Hi all. It’s me again - the one with the 4 year treatment resistant depression.

What symptoms did you get coming off elavil ? I just really want to be off these meds . I know I will crash badly but I don’t know what to do . Being on them is not helping either .

I did go up to 100 mg of lamictal but that was a month ago . She said having terribly repetitive songs with the ocd in my head is extremely rare for lamictal . It actually got worse as I was coming off the elavil but I remember last year with lamictal having the same problem bunt I believe I was also coming down or decreasing a dose of Paxil . I don’t know . All my life is about anymore are these meds . I simply just hang on . It just is no life .

I do the same with my Dr., I always suggest what I want done and he has finally decided to just go with what I think might work - sometimes I'm right, sometimes not, but he knows it is just a guessing game basically, so he lets me "win".
If a month on Lamictal and it is not working then makes sense to go down/off. It is a shame that you felt a bit better on Elavil, and now worse going off, that you couldn't have make that one work for you over time--but I suppose not.
So what, exactly, is your Dr. recommending now -- just stay on 75 lamictal and .75 klonopin?
I suppose you are asking for Trintellix? Is that the debate?
I know your Dr. is frustrated, because it is hard to not be able to help your patient--but you are the one suffering and thus I think you do have a right to make suggestions at this point.

I didn't have any symptoms coming off Elavil because I transitioned to something else (I can't recall what it was). I never just stop something w/o transitioning to something else. Yes, meds are the focus of a life with non-responsive depression, because they seem to be the only hope - so you can't think about anything else. You are close to doing what you wanted to do -- stop everything but remain on low dose of Klonopin, so maybe that is the thing to try now --keep going off Lamictal and add nothing else - but remain on Klonopin for anxiety. Maybe that will help once you get past this week or so of adjusting to being off Elavil.

She is suggesting going down to 75 although she’s not sure that will help with the repetitive songs . I am definitely having increased anxiety , ocd , sobbing and some suicidal thoughts again . She said I could go to a little in the Klonopin . I think I actually won’t do anything right now and just wait a couple weeks to see if stopping the elavil gets any better

And no, I don’t think I’m going to ask for Trintellix . I just can’t stand anymore med trialing right now . I can feel myself slipping more and more but I’m just done with it all . My stomach has protruded out - looks like I’m 7 months pregnant - that has never happened before and the weight gain from all of these is now 60 lbs .

Did you feel more anxiety on Trintellix ?

That is a huge amount of weight for a woman, I'm sure that is very upsetting.
No, only side effect from Trintellix was sick to my stomach and that never went away.

So I've been thinking about all the blowback about taking benzos. I"ve always been ok with taking them, as they are good when needed. But I took the time to really dig into what is known about them and it is true that they CAN/MAY cause depression in some people. You say you have been on them for all this time, thus it is possible that Klonopin is making your depression linger/worse. I know anxiety is your main issue, but I don't know exactly what the anxiety is from (maybe worried
about being depressed?). I wonder what would happen if you tried to slowly go off Klonopin to see how you would feel? I wonder if you were less depressed you would also be less anxious?
Just a thought.

After I stopped drinking 3 1/2 years ago the anxiety was horrible and it has never gone away . My problem has always been anxiety and then depression . I get where you are coming from but every ad I take makes my anxiety worse . When I try to taper the klonopin even more , I really suffer . I remember about a year into this I asked my first psychiatrist to switch to Ativan because I felt like I was more depressed on Klonopin. I don’t remember that it made a hugh difference but to be honest there have been so many changes that I just don’t even know anymore. Thanks for your thoughts . They are appreciated.

For the last two days I have just been sobbing uncontrollably. The only thing different is going off the elavil . My doctor ALWAYS says the depression is because my depression has never gotten better and it’s not from coming off the meds . I don’t know , I am really bad the last two or three days - worse than normal - whatever normal is . Do you think this extreme crying and sobbing will go away or is it my depression just continuing to get worse . I think my anxiety and depression are just all mixed in together .

Excuse me but I just now found this conversation/question and wanted to say/ask voice an opinion.
Are the songs in your head disturbing because of their repetitive nature or is it the lyrics or subject? Do these particular songs bring back certain (bad or depressing) situations?

The songs are disturbing because of the repetitive nature . They just never ever go away . Sometimes at work they do . It could be any song . Mostly the last one I happen to hear somewhere . It increased with the lamictal but I am also on my 4th day of being off elavil and my anxiety is terrible . I am diagnosed ocd so has my anxiety increases , so do the songs .

Elandem . It just seems like everytime I go up or down on these meds , the symptoms I already deal with her worse . And it seems to happen while I am titrating up or down and when I get off . The anxiety is worse, the ruminating is worse , the ocd is worse , the depression I think gets worse as a result of the other two . I’d it happens that quickly wouldn’t it make more sense that it is med related to a certain degree . I agree , I need to get my anxiety under control . But how ? Nothing seems to work for that except the benzos . That’s why drinking worked . Only thing that leveled me off . When I stopped that’s what was so horrible , the anxiety - the depression followed . Trintellix is slightly different although I know it works in seratonin anyway .

So when it comes right down to it , the only thing that helps are the benzos . Or maybe the antipsychotics, which is why I was in them in the first place - to help with anxiety and ruminating. But I gained so much weight from them and had other side effects as well .

Yes, it's clear that going up or down on meds creates problems. If benzos are the only thing that helps then perhaps you are right that trying to take just that for a while might help? As you say, can't hurt. I agree with staying off antipsychotics unless absolutely necessary... their side effects are far worse than those of benzos (IMHO).

Doctor won’t agree to just a benzo . Hard to find another that will . Thinking about Zoloft as it is about the only one I haven’t tried . Or celexa . Also had a little luck on Effexcor but thinking about maybe Pristiq . Is that similar to Effexor ?

Zoloft is worth trying.
Celexa is just lexapro (remarketing) - not worth trying if lexapro didn't work.
Pristiq is same class as Effexor, but I think a bit less nor-epi.

Of those three, Zoloft is the most different (tho just slightly), as it may work a little bit on dopamine.

If you are going to something different why not Trintellix, as someone suggested?

I tried Zoloft years ago during my first depression and it was horribly stimulating and my anxiety was off the charts - but really they all make me like that . I guess I was thing Pristiq because the one the the very few ones I had a slight improvement with was Effexcor at 112.5 but as soon as they raised it to 150 - bad news . Pristiq , I read seems to help anxiety a little more , or so they say . That brings me to Trintellix . I guess I’m just hesitant because it doesn’t do much for anxiety, my doctor even said that and I am so afraid of being even more anxious . Coming off this elavil has made the anxiety really bad again , thus the sobbing and also thing it’s making the repetitive songs in my head worse . Anxiety worse = ocd and ruminating worse . Ruminating has been terrible as I’m sure you can tell by the numerous postings . I feel like I am always talking about me - how have you been ?

