papaloapan: how to detox from psychiatric drugs and eliminate side effects?

[JanCarol]

Hey Papalopan

Quote

Right now I feel lots of anxiety, I can't stay still watching TV, I mean I can stay lie down on the couch but I have to change position or move some parts of my body because of this horrible anxiety,  like akathisya but in very low level because I don't have to stand up and walk to another room of my house. 

Also my very annoying and tiring anxiety includes the irregular strong hearbeats and breathlessness. In the meanwhile/time that I keep with this same dose every day in order to wait for my body and brain to recover from the constant changes of lithium carbonate dose I did in the past, aside of the epsom salt baths, what else can I do to decrease this horrible withdrawal symptoms? I was reading the "Symptoms and self-care"  ->  "Important topics about symptoms including sleep problems" but I'm so tired and feel so bad that I can't keep reading

 

First - akathisia  anxiety, restlessness- maybe you need to get up and walk around the block instead of staying and watching TV.  Just the TV can be anxiety inducing, as its job is to tell you that you "need more stuff" and induce anxiety that you don't "have more stuff."  It does its job very well.  And news is a whole other level of anxiety inducing.  Turn it off.  Read a book.  If you still can't sit still, then take a walk.

 

Sometimes symptoms are there to teach you new ways of being with yourself.  We got drugged first time around because we didn't understand what the symptoms were telling us.  Then we drug ourselves to deal with the situation that our symptoms were trying to get us out of.  The bad job, the toxic relationship, the draining lifestyle, or the harmful habits-of-living.

 

The heartbeats and breathlessness - I am still struggling with these, too.  I learned to detach them as a "physical symptom."  It's just an irregular heartbeat - it doesn't mean that I'm anxious (though it might mean that I'm stressed - which is different).  It's just a symptom.  Mine has been going on for 8 years now, so - there may be some longer consequences but I'm getting them checked out.  So far the docs are not alarmed at what can be a difficult symptom to endure.  Follow my thread to keep up on my cardiac journeys.  I think they are a consequence of the drugs and the surgeries (I cannot distinguish between the two) - but - my life is so much better without the drugs.  

 

Here's where I learned, "It's only a Symptom:"   Dr. Claire Weekes - Recovering from a Sensitized Nervous System

 

Please look into Magnesium and Omega-3 fish oil

 

It sounds like you could benefit best with starting with the magnesium.  Start small, build up to a full dose (maybe even a double dose, I am on a triple dose sometimes), and then add in the fish oil the same way (for psych drug survivors, I like about 6-8000 IU of quality fish oil.  This does not mean costly fish oil!).  These are excellent for soothing the nerves and hundreds of important neurotransmitter and metabolic cascades around the body.  Most of us are deficient in magnesium, and very few of us get enough Omega 3.

 

You had a lot - a lot - a lot - of changes in the last 3 months, and even more drasitic ones in the last 6 months.  It is important to keep steady.  Your last cut was 50%, and you did Every-other day dosing, which is destabilising.  Now you are in "time to hold, time to wait."

 

On this your doc is probably right: these are likely not lithium withdrawal symptoms - but instead - symptoms from your previous tapers that the lithium was "tamping down."  As you lift the lithium, you may still need to experience some of these withdrawal symptoms.  Think of it like a throttle - the lithium closes the throttle and spares you some withdrawal symptoms, but as you come off the lithium, the throttle opens up and more seem to get through.  Sorry, I don't have scientific proof of this, this is from discussions I've had with other lithium survivors.  (so your doc is wrong, too - there is a way you can still be experiencing withdrawal symptoms!)

 

Work on the Mag and fish oil, see if it helps.

 

Look into Non Drug Techniques for Coping with Emotional Symptoms.  Find a Practice which calms  and soothes you.  I am a personal fan of

 

 

7 minutes.  Just 7 minutes.  You (and I) have no excuse!

 

If, after you establish your daily Practice (it's like a savings account, if you put something in it every day - you will have a "bank" of resources upon which to draw later), and the mag and omega 3 - you might consider splitting your lithium dose.

 

Get your scales - really - you're going to need them from here on out - or - perhaps you want to learn how to do liquid tapers?

How to Make a Liquid from Tablets or Capsule

 

They are more precise.  I wish I'd done a liquid taper, as it is smoother and actually easier than fiddling with tiny little bits of powdered tablet.

When you get to a precise measurement, split your daily dose into 2 x 75 mg.  Move the 75 mg forward by an hour each day until you are taking them about 12 hours apart.  This gives you  more steady levels throughout the day.

 

Actually, this is all about 3 months worth of work here - you don't need to passively sit and suffer - there are things you can do.  Preparation makes for an excellent meal.  The same is true of tapering.  Get the prep work done (mag, omega 3, measurement system) while you are holding, and it will improve your mood because you are "doing something" about it.

 

I hope you see the sun today!

[peng]

Fine post, JanCarol, well done.

[Happy2Heal]

hi papaloapan,

I replied to your message.

I don't know of any doctors who can help you with your withdrawal symptoms.

 

you can try meditation, relaxation cds or videos, epsom salt baths, reading, or watching tv if you are able to.

you can try gentle exercise.

try to eat well and go to bed at the same time each day, and stay away from people or things that are too stimulating.

 

you will feel better in time, but sadly, that is what it will take, time.

 

 

[papaloapan]

Thank you scallywag.     Can anybody recommend me a success story-recovery from withdrawal that can help me and that is from a person that took and withdrew the same or some of the drugs that I took and that I'm withdrawing ? (lithium carbonate) and also that had the same or some of the side effects that I have because of taking lithium and withdrawing it? Considering all the drugs I took in the past. (you can see them in my signature). I'm feeling very suicidal, I'm living hell right now

 

My side effects: breathlessness, I feel that my mouth salivates and my throat wants to swallow saliva many times but it can't do it automatically like when I used to be healthy (without psych drugs) so I have to voluntarily swallow the saliva but when I do that I feel I'm drowning (can't breathe), I feel this more when I go to bed.

