Coming off K before Lex, right decision?

Ok...  I'm starting to obsess(surprise surprise).  Lexapro was very stimulating for me when I started it.  That was the reason I started on the klonopin.  I hope I'm making the right decision to go off the K first.  I am going to keep taking the trazodone.  My plan is to stop that after the lexapro.  I know the way I operate.  I know I will be stimulated after coming off K.  I'm afraid I'll start blaming the lexapro for this.  I don't want to make irrational decisions.  I know you're supposed to wait a few months before working on the next drug to come off.  Also, I want to be consistent, I don't want to start mixing things up by starting to taper one drug, stopping to start another drug.

Hi, sierra.

 

I received your PM but I'm going to answer you here, as we can't give out tapering advice via the PM system.

 

If I were you, I'd taper the Lexapro first, following by the Klonopin, followed by the Trazodone. And yes, waiting several months in between tapers is a good idea - it gives your CNS time to settle down.

 

Here's a really good article about deciding which drug to taper first: Taking multiple psych drugs? Which drug to taper first?

 

You mentioned that you're "only taking" 10 mg of Lexapro, but that's actually a moderate size dose for this medication. Lexapro is a very, very potent SSRI.

 

Here are a couple of resources on benzo buddies you may want to read:

 

Antidepressant Withdrawal

 

SSRI Support Group This is a really good support group and they can give you feed back as you taper.

 

 

This is a guide that Dr. David Healy and his team at Rxisk.org compiled that may be helpful:

 

Guide to Stopping Antidepressants

 

 

Please also read through this article from Surviving Antidepressants. You may also wish to get an account with SA, which is free and well worth joining:

 

Tips for tapering off of Lexparo

 

 

I know this is a lot of information to take in, especially when you're not feeling well. But please take the time to read through this and come up with a game plan.

 

From your previous posts, you've been coming on and off meds a bit erratically. This is very, very confusing to your CNS and may make it more difficult in the long run. It's best to set up a plan first and then go slowly, giving your CNS time to recover.

 

After you read over this, please post any questions you have on your thread here.

 

Good luck. I think once you get a good game plan, you'll be in a much better position to finally get off these medications and heal. 

Do you think if I do it in that order I can hold my Klonopin at the dose I'm taking?  I don't want to have to increase.  What about bringing the klonopin down a little more before tapering the lexapro?  I'm afraid the klonopin will just cause more issues if I stay it, but I want to be smart about all this.  I don't want to develop more interdose withdrawal symptoms.  I read that lexapro should be tapered 1mg every month.  I wonder if I could go a little faster since I was on it for a short time.

Do you think if I do it in that order I can hold my Klonopin at the dose I'm taking?  I don't want to have to increase.  What about bringing the klonopin down a little more before tapering the lexapro?  I'm afraid the klonopin will just cause more issues if I stay it, but I want to be smart about all this.  I don't want to develop more interdose withdrawal symptoms.

 

It depends on what you're comfortable with. For me, I went by how much sleep I was getting. Unfortunately, at some point during all of this, I stopped sleeping altogether, so there's only so much that one symptom will tell you.

 

If you're getting enough sleep from the Trazodone, you may be able to come off the Klonopin first.

 

How is your sleep lately? Does the Traz help you go to sleep as well as keep you asleep?

I can get about 5 hours of sleep on the trazodone.  I also don't want benzo withdrawal side effects to increased due to stimulation from lex.  Too many things to think about.  Arghhh...

 

I can get about 5 hours of sleep on the trazodone.  I also don't want benzo withdrawal side effects to increased due to stimulation from lex.  Too many things to think about.  Arghhh...

 

Yes, arghhh is right!

 

Take a few days and read over this information. Perhaps even get an account with Surviving Antidepressants and get their take on it. They're really up on their AD withdrawal.

 

Nobody says you gotta decide tonight. Best to ponder, plan, and then act. A good game plan will make all the difference when you're coming off of multiple meds. 

Ok thanks.  This all happened in 5 months!! 

Ok thanks.  This all happened in 5 months!!

 

I see. I just read some of your earlier posts and you're in recovery from alcohol. Congratulations on that! Getting off alcohol is a huge accomplishment.

 

However, it may have made your CNS a bit more sensitive. So plan a very slow and smooth taper for all your meds, and you'll be golden at the end.

