Veronika Pogrebova

01 · Timeline

Case History

Jan 2024

FQ Poisoning

Hospitalised with pneumonia at Cromwell Hospital, London (private clinic). Given Levofloxacin IV for 2 days. Nobody warned about side effects. Upon discharge: immediate suicidal ideation, couldn't walk normally, severe psychiatric symptoms. Husband was shocked — she came out of hospital a different person.

Jan–Apr 2024

Acute Phase — UK to Spain

Family relocated from London to Spain (Lloret de Mar). Veronika was very ill — thought she was dying, told husband "they will take my kids." Multiple Spanish doctors recommended antidepressants — she refused all of them.

Apr 2024 – ~Apr 2025

Functional Medicine Recovery

Consulted a functional medicine doctor from New Zealand. Followed strict protocol: L-theanine, magnesium, omega-3, B complex, glutathione, iron, adrenal complex. Clean diet, no coffee, daily meditation, yoga, sports. Extremely disciplined for over a year. Gradual improvement.

Apr–Jul 2025

Near-Normal

Working, exercising, functioning almost normally. Started going to parties, drinking wine occasionally, smoking cigarettes.

Jul–Sep 2025

Relapse

After ~3 months of alcohol and cigarettes, all symptoms returned: brain fog, tiredness. Then escalated: complete insomnia (could not fall asleep at all), depression, panic attacks, suicidal thoughts. Geneva checkup: Brain EEG normal, MRI normal, but Ferritin: 4 (critical). Barcelona Delfos Clinic: during hospital sleep study she actually slept well WITHOUT medication (paradox). Visited 5 hospitals, saw 40+ doctors.

~Oct–Nov 2025

Escitalopram (Cipralex)

Doctors prescribed Clonazepam + Escitalopram 10mg. After 6 weeks on escitalopram: no improvement, felt worse. Blood work revealed liver damage: ALT ×7, AST ×5 from normal. Escitalopram stopped immediately. Took Lorazepam about 8 times for sleep during this period — caused worsening (depression, panic, fainting sensations).

10 Dec 2025

First Contact with Dr. Pieper

Anton emails kontakt@praxisdrpieper.de. Pieper replies Dec 12 — offers individual therapy plan for €293 via PayPal. Email only, no video/phone. Sends FQAD Questionnaire.

14 Dec 2025

Questionnaire + Payment Sent

Filled FQAD Questionnaire (Bell Scale: 40) + medical brief ("veronika_brief.pdf") + €293 payment. Bell 40 = can do light work 3-4 hours with rest periods.

18 Dec 2025

Pieper Sends Full Therapy Plan

Package: therapy letter with diagnosis (FQAD, ICD E72.8, GABA metabolic disorder), supplement protocol table, nicotine patch PDF with research papers (Sanders 2022, Leitzke 2023), Visual Snow PDF. Separate message: "and please don't take SSRIs anymore!!!"

End Dec 2025

Cold-Turkey Clonazepam — CRISIS

Ukrainian doctor (online consultation) told Veronika to stop clonazepam in one day. She did it against Anton's advice. Doctor gave quetiapine instead — she felt very unwell, possibly from quetiapine or from abrupt clonazepam withdrawal or both. Day 7: emergency room. Clonazepam reinstated at 0.2mg in drops.

Jan 2026

Clonazepam Tripled + ZEM + TMS

Another doctor increased clonazepam from 0.2mg to 0.6mg/day (0.3 morning + 0.3 evening) — triple the pre-crisis dose. Went to ZEM Wellness Clinic in Altea — no significant improvement, constant rumination. A neurologist started TMS (Saint Protocol).

Jan–Feb 2026

Iron Infusions + TMS Results

Labs Jan 9: Ferritin 9.98 (was 4), Iron Sat 13.19%, GGT 54, AST 39, Vit D 26.1. Started Venofer (Feriv) IV iron infusions — 4 of 5-6 completed. TMS: approximately 30 sessions — appeared to make things worse, she felt more depleted. TMS paused. No periods for 5+ months, estrogen very low. CUN Pamplona MRI/EEG/lumbar puncture scheduled then postponed.