Strong, fast and irregular heartbeats, anxiety, my nose gets congested/full of mucus so every 5 minutes I have to blow my nose, cough/coughing, have to pee lots of times like every 10 minutes, at night I see colored dots with my eyes closed and open, thoughts in my mind that never stop (I can't have my mind clear/calm/without thoughts), tinnnitus (noise in my ears), poor concentration (I have to ask, check and read the same many times), difficulty taking decisions, itching on my head, face, chest and back, sometimes when I stand up I feel like if the floor is moving and my tongue gets tense by involuntarily sticking to my palate. All of these causes for me to not being able to sleep (I go to bed at 12am/midnight and at 5am I'm still awake).

[Zharul]

Hey do you still feel weak?no energy?

[ChessieCat]

13 minutes ago, papaloapan said:

Thank you very much @ChessieCat and @ktp for replying. I want to be very sure about the pristiq 50mg and effexor xr 100mg equivalency. As I said, I read the entire topic, each and every post. I got to the pristiq 50mg = effexor xr 150mg equivalency for the majority of what people said. 50=150 had 7 persons that said was the right equivalency, and 50=100 had 5 persons that said was the right equivalency. And then, after my post, with what you guys (ChessieCat and ktp) said, now 50=100 has 8 persons that say it is the right equivalency, and 50=150 still has 7. Still, I would like for more people in this thread to tell me which equivalency they think is the right one: 50=150 or 50=100. 

Here are all the comments (of the entire topic) about the equivalency:

• Lilu: my conclusion earlier that 50 mg of Pristiq is equivalent 150 mg of Effexor is wrong. Because the 50 mg tablet, even though it might actually have 76 mg, it is still releasing 50 mg of Pristiq continuously into your system. 
• Maybe 37.5 mg of Pristiq = 75 mg of Effexor
• Maybe Pristiq 50mg tablet = Effexor 100mg
• Pristiq 50mg= 100 mg Effexor
• Effexor 150mg and Pristiq 50mg are both "normal" dosages of their respective drugs, they may be roughly equivalent
• perhaps equivalent doses are 150 mg and 50 mg, respectively, because venlafaxine ER's NRI potential becomes noticeable at 150 mg/d, likely comparable to desvenlafaxine's 50 mg starting dose.
• Therefore, in some efficient metabolizing patients, 75 mg of parent venlafaxine ER drug may convert to a 300 mg equivalent of desvenlafaxine. As a result, the jury is out, in that 50 mg of desvenlafaxine metabolite antidepressant might equal 75 mg, 150 mg, or 18.75 mg of the parent drug." 
•  Using this extrapolative method, perhaps equivalent doses are 150 mg and 50 mg, respectively, because venlafaxine ER's NRI potential becomes noticeable at 150 mg/d, likely comparable to desvenlafaxine's 50 mg starting dose. 
•  Desvenlafaxine is about 3 times stronger, mg wise, than venlafaxine. 
• Shipko: Given the lack of research on the topic, my opinions are necessarily anecdotal, and YMMV.  Despite the Effexor XR supposedly having problems with bead tapering because not all beads contain active ingredients, I have had consistently good results bead tapering Effexor XR.  My approach is to change Pristiq to Effexor XR. For 50 of Pristiq I make an immediate substitution of 150 of the Efxr and after a few days the Efxr is decreased to 100 mg and kept stable for a week before tapering from the Efxr.
• I didn't have ANY side effects switching from Effexor to Pristiq, or going from 50mg to 100mg
• 50 mg of Pristiq is about the same as 150 mg of Effexor - it seems reasonable. I think that making the transition is always going to be a trial and error, and that it is best to err on the side of too much Effexor.
• A Dr: My thoughts are that a person can change safely from 50 Pristiq to 150 Effexor
• baroquep: from pristiq 50mg he/she went to effexor xr 75mg
• ktp: “so if you're on 50mg Pristiq you want about 100mg effexor so take a 75mg cap + 25 beads from the next one.“ 

 

I think you might be trying to find a definite answer to the question of equivalent dose of Pristiq to Effexor when there isn't one.  As I responded in the Pristiq topic:

 

2 minutes ago, ChessieCat said:

 

My personal opinion is that it would be better to err on the side of too LITTLE Effexor.  When reinstating it is better to start with a low dose and updose if needed than to start too high.

 

[papaloapan]

I'm about to start tapering Pristiq 50mg by converting to Effexor XR 100mg. What I'm gonna do is to take 1 Effexor XR 75mg capsule and some weighed beads from another 75 mg capsule to complete the 100mg. In the country that I live there's no regular effexor (immediate release) therefore I can't get liquid effexor therefore my last dose of effexor XR of my tapering will be 1 daily bead because XR beads can't be splitted or crushed. Some people mentioned at the "How to taper effexor" thread, that inside the Effexor XR capsules, each bead contains 0.3mg of effexor, therefore the scale needed is one that can measure at least 0.1mg (0.0001 grams) for doing a well-done-complete 10% gradual taper. The problem is that scales that can measure 0.1 mg cost around $2,000 USD which I can't afford. Scales that can measure at least 1mg (0.001 grams) are affordable for me ($30 USD). Anyone knows where can I find an affordable scale that can measure at least 0.1mg? Or can anybody give me some advice of what to do? Maybe the only thing that I can do is to buy and use the $30 USD scale that can measure 1mg, and when I get below 1mg, I would have to taper by counting the last 3 beads, 1 month (or more time) the dose would be 3 beads (0.9mg) the next month (or maybe I should hold it for more than 4 weeks) 2 beads (0.6mg), the next dose would be 1 bead. And the next and final dose after 1 bead would be to jump to zero. Thank you so much.

[ktp]

> inside the Effexor XR capsules, each bead contains 0.3mg of effexor, therefore the scale needed is one that can measure at least 0.1mg (0.0001 grams) fo...

you can find on ebay but YOU DON"T NEED this superfine scale, and it won't work anyway: your margin of error is greater than the weighed subject.  instead, Dissolve and Dilute!

