Jmizz: Lamictal taper suggestions

[Jmizz]

@Altostrata 

 

 

2-7-20

630- restless wake

7-8 stir In bed/low mood 

8-12mg

8-9 horrible stress trying to get son ready for school, get my stuff together to go golf so the cleaning lady can come, rushing all morning

9-10 digestive upset (once)

10-1 play golf with friend, anxiety was bad for no reason but still enjoyed myself

1-2 went to eat at restaurant, don’t do this often anymore, horrible anxiety, dose time coming up

2-5mg

2-3:30 really really struggled to get anxiety under control, picked up son from school, he wanted a Friday treat, didn’t get myself calm til I got home for a bit

4-8 friend brought his buddy to play with son, outside, felt pretty ok, forced myself to eat around 6:30

8-20.5mg epsom bath

8:30-9:30 lay in bed for son to fall asleep, feel ok

9:30 traz50 melatonin5

10:30 sleep 8 hours (had struggled sleeping two nights before with some intermittent waking)

 

I think I was dealing with stuff better for a couple weeks and probably overdid it. Maybe a stress wave coupled with the 5mg hiccup.

2-8-20

Slept good 1030-630

6:30 restless wake (pretty consistent)
7-8 low mood

8-12mg

8:45-10 post dose funk 

10-12 birthday party/anxiety was better than usual in crowds/mainly anxious about physical stuff some nausea and dry mouth manageable

12-2 some fatigue/dosey feels weren’t as bad today

2-5mg water

2-3 felt ok

3:30-4:30 dose funk at another birthday party/anxiety better than usual in these situations

5-8 hungry/aggravated my appetite has gone down this week and I keep getting into situations where I have to eat bc I haven’t eaten much 

8-20.5 mg (Dose feels not as bad)

8-9 1/2 cup epsom bath, feel pretty ok

9:30-traz50 mel5

 

[Altostrata]

You've only been taking the 5mg as liquid for a couple of days, it could take a while to settle in.

 

You're on a break from work now, correct? When does that end?

[Jmizz]

@Altostrata

Feb 18th and then I work 12 of the next 45. With another 13 day off stretch at the end of March.

 

[Jmizz]

@Altostrata

 

2-10-20

 

4am-wake/nausea/diarrhea

fall back asleep intermittently waking to use the bathroom

7:30am-wake for good, stomach upset still 

8am-12mg

8-12relaxed in bed, stomach problems continued til noon, nausea also

12-2pm felt good for a while 

2pm-5mg water

3-7 nausea and anxiety about nausea, or nausea bc of anxiety

8-20.5mg

9-nausea and some dry mouth

9:30 traz 50 melatonin 5

9:30 nausea continues 

😞
 

I don’t know what the stomach stuff is about. The diarrhea settled around lunch. I ate a subway chicken sandwich for lunch yesterday and the chicken was cold, maybe a touch of food poisoning? I also went to two kids bday parties this weekend, so maybe I picked up a bug. Or it just could be the changes, who knows

it’s possible my 5mg mixture is a little less than 5mg. Bc I measure out the water then drop the pill in, so 10ml becomes a little over 10 with the pill weight added to the water. but I’ve done it this way the whole time so i kept doing it. Going from pill to water I prob lost a little bit off the 5mg. There’s also the dumb drop to 20 for two days mixed in. 
 

I forgot how much I hated the nausea.

[Altostrata]

Is this like your lamotrigine queasiness? It looks worse.

[Jmizz]

@Altostrata

 

it seems very similar to the nausea I had when I went from dosing in the morning to spacing my doses 12 hours and also dropped from 50-40. It’s also similar to when I added the afternoon dose and changed dosing from 18.75 twice a day to 15-5-17.5. The diarrhea was different. Never had that before, could have been ate something bad. But I recovered from

that it seems and the nausea is still rough 1-3 hours after doses.

 

i can’t believe how sensitive I am if the slight changes from the last week cause nausea like this. Will this ever improve or is it just going to be a disaster when I one day come off Lamictal?

[Jmizz]

@Altostrata

 

i also changed my mixing method when I went back to 5mg in water. I used to mix each dose in a medicine cup, extract the waste and drink what was left in the cup. Lately I’ve been mixing my 12 and 5mg doses off the same 25 pill since my prescription is only 2 pills a day....but this way I dissolve in medicine cup and extract out 5mg for one dose and 12 for the other and throw away what’s left in the cup. At night I just mix it my normal way. I’m sure this prob has had some effect also.

