Bioidentical progesterone cream causes withdrawal similar to benzo-

G’day!

 

I have a question regarding Bioidentical Progesterone cream.

 

The background: I stopped Clonazepam in November 2010 (for the details please see my signature and also my introduction here

http://www.benzobuddies.org/forum/index.php?topic=36826.0 ).

After about 7 months I almost got through (although I still had severe clinical depression with impending death fixation) but decided to try using Bioidentical Progesterone cream because of my worsening catamenial epilepsy. I did use it occasionally before the Clonazepam Hell and it did not cause any side-effects. After I started using Progesterone cream I felt much better. Depression also lifted by the way.  But then, when I had to stop using Progesterone during my period and a week after I got the symptoms identical to benzo- withdrawal. I tried to get off Progesterone but ended up with semi-psychotic depression with the motto of impending death.

 

I have already learnt that benzo- and progesterone affect GABA-receptors in the same way. So, I concluded that I am hooked on Progesterone just like I was on Clonazepam before. I recently tried lowering the dose of Progesterone cream with the aid of anticonvulsant Keppra (even after I reduced Progesterone just to two thirds of the original dose I immediately got vivid nightmares, panic, and cold-hot waves with “crawling insects” under my skin). Keppra helps with depression and seizures which otherwise are truly awful in my case.

 

A small problem: I am unable tolerate any anticonvulsants – some of them send me into psychosis, some – into depression. Keppra is the only one I can tolerate if I take a very low dose “as needed”, so my balance is very fragile.

 

I have access neither to a neurologist nor endocrinologist (or even to a competent GP), alas - at least for now. Therefore I would appreciate any advice.

 

1. Should I discontinue Progesterone cream slowly or cold turkey? I am sick of everything now and want to get off drugs ASAP.

 

2. I can see that in my case benzo- withdrawal caused post-traumatic stress disorder (with typical symptoms: vivid nightmare with death themes, severe depression, rage, desire to drink). Does anyone have an advice on dealing with it?

 

Thank you.

 

Hi doublewave.

 

I don't have any experience with bioidentical progesterone cream and haven't been able to locate a source for your statement that it affects GABA receptors in a manner similar to benzos.  However, since you are using it to control your epilepsy, I really think you should be discussing this with your doctor.  I'm afraid I am ignorant of PTSD caused by benzo withdrawal as well but I know that there are therapists who specialize in treating PTSD.  Not a lot of help, I know, but I wanted you to know we had seen your post.  Good luck and take care. 

Hello doublewave,

 

 

I stated using bio-identical hormones 9 months before starting to taper from Lorazepam, and approximately 3 months into my taper.  The progesterone did very little for me one way or the other.  I then tapered the Progesterone. The Progesterone does interact with GABA, supposedly to help with sleep. It also can contribute to depression, although it seemed to have helped you in that regard.

 

My only advice would be that if you want to continue tapering the Progesterone, do so very slowly..actually it might be best to hold on to the amount you are on, until you find a doctor who can advise you.   Obviously it is working a lot differently for you than it did for myself. As for pst, it sounds  like it might be symptoms from your Clonazepam withdrawal.  I did have rage, but it's so much less now.  Time is a great healer..I know it sounds trite, but so many buddies who have come so far have said it, and believe it.

 

Kat

P.S.  You did say you didn't have access to a specialist or to a competent GP, but if your symptoms get much worse and out of control, you might work toward a Plan B just in case.

 

Thank you ladies,

 

>> and haven't been able to locate a source for your statement that it affects GABA receptors in a manner similar to benzos

I am sorry I did not provide the references. Here is one:

Hormones & Benzodiazepines

http://www.benzosupport.org/Hormones%20and%20benzo%20diazepines.htm

 

>> My only advice would be that if you want to continue tapering the Progesterone, do so very slowly..actually it might be best to hold on to the amount you are on, until you find a doctor who can advise you.

Thank you. I started tapering very slowly and will continue. As for a doctor, the only doc I have is that one who ordered me to stop Clonazepam cold turkey. Plus one endocrinologist who doesn't know what bioidentical progesterone cream is...

