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Phyber: About to start tapering off Amitriptyline and Alprazolam


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Hello, I'm new here. I'm a 31 year old guy and always had intermittent sleep issues where on some days I could not fall asleep or delayed onset of sleep, but usually the next day I would sleep normally as I would be tired from the previous day's sleep deprivation. However recently I was unable to even do that as I had many days of fragmented sleep and that caused depression along. The hair loss did not help either and I was stressed out as I already had social anxiety (since I'm very skinny/underweight) and became agoraphobic. Since the sleep became bad to worse, my Dad recommended a psychiatrist whom he has consulted before for himself. So this doctor prescribed me Alprazolam .25 and Amitriptyline 25 and told me to come back after 10 days. I was able to sleep well on all days. When I went to the doctor he told me to increase the dose for Amitiptyline to 50 for 10 days and then 75 for next 10 days. The dose for Alprazolam remains the same throughout. During this period I was given relaxation techniques and yoga lessons by the therapist who works at the doctor's office. This doctor doesn't say much about the the overall plan. I guess its because he doesn't want the patient to be stressed out or worried by knowing about the withdrawal issues. I think that is fine, but in the age of the internet the patient will know about it.


I have 5 days left to complete the 10 days on Amitriptyline 75. I noticed that the higher doseage of 75 has much more side effects than 50 like I noticed slight twitching when speaking, hands type the wrong keys when typing, memory/recall issues, even higher heart beat rate, etc. I am not saying its bothering too much but it does make me worry. I wish he didn't up the doseage to 75 as I was fine on 25/50. I am looking for advise from others on the recommended withdrawal plan for the doesage that I have taken until now so that I can know if the doctor is giving me the correct advise or not.


The only side effect that was a positive thing for me is that it me me gain some weight and I think that's because my appetite increased and started eating more. I understand that when I'm off the meds the weight gained will be lost. Any tips on how to retain the gained weight when I am off the meds please?


Alprazolam .25 and Amitriptyline 25 from October 29th to 7th November, 2015

Alprazolam .25 and Amitriptyline 50 from 8th November to 17th November, 2015

Alprazolam .25 and Amitriptyline 75 from 18th November to April 2016
Alprazolam .25 and Amitriptyline 50 from April 2016 to June 2016
Alprazolam .25 and Amitriptyline 25 from June 2016 to September 2016
Tried tapering off both meds myself from October 2016 to January 2017 (Doctor did tell about tapering off Alprazolam .25)

Half of Alprazolam .25 and Amitriptyline 25 from January 2017 to present

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  • Moderator Emeritus

Hi Phyber , welcome to the site.


You'll find loads of information and advice here about how to manage your situation.

You'll also find loads of horror stories about the effects of antidepressants , and the severe symptoms that

can develop when people stop them.


I believe the best thing you can do now is "get out while you can".  

My understanding is you've taken:

10 days Amitriptyline @ 25mg

10 days  "        "         @ 50mg

5   days   "        "        @ 75mg


You could probably go back to 50mg instead of taking any more doses of 75mg.  Then you'll need to wait for 4-7

days and plan your taper depending on how your symptoms are.

Because you've been on the Amitripyline for such a short period , you will be able to go off faster than the usual

rate recommended here (which is no more than 10% decrease at a time).

One of the moderators or Admin will advise you further about this.


You will need to taper the alprazolam too . . . but one thing at a time.


The new symptoms you're having are because the dose floating around your blood-stream is too high for you.  

If your doctor knew better , he would have had you remain on a lower dose and see if things resolved.  


Please could you have a go at filling in your signature.  Then people can see your drug history as it comes

up each time you post.


Best wishes ,  Fresh

1987-1997 pertofran , prothiaden , Prozac 1997-2002 Zoloft 2002-2004 effexor 2004-2010 Lexapro 40mg

2010-2012Cymbalta 120mg

Sept. 2012 -decreased 90mg in 6months. Care taken over by Dr Lucire in March 2013 , decreased last 30mg at 2mg per week over 3 months. July 21 , 2013- last dose of Cymbalta

Protracted withdrawal syndrome kicked in badly Jan.2014 Unrelenting akathisia until May 2014. Voluntary hosp. admission. Cocktail of Seroquel, Ativan and mirtazapine and I was well enough to go home after 14 days. Stopped all hosp. meds in next few months.

