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Iman: weaning off nortriptyline, withdrawal battlefield


Iman

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Hello to all. Please accept my most sincere greetings. I know that all of us here are after a better life and the fact that all of us have ended up here by each other's side under one single umbrella means we all have what it takes to build a better more robust life. We are a precious community giving each other hope, helping hands and the necessary incentive and energy to carry on and reach the finish line with flying colors. We will all make it sooner or later.

 

I for one have come into grips with weaning off of Nortriptyline. After almost 2 years of being on the drug for what initially was diagnosed as depression and anxiety, I recently decided to come off it. From what I had gathered mainly through surfing different websites and reading stories of struggles with antidepressants, I was confident that I my tapering has to happen garadually and smoothly, so distressing i was never instructed by my psychiatrist nor my psychologist about the importance and necessity of slow tapering. My maintenance dose was 100 mg for a year and half, then I went on a withdrawing process. I followed the famous 10 perecnt reduction for every 2 weeks. After almost 3 months, I'm now on 25 mg. I exeperienced a wide ranges of symptoms most notably tingling, paresthasia, insomnia and blurry and at times colorless vision on my right eye. Symtoms have become tougher these last steps leaving me with 2 major problems: 1. Some of my symtoms are so persistent and won't just go away namely tingling and prickling on my body and my declining vision quality with colors looking so drab and lifeless. I'm seriously afraid of continuing my taper as i feel this may deteriorate my current condition eventually leaving me with unstoppable poor vision quality as well as persistent paresthasia. 2. I live in Iran and the lowest-dose pills are 10 mg which are extremly small, the best I could do was to cut them into halves using a pill cutter with extreme difficulty. Now that I'm down to 10 percent of 25 mg, I need 2.5 mg pieces which is almost impossible to get. I'm stuck at this phase and I need some real help and advice from my esteemed co-combatants. I thank each and every one of you up front for helping me out.

Good luck on your evetually brilliant taper journey.

Edited by Shep
added username to title

2015 september zoloft (20 mg updosed to 125) plus clonazepam for anxiety and panic attacks

2016 Jan replaced clonazepam with chlorodiazpoxide 20 mg

2016 April cold turkeyed both after a urinary retention surgery with no withdrawal symtom at all (still bizzare to me how!!!)

2018 Jan perscribed Nortriptyline 10 mg for vestibular vertigo 

2018 Feb due to the horrible side effects which my psychiatrist took for depression and anxiety, Nortriptyline began to be updosed to reach 100 in June

2018 Oct noticed I was experiencing no pleasure in life and decided to taper(zombie-style kind of life)

Tapered to fast to reach 50 mg in 2019 Feb

Terrible withdrawal symtoms began to creep up, had to updose to 75 in June 2019

Began make changes in diet and lifestyle and tapered again to reach 30 by 2020 Jan (only in the middle of this taper did I become familiar with the golden formula of Brassmonkey slide taper ten perecnt each month and I'm forever thankful)

By May 2020 reached 22.5 when my whole taper process hit the wall due to infection to God-damned Covid 19

Late Sep 2020 restarted my taper process using the Brassmonkey 10 percent method and reached 16 mg Jan 20 2020 when I'm writing this now

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  • Moderator

Welcome to SA, Iman.

 

You are tapering twice as fast as we recommend, which explains the withdrawal symptoms you're experiencing.  We recommend tapering no more than 10% of current dose every four weeks.

 

Why taper by 10% of my dosage?

 

So that you have a better idea of what you're experiencing, here is some information on withdrawal and healing.

 

What is withdrawal syndrome.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF)

 

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.  

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

Since you have tapered so fast, you need to hold at 25mg and stop your taper for at least three months to let your central nervous system stabilize. Over the time you've been tapering symptoms have built up and built up and now you need to let your system catch up with the changes.

 

I understand the difficulty of dealing with small doses needed for a taper.  Fortunately, nortriptyline is soluble in water, which allows you to make your own liquid nortriptilyline and avoid dealing with the impossible little pieces of pill.  The following link is specifically about tapering nortriptyline.  However, you won't be tapering for a few months until your system stabilizes.

