success Hibari: tapering Remeron and want to start tapering Lamictal

[Hibari]

5 hours ago, Hibari said:

Hi Alto,  so I skipped the 3am .20 dosage last night and got some sleep.  Dont know how much but I know I slept.  

Had the usual cortisol jolt with sweating, nausea, adrenaline/anxiey and headache but less so.  I also felt mentally clearer and less toxic. 

 

Took 8:30am 1.5 mg dose.  About a 1/2 later, foggy head, pressure in my head, dizzy, feel like crying and nausea. 

 

Very clear this medication is being rejected by my body.  

Just continuing today's log. 

 

I was still buzzy after the 8:30 dose and after crying with a friend. I chose to add the 11am .10 liquid dose to my 12:30 dose.  

 

Took my 12:30 1.5 tablet and  .10 liquid. I felt the usual speediness, not as intense but still a level of anxiety and emotion.  

 

Alto, if my body is saying too much to the medication, would that mean that coming down, as I am doing   would be less stressful on my brain?  That perhaps the wd would not be as intense?  This is probably wishful thinking but I thought I would ask. 

 

It seems the father away I get from when I take my dose, the better I feel.  

 

I am down to 6.3 mg from a high of 200mgs. It has taken me 3 years and 3 months.  

 

 

 

 

 

[Altostrata]

18 hours ago, Hibari said:

Alto, do you think I will be moving lower than 6.5mgs?  That this reaction is more than wd? That it is the adverse reaction to the med?  

 

Yes, I do think you will be reducing further. Rather than thinking of your body rejecting the lamotrigine, I'd rather think your body is saying "the lamotrigine has done its work, I don't need so much of it now."

 

Good to hear dropping the 3 a.m. dose seems to have worked well. Let's see how this plays out over a couple more days.

 

How are you taking a 1.5mg tablet?

 

 

[Hibari]

19 minutes ago, Altostrata said:

 

Yes, I do think you will be reducing further. Rather than thinking of your body rejecting the lamotrigine, I'd rather think your body is saying "the lamotrigine has done its work, I don't need so much of it now."

 

Good to hear dropping the 3 a.m. dose seems to have worked well. Let's see how this plays out over a couple more days.

 

How are you taking a 1.5mg tablet?

 

 

I have 5mg pills and a scale. 

 

I weigh the pill, which includes the filler.  Divide that weight by 5 and then multiply that amount by 1.5.  Each pill has a slightly different weight so I calculated each individual pill. I tried cutting a a bunch of pills in the summer and weigh rhe powder, but it made me sick and hyper.  I'm sensitive to the binders and fillers.  

 

I think the question I meant to ask was do you think I will be dropping at a quicker rate than usual due to the adverse reaction?  

Thank you. 

 

 

[Altostrata]

Yes, you will be reducing somewhat faster than 10% per month. Are you having any problems with the liquid?

[Hibari]

31 minutes ago, Altostrata said:

Yes, you will be reducing somewhat faster than 10% per month. Are you having any problems with the liquid?

Okay.

 

I do have problems with the compounding  liquid.  Right now on taking all tablets except for the tiny liquid liquid doses I am fitting in between my main doses so that I have the full amount of med in my system.

 

 I feel.them when I take them. But now, I even feel.the tablets but they are easier than the liquid.  

[Altostrata]

I am thinking that the liquid doses are so small, you might eliminate them, one at a time, over about 10 days. That would be a reduction of 0.30mg altogether? Plus the mid-night dose you just dropped?

 

Given you've been taking more than 6 mg, that's still less than 10% for the month.

 

Overall, your lamotrigine dosage burden would have gradually decreased and the impact of the 1.5mg tablet doses might be less.

 

Then we can reduce the tablet doses.

[ChessieCat]

Hi Hibari,

 

Your drug signature is getting very large.  I'd like to suggest that you simplify it.  I've made an attempt which is shown below.  Before changing it, you could copy and paste the current drug signature into a post so the information is still available.  

 

Sept 2013-Apr 2014: series of antidepressants.  Zoloft 6 days, Lexapro1 day, Nortriptyline 10 days, Liquid Prozac 1 week, Cymbalta 1 week.

