DMV64: reinstate Saphris?

[DMV64]

OK I will do some posting of my logs. A few things have changed, timing and such. Good idea!

[JanCarol]

Hey D - 

Breathe.  Settle into your root.  

 

I know you think it's klonopin but you also have your anxiety shortly after taking your Vyvanse, too.  Your cocktail is so complex, that it could actually be an interaction between them (a brake and an accelerator) rather than this one or that one.

Please, taper only one thing at a time.  I'm concerned that you are speeding up the Saphris taper, too.  Now that you are down at the lower doses, tiny changes equal greater plasma occupancy shifts.  It's a curve, and it's steeper at the lower doses.  Please be patient with yourself.  

I agree with MMT (and Shep) that keeping your Saphris liquid from light is a good idea.  I'm not really keen on the idea of cutting the tablet before making a liquid, as the active ingredient is not spread evenly through the wafer.  I know you were dry cutting until fairly recently, but the liquid would be much more even and of better quality if you were using the whole tablet.  If you keep it in the fridge in an amber bottle, it should be good for 3 days.

We don't really believe in "tolerance withdrawal" at SA:  

  
There may be tachyphylaxis, or "poop out," but it's not really "tolerance withdrawal."

 

If it is this thing called "tolerance withdrawal" or even "poop out," it will probably be exceptionally challenging to taper it, as poop out means your body wants more of the drug, not less.  Poop out means that you are addicted to the drug - and while your benzo tapers have been easy in the past, that's no guarantee it will go smoothly in the future.  To taper it while you are in "poop out" is adding another challenge to your system.

Please be patient with yourself.  You've been through a lot.  You're working a new job.  Be gentle with yourself, too.

Remember, your nervous system is a wild baby animal!  Don't push it - be gentle and easy with it.  Be kind to yourself.  

 

After all was said and done, I don't know anyone who has said, "I wish I'd tapered faster," but there are many who have said, "I wish I'd tapered slower."  

The cost is too high.  We want you to succeed in getting off of the drugs.

I hope you see the sun today!

[DMV64]

Hey there. Good to hear from you! I’m just getting out of a birth so I am dictating this please excuse errors. I’m pretty sure that I have poop out. I don’t think it’s the Vyvanse.  Doctors will not call in a prescription for that you have to go get it. And my doctors are not that close. Anyway it was over a weekend and actually I  just about ran out of that and had to go down to like 2 mg a day just to keep myself even - then I didn’t even feel it. 

I’m trying to be gentle with myself. Thank you for the reminder. I keep beating myself up. The saphris Tablets all weigh a little bit different from one another. I’m working with a really good math friend of mine who is helping me do the math. And so we came up with the idea of just cutting each one to 20 to make it simpler. I know it’s not perfect. But they’re all different sizes anyway. 

I will read the link you sent once I get my brain back from this birth. 

I have been on the benzo’s so long that I am not surprised if I’m addicted to them. I can feel that my body wants more. And the only way out is down. I really want to start but I understand the idea of waiting. It’s just that I’m so desperate to get out of this constant constant state of anxiety that I live in and also I’m on so many downers that I believe  it’s causing the depression to be much worse if not just causing it period. 

[DMV64]

Also I just really want to know how benzo taper goes? Is it the same way that we do tapering of the other drugs I am on?  Is it going to be different? I would like to know.

[DMV64]

I’m wondering whether my new job is going to work out. I’ve only gone twice  but both times it has taken a lot out of me both times. I’m going to keep trying but I’m also having scheduling conflicts or problems and I have to try to resolve with them. I thought I would have Fridays free but it looks like I’m picking up some summer classes and I need the money so that presents a problem with being consistent on the volunteer job. 

 Not really sure what to do.  I don’t want to push my self too hard not sure if I can do both. 

[Shep]

On 5/29/2019 at 8:48 AM, DMV64 said:

Another thing, and I don't think I posted this at the time it was a while ago, (I realize now I should have) is that one time I accidentally doubled up on a dose of Klonopin and anxiety was practically gone. Of all my unfortunate updosing of my other poly drugs here, that has never happened.

 

Benzos are a bit different than your other drugs. Many people benefit from taking what's called a "rescue dose" of a benzo for emergencies. So the fact that you felt better isn't surprising. That does't indicate tolerance withdrawal, though. JanCarol's post was spot on about that. 

 

Removing a benzo from your current cocktail could remove your ability to sleep. And that withdrawal symptom alone is by far worse than reaching tachyphylaxis (or "poop out"). So even if you have reached a state where the drug is no longer working, removing it can still cause worse problems. Keep in mind that benzos stop working after 2 - 4 weeks and we only stay on them to ward off withdrawal. It's criminal that millions of people are trapped on these drugs for decades knowing this is the case. 

