Allreadygone: need help

[ChessieCat]

22 hours ago, Allreadygone said:

 tryin small amounts of magnesium to see if I tolerate it

 

Please include this in your daily symptoms notes.

[Altostrata]

Why am I not seeing a reduction in Effexor? You know you've had an adverse reaction to it before.

[Allreadygone]

Hi @Altostrata @ChessieCat Sorry I have been off line.Site was triggering me with daily use I have to pop in and out.I decided on Jan 27 to updose eff 3mgs,not sure it did anything but I did get another month long window till March 17th before I fell back.I don’t want to updose further I’d rather hold and try to push thru mental pain.I have had 4 waves and obviously the first was brutal as well as second but these last 2 although still disabling mentality aren’t as deep.Is this normal during wds I read waves and windows and it seems to follow a lot of those post.Can feel better out of no where,make plans only to change when down comes.your thoughts wouod be helpful as insite to what’s goin on.

[brassmonkey]

Here's a copy of the calculations I did via PM.

 

Because of the fillers a half tablet will contain 12.5mg of active ingredient but will actually weigh 40mg on the scales.  If you weigh out 32 mg of tablet that will give you 10mg of active ingredient which when added to the 25mg of active ingredient in a whole tablet gives a total dose of 35mgai (active ingredient) but it will weigh 112mgpw (pill weight) on the scales.

 

You have to make the calculations based on the total weight of the current dose. 

Whole tablet 80mg

1/2 tablet      40mg

total weight 120mg

 

multiply by .94 to reduce by 6%  12 x .94 = 112.8 which can be rounded to 112mgpw. Because of the rounding you would be doing almost a 6.7% reduction but that gets you closest to the target of 35mgai

 

112mgpw minus 80mgpw = 32mgpw

 

So your new dose is 1 whole tablet at 80mgpw and 32mgpw of the half tablet.

[brassmonkey]

"Ok thx so much!I actually got the 37,5 tablets and I shave off so I’m only takin 1 pill.so if after shaving it weights 0.138 is Tgat stil 35mgs?"

 

You PMed me this, indicating that you are now using 37.5mgai tablets.  That changes all the calculations as they will weigh differently than one and a half 25mgai tablets.  

 

First off we need the average weight of  ten of the tablets.

[Allreadygone]

The 25 amd 12.5 was the lamictal from my original DM sorry.They don’t come in 37.5 but the Effexor does.i know 1 weighed 0.150 so tines 10 wouid be 1.5 

[Allreadygone]

Ok average weight is still 0.150 for 37,5 tablets,I’m weighing them at 0.138 now so how do I calculate this to mgs?

[Allreadygone]

I do understand the lamictal calculations u sent.thx it will be very helpfull once I’m ready.im tryin to get next cut for all 3 meds so I can map out again when ready which could be a while.Im gonna use your super slow technique.just need to get Effexor dialed in 

[brassmonkey]

Going from 150mgpw (milligrams pill weight) down to 138mgpw is a reduction of 8%

 

To get the strength of the active ingredient (mgai) you would multiply the original strength 37.5 by .92

 

so 37.5 X .92 = 34.5

 

The strength of your new dose is 34.5mgai (milligrams active ingredient)

 

If you wish to continue doing 8% reductions then next time you would do the same calculation to both of the current numbers:

 

138 X .92 = 127mgpw the amount you would weigh on the scale.

34.5 X .92 = 31.7 mgai the strength of what that dose would be.

[Allreadygone]

 

Thx Brass you are very helpfull,I’m gonna read thru your threads.Is it ok to ask u questions I don’t want to bother u.

8% is way to big but that was my last cut after small updose.Now that I understand your method I’ll be doin 2-5%. This is invaluable thx agsin 

[brassmonkey]

Ask away.  I'm still post surgical and have another procedure next week so I may be a bit slow getting back to you. Also if you need help with the calculations on what ever taper you decide on just ask.

[Allreadygone]

Thx again to get back while your goin thru procedures!Hope your healing is comin fast and steady!

[JanCarol]

Hey Allready - 

 

In our discussions I have discovered that your Effexor is IR, which I think mods have not been aware of until this time.  That's why you haven't been counting beads!  (the beads are XR, giving you a 24 hour dose).  It's also somewhat criminal that your doctors haven't been dosing you at least 2x a day with the IR!  Maybe they mistakenly believe the Remeron will "cover" the withdrawals from the Effexor, which is dead wrong.

 

This may be why you are having trouble stabilising, as the half-life of Effexor IR is only 5 hours.  That means you take your dose in the morning, and then 8-10 hours later go into withdrawal.  This seems to correlate with your symptom reports, that you have more trouble later in the day. 

With IR, it is vital that you split your dose.  With 5 hours, that could be as many as 4 doses a day.  How about you start with splitting your 31.25 mg dose into 2 doses at 12 hours apart.

Let's see if a split into 2 doses improves your symptoms, and then maybe you will find a way to split it into 3 or 4.  The problem, of course, with 4 doses, is that you want them all 6 hours apart, which means you take one in the middle of your sleep.  Perhaps 2 or 3 doses (3 doses would be 8 hours apart) will help you stabilise.

 

I hope this helps, and I hope you see the sun today!