Don't know what country you're in, or where you found 0.3mg-beads but in the USA, TEVA-manufactured Venlafaxine XR (generic for Effexor XR) comes in capsules with nicely consistent beads that have approximately 1.0 mg per bead.  very easy to count.  but eventually you'll need liquid.  so, dissolve a 75mg cap's beads in 750ml of water.  now one cc water = 0.1mg non-XR venlafaxine.  if the beads won't dissolve, try adding a bit of vinegar to mimic acid stomach.  once dissolved, your XR beads are no longer beads and are no longer XR.  so split into 2/day!

[ChessieCat]

If you click on this link and then type "gemini" in the search bar (top right) you will find posts which discuss the Gemini Scale.

 

http://survivingantidepressants.org/topic/1596-using-a-digital-scale-to-measure-doses/

[papaloapan]

I'm about to start tapering pristiq 50mg by converting to effexor XR (pfizer patent) 100mg. I bought already a box of effexor xr 75mg. So my plan is to take one daily 75mg effexor xr capsule plus 25mg of beads from another capsule (100mg for 4 weeks) by using a digital scale to measure those 25mg of beads. But I found a problem: I went to a store to test a digital scale that can measure things of a minimum weight of 0.001g (1mg), and when I placed all of the beads of one 75mg effexor xr capsule on the scale, the scale showed that the beads weigh 0.242g (242mg). By the way, I didn't place the capsule with the beads inside, I took all the beads out of the capsule and placed all of them on the scale. So I got confused because I remember that I read in the "tapering effexor and effexor xr" thread, that capsules are measured by weigh. So, I'm thinking on doing the following , but please tell me if it's the right thing to do: by doing a rule of three or cross multiplication, or also called inverse proportion, if 75mg of effexor xr (in beads) equals to (weigh) 242mg, then 25mg of effexor xr beads equals to (weigh) 80mg (on the scale).

 

So in order to take 100mg of effexor XR, I would have to take one 75mg effexor xr capsule plus beads that weighed on the scale, the scale shows that they weigh 80mg (equivalent to 25mg of effexor xr). Please tell me if this is the right thing to do. I really need your help guys in order to feel sure about starting to do this, I already want to convert to effexor xr 100mg from pristiq 50mg so that then I can taper effexor xr. In the country that I live (Mexico) there is no regular effexor (immediate release). And remember that effexor XR beads can't be crushed, splitted or converted into liquid. Also in Mexico there is no TEVA-manufactured Venlafaxine XR (generic for Effexor XR capsules with nicely consistent beads that have approximately 1.0 mg per bead). Please don't suggest another way to taper pristiq (desvenlafaxine) because I read the whole topic on how to taper pristiq.

 

Thank you so much

 

Edited March 4, 2018 by ChessieCat
spacing

[ChessieCat]

Hi papaloapan,

 

Each member has only 1 Intro topic where they ask questions about their own situation and journal their progress.  This keeps a member's history in one place.  It can also help other members who can see the questions you ask and read the responses.

 

Please do not create any more Intro topics.  Thank you.

[ChessieCat]

13 minutes ago, papaloapan said:

if 75mg of effexor xr (in beads) equals to (weigh) 242mg, then 25mg of effexor xr beads equals to (weigh) 80mg (on the scale).

 

So in order to take 100mg of effexor XR, I would have to take one 75mg effexor xr capsule plus beads that weighed on the scale, the scale shows that they weigh 80mg (equivalent to 25mg of effexor xr).

 

Yes, your calculations are correct.

 

The easier way to calculate it for future reductions is to calculate what 1mgai equals (mgai is mg active ingredient, mgpw is mg pill weight)

 

Please check my calculations.

 

75mgai = 242mgpw

 

divide both sides by 75 =

 

1mgai = 3.2266mgpw

 

When you make a 10% reduction 100mg x 0.9 = 90mg

 

To calculate how much to weigh:

 

90mg - 75mg capsule = 15mg

 

15mgai = 3.2266mgpw x 15 = 48.3999mgpw

 

You will need to weight 48.4mg of beads.

 

Next 10% reduction 90mg x 0.9 = 81mg

 

81mg - 75mg capsule = 6mg

 

6mgai = 3.2266mgpw x 6 = 19.3596mg

 

For the next reduction you will not need the additional capsule.  You can still use the 1mgai = 3.2266mgpw to calculate the weight of beads you need.

[papaloapan]

Thanks a lot ChessieCat. So my next step is to buy the digital scale, the one I mentioned I tested in a store. I want to be sure of buying this digital scale that supposedly can measure things of a minimum weight of 0.001g (1mg). I weighed several times the same capsule and it varied at most 0.002g (2mg) a few times, but I think it's going to be difficult, and also It's going to take me a long time to find a digital scale that can be perfect and precise and to not have those little 2mg variations. I want to start already the conversion from pristiq 50mg to effexor xr 100mg. This scale includes a little 10g cylinder/nut/screw which is used to calibrate the scale. On the top of the nut says it weighs 10 grams. And when I placed the nut on the scale, the scale showed that it weighs 10.000 grams (if I don't place it exactly on the middle of the scale, it shows that it weighs 9.999 grams). Logically, that means that the scale does work fine. But since I've had many bad experiences in my life, it is very hard for me to trust anybody. So I would appreciate very much your opinion/thoughts/comments. Is it fine for me to purchase this scale? Thank you

[Gridley]

It sounds like the Gemini-20 scale I've been using, which I've had good results with.  I've read on this site that around 4 mg pill weight you start getting inconsistent readings.

 

[papaloapan]

I haven't converted from pristiq 50mg to efexor 100mg because last monday, march 12, I got 6 teeth removed by my dentist, and he prescribed me an antibiotic and meds for pain. I write this because I remember I read bad things about tramadol which is one of the meds my dentist prescribed me. 

So he prescribed: for 5 days, every day in the morning and at night one 750mg amoxicillin tablet (antibiotic). For 3 days, in the morning, in the afternoon and at night one 30mg sublingual ketorolac tablet (analgesic). And for 3 days, in the morning and at night 15 drops of Tramadol (100mg/ml, each ml is equivalent to 40 drops) (opioid pain medication). He told me that if I still feel pain that I can continue using tramadol. So I used tramadol one more day (4 days in total till now).

