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Rabe: how to taper and adjust Viibryd while on Clonazepam

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Rabe

also could someone help me with how to update your signature?  I couldn't find it in my profile etc.  Thanks!

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Altostrata
On 3/12/2018 at 9:01 PM, Rabe said:

Altostrata do you know a GABA antagonist can cause issues in a CLonazepam taper?  The potassium sparing diuretic Amiloride is one.

 

This could be a problem. You need to have an in-depth discussion with your doctor about potential drug conflicts.

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Rabe

I did message the kidney doctor.  Seems the doctors don't know about withdrawing AD or Benzos or how other drugs actions may affect that.  I guess f my psychiatrist doesn't know a kidney doctor wouldn't know either.  

I just get to feeling lost...what and where are any answers?  Having the Potassium levels more stable has been so wonderful...my family has commented on the difference as well.  But the days that the anxiety as SO awful ALLL day is just as awful.  I feel my choice is to stay on the AMiloride and know that on day I take it and into next day I will feel poorly or go off it and never know when the low potassium is going to hit.  And trying to control it by eating more potassium just doesn't work.  Was excited to feel was help for something and then to find was not.

He suggests stop the Amiloride and just eat K foods, but was doing that before started the med and was in the ER so often or just feeling awful so often from the low K.

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Rabe

PLEASE does anyone know if Bactroban can cause anxiety in benzodiazepine taper or PAWS?  I started it last evening and today have horrible horrible anxiety...either that or something is really wrong.  Feel hot and cold and so anxious!!!

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Rabe

Thank you I am going to try the supplements.  Was prescribed an antibiotic ointment for a leg wound that wasn't healing well and my system is SO wired since then!  I am leery to walk out the door!  I have to get off the AMiloride but hate to think about the K+ rollercoaster.  Just seems everything is so off and my body wants nothing except to try to heal, but all these meds get in the way.  So down tonight that one little thing can be such a HUGE problem.  Supposed to move tomorrow and have no clue how that will happen with these chills, flushing, fever and anxiety!!!  Don't understand sometimes...well, most of the time.

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Rosetta

Rabe, I would hold your hand if I could. --Rosetta

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Rabe

HI...

I have found a pharmacy to crush and compound the Viibryd!  I am wondering what you think would be a best dose to start decreasing by?  I have no clue how much of the pill I cut off in Dec when I had such a horrible reaction, but I know it was very little and half was the coating it seemed when I looked at it.  The doctor was thinking to go from 10mg to 9.5mg.  Wondering your thoughts on that Brassmonkey and/or Altostrata.  Also wondering re the Clonazepam.  I know that doesn't agree with me much either.  Always wake up with heart skipping and headache.  Am still on the Amiloride though is GABA antagonist as its a choice of dealing with fluctuating potassium or some nervousness....either is not fun but seem to be more stable without the potassium fluctuations.  If you have any thoughts on that as well for a long term please let me know. The psych didn't have any input ... pretty typical...but grateful for his help with the tapers.  My PCP here said to weigh the benefits versus not, but no doctor seems well versed on longer term side effects.  I was just concerned about continuing it and having more disturbing effects down the road??   Thank you for your help!!!

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brassmonkey

I think the 9.5mgai would be a good place to start.  It' a fairly small reduction and will give you a chance to see how you react.  Remember that there will be fluctuations for the first four days while the change becomes steady state in your blood, after that you can see how you're reacting to the decrease.

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Rabe

Thank you SO much brassmonkey for your thoughts.  I am very nervous about doing this given my reaction in Dec and given my not tolerating the Viibryd well even when it was split much less crushed...but hopefully in capsules it will be ok.  Sorry I am so late in replying...I am not getting emails when there is a post.  Don't know how to rectify that.  In any case I am very grateful for your advice!  

Could you please tell me what you mean by fluctuations in the first 4 days?  Do you mean that I may experience all those side effects I had in December but to sit it out for 4 days?  That was really awful....worse than the Clonazepam which was hard to believe!  If is like that it concerns me to be alone.  But hopefully will not be that severe.

Do you think the Viibryd ought to be tapered before the Clonazepam?  Thank you again!!!

