Estman: reducing Anafranil, withdrawal symptoms

[Estman]

10 hours ago, ChessieCat said:

This post is on page 1 of the cortisol topic I linked previously. 

 

 

If trying anything new only make one change at a time and start with a small tester dose to see how you react.  Please also be aware that some members have tried something and it works for some time but then stops working or turns paradoxical.

 

There may be separate SA topics on the things listed in the above post.  Use a search engine and add site: survivingantidepressants.org to the search term to research them further.

 

the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable

 

 

When I reduce anafranil, I usually experience fear and anxiety for 2 weeks
Some vague unfounded fear
However, there is also despair
Is it due to this cortisol?
Or a decrease in serotonin?
Is this the case with other drugs?

[Altostrata]

What is your current Anafranil reduction schedule and method? It sounds like you are going too fast.

 

Are you still taking the other drugs? What is your daily drug schedule?

[Estman]

Hi Alto,

I am currently taking 27 mg a day
I take a 10mg tablet in the morning at 9am
18.45 7 mg (pharmacy-made powders inside the paper)
At 19.45 take a 10 mg tablet

I used to take it in the afternoon, but I moved it to the evening
In the meantime, it was pretty stable
I reduced 25.09 to 2.5mg
5.10 I reduced the sample by another 0.5 mg
Intermediate 10 days were withdrawal symptoms as usual
10.10 situation worsened (sex last night for a long time)
12.10 this fight-escape reaction occurred
So far, it is a constant explosion of cortisol both day and night
I wake up several times in a panic at night
There is a constant feeling of fear during the day, as if I want to escape
There are also digestive problems and gases and nausea, sometimes diarrhea
Indigestion is especially in the evening after taking a dose and at night
Not after the morning dose
The doses made in the pharmacy are in powder form inside the paper and made in February
It is written on the package that it is valid until 22.04
Are they getting old?
Could it be that this 7mg powder is no longer a 7mg active ingredient?

 

Edited November 6, 2020 by ChessieCat
removed quote

[Altostrata]

Can you simply list the drug changes, without the explanation, please? Are you still taking the other drugs? What times of day and dosages do you take your drugs?

 

On 6/11/2020 at 9:05 AM, Altostrata said:

We advised you to taper slower, but you decided to taper faster. You will have to stop tapering and cope with your symptoms until they settle down.

 

If you get side effects from Betaloc, take less. Use common sense.

 

[Estman]

No other drugs are currently being used.

 

 

Edited November 6, 2020 by ChessieCat
removed quote

[ChessieCat]

14 hours ago, Altostrata said:

Can you simply list the drug changes, without the explanation, please?

 

14 hours ago, Altostrata said:

What times of day and dosages do you take your drugs?

 

Please make it easier for Alto.  She gives of her valuable time FREE to help members here.  She does not want to be wasting time having to read through a post to get the information she needs.

[Estman]

Do pharmacy-ready doses (powders inside the paper) also age?
Does anything happen to the active substance when the tablet is crushed?
My doses are made in February

[ChessieCat]

Please answer Alto's question.

[Estman]

I take 10mg of Anafranil in the morning at 8am
18.30 7mg (in powder form)
At 19.30 10mg

In addition to Omega 3 1500mg + D 1000mg per day

Do not take other medicines

Something else?

 

Edited November 6, 2020 by ChessieCat
removed quote

[ChessieCat]

10 hours ago, Estman said:

Do pharmacy-ready doses (powders inside the paper) also age?
Does anything happen to the active substance when the tablet is crushed?
My doses are made in February

 

I suggest you ask your pharmacist about this.  My compounder put a 6 month expiry sticker on my compounded Pristiq capsules but told me that I could ignore it.  I've been taking my capsules well past the stated expiry and had no noticeable issues.  However, your drug may be different; the pharmacist should be able to provide this information.  And if you aren't sure that he knows what he is talking about, you can always ask elsewhere.  I think generally it would be liquids which are more likely to degrade and/or lose potency.

