Spencer Low dose nortriptyline withdrawal.

[Spencer]

I was on low dose nortriyline for 3 .5 years for chronic pelvic pain and potential IC

Unknown to me i stopped the drug almost cold turkey without any knowledge of potential withdrawal

My symptoms have been daily nausea / general low energy and light headeness

My Dr said " impossible its withdrawal from that low dose and sent me for a battery of tests ( all normal)

Its been over a month and nothing eases the nausea ( the am its not bad but gets worse as the day progresses )

I have decided to reinstate the drug to see if symptoms ease up .. If positive I know what is really happening to me and will withdraw slowly

Questions: could this be withdrawal symptoms ? Any advise on how to taper ?

A bit overwhelmed

Thanks

[basildev]

Hi Spencer,

 

welcome to the forum.

 

Your symptoms absolutely do sound like withdrawal. Many people on this forum are sensitive to even the slightest changes in medication doses.

 

Most Doctors don't recognise withdrawal syndrome. Reinstating a small dose of the drug can sometimes help alleviate withdrawal symptoms

 

Please free to add your medication history in your signature. Here is a link about how to do that:

 

http://survivingantidepressants.org/index.php?/topic/893-please-put-your-withdrawal-history-in-your-signature/

 

An expert will be along very shortly to advise you about tapering.

 

In the meantime this information might help:

 

http://survivingantidepressants.org/index.php?/topic/1024-why-taper-by-10-of-my-dosage/

 

 

I wish you all the best.

[Spencer]

Thank you very much for your reply . I will wait for further information.

[Altostrata]

Welcome, Spencer.

 

What dosage of nortriptyline were you taking?

 

I put together this topic for you Tips for tapering off nortriptyline

[Spencer]

I am sorry that I did not mention dose

10ml once daily.

[Altostrata]

Do you mean 10mg or are you taking the liquid?

[Spencer]

10mg capsules.

[tezza]

Hi Spencer,

 

Welcome! I'm glad you found us! This is the best forum on the web, IMHO.

 

Alto is most knowledgeable about tapering and/or reinstating. I've followed her advice and been able to reduce several drugs and gotten much better at the same time.

 

Tezza

[Spencer]

Tezza

thanks for your comment ... I was not efficient in providing all the information needed I look forward to the follow up reply and I am encouraged by your progress.

stay well.

[Altostrata]

Still, even if it's 10mg, you're accustomed to it. For gradual tapering, you'll probably want to use a liquid.

[Spencer]

Its Spencer again , as I mentioned in my last replies I have added the 5mg back hoping for some relief however, I feel worse than I did when I was completly off the medication after going cold turkey . Can you feel worse reinstating a dose and I know it was suggested to consider 7.5 mg but of course I am overwhelmed thinking will it help or hinder .The other thought is that I was off completely should I have stayed and waited it out ? Sorry I am so confused and overwhelmed by what is happening /I feel so awful and of course two Dr's I have seen fail to even consider that what I am experiencing is real.

So do I taper or do I try to add more ? PS It was 7 days since I added the 5mg back / the nausea is strong headache, and hot and cold flashes.

Again , I am sorry for the repeated emails perhaps someone with a similiar experiance could give me some words of wisdom.

 

sincerely,

[Altostrata]

How have your symptoms changed since you added back 5mg?

[Spencer]

Yes, initially I felt a bit better for 2 days and since then I actually feel worse nausea and now headache that was only a bit of fuzziness prior to adding the 5mg.

that is why I am concerned ... should I add to 7.5 or try to go back off ?

thanks again for your support it's appreciated beyond.

 

spencer

[Altostrata]

I would try reducing to 4mg. You may have become sensitized to nortriptyline.

 

Please keep track of your daily symptom pattern and let us know how you do.

[Spencer]

I will try 4mg this evening and monitor symptoms thank you for your suggestion

Is there anything that helps with the nausea ? I cannot seem to find anything on site ?

