Need Help...Don't know where to start :(

Hello~

I’m really glad to have found this website.  I feel my situation is quite complicated and I really don’t know where to start.  I do know that I am addicted to several meds and I definitely want to stop using them.  I have done a lot of research and I know that Klonopin is the worst by far and will be the hardest to kick.  I was directed to this site from another and I would like to get some advice.  I realize I am on a lot more meds than just Benzos but anything you could recommend would be greatly appreciated!  I will start by telling you a little about myself. 

I have been on several different meds for quite some time.  I was in a car accident in 1999 and it has been all downhill since then.  I was also recently diagnosed with Endometriosis after laparoscopic surgery in January.  (I have heavy menstrual bleeding and severe cramping.)  I won’t go into all the other details, it would take too long, but I will just tell you the meds I'm taking and the symptoms I am having now.  Currently I am taking:

Provera 10 mg every a.m. (Endometriosis)

Wellbutrin just went up to 300 mg this a.m. (Depression)

Darvocet N100 twice-three times a day (Pain)

Klonopin 1mg at bedtime (Sleep)

Topamax 200 mg at bedtime (Pain from injury to Brachial Plexus)

Soma 325 mg at bedtime..and sometimes once during the day (Pain/Muscle Spasm)

I will add that I have been on various opiates since 1999.  I’ve been on everything from Lortab to Oxycontin.  I came off the Oxycontin in 2003 after being on it for only a couple of months.  But I’ve continued to be on one opiate or another since.  Eventually, I settled in on Tramadol 100mg every day for almost 2 years.

I was prescribed Klonopin after being on Restoril 30 mg for several years for insomnia.  I tried the cold turkey thing and, boy, was that a bad experience.  I was working for a doc at the time and he suggested I switch to Klonopin to try to wean.  He said it would be easier.  He started me at 2mg (He said it was equal to Restoril 30 mg).  Somehow I managed to quickly get down to 1mg.  That was about 2-3 years ago.  But I never could get lower than 1 mg because I couldn’t sleep.  Now at night I MUST take the Klonopin, Topamax and Soma in order to go to sleep.  (And I still wake up several times each night.)

I have become sooooo depressed over the last 6 months.  I have all the major depression symptoms.  The biggest one is that I do not want to go anywhere; I don’t even want to get out of bed.  I would be happy to just stay at home all the time and not talk to anyone.  I no longer enjoy any activities that I used to enjoy.  I have a wonderful husband and 2 children at home and it is awful that I have to MAKE myself go with them to any of their activities.  I also have a very decreased libido which is definitely putting a strain on my relationship with my husband.

The reason I am writing is that I am trying to figure out my newest symptoms.  The depression is new (well, relatively).  I recently went to the doctor regarding this and also to discuss weaning off some of these other meds because I felt they were the root cause of my depression. This is why I am now on the Wellbutrin (8 days).  The doctor felt I needed to get the major depression under control before starting to wean any of the other meds.  During the discussion he said that I could not continue to take the Tramadol because of the seizure risk with the Wellbutrin so he switched me to Darvocet.  (I will add that I had just started the Provera for the Endometriosis ~ 7 days at the time.) 

The afternoon I started the Wellbutrin and the Darvocet (stopped the Tramadol) I had horrible symptoms….similar to w/d symptoms??  Hot flashes/cold sweats, nausea, shakiness and uncontrollable crying.  (Even though I have been depressed, I hadn’t been crying.)  I cried all afternoon.  My husband called the doctor and he said for me to stop the Wellbutrin and take ½ Tramadol (25 mg.)  He wanted me to do this for several days to do a “rapid wean” off the Tramadol.  He said for me to take the Darvocet as prescribed and then take 25 mg of Tramadol when I absolutely needed it.  Then after the ‘rapid wean’,  restart the Wellbutrin.  Well, I only did this for 2 days because I didn’t seem to need the Tramadol anymore; the Darvocet was working OK.  That was 12 days ago.  I failed to mention that in the meantime, I had to come down to 100mg on the Topamax due to the fact that I am running out of it and we won’t have insurance coverage until April 1st.  (This med is almost $800.00 a month!)  Then out of the blue, Sunday the same symptoms hit me.  Stomach cramps, nausea, hot flashes, cold sweats, shakiness, muscle spasm and uncontrollable crying.  I mean I cried for about 6 hours…until I finally took my night time meds and went to bed.  Then yesterday, I had all the same symptoms. 

