Pilgrim: Clozaril / clozapine and Abilify / aripiprazole injections

[Pilgrim]

I'm currently wanting to withdraw from my medications.  I started these medications in the last couple of years.  ( I have been on other psych meds since 2013 but I don't remember what they were.)  My doctor put me on 300 milligrams of clozaril in 2016 and I've tapered down to 225 clozaril within the last six months.  He is also giving me abilify injections once a month since April of this year. I've had about 3 injections but don't know the dosage.  Before that I was taking wellbutrin and prozac.  I stopped taking the wellbutrin and prozac in April.  Should I be getting off clozaril first or abilify first, or together?  

[manymoretodays]

Hi Pilgrim and welcome aboard,

How have you been tapering the Clozaril?

How did you come off of your Wellbutrin and Prozac?  Was it all at once or did you taper somewhat?

How are you doing on this present combination of medications?

And when was your last Abilify injection?  Do you know what the dosage was of that?

 

We need a bit more information from you, which can be done in the manner below:

 

Please put your withdrawal history in your signature

If your drug history is very long, the last few years will do. FOR READABILITY, SHORT LINES ARE BEST.

 

• A list is easier to understand than one or multiple paragraphs
• Include ALL drugs, doses, and dates (starting and stopping)
• Any drugs prior to 24 months ago can just be listed with start and stop years
• Please use actual dates or approximate dates (e.g. mid-June) rather than relative time frames (e.g. 3 months ago)
• Spell out months (e.g. "January" or "Jan" as 9/1/2016 can be interpreted as 9 Jan 2016 or 1 Sept 2016)
• Please leave out symptoms and diagnoses

Account Settings

Just go back to ^ to do this.  And then remember to tick/click the Save button when you are done.

 

You can create a signature on a cell phone device, but will not be able to view it from that type of device.  The signatures are what are visible below each members post.

 

Welcome again Pilgrim.

Love, peace, healing, and growth,

manymoretodays(mmt)

 

 

 

 

[manymoretodays]

Hi Pilgrim,

And thank you.  I noticed you got your signature done.  Which answered a lot of my initial questions.  Good job.

~2012 Started on psychiatric medications.
~2016 Started Clozaril 300mg (3 tablets @ 100mg each)
~2017-2018 Told doctor I wanted to taper off Clozaril. Not recommended, but dropped to 200mg.  Felt very depressed so went back to 300mg

~Nov. 2017 Began 100mg Wellbutrin

~Jan. 2019 Began Taper off Clozaril – cut 1/4 off 1 tablet, decrease from 300mg to 275mg

~Feb. 2019 Stopped all meds and went into crisis center to get back on

~March 2019 Doctor ordered ?mg Abilify Injections 1/mo & 20mg Prozac.  Wellbutrin cold turkey & no Prozac. Taper Clozaril to 250mg
~June 2019 Taper Clozaril to 225mg

 

I am feeling more depressed after I began tapering the Clozaril, and after stopping the Wellbutrin and switching to an Ability injection.  I also am having difficulty typing these messages because of this and that is why my mom is helping me type, but I do want the help to taper off this medication.  I feel hopeless about the future and lost.

 

Could you go ahead and do some notes, as to when you take your medication(s) each day.  Or have your Mom do this for us.

Note the time on the left and then medication(s) by name and dosage on the left.   On the right you can note any symptoms throughout the day, often in the notes, a rating scale works good.  1- 10, with 10 being the worst.  You can rate things like low moods, or anxiety fears, etc.  Include sleep and any supplements taken.

 

On 7/19/2019 at 8:01 PM, Pilgrim said:

Should I be getting off clozaril first or abilify first, or together?  

We generally suggest just one medication at a time, when it comes to tapering. 

And how are you doing now, as far as WD(withdrawal) symptoms go? 

 

As I'm not certain, as to how much you have scanned the site yet, I'll leave here some links that have important important information.

 

Here at Surviving Antidepressants, we generally recommend, that a person taper by no more than 10% of their current dose, with at least a four week hold in-between decreases.  The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs.

Why taper by 10% of my dosage?

 

Brain Remodelling

What is Withdrawal syndrome.

 

The Windows and Waves pattern of Stabilization

 

Dr.Glenmullen’s withdrawal symptom list.

 

Tips for tapering off Abilify(aripiprazole)

Are you scheduled for any more Abilify injections?

 

And as yet, we don't have anything written up or collected on Clozaril(clozapine) tapering.  For now though, right now........I'd hold until we get to know you a bit better and have more information.  How did you make the dose changes, so far, with your Clozaril?  Your first taper, may have been just too fast, that one in 2017-2018.  And then when WD hit, you got more medications.  How is your doctor now, as far as having you resume tapering.........supportive, or not?

