Cabinhope: Willing to begin

[Altostrata]

Cabinhope, do the headaches follow any pattern? Perhaps after certain foods, like coffee?

 

Reducing by 5% is an appropriately cautious way to proceed.

 

You're taking 37.5mg trazodone, correct? You want to take 25mg in tablet form (1/4 100mg tablet), and the rest liquid?

 

If you have 100mg tablets, the easiest way to do this is to crush a 100mg tablet and add 100mL water to it. Then you have 1mg in 1mL.

 

If you want to take 35.625mg, you'd take one 25mg tablet section and 10.625mL liquid = 35.625mg.

 

You can keep the rest of the liquid in the refrigerator to use over the next week, then discard.

 

PS Trazodone comes in 50mg tablets, splitting one in half will be easier than cutting a 100mg tablet into quarters.

[Cabinhope]

Alto, thanks for this.

My tablets are 50 mg.

I have been taking 1/2 tablet (25) plus 1/4 tablet (12.5).

So, I'll still be taking 1/2 tablet plus liquid.

Should I dissolve 2 tablets to make 100 mg?

I could dissolve a 50 or half of that.

Please tell me what to do. I promise, I'll get the hang of this. Just need to get started. The ratio thing really throws me.

 

My migraines seem to be hormonal.

Quite a few people are squawking at me about mold, how it can disrupt hormones, create psychiatric stuff, etc. Honestly, I can't even think about it. Or should I?

 

Thanks. Please be very detailed about making the liquid....25mg portion dissolved, 50mg pill dissolved, or dissolve 2, 50's? Ugh.

[scallywag]

Cabin: use one 50 mg  tablet of trazodone in liquid to make 4 doses of 12.5 mg.

 

The easiest way to do this depends on the utensil you'll be using to measure your dose.

 

50 mg tablet in 50 ml water --> solution where 1 ml = 1mg; therefore to get the liquid portion of your dose, you withdraw 12.5 ml

 

If you've got an oral syringe that has a good marking every 5 ml but you can't reliably measure to the half-milliliter (ml) level, it's better to use water in a multiple of 20 ml. For example:

 

50 mg tablet in 40 ml water --> 1 ml = 1.25 mg; to get the liquid portion of your dose, withdraw 10 ml

-or-

50 mg tablet in 60 ml water --> 1 ml = 0.83 mg; to get the liquid portion of your dose, withdraw 15 ml

 

If you've got any more questions about this, ask away!

[JanCarol]

Hey Cabin, how are you going?

 

Have you stabilized a bit by being on same dose for awhile?

 

Any windows?  

 

Just checking in to see how you are.

[Cabinhope]

Hi guys,

Sorry it's been a bit. Very hectic. I do have a mold problem and so I've been directing all of my attention to applying for a USDA loan to get the funds needed to repair it. Very very wet where I live.

I still have not gotten my hands on a graduated cylinder. I know it shoudln't be much but I live on such a meager amount...modest and meager. My compounding guy has the syringes. So I've still be dry cutting this Trazodone. I'm taking 25mg plus 12.5mg portion with the corner cut off...so a bit less than 37.5. God knows how much I'm actually getting.

Just got done with a normal length cycle with zero PMS....but mood bottomed out as soon as the new cycle started. I never know what to expect anymore.

Shew. But I do know that addressing the mold will only help my hormones and help the process of sneaking away from these chemicals. It's bound to.

I do really need to get my hands on a graduated cylinder though so I can be more exacting.

Otherwise, very good, motivated, clear thinking. Except for today and the few preceding days which have been affected by hormones.

[Cabinhope]

Lol, so here we go again....

Jan and Scally and Alto, if you guys are around please resopnd.

I'm going to order from Amazon this morning a graduated cylinder and some syringes (don't want to bother with the compounding guy for this).

 

OK, so I'm taking 37.5 mg Trazodone....cutting from a 50mg tablet. I've been taking a half (25) and a quarter (12.5) to get 37.5. As I mentioned, I've been shaving off a tiny portion of that quarter.

