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hartwigd8

hartwigd8 which drug to start tapering?

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hartwigd8

hi    i am currectly on 5 pysch drugs  150mg seraquel, 30mg duloxetine, .75 mg xanax, 60 mg vyvanse and 1 mg of rexulti. i am currently tapering my xanax, my doctor says that i can cold turkey the xanax because of the low dose. i am scared to do this because of the withdraw affects that this could have. please  give me some advice thanks 

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Altostrata

Welcome, hartwigd8.

 

That is quite a cocktail, something from each food group. What is the Xanax supposed to do for you? When was it added?

 

How long have you been taking each drug? What is your current symptom pattern?

 

Please put ALL your drugs in the Drug Interactions Checker https://www.drugs.com/drug_interactions.php
and copy and paste the results in this topic.

 

I suggest you stop tapering Xanax for now while we unravel the knot.

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hartwigd8

hi altostrata   i have been on the seraquel, dulaxetine and xanax for 6 months and the vyvanse for 1 month and the rexulti for 1 week. the doctor put the xanax and seraquel for my sleep. i suffer from depression so the  dulaxetine was added. i suffering from sever fatigue so he put me on the vyvanse rexulti for that. i dont know how to copy and paste the www drug.com website i have been over to that website and got drug interactions on all the drugs i have been taking. i am mad at myself for not doing reserch on the drugs i was priscribed because of the bad withdraw factors with seraquel,dulaxetine and xanax.  if you could direct me on how to copy and paste the drug. com websight i will do that  thanks   dave h  

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ChessieCat

Here it is:

 

Major

duloxetine  lisdexamfetamine

Applies to: duloxetine, Vyvanse (lisdexamfetamine)

Talk to your doctor before using DULoxetine together with lisdexamfetamine. DULoxetine may increase the effects of lisdexamfetamine, and side effects such as jitteriness, nervousness, anxiety, restlessness, and racing thoughts have been reported. Combining these medications can also increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, feverexcessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nauseavomiting, and diarrhea. Severe cases may result in coma and even death. You should contact your doctor immediately if you experience these symptoms while taking the medications. 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

Major

duloxetine  brexpiprazole

Applies to: duloxetine, Rexulti (brexpiprazole)

DULoxetine may increase the blood levels of brexpiprazole. This can increase side effects such as drowsiness, seizure, Parkinson-like symptoms, abnormal muscle movements, and low blood pressure. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if you experience agitation, aggression, confusion, convulsions, muscle spasm, or movements that you can't stop or control such as lip smacking, chewing, puckering, frowning or scowling, tongue thrusting, teeth clenching, jaw twitching, blinking, eye rolling, shaking or jerking of arms and legs, tremor, jitteriness, restlessness, pacing, and foot tapping. Also be alert to symptoms of low blood pressure such as dizziness, lightheadedness, fainting, and/or increased pulse or heart rate. Avoid driving or operating hazardous machinery until you know how these medications affect you, and use caution when getting up from a sitting or lying position, especially at the beginning of treatment or after an increase in dose of brexpiprazole. 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

alprazolam  quetiapine

Applies to: Xanax (alprazolam), Seroquel (quetiapine)

Using ALPRAZolam together with QUEtiapine may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. 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

alprazolam  duloxetine

Applies to: Xanax (alprazolam), duloxetine

Using ALPRAZolam together with DULoxetine may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. 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

alprazolam  brexpiprazole

Applies to: Xanax (alprazolam), Rexulti (brexpiprazole)

Using ALPRAZolam together with brexpiprazole may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. 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

quetiapine  duloxetine

Applies to: Seroquel (quetiapine), duloxetine

Using QUEtiapine together with DULoxetine may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. 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

quetiapine  brexpiprazole

Applies to: Seroquel (quetiapine), Rexulti (brexpiprazole)

Using QUEtiapine together with brexpiprazole may increase side effects such as drowsiness, blurred vision, dry mouth, heat intolerance, flushing, decreased sweating, difficulty urinating, abdominal cramping, constipationirregular heartbeat, confusion, and memory problems. Side effects may be more likely to occur in the elderly or those with a debilitating condition. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. 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.

 

Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication

Antipsychotics

Therapeutic duplication

The recommended maximum number of medicines in the 'antipsychotics' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'antipsychotics' category:

  • quetiapine (active ingredient in Seroquel (quetiapine))
  • brexpiprazole (active ingredient in Rexulti (brexpiprazole))

Note: The benefits of taking this combination of medicines may outweigh any risks associated with therapeutic duplication. This information does not take the place of talking to your doctor. Always check with your healthcare provider to determine if any adjustments to your medications are needed.

Duplication

Psychotropic agents

Therapeutic duplication

The recommended maximum number of medicines in the 'psychotropic agents' category to be taken concurrently is usually three. Your list includes four medicines belonging to the 'psychotropic agents' category:

  • quetiapine (active ingredient in Seroquel (quetiapine))
  • duloxetine
  • alprazolam (active ingredient in Xanax (alprazolam))
  • brexpiprazole (active ingredient in Rexulti (brexpiprazole))

Note: The benefits of taking this combination of medicines may outweigh any risks associated with therapeutic duplication. This information does not take the place of talking to your doctor. Always check with your healthcare provider to determine if any adjustments to your medications are needed.

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hartwigd8

hi  everyone   thank you chessie cat for puttin that information into my post. i recently bought 1000mg  of krill oil supplement, has anyone tried this.  i have not heard back from altostrata on what i should do with these medications i have been taking.  she said to stop tapering the xanax but that is the last i have heard from her. 

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hartwigd8

i am scared to death to do any tapering, reading on these forums all the withdraw pain people are going through or how long some of these tapers take. i need some guideance on what to do. 