Xanax-Clonazapam: Dec 2013-Sept 2014: Xanax after reaction to Lexapro, avg .50-1mg per day. Switched to Clonazepam-midway avg about 0.25-0.50 daily.

Remeron: June 2014: Jan/Feb 2015: 7.5 Remeron up to 41.25mgs

Lamictal: Sept 2014-July 2015: 25mgs of Lamictal titrate up to 200mgs daily. Also stopped the Clonzepam, once I went on Lamictal, after weaning myself down to .12mgs

Completed Remeron taper: 41.25 -0.025mgs from Jan 2015-Apr 2017.  2 years, 3 months. 

Completed Clonzapam taper: Jan 2014-Sept 2014.  When put on Lamictal, stopped benzo, after weaning down to .12mgs. 

Currently: Tapering Lamictal:  200mgs-9mgs from July 2015-Oct 2018. 

4/20/18 9.5mgs 5/6/18 9.25mgs 5/27/18 9mgs 6/21/18 8.8mgs run into drop stabilizing, decide to hold. Aug 2018 Mid Aug-cutting up pills into powder to weigh.  9/4/18 Updose to 10mgs 9/5/18 10mgs Not feeling great 9/6/18 10mgs hard to sleep 9/7/18 10 mgs sick and scared all night. 9/8/18 9.50mgs updose too much, drop down. 9/13/18 9.4mgs  10/1/18 drop to 9.2.  Take 4.2 in water and 5mg pill. 10/12/18 drop to 9mgs.  Get compound formula.  10/15/18 9mg Move to 4 divided doses.10/18/18 8.4mgs. 10/20/18 6.5mg.

Additional Support: Acupuncture with Reflexology,  Alanon, L-Theanine as needed, Bio-indentical Progesterone cream 50mgs 1x a week,  Armour Thyroid 75mgs. Magnesium, Therapy.

 

Edited October 27, 2018 by ChessieCat

[Hibari]

1 hour ago, Altostrata said:

I am thinking that the liquid doses are so small, you might eliminate them, one at a time, over about 10 days. That would be a reduction of 0.30mg altogether? Plus the mid-night dose you just dropped?

 

Given you've been taking more than 6 mg, that's still less than 10% for the month.

 

Overall, your lamotrigine dosage burden would have gradually decreased and the impact of the 1.5mg tablet doses might be less.

 

Then we can reduce the tablet doses.

Okay.  I will do that.  Yes, I just dropped the  .30mg 3am dose.  Will now drop .10mg  of the afternoon dose. 

 

So looking forward to moving off the medication as ur has run its course.   I know everyone on this site feels the same way.  

[Hibari]

1 hour ago, ChessieCat said:

Hi Hibari,

 

Your drug signature is getting very large.  I'd like to suggest that you simplify it.  I've made an attempt which is shown below.  Before changing it, you could copy and paste the current drug signature into a post so the information is still available.  

 

Sept 2013-Apr 2014: series of antidepressants.  Zoloft 6 days, Lexapro1 day, Nortriptyline 10 days, Liquid Prozac 1 week, Cymbalta 1 week.

Xanax-Clonazapam: Dec 2013-Sept 2014: Xanax after reaction to Lexapro, avg .50-1mg per day. Switched to Clonazepam-midway avg about 0.25-0.50 daily.

Remeron: June 2014: Jan/Feb 2015: 7.5 Remeron up to 41.25mgs

Lamictal: Sept 2014-July 2015: 25mgs of Lamictal titrate up to 200mgs daily. Also stopped the Clonzepam, once I went on Lamictal, after weaning myself down to .12mgs

Completed Remeron taper: 41.25 -0.025mgs from Jan 2015-Apr 2017.  2 years, 3 months. 

Completed Clonzapam taper: Jan 2014-Sept 2014.  When put on Lamictal, stopped benzo, after weaning down to .12mgs. 

Currently: Tapering Lamictal:  200mgs-9mgs from July 2015-Oct 2018. 

