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Fisher678 Help with nortriptyline


Fisher678

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Feeling miserable after only 11 days on nortriptyline 25 mg prescribed for neuropathy. I skipped 4 days out of the 11 because of side effects. 

From 2010 to 2013 I tapered slowly off cloneazepam, horrible experience but felt 90% recovered till May 2021 when I got 2nd Pfizer covid vaccination. A tingling sensation in my extremities emerged and I sensed a moderate return of my cloneazapam withdrawal symptoms from 9 years ago. So I saw a neurologist who prescribed 25mg nortriptyline, 1 capsule nightly. 

 

Now I feel very conflicted. Told neurologist I need to quit the nortriptyline, he advised take one pill every other night for a week and then discontinue. Seemed rather extreme to me so I sought a taper plan.

 

So now I am here looking for a reasonable escape route. My question is, considering I have only taken 8 capsules in the last 12 days, do I need to do a long taper per the 10% rule or might a more accellerated taper be reasonable??

 

 

 

#2 acetaminophen with codeine 2003 - present

Daily clonazepam 2005 - 2010

9 month taper, very rough

90% recovery 2012 to present

2nd Pfizer vaccine 5/1/21 - Triggered withdrawal symptoms

Nortriptilyne 25mg 9/3/2021 - 9/14/2021 for nerve pain, skipped 4 days

 

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Hi Fisher678, 

welcome to SA. 

 

we strongly advise against alternating doses as it can cause kindling - sensitivity and coming off of a benzo would have already made your system sensitive. An alternative to that would be to halve your doses but take them consistently. Skipping doses with any neuroactive drug can also increase sensitivity. 

 

It is up to you what to do now. You can choose to do the 10% taper like you did with the benzo and with which you are familiar but you seem to be having side effects.  

 

On the other hand, the longer you stay on the drug, the more adapted your system will become to it. 

 

If it were me, I would stop taking the drug now and deal with the withdrawal effects that emerge whatever they may be. Hopefully they will be short-lived. 

 

If you decide to stay on them longer, I would advise to dose consistently and if you are on them for a longer time period to then do a proper 10% taper. 

 

But in the end, we don't know any more than you do what will happen to you in either direction.

 

@Altostrata do you have different advice? 

 

Good luck, 

OMW

Edited by Onmyway

If you would like to get a response from me directly please type @Onmyway some place in your message so I get notified of your post. I am not able to follow all of the threads all the time.

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months (don't remember dates), trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax/day, then 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week, 

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/2719 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!)

Supplements: magnesium citrate and bi-glycinate

 

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@onmyway thanks, still wrestling with the options, all of them very concerning. 2 rocks and a hard place.

 

The alternating doses for a week and stopping option is out. My options now are:

 

1) quit now cold turkey and reinstate if absolutely necessary

2) rapid taper, 10% per week

3) proper 10% per month

 

This is my first experience with an antidepressant. Took me 2 years to mostly recover from the klonopin. I'm 73 years old now and not sure if I could survive the acute, protracted withdrawal I experienced after the klonopin.

 

In general, is antidepressant withdrawal similar, worse or better than benzo withdrawal?

 

#2 acetaminophen with codeine 2003 - present

Daily clonazepam 2005 - 2010

9 month taper, very rough

90% recovery 2012 to present

2nd Pfizer vaccine 5/1/21 - Triggered withdrawal symptoms

Nortriptilyne 25mg 9/3/2021 - 9/14/2021 for nerve pain, skipped 4 days

 

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  • Altostrata changed the title to Fisher678 Help with nortriptyline
  • Administrator
Altostrata

Hello, @Fisher678

 

On 9/14/2021 at 7:26 AM, Fisher678 said:

So now I am here looking for a reasonable escape route. My question is, considering I have only taken 8 capsules in the last 12 days, do I need to do a long taper per the 10% rule or might a more accellerated taper be reasonable??

 

Yes, after such a short amount of time, you can simply quit. Suggest you advise your prescriber that adverse effects tend to be dosage-related, this dosage may be too high for you.

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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Thank you @Altostrata 

 

I stopped last night but I understand that nortriptyline has a long half life so it may be another day or two before the the wd symptoms really kick in. Gulp.

#2 acetaminophen with codeine 2003 - present

Daily clonazepam 2005 - 2010

9 month taper, very rough

90% recovery 2012 to present

2nd Pfizer vaccine 5/1/21 - Triggered withdrawal symptoms

Nortriptilyne 25mg 9/3/2021 - 9/14/2021 for nerve pain, skipped 4 days

 

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  • Administrator
Altostrata

It is not likely you will have severe symptoms. If you have mild symptoms, they probably will pass in a few days.