 

However, if I feel dramatically worse I will have to consider "plan B" as you said )). Thank you.

 

 

All I know is that I've heard that progesterone is a gaba agonist as are benzos so if that's true, it would make sense.

http://en.wikipedia.org/wiki/Progesterone

 

This report, updated yesterday, also mentions that there is no proof that progesterone derived from yams (which is the source for bio-identical progesterone) is effective. I would be hesitant to take the synthetic, having read of the dangers of this drug.

 

Kat

Kat

 

It is not what I use. Mine made according to the prescription by a compound pharmacy… It is certainly not wild yams – but I forgot what it is exactly.

 

---------------------------------------------------

 

My withdrawal meanwhile is getting worse . I curse the day I started using this cream. My husband, who is a neuroscientist, warned me about the danger (GABA, developing a secondary addiction) but I did it because I was convinced that my “doom and gloom” depression is a symptom of low progesterone. The fact that depression reduced after I started P-cream convinced me I was right. Now I can see that I would feel the same if I was taking Clonazepam again…

 

My neuroscientific husband insists that I stick to a very low dose of Keppra while gradually withdrawing from progesterone cream. Keppra helps! – but it is still very tough.

 

My cream was also made by a compound pharmacy, doublewave.  It was probably from wild yams; anyway, it's all  history now.

 

take care,

Kat

Kat175

 

Perhaps they are deceiving – they claim it is not. Also, as I recall there is a difference between yams cream bought in health food shops and one which made in a chemist. Maybe they alter molecules (?).

 

Still, it is a bloody potent stuff in my case ((.

 

PS

 

What is really bad is that I cannot be completely sure that my current symptoms are due to benzo- withdrawal = progesterone withdrawal. I am tortured by the thought “what if these symptoms are due to progesterone deficiency?” I found some information online that panic attacks, feeling very cold, clouded thinking can be the symptoms of low progesterone… At the same time, these symptoms diminish a little when I take Keppra (anticonvulsant) - this is not consistent with progesterone deficiency.

 

And – the most important thing – although it is said that progesterone is antidepressant, I could never tolerate oral contraceptive, progesterone only pill and others due to depression as a side-effect.

 

However, I am going to take myself of progesterone completely and see how I will feel.

Thank you ladies,

 

>> and haven't been able to locate a source for your statement that it affects GABA receptors in a manner similar to benzos

I am sorry I did not provide the references. Here is one:

Hormones & Benzodiazepines

http://www.benzosupport.org/Hormones%20and%20benzo%20diazepines.htm

 

>> My only advice would be that if you want to continue tapering the Progesterone, do so very slowly..actually it might be best to hold on to the amount you are on, until you find a doctor who can advise you.

Thank you. I started tapering very slowly and will continue. As for a doctor, the only doc I have is that one who ordered me to stop Clonazepam cold turkey. Plus one endocrinologist who doesn't know what bioidentical progesterone cream is...

 

However, if I feel dramatically worse I will have to consider "plan B" as you said )). Thank you.

 

 

 

Thanks for the link, doublewave.  Although the studies have only been done on rats, it does make sense that there there would be that connection.  And I've noticed many of our female members over the years report a worsening of symptoms in the week or so before their periods, which also suggests a connection.

 

After you've been off the cream for a while, I imagine  you could request a progesterone levels test to make sure you your symptoms aren't due to a deficiency. Good luck with Plan A. 

 

 

PS

 

What is really bad is that I cannot be completely sure that my current symptoms are due to benzo- withdrawal = progesterone withdrawal. I am tortured by the thought “what if these symptoms are due to progesterone deficiency?” I found some information online that panic attacks, feeling very cold, clouded thinking can be the symptoms of low progesterone… At the same time, these symptoms diminish a little when I take Keppra (anticonvulsant) - this is not consistent with progesterone deficiency.

 

And – the most important thing – although it is said that progesterone is antidepressant, I could never tolerate oral contraceptive, progesterone only pill and others due to depression as a side-effect.

 

However, I am going to take myself of progesterone completely and see how I will feel.

