John13: tapering amitriptyline drops

[John13]

Original topic title before correcting:  Tampering amitriptyline drops

 

I've been taking 2 drops of laroxyl (amitriptyline) for now 1 year 3 months. Before I was taking laroxyl along with other antidepressants. My doctor has tampered the other drugs and I successfully stopped. However I continued to take amitriptyline as it help me sleep at night. I think I've taken the medication for a too long time. I'm now feel different when tampering the medication. I try to alternate by taking one day 2 drops and one day 1 drop. But one of the symptoms I'm getting is difficulty falling asleep at night. The other symptoms seems a bit difficult to describe. What do you recommend.?

 

Thanks for your time and consideration

 

Edited May 30, 2022 by ChessieCat
added topic title before correcting

[Onmyway]

Hi @John13, 

welcome to SA. First off, if you want to come off of your medicines you should taper them very slowly, at no more than 10% of your previous dose every 4 weeks. Here is the reason why: 

Why taper by 10% of my dosage? - Tapering - Surviving Antidepressants

Why taper? SERT transporter occupancy studies show importance of gradual change in plasma concentration - Tapering - Surviving Antidepressants

 

You should also not skip days or have different doses on different days. Consistency is key for your brain. 

This thread answers a lot of questions on tapering: 

Important topics in the Tapering forum and FAQ - Tapering - Surviving Antidepressants

 

and if you want a video format, this video is very helpful in explaining what you need to do to come off of your drugs. 

https://www.youtube.com/watch?v=PSjYH044-2Q   Can you please list your drug history in your signature so we are better able to help you in the future?  How to List Drug History in Signature - Introductions and updates - Surviving Antidepressants   Important topics in the Tapering forum and FAQ - Tapering - Surviving Antidepressants Important topics in the Tapering forum and FAQ - Tapering - Surviving Antidepressants   This thread has links to important information about symptoms - esp sleep.  Important topics about symptoms, including sleep problems - Symptoms and self-care - Surviving Antidepressants   This is what you can expect during withdrawal:  The Windows and Waves Pattern of Stabilization - Symptoms and self-care - Surviving Antidepressants What is happening in your brain? - Symptoms and self-care - Surviving Antidepressants How psychiatric drugs remodel your brain - Symptoms and self-care - Surviving Antidepressants   We recommend that our members not take any any psychoactive substances like pot, alcohol, other drugs because they make withdrawal worse. However, we recommend magnesium and Omega-3 as many (not all) members find them useful. You can read more about them here:  https://www.survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/ King of supplements: Omega-3 fatty acids (fish oil) - Symptoms and self-care - Surviving Antidepressants   Please take time to read the above links and let us know if you have any questions.  OMW

[John13]

Hi @Onmyway,

I recently see a new psychiatrist to taper my laroxyl I talk about tapering 10%. But she told me to one day take my usual dose of 2 drops of laroxyl and the next day 1 drop. And I should continue to alternate like this. And she also add a supplement mag 2 amp. She also gave me supportive psychotherapy. Should I opt this way?

[ChessieCat]

12 minutes ago, John13 said:

But she told me to one day take my usual dose of 2 drops of laroxyl and the next day 1 drop. And I should continue to alternate like this.

 

NEVER SKIP DOSES TO TAPER

 

OnMyWay has already stated the following about different doses on different days:

 

7 hours ago, Onmyway said:

You should also not skip days or have different doses on different days. Consistency is key for your brain. 

 

From what I have found Laroxyl is amitriptyline:

 

Tips for tapering off amitriptyline

[Onmyway]

Psychotherapy is good and the magnesium also (you don't need ampules though, pills are ok and likely cheaper) but the advice on tapering is wrong. Many doctors first don't admit that withdrawal exists and then give very bad tapering advice which is why sites like SA exist and why so many of us suffer. You need to take a consistent dose of the drug - every day, the same amount of drug. I would also use syringes rather than drops as drops can vary in size. Pls see Chessiecat's link on tapering amitriptyline. 

[John13]

Thanks for the advice @ChessieCatand @Onmyway. How do I convinced my psychiatrist to taper my medication by 10%. I thought maybe the dose was too small to dissolved in water. I take 2 drops of laroxyl everyday (that is 2 mg of amitriptyline). 

[ChessieCat]

23 minutes ago, John13 said:

How do I convinced my psychiatrist to taper my medication by 10%.

