intothewoods: help converting Provigil / modafinil to liquid for slow taper

[intothewoods]

Thank you Altostrata. 

The Prozac was prescribed in 1999 for depression during a divorce and writing a nonfiction murder book. In 2001 I got CFS and in 2005 was prescribed the Provigil to for wakefulness and the fatigue. It allowed me to continue writing to a degree but by 2007, became disabled. 

 

I take them in am as prescribed. If I take either any later in the day, it disrupts sleep. 

 

I take the Elavil and Valium at night. 

 

I conclude that the morning withdrawal is from Provigil because I've experimented with just taking the Prozac then waiting on the Provigil and vice versa. In all cases, I literally feel (or think I do) the Provigil as it slowly takes effect and enables me to be human. The Prozac has such a long half life it wouldnt be the culprit would it? 

 

Also, I've tried several times since mid 2017 to not take the Provigil. I stay in bed and manage the first 24hrs but by next day, need assistance for everything, and shake nonstop. 

 

I live alone and don't have this kind of help available at the moment. So I'm trying to taper the Provigil and now with the liquid, I can. 

 

 

 

[intothewoods]

Drug Schedule:

 

Morning :  50 mg Prozac

                    31 mg Provigil 

 

Midday:  PremPro. 625 mg/ 2.5 mg

 

Evening: Valium 5 mg

                 Elavil 23 1/2 mg

 

** Hydroxyzine 12.5 mg to 25 mg as needed. Now in December 3 - 4 x week, reducing from daily Oct. 10 - November 30 as went thru Hurricane Michael and moved every few days. 

[intothewoods]

2 hours ago, Altostrata said:

 Why are you taking Provigil with Prozac

 

Alto, 

Do you think dosing this together is risky? Should I put some space between them? 

 

Like all of us, I prefer not to ever take them again 😂. But until that day, I'm grateful for all the fast-learning from this forum. 

 

Will submit concise daily notes as soon as can type on my computer again. Thanks for everyone's patience. Every day this week was a roadkill day. 

 

O2C

 

[Altostrata]

When you take two drugs at the same time, we can't tell which drug is causing symptoms that follow the dosing.

 

Yes, Provigil helped you work, it's an alternative to amphetamines.

That is a curious drug cocktail. Why 2 benzos at night?

 

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

[intothewoods]

Alto, 

5 hours ago, Altostrata said:

That is a curious drug cocktail. Why 2 benzos at night?

 

Valium is a benzo but I understand the Amitriptyline (Elavil) to be a tricyclic antidepressant?

 

 

[ChessieCat]

Yes that is correct.

[intothewoods]

On 12/26/2018 at 7:19 PM, ChessieCat said:

Hi Out2C,

 

 

I've put the drugs you are currently taking into a drugs interaction checker and the results are pasted below.

• Prozac
• Provigil
• Amitriptyline
• Valium
• Vistaril
• PremPro

 

Interactions check from https://reference.medscape.com/drug-interactionchecker

Serious - Use Alternative

• fluoxetine + amitriptyline

  fluoxetine and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug.

• hydroxyzine + fluoxetine

  hydroxyzine increases toxicity of fluoxetine by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.

• fluoxetine + amitriptyline

  fluoxetine will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug.

Monitor Closely

• fluoxetine + diazepam

  fluoxetine will increase the level or effect of diazepam by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.

• modafinil + amitriptyline

  modafinil will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.

• modafinil + conjugated estrogens

  modafinil will decrease the level or effect of conjugated estrogens by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• modafinil + diazepam

  modafinil will decrease the level or effect of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• modafinil + medroxyprogesterone

  modafinil will decrease the level or effect of medroxyprogesterone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Contraceptirve failure possible. Use alternative if available.

• amitriptyline + fluoxetine

  amitriptyline and fluoxetine both increase QTc interval. Modify Therapy/Monitor Closely.

• hydroxyzine + diazepam

  hydroxyzine and diazepam both increase sedation. Use Caution/Monitor.

• hydroxyzine + amitriptyline

  hydroxyzine and amitriptyline both increase sedation. Use Caution/Monitor.

• hydroxyzine + modafinil

  hydroxyzine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• diazepam + amitriptyline

  diazepam and amitriptyline both increase sedation. Use Caution/Monitor.

• amitriptyline + modafinil

  amitriptyline increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

Minor

• modafinil + diazepam

  modafinil will increase the level or effect of diazepam by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.

• modafinil + amitriptyline

  modafinil will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• conjugated estrogens + amitriptyline

  conjugated estrogens, amitriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

 

[ChessieCat]

This is the link to the drug interaction checker:

https://www.drugs.com/interactions-check.php?drug_list=1303-775,739-380,1115-648,1647-1020,168-0,862-441

This is a copy of the duplication information from the bottom of the page which shows your drugs by category:

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.

