Tulip52: tapering off imipramine

[Tulip52]

Saw my general practioner doc that I have a great relationship with and have seen him for the last 28 years.  He congratulated me on the slow taper with imipramine.. I’ve come down from 250 mg to 45mg!
 

I told him about the horrible insomnia and restless legs and when it started, we discussed the last dose where I was sleeping better, which was at 60 mg and then he looked at my blood sugar results.  
 

He said bc I’m still really insulin resistant and my body isn’t able to use glucose to fuel my body properly which is keeping me exhausted already and that by tapering and stressing my body even more that it’s just not healthy at this point to continue with the dose I’ve tapered down to.

 

He put me on a med to help my insulin resistance and told me to go back up to 60 mg so my body can rest and once we get the insulin resistance under better control that he is all for me starting the taper with imipramine again.

 

So, not exactly what I was expecting going into the appt but I think I’m going to do as he has suggested but of course I’m scared.  I’ve worked so hard these last few weeks but I’m miserable right now so I guess I have to try what he says.

In the last few weeks I’ve also weaned off of all caffeine and I’ve gotten to where I'm eating under 50 carbs a day.

 

I’m terrified of going back up on imipramine.  I honestly can’t handle anymore issues/withdrawals and if this doesn’t do the trick I will be frantic.  Let’s see what happens!

 

Edited April 11, 2023 by Tulip52
Added more info

[Tulip52]

Ok, so I think bumping back up to 60 mg actually made things worse.  My Restless legs is actually worse 😭 I’m going out of my mind with this ****!!!!!!!

 And I’m so sleep deprived!

 

[Fifree]

Hi Tulip. I’m so sorry you’re going thru this rn. I’m not a mod or mentor, but I have seen them say many times that drs know very little about how these psychoactive drugs affect us physically and you’re better off just taking your advice from here. 

I don’t know anything about your drug but is it related in any way to blood sugar/insulin resistance? It seemed to me you were better on 45 than 50, so why would 60 make you feel better?

 

It takes time to settle whatever you do. Might also be worth putting your new insulin drug into the interactions checker too. 

[Tulip52]

Notes:  

 

50 mg I was having horrible insomnia, restless legs was worse and after taking it I was a basket case of nerves for 30 minutes.

 

45 mg was ok at first and then it seems the liquid 5mg was just hitting too hard 

 

did two days of the 60 mg as my doc suggested and everything was much worse.

 

last night I had no imioramine at all, only the restless legs med and I had no anxiety, no bad restless legs.

 

I now know that it is the imioramine and I can’t seem ti handle taking any of it in liquid form.. it hits way too hard.

 

The imioramine only comes in 10 mg and 50 mg. So to taper, how do I deal with having ti use tablets and liquid?

 

To not have go back to the horrific symptoms of 50mg or deal with taking 40mg in tablet form plus 5 mg in liquid should I just go down to 40 mg (tablet)?  
 

 

 

 

Edited April 16, 2023 by Tulip52
More info

[Tulip52]

April 16-17

4:30 pm tics

5:30 dinner, tics, sleepy

7pm shower, really tired

9 pm took 40 mg imipramine, 2 mg ropinirole

11 pm-5:30 am slept soundly 

6-9 am catnapped

10 am breakfast and boron

11 am - 1pm a little dizzy, and nauseated

2 pm lunch

3:30 pm a little emotional over an upset 

4:30 pm emotionally ok, dizzy and nauseated 

 

4-16 was second night in 40 mg, restless legs much better, better sleep

 

[Altostrata]

Good to hear you're doing better on the lower dose.

 

The sleep problems at lower doses may have been related to a withdrawal effect.

 

On 4/12/2023 at 12:02 AM, Tulip52 said:

He put me on a med to help my insulin resistance and told me to go back up to 60 mg so my body can rest and once we get the insulin resistance under better control that he is all for me starting the taper with imipramine again.

 

I also do not understand the connection between a higher dose of imipramine and your blood sugar. It sounds like your doctor has reservations about your going off imipramine.

 

On 2/9/2023 at 2:10 AM, Tulip52 said:

One of the main reasons I want to get completely off of this medication is bc after I take it I get this combination of feeling sleepy and  restless legs.  I actually dread night time bc if this.

 

As explained before, it appears imipramine is a cause of your restless legs. Ropinirol may be unnecessary, or even causing adverse effects on its own.

