help please-SSRI should I add it

I'm currently tapering klonopin for the second time and the systems are horrible should I ask my Doctor for an SSRI to help with the systems. I can't find anything in doctor ashton manual that suggests to add an SSRI during taper.

thanks

If depression and anxiety are the biggest problems for you yes you may ask your doctor for some SSRIs advice

 

“ Antidepressants. Antidepressants are the most important adjuvant drugs to consider in withdrawal. As mentioned before, depression can be a real problem in withdrawal and can sometimes be severe enough to pose a risk of suicide, though this is unusual with slow tapering. Like any other depression, the depression in withdrawal responds to antidepressant drugs and is probably caused by the same chemical changes in the brain. Both the "old fashioned" tricyclic antidepressants (doxepin [sinequan], amitriptyline [Elavil]) and the selective serotonin reuptake inhibitors (SSRIs; fluoxetine [Prozac], paroxetine [Paxil]) can be effective and an antidepressant drug may be indicated if depression is severe. There is a school of thought, mainly amongst ex-tranquilliser users, that is opposed to the taking of any other drugs during withdrawal. But suicides have occurred in several reported clinical trials of benzodiazepine withdrawal. If depression is severe during benzodiazepine withdrawal as in any other situation, it seems foolhardy to leave it untreated.

There are, however, some disadvantages with antidepressants. One is that they take 2-3 weeks or more to become really effective. This means that the patient, and his/her mentor, must be on the look-out for depression so that treatment, if advised by the doctor, can start early. The second drawback is that anxiety may be temporarily worsened at the start of treatment either with tricyclics or SSRIs. This is a particular risk during benzodiazepine withdrawal when anxiety levels are usually high. To avoid aggravation of anxiety, it is important to start with the lowest possible dose of an antidepressant and then work up slowly, over two or three weeks. Do not be persuaded by your doctor to start immediately on the "therapeutic" dose for depression. There are also fears that antidepressants such as Prozac may in some patients induce an agitated, violent or suicidal state at the start of treatment; low initial dosage and careful monitoring may avoid this risk.

It is usually possible to continue with slow benzodiazepine tapering while starting on an antidepressant, although some may prefer to halt their programme for 2-3 weeks until the antidepressant has "taken hold" (but increasing the benzodiazepine dose should be strenuously avoided). Antidepressants not only alleviate depression but also, after 2-3 weeks, have anti- anxiety effects. They are in fact a better long-term treatment than benzodiazepines for anxiety, panic and phobic disorders, and may in some cases actively help the benzodiazepine withdrawal process.

 

Once started on an antidepressant for depression, the treatment should be continued for some months (usually about 6 months) to avoid recurrence of the depression. Benzodiazepine tapering can continue during this time, and the antidepressant will sometimes act as a welcome umbrella during the last stages of withdrawal. It is important to finish the benzodiazepine withdrawal before starting to withdraw the antidepressant. Quite often, people taking long-term benzodiazepines are already taking an antidepressant as well. In this case they should stay on the antidepressant until the benzodiazepine withdrawal is complete.

Another drawback of antidepressants is that they, too, cause withdrawal reactions if they are stopped suddenly, a fact which has not always been appreciated by doctors. Antidepressant withdrawal symptoms include increased anxiety, sleep difficulties, influenza-like symptoms, gastrointestinal symptoms, irritability and tearfulness - not much different, in fact, from benzodiazepine withdrawal symptoms. These reactions can be prevented by slow tapering of the antidepressant dosage over about 1-3 months (See Table 2). Most people who have withdrawn from benzodiazepines will be experts at tapering dosages when the time comes to stop the antidepressant and will be able to work out a rate of withdrawal that suits them.

Apart from their therapeutic effects in depression and anxiety, some antidepressants have a sedative effect which patients who are particularly plagued with insomnia have found helpful. Low doses (10-50mg) of amitriptyline (Elavil) or doxepin (Sinequan) are remarkably effective in promoting sleep if taken at bed-time. These can be taken for short periods of a few weeks and stopped by reducing the dosage stepwise or taking the drug every other night. Withdrawal is not a problem when small doses are taken for short periods or intermittently.” 

 

Quote from The Ashton Manual Chapter III Extra medication during benzodiazepine withdrawal

Following.

shashal---thank you so much !

Just be prepared to possibly hold your dose for a while.. I started Prozac while trying to taper off ... it made it much more difficult for me. I had to stop the Prozac after two weeks because my anxiety, depression, insomnia and many withdrawal like symptoms messed with me. Had to quit the ssri and I had many problems until it was out of my system completely. I also don’t think I was tapering the smartest way at the time, but I even had to updose to feel normal because of the impact it had on my anxiety especially. I don’t think everyone experiences that though, but SSRIs can take a while to start benefiting you .

Wowzers91-

 

I hear you...yes that's what I finding in my research

thank you for helping me.

While tapering off of Valium,  I was put on an SSRI, extra low dose (2.5 mg Escitalopram) to start with, had to stop after a week because of extreme anxiety and the feeling as if an elephant put one of his legs on my chest...Now my family Dr. wants to put me on Seroxat 2 mg to start with. No way.

Trochsetter---

 

thanks you ! I also was put on Escitalopram took it the last 2 nights  2.5mg and had 2 horrible nights  !!! No more !

all systems increased and  woke up with burning skin all over.

Healing and blessing to you

I'm sorry I don't know how to add previous text in my reply.  I've done a lot of research into drugs and many of the articles I read stated that SSRIs and benzos can cause a reaction.  These were research papers.  I have a page on facebook called benzomicrotaper that you can do a search and the page should come up.  All the links are posted there.  Not everybody reacts to a medication in the same way each time they take the drug.  I took an SSRI many years ago and experienced akathisia.  Now I'm sensitive to just about all medications.  Best wishes.

Hi - FYI, Ashton later revised her viewpoint on the use of antidepressants.  Scroll down to read the article and her complete speech:

 

An Update on Dr. Heather Ashton’s View on Antidepressants:

http://www.benzobuddies.org/forum/index.php?topic=142057.0

 

An excerpt:

 

 

Dr. Aston spoke about this in her lecture at the Bridge Project: 

 

After a while it became apparent that SSRIs, like benzodiazepines, produced a similar withdrawal syndrome, when they were stopped.   The doctors were surprised by this discovery and this was another example of their ignorance and lack of thought. It was already known that the older antidepressants produced a withdrawal reaction. Of course, the drug companies did not test SSRIs for withdrawal  reactions.

 

dancer---

thank you !

Never take a benzo,  Yesterday I consulted my psychiatrist.  She strongly adviced against adding the Seroxat!  Our CNS is already in overdrive, so don't put it under additional pressure, she said. Glad she confirmed my feeling about it.

Trochsetter-

 

Thank you so much for your input it's extremely helpful  !

Thanks for sharing !

 

 

Blessings as we heal