ectactos: help required please to taper off Duloxetine and Clonazepam

[ectactos]

Dear All 

 

I have been taking Duloxetine 60 mg and Rivotril (Clonazepam) 0.5 mg for almost 2 years and I would like to taper them off for the sake of my children. 

 

I need your help and advise please on the best plans and strategies 

 

regards 

ectactos 

Edited April 10, 2020 by manymoretodays
moved to introductions from S and S care, added name to title

[Gridley]

Welcome to SA, ectactos.  We'll be happy to help you with your taper.

 

To start, we recommend tapering no more than 10% of your current dose every four weeks.

 

Why taper by 10% of my dosage?

 

We also recommend tapering only one drug at a time.  Otherwise, if you have a problem, you won't know which drug taper is causing it.  We advise tapering what we call accelerators, which are activating drugs and include SNRI's like Duloxetine, first, and leaving what we call brakes, which are sedating drugs such as your benzo, Clonazepam in place to act as a buffer to be tapered later.

 

Taking multiple psych drugs? Which drug to taper first?

 

This link is specifically about tapering Duloxetine, including how to get the small, non-standard doses you'll need for your 10% taper.

 

Tips for tapering off Cymbalta (duloxetine)

 

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.

 

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

 

 

 

 

 

 

[ectactos]

dear Gridley, 

 

I thank you very much for your kind message. 

 

Since I have read all the listed information and guidelines, I would like to know how many beads are in a Duloxetine (by Biogaran - France) 60 mg capsules. Can you please advise 

 

Thanks in advance 

Ectactos 

[Gridley]

@ectactos

 

I don't know.  The only way to find out is to open a capsule and count them.

Edited April 15, 2020 by Gridley

[ectactos]

Titled:  Starting my tapering Journey

 

Hello Everyone,

 

After counting 8 pills of Duloxetine 60 mg (Biogaran) I can confidently say that beads ranged between 345-352 in numbers.

 

Attached is my tapering plan for your comments and advise please!!!

 

And wish me luck!!!!

Taper Bead Method.pdf

Edited April 15, 2020 by manymoretodays
merged 2nd intro topic with 1st, title added

[ectactos]

@Gridley

 

I have done so opening 8 pills. Beads ranged between 345-352 (Average 348) in case someone needed this piece of info

 

Cheers 

[Gridley]

43 minutes ago, ectactos said:

Average 348)

You should use this average for your taper.  For example, 10% of 348 would be 34.  Remove 34 beads from the capsule and what remains is the dose for your first taper.  Save the beads you removed for later use.  Keep taking this dosage for 4 weeks.  If you're feeling stable, you'd then  be ready for your next 10% decrease.  Specific instruction for tapering by removing beads is in my first post in the the link, Tips for tapering off Cymbalta.

[manymoretodays]

1 hour ago, ectactos said:

Titled:  Starting my tapering Journey

 

Hello Everyone,

 

After counting 8 pills of Duloxetine 60 mg (Biogaran) I can confidently say that beads ranged between 345-352 in numbers.

 

Attached is my tapering plan for your comments and advise please!!!

 

And wish me luck!!!!

Taper Bead Method.pdf 429.92 kB · 1 download

 

Hi ectactos, @ectactos and welcome aboard,

Merged introductions.  We like to keep each member to just one introduction, that way everything is all in one place.

I also moved some of your findings on beads per capsule to the Cymbalta tapering topic and kept, then here as well. 

You'll find them above in the order that they were posted.

 

I looked at the chart you posted and it looks like a fixed taper plan, with tapering every 2 weeks.  You may want to see how you do,  once you begin tapering.  And further adjust your tapering schedules then, depending on how you do. Getting familiar with all the information and making a plan is great ectactos!  And be patient.  No reason to rush to the finish line with this.  Those who seem to do best, just go slow and steady.

The rule of 3 KI's

 

  

On 4/9/2020 at 11:33 PM, ectactos said:

I have been taking Duloxetine 60 mg and Rivotril (Clonazepam) 0.5 mg for almost 2 years and I would like to taper them off for the sake of my children. 