 

Are you able to work and stay as functional as possible? If you're not working, you may be able to handle a more rapid taper, but if you've got a number of responsibilities, that's even more reason to go slow.

 

So factor in how functional you need to be in order to work, drive, care for family, etc.

Mindseeker-  I am working right now, but I think it's coming to an end.  I'm becoming less and less functionable.  The things they are having me do are becoming more difficult.  I'm on the road a lot and been having panic attacks.  I do have the family support to quit.  It's coming.  I want to focus on my recovery.

 

Were you on an SSRI when you jumped off the benzo?

Mindseeker-  I am working right now, but I think it's coming to an end.  I'm becoming less and less functionable.  The things they are having me do are becoming more difficult.  I'm on the road a lot and been having panic attacks.  I do have the family support to quit.  It's coming.  I want to focus on my recovery.

 

Were you on an SSRI when you jumped off the benzo?

 

I'm sorry you're struggling so much you may lose your job. That happened to me when I came off my last SSRI and it took a number of months to find another job. In the long run, I'd much rather lose a good job than risk having to stay on these drugs and risk my health.

 

Here's the order I came off my last drug cocktail:

 

1. Viibryd (SSRI)

2. Sonata (Z drug)

3. Halcion (benzo)

4. Klonopin (benzo)

5. Seroquel (antipsychotic)

 

Even though I really had no clue what I was doing until I read Robert Whitaker's "Anatomy of an Epidemic" and then found this website and Surviving Antidepressants, I still think this was a good way to go.

 

Coming off the SSRI caused mania but I had the other drugs in my system to counteract some of that.

 

And then I came off the drugs with the shorter half lives. And then I tackled the antipsychotic hoping that its sedative effect would help with sleep.

 

It took a couple of really hard years, but it's done and there's nothing left to do now but let the healing come my way. 

 

I'm afraid if I stay on the klonopin longer I'll develop more tolerance.  Although if I start doing the lexapro, I have only been on it since May.  I would have to see how I felt during the taper.  The last thing I want to do though is to get off the klonopin, then go crazy from the lexapro then have to take more benzo to get off the lexapro.  Defeats the whole purpose.  How long did you wait in between tapers?  I'm getting less and less worried about not working.  I have the backing of my family.  I want to get off the meds.  Were you able to stay at a consistent dose of klonopin when you tapered off the other meds prior?  Plus my worst symptom is air hunger.  How long did it take you to get off the ssri?

I'm afraid if I stay on the klonopin longer I'll develop more tolerance.  Although if I start doing the lexapro, I have only been on it since May.  I would have to see how I felt during the taper.  The last thing I want to do though is to get off the klonopin, then go crazy from the lexapro then have to take more benzo to get off the lexapro.  Defeats the whole purpose.  How long did you wait in between tapers?  I'm getting less and less worried about not working.  I have the backing of my family.  I want to get off the meds.  Were you able to stay at a consistent dose of klonopin when you tapered off the other meds prior?  Plus my worst symptom is air hunger.  How long did it take you to get off the ssri?

 

Unfortunately, my experiences with SSRIs are horrific due to serotonin toxicity that was misdiagnosed as psychosis, so I came off Viibryd cold turkey because of this adverse reaction.

 

I waited about 8 months to come off the Z drug and several more months before dropping the Halcion and a few more months before dropping the Klonopin. And then another 8 or 9 months before dropping the Seroquel.

 

After 30 years, this was really fast, but like I said, I didn't know what I was doing for most of my tapers.

 

I just knew to save the most sedating drugs for last because I've always had problems with insomnia.

 

As far as developing a dependency on SSRIs versus benzos, it only takes about 2 - 4 weeks to develop a dependency on benzos and about 4 - 6 weeks for SSRIs.

 

You know how they say it takes about 4 - 6 weeks for an SSRI to "work"? Well, that's how long it takes to become dependent. I really think with short term use though, you won't have nearly the problems as someone with 5 or 10 years on Lexapro.

 

And if you're not having to work, you may be able to speed it up. But please use caution because if you come off too fast, there's no do-over. You'll have to wait out the symptoms as best you can.

 

 

 

 

right...  cut a milligram, wait it out and and see how I feel?  If I do go this route I want to make sure I can hold the benzo at my current dose.  The trazodone definitely helps with my insomnia.  I don't want to have all that anxiety like I had when I first went on the lexapro.

