FreeAlly: Luvox Taper

[FreeAlly]

Hi everyone,

 

I'm new to this site and i am so grateful that it exists.  I have been on 50mg of Luvox for 4 years after falling into a depression after a serious health condition.  I have completely recovered from that.  I have been very well recently and decided that it was time to free myself from Luvox.  I am also on 17.5mg of amitriptaline which was prescribed for pain which i no longer have but i plan to taper off that after the Luvox.  I made my first cut 7 days ago of 1% and good god its been awful.  The symptoms i have had so far are:

- brain fog

- no motivation

- feeling like my body is melting

- feeling of shooting energy from my heart all the way down my arms

- fatigue

- sadness

-apathy

-irrittation

- anxiety

- nausea

 

I am shocked that from such a small cut that i could feel this terrible.  I must admit though that i am incredibly sensitive to medication.

 

Id be happy to hear your thoughts, comments and advice on my taper.  I dont plan to make another cut until i have stabilised from this last cut.  I know this is going to be a very slow process for me.

 

Thanks!

[Gridley]

Welcome to SA, FreeAlly.

 

We generally recommend tapering by no more than 10% of current dose every four weeks.

 

 http://survivingantidepressants.org/index.php?/topic/1024-why-taper-by-10-of-my-dosage/

 

Given your reaction to a 1% reduction, it appears you're going to have to go much more slowly.  Here is information on a micro-taper.  This is the gentlest way to come off psychiatric drugs.  You're wise to wait until you've stabilized before tapering further.

 

Micro-taper instead of 10% or 5% decreases

 

We recommend tapering only one drug at a time, as you're doing.  This link is specifically about tapering Luvox.

 

Tips for tapering off Luvox (fluvoxamine)

 

Many of the symptoms you list are common withdrawal symptoms. So you have a better understanding of what you're experiencing, here is some information of withdrawal.

 

What is withdrawal syndrome.

 

Glenmullen’s withdrawal symptom list.

 

 The Windows and Waves Pattern of Stabilization

 

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. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.  

 

These explain it really well:

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

   On 8/30/2011 at 2:28 PM,  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.

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Please research all supplements first and only add in one at a time and at a low dose in case you do experience problems.

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.

 

Account Settings – Create or Edit a signature.

 

This is your Introduction topic, where you can ask questions and connect with other members.  We're glad you found your way here.

 

 

 

 

 

 

[FreeAlly]

Thanks Griffey for the welcome and all the information.

 

two questions.  Can I continue on the supplements I am already on that don’t relate to tapering?  Also does each cut more or less bring the same level of symptoms?

 

Not sure if I am supposed to post these questions elsewhere on the site?

 

Thanks

Ally

[FreeAlly]

Gridley not Griffin....autotxt

 

also I tried to click on the link to the symptoms checklist but it says the document isn’t there anymore.  Is there somewhere else I might find it?

 

thabks!

[Sassenach]

Hi Ally

 

Can you confirm you have only decreased by 1% ie. you have reduced by 0.5mgs?

On 11/5/2019 at 11:04 AM, FreeAlly said:

am also on 17.5mg of amitriptaline

When did you start taking this?

What supplements are you taking and why?

Are they to help with specifically targeted diagnosed health conditions?

On 11/6/2019 at 12:54 AM, FreeAlly said:

Also does each cut more or less bring the same level of symptoms?

We are all different but in general, yes.

However as you seem to be so sensitive a different approach may be needed.

Try this for for the symptoms list.

dr-joseph-glenmullens-withdrawal-symptom-checklist/

As soon as we recieve the drugs info. we can assess your situation.

In the meantime DO NOT MAKE ANY CHANGE TO YOUR CURRENT MEDS please.

Please feel free to browse the site, it is a wealth of info.

Other members threads will give you an insight and the opportunity to share experiences.

 

Sassenach

Edited November 7, 2019 by Sassenach
omission

[FreeAlly]

Hi Sassensch,

 

Yes I only reduced by 1%, I’m shocked at how terrible I’ve felt since.   It’s been 10 days now and I do feel a lot better but it’s left me feeling low and depleted afterwards.  I have no intention to do another cut until I feel much more stable.

 

The amitriptalyne I started taking around the same time as the Luvox so that would be 4 years ago.  It’s not a new med.  I took it at the time for a nerve condition but that has now resolved.

 

Im on an iron supplement that I have to take as I get extremely low iron so that is non negotiable.   I also take a supplement called Armaforce which is to help with my immune system as I get colds often if I don’t take it.  I also take a probiotic.