 

The goal is to remove the other drugs first and then to remove the benzo at such a slow rate that the GABA receptors have time to repair. 

 

18 hours ago, DMV64 said:

I have been on the benzo’s so long that I am not surprised if I’m addicted to them. I can feel that my body wants more. And the only way out is down. I really want to start but I understand the idea of waiting. It’s just that I’m so desperate to get out of this constant constant state of anxiety that I live in and also I’m on so many downers that I believe  it’s causing the depression to be much worse if not just causing it period. 

 

I think you're right about this. But you're already removing one of the downers, Saphris. 

 

And that's progress. 

 

18 hours ago, DMV64 said:

Also I just really want to know how benzo taper goes? Is it the same way that we do tapering of the other drugs I am on?  Is it going to be different? I would like to know.

 

Yes, the same process applies - 10% or less per month with lots of holds and plenty of non-drug coping skills. 

 

You'll be a pro at this by the time you get to the benzo. 

[DMV64]

 Thank you Shep and JanCarol For all the help and information. So as I understand it the likelihood that the Clonopin is doing anything for me is pretty low. But that doesn’t necessarily mean I’m on poop out?

I have to say I’m disappointed that I can’t start tapering sooner but I understand what you are saying. I did taper off of Clonopin at another time in my life when I was on a smaller dose maybe it was about 10 years ago. Successfully at the time. Going very slowly and using melatonin to help sleep. But then I had a bit of a crisis when I took the Saphris for the first time and I wound up back on it. 

So I guess the benzo is going to be last then?

[DMV64]

@Shep I have a question. As my benzo’s are really not doing anything except keeping me out of withdrawal, doesn’t  that really mean if they’re not working anymore than I’m in a constant state of withdrawl?

[neroli]

Hello DMV46

 

I'm popping in to say hello and see how you are.  It seems that you have been trying to sort out a lot of questions about tapering and dealing with a busy job and volunteering.

 

That's a lot to have on your plate at one time - I hope you can find some way to ease things off a bit, stress does have an effect on my symptoms, so I hope you are managing some self-care.

 

Warm wishes

 

Neroli 💜

[DMV64]

Thanks Neroli. I DO Feel like I am moving a lot. It’s good to know you’re out there. I feel really supported by everybody.

[Shep]

21 hours ago, DMV64 said:

@Shep I have a question. As my benzo’s are really not doing anything except keeping me out of withdrawal, doesn’t  that really mean if they’re not working anymore than I’m in a constant state of withdrawl?

 

By continuing to take it, you are keeping a peg in place.

 

Think of this as a Jenga game: 

 

 

If you pull out the benzo, it could collapse your already destabilized nervous system. 

 

So from this perspective, keeping the benzo in place is helping, even if it's not doing much as far as working. But then again, it depends on your definition of "working". By holding it steady, you're letting the benzo do its job, so in that respect, it is working. 

 

This thread is on AD withdrawal, but since all psych drugs cause overlapping symptoms, it's really a great article about nervous system destabilization. And this can happen with dopamine and GABA receptors, as well.

 

One theory of antidepressant withdrawal syndrome

 

And this is specific to benzos:

 

What is happening in your brain?

 

As long as you've spaced the benzo out so you're not dealing with interdose withdrawal, that's likely the best you can do with it for now. 

[DMV64]

Jenga! Yes I get it. But sooner or later I have to pull that piece. But I guess you are saying by that time there will be less factors/drugs at play. 

Off to check the links 

[DMV64]

 A recent log

 

6AM Wake up with usual anxiety/fear/panic

7AM Fish oil, COQ10,, zinc, vit C, iron, Vit D3, acidophillis, L lysine, Geoden 6mg

9AM Gabapentin 100mg

11AM Gabapentin 100mg Geoden 6mg Vyvanse 3mg

2PM Anxiety getting better

2PM Klonopin .5mg 800 magnesium

7PM geoden 6mg  400magnesium/400calcium

9PM Gabapentin 100mg, Cogentin .5mg, Saphris 1.25ML (mgai .004), XYZAL, Progesterone 100mg

On Estridiol patch .5 2x a week

2AM (wake up like clockwork for bathroom) .5 klonopin. (I moved this to see if it would help with morning anxiety. Not really.

