Question: Very bad inomnia, amitrypiline changed it's function totally.
I am 75 years.
Have dystymia, GAD, 2 strokes.
Got amitryptiline after last stroke because every morning coming bad hangoverlike feeling.
First perfect as sleeping pill. I was using at most 30mg/day during a year. I tought- too much with sertraline. Started cutting down small amounts to experiment. 2.5-5mg
Horrible insomnia followed.
Then I did "semi cold turkey cut" from 27.5mg to 10mg. No effect bad or good to previous 27.5mg all the same!
Then after some time I cut from 10g to 0mg, 3th day horrible withdrawal feeling.
Went back to 5mg. Just the same as with 27.5 or 10 mg insomnia and anxiety no difference from either.
Some minor sleep now with evening 5mg diazepam and 2 mg melatonin.
My question: Is all this from 2 huge cut and can I continue some way from 5mg or it is so that I must go back to 27.5mg and titrate 1 mg/month or something like that?
I should be weaning diazepam, now from 17.5/day, can't with this insomnia
Can all of it be from long time benzo use (40years), not amitriptyline.?

Thanks: tuomo kortesmaa



Horribleinsomia started.. Then I did "semi cold turkey" cut: from 27.5 to 10
I

Very bad inomnia, amitrypiline changed it's function totally.
I am 75 years.
Have dystymia, GAD, 2 strokes.
Got amitryptiline after last stroke because every morning coming bad hangoverlike feeling.
First perfect as sleeping pill. I was using at most 30mg/day during a year. I tought- too much with sertraline. Started cutting down small amounts to experiment. 2.5-5mg
Horrible insomnia followed.
Then I did "semi cold turkey cut" from 27.5mg to 10mg. No effect bad or good to previous 27.5mg all the same!
Then after some time I cut from 10g to 0mg, 3th day horrible withdrawal feeling.
Went back to 5mg. Just the same as with 27.5 or 10 mg insomnia and anxiety no difference from either.
Some minor sleep now with evening 5mg diazepam and 2 mg melatonin.
My question: Is all this from 2 huge cut and can I continue some way from 5mg or it is so that I must go back to 27.5mg and titrate 1 mg/month or something like that?
I should be weaning diazepam, now from 17.5/day, can't with this insomnia
Can all of it be from long time benzo use (40years), not amitriptyline.?

Thanks: tuomo kortesmaa



Horribleinsomia started.. Then I did "semi cold turkey" cut: from 27.5 to 10
I

My current diazepam dose 17.5 mg/day. In fact the dose has been 4x5mg/day,but despite other problems I have taken "only"2x5 and 2x3.75mg =17.5mg / a day



-5mg am 6 o'clock
-3.75 mg pm 2 o'clock
-3.75 mg pm 5 o'clock
-5mg pm 10.30

my sertraline regularily 150mg/day

My current diazepam dose 17.5 mg/day. In fact the dose has been 4x5mg/day,but despite other problems I have taken "only"2x5 and 2x3.75mg =17.5mg / a day



-5mg am 6 o'clock
-3.75 mg pm 2 o'clock
-3.75 mg pm 5 o'clock
-5mg pm 10.30

my sertraline regularily 150mg/day

Dear dr XXXXXXX
still my most prominet problem is insomnia, even with this evening diazepm and melatonin keep me alive. Because of strokes my reserve energy is nonexistent and I have used to sleep even as young 7-8 hours.
Noadays often waking really after 3 hours of from evening medicaton, then some hours to be awake or very light sleeping to 5 am. The other clear problem is high anxiety some mornigs and more ease during day. In additionton this I have ready suicide plan. I am hopeless, unfortunately I am too much coward to commit suicide. I have no future, no hobbies any more, earlier sport mainly body building.
I have regenerated lumbar back.All few of my friends dead already, unable even to do minor repair work at home as earlier. Thinking that this insomnia/anxiety is a key , perhaps after that some hobby as chess or painting.
I am totally unstisfiied "bigpharma" medicines, every worse than earlier. Sure cannot withdraw fully from sertraline and start with an other big experiment.