Tranquilizers

Therapeutic duplication

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

• Vistaril (hydroxyzine)
• Valium (diazepam)

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.

Central Nervous System (CNS) Drugs

Therapeutic duplication

The recommended maximum number of medicines in the 'Central Nervous System (CNS) Drugs' category to be taken concurrently is usually three. Your list includes five medicines belonging to the 'Central Nervous System (CNS) Drugs' category:

• Vistaril (hydroxyzine)
• Prozac (fluoxetine)
• Provigil (modafinil)
• amitriptyline
• Valium (diazepam)

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.

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:

• Vistaril (hydroxyzine)
• Prozac (fluoxetine)
• amitriptyline
• Valium (diazepam)

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

Antidepressants

Therapeutic duplication

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

• Prozac (fluoxetine)
• amitriptyline

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.

 

 

 

[intothewoods]

Thanks. I understand I'm on way too many meds and regret submitting to this "treatment of symptoms" for Chronic Fatigue Syndrome. All I can do, and have been doing, since the too-late realization that this has caused great damage, is educating myself and tapering off. 

 

I'm excited to be making the water titrations. This allows the gradual reduction so sorely needed. Every second of existence is a painful struggle so I try to stay positive and supportive.

 

[Altostrata]

11 hours ago, Out2C8383 said:

Alto, 

 

Valium is a benzo but I understand the Amitriptyline (Elavil) to be a tricyclic antidepressant?

 

My mistake. Why are you taking them at the same time?

 

20 hours ago, Out2C8383 said:

Morning :  50 mg Prozac

                    31 mg Provigil 

 

Midday:  PremPro. 625 mg/ 2.5 mg

 

Evening: Valium 5 mg

                 Elavil 23 1/2 mg

It looks to me like your doctor is very free with the prescription pad, or maybe a believer in random drug cocktails. Your nervous system must be fairly resilient to hold up under that drug burden.

 

That's a hefty dose of Prozac, too. If, by any chance, 3 of 4 of your drugs have been prescribed to address "depression," you should know that "depression" is a side effect of benzos such as the Valium you've been taking for 13 years. Fatigue is another side effect of benzos.

 

To figure out which drug is causing adverse reactions, we need to see daily notes about dosing, symptoms, etc. with the drugs taken at different times in a regular schedule.

 

As taking Provigil later in the day affects your sleep (an indication you're taking too high a dose), suggest you move Prozac later in the day, such as noon. You can do this by taking it an hour later each day.

 

After you get the Prozac settled, please gradually move the Elavil earlier by a couple of hours so it will be separated from the Valium. Or, you can move the Valium later.

 

Please track your symptoms before and after each dose of each drug.

 

You will also need to take your drugs on a regular schedule, we need to see times of day of each dose, not morning, midday, and evening. Taking drugs irregularly can cause fluctuations in symptoms that muddy the side effect picture.

[Carmie]

Hi Out To Sea 🌊🌊🌊, 

 

( I have to write it like that, major water freak here, I even called my soft toy dog Puddles). Thank you for your messages. I’m so sorry you are in this predicament. You n I will eventually get off these dreaded meds, and then we will work on recovering from CFS too. I’m so glad I finally know what causes CFS. It is a CNS illness as you know. 

 

Yes, doctors know pretty much nothing about CFS. I’m really very sorry that they put you on all these meds. The meds have just made it harder for us to recover from our illness. We will get there one day though. 

 

Please write out a daily journal on here. What time you take your meds. What symptoms you get at particular times etc. we might be able to see a pattern eventually.

 

At the moment just work on slowly moving your Prozac to noon an hour at a time. We have to do everything so slowly when our bodies are so sensitised. I’ve been on a myriad of meds n my body is so sensitive too.  Document on here your gradual moving of the Prozac to noon as well in your daily notes. 

 

Well, I hope you’re coping okay today. I actually got on a bus this morning to run some errands after spending pretty much the whole week in bed. I’ve been in a bit of a CFS crash, as you will no doubt know all about. I think the stress of being in a wave of three months has taken its toll. I’m back in bed again. 

 

Sending hugs your way🤗

 

[intothewoods]

Hi Carmie,

 

I'm very thrilled you got out yesterday. Fresh air! The market! Like you say, CFS is its own unique CNS monster (one author aptly calls it "being trapped in extremity") and once I had it, any trip outside, even to walk in sunshine, was like the old days of zooming to France or the Caribbean. Vacation! Freedom! ✈️ And now that I've learned more about windows and waves, it does seem between the two conditions, I have been in a wave of some heighth for at least four years. I love the water and surf, too, though. No crossover. 😊

 

16 hours ago, Carmie said:

Yes, doctors know pretty much nothing about CFS. I’m really very sorry that they put you on all these meds. The meds have just made it harder for us to recover from our illness. We will get there one day though. 

