Central Nervous System problems after sustained Cocaine Abuse

[fatwax]

Hi Guys,

I wondered if anybody could shed some light on this...

I have a problem with my central nervous system that seems to be getting progressively worse over time. Especially after using the gym or drinking moderate levels of Alcohol. A few glasses of wine after dinner.

Back in my Twenties I was a DJ and music producer. Part of the lifestyle back then involved taking (a lot of) 'recreational' drugs (mostly cocaine and MDMA). I first took cocaine in my early twenties and soon became heavily addicted to it. The first 3-4 years of sustained abuse I actually enjoyed the drug very much. But towards the end of my Twenties and up until my thirtieth birthday I hated it. I took it mainly after drinking alcohol... to the point that I couldn't have a drink unless a line of coke followed pretty soon afterwards. If I didn't drink... I didn't want it. And after the first line I absolutely hated myself for taking it... but the need was so intense I had to have a line. In the end I simply stopped drinking to stop the need for coke.

I stopped taking recreational drugs when I hit 30 (I'm now 39). I stopped DJing and got completely out of the scene. I now run my own IT business and go to the gym 4-5 times a week. I live a pretty healthy lifestyle... but not everything is great.

Towards the end of my habit I started to get severe spasms in my CNS after taking a line or 2. I could feel my whole CNS tense up and I would get heart palpitations. Without sounding too dramatic, I honestly thought I was going to die. I immediately kicked the habit and my symptoms subsided. However, when I started going to the gym and training the symptoms would come back.

Essentially what happens is, 30 minutes or so after a training session I can feel my heart beating abnormally a little too heavy. I feel a little tense throughout my body but it's not too serious. I'm pretty much fine throughout the rest of the day. All my problems start when I try to relax.

Because of the symptoms I usually train in the eve. I come home, eat and go to bed about 3 hours after returning home. If I did not take my medication (Clonazepam) the symptoms would be so bad that I would not be able to sleep. The more I relax, the more my heart starts to pound. I feel my CNS tense up throughout my spine and, at the point of falling asleep, my heart goes into an intense Spasm and I jump up out of my 'sleep' in a state of shock. It honestly feels like I'm about to have a heart attack... although as soon as I jerk awake the systems subside. if I get out of bed and walk around a bit I'm fine. But as soon as I go back to bed to relax, it starts all over again.

My Neurologist prescribes me Clonazepam, of which I take half of a 2mg tablet... unless the symptoms are so bad, in which case I'll take a 2mg tablet. This doesn't happen often but has happened in the past. Especially if I do a heavy shoulder set or put excessive pressure on the top of my neck in the gym.

My GP has insisted he will NOT prescribe me Clonazepam AT ALL so if I need further medication I need to pay £300 to see my Neurologist for 15 minutes or fly half way around the world to a back street chemist to get it. Neither solution is ideal!

I told him I was not addicted in any way to Clonazepam and that I only needed it at night to relieve my symptoms. I explained that I'd rather not take any benzos at all! And if he was so concerned about giving me Clonazepam then he should try giving me something else that would do the same job.

He has just prescribed me 300mg Gabapentin to take at night, which I tried a few days ago and today. The first day I took it it had absolutely no effect on my symptoms and I had to take 1mg Clonazepam to relieve them. Today I went for a 45 min swim. After coming home I took a 300mg Gabapentin to see if it would work. It didn't. I then took another 300mg Gabapentin about 3 hours later and it actually made my symptoms worse! I could almost feel the nerve endings miss-firing in the back of my neck. My CNS went into a minor spasm and my forehead felt a little tense. It seems to be reacting with the very nerves that were causing the problems when I was taking cocaine... but instead of nullifying the nerves, it was triggering them... or at least thats how it felt. I took 1mg clonazepam about 30 minutes after getting the symptoms and I'm feeling a little better. Do I need to keep trying Gabapentin? Does it take a long period of time before it starts to work it's magic? Or am I simply wasting my time with it if it's already making my symptoms worse?