Thinking
-is this ever lasing amitryptiline effect, no cure ?or
-tolerance withdrawal of diazepam ?or
-diazepam caused effect, effect turned up side down becuse of too long use?

Btw: my diezepam is far too much at this age.
Still I achieved candidate master level one year ago in solving tactical puzzles on net site, too tired now. Sometimes ,rarely, solving grand master level puzzles.
So, one problem is clearly depression.Cognitive abilities far better than could even hope.

Thanks : tuomo kortesmaa

Dear dr XXXXXXX
still my most prominet problem is insomnia, even with this evening diazepm and melatonin keep me alive. Because of strokes my reserve energy is nonexistent and I have used to sleep even as young 7-8 hours.
Noadays often waking really after 3 hours of from evening medicaton, then some hours to be awake or very light sleeping to 5 am. The other clear problem is high anxiety some mornigs and more ease during day. In additionton this I have ready suicide plan. I am hopeless, unfortunately I am too much coward to commit suicide. I have no future, no hobbies any more, earlier sport mainly body building.
I have regenerated lumbar back.All few of my friends dead already, unable even to do minor repair work at home as earlier. Thinking that this insomnia/anxiety is a key , perhaps after that some hobby as chess or painting.
I am totally unstisfiied "bigpharma" medicines, every worse than earlier. Sure cannot withdraw fully from sertraline and start with an other big experiment.

Thinking
-is this ever lasing amitryptiline effect, no cure ?or
-tolerance withdrawal of diazepam ?or
-diazepam caused effect, effect turned up side down becuse of too long use?

Btw: my diezepam is far too much at this age.
Still I achieved candidate master level one year ago in solving tactical puzzles on net site, too tired now. Sometimes ,rarely, solving grand master level puzzles.
So, one problem is clearly depression.Cognitive abilities far better than could even hope.

Thanks : tuomo kortesmaa

Hi dear dr,
I interpreted your answer saying noting about amitryptiline so that you think the poblem is mainly if not fully diazepam.

Is it so?Nothing about ami!

Any case I feel very clear intense withdrawal feeling with even very minimal cut of ami nowadays(about 1mg cut is bad.)

I believe your advice and plan is very good as a whole but includes one impossible thing- to taper diazepam 1/4 a week.
World famous benzo XXXXXXX XXXXXXX XXXXXXX has published example tapering plans (mainly 1 mg/1-2 week).
I have tried it earlie and went from 20mg diazepam to 10 mg 1mg by 1mg then too hard.
Please see: "https://benzo.org.uk/manual/bzsched.htm#s2"

So, tapering diazepam from 18mg to zero is 25-50 weeks. Realistic?

Can it be that ami effect is permanet damage, not going away never.

Looking at patient rewiews from "withdrawal support group" I can find caseses like " i have tried to taper ami during 10 years 3 times from 5mg to zero, failed!"


Thank:tuomo kortesmaa

Hi dear dr,
I interpreted your answer saying noting about amitryptiline so that you think the poblem is mainly if not fully diazepam.

Is it so?Nothing about ami!

Any case I feel very clear intense withdrawal feeling with even very minimal cut of ami nowadays(about 1mg cut is bad.)

I believe your advice and plan is very good as a whole but includes one impossible thing- to taper diazepam 1/4 a week.
World famous benzo XXXXXXX XXXXXXX XXXXXXX has published example tapering plans (mainly 1 mg/1-2 week).
I have tried it earlie and went from 20mg diazepam to 10 mg 1mg by 1mg then too hard.
Please see: "https://benzo.org.uk/manual/bzsched.htm#s2"

So, tapering diazepam from 18mg to zero is 25-50 weeks. Realistic?

Can it be that ami effect is permanet damage, not going away never.

Looking at patient rewiews from "withdrawal support group" I can find caseses like " i have tried to taper ami during 10 years 3 times from 5mg to zero, failed!"


Thank:tuomo kortesmaa