 

nausea was bad in the afternoon yesterday, so far today it was rough this morning and not bad this afternoon so far, 2 hours post dose

[Jmizz]

@Altostrata

 

 

2-12-20

7:30 wake feel pretty good 

8-12mg with breakfast turkey/egg sandwich/ banana 

9-11 nausea comes on about an hour after taking my dose and lasts for about 2 hours, then settles some, as a result anxiety is bad...went to the store during this time, agoraphobia is back..foggy disassociation

11-2 - back home, feel a little better, maybe mild lingering nausea, eat a banana and a large apple 

2-5mg

3-4:30 or so uptick in nausea

5-8 manageable, stay busy, feel okish, dinner taco soup 

8-20.5 mg

9-traz 50 Melatonin 5

9-1030 nausea bad, basically the last few nights I have to wait for the nausea to settle before I finally fall asleep 

Sleep fine 8 hours 

 

will post tonight  for today.

[Altostrata]

My guess is your have your startup nausea from lamotrigine again, because of the blip with the bad 5mg tablets.

[Jmizz]

@Altostrata

 

2-13-20

7:30 wake felt really pretty good this morning 

8-12mg

8:30 within 30 minutes I start feeling the post dose funk, it builds from there

9-11 some nausea, agoraphobia at store, short of breath anxiety/stomach tension

12-2 anxiety still up, lunch chic fil a chicken fingers and fries 

2-5mg

3-nausea hits

4-ate no sugar added popsicle with my son

4:30 nausea let’s up 

5-digestive issues twice 

5:30-8 feel fine but worried my problems that led me back to drugs are starting again with my stomach, stomach is uneasy but digestive issues stop.

8-20.5mg 
9-traz 50 melatonin 5

 

i agree the nausea is definitely a result of the hiccup last week. Whatever the issue with the 5s was, coupled with changing to water absorption, and the two stay drop of 0.5mg. But I also feel like I’m in some sort of pretty good wave of the ad withdrawal. Maybe caused by the blip I’m sure. I’ve just had some old symptoms resurface. Like I hadnt been afraid to go in public for a while,  it’s prob all related to the surge in anxiety and resulting stress from the blip I guess.

 

the good news is I haven’t been feeling horribly dosey except maybe before the 2pm dose. My aches and pains seemed to have died down a good bit, the tinnitus has been better, and I haven’t had a headache for a while. It’s like some symptoms go and new ones surface and it seems to cycle. I guess that’s pretty “normal”.

 

going to watch what I eat even more for a while, hopefully this stomach stuff will pass.

[Jmizz]

@Altostrata

 

2-14-20

 

7:30 wake feel pretty good 

8-12mg/turkey sandwich banana

9-11 bad anxiety doing nothing at home 

11-anxiety slowly fades and is gone by 11 despite being out and about amongst people

12-2 hints of dry mouth and slight nausea/lunch chicken and noodles 

2-5 mg

2-5 feel pretty good, Still out and about dried up mouth sinus

530-8 back home, hit a kind of funk, moderate headache, dry mouth, some nausea, face tingles on jawline 

8-20.5mg feel decent

9-50 traz 5 melatonin

 

nausea and dry mouth still there today but less pronounced...my morning struggle is consistent between 9-11 and still haven’t pinpointed what’s going on in the afternoon, the uptick in nausea after 2pm dose didn’t seem to happen today, I felt pretty ok til about the 6-8 window 

 

if I could feel how I feel when I wake up all day long...how nice it would be 

 

 

 

 

[Altostrata]

How about moving 1mg from the morning dose to the evening dose?

[Jmizz]

@Altostrata

 

should I try to let my pattern settle or try this tomorrow? Slept good, woke up good. Morning was ok. Day got bad as soon as I took the 5mg at 2pm, peaking at 4:45-5:15.  I seem to still be reeling from whatever happened with 5mg pills and the subsequent switch to water which is prob not exactly 5mg. Just wondering if you think I should let it calm down before switching the 1mg to night or if it won’t make much of difference in your opinion. I know the morning dose needs to be lowered.  I’m definitely still adjusting to something bc my nausea and dry mouth was minimal or non-existent for a while and now it’s back.

 

What you said makes perfect sense to me. I imagine you believe the overall dose is too much, but I need to calm down before lowering the overall dose, so we are trying to make my dose now work. Dose is too high in the morning, gives me a little funk from 9-11. Despite metabolizing fast, the 5mg dose kicks up what’s left of the morning dose so I feel rough, then I feel pretty rough again as the 5mg peaks about 2.5 hours later, and things seem to settle before the dose at 8 some. It’s just not an easy fix. Sorry if I’m frustrating you.

