santy: Tapering Fluvoxamine. Switched to Imeditate Release version and got stuck by reinstating higher dose again.

[santy]

I have tried to taper 50mg first by splitting doses into half and taking 25mg twice a day. I was breaking Controlled Release tablets as I wasn't aware that they shouldn't be split. After 1 month I reduced the dosage to 25mg. I switched to alternate brand (voxidep) as 25mg dosage is not available in the earlier brand (Fluvoxin). Took 25mg of new brand for 15 days and then 12.5 mg for 4 days and then stopped. After stopping everything, I went to vacation for 10 days. Felt no discomfort or withdrawal syamptoms. Exactly after 1 month of discontinuation, started feeling extreme discomfort, increased heart palpitations and dizziness. Since I couldn't tolerate, I resumed 50mg ( I am regretting the higher reinstatement) Now I switched to Immediate Release tablets of original brand (25mg twice a day), as I can cut them easily into smaller parts.

 

Can I reduce by 6.25 (1/8th of 50mg) every month? I am ok with small variations with cuts as I don't want to switch the brand again. 

(The smallest dose I can get with my long time brand (Fluvoxin) is 50mg, no issues whatsoever except that I need to cut the pill into 8 pieces)

 

I have a bought a weighing scale and planning to order my cut pieces in the decreasing order of weights.

Please help me understand if I can be stable again with immediate release pills ? And does my planned tapering (6.25mg every month with immediate release starting from Feb 15, 2022, hoping I will be stable by that time) sound good and feasible?

 

Currently facing dizziness, lost concentration, clear thinking ability, body pain and body imbalance.

 

History:

2002-2010 - Prodep 10mg (Fluvoxetine)

2013-2016 - Prodep 40mg

2018-2020 - Fluvoxin 200mg (Fluvoxamine)

Jun'21 - Jul'21 - Fluvoxin 150mg (cold turkey)

Jul'21 - Apr'22 - Fluvoxin 100mg CR

Apr'22 - September'22 - Fluvoxin 50mg CR

 

[Altostrata]

Welcome, @santy

 

On 2/5/2023 at 1:03 AM, santy said:

Now I switched to Immediate Release tablets of original brand (25mg twice a day), as I can cut them easily into smaller parts.

 

When did you do this? Have your withdrawal symptoms gone away?

 

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.

[santy]

Thank you @Altostrata

 

It's been difficult to find the time in the chaos and pulling all together working in an MNC is really difficult.

Finally came here after finding some time.

Actually when I reinstated 50mg back in January, I felt alright for 3 days. But withdrawal symptoms built up quickly and I am repenting now constantly about I should have tolerated that discomfort (it seemed severe then, but I was really scared) and by this time I should be out of meds comfortably.

I knew soon after, that I made a mistake by reinstating 50mg and since I was not feeling well with 50mg as well, I went bit fast and and tapered down to 25mg in 1 month. I stayed on 25mg for 2 months and waited to have an opinion with the psychiatrist and that allowed me to get stabilized a bit.

The issue is, especially in India, there are no standard compounding pharmacies through which I can get the smaller doses. Even if they exist, I don't think they cater to the specific needs of individual patients unless they are told to do so by the doctor. (And doctors don't take that approach, as in my case, I consulted at the National Institute of Mental Health, and the doctor told 25mg is as good as taking nothing and I can stop from that dose itself. I returned empty handed after failing to convince them how it works and what I am going through).

So I have no other option apart from splitting 25mg pill into quarters and reduce the dose by 6.25mg at a time. So I started with 6.25mg reduction 2 weeks ago. I take 12.5 in the morning and 6.25 in the night. I read making liquid method for Fluvoxamine and I didn't find it convincing, to be frank, to let the pill dissolve overnight and it may be degraded by night and we need to refrigerate it and so on and it says Fluvoxamine is sparingly soluble and again somewhere it says we can ignore the bottom-settled pieces as they are only mud. I tried twice making water solution but the pieces just didn't mix up.