 

For simplicity's sake let's assume I'm still at 37.5 and want to be able to go down by 5%. So the drop would be from 37.5 to 35.625.

I imagine dissolving a 25mg portion in 25ml of water in the cylinder. I will be taking 25mg in tablet form, the remaining 10.625 in liquid.

 

So....what SIZE graduated cylinder to get and what SIZE(S) syringes? I apologize for asking you guys to spell this out in elementary terms. And pipettes vs syringes? What's the difference?

 

THANK YOU. Getting these today as soon as you tell me what to get!!!

[scallywag]

Cabinhope: Just a quick post to let you know that I've seen your message and am working on a response.

 

I'll edit this one with more detail about the measurement. 

 

You may not need a graduated cylinder just yet. If you have a measuring cup with metric measurements, e.g. 250 ml, 100 ml, that can do the job for a while.

 

A syringe has a plunger to draw in and expel liquid.

 

A pipette is a simple glass straw that you cover the end out of the liquid with your finger to create a vacuum so that the liquid stays in the straw when you move it.

 

At this point you'll want syringes/pipettes that have

• gradations for tenths of a ml (millilitre)
  
  ***and***
   
• a capacity of 10 ml or 20 ml.

Edited July 23, 2016 by scallywag
added details for syringe gradations

[Cabinhope]

I'll have to check at home for the measuring cup markings. I'm thinking it isn't marked that way.

And the syringes, ok, capacity of 10 or 20 with .10 ml delineations.

 

This?

https://www.amazon.com/Pack-20ML-20CC-Syringe-needle/dp/B00FHLEV02/ref=sr_1_2_a_it?ie=UTF8&qid=1469288073&sr=8-2&keywords=Oral+syringe+20ml

 

Doesn't seem right but maybe it is.

[scallywag]

That syringe will be accurate to about ½ or 0.5  ml. 

 

It may be that you need to get a 1 ml syringe/dropper/pipette to measure the portion after the decimal.

 

Have you read the thread on oral syringes? Using an oral syringe and other tapering techniques]

 

You'd then use 2 devices. For example if the dose is 10.6 mg and you've got a 1 ml = 1 mg solution, you'd use

- big syringe to draw 10 ml , and

- little syringe to draw 0.6 ml.

[Cabinhope]

Yes, I've read everything repeatedly. I just want someone to tell me what to buy....a 20ml, a 10ml, and a 1ml? Or just a 10 and a 1? Sounds like a 10ml and a 1ml. Mercy!

Thank you for your patience!!!

[scallywag]

If I were at your doses and selecting syringes, I'd buy some 10 ml and some 1 ml. I say some as the quantity because they usually come in packs. You don't know how durable the markings are until you use them so you may  not be able to use one forever.

[Cabinhope]

Perfect, exactly what I have in my Amazon cart. Onward....will keep you posted.

Should I crush the 25mg portion first or let it dissolve and shake it? I've seen both.

[scallywag]

I don't know about crushing or dissolving the tablet.  What's the current wisdom in the trazodone thread?
 
Tips for tapering off trazodone (Desyrel) 
 
I did some quick calculations. To keep things simple, you could use the entire 50 mg tablet not the ½ tablet. You'll get four (4) doses of 10.6 mg from a 50 mg tablet. Discard the leftover solution and make a fresh one on day 5. Repeat.

[Cabinhope]

Ok, so in this case I'd need a 50ml cylinder to keep it at a 1:1 ratio, correct?

[marie123]

I put one of my Traz 100 mg pills in water and it dissolved on it's own. It needed some time. I forget how long-maybe and hour or 1/2 hour. The water looked a bit cloudy with some particles. Just shake it up and draw out your dose. Good luck with your taper.

 

Marie

[scallywag]

50 mg tablet in 50 ml of water, i.e. 1:1 ratio, is good. Good for you -- keeping it simple.

