Catbox: catch 22

[Catbox]

Been on nortriptyline 5 years for pain. Started at 50, got up to 120 last year. Stupidly took herbal tincture which included St. John's wort for a couple of weeks which sent me into serotonin overload. So I stopped it and cut down nortriptyline to 100. I've been in basically a constant panic attack since then, over 2 weeks a ago. Taking the med exacerbates the anxiety, but I can't not take it or I get sick. Can't get into the psychiatrist for 2 more weeks. Primary care have not helped at all. I'm in hell.

 

I would just go back up to 120 except the medication really exacerbates the anxiety. I don't even know what to do now. It will be 3 weeks this Friday and I'm still in a constant state of panic attack unless I take a Valium or Xanax which I am trying to avoid because I don't want to get hooked on benzos.

 

I have been exercising twice a day just take the edge off the anxiety which helps for a couple of hours. I'm on vacation and supposed to be having fun but I am in hell. I have been barely coping at work. I'm supposed to go to train for the position I was promoted to at another office in 3 more weeks. How can I deal?

 

Do I try to go back up to the 120 and then taper much more gradually, even though I wig out when I take it? It used to have a seriously sedating effect. I don't know what's happening! And no one else does either, apparently.

[Petunia]

Welcome Catbox,

I'm sorry to hear you've been having symptoms since adding St Johns Wort to an antidepressant. Its good you realized and stopped taking it.

 

When you say "Taking the med exacerbates the anxiety", what do you mean? Is there a pattern between when you take your dose of nortriptyline and when symptoms get worse?

 

Its difficult to know if you are still experiencing symptoms from your adverse reaction, or whether you are having some withdrawal effects from dropping your dose.

 

When someone experiences any kind of adverse effect from psychiatric drugs, it can sometimes take quite a while for the nervous system to restabilize itself again, sometimes several months. You may have become more sensitive and now 100mg is too much for you, its difficult to know for certain.

 

Your psychiatrist will probably want to add more drugs or increase your dose, but I would be more inclined to stay where you are and try and give yourself more time to recover naturally.

 

Here is the link to our symptoms and self care section, you may find some useful ideas to help manage symptoms as you recover.  Especially read the topics pinned at the top.

 

Many people find magnesium to be calming, see this topic for more information:  Magnesium, Nature's Calcium Channel Blocker

 

Please do be very careful with the benzos. In a nervous system sensitized by withdrawal or an adverse reaction, they can easily turn paradoxical, causing increased anxiety and rebound anxiety when they wear off. It becomes easier to develop a tolerance and a need higher doses. Its better if you can find non-drug ways to manage as you recover.

 

Others may chime in with more suggestions.  Please stay in touch and let us know how you are doing.

 

Petunia.

[Shep]

Hi, Catbox. Welcome to the forum from me, too. 

 

When I came off nortriptyline about 16 years ago to switch to Wellbutrin, I ended up in physical therapy for 6 weeks due to my muscles locking up after my doctor prescribed what I now know to be an extremely rapid taper. The tricyclic antidepressants act like muscle relaxants, so please take your time coming off and listen to your body. 

 

Here are some links to read over:

 

Tips for tapering off nortriptyline 

 

Why taper by 10% of my dosage?

 

What is withdrawal syndrome? 

 

The Windows and Waves Pattern of Stabilization

 

Like Petunia, I would also caution you regarding your Valium and Xanax use - you can become dependent on benzodiazepines in as little as 2 weeks. And they are very difficult drugs to come off of.

 

Please use this thread to keep us updated and to ask plenty of questions.

[Catbox]

Thank you for the replies!

 

Yes I do notice an intense increase in anxiety and discomfort when I take a dose. I have been considering breaking up the dose into 2, rather than taking 100 all at once and instead trying to take 50 mg 12 hours apart. Maybe I will try that tonight,

 

I have been using the benzos in very small doses and judicially, in fact trying to avoid them all together. Like 2.5 mg of Valium once or twice a week. I have an extended release Xanax that is .5 mg which I haven't used in a week. I was going to use it today because we are at Disneyland. I can't belie this all started 2 weeks before our vacation that we planned 2 months ago. I am supposed to meet my husband's aunt in Maryland. I don't know how I will get thru this week. I'm trying to learn a new job at work. I don't know how I am going to do that either. I feel like my life is ruined, and don't know how long this will go on for. I keep waiting to feel better, but I don't.