4/20/18 9.5mgs 5/6/18 9.25mgs 5/27/18 9mgs 6/21/18 8.8mgs run into drop stabilizing, decide to hold. Aug 2018 Mid Aug-cutting up pills into powder to weigh.  9/4/18 Updose to 10mgs 9/5/18 10mgs Not feeling great 9/6/18 10mgs hard to sleep 9/7/18 10 mgs sick and scared all night. 9/8/18 9.50mgs updose too much, drop down. 9/13/18 9.4mgs  10/1/18 drop to 9.2.  Take 4.2 in water and 5mg pill. 10/12/18 drop to 9mgs.  Get compound formula.  10/15/18 9mg Move to 4 divided doses.10/18/18 8.4mgs. 10/20/18 6.5mg.

Additional Support: Acupuncture with Reflexology,  Alanon, L-Theanine as needed, Bio-indentical Progesterone cream 50mgs 1x a week,  Armour Thyroid 75mgs. Magnesium, Therapy.

 

Ok Chessie.  Will do.  

[Rosetta]

Good luck, Hibari.  It's good to see you are getting some sleep. -R

[Hibari]

2 hours ago, Rosetta said:

Good luck, Hibari.  It's good to see you are getting some sleep. -R

I got some sleep, not last night, but the night before.  Yesterday I had some windows during the day but today, it's been a hard day.  Very physically sick and very emotional.  Lots of crying about how awful this process is.   

 

I saw from your thread that you are struggling too at this time.  My heart goes out to you and I know that even that won't take away the pain of this.  

 

In read somewhere that this process is not about winning, but being able to survive it.  Today is all about survival.  

 

Please know I am empathize very much with what you are going through.  

 

 

[Altostrata]

When did you take lamotrigine over the last 24 hours?

 

Did you drop any other doses? May be a good idea not to take any more away for now.

[Hibari]

37 minutes ago, Altostrata said:

When did you take lamotrigine over the last 24 hours?

 

Did you drop any other doses? May be a good idea not to take any more away for now.

Just the .10mg you recommended yesterday. 

 

My dosing schedule yesterday and  today has been.  

10/26 

8:30am  1.5

12:30. 1.5mg + .10mgs (I was buzzy from the medication at 8:30 so wanted to wait on the usual .10mg and added it to this dose).

3:30pm .10mg 

4:30. 1.5

8:30mg 1.5 

Total 6.2mgs for the day. 

 

10/27

8:00pm 1.5 (was awake earlier so took dose)  trying to do 4 hour divideddoses. 

12:00pm 1.5 

2:30pm .10

4:00pm 1.5 mg 

6.00pm. About to take the other .10.mgs

8:00pm will take 1.5mg

Total 6.2mgs for the day

 

So as you can see from my signature, since mid October I have come down, with advice, from 8.4mgs to 6.2mg due to the adverse/paradoxical reaction to Lamotrigine.  

 

 

 

 

 

 

[Altostrata]

What do you think? Do you want to ride out the sleeplessness before making another drop in Lamictal or do you want to skip the 0.10mg dose at 6 p.m.?

[Hibari]

1 minute ago, Altostrata said:

What do you think? Do you want to ride out the sleeplessness before making another drop in Lamictal or do you want to skip the 0.10mg dose at 6 p.m.?

 

Since I already did another .10mg drop yesterday, I think before I drop to 6.1, I will stay at 6.2 for tonight and ride out the night.

 

I continue to try and tease our side effects of the med (speedy feeling, head pressure, blurry eyes, headache, nausea) from the withdrawal part (nausea, headaches, dizziness, weeping, depression).  

Maybe it doesn't matter in the long run.  

[Altostrata]

Right. I hope you get better sleep tonight. It will take about 4 days for the decreases to take full effect, so there may be changes in symptom pattern, possibly for the better, over the next week.

[Hibari]

5 minutes ago, Altostrata said:

Right. I hope you get better sleep tonight. It will take about 4 days for the decreases to take full effect, so there may be changes in symptom pattern, possibly for the better, over the next week.

Okay, so I will hold at 6.2 for the next week and hope things get better.  If not, there may need to be another drop?  

 

I know from doing research about tolerance that if I'm unable able to stabilize, I probably will have to keep tapering.  