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hartwigd8

i am new to these forums and after reading  horror about people starting tapering, i am also confused with the methods of bead couning that i almost would rather stay on the drugs instead of going through the severe withdraw symtoms that come with tapering. please help me. 

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mammaP

Hi hartwigd8, I have moved your new topic to your original introduction, only 1 introduction per member is allowed. 

 

It is very scary when you first start to think about tapering and I am very sad to see that you have been prescribed so many drugs in a short time. Asyou have only been taking rexulti for around 10 days it would be best to stop that one first. You could take 1mg for a few days then stop. Did you start with 1mg then increase to 2mg?  It would be best to wait a while before starting to taper another one to see how you are reacting to stopping rexulti.  Try not to worry, it is possible to taper them all and feel better. 

 

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hartwigd8

i wish to say that my psychiatrist said i could cold turkey the xanax becauise of the low dose of 1mg and cold turkey the dolextine because according to him he has had a couple thousand patients that have gone off dolextine and 50% had no symtoms and 50% had a few symtoms who do i believe. i am not thinking of doing  what he has said because of the horror stories that i read on this and other benzo websites. who do i believe? 

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Altostrata

This site would not exist if people could rely on tapering advice from psychiatrists. We would be happy to send everyone to doctors for tapering information and close this site if they could.

 

If you look around the Introductions forum, you will see hundreds of people like you who followed their doctor's recommendations. Most doctors, by the way, would never suggest cold turkey. But yours seems especially clueless, so he told you to do the most dangerous thing possible.

 

It's up to you if you want to follow his directions.

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hartwigd8

i am on 60mg of vyvanse which is in a powdered form in the capsule. how would i do this, using the water tritation method?  

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ChessieCat

tips-for-tapering-off-vyvanse-lisdexamfetamine-dimesylate

 

Make your own liquid
To taper, you can make their own liquid with water. See How to make a liquid from tablets or capsules.

 

From https://www.drugs.com/pro/vyvanse.html:

Open capsules, empty and mix the entire contents with yogurt, water, or orange juice. If the contents of the capsule include any compacted powder, a spoon may be used to break apart the powder. The contents should be mixed until completely dispersed. Consume the entire mixture immediately. It should not be stored. The active ingredient dissolves completely once dispersed; however, a film containing the inactive ingredients may remain in the glass or container once the mixture is consumed.

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hartwigd8

how would i taper 60mg of vyvanse at a 10% cut using the water tirtation. would i take 60ml of water and add the vyvanse to it and draw out 10% or 6ml of water to give me a 54% dosage and if this is the right way how long would i stay at that dose  

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ChessieCat

Yes your figures are correct.

 

A 10% reduction of 60mg would be 60mg x 0.9 = 54mg.

 

Dissolve 60mg in 60mL of water and dispose of 6mL.

 

Or you could dissolve 60mg in 600mL of water and dispose of 60mL.

 

Use the same equipment and use the same process each time to maintain consistency.

 

SA recommends holding for about 4 weeks before considering another reduction.  It's helpful to keep daily symptom notes on paper to see how the reduction is affecting you.  It's important to listen to your body.

 

The next reduction would be 54mg x 0.9 = 48.6mg.  If you round the number to make it easier to measure a dose, round up.  The next reduction needs to be calculated on the rounded up figure.  So if you rounded up to 49mg, calculate the next reduction on that figure.

 

Why taper by 10% of my dosage?

 

Windows and Waves Pattern of Stabilization

 

Stabilising After a Reduction - What Does That Mean?

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hartwigd8

i am thinking on tapering vyvanse by taking 300ml of water an dissovling my capsule in it and taking 3ml out a day and go 3,6,9ect out, it will take me 100 days to complete. What do you think of this taper program. I will be done with my xanax taper the middle of december, how long should i wait to start my taper of vyvanse. 

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Altostrata

How is your Xanax taper going?

 

If I were you, I'd wait at least a couple of months after finishing Xanax before tapering Vyvanse, to see if there are any repercussions from going off Xanax.

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hartwigd8

i am currently tapeing vyvanse. I started at 60mg and my doctor wants me to drop 10mg every 30 days untill i am done. I know this is kind of fast to taper, but i want off this stuff so bad because it is causing me to lose weight. I am also on 30mg of duloxetine and 150mg fo seraquel. vyvanse also has a major reaction with duloxetine which is another reason i want off. Can you tell me if i am going to have any withdraws by droping by this amount. thanks for reading this post.  

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les625

You might have withdrawals, the brain will have to readjust whether you notice it or not.  Some people can quit stimulants cold turkey, but that is not a good idea.  Stimulant crashes are awful.  You may experience symptoms but gradually tapering is definitely the more patient and safe option.  Especially with polypharmacy, it is good to go slow, since the drugs can be synergistic.

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ChessieCat

You have created several new topics which have been merged to your Intro.  Your Introduction topic is the place to ask questions about your own situation and where you can journal your progress.  Please do not start any more topics that should be placed here.  Thank you.

 

Tips for tapering off Vyvanse (lisdexamfetamine dimesylate)

 

The suggested taper rate is 10% of the current dose followed by a hold of about 4 weeks.  Why taper by 10% of my dosage?

 

You could try going a little bit faster, but if you start experiencing withdrawal symptoms you will need to hold.  However, it is better if you don't go so fast that you start getting bad withdrawal symptoms.  About reinstating and stabilizing to reduce withdrawal symptoms 

 

You would need to listen to your body and symptoms and keep daily symptom notes so you can notice any withdrawal symptoms starting. 

 

You might be able to go a bit faster to start and get your drug load reduced.  However many members find that the lower their dose gets the slower they need to go.  Why taper paper: dose-occupancy curves

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