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alternating tapers from different drugs


watercolor8

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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?

Currently prescribed by neurologist for Akathisia:

August, 2020: 120 mg Propranalol (3 divided doses of 40 mg)

August, 2020: 7.5 mg Zolpidem (Ambien) 3 x day (tapered from 30 mg Dec, 2020-Feb, 2021)

Sept, 2020: 600 mg Gabapentin (3 divided doses 200 mg ea)

Sept, 2020: 1.25 mg Clonazpam divided doses ( .5 night, .5 noon, .25 6 pm)

Nov, 2020:  22.5 mg Mirtazapine (Remeron) 9:30-10pm

Previously-Fast 2 month taper off  Cymbalta Spring, 2020 due to Tardive Dyskinesia

Akathisia began Summer, 2020

Neurologist had me stop other medications abruptly (Clonazepam, Doxycycline, prednisone)

Began with propranalol August, 2020 and meds increased through Fall, 2020 to above current dose.

Thinking I should continue taper zolpidem first, as this would be the drug removed if I had to be hospitalized, don't know how to reduce it past just breaking the tablets. (I can't find specific info on dry or liquid taper for zolpidem.)

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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.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Rhiannon
Posted (edited)
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 by Rhiannon

Started on Prozac and Xanax in 1992 for PTSD after an assault. One drug led to more, the usual story. Got sicker and sicker, but believed I needed the drugs for my "underlying disease". Long story...lost everything. Life savings, home, physical and mental health, relationships, friendships, ability to work, everything. Amitryptiline, Prozac, bupropion, buspirone, flurazepam, diazepam, alprazolam, Paxil, citalopram, lamotrigine, gabapentin...probably more I've forgotten. 

Started multidrug taper in Feb 2010.  Doing a very slow microtaper, down to low doses now and feeling SO much better, getting my old personality and my brain back! Able to work full time, have a full social life, and cope with stress better than ever. Not perfect, but much better. After 23 lost years. Big Pharma has a lot to answer for. And "medicine for profit" is just not a great idea.

 

Feb 15 2010:  300 mg Neurontin  200 Lamictal   10 Celexa      0.65 Xanax   and 5 mg Ambien 

Feb 10 2014:   62 Lamictal    1.1 Celexa         0.135 Xanax    1.8 Valium

Feb 10 2015:   50 Lamictal      0.875 Celexa    0.11 Xanax      1.5 Valium

Feb 15 2016:   47.5 Lamictal   0.75 Celexa      0.0875 Xanax    1.42 Valium    

2/12/20             12                       0.045               0.007                   1 

May 2021            7                       0.01                  0.0037                   1

 

I'm not a doctor. Any advice I give is just my civilian opinion.

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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)

Currently prescribed by neurologist for Akathisia:

August, 2020: 120 mg Propranalol (3 divided doses of 40 mg)

August, 2020: 7.5 mg Zolpidem (Ambien) 3 x day (tapered from 30 mg Dec, 2020-Feb, 2021)

Sept, 2020: 600 mg Gabapentin (3 divided doses 200 mg ea)

Sept, 2020: 1.25 mg Clonazpam divided doses ( .5 night, .5 noon, .25 6 pm)

Nov, 2020:  22.5 mg Mirtazapine (Remeron) 9:30-10pm

Previously-Fast 2 month taper off  Cymbalta Spring, 2020 due to Tardive Dyskinesia

Akathisia began Summer, 2020

Neurologist had me stop other medications abruptly (Clonazepam, Doxycycline, prednisone)

Began with propranalol August, 2020 and meds increased through Fall, 2020 to above current dose.

Thinking I should continue taper zolpidem first, as this would be the drug removed if I had to be hospitalized, don't know how to reduce it past just breaking the tablets. (I can't find specific info on dry or liquid taper for zolpidem.)

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Altostrata

See   

 

 

 

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • 3 weeks later...

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

1995 started Paxil 20mg slowly increasing to 50mg until 2014

-2014 I decided to tapper myself not knowing how too and crashed , DR added 50mg Seraquel

-2015 tried tapering again and crashed

Seroquel Taper

2/11/16 43mg  1/09/17  37.5mg  10/03/10 36.25mg. 17/3/19 35mg 26/3/19 33.75mg  4/4/19 32.5mg  21/4/19 30mg

16/7/19 28.75mg  5/8/19 27.5mg. 19/8/19 25mg   4/8/20 23mg 18/8/20 22.5mg  12/10/20 18.25mg  10/1/21 15mg  3/8/21 UPDOSE 16mg

Paxil Taper

2/11/16 40mg 12/10/17 37mg  28/10/17 36mg  10/1/18. 35mg  24/05/18 33mg  28/8/18 31mg 16/12/18 30mg 20/10/19 29mg  17/11/19 28mg 7/1/20  27mg 12/2/20  26mg 7/3 /20 25mg  11/4/20 24mg 4/5/20 23mg  5/6/20 22mg 23/6/20 21mg 15/7/20 20mg

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