BfromNJ: mirtazapine taper

[BfromNJ]

2 hours ago, BfromNJ said:

@Shep

@Altostrata

 

 

My urine culture came back as showing a bacteria.  Supposedly it's one that could normally be there?   which confused me and I called back for them to further clarify, because I don't want to take an antibiotic for nothing.  but doctor wants me to do an antibiotic.  I'm concerned because they want to give me cipro.  

 

Is this a no no with meds and withdraw?  What else can I do?  Supposedly this is the one that works for this type bacteria.  I am actually going to ask them to see if my previous culture i had done indicated this bacteria since maybe its one that i always have there. 

 

I was also recently having very good days with my tinnitus and I know most antibiotics can be otto toxic.   I am so sensitive to medications as it is and don't want to upset the apple cart.  but I do have the frequent urination and i am uncomfortable. 

 

and with going on the cruise on Sunday having issues with a medication is the last thing i need.   

Also wanted to add - i am trying to see if he will give me amoxicillin. Would this be a better option in withdraw/tapering?  I had always indicated in my file that i thought i may be allergic and now he wont give me it (i got  small rash) .  I was never 100% sure if was from it.   the cipro also seems like a high dose, 500 mg. 

 

Also, I recently stopped my probiotic.  If you recall Alto, i was getting that awful burning and you thought maybe an allergy. It did take the burning away.  But im wondering if maybe it upset the balance of bacteria?  it was a small amount of this particular bacteria. 

 

I was telling the nurse at the office that i am reluctant to take cipro because of the nervous system affects.  I think she thought i was insane. they just don't get it. 

[BfromNJ]

7/16-

4:15- up (cat meowing) . couldn't fall back to sleep. mild anxiety. mind racing.  no body symptoms,  just some throbbing in head.
5:15- up.  fatigued.
- 190 mg (.238) gabapentin
7:00- genital symptoms .  internal tremor/shaking/pulsing.  very noticable in left foot, up to genitals, stomach, chest.  lips tingling.
10:00- tremors better, but genital symptoms very bad. 
11:00- very bad headache and some nausea
11:30- 18.75 mg luvox (moving to the am)
12:15- 190 mg gabapentin (.238 pw)
- genital issues persist thru day.   cant even wear pants (thank goodness for dresses)
-2:00- bad headache- very unusual for me - passed
6:00- genital issues a little better.
7:00- internal tremor/shaking in genital area, legs, stomach
8:30- genital issues returning
- gabapentin. 238 pw
-weird stabbing/burning sensation by left eye-  passes

- constant urination all day and genital sensitivity.  

[BfromNJ]

5 hours ago, manymoretodays said:

And okay.  Good, good.  More information.  I think we are double posting.  Clindamycin may not be a good choice for you either, as far as ABX go then.

And sounds like a good plan, the reculture or recheck.

So doctor will not give me amoxicillin.  Even though I said I dont think it was even an allergy .  My file is marked.  But they said that they normally dont even treat this bacteria with an antibiotic so they said if I can give it a few days.  Which is nuts.  So they were gonna give me cipro????  So I ordered some d-mannose and a cranberry supplement from amazon.  

[manymoretodays]

I don't know, if that's nuts or not, BfromNJ.  Did they mention the bacteria?  By name?

Perhaps it will clear.  Sometimes, the human body is pretty amazing.   

Are you drinking a good amount of fluids?

On a basic search online,  looks like e. coli, is often a common culprit for UTI's.  And then, I saw that Septra and or Keflex, can also be considered to treat that.  Both are non-penicllin derivative ABX, and not floxins, either.

Good to go with loose clothing and all.  Cotton panties, etc.

You are able to google, aren't you?  I mean if your doctors office doesn't do some education around your health concerns?

I could not find, however, what is common urinary tract bacteria?  I'm thinking that they must have meant common pathogens(or causes) for UTI's.

And.....yes, if you had a rash once, with Amoxicillin.......and it's noted.......that's pretty standard, not to give you that again.

You might, or may have already, found some other things that you can try, preventatively, to avoid further infections too.

 

I used to do Pediatrics, mainly.  Tried some other areas as well.  More or less happily retired my license, after some 40 years......as I'd like to pursue other interests, perhaps callings, at this point.  Yet, oh, ever thankful, for the advanced education I pursued, AND the wonderful experiences I had.  Just saying.

 

How are you coming with getting ready for your vacation?  And I think that if, you are going to HOLD, while traveling.  Then, that you might consider also HOLDING on moving your Luvox dose right now.  And as you are adding in a couple additional items, d-mannose and some form of cranberry, you are, in essence, making a change now.  Start low, go slow is always a good mantra to have too.  As your nervous system is likely pretty sensitive right now.  Keep notes, as you are doing.  You might even add in, any non-drug coping that you do, as well.  Have you tried any breathing?  Are you getting in any gentle exercise?