And at the 4th day, for 5 days, in the morning and at night two 400mg ibuprofen tablets  (nonsteroidal anti-inflammatory drug (NSAID)

My questions are: now that the 3 days of taking ketorolac and tramadol have passed, should I wean them off gradually? How? I'm guessing the only one that I have to wean off gradually is tramadol, but tell me please if also I have to wean off gradually ketorolac. And should I also wean off gradually the antibiotic amoxicilin?

And after taking for 5 days the ibuprofen, should I also wean it off gradually? Thank you so much.

 

Here is brief info about the 4 meds the dentist prescribed me: 

Ketorolac: (for pain)

Sold under the brand name Toradol among others, is a nonsteroidal anti-inflammatory drug (NSAID) in the family of heterocyclic acetic acid derivatives, used as an analgesic.^[1][2] It is considered a first-generation NSAID. Ketorolac acts by inhibiting the bodily synthesis of prostaglandins. 

 

Tramadol: (for pain)

Sold under the brand name Ultram among others, is an opioid pain medication used to treat moderate to moderately severe pain. It works by binding to the μ-opioid receptor and as a serotonin–norepinephrine reuptake inhibitor (SNRI).^[8][9] Tramadol is in the benzenoid class. In the body it is converted to desmetramadol, which is a more potent opioid. 

Interactions: Tramadol may interact with serotonergics, monoamine oxidase inhibitors, tricyclic antidepressants, selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, noradrenergic and specific serotonergic antidepressants, serotonin antagonists and reuptake inhibitors. Serotonin reuptake inhibitor (SRI) and norepinephrine reuptake inhibitor(NRI); hence, an SNRI. Tramadol is well-established as a serotonin reuptake inhibitor. In addition, a few studies have found that it also acts as a serotonin releasing agent . Tramadol is also a norepinephrine reuptake inhibitor. Inhibits the reuptake of serotonin and norepinephrine^[3] due to its action on the noradrenergic and serotonergic systems, such as its "atypical" opioid activity

 

Amoxicillin (antibiotic)

Also spelled amoxycillin, is an antibiotic useful for the treatment of a number of bacterial infections. It is a moderate-spectrum, bacteriolytic, β-lactam antibiotic in the aminopenicillin family used to treat susceptible Gram-positive and Gram-negative bacteria.

 

Ibuprofen (for pain)

Is a medication in the nonsteroidal anti-inflammatory drug (NSAID) class that is used for treating pain, fever, inflammation, painful menstruation, osteoarthritis, dental pain, headaches and pain from kidney stones. Like other NSAIDs, it works by inhibiting the production of prostaglandins by decreasing the activity of the enzyme cyclooxygenase. NSAIDs such as ibuprofen work by inhibiting the cyclooxygenase (COX) enzymes, which convert arachidonic acid to prostaglandin H₂ (PGH₂). PGH₂, in turn, is converted by other enzymes to several other prostaglandins (which are mediators of pain, inflammation, and fever) and to thromboxane A₂ (which stimulates platelet aggregation, leading to the formation of blood clots). Ibuprofen is a nonselective COX inhibitor, in that it inhibits two isoforms of cyclooxygenase, COX-1 and COX-2. The analgesic, antipyretic, and anti-inflammatory activity of NSAIDs appears to operate mainly through inhibition of COX-2, which decreases the synthesis of prostaglandins involved in mediating inflammation, pain, fever, and swelling. 

 

 

 

 

 

[papaloapan]

Couldn't edit my last post, I wanted to add: my teeth and mouth still hurt a lot, so my dentist suggests me to keep taking the tramadol drops, so another questions is: should I change tramadol for another pain killer that can be stopped cold-turkey? Should I change  ibuprofen for another pain killer or is it fine for still taking it and for when I withdraw it cold-turkey? And maybe since I've only have taken tramadol for 4 days and each day in the morning and at night 15 drops, maybe I can quit it cold-turkey because maybe it has been a small dose (I don't know). But maybe I'll take tramadol for more days, till my pain disappears. And if I take tramadol for more days, should I wean it off gradually? How?

[manymoretodays]

Hi paploapan,

 

That's a woozy.......dental work and all those extractions.  And ouch!   Sounds miserable.

 

No tapering/weaning from an antibiotic is necessary.   Do take it as prescribed and for as long as prescribed.  That's your Amoxicillin. .

 

Why don't you just use one dose of the Tramadol today and then stop.  Take it only once a day and then stop.  There is no need to taper after 4 days of an opiate used for pain.   It does have some major interactions with both your Pristitiq and quetiapine.  If you would rather......... just take one half of each dose twice a day, as you have been doing......for today, and then stop.   

 

You'll be stopping the Ketorolac as well, when you start the Ibuprofen.  No tapering required for either of those.  Hoping that you are all clotted up now, as far as any post extraction bleeding goes.

 

Always make sure that Dentists, as well as other Doctors are aware of your other medications taken.  Hoping that you can access the site: Drugs.com  to check for drug interactions in case of future needs for pain/comfort medications.

 

Salt water gargles with warm water might help sooth the sore mouth areas.  And make sure you are getting some fluids and nutrition in.  Ice packs may also help to just numb it all up.

 

Today is the day when it  all will start feeling better.  Do let us know how you are doing.

 

Love, peace, and healing.....

manymoretodays

Edited March 17, 2018 by manymoretodays
elaboration, spelling, clarity

[ChessieCat]

Hi papaloapan,

 

Your drug signature is much too complicated, contains a lot of unnecessary information for the moderators and takes up too much of the screen whenever you make a post on the site.  The moderators need a signature which we can glance at quickly to see your history.

 

I will paste your current signature in the next post so that the information is still available.

 

Please keep it nice and simple.  We only need details for the last 2 years.  Date, drug and dose only, no symptoms or diagnoses.  The other years can just be an overview.  

 

This is the preferred format which is helpful for the mods.  Thank you.

 

A request: Would you summarize your history in a signature - ALL drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly?

• Please leave out symptoms and diagnoses.
• A list is easier to understand than one or multiple paragraphs. 

• Any drugs prior to 24 months ago can just be listed with start and stop years.
• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago)
• Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016.
• Link to Account Settings – Create or Edit a signature.