 

Tips for tapering off nortriptyline 

 

Pay special attention to this section in the link:

 

Make a nortriptyline liquid yourself from tablets or capsules

Nortriptyline is soluble in water. See How to make a liquid from tablets or capsules

Use an oral syringe to precisely measure out doses as small as .01mg.

 

You may want to updose/reinstate a small increase in your dosage.  Reinstatement of a very small dose of the original drug is the only known way to help alleviate withdrawal syndrome.  The only other alternative is to try and wait out the symptoms and manage as best you can until your central nervous system returns to homeostasis.  Unfortunately no one can give you an exact timeline as to when you will start feeling better.  

 

Reinstatement isn't a guarantee of diminished symptoms for everyone but it's the best tactic available.  You're still in the time period where reinstatement predictably works, up to 3 months after last dose.  It is best to reinstate as soon as possible after withdrawal symptoms occur. We usually suggest a much smaller reinstatement dose than your last dose.  These drugs are strong, and.your system has become sensitized and If you take too much it may be too much for your brain and can cause you become more unstable.   Then, once you've stabilized on the increased dosage, which can take several months,  you can begin a 10% per month taper down to zero.   Please read:

 

About reinstating and stabilizing to reduce withdrawal symptoms. -- at least the first page of the topic

 

It takes about 4 days for a dose change to get to get to full state in the blood and a bit longer for it to register in the brain.

 

If you decide to updose, I suggest a 5mg increase, making your new dose 30mg.  I would cut one-half of your 10mg pill rather than making a liquid so that there are fewer variables.

 

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) 

 

Add in one at a time and at a low dose in case you do experience problems.

 

I know this is a lot of new information.  Please take your time reading the links and don't hesitate to ask questions.

 

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

 

Gridley Introduction

 

Lexapro 20 mg since 2004.  Begin Brassmonkey Slide Taper Jan. 2017.   

End 2017 year 1 of taper at 9.25mg 

End 2018 year 2 of taper at 4.1mg

End 2019 year 3 of taper at 1.0mg  

Oct. 30, 2020  Jump to zero from 0.025mg.  Current dose: 0.000mg

3 year, 10 month taper is 100% complete.

 

Ativan 1 mg 1986-1991 CT, soon reinstated.  CT 2000. RI 1 mg 2011-2016.  Sept. 2016  0.625mg X 3

Nov.27, 2020, 7-week Ativan-Valium crossover + change to one 18.75mg dose, w/1 month hold.

Feb. 9, 2021, begin 10% every 4 weeks taper.  Current dose as of Feb. 23: 16.0mgai.

 

Imipramine 75 mg daily since 1986.  Jan. 2016 began every 3-weeks 10% taper, down to 16mgai (0.44mgpw).  Aug 2016, discovered SA, holding at 16mg.  Taper is 78% complete.  

  

Supplements: omega, vitamins C, E and D3, magnesium glycinate, probiotic, zinc, melatonin .3mg.


I am not a medical professional and this is not medical advice, but simply information based on my own experience, as well as other members who have survived these drugs.

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Dear Gridely

 

Your thorough explanation was of tremendous help to me, so eye-opening and insightful. I now seem to have a clearcut plan ahead of me thanks to the tips and tricks you kindly shared. I guess my best bet will be reinstatement and an updose of 5mg back to 30 mg as you suggested. I'll apply all your instructions and just can't thank you enough for taking the time and being this much helpful. I owe you big time.

2015 september zoloft (20 mg updosed to 125) plus clonazepam for anxiety and panic attacks

2016 Jan replaced clonazepam with chlorodiazpoxide 20 mg

2016 April cold turkeyed both after a urinary retention surgery with no withdrawal symtom at all (still bizzare to me how!!!)

