gdsequoia: quadriceps cramps and eye accommodation problems - paroxetine, Abilify

[gdsequoia]

@Altostrata

Table done! 

https://docs.google.com/spreadsheets/d/1h11W3G-RVbR32UgrYeCq5j41WbVudZFLvpC34wopuzo/edit?usp=sharing

[Altostrata]

Well done. As you can see, all 4 of the drugs you're taking jam up liver enzyme cyp 2D6.

 

It's possible distributing the aripiprazole dosing made you feel better because it spread out the load on your liver metabolism. When was the last time you had a liver function test?

 

What times of day do you take your drugs, with their dosages? Are your symptoms better or worse after you take each drug?

 

What does "cold" mean in your signature?

[gdsequoia]

Thank you for the info.

 

AFAIK, I've never had a liver function test done. Not sure how to get one, because it should be done in the morning before any food and meds, right? And I can't get to the lab before I've taken my 3.75mg of aripiprazole (because of the pains). Maybe I'll take (drink) just my old B-complex (*) before going to the lab. That should mess up the test results a lot less than aripiprazole, and it does give me joint analgesia.

 

(*) (benfotiamine 40 mg, vitB6 90 mg, vitB12 250 μg; I've stopped taking this B-complex a long time ago)

 

18 hours ago, Altostrata said:

What times of day do you take your drugs, with their dosages?

I guess you mean this info that I posted previously.

 

18 hours ago, Altostrata said:

Are your symptoms better or worse after you take each drug?

tolperisone: my dystonia is reduced. Same with biperiden.

aripiprazole: my joint pain (almost) disappears within a few minutes (maybe 10 minutes).

paroxetine: I think my muscle cramps get worse shortly after I take it. Not sure.

b12: joint pain quickly reduced

magnesium: muscle cramps quickly reduced

 

No other "after taking" effects, I think.

 

19 hours ago, Altostrata said:

What does "cold" mean in your signature?

It means "change done with no tapering".

 

E.g. this:

"SomeMed 10mg (15 July 2019), SomeMed 5mg (25 July 2019, cold)"

means:

"from 15 July to 24 July (inclusive) I've been taking precisely 10mg. Then, starting from 25 July, I was taking precisely 5mg."

 

Note: In my sig, all the changes that don't say "cold" are quick, linear tapers.

[gdsequoia]

@Altostrata

Ah wait! I just looked at my blood results from 7 Nov 2019 and they include ASAT, ALAT, LDH, GGT (all these values are within normal range).

Any other parameters I need to look at/test?

 

(Note: my joint pain began in Feb 2019)

[Altostrata]

No, those probably are the liver panel.

 

What happened just before February 2019? Sorry to ask the same question over and over, but I don't have time to read all prior posts and your signature is not chronological.

 

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, in a simple list format with time of day on the left and notation (symptom or drug and dosage) on the right.

 

[gdsequoia]

8 hours ago, Altostrata said:

What happened just before February 2019?

Two things.

- my doc changed my neuroleptic from amisulpride 500mg to aripiprazole 15mg (quick linear crosstaper). This was done to combat dystonia and it did help in this regard.

- slipped on some ice and broke my left arm. It quickly healed.

8 hours ago, Altostrata said:

Sorry to ask the same question over and over, but I don't have time to read all prior posts and your signature is not chronological.

No problem! I'm honored & thankful to have the forum founder help me.

 

8 hours ago, Altostrata said:

Please keep daily notes of times of day you take your drugs, their dosages, and your symptoms throughout the day.

Ok, I will. Should I include supplements too, or just drugs?

[Altostrata]

Please include supplements to start.

[gdsequoia]

Hi @Altostrata.

I tried to do the report today, but it was too difficult for me, because today I had some OCD problems.

Several things are changing in my life right now and I can't currently add the symptom reports to the list of new habits.

In any case, thank you for the effort you put into this. If I have further questions, I'll post here.

[manymoretodays]

And woah, meaning great gds......this!!!!  And Alto found more on the tolperisone too! 

 

On 1/4/2020 at 3:50 AM, gdsequoia said:

@Altostrata

Table done! 

https://docs.google.com/spreadsheets/d/1h11W3G-RVbR32UgrYeCq5j41WbVudZFLvpC34wopuzo/edit?usp=sharing

 

And just go real simple with the notes.  Look at the link example.  Then post it separately from narratives here in your introduction.