 

 

[Altostrata]

We need to see your symptom pattern before making a plan. Could be the overall amount of lamotrigine in your system has decreased sufficiently and side effects will be reduced.

[Hibari]

4 minutes ago, Altostrata said:

We need to see your symptom pattern before making a plan. Could be the overall amount of lamotrigine in your system has decreased sufficiently and side effects will be reduced.

I will Alto. 

I'm trying to be positive but I have struggled with this inability to stabilize for about 2 months. 

 

I've been doing weekly acupuncture and therapy to heal and I think my body is ready to let go of the med.  

[Hibari]

15 hours ago, Hibari said:

I will Alto. 

I'm trying to be positive but I have struggled with this inability to stabilize for about 2 months. 

 

I've been doing weekly acupuncture and therapy to heal and I think my body is ready to let go of the med.  

Its another very hard day for me today. 

No sleep, extreme anxiety, headache, nausea, panic and anxiety.  

 

I feel I have only a couple of choices here:

Try to stabilize

Go back up some

Or come off the med completely. 

 

I followed the same dosing  schedule from the day before.  I'm considering taking a small dose of valium to make it better today.  

 

My husband got a prescription for 2mg of valium for a procedure he had last week but never used it.  I'm wondering if taking .50mg would be okay?  

 

 

[Altostrata]

When does the headache and nausea occur?

 

@Shep A little rescue Valium?

[Hibari]

The headaches and nausea are there in the morning.  Has always been that way throughout my taper bir more intense lately. 

 

Yesterday and today it is the acute panic and anxiety.  Most of its wd and still some speediness after taking my doses.  Alao nausuea afte I take my medication. 

 

I am trying to relax and I did end up taking about, 25mg of a Valium. Probably not enough. 

[Altostrata]

Did the speediness after the lamotrigine doses increase, decrease, or stay the same?

 

I'm worried about occasional Valium, that could cause rebound symptoms when it wears off, but that will take a couple of days.

[Hibari]

3 minutes ago, Altostrata said:

Did the speediness after the lamotrigine doses increase, decrease, or stay the same?

 

I'm worried about occasional Valium, that could cause rebound symptoms when it wears off, but that will take a couple of days.

The speediness hits and then decreases slightly after each time. It never goes away completely.  

 

Today, after each dose it hit but now its mixed in with the general high anxiety that has been here consistently.  

 

I hope the small amount of Valium wont make things worse. I felt the effects a little but it seems like my anxiety is overriding it.  

[Altostrata]

I'm really sorry, Hibari, it may be rocky for a little while. Please hang in there.

 

It's going to take a few days for the lamotrigine decreases to work through your system.

[Hibari]

47 minutes ago, Altostrata said:

I'm really sorry, Hibari, it may be rocky for a little while. Please hang in there.

 

It's going to take a few days for the lamotrigine decreases to work through your system.

Than you Alto.  I will hang in there.  I want to live life again and despite how horrendous these past two months have been, I still have some determination. 

 

I will stay at 6.2 and hope for relief.  

 

I appreciate you and all the mods responding to me so directly.  

[Shep]

19 hours ago, Altostrata said:

When does the headache and nausea occur?

 

@Shep A little rescue Valium?

 

19 hours ago, Hibari said:

I am trying to relax and I did end up taking about, 25mg of a Valium. Probably not enough. 

 

Hibari, did you mean 25 mg of Valium or 2.5 mg? 

 

Occasional benzo rescue doses are okay, but as Alto mentioned, it does carry the risk of rebound symptoms. Hopefully, with Valium's long half-life, it will slowly ease it's way out of your system and won't cause further problems. Please let us know how you're feeling.

[Hibari]

1 hour ago, Shep said:

 

1 hour ago, Shep said:

 

 

Hibari, did you mean 25 mg of Valium or 2.5 mg? 

 

Occasional benzo rescue doses are okay, but as Alto mentioned, it does carry the risk of rebound symptoms. Hopefully, with Valium's long half-life, it will slowly ease it's way out of your system and won't cause further problems. Please let us know how you're feeling.

 

Hibari, did you mean 25 mg of Valium or 2.5 mg? 