Worth trying Pristiq I would think.
If you were doing well on Effexor at a lower dose, worth going back on that and staying low. I've found I do well on 75 mg effexor.
I'm doing just barely ok--really up and down. I'm trying to cut out benzos and see if that helps, but winter is typically bad for me so we will see.
I know you tried clomipramine, but it is the classic for OCD and you can get benefit from just low doses of 25 mg -- no need to ramp up on that.

Well , I wouldn’t say I was doing well but it gave me a tiny bit of relief at 112.5 for a couple days until it was raised . I know I’m researching a lot again, but Pristiq people say it is horrific to withdrawal from . Also say it is essential to take the name brand as the genetics are horrible . I don’t know . Good luck with the benzos . At the low dose I am on , I tried to cut the .25 in the morning in half and that didn’t go so well . Also I have never said this but when I was on Prozac both times in the past I could only take name brand . Tried generic several times and it was a nightmare .

All these drugs I have been on the last 4 years have all been generics . Do you think that could be the problem ? Does Zoloft even come in name brand or Effexcor ? I know or think Pristiq still does . The anafranil, even at a low dose was horrible . I stopped that after one day because I was out of my mind . That and Cymbalta were the only ones I didn’t go the full 4 weeks on .

People say everything is horrific to w/d from... the only one that really seems to be very bad for many people is Paxil, the w/d from all the rest is very similar. It mainly has to do with their 1/2 life, but as long as you do it correctly the w/d is the same. As I also say, transition from one to another and there is generally no w/d to worry about. I've always done ok with generics, but there can be some subtle differences in absorption rates, etc., but the basic medication is the same. You will not likely get anybody to give you a non-generic these days I'm guessing.
I do agree that even a slight dose change in benzos is noticeable!
Effexor has a better success rate than Pristiq, and since you once had some success there I would go for that over Pristiq and just keep the dose low.

Have tried the Effexcor twice now - first time with a tiny improvement , second time - nothing . I have been off the elavil now for about a week or maybe 10 days or so and it has been rough . Now on 100 lamictal and the Klonopin . Think I will just stay here for a while , regardless of what doctor says . I just can’t do this again right now . I mean , if my depression gets even worse , it can’t be any worse than what I have been through going up and down on all these meds . I really really really want off them all . Wish I could .

Last time I went off lamictal was horrible - but I think I was on Paxil at that same time and maybe going off that too . I don’t know but I was immediately put on Prozac again , which made my anxiety really bad . That was a year ago and ended up with me taking yet another leave of absence from work . I now have no time for FMLA left .

Yes, I think staying where you are for a bit is a good plan, no need to adjust things right now really. Though eventually you may need to either go off lamictal or add another med to augment. Lamictal is rarely used alone for unipolar.

Well now I am being given Trileptal and taken off lamictal . She said in some rare cases lamictal can increase repetitive songs in your head . Also wants to switch Klonopin to Valium . I am just done . I’m so scared of trying something else . I just don’t know what to do anymore .

Well, the switch to Valium should be easy -- it is really no different from Klonopin other than a much longer 1/2 life so you keep a more constant blood level with no "dips" between doses. Though you might need to increase your dose slightly, I don't think .5 Klonopin = .5 Valium--but do whatever your Dr. suggests. I've never heard of that other med, but seems the same class as lamictal (mood stabilizer used for bipolar). How would you feel if you could get the songs under control, is your mood any better in general?

I think getting the songs out of my head would help . My mood is the same . I’m so scared Elandem . I’m so tired off all of this . I really don’t know how many more meds I can take . It is truly wearing me down . Life just seems so very empty .

Elandem With this depression, is it a totally unreasonable thing to just ask to be on a benzo for a while? Will that make the depression worse? I’m just so tired.

sorry but many of my messages are not going thru. I think that is a reasonable request, as the meds
only seem to make you worse, not better -- I don't see any reason not to take a "medication holiday" for at least a while. If you get worse your Dr. can always then start you on something else.

I took one dose of the new stuff . Just can’t do this . Am also tapering down on the lamictal . I am a mess . Bad anxiety . Still on the Klonopin . Called doctor and she said she does not agree and will make note that it is ama . I just don’t know what to do anymore . I know I will probably get worse but I can’t take this anymore.

Also if I am taking just a benzo would Klonopin be worse in depression or Valium ? Sorry I just feel lost and scared because she said this is ama .

I'm so sorry you are struggling so badly (still). As for stopping everything but a benzo, it may be best to take the valium I suppose because it has a longer 1/2 life and you can keep a constant blood level easier--but basically they are all the same in how well they work. I would be sure to make certain the dose is equal to what you have been used to for the past few months on Klonopin (if you switch). The ONLY benzo that is perhaps a bit different is Xanax (and that's debatable). As for her noting ama -- she has to do that to cover herself as clearly this is not what she would suggest. I'm sure both she and you are at your wits end and just don't know where to turn at this point. I don't know what to expect tapering off lamictal, as I have no experience with that med, but I would go slow.

She is tapering me off the lamictal in eight days . She always tapers me off things fast . What do you think of Doxepin? God I am so desperate. And coming off the lamictal is making everything so much worse - if that is possible and it’s only proving that she is right . I feel caught in a loop I can’t get out of.

Well, might as well get off of it quickly I suppose, since you are already about as low as you can go. As for Doxepin, I couldn't take it -- made me really anxious. That said, it was during a time when I was taking one thing after the other and in a really anxious bad place in general. But it is much more norepi than serotonin -- so it is one that will perhaps increase anxiety (which it did with me). The side effect profile says it can make you sleepy, but it sure didn't do that for me. I think I only was able to try it for 3 weeks then had to stop. If you are looking for another med to try, why not Trimipramine? I did well on it for a few months -- it is a VERY different TCA--not really like any of the others at all, and is good for anxiety.

Thanks friend . Man I long for a normal
life .

Does it help anxiety ? I can’t find much about it . When I google it mostly brings up stuff for imipramine. Are they the same ?

just sent long reply about this drug -- seems it will not go thru (says pending, and I have no idea why). I'll try again later if it doesn't make it -- but no it is not imipramine -- completely different.

type Trimipramine and look at the wiki page on it

Well , as I said I am not taking the Trileptal and I am coming off the lamictal . I have been horrible . Had to call off work tonight . Sob multiple times a day and keep telling my husband all
Night long every night that I don’t want to be here anymore . I just can’t fight this anymore with no relief . Maybe after I’m off the lamictal I will feel better, but I doubt it . Increased my Klonopin on my own this morning . Now taking .5 at 10:00 am and .5 at 11:00 pm . If anything it just made me more down . I just don’t care anymore. Whatever happened to me ?

According to my Genomind testing, trimipramine says to use with extreme caution ... great. Did it seem to help with your anxiety and did you have many side effects from it?

