anxious and wired, need some help please!

[CFS_for_19_years]

CFS_for_19_years said: ↑

Antidepressants can't be used off and on

.
From personal experience, I would have to disagree here. The higher the dosage, the more difficult it is to do this. But in low doses, which are often all that is needed when a problem occurs a few days a month, this is quite feasible for many people. Some people can't do this; some people can't tolerate these drugs at all. Like most aspects of medications, it varies on an individual basis.

The same goes for withdrawal. From the first sentence of your source:

After some people stop taking a type of antidepressant known as a selective serotonin reuptake inhibitor (SSRI), they experience a variety of symptoms.

The key word here is "some". As with starting the drug, it is much less likely for someone to get withdrawal symptoms from a low dose than from a high dose. For a high dose, most people need to taper up to the drug when starting and taper down from it when coming off. This would not be done for occasional use. Doing such tapering and not going faster than your body can tolerate avoids the hell you describe.

These are prescription drugs, and taken under the direction of a knowledgeable doctor, they can be taken without problems by most people.

I just went through hell discontinuing doxepin I was taking at 12mg/day - a dose to keep muscle spasms at bay, a small dose by anyone's reckoning. I lost 7 pounds due to nausea and poor appetite. All my psych doc could say is that I was very sensitive - ya think? I had to discontinue the doxepin in order to take a test for metanephrines. Going down by 1mg every 4 days wasn't slow enough.

Everyone will have different tolerances and when I give advice or information I err on the side of caution. What is that phrase - "do no harm." If someone reads your advice thinking they can go off and on antidepressants, and the patient hasn't been warned not to stop them abruptly, that person will be in for some crazy symptoms, all because of your advice. I've known of lots of individuals who have stopped antidepressants abruptly and couldn't figure out if they were coming down with the flu or what. They never connect their symptoms with the discontinuation of their meds.

If someone already has anxiety, then stopping and starting antidepressants is not going to be a fun thing to do.

 

[Jarod]

Neither drug contains fluoride; nor do any of the other SSRIs. Zoloft contains no form of fluorine at all. Prozac and many other SSRIs contain fluorine (not fluoride) that is strongly bonded to carbon, which leaves it unreactive. From

I can't sort it all out at the moment. Here is the article I found on it if somebody is motivated to try and sort it all out.

"Fluoride is any combination of elements containing the fluoride ion. In its elemental form, fluorine is a pale yellow, highly toxic and corrosive gas. In nature, fluorine is found combined with minerals as fluorides. With hydrogen it forms hydrogen fluoride gas which, in a water solution, becomes hydrofluoric acid...Fluorine compounds or fluorides are listed by the US Agency for Toxic Substances and Disease Registry (ATSDR) as among the top 20 of 275 substances that pose the most significant threat to human health."

"Schuld cites concerns about both Paxil and Prozac, popular anti-depression drugs. He claims that the fluoride-enhanced drugs not only have a risk of causing liver damage, but also interfere with thyroid hormones and potentially even with thyroid medications routinely taken by millions."


Also..The Agency for toxic drugs lists fluorine as a toxic substance....

ATSDR article with pdf....

http://www.atsdr.cdc.gov/toxprofiles/tp.asp?id=212&tid=38

Toxicological Profile for Fluorides, Hydrogen Fluoride, and Fluorine

Toxicological Profile Information
The ATSDR toxicological profile succinctly characterizes the toxicologic and adverse health effects information for the hazardous substance described here. Each peer-reviewed profile identifies and reviews the key literature that describes a hazardous substance's toxicologic properties. Other pertinent literature is also presented, but is described in less detail than the key studies. The complete list of topics covered (chapter titles) is shown at the left and in more detail further down this page.

 

[zzz]

I just went through hell discontinuing doxepin I was taking at 12mg/day - a dose to keep muscle spasms at bay, a small dose by anyone's reckoning. I lost 7 pounds due to nausea and poor appetite.

Sorry to hear that - really!

Everyone will have different tolerances and when I give advice or information I err on the side of caution.

I agree completely. I've had too many reactions to things where I wasn't warned by my doctors to believe otherwise.

If someone reads your advice thinking they can go off and on antidepressants...

...then they haven't read what I said closely. From my original post:

If these symptoms occur only a few days each month, you may be able to relieve your symptoms by using these drugs only around those days.