My fitness and gym lifestyle is really important to me. I don't want to stop training. But at the same time I'm worried about having to take Clonazepam for the rest of my life and I worry about the fact that I may be damaging the CNS even more with my training regime.

I've seen half a dozen Neurologists about my symptoms and nobody seems to be able to work out exactly what is going on. My doctor won't prescribe me my medication and his alternative just makes things worse.

Obviously I'd love to be able to cure my problem but I don't think this isn't going to happen. The damage is already done it seems. I'm just wondering:

1. Has anybody had any experience with these types of symptoms? And do they have a medical explanation/solution for a possible treatment program other than taking Clonazepam? Can anybody tell me exactly what is going on with my CNS and what the prognosis is?

2. I've heard recently that prolonged use of Benzos can lead to early dementia? Are their any conclusive reports of long term use of Clonazepam that support this claim? I'm certainly by no means addicted to it and do not take it, or have any need to take it, when I don't train or have any symptoms.

It's either stay out of the gym, stop training and reduce the amount of medication I'm taking. Or stay in the gym, be as healthy as possible but run the risk of further health issues in the future. Neither option is a great one for me.

BTW...

*Let this be a lesson to anyone out there taking Cocaine and reading this... STOP IT NOW!!!! It WILL have a long term effect on your health... Learn from other peoples mistakes. Get down to the gym and live a healthy life!*

 

[neurotic]

i don't think it's brain damage. it really sounds like anxiety. an anxious mind can easily convince itself of the craziest things

heart palpitations and thinking you are going to have a heart attack is like, extremely common with cocaine. some people even get it when they smoke weed. i have read about ex cocaine users working out because the pounding heart reminded them of cocaine - due to some kind of conditioning, they liked it. i think it's reasonable to say that because of the same conditioning - your last cocaine experiences where you thought you were going to die - you start to get anxious when you notice your heart pounding, which is completely normal after working out.

you could get your heart checked out by a cardiologist - if there is any damage that cocaine does that can be measured, it is probably to the heart.

furthermore, if it goes away with clonazepam, it's most likely well, anxiety related.

 

[fatwax]

Hi 'Neurotic'. Thanks for your input. I know there are a lot of people out there who have all kinds of crazy experiences on drugs and can become neurotic and anxious when high. However, I can confirm 100% it has absolutely nothing to do with anxiety or an anxious mind. I've had these symptoms for well over 5 years now. I have them when I train or drink alcohol and I don't have them when I don't do either. For the record, I also can not drink tea or coffee or have any kind of stimulant as this also triggers the symptoms. The symptoms are real and can be incredibly uncomfortable once they start. I am not and have never been an anxious person. I also have not used cocaine or similar drugs for almost 9 years now. This is not happening when I'm high. I don't get high anymore. Although this was a reasonable theory, we can put this absolutely to bed. It is definitely some kind of CNS damage.

 

[Cotcha Yankinov]

Hey fatwax, hope this advice will be of some help. Clonidine is something you should look into as far as medications go, if you're having hypertension/heart problems I think that's important to look into. Benzos can help with vasodilation but not like Clonidine. It would probably work very well for your sleep as well. It basically cuts your adrenaline (Which is good to cut after a workout anyways, bodybuilders used to take opiates to achieve the same effect, even at the cost of testosterone) so it dilates your arteries. Has a longer half life though, could be hanging around a bit in the morning but I think personally you also should look into having an EKG and an echocardiogram if worried about your ticker. It appears cocaine abuse can lead to problems in the smaller blood vessels of the heart that (not to make you paranoid) are hard to pick up on scans, but I would be more worried about the MDMA. MDMA stimulates this serotonin receptor that causes some people to build up collagen on their heart over time, leading to valvular heart disease/cardiac fibrosis (which should definitely be apparent on an echocardiogram). I can't say I know how someone with valvular heart disease / regurgitation or a heart rhythm disorder would do on Clonidine (maybe someone with regurgitation would just get more regurgitation idk) so I hope you can get that checked out first. The incidence of the heart problems in heavy MDMA users (young adults) was around 35% had an abnormal echocardiogram, most with some type of regurgitation. Ever have any problems with your hands getting weak / changing colors, especially with hands above your head? I wonder about the possibility that part of what you are feeling heart palpitation wise is an artery in your neck/collarbone area, have had experience with this myself, thoracic outlet syndrome. (not trying to belittle your problems I swear!). I can recommend slow deep breathing through the belly (chest breathing is horrible) to stimulate vagus nerve / parasympathetic nervous system (very important).

