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Current drugs: - 2012-present citalopram, currently steady at 25mg - 2020 lyrica: max 4mg/day. started tapering after 2 weeks and having worse withdrawal than from 225mg This case history must be very unusal given the low dose and short time. Has anyone heard of a similar case? Also unusual is the bad method I'm stuck with to calculate doses. Recent start and tapering of lyrica ----------------------------------- I started a microdose of lyrica January 1 2020, thinking I could test side effects and stop if they were bad. Worked up to a maximum of about 4mg/day. After 2 weeks I decided it wasn't for mej. Reduced to 70% of max dose and held 4 days but got serious withdrawal symptoms. I thought an increase might help so went up to 80% of my maximum for 2 days, symptoms got MUCH worse, then down to 75% (1 day) and 65%. I thought lyrica and citalopram might be interacting and that tapering citalopram might be easier, so I tried 20% less (25->20mg) one day. I got the worst anxiety of my life and haven't changed it again. Following that I stayed on 65% of my lyrica dose for 2 weeks while I stabilised. Now on day 5 down from 65% to 60% which has not been bad. So, tapering slowly seems best. BUT I cannot measure doses accurately because I'm dividing powder with a knife on a plate (see below). Would switch to liquid but I can only guess how much I'm taking in a day. I'd be grateful for any advice on what I should do! Or information about similar low-dose, short-term cases, or how to handle inaccurate doses. I've been advised by some to go cold turkey given the small dose and short time, and that might have been ok when I started tapering after 2 weeks, but now I've been on it 6 weeks total. I could just about handle the initial 30% drop from my maximum dose but I could not handle what happened when I raised it 10%, then lowered it again. Maybe my case will be useful to someone. If nothing else it shows you can get hooked on a very small dose. The rest of this post goes into background a little and a lot of detail about what I'm doing now, so may be of less general interest. Prior drug history ------------------ - before 2010: prozac then paroxetine then seroquel. never any real trouble getting off them. Just some anxiety/irritability. - 2012 lyrica (only) for 11 days max 225mg/day then tapered off over 5 days with bad withdrawal symptoms for about a week - 2012 mirtazapine for a couple of months, after the lyrica - 2012-present citalopram, starting near the end of the mirtazapine Why is withdrawal worse in 2020 than on a much bigger dose in 2012? ------------------------------------------------------------------- It's hard to compare the two but the current withdrawal seemed considerably worse even before I raised the dose again and made it much worse. Some ideas I had: - I'm also on citalopram now. - Use or withdrawal from lyrica in 2012 primed/changed something. - I got lucky when i went off quickly in 2012, just in time (tapering after 11 days of using it) and just fast enough (5 tapered doses) to escape worse withdrawal. - The down/up dose in first week or withdrawal made it much worse. Also changing citalopram dose for 1 day seemed clearly VERY bad. Switching to liquid ------------------- Day 1 of last taper (65->60%) was partly with liquid I got from a compounding pharmacy. I replaced about 23% of the powder with liquid. Symptoms from underdosing have been bad but less bad than raising the dose, so I aimed low, and took what should have been roughly 45% less liquid than needed (using my rough estimate at equivalance - see dosing method below for details). It was much too strong. I got more sedated than I've ever been on lyrica, lots of muscle twitches, then somewhat agitated when it wore off. I switched back to all-powder doses, and decreased the evening dose by 1/3 to compensate for the morning overdose, and from the next day remained 5% of max dose lower. This has gone surprisingly well despite the updose then decrease. I'm tempted to stay on the powder, but I can't divide into smaller amounts than 1/256 of a capsule with any accuracy at all. That means as I decrease the dose, the reduction step size will get bigger. The most recent step down (65->60%) was about 7.5% of my current dose, but that will become 15% of current dose given a few more steps etc. Also, if a shirtsleeve brushes my reference doses away I'm sunk - I'll have little idea how much to take. But if I switch to liquid, I have to guess how much to take, and try to correct for symptoms, and gradually replace powder with liquid. After the first drop in dose (100% to 70%) it seemed to take a few days for the withdrawal to really get going. If that's still true, adjusting the liquid dose up and down could easily get out of