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Raye

Raye: having a hard time withdrawing from an SSRI. Second time on it

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Raye

 

Hi, So quick background..
i took LUVOX (fluvoxamine) a few years ago and was able to come off of it safely and with minimum withdrawal.
(I reduced 50mg at a time over a few months) (I know this wasn’t the right way to taper but I didnt know at the time)
 
I took Luvox again this year and as I been withdrwaling, I realize it is MUCH harder. I can BARELY withdrawal 10mg at a time and I strongly feel the withdrawal. I been withdrawing less than 5% to.
It just does not make sense to me that I withdrew much faster and easier before and now it is so much harder the second time... I don’t think it has todo with my diet or stress.
If you Any thoughts as to why this is, it would be great :) thanks...
 

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mustangwoman

Hi Raye.  I also am tapering luvox.  The half life is incredibly short for luvox, approx 12 to 13 hours, that can really impact withdrawal.  Also, I have seen a trend in which people were able to stop quickly previously and have to be much more careful the 2nd time around, most likely because their brain/system is sensitized from the cumulative effects.  I went off zoloft way too fast, it was the first ssri I was on, and I had a horrible response with that, actually ended up in a psych hospital for 2 weeks.  (which has helped me as a nurse to be understanding of psych patients)  So, I have proceeded like a snail with luvox to be as easy on my system as possible.   Slow and steady wins the race.  I wish you the best.  There are a lot of kind people here with much wisdom and friendship.  You can read a lot of their stories.  DLB, was able to come off quickly the first time, but later had to use a very slow taper, and there are others as well.

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ChessieCat

Hi Raye and welcome to SA,

 

As mustangwoman mentioned there is a cumulative effect upon the brain/CNS which is why something a person did previously to get off the drugs may not work later.

 

 

Please create a drug signature Create Your Signature.  Please include details for the last 12-18 months of  all drugs, dates, doses and discontinuations & reinstatements.  If you can't remember dates, please write it as "early March" or "mid-August".  Please provide a summary of any drugs prior to that which can just be listed with start and stop years. Please include all prescription, non-prescription drugs and supplements you are currently taking. Phone Instructions:  Withdrawal History Signature. Please also remember to update it with date and dose whenever make a change so that it remains current. Thank you.

 

This is your own Intro topic where you can ask questions and journal your progress.  If you click "Follow" top right you will be notified when someone responds.

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Raye

Hi, 

Thank you for your responses!

I was thinking the same thing.. Platinum star. like with the second time around is much harder.. i never thought this was a possibility. what is CNS and its impact on the brain? Do you know if there is a way to overcome this or if theres any tips? Thank you so much

 

mustang woman..  I agree.. luvox is extremely hard.. what percent are you decreasing? I been going slow but my withdrawal got harder recently so I am planing on staying on 225mg for a month then continuing later. I hope everything goes well for you ad your withdrawal process. 

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Raye

Oh i did some googling and found what the cumulative effect sorta means. very Interesting.. 

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mustangwoman

There have been times in my taper that I have had to hold for a very long time months, even 6-8 months at a time, and other times only 4 weeks, I base it on how stable I am at the time.  Listen to how you feel, if you need to hold, and if you don't think you are ready, wait until you are.  Looking back at my signature closely it looks like the quickest I have reduced is .5 mg a month.  I've been on an ssri for 13 years except for the 2 times I was off zoloft for 6 months each time, so I am extremely cautious because of the horrendous protracted withdrawal from my basically cold turkey attempts in the past, and the long amount of time my brain has been exposed to these ssris.  I would think with shorter periods of time it will make it better.  

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Raye

Ah i see. yea i think i will just stay at 225mg and wait till withdrawal symptoms go away since I’ve already been on 225 for 2 weeks. I probably, as you have, need to stay longer on each dose. I probably will stay on 225 for a good month or two more. I notice it gradually gets better a little bit a day.

I realize I may be withdrawing to fast now. 

Thank you

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mustangwoman

I apologize, looking back there were some months that I did drop a mg a month instead of .5 mg.  I agree that holding can help things level out.  I hope you continue to feel better each day!

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Raye

thanks!

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Altostrata

Welcome, Raye.
 
I moved your post here, only one topic to a customer in the Introductions forum.
 
Please read Tips for tapering off Luvox (fluvoxamine)
 
How often are you taking immediate-release Luvox? 

 

It can be an advantage to work with the immediate-release type, as you can take it as a liquid, which makes reducing by small amounts much easier.

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Raye

opps sorry, i meant  to post it in a new forum but it posted as a comment on accident. 

 

And I’m takin the rapid release now but thinking of making the switch... it does seem easier..

 

I’m going to check with my doctor on how..

