Rabe: how to taper and adjust Viibryd while on Clonazepam

[Rabe]

I definitely had interdose withdrawal in treatment but wouldn't take more Clonazepam.  I think thats why they pushed the Viibryd...and I have to say that somedays I am happy to have it. The bad anxiety around 4 and 8 is pretty standard...so what I meant was the farther away I got from my evening Clonazepam the day before or when I used to take it with the Viibryd in the morning, the more anxious I felt.  So I moved it to later in the day to try to cover that anxiety.

 

I don't know about combining the 2 doses because I have such a hard time getting going in the morning.  I was actually thinking when I asked bout moving doses about taking .05 of night Clonazepam and moving it so would be .25 in day and get to .5 at night.  I fall asleep ok but always wake up about 3 to 4 hours later.  Last night I talked to my niece until 330am..yikes...and woke at 715.  

 

 

 

[Rabe]

"My guess is you're taking too much amiloride with the clonazepam, or too much clonazepam with the amiloride, but you can't reduce the clonazepam any faster. So that leaves the amiloride."

 

And I don't know what to do about this..I feel so frustrated with doctors and therapists and family who seem to believe people like myself don't exist,,,.I cant make them hear me or believe me...not for lack of trying!!!  I get depressed...cry morning and late evening so best to stop now...think about it later when Im better.  

 

[Waterfall]

Hey Rabe, 

Just wanted you to know that I'm thinking of you. 

Oh, why does it have to be so rough on us all?  

I know what you mean about relationships.  

I can't offer any particularly helpful advice, 

but I'm glad you shared such a positive post on my thread the other day, 

after your granddaughters birthday party.  

 

I just know how hard it can be.  

Right now we've just bought into my parents house.  

We have one whole floor.  

My parents have been amazing, and helped us so much. 

Even among some of the most wonderful, patient, and loving people, 

sometimes you say things you regret, or you hear things, that hurt.  

I wish my husband and my mother could get along. 

Sometimes I fear that they are both too similar, and too different.  

It's frustrating.  

 

We have to do our best to forgive them their weaknesses, 

as we hope that they will do for us.  

And the hardest one for me... we have to forgive our own weaknesses.  

Our own mistakes, and struggles.  

 

So glad that you've found the courage to start your taper, 

and even more glad to hear that it's going well enough so far.  

I can also sympathize with that fear.  

The day my husband first mixed something with my clonazepam, 

to make a nicer pill, and make it easier to measure,  I cried.  

I wouldn't have taken it, if he hadn't been sitting there watching me. 

If I'd have any other option to take at the time.  

It's thanks to your signature, that I got the idea to mix it with brown rice flour. 

I decided that brown rice flour isn't so scary.  

 

But anyway, the point was that I sympathize with being afraid of things. 

Of any change, or of any commitment.  

Right now, I worry about every time I'm going to have to stand. 

Or every time I'm going to have to eat.  

Or if I have to drive.  

Or, really, if I have to accomplish anything at all. 

What if I can't do it?  

What if I just can't.  

I still have a young family that depends on me.  

Every day.  

I can't just, not drive them to the bus today. 

All my kids missing school, because Mom couldn't pull herself together to drive today?  

 

Sorry, not trying to take over here, just trying to sympathize.  

To empathize.  

It's hard.  

I sometimes wonder if I say the right things, or make it worse.  

 

Oh, if only there was some way to make it easier on us all.  

If only there was some way to speed the healing.  

[Rosetta]

Rabe, Thank you for looking after me when you are hurting so much yourself.  I really appreciate that.  I got through another day, and it was ok.  I hope yours was as well. - R

[Rabe]

Hi Rosetta,

I'm so glad to hear from you and know that things are even a hair better!!!  Gosh these days can be so so long!!!  UGH!!!  Have you ever had a burning feeling in your bladder (think thats what it is) Rosetta?  Im just wondering...sure hurts sometimes!!!  And I don't think I have ever read anyone having that.

My day was ok.  Horizontal line with ups and downs...very depressed this morning...the ALmiloride makes me feell icky...the Viibryd does couple hours or so after taking it as well, as does tapering it, and the Clonazepam has my ears singing, etc, as usual!  But Im just grateful I got to my daughters Saturday...the rest is ok.  Take care!!!  Hope you sleep better tonight Rosetta!

[Rosetta]

Thank you, Rabe.  No, no burning in my bladder, but it's definitely off.  Everything is off, I suppose.

 

I'm so glad you made it to your daughter's party!!  That is great news.

 

I have to go to bed now.  Sweet dreams. -R

[Hazel]

Hi Rabe,

I just wanted to stop over on your thread to give my support.  You have been so wonderful and supportive to me as I try to maneuver through this wave.  I really do appreciate it and want you to know I am here for you as well.  Hope you had a good day today😊

[Rabe]

 

Oh gosh, thank you SO much Hazel...that is so nice of you!  I am very grateful for your support!