 

Occasional benzo rescue doses are okay, but as Alto mentioned, it does carry the risk of rebound symptoms. Hopefully, with Valium's long half-life, it will slowly ease it's way out of your system and won't cause further problems. Please let us know how you're feeling.

Hi Shep, 

 

I took a quarter of a 2mg pill.  I split the pill in half and then took half of that.  

 

I felt it hit my system about an hour after taking it but and maybe felt calmer for about an hour .   But it did not feel like it stayed. 

 

I still had the usual anxiety and tears after taking my dose of Lamictal. 

 

I did sleep last night and though I woke up with my cortisol spike of nausea, anxiety, headache and sweating, I did feel it was less intense.

 

However, having just taken my morning dose of Lamictal, I do feel emotional, anxious, dizzy and my headache is pretty consistent.

 

I'm hoping the benzo did not make things worse.  

[Altostrata]

 

3 hours ago, Hibari said:

I took a quarter of a 2mg pill.  I split the pill in half and then took half of that.  

 

I felt it hit my system about an hour after taking it but and maybe felt calmer for about an hour .   But it did not feel like it stayed. 

 

I still had the usual anxiety and tears after taking my dose of Lamictal. 

 

I did sleep last night and though I woke up with my cortisol spike of nausea, anxiety, headache and sweating, I did feel it was less intense.

 

However, having just taken my morning dose of Lamictal, I do feel emotional, anxious, dizzy and my headache is pretty consistent.

 

I'm hoping the benzo did not make things worse.  

 

Hibari, when did each of these events occur? For your daily notes, please use a simple list format with time of day on the left and notation (symptom, drug and dosage) on the right.

 

After you took Valium, 2 hours later, you felt it stopped working? What were your symptoms then?

 

Have the reactions after taking Lamictal changed in intensity at all?

 

Good to hear sleep was better last night.

[Hibari]

4 hours ago, Altostrata said:

 

 

Hibari, when did each of these events occur? For your daily notes, please use a simple list format with time of day on the left and notation (symptom, drug and dosage) on the right.

 

After you took Valium, 2 hours later, you felt it stopped working? What were your symptoms then?

 

Have the reactions after taking Lamictal changed in intensity at all?

 

Good to hear sleep was better last night.

Hi Alto,

 

I answered your questions below along with a log. 

 

On a separate note, had a followup consultation with my new psychiatrist.  I shared with her what has been going on and she said, I think you should come off the medication now.  Now she is not the typical doctor who has no clue about withdrawal, this is something she does with her patients.  We had a long conversation about it and she felt that at this point, with how my body is reacting that going down incrementally was not going to make it better.    I expressed my fear around the unknown, would the wd be worse than what I am experiencing, etc.  She said that me getting off was not cold turkey but that I would need support for my system.  She ordered pharmaceutical Gaba, MCT Hemp oil and Kavinance.  I've read about the 3rd one and I know it would be my last choice.  She said these were things I could turn to if things got bad.  She also feels that the relief I will feel about getting off would be a great motivation to help me through. 

 

I did not agree to her plan as I knew I wanted to run this by you.  Your experience is invaluable to me and important.    I do want to get off sooner rather than later and was thinking that if things did not change, I would get off at the end of November. 

 

Today, I took my morning dose and then had a professional obligation in the late afternoon.  I consciously chose not to take my second dose of 1.5 mgs because I could not handle either the speedy reaction or crying that has been occurring after taking my doses.  While I felt hyper from the morning and anxious, I was okay.   I then took my 4PM dose as usual and will take my 8:30 dose as well.   I noted it in the logs for the past 2 days.  

 

Alto asked:

After you took Valium, 2 hours later, you felt it stopped working? What were your symptoms then?

After sobbing with my husband.  I took .50mgs of Valium at around 2PM.   At about 2:45, I felt tired and calmer though had been crying on the phone with my therapist.

At about 4:30 felt my mood drop. 

 

Have the reactions after taking Lamictal changed in intensity at all?

Not by my much but I think the length of how long they last has maybe gotten a little shorter.    

 

Log:

10/29/18

No Sleep

Woke up feeling very ill:                        Nausea, headache, blurry eyes, panicky, sweating, off balance

8:00AM 1.5mg  Lamictal                      1/2 later very speedy, anxious, start to feel panicky and scared. 