On 1/5/2020 at 3:17 PM, Altostrata said:

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, in a simple list format with time of day on the left and notation (symptom or drug and dosage) on the right.

 

It might be really helpful for further suggests.  Can you look at this time, now, as a time to just get your medication/drug situation streamlined?  The time to lower doses and begin tapers will come soon enough. 

I love your intelligence and nerd- ness.  You are doing so great!!  We are all learning as we go, here.  And you are finding some great stuff.  You have much to offer here.

 

L, P, H, and G,

mmt

editing in to add:  https://en.wikipedia.org/wiki/Liver_function_tests 

and it looks like you got some, not all.  If possible, get them done, every 6 mos. too!

OCD discussion

Dealing with emotional spirals

Changes are happening all the time, gds, I have to learn to just roll with it all sometimes too.  Some is good.....the changes.  Other stuff......more difficult.  Do not, however, live in fear anymore.  Life is grand and much too short. ((((((gds)))))

Edited January 7, 2020 by manymoretodays

[gdsequoia]

Thanks, @manymoretodays.

 

I have a specific question.

 

I'm gonna taper the aripiprazole. Just the aripiprazole.

 

The the liquid tapering topic says I should refrigerate the liquid. As you know, in my case, I take the aripiprazole 4 times a day. So in the morning I'll drink my first dose - no problem. But then I go out for a walk, or to run errands, or something. I want to take the liquid with me, but that means taking it out of the fridge.

 

Maybe I should use a thermal bag?

 

[Manny78]

Hi gds. I tapered 10 mgs of abilify. It took me 2 years and it was a hellish taper,and I haven t finished it yet. I see that you want to start tapering it.  I am taking two antipsychotics currently taper risperdal with liquid solution reducing 5 percent. I am having acatisia and dystonia. Having  not been diagnosed of dystonia and aka yet. I have to see a neurologist in May to know what I have. My psychiatrist and gp are crazy. They want me to taper more than 10%monthly. My psychiatrist says it is OK to reduce 1mg of risperidone without no problem. 

Manny 

[gdsequoia]

@Manny78

Thanks for the feedback. How much abilify are you taking now? Is it 10mg as in your sig? If so, what was the dose you tapered from?

[Manny78]

2 hours ago, gdsequoia said:

@Manny78

Thanks for the feedback. How much abilify are you taking now? Is it 10mg as in your sig? If so, what was the dose you tapered from?

Hi gdsequoia, I am taking 10 mgs of abilify. Yes it is as it shows in my signature. I started in 20mg and I was able to lower it down to 10mg. I mixed a  10 mg of abilify pill with water since it was a  pill that disentegrates in my mouth easily. I used a 10ml syringe and I

pulled out 0,2ml.

 

[Manny78]

2 hours ago, gdsequoia said:

@Manny78

Thanks for the feedback. How much abilify are you taking now? Is it 10mg as in your sig? If so, what was the dose you tapered from?

Hi gdsequoia, I am taking 10 mgs of abilify. Yes it is as it shows in my signature. I started in 20mg and I was able to lower it down to 10mg. I mixed a  10 mg of abilify pill with water since it was a  pill that disentegrates in my mouth easily. I used a 10ml syringe and I

pulled out 0,2ml. I had symptoms like inner akathisia.That was the most disturbing symptom. I don't have neck dystonia. I have to have it in my torso area. I have aka for sure. I can't stop moving. 

 

[gdsequoia]

@Manny78

Thanks. Did you crush the Abilify pill into powder, before mixing it with water? And are you taking the actual brand-name Abilify, or a generic?

[gdsequoia]

@Manny78

And another question: Have you tried tapering the biperiden? What was your experience with that?

[Manny78]

7 hours ago, gdsequoia said:

@Manny78

Thanks. Did you crush the Abilify pill into powder, before mixing it with water? And are you taking the actual brand-name Abilify, or a generic?

Hi gdsequoia. I don't remember. I think I mixed the pill with 10ml of water since the pill mixed well with water. I used to shake it a little bit in a glass and then with the syringe measure 10mls and decrease 0,2ml.