2018 Jan perscribed Nortriptyline 10 mg for vestibular vertigo 

2018 Feb due to the horrible side effects which my psychiatrist took for depression and anxiety, Nortriptyline began to be updosed to reach 100 in June

2018 Oct noticed I was experiencing no pleasure in life and decided to taper(zombie-style kind of life)

Tapered to fast to reach 50 mg in 2019 Feb

Terrible withdrawal symtoms began to creep up, had to updose to 75 in June 2019

Began make changes in diet and lifestyle and tapered again to reach 30 by 2020 Jan (only in the middle of this taper did I become familiar with the golden formula of Brassmonkey slide taper ten perecnt each month and I'm forever thankful)

By May 2020 reached 22.5 when my whole taper process hit the wall due to infection to God-damned Covid 19

Late Sep 2020 restarted my taper process using the Brassmonkey 10 percent method and reached 16 mg Jan 20 2020 when I'm writing this now

Link to post
  • 2 months later...

Weaning off nortriptyline, hypnic jerks

 

Hello everyone

Hope you are all doing fine and are staying safe from the condounded covid 19 virus.

 

My trip down the road of nortriptyline has been quite a eerie one. I was first perscribed the pill for my vestibular vertigo almost 2 and a half years ago which at the time found it the scariest experience of my life constantly referring to it as "death vertigo". However, the horrible withdrawal effects i experienced with pamelor made me think twice on my claim about vestibular vertigo being the scariest event of my life. After almost a month of taking 10 mg of Nori, I went for a second visit to my ear doctor and he ordered me to stop taking the 10 mg pill as my symtoms had totally eased off. I did so and stopped taking the apparently small and harmless pill. After day 4, I noticed I was living in hell with quite a few horrifying symptoms flaring up in me: uncontrollable episodes of weeping and crying, cold hands and feet, constant flushing, depressive moods, numerous intrusive and disturbing thoughts, insomnia, night terrors, blurred vision, panic attacks and the list goes on. The symptoms led me to believe that I'd become depressed due to the enormous nervous pressure i was under during my vertigo episodes. So, I decided to pay a visit to my psychiatrist who diagnosed me with depression and panic attacks, once again putting me on Nortriptyline. Like any other antidepressant, I began with a low dose of 10 mg and in a 4-month time span, I increased the dose to 100 which was deemed as the therapeutic dose by my perscriber. I stayed on the dose for almost 4 months during which I noticed creepy things happening to me, the most frightening of which were extreme urinary retention, unsusual weight gain and nightmares. I did quite a research on various websites, read many articles on antidepressants and people's stories of their path on the damned drugs eventually helping to conclude that the harms of such drugs far outweigh their benefits. I began my tapering journey percisely 15 months ago following the "10% golden formula" but made a huge mistake in the mean time, cutting the 10 percent with 2-week intervals which had to be a 4-week one. I mended the process,however, when I was on 50 mg. Eversince, my tapering has been smooth and with few disturbing symptoms. 3 days ago, I cut from 25 to 22.5 mg and I noticed quite a new and bizzare symtom which I'd never encountered before: suddenly jolting awake immediately after falling asleep with a huge amount of fear, now I know it is tecnically called "hypnic jerk". As this is quite new to me and had never occurred during my whole tapering months, I was wondering if anyone could enlighten me on this, making it clear whether this is another withdrawal symptom which i need to put up with and will pass or is another medical issue which I have to see to separately. I'd be infinitely grateful for any feedback.

Edited by manymoretodays
added titled, merged from tapering to introduction, title added

2015 september zoloft (20 mg updosed to 125) plus clonazepam for anxiety and panic attacks

2016 Jan replaced clonazepam with chlorodiazpoxide 20 mg

2016 April cold turkeyed both after a urinary retention surgery with no withdrawal symtom at all (still bizzare to me how!!!)