 

When do you take your drugs?  Could you list the times, and then drug names and dosages, here on your introduction page please?  Thank you.

 

And then this is really helpful, as it allows us to see, at a glance, where you are at, no matter where you might post on site.  Also very helpful to us moderators too!

Please put your withdrawal history into your signature

this is the section you see below others posts, once signed in.  Take a look at the link, and give that a try.

 

How are you doing now?

 

Welcome aboard again ectactos.  You've  now introduced yourself to the community.  Good to ask further questions around your case, right here too, where all your information and history is at.

 

L, P, H, and G,

mmt

Edited April 15, 2020 by manymoretodays

[ectactos]

Hello All, 

 

I am considering switching meds from Cymbalta to Cipralex as the latter tend to have a longer half life thus making it easier for the taper. What would be your advise?

 

Regards

Ectactos 

[ectactos]

On another level, as I have started my taper using beads counting method, beads counting is not easy, how often do I need to calculate the average number of beads in capsules to determine my dosage? is it necessary for each new pack of Duloxetine I open? Or is it merely a one-time process?

[ectactos]

Just now, ectactos said:

On another level, as I have started my taper using beads counting method, beads counting is not easy, how often do I need to calculate the average number of beads in capsules to determine my dosage? is it necessary for each new pack of Duloxetine I open? Or is it merely a one-time process?

@Gridley @manymoretodays

[Gridley]

50 minutes ago, ectactos said:

it merely a one-time process?

It's a one-time process.  The differences in average number of beads from package to package are too small to make a difference.

 

1 hour ago, ectactos said:

switching meds from Cymbalta to Cipralex

 

We advise tapering the drug you're already on. 

[ectactos]

Much appreciated @Gridley. 

 

[ectactos]

Dear All

I made a mistake and would like your advises as to the right course of actions to be back on track!!!

I thought I am a superhero by taking the risks of tapering off Duloxetine quiet fast as per the below schedule:

 

Facts:

• Capsule of 60 mg Duloxetine
• Average Beads in Capsule: 350 beads

Tapering:

• 15 April - 21 April:
  • Cut 33 beads = Take 317 beads
  • Symptoms: Feeling great with no side effects, very energetic, active and happy

• 22 April - 27 April:
  • Cut 66 beads = Take 284 beads
  • Symptoms: Feeling great with no side effects, very energetic, active and happy

• 27 April - 1 May:
  • Cut 150 beads = Take 200 beads
  • Symptoms: I was OK but started to feel less energized and experienced a very sharp nerve pain in my neck and left arm , I was sluggish with swinging mood

• 2 May (Today):
  • Cut 200 beads = Take 150 beads
  • Symptoms: Terrible mood, very tired, depressed and so on.

It was a big mistake to go that fast ignoring all the advises and guidelines and I would like to correct the situation but i need your hep for this as to how to do this?:

• Shall I continue on the current dose until I stabilize?
• Shall I return to the dose at what i was feeling OK (a.k.a. Cut 66 beads = Take 284 beads)?
• Shall I go back to the original full dose and start over?

I appreciate your inputs on the above.

 

Regards

Ectactos

[brassmonkey]

Hi Ectactos-- Yea, you're really tapering quite fast there. It's good that you caught yourself before you got too much further. DO NOT go back up to your full dose, that could cause a lot of problems that will take a very long time to sort out. I would try going back to the 27 April- May 1 dose of 200 beads.  That should help keep a lot of the symptoms to a manageable level.  Then you are going to need to hold for a very long time while your body catches and stabilizes, it will be a pretty bumps ride but stabilization does happen.  Once you get stabilized, then we can come up with a good taper plan that will safely get you off the drug.

[manymoretodays]

Hi ectactos, @ectactos

7 hours ago, brassmonkey said:

I would try going back to the 27 April- May 1 dose of 200 beads.  That should help keep a lot of the symptoms to a manageable level.  Then you are going to need to hold for a very long time while your body catches and stabilizes, it will be a pretty bumps ride but stabilization does happen.  Once you get stabilized, then we can come up with a good taper plan that will safely get you off the drug.