 

Any suggestions of how to taper in a much more gentle way?  It feels extreme to experience what I did after such a small cut....

 

Thanks!

 

[Sassenach]

Hi Ally

 

I have run your drugs through the anteraction checker with the following results:

 

I

Interactions between your drugs

Major

amitriptyline fluvoxaMINE

Applies to: amitriptyline, Luvox (fluvoxamine)

Ask your doctor before using amitriptyline together with fluvoxaMINE this can increase your blood levels of amitriptyline. This combination may cause side effects such as drowsiness, dry mouth, blurred vision, constipation, or urinating less than usual. Talk with your doctor before using these medications together. You may need a dose adjustment or special tests to safely take both medications. 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.

have run your two drugs through the interraction checker with the following results.

 

Because of your reaction to such a small cut I am going to refer this one of our senior mods.

They will need the following questions answered.

What are your current symptoms?

Do they get better or worse at any particular time of day?

Do they get better or worse after taking meds?

Times of day when you take the meds?

What are your current med doses?

 

They know more about possible interdose withdrawal.

We need to establish whether you are simply sensitive to drugs or if there is another reason.

I would be grateful if you complete your drug signature using the link below.

http://survivingantidepressants.org/index.php?/settings/signature/

This may seem like a duplication of info. already given, but will appear below every post you make and will save valuable mod time as you progress

 

Sassenach

[FreeAlly]

Thanks Sadsenach.

i have been on amitriptaline for a quite a few years with the Luvox with no issues so I don’t think that is the problem.

 

My symptoms started 3-4 days after the first cut.  Initially more physical symptoms like feeling like my body was melting, shooting energy from my heart all down my arms and a feeling of restlessness.  Around the 6 day mark I started to have mood swings between sadness, apathy and some anxiety.  They all come in windows and waves and in the beginning it was more like all day.  Now the symptoms only last a few minutes each time and then I have windows of feeling good.

last night I had fever, chills and upset stomach during the night and I have a very big headache which are new symptoms. I still feel somewhat detached from everything which is a really strange feeling.

 

i take half the Luvox in the morning and the other half in the evening.  I’ve come down 1% from 50mg of Luvox.  I shaved off the 1% and weighed using digital scales but perhaps my method is not good.  I have to travel overseas a lot so liquor tapering feels a bit of a challenge really in that way.  The pills varied a lot in weight so I took the average of the pill weights and used that as how to work out the first reduction.

 

no I don’t notice a change after taking the medication.  Or that I’m better at any time of day.   There is no pattern in that way.

 

thank you for your help!

[FreeAlly]

Oh and prior to the cut I felt very very well and that is the reason why I decided it was time to start tapering the Luvox 

[Altostrata]

Welcome, Free.

 

From which Luvox dose, morning or evening, did you take the reduction?

 

What times of day do you take amitriptyline, at what dosage? Do these nasty symptoms occur at any particular times of day?

[FreeAlly]

Well I’m not sure.  The lowest dosage in a tablet of Luvox is 50mg and I’ve slways used a pill cutter to half it for the morning and evening dose.  They were never equal but as long as I took the 50mg each day then I didn’t have any issues.

 

with the taper I just took off 1% off the pill after dividing it.  Do you think I need to make sure that the morning and evening doses are exact?  For example that in the morning i would take 25mg less the 1% cut and then evening 25mg?  Just quite fiddley to do it that way.

[Sassenach]

Hi Ally

On 11/8/2019 at 8:28 PM, FreeAlly said:

The pills varied a lot in weight so I took the average of the pill weights and used that as how to work out the first reduction.

Did they vary in size?

Were they from different manufacturers, if so you should ensure you get the same brand in future.

You can explain to the pharmicist you are tapering and very sensitive during the reductions.

You need to keep exactly the same schedule every day.

The reduced dose should always be taken either am or pm but not varied.

What time of day do you take Amitriptyline, is it the same time every day?

As you are travelling a lot, are you crossing time zones and if so do you adjust your schedule to take this into account?

Constant drug schedules are important to everyone in W/D and tapering but more so if you are very sensitive to the changes.

How do you shave 1% off your half pill?

 

Sassenach

 

[Altostrata]

FreeA, did you take 1% (0.5mg) off both the morning and evening doses? Or just one? Was it the morning or evening dose?

 

For tapering, you may want to get the prescription Luvox liquid to take for one of your two daily doses.

[FreeAlly]

3 hours ago, Sassenach said:

Hi Ally

Did they vary in size?

Were they from different manufacturers, if so you should ensure you get the same brand in future.

