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About reinstating and stabilizing to reduce withdrawal symptoms

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thecowisback

it looks like the first site has gone but i'll have a look at the other one - thankyou ☺

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Altostrata

Please discuss your own personal reinstatement issues in your Introductions topic, @thecowisback

 

Your chart is remarkable, @Lloyd. Is there another column where you identified the member? That would have been helpful for follow-up.

 

 

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Lloyd
19 minutes ago, Altostrata said:

Please discuss your own personal reinstatement issues in your Introductions topic, @thecowisback

 

Your chart is remarkable, @Lloyd. Is there another column where you identified the member? That would have been helpful for follow-up.

 

 

Hi Alto, sorry didn't include the members names in the spreadsheet.

 

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Altostrata

Can you identify and add them?

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Lloyd
2 hours ago, Altostrata said:

Please discuss your own personal reinstatement issues in your Introductions topic, @thecowisback

 

Your chart is remarkable, @Lloyd. Is there another column where you identified the member? That would have been helpful for follow-up.

 

 

 

 

Here you go 😃

 

SADrugReinstatement.xlsx

 

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DavidfromTexas

Is it possible to reinstate with a different drug than the original one?

If so, that seems it would be a better alternative than having to deal with dividing up beads of Cymbalta, where the beads may be designed differently even though they look the same. 

A different drug might be able to be sized down easier, or may come in much smaller doses in the first place. 

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Kittygiggles

@DavidfromTexas You've probably thought of it or considered it in the past but if you're facing difficulty trusting your dosages now, it could be a time to reconsider water titration as a method of reducing your dose accurately:

However, I am not sure if Cymbalta dissolves in water very well; if it does then the difference in bead composition would no longer be an issue. I used water titration with Prozac/fluoxetine and the contents of the capsules dissolved perfectly, although it was a powder inside, not beads. 

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ChessieCat
1 hour ago, DavidfromTexas said:

Is it possible to reinstate with a different drug than the original one?

If so, that seems it would be a better alternative than having to deal with dividing up beads of Cymbalta, where the beads may be designed differently even though they look the same. 

A different drug might be able to be sized down easier, or may come in much smaller doses in the first place. 

 

the-prozac-switch-or-bridging-with-prozac

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ChessieCat
1 hour ago, Kittygiggles said:

However, I am not sure if Cymbalta dissolves in water very well; if it does then the difference in bead composition would no longer be an issue.

 

On 5/7/2011 at 5:26 AM, Altostrata said:

 

Cymbalta is tricky to taper. It does not come in liquid form and cannot be compounded into a liquid. To protect the drug, each bead inside the gelatin capsule has an enteric coating to protect the drug from stomach acid, which would destroy the drug. (It is absorbed further down in the digestive tract.) The pellets cannot be dissolved in any liquid without destroying the active ingredient.

 

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Kittygiggles

I'm sorry, I had no idea, forgive my ignorance about this. That's so unfortunate for those on Cymbalta. Hopefully bridging will work out, if you decide to try it. 

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Rhiannon

Just FYI to add to the total information on this subject:  I tapered very slowly off citalopram but took the last bit from about 0.3 mg down pretty fast, and jumped off at 0.1 mg in early June 2019. Had no acute symptoms, but got hit with the 3-month delayed withdrawal in August. I reinstated to 0.05 mg about the last week of August. It's 10/3/19 today and I am feeling much better. My sleep is still not quite back to normal but everything else is good.

 

So in my case, a reinstatement a little over three months out, to half the dose I stopped off at, after what was mostly a very slow taper but went a little too fast at the end -- I would say it has been successful.

 

Hope this helps somebody.

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mdwstrx
1 hour ago, Rhiannon said:

after what was mostly a very slow taper but went a little too fast at the end

 

Thank you for your  update.  I'm happy to hear you're feeling better! 🌞

 It does concern me that after a slow taper to 0.1 mg, you had the 3 month delayed w/d.

 Isn't that a good point to stop?  I've not read about others doing a proper taper and having to reinstate,

though I guess it happens.  Not good news for us if it does often.  I wonder what makes a difference

between successful and unsuccessful slow tapers?  

 

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Lostboytravles
On 2/12/2019 at 12:00 AM, Lloyd said:

Hi All,

 

Was trying to get an overall idea of how reinstatement worked for people who had posted their stories in this thread. I have compiled a spreadsheet (attached) which details all the user experiences shared in this thread in hopefully an easy to read quick view.

Some of the feedback was a little hard to gather exact details from, however you should be able to at a glance see how many people reported success with reinstatement and the time windows reported.

Hope this helps 😃

 

Edit: I should add that the majority of user experiences reported an improvement in symptoms after reinstatement.

 

image.thumb.png.e3316128fdd680727dd308477fa55050.png

Wow, thanks so much.  Always amazed at the work people put into this site.  My depressed mind was definitely fixating on all the negative experiences in this thread. Looking at that spreadsheet, the results from Lexapro RI are actually quite positive.  I never would have reached that conclusion on my own.

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Snorky

My questions are:

 

What happens if reinstatement failed (for whatever reason?

 

What then happens if ongoing WD or deferred adverse effects become utterly unbearable?

 

Thank you.

 

 

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Altostrata

We want to see what happens with reinstatement first. Plan B is different for everyone.