[ChessieCat]

Drug signature 18 March 2018:

 

8/13- 12/13 got very stressed-> tired: paxil and clonazepam in drops 2.5mg/ml applied directly in my tongue.  12/13 - 1/14 symbyax 6/25 (olanzapine and fluoxetine). 0-0-1. January 20th-3/14 symbyax 6/50 0-0-1. 3/14- 5/14  lamictal and abilify. Started with lamictal 25mg and then 100mg. Abilify 10 mg.  5/14 - 12/14 strattera 1-0-0 sertraline 50mg 1-0-0, topamax (topiramate) 25mg 0-0-1, lamictal 25mg then 50mg 1-0-1, olanzapine 1.25mg 0-0-1  inderalici for a month 10mg 0-0-1. 3/15- 9/15 paxil 20mg 1-0-0, clonazepam in drops 2.5mg/ml 0-0-4, lithium carbonate 300mg 1-1-1, methylphenidate (commercial name is tradea LP which is similar to Concerta) 20mg 1-0-0.  10/15 - 11/15 lithium carbonate 300mg 0-0-1, effexor 37.5mg 1-0-0 and clonazepam in drops 2.5mg/ml 1 drop. 11/15 sertraline starting in 50mg till getting up to 150mg daily (one 50mg tablet in the morning and two 50mg tablets at night) stopped taking them cold-turkey: had a psychosis: I got locked in a psychiatric hospital. 1/25/16 - 2/4/16 Psychiatric hospital: intramuscular inyected haldol for 6 days, haldol tablets 5mg 1-0-1, biperiden (akineton retard) 2mg 1-0-1, triazolam 0.5mg 0-0-1 and risperdal.  february 18 - 5/5/16 (got outside of the psychiatric hospital) Risperdal 1mg 1-0-1, may 5th - 6/6/16 changed dose to 0.5mg 1-0-1, akineton retard 1-0-0 from february 18 till 6/6/16, and clonazepam 2mg tablets 0-0-1 from april 4 till 5/5/16. Changed dose may 5 - 6/6/16 to 0-0-1/2, changed dose june 6 - july 19th 0-0-1. july 19th till 8/9/16 Citalopram 20mg tablets 1-1-0 and dispersible lamictal 100mg 1-0-0 . august 9 till 9/12/16 lithium carbonate 300mg tablets controlled release 300mg 1-1-1 changed to IR Lithium carbonate tablets 1-1-1 starting on 9/12/16. Paroxetine 20mg tablets 1-1-0 starting on 10/11/16. 10/15/16 started gradual taper, first took paxil off gradually, (alternating dosage taper). After I completely came off of paxil, tapered lithum carbonate. I don’t remember how she told me to taper lithium but it wasn’t a 10% reduction, it was a bigger reduction. She told me to suddenly stop taking the night pill (each pill is 300mg). 2/17 I was just taking of lithium carbonate 300mg 1-0-0. 2/17 - 6/17 Was the only time in which I decided the reduction of the dose. I did it not gradually, but faster, until april in which I was taking 1st day no lithium, 2nd day a quarter of a tablet , then the 3rd day started the pattern again, (alternating dosages). Many changes of my lithium dose by myself, some days took 1st day half a tablet, 2nd, 3rd and 4th day a quarter, among other dosages (alternating dosages). But never got below a quarter.  6/2/17 I went back up to half a 300mg lithium carbonate tablet daily 1-0-0 . 7/4/17: reduced dose to 75mg of lithium carbonate 1-0-0 and added Mirtazapine 0-0-1. 7/7/17 - 12/30/17 locked in an addictions (alcohol and ilegal drugs) rehab clinic (I don't have addictions, the owner manipulated my mom in order to lock me). 7/8/17 - 7/11/17 Mirtazapine 0-0-1/2, I was still taking lithium carbonate 75mg 1-0-0. 7/12/17 stopped taking mirtazapine on and continued with lithium carbonate 75mg 1-0-0. 8/7/17 stopped taking lithium carbonate and started taking supplements, Italviron (aminoacids and b6 vitamin) and then Sukrol (glutamic acid, lecithin, phosphorus and thiamin) . 11/30/17 started q-mind (quetiapine) tablets 100mg 0-0-1. 12/1/17 started pristiq (desvenlafaxine) 50mg tablets 1-0-0. Added centrum performance. Then added ginko biloba tablets 80mg for tinnitus. 1/4/18 Free again (got out of the clinic). Started tapering pristiq, psychiatrist told me to alternate dosages, (1st week: first day take it, next day don’t, 2nd week: 1st day take it, 2nd & 3rd day don’t-> couldn’t sleep one whole night. Instead of q-mind quetiapine 100mg: Seroquel XR 300mg 1/5&6/18, 1/7&8/18 changed to Seroquel XR 150mg . 1/9/18 went back to q-mind quetiapine 100mg 0-0-1. 1/9/18 discontinued the aminoacids/b6 vitamin supplement, the supplement that contains glutamic acid, lecithin, phosphorus and thiamin and centrum performance. (still was taking ginko biloba 80mg supp). 1/14,/18 started with one 1.5mg melatonin tablet 0-0-1, one 1.6g  fish oil capsule 1-0-1, 1.29g magnesium capsules 2-0-2. 1/15/18 went back to pristiq first day take it and the next day don’t (alternating dosages). 1/20/18 I learned at SA that alternating dosages is wrong so I went back to one daily pristiq 50mg along with the IR 100mg quetiapine tablet 0-0-1

[papaloapan]

OMG! I took many drops of cannabis oil for the pain of my teeth, and since I couldn't feel relief, I took lots of drops, and I felt a mild happiness and I laughed. But when I tried to sleep I felt lots of fear and kind of a psychosis!!! I felt like drowning, I couldn't feel my legs, felt something very weird and VERY extreme but EXTREMELY AWFUL! Didn't felt reality the same, I felt like I lost reality. I screamed my mom's name because the feeling was so extreme and bad that I was feeling like of I was about to lose reality for ever. Felt extreme dizzinezz. Like extreme fear. Fortunately later it became less severe, I wasn't able to dial the phone but at the end I was able, I couldn't speak clearly but at the end I could. I felt fear for losing reality and obviously for being locked again for getting a psychosis and living hell again with haldol.

