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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 2 of 2. This is the beginning of the thread.
Posted by vic80 on May 25, 2010, at 15:27:44
Lex was tapered down to zero from 20mg in 1.5 months.
Milnacipran was started 11 days ago> current dose 25mg x 24 days ago, for the first time I experienced this disturbing thought/vision of some very gory type, and it sort of petrified me. I didnt bother to dwell on it.
Next night while writing into my journal dealing with a particularly difficult issue - I experienced a vision of standing near a church and being attacked by a bandaged mummy. scared I was! But then it wasnt abnormal.
What started subsequently was reigniting of fears and phobias from my childhood which have long gotten over in my life - fear of the dark, scared there are monsters hiding in the hallway... definitely fears - NOT delusions or hallucinations.2 days on, just ANXITety, which has anyways doubled since I started in Milnacipran
Today evening for about an hour, while on a drive through a lovely terrain, we stopped over for a while.... I started to feel scared - scared of looking at the trees - the lights in the distance - the bells from the local church, the buzzing of a far away radio,the rustling of the leaves - innocent printed designs on my friend's tshirt looked like they had some deep ominous undertone - the gates of the buildings, everything seemed to scare me - I was paralyzed in fear - I thought I was going to turn psychotic. All along there were no hallucinations and delusions....
And then I felt a massive panic attack set in which I miraculously avoided somehow.But the experience has made me all most paralyzed. Now I know the pdoc would have to work through the details of what has happened etc etc...
I wonder if the lex withdrawal has set in... or the high NE from MIL is causing this somehow - anxiety has been bad - but what I experienced today was raw dread.
It seemed to wean off in a while, but the after effects have been a severe sense of foreboding...0.5 mg ativan seemed to calm me, but the overriding fear seems to have gotten stuck now..
Any comments? Is this anxiety or is it something more ominous????
Posted by bleauberry on May 25, 2010, at 17:43:23
In reply to HELP: Lexapro w/d OR Milnacipran induced paranoia, posted by vic80 on May 25, 2010, at 15:27:44
As I've said before, it is my opinion...just an opinion from one person...that both lex and miln are involved.
Regardless of anything, miln is too high as I see it. You should take a 25mg dose, divide into 3 parts (if capsule, empty one out, if tab, cut it up or crush it) and one part breakfast, one part lunch, one part late afternoon. Total daily dose 25mg.
Maybe consider adding back 2.5mg lex, stabilize, and then begin a longer taper in tiny steps by cutting tiny slices off the doses. So that each dose decrease is roughly .1 or .2 mg.
Another possibility is that there is a schizophrenic or bipolar spectrum disorder involved and these med changes just happened to aggravate it and bring it in the open, maybe for the first time ever showing something more that you had never seen or suspected. Instead of relying on benzos, it would be interesting to try a single dose of zyprexa and see what happens. It is fairly reliable to quickly cover the entire spectrum of anxiety, fears, phobias, schizo, and anxieties. Relief is often felt the first day.
Nothing here is anything that I wouldn't do myself, and in reality have actually done myself. I've been in your shoes. I think it is insane to "hold on" expecting things to change. You gotta manage this situation, which if were me, would involve the things I said. I personally would probably:
Add in lex at 1.0 to 2.5mg.
Reduce miln to 25mg and divide it into 3 doses.
Take 2.5mg zyprexa as needed before taking a benzo as needed.Those moves would tell me a lot and give me information to help manage whatever the heck was going on.
This is the end of the thread.
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