[Jmizz]

@Altostrata

 

today wasn’t so bad. Back to work tomorrow. I’ll see how the next few days go.

[Altostrata]

You could do it gradually, move 0.5mg of the morning dose to nighttime, then another 0.5mg in a week or so.

 

Just do everything carefully, self-observe, and keep notes, you've got this.

[Jmizz]

@Altostrata

 

thanks for the support.

It’s looking like I may just have to get used to each new prescription for a few days. I don’t know that it was the 5s in particular. I got a new batch of 25s and today i had some weird sensations with the first dose and a little more anxiety throughout the day. overall it wasn’t terrible. I’m also going to start paying closer attention to foods as I haven’t been so far. Seems I’ve entered an extremely sensitive portion of this saga. What you said about being so sensitive each change however small even if the pills come from the same place is going to take a couple days of adjusting. I plan to try and get a 90 day subscription next time so I’ll be taking pills from the same batch for a longer period of time. I’ll gradually shift 1mg towards to the evening dose. I may even do it in .25 increments every 3 days and see how that goes. If I could make it gradually to maybe 10-5-22.5 then if I decide to reintroduce the 5s at some point that would be more convenient, but I’ll be doing everything slowly as to not mess up my sleep hopefully.

[Jmizz]

@Altostrata

 

today is my 6th month anniversary of the last lexapro pill. We had a building fire last night that was an all night affair. I’ve been a fireman for 11 years and probably had 4-5 all nighters in that time frame. I Can’t catch a break haha. Just making me stronger I guess. I’m doing relatively ok today considering, just wish my body would allow me to power nap. Here’s to 6 months and hoping for a good nights sleep tonight. I’m going to hold off for a day or two before I start moving the 1mg to see how I react to this zero sleep night.

[Jmizz]

@Altostrata

 

hey alto. So the last two days have been pretty good. I am still taking the 12,5,20.5 doses. I still feel some adverse effects on the same timeline as usual after the doses, however they have seemed very much milder than past weeks. The night of no sleep didn’t completely disable me the next day as it would have a few months or even weeks ago. I was even able to take a baby nap at work to catch up on a little lost sleep and this is a landmark moment as it’s the first sleep I’ve had since probably last May without being assisted by trazodone or melatonin. The nap had no effect on my sleep last night either. Nausea is gone, headaches have been minimal and mild, still feel dried up sinus wise and dry mouth occasionally, but everything has been milder the past two days. Anxiety has been way down, mood relatively good most of the day. It seems maybe the 5:30-8 window has been my shakiest portion of the last two days, however it’s very manageable compared to weeks past. I also think sometimes what I eat may have some effects as this is during the timeframe of my big meal of the day. Just wanted to update, I’ll keep you posted.

 

J

[Altostrata]

This is good! How long have you been taking 12, 5, 20.5 doses on the same schedule now?

 

Is the new batch of 5mg tablets more tolerable?

[Jmizz]

@Altostrata

 

i moved from 12.5/5/20 to 12/5/20.5 schedule on January 23rd. The hiccup happened at the beginning of February, which I now think was just an adjustment I have to make each time I get a new prescription. I had two days I dropped 0.5 off the night dose, then went back to 20.5 at night February 7th. So I’ve been taking 12/5/20.5 consistently, all in water, since February 7th. It seemed to take about 9 to 10 days of consistency to recover from the setback. But when I recovered it seemed my days were better than my good days before. My new prescription of 5s is ready but I haven’t picked them up yet. Kind of nervous to change back bc switching from 5pills to water prob amounted to a slight dose reduction. It also seems like my tinnitus, and the zappy sensations have improved since I stopped taking the 5mg pills. I might just keep doing what I’m doing, even though it’s somewhat inconvenient, and then maybe try to reintroduce the 5mg pills down the road. What are your thoughts on this?

[Altostrata]

That's a good idea -- stick with what's working.

 

My guess is you're taking a little too much in the morning dose, you might decrease it by 0.5mg when you feel up to it. Or not -- your choice.

[Jmizz]

@Altostrata

 

I agree with you. To me it seems like that 12 in the morning is slightly too much. I feel kinda yuck starting about 45 minutes after the dose and then after a couple hours, usually around 11, I hit a point where I get really relaxed and almost sleepy. Then it seems like maybe the 5mg at 2pm is maybe slightly too little, I don’t feel it at all, I just usually feel pretty good but then I seem to struggle getting to 8pm. It’s manageable though. Since my symptoms have been manageable, my plan is to continue as is for a few more days or so, that way I can really pinpoint exactly what’s going on now that I have some sort of consistency. I’m wondering if maybe easing 0.5 from the morning into the afternoon dose may help with both issues, but as I’m feeling pretty ok lately I’m going to wait just a bit to make another change.