I can’t figure out what is causing these symptoms.  Are they related to the depression?  Is it the Wellbutrin affecting the Klonopin?  Is it a delayed Tramadol w/d?  Is one of these drugs causing the Klonopin effects to be reduced?  I know that Topamax and a lot of these drugs potentiates each other, so did changing them up get my system out of whack???

I just don’t know what to do or where to go from here.  I totally feel like crap.  I have a totally hopeless, SAD, awful feeling.  I’m NOT suicidal.  I just need to know what is going on.  I haven’t been able to work this week.         

I definitely want to start a Klonopin taper but I’m not sure this is the time to start it with how I’m feeling.  I also don’t know if the Wellbutrin is helping or hurting.  Any advice would be so appreciated!!  TIA!

Welcome Joy!

We'll help you to sort this out. I am so glad that you found us. Heavy menstrual  bleeding and for long stretches  has happened to so many women on benzos. Hysterectomy isn't uncommon, and it's not necessary. It's just the only remedy that doctors can think of when they don't know that the  reproductive organ malfunctions can be benzo complications.

The stomach cramps, nausea, hot flashes, cold sweats, shakiness, muscle spasm and uncontrollable crying are classic benzo W/d symptoms. Yes, a doctor should know this, but few do. 

Your doctor understandably said that you must manage your depression before dropping any meds. He doesn't realize that it's those meds that can be the cause and that benzos certainly can be the cause. 

There may be some not-so-obvious interactions between your meds. I'd avoid starting any new ones unless they are needed to save your life. You always can ask your doctor just how necessary any drug really is.  Psychiatrists commonly require people tapering from benzos to use and A/D. That's unfortunate. It's plainly better to stop using a depressing drug than to cover it's bad effect with another drug.

The Aston Manual, a very reliable source of equivalences, gives 0.5mg klonopin as equal to 20mg temazepam( Restoril).  This is the first time that I've seen a doctor prescribe more K than the Manual suggests. That doesn't mean that you can lower the K. dose now. It must be done by reducing very small amounts at a time.

I'd expect you to be able to stop the Provera, but not until the benzos are long gone. Your pain levels will tell you how much opiate you need. Opiates, as well as many antidepressants, alter the amount of benzo that's in your blood. Wellbutrin may or may not be one of these.

You already provided the information that we'd usually ask for. You want to stop using the benzo. Your doctor agrees but says that you must manage the depression before dropping the benzo. He doesn't see that the benzo IS causing depression. An A/D doesn't cure depression anyway.

One benzo W/D symptom is very tight muscles and sometimes spasms. These may be managed by a non-opiate. Just to start, using Magnesium can be a help. I still use 500mg at bedtime. Benzo W/D had caused some big Charlie Horses, and it's a still fading problem. If one starts, chewing a Mg tablet with a glass of water does the job fast.

As support for depression, omega 3 fatty acids can be a big help. Getting the proper mix of amino acids is also part of the picture. I use whey protein for this. Whey protein also has a good amount to glutathione, one of the building blocks for repair of benzo damage.

We'll offer more nutritional ideas  soon.

You are likely to feel a lot of ups and downs now. You have a lot to manage. As a start, read Nevermore's posts.  She is titrating from a big dose of Klonopin. We  got together and figured a strength of benzo to liquid that would enable her to measure the very small amounts to cut for a daily titration.  Her doctor approved and sent a prescription for that to a comounding pharmacy.Nevermore has  found her ideal taper rate now and is moving along with none of the problems that are so common.

When the very potent benzos like Klonopin and Xanax are to be tapered, a daily titration requiring a weak liquid form of benzo is the best way. Read about it while you're trying to stabilize enough to start titrating.  Because your condition is complicated, being as gentle as possible in tapering is almost a requirement.

I'm glad that you found us. We're here to help people get their lives back. We're people who were there helping others to get out of there.

Jana

Hello Joy,

Welcome to BenzoBuddies.

You are on one hell of a cocktail of drugs. I'm with Jana, you need to simplify things as much as can. It can be next to impossible to determin which side-effect is caused by which drug. Having said that, what you have described does fit with benzo withdrawal - it sound all too familiar to me.

I was on Klonopin, and had similar problems with tapering at that dose. However, I didn't have the complications you have, so just managed to force my way through. It would have been so much simpler to use a titrating technique (making liquid benzos), but I was unaware of it at the time, and didn't appreciate how many of my problems were caused by the benzos anyway.

There is some information here: http://www.benzobuddies.org/buddiesguide/methods We will be adding more information soon. What is not explained there (or explained poorly), we can explain here.

Take care, Joy.

Edit: typos