Jump to content

TaiLeiLe: tapered amitriptyline too fast 3 times - possible kindling?


TaiLeiLe

Recommended Posts

Hey everyone, I'll try to keep this concise.

 

Background: Currently early twenties student in university. In 2017, I was diagnosed with post-concussion syndrome (PCS). 40mg of Amitriptyline was prescribed by my neurologist to treat tension headaches.

 

My first experience with rapid tapering of amitriptyline was in August 2018, when my neurologist asked me to switch from amitriptyline to valproic acid for PCS, at a rate of 10mg Amitriptyline tapered each week until I was fully cold turkey. Unfortunately, I found out around the 10/20mg range I wasn't handling withdrawal too well and was forced to stop and reinstate. 

 

In February 2019, I read about the link between dementia and cholinergic medications and went cold turkey by my own choice. This lasted for two months of difficulty where I struggled through my hardest semester of college. I ended up reinstating in April after a discussion with my therapist.

 

Its important to note that at this point, for both aforementioned times I had attempted fast tapers I was not aware that withdrawal symptoms were a significant issue for antidepressants. Instead, I believed that once amitriptyline fully left my system I would be fine, and that all my symptoms were caused by PCS.

 

In July 2019, I was able to recover from PCS after two years. A month later in August, I spoke to my physician about getting off amitriptyline. He prescribed me a somewhat slower taper at 10mg a month and 7 weeks for the final 10 mg. Thus, I began my taper from 40mg to 30mg. You can probably guess what happened next. This taper put me through hell and lasted a total of a little over four months before I stabilized. In December 2019, I discovered this forum and decided to give slow tapering a shot using liquid titration (water, not ethanol). 

 

In January 2020, I tapered from 30mg to 27 mg. It took me about two months start to finish to stabilize. I was mildly symptomatic, but my symptoms were manageable.

 

In March, I tapered from 27 mg to 25 mg. This time, it took me nearly three months to stabilize. Even stranger, my I found that my symptoms were seemingly worse, even though the percentage tapered was still about 10%.

 

In June, I tapered from 25mg to 24mg, hoping that a tiny dose reduction would alleviate most of my issues with tapering. Flash forward to today. Nearly three months after I had began that taper I find that my symptoms, while very mild at first seemed to have gotten worse over time. Furthermore, a three month long time span for a 4% reduction seems very unusual. Now I that school is starting and I am actively interviewing for internships, I am considering reinstating back to 24.5 or 25 mg. 

 

I'm unsure about why my withdrawals seem to get worse even though I try to reduce my taper amount each time. I can think of a couple theories, those being:

  1. Dissolving with water instead of ethanol causing issues somehow. I think this is unlikely because when I first was testing out a solution in water at my full dosage, I did not experience any withdrawal symptoms. Furthermore, when I switched to 1:10 ethanol:water solution for a couple nights while tapering, I did not experience any improvement in symptoms.
  2. Withdrawals from previous tapers coming back to bite me in my ass. I'm aware of the whole waxing and waning thing and I'm wondering if it's possible that when I began my last taper, I hadn't actually completely stabilized and am now dealing with prolonged symptoms from previous tapers. Not sure how likely this is.
  3. Kindling. This would make sense considering I have had three tried and failed fast tapers that each did a number on me. However, I'm struggling to find any sources regarding kindling in antidepressants to the point where I'm unsure if it's even possible.

 

My symptoms are mainly just hypersensitivity, disheveled sleep/insomnia, and exhaustion.

 

Thanks for reading this far.

 

 

2017: May, Amitriptyline 40m

2018: August, Amitriptyline 30mg-10mg, Valproic Acid. December, Valproic Acid stopped.

2019: February, Amitriptyline 0mg. April, 40 mg reinstate. August, Amitriptyline 30mg

2020: January, Amitriptyline 27 mg .March Amitriptyline 25mg. June Amitriptyline 24mg

Link to post
  • ChessieCat changed the title to TaiLeiLe: tapered amitriptyline too fast 3 times. Possible kindling?
  • Moderator

Welcome to SA, TaiLeiLe.  Sorry for the delay in response.