[Altostrata]

On 2/24/2020 at 12:25 PM, Jmizz said:

I’m wondering if maybe easing 0.5 from the morning into the afternoon dose may help with both issues, but as I’m feeling pretty ok lately I’m going to wait just a bit to make another change.

 

All good ideas! You're becoming a lamotrigine dosing expert.

[Jmizz]

@Altostrata

 

adapt and overcome haha. Withdrawal kind of forces your hand.  I’d be lost in the woods if I hadn’t stumbled across your website finally. You’ve taught me more than I ever cared to learn about drugs and I’ll forever be grateful and pay it forward in every way I can.

[Jmizz]

@Altostrata

 

Hi Alto. Wanted to update. My symptoms seem to be getting milder and milder by the day in this stretch I’m in. I’m still on 12,5,20.5 water dissolved off the 25mg tabs, and I don’t plan to try the 5mg pills anytime soon since I’ve been doing so well. It’s close to a month of consistent dosing off the 25mg pills with no changes and a little over 6.5 months since my last Lexapro pill.  I still maybe feel that morning dose a little bit, but for the most part I don’t feel the medicine anymore. For the first time in a long time, I feel like it really is possible to be me again fully one day, instead of just hoping. The last few days I’ve been music turned up riding around singing, built a patio cover at my house, and just in general I feel like me again almost all day long the past few days. I still seem to get a little head pressure at times but im not so sure most of that cant be tracked back to when I slip and eat stuff that probably isn’t the best for me. Sleep has been great, hard to wake up in the morning, but that was me before meds. I don’t count down the minutes until dose time anymore. At times I’ve actually run past a few minutes bc it’s not the sole focus of my time anymore. Don’t worry, I won’t miss one, I’m still focused enough for that. Hoping this stability continues, and maybe in a few weeks or so I’ll consider slowly taking a touch off the morning dose and see what happens. Everything is so manageable at the moment, I don’t plan to rush it.

 

thanks again for all the help,

hoping for more positive updates to come.

J

[Altostrata]

Thanks for the good news!

[Jmizz]

@Altostrata

 

seems daylight savings may have given me a hiccup. I wanted to keep my dose times the same. We fast forwarded, so normal dose time for my body became 9-3-9. What I did was take my dose at 845-245-845. Next day 830-230-830. Today I did 815-215-815 and tomorrow I’ll be back to normal. Not sure if this had any effect. But the last couple days have been a little shakier than last week. I think I’m noticing a pattern when I work in the yard (cut grass etcc) it seems to ramp up my physical symptoms (head stuff, headaches and ear pressure, back of head tension)which usually increases my anxiety. Today I felt some depression and brain fog I haven’t felt in some time, but I got a little bit less sleep than I had been during my good week the last few days. Hoping it’s just a little hiccup and I’ll be back on track soon. I’m going to get a mask for next time I cut grass and see if that helps.

[Jmizz]

@Altostrata

 

well I think this is the first time since I began withdrawal I’ve actually faced a situation where I would have probably had anxiety before meds. My whole state shutdown today pretty much. It’s not so much a virus worry for me as it is the disruption of day to day life and routines. This is the type of thing that would give me anxiety in normal life. So it’s been a rough few days for me. My anxiety got so bad today my arms went numb and tingly. But I made it out the other side somehow. 
 

I actually felt like I was beginning a wave before this, as I had a few 4:30 wake ups this week, that usually signals a rough stretch. Last week was great but I probably went too hard with the patio build. 
 

I’ve noticed my physical aches and pains have been down. It’s like my wave symptoms cycle. I’ll get anxiety waves and mood stuff and then times my anxiety is down I’ll feel the physical stuff. This seems pretty standard through from looking around on here. I understand you probably have more pressing matters, so I understand if you don’t respond.

J

[Altostrata]

Yes, it's a stressful and confusing time for all of us.

 

Good job adjusting your dosing schedule, that could have affected your symptom pattern as well.

 

Many people find physical stress can heighten symptoms, be sure to pace yourself. And breathe through the anxiety!

[Jmizz]

@Altostrata

 

thanks for the kind words of encouragement. I somehow made it through todays spell. I feel like maybe this will give me confidence for future bad spells. And yes, I imagine the dosing modification probably had some effect and it was just bad timing with all the other craziness. Hopefully it all settles soon and i can get back on another good run.

[Altostrata]

Jmizz, as a first responder, you're still on a regular work schedule, is that correct?

