paaugustine: Beginning Aripiprizole / Abilify Taper

[paaugustine]

Hello paaugustine here! I was prescribed 2mg of aripiprizole and 25 mg of quetiapine, along with lorazepem as needed for anxiety / bipolar. I was not experiencing any delusions / psychosis, but had heightened anxiety and difficulty sleeping. This started after I went to a clinic in mexico and took what is called  "flood dose" of ibogaine in the end of june 2023. For a month I felt fine / great after and then one month (August) after the trip I was hit with a brand new anxiety and insomnia, for which I was prescribed the medication in september 2023. My doctor is unsure what exactly I am dealing with, but reading all of the posts on SA, it seems like the potent serotonin and dopamine antagonist qualities of ibogaine basically put me in a state of a medication withdrawal once the ibogaine wore off although I really don't know for sure, and I don't think I will ever find out.

 

My current journey is slowly tapering the aripiprizole and see how my body adjusts. My brain needs to heal drug free. I went from 2mg to 1 mg on November 1st. In two weeks, I was hit with a very severe depression and heart palpitations, so I reinstated to 1.9 mg of aripiprizole (I purchased a jewlers scale). This helped my sypmtoms to normalize / go away. Starting tomorrow 12 / 3 I will go down 10 percent of 1.9 and see how I adjust. I am not currently tapering quetiapine, and I dont take the benzo more than once every other week if I need it for sleep. During the day I feel fine / lack of emotion and would like to move toward a drug free life.

Edited January 2 by FireflyFyte
Updated title

[FireflyFyte]

Hello paaugustine,

 

Welcome to SA. Thank you for summarizing your drug history in your signature but can you confirm what you are currently taking as far as medication?

 

Since you have decided to start by tapering the aripiprizole, will link to our thread dedicated to it at Tips for tapering off Abilify (aripiprazole).

 

1 hour ago, paaugustine said:

Starting tomorrow 12 / 3 I will go down 10 percent of 1.9 and see how I adjust.

 

I would stay at 1.9mg for at least four weeks to see how you react before making another drop especially with recent increases, and decreases, in dosage. You can read more about our harm reduction model of tapering at Why taper by 10% of my dosage?

 

Thanks,

 

Firefly

[paaugustine]

OK I updated my signature. Also I meant to write starting tomorrow January 3rd, which will be 4.5 weeks at 1.9 mg.

[FireflyFyte]

9 minutes ago, paaugustine said:

Also I meant to write starting tomorrow January 3rd, which will be 4.5 weeks at 1.9 mg.

 

As long as you feel stable, you should be good to drop 10% so your next dosage would be 1.7mg.

[paaugustine]

I made the cut to 1.7. I have a question. I am using aripiprizole generic from aurobindo brand tablets. Previously my psychiatrist was having me cut pills in half when I was on a higher dosage, and from what I read, you can cut / file aripiprizole. I have also read however that some tablets you can't cut or file. Is it safe to file / cut down aripiprizole tablets?

 

I dont want to switch to liquid because It seems harder to travel with (bringing liquid on a plane) and I have heard that switching to liquid can cause withdrawal symptoms because of different bioavailability. I feel comfortable filing down the tablets, and when I get past (God willing!) the half way point and things are going smoothly, I will invest in a analytic balance instead of the cheap jewlers scale, and some fillable gel capsules and make my own pills from crushed tablets. I have read of other people doing this and this seems to be the route I am comfortable with.

 

In terms of any withdrawal symptoms, on day 2 and 3 I had some slight 'pins and needles' but very slight and maybe only noticed them 5-6 times through the entire day, and was not debilitating at all. Today I have had some irritable bowel (not pain but looser stools). Thus far that seems to be it. I am a bit waiting for the "other shoe to drop" in terms of symptoms of withdrawal in the coming week.