[Manny78]

https://www.google.com/search?q=abilify+discmelt+10+mg&tbm=isch&ved=2ahUKEwi06r2GzIjoAhUV_RoKHTBkC78Q2-cCegQIABAC&oq=abilify+di&gs_l=mobile-gws-wiz-img.1.1.0i19j0i30i19.5218.8698..10632...0.0..0.1574.7028.5-1j1j3j1......0....1.........35i39j0.dte28a6uPCQ&ei=ZLJjXrSoJJX6a7DIrfgL&bih=657&biw=360&prmd=niv#imgrc=AXkqJFM9-diAuM

[gdsequoia]

@Manny78

Thanks! Did you see my other question (about biperiden)?

[Manny78]

2 hours ago, gdsequoia said:

@Manny78

Thanks! Did you see my other question (about biperiden)?

Hi gdsequoia. Yes I saw it, but I didn't have time to answer it. I asked one psychiatrist. I don't remember pretty well what he said. I think he said to just discontinue taken it. I understand that it has to be taper it like the other psychotropic drugs.  I am getting bad advice from my gp and my psychiatrist. They are irresponsible. They tell me to cut more than 10 percent. If I can stop seeing my psychiatrist, I will do it. If my gp prescribes the psychotropic drugs, I won't go to psychiatrist because I don't agree with his diagnosis. Also, he said that I would need to take these poisons for the rest of my life. I went to my gp and I explained that I had aka and dystonia because of these Drugs. He agreed to get my off them but he said that he needed to call my psychiatrist as a  way of courtesy(for him to know). After calling him, he called me and suggested me to cut 1mg.I did not tell him the truth. I lied to him. I told him that I was on abilify 2,75mg,and I decreased to 2,64mg. I reduced 5 percent a month, and I told him, I couldn't handle that reduction. He told me that he could not force me to reduce any faster,but I would have to learn to live with aka and dystonia. My family and friends do not understand me. That it is very discouraging. 

 

I am taking akineton retard 4MG(biperiden). The pill breaks in two Pieces(2mg each).Maybe I should get biperiden 2mg that breaks in four pieces and decrease 0,5mg. Looks to me a big reduction too. 

 

best wishes, 

 

Manny 

[Manny78]

https://www.madinamerica.com/2019/08/psychiatric-drug-withdrawal-in-spain/

 

Hi gdsequoia. If you check these article, you will see at the bottom comments. I asked this psychiatrist what to do,and his advice was to stop biperiden, and taper abilify. I spoke with him in private,and he told me to reduce risperidone cutting 0,5mg every 8 weeks. 

[gdsequoia]

@Manny78

Oops, sorry for rushing you!

Yeah, doctors don't know about the correct way to taper. I wonder, don't they see withdrawal syndrome often in their practice?

I'm sorry to hear about your friends and family. I am thankful to have a very understanding family, and great friends.

About the akineton retard - interesting - did the doctors explain why they prescribed the "Retard" (prolonged-release) version?

Thanks for the link.

[Manny78]

Hi gdsequoia. I would like to chat with you to support each other if you don't mind. I think I was giving biperiden prolonged release because I was shaking so bad. I had cold turkeyed Valium, and I was introduced to gedeon 80mg three times a day in combination with klonopin 2mg at night and 0,5mg in the morning. That was in April 2008. I was shaking mad crazy because of the cold turkey of Valium and the gedeon. I have been taking akineton retard since 2011. I don't remember if they prescribed akineton 2 mgs in the year 2008 and later they gave me the akineton retard (biperiden 4mg extended release),but they gave it to me for the tremors and shakiness of antipsicotics for the extrapiramidal side effects. 

 

Manny 

[gdsequoia]

On 3/6/2020 at 9:55 PM, Manny78 said:

 

Sent you a pm

[gdsequoia]

Hey @Gridley.

 

I've found 2 really useful tables on the net:

 

https://imgur.com/a/Np3IYBm

 

May I post them in the relevant threads?

 

Cheers

[Gridley]

10 hours ago, gdsequoia said:

May I post them in the relevant threads?

That's fine.

[Nocturna]

Hi gds, how are you doing with your taper? Sending best wishes, it's a weird time for all..

