sasa withdrawing from Latuda then Lamictal

[sasa]

I just started tapering Latuda last night. I am down from 80 mgs to 70 mgs after noticing rigid, stiff muscle serious side effect among other unpleasant side effects. I also plan to withdraw from Lamictal after that but wills see how this goes. I am concerned about mania after withdrawal. I was on Topamax for side effects and pain but I tapered on that and am off it completely now. 

[Altostrata]

Welcome, sasa.
 
That sounds like a potential serious side effect from Latuda. Since you've been on it for a year, you may wish to taper more cautiously. See

Why taper by 10% of my dosage?

How did you go from 80mg to 70mg? You may wish to get your prescription filled with the 20mg tablets, then split them into quarters to taper by 5mg at a time. This will stay within the 10% guideline until you get to 45mg.

 

According to this Madison, Wisconsin health insurance company, the tablets can be split:
https://www.pplusic.com/documents/upload/p5347-tablet-splitting-program.pdf

 

For more precise tapering, you can weigh the tablet pieces with a digital scale, see see Using a digital scale to measure doses

 

After 45mg, you may wish to take a 20mg tablet and to take the rest

• use a digital scale to weigh smaller amounts, see Using a digital scale to measure doses
• have a liquid compounded, see Compounding pharmacies (US, UK, and elsewhere)
• or make a suspension yourself with water, see How to make a liquid from tablets or capsules

At 20mg, you may wish to halve the tablet, then take the rest in measured amounts as above, until you get to 10mg, at which point you probably will wish to take the entire dosage in a liquid you can easily titrate.

 

General FDA information about Latuda: http://www.drugs.com/pro/latuda.html

[sasa]

Hi! I was referred to this site by someone on a FB page Freedom from Psych Drugs. I am just beginning my journey to taper myself off psych drugs. I was diagnosed in 2004 with Bipolar disorder after experiencing mania. I had some past episodes at age 17 after I was in a car accident that killed my best friend. I was admitted to the hospital but my parents made sure I didn't leave with scripts. I mistakenly sought out a medical professional during a time of pain and was given Paxil. That was how I 'learned I had bipolar. I was told that's why I responded to the drug because of an underlying condition of bipolar which is in my family history. After recently reading Anatomy of an Epidemic I linked all of my episodes to drugs and I am convinced that the chronicity of my illness has been drug induced. I am desperate to get off drugs but I am also scared of managing depression and mania on my own. I don't know how to talk to my family about this. I also sought out a doctor who I am debating going to. They believe in nutrient imbalances and epigenetics as cause for instability. Thanks for having a site like this. I think you should be able to see my med history in my signature. 

 

 

[Altostrata]

sasa, you already have an Introductions topic. Please see my response above.

[sasa]

Hi! I am new here. Thanks for creating this forum. I am wondering if its safe to be tapering my antipsychotic before my Lamictal. I read the posts on Tapering and it seems they are both brake drugs. I am having stiff rigid muscles at times after taking Latuda my antipsychotic so I started with that and am going by 12.5% of original dose every 2 weeks. Evaluating at each step 60 mg, 40 mg and 20 mg. If unstable will hold for awhile and slow down though I have to figure out how to get the doses. I remember when a first antipsychotic was added it was because I had a manic episode with Lamictal alone so they said that because the Lamictal worked as an antidepressant it wasn't enough to protect me from mania. Now I realize that you can't believe these doctors but the fear in me wonders if I am taking the right approach. I am now on 60 mgs of Latuda and 200 mgs of Lamictal. 

 

TIA

[Petunia]

Hi sasa,

I joined the new topic you started with your original intro thread here, its one intro/update topic per member. Please add information and updates about your changing circumstances, and ask questions here.

 

Please see your replies above.

 

I think tapering Latuda first is probably the best way to go.

 

We suggest reducing by no more than 10% of the current dose every 4 weeks, this reduces the risk of withdrawal symptoms arising. Please read through this which will explain why:

  

Why taper by 10% of my dosage?

[gemini]

I take latuda 10 mgs to stabilize my withdrawal symptoms. It's a bare dosage but it's working. Latuda is a frightening drug for me. At 20 mgs I had akathasia so bad I wanted to jump off a bridge.

[sasa]

Ok thanks everyone. Not used to using a forum so I appreciate the guidance. I will have to look into those resources. I know my insurance will only cover 30 pills per month regardless of the dose so I can't simply ask for smaller doses. When I decided to taper I found an extra bottle of 40 mg tablets when I was on a smaller amount that I had saved. So I have been using a cutter to break in quarters. So that's how I went down from 80 mgs to 70 for 2 weeks and now down to 60 mgs. So far I don't have any side effects that weren't there at the original dose. I have noticed being a little more tired lately. I am not working so its not a big problem for me to sleep an extra hour. I was expecting to have trouble sleeping so I am glad so far its the opposite. Thanks again for the guidance and the resources. I will have to figure out how to get some 20 mg tablets. 

[Altostrata]

Good that you had those other tablets. What dosage are they?
 
You may still wish to taper more slowly. See Why taper? Paper demonstrates importance of gradual change in plasma concentration
 

Also see Tips for tapering off lurasidone (Latuda)

 

To get prescriptions covered by insurance for two dosages of a tablet, your doctor probably has to specify "divided doses."

[sasa]

The extra bottle was 40 mgs. So I am able to get down to 10 mgs by cutting twice (into quarters). I will talk to my doctor about divided doses. I hadn't come clean about tapering off completely I told him I wanted to cut my dose because of the side effects. Their other option was Cogentin and I wasn't interested. The plan is to get to 40 and reevaluate but they insisted I would be fine going from 80 to 60 for a month and then to 40. So I took the 60 mg prescription and have been using the quartered 40 mg doses to get my 70 mg dose. 

[Altostrata]

You've been doing the best you can, good for you for using the 40mg tablets.

 

Any doctor can prescribe these drugs, it doesn't have to be a psychiatrist. Do you have a good rapport with your GP?