 

This sounds like an excellent plan ^.  And likely, that you may continue to experience some WD symptoms from a cummulative now, too fast taper.

ectactos.

If you started with a 60 mg dose of duloxetine, with 350 beads.

And went all the way down to 150 beads, you are definitely going too fast.

That represents more than a 50% drop, from your starting dose, in less than a month.

 

Once, you go back up to 200 beads, I come up with a dose of 34.2 mg.  And so yes, a good long hold is in order.  Meaning that you don't make further reductions for a while.

 

What kind of WD symptoms, if any, are you having?

And when do you take your medications/drugs?

Could you note the time on the left, and then each of your drugs on the right by name, and dose on the right.  Then also continue with the times, and note your symptoms as they occur throughout the day.  Like this:  Keep daily notes

I notice that you are taking clonazepam 0.5 mg each afternoon as well, so do please include that, as well as any supplements taken.  Are you sleeping okay?

 

All for now.  I've merged a couple of your posts back here to your introduction page, they appear to be duplicates, so will just preserve one.  This is the best place, right here, to update, as well as seek guidance around your specific case and tapering.  Thanks ectactos.

 

Best,

L, P, H, and G,

mmt

 

[ectactos]

Thanks All for the comments and guidance. 

 

I am now feeling much more better since I tapered up my dose to 200 beads.

 

In response to mmt's questions: 

 

What kind of WD symptoms, if any, are you having?

• Agitation 
• Angry 
• Fatigue 
• Internal Anxiety 
• Feeling something is pulling me from the inside tying me down to the inside 
• Migraines 
• Nerve pain and electric sensation in my left arm 
• Insomnia 
• Constipation 

And when do you take your medications/drugs? 

7 AM - Duloxetine - 200 beads 

7 AM - Concor - 5 mg 

7 PM - Rivotril - 0.5 mg 

10 PM - Magnesium - 250 mg 

 

My sleep cycle is disturbed so I sleep during the day a lot but not at night 

 

I am unfortunately a smoker and coffee person. Recently I started feel very anxious after I have my coffee and I am trying to find a way to stop these addictions as I know they contribute the most to my situation. Can you please advise as to whether it is a wise choice to start quitting smoking and coffee now or leave it for a later stage as I don't want to add more pressure on my system while tapering Duloxetine. 

 

Also For how long I should stay at the 200 beads dose?

 

Regards 

Ectactos 

[Altostrata]

Hello, Ectactos.

 

Why do you take Concor (bisoprolol)? What times of day do you take each of your drugs, with their dosages?

 

When did your sleep problems start?

 

If I were you, I'd definitely taper caffeine intake. This may have a lot to do with your sleep problems. You can do this by reducing the amount of coffee in a cup, add more milk.

 

Going off cigarettes is a little more difficult, you might save that for later.

[ectactos]

Hello Altostra, 

 

My MD gave me concor for palpitation and HBP, although it gives me a relief from palpitations I would opt to manage them with nature alternatives having had the same level of knowledgeI have now now, but I am already hooked up on all these meds so I have to deal with them cautiously until I taper them safely. 

 

My sleep problems comes and goes in episodes. 

 

Will manage caffeine intake and leave cigarettes for a later stage as per your advise. 

 

Shall I stay at 200 beads for 15 days and then start the taper again? if yes, what would be your advise for the afterward plan?

 

Thanks 

[ectactos]

dear All,

 

I am really fed up with the daily episodes of tongue numbness, headaches, eyelid tingling, fatigue, etc... I am exhausted to the fullest. When this struggle is going to end? I want to return to normal again...

 

I want to spend happy times with family and contribute positively to the overall family progress...

 

I am really fed up and exhausted....... Can not say anything more 

 

 

 

 

[Erell]

Dear ectatos, 

 

nobody can answer the' when', but all testimonies here show IT WILL END, and that's a great news !

 

Remember, all this is only temporary.

 

Take care ❤️

 

[ectactos]

Hi All

 

I am glad to inform you that I have doing well so far with my taper plan.

 

I am in total 20 beads now and doing well

 

regards