[gdsequoia]

Hi @Nocturna

 

Short version:
- About 3 weeks ago I had to uptaper Abilify by about 30% because my leg pains had worsened (for some reason). That did help.
- About 4 days ago I tried cutting Abilify by 5%. That worsened my leg pains so I undid it.
- 3 days ago I moved the 2nd tolperisone pill (I take 2 of them) from noon to evening. That helped a lot. Now my leg pains are reduced by ~35-40% in the afternoon.
- Then, excited by that, I tried stopping the second tolperisone pill "cold turkey" since it can't be cut into pieces. But that action lowered my aripiprazole blood levels too much (I can tell by my symptoms). So I undid the tolperisone reduction.

 

I'm happy about the third bullet point from above

[gdsequoia]

And you?

[Nocturna]

Happy that your leg pain got better! Hope you're finally able to taper the Abilify soonish.

I'm considering starting to taper mine slowly to the old dose of 2 mg that I was happy with, but I'm still confused whether I should wait until the Corona situation is over.

[gdsequoia]

@Nocturna

 

Thanks.

 

I personally had some new pains appear (or old pains worsen) during the corona time, and that did confuse me - at some point I was almost certain I had corona.

 

I think the only major intersection between corona symptoms and WD symptoms is myalgia. And if you do get that symptom during your taper, you can always "hold" your dose for a month, and then you'll know if it was the corona or not. Corona testing kits are cheap, too.

 

IMO, don't wait until Abilify gives you permanent problems like diabetes or movement disorders. Lessen the chance by tapering, instead.

[Nocturna]

@gdsequoia thanks, it's useful sharing your experience with Corona! Also thanks for the advice, I'm trying to watch after myself for things like blood sugar. According to my pdoc, Abilify is far better in this regard than the other APs, but there's always a danger. Which made me follow a more strict diet (proper food combining), which seems to be positive overall, also against obesity.

[gdsequoia]

A question to anyone who might know:

 

I used to take Escitalopram (Escitil) 15mg, which means a tablet and a half. The tablets have a score in the middle, so that was easy to do for me. Also, the tablets are film-coated.

 

I uptapered Escitalopram from 15mg to 18mg, which means that I'm currently using a pill cutter (the tablet's score does not let me take the extra 3mg).

 

Since I did this uptapering (about a week ago), my stomach pains (gastritis, I think) have worsened. Is it possible that the pill cutter is the reason?

 

I mean, maybe using a pill-cutter bypasses the film-coating's gastroprotective purpose?

 

TIA!

 

(also tagging @Manny78)

[ChessieCat]

15 minutes ago, gdsequoia said:

I uptapered Escitalopram from 15mg to 18mg

 

From the Tips for Tapering escitalopram topic:

 

On 5/27/2011 at 12:16 PM, Altostrata said:

If you are taking 5mg, it's not tiny, it's equivalent to 10-20mg Paxil or Celexa.

 

You might have updosed too much.

 

You would get a more accurate dose if you make your own liquid for the smaller portion of your dose.  From the same topic:

 

On 5/27/2011 at 12:16 PM, Altostrata said:

Do-it-yourself liquid
People report that they can make their own liquid from Lexapro tablets and water.

It is sparingly soluble in water, see http://www.drugbank.ca/drugs/DB01175 -- stability (shelf-life of dilution) is unknown.

 

 Escitalopram oxalate occurs as a fine, white to slightly-yellow powder and is freely soluble in methanol and dimethyl sulfoxide (DMSO), soluble in isotonic saline solution, sparingly soluble in water and ethanol, slightly soluble in ethyl acetate, and insoluble in heptane. According to RxList,com.

 

Your best bet would be to use a homemade isotonic saline solution (9% salt in water) which is made by dissolving 9 grams of table salt in 100mL of water. This mixture will last for a month or so in the refrigerator if you haven't added the drug to it.  Once the drug is added it will keep for about a week.

See How to make a liquid from tablets or capsules

 

[gdsequoia]

@ChessieCat

Thank you.

I have been taking 30mg Escitil for 6 years with no stomach pain.

[Altostrata]

The coating on an escilatopram tablet is not an enteric coating. Splitting the tablet is not causing your gut pains.

 

If the pain increased after you increased dosage, it could be the dosage increase.

 

Please update your signature with the drugs you're taking now.