So I made up my mind that 6.25mg reduction is the only way to go. But, I am experiencing Diarrhea, Insomnia (getting dreams thought sleep span), extreme brain fog, confusion and weakness (joint pain). I need your suggestion how to overcome brain fog hurdle especially when you need to work in a stressful corporate job. 

I do kind of get mild akathisia in the morning may be due to the fact that I take only 6.25mg in night. I am worrying will I ever make it through this? If I win just the brain fog by somehow, I will regain the strength to battle others. Also my query is, since I started taking SSRI at the age of 7, can my brain work without these drugs as all the growth happened while I was on these and the poor organ don't have much of the drug-free experience. I am not sure how it can heal. 

 

Also I am taking Fish Oil (2500mg) and Ashwagandha root extract supplements daily. The signature threw some error so I couldn't put this in there.

 

[Altostrata]

I am sorry that you cannot figure out a way to make smaller doses. We're only an Internet peer support site, we cannot supply drugs for you.

 

If you're getting withdrawal symptoms from tapering, we recommend that you stop tapering, possibly going up to a slightly higher dose, and staying there weeks or months until withdrawal symptoms go away. Then taper more gradually, by smaller amounts.

 

Unfortunately, you will again have to figure out how to titrate your drugs. This is why we provide information about making homemade liquids.

[santy]

Thank you. I am going with 6.25mg dose reduction. I know it's bit heavy. But I have confidence that I will make it up since currently I am not in very bad state when it comes to physical symptoms. Only thing that is very annoying is brain fog and cognitive impairment. I am worried if this is permanent as I have kindled my brain by reinstating 50mg after 1 month of drug free period. I am taking fish oil daily but failing to adhere to sleep timings and exercise routines. I will take that up very seriously and try to hold my ground. Is brain fog due to knidling a permanent problem that I have to face? Is there anyone who came out of this brain fog and memory issue after messing up with their dosage?

[LostInCanada]

@santy hi, so sorry to hear you are dealing with this. Was it possible to get a weigh scale like Gemini 20 on Amazon. I use a pill cutter, razor(sharp knife will work) and scale. Then you can do a slower taper-10% of current dose is recommended. Your brain will heal with time and a slower taper will help with that recovery. If you revisit  making a liquid solution, use bottled water or distilled, keep refrigerated, stir or shake before extracting the dose. Routine is good and taking the drug at the same time helps as well. 👍

[Altostrata]

@santy suggest you stop tapering if you get withdrawal symptoms. We don't have any magic potions to reverse them if you taper too fast. You'll just have to cope with them.

[santy]

Thank you @LostInCanada @Altostrata.

 

I have ordered gem 20 weighing scale from Amazon. I am planning to go with slow taper as per your suggestion. I realized it's better to go slow and then end instead of hurrying and getting stuck in this loop again and again.

 

My queries are as follows:

1) I feel horrible for 2-3 hours after taking my morning dose. The effects start subsiding slowly as I reach late afternoon and I feel lot better in the evenings. So I am thinking, is this because, I have already stabilized without meds for 1 month and I kindled with high dose and brain doesn't want any meds and that's why it struggles soon after taking meds? In that period (2-3 hours), I feel like stopping altogether so that my brain will feel normal as it does in the evenings. (PS. I take 6.25 in morning and 6.25 at night)

2) Should I go up from 12.5 or stay here and then try tapering from here onwards slowly (10% using dry cut method)? I always keep on repenting about I should not have reinstated 50mg after being drug-free for 1 month and worrying if the effects of kindling will go away or not? And since I am already riding through withdrawal battle now (Which I didn't face in the last attempt as I jumped from 25 to 0), can I still expect delayed withdrawals after reaching zero in the future (I am hoping that withdrawal battle is already inbuilt into this tapering and I will not face horrific delayed withdrawals after reaching zero)

[Altostrata]

On 4/19/2023 at 4:38 PM, santy said:

I take 12.5 in the morning and 6.25 in the night.

 

1 hour ago, santy said:

I feel horrible for 2-3 hours after taking my morning dose.