For a little conspiracy theory of mine; The vagus nerve is important for your heart, it runs through the neck and can be compressed by the sternocleidomastoid, in addition tightness in that area (Scalenes) could definitely cause you to feel palpitations because arteries snake through there, and tight scalenes can pull up on your 1st rib and pinch your subclavian artery between 1st rib and collarbone. That artery is right after the heart so if its getting pinched as you lie on your back and chest breathe I wouldn't be surprised if that could contribute to symptoms. For shits and giggles I recommend stretching your SCM and scalenes, pec minor wouldn't hurt. Stretching is a good healthy way to calm down too. Anyways, I think a heart attack is a real possibility so take it easy on the cardio before you see about an echocardiogram, nothing wrong with a long walk instead.
Now the gabapentin is something that didn't affect me much either, in fact the docs were mystified how I was at max dose (4g) and wasn't really touched just 2 months into it. I am pretty sure the ecstasy caused me to have more excitable/adrenalin (over simplification but oh well) type brain cells (which gabapentin tries to work to shut down) but because you / I have so many of them its not that effective. I don't recommend continuing to take it, the fact that its not working doesn't mean higher dose is needed, be wary of that attitude of doctors. I don't have much personal experience with benzos but you can get really FUCKING addicted if you are on them for too long or a regular basis, and they do harm your brain long term, IQ points mainly has been confirmed and increased risk of dementia type diseases, mainly from fragmented sleep after getting off them and suppressed REM sleep while on them. Definitely not something you want to do forever so I hope you can find something else that works for you. I would avoid the GABA drugs like the plague. Could try Clonidine for everything, or Belsomra for sleep although Belsomra is new and strange and not generic so $$$. Any questions fire away I'd be glad to help. Do you snore btw??

EDIT: I think you could be having hypertension problems judging by your reaction to stimulants, and it makes sense the benzos would help because they are vasodilators as well. Vasoconstriction from adrenalin can play a role. Therapeutically for you I would look into vasodilators after you get your heart checked out.

 

[Zeds(NCO2CH2CH3)2]

Sounds like dystonia, I'm guessing even your doctors think it's dystonia, clonazepam is the first line treatment for this nowadays. You may argue that it isn't but I have seen the frequency of dystonic spasms and ticks In a few people severely exacerbated but also somewhat controlled by stimulants.

I would clearly pitch this as dystonia and get clonazepam as it apparently helps you. Soul searching as many patients do doesn't pan out well, focus on the treatment and not the answer. It's just a word.

Zedz

 

[fatwax]

Hey Gotcha. Thanks for taking so much time out of your day to offer some great advice. It's very much appreciated! A lot of what you wrote there makes a lot of sense!

Regarding my ticker. I've had some pretty good scans of it over the few years. Everything seemed to be as it should be and, like I mentioned in my post, I can train, swim, run, play tennis etc all day long and I don't have any issues with my heart. On that note i'm pretty fit.

Regarding the hypertension. My blood pressure has always been bang on the money. Never had any issues there. The only time I start to get a pounding heart is when I start to relax after exercise. Thats when everything starts to go a bit crazy. I can feel my CNS misfiring and sending signals/muscle spasms throughout my body. Most importantly though, my heart. Have you ever fallen asleep 'too fast' and then jumped up out of bed? It's a very similar experience to that.

