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gdsequoia

gdsequoia: Quadriceps cramps and eye accommodation problems (Paroxetine, Abilify)

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gdsequoia

@Altostrata

Thanks for the info.

 

Sig updated.

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Altostrata

I see you're taking a lot of stuff for your gut. You might be overdoing it and one or more of those things is causing your gut trouble.

 

You are also taking a lot of psychoactive drugs. I suggest you look up the adverse effects of each of them and see if any could be causing your gut problems. Please put ALL your drugs in the Drug Interactions Checker https://www.drugs.com/drug_interactions.php 
and copy and paste the results or a link to them in this topic.

 

When was the last time you had a blood test for liver and kidney function?

 

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gdsequoia
Posted (edited)

@Altostrata

Thanks.

 

Here you go:

 

https://www.drugs.com/interactions-check.php?drug_list=233-0,1013-0,384-0

 

(drugs.com doesn't know about tolperisone*, and also I've left the supplements out, in order to not convolute the info here)

 

* see CC's post for information from drugbank

 

I've added 2 links to my signature.

 

Last liver test was in November 2019. All levels were normal except "Anti-CCP".

 

Never had a kidney test, to the best of my knowledge. I did a CBC and electrolytes blood test recently. All levels were normal. Also tested glycated hemoglobin recently; the level was below the healthy minimum.

 

I'll try pausing the probiotic.

 

My main suspicions (about the stomach pain) are:

* The high (and long-term) magnesium dose

* As you said, the probiotic and the laxative which I've been taking for 3 months non-stop

* The fact that I take the biperiden with little water. The leaflet says I should take it with a lot of water.

* The fact that I tried cutting the tolperisone pill in two halves (2 months ago). That did give me stomach pain, but the pain was sort of short-lived.

 

Taking baking soda + vinegar + water does help me.

 

Edited by ChessieCat
added link to CC's post

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ChessieCat

From https://www.drugbank.ca/drugs/DB06264

 

Quote

 

 

Tolperisone is an oral, centrally acting muscle relaxant. Its precise mechanism is not completely understood, though it blocks sodium and calcium channels. It possesses a high affinity for nervous system tissue, reaching highest concentrations in brain stem, spinal cord and peripheral nerves. Based on existing clinical data, Tolperisone is not sedating and does not interact with alcohol.


 

 

 

Tolperisone may increase the central nervous system depressant (CNS depressant) activities of Biperiden.

 

The risk or severity of adverse effects can be increased when Aripiprazole is combined with Tolperisone.

 

The risk or severity of adverse effects can be increased when Tolperisone is combined with Escitalopram.

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gdsequoia

Thanks, @ChessieCat.

 

The thing about drugbank.ca is that I've tried putting basically any 2 random drugs in it, and it says the same thing every time. So I've stopping used that site.

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Altostrata

Do you have any of the symptoms in the drug interactions report?

 

9 hours ago, gdsequoia said:

My main suspicions (about the stomach pain) are:

* The high (and long-term) magnesium dose

* As you said, the probiotic and the laxative which I've been taking for 3 months non-stop

* The fact that I take the biperiden with little water. The leaflet says I should take it with a lot of water.

* The fact that I tried cutting the tolperisone pill in two halves (2 months ago). That did give me stomach pain, but the pain was sort of short-lived.

 

Any of the above could be causing your stomach pain.

 

If I were you, I would eliminate each of these for several days one by one, see if your stomach issues diminish. Please use common sense about your symptoms.

 

We do not offer general medicine advice here. Please let us know if you have any symptoms related to psychiatric drugs.

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gdsequoia
12 hours ago, Altostrata said:

Do you have any of the symptoms in the drug interactions report?

Yes, I have the following:

* biperiden+aripiprazole: stomach pain

* escitalopram+aripiprazole: abnormal muscle movements (dyskinesia)

 

I will heed your advice, thanks.

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gdsequoia

The stomach pains disappeared when I stopped one of my laxatives. Thanks for the help!

 

Another question to anyone who might know:

 

The last maybe 30-50 days I've began having a slowly-worsening blepharospasm (BSP for short). I'm tapering Abilify as you can see in my signature.

 

I wonder: should I slow down the Abilify taper (maybe the BSP is a WD symptom) or should I accelerate it (maybe the BSP is caused by the current insanely-high Abilify dose).

 

My psychiatrist said I should pause all my supplements and the BSP will go away. But I can't do that, because I'm dependant on most of my supplements.

 

TIA

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Altostrata

How are you dependent on your supplements?

 

How bad is this twitch? It looks like you are tapering Abilify and biperiden at the same time. Is that so?

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gdsequoia
Posted (edited)
12 hours ago, Altostrata said:

How are you dependent on your supplements?

Supps I'm dependent on:

  • vitD and magnesium: To be able to walk (without paralyzing muscle pain in the legs). When I decrease the magnesium, those pains get persistently worse, by which I mean they don't go away even if I reinstate my magnesium dose.
  • melatonin, fish oil and Sedorelax: To be able to feel rested after sleep. If I pause them, I will be very sleepy during the day, so I will be defenseless with regards to my OCD. Note: Sedorelax's contents are valerian and balm.