 

When did you last make changes.......any changes to your medications/drugs?  I'm thinking, from narratives here, it may have been back around June 5th.  Please clarify.  Thank you.

 

And ((((((B))))))

L, P, H, and G,

mmt

[BfromNJ]

The doctors office is going to probably give me amoxicillan.  So I'm waiting.  I was never sure if I got rash from it.   But ketflex I did, so that's a no.  Something is still telling me that this is a pgad type thing, because of the sensation I have of arousal with the frequent urination, but I hope not.  It was not e coli that was present, something else.  I'm not sure I want to go on cruise at this point.  I'm miserable.  And I wont be able to swim, etc.  

 

Yes 6/5 was my first gabapentin drop.  

 

Edited July 18, 2019 by ChessieCat
removed quote

[eymen23]

BfromNJ,

 

E coli is the most common bacteria to cause UTI’s but it could be caused by another such as K pneumoniae or S saprophyticus. 

 

For the doctor to mention that this is a bacteria that is usually present and to later note that they don’t usually treat it, suggests that they might be going with the ‘better to be safe than sorry approach’ and simply treating your symptoms. That’s what doctors will usually do if you continue to complain about symptoms and simple treatments are available. 

 

UTI’s are very common and are often treated with little analysis, to the point that here in the U.K., you can fill in a questionnaire online and have antibiotics shipped to your house the next day, without any testing at all. 

 

Unfortunately, we do not have access to the results of your tests and we are not medical professionals, so you will need to put some degree of trust into your doctor if you’re wanting to treat this with drugs. We can not choose your antibiotic for you or tell you which will be the most effective (if you have a UTI), but we are aware of the floxins being particularly harmful for many (even the FDA recognises this).

 

What I will add is that bladder symptoms can be an adverse reaction of psychiatric drugs and that they can form part of withdrawal too. If the doctor is confident that they don’t usually treat this particular bacteria and is even suggesting you can wait to see if the symptoms clear, it’s probably an option worth considering, especially given the overlap with withdrawal and your fear of an adverse reaction to antibiotics. 

[BfromNJ]

Hello.  I wasnt asking for anyone here to choose for me, I was just stating my concern with the cipro upon reading about the effects on the nervous system.    I did get amoxicillan and I'm hoping it improves it.  The culture was abnormal.  This has been extremely uncomfortable to say the least.  Boy this whole,  withdraw, med, taper, hormone whatever else is a bumpy ride!

 

Edited July 18, 2019 by ChessieCat
removed quote

[eymen23]

 

Understood, but please respect that we are not medical professionals and we can only make so many suggestions. 

 

I’m glad you have settled on a course of treatment for the UTI and I hope things improve in that respect. 

 

Edited July 18, 2019 by ChessieCat
removed quote

[BfromNJ]

7/17- slept thru night.   4:45- up hour before alarm.  unable to fall back asleep (becoming a pattern) 5:45 -out of bed -anxiety.  genital symptoms, mild so far. -gabapentin .238 pw 6:45- meditated - 7:00- genital symptoms get worse. -  tightness in chest.- passes 8:30-  genital symptoms continue.   - mood is calmer today.  10:30- tingling sensation lips, head -nausea (unusual for me) -stabbing hot sensation by left eye 10:30-  luvox 18.75 mg (.096 pw)  11:15- unbearable genital symptoms, continue to worsen.  12:30- .238 pw gabapentin  2:40- genital symptoms unbearable again -uri calm max 2 tablets- for urinary relief 3:15-  mood ok despite severe symptoms listed about.  tremor seems lower today 4:30- a bit of anxiety. tingling in head.  6:15- sat down and noticed tremor in legs.   -genital symptoms worse when sitting 8:00- genital symptoms calmed down some 8:30- .238 pw. 190 mg gabapentin 10:00- 25 mg seroquel

[BfromNJ]

@manymoretodays

@ChessieCat

@Shep

 

 

 

Because of my not feeling well, i have opted not to go on my cruise.  I think its for the best, but i am saddened non the less.   But i just cant muster up the excitement for it.   These past few days have been horrible.   With the symptoms of uti and pgad (not sure what is what), I feel debilitated.  I have extreme anxiety, feel hopeless (mostly centered around the pgad type issue, its EXTREMELY uncomfortable) , depressed and very fatigued. Its hard to muster up getting out of bed.  

 

I dont know if its a window or not, but i seem to feel better(physical symptoms as well) around 6 pm at night i dont know if its a  med related thing.  Maybe the luvox kicks in that i take around 12:30?  that is why i thought to move it up to the morning, so i would have it in my system sooner, if it is having a beneficial effect at this point?  can be sure about this though.,  

 

I also feel better physically when I first awake, most mornings this is the pattern.  then things come crashing down again.   

 

since i am not travelling,  i was going to make another gabapentin reduction soon. 