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Altostrata

How often each day are you taking immediate-release Luvox? 

 

Let's discuss first, you may want to stay with immediate-release.

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Raye

i am taking 225mg each day right now... 100mg in morning and 100 mg at night and 25mg in the middle of the day.. 

I was thinking of first cutting down my mid day dose then switching to from 200mg immediate release to slow release...

 

I wasn’t sure if this was ok todo or how its done by switching from immediate to slow release...

 

Thank you--

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Altostrata

I think you've got the right idea -- whittle down that mid-day dose first.

 

There's quite a ways to go on the others, let's talk more when you're down to 100mg + 100mg per day.

 

Rather than switch to the extended-release Luvox, you may wish to take one 100mg dose in tablet form and one dose in 50mg tablet + the rest in liquid.

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Raye

yes thats a good idea. I was thinking that ER would be easier tho with withdrawing just because from what i understand you have to take a little more beads out at a time. Maybe I’m wrong tho, is the liquid better or more easier? I just don’t want to have to cut up the pills a bunch and do a lot of measurements if I can avoid it

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scallywag

Using a liquid allows for very small changes in dose which can be incredibly helpful at the end of one's taper when doses are less than one-tenth of a milligram, 0.1 mg.  With bead counting you can only go as low as 1 bead.

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Raye

hello~~

I was wondering if I could have some advice on how to taper off luvox via liquid solution as I think I understand how but I just have a few questions.. and want to make sure i know how correctly before I go about it. 

-

I am taking 3 doses a day, 100 mg at night and the morning and 25mg in the mid day for a total of 225mg. I want to cut down the mid day dose first. 

-

If i was going to make a liquid to cut down would I just dissolve 25mg of it in 25 ml of water and take out 5 ml to go to 20 mg for example? Would you recommend buying a ‘suspension solution’ to dissolve it into instead? 

 

I also saw in one of the forms they said to have your compound pharmacist make the liquid for you but I’m confused as to why would you have them make it for you if it is more expensive and you would just need to keep ordering more every week?

 

Im kinda worried it might not be as accurate if I make it at home. I order a cylinder to measure tho and a syringe.

 

Right now I was having the pharmacy make me  1mg drop in capsules but I feel it is very expensive and it would just be easier to make a homemade liquid. 

 

Thank you!

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scallywag

Why are you taking luvox 3x per day?  The median half-life of fluvoxamine is 12 hours. 

 

The simplest method to taper would be to reduce your mid-day dose by half, 12.5 mg or a 5.6% decrease from your current total daily dose of 225 mg. Hold steady at 12.5 mg for the mid-day dose and monitor your symptoms for 4 weeks, If no change, stop taking the mid-day dose (a 5.9% decrease from 212.5) and monitor your symptoms for another 4 weeks.  If you few or no or manageable symptoms after 4 weeks then consider reducing the morning and evening doses.

 

People have a compounding pharmacist make liquid formulations because it's convenient and/or because they don't trust themselves with the arithmetic and measuring.

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Raye

I was wondering the same thing myself.. I think it is because when I always been on luvox  I always have done that because it divides it up throughout the day. But it is true the half life is 12 hours. 

I tried to go down on the mid day dose  5 mg and it was really hard for me so I stopped. Im having a compound pharmacy make me some smaller capsules. Im not sure why its so hard now because it was easier to go down before.

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Raye

I have a question I’m wondering about.. if I take 3 doses of Fluvoxamine a day (100mg morning, 25mg mid day, and 100mg at night) could I move the mid day dose to the night dose or would it “throw” my withdrawal process out of sync? 

I head a few times that Luvox is suppose to be take in only 2 doses.. 

 

I want to see if I can go to two doses , maybe it’d be better for me or easier withdrawal to

Edited by scallywag
split and moved from micro-taper topic

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ChessieCat
On 26/07/2017 at 8:00 AM, Raye said:

I tried to go down on the mid day dose  5 mg and it was really hard for me so I stopped.

 

Did you try to reduce your dose to 20mg or did you try to drop your midday dose to 5mg?

 

If you want to get to 2 x a day dosing without making a reduction, you could try halving your midday dose and bringing 1/2 forward by 1 hour and the other half later by an hour each day.  Or you could do each move for 2 or 3 days.  Please keep notes of paper of your symptoms so that you can pick up on any changes.

 

So:

 

12.5mg at 11 am and 12.5mg at 1 pm

12.5mg at 10 am and 12.5 mg at 2 pm

12.5 mg at 9 am and 12.5 mg at 3 pm etc

 

After getting your dosing to twice daily it would be a good idea to hold for a few weeks to ensure that you are stable before making any reduction in your dose.

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Raye

I went down to 20 mg.. it was to hard so I’m trying to go down slower.

