Utahgal: Hi

[Rhiannon]

You can split up your dosing if you want, or just keep doing as you're doing. Gabapentin is cleared by the kidneys in about six hours, give or take depending on the person. Sounds like what you're doing now is working for you (yay!) You may want to wait and see--as you get to lower doses it might help to take multiple doses over the course of the day. But if you're doing okay, I always say don't mess with success! Just be sure and take long enough holds between cuts so you can be sure your healing is keeping up with the changes.

[Utahgal]

I'm due to drop my gabapentin from 289 down to 270 in a couple of days. So far it has been going really well.

 

I've been on 75 mgs of doxepin for 2 weeks now. It has really lessened my horrible anxiety and has allowed me to eat again. The bad news is, in the last 3 days I have suffered bad depression. I have never had this before. Anxiety has always been my issues. I feel sad, wanting to isolate myself, hopeless, doomed, no motivation. I just want to sit on my sofa and read intros on this site. Completely unlike me. Is this just a side effect of the doxepin, and will it blow over? I am not sure what to make of it. I feel down and lost. What is happening?

[Utahgal]

Correction: I am due to drop gab 280 down to 270.

 

I wish there was a correct feature on this forum.

[cymbaltawithdrawal5600]

Right after you post (and for about an hour afterwards), the 'Edit' word appears near where it says 'multiquote' and 'quote'. Click it and your post comes up in the editor and you can do your corrections then click 'post' again. Hope this helps, I use it a lot because I am a cr@ppy typist myself.

[Petunia]

I've been on 75 mgs of doxepin for 2 weeks now. It has really lessened my horrible anxiety and has allowed me to eat again. The bad news is, in the last 3 days I have suffered bad depression. I have never had this before. Anxiety has always been my issues. I feel sad, wanting to isolate myself, hopeless, doomed, no motivation. I just want to sit on my sofa and read intros on this site. Completely unlike me. Is this just a side effect of the doxepin, and will it blow over? I am not sure what to make of it. I feel down and lost. What is happening?

 

Doxepin is an older tricyclic antidepressant (TCA) sometimes prescribed for sleep issues.  One of its side effects is drowsiness, so that may be causing this new symptom.  According to official FDA information, that side effect may reduce over time.  See here:

http://www.drugs.com/pro/doxepin.html

 

I'm happy to hear your anxiety has lessened and you can now eat, that's a good thing.  If you ever decide to stop taking Doxepin, you will have to taper from it slowly like all anti-depressants.

[Altostrata]

Depression can be a side effect of benzos. What is the relationship of your symptoms to when you take Xanax?

[Utahgal]

Thank you for your posts! I feel so lucky to have found this forum. I now know how to use the edit option, thanks Cymbalta!

 

Thank you for the link, Petu. I'm guessing that is why I am so tired all day. Hopefully it blows over.

 

Alta, I haven't been using Xanax lately. It's been about 2 weeks. The doxepin has really reduced my anxiety. I wonder if I am getting temporary depression as I adjust to it? Is that possible?

 

Today was much better. Not perfect, but much less depression. It may be very touch and go right now while I adjust to my new meds (doxepin and perphenazine). I am sleeping and eating, so that is a plus. Tonight I will reduce my gab from 280 down to 270. Slow and steady! I will get there sooner or later........ Most likely later. Lol!

[Altostrata]

More likely you're still having waves from quitting Zyprexa, etc.

[Utahgal]

My update.....

 

My anxiety seems to be under control on the 75 mgs doxepin. I continue to eat better and sleep better too!

 

I reduced my gabapentin 3 days ago from 280 down to 270. So far, so good! Fingers crossed!

 

My depression is also less and I have been more social and motivated. Things are looking up!

[Utahgal]

I am down to 260 on the gabapentin! So far, so good!

[Altostrata]

Yay!

[Rhiannon]

Nice!

[Utahgal]

I may have spoken too soon. I had some anxiety yesterday and needed to take .5 Xanax twice. I woke again with it this morning.

 

My plan is to go back up to 270 of the gabapentin and hold for a couple of weeks and then try to reduce again. I am so bummed, things were going so well.

 

Do you think I should up dose from 260 back up to 270, or do I just ride it out with some Xanax and hope it goes away in a few days?

[Utahgal]

I'm at 250 and doing fine!

[Meimeiquest]

Great!

[flower]

Are you having to take xanax often?

[Utahgal]

Nope. Maybe twice a week I take 0.5 mgs. The doxepin has saved me!

[Utahgal]

I'm down to 230 on the gabapentin (from 300) and doing fine!

 

I still take 75 mg doxepin and 8 mg perphenazine. When its time to taper, which do I do first? Doxepin comes in a liquids, I believe. But, perphenazine does not. The smallest dose is 1 mg, I think. Would I just cut up the tablet into quarters and taper that way?

[Utahgal]

Ok. So I found out that perphenazine comes in 8 mg, 4 mg, and 2 mg. no mention of 1 mg. can someone help me with a taper plan that I can run by my pdoc? I currently take 8 mgs. I have been on it for 3 months.

[Altostrata]

Do you take perphenazine more than once a day?

 

You could ask your doctor to fill your prescription with 2mg tablets to be taken x times a day.

 

There's nothing fancy about the coating http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=6c76e98d-b8c3-441f-bac5-a9de6dc8f14f

which means you should be able to split them. Use a pill cutter carefully to get precise cuts.

 

Reducing by a quarter of a 2mg tablet (.50mg) should be okay until you get under 5mg, then you might want to use a liquid.

 

A liquid can be made by a compounding pharmacy.

 

I would try the small .50mg reduction first for a few weeks and see how you do with it.

 

But don't reduce more than one drug at a time!

