Denyce: Dothiepin Withdrawal Symptoms

[Denyce]

Hi,

 

Does anyone have any experience with the withdrawal symptoms of the tricyclic antidepressant Dothiepin (Dothep). ? 

[Gridley]

Welcome to SA, Denyce.

 

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.  Please include your original dose of Dothep in mg and what reduction(s) you've been making, along with the rate of reduction.

 

Account Settings – Create or Edit a signature.

 

What dosage of Dothep were you on and how fast have you been reducing it?  If you're having withdrawal symptoms, it's because you're reducing your dose too fast.  We recommend tapering by no more than 10% of your current dose every 4 weeks.

 

Why taper by 10% of my dosage?

 

I've never taken Dothep but I'm very familiar with the withdrawal symptoms from another tricyclic, Imipramine, and these are pretty much the same as withdrawal from the other types of antidepressants.

 

What is withdrawal syndrome.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

Brain Remodelling 

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

Once you've given us more information on your symptoms and reduction from Dothep, we'll be in a better position to help you.  We're a site for going off psychiatric drugs and dealing with withdrawal.

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium (glycinate is a good form) and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

This is your introduction topic -- the place for you to ask questions, record symptoms, share your progress, and connect with other members of the SA community.  I hope you’ll find the information in the SA forums helpful for your situation.  I'm sorry that you are in the position that you need the information, but I am glad that you found us.

[Altostrata]

Hello, @Denyce

 

How are you doing?

[Denyce]

Hi Altostrata, Struggling alot today, Easter Sunday. Only 3.5 hours sleep last night. Don't cope well when I'm tired. Very low mood & no appetite, lots of feelings surfacing & crying alot. I know it's needed but can be very distressing at times coping with feelings whicg were numbed by antidepressants. I have a great husband & kids as support but wish this wasn't so difficult. Thanks for your caring response. 

[Altostrata]

Recovery from withdrawal syndrome can be difficult. How has has your symptom pattern changed in the last month?

 

Many people find fish oil and magnesium supplements helpful, see

 

https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

 

https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

You might try a little bit of one at a time to see how it affects you. Please let us know how you’re doing.

[Denyce]

Thank you for the helpful information, I do take magnesium at night and I did try Cod Liver Oil but it upset my stomach quite a bit. I will try the Omega 3's in capsule form and see if that helps with the GI upset. Only had 2 hours sleep last night which was horrible. Finding it very difficult to work and participate in life at all. I have a doctor's appointment coming up and am hoping to find a solution. Not getting sleep is the worst part of all of this, it adds to the feelings of anxiety and low mood, the nausea, headaches, heart palpitations and loss of appetite are secondary, I've found fresh ginger as tea works well with the nausea. Are these all common symptoms? I will find an answer soon hopefully. I'm trying not to research too much as it confuses me and wears me out as well. Balance is key. I am exercising daily and trying to eat healthily. I also take Vit D, Vit K, B group vitamins (which I have stopped to see if that is what is keeping me awake). I will take your advice and introduce slowly.

 

Thanks again for your support. It's helpful to have someone who understand and believes that these withdrawal symptoms are real.

 

 

[Altostrata]

Those are all classic antidepressant withdrawal symptoms, which indicate your taper was too fast.

 

We have seen low-dose reinstatement, even as low as 3mg dothiepin, can reduce withdrawal symptoms. Using a liquid is the best way to do this. This topic explains how to take a very low dose. Tips for tapering off dosulepin / dothiepin (Dothep, Prothiaden)

 

You'd stabilize on the reinstatement for some months and taper off by tiny amounts later. What do you think?

[Denyce]

Ok thanks. I got 5.5 hours sleep last night which was lovely, I'm feeling so much better today and I've checked with my naturopath to see if he can suggest anything. Metagenics Neurocalm sleep is supposed to be good. I will hear back from him soon and try that.  I've decided to push through, I don't want to go back on the Dothiepin, the side effects were just too horrible, worse than what I am going through now. Thank you though for your advice, It will be something to consider again if my symptoms don't improve in the coming weeks/months. It took me 6 months to come off but I understand after so many years a 6 month withdrawal may have been too quick. I will look into crushing the 25 mg tabs and making into liquid if it comes to that. It's good to have a backup plan anyway so thanks for that information and all your support. I really appreciate you taking the time to respond. Have a great day !