14 Feb 2026

Anton Updates Pieper

Detailed email about the deterioration. Reported: nicotine not started, cold-turkey disaster, TMS, iron infusions, Veronika's low state. Asked about nicotine, CBT, residential programs, estrogen.

21 Feb 2026

Pieper Responds

"This sounds really dramatic and like a severe deterioration." Gives modified nicotine protocol — more cautious: ¼ patch for 2 weeks (not 3 days). Asks 9 specific questions. Offers GABA/Serotonin urine test. Later same day sends "???" — no reply from our side.

~Feb–Mar 2026

Current State Stabilised Somewhat

Rumination reduced. Still nervous, agitated, restless. Swims 3×/week, walks, but in constant anxious state. Cannot focus on children or conversations. Thinks she "forgot how to communicate." Daily online psychotherapy in Russian — therapists all say take antidepressants. Pharmacogenomics test done at CUN. Periods returned (2 in last month after 5 months absent).

23 Mar 2026

Reply Sent to Pieper

Full answers to all 9 questions + 7 additional questions + request for online consultation. Shared case file: veronika.dscff.es. Awaiting response.

📧

Reply sent March 23. Waiting for Pieper's response.

02 · Diagnosis

What Pieper Found

Finding	Detail
Diagnosis	FQAD — Fluoroquinolone-Associated Disability
ICD	E72.8 — GABA metabolic disorder
Focus	Neuropsychiatric
Drug	Levofloxacin IV, 2d, Jan 2024, Cromwell Hospital London

GABA System Damage

GABA = brain's calming neurotransmitter. FQs block GABA receptors → anxiety, hypervigilance, insomnia, panic, depression.

⚠

Benzos are counterproductive. Block brain's own GABA recovery. Taper slowly — never cold-turkey.

Acetylcholine Receptor Blockage

FQ metabolites block nAChRs → cognitive fog, fatigue, mood, sleep. Proven: Sanders 2022.

✓

Solution: Nicotine patches. 30× higher affinity. Leitzke 2023: up to complete remission.

Therapy Goals

Neuroprotection
Adequate sleep
Strengthen GABA
Wean off benzos
Liberate acetylcholine receptors
Hypervigilance therapy daily

03 · Step 1

Nicotine Patch Therapy

⚡

Two versions. Feb 21 is MORE CAUTIOUS. Use modified.

Original (Dec 18)

Phase 1: ¼ patch × 3 days

7mg, cover ¾ tape. + Ambroxol 75mg × 10 days.

Phase 2: ½ patch from day 4, 4 weeks

If no improvement after 4 wks → Ambroxol 10 more days.

Modified (Feb 21)

ℹ

Pieper: "start very cautiously"

Phase 1: ¼ patch daily × 2 WEEKS

Much slower given deterioration.

Phase 2: ½ patch × 4 weeks

Total 4-8 wks. Report Pieper at wk 4.

⚠

Use modified (Feb 21) protocol.

Rules

Don't cut patches in Europe — tape
Side effects 3-5d normal
Improvement → go slowly
Strict pacing = no relapses

04 · Protocol

Supplements + B1 + Benzo Taper + Nervous System

Remedy	AM	Noon	PM	Night	Notes
MVM-A Antioxidant	1		1		Allergy Research
D3 5000+K2 200mcg	1				w/ meals
Omega-3 algae	2				+linseed oil
CoQ10 200	1				+CDP-Choline 250
Mg Glycinate 100	1	1	1		+Ca 1-2g
Mg L-Threonate 2000			1	1-2	=144mg
Spermidine 1.2mg	1	1	1		or wheatgerm
Theanine+Tyrosine+5HTP+Taurine	1-2				+Ashwagandha
SAMe 400-500	1	(1)			+GABA 750-1000
Daridorexant 50				1	benzo taper
Pregnenolone 50			1		+Pomegranate
NMN 500→NAD+	1				4-12 wks

Daily nutrition

MCT drink · Bone broth/Collagen 20g+VitC
Kefir/Kombucha+24-strain probiotic
GABA teas: Valerian, Passion Flower, Balm, Hops

Step 2: B1

3-wk high-dose. Neuroprotective.