Emphasis added. And in my previous post, I emphasized "taken under the direction of a knowledgeable doctor". Not just any doctor, because many doctors are unfamiliar with the less common side effects. Since it's often hard to know how knowledgeable your doctor is, or since you may be stuck with one who isn't, as a rule, I urge people to read the prescribing information themselves. Especially for people with ME/CFS, that applies to any drug we take.

It is foolish for anyone to take prescription drugs and play around with the dosages without knowing what they are doing. It can be downright dangerous, especially for us. This does not apply just to prescription drugs, of course, but the dangers there are usually greater.

As you said, everyone will have different tolerances, and drug reactions are especially common around here. I am not a believer in one-size-fits-all medicine, and so I try to stress that something may help in a certain situation. That's why in my first post alone, I used phrases like "are often extremely effective", "can be very helpful", " It's best to start with low doses on each," and "you may be able to relieve your symptoms". The purpose of my post was to outline some possibilities that have been used successfully for treatment, and not to advise anyone to undertake any particular course of treatment. I am sorry if this was misunderstood.

I can't sort it all out at the moment. Here is the article I found on it if somebody is motivated to try and sort it all out.

"Fluoride is any combination of elements containing the fluoride ion."

I agree with your definition, and that fluoride can be extremely toxic; no argument there. It's just that these drugs don't contain fluoride. They are technically known as fluorinated organics. The strong carbon bond with fluorine keeps these drugs from being reactive, and therefore toxic.

 

[CFS_for_19_years]

I urge people to read the prescribing information themselves. Especially for people with ME/CFS, that applies to any drug we take.

Nobody reads the fine print. That's why discontinuation syndrome is so common. You didn't mention the harm that could happen with starting and stopping antidepressants. Here's more:

http://www.wikidoc.org/index.php/SSRI_discontinuation_syndrome

Who needs this s***?

Symptoms
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated SSRIs. Just because a side effect is stated here, it does not mean that all people using one of these medicines will experience that or any side effect. The discontinuation (specifically when abrupt) of antidepressants can result in a syndrome of adverse events, including somatic, mood and psychomotor reactions:

• Dry mouth
• Headache
• Insomnia
• Somnolence
• Dizziness, or Orthostatic hypotension[33]
• Fatigue
• Cataplexy
• Increased sweating
• Decreased appetite and weight loss
• Increased intraocular pressure or blurred vision
• Paresthesia
• Disturbances of the gut, such as nausea, constipation, diarrhea, indigestion, vomiting
• Tremor
• Nightmares
• Akathisia, (anxiety, nervousness, agitation, suicidal thoughts) [34]
• Palpitations
• Decreased sex drive or difficulty achieving orgasm
• Impotence or delayed ejaculation
• Hot flashes
• Taste disturbances
• Dysphoria
• Difficulty passing urine
• Increase in blood pressure
• Increase in heart rate
• Cold hands or feet
• Jaundice
• Inflammation of the liver
• Depersonalization
• Myoclonus (involuntary muscle twitching)
• Tinnitus
• Extreme yawning,
• Feeling of lack of oxygen
• Extreme sensitivity to fluorescent light

"Brain zaps" and "electric shock sensations"

Prevention and treatment
Patients should be advised of the elimination half-life times on their specific medication, and patients should be aware if changing from a long half-life medication such as fluoxetine, to a shorter one, that taking their dose regularly becomes much more important. Patients taking fluoxetine can often miss several doses without noticing any discomfort, but the shorter halflife of other SSRIs such as venlafaxine, paroxetine, duloxetine, escitalopram oxalate and sertraline (ranging approximately 10 hours) means that a single missed dose may cause withdrawal symptoms.

The condition may be avoided by either recommencing the original, and/or lesser dose of the SSRI (or a similar SSRI), or slowly reducing (titrating) the dosage over several weeks or months. While slowly reducing the dosage does not guarantee that a patient will not experience the discontinuation syndrome, it is considered a safer method than abrupt discontinuation.