[Altostrata]

You may recover naturally from withdrawal syndrome over a period of weeks or months. If you are patient and can cope with the symptoms, you might not want to reinstate.

 

I would be careful with overpriced naturopathic remedies. Suggest you look at the ingredients and purchase the ones we have found to be helpful. Use search in the Symptoms and Self-Care forum to find our discussions of supplements.

 

We have seen many people find fish oil and magnesium supplements helpful, see

 

https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

 

https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

You might try a little bit of one at a time to see how it affects you. Please let us know how you’re doing.

 

[Denyce]

Hi Altostrata, Struggling alot today. Only 2 hours sleep last night. Took 2 prometrium (progesterone)to see if that helped as doctor said it would help with sleep Don't cope well when I'm tired. Very low mood & no appetite, lots of feelings surfacing & crying alot. I know it's needed but can be very distressing at times coping with feelings which were numbed by antidepressants. I have a great husband & kids as support but wish this wasn't so difficult. I will be careful with the supplements & I am taking cod liver oil & magnesium  Thanks for your caring response. 

[KenA]

Was just reading through your thread and noticed that you seem to be having some insomnia as a symptom of your healing process. I also went through the insomnia phase for quite a few months as well. It was exhausting to say the least! But, I just wanted to let you know that it won't last forever. I made it through and now days my sleep is completely back to normal. It just takes time for your brain and CNS to heal and get back into balance! I know it's hard, but you will make it through it for sure!! Just keep hanging in there!!! You are doing awesome!! 

[Denyce]

Hi KenA,

 

Thanks so much for your support. I did sleep last night, probably from exhaustion, but either way, it's a much better day today. The other symptoms I can cope with but the lack of sleep is a major one and seems to be the major issue for lots of other people. I just need to realise that after being on the drug for so long, it's going to take some time for my brain to readjust. Wow ! You've been off for 4 years, well done to you. Do you remember what helped you with your sleep, how long did it take for you ? Oh well, there's a reason for all of this, it's certainly made me value my life much more and be grateful for what blessings I do have. Hope all good in Shreveport, I checked it out, looks lovely. Thanks again, having support from others who have experienced this really helps. 
 

 

[Denyce]

Sorry, I just re read your post and realised you said quite a few months of sleep issues. Healing will take time.

[KenA]

9 hours ago, Denyce said:

Hi KenA,

 

Thanks so much for your support. I did sleep last night, probably from exhaustion, but either way, it's a much better day today. The other symptoms I can cope with but the lack of sleep is a major one and seems to be the major issue for lots of other people. I just need to realise that after being on the drug for so long, it's going to take some time for my brain to readjust. Wow ! You've been off for 4 years, well done to you. Do you remember what helped you with your sleep, how long did it take for you ? Oh well, there's a reason for all of this, it's certainly made me value my life much more and be grateful for what blessings I do have. Hope all good in Shreveport, I checked it out, looks lovely. Thanks again, having support from others who have experienced this really helps. 
 

 

Of course! You are most welcome Glad to hear that you got a bit of sleep. That's how it was for me as well. I would have 1 or 2 sleepless nights and then I would finally be so exhausted, I would crash out and get a good 6-7 hours. It truly does seem harder due to the lack of sleep, but I always would think of it as it was just my brain needing to get some healing done and it wasn't ready to turn off yet. This truly is a waiting game for sure. Just have to give your brain and CNS the time it needs to readjust and get everything fixed. When I was going through the insomnia, the think that worked most for me was honestly just acceptance. When I would have a bad night, I finally learned to just let it be. I would make a movie night out of it. I have a massive DVD collection of movies, so I just started going through them and watching them all over again. The worst of the insomnia lasted about 4-5 months for me. After that my sleep slowly but surely improved. I would say by about the year mark I was sleeping 7-8 hours a night once again. It was a long process for me, but I CT quit everything including alcohol and caffine, so I threw my body for a major major shock. The other think that helped me out was my wife buying me a warmie stuffed animal. You can heat them in the microwave and they are infused with lavender scent. I would heat it up and sit it on my chest. It would help with the adrenaline and cortisol bursts and it was calming. It helped me out so much more than I was expecting. But honestly it was just a time thing. Just had to give it enough time to heal and resolve itself. You will get through this I promise!! Sleep will slowly but surely return  Just remember no matter how bad it gets, it's just all good healing!!