 

I am having a very hard time getting my boyfriend to understand all this, i think hes pretty much checked out on me and has had enough.  Thus this has deadened my feelings towards him.  But i have heard more than one time from him "just stop taking the meds".    My daughter says this too, but she is young and just doesnt understand.   It puts the thought in my head though.  because its all so frustrating.  But my rational mind knows better.   Just a bad few days here.  

 

I have a therapy session at 3 pm today (phone), i am meditating and trying to distract and journal.  Now i will be off all next week and be rattling around an empty house.  Not sure that is for the best, but i dont feel well enough to do anything about it.     Im doing my daily logs, with the exception of yesterday and today.  and i do seem patterns to my symptoms.   

 

Well, one day at a time i guess.......

[BfromNJ]

@Shep

 

or any mod that may read this.  

 

So i planned on doing another reduction in my gabapentin, since i am not travelling this week after all.    I just had a few questions: 

 

 is it okay to do so while i am on an antibiotic, since it can and is causing me some side effects (dizzyness and increase in my tinnitus - just great since it was so good recently!)

 

Also, can an antibiotic worsen the side effects and withdrawal of the meds?  

 

Under a lot of stress this week, with not going on the cruise, but i really dont want to put off reducing. its such a long process to begin with.  

[eymen23]

BfromNJ,

 

If you are under a lot of stress already, have a bladder infection and are experiencing side effects from the antibiotic treatment, it is for the best that you hold and wait until things settle down.

 

You’re right that this is a long process, but if we try to rush, it becomes an even longer and much more painful process. We have seen this time and time again here, and so we always recommend doing things slowly and steadily, holding in times of stress, severe withdrawal symptoms or illness. 

 

Yes, antibiotics and other drugs can make withdrawal symptoms worse. They can often trigger waves and instability that takes time to work itself out. 

Edited July 21, 2019 by eymen23

[Dejavu]

Reason #1 to hold:

4 minutes ago, BfromNJ said:

is it okay to do so while i am on an antibiotic, since it can and is causing me some side effects (dizzyness and increase in my tinnitus - just great since it was so good recently!)

 

Reason #2 to hold:

5 minutes ago, BfromNJ said:

Under a lot of stress this week,

 

5 minutes ago, BfromNJ said:

Also, can an antibiotic worsen the side effects and withdrawal of the meds?  

Yes. Both antibiotics and steroids are notorious for this.

7 minutes ago, BfromNJ said:

really dont want to put off reducing. its such a long process to begin with.  

Understood, but in the grand scheme of things, does a few extra weeks total of taper time make that much difference? It's up to you, but don't be surprised if you have some extra fallout.

 

[BfromNJ]

Just now, Dejavu said:

Reason #1 to hold:

 

Reason #2 to hold:

 

Yes. Both antibiotics and steroids are notorious for this.

Understood, but in the grand scheme of things, does a few extra weeks total of taper time make that much difference? It's up to you, but don't be surprised if you have some extra fallout.

 

yeah I see these are all valid points. I am just feeling so crappy with the med side effects themselves. But i do also think rocking the boat can not be a good idea.  I actually called the doctor on the antibiotic, see if i can just take half the dose.  the tinnitus is terrible again.  damned if i do , damned if i dont.  Thank you for your input.  I have my pills all made up for the week anyway, so probably best to just leave it be.  

 

[eymen23]

3 hours ago, BfromNJ said:

 I actually called the doctor on the antibiotic, see if i can just take half the dose.   

 

I am not a medical professional and I would ultimately take the guidance of your doctor when he responds, but if you are being prescribed a dose of an antibiotic to treat an infection, it might be best you stick it out at the full dosage and for the suggested time period. 

 

The last thing you want is to end up with is a stubborn infection and to need another course at the full dosage. 

Edited July 21, 2019 by eymen23

[BfromNJ]

10 minutes ago, eymen23 said:

 

I am not a medical professional and I would ultimately take the guidance of your doctor when he responds, but if you are being prescribed a dose of an antibiotic to treat an infection, it might be best you stick it out at the full dosage and for the suggested time period. 

 

The last thing you want is to end up with a stubborn infection and to need another course at the full dosage. 

i see what you mean. I will see what the doctor says.    the tinnitus, dizzyness and aggitation are just unbearable today.  whew, deep breaths.  this too shall pass....thank you for your response.  

[Altostrata]

Please consult your doctor about side effects from the antibiotic.

 

As you know, we do not recommend changing more than one drug at a time. This includes the antibiotic.

[manymoretodays]

On 7/19/2019 at 10:50 AM, BfromNJ said:

I have a therapy session at 3 pm today (phone), i am meditating and trying to distract and journal.  Now i will be off all next week and be rattling around an empty house.  Not sure that is for the best, but i dont feel well enough to do anything about it.     Im doing my daily logs, with the exception of yesterday and today.  and i do seem patterns to my symptoms.   

 

Well, one day at a time i guess.......

 

Hi BfromNJ,

How are you doing today?  Any improvement with the UTI symptoms?

Sorry to hear about your missed cruise/vacation.  Perhaps it was the best decision, for you, for now.