 

Monday night I just instead started exercising for half an hour at a time to work up a sweat. This seems to lighten the anxiety for a couple of hours. But then it comes back.

 

Thank you again for the replies and the support. And also for having this website. <3

[Catbox]

Does anyone have experience with valerian root, passionflower and other herbs? I find valerian root does help a bit I want to make sure it doesn't do the same hing to the body that a benzo would.

[Shep]

I'm so glad you asked about this because valerian is definitely something to avoid with benzos. Here's some info on that:

 

Valerian Root

 

This thread mentions passion flower a couple of times. You might want to do a search and see if you can find more.

 

Herb Teas: Camomile, Ginger, Mint, etc

 

You also mention exercise. Many people find that exercising too intensely, especially later in the day, can exasperate symptoms. But it really depends on where you're at in withdrawing and recovering. Some people find it helps, and some find it makes anxiety, insomnia, heart palps, etc. worse. Many people find going for walks is helpful. 

 

You may want to go ahead and do a little research on benzos. Sounds like you've got a lot on your plate, so it's best to get all of the information you can.

 

Members only benzo forum

 

Petunia posted links above to the symptoms and self care section, which is where you can find all sorts of non-drugs ways of coping. This will help limit the need for benzos, as well as help with other symptoms. 

 

Your life is definitely not ruined. Not by a long shot. Once you get stabilized from the recent drug changes, then set up a slow and careful taper to gradually get off. 

 

Check out the Success Stories when you're feeling discouraged. I find that to be very helpful.

 

Success Stories

 

 

[Catbox]

Thank you so much. Everyone is so helpful. I really appreciate you all being here.

[ChessieCat]

Hi Catbox and welcome to SA,

 

Thought I'd drop in and give you some more info which you might find helpful:

 

Brain Remodelling (Rhi's Description of Brain Healing)

Video:  Healing From Antidepressants - Patterns of Recovery

What is Happening in Your Brain
 

And I suggest you read these before seeing your doctor:

 

What should I expect from my doctor about withdrawal symptoms?

How do you talk to a doctor about tapering and withdrawal?

 

Also, thank you for completing your signature.  The history you have given there is covered in your first post so I'd like to suggest that you change your signature to make it a summary and include dates, drugs, doses and how you decreased/increased.  This will allow your drug history to be seen at a glance each time you post.  It is also a good idea to update it each time you make a change so it remains current.

[Catbox]

Arrgh, tried to go back up to 120 to start over and do a gradual taper. After 4 days the anxiety reaction to medication is so bad I can't function. I was getting sick in the afternoons from withdrawal on the lower dose. Going to try 110 and hope that is a good medium. Really lost. 

 

I am seeing a psychiatric Nurse practitioner who says she is familiar with withdrawal and tapering, as she went through it herself. Says I likely won't get good help from a psychiatrist. I will be seeing her on Friday. 

 

Does the 4 day rule apply to going back down as well? (It takes 4 days to metabolize an increase, same with a decrease?) 

 

100mg was making me very withdrawal sick late in the day, even when I split the dose.

[Catbox]

Titled:  Withdrawals symptoms without dosing change

 

Hello,

 

I have been on Nortriptyline for about 10 years.  Tapered from 120mg to 50 mg 4 years ago.  Been on 50mg since.  I take it in the mornings. 

I refilled a prescription on December 27th, about a week and a half later I started getting withdrawals symptoms in the evening. I didn't know what it was at first because I haven't changed anything med-wise or with supplements. 

 

I started taking some extra 10mg tabs I had left over from my taper. They helped at first but each day since Friday that passed the symptoms are worse, and start much earlier in the day.  I was able to take 30mg extra on Saturday and symptoms subsided.  But today I have needed to take 40mg extra and it is only 2:00pm.  I took 2 at noon and another 2 just now.  

 

I'm taking all these pills and it's like they aren't doing anything! They only thing that is different is that I started a low carb diet about 2 weeks ago. (less then 50 carbs.) and Low calorie, less than 1500 a day. 

The generic manufacturer is the same, that hasn't changed. (I got withdrawals once before when the manufacturer was different.)

Why would I suddenly be getting withdrawals?  The Diet? Faulty "batch" of medicine? 