 

6:15 Wake up anxiety, panic, fear

6:30 Fish oil, COQ10,, zinc, vitamin C, iron, Vit D3, acidophillis, L-lysine, Geoden 6mg

9AM Gabapentin 100mg

11AM Gabapentin 100mg Geoden 6mg Vyvanse 3mg

Anxiety and depression lower today, using some of the strategies in the book THE SECRET

2PM Klonopin .5mg 800 magnesium

7PM Geoden 6mg  400magnesium/400calcium

9PM Gabapentin 100mg, Cogentin .5mg, Saphris 1.25ML (mgai .004), XYZAL, Progesterone 100mg

 

 

[DMV64]

@JanCarol @manymoretodays. At some point as I get lower here I’m going to need to jump off. I would like to do that before my son’s wedding on September 14 so I don’t have to drag even more titration equipment with me and I already have. Do you think that would be possible?

[JanCarol]

Hey D - 

13 hours ago, DMV64 said:

At some point as I get lower here I’m going to need to jump off. I would like to do that before my son’s wedding on September 14 so I don’t have to drag even more titration equipment with me and I already have. Do you think that would be possible?

 

Everyone I know who has tried to rush a taper to achieve a time goal has run into problems.

"I want to finish before I start school"
"I need to get pregnant by such and such a time"
"I'm moving / travelling / whatever on X date, and want to be done by then."

Yep.

Heard it before.
 

I think you are on 0.5 mgai (your signature says .005, and that looks confusing).  If this is the case you are at 1/10 of your original dose.
 

Where are you travelling to?

Is this a week long trip?  Or a weekend?

Please read this:
http://survivingantidepressants.org/index.php?/topic/11051-when-to-end-the-taper-and-jump-to-zero/

 

Consider that a week of inconvenience might not be worth months of suffering.

Maybe you will be ready by then, maybe not.

It seems like the Saphris taper isn't changing much about your symptoms, is that correct?  If this is truly the case, then consider - taper June, taper July, Jump in August?

 

That will take you down to around 0.40 mg.  If you quit in August, that gives you some time to settle before the wedding in Sept.

 

It is always a risk to jump to 0.  You never know which Jenga block (thanks for that, Shep!) will topple the tower.  That's why we are so careful.

 

I won't tell you not to, and I can't possibly tell you to.  

If it were me, I'd like to be around 0.25 before I would drop off, and you are getting so close.

You've been doing so well, taking it slow, and resisting your impulses.  I think that's what it's going to take to get through this.

I know this isn't a "do this," kind of answer.  Ultimately, the choice to drop off is up to you.

I hope you see the sun today!

 

[DMV64]

The wedding isn’t till September 14 so if I jump in August that will give me some time.

[JanCarol]

Hey D - 

 

On 6/5/2019 at 11:41 PM, DMV64 said:

The wedding isn’t till September 14 so if I jump in August that will give me some time.

 

Did you read the thread?  9 out of 10 people said:  get down to smallest possible dose before jumping.

[DMV64]

2 hours ago, JanCarol said:

Did you read the thread?

Ok I will wait

[neroli]

Oh, DMV, I know how desperately we all want to be off these drugs but it's wise to do it as slowly and carefully as possible, as the mods. suggest, it could save you a whole heap of grief.

 

I just thought your comment sounded so endearingly wearisome:

 

13 hours ago, DMV64 said:

Ok I will wait

 

Then I hope you will make the wedding in September.  

 

Warmest wishes

 

Neroli 💜

[DMV64]

Thank you. I am trying to be patient. One of the things it seems to be happening more and more is I’m having memory problems. And I know with my drug load and the interactions that this is a symptom. But I have to say it’s getting to be scary. I feel like it’s getting worse. Today I couldn’t remember the name of the person who usually is my massage therapist. It took a good minute before I could call up his name in my mind and it’s not the first time this is happened

[Rabe]

As un nerving as that is Im hoping the memory thing goes along with all this because I dont think I have much of one right now...constantly losing things and forgetting things.  

I do think your memory is very good DMV or you wouldn't be able to do all that you do....which is a lot.  Take care of you!!💜

[DMV64]

Thank you so much! Reading your words gives me hope. I do some things that require memory and you reminded me of that

[Rabe]

I think just the job and all the other things you do would say your memory is ok...you think?  Unless you have a job that requires no memory. 🤔😀

I do online mind games to help keep my mind working...you could do that if think would be reinforcing for you as far as your memory.  Take care DMV.💜

[Rosetta]

Hi DMV,

It's so exciting that you are close enough to think about jumping ofT and how to do it.  You have worked so hard at this.  I'm really impressed.  It's amazing, isn't it, that we can do things that are hard when we are dealing with these symptoms?  Sometimes it builds my confidence to realize how much I have done whilst being so ill.  I'm sure it's going to work out well for you.