[Denyce]

Thanks KenA for sharing your experiences & advice of what helped you. I do use lavender which helps & I also have warm milk before bed. Sounds like your wife is a blessing giving you a warmie stuffed animal to soothe you. My husband also helps me, we are so blessed to have great support. I had another good sleep last night which was lovely. I agree, acceptance is key & I am doing lots of spiritual work & growing from this experience even though it's difficult at times..it's all part of life itself. Accepting that my brain is healing also is helpful to understand. Thanks again 

[Altostrata]

I have never heard of taking progesterone as needed for sleep. Do you do this often? Do you also have a daily prescription for progesterone? How often do you take it irregularly?

[Denyce]

I have a prescription & am on hormone replacement with estrogen gel in morning and progesterone capsule at night to balance each other (yin/ yang)& supplement my hormones since surgical menopause 15 years ago. I wouldn't recommend to anyone not needing it for hormonal reasons but for me these hormones saved my life & one benefit is the calming effect of it. Progesterone works on GABA which promotes sleep & calm. I had a break off it because I thought that was what the nausea was attributed to, but it was an AD withdrawal symptom. After 2 weeks of not much sleep I reinstated it which worked after a week. Lots of women are prescribed AD for menopause but with my medical experience & my own opinion from what I've researched myself (out of necessity), most just need hormonal supplementation to alleviate hormonal imbalance/mood.  Postnatal depression/no sleep in my earlier child raising years was milder,  but a total hysterectomy in 2011 which brought on surgical menopause caused my deep depression (as well as my dad's passing a contributor)  then drugs (which didn't work but knocked me out so I could sleep) just made me worse I believe, I couldn't work for 2 years & was suicidal then they tried ECT & I recovered somewhat but still kept taking Dothiepin. There's nothing I can do about what has happened, but I would make very different choices with what I know now. It's nice that I can use the hormones to balance my moods now after coming off AD.  I was actually a  dispensary technician assisting the pharmacist in pharmacy for many years and saw the effects of all types of drugs including AD but wasn't aware of the lies being told to us about the chemical imbalance story. I just realised that where I worked wasn't making people well, they were just getting sicker, so I left. After covid happened & I was concerned about talk of not being able to access my AD with supply issues, it woke me up again to big pharma & about the meaning of informed consent. I then decided I wanted to be free & clear of these drugs. My sleep has returned to 6 hours lately. KenA was very supportive with suggestions so I am very grateful for his insight and the support I've received from this site. It might take my brain a while to adjust after drugs & ECT but I'm doing my best & that is enough. I'm grateful every day that I made it through & I had the love & support of my family. Sites like this are life savers for people who need to be listened to. Thankfully some doctors & others are now awake to what is going on so the future may be brighter. Blessings to all who give your support on this forum, I am so grateful to not be alone in this experience. 

[Altostrata]

On 4/18/2023 at 6:41 AM, Denyce said:

It's nice that I can use the hormones to balance my moods now after coming off AD. 

 

Are you taking the hormones on a regular schedule? What times o'clock do you take your drugs, with their dosages?

 

Yes, many of us are appalled by the misinformation that passes for medical information regarding psychiatric drugs.

 

On 4/18/2023 at 6:41 AM, Denyce said:

My sleep has returned to 6 hours lately.

 

This is a good sign, and pretty good sleep for withdrawal syndrome.
 

If, as you say, your symptoms were caused by hysterectomy and loss of hormones, hormone replacement may be all you need. I am sorry you got caught up in this psychiatric treatment spiral instead.