What should I do? Should I go back to try to sleep again? I was about to take my uncle (who I trust) to take me to a psychiatric hospital a friend of mine recommended to me when she (my friend) got a psychosis because of smoking too much weed. I feel better reality now but not that much and I still feel a hard dizziness.

[manymoretodays]

7 hours ago, papaloapan said:

OMG! I took many drops of cannabis oil for the pain of my teeth, and since I couldn't feel relief, I took lots of drops, and I felt a mild happiness and I laughed. But when I tried to sleep I felt lots of fear and kind of a psychosis!!! I felt like drowning, I couldn't feel my legs, felt something very weird and VERY extreme but EXTREMELY AWFUL! Didn't felt reality the same, I felt like I lost reality. I screamed my mom's name because the feeling was so extreme and bad that I was feeling like of I was about to lose reality for ever. Felt extreme dizzinezz. Like extreme fear. Fortunately later it became less severe, I wasn't able to dial the phone but at the end I was able, I couldn't speak clearly but at the end I could. I felt fear for losing reality and obviously for being locked again for getting a psychosis and living hell again with haldol.

What should I do? Should I go back to try to sleep again? I was about to take my uncle (who I trust) to take me to a psychiatric hospital a friend of mine recommended to me when she (my friend) got a psychosis because of smoking too much weed. I feel better reality now but not that much and I still feel a hard dizziness.

 

Hi papaloapan,

 

And hopefully you are resting now?  Yes, I think some restorative sleep may be in order.

And good, good that you feel better now, or at your last posting.

My best guess is that this too will pass.  I think you would be more of a rarity than the norm.......if these symptoms persisted very long post/after your ingestion of CBD oil.  If I were you I wouldn't be taking anymore of that, given the reaction that you just had.  

 

We do have a topic on the CBD oil.   It's about 9 pages long.  Perhaps once you have stabilized a bit more and getting into your tapering plan you could read there.  And again, do try not to add anything extra now if at all possible.  You might need some recovery time from the additional medications just taken for your teeth extractions.

 

http://survivingantidepressants.org/topic/5030-cannabis-marijuana-thc-or-cbd-to-ease-withdrawal-s

 

Love, peace, healing/inrecovery, and growth,

mmt

Edited March 18, 2018 by manymoretodays
clarity

[papaloapan]

Hi manymoretodays and thank you so much for replying.Last night was really intense, I felt kind of unconscious, I got really scared and my tongue and mouth were extremely dry. 

Yes, at the end I went back to sleep again. I phone called my uncle and he was kind enough to come to my house last night and he slept with me for taking care of me, his love made me feel better. I feel good again. Yes, the symptoms passed. This symptoms lasted approximately little after I layed down in bed (2:45am) till 3:35am (approx 50 minutes). Then the discomfort disappeared, the caring love of my uncle helped. Agree, I won't take lots of cbd oil again, maybe I'll try it in a future but obviously starting in a very small dose. Also something that could have affected a bit, is my unconscious fear of the recent long traumatic event of being locked against my will for almost 6 months (july-dec 2017) in the rehab clinic. Will Hall says anxiety is a symptom of trauma. But clearly the biggest cause was taking way too much cannabis oil and also it was my first time. 

[papaloapan]

I know manymoretodays kindly told me that "There is no need to taper after 4 days of an opiate used for pain", but now/today it has been 8 days of taking tramadol. Each day, I took in the morning 15 drops diluted in water and at night another 15 drops diluted in water. I checked on drugs.com for interactions between tramadol hydrochloride and pristiq and quetiapine and there are serious bad interactions, even death https://www.drugs.com/interactions-check.php?drug_list=2796-12488,1979-1274,2221-17957

Obviously I don't trust my dentist for asking him how should I taper or stop taking tramadol because in the first place the idiot doesn't even know that tramadol interacts with both pristiq and quetiapine. My teeth still hurt but I'm going to tell my dentist to prescribe me another analgesic that doesn't interact with pristiq and quetiapine instead of tramadol. It is tramadol 100mg/ml in drops, each ml contains 100mg of tramadol hydrochloride, each ml is equivalent to 40 drops.

So given that now it has been 8 days of taking tramadol, should I still taper it the way manymoretodays told me? He/she said "Why don't you just use one dose of the Tramadol today and then stop. Take it only once a day and then stop. (Or) If you would rather......... just take one half of each dose twice a day, as you have been doing......for today, and then stop."  Or should I taper it in a different/more gradual way?

Thank you so much for your time and caring.

 

papaloapan

 

[manymoretodays]

Hi papaloapan,

 

Good job on your signature.  You get 12 lines, which you used well.  Is there anyway you can increase the font size for us.......this is the size of the print.

 

Are you able to copy the drug interactions directly here to your introduction?  I am looking at the same link now and the biggest worry that I have is of "serotonin syndrome or toxicity".  The symptoms of that are spelled out pretty well in the second major interaction listed(I was not able to copy it either ):

 

https://www.drugs.com/interactions-check.php?drug_list=2221-0,2796-12488,1979-1274

 

You do need to get off the tramadol as soon as possible.  We do have a thread on tapering tramadol as well, which you might find helpful:

http://survivingantidepressants.org/topic/11542-tips-for-tapering-tramadol/

 

My suggestion would be to just taper your tramadol for now( do not taper any of your other medications yet)............and I think you might be able to tolerate at least a 10% taper or more.........  as long as you aren't suffering from symptoms of serotonin toxicity right now.

 

Your ibuprofen should have some pain control properties, as well as anti-inflammatory.  So you may not need to bother your Dentist for further pain control/analgesics at this time.  Let's just get you off the tramadol.  Does that sound okay?

 

100 mg. of tramadol is 40gtts. or 1 ml.

My calculations then lead to you presently being on 75 mg. or 30 gtts. each day.  You take 15 gtts. twice a day.

I don't really want to drag this out over weeks if we can help it as you have been on it for just over 1 week. "Tramadol is a pain killer and is now being considered for use as an anti depressant. It is a dreadful drug that has 2 modes of action, a synthetic opoid and anti depressant SNRI."