[ChessieCat]

Generally when splitting doses it is suggested that you move the doses apart gradually as this is more gentle on your nervous system.

 

If splitting into 2 doses you would move 1/2 the dose by 1 hour each day until they are 12 hours apart.  If you do this you might find that the change in your symptom pattern confirms that you are currently experiencing interdose withdrawal.

 

Another option, if you are currently taking your dose in the morning, would be to take 1/3 dose in the morning and move 2/3 dose 1 hour each day until about 8 hours apart and then continue to move 1/3 dose (from the middle of the day) 1 hour each day until another 8 hours apart.

 

If you are currently taking your dose in the evening you would do the above process in reverse, moving the dose 1 hour earlier each day.

[Allreadygone]

Thx for digging this up @JanCarol @ChessieCatThis makes sense as I switched over from ER In 2011 as I thought the ER was causing insomnia due to gettin dosed thru the night.I take the 35mgs Effexor at 545AM with lamictal.Im goin to see how next few days i like to not be in a wave when I make this change even tho it’s a small adjustment.

My Doctors Have never had a clue as most don’t acknowledge Wd syndrome.

Even my bottle says once a day,I know eff has very short half live so maybe I keep having interdose issues.

[Allreadygone]

Should I go to ER?Is it easier to make cuts or stay with IR and weigh cuts? @ChessieCat @JanCarol

[brassmonkey]

I'm going to copy and paste your question here so you will have a proper record of it.

 

So I just weighed my 25mg Effexor andthe mgpw is .100 I need to weigh half and make cuts on that piece.so 12.5 wouid be .050.i need to take 35mgs(25mg in am and 10 in pm)as mods told me this is proper way to take eff IR which I was never told.They think I may be in interdose wds prolonging my waves.

what would the mgai be to get 10mgs  Wouod it be .042? Or .040

 

Short answer is that it would be .040 or 40mgpw

 

These appear to be nice pills to calculate with.  If we divide the pill weight 0.100mgpw by the strength of  the medication 25mgai  0.100 / 25 = 0.004  This means that for every 4mgpw we get 1mgai.  This is called the Active ingredient Concentration (AIC).  If we need a dose of 10mgai we multiply the AIC of  .004 by 10 and get .040.  So you need to weigh out .040mgpw to get a dose of 10mgai.  This holds true only for these pills, if you change to a different manufacturer or strength of pill the AIC needs to be recalculated.

[Allreadygone]

Thx for the quick response I’m gonna move 10mgs an hour a day.Then I will move to 17.5  which will be half. @brassmonkey

[Allreadygone]

Hey @brassmonkey I have moved the 10mgs Effexor up 10hours so I’ll hold here to let me system get used to it.I have a ? As id like to make a cut on the remeron in future.Im on 7.5mgs,The mgpw for 7.5 mgai is .075.seems to actually line up.So to get to 7mgai it would be .070mgpw?

[brassmonkey]

Boy did you luck out with those numbers.  Yes, that would be how it works.  For your records that would be a 9.3% reduction.

[Allreadygone]

I know I wish the other drugs did that as well but it’s impossible.Ok thx for reassuring me,I’ve gotten better at learning your system although to late to save me from a lot of suffering it’s priceless goin forward. @brassmonkey

[Allreadygone]

 It’s been a while since I posted as I was getting triggered by to much.Only have mare a few moves since initial crash.Did 2 small updosed to go from. 31to35/36 Effexor,and just cut remeron from 7-6.5 about 3weeks ago,Moved eff to 2 times a day about a month ago seem to 

be having widows and waves,first 2 were pretty clear in beginning.just oringinal Dp,Dr stuff.now I Have shorter of both.is this a sign of decline?The last few waves were shorter and not as deep,still very painfull mentally.The wave I’m in now is Like the early ones with a few changes.part of it will be eased.lil then a diff part will hurt,mainly brutal fear from pit of stomach.also had moments,hours,days where I can do simple things.must have felt ok enuff to think I could make a cut.i was gonna do a long hold maybe yr to see if I have longer windows.also may have forgot dose before recent wave started a week ago.Looking for feedback  @Altostrata  @JanCarol@Shep  @ChessieCat I’ve read thru windows and waves but thought they get longer and clearer these are shorter and mixed.Do I think splitting dose,cut,missing a day of meds threw me back in bad wave?

[Allreadygone]

@brassmonkey

[Altostrata]

When did you make these drug changes? Please update your signature.

 

When did you split a dose or skip your dose?

 

If the waves are lessening, things are going in the right direction.

[Allreadygone]

I’m not sure how to get to my sig page and change  @Altostrata it was all within the last month.my Waves had got a bit lighter but this one has characteristics of the the early waves.Is that normal?I guess after a cut it’s to be expected,I’m not sure what made me think I couod cut only that my waves had lessened in mental pain and I had some small windows after them but still wasn’t functioning much.My plan was to hold for another yr to see if the windows continue.

[Altostrata]

Every time you make a drug change, it may have repercussions some time later. I can't answer questions such as

 

2 hours ago, Allreadygone said:

Do I think splitting dose,cut,missing a day of meds threw me back in bad wave?

 

without knowing when you made a drug change and when did you get the symptom.

 

I hope your nervous system settles down over a year. Please let us know how you're doing.