Did the trimipramine help with your anxiety and did you have any side effects ?

Yes, trimipramine helped with anxiety and sleep. I don't recall any side effects whatsoever. Again, it is a TCA but it is completely different from all the rest.

Yes, trimipramine helped with anxiety and sleep - no side effects.

Did it help with depression ?

just answered re: anx, side effects.
Ignore the gene results! You just start slow and see what happens, the worst thing that could happen is you need a lower or higher dose -- period, and that applies to everything anyway!

But did it help with depression as well ?

Yes, depression is my main issue now -- anxiety is secondary. In order for something to help my anxiety is MUST help my depression.

I think these drugs are totally frying my brain ... so you are saying the trimipramine helped your depression and anxiety . Did you gain any weight or have any trouble going off ? Did it help
As much as the Lexapro ?

You mentioned about Zoloft . Have you ever tried that ? I mentioned it to my doctor and she now refuses to give me anything serotonergic . Says Trintellix will make my agitation worse and Pristiq also works on serotonin . I tried Zoloft years ago and remember stopping it because of extreme anxiety after two days . But from what I read a lot of people have a lot of trouble with increased anxiety for a while . That has been my experience with all the ssris .

Trimipramine did not cause me any weight gain, but nothing ever has except Mirtazapine - and that was minor and needed.
I never have trouble coming off these meds because I always transition to a new med--that totally eliminates any "withdrawal".
No, it was not as effective as Lexapro (nothing ever has been), and again, my gene profile said Lexapro was BAD for me - which was 100% incorrect.
Zoloft was the first med I was given, and I couldn't take it due to diarrhea that would not subside, but if it were not for that it was a good med for me for a month, but I had to stop it. Then I started Lexapro, which worked well then too--easy transition. Zoloft is more "activating", which may increase anxiety for some.
Why did your Dr. say no more serotonergic meds for you??? Because they don't seem to work, or because you seem to have increased anxiety?? If you eliminate serotonergic meds that pretty much eliminates all but a few augmentation meds -- or Spravato, ECT, or TMS.

They don’t work and they cause more anxiety . I have read a lot of people saying that a lot of meds increase anxiety for them for awhile then it stops . It never stops for me . And yes she did say that about seritonergic drugs . I think that’s why she switched to the mood stabilizers . I have a call with her in half an hour and I’m really scared .

Please, if you get this before the call... ask about thyroid meds -- they are as effective as mood stabilizers in TRD patients (even in those W/O low thyroid function). If you can't do serotonin,
and of course you don't manage norepi well, then I'm pretty sure MAOI's would be out of the question, cos ultimately they work on all systems (in theory). Also, trimipramine does not work
on serotonin, or norepi. I honestly think that one would be well worth trying.

Sorry, I didn’t get it before the call. It was not a good call. I was frustrated with her and vise versa. I am tapering off
the Lamictal and having a horrible time. I started in the Valium tonight. 10mg at night and 5 mg in the morning. She again emphasized that this was not a good monotherapy. Also stressed again how she is very frustrated because I keep suggesting meds then complain when I have trouble with them, then suggest another med in the same area. I explained to her my level of frustration. I guess we will revisit in a couple weeks. I just hope the continued taper of the Lamictal and now the Valium don’t make my depression worse. She has never mentioned thyroid meds. Do you take them alone as a mono therapy? I read a lot about nortriptyline tonight. I did fairly well on a TCA so thought I would mention that, but now I’m afraid to mention anything. The one you mentioned didn’t even have any reviews on Drugs.com. Doesn’t mean I shouldn’t try it? All I know is life just keeps getting unbearable.

Didn’t get it before call . Call didn’t go well . I think we are both very frustrated with each other . Still titrating off lamictal and it has been hell. Started on Valium . 10 mg at night and 5 in the morning .

She stressed again that this was not a mono therapy she supports in any way . I didn’t mention anything else to her as she was quite short with me and don’t think she would have taken too well to more suggestions .

Would thyroid meds be used alone ? I was reading tonight about noritryptoline and it said it was used for depression and anxiety . I responded somewhat to the elavil so maybe that one would work for me .

It's too bad she is upset, tho I understand it, she is the professional and should not show frustration when someone is suffering so badly. But, she is only human.
Thyroid supplementation is the one augmentation (add on) that is equal in response to Lithium and Lamictal. It has been used for years, and seems to work very well for people who have low thyroid, but can even work for people with normal thyroid function. I think you could also take it without anything else, that's just not as typical. She should be receptive to that - a very reasonable request.

Nortriptyline is very similar to Elavil -- not much different at all. I did well on it for a few months, no side effects, helpful for anxiety/depression - no weight gain. I doubt she will want you to try that since Elavil was a failure in the end, and since they are so similar. The only TCA that is different and would be a reasonable request seems (to me) to be Trimipramine. All the others are not likely to be successful given your history. I understand her not supporting monotherapy with a benzo, but I do understand your desire to give it a try.

I don't really support your use of online reviews/reading in order to try and make a reasonable decision about what to take--not being critical, but it just isn't helpful, in fact it is likely harmful. Nothing you read online about how other people respond is likely to predict how you will do on any given med - the mantra "we are all different" is a mantra for a good reason :-) Fine to read them, but you don't seem to put them in their proper perspective... Again, I'm very sorry you are suffering so badly, I hope it eases up soon!

Hi Elandem. I am struggling so very badly . Today is my last day on 25 mg of lamictal and then I am off . I called off work all this past week . Terrible sobbing , suicidal thoughts and anxiety is just horrible . The Valium is at 2.5 in morning and 10 at night . I actually feel more anxiety even when taking the Valium . I can increase to 15 mg if needed . Is that a high dose . I am so lost . Sorry.

I'm so sorry. No, you are on extremely low doses of valium. You should not feel bad about taking what makes you comfortable right now. You need to get your anxiety under control (period) during this transition off Lamictal! So, just take the upper limit of what you are told to take and don't worry about it at all--you can get off it when you get your anxiety under control--the anxiety is what is making your depression worse, I think you must manage that. So, just take the valium and have NO worries about that. Please don't do anything "rash"... suicidal thoughts are one thing, but don't make a plan or even think about doing something final--- you WILL eventually be better, I honestly have full faith in that -- I'm just sorry it is taking so so very long. You may feel better after being off lamictal for a week or so and just on valium... give that a try... and to do so you need to take whatever valium you need.

.5 Klonopin = 10 Valium = 1 lorazepam

10 of Valium is the lowest dose you can take
15 is equal to .75 Klonopin, which is considered a small dose!

Would even being at 20 mg not be so bad ?

What do I do if even higher doses won’t help this anxiety ? Is that where antipsychotics come in ? I have been on 4 of them with something else but I can’t stop the constant songs and now suicidal constant thoughts in my head . If they would just stop, it would help . ECT doesn’t help for anxiety or TMS so I just don’t know is what to do .