I have tried ginger peppermint and pepto bismal to no avail

[areyouthere]

I found that keeping something simple and small in my stomach helps. A few saltine crackers whenever I just start to feel icky works for me. Get the unsalted ones at first. Hope things settle down for you soon. I think they will... just keep trying to be patient. You're doing a good job of listening, trying things and giving it a bit of time.

 

As Alto said, please keep track of your daily symptoms by writing them down. I have found patterns in my symptoms that I would not have noticed otherwise and have been able to " fix" them with simple lifestyle changes.

 

RU

[Spencer]

Dear Alto:

 

I reduced dosage last night to 4mg and woke up with a crashing headache and the nausea remains... I will stay the course for next few days however, I have a question in that I went cold turkey and wa s off the drug approx for 5 weeks reinstated the drug 5mg last Wednesday only.. if the small dose is not helping should I stop again if the symptoms increase before it builds back up in my system ? or do I need to taper regardless at this point. If so , would I need to follow the 10% for 4 weeks ?

If I felt a bit better the tappering would of made so much sense however, I just seem to be a bit confused as to ]best next steps . My husband is concerned and wondering why continue to take it if you feel worse.

I realize that I have asked many questions but I seem not to be following the norm in this whole matter and I am frightened by the way I am feeling 24/7 ?

I have no experiance what so ever with the process .

I will respect your time as well, but if you could help put this in a bit more perspective for me .. I do not want to go backwards.

 

thanking you immensely for your time and expertise

 

sincerely.

[Altostrata]

I would stay at 4mg for a week, it takes time for the dosage to reach steady-state. Track your symptoms.

 

If it reduces symptoms, you should stay there for at least a month or two, then taper by very small amounts.

[Spencer]

Hi there

 

I just wanted to reach out as I discontinued the 4mg on Friday night (22nd) ..... As I cannot blame anyone for this decision but I had pressure from my family to just stop ( they were worried and concerned and read that reinstatement after a month would not work ! I am very confused as you can clearly see.

Saturday and Sunday still had nausea but more tolerable today I think all the strength of the withdrawal is back ... Chills headaches and NAUSEA very bad.

I am so sorry I stopped again and I am embarrassed to write in again however , I feel some despair as not sure where to turn and more importantly what to do now .

 

Sincerely,

 

Spencer

 

Ps public health system in Canada .... So hard to find a Dr and if you do it's months for an appt !!

[Altostrata]

Reinstatement after a month might work, but you need to be consistent with the dosing to find out.

 

I hope your family is otherwise supportive and won't give you a hard time if you continue to have withdrawal symptoms after giving up on reinstatement.

[Spencer]

Thank you for your reply ... Given that I have stopped since Friday would it be suggested I try to reininstate again at 4mg ? How long does it usually take for the reinstatement to settle some of the symptoms . I had reinstated for 8 nights / i think I felt it wasn,t working

I am trusting this lack of confidence is part of what I am going through but I cannot express my appreciation for some guidance

My family is supportive just a bit overwhelmed along with me ... This is all pretty new to us

 

Sincerely

Spencer

[Altostrata]

This indicates the 4mg nortripyline was helping, as it sounds like your symptoms got worse after you dropped it:

Saturday and Sunday still had nausea but more tolerable today I think all the strength of the withdrawal is back ... Chills headaches and NAUSEA very bad.

I guess you can start taking it again. The half-life is pretty long.

 

There are no magic bullets for withdrawal syndrome. With reinstatement, you might get only a small alleviation of symptoms. You have to stick with it to see if it's going to help. Sometimes it takes 6 months or more.

[tezza]

Hi Spencer,

 

When you get a chance, please add your med info lie this:

 

http://survivingantidepressants.org/index.php?/topic/893-please-put-your-withdrawal-history-in-your-signature/

 

(Another member actually requested this, it's helpful to anyone reading your posts)