[Utahgal]

I take both the doxepin and perphenazine just once, at night.

 

So I should wait until I am completely off the gabapentin before I reduce another drug? I hate the thought of waiting another 8 months. I hate the thought of those drugs in my system for so long.

 

Which should I taper first, the doxepin, or the perphenazine?

 

Thanks for your response, Alto.

[Utahgal]

I just read that perphenazine puts me at risk to develop TD, movement disorder. This was very disturbing to learn. I'm thinking I should taper this first. What do you think?

 

I've been on 8 mgs for 3 months. I have a pdoc appt the end of January. I'm thinking I will ask to begin to taper this down to 7.5 mgs and continue to decrease 0.5 mgs every 3 weeks or so.

 

I am in the process of tapering gabapentin. I feel I should taper them both, very carefully. I've had no problems with gaba so far. I decrease 10 mgs every 2 weeks. I am down to 230 mgs.

 

I really want off the perphenazine!!

[Altostrata]

Have the adverse effects you attributed to gabapentin gone away?

 

Did you start doxepin and perphenazine at the same time?

[Utahgal]

I no longer have adverse effects from the gabapentin. The doxepin and perphenazine pulled me out! I don't have any kind of reaction to my 10 mg reductions that I make every 2 weeks. I am down to 230.

 

I started doxepin and perphenazine both at the same time 3 months ago. I take them around 7 PM.

 

I understand that it's best to only taper one med at a time, for obvious reasons. But I was really scared reading about TD. I would like to taper perphenazine first, .5 mg every few weeks. What do you think? Am I being overly concerned?

 

Alto, I know how busy you must be with all these posts and still trying to have a life. Thank you for all you do. You help so many people.

[Utahgal]

I had read in one of Rhi's old posts, about taking turns tapering the drugs down. So maybe I can continue tapering gabapentin, but take turns tapering doxepin and perphenazine. What if I start with perphenazine, taper it down from 8 to 4 mgs. Stay at 4 mgs and then slowly taper down doxepin from 75 maybe down to 50 mgs. Hold the doxepin at 50, then work again on the perphenazine. And so forth. Maybe that would be easier on my system.

 

Thoughts from anyone?

[Altostrata]

If I were you, I'd hold on tapering gabapentin -- leave it for last.

 

See the list of doxepin adverse effects here http://en.wikipedia.org/wiki/Doxepin

 

Interactions: http://www.drugs.com/interactions-check.php?drug_list=935-0,1832-0&professional=1

 

Your doctor has a taste for highly toxic drugs.

 

I guess I'd go off perphenazine first, at a very gradual rate, 0.5mg at a time. Try one reduction for a month and see how it goes.

[Utahgal]

I am down to 200 mgs gabapentin! No problems!

 

I tried to change my signature but it said I already had too many characters.

 

This is huge news for me. Last summer I tried to decrease from 300 mgs down to 200 mgs and I ended up in the psych ward with severe withdrawal syndrome.

 

Thank you to Rhi, Alto, Flower, and others who have helped me immensely. Your support has made a world of difference.

[Altostrata]

Yay!

 

(You could remove "Hoping to start tapering gabapentin soon!" from your signature to make more room.)

[Utahgal]

Things are not going well. I've been at 200 mgs for a few days. I started to have withdrawal symptoms in the form of extreme anxiety.

 

I normally take my dose at 8 at night. The symptoms hit yesterday around 1:00 in the afternoon. I took a Xanax and it didn't help. I then tried my gabapentin dose, 210 (I bumped it back up) and the symptoms resolved. I felt much better.

 

I woke up this morning with more anxiety. I decided to take half the dose. It seems to be working. I feel a little better. I will take the other half this evening.

 

Am I doing this correctly? Any other suggestions? This really took me by surprise. My decreases had been going well until now. Maybe I should hold at this dose for a good while. I had been decreasing by 10 mgs every 2 weeks. I started at 300 mgs and am now down to 210.

 

Hopefully Rhi or Alto will reply. Thank you!

[Altostrata]

If you went from 270mg gabapentin to 200mg, that would be more than a 25% decrease. If I were you, I'd go to 250mg, stabilize, and plan on tapering by only 10% at a time from now on.

[Utahgal]

I didn't go from 270 to 200. I only decreased by 10 mgs at a time. I just don't update my signature.

 

I think maybe my mistake was taking it only once a day. I probably need to split the dose and take half in the morning and half at night. The problem may be the short half life of the drug.

 

Did Rhi divide her doses up? I know she successfully tapered gabapentin.

[Rhiannon]

I did divide up my doses. Gabapentin clears from the body via the kidneys in, if I recall correctly, something like six hours.

[Altostrata]

If you went from 270 to 200mg over 2.5 months, you might have gone too fast.

 

However, Rhi's idea of divided doses might help; I would try that first.

[Utahgal]

Thank you, ladies, for the responses.

 

Dividing the gaba dose did the trick. I've been fine ever since.

 

I had a psych appointment with a new doctor yesterday. She was very good and recognizes the need for very slow tapers in my case. She recommended that I hold my gaba taper at 200 mgs for awhile and begin my doxepin taper. I will slowly taper from 75 mgs down to 50 mgs. When I'm done with that, I can either go back to my gabapentin taper or start my perphenazine taper.

 

I will get there slowly, but surely. I'm glad to have this new doc on board.

[Altostrata]

Wow, that's good news, Utahgal. If you can recommend this doctor, please add her contact info to http://tinyurl.com/7cp8l8v or send it to me and I'll post it.

[Utahgal]

Alto

 

I will note my experiences with this new doctor. If I feel she is worthy, I will give you her name for your list. Time will tell!

 

In the meantime, I am going to do a long hold on the gabapentin. 200 mgs seems like a good place to rest for awhile.