 

It it not improving even with all the extra 10mgs a day, which are from a different batch. 

Do I just say f-- it and eat a damn bagel? 

 

Thanks for any responses.  

Edited January 16, 2020 by manymoretodays
moved to introduction from S and S, added title

[Gridley]

On 1/15/2020 at 3:10 PM, Catbox said:

I refilled a prescription on December 27th, about a week and a half later I started getting withdrawals symptoms in the evening.

 

It looks like you are in poop-out, which means the drug is no longer working.  Upping the dose works briefly, but then stops working.  At this point we would recommend getting off the drug, which is no longer doing anything.

 

Tachyphylaxis or As It’s Lovingly Known “Poopout”

 

We recommend tapering no more than 10% of your current dose every four weeks.

 

Why taper by 10% of my dosage?

 

This link is specifically about tapering Nortryptyline.

 

Tips for tapering off nortriptyline 

 

Please post everything in your main topic in the Introductions forum.  It is important to keep all your posts in the same place.

 

Edited January 16, 2020 by manymoretodays
removed white space

[Catbox]

Oh ok. Thank you. I will post there. 

[Catbox]

Is this different than just when you just get used to a drug and doesn't work on your depression or migraines or whatever you were taking it for?  

This is actually just a sudden rejection of the drug that causes withdrawal?  Even after 10 years? 

How can I taper when I am already really sick at the doses I am taking? Won't I get even sicker? 
 

Sorry for all the follow up questions. 

[Catbox]

I have been on Nortriptyline for about 10 years.  Tapered from 120mg to 50 mg 4 years ago.  Been on 50mg since.  I take it in the mornings. 

I refilled a prescription on December 27th,And about a week and a half later on January 10, I started getting withdrawals symptoms in the evening. I didn't know what it was at first because I haven't changed anything med-wise or with supplements. 

 

I started taking some extra 10mg tabs I had left over from my taper. They helped at first but each day since Friday that passed the symptoms are worse, and start much earlier in the day.  I was able to take 30mg extra on Saturday and symptoms subsided.  But today I have needed to take 40mg extra and it is only 2:00pm.  I took 2 at noon and another 2 just now.  It’s not enough to keep rather intense withdrawal at bay.. nausea, malaise, dizziness, confusion. 

 

I'm taking all these pills and it's like they aren't doing anything! They only thing that is different is that I started a low carb diet about 2 weeks ago. (less then 50 carbs.) and Low calorie, less than 1500 a day. 

The generic manufacturer is the same, that hasn't changed. (I got withdrawals once before when themanufacturer was different.)

Why would I suddenly be getting withdrawals?  The Diet? Faulty "batch" of medicine? 

 

It it not improving even with all the extra 10mgs a day, which are from a different batch. 

I was told in the symptoms forum that this is “Poopout” which is different than just tolerance I guess?  How do I start tapering if I’m already very sick? 

[brassmonkey]

Tolerance and poopout are the same thing. It means that your body has become use to the dose that you are taking and is trying to work around the drug and return to its natural undruged state. It usually creeps up on a person instead of starting up overnight, but it can also happen quickly.  I suspect that the diet change had something to do with bring it on.

 

There are two things that can be done for poopout. The first is to increase your dose and try to force it to cooperate.  This can work for a while but pretty soon your body will figure out what is happening and it all starts again.  This triggers a spiral of ever increasing doses and less and less stability.  The second is to decrease your dose and let your body start to heal while you help it return to its natural undruged state. This can be a very frustrating process because it can be a long time before you see any real improvement, but it does work.  I was in extreme poopout when I started my taper and it took several years to see any progress, this is not to say you will be the same.  You are just entering poopout while I was already there for a number of years.  I had updosed twice and was still gong down hill when I started.

 

Please don't throw any more extra pills at the situation, this will tend to destabilize your body and could trip off a kindling episode, which you really don't want to happen. I would recommend that you return to your regular dose and stabilize for a couple of weeks to work out the extra pills you've taken, and then start a proper 10% taper.  I highly recommend a 10% Brassmonkey Slide as it is fairly quick and minimizes the WD symptoms. If this sounds interesting, let us know and we can help you with the details.