[Rabe]

Does anyone know if massages are ok?  DO they cause problems?  Was thinking about one but had problems before all this so would have just a light massage not the deep tissue.  If any input would appreciate.  Made appt for tomorrow but am wondering....

[Rabe]

Also, does anyone have experience or information on tapering Premarin while tapering bentos n antidepressants? Thanks

[Waterfall]

On 5/14/2018 at 8:38 PM, Rabe said:

Have you ever had a burning feeling in your bladder

 

I'm not sure I'd call mine burning, but it sure feels nasty sometimes.  

(I decided to say nasty, because I feel like I'm overusing 'awful').  

Sometimes I just... feel it.  

Like I can feel exactly where it is. 

Other times it HURTS.  

Other times it keeps going through spasms.  

That I find VERY annoying.  And unpleasant.  

 

Bladder discomfort (to put it mildly). 

Flank pain.  Chest pain.  

Burning.  Tingling.  

Several of our symptoms certainly are similar!

I'm thankful that I've only had a few short spurts of tinnitus. 

I've had a lot more shakes, muscle spasms, and weakness. 

And now nausea.  Starting to wonder if it's because of the new carpet or not... 

 

I had a massage once... years ago.  

It was a ... lighter? massage.  

Definitely not deep tissue.  

Other than the anxiety going in, 

I think it was a very good thing.  

I've thought often about doing it again... 

On the other hand, I tried acupuncture once. 

Not sure I'll ever do that again. 

I felt awful afterwards.  

Anxious.  Sick.  

But other people seem to have great results with it. 

So I think to some degree it's going to be a very individual thing. 

I hope you end up trying it, and that it turns out to be helpful. 

I wish I could go for a massage... 

 

Anyway, wishing you strength, patience, and brighter days ahead!

 

Here's hoping, especially, that your bladder feels better soon.  

(Now not many people get to hear someone say that!  You're special!  😉)

 

Good night, Rabe.  

[Rabe]

Ahh you are so funny!  Yes not many people on the streets discuss their bladder burning...probably cause it doesn't!!  Lucky them!  

Thank you for massage thoughts WF...I am going to try it tomorrow and see...light massage...never could tolerate a deep tissue.

Will let you know.  

I have done the acupuncture with lights?  I think its called color accupunture.  They can start out very slowly which we are and so far I have to say it has been ok and helpful I think.  Perhaps you could check on that.  Good night to you!   Sleep well!

[Altostrata]

I sympathize, Rabe. This is hard.

 

Please remind me where your drug dosing is. Did you reduce anything recently? What, when, how much?

 

I don't see amiloride in your daily symptom pattern,  did you drop it?

[Waterfall]

11 hours ago, Rabe said:

Yes not many people on the streets discuss their bladder burning...probably cause it doesn't!!  Lucky them!

 

Oh, indeed!  Lucky people!  

I think my body must have been sympathetic to you last night. 

Oh, did mine burn last night!  

It made it hard to fall asleep, it was bothering me so much. 

But it's feeling a bit better today!

The lower left rib/chest pain is back in force today, though.

Oh, is it bad. 

If it's not one thing, it's another!

But I'm glad to note that it wasn't so bad yesterday. 

At least I got a break.  

Here's hoping you get one too!

 

You'll have to let me know how the massage goes!

I really hope it will help!

 

In case you can't tell, I like exclamation marks too!!

I'm glad that I can make you smile, or laugh, sometimes.  

We need that.  

[Rabe]

No I have not reduced anything.  No changes.  Schedule of yesterday:

Amiloride 2.5 MWF so not taken 5/15

Viibryd 9.5 930

Clonazepam .2 445

Premarin 830 

Clonazepam .7 1140

 

Amiloride not there cause yesterday was off day...  

Took this morning at 930...couldnt do sooner cause stomach has been so bad.  Took Viibryd at 1120 and just at bout 120 started feeling pretty awful.  Stomach is some better but feel so dizzy and head is so hot...eyes irritated, so anxious.  Only thing new is drinking ginger tea for stomach and bladder.

will continue to move the Clonazepam and try to keep Amiloride away...this morning I couldn't take the AMiloride any sooner than bout 930 again cause stomach felt so torn up.  Maybe Friday.  Will move Clonazepam again tonight.  I have 10 more of the 9.5 compounded Viibryd tablets and then they already compounded next ones at 9.0mg.

Yes it is hard....I know you know....so chilled but hot, so anxious after Viibryd, good purple is favorite color, chest hot, bladder burns, blah blah...

I do less well with unwhole pills for whatever reason. 

Thank you Alto... 