 

Rosetta

[DMV64]

Yes!  It is really amazing. Give me hope, for all the other drug that I have to taper off of. It really is just a question of patience  in many ways. 

 

How are you?

 

[DMV64]

On 6/8/2019 at 1:17 AM, Rabe said:

memory

 I guess it’s just that sometimes when I’m trying to remember something I just can’t find it and I have to wait until I can retrieve it. I haven’t tried any online game, but maybe I will! 

[Rabe]

I find too that if I do forget something it startles me and then  the harder I try the worse it gets...when I let it go it usually pops into my head...usually.  💜

[manymoretodays]

On 5/30/2019 at 7:40 AM, JanCarol said:

Please, taper only one thing at a time.  I'm concerned that you are speeding up the Saphris taper, too.  Now that you are down at the lower doses, tiny changes equal greater plasma occupancy shifts.  It's a curve, and it's steeper at the lower doses.  Please be patient with yourself.  

I agree with MMT (and Shep) that keeping your Saphris liquid from light is a good idea.  I'm not really keen on the idea of cutting the tablet before making a liquid, as the active ingredient is not spread evenly through the wafer.  I know you were dry cutting until fairly recently, but the liquid would be much more even and of better quality if you were using the whole tablet.  If you keep it in the fridge in an amber bottle, it should be good for 3 days.

 

Hi DMV,

I bolded that one part of JC's quote.  And then I am seeing this in your signature now:  July 1 cut Saphris to .014mg. July 29 .013 Aug 29 .012 Sept 29 .011Oct 29 .010 Dec 6 .009 (0.9 mgai) Jan 26 .008 (0.8mgai) Feb 25 (0.7mgai) March 25 (0.6mgai) May 24 begin liquid taper. Cut Cut sublingual tab to .020 in 5ML water. Pull out 1.25ML (.005mgai)

I bolded the .005 mgai because I think it is off.  Further explanation below:

 

Starting with a 2.5 mgai wafer that weighs .025 in grams(the reading on your scale, which btw you don't need to be weighing your wafer of Saphris anymore, you can use the whole wafer and then dissolve it prior to your dose(s)).   You don't have to weigh anymore, DMV.  You just need to dissolve a whole 2.5 mg Saphris wafer in 5 mL of water.

 

(Your Jan 4th post on Saphris wafer weight in grams)

^ just linking that one for reference.

 

So it appears that you are using a pill/wafer weight of Saphris of .020 grampw and then are dissolving it in 5 mL of water:

 

Therefore:  you are starting now with 2.0 mgai per 5 mL of water.

When you take 1.25 mL of your present solution the mgai(dose strength) is then:  0.5 mgai

 

I just thought I would point this out, as the .005 mgai is a much smaller dose than I think you are presently taking.  That's what you have listed in your signature right now.

 

I come up with you taking a dose strength at present of 0.5 mgai.

 

Which is better, as you had been on 0.6 mgai(dose strength) prior to the switch to liquid sublingual. 

 

If you go on back to just using a whole wafer of 2.5 mgai dissolved in 5 mL of water, then it will change things just a bit.

2.5 divided by 5 would then equal 0.5 mgai per each 1 mL of liquid.

You would have 0.5 mgai in each 1 mL of liquid, rather than the 0.5 mgai in 1.25 mL of liquid, that you presently have.

So that is important.

 

Okay, and hope today is a well one for you.

Love, peace, healing, and growth,

mmt

 

 

 

 

Edited June 10, 2019 by manymoretodays
minor edits

[DMV64]

@manymoretodays  hello there! And thank you for all of your information and MathWorks. I have been working with somebody here to help me with the math, just because not everyone in our community is always available to just be standing at the ready to help me when I need it which is completely and totally understandable.

So I hear what you’re saying. About cutting the Saphris tab.  The thing is that I’ve always been cutting it apart because it is a sub lingual tab. So even when I was dry dosing it I was cutting it apart into pieces which means that I might not of been getting the exact dose all the time because as you say the actual active ingredient might not be evenly disbursed. In short I have lived with us through the entire taper. 

So I’m doing the best I can hear. I see what you’re saying about my signature. I’m dictating this now but when I get home I’ll look at it. Thank you for all your help.

[DMV64]

6 hours ago, manymoretodays said:

If you go on back to just using a whole wafer of 2.5 mgai dissolved in 5 mL of water, then it will change things just a bit.