Please plug your current medications in here Drug Interaction Report-Drugs. com

^ Then copy and paste here, on your introductions page.

The Abilify and Clozaril are not a great combination at all!

 

You can also use that site to find out more beginning information on the Clozaril(clozapine) too.  After you do the interactions.  You can do a search from the top box there.  Are you getting some periodic labwork to monitor your WBC ?

 

When we take medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made.  The CNS likes stability. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.

 

Some of your symptoms now, could be due to WD, as you have had a lot of medication switches and then some CT's(cold turkeys too).  As well as from the medications themselves.   So hang on Pilgrim.  You've been through a lot.  Or your nervous system has.  Good to get to a place of WD normal too, before making further changes.  More about that soon.  I've loaded you up with plenty already.

 

This is your introduction page.  Please don't hesitate to ask questions, right here.  You have now also introduced your self to the community.  And can keep a record of your journey here as well.

 

And welcome aboard!  ❤️

Love, peace, healing, and growth,

mmt

 

 

 

 

Edited August 3, 2019 by manymoretodays

[Altostrata]

Pilgrim, why are you taking clozapine and Abilify (injections) at the same time? What symptoms is the Abilify supposed to fix?

 

This is probably why you feel so dull and dopey:

 

https://www.drugs.com/interactions-check.php?drug_list=709-0,233-16107
 

Quote

 

Interactions between your drugs

 

Major

Applies to: clozapine, Abilify Maintena (aripiprazole)

 

CloZAPine may occasionally cause serious cardiovascular side effects such as low blood pressure and cardiac or respiratory arrest, and combining it with other medications that can can also have these effects such as ARIPiprazole may increase the risk. Cardiovascular side effects are most likely to occur at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Other side effects that may also be increased include dizziness, drowsiness, blurred vision, confusion, dry mouth, abdominal cramping, constipation, difficulty urinating, heat intolerance, low white blood cell count, palpitation, and irregular heart rhythm. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. If you miss your cloZAPine doses for two or more days, contact your doctor before you resume treatment, as you may need to restart at a lower dose. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

.....

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.

 

Duplication

 

Antipsychotics

Therapeutic duplication

 

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

 

clozapine

Abilify Maintena (aripiprazole)

 

 

 

If I were you, I'd let the Abilify injection wear off and decline any more. You may also want to find a new doctor.

[Pilgrim]

Does anybody out there know of a Dr. that will taper slowly and at the pace I want in Grand Rapids, MI, or within a 60 mile radius? On Tuesday of this week, the social worker representing my psychiatrist threatened court ordered meds because I refused my monthly Abilify injection for today (which is Friday, 9/6/19).  So this person said the Abilify (300mg)  will leave my system by today anyway so there is no need for tapering.  I am concerned that again, my doctor is trying to sabotage my efforts to safely withdraw off of psychiatric medications. I started Abilify approximately 7 months ago, and have been tapering from 300mg to 200mg of Clozapine, but am staying at 200mg since I stopped the Abilify. Should I try to taper slowly from the Abilify injection, and how would I get the doctor to help me if he said I can stop the Abilify cold turkey without withdrawal symptoms? The doctor and visiting nurse/social worker are all pressuring  me to start a different medication (a few days of pills to test for allergies and then weekly injections) right away in place of the Abilify injections. I want to taper but fear the doctor is tapering me too quickly and dangerously if I don't agree to his orders or I fear he  will switch me to drug injections by court order that I will not be able to taper.  This is why I need to find another Dr. quickly.  My mom and friends have been helping me search for a Dr. and we're having difficulty finding one.

[Altostrata]

This will answer your question about tapering Abilify injections Tips for tapering off aripiprazole (Abilify)

 

Did you get an injection once a month? It wears off gradually. If at the end of the injection period, you don't get withdrawal symptoms, you don't need to do anything else.

 

If you do get withdrawal symptoms, you might take a very small amount of Abilify in tablet or liquid form. How do you feel at the end of the injection period?

 

Are you still taking clozaril? Why does your psychiatrist think you need two antipsychotics that interact? Can you get a patient advocate to work with you?

[Pilgrim]

Yes, I got an injection once a month for seven months.  I feel more miserable at the end of the injection period.

 

Yes, I'm still taking clozaril at  200mg/night.  My psychiatrist thinks I need two antipsychotics that interact because I keep telling him that I'm miserable all the time and nothing is helping.

 

Last week some friends helped my mom and I write up a durable power of attorney for medical.  My mom is my patient advocate.  The county mental health services which I am doctoring under thinks that my mom is making me get off the medications.  They sent out two people from adult protective services to check on that suspicion and I told them it was truly me that wanted to get off my meds.  My mom is supporting me.  So in their eyes they might see a conflict of interest with my mom being the patient advocate. How can my Mom help me?