Anna1120: Doxepin taper

[Anna1120]

I am looking for advice/encouragement on tapering doxepin 10mg. I’ve been taking it for 18 months. This is the lowest dose and it comes in capsule form. How would I go about this? My doctor says I can stop since it’s a low dose but I’m afraid to do that. Thanks in advance. 

[ChessieCat]

Hi Anna and welcome to SA,

 

I'm really pleased that you found SA before getting off your drug.  And I'm very thankful that you didn't take your doctor's advice to just stop.  Not many medical professional understand about tapering and withdrawal from psychiatric drugs, which is why this site exists.

 

Before you begin tapering what you need to know

 

SA recommends tapering by no more than 10% of the current dose followed by a hold of about 4 weeks to allow the brain to adapt to not getting as much of the drug.  Why taper by 10% of my dosage?

 

When the drug is taken away too quickly we can get withdrawal symptoms:  Dr Joseph Glenmullen's Withdrawal Symptoms

 

This topic explains how to get the dose you need:  Tips for tapering doxepin (Sinequan, Zonalon)

 

Tapering Calculator - Online

 

Please create your drug signature to show the following information.

 

Keep it simple.  NO diagnoses or symptoms please - thank you.

• details for last 2 years - dates, ALL drugs, doses
• summary for older than 2 years - just years and drug/s

Account Settings – Create or Edit a signature

 

 

I will provide more information in the next couple of posts.  This is your own introductions topic where your can ask questions about your own situation and journal your progress.

 

Edited February 14, 2019 by ChessieCat
added link to calculator

[ChessieCat]

Here's some additional information which might help you to understand what is happening:

 

Recovery isn't linear it happens in a Windows and Waves Pattern

 

Withdrawal Normal Description

When we take a psychiatric drug, we are adding chemical/s to the brain.  The brain then has to change to adapt to getting the chemical/s.  It might have to change something to do with A and then once that change has been made it affects B so another change has to be made and so on down the line.  It is a chain reaction, a domino effect.

 

The same thing happens when we take the drug away.  That's why it's possible to experience such a vast array of withdrawal symptoms, and they can change, and be of different intensity.

 

are-we-there-yet-how-long-is-withdrawal-going-to-take

 

These explain it really well:

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

On 8/31/2011 at 5:28 AM, Rhiannon said:

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay. When the drug is removed, the remodeling process has to take place in reverse. SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. It's a matter of, as I describe it, having to grow a new brain. I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long.

 

AND

 

On 12/4/2015 at 2:41 AM, apace41 said:

Basically- you have a building where the MAJOR steel structures are trying to be rebuilt at different times - ALL while people are coming and going in the building and attempting to work.

It would be like if the World Trade Center Towers hadn't completely fallen - but had crumbled inside in different places.. Imagine if you were trying to rebuild the tower - WHILE people were coming and going and trying to work in the building!  You'd have to set up a temporary elevator - but when you needed to fix part of that area, you'd have to tear down that elevator and set up a temporary elevator somewhere else. And so on. You'd have to build, work around, then tear down, then build again, then work around, then build... ALL while people are coming and going, ALL while the furniture is being replaced, ALL while the walls are getting repainted... ALL while life is going on INSIDE the building. No doubt it would be chaotic. That is EXACTLY what is happening with windows and waves.  The windows are where the body has "got it right" for a day or so - but then the building shifts and the brain works on something else - and it's chaos again while another temporary pathway is set up to reroute function until repairs are made.  

 

[ChessieCat]

During any taper, there will be times of discomfort.  We strongly encourage members to learn and use non drug coping techniques to help get through tough times.

 

Understanding what is happening helps us to not get caught up with the second fear, or fear of the fear.  This happens when we experience sensations in our body and because we don't understand them we are scared of them and then start to panic.

 

This document has a diagram of the body explaining what happens in the body when we become anxious:

 

https://www.getselfhelp.co.uk/docs/AnxietySelfHelp.pdf

 

Anxiety Stuff - all kinds of stuff about anxiety attacks and things that help ...

 

Audio FEMALE VOICE:  First Aid for Panic (4 minutes)

 

Audio MALE VOICE:  First Aid for Panic (4 minutes)

 

Non-drug techniques to cope

 

dealing-with-emotional-spirals

 

Dr Claire Weekes suffered from anxiety and learned and taught ways of coping.  There are videos available on YouTube.

