gr33nmind: Luvox withdrawal

[gr33nmind]

I have a very serious traumatic brain injury, that happen 24 years ago. Still I have come a ver long way since my injury. Twenty years ago, while living in a group home, I was placed on heavy doses of both anti-anxiety medicine (Ativan,) and an Antidepressant (Anafranil.) I was also placed on many other types of medication, including seizure meds, even though I had a completely clear EEG. I was almost immediately removed from the other medication, as soon as I left the group home.  I successfully titrated the Ativan ten years ago, and am in the process of reducing Luvox. The Anafranil had caused me bad urinary side effects 15 years ago, and I was switched to Luvox..

 

I actually reduce a little bit slower then ten percent. I'm reducing ten milligrams a month out of 150 milligrams of water titrated Luvox. I am currently at just under 1/5 of the dose of Luvox, and am doing well psychologically. My left arm is another story. My injury was right brain, and I damaged some nerves, mainly my radial nerve, controlling my arm, and hand , and thumb in my brain. As the dose becomes less, I am noticing difficulty using it more, and have pain in my forearm. I don't recall myself, or anyone mentioning that I had pain in my arm before. So I think it is basically from being over medicated, ignoring it, and using it wrong for an extended period of time. Body awareness is crucial for physical healing, and the SSRI had me in a fog for an awful long time.

 

Still wt more awareness, and now paying attention to how I use my arm more properly, and have even changed my gym workout to something called Tai Chi weight wlifting. Ta Chi weight lifting is basically less weight 10 - 20 lbs, and a ton of reps. Sometimes hundreds of reps, a least until you muscles are fatigued.  It is less strenuous on short muscles, but still builds long muscle. When I was lifting heavy weights, I was causing my arm muscles and nerves pain and trouble.

 

Question, is it okay to lesson the the speed more then ten percent a month. I was titrating at 10 mg of 150 mg, 6.6.66...% & when I reached 30 mg, out of 150 mg, I began reducing at only 5 mg., or 3.33...%. I am doing it that way, because it is easiest on my body.  My mind could probably handle a faster titrating, but I don't believe my left arm, & other muscles could. I mean is there a reason the we use 10%?

 

Reducing at first was very easy. In fact I actually was able to cut my pill immediately in half, w/o any difficulty. Still as my dosage gets less, I need to slow it down more. Do others have similar experiences. I remember that when I reduced my Ativan years ago, that during my last ten days, although I had been reducing a milligram a day, I had to reduce by a tent of a milligram. SSRI reduction is different the benzo withdrawal, but do they share similarities. I'm just curious if others share any of my withdrawal experience.  

 

[Gridley]

Hello, gr33nmind, and welcome to SA.  That's a great report, and it sounds like you are doing everything right.  

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.

• 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. 
• Please leave out symptoms and diagnoses. 
• A list is easier to understand than one or multiple paragraphs. 
• Link to Account Settings – Create or Edit a signature.

It is absolutely fine to reduce by less than 10% a month.  The 10% is an average  figure at which most can taper safely, arrived at through research and listening to the experiences of others, but is by no means written in stone as shown by the links I've provided below.  The important criterion is to listen to your body, as you are doing.  Some may be able to taper faster and others need to taper much slower.  I taper 2 1/2% per week for four weeks with a two-week hold, which is a bit slower that 10% per month.   These links will explain further about the 10% taper and slower tapers.

Why taper by 10% of my dosage?

 

Brain Remodelling

 

The slowness of slow tapers

 

Micro-taper instead of 10% or 5% decreases

 

Tips for tapering off Luvox (fluvoxamine)

 

You mentioned you found it necessary to taper more slowly at lower doses.  The is a common experiences and in fact is recommended by SA, either to taper by smaller doses or to hold longer.  This link provides evidence why this is necessary.
 

Why taper? Paper demonstrates importance of gradual change in plasma concentration

 

Here is some information on withdrawal:

 

What is withdrawal syndrome.

 

Glenmullen’s withdrawal symptom list.

 

When we take medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.  

 

Youtube video, 4 minutes: Healing from antidepressants

 

Please be aware that sometime withdrawal symptoms don't appear immediately after a too-fast taper.

 

Delayed onset of withdrawal symptoms

 

Healing isn't linear.  There will be ups and downs.

 

Windows and Waves Pattern of Stabilization

 

These link may be helpful in communicating with your doctor.