I know you are not a doctor but I trust your opinion and I am not on good terms with mine right now and can’t find another one at the moment. I almost feel like the Valium is making my anxiety worse or maybe it’s just there isn’t enough coverage with being off the elavil and now lamictal .

You can trust me because I would never overstep what I know. I've worked in the Department of Psychiatry for over 25 years, my husband is a clinical psychologist, I'm a health psychologist, and most of all--I've been using and researching these meds for over 15 years. BUT as always, I totally defer to your Dr. But right now you need a trusted support person, that's all I'm trying to be. No, 20 mg of Valium is not a lot - especially for someone like you (or me) because we have been on these drugs for a while and we can tolerate (and may require) a larger dose. I have read that going from one benzo to another can create more anxiety for a while, so it may be the transition from Klonopin to Valium that is part of the issue? But there are so many possibilities, going off Elavil, going off Lamictal, etc... any and all of those can create anxiety so it is hard to say. But if you take a dose of Valium and w/in an hour or so feel more (not less) anxious, that is not a good sign.

I strongly dislike antipsychotics for depression or anxiety unless 100% necessary because of all the awful health side effects (weight, metabolic changes, movement disorders). That said, if they have worked for you in the past then a short course of an antipsychotic might help shut down the obsessive thinking? I know your Dr. doesn't support monotherapy with Valium, so what is she suggesting you try next?
It is hard for me (at this distance) to really understand what is your primary diagnosis, OCD, MDD, GAD, etc. They all go hand and hand, but you are right that the treatment for OCD and GAD are different than some of the treatments for MDD. ECT can help anxiety, but is more indicated for MDD. For me, if I get my depression under control my anxiety goes away, as well as my OCD tendencies. But you may be different.

Just got a call back from my dr’s office . They will not raise the Valium and she stated through her nurse that going off lamictal has absolutely nothing to do with the increase in my anxiety . I am sitting in my car in the parking lot at work trying to make myself go in . The level of anxiety is so bad I almost feel psychotic . I truly don’t know how I am going to get through this shift .

Slow deep breathing will not fix anything, but it honestly will slow your heart rate and that will help a bit. The worst that can happen is you go in and then have to leave. I don't know if going off lamictal is making the anxiety worse, but I just think all the many many changes add up and then make it hard to say what's what. My guess is your anxiety is so bad partly because you can't get the depression under control, you are afraid of not getting better and that creates loads of anxiety. I'm not surprised she will not increase the dose of the valium, since she doesn't support taking it right now. You might try adding just a small dose of Klonopin back in to see if that helps? Some people cross taper benzos when switching, so you can certainly take your Valium and add just .25 or .5 of Klonopin to see if it works. But ultimately your Dr. is right, you need to control the anxiety with something other than a benzo - but when in crisis mode you do what gets you thru.
WCVet has luck with buspar -- never worked for me, but does for some?

The doctor has mentioned buspar to me . Tried it 30 years ago ... did nothing . Made it through my shift but I am merely existing in life . What are your thoughts on pregabalin ? I’m just a mess . My repetitive songs are beyond constant . And my ruminating is just getting worse and worse .

I didn’t realize you took pregabalin. I thought you took gabapentin. I willing to try anything but I am just so scared anymore . Also the Valium doesn’t really seem to help my anxiety as much . Not that Klonopin was great but I think it was better . I didn’t know you had ocd as a diagnosis . I went out to my house today to get a tree and decorate house for Christmas , mainly for my parents . I haven’t lived there since this depression started four years ago . I have lived at our motel business . The whole day was miserable. Again, highly anxious and irritated and just felt absolutely nothing . Simply existing and holding on . Happy Thanksgiving. I have been beyond thankful for all your support through this .

And what are your thoughts on Seroquel for anxiety, ocd and depression ? I also read that pregabalin Had unbelievable rating a for anxiety but that you build up a tolerance very quickly and that it can sometimes makes anxiety and depression worse and that it is hell to come off of , making the symptoms of anxiety ten times worse than before taking . Any truth to that ?

BTW, you help me too :-) Very nice to have someone so similar in so many ways, and who can understand.

No truth to being hard to come off pregabalin as long as you go slow. It can make anx/dep worse, but the pretty much goes for ALL of these meds. But as I mentioned, if you didn't like gabapentin you likely would not do well on pregabalin -- they are highly similar, just metabolized a bit differently - but the mechanism re how they work is the same.
As for Seroquel - as I always say, I stay away from the antipsychotics - and since you said you gained so much weight on one before, the same would apply to this one -- and it is not likely to work any better than the others. If you have been on gabapentin and other atypical antipsychotics your Dr. is not likely to give you pregabalin or Seroquel because of the very low likelihood they would work.

Some would argue that Trintellix is a bit different than anything you have tried, and of course Spravato is completely different.
Unfortunately all of the serotonergic, noradrnergic, and dopaminergic drugs just don't seem to be effective for you, or you can't tolerate the side effects. So that rules out most all psych meds apart from augmentation meds, and you have tried all but thyroid augmentation (which I still say is worth trying).

I know I’m not a doctor but I do know me . I really feel strongly my problems are
more rooted in the gaba- glutamate inbalance . But I don’t really know what that means as far as treatment . I probably asked you this before but I seem to be having trouble with the Valium . It’s like it hits me hard but then really backs off after about 3 hours and my anxiety gets even worse and I feel more agitated. Somehow the Klonopin seemed to be a little smoother all throughout the day . Does this make sense ? I’ve been on so much - I just don’t even know anymore and if I ask her to change me back to Klonopin already she’ll probably flip a lid. . Does it seem logical to switch back already . I just don’t feel like I’m getting hardly any coverage for the anxiety .

In theory Valium should act like you are describing how Klonopin acts - but these drugs act differently on each person, so bottom line is, you feel how you feel -- period. So, if Klonopin was a better drug for you then I would just say so - especially if you have given it a week or so to adjust to the change. She should not really care which drug you are on as long as the dose is not higher for one or the other, i.e., go back to your original dose of Klonopin (which is a low dose anyway). Then maybe on just klonopin for a while - with nothing else, you will feel better. Keep in mind it will likely take a month or more to know your "baseline" given the numerous changes you have made and such. Do you mind me asking why you live at the motel? No worries if you don't want to say.

She has said it is ok to go back to the Klonopin but again said all this increased anxiety is not from switching to Valium
Or going off lamictal and stresses that a benzo on its own is not going to work . My question ... I am going to dose three times a day now with the Klonopin and she didn’t really advise on when the second dose should be taken . I take one at 10:00 am and one at 11:00 pm . Not sure when to take the second one .

I am praying so much that just being on the Klonopin won’t worsen my depression . It kindof did before . I don’t think I can bare anymore . I am filled with so much panic, fear and anxiety the last couple weeks . Worse than normal . Can’t eat and just feel paralyzed in my brain .