An empty house may be a good thing.

 

I'm not seeing any recent daily logs.   What patterns have you noted?

You can put symptoms in your dailys and use a rating scale(1-10) too.  Just put them to the right of the time notation.

And then, I would be happy to look at a couple days worth. 

Perhaps we could work on the math now, for further reductions and also technique/accuracy/consistency of measurement.

How does that sound?

 

I do agree, that you should just be HOLDING now, while treating infection.  We/you could however plan and get organized for your future tapering now.

 

And then just one thing.......on your logs from the 17th, I notice that you are just posting the mgpw( milligram pill weight) of your gabapentin.  Can you post the actual dose strength, or what we refer to as mgai(milligram active ingredient)? 

 

And then in your narrative, right here, post what you got for starting average pill weights(mgpw) on your Luvox and gabapentin with the correlating dose strength or mgai(milligram active ingredient).

 

As far as symptoms of WD now, have you been able to find any non-drug coping that helps?  Weighted blanket or other? 

You could briefly note non-drug coping(what you use) on your dailys and then how well it worked too.

 

Okay, and all for now.  Hopefully, the peace and quiet of that empty house will work to your advantage now.

Best,

Love, peace, healing, and growth,

mmt

Edited July 22, 2019 by manymoretodays

[BfromNJ]

hello. I am still having uti troubles.  gyno appt. on thursday.  and yes the cruise is a sad thing.  Im really struggling with it.  as well as my relationship with my boyfriend falling apart and a move to Virginia. lots going on, to say the least.  

 

So, intially when i started the gabapentin, i had weighed 10 capsules and gotten an average.  Which i thought was .125.  . I timed this by 2, since that is what i take three times a day (2 capsules).  so my dose amount was .250.   since i wanted to do  a 5% to start i came up with .238 as my new dose amount.  The two capsules are 100 mg each, so i was taking 200 mg three times per day.   600 total.   

 

However, in recently measuring out my capsules. just to double check my math, i may have been off in my initial calculation and i was coming up with more of .260 as my intial average dose weight.  Which really still puts me in the "safe" range by SA standards.  more like an 8% drop i suppose?  so I am not sure what to indicate as my mg i am taking.  Still say 190, for arguments sake?   

 

anyway, my next drop will be 10%.   So .238 less 10% will be .214.   And if i go by the initial mg amount (190) , it will now be 171 mg x 3 = 513 mg a day.  

 

I would like to do this reduction next week, but i am not sure if i am rocking the boat.   but the side effects of the meds are really getting to me.  Especially if the urinary issues are stemming from them.    I will at least be done with the antibiotics though..   

 

I know i have to update my daily logs, i have just been unwell and couch bound.  I felt to obbession about it also.  I think i need to be more brief with them.  the problem is, they dont seem to come on and just pass.  they persist, so whatever i have, is a daily all day thing.  Especially the interal tremors and whole body vibration feeling.  and now the genital sensitivity.   My anxiety and moods swings are back, but i have alot going on and i also think it may be the antibiotics interacting.   whew.   sorry to be so long winded.    

 

Edited July 22, 2019 by ChessieCat
removed quote

[BfromNJ]

daily log started back up today, as i do need some help determining what is going on with me, if that is even possible.   The symptoms i have now are pretty much persistant through out the day, starting shortly after awakening.   They are extremely uncomfortable, making it difficult to go many places and do much.  

 

What i have now, pretty much every day:

 

Internal movements - its like a tremor, pulsing sensation. Like a rumble.   In my feet (mostly the left), legs, groin, abdomen and torso.  

Genital issue - feeling aroused/sensative, frequent urination, throbbing, general discomfort, urethral pain  

tinnitus - had some uptick in this when antibiotic was started, but the dose was lowered and it seems to have improved.  it is still bad at night, but the seroquel knocks me out.  

 

urine culture showed some bacteria, small amount of inflammation - doctor said it could just be a bacteria normally there, but gave me amoxicillian, started on 7/18 in pm.  Symptoms have not improved.  another culture done on 7/22.    Appointment with gyno on 7/25.   I am a scared this might be pgad.   I understand pgad can be caused by withdrawal from and also a side effect of ADs.  That being said, is it my luvox that is the problem?   Either the med itself or the reduction i did in April?  I am taking 18.75 mg (.096 pw) currently.    it was a 25% reduction, due to suspected adverse reaction.  This drop did help with the dp/dr i was having at the time.  

 

I want to do a reduction and i need to get my drug load down, that is for certain.    My plan was for next week.   

 

The seroquel is what is getting me sleep.   it knocks me out.  I normally do not even remember knodding off.   I am getting about 5-6 hours of sleep a night.  i know not alot, but i tend to wake up and not get back to sleep.   but the 5-6 hours is straight through. 

