BfromNJ: mirtazapine taper

[BfromNJ]

6 hours ago, ShiningLight said:

Hey B, I came across some info that I thought may be helpful to you. Not sure if it's been suggested to you yet. Saw on @WiggleIt's thread that pelvic floor physical therapist specialist was helpful for her urinary withdrawal related symptoms.

 

How ironic that you posted this,  because I was just at the urologist yesterday and she is sending me to one.  I will take that as a sign!  😁👍

[ShiningLight]

Great! I'm glad help is on the way for you! 👍

[BfromNJ]

 Daily log for three days- 

 

9/17

6:00- 164 mg gabapentin (50/50 old and new maker for today)

-9:00 legs feel funny.  like stiff and activated at same time.  

-fatigued and just blah

11:00- anxiety, fearfulness.  nervous that new gaba will worsen symptoms, since I think I was finally stabilizing over last drop.

- mild urinary symptoms- urgency and soreness

12:30- 164 mg gabapentin and 18.75 mg luvox

- feeling pretty well the afternoon and into evening.

8:30- 164 mg gabapentin

10:00- 25 mg seroquel

- slept well 

 

day 2 gabapentin 50/50 crossover of old and new manufacturer. 

 

9/18

6:30- 164 mg gabapentin

- urinary symptoms of pressure, urgency and frequency- continues thru morning

8:30- internal tremor/pulsing in left foot, leg, groin.  

10:00- 45 minutes on elliptical 

11:30- legs start to feel activated and funny- passes

12:30- 164 mg gabapentin and 18.75 mg luvox

- urinary symptoms throughout afternoon.  painful.  this was persistant.  some let up in evening.  

8:30- 164 mg gabapentin 

10:00- 25 mg seroquel 

- slept ok

 

9/19

last day of 50/50 gabapentin manufacturer crossover 

 

6:30- 164 mg gabapentin 

8:00- urinary symptoms and menstrual spotting.

9:00- 600 mg aloe vera capsule (for urinary and reflux)

12:30- 164 mg gabapentin and 18.75 mg luvox

- urinary symptoms continue

7:00 or so - tinnitus flare up (may be pressure related as nose has been running as well) 

-600 mg aloe vera capsule

8:30- 164 mg gabapentin

10- 25 mg seroquel

- slept okay

 

- period came today.  first one in about 5 months

 

[BfromNJ]

9/20

 

first day of 100% of new gabapentin manufacturer

 

5:30- 164 mg gabapentin
7:30- 600 mg aloe vera capsule
8:00- tinnitus a bit elevated today.  but humidity is high.  
urinary frequency and urgency in am
12:30- 164 mg gabapentin and 18.75 mg luvox
-urinary symptoms improved later in day
6:30- internal vibration/shaking left foot up leg.
8:30- 164 mg gabapentin
- internal vibration/shaking thru body (felt different than previous tremor I've had)
- tinnitus very bad when going to sleep
10:00- 25 mg seroquel.   slept ok.
 

[BfromNJ]

Daily log for two days

 

9/23

4:30- 164 mg gabapentin

7:30- up.  start with urinary frequency, pain and urgency 

8:00- 2 of 600 mg aloe vera capsules

12:30- 164 mg gabapentin and 18.75 mg luvox

- mild urinary issues in afternoon

6:00- 2 600 mg capsules of aloe vera

8:30- 164 mg gabapentin

9:30- tinnitus elevated.  but I was in car all day. it can aggravate it.

10:30- 25 mg seroquel.  

- slept ok. 

 

 

9/24

4;30- 164 mg gabapentin

7:30- up.  start with urinary frequency, pain and urgency .  settles down

8:00- 2 of 600 mg aloe vera capsules

12:30- 164 mg gabapentin and 18.75 mg luvox

- mild urinary issues in afternoon

6:00- 2 600 mg capsules of aloe vera

8:30- 164 mg gabapentin

9:30- tinnitus elevated.  but I was in car all day. it can aggravate it.

10:30- 25 mg seroquel.  

- slept ok. 

 

8:00- 2 of 600 mg capsules of aloe vera

12:30- 164 mg gabapentin and 18.75 mg luvox

-genital sensitivity symptoms start up in afternoon.  Also internal tremor/pulsing/vibration in foot, leg, groin 

6:30- 2 of 600 mg capsules aloe vera 

8:45- 164 mg gabapentin 

10:00- 25 mg seroquel

slept okay

 

urinary symptoms have been milder, but genital sensitivity symptoms now.  seems to correlate with the internal tremor/pulsing/vibration feeling I get in my left foot, leg,  groin.  maybe nerve related?

