Originally diagnosed with generalised anxiety disorder

Hi, not sure if anyone can relate to this.

 

I was diagnosed with GAD in September 2021 but had bouts of anxiety since age 13. I had success with paroxetine for 8 years. I came off it to have my child.

I then went on fluoxetine in 2019 but had a nervous breakdown in September 2021 and was tried on many different meds. Last April 2022 I was then put on lorazepam with vortioxetine(AD)because my anxiety had got to the point that I could not eat enough and was a non functioning mess. The only warning I had was that lorazepam could cause dementia in later life. I wasn't concerned at the time because I was trying to survive each day.

 

I started to experience severe interdose withdrawals from about June 2022 but I didn't know it was the lorazepam. I thought there was something else wrong, mentally and physically. I managed to reduce the dose of lorazepam from 1.5mg per day in September to 1mg.

 

I then started to experience what I thought were psychosis symptoms - severe dissociation, nothing feeling real, feeling confused, irrational thoughts, feeling like I'm somewhere else, constant flashbacks, deja vu as well as balance problems making walking difficult.

  I spoke to someone from a charity specialising in benzos. She believes the psychosis symptoms are related to the lorazepam tolerance and interdose withdrawal. I'm trying to switch to diazepam to taper.

 

Could it be possible that lorazepam interdose withdrawal  could cause these symptoms or that my original condition has resulted in psychosis or severe dissociative symptoms?

 

I'm frightened.

Your symptoms are consistent with withdrawal. They are all on lists of possible and common benzo withdrawal symptoms. You also dropped your dose by 33%. That's a big reduction. Sounds like the person you spoke to at the charity specializing in benzos, is someone knowledgeable about benzos. If you can hang in there until you switch to diazepam. you won't have to switch to too much. Lorazepam is very short-acting, it's short half-life is what results in interdose withdrawals. Diazepam has a very long half-life, which will eliminate the interdose withdrawals once you are on it for a bit, and it builds up in your system. 

I paid to go into a private psych hospital end of last August, they wanted me off the lorazepam completely, cold turkey but I told them that was dangerous, especially as I was already so unwell. I had no choice but to cut by a third. The interdose withdrawal has just got worse and worse, I tried a direct switch as all doctors and mental health said I could but I was extremely sedated on the equivalent diazepam. I felt a bit more rational on it though, the psychosis symptoms weren't there but I couldn't physically do anything so have had to go back to lorazepam and try slower cross over.

Direct switches don't usually work, though some people using clonazepam have managed to switch or do a faster crossover. It takes time for diazepam to reach therapeutic levels in the body. It is a slower-acting, longer-acting, benzo. At least once you've crossed, the interdose w/d should go away. Psych hospitals are like drug detox facilities, neither knows how to treat a dependent benzo patient. Heck, most psychiatrists don't even know. Crossover can be more difficult for some, but things will get better once you're on all diazepam, and you're stabilized. At that point, you can move to tapering.

Thank you for your reassurance, I really hope I can get on the diazepam. I was just so sedated for the four days when I'd done the direct switch, I could barely stand by the fourth day and breathing was shallow. I also take mirtazapine at night but had to miss it because I was just too sedated.

 

Do you think interdose w/d can cause psychosis-like symptoms, it literally feels like I'm losing my mind.

 

I put myself in the psych hospital(very expensive), because of the psychosis symptoms and the severe mood changes..I didn't expect them to just want to stop the lorazepam CT and had to fight to stay on it. I was supposed to stay there 4 weeks but they kept saying I wouldn't leave with the lorazepam so I left after 2 weeks. I didn't want to go home in acute withdrawal which is what would have happened if I'd stayed. They tried to put me on pregabalin to mitigate the withdrawal effects but I didn't get on with it at all.

Do you think interdose w/d can cause psychosis-like symptoms, it literally feels like I'm losing my mind.

 

Absolutely! You're having both interdose and overall benzo w/d. This causes glutamate excitotoxicity. Then, you don't have enough of the calming GABA. I have seen this analogy used a lot: Glutamate is the gas pedal, accelerating things. Gaba is the brake pedal, slowing things down. With benzo w/d, the gas pedal seems stuck, no matter how much you apply the brakes. There's a few people on the #prescribed harm community on Twitter. They started with benzo's, were experiencing psychotic-like symptoms, then put an anti-psychotics. All are off all meds, their doctors never considered that they had interdose and/or tolerance withdrawal while on benzo, they labelled them psychotic and prescribed AP's. The side effects from AP's are horrible. One has Tardive Dyskinesia and Dystonia  that are permanent. The other was polydrugged for decades on all kinds of psych meds. She's off everything. She's now an activist fighting for change in the UK. Feeling like you're "Losing my mind" is quite common. I think you will feel better once you've crossed to diazepam, and stabilized. The shallow breathing is a common w/d symptom, it's known as "air hunger." I typically have it once I get up in the morning.