[tntd]

I read a suggestion to wrap the syringes and cylinders in clear packing tape so the markings don't rub off over time. Thought I would share it as I think it's a good idea. 

 

Good luck.

[manymoretodays]

Looks like you are doing it Cabinhope!   

 

Urine specimen cups work great.......if you can get a hold of some......probably free at your Dr.'s(non psychiatric)...........then wait for your tablet to dissolve while swirling the liquid around a bit.  They generally hold 100ml. of water or so.   Draw up your dose from the center of the liquid as well.  They are plastic though.......glass would be purer and less "stickage" to the sides.  I think if you are mixing each dose separately though.......you should be fine.  I've found that it is good to have your water for mixing be at room temperature as the tablets dissolve more quickly.  That's all if you go with the 50ml./50mg. decision.  It sounds sound to me. 

 

Not sure........ but you may be able to get syringes free from your pharmacy.  I find if I don't dip too much of the syringe in the liquid, it doesn't wear out(the markings) as quickly.  I use the 10ml. ones and each one generally lasts a long time.

 

You are on your way.

 

Best,

 

manymoretodays

 

p.s.  hoping you are not feeling overwhelmed by all our suggestions and are doing okay.  Read, decide........then keep it simple has worked best for me for this last one of mine(psycho medication).

[Cabinhope]

Hi guys,

Been awhile since I checked in.

Basically, I've been holding for a long time at 37.5 Trazodone.

 

Here's what's been going on....trying to find a new job, sell my truck, get estimates on remediating a pretty significant mold problem in my crawl space which my bedroom sits just above, father's longtime partner committed suicide, took a round of doxy as I got very sick with an upper respiratory thing 2 weeks ago... just a whole lot going on.

 

And...a functional medicine doc prescribed cholestyramine to address mold toxicity. Cholestyramine is a cholesterol med which, off label, removes biotoxins AND neurotoxins from the body.

 

I've lost a ton of weight, spontaneously, after taking it for a month and I'm just very very low. Isolating, emotional, depressed.

I wonder if anyone has ever heard of cholestyramine and/or has any knowledge of it tinkering with and affecting psych drugs.

I just wonder if, since it also binds with neurotoxins, it has made some or all of my medicines less available to my system.

Stress load aside, this is something I worry about.

I have stopped it.

 

Any input?

I hope to reach homeostasis again soon as I'd like to resume this taper.

Hope

[Shep]

Hi, Cabinhope.

 

I'm sorry for the death of your father's partner. It sounds like you've been hit with quite a few difficulties recently, which could definitely rev up symptoms.

 

I placed Trazodone, doxycycline, and Cholestyramine in the drug interaction checker and no interactions came up. 

 

However, too low cholesterol can cause depression.  Did your doctor check your cholesterol level before prescribing the Cholestyramine?  This article explores the link between low cholesterol and depression: 

 

https://www.psychologytoday.com/blog/the-breakthrough-depression-solution/201106/low-cholesterol-and-its-psychological-effects

 

Are you completely off the cholestyramine now? 

 

 

[Cabinhope]

I had my cholesterol levels checked in the spring after my brother had a heart incident linked to high cholesterol. They were low to begin with. So this for sure made them lower.

Yes, I'm off.

I'll check out this link, thanks so much.

[Altostrata]

Cabinhope, cholestyramine sounds like it's not the drug for you. If it doesn't make you feel better, perhaps you should stop it.

 

There's a tendency in alternative medicine towards interpreting suffering as purifying. This does not make sense.

[Cabinhope]

Thanks Alto, for your input. Yep, the thought was this...that treating mold exposure would facilitate smoother removal of these psych drugs AND help my hormones. In reality, low cholesterol worsens mood and hinders normal hormone production. Should have known better than to throw something new into the mix! Way to go, Hope.

Now I know. Will resume Traz taper soon.

[Cabinhope]

OK, so last Saturday, the 10th, I started the liquid Traz taper.