When it all first started I was in Samui, Thailand about 8 years ago. I was lying in bed, and just as I was about to fall asleep, it was like somebody had given me an electric shock in my neck. I jerked awake suddenly wondering WTF was going on. No heart spasms then... just a complete inability to switch from awake mode to sleep mode. Then, as I tried to sleep again the same thing happened. Over and over and over again. I didn't sleep for 3 days until I got back to Bangkok. The sleep specialist there was great and gave me clonazepam and boom... I was away with the fairies catching up on a LOT of Zzzzzs. Over time though my symtpoms have got more intense... especially after training in the gym or doing any kind of fitness. It seems to me the gym/fitness is slowly doing more damage to my CNS... which I'm desperately hoping is not the case.

Interestingly enough, 4 years ago I started doing a LOT of swimming. I'm talking 4-5 miles a session. Long openwater lake swims etc. I even drove to Lake Como and spent 10 days there swimming from Lecco to Belagio... and back! After about 8 months my symptoms started to subside. I decided I'd start training in the gym again to get a bit bigger and for the first 2-3 weeks I had NO symptoms whatever. Then, they came back. I've just started swimming again for cardio purposes but for sure my symptoms won't go whilst i'm lifting in the gym no matter how much I swim. But it's interesting that the swimming definitely had a positive effect on my condition. If I can't find a medical solution to all of this I guess I'll just have to knock the gym on the head and get back into the swimming full time and hope time repeats itself.

Your mention of Clonidine certainly makes a lot of sense. It's as if there is far too much adrenaline running through me when I try to rest and it seems my body, after years of cocaine abuse, has lost the ability to shut itself down normally. Whatever receptor sites/chemicals that are released to shut the body down have clearly got fried over the years. Probably why the Clonazepam works so well. Basically, whatever parts of the brain the Clonazepam is working on is the part that I've damaged somehow. Hence, I need to find a drug that works almost identically to Clonazepam (if there is one) but without giving my doctor the hysteria and paranoia that comes with prescribing my medication to me. I am by no means addicted to Clonazepam... If anything I try my best not to take it whenever possible. I'll only take it when I absolutely need to, which is generally after a heavy gym session. If I don't train for 5 days for whatever reason I will not take it. And I'm not just saying that to prove a point that I'm not a benzo junky... that really is the truth... guv.

I don't think I need a heart scan just yet. I'm generally in pretty good shape and haven't touched anything remotely fun for a seriously long time. I missed my morning f**king coffee though like you wouldn't believe! Whenever I get tired I just have to ride it out and watch all my mates necking double expressos! It's excruciatingly painful to witness.

I haven't tried the deep breathing either but will definitely give that a go. Maybe another thing I've mentioned... when the symptoms are bad it often gets worse when I lie on my side, usually with my neck slightly bent on the pillow. At this point I can literally feel my CNS tensing up all the way down my spine and generating minor muscle spams... when I turn onto my back things settle down a bit... but this doesn't cure the symptoms. It just makes them slightly less intense.

I don't snore much no. Maybe after a big night out but generally no. I have no idea why the missus sleeps upstairs in the spare bedroom with her ear plugs in though! Just kidding.

I'm gonna print all this thread off when it's done and show it to my doc to see if he has any thoughts. Anything to slow down the adrenaline could def be worth a look at so, once again, thanks so much for your advice brother. It's much appreciated!

BTW Zedz, I'll mention the Distonia to my doc too... but my brother in law had distonia and I don't think thats what I have.... very different symptoms... but i'd def take a look. There's no soul searching for the answer here... Although it would be awesome to know WTF is going on. I'm more concerned about having to fly to Asia to go shopping for generic benzos in a back street chemist and getting Dementia along the way! The whole point of this post is to try to find out A. WTF is going on and B. What medicines, if any, can I be legally prescribed by my amazing doctor who i've been with for 20 years without him losing his job because his superiors thing he's smacked out of his head all day long on 'my' Clonazepam!

