Insomniac2: updosing did not work, what happens now with my taper?

[insomniac2]

Hello everyone! I am new here and so grateful for this forum!

I have an updose taper question: I tapered 10% monthly since 2 years of Elavil 25mg down to 1mg without major problems. Last 10% cut below 1mg triggered the worst setback of my taper so far with 0-3 hours sleep per night and it has been going relentlessly for 3 months now.  Here is my question: for a couple of days, I doubled the dose from 1mg to 2mg to seek relief. Now that I see that the up-dosing did not improve anything, my question is: from which dose do I taper now and when do I start the tapering again when insomnia is so terrible at the moment?

[Carmie]

Hi insomniac, 

 

I’m sorry you are having sleeping problems. Reinstating double your dose was probably too much. How many days have you been on 2mg? Usually if you’ve only upped the dose for a  really short time you can just go back to the original dose. I’ll see what the other moderators say. 

 

As regards the insomnia, do you stay away from screens in the evening, including TV, phones and tablets? Do you go to bed and get up at the same time each day? Insomnia is a really common symptom when it comes to withdrawals. It does eventually rectify itself, but it can take some time. 

 

Maybe the 10% drops are too big now, you could try cutting down the percentage amount that you taper too. 

 

Sending hugs🤗

[Gridley]

Welcome to SA, insomniac2.

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.

 

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As we get to the very low doses, it's generally a good idea to slow down your taper.  The 10% rate that worked before is now apparently too much.  

 

When you say, updosing did not improve anything, do you mean your symptoms remained the same?  Keep in mid that though sometime updosing can bring relief within a day or two, it takes about 4 days for a dose change to get to get to full state in the blood and a bit longer for it to register in the brain.  So relief sometimes takes longer.  But you were wise to write and seek help.
When reinstating or updosing, we recommend a VERY small increase over the previous dose.  Doubling the dose from 1mg to 2mg was too much for your system, which had gotten used to the 1mg dose.  I suggest you drop from 2mg to 1.25mg and hold there. Please read:

 

About reinstating and stabilizing to reduce withdrawal symptoms. -- at least the first page of the topic

 

We need to see how 1.25 mg affects you. As I said, it will take about a week for it to get to steady-state in your bloodstream, and the effect should get stronger during that time.

If 1.25mg is enough, it still may take some weeks or months for your nervous system to settle down. You probably will continue to have waves and windows, but symptoms won't be as intense. 

Do not continue your taper until you have stabilized.

 

 

 

 

 

 

 

 

 

[Carmie]

How are you doing insomniac?💚