2018 Jan perscribed Nortriptyline 10 mg for vestibular vertigo 

2018 Feb due to the horrible side effects which my psychiatrist took for depression and anxiety, Nortriptyline began to be updosed to reach 100 in June

2018 Oct noticed I was experiencing no pleasure in life and decided to taper(zombie-style kind of life)

Tapered to fast to reach 50 mg in 2019 Feb

Terrible withdrawal symtoms began to creep up, had to updose to 75 in June 2019

Began make changes in diet and lifestyle and tapered again to reach 30 by 2020 Jan (only in the middle of this taper did I become familiar with the golden formula of Brassmonkey slide taper ten perecnt each month and I'm forever thankful)

By May 2020 reached 22.5 when my whole taper process hit the wall due to infection to God-damned Covid 19

Late Sep 2020 restarted my taper process using the Brassmonkey 10 percent method and reached 16 mg Jan 20 2020 when I'm writing this now

Link to post
  • Moderator
manymoretodays

Hi Iman, @Iman

And welcome back.  I moved your post from tapering on back here.  This is your main introduction page, and an excellent place to put your questions, and updates, around your specific case.

 

On 5/1/2020 at 10:16 AM, Iman said:

Eversince, my tapering has been smooth and with few disturbing symptoms. 3 days ago, I cut from 25 to 22.5 mg and I noticed quite a new and bizzare symtom which I'd never encountered before: suddenly jolting awake immediately after falling asleep with a huge amount of fear, now I know it is tecnically called "hypnic jerk". As this is quite new to me and had never occurred during my whole tapering months, I was wondering if anyone could enlighten me on this, making it clear whether this is another withdrawal symptom which i need to put up with and will pass or is another medical issue which I have to see to separately. I'd be infinitely grateful for any feedback.

 

Helpful for us will be:  Please put your withdrawal history into your signature

Just follow the instructions ^

 

And that's great that your tapering has been smooth thus far.

 

Here is our topic on:  Hypnic/hypnagogic jerks when falling asleep

Take a look at that topic, and you are welcome to add to that discussion as well.

Yes, I think it's a WD symptom.  Your nervous system is now working to re-establish homeostasis, post the changes that the nortriptyline induced.  This can take some time.  And while these readjustments occur, symptoms occur.

 

Are you experiencing any other WD symptoms?

Are you now tapering by 10% every 4 weeks? 

 

Thanks Iman, and best,

L, P, H, and G,

mmt

 

 

Started with psycho meds/psychiatric care circa 1988.  In retrospect, and on contemplation, situational overwhelm.

Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time).

5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014)

12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs.  My last psycho med ever!  Tapered @ 10% every 4 weeks, sometimes 2 weeks to

2016 Dec 16 medication free!!

Longer signature post here, with current supplements.

Herb and alcohol free since 5/15/2016. 

None of my posts are intended as medical advice.  Please discuss any decisions about your medical care with a knowledgeable medical provider. manymoretodays

 

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Hello there Manymoretodays

 

Just can't thank u enough for ur pretty valuable tips and moving me here to stay more relevant to the topic. I can quite connect to your words. Since the beginning of my tapering journey, I've experienced a wide variety of symptoms some of which were quite temporary and short-lived with yet very few lingering to the present and showing almost no sign of abating. The wd symtoms of mine according to order of severity (from most severe to least severe) are as follows: gloomy feelings and extremely intrusive and annoying thoughts, occasional insomnia, derealization and depersonaliziation especially in public places and gatherings, night terrors and nightmares, vivid dreams, racing heart and palpitaion, loud tinnitus on both ears, occasional panic attacks, anxiety attacks with freezing hands and feet and cold sweat, procrastination in fullfilling my plans and aims in life, extreme sensitivity to sound and noise, intolerance and impatience, extreme paresthasia and tingling all over the body, brain zaps, blurred vision and loss of colorfullness of the world around, catasrohphizing, weight loss and uncontrollable weeping and crying episodes. Many of the above-mentioned symtoms usually fade away on day 10 or so of my taper attempt and I'm fully aware I have to put up with them until they go away on their own. Still, few of the symtoms have persisted during all the 1 and half year of my taper journey namely tinnitus, derealization in public places and cold feet and hands with cold sweat all over the body. Hypnic jerk has been quite a new one which I experienced first a few nights ago on my taper from 25 mg to 22.5. I am carefully following the 10% taper every 4 weeks but Nortriptyline has truly taken its toll on me. I hope I can get rid of this poison in body soon.

