WibbleWibble Coming Off (and back on) Imipramine

[WibbleWibble]

I started with a low dose of Effexor about 10 years ago for depression and managed pretty well until early 2010 when 2 years of a hostile divorce and stressful work got on top of me.  I changed to 100mg Imipramine and started a long break from work as I remained fragile and thick-headed. Then, in Jan 2012, I had excruciating nose pain that was diagnosed as a neurological issue (Empty Nose Syndrome), effectively my brain latching on to damage caused 20 years before when I had my nose drilled out to size.  Alas,  6 months of 200mg Imipramine and 200mg Neurontin didn't cure me (50% success rate) so I've been on that for pain management.

 

Six months ago I was coping with life (but not working) but utterly fed up with the lethargy that made doing anything in to a struggle, a bit like carrying heavy blankets on my mind and shoulders, despite 100-200mg Provigil.  To a lesser degree I had brain fog, poor memory and ringing in my ears.  I therefore decided to see if coming off the Imipramine would help and began to taper down 6 months ago.  I reduced my dose from 200mg to 100mg over about 3 months, had a month on 100mg, then went down to 0 over the next 2 months, had a couple of weeks at 0 then started to reinstate some 2 weeks ago (now at 75mg) as I was suffering from potential side effects.

 

The health issues that I had over the taper period were as follows:

• Irritability
• Indigestion
• Dry cough
• Itching in my anus
• Restless legs, particularly in evenings
• Loss of co-ordination, particularly my legs tripping over things or my arms knocking over things that I knew were there.
• Muscle pain

All of these seem to have improved since I went back on Imipramine, albeit I'm wary of these things being in my mind (whether psychosomatic or like my nose pain).

 

I've spent days and days searching on the internet but remain as confused and undecided as ever.

[Petunia]

Hi WW,

 

Welcome to SA and thank you for posting an introduction.  I'm sorry about what you have been through, and are still dealing with.  I had never heard of Empty Nose Syndrome, so did a little research, it sounds like a difficult and uncomfortable condition to have, made worse by the fact that its caused by a medical procedure.

 

Both imipramine and neurontin can cause the side effects which you were getting and in combination there is an increased risk:

 

http://www.drugs.com/interactions-check.php?drug_list=1323-0,1147-677

 

imipramine ↔ gabapentin

Applies to: imipramine, Neurontin (gabapentin)

Using imipramine together with gabapentin may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

 

If they were not significantly helping with your pain, then it makes sense to stop taking them or at least lower the dose to decrease side effects, but as you have found out, its important to taper slowly as there is a risk of experiencing withdrawal symptoms. We suggest reducing by no more than 10% of the current dose every 4 weeks, this reduces the risk of withdrawal symptoms arising.  Please read through this post which will explain why:

 

http://survivinganti...0-of-my-dosage/

 

How are you feeling now that you are back on 75mg?

 

Are you still taking 200mg neurontin?

 

We don't give advice about taking medications, but can offer support for safely coming off medications which you are already taking, if that is something you want to do.  Perhaps by lowering the dose of your drugs, you may still get some benefit of pain relief, but decrease the side effects.

 

Please stay in touch and let us know what you decide to do, you will find a lot of friendly help and support here.

 

Petu.

[WibbleWibble]

Petu, thank you for words, they help a great deal.

 

I've now upped to 100mg Imipramine and intend to stay at that level for a while, say a couple of months, before I start looking at any tapering again.

 

In the meantime I'm looking to investigate different combinations of the Provigil, for example 100mg when I wake up and 50mg or 100mg at lunchtime.