hand and be less gentle than the later, and proportionally bigger, powder decreases. So neither option is good. Powder dosing method (details) ------------------------------ The method I use to dose is awful: I divide capsule's powder into two piles of 1/2, then divide each pile agqin and again. Currently I take 1/64 + 1/128th of a capsule every morning and again at night. This has limited accuracy of course, but it gets worse; there is residue left on the plate after the division. The amount of residue has changed over time since I switched from a big knife to a razor blade, and I haven't been consistent about how much residue I leave. At one point I thought measurements would be more consistent if I kept "reference" piles of each key size: 1/32, 1/64 and 1/128. But I realise now the references are not accurate, and I'm basically eyeballing the new piles now to match the reference ones. To estimate how much my 1/128 actually is, I started a new pill, and divided it with as little residue as possible (using a razor blade, which doesn't leave much at allif you're careful). To my amazement I seem to have left about 50% of the pill as residue. Separately I began sweeping residue from another pill into a pile, which I estimated was about 30% of the pill. Another idea would be to weigh my 1/64th, but I suspect it's too little to measure accurately with any scale I can get my hands on. Potency of my powder -------------------- To make matters even worse, the capsules I'm using expired 4.5 years ago. From a short look on the net and talking with a pharmacist this might not be big deal. But also the powder sits on a plate being slowly divided for up to 2 weeks before I take it, so it may degrade somewhat.
noearthlyfamily posted a topic in Introductions and updateshello all, thx for being here showing the way. my current doses and meds are listed in my signature... i take 68.75mg at night...one 50mg pill and the other a 25 mg pill that i try to "quater" into 6.25mg, not very succesfully! what i need help with now is finding my micro-taper rate and correct schedule, since i suck at math (failed it 2x in high school but they passed me because they pitied me for trying so hard and getting it so wrong!) i had been breaking my 25 mg pills into rough quarters but they no longer break anywhere close to 6.25 mg pieces...so i'm really suffering with the inaccurate pill splitting disaster. i'd love to try the ORA-Pro or actually this one: HUMCO 8916001 Flavor Blend 16 oz, Shape https://www.amazon.com/gp/product/B0773DL1XJ/ref=ox_sc_act_title_1?smid=ATVPDKIKX0DER&psc=1 it's way cheaper looks the same stuff to me...and do a suspension with it and see if i can get a more accurate dose, but after reading all the pages i can find on this site and benzo buddies and others i am still confused... the video on how to make a simple water titration that was for low dose naltrexone as an example showed me how to do the basics measuring 25 ml distilled water and dissolving a 25 mg pill in it for a 1mg medication per 1 ml liquid ratio. i understand that part. and as far as i got it, i would take my nightly 50mg pill of quetiapine whole as a dry pill and then draw out the 6.25mg/6.25 ml of liquid medication from the water solution and dispose of it and then drink/take orally the remainder of the liquid (18.75mg/ml) to make my current total nightly dose of 68.75mg of quetiapine. seems like i could be doing 5 mg/ml cuts instead of 6.25 if i use the solution or a suspension though...and i think i may be going to fast, or at leat the cuts are too abrupt, so i really want to do a microtaper, if someone could do the math part and then maybe i'd have a chance.☺️ where i get messed up is how to mix the ORA-pro/HUMCO suspension liquid with the (mortar and pestle crushed) 25mg pill of quetiapine and then how do i know how much to syringe out of the mixed suspension for my 18.75mg liquid portion dose? or if i did a 20mg/ml would it be easier to measure out? or if i did a microtaper of something closer to a fraction of a mg/ml every few days instead of 6.25mg cut every 4 weeks, maybe that would allow for a smoother taper and less rough withdrawals? i honestly don't even know how to divide 6.25mg by 28 days! i guess you can see why i failed math 2x! anyways... i 'd love to do the 10% (or less) reduction from the last dose as is reccomended, instead of the Ashton method of a "cut and suffer" that i've been trying to emulate...but all of the calculators and spreadsheets just serve to confuse me even more. if anyone here feels my pain and would like to point me to a "micro-taper schedule off of seroquel for dummies" chart or table that shows me exactly what to do for each day of the microtaper ...i don't know what i can offer in return! my eternal gratitude? my kidneys? lol thx again