[Estman]

Thanks, I'm researching this
One very disturbing symptom is abdominal pain and gas, accompanied by nausea and weakness.
However, it is also like stomach and lower back cramps
Anxiety at the same time makes things worse.
Sometimes total diarrhea also occurs, sometimes it can be prevented
It's every day in the evenings, not during the day
I haven't found anything to alleviate it

 

Edited November 6, 2020 by ChessieCat
removed quote

[ChessieCat]

If it is anafranil that you are taking then it might be side effects of the drug, not withdrawal.

 

From https://www.drugs.com/sfx/anafranil-side-effects.html

 

Common side effects of Anafranil include: constipation, dizziness, drowsiness, dyspepsia*, ejaculatory disorder, fatigue, headache, insomnia, myoclonus, nausea, nervousness, paresthesia, tremor, urination disorder, visual disturbance, weight gain, anorexia, diaphoresis, and xerostomia. Other side effects include: anxiety, fever, hot flash, hypertonia, memory impairment, muscle twitching, non-puerperal lactation, orthostatic hypotension, pruritus, skin rash, sleep disorder, tachycardia, tinnitus, vomiting, flushing, and taste disorder.

 

* I had to look up what dyspepsia is and this is one description I found:

https://medical-dictionary.thefreedictionary.com/dyspepsia

 

[Estman]

Hi Chessie,

I think these are withdrawal symptoms
They alternate and have different strengths
The day before, there was total fatigue, weakness and exhaustion with anxiety
I don't know if this is the case with other drugs, but it seems that tricyclics are especially bad in this respect
Not the slightest effort can be made
It has now eased
Digestive problems are stronger one day, better the other day
However, nausea and feeling unwell do not occur all the time
What is controversial is that you feel worse after taking the dose in the evening
As if it were a side effect of the drug
However, after the morning dose, notice this way
At present, there is generally a feeling where one cannot yet experience joy and well-being
I have noticed that the higher the dose I reduce the longer the withdrawal symptoms last
However, reducing a small dose, such as 0.5-1mg, also causes withdrawal symptoms that last for 2-3 weeks.
I learned from the last time that the reduction can only be made once a month
I hope that I still feel normal again

 

Edited November 6, 2020 by ChessieCat
removed quote

[Estman]

Hi,

I got better 20 days after reducing the dose, then on October 24 I felt better
Meanwhile, there were no withdrawal symptoms and no dyspepsia.
In the last two nights, however, sleep has been poor and there are some other symptoms
Today, the mood is worse and there is an unfounded feeling of fear
In the meantime, 6-7 days is relatively normal
Is such fluctuation normal?
I was planning to reduce a small dose soon, should I wait a bit?

 

Edited November 6, 2020 by ChessieCat
removed quote

[ChessieCat]

Have you missed any doses recently?

 

Have you been consuming alcohol and/or caffeine (eg cola, energy drinks, strong/lots of coffee)?

 

Have you taken any antibiotic recently?

 

Have you been sick, eg had a cold or other illness or in pain?

 

If you are experiencing withdrawal symptoms it is generally better to hold for longer before reducing again.  Please see these topic:

 

Stability

 

WDnormal

[Estman]

No dose has been missed
 

Have you been consuming alcohol and / or caffeine (eg cola, energy drinks, strong / lots of coffee)?
Have not consumed cola, energy drinks or coffee or chocolate

 

He has not taken any antibiotic

 

3 days ago there was a headache (at the same time there was also some magnetic storm)
Headache was similar to dose reduction, sleep disturbances, frequent waking at night and mild shortness of breath)
The last 3 nights have been confusing and disturbing dreams

In the meantime, 6-7 days was normal, now a few days of depression and vague fear
In it, I conclude that healing is in waves

Does the stabilization time depend on the dose to be reduced?
A 10% dose lasts longer than, for example, a 5% dose?
or is the time still the same but the severity of the symptom is different?

 

Edited November 6, 2020 by ChessieCat
removed quote

[ChessieCat]

Reducing by 5% is less likely to cause withdrawal symptoms than reducing by 10%.

 

Some members find that the lower their dose gets the slower they need to go, reducing less and/or holding longer.

