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What Causes Trembling, Heart Palpitations, Sore Chest And Brain Fog?

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Posted on Fri, 21 Aug 2015
Question: The question is about anxiety meds. Had a few anxiety attacks a couple of months ago, was prescribed Ativan 1-2 mg/day and effexor 37.5 mg. During the two months I have experienced trembling, heart racing, sore chest, brain fog and not feeling like myself, no concentration, no appetite, basically not functional. I am now tapering off Ativan, doing it over 25 days and am still feeling the same effects as above, plus being exhausted and depressed. I also have a very hard time sleeping and have had diarrhea for the past 6 weeks. Is this withdrawal or have I always had Ativan side effects and now are continuing even if I am tapering off. Is a 25 day taper enough for 2 months of using ativan. I never used an exact dose of Ativan every day, sometimes it would only be .5 or 1 mg or sometimes 2mg I am desperate and need some advise as this situation has left me feeling totally out of control, not functioning and frustrated. Would appreciate any suggestions that may help. Thank you.
doctor
Answered by Dr. Muhammad Hanif (3 hours later)
Brief Answer:
Follow the Instructions below.

Detailed Answer:
Dr. Hanif warmly Welcomes you!

Thanks for consulting at my virtual clinic. I have carefully worked through your case, and can realize your health worries. Being your physician, I will take care all of your medical concerns.

There are many important points in your case history and these need to be addressed properly.

You never had appropriate dosage of the drugs to cover the disease plus you had side effects of the drugs which you described in detail in your question above. Yes they were amongst many of the side effects of drugs you remained on for
months.

You had no follow up regarding dose adjustment of the drug during this whole time period. Your treating physician must have been informed about the feelings you had during whole this period and he must have adjusted the dose.


You never too appropriate dose as prescribed. It is a real bad idea to take sometimes only 0.5 mg and the next day 2 mg. This is also the main reason of lack of effectiveness of the treatment and you never felt better even with the treatment.

Suggestion:-
You are not yet ready to be off of drugs (keep taking the drugs as advised previously by your doctor). You still need treatment otherwise symptoms may extend to suicidal ideations and more deterioration. So, starting from the beginning, please consult a Psychiatrist (change the previous one, if not satisfied). Go for an in-office visit and he will reorder your medications and will adjust the dosages and will help you with the proper treatment.

CAUTIONS:-
Take medicine as advised.
No skip doses, no extra doses, no less dosage.
Keep compliance is the key to your health.

Have a wonderful time ahead. Hope I answered all of your questions. Let me know if you have any further clinical concerns. I will be happy to get back to you shortly. If satisfied here, please give a five star rating and don't forget to close the discussion.

Regards!
DR. XXXXXXX HANIF
USA

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Muhammad Hanif (18 hours later)
I have been on effexor before so I feel that the ativan has caused me the side effects. This is why I am tapering off the drug with the advise of my psychiatrist. Ativan was prescribed to me to take as needed. This is not a drug my psychiatrist wants me on long term. I don`t want to be on this long term either.

You have not answered my question as to whether a 25 day taper off the ativan is sufficient. I am tapering off this drug and would like some advise on how long this taper should be and how to deal with withdrawal symptoms. If you are not able to help me with this question then perhaps I could correspond with a phychiatrist.

Thank you.
doctor
Answered by Dr. Muhammad Hanif (55 minutes later)
Brief Answer:
Deal with Withdrawal symptoms and relapse prevention as guided below.

Detailed Answer:
I welcome you once again with a follow up query and appreciate your thoughts.


You have taken the drug for very short term. Tapering off is more a problem when patient has used the drug for longer duration of time. In your case, 25 days of tapering off is enough for you and is over now. You should leave taking Lorazepam (Ativan). But you should consult your treating physician for follow up of your disease as I think you still need drugs to support your brain's normal and healthy functions.

Yes I agree, you had all of this problem due to Ativan, and during whole of these 2 months you had been facing all of your mentioned symptoms due to it. But don't panic as the new replacement drug will help assist you feel better as it will kick in the system. And that is the best way to deal all the withdrawal systems of trembling, heart racing, sore chest, brain fog, no concentration, selflessness, no appetite.

Your physician was right for not keeping it as the primary drug to treat you, as it is highly addictive medicine and dependance and addiction is caused very rapidly. When you stop taking the medicine, the symptoms of withdrawal starts within 24 hours to a few days after the last dose. The most important is the rebound effect that means the reason why you started taking Ativan, relapses and starts once again. That's why I said you consult Psychiatrist to take an alternative medicine for you to get cure of your primary disease process.

Ativan actually works in the brain to stimulate the production of GABA (an inhibitory neurotransmitter of the brain). This GABA helps reduce anxiety and stress with relaxing the patient and causing a little sedation.


Now as you were on the drug and it has disrupted the balance of the brain chemical, it will take some time for your brain to get repaired and come out of these symptoms of withdrawal.

If I was your treating physician I would have prescribed you with some other short acting benzodiazepines. Some of my patients also get benefits from Barbiturates, Mood stabilizing drugs and concomitant use of antidepressant medications. Your physician may furnish you with a prescription for the same.

Some Patients also get benefits from group therapy and your treating physician may also help you for that if you discuss with him.

Have a wonderful time ahead. Hope I answered all of your questions. Let me know if you have any further clinical concerns. I will be happy to get back to you shortly. If satisfied here, please give a five star rating and don't forget to close the discussion.

Regards!
DR. XXXXXXX HANIF
USA
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
Answered by
Dr.
Dr. Muhammad Hanif

General & Family Physician

Practicing since :2009

Answered : 2369 Questions

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What Causes Trembling, Heart Palpitations, Sore Chest And Brain Fog?

Brief Answer: Follow the Instructions below. Detailed Answer: Dr. Hanif warmly Welcomes you! Thanks for consulting at my virtual clinic. I have carefully worked through your case, and can realize your health worries. Being your physician, I will take care all of your medical concerns. There are many important points in your case history and these need to be addressed properly. You never had appropriate dosage of the drugs to cover the disease plus you had side effects of the drugs which you described in detail in your question above. Yes they were amongst many of the side effects of drugs you remained on for months. You had no follow up regarding dose adjustment of the drug during this whole time period. Your treating physician must have been informed about the feelings you had during whole this period and he must have adjusted the dose. You never too appropriate dose as prescribed. It is a real bad idea to take sometimes only 0.5 mg and the next day 2 mg. This is also the main reason of lack of effectiveness of the treatment and you never felt better even with the treatment. Suggestion:- You are not yet ready to be off of drugs (keep taking the drugs as advised previously by your doctor). You still need treatment otherwise symptoms may extend to suicidal ideations and more deterioration. So, starting from the beginning, please consult a Psychiatrist (change the previous one, if not satisfied). Go for an in-office visit and he will reorder your medications and will adjust the dosages and will help you with the proper treatment. CAUTIONS:- Take medicine as advised. No skip doses, no extra doses, no less dosage. Keep compliance is the key to your health. Have a wonderful time ahead. Hope I answered all of your questions. Let me know if you have any further clinical concerns. I will be happy to get back to you shortly. If satisfied here, please give a five star rating and don't forget to close the discussion. Regards! DR. XXXXXXX HANIF USA