 

sciatic pain is acting up.  

 

This is the 5th day of the new gabapentin manufacturer.  

[BfromNJ]

 @manymoretodays

 

I hope you are doing  well!  Happy friday!  

 

It's a week now I am on the new manufacturer of gabapentin.  Seems like some symptoms that were gone are back.  Mainly the internal tremor of my foot, leg and groin along with genital sensitivity.   It seems like they go hand in hand, maybe it's a nerve that runs all the way up?  

 

I'm taking the .210 pill weight we figured on.  164 mg ai, or so.   But I notice now when I empty the capsules on the scale to redo them that alot of them weigh alot less than I originally had calculated.  If that's the case i suppose it just means that with the new capsules I've kind of went up in my dose slightly, since they aren't as big as I thought.   This manufacturer seems to be more inconsistent.    At least now with weighing I will be exact.  

 

So, I am due to make another drop.  I had wanted to by now.  But with this recent stuff, do I just stay put a bit or make a small drop to keep more in line with where I really should be?  

 

I'm so concerned with being on this crap for longer than I have to.  I am losing my hair now.  Alot.  And from what I have read,  this can happen with gabapentin.   

[BfromNJ]

Feeling a bit better yesterday and today as far as symptoms above go.  For that I am grateful.   

Still staying where I am for the moment

  

[ShiningLight]

It makes me happy to hear that you are feeling better sometimes! You've come a long way.

 

Sorry to hear about your hair. I feel the same way...want the heck off. Usually slower is faster. 😕

[BfromNJ]

5 minutes ago, ShiningLight said:

It makes me happy to hear that you are feeling better sometimes! You've come a long way.

 

Sorry to hear about your hair. I feel the same way...want the heck off. Usually slower is faster. 😕

Thanks I'm just frustrated because I feel like I haven't made any progress taper wise. Only 8% and then 10% of gabapentin before I had a maufacturer change, which I think because of the weight difference really made my drop even less.    I just feel like I'm starting over.  😕

[ShiningLight]

You've made incredible progress in your ability to function though!!! That's more important. I know it can be discouraging; I feel similarly. But ability to function and minimizing wd symptoms are the priority, not speed.

[ShiningLight]

I feel that way especiaally when friends or family ask about it. Nope, still at 320! Nope, still at 320! Most people have no concept for how slow we have to go 

[BfromNJ]

8 minutes ago, ShiningLight said:

You've made incredible progress in your ability to function though!!! That's more important. I know it can be discouraging; I feel similarly. But ability to function and minimizing wd symptoms are the priority, not speed.

Thanks.  I see that you have as well.   Your progress is impressive!  

[ShiningLight]

That's very kind, thanks! We are in a fortunate spell! ⛅

[manymoretodays]

Hi B,

I promise, I am not ignoring you, and will get back to you when I can.

Unanticipated bumps in my road lately.......

 

Doing a good day dance for you......that is great!

[BfromNJ]

2 hours ago, manymoretodays said:

Hi B,

I promise, I am not ignoring you, and will get back to you when I can.

Unanticipated bumps in my road lately.......

 

Doing a good day dance for you......that is great!

Hey there no worries! I was worried.  Thanks for checking in.  Sorry to hear about  those bumps.  😔

[BfromNJ]

@manymoretodays

@brassmonkey

@ChessieCat

 

 

Hello.  I have a new manufacturer with my seroquel.  Right now I have 8 days of my old manufacturer pills and I have my bottle of the new ones.  I suppose I should crosstaper.   What's the easiest.  I know I just did it with gabapentin, but they were capsules so I had to weigh them out.  With the pills, do I just cut them in half and do a 50/50, half of each?  

 

Thank you in advance.  

[brassmonkey]

Eight tablets isn't a lot to work with but we can try an accelerated cross taper which may help. It won't be really accurate in the dosing but should be pretty close.

 

I would try 3/4 of an old tablet and 1/4 of a new tablet for 4 days (save the left over 1/4 old tablet)

Next I would do 1/2 of an old tablet and 1/2 of a new tablet for 5 days

Follow up with 1/4 old and 3/4 new for 5 days.

Then continue on with the new tablets.  This should use up all of your old tablets and give you a reasonably slow/smooth transition.

 

Don't obsess about wd symptoms but watch out for any major shifts to the worse, as they are the ones that could be signaling trouble.  Once you have switched over I would hold for four to six weeks before starting to taper.

 

Keep us posted as you go along.

[BfromNJ]

52 minutes ago, brassmonkey said:

Eight tablets isn't a lot to work with but we can try an accelerated cross taper which may help. It won't be really accurate in the dosing but should be pretty close.