 

 

^This suggests the larger 12.5mg dose is TOO HIGH for you and you are getting adverse effects after you take this dose. 

 

If I were you, I'd reduce the morning dose to 10mg. Please let us know how you're doing.

[santy]

On 4/30/2023 at 8:38 PM, Altostrata said:

I am planning to shift my split dosages to night entirely. Is it a good idea. I am holding on 6.25 in the morning and 6.25 at night. Now planning to take 12.5 and wait for couple of weeks to stabilize. Is it a good idea? I just didn't take my dose today morning and feeling lot better. Headaches were gone. So planning to taper when I stabilize on 12.5 at night. The only thing that is bothering me is brain fog and decreased cognitive function. I am seeing no signs of any improvement.

 

[Altostrata]

Please clarify what it is you're doing now and what you intend to do.

[santy]

I am taking 6.25mg Fluvoxamine in the morning and 6.25mg in the evening. But I am getting severe headaches soon after taking the morning dose. So I am planning to skip the morning dose and take 12.5mg before bed. Once I stabilize, I will taper slowly again using 10% method.

[Altostrata]

On 4/19/2023 at 4:38 PM, santy said:

I take 12.5 in the morning and 6.25 in the night.

 

On April 19, you were taking 12.5mg in the morning. How is it you are taking 6.25mg in the morning now?

[santy]

Apologies, I had not updated the signature. I switched to 6.25 in the morning from Apr 28. After 4 days, i started to get severe headache after taking the morning dose so I thought of taking the full dose at night but I couldn't feel better so again switched to 6.25 in the morning and 6.25 in the night. 2 hours after taking the morning dose, I feel worse but apart from that I feel better at rest of the times.

I have purchased gem 20 scale and bought empty gelatin pills as well. Hoping to proceed with dry cut method. The pill size is very small so I need to convert it into powder. I am not sure it works or not. Any suggestions?

I tried to make liquid solution using salt walter and left it for more than 20hours but I could still see large chunk of powder settled at the bottom of vessel. So I dropped the  idea of liquid tapering method.

 

The accuracy of weighing scale is 5mg. And my pill is weighing 130mg. I am worrying that whether I would mess up with my pill dosage accuracy. Sorry for my english, I am finding it difficult to frame sentences and use proper words nowadays...

[Altostrata]

On April 19, you reported taking 12.5mg in the morning. I suggested you take 10mg instead. Some time since, you cut to 6.25mg in the morning. 

 

It is possible that you got withdrawal symptoms from abruptly cutting your morning dose in half, though you were advised to only slightly reduce it.

 

After that, you've been playing with your dosing. Fluvoxamine must be taken twice a day. Doses 12 hours apart are best. 

 

Suggest you stabilize on a consistent daily schedule of 6.25mg in the morning and 6.25mg at night before considering tapering.

 

 

[LostInCanada]

@santy so your 25mg pill weight is 130mg or .130 on your scale. If that is correct then half a pill is .065 on the scale which is 12.5 mg of the drug. Therefore to get 6.25 mg of drug, the scale weight will be .0325 or .033.  Stabilizing is now important for success.❤️

[santy]

1 hour ago, Altostrata said:

On April 19, you reported taking 12.5mg in the morning. I suggested you take 10mg instead. Some time since, you cut to 6.25mg in the morning. 

 

It is possible that you got withdrawal symptoms from abruptly cutting your morning dose in half, though you were advised to only slightly reduce it.

 

After that, you've been playing with your dosing. Fluvoxamine must be taken twice a day. Doses 12 hours apart are best. 

 

Suggest you stabilize on a consistent daily schedule of 6.25mg in the morning and 6.25mg at night before considering tapering.

 

 

Hi ,

I got your post on Apr 30. But I already started with 6.25 on 28th. So I needed to go with 6.25. the thing is, around that time, I was still figuring out how to make small dose reductions and didn't have weigh scale with me.

Thank you, I will stabilize with equal 6.25 dosage now. And then follow the 10% reduction technique using weighing scale. 