 

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Rabe

Thank you Rosetta!  In all honesty there are times when I did have someone closer who understood....I find it hard to accept myself and what happens to 'me' going through this when those I love find the changes that occur 'unacceptable'.  Bless you for your thoughts! Not sure what I would do without having come upon all of you!!

 

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Rosetta

I know exactly what you mean!

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brassmonkey

It takes a minimum of four days for these drugs to become steady state in the blood.  Meaning that there is the same amount of drug active at all times.  During those four days it is not uncommon for the fluctuations in drug level to be felt a changes in symptoms.  These should be mild and not like the reaction you had previously.  Also for some reason I was thinking about updosing as I wrote that.  Making a reduction in dose like you're doing can be similar, but the pattern is a bit different.  

 

After a reduction symptoms usually start to show up after a couple of days as the steady state of the drug decreases in the blood.  Again the first four days are the most variable while the change is being made.  Once the drug is steady state your body can figure out how it's going to react to the change, the symptoms should stabilize and then over the next several weeks start to decrease.  Seeing as how this is a much smaller decrease than your last one the symptoms should be smaller too.

 

Starting any taper is a pretty scary thing to do, I was quite scared when I started mine, and having a previous bad experience doesn't help.  Try to relax into it as best as you can and roll with what ever happens.  Please keep letting us know how things are going, and keep notes about what is going on.  

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Rabe

Brassmonkey....could you please tell me how long you would suggest I then hold at the 9.5, then 9.0 etc?  Not sure how many capsules to have made.  I think the dr is thinking go down every 2 weeks...but ?

 

Also, if you or anyone has knowledge of this ..... saw doctor today who had done some labs and my zinc is low, copper high and histamine high....guess would be good to have the zinc higher and some methylated B6 to start with as the high histamine suggests not methylating well probably r/t MTHFR mutation?  He suggests starting out very small doses as I am so sensitive right....small dose of Zinc  (10 to 15mg) and a small dose of B6 (50mg) to start.  Does anyone have any knowledge or thoughts re these?  I am SO very leery to take anything right now but if it would help my system (he said it would help support the nervous system) then maybe?  I just feel the more that has been thrown in the works, or taken out, hasn't made it better ... but admit much of that is simply my fears of reacting poorly to foods and meds of late.  Thank you much if anyone could help me with this!!!  Thank you again Brassmonkey for you explanation about steady states...makes sense.

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Rosetta

Hi, if you type in "survivingantidepressants.org b6" to google you will find several threads on SA about how activating the B vitamins tend to be to people in ADWD.  B6 is mentioned several times as being a problem for us.  It's very frustrating that so many of the natural treatments for our symptoms are risky.  I have seen other members try to use food sources of the vitamins instead.  Good luck.

 

I hope a Moderator will be by about reducing your dose two weeks.  I know you gave some extenuating circumstances, but I suspect that's a bad idea.  I'm not sure.  Wishing you all the best!

 

Rosetta

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brassmonkey

Hi Rabe-- two weeks is way too fast, especially given that you've had trouble in the past.  SA recommends a minimum of four (4) weeks between drops, but many people find 6-8 weeks to work better. I did 6 with very few problems.  I think the 6 weeks would be a good place to start and see how things go. Hopefully the doctor will work with you in this.  Also it probably would not be a good idea to be changing anything else until you see how the taper is going to effect you.  Balancing the zinc would be a good idea.  Like Rosetta mentioned I would be very careful with the B6, too many people have mentioned too many problems with it. Making changes in supplementation can make it hard to understand just hoe the taper is affecting your system.  Which is why recommend that people only change one thing at a time and then stabilize before making any other changes.

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Rabe

Thank you so very much for your help.  I don't get notifications so am late in responding.  Very down today.  Have dropped below 115 pounds and am so tired.  Decided to finish my move and go back to bed today rather than join my daughters husbands family for Easter.  Sad day....I just feel like Im slipping away.  Don't know who I am inside or outside anymore it seems.  Sorry.  All that has happened and is happening is so scary and overwhelming.  Im hoping things will be better soon.  Blessings to all on this Easter.

