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Dr_Anderson, Doctor
Category: Mental Health
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Experience:  Psychiatrist
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Confused- thought my lorazapem withdrawal was the intense one-

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Confused- thought my lorazapem withdrawal was the intense one-
The intense symptoms I had were pinpricks, muscle burning, and joint pains- elevated than ever before. These I know are listed for loraz withdrawal.
The sore throat, fever chills, swollen glands and fatigue - are the herxing.
Could the muscle and joint aches also be some herxing?
Submitted: 2 years ago.
Category: Mental Health
Expert:  Dr_Anderson replied 2 years ago.

Dr_Anderson :

Actually, I thought they were BOTH intense, especially given they are both happening at the same time. Your lorazepam withdrawal symptoms peaked around day 4 from an earlier post, with some falling off of intensity, and it sounded like the herxing began to take over from there and climb in intensity. Certainly the muscle and joint aches could be herxing, this would be consistent. It would be unusual to get a "double hit" of withdrawal from the lorazepam without a further (new) dose decrease...

Customer:
Dr_Anderson, Doctor
Category: Mental Health
Satisfied Customers: 335
Experience: Psychiatrist
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Customer: replied 2 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
OTHER TESTS




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




QUESTION 1 - should I show my doctor- are any of these underlined #s significant? don't understand? and 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 QUESTION5 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. Margo


 


Optional Information:
Person's Gender: Female
Person's Age: 54

Expert:  Dr_Anderson replied 2 years ago.
Greetings! Let us look at each lab in turn:
> BUN/Creatinine ratio - being high is not necessarily bad. A low creatinine (Cr) is a good thing, so if the Cr is low, it tends to drive up the ratio.
> Vitamin B12 being high - this could just mean you are getting more B12 than you need, versus a processing problem your body has in using available B12.
> Serum glucose looks fine
> Blood chemistries (RDW, HCT, Hgb, etc.) all look relatively benign as compared to 7/5. The only ones of real interest are your hematocrit and hemoglobin, which are still not too bad, but a bit lower notably than they were several weeks ago.

So, to the questions:
(1) Yes, I'd show them. We are interested not only in absolute numbers, but also in trends.While none of these numbers are worrisome, they do provide a trend of what your labs are doing.
(2) The blurry vision could have nothing to do with the pulses. Typically, if the pulse is too low, the BP will go up to compensate, but yours is normal. This tells me that your body "thinks" the heart rate is ok for it. For athletes, a HR of 48 is normal. You are walking a good bit every day, so your heart may be healthy. Other reasons for a HR of 48 (bradycardia) includes heart blocks, but I think you said you got an EKG that was normal, correct?
(3) For now, I'd hold off on the Cardiologist and see how this all develops (improves).
(4) Hard to say what did this, but I doubt it is the cut in lorazepam. So, another cut by 0.25 mg seems in order. You may get the withdrawal symptoms, as before, in timing and intensity - or maybe not! Good news is, you will be at less than 1 mg, so on the home stretch to getting off it! :)

Regards,

Dr. Anderson
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Category: Mental Health
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Experience: Psychiatrist
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