 

My current med schedule:

5:30- 190 mg gabapentin (.238 pw)

8:30- 437 mg amoxicillan 

12:30- 190 mg gabapentin and 18.75 mg luvox (.096 pw)

8:30 PM- 190 mg gabapentin 

10 pm- 25 mg seroquel

 

 

 

 

 

 

 

 

 

[BfromNJ]

7/23 daily log-

 

4:15- woke up and took 190 mg (.238 pw) gabapentin

7:00- up

7:30- genital symptoms (sensitivity,  arousal feeling, pulsing) 

-internal tremor/shaking/pulsing- very bad left foot and groin.  legs torso, abdomen

9:00- amoxicillan 437 mg 

10:15- anxiety kicks up.  - settles down

-genital symptoms worsen- persist.   

11:00- abdominal pressure.  

- tinnitus increase (probably from antibiotic)

12:00- genital symptoms subsided some- but doesnt last

12:15- 190 mg gabapentin and 18.75 mg luvox

1:00 - internal tremor/pulsing subsided some.

2:00- internal tremor/pulsing increases again- 

 3:00- genital symptoms are unbearable, along with internal, pulsing/tremor particularly bad in groin and left foot and leg

-took dog for walk 

5:30- symptoms improved (this is usual time symptoms sometimes improve)- some flares

8:30- 190 mg gabapentin

10:00- 25 mg seroquel

11:00- bed. shakey feeling in head.  flashes of light behind eyes when closing them. 

 

the internal tremors, pulsing feeling or whatever they are are an all day consistent symptom.  (most severe in left foot and goes up the middle of body) same for the genital issue.  not sure if they are related.  I have no other symptoms that are bothersome.  I am going to consult a neurologist and gyno.   Its hard to even want to leave the house, because the genital issues are so uncomfortable.  

 

relief from symptoms seems to come in the evening.  seems to me like the pattern.  

 

 

 

  

 

 

[eymen23]

BfromNJ,

 

Are you still taking the antibiotic? As we suggested, It’s quite possible that this is aggravating a lot of your symptoms. 

 

Please get further testing done to see whether the antibiotic worked in getting rid of your UTI. If your next urine culture comes back as normal and you’ve been off the antibiotic for a few days, I think we’ll be able to confirm the bladder issues are drug/withdrawal induced.  

[manymoretodays]

Hi BfromNJ,

And thank you for all the information.  I love checking math!

I'm going to have to get back to you in a bit though.

Hang in there for now.

L, P, H, and G,

mmt

[BfromNJ]

2 hours ago, eymen23 said:

BfromNJ,

 

Are you still taking the antibiotic? As we suggested, It’s quite possible that this is aggravating a lot of your symptoms. 

 

Please get further testing done to see whether the antibiotic worked in getting rid of your UTI. If your next urine culture comes back as normal and you’ve been off the antibiotic for a few days, I think we’ll be able to confirm the bladder issues are drug/withdrawal induced.  

Antibiotic stopped yesterday.  Culture is normal.  Still symptomatic although maybe a bit better.  I do see that the antibiotic was aggravating things, such as my mood, anxiety,  tremors, etc .  But I do still have issues so Dr suggests gnyocologist.  It it's all drug/withdraw induced I guess I need to determine which one? Is one more prone to or do all these drugs i am on cause these issues ?

[manymoretodays]

Gabapentin Side Effects, Drugs.com

I do see some of the urinary tract issues mentioned there.

 

[BfromNJ]

2 minutes ago, manymoretodays said:

Gabapentin Side Effects, Drugs.com

I do see some of the urinary tract issues mentioned there.

 

Unpleasant to say the least.  I took the dog for a walk yesteday, and just must have stepped the wrong way and all of a sudden i thought i might lose my urine.  not fun.  so might as well continue as planned with the reduction of gabapentin,.     I read the luvox can have a side effect of frequent urination as well.    wonderful.......

[eymen23]

3 hours ago, BfromNJ said:

Antibiotic stopped yesterday.  Culture is normal.  Still symptomatic although maybe a bit better.  I do see that the antibiotic was aggravating things, such as my mood, anxiety,  tremors, etc .  But I do still have issues so Dr suggests gnyocologist.  It it's all drug/withdraw induced I guess I need to determine which one? Is one more prone to or do all these drugs i am on cause these issues ?

 

BfromNJ,

 

Now that your urine culture is normal and you have stopped the antibiotic, I think it would be useful to pay close attention to your symptoms over the coming days. 

 

If the genital symptoms persist, then I think it’s clear they are drug or withdrawal related. 

 

In regards to making more dosage reductions, I would try and be patient. You have documented several causes of stress and you have just completed a course of antibiotics. Adverse reactions to drugs are not nice, but making a dosage reduction at the wrong time can fare much worse.

 

Please try to accept the uncomfortable symptoms as best you can. This is a long and difficult journey, and some suffering is to be expected. We have seen it many times, where becoming impatient and trying to avoid suffering altogether, can ironically lead to very prolonged, severe suffering. 