 

 Your withdrawal symptoms likely will gradually resolve, with waves and windows of symptoms, over months as you stabilize on your hormone therapy. You may still find fish oil and magnesium helpful.

[Denyce]

Thanks for your support Altostrata,

 

Hormone replacement info

 

Estrogen (Sandrena) gel 1g daily on skin on upper thigh or inner arm

Progesterone (Prometrium) 100mg capsule at night.

 

Unfortunately only 4 hours sleep last night. I'm a mess today, doing everything I need to do to promote sleep but most nights only 4 hours. Not sure how long I can keep going on this amount of sleep but I am meditating & trying to accept what comes.  Luckily I don't have to work today and my work is flexible with owning our own business, I feel so sorry for others who have to go to work with little or no sleep 🙃 Sending hugs & love to all those who are struggling 🤗 

 

[Altostrata]

If you've jiggered your estrogen and progesterone dosage recently, that may be adversely affecting your sleep. If you take too much, you can get a paradoxical reaction.

[Denyce]

Ok, thanks for the information. Much appreciated. 

[Denyce]

Hi all, having been off Dothep since December 2022 I am still struggling to sleep. Lucky to get 4 hours per night,  on a bad night 2 hours. First four months

completely off I was fine and back to my old self before AD. I've tried nearly everything for the sleep issues. I'm currently trying melatonin sublingual drops, first night last night. Got 5 hours sleep which was great. As this sleeplessness has gone on now for 4 months, I'm thinking of reinstatement of low dose dothep, i have 25mg caps & have seen the way to make liquid form on this site. As I've been off completely for 7 months I'm unsure whether it might help. Altostrata what do you think ? Or anyone else out there ? I'm unable to work, socialise or really participate in life in general. My anxiety eases as my sleep improves but it comes & goes. Being unable to stay asleep (get to sleep fine) & some anxiety are my only remaining symptoms. Can anyone suggest anything please 🙏 

[Altostrata]

What did you do about your estrogen and progesterone doses?

 

When did you start estrogen and progesterone?

 

How much sleep do you get per night now? How has your symptom pattern changed in the last 4 months?

[Denyce]

Thanks for your response Alto. I've been on estrogen for for approximately 15 years & both estrogen & progesterone together for approx 8 years as I had a surgical menopause at age 38, I'm now 53.

 

I tried off my estrogen gel for 1 week then noticed I was more anxious/mood dropped off than on so have reinstated in the last couple of days. Progesterone I tried doubling of a night to 200mg for a couple of  nights but no success with sleep there. My doctor advised to try off the estrogen to see if my sleep improved & to double the progesterone for a couple of nights.

 

My sleep varies, I might have 4 hours most nights, sometimes I'm lucky & get 5 but only after I'm exhausted from only 4 hours or less for 2 or 3 nights. Last night I only got 2, I did eat curry & I'm thinking that might have been part of the problem, It took me an hour to get to sleep, which hasn't happened before,  usually I'm so exhausted that falling asleep is never the issue. I went to bed at 10 on the advice of my doctor to restrict time in bed,  didn't get to sleep til after 11 then woke at 1am. I got up out of bed 3 times & read in another room under low light but once I'm up, I can never settle back into sleep regardless of if I meditate, do breathing exercises etc.

 

I've incorporated all the sleep hygiene stuff, dark room, cool room, lavender, background white noise etc. My diet is very healthy, I don't have much appetite but I am careful with what I eat & drink especially close to bedtime. I didn't have a hot shower last night, which I have been doing every night,  started with baths in Epsom salts then that got too much after a while so showers seemed a better idea.

 

I had been taking magnesium L threonate for a couple of weeks 3 times a day but was getting bad headaches so changed to only 1 in the morning (dose they recommend is 3 per day). I have a tendency to panic when I get a bad night's sleep & get low & perhaps change things too often rather than try off one thing for a week or so.

 

It's difficult to work it all out, there are so many variables with supplements & hormones. My doctor said to go off metagenics methyl active which is a large dose of b6. I am also wondering if the vit D3 I take may be contributing but I need to take this & VitK2 for my bone health. I did stop vitD to see if that helped but after a few days went back on, again, out of fear.