You can explain to the pharmicist you are tapering and very sensitive during the reductions.

You need to keep exactly the same schedule every day.

The reduced dose should always be taken either am or pm but not varied.

What time of day do you take Amitriptyline, is it the same time every day?

As you are travelling a lot, are you crossing time zones and if so do you adjust your schedule to take this into account?

Constant drug schedules are important to everyone in W/D and tapering but more so if you are very sensitive to the changes.

How do you shave 1% off your half pill?

 

Sassenach

 

Hi Sassenach,

 

i use the same brand movox - I use Gemini scales to weigh them and they did vary in weight and I read on here to take the average and go off that.  

 

I will make sure I take the doses at the same time each day and I hadn’t thought about time zones but yes I will need to adjust accordingly.

 

To shave, I split the pill in half and then shave along the split line if that makes sense.  So from the middle of the pill.

 

Thanks so much for your help.

[FreeAlly]

2 hours ago, Altostrata said:

FreeA, did you take 1% (0.5mg) off both the morning and evening doses? Or just one? Was it the morning or evening dose?

 

For tapering, you may want to get the prescription Luvox liquid to take for one of your two daily doses.

 

Hi Altostrata,

 

i took off 0.5g off the full dose, not off both the morning and evening.  So a total of 0.5g.  The only thing was that I wasn’t taking it at the same time each day which I will start doing.

 

i thought about the liquid but then read on here that people have difficulty going from the tablet to the liquid.  I wondered with my sensitivity whether it would be too difficult....   How do people generally tolerate the change?

 

thanks

Ally

[Altostrata]

They switch from tablet to liquid gradually, by taking part in tablet form and part in liquid form.

 

Did you take 0.5mg off the morning or evening dose?

 

Yes, you'll have to take your drugs on schedule to establish a baseline symptom pattern. Please keep daily notes of times of day you take your drugs, their dosages, and your symptoms throughout the day. You can post 24 hours of notes at a time in this topic, with a simple list format with time of day on the left and notation (symptom or drug and dosage) on the right.

[Sassenach]

Hi Ally

 

23 hours ago, Sassenach said:

What time of day do you take Amitriptyline, is it the same time every day?

This could be important because of possible interdrug reactions. Do you take it at the same time as one of your Luvox doses?

 

On 11/10/2019 at 2:50 AM, FreeAlly said:

 They were never equal but as long as I took the 50mg each day then I didn’t have any issues.

 

You were stable then but a destabilised CNS reacts more strongly to dose and time changes, more so as your's seems so sensitive.

It seems a change to liquid would be the best way of ensuring accurate dosage.

Are liquids ok on aircraft?

 

@Altostrata has not commented on Amitriptyiline.

Can you please follow this link to fill in your drug signature which will then appear below every post you make, and provides a snapshot of your drug and supplement history.

Please add a signature.  Include drugs, doses, dates, and discontinuations & reinstatements in the last 12-24 months. Also include supplements. This will help us give you the most accurate advice we can. 

• Any drugs and supplements prior to 24 months ago can just be listed with start and stop years. 
• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago) 
• Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016. 
• Please leave out symptoms and diagnoses. 
• A list is easier to understand than one or multiple paragraphs. 
• /settings/signature/This is a direct link to your signature:

You need to stabilse before making any further changes.

How are you feeling today?

19 hours ago, FreeAlly said:

To shave, I split the pill in half and then shave along the split line if that makes sense.  So from the middle of the pill

Just noticed this Ally.

If you have scales why are you shaving pills?

 

Sassenach

[Altostrata]

19 hours ago, FreeAlly said:

The only thing was that I wasn’t taking it at the same time each day which I will start doing.

 

This is probably the reason you got those odd symptoms. Do you ever accidentally forget to take a dose?

 

Going off Luvox before amitriptyline prescribed for pain makes sense to me.

 

Please take care to answer all questions from the staff.

 

Prescription liquids are permitted on aircraft.

[FreeAlly]

1 hour ago, Sassenach said:

Hi Ally

 

This could be important because of possible interdrug reactions. Do you take it at the same time as one of your Luvox doses?

 

You were stable then but a destabilised CNS reacts more strongly to dose and time changes, more so as your's seems so sensitive.

It seems a change to liquid would be the best way of ensuring accurate dosage.

Are liquids ok on aircraft?

 

@Altostrata has not commented on Amitriptyiline.

Can you please follow this link to fill in your drug signature which will then appear below every post you make, and provides a snapshot of your drug and supplement history.