July 2014 felt v.depressed - couldn't stop crying. Started pristiq 50mg. Felt improvement within days and continued to improve, so stayed on 50mg for 8 months.

Began taper 28 Feb. 2015. Pristiq 50mg down to 45mg. Had one month of w/d symptoms. Started CES therapy in March. No w/d symptoms down to 30mg.

October 2015 , taking 25mg Pristiq. Capsules compounded with slow-release additive.

March 2016 , 21mg

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  • Administrator

Welcome, Phyber.

If I were you, I would go back to 50mg amitriptyline right away and not deal with the adverse effects of a higher dose. There is no fixed "therapeutic" dose of any drug. There is no reason for you to take a higher dose if it makes you feel odd or worse.


I would give 50mg amitriptyline at least 4 days, then consider whether you want to reduce further. You are right on the borderline of withdrawal syndrome risk, which is a month of a drug (but people have had withdrawal problems taking a drug for much less time). I would not jump from 50mg to 25mg, but step down by 5mg a week; stop if you get withdrawal symptoms.


Here's some background information: Tips for tapering off amitriptyline


If I were you, I would assume that since you've been taking alprazolam regularly for 25 days, you are at high risk of withdrawal. You will need to taper that after you resolve the amitriptyline dosage.


Your sleep problems and underweight suggest to me that you could make some lifestyle changes to remedy them, rather than taking a drug cocktail. Perhaps you're working on this with the therapist. You might want to talk to a dietitian, too, it sounds like you might be lacking in some nutrients.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • Moderator Emeritus

Welcome Phyber,

I'm sorry you have ended up on these drugs and are now having side effects. There are natural, healthier ways to improve sleep without taking harmful drugs.


Scroll half way down in this topic for some ideas:


Important topics about symptoms, including sleep problems


I'm also curious about what your doctor has planned for you and don't understand why he would increase your dose if the lower dose was working fine.


As Fresh has mentioned, you have only been on Amitriptyline a short while, so probably don't need to taper as slowly as we usually recommend, dropping back down to 50mg now would be my suggestion too.


Here is our Amitriptyline tapering information, we usually recommend dropping by no more than 10% of your current dose every month, but that usually applies when someone has been on the drug for several months or longer. In your case, I hope you will be able to taper much faster without encountering withdrawal symptoms. But if you do, you will need to slow down.


Tips for tapering off amitriptyline


As you are also taking Alprazolam daily, you will develop a physical addiction/dependence on this, so it will also need to be tapered. The longer you take this, the more likely it is that you will become dependent on it.


It would be great if you would put your drug and withdrawal history in your signature. Doing this helps people understand your context, it appears below each of your posts. Here are instructions for how to do it:




I googled 'how to increase weight and appetite naturally with supplements' and got a lot of hits, here are a couple:


Which are the Best Food Supplements to Gain Weight? | 5 ...


3 Ways to Increase Your Appetite - wikiHow


Please feel free to write whenever you want, you will find a lot of friendly help and support here. You can use this thread as your ongoing journal to track progress, write about symptoms, ask questions and communicate with the community. Its a good idea to bookmark it or follow it, so its easy to find again.




edit: posting the same time as Alto, similar advice given.

Edited by Petunia

I'm not a doctor.  My comments are not medical advise. These are my opinions based on my own experience and what I've learned. Please discuss your situation with a medical practitioner who has knowledge of tapering and withdrawal...if you are lucky enough to find one.

My Introduction Thread

Full Drug and Withdrawal History

Brief Summary

Several SSRIs for 13 years starting 1997 (for mild to moderate partly situational anxiety) Xanax PRN ~ Various other drugs over the years for side effects

2 month 'taper' off Lexapro 2010

Short acute withdrawal, followed by 2 -3 months of improvement then delayed protracted withdrawal

DX ADHD followed by several years of stimulants and other drugs trying to manage increasing symptoms

Failed reinstatement of Lexapro and trial of Prozac (became suicidal)

May 2013 Found SA, learned about withdrawal, stopped taking drugs...healing begins.

Protracted withdrawal, with a very sensitized nervous system, slowly recovering as time passes

Supplements which have helped: Vitamin C, Magnesium, Taurine

Bad reactions: Many supplements but mostly fish oil and Vitamin D

June 2016 - Started daily juicing, mostly vegetables and lots of greens.

Aug 2016 - Oct 2016 Best window ever, felt almost completely recovered

Oct 2016 -Symptoms returned - bad days and less bad days.

