Utahgal: Hi

[Altostrata]

How did you find this doctor? We all want to know!

[Utahgal]

It was luck of the draw that I found her. My insurance had changed and she was on the list. She graduated from Yale, not too shabby. She was really into long, slow tapers. She also really seemed to listen to me. I will keep you updated on future appointments and let you know if I truly recommend her. So far, so good.

[Utahgal]

So, I experimented a bit and found that at 200 mgs of gabapentin, I must divide the dose to prevent interdose withdrawal. I now take 2 ml at 8 AM, another 1 ml at 3 PM, and my last dose of 1 ml at 8 PM. I have completely avoided symptoms by doing this.

 

I will hold here for about 6 weeks while I turn my attention to doxepin. Tonight I will begin my doxepin taper. I currently take 75 mgs and would like to taper down to 50 mgs. The lowest dose in capsule form is 10 mgs. So, I will decrease as follows.....75, 70, 60, 50. I will hold at 50. When I so eventually taper further, I will get the doxepin in liquid form and make smaller cuts.

 

I will still have 8 mgs of perphenazine to contend with at some point. But this is my plan so far.

[Utahgal]

I continue to hold at 200 mgs of gabapentin.

 

I decreased my doxepin by 5 mgs. I'm now at 70 mgs (was at 75). The first night was fine. The second night I had trouble falling asleep. The third night was fine. Hopefully I will continue to be fine. In 2 more weeks I will cut another 10 mgs and be down to 60 mgs.

[Altostrata]

Strongly suggest that if a 5mg decrease works, do that again rather than 10mg.

[Utahgal]

The problem is that the lowest dose is 10 mgs. Maybe I will empty half a 10 mg to get approximately 5 mgs. I will get the liquid after I reach 50 mgs.

[Altostrata]

Please read http://survivingantidepressants.org/index.php?/topic/3914-tips-for-tapering-doxepin-sinequan-zonalon/

[Utahgal]

Gabapentin (liquid) ...... I continue to hold at 200 mgs. No problems. I now split my dose 3 times a day. It's working great.

 

Doxepin....... I began at 75 mgs and tapered to 70 mgs two weeks ago. I had maybe 2 nights of insomnia, but it blew over. Other than that, uneventful. 3 nights ago I lowered to 65 mgs. I had to open a 10 mg capsule and dump half out to make 65 (25 mg, 25 mg, 10 mg, half a 10 mg). So far, so good. No symptoms to report.

 

I have a follow up with my new psychiatrist next week. She wanted me to go from 75 to 70, to 60, to 50 mg. I hope I don't get in trouble for opening up a capsule and dumping some out to make a 5 mg capsule. I was too scared to lower my dose by 10 mgs so I only lowered by 5 mgs. I hope she doesn't get upset with me for not following her orders.

 

I continue to post these updates in case anyone else wants info on these drugs. Hopefully it will help someone else.

[Altostrata]

Very good to hear! Why don't you tell the psychiatrist YOU decided to taper slower because you're more comfortable with that?

[Utahgal]

Gabapentin........... Started at 300 mgs, am down to 180 mgs. No problems so far. The 10 mg reductions are working out fine,

 

Doxepin......... Started at 75 mgs. Am now down to 55 mgs. My doctor ordered me 5 mgs capsules from a compounding pharmacy. I will reduce by 5 mgs each week. So far it's working. If I have problems, I will slow down. I really need off of this drug as it really messes me up. I feel hungover most of the day. It's also not good for my thyroid meds. I need off ASAP.

[Altostrata]

Good to hear your new psychiatrist is being helpful.

 

I am concerned about your changing two drugs at once. This could lead to a lot of confusion. Can you hold on the gabapentin and just reduce the doxepin?

 

How do you know it's the doxepin causing your symptoms?

[Utahgal]

I don't *know* for fact that my problems stem from the doxepin. It could be thyroid. I do know that since starting the doxepin that I feel like one of the zombies from the walking dead. Lol. It could just be my thyroid getting worse, who really knows.