9:00AM 200mgs magnesium             Lie on the couch for most of the morning with eye mask on feeling physically shaky. 

11:00Am .10mg                                     Continue to feel speedy, inability to relax, panic increases, headache, nausea

2PM  .50mg Valium                               2:45 I felt tired and calmer though had been crying on the phone with my therapist.

3.30 .10mg Lamictal

4:00PM 100mg Magnesium

4:30PM                                                    Feel my mood drop

4:45 1.5 Lamictal                                   1/2 hour later feel speedy, scared, feel like crying

9:00PM  1.5 Lamictal                            Feel slightly speedy, some anxiety.  Drink Camomile tea,

9:30PM 200mg Magnesium                Take 200mg Magnesium and breath into a brown paper bag to calm down

11PM Bed

 

10/30/18

Slept, woke up a few times but able to go back to sleep-Valium?

Cortisol spike in morning.                        Sweating, headache, nausea, some anxiety but less .

9:00AM 1.5 Lamictal                                1/2 hour later, hot flash, sweating, dizzy, increase in anxiety, feel like I'm going to throw up, headache intensifies but may be due to Chamomile tea

11:AM no med

12:30AM no med                                       Feel low grade anxiety for most of the day, low grade headache but much less anxiety and fear

4:00PM 1.5 Lamictal                                1/2 hour later feel some speediness, hour later feel like crying,

Currently:                                                    Have a headache and feel some general health anxiety but okay

8:30-9PM                                                    I plan to take my 1.5 dose of Lamictal

 

 

 

[Altostrata]

32 minutes ago, Hibari said:

She ordered pharmaceutical Gaba, MCT Hemp oil and Kavinance.

 

We haven't seen these to be of help. Kavinace contains a benzo-like substance, phenibut, which can incur dependency. Some people are reporting good results with CBD oil.

 

I am not seeing withdrawal symptoms from your lamotrigine decrease, except perhaps for sleep disruption on alternate nights (the Valium might be doing this). This might be expected as your nervous system regroups.

 

Instead, we still see your pattern of adverse reaction to lamotrigine.

 

Not seeing withdrawal symptoms, I might drop the two 0.10mg doses you're taking at 11 a.m. and 3:30 p.m. Please continue to take notes.

 

[Hibari]

3 minutes ago, Altostrata said:

 

We haven't seen these to be of help. Kavinace contains a benzo-like substance, phenibut, which can incur dependency. Some people are reporting good results with CBD oil.

 

I am not seeing withdrawal symptoms from your lamotrigine decrease, except perhaps for sleep disruption on alternate nights (the Valium might be doing this). This might be expected as your nervous system regroups.

 

Instead, we still see your pattern of adverse reaction to lamotrigine.

 

Not seeing withdrawal symptoms, I might drop the two 0.10mg doses you're taking at 11 a.m. and 3:30 p.m. Please continue to take notes.

 

I think the wd is mixed in with the adverse reaction.  Meaning I know that headaches and nausea are wd reactions as well as side effects. 

The ongoing morning nausea and headache just go with Lamictal?  I know that Monica on Beyond Meds had the constant nausea.

 

So jumping off at this point is too early?   I have a feeling I know the answer. 

[Altostrata]

Do these symptoms get worse after you take a dose of Lamictal or are they constant?

[Hibari]

6 minutes ago, Altostrata said:

Do these symptoms get worse after you take a dose of Lamictal or are they constant?

They start every morning and stay at a low grade level for most of the day. 

[Altostrata]

I am confused. Your notes indicate spikes in symptoms about a half-hour after you take the lamotrigine doses.

[Hibari]

24 minutes ago, Altostrata said:

I am confused. Your notes indicate spikes in symptoms about a half-hour after you take the lamotrigine doses.

There are spikes in symptoms, speediness, anxiety, headaches nausea 1/2 hour afte I take my meds. The nausea increases and so does the head pressure.  

 

And every day, since I have been tapering Lamictal only, I wake up with nausea and a headache.  As I have gotten lower there is also sweating and a cortisol spike in  anxiety that then recedes.