 

We so not know how long it takes after a reduction for the withdrawal symptoms to settle down.  It can be different for different people and different drugs

 

It can be different at different times during your own taper.  Members have found that they have more difficulty with some doses than others.  Again there is no rule about what dose.  It is individual.  If you have been experiencing more stress than usual or have done too much exercise, or not been sleeping as much, these can all increase withdrawal symptoms.

 

The 4 week hold after a reduction is the suggested hold time.  Some people notice that their symptoms lessen after a few days, for some people it is after 1-2 weeks and for some it is 3 weeks.  But it is best to hold for the full 4 weeks because the brain might be making some changes that we don't notice.

 

This is why it is very important to listen to your body/symptoms and use them as a guide for when you can reduce again.

 

You might consider changing the way you taper.  The BrassMonkey slide is a gentler way of tapering.  You can choose what percentage reduction you make.  Please have a look at the topic and if you need help please ask questions and we will do our best to answer them.

 

Brass Monkey Slide

[Estman]

I can try this Brassmonkey Slide Method next time
So far, I've made about 10% reductions every 4 weeks
As others have mentioned, I also always have the fear of being reduced again
Withdrawal symptoms usually begin in 4-5 days and last until day 20 (although symptoms are intense)
Usually then on the 20th day it gets better
This was also the case this time, it was relatively normal for about 6 days
But 3-4 days ago, symptoms such as anxiety, depression, bad dreams reappeared
Since I was planning to reduce it again soon, it also caused fear
But now the last few days have been very depressed and desperate
As if the second wave (the first then started in 5 days and lasted for 20 days)
I do not understand why the body so reacts that in the meantime it is a week normal, it seems that now the symptoms are gone and then again such
Hopefully, however, the depression will pass again this time as well

 

Edited November 6, 2020 by ChessieCat
removed quote

[Estman]

Hi Chessie,

Last night and night there was constant pressure in the nest and panic anxiety
There were strong compulsions and a constant fight-escape reaction
I measured my blood pressure in the evening and it was 161/104
In addition, there was a very bad feeling, nausea
I think high blood pressure causes a feeling of pressure in the head.
The last time I reduced it was 31 days ago, in the meantime it was 7 days normal, now 5 days wave
I hope I survive and the horror passes!

 

Edited November 6, 2020 by ChessieCat
removed quote

[ChessieCat]

There is generally no need to quote a post.  Unnecessary quotes make it harder to see your replies.  It also adds makes your posts longer which means that there are fewer posts on a page.  This can make it harder for the mods because they have to open a previous page to see posts.

 

It is possible to quote a portion of a post (instead of quoting the whole post) by selecting the text you want to quote and waiting for the Quote Selection box to appear.  Click on that and it will put the quoted text in the reply box.  You then click below the quote box, not in the quote box, and type your response.

[Estman]

It seems to me that the blood pressure drugs Micardis and Betaloc
increasing anxiety and malaise and nausea
Does it just seem that way to me, or have others noticed it?
I am thinking of the dose tapering period
What to do with high blood pressure and fast heart rate?
Wait when it itself becomes normal?

[ChessieCat]

15 hours ago, Estman said:

It seems to me that the blood pressure drugs Micardis and Betaloc
increasing anxiety and malaise and nausea

 

Sorry but SA doesn't counsel about general medical issues.

 

I suggest that you research the side effects of ALL of your drugs.  If you have concerns please consult your medical professional.

[Estman]

On 11/3/2020 at 11:33 PM, ChessieCat said:

Reducing by 5% is less likely to cause withdrawal symptoms than reducing by 10%.

 

Some members find that the lower their dose gets the slower they need to go, reducing less and/or holding longer.

 

We so not know how long it takes after a reduction for the withdrawal symptoms to settle down.  It can be different for different people and different drugs

 

It can be different at different times during your own taper.  Members have found that they have more difficulty with some doses than others.  Again there is no rule about what dose.  It is individual.  If you have been experiencing more stress than usual or have done too much exercise, or not been sleeping as much, these can all increase withdrawal symptoms.

 

The 4 week hold after a reduction is the suggested hold time.  Some people notice that their symptoms lessen after a few days, for some people it is after 1-2 weeks and for some it is 3 weeks.  But it is best to hold for the full 4 weeks because the brain might be making some changes that we don't notice.