If you are taking 10:00 am/ 11:00 pm, then you should take the middle dose at ~ 4:30 in order to best keep a steady blood level (which is the goal).
I would also suggest taking the same amount at each time.
No way to say if switching or stopping is creating your heightened anxiety - but I can't help but think it does matter somewhat (if nothing more than the "placebo" effect of you being concerned that it matters :-)
I hesitate to mention this, but given the length of time you have been on benzos it is possible (NOT certain tho) that you are building a tolerance which is why none of them are working as well.
Pls don't freak about that, but you do need to consider all realistic possibilities about what might be going on.

She told me to take .25 in morning , .25 in afternoon and .50 at night . Guess I never thought about the tolerance thing . I’m just so anxious , yet so depressed . And exhausted, as everything I do takes everything I have to do .

I keep having this pipe dream that just being on this will make everything in my life go back to normal , but I know I’m my heart that’s not true . Life is hard but it shouldn’t be unbearable every minute of the day .

Well she advised me to dose that way so , what do I know . I guess it would be pretty dangerous to increase dose , which I doubt she would do anyway . When you say come off do you mean come off of everything ? I don’t think I will ever be able to get off benzos at this point . Coming off alcohol was horrific and I know benzos are the same . I read so much about people being on benzos their whole life and function fine , but I guess they didn’t have depression as well .

I would take them as your Dr. suggests, as she knows you better than I do for sure. Yes, I doubt she would increase the dose and I honestly would not push for that either right now. I think you need to see how you feel in a week or two of being off everything (except benzos). You can stay on them "forever", and you may be someone who does not build up tolerance and if so there is likely no harm in doing so. I don't think we really know if benzos are bad for depression, as it varies so much person-to-person. Some people like WCVet would argue long term use is harmful, regardless, and some would argue the opposite... My motto is always you do what you have to do to get thru this awful illness and unfortunately it takes LOTS of time to figure out what that is.

All I know right now is that I just continue to feel Worse and I didn’t think that was possible . Just dread everyday . Today the depression just feels unbearable whereas yesterday the panic and anxiety was horrible . Took Valium last night and back to Klonopin this morning . My goodness , what has my life become .

I know you think your Dr. is upset with you, but she really needs to hear and understand the extent of your suffering. 4 years is a long time to have no relief. Don't beat yourself up for taking meds, you have no choice right now. Hang in there, bev

She does know the extent of my suffering which is why she says I cannot just take a benzo but I just feel so trapped at this point . Nothing has worked so far and I have just given up on trying more things as the whole process has just taken so much out of me . It really isn’t her fault . She has tried and I just keep bucking her with refusing to take some things at this point that she suggests . So at this point, I think it’s all my fault . I’ve just kind of given up . I’m just not that strong anymore .

Well, I don't think it is anybody's fault, it is hard to make yourself to try things that frighten you, and she has a limited number of options unfortunately. From what you have told me you have tried almost everything she suggests, right? What have you refused? I know you sometimes have not stayed on things for long enough (possibly), but I now how hard that is and my take on it is if it makes you feel worse after a couple of weeks it will not likely make you feel better (ever). Is there anything she has suggested you have not tried?

She wanted to replace the lamictal with that other mood stabilizer, Trileptal I think , but I just couldn’t bare to take anything else . That’s when we went to Valium only as I think I still have some lamictal
In my system . I probably already asked you this but this morning I switched back to the Klonopin. When I got out of bed around 2 I felt so despondent and totally zombie like - like I didn’t even know where I was . I took my second dose at 4 and now I feel panicked and anxious again. What is going on ? She said going back to Klonopin from Valium should be seamless but that even going back on Klonopin I would not get relief from the anxiety and ruminating. I’m sure as you can tell , the ruminating is horrible . I feel horrible anxiety and panic and then feel totally despondent and not know where I am all at the same time . Any thoughts ?

I kind of want to mention Zoloft but I know she will not agree because I have failed almost all the other ssris and I didn’t do well on Zoloft years ago . I know it made my anxiety horrible, as they all have and years ago, I stopped it after only a couple days .

I'm not sure the transition from Valium to Klonopin is really the problem. But I think you just can't sort out what is going on till you manage to stay on just one thing for at least a week or two with no additional changes. You could feel that way due to coming off Lamictal, and/or building tolerance to the benzos, and/or still having residual effects from the Elavil (even though it was a few weeks ago). The body/brain just doesn't change as quickly as you are making medication changes and I think it can't keep up -- perhaps creating feelings of all kinds that you can't really understand or predict. If it were me I would not suggest zoloft, it isn't logical since it didn't work before and likely to only make your anxiety worse. Again, if anything makes some sense it would be Trintellix or Thyroid augmentation IMHO, or maybe the med your Dr. suggested, tho I know nothing about it. Sorry you are struggling so badly.

What would the thyroid be augmenting - the benzo ? Also , she has said she is hesitant about the Trintellix because of it causing anxiety and agitation . As I recall since you struggle with anxiety as well, that didn’t happen with you on Trintellix . But I know , we are all different . I keep thinking about Pristiq , only because I had a glimmer on Effexcor . I’m sorry I keep bothering you . When I say I am consumed it is beyond an understatement. I know it is rumination but it is also just complete despair in wanting to find something to just tread water . This is all my life is - it is all my brain thinks about , no matter how hard I try to shift gears . Feel free at anytime to just stop communicating- I would totally understand that . I want to get away from me too .

Well, they call it "augmentation", but it is really works as a monotherapy - does not need to be added to anything, tho it can be.
--- "Interest in treating major depression with thyroid hormone initially arose in part because of overlap in the symptoms of major depression and hypothyroidism, including dysphoria, psychomotor retardation, cognitive impairment, fatigue, and weakness. Although diminished thyroid function is present in some cases of major depression, adjunctive T3 may be effective for depressed patients who are euthyroid."
And you said you were somewhat low thyroid I thought. And you seem to have all the above symptoms to some degree.
Nope, Trintellix did not cause me any anxiety... none at all.
I understand treading water, and I'm just trying to keep you from going under -- it is not a problem and you are not bothering me.

Thyroid medication is generally given to TRDep patients, so it is called an augmentation med because most all TRD patients are already on something. But it likely works as monotherapy -- doesn't actually augment anything (other than perhaps an improperly functioning thyroid).
You are not a bother, I'm trying to keep you from going under while you are treading water...
Trintellix did not cause me any anxiety at all, only nausea.

I do ok with what is happening to me but the last two days I feel absolutely catatonic . I am sitting up but there is nothing in my brain at all and I feel like I am unable to do anything but sit on the chair and stare into space . This has happened before but never to this level . I just feel completely and totally absent from life .