 

Hi doublewave,

 

That is one reason why I continued taking the progesterone for a few months after starting tapering..to somehow find out if it would finally work..don 't ask me how because we know anything goes in withdrawal lol.. but I had to know how I'd feel taking progesterone and tapering. I also wanted to establish as "normal" a base as possible, i.e....not stopping/starting any supplements/drugs I was on when beginning to taper.  Since it didn't seem to make a difference, that's when I decided to stop the progesterone.  I'm glad I did, and am glad you are willing to try.

 

God Bless,

Kat     

Beeper

 

You are welcome; link is interesting indeed )).

 

>> I imagine  you could request a progesterone levels test to make sure you your symptoms aren't due to a deficiency.

 

I’ve just done the blood test. The results will be ready in a week or two. Previous test showed a normal level of progesterone and farf too high of estrogene; at that point I was using it a lot of progesterone cream. Now I am using tree times less.

 

 

Kat175

 

Actually, I started suspecting that lots of stress & benzo- withdrawal itself could course low progesterone in me. I read that some females have disrupted periods or even losing them altogether during withdrawal and even after – this is what happened with me. I speculate if a few months of progesterone could “perk up” my body enough to produce my own progesterone. Of course I can only guess.

Hi doublewave,

 

This is the second time I'm hearing about this. My w/d coach Elizabeth came off Xanax years ago. She is not active on these boards unfortunately. Wish you could talk to her.

 

Progesterone cream is the reason she was put on benzos in the first place.  She used it for 2 weeks to relieve menopause sxs and then caught a cold and stopped c/t, not realizing that could harm her. Well it sent her into rolling panic attacks for days. She rushed to the dr and was put on Xanax and the rest is history.

 

I would suggest being really careful about how you stop using the cream and definitely taper it. Listen to your body and that will determine how fast or how slow you should go.

 

-L-

Hi prinncezz,

Thank you very much, it is a very valuable information.

The following link has to do with seizures, cycles and hormones and  there is a quote near the end of the article that I thought was pertinent and interesting and why the use of progesterone in any capacity should be given serious consideration and research before beginning any kind of hormone therapy.  Just another piece of the puzzle...

 

By gaining a better understanding of how the hormones affect seizures, it is possible researchers are one step closer to finding solutions. “If you don’t ovulate, you don’t make progesterone, hence the importance of estrogen-to-progesterone ratio,” Dr Herzog explained in a statement to the press. “Estrogen tends to promote seizure occurrence and progesterone has a metabolite that has powerful antiseizure properties comparable to barbiturates and benzodiazepines.”

 

http://hcp.obgyn.net/news/content/article/1760982/1932597

 

Hi everyone, after reading these posts and looking at the related links, I am more confused about progesterone and whether it is recommended or not recommended. 

 

My troubles began in Aug/Sept when I started having severe breathlessness and anxiety.  Unfortunately I took a lunesta and klonopin to try to sleep and then things got worse.  I am now trying to taper off the lunesta.  My OD took blood levels and determined my anxiety and breathlessness was caused by low progesterone/high estorgen.  The first week I took the progesterone it did help with the sleep but now I'm back to having severe anxiety and adrenalin surges at bedtime.  I don't know which way is up.  Don't know if I'm withdrawing from the lunesta, the occasional .25 mgs of ativan I have been taking about once a week, and I now don't know what role the progesterone is playing.  Is progesterone recommended or not?  Mine is a bioidentical pill format in 100 mgs made at a compounding pharmacy.

Here is a link to a thread where we discussed this you may want to read:

 

http://www.benzobuddies.org/forum/index.php?topic=40042.msg555384#msg555384

 

Good luck!

Hello,

Here is my update about progesterone withdrawal.

 

I had three menstrual cycles after I stopped Prog. The symptoms of WD are reducing but VERY slowly.

Almost two months ago I said "no" to alcohol; it helped with seizures but didn't change other things. Then I added magnesium. It improved my sleep and reduced panic attacks (I also do CBT for panic).

Yesterday I had a thought to add calcium to my diet. I started taking it and already can say that my brain is calmer - but time will tell if it not just a wishful thinking.