[Tulip52]

There’s no connection of higher dose of imipramine and blood sugar and he’s fine with me going off.  He asked me at what dose was I actually sleeping prior to tapering  and I said I hadn’t really slept  well since tapering from 60.  He suggested I go back to 60 to try and get some rest.

 

I have had three nights of taking just 40 mg but so far I can handle the withdrawals which are looking for words, stuttering and experiencing dizzy spells.  

[Tulip52]

April 17-18

 

4:30 pm nauseated and stomach ache

5:30 pm emotionally ok, tics, no restless legs

7:10 pm tics more pronounced

8:15 pm dinner, hot flashes, a little sad

40 mg imipramine, 2 mg ropinirole

 

9:30 pm - 11:30 pm slept

11:45 pm -  1:45 am slept, took one aleeve

2 am- 8 am watched tv and catnapped

9 am no restless legs, watching tv

10 am breakfast, boron, tics, lightheaded 

11:15 am - 1:30pm catnaps, no restless legs

1:45 pm lunch and diatomaceous earth

2:50 tics, no restless legs

4pm a little dizzy, headache, tics 

5 pm sleepy, tics

 

[Tulip52]

April 18-19

6:45 pm sleepy, headache

8 pm 40 mg imipramine, 2 mg ropinirole

8:35 pm hot flashes, restless

9:30 pm - 12:30 am slept 

1:45 am - 9 am some sleep, tv, a little sad

9:15 am breakfast and boron 

10:20 am lounging, a little sad

11:30 am tired, a little dizzy

12:30 pm walk at park (exercise)

2:15 pm lounging, emotionally on, tics

4 pm tics, a little anxious

5 pm tics, dinner, sleepy, feeling lonely

 

[Tulip52]

Ok, So I am at 40 mg for 5 nights and the Restless legs or akithisia is much better but this morning I am having more anxiety.  What a trade off!  Will ride the anxious moment out and remind myself this is just a withdrawal symptom and I do not have to worry myself to death.

[Tulip52]

Update:  I must have been dehydrated.  I had a Gatorade and feel better.  Note to self, stay hydrated!!

[Tulip52]

It seems I just can’t tolerate the liquid form of imipramine and  hydration is super important.  I need to keep up with my adrenal cocktails.  If the 40 mg proves to be my sweet spot for now I am going to sit here for a while. I also want to remember that the little bit of anxiety that I’m having in the morning is prob the cortisol surge saying it’s time to wake up… no need to start surfing for what issue I need to attach the feeling to.

[Altostrata]

On 4/20/2023 at 4:20 PM, Tulip52 said:

the Restless legs or akithisia is much better

 

This is an improvement and demonstrates too much imipramine probably caused your "restless legs". The ropinirol may have been unnecessary,

 

You may occasionally have spells of anxiety, a withdrawal symptom, as your system gets used to the lower dose of imipramine.

 

Please stay hydrated.

[Tulip52]

Please assure me that waking up several times a night and laying there with negative thoughts is part of the withdrawals.

[Altostrata]

 

What is the sleep cycle?

 

Waking with panic or anxiety -- managing the morning cortisol spike

 

Tips to help sleep -- so many of us have that awful withdrawal insomnia

 

Path to Better Sleep FREE online for everyone from the US Veterans Administration

 

Music for self-care: Calms hyperalertness, anxiety, aids relaxation and sleep

 

White noise devices for sleep

 

Melatonin for sleep: Many people find it helpful

 

TV or computer use in evening can disrupt sleep: Bright light signals the brain that it's daytime

 

Strange sensations while falling asleep -- surges, zaps, jerks

 

Hypnic / hypnagogic jerks when falling asleep

[Tulip52]

So, surprisingly I’m really a lot better then I thought I would be since having to take the jump from 50mg - 40mg starting on April 5.  
 

I think it was that my system would just not tolerate the liquid form of imipramine or like Alto suggested, I may be having the opposite effect now.

 

iT would be great if I get get off of it completely in 5-6 months bc I think this med is the main reason I’m insulin resistant.

[Altostrata]

13 hours ago, Tulip52 said:

So, surprisingly I’m really a lot better then I thought I would be since having to take the jump from 50mg - 40mg starting on April 5.  

 

Please describe how your symptom pattern has changed.

[Tulip52]

I don’t have severe anxiety for thirty minutes after taking the 40 mg of imipramine.  I still get restless legs when it gets near the time to take the ropinirole but no where near what it was before dropping to 40 mg of imipramine.