 

Claire Weekes' Method of Recovering from a Sensitized Nervous System

 

Audio:  How to Recover from Anxiety - Dr Claire Weekes

 

CBT Course:  An Introductory Self-Help Course in Cognitive Behaviour Therapy

 

Resources:  Centre for Clinical Interventions (PDF modules that you can work through, eg:  Depression, Distress Intolerance, Health Anxiety, Low Self-Esteem, Panic Attacks, Perfectionism, Procrastination, Social Anxiety, Worrying)

 

On 4/28/2017 at 4:03 AM, brassmonkey said:

 

AAF: Acknowledge, Accept, Float.  It's what you have to do when nothing else works, and can be a very powerful tool in coping with anxiety.  The neuroemotional anxiety many of us feel during WD is directly caused by the drugs and their chemical reactions in the brain.  Making it so there is nothing we can do about them.  They won't respond to other drugs, relaxation techniques and the like.  They do, however, react very well to being ignored.  That's the concept behind AAF.  Acknowledge, get to know the feeling involved, explore them.  Accept, These feelings are a part of you and they aren't going anywhere fast. Float, let the feeling float off as you get on with your life as best as you can.  It's a well documented fact that the more you feed in to anxiety the worse it gets.  What starts as generalized neuroemotinal anxiety can be easily blown into a full fledged panic attack just by thinking about it.

 

I often liken it to an unwanted house guest.  At first you talk to them, have conversations, communicate with them.  After a while you figure out that they aren't leaving and there is nothing you can do to get rid of them.  So you go on about your day, working around them until they get bored and leave.

 

It can take some practice, but AAF really does work.  I hope you give it a try.

 

 

[Anna1120]

@ChessieCat thank you for this great info. I will look through it all Asap. Is there a section that describes how to decrease by 10% with a capsule? 

[ChessieCat]

On 3/2/2013 at 6:47 AM, Altostrata said:

Make a doxepin liquid yourself from tablets or capsules
Doxepin is soluble in water. See How to make a liquid from tablets or capsules

Doxepin may degrade when exposed to light. If you make your own liquid, do not store it -- discard after you take your dose.

 

Use an oral syringe to precisely measure out doses as small as .01mg.

 

[ChessieCat]

Sorry, that was a bit abrupt.  I'm about to log off to get ready for work.

 

You are very welcome.  ☺️

[Carmie]

Hi Anna, 

 

How are you doing?💚

[Anna1120]

@Carmie doing well, thank you for asking! 😊

[Carmie]

On 3/20/2019 at 10:24 PM, Anna1120 said:

@Carmie doing well, thank you for asking! 😊

 

Glad you’re doing well Anna, 

 

Have you started tapering? Sending hugs🤗

[Anna1120]

Yes I’ve been off completely for several weeks. 

[Carmie]

 

45 minutes ago, Anna1120 said:

Yes I’ve been off completely for several weeks. 

 

Did you cold turkey Anna? 

 

I know you may be doing okay at the moment, but sometimes withdrawals can be delayed. Take care💚

 

P.s. Just concerned about you as cold turkeying can cause problems. Slow and steady tapering is the way to go.

Edited March 22, 2019 by Carmie
P.s.

[Anna1120]

No I did not cold turkey and please don’t try and put fear into something that may or may not even happen. Thanks!!

[Carmie]

What did you mean by you’ve been completely off for several weeks Anna?

 

Are you still on 10mg or have you tapered a bit? Could you please put in a drug signature, just press on the link ChessieCat gave you, Thanks a lot. 

 

Wasn’t trying to create fear, we just want people to know that going cold turkey isn’t a good option. Doctors have done that to me in the past and it was terrible. 

 

Wishing you all all the best in your tapering 💚

[DogLover]

Anna,

I don't think that anybody is trying to put fear into your situation. They just want to get a timeline of your taper process. Could you briefly describe it?

Please take care!

[ChessieCat]

Hi Anna,

 

I am providing this information because we are concerned that you have either reduced your drug too quickly or have stopped it abruptly.

 

I am not trying to scare you but want you to have the information if you need it.  If you get withdrawal symptoms and go back to see your doctor, he will probably put you on a much higher dose than SA would suggest, add another drug in, or change to a different drug.  It is better to reinstate the original drug.

 

Please be aware that we have followed the experiences of many members on this site and we try to pass on helpful information so that members don't suffer unnecessarily.

 

Withdrawal symptoms can be delayed.  When I cold turkeyed a drug I felt great for 2 to 3 months and then got very sick and was bedridden for 2.5 weeks and lost 8kgs because I couldn't eat.  I found out later that it was withdrawal.   Please check this list so that you can recognise any unusual symptoms which you experience.  Many people can have withdrawal symptoms and not realise that that is what they are:  Dr Joseph Glenmullen's WD Symptoms Checklist

 

If you start to get withdrawal symptoms, please note that the only known way to reduce the withdrawal symptoms is to reinstate the drug you have been taking as soon as they appear.  Please read Post #1 of this topic and note that SA recommends starting with a small dose and increasing by a small amount if needed.  If you take too high a dose after you experience withdrawal symptoms it can make things worse.

 

About reinstating and stabilizing to reduce withdrawal symptoms