 

The worst symptom for me is "gloom and doom and death" depression which returned after my stupid experiment with alcohol - I drank one glass of... forgot the name, like beer - "a viking drink".

 

I am not attempting to make generalizations here but I am quite convinced that natural progesterone is acting as a soft benzo-. So indeed introducing prog. helps temporary but then a person develops an addiction to it just like to benzo-. At least it is my experience. I am also convinced that prog. as such has many benefits, particularly for peri-menopausal women and it is well and good to use it but not for a person who has just came of benzo-. I think benzo- screws GABA to such extent that they react to prog. in a completely abnormal way.  If I didn't use Clonazepam in the past I would use prog. right now.

However, everyone makes her own choice.

 

Conclusion: I am not using prog.; I will not use it for at least a year; I am planning to abstain from alcohol for at least a year; I will continue with magnesium and calcium, and also Keppra.

Hello,

Here is my update about progesterone withdrawal.

 

I had three menstrual cycles after I stopped Prog. The symptoms of WD are reducing but VERY slowly.

Almost two months ago I said "no" to alcohol; it helped with seizures but didn't change other things. Then I added magnesium. It improved my sleep and reduced panic attacks (I also do CBT for panic).

Yesterday I had a thought to add calcium to my diet. I started taking it and already can say that my brain is calmer - but time will tell if it not just a wishful thinking.

 

The worst symptom for me is "gloom and doom and death" depression which returned after my stupid experiment with alcohol - I drank one glass of... forgot the name, like beer - "a viking drink".

 

I am not attempting to make generalizations here but I am quite convinced that natural progesterone is acting as a soft benzo-. So indeed introducing prog. helps temporary but then a person develops an addiction to it just like to benzo-. At least it is my experience. I am also convinced that prog. as such has many benefits, particularly for peri-menopausal women and it is well and good to use it but not for a person who has just came of benzo-. I think benzo- screws GABA to such extent that they react to prog. in a completely abnormal way.  If I didn't use Clonazepam in the past I would use prog. right now.

However, everyone makes her own choice.

 

Conclusion: I am not using prog.; I will not use it for at least a year; I am planning to abstain from alcohol for at least a year; I will continue with magnesium and calcium, and also Keppra.

 

Sounds like a good plan, especially given the history you've described.

 

Keep in mind that many people after a CT of benzos find that it takes more than a year to feel normal, often  up to two or three years, even without any complicating hormonal issues.  In fact I would say that after a CT it's pretty unusual for someone to feel back to normal after just one year.  So hang in there.  You WILL heal.

Hi everyone, after reading these posts and looking at the related links, I am more confused about progesterone and whether it is recommended or not recommended. 

 

My troubles began in Aug/Sept when I started having severe breathlessness and anxiety.  Unfortunately I took a lunesta and klonopin to try to sleep and then things got worse.  I am now trying to taper off the lunesta.  My OD took blood levels and determined my anxiety and breathlessness was caused by low progesterone/high estorgen.  The first week I took the progesterone it did help with the sleep but now I'm back to having severe anxiety and adrenalin surges at bedtime.  I don't know which way is up.  Don't know if I'm withdrawing from the lunesta, the occasional .25 mgs of ativan I have been taking about once a week, and I now don't know what role the progesterone is playing.  Is progesterone recommended or not?  Mine is a bioidentical pill format in 100 mgs made at a compounding pharmacy.

Definitely go to page one of Perseverances link from this thread on reply #17. I'll just link it again here.  Read her reply #2 & 4 on page one of this link.  Here's a copy and paste of her response #2 in the link. I'll link my progesterone forum info after that.