 

[Cotcha Yankinov]

No problem man, seems to be a lot of us eating the mistakes from their youth these days so anything we can do to help each other and move forward is what its all about now. Your CNS symptoms are interesting. That they could be posture related or get worse with different positions is ESPECIALLY interesting to me. I could suggest a couple things and maybe something will click for you, hope I'm not belittling anything! As far as what might be happening when you try to sleep/relax heavily, it could be something in the range of a hypnic jerk - https://en.wikipedia.org/wiki/Hypnic_jerk I am not that knowledgeable regarding specifically cocaine (MDMA is my area) but coke increases the sensitivity of adrenergic nerve endings to norepinephrine. And I will say that most uppers are now known to ultimately increase the amount of excitable brain receptors essentially. What happens to someone who takes a downer on a regular basis though is basically that their brain thinks they don't need to make that downer brain chemical themselves because they actually have too much of it from the drug, so when they stop taking the drug their brain has to start making it again. However with uppers your brain chronically just becomes more excitable. Adrenaline and more usual stress hormones like cortisol can stick around (sometimes 3-4+ hours I believe on the hormones) so if you happen to have a big stress response to a hypnic jerk that could lead to more adrenaline/excitability and more hypnic jerks. And adrenaline begets adrenaline, your sensitivity to adrenaline increases when you have more of it in your system already, so if you had a really hard workout you would really be getting a big stress response. The palpitations (wherever you feel them) might have something to do with vasoconstriction but hard to say.

Ultimately a lot of hypnic jerks (if that's some of what you're getting) indicate sleep architecture problems, which would be my main concern. If we're going down that line of thinking a sleep study would be very important, and not just to look at the summary of the polysomnograph (this amount of average percentage stage 2 blah blah blah) but to actually get past the 30 second epochs (averages) that the sleep tech takes/software takes and tech glances at, but to actually look at the brain waves. A lot of hypnic jerks to me would suggest that you are getting wakeful brainwave intrusion into your sleep (aka alpha intrusion). I could be theorizing a lot of your problems are from MDMA just because that's my area and that's whats happening to me (ecstasy has destroyed my sleep), but MDMA can really fragment your sleep architecture, which typically fragments a lot as you get older anyways. It would be a big plus to rule out if sleep apnea is playing a role. Skinny people have it too and its more common than people think... And abstinent mdma users actually have a much higher rate of it, actually a bigger correlation between MDMA abuse and obstructive sleep apnea than obesity and sleep apnea. They are investigating drugs for obstructive sleep apnea now that work on similar pathways as MDMA, has to do with how your brain handles the muscle tone in your neck/throat when you sleep. But sleep apnea could contribute to the wakings/sympathetic arousal but mainly just to check your sleep architecture. Your sleep is vital to your healthy aging. MDMA and the like are really hard on your sleep, the areas of your brain that generate sleep could very well have been victim to it. Studies essentially say that the sleep generators have too much excitable neurons and not enough inhibitory (Which could contribute to awakenings).
Now if I had to guess about the twitching that is somewhat posturally dependent, I would have to guess fasciculations https://en.wikipedia.org/wiki/Fasciculation Very posturally dependent for myself. Your nerves consume about 20% of your body's oxygen supply and they can get cranky when they get compressed anyways. Interestingly wiki says "Fasciculation also often occurs during a rest period after sustained stress, such as that brought on by unconsciously tense muscles. Reducing stress and anxiety is therefore another useful treatment.<sup>" II wouldn't jump to any horrible conclusions on the cause of fasciculations though, I think it tends to happen more in people who have an over excitable CNS. Have you tried many vitamins or at least a multi vitamin btw? I think magnesium is important and some people are deficient, and that wiki mentions magnesium as well. Whens the last time you had any bodywork/massage done? I would suggest (if you have the money) finding someone who does myofascial work, its typically the fascia and scar tissue (collagen) that gives nerves the most problems and MDMA is known to stimulate the kinds of cells that make collagen (fibroblasts). Even if its something else, a regular massage could help with tension/stress I suppose. I think the abnormal muscle tone/dystonia is something to look into, as in, why are the muscles firing and why/when does it get worse? If any specific muscle becomes a horror botox or lidocaine, similar injection could help reset the muscle tone but could be a pain with insurance.

