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Lunesta Withdrawal - Any Experience?

lunesta z-drugs benzo withdrawal

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#1 Daniel Cooper

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Posted 09 July 2015 - 12:03 AM


Need a little help and advice.

 

I have been on one z-drug or another chronically for the better part of a decade due to sleep issues associated with chronic pain.

 

In recent years the chronic pain has gotten better so the last two drugs I'm taking on what used to be a long list are an meloxicam (NSAID) and Lunesta.  The Lunesta I've been on for about 5 years.  Before that it was Ambien.

 

Previous dose was 3mg, but I tapered that down to 1mg and have held at 1mg for over 6 months.

 

About two weeks ago, I discontinued the Lunesta.  I switched over to Trazadone which I started at 50mg at bedtime and in the last several days I've cut that to 25mg.  I'm actually sleeping ok, better than I expected. The goal is to take nothing for sleep.

 

About 3 days after ceasing the Lunesta I had a bout of diarrhea that was pretty severe that lasted two days.  After that, I started feeling better and thought that I was getting this behind me.

 

However, last night I had this episode of feeling week, shaky, nauseous, dizzy, and intense sweating and eventually developed a high heart rate. It was disturbing to the point that I went to the emergency room to make sure I wasn't having any cardiac issues.  After a workup in the ER the only thing they found was slightly below normal potassium.  They gave me some potassium tablets and sent me home.  Went to see my PCP and she's stumped.  Still feel bad today.  Bouts of shakiness and sweating, particularly after a meal for some reason.

 

What I'm wonder is if this is withdrawal from the Lunesta?  Given the low dose I've been on for the last 6 months (1mg) and the fact that it's been almost 2 weeks, I'm a little surprised that withdrawal is an issue. 

 

Anyone with any experience or expertise in this area?  My PCP and the ER doc don't have any experience with Z-drug withdrawal, especially at what is a pretty low dose.

 

 

 

 

 



#2 Duchykins

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Posted 11 July 2015 - 09:24 PM

It's withdrawal.  2 weeks is just about the right time for the bigtime withdrawal to set it for ambien, other Zs and benzos.

 

If you also had caffeine any time that day, it made it worse with the potassium loss.

 

But electrolyte screw-ups are one of the biggest reasons people feel withdrawal in the first place.



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#3 Daniel Cooper

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Posted 12 July 2015 - 03:38 AM

Thanks for the reply.

 

So I've continued to feel pretty lousy, but less lousy than the night at the ER.  Any idea how long I can expect this to last?  Anxiety has also been up quite a bit.  I assume that's the Lunesta as well (hits GABA so expected).

 

This stuff is evil.  I had thought that the withdrawal would be minimal given the ramp down to 1mg for so long.

 

Thanks again.



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#4 Duchykins

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Posted 12 July 2015 - 05:42 AM

Thanks for the reply.

 

So I've continued to feel pretty lousy, but less lousy than the night at the ER.  Any idea how long I can expect this to last?  Anxiety has also been up quite a bit.  I assume that's the Lunesta as well (hits GABA so expected).

 

This stuff is evil.  I had thought that the withdrawal would be minimal given the ramp down to 1mg for so long.

 

Thanks again.

 

 

You were on it at 6 months + at the 1 mg dose?  Lunesta and ambien are relatively potent at low doses, which I'm sure you know.  Dropping off of 1 mg can still be too soon.

 

For tapering from antidepressants, it is typically advised to cut back 10% of the drug every month if the pills can be cut or a liquid solution can be made from it.  For a benzo I would imagine a longer taper, 10% every 2 months.

 

I would estimate you wouldn't be back to normal for many moons.  Though your symptoms would become more tolerable, less extreme over time, of course.

 

Benzo withdrawal is a two-phase process stretching out over months and months, some former addicts or long-time nonabusive dependents can have the milder symptoms for up to 2 years later.

 

I keep speaking of benzos because even though Lunesta and Ambien are nonbenzos, they are very very close to benzos, and behave much like them and have similar withdrawals.  Benzo withdrawal has been much more studied than the z-drugs, that's all.  But this withdrawal is the primary reason why benzos are scary devils.

 

I'll tell you what I've done, it helped me so it might help you too a bit (but it's not likely to outright banish all symptoms).  I've been on and off Ambien a few times in the past ten years, with years between short use, but now I am on Ambien (10mg immediate release) indefinitely unless I chose to stop.  There have been a few hiccups in the past with a previous doctor's office failing to fax refill requests back to pharmacies in a timely fashion.  They did this to me three times, every time blaming the pharmacy for the fuck up (which was wrong).  So I was suddenly cut off from Ambien for weeks, one time it was a whole month and a half. Needless to say, I got a new doc, who is much because he oversees all his patients' prescriptions directly instead of delegating it to lazy, stupid office clerks.