 

[santy]

52 minutes ago, LostInCanada said:

@santy so your 25mg pill weight is 130mg or .130 on your scale. If that is correct then half a pill is .065 on the scale which is 12.5 mg of the drug. Therefore to get 6.25 mg of drug, the scale weight will be .0325 or .033.  Stabilizing is now important for success.❤️

Yes. I am hoping that even if my scale doesn't show up weights accurately on absolute basis, I can get correct reductions relatively. I hope absolute numbers don't matter as long as I stick to proper reductions based on whatever number it displays. I hope I can follow this. Please let me know if my thinking is not right. I guess these machines don't show up accurate numbers at milligram accuracy. I saw some lab scales for measuring in milligrams that cost thousands of dollars which we can't afford.

[santy]

Also, I saw the DIY post for liquid solution. But my pill is not working that way. It just sits at bottom no matter what you do and it's mostly insoluble. That is triggering me mild anxiety (may be my ocd is creeping in slowly) that I am taking a substandard pill. My earlier taper failed because I tried to get rid off this new brand asap (The one which I am taking now, as only this comes with 25mg dose - Voxidep). The standard reputed pill - Fluvoxin, comes in only 50mg as last dose.

I checked with some doctors online about the genuineness of this new pill and they said I could use it. (I lost the faith in doctors too btw!!) Anyway, used that new pill till now upto 6.25mg. I am thinking if I can get that old pill in 50mg and powder it, and fill it in empty capsules after weighing the dosages. But not sure if it causes kindling after changing the brand. This thought of going back to old pill just came in while I am typing this. 

PS: I tried making liquid using my old pill Fluvoxin too, and that also didn't dissolve that much. Only reassuring thing about that is, it comes from one of the most reputed pharma companies in India.

[LostInCanada]

@santy I have had quality issues in Canada as well. I got my pharmacist to call the company to get the weight each pill should be so I could be consistent. You can weigh 30 pills, add all weights together and divide by 30 to get a consistent weight. I did that and it was the weight the company said it should be. Then no matter what the pill weighs you just always use that same dosage for example.033 for you. I would think your new drug company would be okay or the main manufacturer would be calling them into question because of profit loss. But do what you are comfortable with. Make sure you calibrate the scale every time. Do not have air movement either.

[santy]

Thank you @LostInCanada @Altostrata

My question is can we recover from kindling or is it like too much damage done to my brain?

[Altostrata]

Rather than worry about kindling, I suggest you stabilize on a consistent dosing schedule. We know for a fact that irregular dosing can cause serious problems.

[LostInCanada]

@santy how are you doing? 

[santy]

Hi @LostInCanada

I am doing ok now. Brain fog is reduced significantly but I am feeling tired all the day. I need to urinate frequently. Some days I feel doing good and some days I feel very weak. 

[LostInCanada]

@santy I so hate these drugs. We are all suffering together. Time will heal.

[santy]

Hello,

@Altostrata @LostInCanada

 

It's been a while. So I thought of checking here again. Hope you are doing well.

 

Just to brief, I ended my tapering on August, 2023 last year. 

 

I was away from the forum as I was studying for my new job. I am grateful that I cracked it midst of all the brain fog, nerve pain amd confusion and diarrhea.

 

I am moving on to a new job, still further details are unknown but it would be bit far from my home location. That's bit concerning but the good thing is the jobe would be less stressful.

 

Meantime, coming to my current situation, I am currently in a bad wave. It changes hour by hour, how I am going to feel. Currently I am experiencing cognitive issues which is kind of very frustrating. I was regarded as a super brilliant since I was kid and acting like a  dumb idiot in front of them is making me very embarrassed and sad. But the good thing is that I am feeling like I have more avenues to look at a situation and be more creative which was completely killed earlier.

 

I am worrying if I did a blunder by not reading about the tapering process earlier. I did a blunder by reinstating again to 50mg back in January last year. Then I followed a slow taper but it was very painful. I took it slow but I was not sure whether I was infact adding more chemical to my brain since I reinstated. So I took a balanced approach and made it slow as much as I could.