2.5 divided by 5 would then equal 0.5 mgai per each 1 mL of liquid.

You would have 0.5 mgai in each 1 mL of liquid, rather than the 0.5 mgai in 1.25 mL of liquid, that you presently have.

So that is important.

Ok maybe I will do it this way.

[DMV64]

I don’t know if I mentioned this here but my ex sponsor told me you know you don’t even look the same like you looked a year and a half ago. And I was like what are you saying. And she said you look just exhausted. It really hurt my feelings. It made me think is it that obvious that I look so depressed. I don’t know just didn’t seem like a kind thing to say

[manymoretodays]

1 hour ago, DMV64 said:

I don’t know just didn’t seem like a kind thing to say

 

Oh DMV.  Yes, she might have asked.......what can I do to help?  Sometimes......when stuff hits me in a hurtful way, I do the thing or thought of "Be the change I want to see".  And then remember, these are sick people that we deal with.  Even after sobriety......the whole dis  ease thing.  It's a process and practice.  I can only work on my own inner world.  In other words, Love them anyway.....something like that.

 

Cut sublingual tab to .020 in 5ML water. Pull out 1.25ML (.05mgai)

(from your sig ^) 

19 hours ago, manymoretodays said:

So it appears that you are using a pill/wafer weight of Saphris of .020 grampw and then are dissolving it in 5 mL of water:

 

Therefore:  you are starting now with 2.0 mgai per 5 mL of water.

When you take 1.25 mL of your present solution the mgai(dose strength) is then:  0.5 mgai

 

.020 gram weight on your scale : 2.0 mgai

2.0 mgai divided by 5 mL = 0.4 mgai per 1 mL  (This also is the AIC, for active ingrediant concentration)

0.4 mgai X 1.25 mL = 0.5 mgai(this is your current dose, or dose strength)

 

You're getting close.  Mathwise work.   And you didn't make any error at all, in your first liquid taper.  I can understand that you are being consistent, which is good too.  Great!  With sticking with the same method of weighing before liquefying.

It CAN be mind boggling.  I like to do it as sort of a brain challenge personally. 

 

L, P, H, and G,

mmt

 

 

 

 

Edited June 11, 2019 by manymoretodays

[DMV64]

5 minutes ago, manymoretodays said:

can I do to help? 

Would t that have been nice? Except she dropped me because I would not get rid of my dog and said I was being willful. Oh well. I have a great new sponsor. 

So I am probably going to switch to whole pill and have you and my math friend here help me as I drop in 10% or close to it increments. 

[DMV64]

I am excited about getting close. I am almost 100% positive the morning anxiety is the benzos. Eventually will get there I think after Geoden. 

[Rosetta]

Your ex-sponsor might be the type of person who says things to others just to upset them.  Maybe she gets a sense of power by affecting your mood.  Some bullies are like that.  They enjoy having the power to affect other people.  I fe!t that she could have been playing a power game with you over the dog.  She may not even realize she is doing this to people, but it makes her feel superior or better about herself if she can bring someone else down.  My mother is like that.  She tries to upset me and she won't stop until I get angry or cry.  Then, she's very satisfied, and either plays the victim - how could I accuse her of such a thing?! -- or having devastated me she would be very friendly and warm to someone else within earshot of me.  She did that to me as a kid all the time. 

 

The only solution is to stay away from someone like that.  If I'm right about this woman, she's a classic - trying to separate you from your dog with threats of abandonment.  She might have been hoping you would come running back to her, and agreed to give up the dog.  Then she would know you were a good target. I'm really glad you stood your ground. So, I would not let her back in.  Keep her at a distance.  She might be trying to make another attempt to be close to you.  I suspect she hasn't found someone who reacts the way she wants to see.  That's my two cents.  

 

I'm sorry she said that.  So what if you are exhausted?  I doubt you look worse, but even so why point that out unless she wanted you to be hurt.  I think it was retaliation.  I have ways of making people like that avoid me, lol.  It requires a bit of discomfort and awkwardness that I don't have the energy to withstand right now, but it works, usually.  I turn the tables.  They hear things about themselves they don't like a couple of times, and then they stop bothering me.  The only problem is that they don't give up right away.  So, it's upsetting to endure that part.

 

Rosetta 

[DMV64]

2 hours ago, Rosetta said:

upset

I think you’re right about that. Well, I guess it worked because I was upset. I’m still holding onto resentment but I’m trying to let it go. She just doesn’t really have much compassion, you know? So I think it was the best thing that could’ve happened. Now I have a new very compassionate sponsor. Thanks for all your support