 

 

For sure. Perhaps one of most tragically ironic cases is that of Whitney Dafoe, whose father is a Stanford U scientist who oversaw the research on the human genome. Whitney was a journalist like me only photojournalist and his spiral down is hauntingly similiar in that, the more he sought medical help, especially through the family connections he had -- the more he was treated for depression and loaded with psych meds. He talks about it on his blog. He hasn't written in years though because he is unable to speak or eat food solid food, lives in the his parents' back bedroom in Palo Alto, California. He absolutely cannot tolerate any stimuli; even knowing a friend might visit sends him to the E.R.

 

One reason I mention this too is that earlier this year, Whitney was temporarily able to speak a little bit to his parents. He was given Ativan. But it didn't last. The CFS forums discuss it at length and several CFS veterans talk about their own cocktails of Klonopin/Elavil (THE classic CFS nighttime cocktail as prescribed en masse).  My favorite story on Whitney ran in the Washington Post in 2015. It's very balanced in its coverage of science, meds, and chronic illness and the mysteries that surround them. 

 

Other esteemed individuals perhaps harmed by psych meds,  as I worked in their "circles" so to speak, as a food, wine, travel and fashion writer from the early 1990s on, are Kate Spade and Anthony Bourdain. I remember being at a fashion reception with my literary agent and Kate was there. They all spoke about this exciting new drug that made you sleep: Ambien. Just about all my editors at the magazines, even my travel book publisher's staff in Berkeley..they were taking Xanax and Ambien and Prozac or Paxill. I remember being intrigued by it all. 

 

After Kate's suicide, her husband said she was "being treated" by a Manhattan psychiatrist for quite a while. Likewise, Anthony's girlfriend said he had taken some of the meds above for years every day. I knew that. It was like a culture among anyone who had to travel, be exposed to massive stress by media, and in my case (theirs too, even more, I'm sure) was repeatedly told that as "a tortured artist," I would need to be on ADs and anti-anxiety meds my entire life. Sylvia Plath and Virginia Woolf  (my writing was shaped hugely by both) were often mentioned by doctors. They'd say neither would have committed suicide had they had Prozac. I remember a psychologist in Key West telling me that when I first went on Prozac. I believed, as she did, that we were very fortunate to have something to alleviate the bad chemistry. 

 

We were all wrong. African-American slavery was wrong. There is and has always been human error. "It does not belong to man who is walking even to direct his step" says an ancient book of wisdom. We have experienced it and now, we work for harm reduction. Physically, emotionally, mentally. 

 

I hope you have another up day today and will wrtie more later.

 

Hugs back to you,

 

Out2C

 

 

[intothewoods]

One important part of the story that I left out. After being on Prozac a year, I told my GP I wanted off. I was no longer depressed, had left my husband, and was happily zooming everywhere. Although he said it's  impossible, I tried. I tried several times and every time, made S.O.S. calls to my ex-husband who couldn't believe how powerful the meds were. My last attempt was in 2001 and I gave up.

 

The happy ending: He is helping me with basic living expenses to this day because he said beyond any shadow of a doubt, the Prozac destroyed my CNS. He said he watched me become a person with "nervous energy who couldn't sleep." Wild, eh? We were best friends (he is a city manager and I was covering city hall when we met and married in 1984) and still are. I'm grateful for his input historically. His own mother died in a nursing home a few years ago, in a seizure while withdrawing, or attempting to withdraw, from 17 psych meds. Tragic. 

[Carmie]

 Hi out to sea🌊, 

 

Your post was very interesting. I always wonder when I hear people committing suicide whether they are on meds, and whether the withdrawals from them gave them so much distress that they committed suicide. Having suffered from severe akathisia myself I was extremely suicidal. At the time I didn’t know what was wrong with me though. I thought there was something terribly wrong with me mentally n physically, nope, it was withdrawals.

 

The story of Whitney Defoe is really, really sad. It breaks my heart. Suffering from CFS like us, and then put on  meds, it was quite a downward spiral. It really is so hard to understand how psychiatrists n doctors end up causing more harm to us when we are already struggling so much. They only know what they are taught, I guess, which really is detrimental to us. 

 

I watch the Lucinda Meyers videos on YouTube too, it breaks my heart every time I watch them, and I do not recommend watching them if you get triggered easily. She was cold turkeyed off meds and her akathisia is so severe. I watched her latest one, and she is no better. Boy, the doctors n pharmaceutical companies have a lot to answer for. 