Yes, that makes sense. I have been prescribed several antipsychotics, I tried olanzapine and quietiapine. I took quietiapine for 2 days, then stopped due to sedation.  I then started ringing my neck constantly uncontrollably. I was only on 25mg. I'd read that quitting benzo CT could cause psychosis but not whilst still taking it.

 

I no doubt have some serious mental health issues but the interdose withdrawal has been absolute torture to another level, both physically and mentally. It's cruel we have to go through this. I'm now awaiting a neurologist appointment because I can barely stand for more than 5 minutes and walk like I'm on a bouncy castle. Do you think I'm on a high or low dose of lorazepam ? Does dosage matter in terms of damage done? I'm sorry for the questions, you have given me some welcomed reassurance and support..thank you so much 🫂

c/t off of benzos exacerbates things. I see people on here describing having 15 to 20 symptoms. AP's seem helpful at first, because of their action on dopamine, but they end up being a whole new kind of hell to deal with. They are very sedating, so they can make you feel calm. But it's an abnormal calm, due to AP's sedating properties.

 

Neurologists are surprisingly knowledgeable about benzo w/d, much more so than psychiatrists. Some BB members see them for w/d. I can't recall who, but one BB member has in their profile a saying about when you walk through hell, act like you own the place. I've been in hell, I'm in it now. We all are there, with demons disguised as doctors and big pharma torturing us, all in the name of profits.

 

Your Ativan dose isn't super low, but it isn't significantly high either. Dose is only one factor, length of use is another. The higher the dose, and the longer you've been taking it, the more down-regulated the GABA receptors become. Your dose isn't super high, it's fairly average, and your time of use is about a year. 

I think it's mostly genetics though. I was on for 12 days but on day 5 I felt the elecricity go off in my heqd and then slowly symptoms started to show. So it just overflooded my system immediately, poor thing. Like yes, compared to yourself a higher dose and longer time would be worse, but not compared to others.

There's been some discussions about genetics, and the role it plays. Genes involved in metabolizing, methylating, histamine, so many more. Some people already hit the bad genetic lottery, and just going on benzos for any period of time floxxed them. Some wind up with paradoxical reactions. Some have had genetic tests to hopefully understand why they aren't responding like others. There have been shorter term users as messed up as longer term ones. Like many say, there is no rhyme or reason to any of this.

Maybe your "psychosis" (probably not that quite so much) may be better characterized as depersonalization, which is equally unsettling as I know from personal experience. And with your life long history of anxiety, I can imagine that you are experiencing it. Just remind yourself when it hits that it is not permanent, although one can be fearful that it is.

I had depersonalisation before going on a benzodiazapine but what I'm experiencing now seems more like psychosis. The confusion/muddled thoughts, cognitive decline, flashbacks, surroundings and family look unfamiliar. I just feel like I've gone completely mad.

 

I'm also worried about the damage already done. Im very sensitive to meds, both side effects and withdrawals.

My psych thinks there could be genetic predisposition to struggling with metabolising meds.  I don't know the ins and outs but she said something about certain enzymes. I've previously been accused of making up side effects of meds, but I don't think this is the case as I've had actual allergic reactions, even to citalopram and cyclizine.

 

It's possible that some people could be more at risk of severe withdrawal due to genetics. Probably explains why some people are not affected at all.

I had depersonalisation before going on a benzodiazapine but what I'm experiencing now seems more like psychosis. The confusion/muddled thoughts, cognitive decline, flashbacks, surroundings and family look unfamiliar. I just feel like I've gone completely mad.

 

I'm also worried about the damage already done. Im very sensitive to meds, both side effects and withdrawals.

My psych thinks there could be genetic predisposition to struggling with metabolising meds.  I don't know the ins and outs but she said something about certain enzymes. I've previously been accused of making up side effects of meds, but I don't think this is the case as I've had actual allergic reactions, even to citalopram and cyclizine.

 

It's possible that some people could be more at risk of severe withdrawal due to genetics. Probably explains why some people are not affected at all.

 

There is no permanent damage, but what you are describing sounds like horrible depersonalization and yes genetics is very influential. ADs can be tricky, because what works for one person can be horrible for someone else. I am not advocating any pharmacologic strategy, but what worked for me during my inpatient psych hospitalization and detox was remeron and cymbalta.

Same here...with looping songs and extreme head tension

How do we know if it's psychosis or a withdrawal symptom or brain injuries?

Same here...with looping songs and extreme head tension

How do we know if it's psychosis or a withdrawal symptom or brain injuries?

 

Avoid labels. It is what it is and it goes away but it sucks.

Same here...with looping songs and extreme head tension

How do we know if it's psychosis or a withdrawal symptom or brain injuries?

 

 

Looping songs, looping thoughts, been there, still doing that at times. Head tension, pretty rare for me, but I've seen many others experience this. Psychosis and/or brain injury, unlikely. Withdrawal symptom, very common.

i think its the benzo your on. My advice is to switch over to valium, deal with side effects for the two weeks....after 30 days youll see. No dizzyness, all interdose withdrawls gone, you have your mind back. Now you still have to taper off the valium, but at least your sane enough to start. Thats my advice.