[Rabe]

and my BP for now has gone up not down

[Rabe]

 the AMiloride days make it more challenging...but also seems get more nervous on weekend when don't take it for 2 days...IDK Alto...

have wondered if reason reacted so to Viibryd drop in Dec was rapid taper in Sept. and was thinking bout dropping .1 next time but since capsules are already compounded will do the .5 drop

Thank you again...I have to do something... to ease this.  Take care!  Thank you again!!!

 

[Rabe]

did get in touch with doctor last week re amiloride and they were going to talk to a pharmacist..nothing yet..but asked a pharmacist 

long time ago and he had no answers....

[Altostrata]

Blood pressure increase is a good thing, correct? You usually have low blood pressure?

 

I would rather you take a smaller dosage of amiloride per day than skipping days. That's a recipe for weird symptom fluctuations.

 

We talked about splitting the tablet, did you do that?

 

It could be you are a slow metabolizer of amiloride. What is the status of your kidney health?

 

Did you do this: Put ALL your drugs in the Drug Interactions Checker https://www.drugs.com/drug_interactions.php
if so, please post link where you pasted it. Thanks.

 

[Rabe]

Could you tell me if just changing med times can affect symptoms?  Abnormally challenging day today..though some better since after meds am  

 

yes usually low BP.  

 

Yes...might help to take less daily, though feel better on day don't take it..not so much 2nd day on weekend.  Try to take smaller part of pill anyway. Finding it hard to split twice cause has raised ridges.  Wanted one without yellow dye cause of that allergy but is none.

 

Funny you should ask re kidneys.  Their functioning has decreased since started too fast taper at home...have wondered if Clonazepam affected them.  Not what they were before all this though said rapid metabolizer on genetic test for meds and if I react to things it is soon after taking.  Shadows on kidneys that they think r/t numerous kidney infections as child.

 

Have put all meds in interaction checker(s) more than once...some sites have the minor interaction, this one has others..drugs .com which is one I usually use 

Interactions between your drugs

Moderate

amiloride  clonazepam

Applies to: amiloride, clonazepam

AMILoride and clonazePAM may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. 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.

Switch to professional interaction data

Moderate

amiloride  vilazodone

Applies to: amiloride, Viibryd (vilazodone)

Treatment with vilazodone may occasionally cause blood sodium levels to get too low, a condition known as hyponatremia, and using it with aMILoride can increase that risk. You should seek medical attention if you experience nausea, vomiting, headache, lethargy, irritability, difficulty concentrating, memory impairment, confusion, muscle spasm, weakness or unsteadiness, as these may be symptoms of hyponatremia. More severe cases may lead to hallucination, fainting, seizure, coma, and even death. Vilazodone can also affect your blood pressure and heart rate. You may need a dose adjustment or more frequent monitoring of your blood pressure and pulse to safely use both medications. You should avoid rising abruptly from a sitting or lying position while taking these medications, especially at the beginning of treatment or after an increase in dose. Call your doctor if you experience dizziness, lightheadedness, fainting, or a rapid heart beat. 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.

Switch to professional interaction data

Minor

clonazepam  calcium carbonate

Applies to: clonazepam, Tums Regular Strength (calcium carbonate)

Consumer information for this minor interaction is not currently available. Some minor drug interactions may not be clinically relevant in all patients. Minor drug interactions do not usually cause harm or require a change in therapy. However, your healthcare provider can determine if adjustments to your medications are needed.

Thank you!!!! 

[Rabe]

No massage today  feeling so ill today.  

[Rabe]

nothing mentions amiloride affects on GABA...may be part of things too. IDK

[wantrelief]

I am sorry to hear you are feeling so ill today, Rabe.  I hope you feel better very soon.

[Rabe]

Actually a really awful day....had such better day yesterday, like after a taper...and today is such a crash! Could not even get out today so weak and short of breath and dizzy and anxious and now depressed. I was afraid to drive or walk...finally did and almost got into an accident at a round about which was so scary!  Not thinking or concentrating well I guess.  Grateful nothing happened!!  Feeling disheartened ... been awhile since was this way ... but guess I ought to feel grateful for that.

 

Does someone know if color puncture can affect your system?  My therapist did a very small treatment Monday, cause knows how sensitive am, for the Endocrine system...didnt think bout it til now.  Thanks.

[Altostrata]

amiloride effects on GABA are not relevant, it's the interaction that lowers blood pressure that's important.

 

Yes, taking drugs at different times affects symptom pattern. I would rather you take a consistent lower dose of amiloride rather than skipping doses. Please keep daily notes about your drug dosing schedule.

 

Yes, acupuncture can affect your symptom pattern. It could be the acupuncturist gave you the wrong treatment. Often they try to stimulate rather than calm.

[Rabe]

I am keeping a journal and will post today tonight before bed and will continue that.  Waiting to hear from K doctor.