I'm taking 25mg in table and an additional 10 in liquid. In doing so I dropped from 37.5 to 35. I realize you're not supposed to drop at all when transitioning to liquid, but I felt that this basically 5% was modest.

 

Two days in I awoke in the night to find my beloved Chesapeake struggling and paralyzed. Long story short, rushed her to the nearest teaching hospital where she had major spinal chord surgery to repair a blown disk. Man, life just keeps giving the challenges and lessons lately! Needless to say, very stressful. She's home now, and I have to lift her, 115 lbs, to ambulate. Recovery will require patience and months. But she's my world.

 

I considered reinstating due to the upheaval but decided to stay the course. In all, I'd say this tiny drop has gone well...similar to my prior drop from 50 to 37.5 despite being much smaller. Just an intense feeling in my chest, not anxious really, just intense. Sleep has been choppy, wierd dreams. What I have experienced is total exhaustion. Difficult to tease apart which is from dealing with Sister, beloved dog, or Trazodone. Exhausted. And it's been an emotional week with crying spells.

 

I figure I'll go down by 1mg increments from here for awhile with 1 week holds or as tolerated. Then slow it up as I get further down.

Thoughts and input always appreciated.

Love you guys.

[ChessieCat]

HI CH,

 

Really sorry to hear about the issues with Sister.  It would have understandably been an extremely distressing time for you.  Please be careful with lifting that you don't injure yourself.

 

Concentrated deep breathing can be helpful for the minor anxiety you are getting.  I had it the other day and set a beeper every hour for the morning to remind myself to check in with how I was feeling and also to do some deep breathing.  It definitely helped.

 

Because of the additional stress from this situation I suggest you listen to your body very carefully and consider a longer hold to ensure that you are stable.  It would be better to hold longer before dropping again than to keep dropping and end up with bad withdrawal symptoms and the possibility of having to updose.  If that happened it could end up taking longer.

[Cabinhope]

Thank you and I agree it's most prudent to HOLD.

[JanCarol]

Wow Cabinhope, you've been through a lot since I last checked in.

 

I'm glad you're off that whatever cholesterol confusing drug, and that you intend to hold for awhile.  

 

Maybe even until after the holidays?

 

It does sound like you are dealing with things really well, even though you have a lot on your plate - your attitude towards them is to take what comes and do what you can and let go and let G-d.  Really, that's all we can ever do (but too often we get caught in rumination and cycles of worry that make symptoms worse - I don't think you are doing that, which is really excellent!)

 

Have you got your syringes and cylinder yet?  Liquid really is easier than dry cutting, I learned that after I finished my taper!

 

I hope you see the Sun today!

[Cabinhope]

Hi Jan and everyone,

Trazodone taper going well, slowly. I've been with liquid, 10mg/ tablet, 25mg for a few weeks now. Just last night I dropped the liquid to 9mg making 34 total. I'm proceeding so slowly, going down by .25 mg basically. For the coming weeks I hope to go by 1mg per week which is still in keeping with the 10% recommended drops.

 

Here's the question. I'm obviously dropping the liquid down while the tablet amount stays static at 25mg. When I do get down to 25mg I'll be back to tablet only. At some point should I be graduating over to all liquid in advance of this? Otherwise, I'd be faced with the same wierd transition from only tablet over to some liquid again.

 

I guess I could try to cut the 25mg (1/2 tablets of 50) into quarters making 12.5mg? And keep the rest liquid? When would I do this?

 

Thanks again. Things are smooth except for the hormonal stuff.

Hope

[Cabinhope]

Hi everybody.

Still need to hear from someone regarding maintaining more or less the same pill:liquid ratio.

I am currently doing 25mg pill, 8mg liquid....and as the liquid goes down I worry I'll have to adjust again to more liquid/less pill. Have no idea if this makes sense.

 

On another note, I decided it was time to quit my pack a day habit that I'd picked up again about 15 months ago. I like hiking, I like being able to breathe, I don't want to be on oxygen, etc. I've quit a few times before for generous lengths of time, and I don't recall it ever being like this...I think it's why I've started again without trepidation, because it's always seemed so easy to quit.