 

That being said, I no longer have anger towards them as it serves no purpose. I just try n focus on what I can actually do day to day on the road to recovery. I’m quite positive by nature, but that doesn’t mean I don’t hurt. 

 

I’m glad you’re getting some support. How horrible though that your mother in law died from a seizure due to withdrawals from drugs. Seventeen psych meds!! Totally nuts!!  I can’t remember the name of the person, but I could check it out. One person on YouTube nearly died too from cold turkeying off benzodiazepines. Never a good idea. 

 

I’d like to end on a positive note though. WE WILL WIN THIS FIGHT!!!!

 

Sending lots of hugs, we will get over these withdrawals, and once we have done that, we will work on recovering to get over CFS.💚💚

 

[Carmie]

Hi Out To 🌊, 

 

I’ve been wondering how you’re doing. Hope you’re coping okay. 

 

Sending hugs🤗

[intothewoods]

Hey Carmie, I was just sitting down to write and say, sorry I sailed off the horizon after my last post which I certainly didn't mean to. 

 

Thank you for checking in and wow, I've learned so much in just two weeks on this forum. I've been reading as others come on, or recently came on, and then in the past as members went down the rocky path of healing and made it through. Those who have been struggling for years. It's like on the one hand, this entire profession (psychiatry) is shooting victims down one day and surivivingantidepressants.org is helping them recover the next. Exhilarating to see the hard work, all volunteer, by Alto and the mods, as they rescue people from the darkest life places, literally and figuratively. (Psych wards are for another post but with some experience in both, I can say that Death Row, at least in Florida, is not all that different and in many ways, better)

 

I messed up on Tuesday and changed too much too fast in my med scape. As documented in my thread, on December 15th, I converted Elavil to liquid and on the 20th, lowered the dose 10 percent which was too much, then raised it four percent. A few days later, I converted Provigil to a liquid and began a game of "moving target" to determine how much I've actually  been taking the past few months as I cut a 100 mg tablet into fourths and then it crumbles, etc. I thought it was about 18 mg but it seems to be more like 23 mg. 

 

Then decided Tuesday to take my morning Prozac an hour later to separate it from the Provigil. This would seem a relief for the body and brain but within hours, I felt I jumped out of a plane sans parachute and have been hurtling in delirious disbelief toward solid ground ever since. Mainly, flat on my back in a dark room no food no sound no nothing except rolling over every possible time to read another post on this forum. I see this is not unusual. 

 

Today is a little better and I'm thinking the wise course may be to continue taking the Provigil and Prozac simultaneously in the morning while tapering off the Provigil. Using the Brassmonkey Slide, I will be free of the Provigil within a year of so and then, the Prozac is alone. At night, I will continue the Elavil taper via the same Slide and be done in same time. That leaves only Valium at night. And only 5 mg. How happy I am that my primary doctor since 2001 (except for 2012-2015) kept the Valium at that dose although CFS specialists tried to raise it and switch me to high doses of Klonopin. 

 

Regarding my doctor: She is one of us. I mean, she went along with the whole medication thing for 20 years but now, is 100 percent on our side, has talked with the pharmacist who helped me liquify the Elavil (and, is now helping others in my small fishing village do the same...most are elderly) with SA formulas, and said my case has "transformed the way I practice medicine." Her husband is a cardiologist. They are amazing doctors -for-the-people, three clinics in three small Florida towns, having left the big clinic life early on to help poor people. 

 

So my doctor is on board, my pharmacist is on board, and now I just have to get stabilized again like I was when I first posted less than a month ago and begin submitting concise blocks of daily notes with symptoms. I understand the mods need this format or they'll be days wading through essays like this and not be able to help everyone. I also realize many  of us newbies are tempted to vent our vicious symptoms in every post but.....that is pointless. A quick read of 100s of other posts on the forum shows we are not alone. We are in the majority. Winning this battle. 

 

My family is so excited about SA and the liquid conversions. My mother in particular. I just helped her get back on a low dose of Effexor to be alive and she will soon be 80. A year ago, she decided that based on my experience with these drugs, she should jettison her Effexor, Restoril and Xanax one at a time. All came to her over decades'' time and with various doctors and as she has developed serious health conditions. I begged her not to listen to her doctor about the Effexor, not to allow herself to be ripped off the drug in one month. She was on 225 mg. She's a very smart, amazing woman who I am privileged to call my best friend. We began jogging together when I was a teenager and we both ran every day until the meds got us. 

