Lexapro and Rexulti. Plus Klonopin

@flow65. Welcome. I'd like to help you figure out what you'd like to do but I have some questions. I'm not sure from what you wrote who is suggesting what. I will suggest that weaning off Xanax is a good plan as there are other medications that work for anxiety that are safer to take.

What are you currently taking?

What does the psychiatrist recommend?

What does the nurse practitioner recommend?

What would like to do? Are you interested in reducing all of your medications?

Currently I’m on 40 mg of celexa (for years I was on 20 mg of celexa and I stopped taking it in 2020). Also on Xanax at 3.5 mg a day. This is what psychiatrist has me on. Some confusion last week on how to taper. We thought he wanted me to remove 0.25 mg away a day. My primary dr said that’s too fast. She thought 0.25 a week. The psychiatrist wanted me to go up on 60 mg of celexa or add Buspar. My husband and I don’t want me to take Buspar. Or really go up on Celexa. The nurse practitioner wants me to change from celexa to Lexapro 20 mg and rexulti 0.5 mg and to take 2 mg of klonopin instead of Xanax and eventually wean off klonopin. But there’s no weaning from my meds I’m on now to the new ones that the nurse practitioner suggested. A pharmacist said there’s no issues going from one to the other. Primary dr thought it was all ok to try. She doesn’t know anything about rexulti. My husband and I want me to be off of Xanax. My body built up a tolerance to it. Everyone in my family thinks these symptoms or withdrawals/built up tolerance I’m having is easy to control. Thank you for your help.

@flow65 Thank you for the explanation. That helps me to understand your initial questions.

Adjusting meds isn't easy and you have to work with your doctor or medical provider to get them right. I can understand why your psychiatrist wants to you to try Buspar as it's prescribed for anxiety and I don't think people build up a tolerance to it and need more to get the same effect like you said you've experienced with Xanax. If you do wean off Xanax as you'd like to then you will want an antidepressant that targets depression and anxiety really well. I'll give you my own thoughts based on my experiences for myself and my family members.

Buspar didn't work for anxiety for anyone in my family however that doesn't mean it won't work for you. It is worth a try which I did at the time. What did work was finding an antidepressant that worked better for anxiety as well as depression and for us my brother and I both found that Cymbalta (duloxetine) worked. We talk on the phone every week as we don't live near one another and when one of us is going through something tough (we've both been diagnosed with cancer over the past few years) we talk about how we are feeling. That's how we both figured out that medication that works for one of us is worth a try with the other one of us.

May I ask your age? Some medications like Rexulti (it's a newer medication and acts very much like Abilify) should be used carefully with anyone over the age of 65. I read up on Rexulti and it's used to "boost" the effects of antidepressant medication and can help with anxiety. I'm posting below what I read so it will help you know more about that medication.

-- https://www.rxlist.com/rexulti-drug.htm#description

I'm 70 years old so I don't think my doctor would suggest Rexulti for me.

You wrote "Everyone in my family thinks these symptoms or withdrawals/built up tolerance I’m having is easy to control". It's a personal choice. You decide what is best for you and what your body tells you. Working through tolerance and withdrawals is not an easy path so I'm going to be really up front here and say listen to your doctors and not your family about this. You figure out what's good for you.

One other suggestion. You can get a third opinion too. Would you like to do that?

Oh my gosh! Too many cooks spoil the broth! A pharmacist, physchiatrist, husband, nurse practitioner and a Primary?

Klonopin has been the worst hell of my life to come off of. They tapered me too fast, I got through the withdrawals, now my nervous system is shot and my hair is falling out. I want to die. As far as anti depressants I liked celexa, but I think I had weight gain from it. It all depends on the person and what you are using it for.

@flow65. I'd like to check in with you and see how you are doing. Have you made any decisions about your medications and who you would like to work with?

Thank you for checking in. Working with my psychiatrist. He has me on klonopin instead of Xanax. It’s been a couple of rough days. Was told there’s an adjustment period. But I’ve been going thru a lot since being on Xanax. Right now how I feel I don’t know who to turn to. Thank you.

@flow65. It's good you are working with your psychiatrist. is there a patient portal you can check in with your psychiatrist when it's rough? Or call the nurse? What sorts of activities or things do you do to take care of yourself? I've experienced anxiety for most of my life and when it rears up I have activities I do. The activities don't take the anxiety away completely but they do help. Do you like to go for a walk? Take a bath? Do yoga?

My psychiatrist doesn’t have a portal. There’s no nurse. I believe there’s a nurse practitioner. Activities have been difficult. I’ve been trying to work on a hobby from time to time. Just today I made chicken soup for my husband and myself. Haven’t cooked in awhile. Due to this anxiety I’ve lost lots of weight. I like taking baths but I hurry. It seems everything I do is in a hurry like frantic. Use to enjoy watching tv. Not so much now. My husband and I liked going to movies. We don’t because of me. I’m paranoid of Covid. Had our vaccines in 2021. My primary dr thinks not to get it right now because they didn’t test on humans just mice. My psychiatrist said to get it asap. My husband doesn’t want to get it. I’m afraid of getting sick. So undecided. We have dogs and it’s difficult for me to get joy from them. We had a session with my therapist. May I ask if you’re on meds for anxiety? Sometimes I think I write too much or not enough. Thank you for checking in me.

IF IT'S UCSF PSYCHIATRIST, LOOK ELSEWHERE. I HAVE HAD HORRIBLE, HORRIBLE SIDE EFFECTS TAPERING OFF LORAZEPAM WITH KLONOPIN. THERE IS SOME LINK TO BURNING MOUTH SYNDROME AND KLONOPIN. WHEN TAPERED WAS FINISHED I GOT RECEDING GUMS, SOARS IN MY MOUTH, SWELLING INSIDE MOUTH OF LIPS. THIS WAS WITH THE ORAL DISINTEGRATING TABLETS. ACTUALLY I WAS PRESCRIBED CLONAZEPAM, THE GENERIC FOR KLONOPIN. I HAVE TWO IMPLANTED TEETH AND MY GUMS RECEDED SO BAD YOU CAN SEE THE METAL OF THE IMPLANTS.