Myoclonus is interesting, would DEFINITELY read. https://en.wikipedia.org/wiki/Myoclonus From wiki "Most myoclonus is caused by a disturbance of the central nervous system. Some are from peripheral nervous system injury. Studies suggest several locations in the brain are involved in myoclonus. One is in the brainstem, close to structures that are responsible for the startle response, an automatic reaction to an unexpected stimulus involving rapid muscle contraction.[citation needed]
The specific mechanisms underlying myoclonus are not yet fully understood. Scientists believe that some types of stimulus-sensitive myoclonus may involve overexcitability of the parts of the brain that control movement. These parts are interconnected in a series of feedback loops called motor pathways. These pathways facilitate and modulate communication between the brain and muscles. Key elements of this communication are chemicals known as neurotransmitters, which carry messages from one nerve cell, or neuron, to another. Neurotransmitters are released by neurons and attach themselves to receptors on parts of neighboring cells. Some neurotransmitters may make the receiving cell more sensitive, while others tend to make the receiving cell less sensitive. Laboratory studies suggest that an imbalance between these chemicals may underlie myoclonus.[citation needed]
Some researchers[according to whom?] speculate that abnormalities or deficiencies in the receptors for certain neurotransmitters may contribute to some forms of myoclonus. Receptors that appear to be related to myoclonus include those for two important inhibitory neurotransmitters: serotonin, which constricts blood vessels and brings on sleep, and gamma-aminobutyric acid (GABA), which helps the brain maintain muscle control.[citation needed] Other receptors with links to myoclonus include those for benzodiazepines, drugs that induce sleep, and for glycine, an inhibitory neurotransmitter that is important for the control of motor and sensory functions in the spinal cord.[citation needed] More research is needed to determine how these receptor abnormalities cause or contribute to myoclonus.
Treatment:
Concerning more serious afflictions, the complex origins of myoclonus may be treated with multiple drugs, which have a limited effect individually, but greater when combined with others that act on different brain pathways or mechanisms. Treatment is most effective when the underlying cause is known, and can be treated as such. Some drugs being studied in different combinations include clonazepam, sodium valproate, piracetam, and primidone. Hormonal therapy may improve responses to antimyoclonic drugs in some people.
Some studies have shown that doses of 5-hydroxytryptophan (5-HTP) leads to improvement in patients with some types of action myoclonus and PME.[citation needed] These differences in the effect of 5-HTP on patients with myoclonus have not yet been explained." Also "People suffering from Benign fasciculation syndrome can often experience Myoclonic jerking of limbs, fingers and thumbs." This might not be the source of your palpitations or whatever you feel/hear but thought it was interesting too "Middle Ear myoclonus occurs in the muscles of the middle ear. These muscles may include the tensor tympani and stapedius muscles. It can involve the muscles surrounding the Eustachian tube, which include the tensor veli palatini, levator veli palatini, and salpingopharyngeus. Sufferers describe it as a thumping sound or sensation in the ear.".
INTERESTING... Clonazepam is mentioned HOW many times in that wiki.... I think the myoclonus seems to be a lack of inhibitory brain cells problem as well and it mentions boosting the inhibitory brain cell precursors as a treatment. Also it does mention more physical injury/spinal cord problems as a cause too. It being somewhat posture related with your neck would encourage me to keep that open as a contributing factor.