 

She didn't believe it could be this way; she is an RN and worked in brain surgery at Tampa General Hospital. After one month "taper" off  Effexor, she was in horrific WD, my dad thought she was drunk, she couldn't walk, ..... it was like my life of 2015 repeated. I was grateful to be able to help her 1) not get Baker-acted and 2) come to the realization that these meds were destroying her life. She held out for three months, no Effexor, then her doctor tried Wellbutrin and then Pristiq -- within a four-day period. My mother finally said: Help me. This is evil and I am so, so sorry I had no idea what you've been living through and I will do everything in my power to help you get free of these drugs. 

 

And she has. We just talked and when I told her about my trifecta of the past three weeks (two liquid conversions, moving the Prozac), she said how could you know? Yet we are so sensitive that we cannot go too slow. She loves this website and also The Withdrawal Project. I have come to know Laura Delano, the founder of TWP, a little and helped a little get that site started. I cannot recommend it enough; the New York Times quoted it in a May 2018 Sunday 1A piece on how people can't get off AD. She credits SA as helping greatly in putting together her site. 

 

I apologize for the novella. Hopefully it helps someone other than me but for sure, it helps to chronicle all this. Altostrata says that our thread can become a record of our recovery. It's important to see where we start, whereforth we came. 

 

By Jan. 15th or so, I should be stable on the liquid Provigil and Elavil. Then, forward......

 

Thanks and I'm grateful to be a part of this forum.

 

Out2C 

 

 

 

 

 

[Altostrata]

2 hours ago, Out2C8383 said:

I messed up on Tuesday and changed too much too fast in my med scape. As documented in my thread, on December 15th, I converted Elavil to liquid and on the 20th, lowered the dose 10 percent which was too much, then raised it four percent. A few days later, I converted Provigil to a liquid and began a game of "moving target" to determine how much I've actually  been taking the past few months as I cut a 100 mg tablet into fourths and then it crumbles, etc. I thought it was about 18 mg but it seems to be more like 23 mg. 

 

Then decided Tuesday to take my morning Prozac an hour later to separate it from the Provigil. This would seem a relief for the body and brain but within hours, I felt I jumped out of a plane sans parachute and have been hurtling in delirious disbelief toward solid ground ever since. Mainly, flat on my back in a dark room no food no sound no nothing except rolling over every possible time to read another post on this forum. I see this is not unusual. 

 

Today is a little better and I'm thinking the wise course may be to continue taking the Provigil and Prozac simultaneously in the morning while tapering off the Provigil. Using the Brassmonkey Slide, I will be free of the Provigil within a year of so and then, the Prozac is alone. At night, I will continue the Elavil taper via the same Slide and be done in same time. That leaves only Valium at night. And only 5 mg. How happy I am that my primary doctor since 2001 (except for 2012-2015) kept the Valium at that dose although CFS specialists tried to raise it and switch me to high doses of Klonopin. 

 

Hi, O2C. I really, really need to see your daily drug schedule in a list format, with dosages. I also need to know your symptom pattern before and after you take your drugs. Please keep daily notes on paper about your symptoms, when you take your drugs, and their dosages. Use a simple list format with time of day on the left and notation (symptom, drug and dosage) on the right.

 

It's generally a good idea to make the conversion to liquid at the same dosage and monitor for at least a week to see the effect of the change. I know you're anxious to minimize the drugs, please don't take shortcuts now -- we need to establish a baseline symptom pattern for safe tapering.

 

2 hours ago, Out2C8383 said:

Regarding my doctor: She is one of us. I mean, she went along with the whole medication thing for 20 years but now, is 100 percent on our side, has talked with the pharmacist who helped me liquify the Elavil (and, is now helping others in my small fishing village do the same...most are elderly) with SA formulas, and said my case has "transformed the way I practice medicine."

 

Does your doctor visit SA? Gratifying to hear she's adopted the "SA way" of gradual tapering by using liquids etc.

 

2 hours ago, Out2C8383 said:

She credits SA as helping greatly in putting together her site. 

 

LOL. Good to hear Laura is doing this behind the scenes, as she's overlooked making the public acknowledgement I requested.

[ChessieCat]

11 minutes ago, Altostrata said:

Hi, O2C. I really, really need to see your daily drug schedule in a list format, with dosages. I also need to know your symptom pattern before and after you take your drugs. Please keep daily notes on paper about your symptoms, when you take your drugs, and their dosages. Use a simple list format with time of day on the left and notation (symptom, drug and dosage) on the right. 