Step 3: Benzo Taper (later)

0.6mg/day now. She believes clonazepam makes her worse and wants off. Tried Daridorexant briefly — had some side effects. She sleeps normally now without problems. Taper timing: waiting for Pieper's guidance.

Step 4: Hypervigilance (ongoing)

Polyvagal, somatic tracking, slow breathing.

Pieper rec.

Dr. Eleanor Stein

Neuroplasticity course

→

Pieper rec.

Gupta Program

Free 28d trial

→ iOS

Pieper rec.

CFS School

Trauma-informed

→

Book

Body Keeps Score

van der Kolk

→

05 · Diet

IF 16:8 · Low-Carb · Low-Histamine

✕ Avoid

✕ Gluten
✕ Sugar
✕ White flour
✕ Coffee
✕ Alcohol
✕ High-histamine
✕ Non-organic
✕ Farmed fish

✓ Include

✓ Organic only
✓ Wild fish
✓ Low-carb
✓ Bone broth
✓ Fermented foods
✓ GABA teas
✓ 16:8
✓ Linseed oil

06 · Restrictions

Absolute No-Go

⚠

Any = relapses + severe deterioration.

No SSRIs/SNRIs — liver damage
No Quetiapine
No cortisone
No NSAIDs
No extra benzos
No vaccines
No antibiotics (FQs EVER)
No long flights
No stress
No antidepressants w/o Pieper
No unnecessary interventions

07 · Assessment

Visual Snow Syndrome

⚡

Veronika: review, mark matches, include in reply.

Visual

Visual Snow

Pixelated/flickering dots, TV static, all lighting.

Afterimages / Trailing

Imprints persist. Moving objects leave trails.

Floaters / Blue-Field

Cobwebs indoors. WBC on wiggly paths.

Photopsia / Photophobia

Random flashes. Light painful.

Night Blindness / Halos / Starbursts / Glare / Ghosting

Low light trouble. Circles/rays. Ghost images.

Pulsating / Flickering / Contrast / Pattern Glare

Heartbeat vision. Heat-haze. Washed out. Patterns shimmer.

Non-Visual

Tinnitus

62% of VS patients.

Depersonalization / Derealization / Brain Fog

Detached. Dreamlike. Confusion.

Vertigo / Tremor / Twitching

Spinning. Involuntary.

08 · Correspondence

Questions Between Us & Dr. Pieper

📧

Reply sent March 23, 2026. Awaiting Pieper's response.

Pieper's Questions to Us (Feb 21, 2026)

He wrote: "to sort things out I'd have to know more about the different aspects." These are his exact questions:

#	His Question	Status
1	What is your main issue?	Answered in letter. Nervousness, agitation, circular thoughts, can't focus, can't communicate.
2	What is your assessment on the Bell scale?	Answered — said we're not sure, described her state, asked him to help rate it.
3	Are you still adhering to any remedies on my treatment plan or what exactly has changed since when and why?	Answered — not following full protocol, only Mg + NAC + clonazepam. Explained December crisis timeline.
4	What protocol are you on at the moment?	Answered — full current list provided.
5	Are you still following the dietary recommendations?	Answered — partially.
6	What works and what doesn't?	Answered — detailed breakdown of each treatment.
7	Are there any new blood values?	Answered — Jan 9 labs sent. New labs drawn, results pending.
8	Could I send you a test-set for GABA and Serotonine (in urine) to Spain for you sending it back to Germany by express?	Answered — YES. Address provided.
9	Are you still on the TMS?	Answered — paused after ~30 sessions, believed it worsened state.