[Catbox]

Thanks for the response!  Let me see if I can get stabilized... I've been on this medication for a long time, I don't use it for any pain symptoms anymore. I tapered down to 50mg in 2017 I think, and lowering it anymore just became too difficult so I resigned myself to needing this forever.

My current working theory of this situation is that there is something wrong with that particular bottle of pills.  I have replaced the pills I was taking with some old 10mgs I had, and since doing so my symptoms have stopped. (Just took my regular 50mg dose today, none extra so far *cross fingers*) So I am wondering if the batch of pills was bad, or maybe I left them near the stove for too long? For some reason that bottle of pills was giving me withdrawal. 

This site and all of you helped me a lot the last time I tapered. I am really grateful for this resource. 

[manymoretodays]

Welcome back Catbox, @Catbox

I was able to locate your introduction from before, and merged you all up.  One introduction per member please.  Very helpful for us, and you as well, to see previous posts and all, and keep your main information all in one place.

 

L, P, H, and G,

mmt

 

 

[Catbox]

oh ok  great. Thank you!

[Catbox]

Hello,

 

Back again, I think I am posting in the correct place? (Am I in introductions?) 
 

I am going through Nortriptyline withdrawal again despite not changing my dosage. So I guess I am in “poop out” for real this time, as changing the manufacturer is not helping relieve symptoms like it did last time. 
 

My doctor told me increase my dose from 50 to 75 to stabilize, then taper from there. I tried that the last few days and first it still wasn’t enough, and last night I think the extra dose made things much worse, as I felt terrible last night after taking it. I feel awful this morning, like my skin is made of needles. I delayed my regular 50mg morning dose until 10:00am because I was afraid to take more too close to my last dose last night around 10:00pm. 
 

Not sure what to do now. Based on posts from last time, it sounds like I should just tough it out for a few weeks at the 50mg dose even though it’s making me sick. Will it eventually stabilize if I don’t mess with it for a few weeks? Then I can take a slow taper from there.  
 

I have been using valerian root and chamomile tea most nights (but not every night) on and off for a couple of weeks. I just saw other posts may that say valerian acts like an benzo, so that may also be complicating things. Is it safe to just stop the tea do you think? 
 

Anyway thanks for being here and thanks for all you do. 

I am armed for tapering.. my doc prescribed me 10mg pills and the liquid nortriptyline. 

 

 

[Catbox]

Hi,

 

is it ok add onto my post again?

 

I’m afraid I may be in kindle situation. 
 

When my med (nortriptyline) starting giving me withdrawal, with no change in dosage the doctor told me to raise it to 75mg and then start a slow taper from there. After a couple of days the medication seemed to make things worse. It’s mostly a skin full of needles feeling.  Thursday I felt terrible after the last night of extra med on Wednesday.

 

So I went back to 50 mg a day on Thursday. Yesterday (Friday) I started to split the dose, 30mg in the morning and 20 in the evening and I felt mostly ok. Kind of blah but nothing I couldn’t handle. 
 

I didn’t feel too bad when I woke up today (Saturday), took 30mg at 10:00am. By 11:00 the needles were back really badly. Took the remaining 20mg (of 50mg daily) at 4:00pm. Now it’s 4:50 and I still feel terrible. Can’t tell if it’s getting worse or better.  
 

not sure what to do now or how long this needles feeling will last. It’s just so strange that yesterday I felt mostly ok. I didn’t change anything today and I can hardly stand the pain and discomfort. 
 

anyway, sorry. Probably not much to tell me at this point besides to ride it out? For weeks? Months? Days? 
 

thanks. 

[Altostrata]

Hello, @Catbox We haven't heard from you in 2 years. Back then, you were taking 50mg nortriptyline. How is it that you recently developed withdrawal symptoms, which your doctor tried to address by an increase to 75mg? Did you forget to take any doses, take one off-schedule, had any alcohol, antibiotic treatment, or covid?

 

Clearly, the increase to 75mg made you feel worse.

 

We would never have told you to jump from 50mg to 75mg. If you've been tapering too fast and got withdrawal at 50mg, increasing to 55mg or 60mg might have helped.

[Catbox]

Hi, thanks!

 

that’s the weird thing. I was just plugging along at 50mg since two years ago. Then I started getting withdrawal without changing anything.  It helped to switch manufacturers, but now even that isn’t helping.  
 