Well, that is an odd feeling for sure. I think you are likely so burnt out from such a high level of stress that may be your body/brain just trying to "check out" to cope? That said, I would probably mention this to your Dr. as it is a "new" symptom of sorts. You are not on a high enough level of benzo to create that sort of feeling, so I'm not sure what it is about -- perhaps coming off Lamictal?
"Some of the withdrawal symptoms of Lamictal may include: mood swings, anxiety and irritability, which may feel very similar to the symptoms of bipolar disorder. headaches. dizziness"

Me again . I am now waking up with terrible panic and anxiety , which isn’t unusual but much worse . All of my anxiety stuff , like the panic feelings the sob , the terrible ruminating etc are really really bad again . This is how I know my dominant issue is anxiety . Would taking .5 mg of Klonopin be a really high dose ? I know she probably won’t go for that but what else is there to prescribe for anxiety ? Thyroid would just help with depression right ?

No, .5 of Klonopin is actually the lowest dose you can take. My Dr. laughs when I even suggest that taking .5 twice a day feels like a lot.
So, you should take .5 now, given how you are feeling and it should kick in w/in 1 hour or so. Then perhaps let you Dr. know how bad you feel right now.
Yes, anxiety is clearly your main problem--it creates the depression. I DK if thyroid augmentation would help with anxiety, but I sort of doubt your Dr. will give you that anyway (I think you said before she didn't think it was right for you.

FYI I've been on .5 Klonopin 3 times per day a while back when I was having lots of anxiety issues.
Maybe time for you to try Buspar, in addition to Klonopin -- it might be something your Dr. would approve of too? It takes about 2 weeks to kick in for anxiety, but some have good results with it. Or, as you mentioned Pregabalin? I just don't think your Dr. is going to approve upping your Klonopin to the amount you need to control your anxiety.

No actually I meant taking .5 3 times a day . It is already at .25 in am .25 in afternoon and .5 in evening . It was raised to this on Saturday but Instill don’t feel like it’s doing much .

Oh, well as I mentioned I've taken 0.5mg 3 times per day in the past and it isn't a high dose.
So, here is what is stated here on Drugs.com for panic disorder (as you can see 1mg is recommended, but 1.5mg isn't in the range of high):
The recommended dose of 1mg/day is based on the results from a fixed dose study in which the optimal effect was seen at 1mg/day. Higher doses of 2, 3 and 4mg/day in that study were less effective than the 1 mg/day dose and were associated with more adverse effects. Nevertheless, it is possible that some individual patients may benefit from doses of up to a maximum dose of 4mg/day, and in those instances, the dose may be increased in increments of 0.125mg to 0.25mg twice every 3 days until panic disorder is controlled or until side effects make further increases undesired. To reduce the inconvenience of somnolence, administration of one dose at bedtime may be desirable.

Elandem - do you have an explanation for why in the last couple days I just feel
Completely not present . I have gone through this whole day and feel like I wasn’t even close to being present in it . Like I will just stare at paperwork for hours . Just sit there and stare . I have been disengaged and apart from the present this whole four years , but this is a whole different level . Could this be from just being on the Klonopin ? I’m scared . I feel like I’m just going through the motions but not really even aware of what I’m doing .

Below is a list of Lamictal w/d symptoms - I think the "Loss of Focus" somewhat applies to what you are describing...
Lamictal Withdrawal Symptoms
Moodiness.
Hostility.
Loss of focus.
Lethargy.
Headaches.
Body tingling and other such sensory effects.
Suicidal tendencies.

Perhaps it is an interaction of 1) going off lamictal, 2) changing benzos, 3) changing dose of benzos,
4) you being utterly exhausted mentally at this point.
I would do your best to get a good nights rest and see how you feel tomorrow, if not at least a tiny bit better then certainly you should speak with your Dr.

I am like an outside observer looking at my life the last couple me days . I feel totally removed - like a robot . My psychologist thinks it’s depersonalization and disassociated . I saw that lamictal
Is prescribed with an antidepressant to help this . Wonder if coming off it has created it . Are you familiar with this ? My psychologist says she has never worked with anyone with this and I need to talk to the psychiatrist as only meds will help . I think I’m in a lot of trouble . I look around like I’m in a dream . I kept looking at two things of paperwork today - just staring at them and couldn’t accomplish getting them done .

I hope by now you are feeling somewhat better -- more connected? I've never heard of medications causing this sort of thing, but you have been thru so many changes it is really impossible to say what is going on. I would try to just let a few more days pass, if your anxiety is not too high, and then see if this passes. Again, I think this is overload from all the prolonged stress, and changing of meds so many many times over the past few months. Psychiatrists seem to think it only takes a few days/weeks for withdrawal symptoms to pass, but the data show they are very wrong about that. They also tend to take people off of things to quickly, which may be what has happened to you. But I'm just guess at this point.

Thanks for your thoughts and I am not feeling any better . The doctor said today the lamictal is long out of my system and the ocd and anxiety have picked up because the elavil and lamictal are no longer there . She is starting me on sertraline and stressed that she felt certain it would not be able to help completely if at all and that another med would need to be added in the future . I am simply a guinea pig at this point and I no longer care .

Well, at least you said you did want to try zoloft, so hopefully she is wrong and it will help. I couldn't take the diarrhea that often comes with zoloft -- it never went away so I had to stop it. It was the first med I ever tried. I don't recall if it helped because I could only stay on it for 2-3 weeks if I recall. That was when I was switched to Lexapro. Zoloft and Klonopin should be enough to help, and I hope you don't have to add anything else.

How is it going on Zoloft? Good I hope.

Not well . Have only taken 12.5 mg for three days . She raised it to 25 today . I just feel like I am getting worse and worse . The repetitive songs and very bad thoughts are horrible . I called her yesterday to see if we could add seroquel or something just so maybe it could help stop all the turmoil in my head . I don’t want to take an antipsychotic but I don’t know what else to do . Ive tried Abilify before , not great but helped a tiny bit . This Zoloft just feels like they all do - very activating which just makes my anxiety and ruminating worse . From morning til night all I am is consumed by this for four years . I wish one day I could just get up and say ,”Hey, let’s go to the store or out to dinner .” I don’t want to live like this anymore .

Wow . How wonderful that you are lowering your dose of the benzo . Pretty sure at some point I will have to go away to get off those . I have pretty much given up on everything. Dr will not prescribe anything else and raised the Zoloft to 25. Guess I just suffer in the meantime , but like I said - I go around a complete empty shell . There is nothing left of life for me. I couldn’t even describe what life looks like anymore . I really am just done . Thank you for all your support and I wish you an amazing life . You have been A God send to me through all of this . I hope someday you find what makes you completely well my friend .

So I called the doctor in absolute distress today and asked if I could go in abilify . She said no. Told me to keep the Zoloft at 25 and increase Klonopin to 2 mg a day . Please convince me that I shouldn’t be scared to death if this . I need something to get me out of bed - I’m just so confused . She wants me to take a milligram of Klonopin at night . How in the hell is that going to get me out of bed in the morning .?