Please add a signature.  Include drugs, doses, dates, and discontinuations & reinstatements in the last 12-24 months. Also include supplements. This will help us give you the most accurate advice we can. 

• Any drugs and supplements prior to 24 months ago can just be listed with start and stop years. 
• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago) 
• Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016. 
• Please leave out symptoms and diagnoses. 
• A list is easier to understand than one or multiple paragraphs. 
• /settings/signature/This is a direct link to your signature:

You need to stabilse before making any further changes.

How are you feeling today?

Just noticed this Ally.

If you have scales why are you shaving pills?

 

Sassenach

Hi Sassenach,

 

yes i guess prescription liquids but of course not my own liquid taper solution would be allowed on a plane.

 

No I take the Amytriptalyne 4 hours after the Luvox dose.  I don’t notice any change in symptoms after taking the dose.

 

What do you mean about if I have scales, why am I shaving? What is the other

option?  Is it to crush the pills instead?

 

Im feeling 99% better now.  Just very mild symptoms now. Still not going to make any changes yet.  Thinking of waiting another month or so and  I want to make a decision first about moving forward and the best way to taper anyway.  

 

Its probably also important to say that I have a big history of withdrawal symptoms coming off meds.  I was started on half the lowest dose of thyroid medication many years ago which basically poisoned me so I had to stop it and coming off that was horrific for months.  Very similar symptoms really.  Also years ago I took prescribed sleeping medication for a couple of weeks and was only taking a quarter of the lowest dose and again had severe withdrawals afterwards which again were very similar to what I experienced these past two weeks.  The doctors are always shocked at what happens to me. I am an incredibly sensitive person so I think it was always going to be tough coming off these meds but it’s probably even more critical for me to get the dosage accurate and on time.  I was very unwell physically going on the Luvox and at the time I got a whole lot worse with all over body nerve pain and other symptoms and I never thought until now how it was probably starting the Luvox that brought those symptoms on.

 

Since the 1% cut was too big, what would be a next appropriate cut?  Halve that again?

 

Many thanks!

[FreeAlly]

1 hour ago, Altostrata said:

 

This is probably the reason you got those odd symptoms. Do you ever accidentally forget to take a dose?

 

Going off Luvox before amitriptyline prescribed for pain makes sense to me.

 

Please take care to answer all questions from the staff.

 

Prescription liquids are permitted on aircraft.

Hi Altostrata,

 

I hope that with more stable dosing that things will improve.  I’m thinking that maybe the liquid medication might be the way to go for half the dose - the dose that I am tapering which will be the morning dose.  I think it’s better though that I first start on the liquid and don’t taper any further and stabilize on that first then start the next cut when I’m all settled....  I think also that Luvox brand makes a children’s dose of 25mg which would help make sure the pm dose was correct.  Anyway I will go see my gp about it.

 

thanks for your help.  In the meantime I am much much more stable now.  99% better, just few small symptoms left.  It has taken two weeks so far to feel to this stage of stabilization.

 

ally

 

 

[FreeAlly]

21 hours ago, Altostrata said:

They switch from tablet to liquid gradually, by taking part in tablet form and part in liquid form.

 

Did you take 0.5mg off the morning or evening dose?

 

Yes, you'll have to take your drugs on schedule to establish a baseline symptom pattern. Please keep daily notes of times of day you take your drugs, their dosages, and your symptoms throughout the day. You can post 24 hours of notes at a time in this topic, with a simple list format with time of day on the left and notation (symptom or drug and dosage) on the right.

I took 0.5% off but wasn’t keeping track of if it was the morning or evening dose so that may have caused more disruption than necessary.

[FreeAlly]

1 hour ago, Altostrata said:

 

This is probably the reason you got those odd symptoms. Do you ever accidentally forget to take a dose?

 

Going off Luvox before amitriptyline prescribed for pain makes sense to me.

 

Please take care to answer all questions from the staff.

 

Prescription liquids are permitted on aircraft.

Forgot to say that no I haven’t forgotten to take a dose.  I am very committed in that way.

[Altostrata]

10 minutes ago, FreeAlly said:

I think also that Luvox brand makes a children’s dose of 25mg which would help make sure the pm dose was correct.

 

Pretty sure this is what you want.

 

I would go back to 50mg Luvox, get your drug schedule regular for 2 weeks, let us know how your symptom pattern changes.

[FreeAlly]

7 minutes ago, Altostrata said:

 

Pretty sure this is what you want.

 

I would go back to 50mg Luvox, get your drug schedule regular for 2 weeks, let us know how your symptom pattern changes.

