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Dr_Anderson, Doctor
Category: Mental Health
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Experience:  Psychiatrist
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Margo here with lorazapem, doxy/ VSL probiotic Changed my dosages of medications and have some questions: PREVIOUSLY- 100mg doxy per day 1.25mg Lorazapem per day 2 VSL Probiotics CURRENTLY 150mg doxy 1G Lorazapem - taken .25mg 2 xdaily .50mg - at night - Siince I cut the lorazapem dosage - I HAVE NOT EXPERIENCED racing heart but the following: severe muscle soreness, very sore throat , burning sensation, pin pricks, chronic fatigue, chills, and feeling warm. In honesty for the first 2 days I actually was over zealous and cut .25mg plus .125mg = .365 mg. After the lump in my throat - I put back the .365mg. Symptoms were their worse 2 days later- had one day of agitation - and started today with the muscle pains on a diminished level - today is day 6. QUESTION 1 ---Since I am on greater doxy, (but still under 200mg per day) is any of this herxing or is this the withdrawal symptoms of Lorazapem? I understand I should not make anymore reductions to Lorazapem because this would be too too difficult. QUESTION 2- will these symptoms abate in the next 8 days - for my next appt to raise the doxy to 200mg per day? Had better days but don't want to return now to higher level of lorazapem...Took my everything to get down to 1G. Your advice greatly needed and appreciated. Margo

Dr_Anderson :

Greetings, and thank you for the questions.

Dr_Anderson :

Sorry for the delay, I'm in a low reception area! But, to answer your questions...

Dr_Anderson :

(1) Sounds actually like a mixture of both, but this time the withdrawal symptoms are less intense when compared to the herxing symptoms. I also agree with you about waiting on any more reductions in the Ativan until things "simmer down" a bit.

Dr_Anderson :

(2) Yes, the symptoms of withdrawal should diminish over the next week or so. However, given that you have an ongoing anti-bacterial treatment underway, the herxing may continue as you increase your dose of antibiotics (although typically, from my understanding, the herxing symptoms should also go away).

Dr_Anderson :

I'd hold at your current dose of Ativan. I don't think it will be necessary for you to increase it. Plus, keeping it at this level will help settle out what is herxing and what is Ativan withdrawal.

Dr_Anderson :

Hang in there! As always, my pleasure to assist. :)

Dr_Anderson :


Dr_Anderson :

Dr. Anderson


Here is my confusion: for herxing symptoms I read its chills, sore throat, swollen glands and fatigue-

is that correct?


For Lorazapem withdrawal: numbness, muscle and joint aches, burning - HAD THOSE more intense than usual on day 4 of subtracting Lorazapem. Could some of that be attributed to herxing?



Or are those just lorazapem withdrawal symptoms....

Last impt question- Dosage in AM - should I move around or keep?


9am DOXY (will change soon to 2 pills)

then 1pm (1/2 Loraz)


evening is perfect - back to back

6pm 2 doxy


7pm - 1/2 loraz



should I MOVE my 1pm loraz to 10am behind the doxy or leave it?


Dr_Anderson and other Mental Health Specialists are ready to help you

(1) Yes, you are correct, those are common symptoms. Anything sepsis-like in nature could be herxing symptoms.

(2) Certainly the aches can also be due to herxing, though the numbness and burning, depending upon what it felt like, could be the Ativan (does not sound like a "typical" herxheimer symptom).

(3) for now, I'd keep all doses at their same times, to let things settle out. Moving them around may stir up new symptoms or exacerbate existing ones, so in order to tell what is due to what, keeping the meds the same and at least controlling that variable will help us out in deciding the next course of action.


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Dr_Anderson and other Mental Health Specialists are ready to help you
Customer: replied 4 years ago.

Dear Dr Andersen:

Need your excellent advice


Had several lab tests done.

bun/creatinenine ratio 24 High

vit b12 964 high

glucose,serum (not fasting) 90

current w doxy 7/ 27 vs 7/5 (prior to doxy)

lymph absolute 1.7 1.5

RBC 4.48 4.84

mcv 91 92

mch 30.6 31.2

platelets 183 195

WBC 6.3 7.3

hemoglobin 13.7 15.1

Rdw 13.9 13.6

hemoatocrit 40.9 44.7

protein, total 6.4

bilirubin, total .3 .4


QUESTION 1 - should I show my doctor- are any of these underlined #s significant? don't understand?


my pulse on two ocassions in doc office was 48-

QUESTION 2 -IS THIS A CONCERN. I get blurry vision. 120/80 bp

nervous that my pulses are getting reduced. I have been doing 45 min a day at 4.0 walking on treadmill.

I am 5ft 6 136lbs - no athlete or skinny jane.

Question 3 -do i see cardiologist- am I over reacting, just feel off is this serious or just herxing stuff?

Question 4 Did reducing the loraz do this or

QUESTION %should I cut another .25mg or leave alone? I am at 1.0 loraz daily

Now I have typing herxing symptoms - sore throat, chills dehydrated and dizzy and minute pin pricks, - no burning and muscle aches on 4 th day when decreased loraz.

Your help greatly appreciated and will comp as usual.



This was answered in another string, so please let me know if it showed up ok or not!


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