 

Today is the third day, tonight will mark 72 hours. I am totally zoned out, confused, out to lunch, and today brought crying and considerable anger. It's awful. Of course it's obvious that now I'm doing it whilst coming off Trazodone....it's harder. I'm not in good shape.

 

To add to the layers, I made the mistake of reading an article Laura Delano posted on Facebook, a Washington Post article so I thought it would be well done. Basically it was about an overall trend in 50-something white women who have been poly drugged to commit suicide. Or so was the case among a number of women around Durango, CO, one of whom had given herself 6 years to come OFF of them.....and she ultimately decided to kill herself.

 

I guess it just never occurred to me before. That this huge and lofty undertaking to get myself off meds, over many years, might NOT be rosy...might not turn out well. I've just chosen to believe the good stories, because that's all I've read, that people often begin to feel BETTER well before being off of everything. That it's an amazing journey, coming off. It's all been such good news that has fueled me with anticipatory momentum. So to read this article, already feeling remarkably vulnerable, about women who are 'lost souls', who have, through no fault of their own, ended up on so many meds at the same time (like me).....about women who couldn't recover, were too damaged, etc.

 

And then I began to think about the idea that these drugs are harming me cumulatively. I've thought this recently as my memory seems to be worse than ever, my thinking less sharp. 6 of the drugs were added, nearly in unison, in 2013. Could it be that damage is being done?

 

Anyway, having a hard time. Quitting smoking wasn't hard like this before. I wish I hadn't read that article, I'm usually much more judicious about what I read. So. There it all is.

[Cabinhope]

Oh, and I'm 8 years sober today. Yehaw.

[scallywag]

Yes, the decreasing proportion of liquid could require another adjustment. How are you making the 8 mg liquid dose?

 

 

Congratulations on 8 years of sobriety!

 

 

[Cabinhope]

I am dissolving a 50mg tablet in 50ml water, using a 10ml syringe, drawing up 8ml liquid.

Failed attempt to quit smoking. Perhaps now is not the time. Really affected, or seemed to, my mood.

[scallywag]

Get through the CNS symptoms of having tried to quit smoking. Stabilize.

 

Keeping your dose the same, you could cross-over to liquid in 2 steps:

1. cut the 50 mg tablet in quarters, take 12.5 mg as solid and the remaining 20.5 mg as homemade solution for 2+ weeks. When symptoms, if any, from the switch have settled, then
    
2. take 100% of dose liquid.

[Cabinhope]

Sounds very doable. It's going well.

 

I'd really like to hear from you guys, specifically Alto, about where things could go from here, after the Trazodone is gone.

In what order will things go? Will any of them come down in tandem? Or one by one? In which order and logic behind it?

 

Thanks. It's helpful for me to hold a vision of how things might go, something tangible. I understand of course that things can change course. I'm also curious to know and try to understand the metabolic/neurologic reasoning behind the way to go about this. Like the Trazodone, because of its impact on the liver, was chosen first.

 

Thanks.

[scallywag]

Probably at least partial reductions in Lithium and/or Paxil.

• Lithium because of toxicity issues
• Paxil because it's a tenacious devil which many have difficulty tapering. It would be good to have other meds buffering the w/d.

Are you getting regular testing done for Lithium concentrations and kidney function?

 

Here's a chart I put together with your meds and the interactions:

 

Without trazodone:

[Cabinhope]

I spoke with my psychiatrist today about my cognitive issues lately, and he too thinks Lithium might be good to do next.

 

Question...finish the Trazodone or hold that and start Lithium? I take 450 lithium CR. It is scored. I've read through threads in here about lithium CR but don't find it clear whether it's ok to cut smaller pieces beyond the scored half. And if I were to do liquid can I just dissolve the whole tablet and take part in tablet, part in liquid like I've been doing with the Traz?