 

You don't need to convince your psychiatrist to taper your drug by 10%.  Just like many other members here at SA you will need to learn how to self advocate and tell them in a gentle way that you would prefer to go more slowly.  Some members don't even tell their doctor that they are tapering.  This is something that only you can do, we cannot do it for you. 

 

The thing that you need is to be able to continue getting a prescription for your drug for the length of your taper.  In many countries family doctors can write the prescription; it doesn't have to be a psychiatrist.

 

And remember, the way you taper your drug is not going to affect the doctor/psychiatrist, it is you who is going to be affected if you go too quickly.  Some things that have happened to SA members who have gone too fast:  end up with broken relationship/s, end up losing their job, have to move in with family of friend, end up bedridden.  Some end up changing their drug and/or adding more drugs and it doesn't work and things get worse.

 

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

 

Please watch this video.  But note that SA's taper rate is no more than 10% of the current dose with a hold of at least 4 weeks to allow the brain to adapt to not getting as much of the drug.  And it is important to listen to your body/symptoms and do no keep tapering if you are not stable.

 

Antidepressant Withdrawal Syndrome and its Management

 

Edited June 3, 2022 by ChessieCat

[John13]

@ChessieCat Thanks for the advice. But how should I proceed with the 10% tapering. Should I put 2 drops in 10 cl of water for example and throw and drink 9 cl of the water. Then 8.1 cl of the water. But is the laroxyl drop dissolved equally in the water. Or will it be more concentrated at the bottom. Thanks again for helping 

[ChessieCat]

1 hour ago, Onmyway said:

I would also use syringes rather than drops as drops can vary in size.

 

Onmyway has already mentioned that using a small syringe would be more accurate.  You can get 1mL/1cc and sometimes 0.5mL/0.5cc which you might get online of from a veterinarian.

 

You are discussing cl for your liquid which from what I have found online is:

 

1cl = 10mL/10cc

 

The prescription liquid contains water which means that it is okay to dilute it with water:

 

From https://www.medicines.org.uk/emc/product/6910/smpc

 

6. Pharmaceutical particulars

 

6.1 List of excipients

Methyl hydroxybenzoate (E218)

Propyl hydroxybenzoate (E216)

Propylene glycol

Ascorbic acid

Orange flavour 10950-56 (contains ethanol).

Orange/tangerine flavour 10888-56 (contains ethanol).

Sucralose powder

Liquid maltitol

Purified water

 

Q:  What dose in mg are you currently taking?

 

Q:  How much in cl are you taking?

 

Q:  What amount is 1 drop equal to; please ensure you clearly state the unit of measurement?  If you can, please state both dose mg and liquid amount.

 

Once we know these numbers it will be easier for us to help you work out what amount of water to use and how much to take.

[John13]

@ChessieCat I'm currently taking 2 drops of this in 10cl of water. The laroxyl drop by teofarma. I don't understand too much how much amitriptyline is in there in the drop I think it's 40 mg per ml

[ChessieCat]

Please double check my calculations.

 

I've done a translation using deepL:

 

40 mg pour 1 ml de solution     40 mg for 1 ml of solution

1 goutte = 1 mg                          1 drop = 1 mg

 

2 drops = 2mg in 10cl / 100mL/cc water

 

If you have been taking 2 drops and want to make a 10% reduction you multiple the amount of liquid by 0.9.

 

Because you are working with a percentage when you calculate the percentage for each of the measurements it will be the same.  So the amount of liquid you would take would be 9cl or 90mL depending on what you are using to measure the liquid.  The dose is also calculated by multiplying by 0.9 so you can see what dose you would be taking.

 

2mg x 0.9 = 1.8mg

 

10cl x 0.9 = 9cl

 

100mL/cc x 0.9 = 90mL

 

The next reduction would be calculated on the new dose so:

 

1.8mg x 0.9 = 1.62mg

 

9cl x 0.9 = 8.1cl

 

90mL/cc x 0.9 = 81mL/cc

 

I hope that helps.

[ChessieCat]

40 mg pour 1 ml de solution     40 mg for 1 ml of solution

 

Divide both sides by 40:

 

1mg dose = 0.0025cl or 0.025mL/cc

[John13]

@ChessieCat  I also got 10cl to 9cl to 8.1 cl of water. I was thinking of putting the 2 drops in the 10cl of water and then remove 10% from that water. I thought it will also deduct 10% concentration of the water by doing that. I'm a bit lost on the 1.8 and 1.62 calculation.