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

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.

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.

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Above answer was peer-reviewed by : Dr. Naveen Kumar

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

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.

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Above answer was peer-reviewed by : Dr. Naveen Kumar

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

Answered by Dr. Alexander H. Sheppe (4 hours later)

Brief Answer:
Followup

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

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Above answer was peer-reviewed by : Dr. Raju A.T

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!

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.

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Above answer was peer-reviewed by : Dr. Sonia Raina