 

Example:

 

6 a.m. Woke with anxiety
8 a.m. Took 2.5mg Lexapro
10 a.m. Stomach is upset
10:30 a.m. Ate breakfast
11:35 a.m. Got a headache, lasted one hour
12:35 p.m. Ate lunch
4 p.m. Feel a bit better
5 p.m. Took 2.5mg Lexapro
6 p.m. Ate dinner
9:20 p.m. Headache
10:00 p.m. Took 50mg Seroquel
10:20 p.m. Feeling dizzy
10:30 p.m. Fell asleep
2:30 a.m. Woke, took 3mg Ambien (NOT "took 1/2 tablet Ambien")
2:45 a.m. Fell asleep
4:30 a.m. Woke but got back to sleep

[intothewoods]

36 minutes ago, Altostrata said:

Hi, O2C. I really, really need to see your daily drug schedule in a list format, with dosages. I also need to know your symptom pattern before and after you take your drugs. Please keep daily notes on paper about your symptoms, when you take your drugs, and their dosages. Use a simple list format with time of day on the left and notation (symptom, drug and dosage) on the right.

 

It's generally a good idea to make the conversion to liquid at the same dosage and monitor for at least a week to see the effect of the change. I know you're anxious to minimize the drugs, please don't take shortcuts now -- we nee

Ok, I can do this!   

And I understand the peril of shortcuts. With the water conversion on the Provigil, I've gone from 20 mg up to 33 in one week with various stages of "wakefulness" (as the drug is supposedly intended for). Part of the problem is being able to take less the days I'm unable to move from bed in a CFS crash, which are 2-3 days a week. On the other days, I barely move around doing basic life stuff. I am trying to find a baseline of Provigil that will work in or out of bed. At least I have a syringe with lines instead of trying to dust-particle taper until I can stand up. I am getting close now. Any suggestions are welcome. I'm no longer near or above 30 mg since last week when you were right, I took too much later in the morning. 

 

[intothewoods]

46 minutes ago, Altostrata said:

Does your doctor visit SA? Gratifying to hear she's adopted the "SA way" of gradual tapering by using liquids etc.

 

Absolutely. I send her links to the website and also the pharmacist. He used SA's water conversions and compared it to his pharmaceutical resources and all was in perfect harmony. That's how I jumped to liquid Elavil. 

[Altostrata]

19 minutes ago, Out2C8383 said:

Absolutely. I send her links to the website and also the pharmacist. He used SA's water conversions and compared it to his pharmaceutical resources and all was in perfect harmony. That's how I jumped to liquid Elavil. 

 

Very pleased we were able to help the pharmacist's entire community.

[ChessieCat]

3 hours ago, Out2C8383 said:

The Withdrawal Project.

 

inner-compass-and-the-withdrawal-project

[Carmie]

Hi Out to 🌊, 

 

I’m glad you’ve found lots of information on this site to help you. It made me smile when you said your family is exited about what they’re learning too.

 

I’m glad you’ve got your doctor and pharmacist on board too. How are you doing? Have you been able to get out and about a bit, or has your bed not wanted you to leave. Those beds canget quite clingy🛏😄. Mine seems to cling to me like glue a lot of the time. I had a ball yesterday though at the aqua park. Soooooo much fun!

 

Please don’t put a calendar on when you will taper again. It’s best to listen to your body.

 

Sending sunshine your way☀️☀️☀️

 

 

 

 

[intothewoods]

I'm so glad you had a water day, Carmie. It's immense balm for the soul, especially with a near-glued-on-bed like we have. 

 

I definitely won't put a date on moving anything. I'm in the worst crash since 2016, struggling for any basic existence out of bed. Made too many changes too fast in two weeks. I will post a schedule if I am able at some point as I know staying focused is the way to do it. Any internet or even sitting up is blindingly painful right now. 

Am grateful to get a shower. We all know this space. ....whew!

 

Thank you for checking in. Same solution always: Time and rest (and no more rapid med shifts :).

 

All the best,

Out2C

[Carmie]

Hi Out2C, 

 

I’m sorry you’ve been in a crash. I’m slowly coming out of one at last. I couldn’t get out of bed until the afternoon yesterday though, but managed to get up and about after that. Wanted to run a couple of errands but didn’t have the strength for that. I’m so sorry you’re unable to do anything. I hope you manage to get your shower. 

 

The first night of my crosstaper went well, no additional symptoms.Yay! Let’s see what the rest of it brings. 

 

Yes time and rest is the only solution as you said. Rest up and take care of yourself.💚

[intothewoods]

Thanks for the messages, Carmie. Of course I'm elated that your crosstaper is smooth. Not surprised, though. You are diligent and have endurance. I learn so much every day it's like tidal waves of new awareness. Was it two weeks ago that I said I knew how to taper? That was insane. Truly  

 

I'm going to post notes from the past few days and appreciate you guys helping find patterns and triggers. 