 

This is why it is very important to listen to your body/symptoms and use them as a guide for when you can reduce again.

 

 

Brass Monkey Slide

Hi,

I tried the low dose reduction method for a month
I divided the 10% dose into 4 portions and then took it a week apart
Unfortunately, this does not seem appropriate to me
At first, the symptoms are milder for 2 weeks, but if you continue to reduce them in the second half of the month, there will still be a crisis
Possibly a 10% reduction per month is a lot for me
Last time I reduced 6 days ago and only 0.5mg
Then I felt normal, but 2 days ago the situation suddenly got very bad - nausea, feeling unwell, great restlessness, confusion
The body seems to add up these small doses and when, for example, it reaches 10% of the total dose, it gets out of control
It seems to me that it is better to reduce once and then keep for at least a month. In the meantime, you should feel good to see that the symptoms disappear.
Every week I reduce them as they persist and become harder

[ChessieCat]

If you are getting withdrawal symptoms then you hold at that dose for longer before reducing again.

[Estman]

On 12/17/2020 at 10:09 AM, ChessieCat said:

If you are getting withdrawal symptoms then you hold at that dose for longer before reducing again.

It is better for me to reduce the dose once a month and then stay at the same dose (it seems that not more than 6-7% at a time)

Yes, there are strong withdrawal symptoms at the moment.
There is a sense of despair and hopelessness
There is also some confusion. Are there any observations about this last symptom?
Do others have that too?

[ChessieCat]

Dr Joseph Glenmullen's WD Symptoms Checklist

 

brain-fog-blank-mind-comprehension-concentration-cognitive-and-memory-problems

 

[Estman]

The withdrawal symptom of clomipramine for me is nausea and at the same time diarrhea.
Although 10 days have passed since the last dose change, but I would like to vomit.
Does time alone help, or are there any special medications used?
I don't want to see a doctor because they would definitely prescribe a new drug, at the moment I'm only taking this Anafranil.
Such a closed circle.

[Estman]

On 12/12/2020 at 11:21 PM, manymoretodays said:

Hi heliosa and welcome,.

 

And oh my, sorry it's taken so long to get you started.

And I am not real familiar with your medications, so am going to just post my preliminary findings right here too.

Dromperidone-

Domperidone is a medicine that increases the movements or contractions of the stomach and bowel. Domperidone is also used to treat nausea and vomiting caused by other drugs used to treat Parkinson's Disease.

 

Domperidone is to be given only by or under the immediate supervision of your doctor.

( https://www.mayoclinic.org/drugs-supplements/domperidone-oral-route/side-effects/drg-20063481?p=1)

 

Reglan-  Drugs.com Reglan Uses, Dosage and Side Effects

and professional info, from Drugs.com :  https://www.drugs.com/pro/reglan.html

 

What are you taking now?  I am noticing in your signature you put:  12/9/20 - got back on full dose of dom

Does dom stand for Domperidone?

And any other medications right now?

 

And why are you on these medications, if you don't mind saying?

 

Thank you,

L, P, H, and G,

mmt

 

 

Hi ,

Does domperidone relieve withdrawal symptoms in some cases?

Does it help relieve nausea?
Is it an addictive drug in itself?
What are the side effects?
Does anyone have any observations?
If you have not taken such a medicine before, is it worth trying?

[manymoretodays]

Hi Estman, @Estman

I just moved your question on heliosa's Introduction over here to yours.  I don't want heliosa to think they need to advise at this point.

The domperidone isn't really a drug that we deal with here much.  We have had some who have used it for milk supply while nursing babies, who have run into difficulties getting off it as well.

 

So no, it would not be a medication worth trying, in my opinion for AD WD.

 

How long have you been taking the Levopromazine 5 mg.  Is this an oral medication, or do you get injections?

And okay, I'm seeing in your signature you've been on it from March of 2019 until December 2019?

So are you off of it now?

(it looks like maybe the Levomepromazine trial just needs to have it's own line in your signature)

 

And then what are you on now with the Anafranil, dose taken?