----

Thank you, That is a good idea. I will try that in a few weeks once i get back to my home. 


The reason I wanted to do 2 doses was because I was traveling and It seemed to complicated to do the time zone difference and take a medication 3x a day.

 

I however switched my dose from 11:30 am 5:30pm and 11:30pm to---11:30 am 11:30 pm and 5:30am... because when I go overseas the mid dose at 5:30am will go back to the day... I think this is fine... I did this though as Im tapering so I’m not sure if I’m having side effects from it or still the taper.. I think it is the taper tho. 

 

I will however go to 2x a day once I return to the states and feel stable because it seems better todo 2x in general with the short half life. 

 

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Raye
12 hours ago, ChessieCat said:

 

411mgpw / 48.3 mgai = 8.5  (it's best to use the weight of a whole pill and the listed strength from the bottle, but this will get us surprisingly close.)

(so for Raye that would be 130mgpw / 25 mgai = 5.2)

Thanks for your reply~

 

I am trying to understand the caluations as best I can. I see how the pill weight is different from the active ingredient. So would this mean if I want to drop one mg of my tablet, I should drop 5.2 mg on the scale? so it would look like .052 reduction on the scale since I would need to move the decimal over. I want to drop 1mg of pill material however

 

I want to go down 1 mg at a time.. 25mg to 24mg to 23mg I had a compounding pharmacy make these pills for me before. But the compounding pharmacy can be expensive 

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ChessieCat

Just copying this into your Intro topic so you have the information on hand if you need it.

 

13 hours ago, ChessieCat said:
13 hours ago, Raye said:

 

Im confused with my scale because my pill is a 25mg and when I weigh it it says its 0.130 grams. Is this inaccurate because shouldn’t it be 0.025mg? 

 

25mg is the dosage of the drug in the tablet (mgai = milligram active ingredient).  The tablet weighs 130mg (mgpw = milligram pill weight).  The tablet contains fillers.

 

Here is an example.  I've shown your own tablet and dose in green (however please double check that my calculations are correct).

 

On 14/02/2018 at 2:27 PM, brassmonkey said:

Hi Gardenlady--  Trying to make sense of the numbers can be really frustrating, especially when we are worried that any little slip up could cause a lot pf pain.  For the sake of our other readers a "microtaper" is achieved by doing reductions that are very small, frequently less than 1%.  This is often done using the liquid version of the drug in question, but can be done very nicely using the scales that we are all use to using.  A microtaper done using the scales can not be as finely tuned as one done with liquid, but with a little care surprisingly small reductions can be achieved.

 

The key to doing a microtaper with scales is to use the Active Ingredient Concentration as the basis for your calculations.  The Active Ingredient Concentration is the weight of the pill divided by the strength of the full dose.

 

If we use the numbers that Gardenlady provided above it would look like this;

 

411mgpw / 48.3 mgai = 8.5  (it's best to use the weight of a whole pill and the listed strength from the bottle, but this will get us surprisingly close.)

(so for Raye that would be 130mgpw / 25 mgai = 5.2)

 

This means that for every 8.5mg (Raye: 5.2mg) of pill material you get 1mg of active ingredient.  To take it one step further, we divide that 1mgai by 8.5 mgpw and get 0.12 (divide 1mgai by 5.2 mgpw  = 0.1923). Which means that every 1mgpw contains 0.12mgai (0.1923mgai).  That's just over 1/10 of 1mgai or written out in long form 0.00012mgai.  However you write it, there's not a whole lot of active ingredient in 1mgpw of pill material.

 

This is telling us that the small fluctuations in the scales accuracy don't make a whole lot of difference in the actual dose that you weigh out.

 

You can figure out the weight of a specific dose using the Active Ingredient Concentration.  Again  I will use the numbers Gardenlady provided above for an example.  Say she wants to do a 1/2% drop for her next taper.  She is currently taking 48.3mgai for her dose. We would multiply that by .995 to get the new dose.  48.3mgai X .995 = 48.0mgai

 

We then multiply the new dose by the Active Ingredient Concentration of 8.5.    48.0 X 8.5 = 408  So the weight that we measure out on the scale for the new dose is 408mgpw. The only tricky part now is manipulating the little beads to get the correct weight.

 

Hope that helps.

 

Brassmonkey

 

 

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ChessieCat
45 minutes ago, Raye said:

I want to drop 1mg of pill material however

 

No.  This would mean you would being going from 130mgpw to 129mgpw.

 

45 minutes ago, Raye said:

I want to go down 1 mg at a time.. 25mg to 24mg to 23mg

 

25mgai = 130mgpw

 

1mgai = 5.2mgpw

 

24mgai = 5.2mgpw x 24 = 124.8mgpw

 

Weigh 0.1248 grams on the scale.