 

I do know that I don't need the doxepin anymore. I was started on it back in October (6 months ago) to end my suffering from the gabapentin taper. Psychiatrist # 1 really messed up my taper and put me into severe withdrawal that didn't even improve with the reinstatement of the gabapentin.

 

My withdrawal symptoms have been gone for some time, so I don't need the doxepin anymore.

 

I'm still at 180 mgs of gabapentin (down from 300) so I have a ways to go. I'd rather not put that taper on hold for 12 weeks while I taper the doxepin. Even if I only decrease by 30 mgs over 2-3 months, I will feel like I made *some* improvement and made it that much further toward freedom. If I have any symptoms, I will back off.

 

If this new psychiatrist continues to be as good as she's been, I may recommend her for your "good doctor" list. I'll give it some more time to be sure.

[Altostrata]

You know we caution people not to change two drugs at once, because it muddies the waters when you're trying to figure out a bad reaction.

 

Please consider holding on the gabapentin while you go off the doxepin.

[Utahgal]

Slowly, but surely, I am getting there.

 

Gabapentin........120 mgs (down from 300)

 

Doxepin.........20 mgs (down from 75)

 

Yay!!!

[Rhiannon]

Yay for you UG! Way to go!

[Altostrata]

Excellent. How are you feeling?

[Utahgal]

I'm feeling the same. No better. No worse.

 

I was hoping to have less brain fog and more energy, but that has not happened.

 

In any event, I am thrilled to be on less toxic drugs!! Yay!!!

 

Thank you for being happy for me. I appreciate it.

[Utahgal]

My update.......

 

Gabapentin 80 mgs. (Began at 300)

 

Doxepin. 0 mgs I finished! (Began at 75)

 

Perphenazine. 4. Mgs. (Began at 8)

 

 

Well....... I definitely am not as fatigued. But..... the early morning anxiety has returned as well as the constant low grade nausea and poor appetite. These were the reasons for starting the doxepin to begin with. It looks like these wretched symptoms have returned. I am very thin and cannot afford to lose much more weight. I'm down to 108 lbs and I'm 5'8".

 

I'm not sure what to do. I really hate to go back on the doxepin, but I might have to.

 

All of these blasted symptoms started last summer when my psychiatrist reduced my gaba too much and sent me into withdrawal. I was fine before that, and have not been the same since. Is it possible that permanent damage was done? It's been almost a whole year and I still feel terrible.

 

Thoughts?

[Rhiannon]

I doubt it's permanent damage. I think you probably just tapered too fast and you're having withdrawal symptoms again now, probably some from the doxepin and some from the gabapentin.

 

Tapering multiple meds at the same time is tricky because you get overlapping withdrawal and it's hard to tease out what is causing what and make the most helpful adjustments. The way I have coped with this has been by just tapering extremely slowly and stopping and holding everything whenever I get withdrawal symptoms.

 

I am actually right now for the first time tapering only one med and holding the others. It definitely makes it easier to figure out what to tweak when!

 

If I were in your position I would probably do a very small reinstatement (say 1-4 mg) on the doxepin and hold tight on the gabapentin, and hold both of those dosages steady for three months or so. (I say three months because for me that seems to be the magic time frame. But that's me.)

 

Also, take a look at the charts in this paper. It doesn't have the drugs that you're on, but it's entirely possible that the same kind of curve exists with those--from anecdotal experiential evidence it does seem so. I definitely had to taper my gabapentin more slowly when I got under 100 mg.

 

It helps me visualize why I need to be tapering more slowly at these low doses and helps give me patience for that.

http://survivingantidepressants.org/index.php?/topic/6036-why-taper-paper-demonstrates-importance-of-gradual-change-in-plasma-concentration/

(Charts page 4 and after)

[Utahgal]

I tried to reinstate 10 mgs doxepin for the past week. It really hasn't helped much and I've had to increase my Xanax use to help with the terrible morning anxiety. I will call my doctor tomorrow and get a bigger increase of the doxepin.