[APhoenixRising]

Hiya paaugustine! I don’t really have advice for you but I just wanted to mention that I’ve also been tapering Abilify. I was on 20mg down to 5.5mg. I’m going to hold at 5 mg while focusing on tapering EffexorXR for awhile. Welcome!

[FireflyFyte]

15 hours ago, paaugustine said:

Is it safe to file / cut down aripiprizole tablets?

 

Yes, it appears that it is safe to cut/file them.

 

15 hours ago, paaugustine said:

Thus far that seems to be it. I am a bit waiting for the "other shoe to drop" in terms of symptoms of withdrawal in the coming week.

 

Hopefully this is the worst of the symptoms that you experience since you are doing a slow taper.

[paaugustine]

APhoenixRising , what has been your experience been as you lower the dose of abilify? 

[APhoenixRising]

I feel like I wasn't affected much by tapering in the beginning but I probably went too quickly for comfort. I did however taper 2 drugs at once due to impatience, I know that is a big no-no. If I made too big of a leap with Abilify I would usually feel it around day 12. I once used an expired but sealed bottle to taper with as my psychiatrist was giving me a hard time about writing new scripts. That was hellish. Anxiety, irritability on a new level, like not being able to be around anyone, or loud noises, bright lights etc... I had to quickly get "fresh" meds, begging the psych doc, because it was a dire situation that scared the hell out of me. That experience has made me respect what Abilify was capable of doing to me and be more conservative in the future. I see you're on a much lower dose than I. I am nervous now going forward I know under 5mg will be more tricky for me and I must go much slower.

[paaugustine]

Thanks for your insights. I started my most recent cut on January 3rd, although I had the amounts wrong, I'll update it in my signature. I've been doing 10 percent of the recent dose cuts. So far I have had few symptoms except for those stated above. Yesterday I was exceedingly tired, and not sure if that was because of the taper or just life. Today is a lot better. Additionally, I have had a new bout of constipation. its not that my stool is hard, it seems like I might have "hypomotility", or a really slow digestive tract because of the meds. I've been taking fiber once a day and eating prunes, but I might up the fiber. I've also noticed a rash now for about 10 days on my arm, near my elbow. It doesn't itch and is not growing, and its only there. I wonder if it might be ringworm from the gym, so I'm using a topical antifungal. (Thought of this because I used to wrestle in high school). As I look up information on stephen johnson syndrome or other medication rashes, this doesn't seem to be that. Also my heart palpitations / pvcs are much reduced or almost gone. I notice them occasionally. My next planned 10 percent cut would be on january 31st, if things continue to go well. 

[paaugustine]

An update here. The last month has overall been good. The symptoms I had did not really get worse. An occasional persisting light headache, and occasional heart palpitations. The constipation has cleared up which is a relief, and the rash on my arm has not gotten any larger and no other rashes. I've been using a topical antifungal in case it is ringworm from the gym. It seems like it is getting better, although its hard to tell, and I'm not sure really what its from. My mood has also improved as well - less or no moments of depression, which is always a relief. I lowered my dose of aripiprazole on January 31st to 1.45 mg. I am looking at a couple year taper and sometimes I find myself restless to be done, but I know it is a marathon not a sprint. I spoke with my psychiatrist about lowering the 25 mg of quetiapine and she said I could just stop taking it, but reading other's reports, that seems unwise. I know I am on a low enough dose for it to not have a great effect on dopamine, but I would get a big impact when I jump off because of its antihistamine effect. I decided to lower it by 10 percent of the original dose - a linear drop, every week over 10 weeks. I have done the first two weeks with no withdrawal effects. 

[FireflyFyte]

On 2/5/2024 at 10:31 PM, paaugustine said:

I spoke with my psychiatrist about lowering the 25 mg of quetiapine and she said I could just stop taking it, but reading other's reports, that seems unwise.

 

25mg is a high dose to jump off from and we would recommend avoiding that as an option. 

Are you tapering the aripiprizole and quetiapine at the same time?

[KaiLee]

I'm glad to hear that you're feeling better.

