ActivistScientist: Problems with Lyrica taper

[ActivistScientist]

I was on 75 mg of Lyrica for 4 months for nerve tingling due to back issues.

 

Was advised by the nurse to stop if I wanted to go off it but I suggested that we go to 50 mg as I did not find much on the web (unfortunately, not this site till it was too late)! Eight days later, I was in bad shape with anxiety, insomnia and tremors. Went back to 75 mg after two weeks but to no avail.

 

I found this site. Tried the liquid taper - and that was horrendous. I just reduced the dose by 1 mg from 75 mg but used liquid and woke up at 2 am with head to toe tremors. Tried it again at regular dose split into two of 37.5 mg to take twice a day in liquid form and that was horrible as well. I consulted an academic experienced psychaitrist and he told me that the liquid and capsule have very different absoprtion kinetics and that is why I was having the problems.

 

After a couple of months at 75 mg capsules again, I started tapering by 5 mg every 10 days using a compounding pharmacy to make capsules for me. So, I went 75>70>65>60>55>50>45>40>36>32>29>27>25 .. then held for about 2 months and then have started tapering again. 25>23>21>19>17 ..

 

I have insomnia and am taking 2/3 of a tablet of Benadryl and sometimes, take 0.25 mg of klonopin but maybe, once in 10 days or so to take the edge off. I am a poor metabolizer of klonopin (have determined this by genetic testing) and so, it stays in my system for longer but also why I dont think it is a good idea to take it really.

 

I also have tinnitus but am not sure if it was started by Lyrica and then the withdrawal contributed to it. I am planning to continue the taper at a slow pace trying not to go below 10% but wonder if anyone else has experience with Lyrica once they get to the dose in teens as I have. I plan to continue to use the compounding pharmacy but not sure if that is an overkill once i get to 10 mg.

 

Anybody else have the same experience with the liquid taper. The psychiatrist told me that he does not recommend switching from tablet or capsule to liquid with other psychotropic meds as well.

Edited June 11, 2015 by Altostrata
added paragraph spacing

[Fresh]

Hi  ActiveScientist , welcome to the site.

 

I haven't been on Lyrica myself , but people generally seem to find decreasing tougher as they get to lower doses.

There are also many who've had trouble switching from tablets to liquid , or even changing brands.

 

Take a look at the Tapering section -  you may prefer to make your own liquid from your tablets , and there are all the instructions you need there.

Try putting  your meds. into the interaction checker at  www.drugs.com and see the interactions.

 

Others will be along with input soon.  If you click FOLLOW THIS TOPIC at the top right , you'll receive an email each time someone posts.

 

Good to have you on board ,  Fresh

[mammaP]

Hi AS, welcome to SA. I'm sorry that your switch to liquid didn't go well, many people have problems but others are fine with it. I couldn't tolerate a switch to liquid either and had to go back to effexor capsules.  Here at SA we recommend tapering no more than 10% of the current dose with at least 4 weeks between cuts to allow the brain and nervous system to catch up as the dose lowers. I would hold your taper for a while to stabilise properly, a month at least to give your brain a rest from tapering, then start to taper off the remainder.  It is usually more difficult at the low doses, and many people tend to stop too soon thinking they have gone low enough only to get crushing withdrawal symptoms. I hold my hands up and admit that I did this too and found out the hard way that I should have slowed down towards the end and carried on tapering that last 1mg instead of thinking I was done!   

 

Here is our topic for tapering lyrica, including instructions on making a liquid from your tablets or capsules, which will save you a bunch of $ and as it is from the same drug shouldn't have any adverse reactions.

 http://survivingantidepressants.org/index.php?/topic/2381-tips-for-tapering-off-lyrica-pregabalin/

 

Why we recommend 10% cuts  every 4 weeks

 

 http://survivingantidepressants.org/index.php?/topic/1024-why-taper-by-10-of-my-dosage/

 

The 3 KIS http://survivingantidepressants.org/index.php?/topic/6632-the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable/

[primrose]