Edited July 24, 2019 by eymen23

[BfromNJ]

7/24 daily log

 

4:45 am- woke up and took 190 mg gabapentin

-back to bed- not really sleeping.

7:30- up.  mild anxiety. 

8:30- tremor/pulsing in chest, legs, torso, genitals

9:00- genital symptoms- sensitivity,  arousal

9:45- bad anxiety- lasts about 30 minutes 

11:30-  extreme tiredness

- tremor/shaking/pulsing left leg, foot, abdomen , genitals, chest (milder today)

12:15- 190 mg (.238 pw) gabapentin and 18.75 (.096 pw) luvox

1:00-  tinnitus increase.  very annoying.

1:30- genital symptoms increase 

2:00- anxious and depressed.  

4:00-genital symptoms worse. 

5:00- noticed tremors/pulsing in feet, legs, genitals, abdomen when at rest.

-genital symptoms were greatly improved for the evening. tinnitus persistant

8:15- 190 mg gabapentin

9:30- genital symptoms return.

10:15- 25 mg seroquel

 

frequent urination throughout the whole day

[BfromNJ]

17 hours ago, eymen23 said:

 

BfromNJ,

 

Now that your urine culture is normal and you have stopped the antibiotic, I think it would be useful to pay close attention to your symptoms over the coming days. 

 

If the genital symptoms persist, then I think it’s clear they are drug or withdrawal related. 

 

In regards to making more dosage reductions, I would try and be patient. You have documented several causes of stress and you have just completed a course of antibiotics. Adverse reactions to drugs are not nice, but making a dosage reduction at the wrong time can fare much worse.

 

Please try to accept the uncomfortable symptoms as best you can. This is a long and difficult journey, and some suffering is to be expected. We have seen it many times, where becoming impatient and trying to avoid suffering altogether, can ironically lead to very prolonged, severe suffering. 

I'm trying .  Been listening to meditation on radical acceptance.   It's even harder when alone and "in your own head" so to speak.  I will mull over my decision.  What about a brass monkey slide? 

[eymen23]

27 minutes ago, BfromNJ said:

I'm trying .  Been listening to meditation on radical acceptance.   It's even harder when alone and "in your own head" so to speak.  I will mull over my decision.  What about a brass monkey slide? 

 

Try and keep occupied as best you can. Even basic things like going for a walk, phoning a friend, drawing, reading etc can be of big assistance in getting through the difficult days. 

 

Yes, a Brass Monkey slide will be a sensible idea when things settle down. However, it is still a form of tapering and as such I wouldn’t suggest that right now. 

Edited July 25, 2019 by eymen23

[BfromNJ]

7/25 daily log

 

7:30- up . mild anxiety, slight tinnitus

9:30- internal tremor/pulsing in chest, left foot genital area -persists the day on and off

10:00- genital symptoms

12:15- 190 mg gabapentin and 18.75 mg luvox

1:00- genital symptoms 

2:00-  sense of hopelessness and depression sets in. 

3:00- phone therapy session

5:00- genital symptoms- they had died down for hours 

5:30- internal tremor/pulsing in chest,  abdomen, groin

8:00- slight genital symptoms- passes

8:30-  190 mg gabapentin

10:00- 25 mg seroquel

11:00- bed.  shaking feeling in head and tinnitus (been worse recently than usual)

[manymoretodays]

On 7/22/2019 at 1:36 PM, BfromNJ said:

So, intially when i started the gabapentin, i had weighed 10 capsules and gotten an average.  Which i thought was .125.  . I timed this by 2, since that is what i take three times a day (2 capsules).  so my dose amount was .250.   since i wanted to do  a 5% to start i came up with .238 as my new dose amount.  The two capsules are 100 mg each, so i was taking 200 mg three times per day.   600 total.   

 

However, in recently measuring out my capsules. just to double check my math, i may have been off in my initial calculation and i was coming up with more of .260 as my intial average dose weight.  Which really still puts me in the "safe" range by SA standards.  more like an 8% drop i suppose?  so I am not sure what to indicate as my mg i am taking.  Still say 190, for arguments sake?   

 

anyway, my next drop will be 10%.   So .238 less 10% will be .214.   And if i go by the initial mg amount (190) , it will now be 171 mg x 3 = 513 mg a day.  

 

Hi BfromNJ,

Okay.  Math or maths!  I told you I would get back to this for you.  Here we go:

 

mgpw- milligram pill weight- refers to the physical weight of the dose

mgai- milligram active ingredient- this refers to the actual dose strength, and is the number we like to refer to when talking about the dose you are taking

 

Average milligram pill weight(mgpw) for 1- 100 milligram active ingredient(mgai) gabapentin capsules = .130 mgpw for each 100 mgai capsule.

With 2-capsules = .260 mgpw

 

The read out on the Gem20 scale is in grams by the way.  So I just went to a gram to milligram converter and came up with 130 as the milligram pw. 

Is the .130 mgpw you are reporting(this is weight again) the actual read out on your scale?

