soliDg: amitriptyline withdrawal

[soliDg]

Hi, and thanks for so much letting me join the community here. Below is my current history.

 

AMITRIPTYLINE HISTORY (PUT ON THIS FOR GUT ISSUES)

- - All these symptom/severities are atypical for me. - - 

Early Dec 2019 - 10mg, ~6 weeks - depressive episodes started, foggy, gut slower than normal

Late Jan 2020 - 20mg, ~1 month - depressive episodes, foggy

Late Feb 2020 - 10mg, 2 weeks - flu-like aches, foggy

Early Mar 2020 - 5mg, ~4 days - very strong flu-like aches, emotionally ragged, foggy

Mid Mar 2020 - 10mg, ~1 month - flu-like aches, after break emotionally ragged again, foggy

Late Apr 2020 - ~15mg, ~2 weeks (pill cutter) - flu-like aches, foggy

Early May 2020 - ~16mg, ~2 weeks (pill cutter) -  foggy

[Mid May 2020 - 1 episode of diarrhoea] instantly followed by severe ongoing depression, tingling scalp, foggy

Mid May 2020 - 17mg - 4 months (compounding chemist) - severe ongoing agitation, then severe ongoing depression (tingling scalp), then both, foggy, memory problems

22 Sept 2020 - 1 missed dose - felt almost normal

23 Sept 2020 - 10mg - depression

24 Sept 2020 to present - 17mg - ongoing depression, severe agitation, tingling scalp, fogginess, memory problems, gut still slower than normal

 

OTHER CURRENT MEDS

Multivitamin: Since early 2017 - 1 tablet, irregularly; since Sept - 1 tablet, daily

Motillium: Since late 2017 - 10mg, 3 times a day

Movicol: Since early 2017 - varied amounts daily

Ural: Since ~Sep 2020 - ~4 sachets a day

Electrolyte: Since Jul 2020 - ~1 tablet, irregularly

Vitamin C Powder: Last several years - ~1 teaspoon, irregularly

Coloxyl + Senna: Since ~Late Nov 2020 - ~2 tablets, irregularly

 

PREVIOUS MEDS (TAKEN BETWEEN 2017 AND 2018)

Ondansetron, metaclopramide, simethicone (also briefly in 2019), prochlorperazine, valium, fluoxetine, oxazepam, olanzapine, pregabalin, atenolol, perindopril

 

Thanks in advance for any help with this. I really appreciate what you do here.

Edited November 15, 2020 by Gridley

[Gridley]

Welcome to SA, soliDG.  Thanks for the helpful information and signature.

 

Looking at your history, it seems to me that the symptoms you mention, all of which are typical withdrawal symptoms, stem largely from you fast taper early in 2020.  How are you feeling now at 17mg?  If I'm reading your post correctly, you've been holding at that dose since May of this year, correct?

 

When the time comes for you to taper again--and when will depend on your answer to the question above--we recommend tapering by no more than 10% of your current dose every four weeks.  It's very good you're now using a compounding pharmacy.

 

Why taper by 10% of my dosage?

 

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

 

What is withdrawal syndrome.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

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.

 

Brain Remodelling 

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

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. Get supplements that are single ingredient (not mixed with other types of supplements).  We don't recommend multi-vitamins because if there's a problem, you won't know the cause.

 

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

 

 

 

 

[soliDg]

Hi Gridley, and thanks so much for all this information.

 

Yes, I’ve been holding at 17mg since May (with that missed dose exception). While the amitriptyline caused depression before tapering, a lot more problems happened after.

 

I have been awful on the 17mg - to the point of considering an emergency admission earlier on this year. Whilst I have learnt a few strategies for dealing with symptoms (thankfully), I have continued to have severe symptoms - significant depression (perhaps decreased since May) and agitation (increased since May).

 

The symptoms seem a lot more difficult to manage than what I experienced on 10mg.

