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Pinchy

Trintellix Taper: Advice for going to liquid?

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Pinchy

My Gemini scale arrived this week with a set of glass graduated cylinders. I've read that the transition from solid to liquid dosing can be a little hairy. Can anyone help with suggestions for making the switch?

 

Am currently taking ~8mg, in pieces, with a glass of water. I would like to be dosing completely in liquid form by the time my dose gets down to 5 mg in a few months. Should I just start dissolving all 8mgs now, or divide the dose into liquid and solid portions. If so, is there any ratio I should be targeting? I also have 00 gelatin capsules that I can fill with solid portions to conserve the bits that disintegrate to powder if necessary.

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brassmonkey

Hi Pinchy-- welcome to SA, I'm so glad you found us, but so sorry that you are in a position to need our help. Thank you for adding a signature block, it really helps us to see what is going on.  We are quite familiar with transitioning from tablets to liquids and although it is a bit fiddly and time consuming the process is pretty straight forward.  Looks like you have the right equipment coming in the mail.  A graduated syringe will probably be helpful too, but that is down the road a little bit.

 

I see that you refer to your dose as approximately 8mg.  It is very important that the doses be as exact a possible, consistency  is a major key to a smooth taper. So the first thing to do with the scales is to determine the exact dose you are taking, and make it so you are taking the same amount consistently.

 

Switching from tablet to liquid is done by employing a "cross taper" where you decrease the amount of tablet in a dose and replace it with liquid.  This is usually done over four to six weeks and is followed by several weeks at the same dose to stabilize and work out any kinks.  Once stable you can start to reduce the dose according to your plan.

 

Why are you wanting to change over to liquid? If it is for more accurate dosing, there may be other options.  Making a homemade liquid with Trintellix is going to be a multi step process because it is not directly soluble in water.  It must be dissolved in a bit of vodka first and then added to the water to make up the desired volume.  We can get into the details later.

 

Brassmonkey

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Pinchy

Thanks for your reply. 

 

I had been dosing with 10 mg, every other day, when I joined the site earlier this month. Last week I took another member's advice and switched to daily dosing.  It was impossible to measure accurately until the scale arrived this week, but I did my best to aim for 8 mg until then. Now that I can portion the doses more accurately,  the plan is to stabilize on 8mg for the next 30 days.

 

I portioned out my doses for the coming week and the scale was pretty touchy. I used pieces instead of grounding the pill all the way down, and I estimate that each dose is 62-63 mg, give or take 5 mg for small variations in pieces and measurement. I put each dose in a gel cap.

 

I have been very fortunate to have not had any significant withdrawal symptoms so far. My understanding is that changes become less tolerable as the dose decreases,  so it's probably best to make the transition from solid to liquid before the next dose reduction. I plan to use a small amount of vodka to dissolve the pills and then dilute to a manageable volume to keep the dosing accurate and precise. I forgot to mention in my previous post that I have some syringes on hand in addition to the graduated cylinders. 

 

Where can I find more info on cross tapering? Is 3-4 steps from solid to liquid a reasonable plan?  Maybe start with 6mg solid to 2 mg liquid, and then adjust in increments of 1-2 mg per week?

 

I would also be interested in better alternatives if there's something more convenient than the cross taper. I have a stone mortar and pestle to grind pills in, but I can tell that powder is going to be tricky on the milligram scale.

 

(Edited for typo.)

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Gridley
12 hours ago, Pinchy said:

 

Where can I find more info on cross tapering? Is 3-4 steps from solid to liquid a reasonable plan?  Maybe start with 6mg solid to 2 mg liquid, and then adjust in increments of 1-2 mg per week?

 

Our general recommendation for a crossover, whether from new brand to old brand generic or tablet to liquid is:

 

3/4 old, 1/4 new for 3 to 7 days 

1/2 old, 1/2 new for 3 to 7 days

1/4 old, 3/4 new for 3 to 7 days

all new thereafter

 

Stay at the same dose during the crossover period.

 

12 hours ago, Pinchy said:

 

I would also be interested in better alternatives if there's something more convenient than the cross taper. I have a stone mortar and pestle to grind pills in, but I can tell that powder is going to be tricky on the milligram scale.

 

 

I grind my Lexapro into a powder using two spoons and haven't had any difficulty.  I use the little spoon that comes with the Gemini scale to subtract, brushing it off onto a post-it.  I also use the little tongs or the spoon to add back to get the desired weight.  Once you get the right weight you can pour into a capsule (I use size 00) using a folded post-it or the (I don't know what you call it) the little circular thing with the groove that comes with the scale.  

 

 

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brassmonkey

Gridley has given good information on doing the cross taper, It's really pretty straight forward.

 

The alternative to the liquid would be grinding up the tablets, weighing them on the scale and putting it in gel caps.  It really comes down to which is easier for you.

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Pinchy

Thank you Gridley and Brassmonkey for the good info. I'll be considering the next step and will post an update when the time to change it up comes closer. 

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