 

I'm going to assume that is so.  So you have 130 mgpw or .130 in grams of pw(the scale read out that you see)

 

And then your present dose  in mgai = 183 mgai taken 3 times each day

I came up with 183.076 when doing some further math.

So you are taking 183 mgai of gabapentin now 3 times/day or a total dose of 549 mgai/day.

This is number you can report as your dose.  Good to use the abbreviations too.    mgai

 

Best to be accurate in reporting your dose strength or mgai.  No arguments needed.  This is just good to do going forward.  Accuracy and consistency can and do pay off.

 

So yes, looks like you did a initial taper decrease of 8.5 % from your starting dose.

 

Another abbreviation, that will come in handy with future maths is the AIC- the active ingredient concentration.  This is the ratio of how much active ingredient is in a set amount of pill.  I'm going to go with 100 mgai divided by 130mgpw or 100 mgai/130 mgpw = .77 mgai per 1 mgpw.  This will come in handy too, with future maths.

 

I think I'll stop here with the maths, so that you can look at it.  And ask away, if you have questions.  This can all be really tough, while you are in WD.  Many thanks to brassmonkey for explaining to us, some of this, and putting it into some words too!  We'd like to get a more standardized way for members to report on their doses, when using the scales.  So thanks with your help with this too BfromNJ.

And agree, that just HOLDING for a little bit longer, will be worth it for you I think BfromNJ.  So may changes you had, and then so many shifts around and all.  I think your body/nervous system will thank you.  There is no benefit to going too fast, none at all.  The turtle often wins this race.  Try and hold steady and work on some of your non-drug coping practices. 

What has helped?  What is going well?

And thank you, great notes!!!   Yikes, did you skip your morning dose of gabapentin yesterday?  I'm not seeing it.  Maybe it was taken earlier?  B, try and stay with the same dosing times for your medications too.  Switches around in timing of doses is often just like doing a dose change.......in the way your system may react.

......and a link:  The rule of 3 K's  simple, slow, and stable.  Turtle.  No change is often better than too many changes.

((((((BfromNJ))))))))

 

L, P, H, and G,

mmt

 

 

 

Edited July 27, 2019 by manymoretodays
additional, mg and grams, scale readout

[BfromNJ]

7/26 

7:45- up .  anxiety

- 183 mg gabapentin.  

- breakfast

-genital symptoms - mild

10:00- internal tremor/pulsing in chest, abdomen, groin, left foot and legs

-increase in genital symptoms- passes

12:30- 183 mg gabapentin and 18.75 mg luvox

- internal tremor/pulsing and genital symptoms increase

2:00- feeling depressed. 

-genital symptoms better through rest of day.

- internal tremor/pulsing in legs, left foot, groin, abdomen 

6:00- dinner

8:30- 183 mg gabapentin

10:00- 25 mg seroquel

[brassmonkey]

BfNJ and MMT, I ran through your calculations and they look fine.  

 

Typically the average pill weight is used only for calculating the beginning dose of a taper. It gives us a specific weight for a set amount of powder.  After that it loses its relevance because the doses are measured to a specific weight from a "stockpile" of powder. The stockpile being the contents of several capsules or crushed tablets.

 

In some cases, like B's, where multiple capsules are being taken at the same time a small discrepancy  can show up depending on how they measure their dose.  If a person were using the contents of two capsules to make up their dose: if they emptied both capsules and weighed out the dose from there, there would be no discrepancy, but if they left one capsule whole and only weighed out the difference to make up the total, then the slight difference in weight of the original capsules would show up. That difference in weight would be the difference between the average weight used in the original calculation and the actual weight of the capsule used.  In the example above that would be 5mgpw.

 

If we apply the AIC to this we get a difference of 3.85mgai. Which changes the dose amount by several percent. Still within the recommended limits, but depending on the capsules used it could produce a wide variation between doses.  So you could recalculate each dose as you make it up, if you wish to use one unopened capsule per dose.  This would become a total pain after a few times.  Or you could just open both capsules, combine the contents, weight out the target dose weight and put it back into the capsules.  Those capsules wound then need to be kept in pairs until they are taken.  The leftover powder goes into the "stockpile" for future use. This is what I would do.

 

Brassmonkey

[BfromNJ]

32 minutes ago, brassmonkey said:

BfNJ and MMT, I ran through your calculations and they look fine.  

 

Typically the average pill weight is used only for calculating the beginning dose of a taper. It gives us a specific weight for a set amount of powder.  After that it loses its relevance because the doses are measured to a specific weight from a "stockpile" of powder. The stockpile being the contents of several capsules or crushed tablets.

 

In some cases, like B's, where multiple capsules are being taken at the same time a small discrepancy  can show up depending on how they measure their dose.  If a person were using the contents of two capsules to make up their dose: if they emptied both capsules and weighed out the dose from there, there would be no discrepancy, but if they left one capsule whole and only weighed out the difference to make up the total, then the slight difference in weight of the original capsules would show up. That difference in weight would be the difference between the average weight used in the original calculation and the actual weight of the capsule used.  In the example above that would be 5mgpw.