[Gridley]

29 minutes ago, soliDg said:

and agitation (increased since May).

I'm sorry you're experiencing these increased symptoms.  Protracted withdrawal, which it appears you are in the midst of, will eventually fade and heal, but unfortunately there is no way to predict how long it will take.

 

 Consider the magnesium and omegas (one at a time and at a low dose) that I suggested earlier.

 

This restorative yoga pose is helpful for anxiety.

 

10 minute Restorative Yoga for Relaxation | Up the wall

 

[Mia1]

Hi,

Just read your posts. I’m coming off of Amitriptyline myself, am down from 50 mg to 9mg. I notice every time I decrease my heartbeat is irregular for about a week and I have increased anxiety. Does this happen with you?

[soliDg]

Hi Mia1,

 

Sorry to hear that you're having to deal with that, that sounds pretty rough. I personally haven't experienced those symptoms, but have read similar things on a Facebook Amitriptyline group.

[soliDg]

Hi, it’s now been 8 months on 17mg of amitriptyline. I continue to have many of the same severe side effects from this medication (depression and agitation), without sign of it going away. (I haven’t tried the magnesium or fish oil yet sorry, although I do take a multivitamin which is required for another condition).

 

Do I:

• go back up to 20mg (which is a LOT cheaper than compounded scripts)
• hold for longer and try supplements
• start tapering (I can drop 0.1mg every few days)

 

The side effects seem very serious at this point.

 

Thanks for any help.

[soliDg]

Well, that’s some ridiculously large text...! I’ll try to see if I can fix it when I’m back on my computer....

[Mia1]

I’m so sorry you’re going through this. Have you tried meditation? I’m also tapering Amitriptyline and found that a practice of meditation every morning has helped A LOT with my thoughts which had been affecting my mood. Sending you good vibes.

[ChessieCat]

  

1 hour ago, soliDg said:

I’ve been on 17mg of amitriptyline for 8 months now. I’m not confident that I’ve seen any change in side effects for months.

 

The symptoms (severe agitation, depression, brain fog amongst others) have had a significant impact on me, my finances, my safety, my health and my relationships, and I’m not convinced that waiting is helping any area of health other than my coping strategies.

 

What should I do?

 

A - go up to 20mg (my highest dose before decreasing to 10mg then 5mg, was more ‘stable’ but still caused some depression; also a LOT cheaper)

 

B - hold longer

 

C - start dropping (I can get 0.1mg or lower doses to make for smoother transitions)

 

D - ????

 

My body had a negative response to this drug prior to withdrawal - the original reduction of dose just seems to have added to the sensitisation. Because of this, and the significant lack of change for the last while, I’m not yet convinced that holding is the best idea.

 

Thanks for any help with this!

 

If nothing else has changed/happened (see below) that may have made things worse during this time then you could try a tiny reduction.    It  is really the only way to find out if you can start reducing.  This would be a test to see how reducing affects you.  If you reduce and things worsen a bit then that you know that is not the answer.  If you reduce and feel no worse or possibly feel a bit better then you can make a bit bigger reduction after about 2 weeks.

 

What other things have been going on during the 8 months.  Of course covid, riots and election.  How have these affected you?  Have you been sick, or had surgery?  Taken antibiotics, other new drugs (non psychiatric) other supplements (or stopped)?  Have you been drinking alcohol?  Any deaths or other stressful events (eg relationship breakdown, financial issues, moving).

 

If any of the above or similar have happened then possibly holding for longer might be the better option.

 

If you did decide to updose, then my suggestion would be only a very tiny amount.  Definitely NOT back to 20mg.  It is better to start with a small amount and increase gradually than to risk taking too much, which could make things a lot worse.  It takes about 4 days for a dose change to get to steady state/full level in the blood, and a bit longer for it to register in the brain.

 

Please update your drug signature when you make a change so that it remains current.

 

Please let us know what you decide to do and update us on how things go.

 

 

[Mia1]

How are you doing?