 

In the meantime, I will hold my gabapentin dose at 60 mgs. I take .4 ml 3 times a day. I will stay here for a long while.

 

I did also manage to get off the perphenazine. 8.....6.....4.....2......0. So that's one less med to deal with.

 

I guess for now, it's a matter of getting back on the right dose of doxepin to help with the anxiety and to help me eat again.

 

My pdoc wanted me to try mirtazapine, but after reading all the trouble some people have, I said NO WAY!!!

[Petunia]

I tried to reinstate 10 mgs doxepin for the past week. It really hasn't helped much and I've had to increase my Xanax use to help with the terrible morning anxiety. I will call my doctor tomorrow and get a bigger increase of the doxepin.

 

One week is often not long enough for a reinstatement or updose to work, you might want to give it a bit more time before going higher, as long as there are not obvious adverse effects, we generally advise giving it about 4 weeks.  Also, please be careful with the Xanax, its very easy to become dependent on it, it also causes rebound anxiety.

[Utahgal]

Hey Petu!

 

I just couldn't hold out any more. I upped my doxepin to 50 mgs and it finally did the trick. I am now stable. I originally went on doxepin (75 mgs) and perphenazine (8mgs) last fall to end my horrific suffering from gabapentin withdrawal. Thank goodness it worked, I was about to end it all.

 

I took 300 mgs of gabapentin for about 3 years to help anxiety. It worked great. I hadn't experienced anxiety for over a year or more, so my psychiatrist suggested I taper off. He wanted me to taper down 100 mgs a week. After the first 100 mg cut, I felt some bad anxiety. Like an idiot, I cut another 100 the next week (doctor's orders) and had such severe withdrawal, that I ended in the psych ward. Reinstating back to 300 mgs didn't help one bit. My nervous system was a mess, the damage was done. The doxepin pulled me out of it. I've been on it since. That was last fall.

 

I am now down to 60 mgs gabapentin. I've had NO problems tapering. I think I may hold here for the summer though.

And continue to taper in the fall.

 

My doxepin taper was very smooth. No problems. I began at 75 mgs and decreased by 5 mgs each week. I didn't have any symptoms until I was completely off. Then the anxiety returned full force.

 

I'm wondering if what I experienced was the horrific symptoms from last summer, or was it simply doxepin withdrawal. I liken my experience with gaba to what benzo withdrawal is to the benzo people. Benzo people talk about recovering for months or years and often needing another drug to help relieve their horrific symptoms.

 

Will the doxepin help me once I finally jump off my last gaba dose? Or will i end up in the psych ward again? Once I get off the gaba, will I be stuck on doxepin for years to mask the gaba withdrawal symptoms?

 

I'm really scared and confused.

[Petunia]

Hi Utahgal,

 

I'm glad you are feeling better. 

 

I think a long hold through the summer is a good idea, it will give your nervous system a chance to settle down.  Then perhaps continue with your gabapentin taper.  If you taper slowly, holding when symptoms increase, I think you should be able to get off it.  Also, if you taper the doxepin slowly and safely, I think you should eventually be able to come off that.  This may all take longer than you would like.

 

We recommend tapering medications by 10% of the current dose every 4 weeks, this is a harm reduction method.  Once a nervous system become unstable, it can take a long time before things are working properly again, until then, its best to make as few changes as possible.

 

Here is our gabapentin tapering thread:

 

http://survivingantidepressants.org/index.php?/topic/2309-tips-on-tapering-neurontin-gabapentin/?hl=%2Bhow+%2Btaper+%2Boff+%2Bgabapentin#entry26492

 

Here is the doxepin tapering thread:

 

http://survivingantidepressants.org/index.php?/topic/3914-tips-for-tapering-doxepin-sinequan-zonalon/?hl=%2Btips+%2Bfor+%2Btapering+%2Boff+%2Bdoxepin

 

Please read through them, including the link which explains why we suggest a 10% taper.

 

I think your problems have been caused by too fast tapering, I think you will be fine if you taper properly.

 

Petu.