 

Thanks again........ Out2C

 

 

[Carmie]

Hi Out2C, 

 

We will get there in the end. Lots of time and patience is definitely needed in this horrific journey. I’ll have to see how the rest of the crosstaper goes. I’m just glad I didn’t get severe akathisia last night, which is what happened on the first night when I changed to compounded without a crosstaper. 

 

I’m starting to feel a few extra symptoms in the last hour or so. As long as I don’t get severe akathisia I’m fine. I just keep plodding on. Can’t wait to get back to the original tablets again, stabilise, and finally move forward. It’s an hour at a time in this journey.

 

Wishing you all the best in this healing journey💚

 

 

 

[intothewoods]

RECAP of Swan Dive:

April 2018:       Drop from 60 mg Prozac to 50 mg. 

Dec. 15:           Crossover from 25mg Elavil tablets to 25 mg liquid.
Dec. 20:           Decrease liquid Elavil to 22 1/2 mg.
Dec. 23:           Increase liquid Elavil to 23 1/2 due to CNS shock and insomnia.
Dec. 26:           Convert Provigil to liquid and begin target shooting between 18-33 mg. 
Jan 1:              Move Prozac dosing an hour later than Provigil. CNS annihilation. Enter crisis mode first time since 2016.
 

~~~~~~~~~~~~~

Jan 4:    

     
 9 am      Withdrawals as usual last 18 months
                28 mg Provigil
                 50 mg Prozac
11 am      Green smoothie
11:30       Write stressful proposal. 
1:30         Electric jolts, tremors, depression. 
3 pm        Errands in town through dense bleakness. Everything surreal and confusing.
5 pm        More computer writing. 
7 pm        Dinner

9 pm         23 1/2 mg Elavil and 

                  5 mg Valium

10 pm      Relaxed .Read. 

11 pm     Can't fall asleep first time in over a year but keep resting. Dysphoria.

4 am        25 mg Vistaril

5 am-9 am  Doze off couple of times.
 

~~~~~~

Jan. 5: 

9 am        Withdrawals. Know can't move from bed. 
                  22 mg Provigil (due to little sleep)
                 50 mg Prozac     

9 am -5pm    Llistless in bed. Half sleep, half rest.

8 p.m.       23 1/2 mg Elavil
                   5 mg Valium

9 pm            Relaxed

11 p.m.   Still no sleep. 12.5 mg Vistaril.

1 am        No sleep. 12.5 mg Vistaril.

3 am       Fitful sleep. Thrashing, night terrors.

 

~~~~~~~~~~~~~

Jan 6
9 am        Withdrawals.
                  22 mg Provigil
                  50 mg Prozac

9- 1 pm    Listless in bed.

1 p.m.       Green smoothie.

3 pm         Read, play scrabble.

4 pm        Rest/sleep

9 pm         23 1/2 mg Elavil
                  5 mg Valium

10 pm        Relaxed

Midnight      Sleep flailing around, sweating, gasping for breath. This about half my nights for four years.

~~~~~~~~~~~~~~~~~~

Jan 7 
 9 am       Withdrawals
                 Provigi 22 mg
                  Prozac 50 mg

10 am      Still in withdrawals. No hope of getting out of bed for third day in row. 
                  2 mg Provigil

11 am       Still can't sit up
                  2 mg Provigil

11:30         Some alertness. Force self to get up. Make green smoothie. 

1 p.m.       Calmer. Housework.

2 p.m        Light lunch

4 p.m.       Huge crash of energy. Anxiety.

5:30 pm    Back to bed. Read. Relief to be lying down. 

9 pm          23 1/2 mg Elavil
                  5 mg Valium

10 pm       Read. Relaxed.

10:30 - 12:30    Lay awake

12:30   a.m.    25 mg Vistaril

1 am-9 am      Sleep sound.
 

 

 

 

 

[intothewoods]

Not sure why but on my tablet, the schedules are in straight columns. On my phone, there are some breaks. Let me know if problems.....Thanks ~ C 

[intothewoods]

To help frame my WD schedule or fill in some gaps:

 

Every morning  I wake in full-blown withdrawal from Provigil. It's so violent I can't hold a glass of water until lots of deep breaths and determination. My one goal for an hour is to calm to a state of being able to get out of bed (vs falling out... LOL). It's gone on for almost 18 months so in a way, it seems quite "normal."

 

As well, I feel like I'm vibrating from the inside out, those infamous akathesia electric shocks, in near perpetuity along with the dyskinesia daily. I just shudder always. Some seems from WD. Some seems from the meds. My doctor and I know the Elavil causes cervical dystonia and causes my left hip to jerk for several hours after it enters my bloodstream at night. That's happened like clockwork for two years. 