 

Each gtt of tramadol equals 2.5mg, again according to my calculations.  It's up to you really to decide now how much you want to go down on the tramadol.  My best suggestion would be to take off 2 gtts. to 7gtts. from each dosage to start.  Which is more than a 10% drop from your current dosage but as this was given mainly for short term pain control you may tolerate that.  You'd be reducing your dose down to 65mg./day or even by one half, down to 38 mg./day.  See how you do with that and report back as soon as possible.  Like I said, I don't really want to drag this out over weeks.  It's up to you.  You've got some information to look at to guide your decision now.

 

papaloapan, 

I hope I don't sound like your Mom here, but please abstain from any other drug or chemical use at this time.

 

I've been out of town and away from my computer.  Hopefully I covered what you asked about via PM.

 

Love, peace, healing/inrecovery, and growth,

manymoretodays

 

Edited March 21, 2018 by manymoretodays
additional thoughts and comments, highlighting

[papaloapan]

Hi, I have been on tramadol drops just for 8 days. Right now I'm also on pristiq 50mg and quetiapine 100mg. I took tramadol because my dentist told me to take it for the pain for when he extracted 6 of my teeth. It is tramadol 100mg/ml in drops, each ml contains 100mg of tramadol hydrochloride, each ml is equivalent to 40 drops. For those 8 days I took 15 drops diluted in water in the morning and 15 drops diluted in water at night. 30 drops per day = 75mg of tramadol. I have not had any side effects for taking tramadol, along with pristiq and quetiapine. I feel good.

So what I want to know guys, is that if I took tramadol for a very short time (8 days), I guess I can taper tramadol much more faster than a 10% reduction every 4 weeks. I really don't want to make it a long taper for tramadol. Just knowing that I do have to do a 10% reduction every 4 weeks with pristiq and then with quetiapine, makes me to not want to taper slowly tramadol at all. Can I just cold-turkey tramadol? Or how should I taper it? I think it's logical and obvious that if I took it for only 8 days, it can be weaned off pretty fast, maybe even cold turkey, or maybe just a much bigger and faster reduction like maybe a 30% reduction every 5 days or something like that. ???

[papaloapan]

Thank you so much manymoretodays for replying, I really appreciate your time & caring.

I increased the font size of my signature from 8 to 9 in which there is still the important recent history of my meds. If it's still too small, just tell me which number of size is the right one and I would have to erase some of the first lines.

Here is the copy of the drug interactions:

Interactions between your drugs

Major

tramadol  quetiapine

Applies to: Tramadol Hydrochloride ER (tramadol), quetiapine

Using narcotic pain or cough medications together with other medications that also cause central nervous system depression can lead to serious side effects including respiratory distress, coma, and even death. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Do not drink alcohol or self-medicate with these medications without your doctor's approval, and do not exceed the doses or frequency and duration of use prescribed by your doctor. Also, you should avoid driving or operating hazardous machinery until you know how these medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

 

Major

tramadol  desvenlafaxine

Applies to: Tramadol Hydrochloride ER (tramadol), Pristiq (desvenlafaxine)

Talk to your doctor before using traMADol together with desvenlafaxine. Combining these medications can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, blurred vision, muscle spasm or stiffness, tremor, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should contact your doctor immediately if you experience these symptoms while taking the medications. Using traMADol with desvenlafaxine may also increase the risk of seizures not related to the serotonin syndrome. The interaction may be more likely if you are elderly, undergoing alcohol or drug withdrawal, have a history of seizures, or have a condition affecting the central nervous system such as a brain tumor or head trauma. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

________________________________________________________

 

Yes, it sounds ok to just get me off tramadol for now. Of course, I'll abstain from any other drug or chemical use at this time.

 

I already post my question on the "Tips for tapering tramadol" of how to taper it given that I've been on it now for only 9 days. 

 

Yes, of course I can tolerate a much bigger and faster reduction than 10% every 4 weeks. I think it's logical and obvious that if I've been on tramadol for only 9 days, I can do a much bigger and faster reduction than 10% every 4 weeks. I have not had any side effects for taking tramadol, along with pristiq and quetiapine. I feel good. I am not suffering from any symptoms, also not from serotonin toxicity.

 

I was even thinking on cold-turkeying it. But I'm waiting for the people at "Tips for tapering tramadol" to answer me. I also sent a private message to MammaP because she conducts that thread, I'm also waiting for her to answer it. 

Agree, I'm staying only with ibuprofen for my dental pain. 

 

Yesterday (the 8th day) at night I decided to only take 12 drops intead of 15. And today (the 9th day) in the morning I also took 12 drops. I feel good. But I'm really sure to start a much bigger and much faster taper. I'm thinking something around a 33% reduction every 3 days or something like that. I don't know exactly. That's why I ask people at SA to please tell me. 

 

You said "My best suggestion would be to take off 2 gtts. to 7gtts. from each dosage to start". You mean that I can choose to decrease from 2 drops to 7 drops to start? That means instead of 15 drops in the morning and at night, I can choose to take between 13 to 8 drops in the morning and at night? Sorry but it wasn't clear for me when you said "You'd be reducing your dose down to 65mg./day or even by one half, down to 38 mg./day." I know that at the end I will decide how much I'll decrease and how fast. But I would feel more secure if you guys tell me approximmately how much and how fast can I taper. 

 

Manymoretodays, and everyone else, I think the best way for you to tell me how to taper tramadol, so that I can understand how fast I can taper, is by telling me the percentage of reduction and for how many days. For example: 33% every 3 days. 

 

papaloapan

 

Edited March 21, 2018 by ChessieCat
reduced font size & added spacing

[papaloapan]

Now it has been 9 days of being on tramadol. Yesterday (the 8th day) at night I decided to only take 12 drops intead of 15. And today (the 9th day) in the morning I also took 12 drops. I feel good. Manymoretodays told me that because tramadol was given for me mainly for short term pain control, that I can tolerate a bigger reduction than 10% every 4 weeks. He/she also said "I don't really want to drag this out over weeks if we can help it as you have been on it for just over 1 week."