[Utahgal]

I need some advice about how to get off my gabapentin. I have the liquid form which is 250 mg per 5 ml. So, each .2 ml equals 10 mgs.

 

I started at 300 mgs and decreased 10 mgs per week (.2 ml). Once I got below 200 mgs, I needed to split my dose 3 times a day to prevent interdose withdrawal.

 

I have slowed my taper down to 5 mg decreases every 2 weeks. I am currently at 55 mg (.3ml, .4ml, .4ml)

 

Each .1 ml drop equal 5 mg.

 

My plan is to taper as follows:

 

50 mg (.3,.3,.4)

45 mg (.3,.3,.3)

40 mg (.2,.3,.3)

35 mg (.2,.2,.3)

30 mg (.2,.2,.2)

 

25 mg (.1,.2,.2)

20 mg (.1,.1,.2)

15 mg (.1,.1,.1)

 

My problem is this. I use a 1ml oral syringe. It's marked in increments: .1,.2,.3,.4,.5.......1.0

 

Once I taper down to the .1 level, there really isn't that much that squirts out of the syringe. Barely a drop! How is my body going to absorb and recognize that little amount?

 

And how to I get doses less than 15 mg?

 

Do I take 10 mgs (.2 ml) and dissolve it in water to make a solution and then achieve smaller doses like 12 mgs, 10 mgs, 8 mgs, .....

 

I tried to read the link about making solutions for liquid taper, but I just don't understand. Will someone help me please come up with a plan? I really need help.

 

At the rate I am tapering, I won't be there for awhile, but I would like to look ahead and be prepared. My pdoc is letting me do this taper at any rate I want. For me, the slower the better.

 

Someone please help! I need a plan.

[Utahgal]

If I dissolve 100 mgs of gabapentin in 100 ml of water then my dosing would be 1:1?

 

So 18 ml of the solution would equal 18 mgs of gaba? Is this correct?

[Petunia]

That sounds right to me utahgal, but I will try and get some more help for you.

[Utahgal]

Thank you. I ran it by my pharmacist and she said it should work.

[Altostrata]

Excellent idea, pharmacist can do math! You were correct.

[Utahgal]

Thank you Alto and Petu. I feel much better knowing I have a plan to dose at lower levels. I was not comfortable jumping off the gaba at 30 mgs! I'd like to get below 10 mgs.

 

The pharmacist was helpful, but thought I was nuts. Lol. She had never heard of anyone experience withdrawal syndrome on gabapentin! This time last summer I was in the psych ward because the symptoms were so horrific that I was suicidal! And I don't have a suicidal bone in my body! I'm currently at 55 mgs, and hope to be off this poison by winter.

 

Thank God for this site and its invaluable mentors.

[Utahgal]

Hey everybody!

 

I wanted to give an update. I spent a year tapering off GBapentin with the help of Alto, Rhi, and others. I finally got off! It went fine! I had NO PROBLEMS. I just got the gaba in liquid form and took it slow. I divided the doses into thirds and took it 3 times a day to prevent withdrawals. I believe I tapered down to 9 mgs and then I jumped with NO problems! It took me a year to go from 300 mgs down to 9 mgs. So, slow and steady wins the race.

 

I suffered with severe anxiety and panic attacks for the last 6 years. That's how I got hooked on the gaba. Well, I recently learned that I suffer from late stage neurological Lyme disease! My doctors all missed it! It's the Lyme disease causing my psych symptoms! Imagine that! I've had a severe brain infection for 6 years and was being treated with psych drugs! Duh!

 

I've been on antibiotics since September. Unfortunately, they don't seem to be working. I may need IV antibiotics.

 

Please consider Lyme disease if you suffer from unexplained symptoms. The regular lab is very inaccurate. You need to order the IGenex lab from California. It shows more bands.

 

Many people are misdiagnosed with CFS, fibromyalgia, MS, depression, anxiety.......when it really is LYME!

 

I never saw a tick on me, and I never had the bullseye rash. I just "came down" with panic attacks. Over the years, other symptoms piled up.....hair loss, muscle weakness, insomnia, brain fog.....