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Rosetta

Thinking of you, Rabe.  Just rest if you can.  I know you are sad.  

 

You are the same person you were before meds, but you are ill right now.  I get very tired of the emotional or psychological aspect of this making me question who I am.  It's a trick of the WD brain chemistry.  You remain yourself even if you can't access the best parts of you right now.  I can see that when I don't feel very bad.  Then, I lose my conviction when the wave is deep, but I always know later that it was a trick of the faulty chemistry.  I know the sodium issue is a complicating factor for you.  I'm sure that makes a difference, too.  

 

Rest and take care.  Everyone here is rooting for you! -- Rosetta

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Rabe

Do you fluctuate like this even when you are not actively tapering Rosetta?  Just so up and now and so much stress with the move.  And I am reacting to all foods and medications...just don't know what to eat or how to eat or how to tolerate medications.  And no one close understands...thank you so much for what you said.  I am so grateful!  I feel so very alone and lost today and kind of hopeless...but hopefully it will pass.  I do know there have been better days...bless you!!!

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Downbutnotout
On 3/30/2018 at 2:39 AM, Rabe said:

Brassmonkey....could you please tell me how long you would suggest I then hold at the 9.5, then 9.0 etc?  Not sure how many capsules to have made.  I think the dr is thinking go down every 2 weeks...but ?

 

Also, if you or anyone has knowledge of this ..... saw doctor today who had done some labs and my zinc is low, copper high and histamine high....guess would be good to have the zinc higher and some methylated B6 to start with as the high histamine suggests not methylating well probably r/t MTHFR mutation?  He suggests starting out very small doses as I am so sensitive right....small dose of Zinc  (10 to 15mg) and a small dose of B6 (50mg) to start.  Does anyone have any knowledge or thoughts re these?  I am SO very leery to take anything right now but if it would help my system (he said it would help support the nervous system) then maybe?  I just feel the more that has been thrown in the works, or taken out, hasn't made it better ... but admit much of that is simply my fears of reacting poorly to foods and meds of late.  Thank you much if anyone could help me with this!!!  Thank you again Brassmonkey for you explanation about steady states...makes sense.

Be careful of the B6. I had a psychiatrist give me that and it made me very hyper. She just told me to keep taking it. But they gave me 15 mg. 

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Rabe

Thank you so much!...think I will hold off on anything extra at this point.

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Rosetta
Posted (edited)
On 4/2/2018 at 7:22 AM, Rabe said:

Do you fluctuate like this even when you are not actively tapering Rosetta?  Just so up and now and so much stress with the move.  And I am reacting to all foods and medications...just don't know what to eat or how to eat or how to tolerate medications.  And no one close understands...thank you so much for what you said.  I am so grateful!  I feel so very alone and lost today and kind of hopeless...but hopefully it will pass.  I do know there have been better days...bless you!!!

 

Yes, I think so.  I don't know how the sodium issue feels (unless I have it, but am unaware), but I have been bouncing around like a ping pong ball.  It's awful.  I have no idea what to do about it or if there is anything I can do.  The Mods say cold turkey is much worse, the ride is very bumpy, and the symptoms are more severe.  If there is anything exacerbating issues for me other than CT, I'm thinking it's my menstrual cycle and histamine issues.  Maybe the two are interconnected?  I have poor appetite, and I sometimes get very hungry.  I find it hard to eat on a regular schedule, and I am nervous about what to avoid eating, but I suspect there are blood sugar issues especially when I don't eat well.  I think the change to Spring affects me, too.  Ultimately, it might boil down to the fact that while in WD any change in anything that affects neurotransmitters is going to hurt* (please see BrassMonkey's comment in next post) me even things completely out of my control. This may mean hormones, lengthening days, and changes my body makes regardless of what I eat or do.

 

Edited by ChessieCat
added note *

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brassmonkey

"Ultimately, it might boil down to the fact that while in WD any change in anything that affects neurotransmitters is going to hurt affect me even things completely out of my control. This may mean hormones, lengthening days, and changes my body makes regardless of what I eat or do."