I was on 75 mg of Lyrica for 4 months for nerve tingling due to back issues. Was advised by the nurse to stop if I wanted to go off it but I suggested that we go to 50 mg as I did not find much on the web (unfortunately, not this site till it was too late)! Eight days later, I was in bad shape with anxiety, insomnia and tremors. Went back to 75 mg after two weeks but to no avail. I found this site. Tried the liquid taper - and that was horrendous. I just reduced the dose by 1 mg from 75 mg but used liquid and woke up at 2 am with head to toe tremors. Tried it again at regular dose split into two of 37.5 mg to take twice a day in liquid form and that was horrible as well. I consulted an academic experienced psychaitrist and he told me that the liquid and capsule have very different absoprtion kinetics and that is why I was having the problems. After a couple of months at 75 mg capsules again, I started tapering by 5 mg every 10 days using a compounding pharmacy to make capsules for me. So, I went 75>70>65>60>55>50>45>40>36>32>29>27>25 .. then held for about 2 months and then have started tapering again. 25>23>21>19>17 .. I have insomnia and am taking 2/3 of a tablet of Benadryl and sometimes, take 0.25 mg of klonopin but maybe, once in 10 days or so to take the edge off. I am a poor metabolizer of klonopin (have determined this by genetic testing) and so, it stays in my system for longer but also why I dont think it is a good idea to take it really. I also have tinnitus but am not sure if it was started by Lyrica and then the withdrawal contributed to it. I am planning to continue the taper at a slow pace trying not to go below 10% but wonder if anyone else has experience with Lyrica once they get to the dose in teens as I have. I plan to continue to use the compounding pharmacy but not sure if that is an overkill once i get to 10 mg. Anybody else have the same experience with the liquid taper. The psychiatrist told me that he does not recommend switching from tablet or capsule to liquid with other psychotropic meds as well.

Hi ActiveScientist

 

Sorry you have had such trouble with lyrica.

I am about to start a taper with lyrica.

I will be making my own liquid out of capsules.

Lyrica (pharmecutical name-pregabalin) is water soluble, if you go to drugbank.ca and enter pregabalin in the search box and scroll down, you will see it is water soluble, so, with a syringe, it is very easy to divide.

 

I was on a diazepam taper, and I took diazepam liquid but much preferred to make my own liquid out of the tablets.

How are you getting on with your lyrica taper.

How soon after reducing your dose did withdrawal symptoms appear?

[Altostrata]

Welcome, AS. Did this psychiatrist have any suggestions about how to taper Lyrica?

 

You might finish your taper by having 5mg capsules made and take the rest in liquid until you get down to 5mg. Then, get 2.5mg capsules made and take the rest in liquid, etc.

 

At 2.5mg, you'd have to see how decreases are going before you can estimate when to stop.

 

(Please put paragraph spacing in your posts, large blocks of text are difficult to read.)

[ActivistScientist]

Thanks for your suggestions, Alto. The psychiatrist and my internist did not really have any suggestions on tapering Lyrica. I just experimented which went horribly at first and then settled on my own strategy.

 

My Lyrica taper with compounded capsules was going pretty well - I know it is more expensive but after all the challenges I had when I made the switch from capsule to liquid and productive work time lost, I really did not want to risk it.

 

My sleep continues to be disturbed some nights and I have developed pulsatile tinnitus in one ear. Not sure if that is related to this taper or not but I don't have the tremors and in general, am much more settled.

 

I have become lactose intolerant due to the serious gut issues I developed after taking the Road back Program supplements briefly when I first started having issues and so I make sure that the pharmacy uses an inert filler(Avicel) to make the capsule.

 

I made it down to 9 mg and then on day 3 of the new dose, I started having new WD symptoms (high-pitched ringing in one ear and a rapid heartbeat). My doctor told me to take clonazepam every 2nd or 3rd day and I tried to take 0.25 mg on day 3 and day 6 of the the new dose but I just did not feel right and have decided to stay away from that. Instead, I take 100 mg of L-theanine in the AM and 200 mg at bedtime. That seems to help.

 

I made a smaller reduction the next time to 8.5 mg but on day 3, the WD symptoms as above appeared again. I took an additional 100 mg of L-theanine in the middle of the day on days 4 and 5 and the tinnitus seemed to quell after that.  