 

I would try 3/4 of an old tablet and 1/4 of a new tablet for 4 days (save the left over 1/4 old tablet)

Next I would do 1/2 of an old tablet and 1/2 of a new tablet for 5 days

Follow up with 1/4 old and 3/4 new for 5 days.

Then continue on with the new tablets.  This should use up all of your old tablets and give you a reasonably slow/smooth transition.

 

Don't obsess about wd symptoms but watch out for any major shifts to the worse, as they are the ones that could be signaling trouble.  Once you have switched over I would hold for four to six weeks before starting to taper.

 

Keep us posted as you go along.

I'm not tapering seroquel at all right now.  What do you mean by major shifts?  

 

I dont need to crush and measure right?  I can just split the tablets?  

 

I am due for another gabapentin drop this Monday.   Should I hold off on that?  

[BfromNJ]

@brassmonkey

 

Update to the above-  I cannot split my pills evenly.   Either the old or new. If I am working with uneven pills this may make it even worse no?   

[manymoretodays]

Hi B,

Change in drug manufacturer

This might help.  No one is talking specifically about seroquel in that link, but you'll get the gist.  Then use your best judgement as to how to adapt a cross over.

  

I think that yes, you should hold off on your next gabapentin taper.  As this cross over will, no doubt, go into next week.  Give it a few weeks on the new and then resume your tapers of the gabapentin.  That's what I'd do.

 

1 hour ago, BfromNJ said:

Update to the above-  I cannot split my pills evenly.   Either the old or new. If I am working with uneven pills this may make it even worse no? 

No surprise with that.  Do the best you can.  Use your scale.   Get the total weight of the old, get the total weight of the new.  You'll probably have to do it pill by pill.    And then you can get 1/4 or 1/2 accordingly.   Just try and do some form of cross over from old to new.  Maybe 1/2 old and 1/2 new will work well.   So you'd be doing 1/2 and 1/2 for 2 weeks time.  And then on to all new.  

 

You can do this one BfromNJ. 

Best,

L, P, H, and G,

mmt

 

[BfromNJ]

12 hours ago, manymoretodays said:

Hi B,

Change in drug manufacturer

This might help.  No one is talking specifically about seroquel in that link, but you'll get the gist.  Then use your best judgement as to how to adapt a cross over.

  

I think that yes, you should hold off on your next gabapentin taper.  As this cross over will, no doubt, go into next week.  Give it a few weeks on the new and then resume your tapers of the gabapentin.  That's what I'd do.

 

No surprise with that.  Do the best you can.  Use your scale.   Get the total weight of the old, get the total weight of the new.  You'll probably have to do it pill by pill.    And then you can get 1/4 or 1/2 accordingly.   Just try and do some form of cross over from old to new.  Maybe 1/2 old and 1/2 new will work well.   So you'd be doing 1/2 and 1/2 for 2 weeks time.  And then on to all new.  

 

You can do this one BfromNJ. 

Best,

L, P, H, and G,

mmt

 

Okay.  Should I crush them and put in capsule?  Os that necessary to be that exact?   Or did you mean just for the weight of each half?  I was trying to avoid crushing because I already do this with my two other meds.   Maybe I can get another splitter to see if it works better.  

[brassmonkey]

I think just cutting them as carefully as possible will work.  Do you have an Xacto knife?  It may be easier to cut with that instead of a pill cutter. You can line up the blade better.

[BfromNJ]

3 hours ago, brassmonkey said:

I think just cutting them as carefully as possible will work.  Do you have an Xacto knife?  It may be easier to cut with that instead of a pill cutter. You can line up the blade better.

I'll see if there is one in the house.  Good idea. Since my new pills are so tiny I think I'll have to do 50/50 crossover.  

[BfromNJ]

@manymoretodays

@brassmonkey

 

So good news. In my opinion at least.  I thought I had to use a certain pharmacy with my new insurance when I moved.  Turns out I could have used walgreens all along and I would not have had to change manufacturers!  Dummy me.  So I can actually get my old maker of gabapentin!  I would say I'll just stick with the new one but I really want to go back to the old, because I think the new has something in it that has aggravated my silent reflux.   Can I just go straight back to the old manufacturer since I have taken it before and I know I'm ok with it?  Ive been on new one maybe about 3 weeks.  

 

Same may be for my seroquel, but I've just started the crosstaper it's been a few days.  I think with this I can just go right back to old?  I'm going to see if walgreens can fill the seroquel if insurance will allow it and if it's my old manufacturer.  

 

What a pain this all is!  Life would be much easier without all this drama.  Lol.  