Thank you re thoughts re amiloride, moving meds and color puncture Monday.  It helps to know that those

things can affect.  Thank you so so much Altostrata...I just don't know how to express the gratitude for all the time and effort you and the

other moderators extend.  How did you navigate YOUR way without a forum like this?  In any case, thank you again!

[Rabe]

Was reading the interactions again...seems is double whammy...both drugs can affect BP...

 

Wondering about going back to taking the Amiloride in afternoon away from both meds while look into dosing twice...thoughts?

My moving it to morning seems more problematic...

 

Ill just keep doing the journal and see what thoughts are.  Thanks 

[Waterfall]

I'm so sorry to hear that, Rabe. 

Me too. 

Wish I could come give you a hug.  

 

I was imagining sitting here together with you, sharing our misery. 

It reminded me of the time, many years ago, when my oldest two were quite little. 

My husband and I both came down very suddenly with a bad case of the stomach flu. 

I remember a point when we were both sprawled out, and the conversation went something like this:
  "I think our daugher has a stinky diaper..."
  "Do you want to go check?" 

  "No.  Do you?" 

  "No."

...

...

   "We can't just leave her."

   "True."
   "Do you think you can do it?"

   "No.  Can you?"
   "Not right now.  Maybe in a minute."
...

...

Yeah.  That was a rough day. 

I think eventually my husband changed her.  

What a nice guy.  

 

My son fed himself cereal straight from the box that day.  

 

So.  In my mind, you and are I sprawled out, Rabe. 

And we're talking to each other, 

about how we can't do much just yet, 

but maybe in a minute, we'll do a little. 

And maybe later, we'll feel a bit better. 

We might be kinda sick right now, 

Today might be a pretty awful day, 

but maybe later, maybe tomorrow, 

we'll feel a little better. 

And then we can do something.  

[Rabe]

That would definitely be it!  I was having that conversation with myself today.  Lesson learned to stay home when so weak, tired, and unable to think cause nearly got in accident! Geez! Scary!  Talk bout doing something!  Scared me awake!

[Altostrata]

Yes, your doctor should be more concerned about the drug interaction.

 

Given we're talking in 2 topics, I don't remember what we agreed on. Maybe taking a half-dose of amiloride once a day would be a better direction than dividing the dose.

 

You can get a pill cutter from the pharmacy, that might make splitting the tablet easier.

[Rabe]

Oh Altostrata..not sure what to do. so weak and off mentally today that almost got in car accident..scared me so. truly feel awful..like electrolytes are off.  Always take smaller half of .5 split Amiloride tablet.  Maybe ought not do that...maybe more salt would help but basically stopped it years ago after ER.  

 

I'll keep journaling n message doctor again and at very least perhaps he'll check lab tomorrow.  All he has said is just stop it n try eat more K+ but that didn't work for months so won't now.  He mentioned Propanolol but think that interacts too.  Not lots of options seems cept to get off meds.  Thots of just quitting them..at least one...but that would be challenging.

 

Woke up ok today.  After Amiloride usual after take it icky...after Viibryd was more than usual Viibryd ickiness...didnt quit and got worse.  Took them closer today.  

 

Anyway enough of that...thank you again for everything.  Sorry to complain.  Boy I feel so not with it and dizzy and all.  Sleep will be nice.

thank you. Take care! 

[Rabe]

Up 410 and 8

Stomach so awful could not take Amiloride early. Ginger tea.

930 Amiloride .25 with food BP 90/60

1000 stomach worse

1115 stomach pain continues

1120 Viibryd 9.5 with oatmeal. Stomach awful. Ginger tea

120 stomach som

245 some better but head so hot

1330 Head not right. Dizzy, hot, chilled BP110/90

230 Anxious, short of breath, eyes puffy under

245 short of breath, weak, anxious, hands tingly, dizzy, ears ringing

300 more dizzy, weak, SOB, pale, depressed

400 anxious, dizzy, SOB, chest hot, depressed, really don't feel well

430 same

500 Clonazepam .2 with food

600 tad better

630 chest hot, SOB, ears ringing, anxious

700 finally felt well enough to go to Y - palpitations, sweaty, tired, weak, not alert

830 premarin with food

900 headache, crampy

1000 hot headache

1030   head so hot and feels so weird cant describe, depressed, crying, short of breath, feel not right at all

1100 off balance, head not right, cant think, etc

1130 dishes...mostly rested today

1145 Clonazepam  .7 with milk and water

1200 ready for bed

will be in bed by 1215

 

 

 

 

 

 

 

[Rabe]

above journal is for 5/16 ... sorry

[Rabe]

finally feel bit better at 1240...good night...

[Carmie]

9 hours ago, Rabe said:

No massage today  feeling so ill today.  

 

Sorry you missed out on your massage Rabe, 

 

Do u find it relaxes you?

 

Im hoping to go to acupuncture again soon xxx

[Altostrata]

What was your drug intake yesterday and so far today?