 

So the next reduction would be:

 

23mgai = 5.2mgpw x 23 = 119.6mgpw

 

Weigh 0.1196 grams on the scale.

 

Please double check my calculations.

 

Edited by ChessieCat

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Raye

Okay, I studied the calculations more and I feel that I understand it now. Great thanks for your help ~

 

I heard the water method is better. However, I feel like the scale may be better because you can see the exact weight, where as in water some particles just sink to the bottom of the glass so I always wonder if its accurate 

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ChessieCat

You are very welcome and I'm glad you understand it.  I will admit that it was only because of BrassMonkey's calculations and me being able to substitute your numbers that I was able to understand.  So I've learned something too and it means that I can help members with weighing doses now, which I couldn't before.  So thank you to you too.  I love learning new things.

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Raye

Hello,

 

I am currently tapering Luvox and I went from 222 mg to 220 mg. I am doing this very slow. However, even with this little taper LESS THAN 1%.. I still feel terrible symptoms.. my head feels really weird and it feels like I’m having a out of body experience... 

I dont get why because even tho I’m tapering so slow but I somehow still have withdrawal symptoms! I don't mind withdrawal symptoms but I didn't expect it to be this bad on such a low taper.... is this normal ? 

 

I was thinking maybe it is because I had caffeine (jasmine tea) a few days into the taper by accident and I know that interacts with luvox.. but I’m just pretty confused 

because I was steady on 222 mg for a few months.

 

-side note... I went from 223 mg to 222mg in the past and it was awful but I think that was because I was bouncing the dose around to much then as I had a lot caffeine  that ‘interacted’ with it. 

I was on 222mg steady no interactions for a few months until I dropped to 220 mg this week... I just had the tea which could have interacted with it.. I don't know if that would cause my taper to go bad.

Thank you~

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Altostrata

Hi, Raye. How long have you had this symptom? Has it gotten better or worse?

 

I'm going to attach this to your existing Intro topic, to keep your info all together.

 

What is your drug schedule now? Please update your signature.

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Raye
9 minutes ago, Altostrata said:

Hi, Raye. How long have you had this symptom? Has it gotten better or worse?

 

I have it really strong for half a day.. It started last night tho when I felt the tapering withdrawals began to build up. 

I feel that it will get worse before it gets better from my past experience.

 

I didn't feel any different the first day of the taper but then It gets worse as time goes on... the half life is short for luvox, however I heard that the half life is longer in the brain.. 

 

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Altostrata

What times of day are you taking Luvox?

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Raye

I take it at

11:30 AM-  (100mg)

 5:30 PM-   (20 mg)

11:30 PM - (100mg)

I’m not suppose to take it 3 times a day but I’m trying to taper off the midday dose...

 

Also... I am feeling a little bit better suddenly... hopefully it hold out... guess I just need to fight through it... mornings are rough

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Raye

Hey all,

 

I am just curious has anyone ever gone to a compounding pharmacy and got a wrong medication instead of there antidepressant/ benzo? I swear this happened to me recently.. I was on 218 mg of fluvoxamine (100 in the morning, 18 mid day, 100 at night) and then I start taking the 18mg mid day from a new compounding pharmacy... I noticed pretty bad  withdrawal effects like I could only sleep 5 hours a night for a week and my mood changed a lot. I thought something had interacted with my medication until I ran out of the prescription after 30 days and began taking my 18mg a day through the water measurement. 

Once I started taking it through water measurement I felt like I was starting to get symptoms of serotonin syndrome because my heart would be pounding and I kept waking up every 2 hours. I cut down my mid day dose to 5 mg.. I feel better now.  I just can’t come to any other conclusion instead of the pharmacy messed up the medication somehow.. Im very carful not to eat or drink anything that interacts with my medication. I got a refill from them and I'm afraid to take it. 

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ChessieCat
38 minutes ago, Raye said:

I got a refill from them and I'm afraid to take it. 

 

Not having confidence that you are taking the right drug/dose is going to cause stress and worry.  If you take the refill and have issues, you will not be sure if it is withdrawal, stress/worry or the refill causing the problems.

 

If it was me, I wouldn't be taking the refill and sticking to what you know is the correct drug/dose.

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Raye

Thanks i agree with this.. I won’t take it. I think they might have given me someone else's medication or the recipe they used was expired.     

I was wondering tho... if I just do water measurements to taper.. is it safe todo long term? I’m just wondering if it would be the same ‘dose' each time with the water taper. 

 

I was doing the compounding pharmacies for accuracy with the doses 

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ChessieCat

This is the most recent information we have about making your own Luvox liquid:

 

 

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