[Altostrata]

On 4/26/2023 at 3:53 PM, Tulip52 said:

I don’t have severe anxiety for thirty minutes after taking the 40 mg of imipramine.  I still get restless legs when it gets near the time to take the ropinirole but no where near what it was before dropping to 40 mg of imipramine.

 

Please explain. Are you not taking the 2 drugs at the same time?

[Tulip52]

Once I got down to 50mg of imipramine I would get extremely anxious and the restless legs was really bad for about 30 minutes after I would take it.  I was taking the 2mg of ropinirole at the same time but a few times I had to up it to 3 mg to manage.

 

Yes, I’ve always taken the two meds at the same time, before bed.

 

Since getting to 40mg 12 days ago I am much better.  Still not sleeping well, though.  I can see myself off of this med completely by the end if the year.

[Altostrata]

I'm confused. Is the "restless legs" symptom better or worse after you take 40mg imipramine with ropinirol, compared to when you were taking 50mg imipramine? 

 

If it is better, your "restless legs" have been caused by too-high dosing of imipramine.

[Tulip52]

Better since getting to 40 mg.

 

Yes, I think the imipramine has caused the restless legs.  The restless legs and so much weight gain that I’ve become insulin resistant/type 2 diabetic are the main reasons I want off of the drug.

[Altostrata]

The unnecessary ropinirole probably has done its part as well.

 

Do you feel all settled from the imipramine decrease? Has your sleep been stable?

[Tulip52]

You’re probably right about the ropinirole.

 

I do feel settled with the imipramine decrease  other then my sleep.  I haven’t slept more then 5 hours of sleep since I started tapering imipramine again in November 2022.  And, that is sleeping 2 hours, waking for an hour or two and then sleeping 2 or so hours again until I finally get up for the day.

[Altostrata]

Please give more detail about what happens after you take your nighttime drugs and your sleep pattern.

[Tulip52]

Take both meds an hour before bed.  Sleep 2-3 hours, wake and stay awake about two hours, sleep an hour or so, wake up, 2 more hours and then awake for the day

[Altostrata]

6 hours ago, Tulip52 said:

Take both meds an hour before bed.  Sleep 2-3 hours, wake and stay awake about two hours, sleep an hour or so, wake up, 2 more hours and then awake for the day

 

How long has this been your sleep pattern?

 

If I were you, I'd plan to taper ropinirole, it may be affecting your sleep. It has a short half-life, so you can taper off relatively quickly, but it may be interacting with imipramine, so it's wise to taper carefully.

[Tulip52]

I’m not  ready to start tapering another med at this point.

 

I'm 19 days on 40 mg and my sleep may actually be a little better but the ozempic med for my insulin resistance may play a part.

 

I am going to stay at 40mg for about three more weeks.  The thing is, I know I can’t tolerate the liquid so the next taper will have to be down to 35mg which is a 12 % cut.  I’ll deal with it when the time comes.

[Altostrata]

Ozempic is a new one and not in your signature. For your own information, suggest you put ALL your drugs in the Drug Interactions Checker https://www.drugs.com/drug_interactions.php 

 

As this is a site offering peer support for going off drugs, we cannot assist with adverse effects of other drugs you voluntarily add to your cocktail -- that's your doctors' job.

 

Please let us know when you want to reduce your psychiatric drug burden.

[Tulip52]

Today marks one month on 40 mg and I am comfortable at this dose.  I do not feel as drugged, I can feel, I can actually think and work on what needs healing in me which is issues from childhood abandonment.  I may sit at this dose for a while. 

[Tulip52]

I just got a text from my pharmacy  to let me know that my 25mg pills of imipramine is ready for pickup.   
 

As I mentioned before, I do not tolerate the liquid imipramine well at all so my next taper will be from 40 mg to 35 mg.  
 

I just increased my dose of diabetic med so I’ll wait a week or so before starting the imipramine taper.

[Tulip52]

Tapering down to 35mg.. first dose tonight 🙏 

 

Note to self, it’s normal to experience increased anxiety for a couple of weeks during a taper.

[Altostrata]

Please let us know how you're doing.

[Tulip52]

I’m pretty stable now and  my last taper was 10 1/2 weeks ago so I think I’m ready.

 

2nd night on 35mg and I already had insomnia.

[Altostrata]

Did you have insomnia the first night on 35mg?

[Tulip52]

First night - no insomnia 

second night - insomnia

third night - forgot to take imipramine and slept better then usual (woke up and took it at 3 am and went back to sleep)

 

Emotionally ok