2015 september zoloft (20 mg updosed to 125) plus clonazepam for anxiety and panic attacks

2016 Jan replaced clonazepam with chlorodiazpoxide 20 mg

2016 April cold turkeyed both after a urinary retention surgery with no withdrawal symtom at all (still bizzare to me how!!!)

2018 Jan perscribed Nortriptyline 10 mg for vestibular vertigo 

2018 Feb due to the horrible side effects which my psychiatrist took for depression and anxiety, Nortriptyline began to be updosed to reach 100 in June

2018 Oct noticed I was experiencing no pleasure in life and decided to taper(zombie-style kind of life)

Tapered to fast to reach 50 mg in 2019 Feb

Terrible withdrawal symtoms began to creep up, had to updose to 75 in June 2019

Began make changes in diet and lifestyle and tapered again to reach 30 by 2020 Jan (only in the middle of this taper did I become familiar with the golden formula of Brassmonkey slide taper ten perecnt each month and I'm forever thankful)

By May 2020 reached 22.5 when my whole taper process hit the wall due to infection to God-damned Covid 19

Late Sep 2020 restarted my taper process using the Brassmonkey 10 percent method and reached 16 mg Jan 20 2020 when I'm writing this now

Link to post
  • 5 months later...

Fluoxetine for the treatment of SSRI discontinuation syndrome

 

Hey everyone,

 

Has anyone ever tried the strategy mentioned in this article for alleviating AD withdrawal? How authentic is this? 

 

https://academic.oup.com/ijnp/article/11/5/725/968953

 

Check this one out too, it's awesome if true (seems too good to be true to me though)

 

https://ajp.psychiatryonline.org/doi/10.1176/ajp.156.4.661a?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub 0pubmed

 

The articles confidently asserts that in their case studies and reports, short-time switch to fluoxetine has been able to fully disappear the discontinuation syndrome and is definetely a solution for the many unsuccessful tapers which often times result in much suffering and pain.

 

I'd infinitely appreciate it if anyone with some solid experience could provide me with some relevant feedback.

 

Edited by ChessieCat
added topic title

2015 september zoloft (20 mg updosed to 125) plus clonazepam for anxiety and panic attacks

2016 Jan replaced clonazepam with chlorodiazpoxide 20 mg

2016 April cold turkeyed both after a urinary retention surgery with no withdrawal symtom at all (still bizzare to me how!!!)

2018 Jan perscribed Nortriptyline 10 mg for vestibular vertigo 

2018 Feb due to the horrible side effects which my psychiatrist took for depression and anxiety, Nortriptyline began to be updosed to reach 100 in June

2018 Oct noticed I was experiencing no pleasure in life and decided to taper(zombie-style kind of life)

Tapered to fast to reach 50 mg in 2019 Feb

Terrible withdrawal symtoms began to creep up, had to updose to 75 in June 2019

Began make changes in diet and lifestyle and tapered again to reach 30 by 2020 Jan (only in the middle of this taper did I become familiar with the golden formula of Brassmonkey slide taper ten perecnt each month and I'm forever thankful)

By May 2020 reached 22.5 when my whole taper process hit the wall due to infection to God-damned Covid 19

Late Sep 2020 restarted my taper process using the Brassmonkey 10 percent method and reached 16 mg Jan 20 2020 when I'm writing this now

Link to post
  • ChessieCat changed the title to Iman: weaning off nortriptyline, withdrawal battlefield
  • Moderator Emeritus

NEW!!!     INTERVIEW with Altostrata, SA's founder    NEW!!! 

 

Plodding along inch by inch:  12" = 1',  3' =  36 " or 1 yard,  1760 yards  = 63,360" or 1 mile

Current from 6 Mar 2021:  Pristiq 0.328 mg

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering Oct 2015 

My tapering program   My Intro (goes to my tapering graph)  My website

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions.

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