 

Thanks all.  

[brassmonkey]

Well, that's good to hear, makes things a lot easier. 

 

Just switching back on the seroquel shouldn't be a problem if you do it right away.  If it takes a few weeks to sort out the prescription then you should do a quick cross taper.

 

I would suggest doing a cross taper with the gabapentin.  It's been long enough on the new brand.  Also each time we make a change it changes our bodies so even though you didn't have problems in the past doesn't mean you won't have then this time.

[BfromNJ]

@manymoretodays

@ChessieCat

@brassmonkey

 

So I've crossed over to my new seroquel maufacturer.   Seems to be okay so far.  Slight increase in tinnitus,  but there has been weather change.  Also, my silent reflux has returned with a vengeance.    This started a month or so ago, so I dont think its related.   Coincidentally it came about after a crossover to new gabapentin brand.  I have been able to switch pharmacies and get my old brand back and I started it yesterday.  I didn't crosstaper since I was previously on it.  I know its recommended.  

 

I'm just really bothered by the silent reflux at the moment.  With me, it's a constant post nasal drip and continual need to swallow.   I feel like I'm choking.    Pepcid has not helped and I will not take a ppi.    Doctor also gave me claritin,  which may help the drip but I dont wanna add another med to the mix.

 

Can someone tell me out of my three meds if there is one that is more prone to cause the reflux?  Thanks all

[BfromNJ]

@brassmonkey

@manymoretodays

@ChessieCat

 

Hello.  I hope everyone had a great thanksgiving!  

 

I had a question-  

 

I was basically told in a facebook group that I am doing my gabapention taper wrong, because I'm dry weighing and by doing so I cant be sure that I'm getting an equal mix if ai and filler each dose.  I thought I was doing ok!  I'm weighing out each capsule on the scale and removing enough to be at the weight I need, then putting back in capsule. 

 

I was told water titration is best.  But taking it there times a day is kind of hard to bring a water mixture with me on the go.  I'm afraid I will forget it. 

 

Also said I could be putting myself into a constant state of withdraw and problems.  But is mixing with water a 100% exact mix either?  I would think any method has room for error no?   

 

I trust what you all say and I've always gone by what is recommended here first.   Should I be using water method?  If so, where do I start?  Is it 400 mg to 400 ml of water? 

 

Are there others on here who are tapering gabapention dry like myself?  

 

Fyi-  currently at .170 pw three times a day.  Which is the equivalent of 399.6 mg roughly.  I say roughly because I've been measuring by pill weight so long I cant be sure of exact mg.  But that is pretty darn close I suppose 

 

[brassmonkey]

It is a major misconception that the active ingredient is not mixed evenly through out the tablet or capsule.  Many years ago there was a case come up of a unlicensed generic manufacturer that had poor mixing quality and even some batches that didn't have any active ingredient at all.  This was a one off problem that has plagued the industry ever since.  If you by from a reputable manufacturer you should be getting a quality product.  There are manufacturing standards that the makers have to adhere to or they face heavy fines and loss of their license.  In regards to even distribution of the active ingredient in the filler there is no problem with dry cutting tablets or taking the powder out of capsules. The same goes for commercially made liquid products.

 

A problem can come up with homemade liquids.  The solubility of each medication in water is different, some have to be dissolved in alcohol before adding to water, and some won't dissolve at all and have to be suspended.  All of these variables contribute to the possibility of not getting a consistent dose.  Even with all of these potential problems, it is still quite possible to get very accurate and consistent dosing using a homemade liquid.

 

Is one method preferable to the other, not really.  The better method is the one that the individual feels the most comfortable in using.  I prefer crushing and weighing because I have many years of experience in that sort of thing.  I find making and using liquid to be tedious and time consuming.  But that's my preference, we have many members who can't get the hang of dry cutting and much prefer their homemade liquid.

[BfromNJ]

7 hours ago, brassmonkey said:

It is a major misconception that the active ingredient is not mixed evenly through out the tablet or capsule.  Many years ago there was a case come up of a unlicensed generic manufacturer that had poor mixing quality and even some batches that didn't have any active ingredient at all.  This was a one off problem that has plagued the industry ever since.  If you by from a reputable manufacturer you should be getting a quality product.  There are manufacturing standards that the makers have to adhere to or they face heavy fines and loss of their license.  In regards to even distribution of the active ingredient in the filler there is no problem with dry cutting tablets or taking the powder out of capsules. The same goes for commercially made liquid products.

