Grizzly: About to begin tapering

[SquirrellyGirl]

Here are a couple of links relevant to speaking with your doctor, if you haven't seen them :-)

 

What should I expect from my doctor about withdrawal symptoms?

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

 

Good luck, Grizz - you "sound" good 

 

SG

[scallywag]

Grizzly, I posted in another thread about describing this process as "working slowly to find the minimum tolerable and effective dose." Using that phrasing with your doctor may enlist his support. You don't need to reveal that your desired MTED is zero.

[Grizzly]

Thank you. 

[Grizzly]

I met today with my psychiatrist, a man I admire and respect. And our discussion about Anatomy of An Epidemic and my desire to drop some meds did nothing to diminish those feelings. There was some gentle pushback but no defensiveness.

            He was not familiar with the book and asked some good and pointed questions. He is familiar with my work as a regional journalist and seemed to value that I found the book credible. He said he will get a copy and I believe him.

            He even sounded rueful at one point, acknowledging he might add an anti-depressant  to a patient's prescriptions without dropping a preceding anti-depressant it is meant to replace because that drug had worked for the patient for a while. And he acknowledged that sometimes he simply doesn't know what to do to help a patient.

            A few years ago, he told me, "I've never seen anyone fight depression harder than you do." Today, he said many patients aren't willing to adopt lifestyle changes, such as adding exercise or changing their diet. They simply want a pill, he said.

 

            More specifically, he supported my ongoing taper off trazodone. He suggested that the next target should be the generic for wellbutrin. He warned against cutting the SR pills, though I have read that some people believe that's OK. He prescribed a 100 mg dose to replace the 200 mg dose I take now each day and suggested I would not experience withdrawal. I did not argue the point with him or reference the 10 percent taper recommended by this site.

            Regardless, I won't start the wellbutrin generic taper until I'm farther along with the trazodone taper. That's still at 25 percent and there are a few related side effects - some anxiety, some brain flutters - but nothing intolerable.

 

            I welcome any reactions and recommendations.

 

Thank you. 

[scallywag]

It's wonderful that your psychiatrist takes that kind of time with you and that he is open to discussing your thoughts about your prescriptions. It's also nice to hear that he's intelligent and confident enough to acknowledge that sometimes he doesn't know what to do. Aside from prescribing the 4 ADs for you, he sounds like a great doc to have in your corner.

 

The good news about the bupropion is that you've got lots of time to research how to taper your formulation before starting. You may well uncover information that educates your doc and helps his other patients.

 

Just a caution: it's safest to taper one drug at a time, especially when you're making large reductions like 25%. Please consider completing your traz taper before starting on the bupropion.

[scallywag]

Grizzly I'm going to hide your duplicate post, the ones asking about your previous post, etc. 

[Grizzly]

Grizzly I'm going to hide your duplicate post, the ones asking about your previous post, etc. 

Thanks very much. I could not figure how to do that.

[Grizzly]

I attempted last night to drop another 25 percent on the 50 mg trazodone. I'd stayed up late the night before, felt tired and believed I'd fall asleep and stay asleep with the 25 mg of trazodone and 100 mg of amitriptyline.

But I woke at about 1 a.m. and stayed awake. I felt as though I could feel my brain pressing against my skull. Strange sensation. After about 20 minutes of this, I added back the other 25 percent. 

 

It is daunting and sobering to think that a tiny quarter of a 50 mg pill has that much power. My X-acto knife can't really slice the 50 mg pill into eighths.

I intend to try again tonight after a busy day off from work. 

[SquirrellyGirl]

I think it may be time to invest in a milligram jeweler's scale, Griz

 

Using a digital scale to measure doses

 

SG

[Grizzly]

 

Grizzly I'm going to hide your duplicate post, the ones asking about your previous post, etc. 

Thanks very much. I could not figure how to do that.

 

So, I'm running into the same problem. I write something, hit "Post" and nothing shows up. Is there a lag time before something is posted? Or am I doing something wrong? This didn't seem to happen when I first started posting. Thanks.

[scallywag]

Yes some times there's high demand on the server and the response time is slow.

[Grizzly]

Yes some times there's high demand on the server and the response time is slow.

So, should I just wait for it to show up instead of re-posting?

[Altostrata]

Yes, give the system a minute to process your post.
 

Thank you, Altostrata. I believe the amitriptyline was added about three years ago, I believe. It's interesting...he's been pushing me to stop the Trazodone, saying the amitriptyline should provide enough of a sedative effect for me to sleep. I think he's been pushing that because he is afraid of the serotonin syndrome. But he NEVER suggested tapering the Trazodone. He just suggested I stop. I tried that one night several months ago and after a few hours of not sleeping I went ahead and took it. 
The only daytime symptoms are the ones I described, the fluttery feeling in my brain and some anxiety in my chest.
 