So the doc said the medication was no longer binding properly (or something like that, I forget what she said exactly). It seemed to help for a few days to raise it, I took the regular 50mg in the morning then added the 25 mg in the evening. 
 

so now the medicine seems to be making symptoms worse or no change. I thought splitting the dose might help. (30mg in the morning, 20mg in the evening). Yesterday that seemed to work because I felt pretty good but today it’s just as awful as it was Thursday. 
 

This is what I get for listening to doctors I guess.  So I guess, I just stay at 50mg?  I have liquid now too so I can take a very small amount if need be but I’m not sure that sounds like a good idea. 
 

also wondering if the valerian tea I’ve been drinking before bed most nights for about 2 weeks (but not every night) is complicating matters, so I didn’t drink it last night. I was alarmed to see it can act like a benzo! I had no idea. 

[Catbox]

Oh but I did have Covid back in October. 

[Altostrata]

You might have had post-covid symptoms rather than withdrawal.

 

As we provide peer support for going off drugs, please consult with your prescriber about adjusting your dosing.

 

Please let us know when you want to taper off your drugs.

[Catbox]

I understand. I actually do want to taper off. Lined it up with my prescriber with liquid to taper. I just wasn’t sure if I should try to stabilize first and I wasn’t sure how to do that.  
 

I’ll try to figure it out. 
 

thanks

[Altostrata]

1 hour ago, Catbox said:

Then I started getting withdrawal without changing anything.  It helped to switch manufacturers, but now even that isn’t helping.

 

We would have to investigate the chronology of these symptoms. But if you'd rather take your prescriber's advice, please let us know when you're ready to taper.

[Catbox]

Well, this did happen once back in 2018. But switching manufacturers seemed to fix it. 
 

then it happened in Sept 2022, switched manufacturers again. And the symptoms stopped. 

got Covid Oct 2, stopped testing negative after 14 days

withdrawal began to happen again at the end of November. 
switched to two 25mg instead of one 50mg

That worked until last week, I’ve switched to five 10mg pills from a different manufacturer but that hasn’t seemed to help this time. 
 

it’s the weirdest. I’m really sensitive to meds, I know that. 
when I was taking atenolol for my migraines, certain manufacturers would work to keep them away, and others didn’t. Pharmacist thought I was full of it because “it’s the same medicine.” 
 

I’ve just stayed at 50mg a day since Thursday.  I thought it was getting better yesterday but the needles-on-my-skin feeling is back today. It seemed to get worse after I took the medicine. 
 

I want to stabilize then hold, then try by a really small amounts less, like 2 mg and see what happens. Even if it takes me 10 years to get off the stuff, it would be better to be off of it 10 years from now, rather than still dealing with the spinning wheel of will-it-or-won’t-it cause this withdrawal for no reason again! 

 

since the burning needles feeling happens after I take the meds, I’m assuming this is a reaction to the medication, and not a withdrawal from it. 
 

I’m sorry, I know this all sounds crazy.  I’ll keep it at 50 until the symptoms settle, then hold so I know I’m stable. Then start tapering, if that sounds like a good plan. I don’t think I trust any docs or prescribers at this point.  Thanks for listening. 
 

 

 

[Altostrata]

What are the symptoms that you attribute to withdrawal?

 

What times o'clock do you take each of your drugs, with their dosages? Have you made any changes in your other drugs prior to "When my med (nortriptyline) starting giving me withdrawal"? What were those changes?

 

 

Please put ALL your drugs in this Interactions Checker and post the report or a link to it in this topic.

[Catbox]

7 months later! Here is the report.

https://www.drugs.com/interactions-check.php?drug_list=100-0,2574-15969,2758-0,2682-20175,1454-13156,1937-2171,1675-0,1734-0,4136-19408,2031-0&consumer=1&types[]=major&types[]=minor&types[]=moderate&types[]=food&types[]=therapeutic_duplication

 

I managed to get from 54mgs in Feb (where I ended up to plateau to stop the withdrawals.) down to 43mgs in May. Took a bit of a break in May because I was tired of the constant headaches.  A week or two ago the withdrawals started again. Tried adding back 4mg last week and that was too much. So I added back 1 mg yesterday (in the evening when the WDs are happening, I take my typical full 43mg dose in the mornings.) I still feel crappy, but I’m no longer getting WD halfway through the day. But I’m getting mild adverse neurological effects after adding it back. Jittery, nausea, and some needles and pins. But the withdrawal symptoms over the weekend were way worse.  I’m getting very very sick without the extra 1 mg, but I’m worried in 4 days I’ll get a full blown kindling episode even with just the 1 mg. But I shouldn’t try to change that yet, right? Like lower that extra 1mg to 1/2 a mg?
 

god I feel so trapped! I wish it was possible to just quit and go through the acute phase for a couple of weeks without a protracted withdrawal. 
 