 

<<Progesterone is a neuroactive steroid and is cross tolerant to benzodiazepines:

 

"Neuroactive steroids, e.g., progesterone and its active metabolite allopregnanolone, are positive modulators of the GABAA receptor and are cross tolerant with benzodiazepines.[27] The active metabolite of progesterone has been found to enhance the binding of benzodiazepines to the benzodiazepine binding sites on the GABAA receptor.[28] The cross-tolerance between GABAA receptor positive modulators occurs because of the similar mechanism of action and the subunit changes that occur from chronic use from one or more of these compounds in expressed receptor isoforms. Abrupt withdrawal from any of these compounds, e.g., barbiturates, benzodiazepines, alcohol, corticosteroids, neuroactive steroids, and nonbenzodiazepines, precipitate similar withdrawal effects characterized by central nervous system hyper-excitability, resulting in symptoms such as increased seizure susceptibility and anxiety.[29]"

 

http://en.wikipedia.org/wiki/Benzodiazepine_dependence

 

I personally wouldn't take it.<<

 

 

*As well, there are support forums with women getting progesterone creme anxiety and if you read these discussions a Sugette was told by her doctor to 'combat' progesterone anxiety with a benzo and ssri. What a cycle. I've heard of many woman getting withdrawal from it and Perseverance's link above, reply #2 & 4 explains why.

Here's the progesterone forum discussion.

http://www.power-surge.com/php/forums/index.php?showtopic=27746

 

Many women have trouble with it on or off benzos. It can set women back if they have prior benzo use.

I get all this about progesterone "binding to the gaba receptors" and all, but what is a woman to do if her progesterone is just too low? Before benzos and during benzos, and during benzo withdrawal and now at 18 months off benzos..my progesterone won't budge..it's drastically low. So are we women just supposed to do nothing and suffering the anxiety, insomnia, erratic menstrual cycles, major mood swings caused from low Progesterone?

Sunny,

 

If your progesterone was low before benzo usage you may have something else going on.  IMO it is always best to find out the reason why a hormone is low before taking a hormone replacement.  Perhaps your doctor could investigate this further to rule out other possibilities.  Best of luck to you.

Sunny,

 

If your progesterone was low before benzo usage you may have something else going on.  IMO it is always best to find out the reason why a hormone is low before taking a hormone replacement.  Perhaps your doctor could investigate this further to rule out other possibilities.  Best of luck to you.

 

I agree, but what tests can they run for that? I have a great doctor, but I'm not sure anyone can really know why our bodies stop doing what their supposed to...why do our thyroids stop functioning properly...why do some have estrogen dominance, and others too little..I think the only answer is that we are imperfect and slowly but surely getting older and going through the dying process..

Sunny,

 

While levels of Progesterone decline as we age, there still should be enough produced to get us through our ‘Golden Age’…so low levels later in life using the menopause or post menopause (depending where you are with regards to menopause) test specs is not normal.  During menopause, hormone levels decrease to a level below what is needed for pregnancy- but we should be producing enough for the other normal body functions.

 

There are many things which can affect Progesterone levels.  For example, stress can dramatically reduce Progesterone levels.  When we are stressed the body diverts much of our Progesterone to Cortisol production.  The increased need for Cortisol can deplete the Progesterone levels.  As more Progesterone is shunted or sequestered to make Cortisol, less is available to balance off the Estrogen and can cause a condition known as Estrogen Dominance.

 

Another common reason for low Progesterone levels is an anovulatory cycle (a menstrual cycle in which there is no ovulation). Without the ovulation there is no corpus luteum to make additional Progesterone for the cycle.

 

Other things you doctor may want to rule out are things like genetic diseases that interfere with proper ovulation, weight loss amenorrhea, Ovarian Tumors, and problems with the Adrenals.

 

Agents which alter central neurotransmission and hypothalamic function (e.g. elevated prolactin and psychotropic medications- e.g. benzos) or other things which can cause hypothalamic insufficiency can result in insufficient stimulation of the ovaries.  So even though you are feeling ‘healed’, your endocrine system may perhaps still be not up to par yet- and still have a ways to go.

 

http://www.ncbi.nlm.nih.gov/pubmed/22283375

 

The bottom line is there are many things which can cause Progesterone levels to be low.  Also Progesterone levels vary across the luteal phase so this must be considered when running tests.  Checking levels across the luteal phase is much more accurate and can help in the investigation.

Menopause sx’s are temporary…and in time should fade on their own.  Since HRT carries risks one needs to weigh these things out when making a decision.  IMO if your Progesterone levels are consistently abnormally low it would be worthwhile to rule out other causes.