Treatment is dependent on the severity of the discontinuation reaction and whether or not further antidepressant treatment is warranted. In cases where further antidepressant treatment is required then the only step required is restarting the antidepressant; this is usually the case following patient noncompliance with the drug. If antidepressants are no longer required, treatment depends on symptom severity. Mild reactions may only require reassurance. Moderate cases may require symptom management, for example benzodiazepines can be used for insomnia. If symptoms are severe, or do not respond to symptom management, the antidepressant can be reinstated and then withdrawn more cautiously.[15]

For severe withdrawals, many doctors have patients taper their medication no more than 5% per week, as to avoid a drastic drop in serotonergic activity. This slow taper can be done either by purchasing oral suspension versions of the drug (if available), cutting pills, or dissolving capsules of the medication in orange juice.[38]

Tapering regimen
A tapering regimen is not provided in manufacturers' package inserts. The optimum tapering regimen for each agent has yet to be determined by comparative clinical trials. From a review of the case reports (MEDLINE search from 1982 to May 1997), the following tapering schedules presented are suggested.[39]</center>

Suggested SSRI and SSNRI Tapering Schedule Fluoxetine: Reduce by 5 mg every two weeks until dose is 5 mg/day, then 2.5 mg/day every two weeks
Fluvoxamine, Sertraline, Venlafaxine: Reduce by 25 mg every two weeks until dose is 25 mg/day, then 12.5 mg/day every two weeks
Paroxetine: Reduce by 10 mg every two weeks until dose is 10 mg/day, then 5.0 mg/day every two weeks

Example Case: A patient is receiving 20 mg/day of fluoxetine. Upon discontinuation patient experiences symptoms of SSRI withdrawal. Resume fluoxetine at a dose of 20 mg/day until symptoms abate. Then decrease the dose by 5 mg to 15 mg/day for two weeks. If the patient tolerates the lower dose without withdrawal symptoms decrease the dose to 10 mg/day for two weeks. Continue the taper according to the above schedule.

If you want to continue a discussion of discontinuation syndrome we should probably start a new thread.

 

[Jarod]

I urge people to read the prescribing information themselves. Especially for people with ME/CFS, that applies to any drug we take.

Good advice.

 

[alice111]

reposting my original question to bring the convo back. thanks so far for all the input! anyone have any other suggestions?

so this being wired and very anxious is something a lot of people seem to deal with on here. I myself have had it on and off, however lately it has been very constant, and very severe. The one plus is that my energy has improved a bit (I was pretty much bedbound, but am now able to putter and do some things around my room) - the problem is that I feel soooo wound up!!!

The anxiety is really extreme and overwhelming, and the feeling "wired" feels like its taking its toll, like i dont have enough energy to "keep up" with this half of my body that is all reved up.. i hope that makes sense?

anyway, I would really like some suggestions for things that can help with this!

I have tried a lot of things including magnesium, progesterone cream, and "hip"s suggestion of N-A-G, but nothing seems to help..
the only things that seem to take the edge off so far are alcohol and xanax.
ok, any suggestions would be very appreciated!

 

[CFS_for_19_years]

Some people find the prescription antidepressant paroxetine helpful for anxiety, but an effective dose might make you drowsy during the day, so if you do take it I would recommend taking it at night. You can't take it for a few days and quit and start up again. It needs to be taken every day. Hope that info helps.

 

[Hip]

I have tried a lot of things including magnesium, progesterone cream, and "hip"s suggestion of N-A-G, but nothing seems to help..

I don't know if you are interested in trying out other anti-anxiety supplements from my list, but you might consider arginine pyroglutamate 5 grams twice daily which I find pretty effective.

High dose inositol powder 15 grams daily is another good option. This boosts the serotonin system, which has a good anti-anxiety effect. SSRIs work on serotonin too, but inositol can provide similar anti-anxiety benefits without the side effects or withdrawal symptoms of SSRIs.

 

[Hip]

If you are looking at SSRIs, this post is very interesting:

My personal experiences with ALL SSRI drugs

The guy that wrote that post found that Lexapro reduced anxiety far more than the other SSRIs.

 

[CFS_for_19_years]

This guy writes some pretty good stuff - please don't be put off by the name of the website:

http://www.crazymeds.us/pmwiki/pmwiki.php/MedClass/Anxiety

I disagree with a statement he made on this page:

If you can leave you house, hold down a job (even one that involves as little contact with people as possible), and otherwise function, no matter how little interaction you have with anyone else, you can probably overcome the condition with therapy.1 Drugs, if needed, would be used for a very short time.