 

That pretty well sums it up Rosetta. I did make the edit in red to make the statement more accurate.  This is a point we are constantly telling people but it never really seems to sink in.  When it comes down to it EVERYTHING has some affect on the WD process and it's usually negative.  The only thing proven to work is time. lots and lots of time.  Anything else is variable by individual as to whether it will help or hinder.

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Rabe

Hi Rosetta,

I am so sorry I am late to reply...I don't get the alerts via email anymore so I don't know whats up.  Sorry to hear you are a ping pong ball...what a spot on description, but a sad one!!!  I'm sorry.  Those rapid tapers are awful...can't imagine a CT!!!  Oh dear Rosetta!  Did you do that or a doctor?

 

Its actually my potassium that fluctuates rapidly, but has been better on the Amiloride, a GABA antagonist of course...geez!!!  But trying to weigh pros and cons though in reality I'm not sure what they are cause nobody seems to know except those here....SO grateful for this haven with kind wise people who care to take time to share and help others on this journey.  The potassium started after my rapid taper in September and was horrible and was ping pongish....ok and then in a blink I was nervous and weak and depressed and pale and no appetite and dizzy and foggy....then drink some potassium and improve and then back down...up and down and every joint and muscle affected as well as my head and brain.  You might be well served to have it checked...look symptoms up and see if applies.  I am more stable than I was...I'll take it!  If you have a sodium or potassium issue it throws Everything off!ll  And yes, no appetite and yet sometimes craving sugar or salt or just food...and then not.

And the blood sugar issues can be related to electrolytes too as many of these drugs affect the ion channels in the brain which throws electrolytes off and acid and alkaline come into play which affects blood sugar.  Truly, you might think about looking into it further Rosetta because if you DO have issues with them you would feel less ping pongish if they were better controlled. 

 

I also have the histamine issues...he wanted me on zinc and B vitamins to help but I think I'm going to pass on that right now and try an antihistamine or low histamine diet...I just feel SO overreactive to Everything that it drives me crazy!!!  Do you do that as well?  Took a Prevacid today to help my stomach and thought I was going to end up in ER!  Scary!  And I SO understand and sympathize with the what to eat issue.  If I didn't have to take these pills or eat I would be much better!  Food makes me feel ill.  I have done some research on sulphite allergy only because I reacted to an ointment with them in it and with Sulfa allergy guess they can cause issues, or without it.  You could look that up as well and see if any of the foods you eat that cause problems have them.  I am trying to eat less of them but have to also keep weight on so it becomes *** for tat.  I'm so phobic about food and medications that I have an eating disorder and neurosis re meds on top of everything else!!! :))))))

 

The hormones would definitely also be in play...well I think so anyway.  After I take my Premarin I feel worse sometimes and sometimes not but have bigger fish to fry so will worry bout that later I guess.  Just still not sure of whether to get rid of the Clonazepam or Viibryd first.  Im terrified of the Viibryd but the Clonazepam is causing issues.  Hard call.  

Wishing and praying your tomorrow to be better, Rosetta.  I wish I would be there to hold YOUR hand!!!  It is so hard....when have a better day it feels so nice and my kids think I'm cured....and then not....everyone is affected and I wish that were not the case.  I try to stay away....Easter was a bit lonely but fine too.  One day at a time.

Blessings to you!  Thank  you for sharing monkeys wisdom....he is right!  You are both so special!  Take care and give some thought to checking into those things...if it would help even a little would be nice!

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Rabe

I love your wisdom, Brassmonkey....I know in my heart it is true...but have to admit wish it were not.  Nice to be reminded because I am constantly trying to figure out WHY this is this way today instead of just letting it be and moving through...except for the issues like the Potassium.  But the rest it would be nice to accept and ride the wave....thank you!!!!

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Rabe

Let me know if anything applies to you, Rosetta.  I so wish for some daylight for you!!!!   HUGSSSSSSSS!!!!!!

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Rosetta

Thanks, Rabe.  I'll look into it.  I know you are struggling, and it's difficult for the kids.  I'm sorry.  All we can do is distract, try to relax and wait.  Brassmonkey is so supportive.  I'm glad he can help.  I don't know what to say about your taper.  I really don't know what that is like.  I did a fast taper, but I call it a CT.  That was the effect.  I followed mainstream medical advice, but no, there was no live doctor involved.  I didn't see the need.  I may have dodged a bullet because I would probably be just as sick, but on 2 or 3 medications now if I had consulted a doctor.