Have you done any tapering or updosing since that huge drop from 75 mg to 35 mg?  Or possibly from December 2019 to May of 2020?

And again, enlighten me, if I am mis- reading your signature please.

Please summarize your withdrawal history in your signature

It might be best to check the link ^, and then do an update/edit of your signature for clarity's sake( and I'll even extract the instructions right here):

 

Staff needs this information to answer your questions. In your signature, we need to see

- Exactly what you're taking now, with dosages and when you started each drug

- What you were taking before, with dosages and start and stop dates

 

As the signature is limited to 12 lines, we expect you will condense your drug history. The last few years usually will do.

 

FOR READABILITY, SHORT LINES ARE BEST.

• A list is easier to understand than one or multiple paragraphs
• Include ALL drugs, doses, and dates (starting and stopping)
• Any drugs prior to 24 months ago can just be listed with start and stop years
• Use actual dates or approximate dates (e.g. mid-June 2018) rather than relative time frames (e.g. 3 months ago)
• Spell out months (e.g. "January" or "Jan" as 9/1/2016 can be interpreted as 9 Jan 2016 or 1 Sept 2016)
• Please leave out symptoms and diagnoses

 

Example:

2001–2002 paroxetine 
2003  citalopram 
2004  paroxetine
2008  paroxetine slow taper down to 2016 Aug off paroxetine
2016  citalopram May 20mg  Oct slow taper down
2018  citalopram 13 Feb 4.6mg 15 Mar 4.4mg 29 Apr 4.2mg

 

If you edit your signature, the new one replaces any prior signature. It will appear in your signature under all your posts, even your old posts. If you want to save the information in the old signature, copy it and save it in a file on your computer or in a post in your Introductions topic.

 

(As of 12/31/13: Signatures are limited to 12 lines of text.)

How to add or edit your signature

1. Click on this link to open the correct page in User Settings:
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2. Enter your signature in the space provided.
3. When you are done, Click on the big black Save button at the bottom.
    

If the link isn't working, follow these steps:

1. Click on the small downward arrow next to your name in the top right corner of any page.
2. Select Account Settings from the list.
3. On the left of the Account Settings page, click on the Signature tab. You will be able to add or edit your signature.
4. Click on the big black Save button at the bottom when you are done.

 

And usually, yes, time is really of the essence sometimes with WDsyndrome, and once it has set in.

 

10 hours ago, Estman said:

I don't want to see a doctor because they would definitely prescribe a new drug, at the moment I'm only taking this Anafranil.
Such a closed circle.

 

Yes.  And then sometimes though, we look for a drug solution as well, which can sometimes complicate things a lot.

 

When was your last Anafranil decrease, and from what dose, to what dose?  What kind of percentage drop were you doing?

(and again, you can clarify this in your signature now too, thank you)

 

It sounds like much of your symptoms are gastrointestinal now, vomiting and diarrhea?  Any other WD symptoms of note?

 

Okay, and thank you Estman for clarifying some more, when you get to it.

 

L, P, H, and G,

mmt

 

 

 

 

Edited December 21, 2020 by manymoretodays

[manymoretodays]

Hi Estman,

I will go ahead and quote that other post above mine back over to heliosa's topic too.

As now, I'm wondering if that was offering support to them, questions that they should ask themselves?

 

Kay.  Forgive, I think I've gotten a bit screen weary.

[heloisa]

Domperidone is a prokinetic which blocks dopamine d2 receptors. It is not supposed to cross the blood brain barrier, but in some cases it does. And that’s when it becomes dangerous. But if it doesn’t, it shouldn’t cause any withdrawal symptoms. If you’re dealing with withdrawal I don’t recommend it since you should be very sensitive by now

 

maybe herbal supplements like ginger?

[Estman]

14 hours ago, manymoretodays said:

 

  

 

And so, this was in response to your last post I believe.

 

And forgive, I've gotten a bit screen weary today I think.  Too many hours at once.  Beautiful day.  Happy Holidays!  Off to be jolly now.