 

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

What should I expect from my doctor about withdrawal symptoms?

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Please research all supplements first and only add in one at a time and at a low dose in case you do experience problems.

 

While it is often a first response to stress to take a B-Complex, in withdrawal it can be overstimulating.

 

Hypersensitive to B Vitamin or B-Complex  

 

Many members have found the techniques in the following two links helpful in coping with withdrawal.  

 

The Dr. Claire Weekes Method of Recovering from a Sensitized Nervous System

 

Non-drug techniques to cope with emotional symptoms.

 

This is your introduction topic -- the place for you to ask questions, record symptoms, share your progress, and connect with other members of the SA community.  I hope you’ll find the information in the SA forums helpful for your situation.  I'm sorry that you are in the position that you need the information, but I am glad that you found us.

 

Best, 

Gridley

 

Edited April 6, 2018 by ChessieCat
removed white space

[gr33nmind]

A little more history. In 1994, I suffered a subarrachoid hemorrhage,  and hypoxia (1/2 an hour,) after literally freezing to death. I was placed on Anafranil prior to this injury. I was then placed on Ativan 22 years ago, and a ton of the medicine, but I can't recall what it was. What I learned is that every medicine they placed me on caused me detrimental cognition issues.

 I stopped taking the Ativan in approximately 2012. I reduced by 1% a day, & the final percent, reduced by a 1/10 percent a day.

I was original placed on Anafanil 24 years ago, changed to Luvox, about 1 years ago. I started easily by just cutting the pill in half, in 2015 (exact dates, can be difficult to remember because of my TBI) and quickly felt right as rain in about a week. I stayed wt that reduction until about 4 months ago. My doctor had told me too go cold turkey off of it, and the side effects (mostly obsessive thinking, and left radial nerve pain) scared me to try again, until recently. I then started to water titrate only 6.6% a month or 10 mg. of 10 mg. starting Aug 20 2017. The reason I use 150 ml., and not 100 ml of water, is because even at 75 mg. or half a pill, the waters absolutely gross. I really had a reaction to it being swallowed. Luvox is 'very' caustic, and even titrated can cause trouble. Years ago, in a bind I have taken the pill w /o water. Big Mistake!

I'm at 25 mg of 150 mg. now, and although I'm doing well, I decided to reduce, by only 5 mg. a month, for the remainder. I'm doing well, but am having more awareness, of my radial arm pain, and I'm also dealing wt the recent death of my 39 year old nephew from lung cancer. I realize that stopping this med will take me the better par of a year, but one thing SSRI's do, and especially in individuals wt brain injuries, is that they cause brain chemistry changes in the brain. I've actually read that they can help heal a brain after an injury. Still the benefit only lasts for a few years, and after can cause cognition problems. 

Supplements - 5000 mpg Methylcobalamin b12 sublingual 2X a day. - this helps remove oxidants that form around my injured brain neurons. The oxidants can cause even more trouble wt cognition, then the original injury did.

[Gridley]

Did you mean reducing by 5% or 5mg a month?  A reduction of 5mg from 25mg is 20% and is too fast.  If you continue at 5mg rate, you will be reducing by an increasing percentage each drop, the opposite of what we recommend.  Please remember what I wrote in my previous post about the advisability of going more slowly at the lower doses.  

 

The 5% reduction you spoke about would be calculated by multiplying current dose by 9.5.  0.95

 

I know there are memory issues, but please do the best you can completing your signature.  It is very helpful to the moderators.  Here are the instructions:

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.

• 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. 
• Please leave out symptoms and diagnoses. 
• A list is easier to understand than one or multiple paragraphs. 
• Link to Account Settings – Create or Edit a signature.

 

Edited April 7, 2018 by ChessieCat
corrected multiplier

[powerback]

Hi Gr33nmind welcome to SA .reading your posts here shows a tremendous amount perseverance and tenacity ,what an amazing achievement to come so far .you seem very articulate for someone that went trough a dramatic brain injury.

A story like yours is greatly appreciated for long standing situations withdrawal or not .

Take care and the best of luck .

Powerback . 