Take care, R

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Rabe

Thank YOU Rosetta.  You are so right about not having a Dr involved....you WOULD have more meds to get off of....just sorry you are going through the tumult of a rapid taper....it sure throws the system off!   Sorry I wrote so much....just sharing the little I have come upon since my rapid taper in hopes might help you or others at all. Take care of you!  Thank you SO much for your support, Rosetta.  Can't tell you how much it means to me!!!!  

Blessings, B  

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Rabe

Does anyone have advice for a system way overreacting to meds and foods....would the omegas help that maybe?  Claritin?  Thank you!

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ChessieCat

What exactly do you mean by overreacting?

 

Claritin is an antihistamine.

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Rosetta

Sorry you are struggling.  I wish there were something we could take, of course.  I'm afraid it's nothing but except mag and omega 3 for me.  Thinking of you.  I use a "shoulder wrap" heating pad on my shoulders and neck -- for just about everything -- insomnia, aches, sadness and anxiety.  It helps with all of those!  They have them at Bed Bath & Beyond.

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Rabe

Hi ChessieCat, My stomach burns and my eyes get red and irritated and puffy...I just feel not well...like I do when I have an allergy to a medication...except its to everything.  If I go in a store my eyes get red and burn ... think from all the odors and new products.  I don't know.  My stomach and reflux have been a challenge but I am finding it really hard to take any meds and desire any food because I feel not well when I do either.   

I did look at a fish oil today at the health store but there were so many I left.  I know Im low in Zinc and not methylating well but don't really want to tackle that right now.

Think maybe the fish oil at least? IDK.  Just wondered.

I also think with the .2mg Clonazepam later in day and .7 at night my system is so revved that doesn't help either.  Have wondered about more equal doses as weill be starting Viibryd taper soon.  :0

 

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Rabe

Hi Rosetta...I know you struggle with all this as wel.  Thank you so much... I will look for the wrap.  I do have a heating pad and that helped the feeling of my stomach and bladder being on fire.  It settles after the evening Clonazepam which makes me angry  but oh well.  Thank you again!  Take care of you!.  Think about you often.  I do wonder when and how this all resolves...

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Rabe

Well  have a compounded capsule of Viibryd and haven't gotten the courage to take it as of yet.  I had problems when cut one table10mg tablet last year at this time to decrease from 20mg to 10mg...always been the case with me it seems...didnt do well with the dissolving Klonopin either...if gets into my system too fast I don't do well and thats my concern with the crushed compounded Viibryd.  Not that there are lots of options.  Does anyone have any thoughts?  Thanks. I didn't feel this way when first started just tapering the Clonazepam on my own in 2016 but seems like everything doctors have done have made things worse and I am so leery of EVERYthing at this point.  Thanks...

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SkyBlue
22 minutes ago, Rabe said:

 I had problems when cut one table10mg tablet last year at this time to decrease from 20mg to 10mg...

 

Hi Rabe, 

Yes, going from 20mg to 10mg is a 50% decrease which is quite drastic. 

 

In December you began a 10% taper, so is that what you are continuing with? Was your compounded capsule made with this 10% rate in mind?

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Rabe

Hi SkyBlue,

Sorry if I wasn't clear...I cut a 10mg Viibryd and took parts of it with another 10mg to decrease to 10mg last year.  Went very well.  In Dec when I tried a taper of a very very small piece of a 10mg tablet it was horrible.  I always did worse with cut pills...dont know why...but this was not that...it was just awful symptoms.  I am going from 10mg to a compounded 9.5mg so as to go slowly d/t what happened in Dec.  It is just concerning that one compounding pharmacist said it can't be crushed because of the chemicals in it and another found no problems in doing so...in the same compounding pharmacy!  My fear is just so profound since coming to the tx center and all that happened before during and since that it really overwhelms me...and I get afraid to do anything d/t my saying 'oh ok' to all the things that have led me here.  Sorry ...and thank you for responding.

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