I also suffer from abilify, although I did cold turkey instead of tapering it. 

I sincerely wish you a good luck.

[paaugustine]

On 2/7/2024 at 2:55 PM, FireflyFyte said:

 

25mg is a high dose to jump off from and we would recommend avoiding that as an option. 

Are you tapering the aripiprizole and quetiapine at the same time?

I should have been more clear. Although I pondered it for a little, bit, having read enough advice from this site, I am not / will not jump off from 25 mg. I have been lowering it each week by 2.5 mg, so far with no adverse effects. My plan at this point is do that until I am at 2.5 mg, and hold that for a bit. Yes I have been doing that while tapering the aripiprazole. An update on that, I am at the two week point right now on my most recent cut, with hardly any noticeable withdrawal symptoms! Yay!

[paaugustine]

7 hours ago, KaiLee said:

I'm glad to hear that you're feeling better.

I also suffer from abilify, although I did cold turkey instead of tapering it. 

I sincerely wish you a good luck.

Thank you for the good wishes. It sounds like you are going through a hard time reading through your introduction. I hope things will go well for you too. 

[FireflyFyte]

19 hours ago, paaugustine said:

Yes I have been doing that while tapering the aripiprazole.

 

We recommend only tapering one medication at a time so if withdrawal symptoms arise, the cause can be easily identified.

[paaugustine]

I understand that if I get into trouble it will be hard for the moderators to offer advice. Thus far, things have been going really well. I've gone from 25 mg to 15 mg  on the quetiapine and it has gone great. I know that as I get closer to zero things can get trickier. I'm hopeful that I can continue to share more story here. 

[paaugustine]

An update - on March 31 I took my last dose of quetiapine. I had some trouble sleeping that night. The next night i took half a lorazepem (I think .25 mg) and I slept fine. I had no itching / histamine problems. The last two reductions of quetiapine i had some major nausea and stomach cramps, but none when I stopped it outright. From 3/31 until last night (April 14, 2024) I slept well every night, falling asleep within 30 minutes of laying down and staying asleep. Last night however was another story. I was feeling so good since my last aripiprizole reduction, that I decided to lower it again, and I am wondering if the reduction was too soon and is disrupting my sleep. I also am wondering if a couple other factors are at play - last night I had two chocolate chip brownies at night, so perhaps the caffeine in the brownie didn't help. Additionally, I was on my computer until about 10:30. I had my window open at night and the breeze was making the curtains flap around until finally I got up to close them. THen I had to pee....lots of distractions keeping me up, so am thinking all of this contributed to struggle falling asleep until 1:30 - 2:00 AM.  I feel great actually, I have no heart palpitations the last few weeks, my mood is great, no headaches at all today, my gut feels fine. I am not particularly tired today, although I did drink a cup of coffee this morning at 7am - I allow myself one cup a week on sundays as a little treat, as it boosts my mood. SO aside from the lack of sleep last night, I feel great, and with the coffee this AM, I dont feel tired right now. I even went for a 40 min run in the beautiful weather. I don't think I will lower the dose again until sleep is back to normal.

 

Anyone who reads this - in reducing aripiprizole, did anyone else struggle with insomnia as the dose was lowered?

[FireflyFyte]

15 hours ago, paaugustine said:

Anyone who reads this - in reducing aripiprizole, did anyone else struggle with insomnia as the dose was lowered?

 

Insomnia is a common withdrawal symptom and you have made a lot of changes in a short period of time which might be compounding what you are experiencing. I would recommend holding at your current dosage for at least several weeks to see if your symptoms improve before making another drop.

[paaugustine]

Last night I fell asleep just fine, wondering if it was all the chocolate I ate before bed. Anyway, will make sure I have consistent nights of sleep before I lower again.

[paaugustine]

Just a little update for the internet world. Lowered medication again by 10 percent and feeling good, no trouble with sleep. I'm starting to think my body / brain can handle 10 percent once a week just fine