 

Again, it all seems like part of life and I don't focus on it yet realized it should be mentioned as ongoing daily symptoms for my log. 

Thanks again for all the help. One thing for us, life is never dull! 😅

 

 

[Carmie]

Hi Out2C, 

 

I’m so extremely sorry that your mornings are so hard. It must be so awful for you. I remember when I was on high doses of Seroquel I never wanted to go to bed because I was petrified of the mornings. I had such severe inner shaking every morning, it would wake me up. It’s hard to explain to anyone unless they’re going it themselves.

 

 You have an amazing attitude! Keep up the good work. It’s not easy whatsoever, but we will get there in the end.

 

Sendng lots of hugs🤗🤗🤗 

 

 

 

 

[intothewoods]

Hi Carmie,

 

That's a terrible feeling, being petrified of going to bed because you know what you will wake up to. I'm sorry you have been through so much with such a diabolical drug (my brother calls Seroquel "the psychopath drug" 😅)  . I had several doctors, most GPs, insist I keep trying it for sleep at night. It does change mechanisms by the day, sometimes the moment. I'm so glad you'll be off and yes, we'll get there!

 

 

[intothewoods]

Jan 8 

 

9 a.m.     Withdrawals more extreme than usual. 
                 26 mg Provigil
                 50 mg Prozac

10:30       Still can't sit up in bed.
                 2 mg Provigil

11 am      2 mg Provigil .30 mg TTL

11:30     Get up. No energy, ability to navigate basic life. 

Noon      Depression, blackness, disorientation haven't had since Trintellix WD 2015

1 pm       Green smoothie

3 pm.      Light meal

5 pm       Massive effort take trash to curb. Remind myself I live in the woods. Beautiful but        inaccessible for now.

6 pm       Computer work

9 p.m.     23 1/2 mg Elavil
                 5 mg Valium

10 pm     In bed not able to relax

1:30 am    12.5 mg Vistaril

3-7 am    Sleep
 

[Carmie]

Hi Out2C, 

 

Just checking in to see how you’re doing. My heart goes out to you that you struggle so much in the mornings. Must be horrible not being able to hold a glass when you first wake up. When I’ve had bad mornings from Seroquel in the past I woke up scared, so I would turn on the light straight away and distract myself with something. Just lying there made it more scary.

 

I’m really sorry you get akathisia too, it’s the worst symptom EVER, it’s one of those things that you really can’t put into words, they are no words that describe the intensity of it. 

 

Having CFS as well, like myself, on top of it is no walk in the park. There’s someone else I just saw that has CFS as well, luv2knit. I couldn’t read her whole thread, but she had it when she joined in 2014 or so. Being on these meds makes it impossible to get over this illness, but there is hope once we get off them. Yay!

 

Hope you’re coping as best you can, sending hugs🤗💚

 

 

 

[intothewoods]

Met  with my doctor today and learned something that might be helpful if we are hospitalized for any length unexpectedly (appendicitis, car accident, etc). Many of us are on water titrations, I am on two, so to avoid being dosed with a pill that's too high or low in strength -- have instructions prepared that we require "Home Medications" per our primary doctor with name. 

 

My durable power of attorney with health surrogates is in my wallet so I will add this info.

 

I've mentioned that my doctor is on the curve with us, way ahead of the curve of her profession, in psych med harm and reduction. It was an exhilarating meeting today as she was eager to learn the water titration instructions, the morning cortisol surge that sends many of us into spins and dread daily for years, all the myriad factors that affect this precarious journey -- all the things I'm learning on SA and other sites but especially SA. She had the nurse scan a copy of Brassmonkey's "Are We There Yet?" essays (trying to paste this in...help from a mod??? DONE) and we watched the Windows and Waves Video (ditto a link for this? it embeds the whole video) together Video:  Healing From Antidepressants - Patterns of Recovery . She asked a zillion wonderful questions about current patients, mainly, what would I want differently as a patient like I was 18 years ago when it all began. 

 

Heavy stuff. But a privilege.

 

Am exhausted but wanted to get this out there while fresh in my head, about the "Home Medicines" with your doctor's name and number. I asked how she would get the home meds and she said, of course, she'd dispatch a friend to fetch them from my fridge. Honestly. She would. But she said any doctor could make the titrations and take them to the hospital to override the physician on call. She said doctors do it often for their family members and she was all for doing it for any patient who could be in danger of having their taper wrecked because conventional medicine doesn't recognize slow tapering. 

 

Grateful. More later.......

 

 

 

Edited January 30, 2019 by ChessieCat
grammar/link

[intothewoods]

15 hours ago, Out2C8383 said:

trying to paste this in...help from a mod??? DONE) a

Thanks, ChessieCat 😊