Robynne: tapering Neulactil

[Robynne]

I’ve been on neaulactil 2.5 for 5 years for anxiety. I tried to switch to another antidepressant but after only taking 1/2 of one of the anti depressants  while still taking half neaulactil I was violently ill. After having a wafer on my tongue in hospital I went home and didn’t take anything at all. No nausea so I was happy enough but  After 6 weeks of chronic insomnia I went back on neaulactil 2.5 mg. Now 10 days Ago I tapered my drug by half And now I have awful nausea all day although the half a tablet gets me to sleep. I don’t no what to do as the last 6 days of nausea had been dreadful, I only am trying to go off them

as I read awful things about them but while on them I have no side effects that I no of.

[Altostrata]

Welcome, @Robynne

 

Tapering any psychiatric drug too fast can cause bad withdrawal symptoms, as you have described.

 

What form is your periciazine? Is it a tablet or wafer? Please check with your pharmacist, is it available as a prescription liquid?

 

Here is how we advise tapering psychiatric drugs very gradually, to avoid withdrawal symptoms Why taper by 10% of my dosage?

 

Using the liquid form of the drug is usually the easiest way to do this.

 

To help us out, follow these instructions Please summarize your drug and withdrawal history in your signature You may need to use a computer to do this.

[Robynne]

Thank you for your reply ! I was cutting the 2.5 mg Pericyazine tablet in half and took 1.25mg. Because the nausea and stomach pain got to me I’m taking the 2.5 mg Pericyazine again. Unfortunately I’ve had compounding stresses in my life with one In particular is an illness my 3 year old grandson could have that is life threatening . At that stage I still have tummy pain but now that I realise it’s anxiety I’m suffering not a stomach virus like i thought,everything is easing. I’ve been taking this med for 5 years with no problems but I decided myself I needed to get off it. The only other med I take is blood pressure Mizart hct. 40 mg.  ultimately Id like to get this drug out of my system but I just don’t know how. The reduction by 10% looks difficult as I live remotely in the country and will have to search to find a chemist that goes liquid. I also will need to get a handle on this compounded anxiety that’s my big issue , I’ve once tried to ween Off pericyazine and onto a SSRI but 1/2 tablet of them made me violently ill so I threw them away, I was also on mirtazspjne for 6 months after a trauma, but came off them easily, I’d keep taking them for anxiety but they inflicted restless legs onto me. so I’m feeling a little bamboozled, to say the least 

 

 

[Altostrata]

When you talk about your drugs, please use the pharmaceutical name rather than the marketing name, so we can recognize the drug.

 

Pericyazine may be available in a ready-made prescription liquid. Can your pharmacist order it? Then you will have to ask your doctor to write a prescription for it. The pharmacy should have oral syringes to take liquid drugs.

[Robynne]

I’m back to square one with bad nausea and stomach pain after halving my pericyazine  2.5 mg tablet again . I actually went to my local GP with my nausea etc they said I had bad reflux and doubted it was my meds. I reinstated the tablet as I felt so awful and after a couple weeks felt good again. Stupidly  I halved them again I only lasted 3 days and felt awful so  I’m taking  the 2.5 mg again and after 6 days Am hoping to feel better soon. I can now see you are right I need to taper slowly and I’m going back to doctor to see if I can get a script for a liquid. I’m worried here in Australia they don’t make that, and living in the country I don’t feel i have any support. I’m not sure how long I should wait before I start the tapering process again and I’ll be doing it far more slowly when I figure out how. 

[Robynne]

Also what is normal time to restablise when you go back to normal dose 

[Altostrata]

It can take some time to restabilize. Please let us know how you're doing.

 

Please summarize your drug and withdrawal history in your signature You may need to use a computer to do this.