Writing that stuff out made me make a couple of decisions:

  • I will decrease vitD from 2x1000 IU to 2x400 IU which *is* enough for me. Can't go below that dose.
  • I will pause the probiotic as I'm not dependent on it. Unlikely to be related, but still.
  • I will stop the vitB6 (4.2mgas I'm not dependent on it. (it is bundled into my melatonin supp, so I'll change melatonin brands)

Thanks for the writing-prompt. It helped me.

 

12 hours ago, Altostrata said:

How bad is this twitch?

Currently it is mild. Doesn't interfere with my life. On a 0-10 scale it's a 2. I'm just worried because it seems to slowly progress (*and* to be incurable since it is likely a form of dystonia). I read that it can progress to functional blindness (due to being unable to open the eyelid) that requires botox injections in the eyelid.

 

12 hours ago, Altostrata said:

It looks like you are tapering Abilify and biperiden at the same time. Is that so?

I'm no longer decreasing biperiden - my current dose is necessary-and-sufficient for suppressing my cervical dystonia.

 

I admit I was tapering both at the same time - for a brief period. I had to.

 

Edited by ChessieCat
added then removed note - wrong product

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Altostrata

A lot of us have twitches that go away as we taper the drugs. I would not leap to conclusions about that twitch.

 

How do you feel on a lower dose of Abilify?

 

In your signature, you have noted some reductions in July 2020. Do you mean June?

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gdsequoia
1 hour ago, Altostrata said:

A lot of us have twitches that go away as we taper the drugs. I would not leap to conclusions about that twitch.

Ok, thanks! Still, I decided to reinstate 2.7mg biperiden starting tomorrow.

 

The biperiden leaflet says (my attempt at translating from Bulgarian to English):

"One should avoid sudden discontinuation because of a danger of a victory of the counterregulation". And I had stupidly done two 10% reductions separated by only 2 weeks.

 

I know for a fact that I'm in danger of eyelid-dystonia (aka blepharospasm), as I already have another kind of dystonia (cervical).

 

1 hour ago, Altostrata said:

How do you feel on a lower dose of Abilify?

I had a moderate worsening of my OCD, but I then started going to psychotherapy and am feeling mentally well already.

 

Also, the constipation is much reduced now, which is nice.

 

Those are the two "tangible" (observed) changes so far.

 

1 hour ago, Altostrata said:

In your signature, you have noted some reductions in July 2020. Do you mean June?

Yeah, sorry, my bad. Fixed.

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gdsequoia

Another question for everybody:

 

Say I'm taking 2 drugs, "A" and "B" that are both substrates of the same enzyme (namely CYP2D6). I'm decreasing my oral dose of "A". Does that mean I should increase my oral dose of "B", in order to still get the effect I require of "B"?

 

(in my case, "A" is abilify and "B" is tolperisone)

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Altostrata
On 6/30/2020 at 6:12 AM, gdsequoia said:

Say I'm taking 2 drugs, "A" and "B" that are both substrates of the same enzyme (namely CYP2D6). I'm decreasing my oral dose of "A". Does that mean I should increase my oral dose of "B", in order to still get the effect I require of "B"?

 

What is the effect you require of B? As this is a site for going off drugs, we're not much for tinkering with cocktails.

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gdsequoia

@Altostrata

Ok, I see.

 

The effect I require of "B" (tolperisone) is a suppression of my severe cervical dystonia.

 

I can't afford to have cervical dystonia, since it's ruining my spine (if I don't suppress it with meds).

 

So the idea is to taper drug "A" (Abilify), while (approximately) maintaining my blood levels of my other 3 meds (Escitalopram, Tolperisone, Biperiden).

 

Quote

As this is a site for going off drugs, we're not much for tinkering with cocktails.

Does this mean "we don't approve of tinkering with cocktails" or "we're not very good at tinkering with cocktails"? Sorry, English is not my native language.

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ChessieCat

The admins, mods and mentors are all assisting members on a voluntary basis, and are not doctors.

 

SA is a site for helping people get off or reduce their psychiatric drugs, because very few medical professionals know how to get people off their drugs.

 

From the topic About Surviving Antidepressants:

  

On 3/17/2011 at 11:02 AM, Altostrata said:

 

SurvivingAntidepressants.org provides volunteer peer support for psychiatric drug withdrawal, while tapering and after you've quit.

 

(This site offers information to empower you to talk with your doctor. For medical advice, consult a knowledgeable medical caregiver.)

 

Taking a harm reduction approach to psychiatric drugs, we recommend reducing your dosage to the lowest effective dose for you, minimizing your drug burden for the sake of your general health. Many will continue to wean off psychiatric drugs entirely.

 

 

 

From drugs.com:

 

"Tolperisone is an oral, centrally acting muscle relaxant. Its precise mechanism is not completely understood, though it blocks sodium and calcium channels. It possesses a high affinity for nervous system tissue, reaching highest concentrations in brain stem, spinal cord and peripheral nerves. Based on existing clinical data, Tolperisone is not sedating and does not interact with alcohol."

 

SA is not able to provide assistance regarding what dose you should be taking of Tolperisone.  That is your doctor's responsibility.  Please discuss this with your prescribing doctor.

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Altostrata

We don't help you fine-tune drug cocktails for a specific effect, that's your doctor's job.

 

If I were you, I'd wait to see the effect of the Abilify reduction before tinkering with your cocktail. Your theory may not be borne out in reality.

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