 

A problem can come up with homemade liquids.  The solubility of each medication in water is different, some have to be dissolved in alcohol before adding to water, and some won't dissolve at all and have to be suspended.  All of these variables contribute to the possibility of not getting a consistent dose.  Even with all of these potential problems, it is still quite possible to get very accurate and consistent dosing using a homemade liquid.

 

Is one method preferable to the other, not really.  The better method is the one that the individual feels the most comfortable in using.  I prefer crushing and weighing because I have many years of experience in that sort of thing.  I find making and using liquid to be tedious and time consuming.  But that's my preference, we have many members who can't get the hang of dry cutting and much prefer their homemade liquid.

Thank you brassmonkey.  You have assured me that I'm doing ok with what im doing.  I appreciate the response.   

[BfromNJ]

@brassmonkey

@manymoretodays

@ChessieCat

 

The above from brassmonkey has assured me I'm doing okay with my way of tapering.  I was leery of water method for myself because if I messed up I'd be less that dose. 

 

I have one more question/concern.   I've been reading that in getting down to the lower doses (under 100 mg) of gabapentin is very difficult in tapering.  I've read that some people stop at  100 mg.  I know that if you compare to other meds, the dosage in mg is much higher with gabapentin.   So would jumping off at 100 maybe be equivalent to jumping off say another med where you may have started at say 20 mg, now you are at 5? Am I making sense with that?  

[manymoretodays]

Hi B,

......maybe jumping ahead a bit is all. 

From what I can gather quickly.......you've got a ways to go until you will be down to 100 mg total of gabapentin/day. 

And I think that 100 mg would be way too high of a dose to jump off of, for any drug.

I jumped from oxcarbazapine at 24 mg and probably should have stayed the course, until I got much lower........as that was a bit reckless and might have produced more harm than good.

 

We might have to get down to eyeing your piles, when your scale readings get to around .004 grams on the Gem-20, but that's preferable to jumping too soon.

 

That's what I've got to say on that. 

 

Love, peace, healing, and growth,

mmt

? your flash moderator......I don't know.......back soon, my break may have been prolonged a bit.......just really craving anonymity/privacy at this time, thanks all.

Edited December 5, 2019 by manymoretodays

[BfromNJ]

12 minutes ago, manymoretodays said:

Hi B,

......maybe jumping ahead a bit is all. 

From what I can gather quickly.......you've got a ways to go until you will be down to 100 mg total of gabapentin/day. 

And I think that 100 mg would be way too high of a dose to jump off of, for any drug.

I jumped from oxcarbazapine at 24 mg and probably should have stayed the course, until I got much lower........as that was a bit reckless and might have produced more harm than good.

 

We might have to get down to eyeing your piles, when your scale readings get to around .004 grams on the Gem-20, but that's preferable to jumping too soon.

 

That's what I've got to say on that. 

 

Love, peace, healing, and growth,

mmt

? your flash moderator......I don't know.......back soon, my break may have been prolonged a bit.......just really craving anonymity/privacy at this time, thanks all.

Hey thank you for the reply  glad to hear from you.  Okay so I will cross that bridge when I come to it.  Oh and as far as a scale,  I had to retire my Gemini and get another one.  It wasnt working well anymore.  Pretty annoying since I just got it in like March.  No batteries I put in would keep it working.   I got another brand I like just as well.  I'll have to share it.  😁

[BfromNJ]

I just wanted to check in .  Tapering gabapentin now and staying the course.  Down to around 360 mg from 600.  I would say that is progress.  Started in June.  Had to hold a bit longer at certain times,  but just recently I've done every 4 weeks.  I'm hoping to shorten that, as I'm having significant hair loss,  which I think may be med related.   Among the other myriad of side effects.  Thank you to whomever sees this and for your ongoing support and help!  

[ShiningLight]

Great!!!! Glad you're doing so well. In my experience, slower IS faster.

[readyfortheworld]

Hi @BfromNJ, I saw in your earlier posts that you were dealing with silent reflux. Are you still dealing with it? What helped you alleviate it or you just let it be? Thanks 

[BfromNJ]

5 minutes ago, readyfortheworld said:

Hi @BfromNJ, I saw in your earlier posts that you were dealing with silent reflux. Are you still dealing with it? What helped you alleviate it or you just let it be? Thanks 

Well I have times where it does not bother me.  And times it flares.  I watch my diet, take tums and I drink aloe vera.   I think the aloe vera drink has really helped.  Also use a wedge pillow and I dont eat late at night.  I bought I great book called dropping acid by Jamie Kaufman.  She is a doctor who wrote it.  Very helpful.  Otherwise I guess its something I have to live with.  I did try pepcid but I didnt feel it helped and why add another med.