[Robynne]

Went to the Doctor to discuss yesterday he is unsure that the periciazine is causing me all the nausea and said the only way to truly know was to go cold turkey and I would be either better in 5 days or if I'm still sick it would be something else. I told him I was was not going to go Cold turkey I really do feel it was the drug halving making me so sick, yet he wouldn't confirm that. Im going to keep taking the full 2.5mg of this tablet as I feel Im getting better. I will either stay on in if I stabilise as I have been on it for 5 years with no side effects. I only went off it as another doctor said I should try to wean off it with no real reason why?? I am just looking forward to feeling my old self again.

[Robynne]

Actually feeling very nauseous now, will this get better ??

[Robynne]

Had a terrible day which is very disappointing just so nauseous. I even rang the pharmacist today and she feels I could be sick another week but also a bit surprised such a small dose has effected me this badly, I’m feeling worried 

[Robynne]

Not getting much better constant tummy pain with a creepy feeling and nausea 

[Robynne]

I feel so awful just so anxious and I can’t will it away. Will this drug kick in or will I go completely nuts.

[Robynne]

Tapering periciazine

 

Im Back trying to get off periciazine! A doctor put me on mirtazapine 15mg and said halve my periciazine 2.5 mg for a week then stop them. When I was in my third week which was 2 weeks off periciazine I was anxious nauseous and felt terrible. I rang doctor who said go back on periciazine and i stopped the mirtazapine as I felt like a zombie. I changed doctors and new doctor said I have to get off periciazine and writs me a plan where I take full 2.5 mg one day and half the next And armed me with ondansatron for nausea. Well day 5 and I feel shocking, please someone give me some exact advice I feel like giving up. I don’t even no why I was put on this drug as years ago I only went to doctor with menopause itching problems  

 

Edited July 10, 2022 by ChessieCat
added topic title before merging with intro topic

[ChessieCat]

Please update your drug signature with all the drug and dose changes since November 2021 and include the dates and the last dose you took if you stopped a drug:

 

Account Settings – Create or Edit a signature

 

I've asked the other staff for their assistance.

 

[Altostrata]

@Robynne, we advise a much more gradual taper to avoid withdrawal symptoms. A liquid formulation is a good way to do this.

Why taper by 10% of my dosage?
 

Do you recall this?

 

On 10/5/2021 at 11:54 AM, Altostrata said:

....

Pericyazine may be available in a ready-made prescription liquid. Can your pharmacist order it? Then you will have to ask your doctor to write a prescription for it. The pharmacy should have oral syringes to take liquid drugs.

 

[Robynne]

1 hour ago, Altostrata said:

@Robynne, we advise a much more gradual taper to avoid withdrawal symptoms. A liquid formulation is a good way to do this.

Why taper by 10% of my dosage?
 

Do you recall this?

 

 

I’m presently making phone calls to compounding chemists I’m going to have to get firm with doctors as None of believe about the 10% taper. Im hoping I can track down this drug in liquid form 

[ChessieCat]

There is a link to a print out about withdrawal in Post #1:

 

how-to-talk-to-a-doctor-about-tapering-and-withdrawal-what-to-expect

 

 

[Robynne]

Tapering periciazine

 

Well I’m on day 8 of 2.5mg periciazine one day 1.25mg the next. I spoke to a doctor yesterday about tapering she felt I had to reduce at the rate I was comfortable. Despite that she didn’t write me a script for smaller doses which I have found a compounding pharmacy will do for me. She said I was only reducing at 8% which I can’t figure out how she got that figure. Im

still feeling sick but it could be from the previous doctor making me go cold turkey for 2 weeks and adding mirtazapine which I have given up. Wouldn’t you no

it this latest doctor who seems to be better is leaving to live interstate now I don’t no where to go. Doctors in the country are hard to find and be good ones. 

 

Edited July 13, 2022 by ChessieCat
added topic title before merging with intro topic

[ChessieCat]

Robynne, please post updates about your situation here in your Introduction topic.

[ChessieCat]

22 minutes ago, Robynne said:

Despite that she didn’t write me a script for smaller doses which I have found a compounding pharmacy will do for me.

