blueberry0: Tapering Nortriptyline ...trying.

[blueberry0]

Hi all,

I am new to this website and I wanted to say a few words about what I am going through.

I was put on Nortriptyline 50 mg and Venlafaxine 37.5 mg for vestibular migraine. Actually first nortriptyline with no success for my vestibular migraine. Instead of weaning off at the time the DR kept me on both medication so finally I decided in 2020 that I wanted to get off the nortriptyline.

The first 10 mg was fine, then some restless legs symptoms but got through it till managing to get to 25 mg. Then hell. 

I found a pharmacy that custom made my doses to allow me to drop 1 mg at the time (no liquid version where I live). 

I am currently on 17 mg with horrible stomach issues. ( I dropped 2 mg last month).

I have no support from my neurologist so that is why I am here.

I will follow the advise of 10% per month (or less), just hoping that all this stomach issues will subside, it's so hard!!

 

Edited May 2, 2021 by Gridley

[Gridley]

44 minutes ago, blueberry0 said:

I will follow the advise of 10% per month (or less), just hoping that all this stomach issues will subside, it's so hard!!

 

Welcome to SA, blueberry0.

 

It is better to taper by percentage (10% of current dose every four weeks) rather than a linear taper of 1%.  With a percentage taper, your reduction gets smaller and smaller as you go lower in dose, which is easier on your system.  With a straight 1mg taper,  your reduction gets larger and larger as you go lower, which is opposite of what you want.  This is especially important when you get to the low doses below 10mg.

 

Since you're having your doses compounded, there should be no problem is getting 10% doses.  To arrive at a 10% reduction, multiply your current dose by 0.9.  So your next dose would be 17mg X 0.9.

 

The reason we suggest an exponential taper (cutting the dose by smaller amounts as we taper) is because there is a high rate of receptor occupancy at low doses of the drug.  That is to say, even on low doses of the drug, it is still having a major effect on the brain.  Please see this link: 

 

SERT Transporter Occupancy Studies

 

Is there a reason why you chose to taper the Nortriptyline first rather than the Effexor?  When did the stomach issues start?  Did they stat when you added the Effexor?

 

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).

 

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

[blueberry0]

Hi Thank you for your reply.

The reason I am tapering the nortriptyline is because actually the venlafaxine help a lot with my symptoms and i am a little scared to stop it and get my symptoms back so it's not for now.

The stomach pain started last month. I also had them last year when I went from 25 to 20 (failed attempt).

Thank you for the advise on the 10% and get my dose non linear will definitely look if they would alter my compound

[blueberry0]

oh gosh! after reading in the website I think I just realised that the cause of my dizziness (since 2016) is because i stopped a medication containing and SSRI

[blueberry0]

Hello

I have been taking Effexor XR 37.5 and nortriptyline 50 mg (currently on 16 mg) since 2016 for vestibular migraine (wrong diagnose).

Anyway I have been tapering nortriptyline since January 2020 and having GI problems at low doses so tapering very slow.

 

My end goal is to taper both meds.

 

My question is: at this point is it better, due to the short half life of venlafaxine, to taper first effexor and then the remaining nortriptyline or shall I finish tapering the nortriptyline first?

Second question: is there a protocol to follow for tapering effexor ? I was thinking of counting beads but not all capsules have the same number of beads, how do you get around that?

 

thanks for your help

[getofflex]

Previous post moved to your intro topic to keep your history all in one place.  Please post questions and discussion about your situation in this one thread, to avoid confusion and duplication of efforts.  Thank you.  

[blueberry0]

Hi all,

maybe someone can help. One week ago I had the covid jab and reacted quite badly to it. I now have myoclonus (spasm of the legs muscles) 

Could it be that it's something to do with the jab interacting with the antidepressants?