Robynne: tapering Neulactil

[Robynne]

Yes I will Thankyou for helping ! Ill take my half now but I’m worried 

[ChessieCat]

3 minutes ago, Robynne said:

but I’m worried 

 

That's understandable.  Just try to relax and get through the discomfort that you are currently experiencing.

[Robynne]

16 hours ago, ChessieCat said:

 

That's understandable.  Just try to relax and get through the discomfort that you are currently experiencing.

Got through the night ! Tried to not take the sleeping pill but I gave up at midnight, bugger! I took my second 1/2 this morning at 6am I think I feel better than this time yesterday my husband  took me For a walk and I feel ok.  I only have the anxiety feeling in my stomach but not as drastic. I’ll push on today and do what you suggest and take 1/4 tonight at same time as last night and I’m writing everything down too. Your support is unbelievable 

[ChessieCat]

Oh I am so pleased to read that.  It is great news.  Thank you very much for letting me know that you do feel some improvement.

 

Don't beat yourself up over taking a sleeping tablet.  You did what you had to do to get through a really rough time.  Sleep is very important but you don't want to cause another problem.

 

So I would caution against taking it again tonight "just in case" - you have to watch out for anticipatory anxiety.  If you do get desperate would it be possible to take half a dose instead?

[Robynne]

I’ll try the night without a sleeping pill then yep a half a tablet , sleep has always been a problem. I’m am thinking I feel better today as in theory I’ve had a whole tablet with the 2 halves but I really do appreciate feeling better today. 

[ChessieCat]

It would be better to stick with the 1/2 + 1/4 tablet for a week at least to see how things go.

 

Please try to keep other things consistent and additional things to an absolute minimum because you don't want too many variables.

 

I'm writing my thoughts here whilst I have it clear in my head.  That will save me having to try to remember what's happened up until now and what might be the next steps.

 

Then if there are still issues after 1 week, try 1/4 + 1/4 + 1/4.

 

As a last resort after a week on 3 doses a day, a small updose.

[Robynne]

Ok ! I’ll keep at it! It’s given me hope feeling better today I’ll keep taking anti nausea every 8 hours as the doctor wanted me too 

[ChessieCat]

41 minutes ago, Robynne said:

anti nausea

 

I suggest that you do some research on this before stopping it.  I cannot remember what the name of it was.  It might need/be better to taper it, possibly not as slowly as other drugs, but it will depend on how it works.

[Robynne]

Emexlon I think it’s known as maxilon I’ve only been taking it for 3 days at this stage and doctor said only fir 5 days 

[ChessieCat]

If it was me I would be trying to stop taking it Maxolon as soon as possible:

 

From:  https://pubchem.ncbi.nlm.nih.gov/compound/Metoclopramide-hydrochloride

 

A dopamine D2 antagonist that is used as an antiemetic.

 

This means that it affects the brain.

 

You might find that now that you have changed your dosing regimen (remember you were alternating days so getting extreme interdose withdrawal), that you might not need it.

 

You could try missing the next dose and see how you feel.

[ChessieCat]

If you stay Maxolon for 1 week then you will most likely need to do a fast taper off it, not an abrupt stop.

[Robynne]

I’ve already skipped todays dose so I’ll keep going and miss the next one too! 

[ChessieCat]

Oh that's good.  Hopefully you won't need it any more.  It just goes to show that we need to be vigilant and do our own research.

[Robynne]

You certainly are guiding me ! I just get confused so much when a doctor that is seemingly very caring can give out prescriptions and I just take them so willingly. I’m still ok by the way not perfect but better than yesterday 

[ChessieCat]

I've learned by experience not just from SA but from other personal experiences with the medical profession.

 

That's good that you are noticing the improvement.

 

Just remember that your next dose will be 1/4 tablet tonight and then 1/2 tablet in the morning.  You might notice a worsening before taking the morning tablet until it kicks in (remember the half life 6-7 hours), so be prepared to not panic and remind yourself that your brain is still adapting to the new dosing.

 

It's important to try not to panic and understanding what is happening can help with that otherwise we can make bad decisions.

[Robynne]

Yes im Starting to feel yuk again as it’s been over 8 hours now since my half a tablet at least I ate a good lunch today. I’m going to go for a walk as it’s 31/2 hours before I can take my 1/4 tablet. It is easy to panic I agree, I feel I won’t get off it but I try to talk my head into bring positive 

[ChessieCat]

Wow, that's not good.  At least we know what is happening.

 

Perhaps take 1/4 now and then 1/4 as late as possible tonight and then start on 1/4 x 3 tomorrow.

 

[ChessieCat]

I'm thinking that it would be better to keep take extra periciazine than to take other stuff.

[ChessieCat]

But I wouldn't deliberately stay up late to take the dose.  If you are ready to go to bed then take the next 1/4 tablet.

[ChessieCat]

2 minutes ago, ChessieCat said:

I'm thinking that it would be better to keep take extra periciazine than to take other stuff.