April 2018 - No windows, but significant improvement, it feels like permanent full recovery is close.

VIDEO: Where did the chemical imbalance theory come from?

VIDEO: How are psychiatric diagnoses made?

VIDEO: Why do psychiatric drugs have withdrawal syndromes?

VIDEO: Can psychiatric drugs cause long-lasting negative effects?

VIDEO: Dr. Claire Weekes




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Phyber this is your lucky day ..finding sa at this early stage of the druggery game.


If you have access to a library i rec getting 'Anatomy of an epidemic; by Robert Whitaker.

In it there is a whole chapter or part thereof on xanax (alprazolam).


What on earth is your doctor doing?? Perhaps pharma prescribing commissions are a function of dosages...who knows.



Thought for the day: Lets stand up, and let’s speak out , together. G Olsen

We have until the 14th. Feb 2018. 

URGENT REQUEST Please consider submitting  for the petition on Prescribed Drug Dependence and Withdrawal currently awaiting its third consideration at the Scottish Parliament. You don't even have to be from Scotland. By clicking on the link below you can read some of the previous submissions but be warned many of them are quite harrowing.


Please tell them about your problems taking and withdrawing from antidepressants and/or benzos.

Send by email to petitions@parliament.scot and quote PE01651 in the subject heading. Keep to a maximum of 3 sides of A4 and you can't name for legal reasons any doctor you have consulted. Tell them if you wish to remain anonymous. We need the numbers to help convince the committee members we are not isolated cases. You have until mid February. Thank you

Recovering paxil addict

None of the published articles shed light on what ssri's ... actually do or what their hazards might be. Healy 2013. 

This is so true, with anything you get on these drugs, dependance, tapering, withdrawal symptoms, side effects, just silent. And if there is something mentioned then their is a serious disconnect between what is said and reality! 

  "Every time I read of a multi-person shooting, I always presume that person had just started a SSRI or had just stopped."  Dr Mosher. Me too! 

Over two decades later, the number of antidepressant prescriptions a year is slightly more than the number of people in the Western world. Most (nine out of 10) prescriptions are for patients who faced difficulties on stopping, equating to about a tenth of the population. These patients are often advised to continue treatment because their difficulties indicate they need ongoing treatment, just as a person with diabetes needs insulin. Healy 2015

I believe the ssri era will soon stand as one of the most shameful in the history of medicine. Healy 2015

Let people help people ... in a natural, kind, non-addictive (and non-big pharma) way. J Broadley 2017



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  • Moderator Emeritus

Hello Phyber and welcome to s/a,


Something I learned this year was how to regulate my hunger feelings.  Over the last year or so I had trouble knowing when I was hungry.  I tend to be quite skinny most of the time, then with w/d was putting on a little weight. 


Basically, we have something called a vagus nerve running from brain to heart to stomach.  If it's sluggish or has been hurt, it doesn't send messages as well as it should, including hunger messages.  (It can be hurt by psych meds, stomach meds, benadryl or infection).  Things we can do to stimulate our vagus nerve include:


- meditation

- chanting, singing loudly, coughing, tensing 'pooping' muscles

- back bends to stretch spine and open chest, or 'cat & cow' yoga movemnt

- side bends

- dipping face in cold water


This nerve also helps us fight depression, moderates heart-rate, reduces stress-hormones, helps restore natural immune function - and other stuff.  BeyondMeds had a really good post on it once.


Now I easily know when I am hungry - and it feels good.




2010  Fluoxetine 20mg.  2011  Escitalopram 20mg.  2013 Tapered badly and destabilised CNS.  Effexor 150mg. 

2015 Begin using info at SurvivingAntidepressants.  Cut 10% - bad w/d 2 months, held 1 month. 

Micro-tapering: four weekly 0.4% cuts, hold 4 weeks (struggling with symptoms).

8 month hold.

2017 Micro-tapering: four weekly 1% cuts, hold 4 weeks (symptoms almost non-existent).

2020 Still micro-tapering. Just over 2/3 of the way off effexor. Minimal symptoms, - and sleeping well.
Supplements: Fish oil, vitamin C, iron, oat-straw tea, nettle tea.

2023 Now on 7 micro-beads of Effexor. Minimal symptoms but much more time needed between drops.

 'The possibility of renewal exists so long as life exists.'  Dr Gabor Mate.

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