 

Here in NSW, Australia, I didn't need the doctor to write a prescription for compounding.  I took my tablets to the compound pharmacist and they would create the doses I wanted.  However, if you have health insurance that covers compounding then you might need to get a prescription.  If this is the case, then you will probably have to tell the doctor what you need; see the compound pharmacist first and ask them what they require so that you can tell the doctor.  Also ask the pharmacist if the doctor questions your request could the doctor ring them and speak to them directly about it.

[Robynne]

3 hours ago, ChessieCat said:

 

Here in NSW, Australia, I didn't need the doctor to write a prescription for compounding.  I took my tablets to the compound pharmacist and they would create the doses I wanted.  However, if you have health insurance that covers compounding then you might need to get a prescription.  If this is the case, then you will probably have to tell the doctor what you need; see the compound pharmacist first and ask them what they require so that you can tell the doctor.  Also ask the pharmacist if the doctor questions your request could the doctor ring them and speak to them directly about it.

Well that is interesting information thank you! I do live in the country and will have to wait to get to Adelaide but Ill try that.

[Robynne]

4 hours ago, ChessieCat said:

Robynne, please post updates about your situation here in your Introduction topic.

Im having difficulty understanding the doctor when she said I was only reducing by 8% when I was taking full 2.5mg tablet one day and then 1.25mg the next I think she was wrong, to me I have reduced by 25% am I right.

[ChessieCat]

Make sure you gets several quotes.    Some charge like wounded bulls.  There are some online compounding pharmacies.  I'm trying to find one that JanCarol told me about in Queensland.

[ChessieCat]

Here is a compounding pharmacy finder.  You will have to change the country to Australia before selecting the state and city.

 

https://www.pccarx.com.au/Resources/FindACompounder

[ChessieCat]

SA's recommended taper rate is 10% of the current dose followed by a hold of about 4 weeks to allow the brain to adapt to not getting as much of the drug.

 

SA also recommends NOT tapering by alternating doses/days.

 

11 minutes ago, Robynne said:

Im having difficulty understanding the doctor when she said I was only reducing by 8%

 

I don't think you provided any information about the previous dose and the new dose so I cannot comment.

[Robynne]

8 days ago my dose was 2.5mg periciazine per day, the doctor told me to take 2.5mg one day and reduce the alternate day to half of that being 1.25mg. I have been doing that! now I think Im in a pickle I don't know what dose to do I don't think Ill do anything different until I can get to a compounding pharmacy. Im not feeling quite as anxious  and Im controlling nausea with ondansetron, this is hard though but I have to believe the doctors when they say this drug is not a good drug.

[ChessieCat]

8 minutes ago, Robynne said:

Im controlling nausea with ondansetron

 

Just be aware that you might need to do a fast taper to get off it depending on how long you taken it for.

[ChessieCat]

18 minutes ago, Robynne said:

I don't know what dose to do I don't think Ill do anything different until I can get to a compounding pharmacy.

 

Q:  How long will that be?  It might be better to go back to taking 2.5mg daily or taking 1 whole tablet + 1/2 tablet every day.

 

Edited July 14, 2022 by ChessieCat
corrected error

[ChessieCat]

Sorry.  I've made a mistake.  That would be 2.5mg + 1.25mg

[Robynne]

18 minutes ago, Robynne said:

8 days ago my dose was 2.5mg periciazine per day, the doctor told me to take 2.5mg one day and reduce the alternate day to half of that being 1.25mg. I have been doing that! now I think Im in a pickle I don't know what dose to do I don't think Ill do anything different until I can get to a compounding pharmacy. Im not feeling quite as anxious  and Im controlling nausea with ondansetron, this is hard though but I have to believe the doctors when they say this drug is not a good 

[ChessieCat]

Q:  Can you cut a tablet into 4 and take 3/4 of 2.5mg?

[Robynne]

  

22 minutes ago, ChessieCat said:

Q:  Can you cut a tablet into 4 and take 3/4 of 2.5mg?