 

mmt

 

 

Hi,

I last took Levopromazine exactly a year ago
I am currently only taking Anafranil (now 27mg day)
Yes, the reduction has been rapid (perhaps even too much) but has always stabilized
I have tried to find the most optimal reduction schedule for myself
Nevertheless, there are excruciating nausea and diarrhea-pain when reducing this medicine
Therefore, I researched whether anyone was using any drug to alleviate it
But on the other hand, anti-nausea drugs seem to have bad side effects
The only way seems to be to try to wait until the symptoms go away

Happy Holidays!

 

[Estman]

12 hours ago, heloisa said:

Domperidone is a prokinetic which blocks dopamine d2 receptors. It is not supposed to cross the blood brain barrier, but in some cases it does. And that’s when it becomes dangerous. But if it doesn’t, it shouldn’t cause any withdrawal symptoms. If you’re dealing with withdrawal I don’t recommend it since you should be very sensitive by now

 

maybe herbal supplements like ginger?

 

Hi heloisa,

Ginger like does not help much
If I reduce my dose, nausea and feeling very unwell will usually last for 2 weeks before
Along with nausea, there is severe restlessness, anxiety and diarrhea, and gas
I vomited directly, but I don't always feel that I can't hold it back
Thus, there are several symptoms at once
I understand, however, that you do not recommend other medications
They also have side effects and may add to the anxiety-akathisia

[manymoretodays]

Hi Estman, @Estman

I got your other post moved as well this morning.  2 posts up ^ and quoted below.

 

3 hours ago, Estman said:

Hi,

I last took Levopromazine exactly a year ago
I am currently only taking Anafranil (now 27mg day)
Yes, the reduction has been rapid (perhaps even too much) but has always stabilized
I have tried to find the most optimal reduction schedule for myself
Nevertheless, there are excruciating nausea and diarrhea-pain when reducing this medicine
Therefore, I researched whether anyone was using any drug to alleviate it
But on the other hand, anti-nausea drugs seem to have bad side effects
The only way seems to be to try to wait until the symptoms go away

Happy Holidays!

 

Yes, I'm a big fan of HOLDing for the Holidays.  And then, when you resume tapering, if I were you, I'd just go with 10% or less.

Current dose Anafranil is 27 mg.

27 mg X .90 = 24.3 mg, which would represent a 10% reduction, from 27 mg

27 mg X .95= 25.6 mg, which represents a 5 % reduction from 27 mg

 

Ideallly then, or optimally the taper would be tolerated, without such excruciating nauseau and gut pain.  You could even do a 2.5 % reduction next.

27 mg X .975 = 26.3 mg, which represents a 2.5 % taper from your present dose.

 

AccountSettings/signature  should take you right to your signature for an update.  Please get your most recent taper of Anafranil in there, with the date that you reduced.  Thank you.

 

Yep, lovely season now. 

Best, L, P, H, and G,

mmt

[heloisa]

If you don’t have gastritis you could try Betaine HCL for the nausea

[Estman]

On 12/22/2020 at 6:13 PM, manymoretodays said:

Hi Estman, @Estman

I got your other post moved as well this morning.  2 posts up ^ and quoted below.

 

 

Yes, I'm a big fan of HOLDing for the Holidays.  And then, when you resume tapering, if I were you, I'd just go with 10% or less.

Current dose Anafranil is 27 mg.

27 mg X .90 = 24.3 mg, which would represent a 10% reduction, from 27 mg

27 mg X .95= 25.6 mg, which represents a 5 % reduction from 27 mg

 

Ideallly then, or optimally the taper would be tolerated, without such excruciating nauseau and gut pain.  You could even do a 2.5 % reduction next.

27 mg X .975 = 26.3 mg, which represents a 2.5 % taper from your present dose.

 

AccountSettings/signature  should take you right to your signature for an update.  Please get your most recent taper of Anafranil in there, with the date that you reduced.  Thank you.

 

Yep, lovely season now. 

Best, L, P, H, and G,

mmt

Hi manymoretoday,

Thank you for the information!
Next time I will try to reduce by no more than about 5-6%
I have had a viral disease that has increased my symptoms again
At night there are very confused and distressing dreams
During the day you feel depressed and unhappy
There is a vague sense of fear
It seems that viral illness or cold causes me a mental problem
How long could it be normal to reduce again?