paullee: Advice on how to taper Dogmatil/sulpiride and Mirtazapine

[paullee]

Hi everyone! I have been on Mitarzapine (Remeron) and Dogmatil for more than 2 years because of mild anxiety and mostly IBS. I tried to come off them several times but never succeeded. A few months ago I tried to taper them but I think I went too fast and had severe withdrawal symptoms. I stopped Dogmatil cold-turkey and tapered Mitarzapine from 7.5mg in about 2 months. Now I am on 7.5 mg Mizartapine and 50 mg Dogmatil (Sulpiride) and I want to taper very carefully. I am thinking about tapering Dogmatil first but totally confused how to do so with a capsule. But I read here that Dogmatil is an antipsychotic drug, not antidepressants, so it is necessary to taper it? 
 

I would like you guys to suggest me with the most comfortable and precise method to reduce the doses of Mitarzapine and Dogmatil? For Mitarzapine, I can only cut the pill but it is not totally precise, and since I am lowering the dose to smaller than a quarter, it is extremely difficult to divide the pill because of the shape of it? For dogmatil, it is a capsule with powder inside, so I also don't know how to reduce the dose?

 

Please note that I come from a Latin-speaking country where it is hard to find access to all the tapering equipment and method, so I hope you guys can suggest links to the place where I can buy the equipment and ship it to my country. From what I heard, using a milligram scale seem to be the easiest method for me? Does it work for both drugs?

Thanks you guys so much for reading and answering me.

[mammaP]

Hi Paullee, welcome to SA.  I apologise for the delay in replying.  

Dogmatil is an anti psychotic and after 2 years will need tapering. We recommand tapering no more than 10% of the CURRENT dose with at least 4 weeks between cuts.  This is to allow the brain to adjust to the lower dose. If you are ok with the 10% you could  taper Dogmatil a little faster, maybe every 3 weeks. If you have any withdrawal it means you have gone too fast and should slow down.  We do not have a topic here for tapring dogmatil but it will need the same care as other antipsychotics.  You can taper by opening the capsule and mixing the powder with water. It is quite simple when you are used to it. 

This topic tells you how to make a liquid from tablets or capsules

https://www.survivingantidepressants.org/index.php?/topic/2693-how-to-make-a-liquid-from-tablets-or-capsules/

 

This one tells you how to use a digital scale. 

https://www.survivingantidepressants.org/index.php?/topic/1596-using-a-digital-scale-to-measure-doses/

 

All the equipment you need can be bought on Amazon. 

 

Mirtazepine also needs tapering slowly, here is the topic for tapering mirtazepine. 

https://www.survivingantidepressants.org/topic/5301-tips-for-tapering-off-mirtazapine-remeron/

 

This explains why we need to taper very slowly. The taper will take years but is worth it to get off the drugs without being desabled by withdrawal. Almost all of us here were like yourself  and tapered too fast, which is what brought us here too! 

 

https://www.survivingantidepressants.org/topic/1024-why-taper-by-10-of-my-dosage/

 

We ask all our members to fill in their signature and update it with any changes,  this makes things easier for staff. You can find instructions here.. 

https://www.survivingantidepressants.org/topic/12364-please-put-your-withdrawal-history-in-your-signature/

 

[paullee]

Hi mammaP, thanks for your awesome response. I still have 2 more questions:

 

1. Since dogmatil is manufacture in capsule form, I guess the capsule is a form of protection so that the powder inside can thoroughly reach the stomach before dissolving. By making liquid from it, would the effect of the drug remain unchanged?

 

2. I notice that most people on this forum use plenty of supplements. Are they necessary? Currently I am only using probiotics but I don't think my immune system is as good as that of a normal person. Should I consider using some?

[mammaP]

Not sure about the capsule, I did some research and didn't find anything that said it has a gastro resistent coating. There are some drugs that need it and it is in the information leaflets. Can you look at the leaflet that is with the prescription?   

 

We only recommend 2 supplements, fish oil and magnesium. We have lots of topics on supplements in the symptoms and self care forum. Most of them simply make very expensive urine , but it is up to each member whether they want to try them. If you do try any start with a very small dose and increase gradually. 

Probiotic can be helpful, I used to take them but now I just have kefir and it seems to keep my gut in order. 

 

Fish oil

https://www.survivingantidepressants.org/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

 

Magnesium

https://www.survivingantidepressants.org/index.php?/topic/1300-magnesium-natures-calcium-channel-blocker/

[paullee]

May I ask what is the ratio between water and antidepressants when I mix them together? I guess that my 50mg Dogmatil should dissolve in a different amount of water compared with the amount needed to taper my 7.5mg Mitarzapine.

[Kostas]

1 hour ago, paullee said:

May I ask what is the ratio between water and antidepressants when I mix them together? I guess that my 50mg Dogmatil should dissolve in a different amount of water compared with the amount needed to taper my 7.5mg Mitarzapine.

Hi, 

If you dissolve the 50 mg of dogmatil in 50 ml of water, then for every 1 ml of this solution you get with the syringe, you will have 1mg of dogmatil in it. 

But wait before do it, for a verification from a mod! 

[Altostrata]

Yes, that is a good way to make a liquid from a 50mg tablet. Thank you, Kostas.