 

Yes I could do that so let  me get this right I’ll take 3/4 of the 2.5mg one day then half the next night. I honestly don’t want to go backwards and take 2.5 every night again  I’ve never taken Larger dose than that, I can see I should not have alternated bugger! I thought the doctor was right. 

 

Edited July 14, 2022 by ChessieCat
extracted response from quote

[ChessieCat]

 

No.  You would take 3/4 of 2.5mg every day.  You are changing from alternating days to every day dosing.

 

Currently you are taking 2.5mg and 1.25mg which averages out to 1.875mg a day.

 

Taking 3/4 of 2.5mg equals 1.875mg.

 

I would prefer for you to do an updose as well as change to daily dosing of the same amount and taking 2.1875mg (7/8th tablet: 1/2 tablet + 3/4 of 1/2 tablet) but you have limitations on how to get a consistent dose.

 

Q:  Have you tried making a liquid from a tablet?

 

I think taking the same dose of 1.875mg every day might help a bit.

[Robynne]

4 minutes ago, ChessieCat said:

 

No.  You would take 3/4 of 2.5mg every day.  You are changing from alternating days to every day dosing.

 

Currently you are taking 2.5mg and 1.25mg which averages out to 1.875mg a day.

 

Taking 3/4 of 2.5mg equals 1.875mg.

 

I would prefer for you to do an updose as well as change to daily dosing of the same amount and taking 2.1875mg (7/8th tablet: 1/2 tablet + 3/4 of 1/2 tablet) but you have limitations on how to get a consistent dose.

 

Q:  Have you tried making a liquid from a tablet?

 

I think taking the same dose of 1.875mg every day might help a bit.

Ok I’ll give that a try ! The compounding chemist told me yesterday he couldn’t make it in liquid but he could make 1mg capsules and 0.25 mg capsules. I’m 250 km from chemist but I’m going to make the drive next week. I’ll ring him again and see if I need a script or just take in my tablets 

[ChessieCat]

You might be able to make a liquid from the 0.25mg capsules when you get them.  I was able to from my for Pristiq because they were ground up very finely.

 

For now, try grinding up one whole tablet as finely as possible and put it in 25mL water.

 

2.5mg     50mL

 

divide both sides by 50

 

0.05mg         1mL

 

Sorry but my brain has just given up (I've got a cold at the moment) so I'll just explain what I think you should do and you can try to work it out.

 

What I am suggesting is that you take 3/4 of a tablet which = 1.875mg.  Then take enough liquid to make as close to 2mg total dose as possible.  So 2mg - 1.875mg = 0.125mg that you need to take as a liquid.

 

I will have a bit of a break and come back to it if my brain wakes up a bit.

 

I would only take the smallest part of the dose as liquid.  Kept the remainder in a covered container in the fridge.  It would probably be okay for 3 days.

[Robynne]

8 minutes ago, ChessieCat said:

You might be able to make a liquid from the 0.25mg capsules when you get them.  I was able to from my for Pristiq because they were ground up very finely.

 

For now, try grinding up one whole tablet as finely as possible and put it in 25mL water.

 

2.5mg     50mL

 

divide both sides by 50

 

0.05mg         1mL

 

Sorry but my brain has just given up (I've got a cold at the moment) so I'll just explain what I think you should do and you can try to work it out.

 

What I am suggesting is that you take 3/4 of a tablet which = 1.875mg.  Then take enough liquid to make as close to 2mg total dose as possible.  So 2mg - 1.875mg = 0.125mg that you need to take as a liquid.

 

I will have a bit of a break and come back to it if my brain wakes up a bit.

 

I would only take the smallest part of the dose as liquid.  Kept the remainder in a covered container in the fridge.  It would probably be okay for 3 days.

Oh gee you are working hard for me !! I’m trying to get my head around your plan. I’m definitely waiting to get smaller capsule, but I’ll start on 3/4 tablet tonight I think. Having better day today so maybe I’m stabilising. 🤷🏼‍♀️Im upset really that this little tablet is causing me so much grief