Ive been a regular cannabis user since 2020 (weekends), but using it makes my withdrawal symptoms way worse (and I feel like it’s confusing things) so I’m giving it a break for the moment.  
 

thanks so much to everyone here. 

 

[Altostrata]

We advise people not to continue to taper while they have withdrawal symptoms. If the headaches were withdrawal symptoms from tapering, and you have tapered anyway, you've made the withdrawal symptoms worse. Suggest you not make any more drug changes until you're back to baseline without withdrawal symptoms.

 

7 hours ago, Catbox said:

Ive been a regular cannabis user since 2020 (weekends), but using it makes my withdrawal symptoms way worse (and I feel like it’s confusing things) so I’m giving it a break for the moment.  

 

If you've been using cannabis daily, you may get withdrawal symptoms from stopping it.

[Catbox]

Ah ok got it.  I don’t use cannabis every day, but like 4 days a week. (Fri-Sun and maybe a Monday or Wednesday) I was wondering about that. 
 

yeah that’s why I stopped the taper back in May, to give my body a break and go to baseline. And I felt fine at 43mgs every morning until 2 weeks ago when I went into WD again. 
 

I added 1 mg in the evenings starting on Sunday.  So it was 43mgs every morning, until Sunday, when it became 43mgs in the morning, and 1mg in the evening about 12 hours later. I did that Sunday and Monday. And it seemed to be working. Felt almost normal after the 1mg last night, even slept well! 
 

Today, I took my morning 43 mgs and now I feel super amped and jittery. I guess I need to see if I stay jittery or if it calms down today later. 

 

Seems like I have a few options:

• Go back to only 43 mgs a day for a few days until I no longer get jittery, and then try to add back 0.5mgs instead of 1mg.
• This evening, instead of taking 1mg or nothing, take 0.5mgs, then 43 mgs tomorrow morning.
• Take 1mg or 0.5mg tonight, but break up the dose more tomorrow, e.g. take like 40mgs in the morning, and 3.5mg or 4mg at night. And make that my new dosing schedule if it works, just so I am not getting as much medicine at one time. 
   

From what I have read on this site, I need to minimize changes at one time. So changing the amount and the dosing schedules at the same time seems ill advised, right? 
 

I may just have to wait and see how the day goes. If the jittery feeling calms down, then maybe it’s just too much medication at once? 

[Altostrata]

4 hours ago, Catbox said:

 I don’t use cannabis every day, but like 4 days a week. (Fri-Sun and maybe a Monday or Wednesday)

 

You might still get withdrawal symptoms if you quit without tapering.

 

4 hours ago, Catbox said:

And I felt fine at 43mgs every morning until 2 weeks ago when I went into WD again. 

 

Since you were taking 43mg, please explain how you went into withdrawal again. Did you skip or forget any doses?

 

What times o'clock do you take each of your drugs, with their dosages?

[Catbox]

Quote

Since you were taking 43mg, please explain how you went into withdrawal again. Did you skip or forget any doses?

ah! That is the billion dollar question! This has happened several times since 2018.  I don’t change or forget anything but I start getting WD symptoms in the latter half of the day. I take my nortriptyline in the morning, (I’ll post schedule below) and then later in the day I’ll start getting WD.  Malaise, nausea inability to function. Just really really sick. It goes away if I take more meds. In the past, if I switched manufacturers this would resolve the issue after a day or two. But now I’ve gone through all the manufacturers, so there is nothing else to switch to.  It’s almost like my body gets used to the med formation in some way and doesn’t stay steady in my system, and it drops off in the afternoon. If I don’t add more meds or change anything, this drop off happens earlier and earlier in the day each day that passes.  