 

Please let us know how you're doing.

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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I tried to just quit for the second time this month, made it 3 days each time. Had to reinstate last night at 10mg instead of 25mg beacuse the anxiety, brain zaps, muscle twitches and insomnia became overwhelming. I will try to stay at 10mg for a week in hope that I can get at least partial symptomatic relief and then consider a proper 10% taper.

 

All of my symptoms are anxiety related. I am not now suffering and never have suffered from clinical depression. The symptoms that emerged 4 months ago, after my 2nd vaccination, are EXACTLY the same as when I was undergoing protracted withdrawal from Klonopin 10 years ago which was prescribed to me 15 years ago as a "sleep aid" (had no anxiety or psychosis before then).

 

I am loathe to do it but desperation is making me consider going back on another benzo. I will however give the lower dosage nortriptyline a chance to stabilize me before doing so. 

 

Thanks for your continued support!

#2 acetaminophen with codeine 2003 - present

Daily clonazepam 2005 - 2010

9 month taper, very rough

90% recovery 2012 to present

2nd Pfizer vaccine 5/1/21 - Triggered withdrawal symptoms

Nortriptilyne 25mg 9/3/2021 - 9/14/2021 for nerve pain, skipped 4 days

 

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17 hours ago, Altostrata said:

It is not likely you will have severe symptoms. If you have mild symptoms, they probably will pass in a few days.

 

Please let us know how you're doing.

 

Just now, Fisher678 said:

I tried to just quit for the second time this month, made it 3 days each time. Had to reinstate last night at 10mg instead of 25mg beacuse the anxiety, brain zaps, muscle twitches and insomnia became overwhelming. I will try to stay at 10mg for a week in hope that I can get at least partial symptomatic relief and then consider a proper 10% taper.

 

All of my symptoms are anxiety related. I am not now suffering and never have suffered from clinical depression. The symptoms that emerged 4 months ago, after my 2nd vaccination, are EXACTLY the same as when I was undergoing protracted withdrawal from Klonopin 10 years ago which was prescribed to me 15 years ago as a "sleep aid" (had no anxiety or psychosis before then).

 

I am loathe to do it but desperation is making me consider going back on another benzo. I will however give the lower dosage nortriptyline a chance to stabilize me before doing so. 

 

Thanks for your continued support!

 

#2 acetaminophen with codeine 2003 - present

Daily clonazepam 2005 - 2010

9 month taper, very rough

90% recovery 2012 to present

2nd Pfizer vaccine 5/1/21 - Triggered withdrawal symptoms

Nortriptilyne 25mg 9/3/2021 - 9/14/2021 for nerve pain, skipped 4 days

 

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  • Administrator
Altostrata
5 hours ago, Fisher678 said:

I will try to stay at 10mg for a week in hope that I can get at least partial symptomatic relief and then consider a proper 10% taper.

 

This is a good idea. It appears that your nervous system has adapted to the drug in an unusually short amount of time.

 

If I were you, I'd stay at 10mg for at least 2 weeks. Make sure any withdrawal-related symptoms are well past.

 

Please let us know how you're doing.

 

5 hours ago, Fisher678 said:

All of my symptoms are anxiety related. I am not now suffering and never have suffered from clinical depression.

 

Most withdrawal symptoms are often mistaken for anxiety.

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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Tried to CT after 3 days because of side effects, did not work. Reinstated at lower dose, did not work, so just several days ago I reinstated at original dose 25mg. Now high anxiety and insomnia has turned into panic attacks and over-the-top anxiety. I don't know if this part of my vaccine reaction, side effects (or kindling) from nortriptyline or a drug interaction from my long term use of tylenol with codeine.

 

Almost went to ER but afraid they might give me a benzo from which I had an awful protracted withdrawal after tapering 10 years ago.

 

So I am looking for advice. Should I give the reinstatement more time to work or accept the fact that I may need a new benzo?

 

Thank you in advance!

#2 acetaminophen with codeine 2003 - present

Daily clonazepam 2005 - 2010

9 month taper, very rough

90% recovery 2012 to present

2nd Pfizer vaccine 5/1/21 - Triggered withdrawal symptoms

Nortriptilyne 25mg 9/3/2021 - 9/14/2021 for nerve pain, skipped 4 days

 

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