Thank you for your insights and concern.

 
If you felt odd symptoms during the day (before you started tapering anything), it probably was because of trazodone interacting with your other drugs (though with 4 drugs on board, it could have been anything interacting with anything).
 
Please read Tips for tapering off trazodone (Desyrel)
 
Tips for tapering off Wellbutrin, SR, XR, XL (buproprion)
 
Wellbutrin tends to be activating, so it is possible that when you go off trazodone, you may experience a side effect of sleeplesness from Wellbutrin. This can also be true of Pristiq. This suggests you go off the amitriptyline last. See Taking multiple psych drugs? Which drug to taper first?
 
Most likely, your psychiatrist keeps people on drugs because he doesn't know how to get them off without withdrawal symptoms, which is a very serious gap in his knowledge.
 

Grizzly, I posted in another thread about describing this process as "working slowly to find the minimum tolerable and effective dose." Using that phrasing with your doctor may enlist his support. You don't need to reveal that your desired MTED is zero.

 
Brilliant formulation, SW.

[Grizzly]

Yes some times there's high demand on the server and the response time is slow.

I think something else is at play here. I type a message and hit post and nothing happens. Other times, I hit post and the message shows up along with my signature. 

[Grizzly]

I have decided to abandon the 50 percent taper of trazodone and return to the 25 percent taper. So, I'm back to taking 75 percent of a 50 mg dose of trazodone. I have felt my mood slipping and I had trouble getting to sleep last night. I read the links recommended by Altostrata. My psychiatrist has no idea how thorny a taper off trazodone can be. 

I hope I'm doing the right thing by choosing to try to free myself from these meds. Ihope there will be, at some point down the road, a tangible payoff of some sorts. 

[Altostrata]

How about a 10% taper? You might be able to make smaller reductions more often than once a month.

 

 

Yes some times there's high demand on the server and the response time is slow.

I think something else is at play here. I type a message and hit post and nothing happens. Other times, I hit post and the message shows up along with my signature. 

 

 

Some times the server is slower than others.

[Grizzly]

I haven't posted here since June. I'm struggling now and could use some input if anyone cares to weigh in. 

 

Since my post in June, I have tapered completely off the Trazodone, which was challenging, and the Buproprion, which wasn't bad. My psychiatrist was on board. We agreed, sometime in late July or early August, that I would next tackle the Prestiq. We agreed to wait until an appointment I have with him soon to start on the Prestiq, with him prescribing a smaller dose than 100 mg. 

BUT...in early August, I started dating - after a long spell of not being in a relationship. The woman has no experience with clinical depression or psychiatric meds. We started dating on a slow pace, partly because she had recently been ditched and felt deep heartache about that. But I began to anticipate that we would eventually be sexual. And I worried about the effects of old-school amitriptyline on sexual function. 

Thus, I started tapering the amitriptyline, without doing much research about it and without talking to my psychiatrist. 

 

I tapered aggressively too...in 25 mg increments...and was off the amitriptyline completely in about a month. 

Then, the trouble started. First, the woman I was dating began to pull away. And I began to experience terrible trouble sleeping. 

I was determined for a few weeks to not go back on the amitriptyline. I tried natural remedies, instead. Melatonin, Valerian root, etc. Nothing helped. 

Last weekend, the woman I was dating told me she wasn't ready for a relationship. I took that hard. 

And I finally started back with 25 mg of amitriptyline. But I discovered that sleeping required 50 mg. So, I'm back to 50 mg. 

 

And feeling depressed and disheartened and discouraged. It's tough to tease out the reasons, giving I just lost a relationship that seemed promising in its early stages. 

I'll talk to my psychiatrist this week. 

I KNOW that I tapered off the amitriptyline too aggressively. 

 

I welcome any advice. Thank you. 

[scallywag]

Sorry to hear that something as promising as a new relationship didn't turn out the way you'd hoped. That's often a rotten experience.

 

The highs of attraction and getting to know someone early on are delightful and hard to resist. I've found they can be a bit destabilizing for me. Much as I might want to explore the possibility of dating or I've chosen to postpone anything other than pleasant and sometimes playful conversation. I'm simply sharing what I've learned and my choice for my life, not saying you should do this.

 

I hope that your return to a higher dose of amitriptyline settles down your symptoms in time and that you can find some peace beyond the "D" emotions you've been experiencing. Please keep us posted on how you're doing.