 

I would coast strangely well for the first 10 days to 2 weeks with some mild anxiety/irritability increase, aside from the fact that my sleep schedule was obliterated and gave me monster migraines (Ambien is the very first ingredient in my migraine prophylaxis regimen).  Then the mega-tsunami hit me all of a sudden with a vengeance.  What. the. fuck. is this black magic?

 

Since I was unprepared, I had to use what was already in my house.  Obviously the goal here is to handle a GABA crash which results in a glutamatergic shitstorm (which can actually do real damage to neurons, especially related to hearing -- tinnitus is one of the semipermanent or suspected permanent symptoms of benzo withdrawal because glutamate went shoop da whoop at the major auditory nerves).   You can simultaneously do things that could help level out the GABA and things that control glutamate.

 

With OTC stuff there is not a whole lot you can do about GABA.  The benzos and z-drugs act on GABA-A, but with OTC substances you typically get ones that act on GABA-B (herbs, mostly).  So you're left with these supplements: GABA itself, picamilon, taurine, active B complex, magnesium, lithium, potassium,   maybe theanine.  Foods: kefir!  Herbal teas like these (my favorites, I'm pretty particular about teas because of all the BS in most major tea brands):

 

http://www.amazon.co...s/dp/B00E5CPB1C

http://www.amazon.co...e/dp/B0030EGQ7E

http://www.amazon.co...k/dp/B000CMIYWM

http://www.amazon.co...f/dp/B007M8FRV0

 

You'll note the presence of licorice root all over the place in teas because it's most often used as a sweetener.  But it turns out that licorice might be awesome for your purpose:  

 

http://www.ncbi.nlm....pubmed/22543233

 

Hypnotic effects and GABAergic mechanism of licorice (Glycyrrhiza glabra) ethanol extract and its major flavonoid constituent glabrol.

 

Abstract

Licorice (Glycyrrhiza glabra, GG) is one of the most frequently used herbal medicines worldwide, and its various biological activities have been widely studied. GG is reported to have neurological properties such as antidepressant, anxiolytic, and anticonvulsant effects. However, its hypnotic effects and the mechanism of GG and its active compounds have not yet been demonstrated. In this study, GG ethanol extract (GGE) dose-dependently potentiated pentobarbital-induced sleep and increased the amount of non-rapid eye movement sleep in mice without decreasing delta activity. The hypnotic effect of GGE was completely inhibited by flumazenil, which is a well-known γ-aminobutyric acid type A-benzodiazepine (GABA(A)-BZD) receptor antagonist, similar to other GABA(A)-BZD receptor agonists (e.g., diazepam and zolpidem). The major flavonoid glabrol was isolated from the flavonoid-rich fraction of GGE; it inhibited [(3)H] flumazenil binding to the GABA(A)-BZD receptors in rat cerebral cortex membrane with a binding affinity (K(i)) of 1.63 μM. The molecular structure and pharmacophore model of glabrol and liquiritigenin indicate that the isoprenyl groups of glabrol may play a key role in binding to GABA(A)-BZD receptors. Glabrol increased sleep duration and decreased sleep latency in a dose-dependent manner (5, 10, 25, and 50mg/kg); its hypnotic effect was also blocked by flumazenil. The results imply that GGE and its flavonoid glabrol induce sleep via a positive allosteric modulation of GABA(A)-BZD receptors.

 

That said, don't overdo the licorice.  You can have one of each of those teas daily for a while with no problem.  I do all the time, especially the ginger/turmeric.

 

With GABA and GABAergic substances you often have to wait 2 hours before it kicks in (it's the same deal with gabapentin and similar drugs), so you need to keep this in mind and plan ahead.

 

I didn't list phenibut... because it's phenibut.  I did use it a bit in these periods of panic, but I don't think it's good to use for the purpose of stopping a benzo. 

 

I know I'm forgetting some stuff right now.  I'm sure someone else would have something to add.  

 

 

What not to do:

 

stimulants, caffeine included , unless they are like ginger which shouldn't mess with glutamate (except to perhaps modulate it a bit) or cause you to lose electrolytes faster than usual (like caffeine increasing Mg and K loss)

 

substances that are claimed to be anxiolytic but interact with glutamate in an undesirable way (you see nearly everything being called anxiolytic these days including sunifiram and aniracetam, but they do something one way or another to stimulate glutamatergic neurotransmission so you have to check for things like this)

 

skip meals (lowered or impaired cell energy production = lowered glutamate excitotoxicity threshold)

 

fail to hydrate (same)







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