s a feeling like I am detached from my body. Not sure whether this is FND related or withdrawal related, but it’s very unnerving. 

 

I took 1mg of Valium earlier today. I am not sure it has done much, I haven’t gone into a full blown panic attack but anxiety is definitely there. 
 

I am just clinging to hope that this will all get better at some point, hopefully sooner rather than later. 


#8 fishinghat

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Posted 23 November 2022 - 06:59 AM

 "I took 2mg before bed last night and it does nothing to help me sleep. I think if anything it’d be better to take during the day to help alleviate symptoms. "

 

I fully agree.

 

Your symptoms will continue to change with time. Some will fade soon and others will develop. That is normal. After being on this site for 10 years I can tell you that your symptoms, while very distressing, are usually far worse than this. I know that doesn't help you feel any better but I like to tell it like it is. The fact you have times where you feel better is a good sign but based on others experiences here I would say around 4 months or so to begin to see improvement. Now that is just an educated guess based on experiences seen on this site. You will need to be very patient and try to minimize stress during this period. 


#9 Mocha

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Posted 29 November 2022 - 12:12 AM

Well last few days I feel like I am improving. The times where I feel so anxious and dissociated have lessened. The more anxious I get, I notice the dissociative symptoms increasing. 
 

I try and keep busy. I am finding night time the hardest, being at home just me and my son I feel more anxious, not having additional support available. When I get tired, my anxiety increases a lot. I am guessing the physical symptoms of tiredness bring on a feeling of panic for me. 
 

I am taking about 1.25mg Valium just before bed and sometimes I take the same amount during the day sometime if I feel I need it. 
 

I am hopeful I will continue improving. Work is difficult, the days I need to go into the office are really hard. My anxiety flares up and my body just tenses up so much I am exhausted by the end of the day. I long for the day I might just feel ‘normal’ going into the office and not worrying about how I feel, or how my body will cope. But I know it is going to take some time. Unfortunately I seem to have injured my lower back somehow and am experiencing a lot of pain at the moment, and sitting in the office does not help!

 

I see my neurologist next week regarding my FND diagnosis. I will probably discuss the Lyrica and potentially tapering off that, but likely not for a few months… don’t want more stress on my body just yet. 

 

Lastly, I still need to do the Holter monitor before I can trial the Clonidine, but at this time of year it is hard to get organised. Hopefully I can get this done soon. 

 

Hope you are well and thank you for your support so far, it has been very helpful to know there is support available. 
 


#10 fishinghat

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Posted 29 November 2022 - 07:00 AM

That sounds like a good sound approach. Watch the Lyrica. It has a nasty withdrawal as well. When it comes time to wean off the benzo let us know. We have an effective slow process that minimizes the withdrawal for most.


#11 Mocha

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Posted Yesterday, 01:43 AM

Think I spoke too soon, the last few days I‘ve had periods which I wasn’t sure I was going to come out from. 
 

I am noticing a pattern to it, around 10am it starts, I’d be feeling okay and then gradually these feelings of doom start..l I feel terrified, feel like I can’t go on, can’t cope with everything. I would describe it like a panic attack except I don’t have a racing heartbeat or sweating etc. it’s just a terrible feeling in my head and I feel sick to the stomach. Valium does not seem to help, at least the dose I am taking anyway which is just 2mg. 
 

I am starting to wonder if it’s a reaction to the Lyrica. I take 2x25mg around 7-8am in the morning and the same around 8pm at night. 
 

Any thoughts? Or is this just part of the Cymbalta withdrawal maybe. I don’t know. All I know is it’s terrifying, so far I’ve made it through but there are times when I feel like I’m ready to drive myself to hospital. By around 1 to 2pm I feel better again, well better enough to cope anyway.


#12 fishinghat

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Posted Yesterday, 08:58 AM

Hi Mocha

 

A couple thoughts here.

 

First, I can not rule out that this could be a reaction triggered by Lyrica although I can not say i have seen this before. The best way to see if this is the case is to change your schedule on taking Lyrica by about 2 hours. Instead of 7 - 8 AM try 9 -10 AM. If it is caused by the Lyrica then the feeling of doom will shift to a later time as well. If this is the case then let me know and I will pass along what other members have done with similar situations.

 

I also suffered with thoughts of impending doom for around 6 months. Hang in there. We will work through this together.





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