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pinciukas

Guys please help me I am tapering from Seroxat 20 mg I am now on 5 mg but WD symptoms hited me 2 months ago and persist until now. Anxiety mild agoraphobia micro panic attacks ( I am glad that insomnia disappeared) what should I do? Can I rise dose to 6-7 mg or higher? Now I am just using 1.5 mg Lexotan if I feel bad but I don't want to make a habit from it. 

 

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thecowisback

how long do people usually go between upping doses during reinstatement? do they increase after a week to ten days or wait a little longer for the effects of the drug to kick in? 

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Gridley
2 hours ago, thecowisback said:

do they increase after a week to ten days or wait a little longer for the effects of the drug to kick in? 

Yes, wait around a week to ten days for the new dosage to reach full state in the blood. During this time there should be some gradual improvement as the days pass.   If there has been improvement, hold there to see how that dosage over the following weeks.  If after ten day there has been no improvement and symptoms remain intolerable, you can increase by a very small amount, like 1mg.

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thecowisback

Thankyou :) 

 

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thecowisback

what is the best thing to do if symptoms worsen after increasing the dose? is it better to drop back to the previous dose or carry on at the new dose?

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Sleepan

I hope a veteran member answered you already to know if you can reduce a dose that you just increased and feels like it is too strong.  I'm new here.  I just started a reinstatement 5 weeks ago with higher dose instead of the lowest dose.  I made a big change by splitting the dose in 2, one am and one pm.  One day, I increased the total dose from 25mg total to 30mg and I freaked out.  I reduced it the next day and it worked for me.  I wish I had started on the lowest dose possible as recommended here in this forum, but I just found SA last week.  I had a problem reducing it by 10% taking it from the am dose, and I had new scary symptoms such as a tremor for few seconds and insomnia again.  What helped me today is finding a French video by Dr. Christophe André who really helped me to learn how to meditate.  It worked so well that listening to some after lunch, I wanted to sleep and did for 3hrs.  I really know now how to meditate.  Do you meditate yourself?  And keep me updated if you find an answer to your question or if not, what you did and how it worked for you.  

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thecowisback

thankyou . i've tried mediation many times in the past but i've never been able to grasp it properly. 

i'm still on the higher dose and wondering what to do for the best. 

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Sleepan

@thecowisback  I hope you will get an answer soon as to know if you can reduce the higher dose.  You are trying to reinstate again Prozac, yes?  Could you edit your Signature to show this new reinstatement if so?  

 

As for meditation, I recommend to you "Mindfulness for beginners audio program (by Jon Kabat-Zinn)" on YouTube or other video by him.  He's the best.  Mindfulness is just to gently observe your breathing or something else without judging, without forcing your breathing, and every time random thoughts come, to gently put it away.  Random Thoughts are making Mindfulness work, as you are aware of them and put them away to continue to observe what's going on now.  I'm still a beginner, but this is what I understood, and I can almost meditate even without videos.  It's very easy.  I saw a video yesterday that in France, Alzheimer patients meditate and have great benefits from doing it.  Even children can do it.

 

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thecowisback

thanks 😊 

i keep forgetting to update my signature when i'm on the puter. 

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Mars15

I apologize if this was addressed somewhere and I missed it somehow, but I read the entire thread and the following is still not clear to me:

 

While I understand that reinstatement of a low dose is the only known method to relieve withdrawal symptoms, I am confused as to the theory behind reinstatement. It's not clear to me what the consensus of the goal of reinstatement is, or if there is a consensus among forum members about what the goal is. Is the purpose of reinstatement to try to stabilize withdrawal symptoms in any case, or to is it just to mitigate them in the case that they have become unbearable? In other words, is it always preferrable to try to stop withdrawal symptoms by reinstating while within the appropriate time window, or is it only recommended for those whose withdrawal symptoms have become so severe that they are unbearable? Is the argument in favor of reinstatement saying that reinstatement is a relatively low-risk method to stabilize and mitigate withdrawal symptoms before they worsen?

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Lloyd

My thoughts are that re-instatement is an option for people experiencing severe withdrawal symptoms to try & alleviate them and give the mind and body time to stabilize before trying to reduce again. For some of us it's to help us cope with what can be a truly awful experience.

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thecowisback

that is why i've gone back on prozac. i'm hoping to stabilize then wean off slowly over a number of years. i felt like i had nothing to lose by trying reinstatement as my quality of life had got so bad. 

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Albert
On 8/22/2015 at 3:51 AM, Vonnegutjunky said:

So I am almost a week stabilized after 3 months of a double dose of reinstatment A

 

it was like a switch just flipped on Tuesday and bam I feel normal! I still have ringing in my ears, some side effects, a little anxiety but all of these things are before and after medication symptoms so I would not say they are wd related.

 

My doc really wanted me to switch meds- she said the Paxil was no longer working- I can't say I will be like this in an upward feeling of normalcy without anymore waves; I don't discount that I will probably have some, but it really is a huge difference; I think patience is the key with reinstatment (imo) as alto says our cns is unstablized and it needs stability.

 

So just wanted to post my experience here; and I hope my bad wd experience has prepared me for anything I might face when I begin to taper next year.

I am in a similar situation as you.  You mentioned that it took you about 3 months to stabilize?  I am just over 3 weeks from reinstatement at 20mg vs 30mg of Paxil and really very little relief.  However in your case it would indicate to just stick it out and stabilize will happen? 

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Vonnegutjunky

That’s what seems to have happened for me. But it was much long than 3 months. Hang in there. 

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