Once you've decided that the only option left is to try a prescription (as opposed to just supplements) I would recommend finding the best psychiatrist you can, preferably someone who is comfortable treating someone with complex medical conditions and understands CFS/ME. Primary care doctors just aren't as sharp as psychiatrists in the use of psych meds.

 

[Hip]

One thing about using supplements for treating generalized anxiety disorder: a single supplement is not going to be a powerful as anti-anxiety drugs such as benzodiazepines or SSRIs.

So this means that you will need to take several anti-anxiety supplements together, in order to quash the anxiety.

N-acetyl-glucosamine can be quite good at reducing anxiety (and by the way, NAG should be taken on an empty stomach), but NAG is not powerful enough on its own.

The supplements I take each day to counter my anxiety are:
N-acetyl-glucosamine 750 mg
Turmeric 1000 mg
Flaxseed oil 15 ml
Vitamin A 25,000 IU
Vinpocetine 10 mg (must be taken with food)

These all help counter brain inflammation (and intestinal inflammation), and my theory is that these will work very well if your anxiety is underpinned by brain inflammation.

Each individual supplement will only reduce anxiety levels by around say 20%, and this is why you need to take several together to get a 100% remission from the anxiety.

I find on some days even the above set of anti-anxiety supplements is not enough to quash my anxiety, so then I have to add some additional supplements, just on those bad days, such as:

Arginine pyroglutamate 5 grams
High dose inositol powder 15 grams daily
Taurine 4 grams
Transdermal magnesium cream applied to skin once or twice daily (how to make your own magnesium cream is described here)


As I mentioned, the full set of supplements that I found had noticeable anti-anxiety effects for me are listed here.

 

[alice111]

@Hip thank you so much!!

I have actually been going through your list and trying as many things as possible.. ive been quite desperate so trying as many as I can.
unfortunately so far none of it has really helped.. I am now taking the NAG, the falxseed oil, and the turmeric.
I have found magnesium baths to be helpful-ish so im going to get some magnesium cream to try next!
I would ideally like to avoid going on another anti depressant, im already on cipralex... but i will do that if it comes to it.
I noticed that you have a post on amisulpride, do you still take this along with your supplement mix?
thanks so much for your help!

 

[alice111]

I also have a feeling that the anxiety I get is hormone related.. but I dont know if that makes a difference in the treatement.

The frusrating thing is that it's as if my energy and anxiety are linked - so every time my energy is good my anxiety/wiredness is out of control.. then the only time I get a reprieve from the anxiety im totally exhausted and wiped.
anyone have advice for this?

 

[Hip]

@Hip thank you so much!!

I have actually been going through your list and trying as many things as possible.. ive been quite desperate so trying as many as I can.
unfortunately so far none of it has really helped.. I am now taking the NAG, the falxseed oil, and the turmeric.
I have found magnesium baths to be helpful-ish so im going to get some magnesium cream to try next!
I would ideally like to avoid going on another anti depressant, im already on cipralex... but i will do that if it comes to it.
I noticed that you have a post on amisulpride, do you still take this along with your supplement mix?
thanks so much for your help!

That's good you've found something that helps a bit: the magnesium baths. I take it you are putting some magnesium sulfate (Epsom salts) in the bath. It might an idea to focus on this then, if it works for you.

If you actually apply magnesium cream (which is magnesium chloride in water), or highly concentrated magnesium sulfate solution on your skin (which you can make yourself very cheaply using Epsom salts), this should give you far better results than the baths, because you will absorb much more magnesium.

Obviously in the baths, the magnesium sulfate solution is not very strong, because it gets very diluted in all that bath water. But when you apply a strong solution of magnesium chloride (magnesium cream) or magnesium sulfate to your skin, you have a high concentration of magnesium on the skin, and so the skin absorbs more.

When my anxiety was severe (and before I discovered NAG, flaxseed oil, etc), I used to apply either magnesium cream or highly concentrated magnesium sulfate solution to my body skin, from head to toe, twice a day. This really did help.

The reason you have to apply magnesium to your skin, rather than taking an oral magnesium supplement, is because you cannot absorb that much magnesium orally (as high oral doses cause diarrhea). However, the skin can absorb good amounts without problems.

High dose magnesium works because it prevents the overactivation of the NMDA receptor on neurons in the brain. My theory is that when the NMDA receptor is over-activated, it can lead to anxiety (when the NMDA receptor is over-activated, it can overexcite neurons, which I hypothesize can cause anxiety).

