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What Causes Chronic Nausea, Dizziness And Fatigue Post Withdrawal From Xanax?

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Posted on Mon, 4 Jul 2016
Question: I have been having chronic nausea since tapering off xanax (took .25 mg for three years), then switched and stopped klonopin (0.5 mg) three months ago. Then I was put on lamictal (up to 37.5 x 2 day) and experiencing dizziness and fatigue. Tried going back on klonopin in the last 36 hours (0.5 every 12; hours) but isn't helping. Continue to have nausea, anxiety, and dizziness. Dizziness got worse with lamictal.
doctor
Answered by Dr. Alexander H. Sheppe (23 minutes later)
Brief Answer:
Consultation

Detailed Answer:
Hello, and thanks for your question.

I'm sorry you are suffering so much. Here are my thoughts.

I agree with your physician that your symptoms are not consistent with benzodiazepine withdrawal. Instead, your symptoms are consistent with severe anxiety and possibly but not definitely a major depressive episode. Anxiety and depression are both treated with, in the case of bipolar 2 disorder, a mood stabilizer, and not benzodiazepines. Benzodiazepines are not meant to be used for more than 3 months, as continued use leads to dependence, cognitive decline, memory loss, falls, and risk of seizure and death.

Your dose of Lamictal is very low, as it has to be uptitrated carefully due to risk of rash. Your symptoms that you describe will improve over time as the Lamictal is increased. Using benzodiazepines will not help and will only make things worse through its significant side effects.

Please remember to rate and close this answer thread when you are finished and satisfied.


Above answer was peer-reviewed by : Dr. Naveen Kumar
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Follow up: Dr. Alexander H. Sheppe (1 hour later)
I have asked my psychiatrist to reinstate elavil with the limictal and she has prescribed 10 mg in the evening. I will stop the klonopin per your advice.

What do you think. I was previously taking 25 mg of elavil. I'm very sensitive to medications. Going to have genetic testing done to determine which pych meds are best.

Thank you
doctor
Answered by Dr. Alexander H. Sheppe (1 minute later)
Brief Answer:
Followup

Detailed Answer:
I think your approach is entirely correct. I would absolutely obtain genetic testing if you believe you are sensitive to medications, to narrow down which ones would be best for you. Elavil + Lamictal is a perfectly reasonable regimen for bipolar depression and very effective.

Please remember to rate and close this answer thread when you are finished and satisfied.


Above answer was peer-reviewed by : Dr. Naveen Kumar
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Follow up: Dr. Alexander H. Sheppe (1 hour later)
My nausea and anxiety are the worst in the morning, starting at 6 am (usually wake at 2-3 am) through 2-4 pm. Peak from 10 am - 12 pm. I'm always okay in the late afternoon and evening. Is that kind of pattern normal?

Thank you
doctor
Answered by Dr. Alexander H. Sheppe (4 hours later)
Brief Answer:
Followup

Detailed Answer:
Yes, this is a typical pattern of anxiety.

Please remember to rate and close this answer thread when you are finished and satisfied.


Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Alexander H. Sheppe (4 hours later)
Why is does anxiety follow a pattern like that? How do you recommend breaking that pattern?

I also see a therapist. Done hypnotherapy and meditation. Try to take a walk every evening. In marriage counseling. Lost my job last week so that has been very stressful and I need to reduce my stress by trying to be more positive. I have 7-8 good hours left in the day when I'm not nauseated, so I have to make the best of them.

Thank you!
doctor
Answered by Dr. Alexander H. Sheppe (23 hours later)
Brief Answer:
Followup

Detailed Answer:
The honest answer is we don't know why anxiety works like this. It's different between every person, likely related to your unique underlying biology. We do know that with treatment, your anxiety will get better. A combination of medication and therapy yields the best results. You will get better! You are most welcome.

Please remember to rate and close this answer thread when you are finished and satisfied.

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Sonia Raina
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Answered by
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Dr. Alexander H. Sheppe

Psychiatrist

Practicing since :2014

Answered : 2236 Questions

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What Causes Chronic Nausea, Dizziness And Fatigue Post Withdrawal From Xanax?

Brief Answer: Consultation Detailed Answer: Hello, and thanks for your question. I'm sorry you are suffering so much. Here are my thoughts. I agree with your physician that your symptoms are not consistent with benzodiazepine withdrawal. Instead, your symptoms are consistent with severe anxiety and possibly but not definitely a major depressive episode. Anxiety and depression are both treated with, in the case of bipolar 2 disorder, a mood stabilizer, and not benzodiazepines. Benzodiazepines are not meant to be used for more than 3 months, as continued use leads to dependence, cognitive decline, memory loss, falls, and risk of seizure and death. Your dose of Lamictal is very low, as it has to be uptitrated carefully due to risk of rash. Your symptoms that you describe will improve over time as the Lamictal is increased. Using benzodiazepines will not help and will only make things worse through its significant side effects. Please remember to rate and close this answer thread when you are finished and satisfied.