 

Now it's been almost 5 months since I made it zero. Now I am feeling like should I start with a very small dosage of fluvoxamine and bridge it with fluvoxetine may be as it has long half life. But I am not sure whether it causes more pain or I will be relived. 

 

Please suggest. I am feeling that my tapering was not okay and decent enough to get healed. If I use that fluvoxetine method, can I be in a better place than this ??

[LostInCanada]

Hi @santy please do not tag Altostrata. She is no longer involved with the day to day on this site.

Sorry to hear you are doing badly. Unfortunately you did not stabilize like suggested after reinstating and the you tapered way faster than suggested. Your central nervous system has been affected and it will take alot of time to heal. 

No you should not reinstate any drug. You said you were having an adverse reaction from the drug. It will be worse if you try and take it again as your system is even more sensitized. These drugs are dangerous and not to be taken lightly. 

Time is now your best healer. 

Do all you can to help that happen. No caffeine, no alcohol, no drugs, eat healthy, moderate exercise, regular schedule of sleep.

Do you take magnesium bisglycinate or Omega 3? If you choose to add them, do only one at a time for a couple weeks before adding the other. 

Look at the self care section on here.

11 hours ago, santy said:

I am feeling that my tapering was not okay and decent enough to get healed

You will heal. It could have been slower and more accurate but you are at zero. Now just work to make that a success. Not an easy road for any of us but acceptance and kindness will make us successful.♥️

[santy]

Thank You @LostInCanada

 

May I know how are you feeling ? In your experince, do you find that cognitive abilities will come back ?

Touchwood, I am feeling better since last 2 days. It's just that when we are in wave, we feel like it's going to be like this forever.

But what I observed is that I feel too much nerve pain espcially after taking bath and during afternoon. Too much of fatigue and body pain makes it very difficult. How to tackle this ?

On 2/1/2024 at 10:50 PM, LostInCanada said:

Do you take magnesium bisglycinate or Omega 3?

Regarding supplements, I have tried fish oil in the past, but didn't feel it to be magical. It was so much blurry that I couldn't recognise whether it made me feel better or not. Another reason could be I was not consistent in my dosage schedule.

Regarding Magnesium, I am yet to try that. Do I need to undergo blood test before starting Magnesium? currently I am bit scared to add any chemical into my body. But I have heard about Magnesium so many times that I want to give it a try this time. But will it be safe enough ? Did it help you significantly ?

On 2/1/2024 at 10:50 PM, LostInCanada said:

You will heal. It could have been slower and more accurate but you are at zero. Now just work to make that a success. Not an easy road for any of us but acceptance and kindness will make us successful.♥️

Thank you so much for the hope. I wish I could change my past. I repeatedly feel like it was very bad to start with these drugs at the age of 7 and my chances of recovery are very minimal.

But sometimes I hope the theory of neuroplasticity is actually true and with positive belief and affirmations (Along with good habits) I can completely take it back to the healthy stage. What's your opinion on this ?

[LostInCanada]

26 minutes ago, santy said:

May I know how are you feeling ? In your experince, do you find that cognitive abilities will come back

I am doing better. It is slow but I see positive changes. I am definitely not fully healed cognitively. I find when I am stressed or being rushed I struggle with thinking. I need to plan and have things executed in order or else I struggle.

29 minutes ago, santy said:

Do I need to undergo blood test before starting Magnesium?

You can. I read that your magnesium intake should equal your calcium intake. Just do not take them within 2 hours of each other. Honestly I don't know if the magnesium or the omega 3 helps me significantly but for me they don't hurt so I am sticking with it.

32 minutes ago, santy said:

it was very bad to start with these drugs at the age of 7 and my chances of recovery are very minimal.

The body is resilient and you have youth on your side. Hope and being positive are great healers.👍💯

 

35 minutes ago, santy said:

sometimes I hope the theory of neuroplasticity is actually true and with positive belief and affirmations (Along with good habits) I can completely take it back to the healthy stage. What's your opinion on this ?

I think you are going to be okay if you keep this attitude. Good for you.