[gr33nmind]

Gridley, I am currently at about at 16% of my 25mg dosage of Luvox a day. I am reducing 10 mg, out of a 150 water titrated mixture of one 25 mg pill, of Luvox, or about 6.6% a month. I will be only reducing 3.3% month, now that I am at a 25 mg of the mixture. When I was first placed on Luvox 20 years ago, I was taking 50 mg twice a day, and I felt like an absolute zombie. Far too many numbers to keep track off ... LOL

 

Thank you Powerback, luckily I had just finished college wt a BS in communications, just before my injury. Writing, or rather typing,  is one of my better abilities. 

[Gridley]

That sounds great.

[gr33nmind]

Question, is there a way to reply to a single post, instead of replying to the entire thread? Also is there a way to edit one of your posts? I don't see a way. I wanted to change 16 percent into 20 percent. 25 mg. out of 150 mg. is 1/5. I have no idea how I came up wt 16 percent. sometimes I hate math  ..

[ChessieCat]

8 hours ago, Gridley said:

The 5% reduction you spoke about would be calculated by multiplying current dose by 9.5.  0.95

 

Please note the above correction.

[gr33nmind]

Chessie, Isn't the amount figured out by multiplying 25 mg by .05 instead of .95? Isn't a 5% reduction only 1.25 mg. a month. Twenty Five mg X .95 would be 23.75 mg., & almost an entire pill. Five percent would only be 1.25 mg. Perhaps I'm misunderstanding your reply.

 

Question, where do we put our medication history, so that it can be included wt each post. If I type it out every time it would take forever.

 

They give people wt TBI's far too much medicine. I can't recall it all, since my history is actually much larger then this. Still this is what I know.  

 

Started taking 100 mg Anfranil twice a day,  2 mg of Ativan nice a day, in 1994. Began taking 10 mg of Inderol 4 times a day in 1996.

 

The doctor reduced my dose of Ativan at my request to 1 mg a day.

I then asked him if he could take .5mg twice a day

I then asked if I could use take it once a day
I don't know the exact dates, but around 5  years ago, I reduced a mg a day, on my own

The last milligram I had to reduce over a ten day period
 

Sometime after I stopped taking Ativan, I began to reduce my beta blocker Inderal on my own, I tried to water titrate it, between I got to about 50 percent of the dose, it caused chest pain. The pain would only occur after a small dose, so I simply stopped it. My blood pressure was higher then anticipated for about a week, and quickly settled don.

Switched to Luvox in about the year 2000 after experiencing urinary side effects

Began reducing my dose of Fluvoxamine more then 10 years ago. 

50 mg twice a day

Then about 8 years ago to once a day

About 6 years ago, I asked my doctor if he could split my dosage of 2 mg to twice a day

Then 5 years ago to 25 mg once a day

August 10, 2017 I began reducing 6.6% of 25 mg a month
April 1st 2018, began reducing 3.3% a month

I should be finished taking it on June 15, 2018

 

Oh yeah, I also take 5000 mcg of the supplement Methylcobalamin b12 twice a day, but I have no future plans on reducing that! 

 

[ChessieCat]

1 minute ago, gr33nmind said:

Question, where do we put our medication history, so that it can be included wt each post. Typing it out overtime takes me forever.

 

Account Settings – Create or Edit a signature.

[ChessieCat]

2 minutes ago, gr33nmind said:

Chessie, Isn't the amount figured out by multiplying 25 mg by .05 instead of .95? Isn't a 5% reduction only 1.25 mg. a month. Twenty Five mg X .95 would be 23.75 mg., & almost an entire pill. Five percent would only be 1.25 mg. Perhaps I'm misunderstanding your reply.

 

Multiplying by 0.95 gives you the new dose to take.  Multiplying by 0.05 gives you reduction amount which you then deduct from the previous dose amount.

 

Current dose 25mg

 

25mg x 0.95 = 23.75mg     this is the new dose to take

 

which is the same as:

 

25mg x 0.05 = 1.25mg      25mg - 1.25mg = 23.75mg

 

If you work it out both ways, then you have double checked your calculations.

[gr33nmind]

Thank you Cassie, I'm currently at 16% or 4 mg. of a 25 mg. pill, I discard 84% or 21 mg. The reason the numbers aren't uniform (10 or 20%,) is because I'm using 150 mg. of water to titrate. It might seem a little bit more complicated using 150 mg of water, but I use that instead of 100 mg, much because at higher percentages of the med, Luvox titrated was extremely caustic on my throat. I'm sure I could use less water now, but the slower titration worked all this time, so why change what has worked.