 

Should read better to take extra periciazine

[Robynne]

I think I can tough this out I’m going to have a tea and my husband going to light an outside fire id like yo try the 1/4 tablet at 6.30 then see if I can get through the night until half a tablet in the morning 

[Robynne]

If I struggle during the night I’ll take another 1/4 

[Robynne]

I’ve taken so much on board you have told me the big one is to relax and not panic, I’m very lucky my husband so supportive and my adult family and there partners all being  positive. I do fear tommorrow all the time but at the moment I’m ok 

[Robynne]

I’ve got good and bad to  report. I didn’t take sleeping pill but sleep wouldn’t come to me so I took a phenergan at about 1am 🤷🏼‍♀️I got to sleep and woke at 5.30 am so I took my half tablet neaulactilI,felt nauseas at 7.30 so took a maxilon. I’m mad with myself for not bearing up to the nausea and the Sleep problem  but I’m ok now.  The positive is I hadn’t taken a maxilon for 28 hours and my aim is to not take them .Sleep is a big issue with me as the neaulactil has been putting me to sleep for years without it or less a tablet keeps me awake and I panic in the middle of the night, damm!! I’m actually feeling ok now so that’s good. I do think the half in the morning is keeping me more stable and I reckon the nausea was me being be very tired 

[ChessieCat]

I hope today is better for you.

[Robynne]

StArting to feel crap again 🥲I’m starting to think about giving up it’s been 6 weeks and I’m driving myself mad and whole family. I was hopeful today but I can’t seem to drop even to this 3/4 tablet it’s crazy 

[ChessieCat]

It might not be the periciazine causing the issues.  You might still be recovering from having taken and/or stopped the mirtazapine.  And if you took the Maxolon for a few days in a row and then stopped that then it might be caused by that.  Or a combination of both.

 

When there has been more than one variable (change, taking/stopping something) it can be difficult to work out the cause.

 

For many psychiatric drugs it takes about 4 days for a dose to get to full level in the blood and a bit longer for it to register in the brain.

 

The best suggestion that I can think of is to stick to taking the periciazine at set times.  The aim is to get that set up to be consistent and then once that is done then it might be easier to see if there is something else causing things.

 

Please understand that every time you change something then it means you cannot tell if the regular dosing of the periciazine is helping.

[ChessieCat]

Please add when you first started periciazine to your drug signature.  The way it reads at the moment it looks like you only started it in June this year.

 

Thanks.

[Robynne]

19 minutes ago, ChessieCat said:

Please add when you first started periciazine to your drug signature.  The way it reads at the moment it looks like you only started it in June this year.

 

Thanks.

Ok! I’m going to keep taking periciazine at same time I’ve got it written Down in my

Notes. I’m presently trying to figure out how to change my signature I’m floundering around on the website ? Mind you I can’t even remember when I started taking them maybe 6 years ago with an effort to give up last year 

[ChessieCat]

This goes straight to your signature and remember to click SAVE:

 

Account Settings – Create or Edit a signature

[Robynne]

I’ve just read my notes and yesterday I forgot to take my nexium. Today I did, I’m going to skip it tommorrow and eliminate that. You’d notes have  brfn good to read back on as I can’t seem to think clearly.

[ChessieCat]

18 minutes ago, Robynne said:

I forgot to take my nexium.

 

Depending on how long you have been taking that for you might need to taper it.

 

tips-for-tapering-off-stomach-acid-blockers-or-ppis-esomeprazole-lansoprazole-omeprazole

 

I don't have any experience with it but the above topic might be helpful.

 

[Robynne]

Still not feeling great ! The stomach pulling feeling has gone really believe it was the nexium. But nausea is my biggest problem I have times mainly afternoon when I feel better. Still taking 1/4 in evening 1/2 at 6am. Woke every 2 hours with nausea.I’ve been trying not to report to you so much I’ve got to figure this out. 

[ChessieCat]

It's good that you have noticed something improving.  Just remember that you are still in the early stage of getting your dosing regular.

 

When posting an update please list what other drugs/supplements and the dose and time that you took them.

 

8 minutes ago, Robynne said:

Woke every 2 hours with nausea.

 

10 minutes ago, Robynne said:

I have times mainly afternoon when I feel better.

 

Keep an eye on this for a pattern.  One instance doesn't make a pattern but if the same thing happens two days in a row then it is a bit more evidence. 

 

Obviously the aim is stop this from happening.  If it was me I would be changing to 1/4 tablet 3x a day.  If you want to do that today then you would have to take 1/4 tablet middle of the day and then 1/4 tablet tonight but you would then go to 1/4 tablet 3x a day from tomorrow.  It's up to you to decide if you want to increase the dose for 1 day.

 

These are the times that I am thinking might be good to start with:

 

6am, 1pm and 8pm - that is 7 hours apart and because you feel better in the afternoon, hopefully the 1pm would help for the early part of the night and the 8pm would help with the morning part of the night.

 

Your aim is to get off the drug so I think increasing to a full tablet every day should be the very last resort.

 

I'm writing all my thoughts down for you so that you can see the reasons for why I am suggesting things.

[Robynne]

I’ll see how today pans out might start the 3  doses from 8 pm I seem to be managing nausea as it comes and goes I’ve stopped the maxilon but took half dose sleeping pill last night. I’ll try to cease that tonight. I’ve had a good think and at the moment the only reason I want to go back to full dose is to stop the nausea and To sleep so that seems stupid when there’s so many side effects with this drug. I’ve got to push on, I’ve also wondered if maybe cutting the tablet is effecting my stomach lining , just a thought 

[ChessieCat]

It's important to maintain sleep.  Sleep is restorative and things feel so much worse and harder to cope with when sleep is reduced.

 

The idea is to keep the additional things to an absolute minimum and only as absolutely necessary.  So taking 1/2 sleeping pill was better than taking a whole one.

 

I'll see what I can find out about the effects of cutting the tablet.

 

Have you been on any other forums (eg breastfeeding) and seen anything there about how to taper?  I'm assuming that they would only be skipping days/doses.