If you want to spend a little money on supplements (worth it IMO) I would definitely try 5-HTP at maybe 100mg a day/ 50mg 2 times a day, morning/night,(don't mix with SSRI's or anything), L-theanine/GABA/Glycine for your inhibitory cells in your CNS. I think that at least taking the precursors to these neurotransmitters could benefit your CNS. SO 5-HTP/L-theanine/GABA/Glycine. And a good multi wouldn't hurt, there are cofactors in it that will help absorption, specifically b-6 (pyridoxine) with 5-HTP. But if you start getting insomnia/anxiety or worse myoclonus type stuff. cut out the 5-HTP and just leave the L-theanine/GABA/Glycine supplements, you could take a lot of the latter and I wouldn't expect any real side effects. The wiki on myoclonus mentioned excess serotonin as a cause of myoclonus so that's why I would be on the lookout for 5-HTP having a rare chance of aggravating something. I might also mention the Clonazepam basically decreases serotonin binding, which could be part of its therapeutic effect (not just its GABA effect) if too much serotonin in the wrong part of the brain is contributing to your problems.

Anyways, its important to get your stress/excitability down somehow, and I don't believe GABA drugs/benzos are a good longterm option. Even if taking sporadically if we're talking 10 years in my opinion. Rather than abusing your inhibitory brain cells to shut down your excitable brain cells, I would antagonize your excitable brain cells directly and skip your inhibitory brain cells (save them!). Belsomra could help and it works in a manner that's probably better for long term, just shuts down your wakefulness. Just good for sleep though. Similar to clonidine but clonidine is more for hypertension/vasodilation and will have more withdrawal/longterm effects I think. Though we don't know about Belsomra long long term yet. And its not generic. But you can print off a coupon to try and get 10 free pills I'm pretty sure somewhere online, I hope its available for you its been a blessing for me, not perfect but decent and good long term. Now for a better option than Clonazepam I would try Clorazepate, but its a long half life so If you don't need it during the day you would probably do better long term with something shorter acting, shorter acting as possible in fact just to get you through your sleep without "eating into your benzo tolerance" during the day needlessly. I will say on the matter of benzos that your REM sleep (deepest dream sleep) is very important to your brain/CNS (Which you already seem to be having problems with) and benzos can suppress that. If its between benzo sleep and no sleep though I can understand benzo sleep though lol.

But yeah between hypnicjerks/myoclonus, (Hyperekplexia as well maybe idk)/fasciculations I think that's a lot of ideas about whats going on.
Best of luck with the recovery and staying away from the bad drugs man any questions fire away. hope this helps whoever might read it.</sup>

 

[Hammilton]

Nothing you've said suggests it isn't anxiety, all of it actually reinforces the idea that it is. Caffeine making it worse, is a big clue. You'd think, if it was anxiety related drinking would make it better, it is an anxiolytic, but in this case I'd expect it to make it worse, actually. Why? Because you so wrapped up drinking and your coke use (as you said, you couldn't drink without a line) that I would expect it to trigger memories (conditioned place response, in a way, just in this case instead of place, it's more 'state' or condition).

You should give more credit to your mind, and accept that it probably is anxiety. But you probably won't- accepting that it was anxiety would relieve your anxiety, and the mind has a hard time performing that sort of ju-jitsu. I have had many similar experiences, not as long lasting, though. I could only piss sitting down for quite a while because I would have anxiety about the effect opioids had on my ability to piss, so unless I could do something to take my mind off of it (read, go through my wallet, etc. I still have the anxiety (it's not experienced as worry, either, like yours, though I now know what it is) but the problem is instantly solved by taking my mind off of it, usually reading the news on my phone now.

We can become hyper-aware of our bodies when anxious and cause physical problems. You know how many people have convinced themselves they're having a heart attack and walk away with a xanax prescription?

Additionally, what you describe, unless there's more I missed in your book-long OP, are not CNS symptoms, they're peripheral nervous system symptoms.

Have you ever had your BP or HR checked during one of these attacks? I bet both elevate to some degree.