 

How do you sleep now?

right...  cut a milligram, wait it out and and see how I feel?  If I do go this route I want to make sure I can hold the benzo at my current dose.  The trazodone definitely helps with my insomnia.  I don't want to have all that anxiety like I had when I first went on the lexapro.

 

How do you sleep now?

 

Yep, you got it - cut, wait, and see how you feel. And hold your other meds steady.

 

My sleep is a hit or a miss. I went from 0 - 2 hours a night to 3 - 4 hours a night. Sometimes I get a good solid 6 hours. So it's improving, it's just really slow.

 

Were you working through all this?

 

I posted on survivingantidepresants.  So far the only response was somebody suggesting a round robin.  I said that sounds dicey.

 

Uggh.....  I wish I knew what to do.  This is all so scary.  I don't want my tolerance level of the K to go up anymore.

 

But it seems like you might be able to come off lex a little faster.

I'm going to check out the SSRI page.  Hopefully I can get some comfort there.

Were you working through all this?

 

I posted on survivingantidepresants.  So far the only response was somebody suggesting a round robin.  I said that sounds dicey.

 

Uggh.....  I wish I knew what to do.  This is all so scary.  I don't want my tolerance level of the K to go up anymore.

 

But it seems like you might be able to come off lex a little faster.

 

Has a SA moderator responded to you yet? Sometimes it takes a bit, but the round robin idea isn't always the best way to go so I'd wait for the advice of a mod.

 

But to answer your question, I didn't work right after my AD withdrawal, but I did work throughout the benzo and antipsychotic withdrawal.

A moderator did respond.  She wanted more information.  I don't know what to do at this point.  Perhaps I should stick to my original and come off K first.  No mater which path I chose, it's not going to be fun.

A moderator did respond.  She wanted more information.  I don't know what to do at this point.  Perhaps I should stick to my original and come off K first.  No mater which path I chose, it's not going to be fun.

 

I'm glad you're in contact with them. Give them a bit more time to get back to you - it may take a day or so to get you set up with a plan, but it's best to get all of the information first.

 

No, it's not going to be fun - I agree with you there, but you're going to be okay. And there are no perfect plans so take their advice, the advice you get here, and use your own gut instinct.

 

My only advice is to go slowly. Your CNS has been through a lot over the past few months, so treat it gently.

I know it's a personal thing,  but i wish there was somebody who could tell me how fast to go.  Will it take me 6 months to get off everything?  A year?  Too many unknowns.

For what it is worth, I believe that the general advice is to get off the AD before the benzo.

Because the AD is activating, the benzo 'sedating'.

 

Your case is a bit more complicated. It is indeed best not to stay on the clonazepam for too long.

On the upside, you were never on a high dose. Your current dose is certainly not high.

Any chance there is some kind of interaction between the two drugs ?

 

A good rule of thumb is not to taper longer than you have been on the drug.

 

 

exactly!!! that's what I heard too, don't taper longer than you were on it.  I think I may stick with the plan and try to get off the K.  When I c/t'd the k, I was doing fine.  Yes I was definitely in withdrawal, but I think I was making sloooow progress.  Then I messed with the trazodone and screwed everything up. 

 

I don't know if there's an interaction going on.  Do you think the trazodone will be enough to help with the sedation? 

 

All I know is I have to get off these meds.  They made my life so much worse.  I will probably have to find a good therapist too.

exactly!!! that's what I heard too, don't taper longer than you were on it.  I think I may stick with the plan and try to get off the K.  When I c/t'd the k, I was doing fine.  Yes I was definitely in withdrawal, but I think I was making sloooow progress.  Then I messed with the trazodone and screwed everything up. 

 

I don't know if there's an interaction going on.  Do you think the trazodone will be enough to help with the sedation? 

 

All I know is I have to get off these meds.  They made my life so much worse.  I will probably have to find a good therapist too.

 

Liberty is right - there are interactions. I put your meds in a drug interaction checker and you can view it here:

 

http://www.drugs.com/interactions-check.php?drug_list=2228-0,703-357,1013-565

 

There are no rules set in stone on the order you should come off. The reason many people find that coming off (or at least reducing) meds like Lexapro first works better is because it lessens your chances of getting slammed with insomnia.

 

If you do decide to taper the Klonopin first, start out slowly and that way, if you pick up withdrawal symptoms that are intolerable, you can switch plans and taper the Lexapro.