 

Symptom pattern has shifted to mainly affect my sleep in the past 4 months, which has a detrimental effect, not much appetite, headaches, anxiety & low mood. I know I'm not depressed, as when I have 5 hours I cope ok that next day so I truly believe this is lack of sleep which causes my mood to change. Hence I have tried most things for sleep,  melatonin only for 2 nights so far. I also tried Inositol powder one night & it gave me a racing heart so I haven't taken it again. I've tried homeopathics & herbs for the anxiety but seem to go ok, then next it makes me worse. I'm not wanting to go back on dothep but the sleep issues are sending me that way. Melatonin is my last hope.

 

I know I've rambled on but I'm getting desperate. I have to get a blood test to check my bloods but have been too unwell to get there yet, doctors appointment in another 12 days or so to check in. What do you think? 

Edited July 2, 2023 by Altostrata
added line breaks

[Altostrata]

@Denyce please use line breaks to make long post readable.

 

On 4/10/2023 at 6:59 AM, Denyce said:

Not getting sleep is the worst part of all of this, it adds to the feelings of anxiety and low mood, the nausea, headaches, heart palpitations and loss of appetite are secondary,

 

Aside from sleep, how has this symptom pattern changed in the last month?

 

Did you go on dosulepin for sleep problems? When did the sleep problem start?

 

Did you get unusual symptoms after you stopped dosulepin December 13, 2022?

 

What times o'clock do you take your drugs, steroids, and supplements, with their dosages?

 

 

 

[Denyce]

Thanks for your reply Alto. Pattern has changed in last month to headaches are nearly every day. Not sure if from tiredness or magnesium supplements. Will drink more water, usually helps a bit. Lack of appetite & weight loss about 7kgs in last 6 months ( from being off dothep). Anxiety is high in social situations especially crowds.

 

Hypersensitivity to noise, stress, get cold easily, losing interest in things I used to enjoy. Withdrawing from friends as I'm anxious alot.

 

Dothiepin for major  depression 2019 (after hysterectomy surgical menopause 2008.) Tried different hormones for symptoms for at least 12 months. Had 26 treatments ECT in 2010 as suicidal. Waking with hot flashes, sleep issues. Had post natal depression both children although only mild was put on antidepressants then for a while, citalopram I think but eventually got off. Past is very hazy memory wise as lots of memory wiped from ECT. 

 

Sleep problem this time started 4 months ago after going off dothep which used to knock me out for at least 7 hours.

 

After stopping dothep (after 4 months of feeling quite good til approx March) even though I had really bad nausea, heart palpitations, headaches, the  anxiety, low mood/feelings of disconnection/loneliness sadness/crying only started after 4 months off. My daughter also moved out about that time & I miss her as I don't have many close friends or family here except my husband, son, & daughter. 

 

Sandrena gel 1g morning 9am

Progesterone 100mg capsule night 8pm

Magnesium L Threonate 144mg 3 times daily with meals 9am, 1pm & 7pm have reduced to 1 morning to see if reducing quantity helps with headaches

Magnesium Biglycinate 200mg night 8pm (started last night to see if better for sleep)

Metagenics Metazinc with vit c powder 1/2 teaspoon morning 9am

Vit D3 5000iu & Vit K2 both with breakfast 9am have just stopped these over past week to see if helps with sleep issues as they both can cause sleep disturbance. 

 

I am exercising daily walk on beach for 1 1/2 hours which helps me being out in nature. Sometimes with a friend but mostly on my own.

 

I woke this morning at 1.30am after 4 hours sleep.

 

Hope this clarifies a few things & that you might have some suggestions please. 

 

Thank you 

 

 

 

 

 

[Altostrata]

On 7/2/2023 at 6:53 PM, Denyce said:

Sleep problem this time started 4 months ago after going off dothep which used to knock me out for at least 7 hours.

 

 

At the time this sleep problem started, had you made any changes in your hormonal treatment?

 

Please review adverse effects of the hormones you're taking. I ask this because it may be that your symptoms are not from Dothep withdrawal.