Note: if you are dosing with transdermal magnesium cream / magnesium sulfate twice daily like this, it's a good idea to take a 500 mg oral calcium tablet daily, as magnesium and calcium should ideally be taken in balanced proportions.



Another supplement that helps prevent NMDA overactivation is progesterone, which you say you have already tried, and it did not help you. I wonder what dose of progesterone you used. When I use transdermal progesterone cream, I take a dose of 10 mg of progesterone (the cream I have has 17 mg of progesterone per gram, so 10 mg of progesterone works out to around 600 mg of cream). I have one those cheap digital scales that weights down to 1 mg, so I am able to weigh out my cream quite accurately.

I find 10 mg of progesterone does have a useful anti-anxiety effect, but it is not as powerful as taking transdermal magnesium cream twice daily.



Another thing that I found works quite well to reduce my anxiety was any anti-inflammatory that lowers COX-2 inflammation. Bee propolis is a pretty potent inhibitor of COX-2, and I found 4000 mg daily of propolis helpful for anxiety. This is best taken in the morning, because propolis can keep you awake if taken in the evening. Curcumin 1000 mg is another good inhibitor of COX-2 that I found beneficial. (Aspirin lowers COX-1 inflammation, but this I found did not help me).



Antihistamines like cetirizine (Zyrtec) or loratadine 10 mg daily are worth trying. I found these can have some mild anti-anxiety effects.



Regarding very low dose amisulpride: I found that this was helpful for my anxiety psychosis (when generalized anxiety disorder gets extreme, it can precipitate some psychosis symptoms); and this drug helps with the sound sensitivity of ME/CFS, but for anxiety itself, I found amisulpride less effective than NAG.

I also have a feeling that the anxiety I get is hormone related.. but I dont know if that makes a difference in the treatement.

Do you mean that the anxiety symptoms follow the monthly menstrual cycle?

Hormones such as estrogen, progesterone, cortisol (and thyroid hormone if your levels are abnormal) can affect anxiety levels.

You might want to try the oral hormone supplement pregnenolone 25 to 50 mg daily. I found this can have useful anti-anxiety effects. (Pregnenolone is not to be confused with progesterone, of course).

 

[alice111]

@Hip thank you so much for all your help!!!!
is bee propolis the same as royal jelly? I have some royal jelly at home

 

[Hip]

@Hip thank you so much for all your help!!!!
is bee propolis the same as royal jelly? I have some royal jelly at home

No they are different bee products.

 

[u&iraok]

I was having the continuous anxious/wired problem to the point where I preferred the fatigue. Not sleeping, I longed for hypersleep. What helped me were supplements that help serotonin and gaba:

l-theanine (I particulary like LEF's Natural Stress Relief which has l-theanine and lemon balm)
taurine
5-HTP
Tryptophan

What I like about them, also, is that they seem to have a long-term effect, even after I stopped taking them.

 

[alice111]

@u&iraok thank you!

I was having the continuous anxious/wired problem to the point where I preferred the fatigue.

this is how i feel.. which i hate, because i feel i should be grateful for the improved energy! but man.. the wired feeling is just somehow even worse..
what time of day do you take the supplements you listed?

 

[alice111]

@Hip re the progesterone cream do you take it everyday? what time of day - before bed, or morning?

also, in response to your earlier post

Do you mean that the anxiety symptoms follow the monthly menstrual cycle?

currently NO. the symptoms are just all month at random. but the reason i'm thinking it might be hormone related is its used to be cyclical. The only time I have had this "wired anxiety" symptom throughout the course of my illness has been during "PMS", but now the past few months it has taken a life of its own..so not sure what the cause is...

 

[u&iraok]

@u&iraok thank you!

this is how i feel.. which i hate, because i feel i should be grateful for the improved energy! but man.. the wired feeling is just somehow even worse..
what time of day do you take the supplements you listed?

Isn't it crazy?! But I wouldn't call it 'improved energy' More like 'twisted and sick energy' or 'pseudo-imposter-energy--that-can't-even-begin-to-approximate-proper-energy'.

I took l-theanine any time of the day and the other three in the evening in case they made me sleepy and because I wanted to benefit from the relaxation to help me sleep.

I hope it helps you.