 

I now would like to get off abilify. Can anyone steer me in the right direction?

 

Thanks,

Utahgal

 

Please feel free to use my gaba experience as a success story. I'd be more than happy to help others.

 

Xxoo

[Utahgal]

Can someone help me with an abilify taper schedule? I just read on a post that the liquid form is no longer available.

 

I took 2 mgs for 2 weeks. Then bumped to 5 mgs for 2 weeks. I noticed that I was waking every night at 4 AM! I would have to get up for the day. I've never had that happen before. So, I decided to drop back to 2 mgs the past 2 weeks. I'm still waking up. So, after 2 weeks a 2 mgs, I stopped the drug. I was fine for 3 days. Slept great. By day 4 I experienced increased nervousness. By day 5 I was a panic and anxiety mess. Completely dysfunctional! In bed all day!

 

I took 2 mgs last night, and feel about 50% better today. Not great, but more functional. I'm thinking that I should stay at this dose for 2-3 weeks until thing settle. I was hoping I could liquid taper the abilify, but learned they no longer sell the solution?

 

How do I get off this stuff?

[Petunia]

Here is our abilify tapering topic, it has several options for tapering:

 

http://survivingantidepressants.org/index.php?/topic/1896-tips-for-tapering-off-abilify-aripiprazole/

 

If I were you I would hold for about a month before continuing to taper to give your NS chance to settle again.

[MissSerene]

Utah: Don't know anything about Abilify, but just wanted to say good for you, and keep up good work. Have heard so much about missed cases of Lyme disease. Have wondered about this for myself and even asked internist to test me for it, and she didn't. Will maybe try again. Good luck!

[Utahgal]

I'm only on 2 Mgs of abilify and I want to get off. My pdoc said to just quit since it's such a small dose. But I knew better! I demanded the liquid form. I tapered from 2.....1,5.....1.0......0.5......off.

 

I experienced the worst withdrawal symptoms.....sweats, headaches, panic and anxiety. I immediately went back on 1.0 Mgs and am just starting to feel better after 2 days.

 

Obviously I tapered way too fast. Can anyone suggest a better taper plan that I might try? How long do I wait in between cuts? I was cutting every week. Maybe I should wait longer between cuts?

 

How long is this going to take?

[Utahgal]

Can I taper every 2-3 weeks.....

 

1.0 ml

0.8

0.6

0.4

0.3

0.2

0.1

Off

 

Does that seem like a reasonable taper?

[SquirrellyGirl]

Hi Utahgal, it is one Intro per member so I have merged your new Abilify post with your original Intro thread. This keeps all your information together.  Be sure to click Follow above if you haven't, so that you will be notified of responses to your thread.

 

Yes, your taper was too fast, with cuts being 25%, 33%, 50% and then off.  So, they got bigger relative to the previous dose.  You did not say how long you were at each dosage, so if it was in rapid succession then it amounted to a cold turkey.

 

Your proposed taper is still a bit problematic, given how sensitized you are from this last attempt.  0.8 from 1.0 is still 20%, especially every two to three weeks.  I know it must feel agonizingly slow to have to take it to 10% every 3 to 4 weeks, but you want every chance at success to finally be done, right?

 

Since you came down from 2.0 with this last taper, and are now at 1.0, I would hold there for a couple of months.  This is because your taper exceeded your nervous system's ability to keep up, and it is still working on the 50% cut between 2.0 and 1.0.  You must feel good and stable before resuming.

 

From there, a proper taper would look like this, every four weeks:

 

1.0

0.9

0.81

0.73

0.66

0.6

0.53

0.48

 

and so on, with an extra hold thrown in to be sure your nervous system is caught up.

 

When people exceed their nervous system's ability to keep up, they get destablized and then must updose and hold sometimes a few months before resuming, and when all is said and told, their taper takes longer than if they had just gone ahead and done the proper 10% taper to begin with!  Throw away the calendar and focus on living your life.  You'll always be taking less and less, which is better than still being on the full dosage from where you came, so it's all good, right?

 

SG