 

If we apply the AIC to this we get a difference of 3.85mgai. Which changes the dose amount by several percent. Still within the recommended limits, but depending on the capsules used it could produce a wide variation between doses.  So you could recalculate each dose as you make it up, if you wish to use one unopened capsule per dose.  This would become a total pain after a few times.  Or you could just open both capsules, combine the contents, weight out the target dose weight and put it back into the capsules.  Those capsules wound then need to be kept in pairs until they are taken.  The leftover powder goes into the "stockpile" for future use. This is what I would do.

 

Brassmonkey

Yes I do this.  Empty two,  remove enough to get to .238, which is my now targeted dose and then put this into a new capsule.  Or I empty a bunch of capsules at once and measure out.

[BfromNJ]

9 hours ago, manymoretodays said:

 

Hi BfromNJ,

Okay.  Math or maths!  I told you I would get back to this for you.  Here we go:

 

mgpw- milligram pill weight- refers to the physical weight of the dose

mgai- milligram active ingredient- this refers to the actual dose strength, and is the number we like to refer to when talking about the dose you are taking

 

Average milligram pill weight(mgpw) for 1- 100 milligram active ingredient(mgai) gabapentin capsules = .130 mgpw for each 100 mgai capsule.

With 2-capsules = .260 mgpw

 

The read out on the Gem20 scale is in grams by the way.  So I just went to a gram to milligram converter and came up with 130 as the milligram pw. 

Is the .130 mgpw you are reporting(this is weight again) the actual read out on your scale?

 

I'm going to assume that is so.  So you have 130 mgpw or .130 in grams of pw(the scale read out that you see)

 

And then your present dose  in mgai = 183 mgai taken 3 times each day

I came up with 183.076 when doing some further math.

So you are taking 183 mgai of gabapentin now 3 times/day or a total dose of 549 mgai/day.

This is number you can report as your dose.  Good to use the abbreviations too.    mgai

 

Best to be accurate in reporting your dose strength or mgai.  No arguments needed.  This is just good to do going forward.  Accuracy and consistency can and do pay off.

 

So yes, looks like you did a initial taper decrease of 8.5 % from your starting dose.

 

Another abbreviation, that will come in handy with future maths is the AIC- the active ingredient concentration.  This is the ratio of how much active ingredient is in a set amount of pill.  I'm going to go with 100 mgai divided by 130mgpw or 100 mgai/130 mgpw = .77 mgai per 1 mgpw.  This will come in handy too, with future maths.

 

I think I'll stop here with the maths, so that you can look at it.  And ask away, if you have questions.  This can all be really tough, while you are in WD.  Many thanks to brassmonkey for explaining to us, some of this, and putting it into some words too!  We'd like to get a more standardized way for members to report on their doses, when using the scales.  So thanks with your help with this too BfromNJ.

And agree, that just HOLDING for a little bit longer, will be worth it for you I think BfromNJ.  So may changes you had, and then so many shifts around and all.  I think your body/nervous system will thank you.  There is no benefit to going too fast, none at all.  The turtle often wins this race.  Try and hold steady and work on some of your non-drug coping practices. 

What has helped?  What is going well?

And thank you, great notes!!!   Yikes, did you skip your morning dose of gabapentin yesterday?  I'm not seeing it.  Maybe it was taken earlier?  B, try and stay with the same dosing times for your medications too.  Switches around in timing of doses is often just like doing a dose change.......in the way your system may react.

......and a link:  The rule of 3 K's  simple, slow, and stable.  Turtle.  No change is often better than too many changes.

((((((BfromNJ))))))))

 

L, P, H, and G,

mmt

 

 

 

Yes i thought i was around 8% or so.  I suppose i can hold.  Just suffering so terrible with the adverse reactions and side effects.  if i wait too long to taper and get off these meds, do i run the risk of some of these terrible things being permanent (such as tremors, etc).      I do notice that my physical symptoms seem to improve (the genital issues, at the moment) a few hours after my luvox dose at 12:30.  so evening i seem to get relief sometimes.   Have to review my logs to see.    BUT - it seems like after the luvox i get really down in the dumps.   

 

I had thought of taking the luvox in the am instead, if it is helping with the physical symptoms, but  with this deep depression and hopelessness i development im not so sure.  maybe its just that my drug load by then is too much in general?

 

Oh no, i did not skip my dose.  must have just not copied and pasted over.   

 

Most bothersome symptoms:

genital issues-sensitivity, arousal, frequent urination (still waiting for some tests back from gyno)

tremors/pulses in legs, left foot, abdomen, chest, torso

tinnitus (at times) - ive learned to adapt to this i think by now, but nighttime its terrible

ahedonia and apathy

blunted emotions (towards boyfriend mostly) 

 

Thank you for your help and kind words.  it means alot .