Well, you should not be afraid of taking 1 mg of Klonopin at night, and not afraid of taking 2 mg per day total. I think it might help your anxiety, which of course would help the racing thoughts, etc. Keep in mind, you can always STOP if it doesn't help. So, don't stress about it. If it were me I'd be more concerned about going back on an antipsychotic than about slightly increasing the dose of Klonopin. I would try it, see if it helps, and go from there... I think your Dr. is just trying to not put you on something else that is not likely to help, that's all. It is actually good she is willing to go up on Klonopin, trying to help. You can go up to 4 mg (tho I know you would rather not).

Actually, the 1 mg klonopin at night will help you get up in the morning if it let's you get a good nights rest and decreases anxiety.

But I really haven’t been having a hard time sleeping and how does something like Klonopin get you out of bed ? I called because my staying in bed has gotten a lot worse . I just stay in bed and get myself to work - that is my life . I have no want to in me at all . I thought that was depression, I don’t know , maybe it is anxiety . Just two weeks ago I was taking .75 mg now it is more than doubled .

Isn’t it dangerous to double a dose in that amount of time ? And what if it is making depression worse . God I am so sick of this ...

Your symptoms are both anxiety and depression, but clearly you have depression and not just anxiety - since anhedonia is not related to anxiety -- and you seem to have extreme anhedonia. If you are curious just google HAMD depression scale, take it, then see how you rank--my bet is very very high. Doesn't really matter which is worse/primary, since you have both and need to treat both.
Doubling the dose to 2 mg isn't dangerous, as the worst that can happen (short term) is you are groggy and feel medicated for a bit. But if it helps your anxiety that will in turn help your depression. But you don't have to take anything you don't want to take, especially if it makes you really uncomfortable.

Just called off work again today . That four times in two weeks . Pretty sure I will lose my job at this rate . Took the 1 mg last night and woke up with panic and have not been able to do anything . Honestly my life is bed and work if I can get there . I’m just completely done .

If you wake up in a panic do you take 1 mg in the morning and then feel better in ~ an hour? If you are not feeling better after taking a 1 mg dose then the klonopin is not working.
By the time you wake in the morning the 1mg at night is likely out of your system, which may be why the early panic.
Of course this is all balanced by your being on 25 mg of Zoloft, but honestly, that is such a low dose and while it may cause a bit of "activation", it should not create that much anxiety.
Is your Dr. planning on increasing Zoloft at some point?

She told me to take .5 in morning , .5 in afternoon and 1 at night . Just doing as I’m told . Quite frankly , I simply feel nothing. Suicidal thoughts won’t stop and psychologist wants me to go to the hospital. I’ve been inpatient three times . All they do is put you on even more meds , do group therapy and color pictures . I’d rather be dead . Called off all this week again . Probably won’t have a job and will ruin all we have tried to work for for our daughter . Just keeps getting better ...

Psychologist thinks the additional Klonopin is making my depression worse . These last couple days have been very bad for me and she thinks it’s the Klonopin increase . I told her I’m not having any more med conversations with the doctor . I don’t know if I agree with her or not . In last month coming off elavil and lamictal and just being on benzo , then adding Zoloft and increasing benzo - who the hell knows. Wish I could go somewhere where they monitor you getting off everything.

Do you think the Klonopin could be making me worse as far as the depression ?

Also ... I have read so many many many horrible benzo withdrawal stories and I do believe there is truth to that . I have been on them everyday for four years . And she just keeps increasing the dose. I am now so very scared . Please help me with my fear of this and if it is best to go to a treatment center for this .

I wrote several msg yesterday, none went thru. Briefly, yes I do think Klonopin could be making
your depression worse, not better. Also, since it obviously doesn't work properly to control your anxiety I'm not sure what good it is doing? RE: treatment centers, I know they are out there but I'm not sure exactly what the treatments are? Finally, Ketamine is the best treatment for suicidal ideations, if you went to the hospital they might try that and it really might help.

Your question about Klonopin use seems to have been deleted. But whatever it was I am 100% certain you are going to hear that long term use of any benzo is contraindicated -- regardless. That said, many Docs still give it to people for the long haul. The thing is, some people develop tolerance and some do not--for those that do not long term use may be ok (esp if clinically it is helpful). However, for many it creates far more problems than it helps - including rebound anxiety and depression.

I feel like through all this the Klonopin has helped somewhat but in the last couple weeks with more than doubling it I don’t know. I feel more anxious, more depressed and more suicidal and in bed more than I was. And calling off work. All this has been in the last month. I have definitely taken a turn for the worse. I know she increased the Klonopin at my request so I only have myself to blame for that. I think part of that was to help with the Zoloft. I’m still only in 25 mg. I know it’s going to be rough but I kind of want to go to 50 now to see if it helps at all

She is not raising the Zoloft dose past 25mg for now. Do you think doubling up on Klonopin in two weeks could cause a worsening of suicidal thoughts?

Yes, that is what I was trying to suggest -- the klonopin may not be helping you at this point, and it may be making you worse. It is impossible to know, but you can try going down on the dose and see if it helps. You sound better today, a bit anyway. Just because you asked her to increase the dose and she did, doesn't mean you have to take it! Of course be honest with her if you don't, but no reason to swallow a pill that you think is making you worse. If you increase a med that is supposed to lower anxiety and yet anxiety gets worse it seems pretty obvious that is it not helpful -- right?

I just don’t know anymore what is causing what. She put the Klonopin back to 1.5. Less during the day , more at night. I simply don’t have a life. Go from my bed to out on a chair around 7pm. That’s it. Zoloft will stay at 25 mg. I have been suicidal badly for a week and yet today she says it sounded like I sounded more linear. Wth ? Guess the next thing is TMS. Wish I could be more hopeful but I don’t see TMS remitting a four year depression. Guess that’s just where I’m at all the time anymore.

Linear??? Never heard that one?
Good you are going back down on klonopin.
I think TMS actually could really help -- it is typically ONLY done on treatment resistant patients - so the fact it has a relatively good success rate (actually a bit higher than all antidepressants) AND is done on TRD patients is encouraging. Plus, in theory it works very differently than medication, so it may work with nothing else has (like with WCVet's sister). They have also made a lot of progress with TMS in the past few years, and given the recent push to not use medication (since recent studies suggest they may be harmful in the long term) TMS is being increasingly refined/used. As soon as COVID is no longer a threat I'm starting TMS. Finally, newer studies show it works on anxiety and NOT just depression.

How have you been doing with coming off the Klonopin? I now want to get off again because I don’t feel like it’s helping me but she wants me to stay at the 1.5 and 25 of Zoloft til the end of the month. I feel so trapped because I know if I come off the Klonopin my anxiety will be terrible and my depression has never gotten better. With the TMS I have read that if it works it only lasts for nine months at the most. And if they don’t do it right it makes anxiety worse. But looks like I will be doing it anyway. What a great attitude, huh? I just want off the Klonopin but have been reading absolute horror stories. They say it’s worse than alcohol and believe me, that was horrible and what started this mess. Does anyone get off Klonopin being on it for four years and not have withdrawals?