[Denyce]

Hi Alto,

Ok, thanks for your insight. I will look at that possibility. 

 

[Denyce]

Hi Altostrata, Have checked into hormones. No changes. Everything seems ok there. I believe it may be protracted withdrawal from Dothep. Still have terrible insomnia. No sleep at all last night. Anxiety & low mood is through the roof today, unable to work or even go outside for very long, feeling very vulnerable but have started seeing a psychologist. I'm so exhausted. Doctor suggested book about curing insomnia to try & train me to get a handle on the sleep issues, I've been trying that over the last few nights. They've tried me on chlonidine blood pressure meds for the past month for anxiety/sleep/help with withdrawal but not much luck there. Any suggestions anyone?

[Altostrata]

You may wish to try reinstating 1mg to see if it helps. This topic explains how to make a liquid Tips for tapering off dosulepin / dothiepin (Dothep, Prothiaden)

 

Please let us know how you're doing. 

[Denyce]

Hi Altostrata, I have reinstated 1mg tonight as per your advice. Would you advise how long to do this? Until I find relief? How will I know if it is helping ? By cessation of some symptoms? Is there a general time frame known?  Any ideas on symptoms which will indicate if I need to cease reinstatement? My doctor wanted me to start at 25mg but I'm glad I read about reinstatement dangers on your site. There is no information that I can find on how to proceed and move forward. I have really battled for 8 months trying to stay off these drugs but the constant sleeplessness & anxiety has made it too difficult. I am actively doing all the other stuff to stay well including seeing a psychologist. Being unable to work or participate in life hardly at all has led me to this decision. Thanks for your continued support. Kind regards, Denyce 

[Altostrata]

What effect do you feel from 1mg?

[Denyce]

Thanks for your response Altostrata. Nothing as yet, I only used it first time last night. Although I have recently discontinued clonidine which I was only on for one month (see signature) although it was only to help with anxiety, my blood pressure has always been normal. I had a rough night of not much sleep again (3 hours). My blood pressure has increased and I am feeling very anxious &  depressed today. Maybe doing both at once wasn't the best idea? I'm just needing to feel better as I feel I am running out of options. Any ideas? 

[Denyce]

Is there anyone out there who can offer me support ? I am doing my best to cope with withdrawal symptoms 8 months out. I'm unable to work, maintain relationships and am losing all hope. Please someone give me words of encouragement if you can spare the time. This forum is the only one where people can understand. I have tried all the self help techniques & try to stay positive but with little sleep & high anxiety I am drowning here. Please help  Denyce 

[Altostrata]

On 8/26/2023 at 8:06 PM, Denyce said:

Although I have recently discontinued clonidine which I was only on for one month (see signature) although it was only to help with anxiety, my blood pressure has always been normal. I had a rough night of not much sleep again (3 hours). My blood pressure has increased

 

Has this gone away? You need to taper off blood pressure drugs that you take every day.

 

Do you feel any effect from 1mg Dothep? 

 

How long have you been taking 100mg progesterone nightly? Please review adverse effects of daily progesterone.

[Denyce]

Thanks very much for your response Altostrata. Blood pressure is still on the high side but only 133/7 which isn't too high anyway. I tapered off clonidine over the space of 2 weeks going to nil 4 days ago so there are probably still some effects from that. I have seen that clonidine is problematic to come off but my doctor suggested I go off over 4 days!! Seeing I'd only been on it for a month and the side effects were bad affecting the anxiety & causing dizziness I thought better to get off it sooner than stay on it.

 

No effect from Dothep as yet. I am more depressed and anxious today and getting quite despondent.

 

I am trying to stay positive and am seeing my psychologist weekly to deal with thoughts and feelings arising from these side effects. Sleep was about 3 hours maximum last night even with melatonin sublingual .03mg.

 

I have been on Progesterone for 12 months as well as Estrogen gel. Afraid to change this as well as everything else. I have tried off my hormones previously for 2 weeks which had no effect on sleep. Especially need estrogen for mood but could try off progesterone at later date once I stabilise a bit from these. What are your thoughts please?