alternating tapers from different drugs

[watercolor8]

I was put on multiple drugs last summer for akathisia. (30 mg zolpidem, divided doses; 600 mg gabapentin, 80 mg propranolol, 22.5 mirtazapine, 1.5 mg clonazepam) last winter I tapered a little fast to get the zolpidem down to 20 mg. Last taper was in February. Akathisia still horrific. Wondering if there’s an advantage to reduce drugs by slow taper, rather than completely taper off each one fully. Starting with one (which one??!) tapering down, holding, then tapering a different one. Could that give me an idea if one particular med is making the akathisia worse? Do I have to completely taper off one at a time, or can I slowly alternate?

[Altostrata]

@watercolor8, one may rotate gradually tapering among your different drugs. The safest way is to reduce one at a time and observe for a month to make sure you're clear of withdrawal symptoms from that one drug before carefully reducing the next.

 

This is especially helpful if you have 2 drugs that are interdependent and both are causing adverse effects. For example, if you're taking clonazepam because escitalopram gives you insomnia, but the clonazepam makes you dopey, you might gradually reduce the clonazepam to a level that maintains sleep but is not as impairing.

 

Then you might reduce the escitalopram part way until you feel the clonazepam becomes too sedating again, not having the stimulation from the escitalopram to counteract the dopiness. That would be a sign to carefully reduce the clonazepam again. And so forth.

 

However, there are a lot of factors and what you should do personally with your drug cocktail is best discussed in your Introductions topic, where we might refer to your earlier posts.

[Rhiannon]

On 6/20/2021 at 4:31 PM, Altostrata said:

@watercolor8, one may rotate gradually tapering among your different drugs. The safest way is to reduce one at a time and observe for a month to make sure you're clear of withdrawal symptoms from that one drug before carefully reducing the next.

 

This is especially helpful if you have 2 drugs that are interdependent and both are causing adverse effects. For example, if you're taking clonazepam because escitalopram gives you insomnia, but the clonazepam makes you dopey, you might gradually reduce the clonazepam to a level that maintains sleep but is not as impairing.

 

Then you might reduce the escitalopram part way until you feel the clonazepam becomes too sedating again, not having the stimulation from the escitalopram to counteract the dopiness. That would be a sign to carefully reduce the clonazepam again. And so forth.

 

However, there are a lot of factors and what you should do personally with your drug cocktail is best discussed in your Introductions topic, where we might refer to your earlier posts.

This is actually how I have mostly done my own multi-drug taper, with short periods of focusing on one or another of them, holding to make sure I'm pretty stable, then holding that one and going to a different one for a few cuts.

Edited June 22, 2021 by Rhiannon

[watercolor8]

but how much water do I need to add to say a 5 mg tablet ( my total zolpidem is 20 mg, so I guess for 10% I would be reducing 2 mg, which is less than 1/2 tablet, and it won’t cut evenly)

[Altostrata]

See   

 

 

 

[Cheeky]

I started my taper going from 50mg Seraqul to 25mg then I started my   Paxil and went from 40mg to 20mg and all was good, had withdrawal symptoms but could handle them, I then started the Seraquel from 25mg to 15mg and my last drop has been really tough. Once Im stable should I continue the Paxil tapper @Rhiannon