Our Questions to Pieper

Questions we asked in the March 23 letter, awaiting his answers:

#	Topic	What We Asked
1	Nicotine + low estrogen	Is it safe to start nicotine patches when estrogen is very low? Should we fix estrogen first?
2	Estrogen / Progesterone	No period 5 months → then 2 periods in one month. Gynaecologist suggested supplementation. Could hormonal imbalance be driving the nervous state?
3	Iron and symptoms	Could ferritin 9.98 alone be causing the nervousness and exhaustion? Continue infusions?
4	TMS damage	Could 30 TMS sessions have caused harm? Avoid entirely or was it wrong timing?
5	CUN Pamplona tests	Pharmacogenomics done. They wanted MRI+contrast, EEG, lumbar puncture. Should we proceed?
6	Clonazepam taper	She believes clonazepam makes her worse. When to start tapering from 0.6mg? She tried Daridorexant briefly, had side effects. She sleeps normally now.
7	Residential program	English-speaking program for FQAD? Looked at Sea Recovery — not FQAD-specific.
8	Online consultation	Can he do a video call with Veronika so she feels someone is in charge of the plan?

Still Needs to Be Sent

⏳

Visual Snow checklist — Veronika needs to review symptoms from his PDF and send her assessment.
New blood results — blood drawn, waiting for lab results, will forward to Pieper.
Pharmacogenomics results — from CUN Pamplona, when received.

09 · Patient Data

Field	Value
Full name	Veronika Pogrebova
Date of birth	14 October 1992 (age 33)
Weight / Height	58 kg / 175 cm
Profession	Tattoo artist (currently not working)
Marital status	Married
Children	2 sons — Aang (born 2016) and Luca (born 2023)
Languages	Russian, Ukrainian, English
Address	Carrer Costa den Bandina 31, 17310 Lloret de Mar, Spain
Phone	+34 641 022 283
Insurance	AXA

Husband / Primary Advocate

Field	Value
Name	Anton Zinoviev
Phone	+34 641 022 317
Email	a.zinoviev@me.com
Languages	Russian, Ukrainian, English

Doctors Involved

Doctor	Role	Contact
Dr. Stefan Pieper	Lead — FQAD specialist, integrative medicine	kontakt@praxisdrpieper.de · Eichhornstr. 7, 78464 Konstanz · +49 7531 61133

Key Lab Values (Jan 9, 2026)

Marker	Value	Note
Ferritin	9.98	Was 4 before infusions. Critical — normal 30-100.
Iron Saturation	13.19%	Low — normal 20-50%.
GGT	54	Elevated.
AST	39	Borderline. Was ×5 during escitalopram.
Vitamin D	26.1	Low — target 40-60.

10 · Execute

Action Plan

DONE
~~Reply to Pieper~~ — sent March 23
NEXT
Buy 7mg nicotine patches + tape + Ambroxol 75mg — but check Pieper's reply re: estrogen first
NEXT
Get new blood results — already drawn, waiting for lab
THIS WEEK
Veronika: review Visual Snow symptoms — send follow-up to Pieper
THIS WEEK
Complete 5th iron infusion
DAILY
Polyvagal + breathing exercises (5 min minimum)
WHEN RESULTS
Send new labs to Pieper — iron panel + estrogen
WHEN PIEPER REPLIES
Start nicotine patches — cautious protocol (¼ × 2 weeks)
WHEN PIEPER REPLIES
Clarify Daridorexant / clonazepam taper plan
ONGOING
Clonazepam stable 0.6mg. TMS paused. No SSRIs.

Timeline

Period	Actions
Wks 1-2	Nicotine ¼. Ambroxol 10d. Reply. Iron. Breathing.
Wks 3-6	Nicotine ½. B1. GABA test. Report Pieper wk4.
Wks 6-8	Assess. Plan taper. Daridorexant.
Mo 3-6	Slow taper. Neuroplasticity. Reassess.

