[Abyssos]

Hello! I am desperately seeking for help. Please read the whole story.

In December 2013, I had a surgery on my right groin because of a hernia. I was prescribed Oxycodone retard for 4 weeks. After I have broken my right acromion doing mixed martial arts 1 month later, my doctor prescribed me oxycodone until I decided to get surgery in April 2015 because the acromion didn't fuse by itself anymore. So basically, I was on 40mg oxycodone retard a day for more than 1 year. Because I couldn't handle the neuropathic pain in my groin due to a nerve injury during surgery I smoked a lot of cannabis to numb myself and get rid of the pain induced depression I had. Before the shoulder surgery, I also had a left groin repair in March 2015. I suffer from neuropathic pain in my left and right groin that doesn't go away. The doctors suspect that the genito femorialis nerve was damaged due to surgery. After my shoulder surgery in April 2015, the shoulder pain was so heavy that my doctor prescribed me buprenorphine (known as subutex) (0,4mg 3x a day) instead of oxycodone because I couldn't sleep for 4 days post-op. Laying down was impossible with the screws in my shoulder. The buprenorphin didn't help much with the pain either but due to extreme tiredness I finally could sleep on the 5th day after I have smoked a cannabis the evening before. When I woke up, all my problems started.

I had extreme visual snow, there was a "vibration feeling" in my head every few minutes combined with the feeling of passing out. I got so dizzy that I got rushed to the hospital, they did some tests (blood, heart) and everything came back fine. I still had this "vibration feeling" in my head for another 3 days and also some very weird visual distortions.

Since that day my life has changed.

I suffer from following symptoms since that day:

- visual snow

- panic attacks with choking feeling due to neck muscle spasm when sensory overload happens (malls, public places)

- strong lightheadedness

- shopping malls trigger fainting spells because I feel overwhelmed by sound and lights

- depersonalization and derealization

- slightly shaky vision (can't fixate objects with my eyes)

- focus problems (eyes often go out of focus)

- dysphoria

It's like some kind of filter has been turned off because I am literally feeling faint and dizzy when I am in an enviroment with a lot of lights and different sounds. Since May, I have stopped opioids. Neck and head MRI showed that nothing was wrong with me so my psychatrist just said it's an panic disorder and prescribed Zoloft. Zoloft made every symptom worse and I couldn't eat because it upset my stomach so I stopped it. I then was prescribed xanax and I finally could go out to shopping malls and in crowded enviroment because I could handle the lights and sounds again. However, Xanax made me incredibly tired and it also didn't work long enough so I had to take 3 pills a day to stop a rebound.

Because none of the doctors I have visited could tell me whats wrong with me, I googled about my symptoms. I have found something about sensory overload which lead me to an article about an imbalance of GABA and NMDA. I asked my psychatrist for clonazepam and I must say that I finally can go out again.The lights and noises in shopping malls or in enviroments with a lot of people are bearable again.
I take 0,5mg in the morning, 0,5mg mg in the evening. But it makes me totally dysphoric and my relationship suffers because I do not have any emotions left.

Now my question is. What triggered all those symptoms on the 5th day post op? Was it an instant opioid withdrawal because my doctor put me on buprenorphin after I took oxycodone more than 1 year? Or is it a post traumatic stress disorder due to all the pain and surgeries I had in the last 2 years? Eventhough I am on clonazepam, I still suffer from derealization, lightheadedness (mild), visual snow, chronic nerve pain and strong dysphoria. Oh, I forgot. Horrible brain fog, too! Should I up the dose in the hope to get rid of the DP and visual snow or will it make things worse?
I am also taking magnesium, valerian herb, multivitamines, vitamin B12, fish oil, l-taurine, OPC...

I have also read that a lack of serotonin and GABA are responsible for sensory overload because they have a "filter" function.
I am not sure what's wrong with me, though. Maybe it's POST ACUTE WITHDRAWAL from the opioids still? Or was the 4 days without sleep, combined with buprenorphine and weed a trigger for HPPD?

I don't know what neurotransmitters are lacking and which ones are overloaded. I tried 5-HTP which made me jittery, I tried L-Thyrosin which didn't help either. At the moment I am trying to tapper down the clonazepam and try oxycodone in low doses again, but the last time I tried oxycodone I almost freaked out in a big shopping mall because I was so overstimulated by all the sounds. Is this perhaps due to too much dopamine caused by oxycodone? I once read that too much dopamine can lead to sensory overload as well because it puts you in an "alert" state.

What bothers me the most is the visual snow. When I watch a "TV noise" youtube video for 5 mins, the visual snow is gone for 30 seconds and during those 30 seconds, all motions are normal again and I do not feel derealized. So I think that the visual snow is causing the derealization and the panic feeling in public due to the weird motions, the constant shimmering of walls and so on.

Brain and neck MRI was fine. Blood tests were fine too.

I am looking forward for your answer and hope someone with knowledge about that topic can jump in and give me some advise.
Kind regards

 

[rafateodo]

how you feels today? I'm feeling the same since Oct22, takink clonazepam and feeling that dprp and brain fog seems to reduce Hugs!

 

[Peter]

Was it an instant opioid withdrawal because my doctor put me on buprenorphin after I took oxycodone more than 1 year?

Your symptoms are not typical withdrawal symptoms from opioids and you would have also needed to experience typical withdrawal symptoms in order to argue for opioid withdrawal (like runny nose, muscle pain, nausea, fever, sweating, ...).

Or is it a post traumatic stress disorder due to all the pain and surgeries I had in the last 2 years?

This would require symptoms of post traumatic stress disorder to be present, like re-experiencing and hyperarousal, in connection to reminders of whatever singular event might have been traumatic to you (for example the surgery).

Should I up the dose in the hope to get rid of the DP and visual snow or will it make things worse?

Since clonazepam apparently works both for depersonalization disorder and visual snow in some cases, it's possible that a dosage increase might result in improvement. However like all benzos clonazepam can be very hard to get off once you took it for an extended period of time.

I am also taking magnesium, valerian herb, multivitamines, vitamin B12, fish oil, l-taurine, OPC...

Some vitamins like vitamin A and B6 are easy to overdose and shouldn't be taken unless there is a deficiency.

I have also read that a lack of serotonin and GABA are responsible for sensory overload because they have a "filter" function.

Unfortunately brain disorders aren't as simple as that.

I am not sure what's wrong with me, though. Maybe it's POST ACUTE WITHDRAWAL from the opioids still? Or was the 4 days without sleep, combined with buprenorphine and weed a trigger for HPPD?

I would say that Cannabis was likely the main culprit, perhaps due to being combined with other medications or the cocurrent stress.

At the moment I am trying to tapper down the clonazepam and try oxycodone in low doses again, but the last time I tried oxycodone I almost freaked out in a big shopping mall because I was so overstimulated by all the sounds.

Did you never try more traditional neuropathic pain medications (e. g. Gabapentine, Amitriptylin) or didn't they work well enough? Although opioids can work for neuropathic pain it looks strange to me, that they threw opiods first at it.

What bothers me the most is the visual snow. When I watch a "TV noise" youtube video for 5 mins, the visual snow is gone for 30 seconds and during those 30 seconds, all motions are normal again and I do not feel derealized.

This is a well known phenomenon. However it's interesting that your derealization also seems to respond to this. This would confirm that depersonalization can indeed be secondary to visual snow.

I am looking forward for your answer and hope someone with knowledge about that topic can jump in and give me some advise.

Since your visual snow is drug induced Levetiracetam, Lamotrigine and a combo of Tolcapone and Sinemet might work for it.