 

I thin your analysis of why your withdrawals are getting worse despite smaller reductions is correct.  Your system is highly sensitized from the failed tapers (your #3) and going up and down in dose. Whether you call it kindling or whatever, there's no doubt that repeated destabilizations leave the system increasingly sensitized.   It's also very possible that (your #2) you weren't stabilized and are now now dealing with symptoms from previous tapers.

 

It seems to me that a very long hold at current dose of 6 or more months is what's needed.  With the failed tapers in your past, it's impossible to tell what's causing what, but a very long hold would allow you to stabilize and for your system to catch up.

 

Once you've stabilized, and it may take longer than 6 months, you might want to look at taper methods more gentle than the 10% method.You may  want to switch to a micro-taper going forward. This is the gentlest way to come off these drugs. 

 

Micro-taper instead of 10% or 5% decreases

 

The Brassmonkey Slide is a way of making micro-taper reductions weekly, as opposed to a larger reduction once a month. This taper calls for four weeks 2 1/2% cuts with a two week hold, but you could reduce the to four 1% cuts.

 

The Brassmonkey Slide Method of Micro-tapering

 

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

 

What is withdrawal syndrome.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

The Windows and Waves Pattern of Stabilization

 

When we take psychiatric 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.  These explain the healing process really well:

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

Brain Remodelling 

 

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 wy 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.

Link to post
  • 4 weeks later...

Hi TaiLeiLe,

 I was reading your introduction and wanted to see how you are doing?

Been on medication since 1999. Previous medications include Remeron, Zoloft, Celexa, Lexapro, Lamictal, Xanax, Ativan, Valium, Ability.

 

Current medication:

Amitriptyline: 50 mg 2015-5/20. Decreased 50mg to 25 mg first week in May, 25mg to 12mg second week in May, 25mg to 10mg third week in May, 10mg to 8 mg fourth week in May. Stayed here for a month and reinstated 2 mg in July.

1/21 9 mg

Klonopin: .5 mg since 2001

 

Supplements:

Magnesium citrate: 250 mg

Fish oil: 1200 mg

 

 

Link to post
  • ChessieCat changed the title to TaiLeiLe: tapered amitriptyline too fast 3 times - possible kindling?
  • 3 weeks later...

Hi everyone, 

 

Quick update, I'm still hanging at 24mg. About 4 months after my last reduction, I still have very minor withdrawal symptoms but overall am doing well.

 

I plan on getting to 20mg at some point in the (perhaps far) future. What I plan to do after that, I'm not sure. To be honest, I will be graduating in the next year and don't want to spend my early career dealing with withdrawal illness, especially when I'm lucky enough to have very little side effects from amitriptyline. I don't really have a concrete plan yet though.

2017: May, Amitriptyline 40m

2018: August, Amitriptyline 30mg-10mg, Valproic Acid. December, Valproic Acid stopped.

2019: February, Amitriptyline 0mg. April, 40 mg reinstate. August, Amitriptyline 30mg

2020: January, Amitriptyline 27 mg .March Amitriptyline 25mg. June Amitriptyline 24mg

Link to post
  • 4 months later...

Hi TaiLeiLe

 

I was wondering how you were getting along? Are you still holding or perhaps you've decided to taper again? I'm interested in how things are going for you as there are similarities in our situations (although different drugs). Hope it's going ok.

▪︎2000 - Seroxat (25mg?) 6 months C/T

▪︎2015 - 7.5mg Zopiclone 1 month C/T

▪︎ 2016 - 2018 - Diazapam and Phenergan occasionally

▪︎2017 June to Oct - Mirtazapine 7.5mg C/T

▪︎2018 April - 2019 Oct Mirtazapine 7.5mg tapered to 1.5mg.

▪︎2019 October - Mirtazapine 1.5mg (Skipped alternate doses on doctor's advice then stopped - Insomnia.) Phenergan

▪︎2020 Jan 6th - Mirtazapine 1.5mg

▪︎2020 Jan 13th - Mirtazapine 7.5mg

▪︎2020 - Feb - May, holding 7.5mg

▪︎2020 1st June, 7.35mg. 27 June, 7.2mg. 7 July, 7.05mg. 18 July, 6.9mg. 28 July, 6.75mg. 27 Aug, 6.6mg. 7 Sep, 6.45mg. 17 Sep, 6.6mg. Holding

 

Fish oil and vitamin E capsules.

Link to post

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
×
×
  • Create New...

Important Information

Terms of Use Privacy Policy