 

I am honestly too afraid to change anything at the moment like to go back up to 50.  The last two weeks have been hell and I’m only just beginning to feel normal now and the thought of more changes to my CNS seems like adding fuel to the fire?

[Altostrata]

Okay, stay where you are -- but on a regular schedule. Keeo in touch.

[Sassenach]

Hi Ally

 

If you switch to liquid I suggest you use a pipette to measure your doses and not rely on number of drops.

 

Sass

[FreeAlly]

On 11/12/2019 at 7:22 AM, Altostrata said:

Okay, stay where you are -- but on a regular schedule. Keeo in touch.

 

On 11/12/2019 at 7:22 AM, Altostrata said:

Okay, stay where you are -- but on a regular schedule. Keeo in touch.

Thank you very much for your guidance. Much much appreciated.  

 

Just one one more thing.  I won’t be able to switch over to the liquid until next week as I am going overseas tomorrow and just can’t get everything in order before then.  I will continue using the scales until then.  Is it more accurate to shave the pills or crush them and then weigh them?

 

thanks

ally

[FreeAlly]

18 hours ago, Sassenach said:

Hi Ally

 

If you switch to liquid I suggest you use a pipette to measure your doses and not rely on number of drops.

 

Sass

Is a pipette the same as a syringe?  I’m guessing I’d have to find super small ones...

 

Thanks

Ally 

[Sassenach]

2 hours ago, FreeAlly said:

 Is it more accurate to shave the pills or crush them and then weigh them?

Weigh would be preferable but as you have been shaving so far might be easier to continue on your trip.

More important to keep times regular.

2 hours ago, FreeAlly said:

Is a pipette the same as a syringe?  I’m guessing I’d have to find super small ones...

Pretty much but ther have a flexile bulb rather tahn a plunger which many find easier to use at low dose.

Look online you will find plenty of choice.

Enjoy your trip.

 

Sass

[FreeAlly]

On 11/14/2019 at 1:44 AM, Sassenach said:

Weigh would be preferable but as you have been shaving so far might be easier to continue on your trip.

More important to keep times regular.

Pretty much but ther have a flexile bulb rather tahn a plunger which many find easier to use at low dose.

Look online you will find plenty of choice.

Enjoy your trip.

 

Sass

Thanks so much for your help Sass. Very much appreciated.  I’ll get on to it this week.

 

Ally

[Sassenach]

Hi Ally

 

How are you doing?

 

Sass

[FreeAlly]

Hi Sass,

thanks for checking in.  On the whole I’ve been a lot better but still not back to feeling 100% but perhaps that won’t happen.   I still haven’t managed to go across to a liquid form yet, I’m going to organize it next week.  I have come across a stumbling block though.  I am overseas and before I left I filled my prescription.  I asked the chemist for the specific brand and they said yes but they had put it on a bag and I didn’t check and I’ve come overseas and realized that they have me a different brand of the medication.  The weight of the tablets is different.  Do I find an average of these tablets and do the same 1% reduction.  

I haven’t done another cut since the first cut, I’m waiting to stabilize.  I hope that this change in brands won’t make things worse.

Thank you!

Ally

[Sassenach]

Hi Ally

 

Apologies for delay.

 

Yes, use exactly the same calculations.

The average starting weight will be different but result will be the same.

Some folks who are sensitive to meds, like yourself, have been known to react to a different brand.

This usually settles within a couple of days

Any problems get back to me.

Worth telling the Parmacist when you get back what happened and how important it can be.

At least some pharmacists are beginning to understand W/D.

Sass

[FreeAlly]

3 hours ago, Sassenach said:

Hi Ally

 

Apologies for delay.

 

Yes, use exactly the same calculations.

The average starting weight will be different but result will be the same.

Some folks who are sensitive to meds, like yourself, have been known to react to a different brand.

This usually settles within a couple of days

Any problems get back to me.

Worth telling the Parmacist when you get back what happened and how important it can be.

At least some pharmacists are beginning to understand W/D.

Sass

Thanks so much Sass, that makes me feel a lot better about the medication mix up and dosage calculation.  And yes good idea about telling the pharmacist!

 

wishing you a beautiful Sunday.

Ally

[FreeAlly]

On 11/13/2019 at 4:52 AM, Sassenach said:

Hi Ally

 

If you switch to liquid I suggest you use a pipette to measure your doses and not rely on number of drops.

 

Sass

Hi Sass,

 

Just wondering what what size pipette to buy?   What would give small enough measurements to reduce by 1% or less do you think?

 

Thanks

Ally

[Sassenach]

Remind me Ally, are you currently on 25mg or 50mg tablets?