11 · Email Log

Full Correspondence with Dr. Pieper

Complete chronological log of all email exchanges between Anton Zinoviev and Dr. Stefan Pieper (kontakt@praxisdrpieper.de).

~10 Dec 2025

Anton → Pieper: First Contact

Initial email to kontakt@praxisdrpieper.de describing Veronika's case — FQAD after IV levofloxacin (Jan 2024, Cromwell Hospital London), severe psychiatric symptoms, multiple failed medication attempts. Requested consultation.

~12 Dec 2025

Pieper → Anton: Reply + Offer

Dr. Pieper responds. Offers individual therapy plan for €293 via PayPal. Consultation is email-only (no video/phone). Sends his FQAD Questionnaire with Bell Scale on the last page for Veronika to fill out.

14 Dec 2025

Anton → Pieper: Questionnaire + Payment

Sent: filled FQAD Questionnaire (Bell Scale answer: ~40 = can do light work 3-4 hours with rest periods), medical brief document ("veronika_brief.pdf"), and €293 PayPal payment.

18 Dec 2025

Pieper → Anton: Full Therapy Plan

Complete package received:
1. Therapy letter with diagnosis: FQAD, ICD E72.8, GABA metabolic disorder, hypervigilance.
2. Supplement protocol table (~15 items with AM/Noon/PM/Night schedule).
3. Nicotine patch therapy PDF with research papers (Sanders 2022, Leitzke 2023).
4. Visual Snow syndrome PDF for symptom assessment.
5. Separate message: "and please don't take SSRIs anymore!!!"

14 Feb 2026

Anton → Pieper: Deterioration Update

Detailed email about everything that happened since receiving the plan:
• Nicotine patches NOT started yet
• Cold-turkey clonazepam disaster (Dec 28 → ER, kindling)
• Clonazepam tripled to 0.6mg/day
• TMS started (~30 sessions) — appeared to worsen state, paused
• 4 of 5-6 IV iron infusions completed
• Veronika's continued low state: agitation, nervousness, circular thoughts
• Asked about: nicotine safety, CBT, residential programs, estrogen

21 Feb 2026

Pieper → Anton: "Sounds Really Dramatic"

"Dear Veronica and Anton, this sounds really dramatic and like a severe deterioration of your condition."

Modified nicotine protocol — MORE CAUTIOUS: ¼ patch daily × 2 weeks (not 3 days), then ½ patch × 4 weeks.

Asked 9 specific questions:
1. What is your main issue?
2. Bell scale assessment?
3. Still on treatment plan? What changed?
4. Current protocol?
5. Following diet?
6. What works / what doesn't?
7. New blood values?
8. Can I send GABA/Serotonin urine test to Spain?
9. Still on TMS?

Later same day: sent "???" — no reply from our side yet at that point.

23 Mar 2026

Anton → Pieper: Full Reply

Comprehensive reply answering all 9 questions + 7 new questions from our side:
Answers sent: main issue (nervousness, agitation, circular thoughts), Bell Scale (~40 described), treatment plan status (only Mg + NAC + clonazepam, not full protocol), current protocol list, diet partially followed, what works/doesn't, Jan 9 labs, YES to GABA test (address provided), TMS paused after ~30 sessions.

Our questions: nicotine + low estrogen safety, estrogen/progesterone issues (5mo amenorrhea then 2 periods), iron and symptoms, TMS damage, CUN Pamplona tests, clonazepam taper, residential program, online video consultation request.

Shared case file: veronika.dscff.es
Status: Awaiting response.

📧

7 exchanges total. Last message sent March 23. Awaiting Pieper's reply to answers + 7 questions.

⏳

Still pending from our side:
• Visual Snow symptom checklist (Veronika needs to review)
• New blood results (blood drawn, waiting for lab)
• Pharmacogenomics results (from CUN Pamplona)

12 · Sources