 

However, after these last two cuts, I have decided to do a longer hold with the next dose of 8 mg. The pharmacist charges $15 for the capsules and it does not matter if I order 7, 10, 15 or 20 and insurance pays for the actual drug which is the most expensive part. He does mail orders as well if anyone is interested. 

 

Another thing I have started doing is "earthing" - not with any of the mats and sheets that one can buy but just walking on grass or sitting with my bare feet on natural stone that has been wetted. You can read the reviews of the book on Amazon. 

[ActivistScientist]

The one thing the psychiatrist told me was that the liquid and capsule don't substitute very well and that this true for many of the meds .. and the compounding pharmacist told me that for many of his clients the liquid formulation of Lyrica did not give them relief the way the capsule did. 

 

I know in a sidebar conversation with Skyler, she did tell me that the first two months after she started with the home-made Lyrica solution, she had a rough time and that it settled down eventually. 

 

I think the Instructions on liquid taper on the SA site should have this warning as many of the problems I had in the beginning were due to the substitution of the liquid for the capsule and I had no idea this would happen based on what I read about the liquid taper at the SA site. 

 

I don't mean to be ungrateful ... just that when one is already in bad shape, anything that could worsen the situation is not a good thing as happened in my case. 

[Altostrata]

Many people have no difficulty using liquids to taper, but some do feel the difference. The liquids are absorbed faster. Some people can feel any difference in preparation, including switching brands.

 

I am sorry you were sensitive to the differences in preparation.

 

We have many, many people using liquids to taper. I've done it myself. I would take what that psychiatrist said with a grain of salt, particularly given he has no further ideas about how to go off Lyrica.

 

Tinnitus can be a withdrawal symptom. If you have been reducing 10% every 10 days as your signature indicates, you are reducing too fast for your nervous system (and 3 times faster than monthly decreases we generally recommend). That may be the source of your difficulties. You may wish to hold on tapering for a while and let your nervous system settle down.

 

Taking part of one's dosage in capsule form and part in liquid is a way to ease into the liquid without triggering sensitivities. If the compounding pharmacy charges the same no matter the number of capsules, one could get, for example, 90 capsules of 2mg each, compose your dose of some number of the 2mg capsules, and take the odd amounts -- which would be a fraction of your total daily dosage -- in homemade liquid.

 

If you prefer to get every dose stage custom-compounded, that's entirely up to you. $15 plus materials for compounded capsules is quite reasonable.

 

Please add your recommendation of the compounding pharmacy to Compounding pharmacies (US, UK, and elsewhere)

[ActivistScientist]

I have not been on the site for a few years but wanted to summarize how I did my Lyrica taper. I made the ill-fated mistake of reducing once daily Lyrica from 75 mg to 50 mg once daily on 3/27/2014 and all hell broke loose. I had anxiety like never before, tremor from head to toe at night, insomnia and diarrhea. I stayed with 50 mgs daily till 4/12/2014 and tried all kinds of things including benadryl but it was no use. I went back to 75 mgs once daily but could not recoup. On 5/17/204 I switched to 50 mg of Lyrica and 200 mg of neurontin but four days later, went back to 75 mg of Lyrica. I finally decided to try to compounding (with capsules) to reduce the amt of Lyrica I was taking and reduced it 5 mg at a time for 10 days. I took a very small amount of Klonopin on every third day during the taper. I did this till I got to 40 mg. Then, I started to reduce by no more than 10% at a time over a period of 10 days each time. So, 40 mg, then 36 mgs, 32, 29, 26, 25 mg .. I rode out the 25 mgs for about 4 months to stabilize and then 23, 21, 19, 17, 15.5, 14, 13, 12, 11, 10, 9, 8.5, (these over 10 day stretches),  8 ( rode it out for 20 days),  then 7.75, 7.5 ... reducing by 0.25 mgs every 6 days till I WAS FINALLY DONE ON 1/9/2016!   

 

One of the main issues I had was tinnitus in my ear and insomnia.  I also ended up with really bad diarrhea from a supplement I bought online early on that pretty much did me in. I was finally feeling myself about 6 months fer the taper ended.  All in all it took me a year and a half to complete the taper. Thanks to all the people who helped support me during the taper. 

 

[Altostrata]

Thanks for coming back to report. So you've been off Lyrica since January 2016?

 

What happened after that? How are you feeling now?