But I'm really sure to start a much bigger and much faster taper. I'm thinking something around a 33% reduction every 3 days or something like that. I don't know exactly. That's why I ask you guys to please tell me. I'll feel more secure if you guys tell me how to taper tramadol. 

[brassmonkey]

Being a combination of an opiate and ssri tramadol is a very tricky drug once it gets it's claws into you.  I don't think that 9 days should be too much of a problem though.  I think a fast taper of 25% every five days might work.  Pay attention to your symptoms and keep a written journal of them so you can watch for any patterns.  Don't panic if there is an uptick in symptoms.  Roll with them and keep us up to date on what is happening.

[papaloapan]

Thanks a lot brassmonkey, I appreciate it. This is a nightmare, my patience was ok for knowing that I have to taper 10% every 4 weeks for 2 drugs, 1st pristiq and then quetiapine. Also, finally, after a long time, my body adapted well to pristiq and quetiapine, I was feeling good and my body was doing fine. And now I allowed the stupid dentist to add tramadol... I don't want to be hooked to a 3rd drug, I'm so ****** pissed off, and tired of all this. Now I'm in a dilemma: since it has been for now only 10 days of tramadol, I know I can taper it fast, but I don't know if I do it way too fast maybe I would have wd symptoms. But also I think that if I make a long-slow taper, I'm gonna let tramadol to be more time in my body, therefore it is going to be more likely that my body gets more dependent to tramadol therefore I would have to taper it more gradually. 

 

The last psychiatrist I was with, recommended me to taper by reducing 6 drops daily (3 of the morning and 3 of the night) till I get off completely from tramadol. That would be getting off tramadol in just 4 days: 1st day 12 drops in the morning and 12 at night, 2nd day 9 drops in the morning and 9 at night, 3rd day 6 and 6, 4th day 3 and 3, and by the 5th day I would be taking no tramadol. He said "Generally tramadol can be cold-turkeyed and does not give problems". But this psychiatrist was the same idiot that told me to alternate dosages with pristiq in order to get off it (which led me to not be able to sleep one whole night, it was horrible). I'm also afraid of the major interactions between tramadol and pristiq and quetiapine, even the psychiatrist says that, even though it's rare that it happens, that the serotonin syndrom/toxicity can happen.

Brassmonkey's suggestion: 25% every 5 days would take 45 days (6 and a half weeks), I think that's a lot of time, I don't like that. And I don't know if my body can tolerate the psychiatrist's fast recommendation. I'm sorry guys, I'm not good at making decisions, I hate that. I hate that all these takes a lot of my time. I don't know what to do.       And last night when I layed down in bed I felt a little bit of breathlessness and right now I feel a little bit of a very weird feeling inside my head, like pressure  

 

papaloapan

[papaloapan]

I already decided: I'm gonna do this:

 

The psychiatrist's way, but instead of changing the dose every day, I'll change it every 2 days. So it's a taper of 8 days. I started yesterday, so in 7 days I'll be off completely from tramadol. Plus 11 days (till now) of taking it, in the end, the total of days of taking tramadol: 18 days. I'm sure that if I let tramadol more days in my body, my body will become dependent on it. I already set in my mind the belief that I can do this. The psychiatrist says that since it has been only 11 days and that I already started to taper, that it is practically impossible that my body will suffer the taper. I take that comment of the psychiatrist as a positive tool for my mind

[manymoretodays]

Good job then paploapan.

 

On 3/22/2018 at 12:08 AM, brassmonkey said:

if there is an uptick in symptoms.  Roll with them and keep us up to date on what is happening.

 

You may hit some tough spots but yes, roll with them.  The tramadol did work a bit like some of the antidepressants we are more familiar with.  So W/D symptoms may result.   And yes, keep up some positive relations with the psychiatrist.   You will be needing someone to write scripts for you in the future.

 

Upbeat and positive.

 

mmt

[papaloapan]

march 12 at night started 15 drops of tramadol

march 13 to march 19:  15 drops twice a day (in the morning and at night) 

march 20: morning 15 drops, night 12 drops

march 21: morning 12 drops,  night 10 drops

march 22:  morning 12 drops,  night 12 drops

march 23: morning 12 drops,  today @1pm and now I'm feeling a disturbing mix of kind of dizziness, kind of a head pressure, it feels bad

[papaloapan]

I NEED HELP: (continuation of tramadol tapering)

march 24 morning 9 drops night 9 drops

march 25 morning 6 drops night 6 drops, that night (yesterday) I could not sleep most of the night, I felt a horrible adverse effect (or I think it was a withdrawal effect) like something inside my head was moving, very disturbing, couldn't breathe right through my nose because my nose felt stuffed? I don't know how to translate from spanish. I have to say that since I hang out with friends on the weekend, friday and saturday night I slept later, friday night 2am and saturday night 3:30am. Saturday in the morning I got up from bed at 2pm and also sunday in the morning I got up from bed at 2pm. Sunday at night I layed down at bed at 11:50pm. Maybe that could affected because in the weekend I didn't take tramadol at the same time as the weekdays (weekdays I go to bed early, 11:30pm and in the mornings I wake up at 8:30am). 

So should I stay in 6 drops in the morning and night for more days? Or what should I do? 

 

[papaloapan]

I spoke with the neuropsychiatrist and he told me that I can taper tramadol depending on how I'm feeling. He said that  it is important to stop taking it in short-term and that I should taper it in no more than 10 days, starting from today. He says that because of the same reason that I think it is important to stop taking it in short-term: because the more days I take tramadol the more my body will be dependent of it and therefore I would have to taper it very slowly.

[papaloapan]

 @Altostrata  you said I don't remember where in SA (please remind me where) you wrote that when anybody is going to start to taper any psychiatric drug, that supplementing daily with vitamin b12 and folate strengthens and prepares the nervous system. But can you please tell me how much of vitamin b12 and how much of folate should I take daily in supplements? Thank you so much

[papaloapan]

If psychiatric drugs have damaged our nervous systems, do you now who is the health care professional/doctor indicated for treating and healing our nervous system? By the way neurologists also prescribe psychiatric drugs so neurologists are not good.