 

This being the case, I added 1 mg in the evening on Sunday. It relieved the symptoms a bit on Sunday for like an hour, then the symptoms came back.  Yesterday I waited and took the 1mg in the evening to space it out from my morning dose, and I felt like 90% better, and the symptoms didn’t really come back. I took my regular 43mg dose this morning and got quite jittery. Not a full blown kindling like I got in January this year when the doc raised my dose by 25mgs. Just jittery/anxious.  Sometimes I get this feeling when I change something, it isn’t unique to the Nortriptyline. This jittery feeling has mostly gone away now and I feel like the med is dropping off again, but I don’t feel blown sick.  I haven’t taken the evening dose yet. Not sure if I should take 1mg or 0.5mg now, or redistribute my Nortriptyline doses so I take less in the morning and more in the evening. (As described in previous post)

 

 

Morning meds (between 7:30 - 8:30am)

Nortriptyline 43mgs

Nadolol 40mgs

Nurtec 75mgs (every other day as directed)

Curcumin 500mgs

Acyclovir 400 mgs

Acetyl L Carnitine 1000mgs

R-alpha-lipoic acid 300mgs

Palmitoylethanolamide (PEA) 350 mgs (this is an amino acid type supplement that helps nerve pain)

 

Night meds (10:00pm)

Lyrica 100mgs

Rosuvastatin 20mgs 

Acyclovir 400mgs

Curcumin 500mgs

PEA 350 mgs 

 

Since Sunday, I’ve added 1 mg Nortriptyline at around 7:00pm 

 

Quote

You might still get withdrawal symptoms if you quit without tapering.

 

Okey doke! No cold turkey on the THC then. I’ll use a bit tomorrow, rather than just stop it. That would keep it “on schedule” so it stays in my system. 

 

 

[Altostrata]

Why do you take your drugs in 2 batches?

 

3 minutes ago, Catbox said:

I don’t change or forget anything but I start getting WD symptoms in the latter half of the day.

 

Did you add or remove other drugs when you experienced these sudden withdrawal symptoms?

 

Rather than increasing your single dose of nortriptyline, did you consider taking it in divided doses, twice a day?

 

Please put ALL your current drugs in this Interactions Checker and post the report or a link to it in this topic.

[Catbox]

Report:

https://www.drugs.com/interactions-check.php?drug_list=100-0,2574-15969,2758-0,2682-20175,1454-13156,1937-2171,1675-0,1734-0,4136-19408,2031-0&consumer=1&types[]=major&types[]=minor&types[]=moderate&types[]=food&types[]=therapeutic_duplication

 

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Why do you take your drugs in 2 batches?

Some of my meds make me sleepy so I take those at night. Others are stimulating so I take them in the morning, some need to be taken twice a day. 
 

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Rather than increasing your single dose of nortriptyline, did you consider taking it in divided doses, twice a day?

Yes I was wondering if that is something I should do. But if I split the dose at the current level, I figured the WD symptoms would start much earlier in the day, if they even went away at all. (Not sure half of my daily dose would get rid of them in the morning).  I was thinking of trying this tomorrow. 22mgs in the morning and 21.5 or 22 in the afternoon. 
 

I didn’t want to take the extra 1mg with my regular dose, because I was trying to spread it out more. Too much at once and I’d get the jitters. (But I got the jitters this morning anyway)
 

 

[Altostrata]

You seem to be taking a lot more drugs than you were in 2016. Have you discussed reducing your drugs with your prescriber?

 

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Central Nervous System (CNS) Drugs

Therapeutic duplication

The recommended maximum number of medicines in the 'Central Nervous System (CNS) Drugs' category to be taken concurrently is usually three. Your list includes four medicines belonging to the 'Central Nervous System (CNS) Drugs' category:

• cannabis
• Lyrica (pregabalin)
• nortriptyline
• Nurtec ODT (rimegepant)

 

 

So, as I understand it, you're here because of what might have been "withdrawal" from nortriptyline and that you can't seem to raise the dosage enough?

 

I think that's taken care of by dividing your daily dose, take 12 hours apart. Once you get stabilized on this, it's feasible to reduce either or both of the doses in a gradual taper, which you know how to do.

 

As for the "withdrawal" you experienced earlier, it may have been caused by addition or other change in your other drugs. Because drugs interact, odd things can happen in a drug cocktail. Sometimes a new drug may cause another drug to be metabolized faster. This can also occur because of removal of another drug that was blocking metabolism of nortriptyline.