I’ve recently been feeling a good deal better after 2 months of fairly debilitating symptoms. I’m currently 5 months off of the drug and experienced my most pronounced ‘crash’ two months after quitting. My primary symptoms are mostly two-fold: head pressure/dizziness (with the occasional accompanying saccadic eye problems) and acute insomnia. I’ve done a prodigious amount of research over the past few months (my background is in biology), manifold blood and saliva tests, and am taking quite a few supplements and medications to counteract my problems to very good effect, so I thought I’d share. The unfortunate problem for us is that there is no one-size-fits-all solution and our problems run the gamut of second and third order effects induced from the drug.
Firstly, here are the results of my 24 salivary cortisol test. To preface, I’ve never had anxiety, depression, or sleep problems in my life. Now, however, I have extreme hypercortisolism (7 times higher than the low range for AM cortisol), and a further blood test confirmed I have very high serum catecholamine levels as well. A bit of conjecture is that our cortisol clearance pathway has been mightily obstructed (5AR mediates one route of cortisol reduction in the liver). This squares with the symptoms I was feeling at night–rapid heartbeat, nighttime jerks, anxiety, and general unsettledness. There’s no feedback loop on adrenaline production and PNMT, the enzyme that synthesizes epinephrine, is further potentiated by glucocorticoids. In effect, I was on a runaway train of stress and adrenaline production.
I wanted to address my sleep problems first as this was the most debilitating and likely lead to various other irregularities in my most recent blood test as compared the one I did a week after I crashed. I’ll include my recent blood test results in my user story.
Here are the supplements/drugs (and the reason I take them) that have largely ameliorated my adrenal issues and seem to continue helping with my progressive improvement (there’s likely an additive effect as my sleep continues improving):
-Trazodone (a very weak SRI and used for primary insomnia) – I’m taking a low dose, 50 mg.
-Atenolol - 25 mg (a beta blocker with selective Beta1 receptor antagonism; I used this initially to break the cycle of the positive feedback loop in runaway hypercortisolism. At the very least, it made me less conscious of my bounding heart)
Supplements (descending order of what I believe helped the most):
-L-Taurine (3g/day - amino acid that can slow the release of adrenaline from the adrenal medulla; is also good for cholesterol and has a general sedative effect)
-Rauwolfia serpentina root (1g/day; must contain Reserpine, a catecholamine-depleting compound that inhibits the transport of epinephrine, norepinephrine, and dopamine into the synaptic cleft; note: this is tough to get in the US, but I ordered it on eBay from an Indian purveyor)
-A “cortisol health supplement” with:
Magnolia Bark Extract
-CBD oil (I use Irwin Naturals CBD which is putatively reputable, 40 mg/day)
-I would also still be using both HTP and Tryptophan at bedtime if I weren’t taking Trazodone, but we ought to be especially aware of serotonin syndrome, even in a mild manifestation, as it can cause anxiety-like symptoms and much more grievous issues.
Regarding my head issues and the amorphous term " brain fog", here are the drugs/supplements that have helped me the most. An important note is that I believe a majority of my cognitive problems are derived from allopregnenolone underproduction (and likely isopregnenolone too) as 1. my serum pregnenolone levels were on the low end of the spectrum in my last blood test, 2. most of my symptoms are in-line with allopregnenolone dysregulation, and 3. many of my symptoms have improved noticeable with Gaba agonist agents.
Baclofen (10 mg - a small dose is enough for me and tolerance hasn’t been a problem; it works as a GABA,b agonist and seems to really have stabilized my vision and dizziness.This isn’t much of a surprise as it has similar pharmacodynamics to that of GHB, which a few people have “recovered” with.)
-Keto Diet - carbs really exacerbate my head pressure, and going very low carb has helped considerably.
-Turmeric - (1.5 g twice daily) helps with some of the brain inflammation I have and seems like a good substitute for ibuprofen
-Niacin - (750 mg/day – A positive allosteric modulator of GABA,a like allopregnenolone and also helps with cholesterol)
-A sleep supplement containing:
L-theanine (another positive allosteric modulator of GABA,a)
-Fish Oil - I use a very expensive one called PRN and it helps considerably as well
-One a Day multi
Hopefully someone can glean something useful from this or try a therapy they have yet to. I’ve seen steady improvement with this protocol, which again is me-specific, but hopefully it can prove helpful for some of you as well.