[Jmizz]

@Altostrata yes I am, I go back to work tomorrow. I have 3 working days this week and then I’m off for 2 weeks.

 

As I understand our dispatch office is going to be screening calls for people with symptoms related to COVID. As we normally respond to any and every call for 911 which sadly often times is abused by people who have common illness, I think an effort is going to be made to limit firefighters exposure to non-life threatening responses. That said I’m not happy about going to work during this, and I’ll try to get through these three days exercising as much caution as possible. Then at least I’ll have a couple weeks to distance myself. 
 

while I got you here. I wanted to let you know, this current wave I’m in (triggered by stress) feels exactly like the wave I was in a year after my first experience with Zoloft when I restarted and everything went haywire. I sleep fine til 4:30 and then it’s restless til I get about about 7:30. I have horrible morning depression and fog which lifts around noon and then I feel half way ok the rest of the day. The only thing this wave lacks when compared to that one is the digestive issues. I find it odd the timing though, it’s almost exactly the same time as last year...like some sort of reverse seasonal affective disorder mixed in too, as the weather warms up. I noticed last summer at the beach my mood would instantly improve with cloud cover. Very odd. 
 

anyway, this wave feels 100% related to the AD withdrawal. I don’t really notice the lamotrigene when I take it anymore, as far as feeling the medicine or feeling like I need to take a dose.

 

i know I’m probably a ways off, but I had a question. When the time comes to try to reduce this stuff. Do you think I’d be able to reduce and discontinue the 5mg at 2pm first? Or am I going to have to dose 3 times a day throughout? I find a great deal of my anxiety revolves around planning my day to make sure I can get that dose in, it’s worse at work, and I feel that’s why I probably struggle at work more with symptoms. I basically carry around my next dose in a yeti water bottle bc I never know when I might be tied up for a few hours. Just thought I’d ask.

[Jmizz]

@Altostrata 

sorry for the huge long message. Timing probably wasn’t right. A lot going on. I’m back at work, we responded around 10 times today so far, our dept has issued everyone suits and masks as well as glasses and told us to advise extreme caution on any calls where even some of the symptoms were mentioned. My anxiety is bad, I’m working on my breathing to get through, but I’m sure everyone is having a tough time. Blessings to you and everyone else.

[Altostrata]

On 3/15/2020 at 7:12 PM, Jmizz said:

i know I’m probably a ways off, but I had a question. When the time comes to try to reduce this stuff. Do you think I’d be able to reduce and discontinue the 5mg at 2pm first? Or am I going to have to dose 3 times a day throughout? I find a great deal of my anxiety revolves around planning my day to make sure I can get that dose in, it’s worse at work, and I feel that’s why I probably struggle at work more with symptoms. I basically carry around my next dose in a yeti water bottle bc I never know when I might be tied up for a few hours. Just thought I’d ask.

 

We'll have to see how a test reduction works. When your system doesn't want the lamotrigine any more, it may not be as sensitive to dosage gaps. It may be you'll be able to taper off the afternoon dose first. Or, it may be you'll reduce each of your daily doses.

 

An early-morning wake-up corresponds to the normal daytime cortisol spike. The time change and brighter morning light in the spring may have amplified this. You can dampen this with keeping your bedroom very dark (blackout shades, etc.) and wearing a sleep mask to keep the light stimulation down.

 

Wondering if the morning depression might not be lamotrigine breakthrough withdrawal. Does it change after you take your morning dose?

[Jmizz]

@Altostrata the morning dose doesn’t change the depressed moods, it seems. My mood seems to start improving around noon, and I take the morning dose at 8. And I would be confused as to why the week before all this virus stuff started and the time change seemed to be such a good week all around, mood included. It could be an uptick in depression bc of less quality sleep for the last week. But before I got into any of this mess, 12-13 months after I quit Zoloft the first time, my pattern that led me back to Zoloft and the adverse reaction seemed the same, id struggle in the mornings and do better in the afternoon. That wave was definitely caused by increased stress, and it seems this one is as well for obvious reasons. It’s most likely the poor sleep combined with the horrible uptick in stress and anxiety around this whole virus situation. I’m also noticing as it warms up that I don’t care for being out in the heat. Seems it takes a while to cool down when I come inside. 
 

also I wonder how you knew it was time to reduce? I remember you reduced once and had to go back up and I remember you said it made you queasy. Anything else?

[Altostrata]

I think you might be sensitive to the cortisol surge in the morning. Please try cutting down early morning light.

 

Not to worry, your nervous system will indicate when it's had enough lamotrigine. All's good so far.