Did you taper off the Klonopin on your own and how did you know how to do it? I want to come off but I know my anxiety will be horrible. Are you feeling any better with coming off? As far as the TMS,I read the 9 months on one of the Neurostar TMS sights and the doctor here who actually does it told me he did have to stop treatment in a patient whose anxiety it made worse. What I don’t understand is, they say it is a med alternative yet my doctor says I would be continuing on meds. Anyway, I will try to go in with a somewhat ok attitude - it just wears you down after 4 years when nothing has worked. The TMS I would be doing would be rTMS.

I used the most well documented manual for doing this. If you put this in your
browser you can pull it up. (I'll write more in a minute if this goes thru)
file:///C:/Users/brummett/Desktop/RECOVERY%20RELATED/Benzo_Gaba/Ashton-Manual.pdf

The reason I'm trying to cut meds is because 1) they do not get me to anywhere near remission or full recovery, 2) a ton of new studies have come out in the past year suggesting (actually I would say almost proving) that they do more harm than good in the long term (meaning for more than just a few months). Many studies show that people who don't go on any meds and just gut it out and finally recover on their on ( usually w/in 6 months) have significantly better long term outcomes than people who go on these meds for a year or more. They actually say that these meds are iatrogenic (they cause the problem the are supposed to help). That said, they do seem to keep me "afloat", but basically always treading water. Nobody really can predict who can stop and who can't -- sadly. I know when I try to go lower than 7.5 of lexapro I can't do it (yet anyway).

Well this is why I want to stop them as well. But both times I have tried it has been disastrous, but being on them is as well. And I don’t have a doctor who supports me and keeps reminding me how suicidal I become . She’s right so I have nothing to stand on. I cut down to 1.50 mg from only 2 days on 2 mg and I already feel more anxiety than I deep two weeks ago when I was in 0.75mg. I just feel like I’m getting worse.

I'm doing this very slowly doing this myself. If I get it trouble I can always start back.
It will likely take several months to get off Lexapro, then maybe a year to get off Remeron. I'm going to resist the urge to try yet another med because 1) it never helps much, 2) are no remaining meds I am willing to try.
You may get worse when you go off meds because you go too fast? You are suicidal on meds, so sadly they are not helping much.
On the surviving antidepressants forum I read about a man who got off all meds after years on them and he is doing great 3 years later. He had kidney failure from these meds (1 month in hospital, lost 1 kidney) so that prompted him to stop. He said Seroquel was the hardest by far to stop. There are many stories like his on this cite.

Hope no news is somewhat good news and that you are slowly getting less anxious on 25 of Zoloft.
I've been off all benzos for over a week and don't miss it at all. I've been working very hard on CBT and that is helping in some ways I think - I've never really dug in and done it before, but this time I am because the success rates for that are actually better than any med and no side effects.

So so very happy for you. I feel like I am getting worse. Is it possible the longer you take the Zoloft , the worse the anxiety gets ? I’m only on 25 mg. I feel like I want to move up just because I feel awful and just want this anxiety to go away. I know it takes a lot of time but I’m so confused now on what dose and how long and blah blah blah. I have been on the 25 mg for a little over two weeks. I’m sorry , I’m just so miserable. My psychologist said it’s one of the most popular ones they use for anxiety so WTH !!! Anyway , thanks for checking in and I’m so happy for your progress off the meds. I just keep increasing my Klonopin. What a success story I am.

So what dose of Klonopin are you on now?
You are a big success IMHO, as you keep on keeping on, regardless of how hard it is. I'm not a good one to ask about meds right now I suppose, because I'm pretty down on all of them - I honestly think they make things worse, not better, for most people. Drugs.com say (regarding doses) -- so as you can see you are at a point where you clearly should clearly increase the dose if the current dose is not effective:
Obsessive-Compulsive Disorder
Initial: 50 mg PO qDay
May increase by 25 mg at 1-week intervals; not to exceed 200 mg qDay
Panic Disorder, Posttraumatic Stress Disorder
Initial: 25 mg PO qDay
May increase by 25 mg at 1-week intervals; not to exceed 200 mg qDay

You are the brave one, holding out for so long. Your dose of Zoloft is the lowest possible, and for OCD you go up to 200, for anxiety 25-200 - with dose increased after 1 week. So, you should be able to go up now for sure--can't really hurt would be my thought. What is your Klonopin now?

Gosh - Was just continue to feel worse and she just continues to say it is not the sertraline. I was on 2 mg of Klonopin for like a week or something, I don’t even know anymore. Now I am back to 1.5mg and I guess I am holding at the 25 mg of Zoloft til end of month. The last week has been awful. Terrible anxiety, panic, agitation and suicidal thoughts. I am so willing to put up with all of it if it gets better. Have read a lot of people who said it gets much worse first - which I already know from the others. But these are people who are just starting to take these meds. Honestly, do you think after 4 years that something like Zoloft will help after all the countless meds I’ve been on? I also feel like I am reaching for my Klonopin dose hours before I am due to take it now and I know that’s not good. She won’t let me increase the Zoloft yet and I understand but I don’t have much left in me.

Sure, it may work, it is a bit different than other SSRI's, so worth hanging in there. I'm not sure about worse before better, but I would hope you would start getting better within a week or so. Holding at 25 mg for a month makes sense, given you don't tolerate high doses. I would try to stay at 1.5 mg klonopin if possible. The more you take the more you need, over time--so lower is best and hopefully in a couple of weeks Zoloft will decrease your anxiety and you can then decrease the klonopin soon. It's good that they use Zoloft for OCD too.

I just feel like I’m getting worse and worse. I don’t know if it’s the Klonopin or the Zoloft but my agitation and irritability is off the chart . I have been on the Zoloft for about 19 days no . I don’t know how much longer I can hold o . I am so mean and miserable - it is just not who I am as a person. Could this be the Zoloft and could it get better?

Yes, it can get better. I will say though that I've been on/off many (as many as you actually) meds over the past 15 years and I've never had the "gets worse for weeks, then gets better" experience. Gets worse for maybe a few days, but not weeks. I also tend to side with the literature that suggests if you don't see improvement after 3 weeks there is only a 10% chance of getting better on any med. So, yes, stay on for another week as your Dr. suggests, but then I would certainly go up or off if you don't see improvement --as you say, you can't do this "forever". I think that you have likely built up a tolerance to Klonopin and it is not helping you now. I say this because being on 1.5 per day and being so agitated clearly says it is not effective any longer. Sadly, that is what often happens with all benzos. Did you look at the Ashton manual on benzos--it talks about your pattern of symptoms (agitation, ect.).